Hurley, Jeremiah; Guindon, G Emmanuel; Rynard, Vicki; Morgan, Steve
This paper presents the findings from simulations of the introduction of publicly funded medical savings accounts (MSAs) in the province of Ontario, Canada. The analysis exploits a unique data set linking population-based health survey information with individual-level information on all physician services and hospital services utilization over a four-year period. The analysis provides greater detail along three dimensions than have previous analyses: (1) the distributional impacts of publicly funded MSAs across individuals of differing health statuses, incomes, ages, and current expenditures; (2) the impact of differing degrees of risk adjustment for MSA contributions; and (3) the impact of MSA funding over multiple years, incorporating year-to-year variation in spending at the individual level. In addition, it analyses more plausible designs for publicly funded MSAs than the existing studies. Government uses information available from year t - 1 to allocate its budget for year t in a manner that is ex ante fiscally neutral for the public sector: the government first withholds funds equal to expected catastrophic insurance payments under the MSA plan, and then allocates only the balance to individual MSA accounts. The government captures the savings associated with reduced health-care utilization under MSAs and we examine deductibles that vary by income rather than by current health-care expenditures. The impacts on public expenditures under these designs are more modest than in the previous studies and under plausible assumptions MSAs are predicted to decrease public expenditures. MSAs, however, are also predicted to have unavoidable negative distributional consequences with respect to both public expenditures and out-of-pocket spending.
Knudsen, Hannah K; Roman, Paul M
Medications for the treatment of substance use disorders (SUDs) are not widely available in publicly funded SUD treatment programs. Few studies have drawn on longitudinal data to examine the organizational characteristics associated with programs transitioning from not delivering any pharmacotherapy to adopting at least one SUD medication. Using two waves of panel longitudinal data collected over a 5-year period, we measured the transition to medication adoption in a cohort of 190 publicly funded treatment organizations that offered no SUD medications at baseline. Independent variables included organizational characteristics, medical resources, funding, treatment culture, and detailing activities by pharmaceutical companies. Of 190 programs not offering SUD pharmacotherapy at baseline, 22.6% transitioned to offering at least one SUD medication at follow-up approximately 5 years later. Multivariate logistic regression results indicated that the employment of at least one physician at baseline, having a greater proportion of Medicaid clients, and pharmaceutical detailing were positively associated with medication adoption. Adoption of pharmacotherapy was more likely in programs that had greater medical resources, Medicaid funding, and contact with pharmaceutical companies. Given the potential expansion of Medicaid under the Affordable Care Act, patients served by publicly funded programs may gain greater access to such treatments, but research is needed to document health reform's impact on this sector of the treatment system.
Anatoly A. Kozlov
The article justiﬁes the introduced proposals for a management accounting of theFederal Compulsory Medical InsuranceFund formation and the characteristics and principles of management accounting forms for the analysis of the territorialcompulsory medical insurance programs.
Ortuno-Ortin, Ignacio; Schultz, Christian
This paper concerns public funding of parties. Parteis receive public funds depending on their vote share. Funds finance electoral campaigns. Two cases are investigated. In the first, some voters are policy motivated and some are ?impressionable? ? their vote depends directly on campaign...... expenditures. In the second, campaigning is informative and all voters are policy motivated. Public funds increase policy convergence in both cases. The effect is larger, the more funding depends on vote shares. When campaigns are informative, there may be multiple euqilibria. Intuitively, a large party can...... stay large since it receives large funds...
Ortuno-Ortin, Ignacio; Schultz, Christian
expenditures. In the second, campaigning is informative and all voters are policy motivated. Public funds increase policy convergence in both cases. The effect is larger, the more funding depends on vote shares. When campaigns are informative, there may be multiple euqilibria. Intuitively, a large party can......This paper concerns public funding of parties. Parteis receive public funds depending on their vote share. Funds finance electoral campaigns. Two cases are investigated. In the first, some voters are policy motivated and some are ?impressionable? ? their vote depends directly on campaign...
This paper outlines some of the arguments for and against the funding of public pensions, with a view to establishing whether there is an economic basis for judging funding to be superior to pay-as-you-go (PAYG). It is argued that funding does not have a clear advantage, and the case for a shift from PAYG to funding is thus an uneasy one. There is nonetheless growing advocacy of funded public pensions as part of an ideal pension system, which raises more general issues about the role of the p...
Man, Jonathan P; Weinkauf, Justin G; Tsang, Monica; Sin, Don D
National factor(s) influencing publication output in the highest ranked medical journals are largely unknown. We sought to examine the relationship between national research funding and English proficiency on publication output. We identified all original research articles appearing in the five highest ranked general medical journals between 1997 and 2001. Using the country of the corresponding author as the source nation for each article, we determined a standardized publication rate across developed nations. We used multiple regression techniques to determine the influence of national expenditures on research and scores from the Test of English as a Foreign Language (TOEFL), a surrogate for English proficiency, on publication output. There was a significant relationship of national spending on research and TOEFL scores to publication output of developed countries (p = 0.04; p < 0.01, respectively). These two variables explained approximately 71.5% of the variation in publication rate across developed nations around the world (R = 0.85; p < 0.01). Normalized for population size, English-speaking nations and certain northern European countries such as Denmark, The Netherlands, Switzerland, and Sweden had the highest rate of publication in the five highest ranked general medical journals, while Asian countries had generally low rates of publication. Research spending and English proficiency were strongly associated with publication output in the highest ranked general medical journals. While these data cannot be considered definitive due to their observational nature, they do suggest that for English-language medical journals, research funding and English proficiency may be important determinants of publication.
Olivia S. Mitchell; Smith, Robert S.
This paper explores the determinants of pension funding in the public sector. We formulate and test several hypotheses about the determinants of public employer pension funding practices, using a new data set describing financial and other characteristics of state, local, and teacher plans. The data show that, on average, public sector pension plans were relatively well-funded during the late 1980s. There were, however, wide variations in funding practices in our sample. Our analysis of these...
May 14, 2010 ... l'enseignement, de financement, de recherche/publication. Dans cet ..... of us has previously applied twice for funding to the Medical Research. Council. ... Often the feedback is also so sketchy that the questions remain unan-.
This investigation compared self-reported use of public libraries and public opinion about library services with levels of per-capita library funding over time. Results showed a small relationship between self-reported use of libraries and levels of library funding. There was no relationship between public opinion and funding levels. Non-economic…
Kolympiris, C.; Kalaitzandonakes, N.; Miller, D.
A long stream of academic literature has established that public funding towards research and development matters for economic growth because it relates to increases in innovation, productivity and the like. The impact of public funding on the creation of new firms has received less attention in thi
Finding alternatives in public good financing is one of the most recent issues in the government sector. Tax-financed for pure public good is well known results further problems like externalities and economic inequity. This paper only addresses the qualitative analysis in discussing benefits and costs of the society in applying some alternatives in funding public good provisions, pure and impure one.
Full Text Available The development of this article started from the fact that in the field of public institutions accounting there have been many changes and it aims to capture the essential aspects of their financing. Thus the article covers a series of issues related to the credit officers, to employment, to settlement and payment of public institutions expenditure, to the budgeting and budgetary credits accounting. It also presents a brief classification of the public institutions according to several criteria, as well as their financing sources. The paper also practically presents the accounting of the budgetary credits and their sharing mechanism between the principal, secondary and tertiary budgetary credits officers.
Research in astronomy is strongly dependent on public (taxpayer) dollars. In this study we examine the attitudes of college students toward funding of astronomy projects. A survey was given to 269 college students prior to taking an introductory astronomy course. Students were given a short test designed to examine misconceptions about astronomy. They were then asked about their willingness to support public funding for astronomy projects. Students with fundamental misconceptions about mundane topics such as the cause of the seasons and phases of the moon were less than half as likely to support public funding of astronomy projects. Results are also reported showing the relationship between a willingness to fund projects and whether the students had experiences including reading books or magazines on astronomy, exposure to astronomy in high school, and using a telescope.
Addonizio, Michael F.
Discusses sources of nontraditional revenue for public school systems: the result of donor activities (the solicitation of goods, services, and money via direct and indirect donations); enterprise activities (the selling or leasing of services or facilities); and shared or cooperative activities (pooling functions with other agencies or…
Kleven, Henrik Jacobsen; Kreiner, Claus Thustrup
This paper extends the theory and measurement of the marginal cost of public funds (MCF) to account for labor force participation responses. Our work is motivated by the emerging consensus in the empirical literature that extensive (participation) responses are more important than intensive (hours...
Lowe, Gregory F.; Berg, Christian E.
the complexion of media systems in the 21st century as a consequence of greater instability and higher uncertainty. A model describes 4 modes of funding for media and assesses operational implications for each. This work elaborates on earlier research questioning the premise that big, rich countries are suitable...... funding public broadcasting is not only about funding; it is about wider issues only partly rooted in the current economic malaise. An underlying dynamic is keyed to the digitalization of the media system at large, co-related with growing complexity in media competition, fuelling debate over......, for consideration of implications in how media are understood and organized and the purposes for which media are mandated...
Zigler, E F; Finn-Stevenson, M
Ensuring the availability of high-quality, affordable child care to all families who need it is a goal of national importance. The authors suggest that a comprehensive financing and service delivery system for child care is needed to achieve this goal, and the system should ideally be grounded in an existing institution, already present in every community--the public school. The linkage of child care with the public education system would eliminate the false distinction between child care and education, and would create a universally accessible system of child care services for children. The School of the 21st Century is an example of such a system. Initially conceptualized by Zigler, it has now been implemented in 400 schools across 13 states, with the leadership and direction of Finn-Stevenson. This article describes how school districts that have implemented the program employ a mixture of parent fees and local, state, federal, and private dollars to fund it, and then proposes an ideal financing model for the program. In the ideal model, the same mix of funding sources would be retained, but a per-pupil expenditure of about $9,000 per year is advocated to deliver child care and other social services to three- and four-year-olds. Funds for initial start-up could be derived from reallocation of existing dollars, especially state prekindergarten programs, but eventually new funds would be needed to support ongoing operations.
Full Text Available The healthcare enterprises are very disconnected. This paper intends to propose a solution that will provide citizens, businesses and medical enterprises with improved access to medical virtual public services. Referred medical services are based on existing national medical Web services and which support medically required services provided by physicians and supplementary health care practitioners, laboratory services and diagnostic procedures, clinics and hospitalsÃ¢Â€Â™ services. Requirements and specific rules of these medical services are considered, and personalization of user preferences will to be supported. The architecture is based on adaptable process management technologies, allowing for virtual services which are dynamically combined from existing national medical services. In this way, a comprehensive workflow process is set up, allowing for service-level agreements, an audit trail and explanation of the process to the end user. The process engine operates on top of a virtual repository, providing a high-level semantic view of information retrieved from heterogeneous information sources, such as national sources of medical services. The system relies on a security framework to ensure all high-level security requirements are met. SystemÃ¢Â€Â™s architecture is business oriented: it focuses on Service Oriented Architecture - SOA concepts, asynchronously combining Web services, Business Process Management Ã¢Â€Â“ BPM rules and BPEL standards.
Gaurie Tilak BA
Full Text Available The number of authors per manuscript in peer-reviewed medical journals has increased substantially in the last several decades. Several reasons have been offered to explain this authorship growth, including increased researcher collaboration, honorary authorship driven by increased pressures for funding and promotion, the belief that including senior authors will facilitate publication, and the growing complexity of medical research. It is unknown, however, whether authorship has grown over time due to growing complexity of published academic articles, in which case growth could be warranted, or whether it has grown due to pressures of funding and academic promotion, which have created “authorship inflation.” To answer this question, we analyzed data on authorship count, study type, and size of study population for the first 50 original articles published in each decade during 1960-2010 in 3 major medical journals. Within each type of study we considered (eg, randomized trials, observational studies, etc, average authorship rose more than 3-fold during this period. Similar growth persisted after adjustment for changes in study population sizes over time. Our findings suggest that increasing research complexity is an inadequate explanation for authorship growth. Instead, growth in authorship appears inflationary.
Pei, Lei; Gaisser, Sibylle; Schmidt, Markus
We analysed the decisions of major European public funding organisations to fund or not to fund synthetic biology (SB) and related ethical, legal and social implication (ELSI) studies. We investigated the reaction of public organisations in six countries (Austria, France, Germany, the Netherlands, Switzerland and the UK) towards SB that may influence SB’s further development in Europe. We examined R&D and ELSI communities and their particular funding situation. Our results show that the funding situation for SB varies considerably among the analysed countries, with the UK as the only country with an established funding scheme for R&D and ELSI that successfully integrates these research communities. Elsewhere, we determined a general lack of funding (France), difficulties in funding ELSI work (Switzerland), lack of an R&D community (Austria), too small ELSI communities (France, Switzerland, Netherlands), or difficulties in linking existing communities with available funding sources (Germany), partly due to an unclear SB definition. PMID:22586841
Gruppen, Larry D; Durning, Steven J
Medical education research suffers from a significant and persistent lack of funding. Although adequate funding has been shown to improve the quality of research, there are a number of factors that continue to limit it. The competitive environment for medical education research funding makes it essential to understand strategies for improving the search for funding sources and the preparation of proposals. This article offers a number of resources, strategies, and suggestions for finding funding. Investigators must be able to frame their research in the context of significant issues and principles in education. They must set their proposed work in the context of prior work and demonstrate its potential for significant new contributions. Because there are few funding sources earmarked for medical education research, researchers much also be creative, flexible, and adaptive as they seek to present their ideas in ways that are appealing and relevant to the goals of funders. Above all, the search for funding requires persistence and perseverance.
Chen, D.H.J.; Beetsma, R.M.W.J.; Ponds, E.H.M.; Romp, W.E.
We explore the benefits of intergenerational risk-sharing through both private funded pensions and via the public debt. We use a multi-period overlapping generation model with a pay-as-you-go pension pillar, a funded pension pillar and a government. Shocks are smoothed via the public debt and
Honingh, M.E.; Oort, F.J.
Purpose - The purpose of this paper is to compare teachers' organisational behaviour in publicly- and privately-funded schools in the Dutch Vocational Education and Training (VET) sector. Design/methodology/approach - A percentage of all middle managers in publicly and privately funded schools (72
Honingh, M.E.; Oort, F.J.
Purpose - The purpose of this paper is to compare teachers' organisational behaviour in publicly- and privately-funded schools in the Dutch Vocational Education and Training (VET) sector. Design/methodology/approach - A percentage of all middle managers in publicly and privately funded schools (72 p
Chen, D.H.J.; Beetsma, R.M.W.J.; Ponds, E.H.M.; Romp, W.E.
We explore the benefits of intergenerational risk-sharing through both private funded pensions and via the public debt. We use a multi-period overlapping generation model with a pay-as-you-go pension pillar, a funded pension pillar and a government. Shocks are smoothed via the public debt and variat
Deutsche Forschungsgemeinschaft (DFG)
The Funding ATLAS is a reporting system (previously referred to as the Funding Ranking) employed by the German Research Foundation (DFG) to provide information in the form of indicators of key developments in publicly funded research in Germany every three years. This English version of the Funding ATLAS 2012 presents selected findings from the more comprehensive German edition. At the core of the report are indicators that provide information on which subject areas have received funding at higher education and other research institutions in the period 2008-2010. This report also includes, as a supplement not found in the German edition, the decisions on the Excellence Initiative, which were taken shortly after the German edition of the Funding ATLAS 2012 was published. The report also addresses the subject of internationality by presenting selected indicators that show how attractive Germany's research institutions are for visiting scientists. In summary, the DFG Funding ATLAS furnishes reliable indicators o...
Lockart, Barbetta L.
Although provisions in countless treaties have mandated Indian educational services, federal and state governments were for many years unenthusiastic about accepting the responsibility for educating the Indian people. Inadequately funded educational services provided by the Bureau of Indian Affairs did little to reflect the realities and needs of…
David Card; Martin Dooley; Abigail Payne
The province of Ontario has two publicly funded school systems: secular schools (known as public schools) that are open to all students, and separate schools that are open to children with Catholic backgrounds. The systems are administered independently and receive equal funding per student. In this paper we use detailed school and student-level data to assess whether competition between the systems leads to improved efficiency. Building on a simple model of school choice, we argue that incen...
Marquez, Monica; Patel, Prachee; Raphael, Marisa; Morgenthau, Beth Maldin
Since 2001, the New York City Department of Health and Mental Hygiene (NYC DOHMH) has built a strong public health preparedness foundation, made possible in large part by funding from the Public Health Emergency Preparedness (PHEP) Cooperative Agreement provided by the Centers for Disease Control and Prevention. While this funding has allowed NYC DOHMH to make great progress in areas such as all-hazards planning, risk communication, disease surveillance, and lab capacity, the erosion of federal preparedness dollars for all-hazards preparedness has the potential to reverse these gains. Since the initiation of the PHEP grant in 2002, PHEP funding has steadily declined nationwide. Specifically, the total federal allocation has decreased approximately 20%, from $862,777,000 in 2005 to $688,914,546 in 2009. With city and state budgets at an all-time low, federal funding cuts will have a significant impact on public health preparedness programs nationwide. In this time of strict budgetary constraints, the nation would be better served by strategically awarding federal preparedness funds to areas at greatest risk. The absence of risk-based funding in determining PHEP grant awards leaves the nation's highest-risk areas, like New York City, with insufficient resources to prepare for and respond to public health emergencies. This article examines the progress New York City has made and what is at stake as federal funding continues to wane.
In the second half of the 19th century, Jean-Martin Charcot (1825-1893) became famous for the quality of his teaching and his innovative neurological discoveries, bringing many French and foreign students to Paris. A hunger for recognition, together with progressive and anticlerical ideals, led Charcot to invite writers, journalists, and politicians to his lessons, during which he presented the results of his work on hysteria. These events became public performances, for which physicians and patients were transformed into actors. Major newspapers ran accounts of these consultations, more like theatrical shows in some respects. The resultant enthusiasm prompted other physicians in Paris and throughout France to try and imitate them. We will compare the form and substance of Charcot's lessons with those given by Jules-Bernard Luys (1828-1897), Victor Dumontpallier (1826-1899), Ambroise-Auguste Liébault (1823-1904), Hippolyte Bernheim (1840-1919), Joseph Grasset (1849-1918), and Albert Pitres (1848-1928). We will also note their impact on contemporary cinema and theatre.
Ortín, Ignacio Ortuño; Schultz, Christian
’s dependence on vote shares induces fur- ther moderation and improves welfare. If parties are asymmetric, vote share dependent public funding bene…ts the large party and makes it moderate its candidate, while the smaller party reacts by choosing a more extremist candidate. On balance, however, if the parties...... are not too asymmetric, an increase in vote share dependent funding improves welfare and increases the likelihood that a moderate candidate wins the election...
G. Thomas Sav
Full Text Available Problem statement: Private giving and government funding are critical revenue sources for public colleges and universities. If increased private giving reduces government funding, then that type and extent of crowding out carries important managerial and public policy implications. Approach: The study used a government funding reaction function and an instrumental variable approach to empirically estimate the potential for crowding out. Results: The study examined the extent to which private giving reduces or crowds out state government funding of public colleges and universities. Government free riding was at question and investigated to determine how active it is in terms of private donations partially or wholly displacing state government funding. The findings suggested that the rate of crowding out was 43% on the dollar. That compares to the 45% political substitution of the 1960’s but is much diminished from the 1980’s dollar for dollar crowding out. Those are aggregate comparisons for all public institutions. A disaggregated approach in this study additionally revealed that doctoral universities were victims of the same 43% crowd out but that at two other levels, master degree granting and associate degree granting colleges, there was the opposite effect of crowding in. Those colleges received state funding augmentations of 32-92% on their dollar of privately provided donations. Conclusion/Recommendations: The study’s finding of the existence of both crowding out and crowding in can carry important policy implications for college and university funding. Future managerial and public policy decision making should take that into account. However, political sustainability and economy wide and localized effects over time of crowding out and in could prove fruitful avenues of inquiry for future research.
Gabbe, Steven G; Lockwood, Charles J; Marsh, Clay B
Academic health centers are traditionally dependent on extramural agencies like the National Institutes of Health to fund medical research. The still-struggling U.S. economy has kept federal paylines stagnant in recent years even as research costs climb. Academic health center leaders need to find new funding sources to ensure that critical medical research continues. Myers and colleagues, in their report in this issue of Academic Medicine, found that scientific research funding by philanthropic nonprofit organizations rose 26% from 2006 to 2008. Even though the time frame for their study precedes the recent economic recession, their findings provide hope and guidance to academic health centers. Stable research portfolios should include a variety of sources, and Myers and colleagues suggest that partnership opportunities exist between federal and not-for-profit funding sources to focus on key disease areas. Seeking broader research funding may benefit at-risk groups like junior investigators, as the average age of a first-time NIH grant recipient in 2008 was 42 years old. To foster the new discoveries and ideas that come from young scientists, academic health centers need to diversify their research funding sources.It is encouraging that high-visibility philanthropic organizations enhanced funding by 26% from 2006 to 2008. However, between 2008 and 2010, overall grant support from foundations declined 2.3%. Should federal and private funding continue to fall, there is an eminent threat of losing a generation of investigators. Thus, creative solutions and partnerships are needed to fund more high-priority research to cure disease and create the future of medicine.
Chen, Frederick M; Phillips, Robert L; Schneeweiss, Ronald; Andrilla, C Holly A; Hart, L Gary; Fryer, George E; Casey, Susan; Rosenblatt, Roger A
Medicare provides the majority of funding to support graduate medical education (GME). Following the flow of these funds from hospitals to training programs is an important step in accounting for GME funding. Using a national survey of 453 family practice residency programs and Medicare hospital cost reports, we assessed residency programs' knowledge of their federal GME funding and compared their responses with the actual amounts paid to the sponsoring hospitals by Medicare. A total of 328 (72%) programs responded; 168 programs (51%) reported that they did not know how much federal GME funding they received. Programs that were the only residency in the hospital (61% versus 36%) and those that were community hospital-based programs (53% versus 22%) were more likely to know their GME allocation. Programs in hospitals with other residencies received less of their designated direct medical education payment than programs that were the only residency in the sponsoring hospital (-45% versus +19%). More than half of family practice training programs do not know how much GME they receive. These findings call for improved accountability in the use of Medicare payments that are designated for medical education.
Lund, Thomas Bøker; Sandøe, Peter; Lassen, Jesper
, the perceived controllability of obesity, self-reported BMI, and additional attitudinal and sociodemographic characteristics. Public funding of some obesity treatments, such as weight-loss surgery, attracted only limited public support. A majority of the Danish public did support ‘softer’ treatment......The aim of this study was to investigate the Danish public’s support for publicly funded obesity treatment and prevention. It was also examined whether levels of support could be explained by dislike of obese people and / or the belief that those who are obese are personally responsible...... interventions and preventive initiatives. Attitudes to the treatment of obesity were clearly best predicted by the belief that individuals are personally responsible for their own obesity. Dislike of obese persons had no direct effect on the preference for collective treatment initiatives and only a small...
... the private sector within the meaning of UMRA. Environmental Impact A Finding of No Significant Impact... February 7, 2011 Part II Department of Housing and Urban Development 24 CFR Parts 903, 905, 941 et al. Public Housing Capital Fund Program; Proposed Rule #0;#0;Federal Register / Vol. 76, No. 25 /...
Guibault, L.; Margoni, T.
Internet growth, content digitisation, and expanding "big data" and data analytics capabilities have affected the ways in which publicly funded research results are accessed, disseminated and used. While these technological advances have made sharing and processing information easier, that does not
Son, Colin; Tavakoli, Samon; Bartanusz, Viktor
Industry sponsorship of clinical research of degenerative diseases of the spine has been associated with excessive positive published results as compared to research carried out without industry funding. We sought the rates of publication of clinical trials of degenerative diseases of the spine based on funding source as a possible explanation for this phenomenon. We reviewed all clinical trials registered at clinicaltrials.gov relating to degenerative diseases of the spine as categorized under six medical subject heading terms (spinal stenosis, spondylolisthesis, spondylolysis, spondylosis, failed back surgery syndrome, intervertebral disc degeneration) and with statuses of completed or terminated. These collected studies were categorized as having, or not having, industry funding. Published results for these studies were then sought within the clinicaltrials.gov database itself, PubMed and Google Scholar. One hundred sixty-one clinical trials met these criteria. One hundred nineteen of these trials had industry funding and 42 did not. Of those with industry funding, 45 (37.8%) had identifiable results. Of those without industry funding, 17 (40.5%) had identifiable results. There was no difference in the rates of publication of results from clinical trials of degenerative diseases of the spine no matter the funding source.
Full Text Available The impacts of natural hazards as well as their frequency of occurrence during the last decades have increased decisively. Therefore, the public as well as the private sector are expected to react to this development by providing sufficient funds, in particular for the improvement of protection measures and an enhanced funding of damage compensation for affected private individuals, corporate and public entities.
From the public stance, the establishment of an appropriate regulatory environment seems to be indispensable. Structural and legal changes should, on the one hand, renew and improve the current distribution system of public catastrophe funds as well as the profitable investment of these financial resources, and on the other hand, facilitate the application of alternative mechanisms provided by the capital and insurance markets.
In particular, capital markets have developed alternative risk transfer and financing mechanisms, such as captive insurance companies, risk pooling, contingent capital solutions, multi-trigger products and insurance securitisation for hard insurance market phases. These instruments have already been applied to catastrophic (re-insurance in other countries (mainly the US and off-shore domiciles, and may contribute positively to the insurability of extreme weather events in Austria by enhancing financial capacities. Not only private individuals and corporate entities may use alternative mechanisms in order to retain, thus, to finance certain risks, but also public institutions.
This contribution aims at analysing potential solutions for an improved risk management of natural hazards in the private and the public sector by considering alternative mechanisms of the capital and insurance markets. Also the establishment of public-private-partnerships, which may contribute to a more efficient cat funding system in Austria, is considered.
The impacts of natural hazards as well as their frequency of occurrence during the last decades have increased decisively. Therefore, the public as well as the private sector are expected to react to this development by providing sufficient funds, in particular for the improvement of protection measures and an enhanced funding of damage compensation for affected private individuals, corporate and public entities. From the public stance, the establishment of an appropriate regulatory environment seems to be indispensable. Structural and legal changes should, on the one hand, renew and improve the current distribution system of public catastrophe funds as well as the profitable investment of these financial resources, and on the other hand, facilitate the application of alternative mechanisms provided by the capital and insurance markets. In particular, capital markets have developed alternative risk transfer and financing mechanisms, such as captive insurance companies, risk pooling, contingent capital solutions, multi-trigger products and insurance securitisation for hard insurance market phases. These instruments have already been applied to catastrophic (re-)insurance in other countries (mainly the US and off-shore domiciles), and may contribute positively to the insurability of extreme weather events in Austria by enhancing financial capacities. Not only private individuals and corporate entities may use alternative mechanisms in order to retain, thus, to finance certain risks, but also public institutions. This contribution aims at analysing potential solutions for an improved risk management of natural hazards in the private and the public sector by considering alternative mechanisms of the capital and insurance markets. Also the establishment of public-private-partnerships, which may contribute to a more efficient cat funding system in Austria, is considered.
Sadat, Somayeh; Carter, Michael W; Golden, Brian
Originally developed in the context of publicly traded for-profit companies, theory of constraints (TOC) improves system performance through leveraging the constraint(s). While the theory seems to be a natural fit for resource-constrained publicly funded health systems, there is a lack of literature addressing the modifications required to adopt TOC and define the goal and performance measures. This paper develops a system dynamics representation of the classical TOC's system-wide goal and performance measures for publicly traded for-profit companies, which forms the basis for developing a similar model for publicly funded health systems. The model is then expanded to include some of the factors that affect system performance, providing a framework to apply TOC's process of ongoing improvement in publicly funded health systems. Future research is required to more accurately define the factors affecting system performance and populate the model with evidence-based estimates for various parameters in order to use the model to guide TOC's process of ongoing improvement.
Full Text Available Following a brief overview of the history of CPCs in the United States and the “abortion alternatives” program in Pennsylvania, this Note examines possible legal claims in terms of legal standards and likelihood of success. The results of a Right to Know (“RTK” request directed toward the Pennsylvania DPW, including both what the DPW offered to produce and what it refused to produce, will supplement this evaluation of possible legal claims. This Note also proposes Public policy recommendations aimed at eliminating the DPW’s liability for these claims in the interest of preventing abusive tactics by CPCs and conserving public funds. Finally, this Note compares the relative benefits and disadvantages of legislative and regulatory reform to those of litigation. Either litigative or legislative action is necessary to prevent publically funded CPCs from inflicting further harm on pregnant Pennsylvanians.
Becerril-Ángeles, Martín; García-Gómez, Francisco
Fraud can be present in some scientific medical publications; however, the magnitude of this situation is unknown. One of the associated factors for this transgression of the good practice of investigation is the need to publish and obtain recognition and benefits, regardless of the means. The deliberate fabrication and falsification of data, plagiarism and duplication of publications are some of the scientific misconducts. Many cases of fraud in publications are known, and they have reached public opinion and have been a matter of legal sanctions (the names of Woo Suk Hwang, Jon Sudbo, Joachim Blodt, Robert Slutsky, and William Summerlin reminds us a few known cases). In the last decades, national and international regulatory organisms have been created in order to intervene against this scientific misconduct. Currently, we can rely on several effective software programs, whose function is to detect plagiarism and falsification of data. The prevention of scientific misconduct through information and education of the investigators could lead to the decrease of the presence of this problem, which damages scientific credibility and put at risk the patient's safety.
Guisado Tato, M.; Vila, M.; Guisado Gonzalez, M.
This paper contrasts how business cooperation at the level of RandD, the size and the membership in printing industry determine the participation of innovative manufacturing companies in the systems of public support for innovation. Material and methods. From the microdata of the survey on technological innovation 1998-2000, of the National Institute of Statistics (INE), a database is created by the manufacturing Spanish companies involved in innovation. Afterwards, by univariate and multivariate statistical methods, we contrast whether cooperation, size and membership in printing industry determine the participation of the manufacturing innovative companies in the systems of public support for innovation, as well as the direction of that conditioning. Results. The tests carried out indicate that more cooperation between companies at the level of a larger size have a positive influence on the degree of business involvement in the systems of public support for innovation.Discussion. Public administrations seek to foster the development of innovation among manufacturing companies facilitating by providing funds to the companies that cooperate in the area of IandD. Likewise, public support for innovation are targeting in larger firms, while the companies, belonging to the printing industry have less likely to obtain public funding for their innovative projects that the remaining companies of the Spanish manufacturing sector. (Author).
Sasaki, Tatsuya; Unemi, Tatsuo
Which punishment or rewards are most effective at maintaining cooperation in public goods interactions and deterring defectors who are willing to freeload on others' contribution? The sanction system is itself a public good and can cause problematic "second-order free riders" who do not contribute to the provisions of the sanctions and thus may subvert the cooperation supported by sanctioning. Recent studies have shown that public goods games with punishment can lead to a coercion-based regime if participation in the game is optional. Here, we reveal that even with compulsory participation, rewards can maintain cooperation within an infinitely large population. We consider three strategies for players in a standard public goods game: to be a cooperator or a defector in a standard public goods game, or to be a rewarder who contributes to the public good and to a fund that rewards players who contribute during the game. Cooperators do not contribute to the reward fund and are therefore classified as second-order free riders. The replicator dynamics for the three strategies exhibit a rock-scissors-paper cycle, and can be analyzed fully, despite the fact that the expected payoffs are nonlinear. The model does not require repeated interaction, spatial structure, group selection, or reputation. We also discuss a simple method for second-order sanctions, which can lead to a globally stable state where 100% of the population are rewarders.
... Community Development Financial Institutions Fund Request for Public Comment: Community Development Financial Institutions Fund, Community Development Financial and Technical Assistance Awards, Native Initiatives, and Bank Enterprise Awards AGENCY: Community Development Financial Institutions Fund,...
Sudeep S Gill
Full Text Available BACKGROUND: Following initial regulatory approval of prescription drugs, many factors may influence insurers and health systems when they decide whether to add these drugs to their formularies. The role of political pressures on drug funding announcements has received relatively little attention, and elections represent an especially powerful form of political pressure. We examined the temporal relationship between decisions to add one class of drugs to publicly funded formularies in Canada's ten provinces and elections in these jurisdictions. METHODS: Dates of provincial formulary listings for cholinesterase inhibitors, which are drugs used to treat Alzheimer's disease and related dementias, were compared to the dates of provincial elections. Medical journal articles, media reports, and proceedings from provincial legislatures were reviewed to assemble information on the chronology of events. We tested whether there was a statistically significant increase in the probability of drug funding announcements within the 60-day intervals preceding provincial elections. RESULTS: Decisions to fund the cholinesterase inhibitors were made over a nine-year span from 1999 to 2007 in the ten provinces. In four of ten provinces, the drugs were added to formularies in a time period closely preceding a provincial election (P = 0.032; funding announcements in these provinces were made between 2 and 47 days prior to elections. Statements made in provincial legislatures highlight the key role of political pressures in these funding announcements. CONCLUSIONS: Impending elections appeared to affect the timing of drug funding announcements in this case study. Despite an established structure for evidence-based decision-making, drug funding remains a complex process open to influence from many sources. Awareness of such influences is critical to maintain effective drug policy and public health decision-making.
Although respect for parents' decision-making authority is an important principle, pediatricians should report suspected cases of medical neglect, and the state should, at times, intervene to require medical treatment of children. Some parents' reasons for refusing medical treatment are based on their religious or spiritual beliefs. In cases in which treatment is likely to prevent death or serious disability or relieve severe pain, children's health and future autonomy should be protected. Because religious exemptions to child abuse and neglect laws do not equally protect all children and may harm some children by causing confusion about the duty to provide medical treatment, these exemptions should be repealed. Furthermore, public health care funds should not cover alternative unproven religious or spiritual healing practices. Such payments may inappropriately legitimize these practices as appropriate medical treatment.
Schlenker, Thomas; Huber, Carol A
In addition to the Affordable Care Act, states are more frequently turning to Medicaid waivers to achieve the "Triple Aim" goals of improving the experience of care, improving population health, and reducing per capita costs. These demonstration waivers provide opportunities to test innovative ways to finance and deliver care. Texas is currently implementing a waiver known as the Transformation and Quality Improvement Program. Its inclusion of public health agencies is a unique approach to a system typically limited to traditional providers. San Antonio Metropolitan Health District is one public health agency taking advantage of this new funding opportunity to implement 6 new or expanded programs targeting health issues of highest priority in this south Texas region. This article discusses the use of Medicaid waivers and the advantages and challenges of public health agency participation.
Cunningham, James; O'Reilly, Paul; O'Kane, Conor; Mangematin, Vincent
International audience; Securing public funding to conduct research and leading it by being a principal investigator (PI) is seen as significant career development step. Such a role brings professional prestige but also new responsibilities beyond research leadership to research management. If public funding brings financial and infrastructure support, little is understood about the inhibiting factors that publicly funded PIs face given the research autonomy offered by publicly funded researc...
... unclassified digital data that result from federally funded scientific research. The public input provided... unclassified digital data that result from federally funded scientific research. The public input provided... to digital data resulting from federally funded research, and a summary of public input...
Wangenge-Ouma, G.; Cloete, N.
The funding of public higher education is currently a moot issue in South Africa. Public funding has been declining and opportunities for winning non-government revenue remain limited. The frequent raising of tuition fees, which is one of the main strategies public universities have resorted to mitigate declining state funding is not without…
This study examines Utah's funding system for public education and provides an analysis of the fiscal impact of allowing parents to use a portion of their child's state education funding to attend a school of their choice, public or private. Like many states, Utah is facing pressure to improve its system of public education funding. The state's…
van Lent, Marlies; Overbeke, John; Out, Henk J
Numerous studies on publication bias in clinical drug research have been undertaken, particularly on the association between sponsorship and favourable outcomes. However, no standardized methodology for the classification of outcomes and sponsorship has been described. Dissimilarities and ambiguities in this assessment impede the ability to compare and summarize results of studies on publication bias. To guide authors undertaking such studies, this paper provides recommendations for a uniform assessment of publication bias related to funding source. As part of ongoing research into publication bias, 472 manuscripts on randomised controlled trials (RCTs) with drugs, submitted to eight medical journals from January 2010 through April 2012, were reviewed. Information on trial results and sponsorship was extracted from manuscripts. During the start of this evaluation, several problems related to the classification of outcomes, inclusion of post-hoc analyses and follow-up studies of RCTs in the study sample, and assessment of the role of the funding source were encountered. A comprehensive list of recommendations addressing these problems was composed. To assess internal validity, reliability and usability of these recommendations were tested through evaluation of manuscripts submitted to journals included in our study. The proposed recommendations represent a first step towards a uniform method of classifying trial outcomes and sponsorship. This is essential to draw valid conclusions on the role of the funding source in publication bias and will ensure consistency across future studies.
Hao, Aimin; Yi, Tao; Li, Xia; Wei, Lei; Huang, Pei; Xu, Xinzhou; Yi, Lihua
Purpose: The quality of medical services provided by competing public hospitals is the primary consideration of the public in determining the selection of a specific hospital for treatment. The main objective of strategic planning is to improve the quality of public hospital medical services. This paper provides an introduction to the history, significance, principles and practices of public hospital medical service strategy, as well as advancing the opinion that public hospital service strategy must not merely aim to produce but actually result in the highest possible level of quality, convenience, efficiency and patient satisfaction.
Full Text Available In prisoner's dilemma game (shortly, PD game, punishment is most frequently used to promote cooperation. However, outcome varies when different punishment approaches are applied. Here the PD game is studied on a square lattice when different punishment patterns are adopted. As is known to all, tax system, a common tool to adjust the temperature of the economy, is widely used in human society. Inspired by this philosophy, players in this study would pay corresponding taxes in accordance with their payoff level. In this way, public benefit fund is established consequently and it would be utilized to punish defectors. There are two main methods for punishing: slight intensity of punishment (shortly, SLP and severe intensity of punishment (shortly, SEP. When the totaling of public benefit fund keeps relatively fixed, SLP extends further, which means more defectors would be punished; by contrast, SEP has a smaller coverage. It is of interest to verify whether these two measures can promote cooperation and which one is more efficient. Simulate results reveal that both of them can promote cooperation remarkably. Specifically speaking, SLP shows constant advantage from the point of view either of fractions of cooperation or average payoff.
Escue, Carlee Poston
The purpose of this research was to address the public policy of adequacy by the creation of a Florida state-wide poverty index model to assist in the distribution of state and local dollars in funding public education. This poverty index model would measure the amount and severity of poverty in every public school within the state each year and…
Escue, Carlee Poston
The purpose of this research was to address the public policy of adequacy by the creation of a Florida state-wide poverty index model to assist in the distribution of state and local dollars in funding public education. This poverty index model would measure the amount and severity of poverty in every public school within the state each year and…
Emilia, Calefariu; Traian Alexandru, Buda
Technological SMEs are in a constant struggle for growth or sometimes maintaining the production capacity, increase market share, supporting tax burden, ensuring employees' salaries, profit growth. They constantly consider short-term survival of the company, with trying to maintain a long-term uptrend for the business. Entrepreneurs are again in a position to access public financing under quite favorable conditions. The paper aims to analyze the opportunity of accessing these external financing options, which have both advantages and a series of long-term constraints which should not be excluded before the final decision to access this funding. New research is required, thus sustainable development can be maintained for the business environment in order to increase efficiency, competitiveness, sustainable development strategies that generate job security, regional growth and rewarding the risk-taking of the entrepreneur.
Crowdfunding websites allow users to post a public appeal for funding for a range of activities, including adoption, travel, research, participation in sports, and many others. One common form of crowdfunding is for expenses related to medical care. Medical crowdfunding appeals serve as a means of addressing gaps in medical and employment insurance, both in countries without universal health insurance, like the United States, and countries with universal coverage limited to essential medical needs, like Canada. For example, as of 2012, the website Gofundme had been used to raise a total of 8.8 million dollars (U.S.) for seventy-six hundred campaigns, the majority of which were health related. This money can make an important difference in the lives of crowdfunding users, as the costs of unexpected or uninsured medical needs can be staggering. In this article, I offer an overview of the benefits of medical crowdfunding websites and the ethical concerns they raise. I argue that medical crowdfunding is a symptom and cause of, rather than a solution to, health system injustices and that policy-makers should work to address the injustices motivating the use of crowdfunding sites for essential medical services. Despite the sites' ethical problems, individual users and donors need not refrain from using them, but they bear a political responsibility to address the inequities encouraged by these sites. I conclude by suggesting some responses to these concerns and future directions for research.
李明; 张韬; 王洪兴; 厉勤; 李幼子
While the coordinated management of fund for basic public health and basic medical services provides an opportunity for the integration of content and resources of basic public health and basic medical services,the principle of labour voucher creates technical conditions for this opportunity:the principle of labour voucher has resolved the financial accounting issues,eliminating the following problems of community health services;the building of the mechanism of funds allocation by the principle of labor voucher could ensure the transparency of information and is conducive to the establishment of performance appraisal system for community health service settings and their staffs,effectively guiding supply - side behavior;the fund allocation mechanism could also guide residents′ health seeking behavior indirectly through the supply side,and promote residents and medical staffs to improve their health and save fund together by price leverage and reward allocation. The study is still at theoretical stage,thus the feasibility of the research result needs to be further tested.%基本公共卫生和基本医疗服务经费的统筹管理，为基本公共卫生和基本医疗服务内容整合和资源整合提供了契机，而工分制原理则为这种契机创造了技术条件：工分制原理首先解决了经费核算问题，为社区卫生服务机构解决了后顾之忧；通过工分制原理构建经费分配机制，保证了信息透明性，有利于社区卫生服务机构绩效考核和机构内员工绩效考核机制的建立，从而有效引导供方行为；基于工分制原理构建的经费分配机制，可以通过供方间接引导居民就医行为，也可以通过价格杠杆和分配奖励促使居民与医务人员一起为提高自身健康水平和节约经费努力。本研究尚处于理论阶段，研究成果的可行性还有待实践的检验。
This article proposes the establishment of a prize fund to incentivise public health research within the BRICS association, which comprises the five major emerging world economies: Brazil, Russia, India, China and South Africa. This would stimulate cooperative healthcare research within the group and, on the proviso that the benefits of the research are made freely available within the association, would be rewarding for researchers. The results of the research stimulated by the prize would provide beneficial new healthcare technologies, targeting the most vulnerable and needy groups. The proposed fund is consistent with current international patent law and would not only avoid some of the problems associated with the "Health Impact Fund", but also create a new model for healthcare research.
Marchildon, Gregory P
To help clarify the confusing debate concerning the public-private divide in Canada and the respective positions of the Romanow and Kirby reports, a new approach is proposed. The funding, administration and delivery of the healthcare "system" is split into distinct analytical categories and then applied to three major coverage groupings: universal public (Canada Health Act) coverage for medically necessary/required services; mixed coverage for drug care, home and long-term care; and private health goods and services. While there were no fundamental differences between Romanow and Kirby concerning the funding of public healthcare in Canada, there were some important differences on issues of administration. In particular, the Romanow report recommended that home mental healthcare services become universally covered under the Canada Health Act as well as fundamental changes to the regulation and administration of prescription drug care. The reports also differed in terms of framing the private delivery question, with the Romanow report questioning whether the evidence justified private-for-profit delivery replacing current private not-for-profit or public arm's length delivery modes.
Full Text Available India is becoming one of the hubs of clinical research. Commensurate with these advances, the government funding for biomedical research in thrust areas is also increasing. The Indian Council of Medical Research (ICMR, Department of Biotechnology (DBT, Department of Science and Technology (DST are some of the government organizations which provide financial support for various research projects. The results of the funded research projects are published in various international journals. Most of these journals have an access to paid subscribers only. Hence it is unethical to use the research grants from government (people′s money and not allow the scientific community free access to the results of the study. To tackle such issues, these agencies should sign the Berlin declaration and create open access repositories. A public access policy should be formulated and listed in JULIET. The funding bodies in India should also join Pubmed Central (PMC to form PMC India so that every investigator who has received grants would submit the full text of the paper published from his study and these can be made freely accessible to everyone. Universities and research institutions should also develop institutional open access repositories. The public access policy has definitive advantages and should be implemented.
Manikandan, S; Vani, N Isai
India is becoming one of the hubs of clinical research. Commensurate with these advances, the government funding for biomedical research in thrust areas is also increasing. The Indian Council of Medical Research (ICMR), Department of Biotechnology (DBT), Department of Science and Technology (DST) are some of the government organizations which provide financial support for various research projects. The results of the funded research projects are published in various international journals. Most of these journals have an access to paid subscribers only. Hence it is unethical to use the research grants from government (people's money) and not allow the scientific community free access to the results of the study. To tackle such issues, these agencies should sign the Berlin declaration and create open access repositories. A public access policy should be formulated and listed in JULIET. The funding bodies in India should also join Pubmed Central (PMC) to form PMC India so that every investigator who has received grants would submit the full text of the paper published from his study and these can be made freely accessible to everyone. Universities and research institutions should also develop institutional open access repositories. The public access policy has definitive advantages and should be implemented.
Vasiliadis, Helen-Maria; Dezetter, Anne
Quebec's HealthCommissioner on the performance of the health system clearly highlighted gaps in the collaboration between primary care physicians and mental health specialists, decreased accessibility and inequity in access to effective mental health services such as psychotherapy.Objectives The aim of this article was to describe the implementation of two publicly funded programs of psychotherapy in Australia and England with similar gatekeeper systems to the one in Quebec.Findings Following the Access to Allied Psychological Services (ATAPS) program introduced in Australia in 2003, one of the most important initiatives from the Council of Australian Governments' National Action Plan on Mental Health 2006-2011 was the Better Access Initiative which commenced in 2006. The plan included AUD1.2 billion in funding for integrating and improving the mental health care system. The purpose of Better Access was to improve the treatment and management of mental illnesses and increasing community access to mental health professionals and providing more affordable mental health care. GPs were encouraged to work more closely with mental health professionals. Under this program, these professionals are able to provide mental health services on a fee-for-service basis subsidized through Medicare. Access to psychological therapies is provided through private providers, rather than through fund holding arrangements. As of 2009 in Australia, 2 million people (1 in 11) had received over 11.2 million subsidized mental health services. A recent study showed clinical improvements in patients with depression associated with Better Access, concluding that the program is meeting previously unmet mental health needs.In the case of England, the IAPT - Improving Access to psychological Therapies-program enabled primary care trusts (PCTs) to implement evidence-based psychological therapies as recommended by National Institute for Health and Clinical Excellence for people suffering from
R Grant Steen
Full Text Available The essence of writing for publication in the medical field is distilled into a dozen precepts to guide the anxious author. These precepts focus on the attitude of the writer, rather than the mechanics of writing. A medical author must strive to be the following: Original, honest, innovative, organized, careful, clear, modest, fair-minded, frank, persistent, rigorous, and realistic. These attributes are essential because there is a new climate of skepticism among the lay public as to the validity of scientific and medical claims. This climate has encouraged journal editors to be demanding of authors and to be especially vigilant about plagiarism; originality of all contributions is therefore essential.
Carter, Drew; Braunack-Mayer, Annette
Certain restrictions on public funding for assisted reproductive technology (ART) are articulated and defended by recourse to a distinction between medical infertility and social infertility. We propose that underlying the prioritization of medical infertility is a vision of medicine whose proper role is to restore but not to improve upon nature. We go on to mark moral responses that speak of investments many continue to make in nature as properly an object of reverence and gratitude and therein (sometimes) a source of moral guidance. We draw on the work of Ludwig Wittgenstein in arguing for the plausibility of an appeal to nature in opposition to the charge that it must contain a logical fallacy. We also invite consideration of the moral plausibility of some appeal to nature. Finally, we examine what follows in the case of ART. Should medicine respect as natural limits that should not be overcome: the need for a man and a woman in reproduction; menopause; and even declining fertility with age? We must first ask ourselves to what degree we should defer to nature in the conduct of medicine, at least in the particular if not the general case. This will involve also asking ourselves what we think is natural and in what instances and spirit might we defy nature. Divergent opinions and policies concerning who should receive ART treatment and public funding are more easily understood in view of the centrality, complexity and fundamental nature of these questions.
Full Text Available Abstract To examine patterns of mono- versus polydrug abuse, data were obtained from intake records of 69,891 admissions to publicly funded treatment programs in Tennessee between 1998 and 2004. While descriptive statistics were employed to report frequency and patterns of mono- and polydrug abuse by demographic variables and by study years, bivariate logistic regression was applied to assess the probability of being a mono- or polydrug abuser for a number of demographic variables. The researchers found that during the study period 51.3% of admissions reported monodrug abuse and 48.7% reported polydrug abuse. Alcohol, cocaine, and marijuana were the most commonly abused substances, both alone and in combination. Odds ratio favored polydrug abuse for all but one drug category–other drugs. Gender did not affect drug abuse patterns; however, admissions for African Americans and those living in urban areas exhibited higher probabilities of polydrug abuse. Age group also appeared to affect drug abuse patterns, with higher odds of monodrug abuse among minors and adults over 45 years old. The discernable prevalence of polydrug abuse suggests a need for developing effective prevention strategies and treatment plans specific to polydrug abuse.
Knudsen, Hannah K; Abraham, Amanda J; Oser, Carrie B
Despite growing interest in the use of evidence-based treatment practices, adoption of pharmacotherapies for treating substance use disorders (SUDs) remains modest. Using data from telephone interviews with 250 administrators of publicly funded SUD treatment programs, this study estimated a model of adoption of medication assisted treatment (MAT) for SUDs and examined the relative importance of regulatory, cultural, medical resource, patient-level, and funding barriers to MAT implementation. MAT-adopting programs had significantly greater medical resources, as measured by the employment of physicians and nurses, than non-adopting programs. Administrators of non-adopting programs were asked to rate the importance of 18 barriers to MAT implementation. The most strongly endorsed barriers were regulatory prohibitions due to the program's lack of medical staff, funding barriers to implementing MAT, and lack of access to medical personnel with expertise in delivering MAT. Barriers related to insufficient information about MAT and unsupportive staff attitudes were not widely endorsed. These findings suggest that efforts to promote the implementation of MAT that are inattentive to funding barriers and weaknesses in medical infrastructure may achieve sub-optimal results.
Swami, Viren; Furnham, Adrian; Haubner, Tanja; Stieger, Stefan; Voracek, Martin
Very little prior research has examined public perceptions of research funding and the life chances associated with various fields of study. In the present task, 315 members of the Austrian general public rated 34 higher-education courses in terms of funding cuts or increases, and the perceived life chances of graduates, respectively. The results…
Meijdam, A.C.; Ponds, E.H.M.
Abstract: This paper explores the optimal degree of funding of public sector pension plans. It is assumed that a benevolent social planner decides on the contribution of current taxpayers to the funding of public sector pensions next period, weighing the interests of current and future tax payers. T
Schlegelmilch, Jeff; Petkova, Elisaveta; Redlener, Irwin
Federal funding for health and medical preparedness in the USA has created an important foundation for preparing the health and medical systems to respond to a wide range of hazards. A declining trend in funding for these preparedness activities threatens to undo the progress that has been made over the last decade and reduce the state of readiness to respond to the health and medical impacts of disasters.
Meijdam, A.C.; Ponds, E.H.M.
Abstract: This paper explores the optimal degree of funding of public sector pension plans. It is assumed that a benevolent social planner decides on the contribution of current taxpayers to the funding of public sector pensions next period, weighing the interests of current and future tax payers. Two elements play a role in the optimal funding decision: the optimal-portfolio choice (i.e. the tradeoff between the expected excess return and the additional risk of funding vis-à-vis pay-as-you-g...
Full Text Available Over the few years medical marijuana is growing in the United States. Because of the medical marijuana legislators able to legalized recreational marijuana in the two states in the US. Marijuana has several potential benefits that help in certain disease. The delivery of marijuana is also important because smoking marijuana has severe side effects. Physicians also play important role in medical marijuana, physicians also divided on the use of medical marijuana. Their attitude towards medical marijuana important for the treatment of disease is important for the community. Marijuana is the most commonly used illegal drug in the US and all over world, several risks associated with it. Major concern is medical marijuana increased the use of marijuana and will create the public health problem in the society. There are several medical benefits from the marijuana but require more research to establish the marijuana as a medicine. Control of medical marijuana is also major issue for the law enforcement agencies and challenge for policymakers also in the United States. [Int J Basic Clin Pharmacol 2013; 2(2.000: 136-143
Qiu, Lan; Chen, Zi-Ya; Lu, Deng-Yu; Hu, Hao; Wang, Yi-Tao
In recent years, China has experienced tremendous growth in its pharmaceutical industry. Both the Chinese government and private investors are motivated to invest into pharmaceutical research and development (R&D). However, studies regarding the different behaviors of public and private investment in pharmaceutical R&D are scarce. Therefore, this paper aims to investigate the current situation of public funding and private investment into Chinese pharmaceutical R&D. The primary data used in the research were obtained from the China High-tech Industry Statistics Yearbook (2002-2012) and China Statistical Yearbook of Science and Technology (2002-2012). We analyzed public funding and private investment in five aspects: total investment in the industry, funding sources of the whole industry, differences between provinces, difference in subsectors, and private equity/venture capital investment. The vast majority of R&D investment was from private sources. There is a significantly positive correlation between public funding and private investment in different provinces of China. However, public funding was likely to be invested into less developed provinces with abundant natural herbal resources. Compared with the chemical medicine subsector, traditional Chinese medicine and biopharmaceutical subsectors obtained more public funding. Further, the effect of the government was focused on private equity and venture capital investment although private fund is the mainstream of this type of investment. Public funding and private investment play different but complementary roles in pharmaceutical R&D in China. While being less than private investment, public funding shows its significance in R&D investment. With rapid growth of the industry, the pharmaceutical R&D investment in China is expected to increase steadily from both public and private sources.
Full Text Available To present the basic principles and standards of Ethics in medical research and publishing, as well as the need for continuing education in the principles and ethics in science and publication in biomedicine. An analysis of relevant materials and documents, sources from the published literature. Investing in education of researches and potential researches, already in the level of medical schools. Educating them on research ethics, what constitutes research misconduct and the seriousness of it repercussion is essential for finding a solution to this problem and ensuring careers are constructed on honesty and integrity.
Raudla, Ringa; Karo, Erkki; Valdmaa, Kaija; Kattel, Rainer
The main goal of the paper is to explore--both theoretically and empirically--the implications of project-based research funding for budgeting and financial management at public universities. The theoretical contribution of the paper is to provide a synthesized discussion of the possible impacts of project-based funding on university financial…
Raudla, Ringa; Karo, Erkki; Valdmaa, Kaija; Kattel, Rainer
The main goal of the paper is to explore--both theoretically and empirically--the implications of project-based research funding for budgeting and financial management at public universities. The theoretical contribution of the paper is to provide a synthesized discussion of the possible impacts of project-based funding on university financial…
Ritzhaupt, Albert Dieter; Hohlfeld, Tina N; Barron, Ann E.; Kemker, Kate
This empirical research investigates trends in technology planning and funding in Florida's K-12 public schools between the 2003-04 and 2005-06 academic years. Survey items that focused on funding and planning issues on Florida's statewide school technology integration survey were analyzed using logistic models. Results indicate a significant…
... WATER INDIAN RESERVATION ROADS PROGRAM Planning, Design, and Construction of Indian Reservation Roads Program Facilities Public Hearings § 170.436 How are public hearings for IRR planning and projects funded... 25 Indians 1 2010-04-01 2010-04-01 false How are public hearings for IRR planning and projects...
Greenhalgh, Paul; Hargreaves, Sylvia
This report describes the policy framework through which urban regeneration is promoted and highlights the difficulties encountered in co-ordinating the current public funding initiatives to secure effective urban regeneration and maximise value for money.
... National Telecommunications and Information Administration Public Telecommunications Facilities Program: Notice of Availability of Funds AGENCY: National Telecommunications and Information Administration, U.S.... SUMMARY: On December 2, 2009, the National Telecommunications and Information Administration...
In June 2006, the Canadian AIDS Society (CAS) released a comprehensive report with recommendations to overcome barriers to the use of cannabis for medical purposes faced by people living with HIV/AIDS in Canada. On 25 September 2006, as part of package of spending cuts, the federal government announced plans to eliminate its marijuana medical research program.
Keene, Lyndon; Bagshaw, Philip; Nicholls, M Gary; Rosenberg, Bill; Frampton, Christopher M; Powell, Ian
Successive New Zealand governments have claimed that the cost of funding the country's public healthcare services is excessive and unsustainable. We contest that these claims are based on a misrepresentation of healthcare spending. Using data from the New Zealand Treasury and the Organisation for Economic Cooperation and Development (OECD), we show how government spending as a whole is low compared with most other OECD countries and is falling as a proportion of GDP. New Zealand has a modest level of health spending overall, but government health spending is also falling as a proportion of GDP. Together, the data indicate the New Zealand Government can afford to spend more on healthcare. We identify compelling reasons why it should do so, including forecast growing health need, signs of increasing unmet need, and the fact that if health needs are not met the costs still have to be borne by the economy. The evidence further suggests it is economically and socially beneficial to meet health needs through a public health system. An honest appraisal and public debate is needed to determine more appropriate levels of healthcare spending.
Abd Rahman Ahmad; Alan Farley
The purpose of this paper is to explore the shift in funding reforms currently facing at Malaysian public universities focusing on issues and challenges experienced by the Focused Universities in particular. Previous research has shown that shifts in funding mechanisms to public universities are more likely to result in behavioural changes at such institutions. Under the National Higher Education Strategic Plan beyond 2020, the Federal Government has launched a strategic plan of government ob...
Output-driven funding systems are systems in which payments made to service-delivery agencies by government are an explicit function of quantities of outputs delivered by those agencies. This paper considers the feasibility of such systems for the funding tax-financed public services. It focuses upon the implications of key characteristics of public sector outputs, and specifically upon the prevalence of heterogeneous outputs, the predominance of services (as opposed to physical goods), and t...
ALBERT DIETER RITZHAUPT
Full Text Available This empirical research investigates trends in technology planning and funding in Florida’s K–12 public schools between the 2003–04 and 2005–06 academic years. Survey items that focused on funding and planning issues on Florida’s statewide school technology integration survey were analyzed using logistic models. Results indicate a significant increase in the number of schools revising their technology plans on a regular basis; a significant increase in the frequency with which Florida’s K–12 public schools are seeking funding for technology-related initiatives; a significant increase in parent, administrator, teacher, and student involvement in the technology planning process; and a significant decline in adequate funding for software and hardware needs. In addition, schools with low proportions of economically disadvantaged students sought and were awarded significantly more funds from donations and federal and state grants. Implications for educational leadership and policy are provided.
Sismondo, Sergio; Doucet, Mathieu
It is by now no secret that some scientific articles are ghost authored - that is, written by someone other than the person whose name appears at the top of the article. Ghost authorship, however, is only one sort of ghosting. In this article, we present evidence that pharmaceutical companies engage in the ghost management of the scientific literature, by controlling or shaping several crucial steps in the research, writing, and publication of scientific articles. Ghost management allows the pharmaceutical industry to shape the literature in ways that serve its interests. This article aims to reinforce and expand publication ethics as an important area of concern for bioethics. Since ghost-managed research is primarily undertaken in the interests of marketing, large quantities of medical research violate not just publication norms but also research ethics. Much of this research involves human subjects, and yet is performed not primarily to increase knowledge for broad human benefit, but to disseminate results in the service of profits. Those who sponsor, manage, conduct, and publish such research therefore behave unethically, since they put patients at risk without justification. This leads us to a strong conclusion: if medical journals want to ensure that the research they publish is ethically sound, they should not publish articles that are commercially sponsored.
Hyde, Justeen; Kim, Basil; Martinez, Linda Sprague; Clark, Mary; Hacker, Karen
Local public health authorities (LPHAs) are recognized as playing critical roles in response to biological, chemical, and other health emergencies. An influx of emergency preparedness funding has created new and expanding responsibilities for LPHAs. Concern that funding for emergency response is diverting attention and resources away from other core public health responsibilities is increasing. In order to determine the impact of emergency preparedness funding on public health infrastructure, qualitative interviews with 27 LPHAs in the metro-Boston area were conducted as part of an on-going evaluation of preparedness planning in Massachusetts. Feedback on the benefits and challenges of recent emergency preparedness planning mandates was obtained. Benefits include opportunities to develop relationships within and across public health departments and increases in communication between local and state authorities. Challenges include budget constraints, staffing shortages, and competing public responsibilities. Policy recommendations for improving planning for emergency response at the local level are provided.
Bernet, Patrick M
Public health services are delivered through a variety of organizations. Traditional accounting of public health expenditures typically captures only spending by government agencies. New Hampshire collected information from public health partners, such as community centers that host smoking cessation classes or health education done by Girls, Inc. This study compares the new data to spending by government agencies, focusing on breakdowns by fund source and service categories. Expanded funds secured by these partners account for a 42% of all local public health spending, and they spent 4 times more than government agencies on promoting healthy behavior. The funding formula analysis tool revealed that these partners spent in ways that would be politically difficult to achieve. In an era of declining budgets, an understanding of public health's partners is increasingly vital.
Hackney, James R., Jr.
Uses the theories of John Rawls (democratic/egalitarian) and Robert Nozick (libertarian) as prisms through which to analyze judicial opinions underlying court decisions regarding public education financing. (302 footnotes) (MLF)
Hackney, James R., Jr.
Uses the theories of John Rawls (democratic/egalitarian) and Robert Nozick (libertarian) as prisms through which to analyze judicial opinions underlying court decisions regarding public education financing. (302 footnotes) (MLF)
Jane Anne Fischer
Full Text Available Context Little is known about the proportion of the Australian population using alcohol or other drugs who may seek treatment. There is a need to have some additional estimates of population morbidity which reflect harms associated with use. Objective To determine Australian population rates of publicly funded community based specialised alcohol and other drug treatment and in-patient hospital care by those ‘at risk’, by drug type, sex and age. Design and setting The design is secondary data analysis of publicly available datasets. We use the latest available complete data on Australian general population incidence of alcohol, cannabis amphetamines and ecstasy use (2007 National Drug Strategy Household Survey and nationally collected administrative data on publicly funded specialised alcohol and other drug treatment services (2006–2007 Alcohol and Other Drug Treatment Services National Minimum Dataset and public hospitals (2006–2007 National Hospital Morbidity Minimum Dataset to calculate rates of drug treatment and in-patient hospital care per 1000 Australians. ‘At risk’ for alcohol is defined as being at risk of short term harm, as defined by the National Health and Medical Research Council (2001. ‘At risk’ for illicit drugs is defined as those exposed to potential harm through at least weekly use of cannabis, amphetamines and ecstasy use. Results Risky alcohol consumption followed by recent cannabis use appears to lead to most harm. Greater harm seems to be experienced by males rather than females. Younger adults (15–19 years and older adults (40+ years seem also to experience the highest rates of harm. Conclusions It is possible to derive population estimates of harms associated with licit and illicit drugs use. Treatment rates vary across drug type, gender and age. Alcohol and cannabis are the substances whose use leads to the greatest demand for services. Ecstasy appears to generate few presentations for treatment
Silvestre, Jason; Ahn, Jaimo; Levin, L Scott
The National Institutes of Health (NIH) is the largest supporter of biomedical research in the U.S., yet its contribution to orthopaedic research is poorly understood. In this study, we analyzed the portfolio of NIH funding to departments of orthopaedic surgery at U.S. medical schools. The NIH RePORT (Research Portfolio Online Reporting Tools) database was queried for NIH grants awarded to departments of orthopaedic surgery in 2014. Funding totals were determined for award mechanisms and NIH institutes. Trends in NIH funding were determined for 2005 to 2014 and compared with total NIH extramural research funding. Funding awarded to orthopaedic surgery departments was compared with that awarded to departments of other surgical specialties in 2014. Characteristics of NIH-funded principal investigators were obtained from department web sites. In 2014, 183 grants were awarded to 132 investigators at 44 departments of orthopaedic surgery. From 2005 to 2014, NIH funding increased 24.3%, to $54,608,264 (p = 0.030), but the rates of increase seen did not differ significantly from those of NIH extramural research funding as a whole (p = 0.141). Most (72.6%) of the NIH funding was awarded through the R01 mechanism, with a median annual award of $343,980 (interquartile range [IQR], $38,372). The majority (51.1%) of the total funds supported basic science research, followed by translational (33.0%), clinical (10.0%), and educational (5.9%) research. NIH-funded orthopaedic principal investigators were predominately scientists whose degree was a PhD (71.1%) and who were male (79.5%). Eleven NIH institutes were represented, with the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) providing the preponderance (74.2%) of the funding. In 2014, orthopaedic surgery ranked below the surgical departments of general surgery, ophthalmology, obstetrics and gynecology, otolaryngology, and urology in terms of NIH funding received. The percentage increase of NIH
... Mae) and to the Federal Home Loan Mortgage Corporation (FHLMC or Freddie Mac) that use these indices... determine, after notice and opportunity for comment, that (A) the new indices are based upon data... values and changes of 17 publicly available indices on a monthly basis from January 1990 through...
Miller, Jeffrey C; Andersson, George E; Cohen, Marcia; Cohen, Stephen M; Gibson, Scott; Hindery, Michael A; Hooven, Martha; Krakower, Jack; Browdy, David H
Medical schools conduct research, provide clinical care, and educate future physicians and scientists. Each school has its own unique mix of revenue sources and expense sharing among the medical school, faculty practice plan(s), parent university, and affiliated hospital(s). Despite these differences, revenues from clinical care subsidize the money-losing research and education missions at every medical school.In this perspective, the authors discuss the flow of funds among a medical school, its faculty practice plan(s), parent university, and affiliated hospital(s). They summarize where medical school revenues come from, how revenues and expenses flow within a medical school and between a medical school and its partners, and why understanding this process is crucial to leading and managing such an enterprise. They conclude with recommendations for medical schools to consider in developing funds flow models that meet their individual needs and circumstances: (1) understand economic drivers, (2) reward desired behaviors, (3) enable every unit to generate a positive margin, (4) communicate budget priorities, financial performance, and the use of institutional resources, and (5) establish principles for sharing resources and allocating expenses among entities within the institution.Medical schools should develop funds flow models that are transparent, aligned with their strategic priorities, and reward the behaviors necessary to produce effective collaboration within and across mission areas.
Frye, Joanna R.
The dynamics of state funding for public higher education in the United States are changing. Per-student state appropriations to higher education have decreased over the past few decades and have become increasingly volatile from year to year. As public higher education institutions seek ways to educate more students with fewer and less…
Sexton, Thomas R.; Comunale, Christie L.; Gara, Stephen C.
We propose an efficiency-based mechanism for state funding of public colleges and universities using data envelopment analysis. We describe the philosophy and the mathematics that underlie the approach and apply\\break the proposed model to data from 362 U.S. public four-year colleges and universities. The model provides incentives to institution…
..., Office of Public and Indian Housing, Real Estate Assessment Center (REAC), 550 12th Street, SW., Suite... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT Changes to the Public Housing Assessment System (PHAS): Capital Fund Scoring...
Marino, Marianna; Parrotta, Pierpaolo; Sala, Davide
Any economic criteria for an effcient allocation of resources is based on marginal "thinking". Such criteria can equally be applied to the evaluation of the public allocation of R&D funds. Differently from the usual evaluation schemes - mainly dichotomous - this study implements the continuous...... treatment matching approach to investigate the optimality of the modulation of public grants. With this method, the marginal treatment effects can be identified and sub-optimal amounts of public funding determined. Although we can distinguish cases of input additionality, the substitutability outcome seems...
Utilizing resource dependence theory, this study investigates the relationship between institutional reliance on net tuition dollars as a source of revenue and institutional expenditures for education and related activities at public, four-year institutions of higher education in the United States. Drawing on an 11-year panel of university-level…
Jayakar, Krishna; Park, Eun-A
The National Broadband Plan (NBP) recently announced by the Federal Communication Commission visualizes a significantly enhanced commitment to public computing centers (PCCs) as an element of the Commission's plans for promoting broadband availability. In parallel, the National Telecommunications and Information Administration (NTIA) has…
Sathaye, Jayant A.; Holt, Elmer C.; De La Rue du Can, Stephane
The term technology transfer refers to a broad set of processes that cover the flows of know-how, experience, and equipment for mitigating and adapting to climate change amongst different stakeholders, including governments, the private sector, and financial institutions, environmental organizations, and research/education institutions. (Metz et al. 2000). Transfer encompasses diffusion of technologies and technology cooperation across and within countries, and forms one element of the overarching goal of the Climate Convention (UNFCCC) to stabilize greenhouse gas concentrations in the atmosphere. Governments devote varying amounts toward sponsoring or in some manner supporting a broad array of research activities pursuing a diverse set of outcomes ranging from medicine to energy and the environment. These activities can take place within government-owned facilities, private companies, or universities or some combination thereof. Such pursuits may result in the identification of a patentable technology or process, as well as copyrightable computer programs or other publications worthy of intellectual property rights (IPRs) protection. Although the precise arrangements vary from country to country, there is a high degree of commonality in the manner in which the property rights to these publicly-sponsored results are assigned. Except in the case of 'pure research' the property rights are assigned to one or more of the participants to the research process; government, university, private contractor, etc. For example, captured under the 'pure research' classification is genomic sequence data that is immediately shared with the public at large and to a significant extent climate data resulting from government-sponsored research is placed in the public domain. The results of this review are intended to inform the Expert Group on Technology Transfer as called for by 2005 program of work.
Full Text Available Increasing healthy food options in public venues, including recreational facilities, is a health priority. The purpose of this study was to describe the public recreation food environment in British Columbia, Canada using a sequential explanatory mixed methods design. Facility audits assessed policy, programs, vending, concessions, fundraising, staff meetings and events. Focus groups addressed context and issues related to action. Eighty-eighty percent of facilities had no policy governing food sold or provided for children/youth programs. Sixty-eight percent of vending snacks were chocolate bars and chips while 57% of beverages were sugar sweetened. User group fundraisers held at the recreation facilities also sold ‘unhealthy’ foods. Forty-two percent of recreation facilities reported providing user-pay programs that educated the public about healthy eating. Contracts, economics, lack of resources and knowledge and motivation of staff and patrons were barriers to change. Recreation food environments were obesogenic but stakeholders were interested in change. Technical support, resources and education are needed.
Schneider, Jesper Wiborg; Costas, Rodrigo; Henriksen, Dorte
, the interaction with host institutions, and the governance and management of the DNRF. The evaluation concludes that the DNRF has had a very positive impact on the quality of research in Denmark and recommends that the foundation is re-funded. The evaluation is based on a bibliometric study, self......-assessment report by DNRF, numerous interviews and desk studies. Appendix 5: Bibliometric analyses of publications from Centres of Excellence funded by the Danish National Research Foundation...
Full Text Available In this paper we contrast different aspects of non-profit organizations’ performance from the perspective of their funding sources. Based on previous empirical results indicating that sources of funding influence fundraising performance, we extend the existing research to the analysis of overall non-profit organizational performance. We use the social constructivist approach to non-profit performance to discuss contrasts between privately and publicly funded humanitarian organizations in Croatia. Some differences in growth- and development-oriented measures of nonprofit performance for these groups are identified and discussed in the context of future regional research.
Dhingra, Dhulika; Mishra, Devendra
This study was planned as an exploratory study to determine the extent of occurrence of misconduct in publication (gift-authorship,ghost-authorship, falsification of data, fabrication of data,plagiarism, and duplication) amongst biomedical researchers.It was a questionnaire-based study, conducted at 9 institutions;6 medical colleges (4 government-run and 2 private), 7 non teaching government hospital, and 2 corporate hospitals, located in northern, central and southern India. The study was conducted between August 2072 and March 2073. 755 senior residents (misconduct. 7 55 responses were included for analysis. 7 4 7 (9 7 %) respondents agreed that they had some knowledge of publication ethics; but only 29% believed it was adequate. The most commonly observed misconduct was offering gift authorship, reported by 707 (65%); followed by alteration of data reported by 88 (56%). Plagiarism was observed by 83 respondents (53%); while 52 (33.5%) respondents had observed a colleague's name being omitted from a paper to which she/he had significantly contributed. A majority of respondents in the present study reported witnessing publication misconduct,thereby revealing the common occurrence of this problem among Indian biomedical researchers.
Choi, Phillip A; Xu, Shuai; Ayanian, John Z
Despite a growing need for primary care physicians in the United States, the proportion of medical school graduates pursuing primary care careers has declined over the past decade. To assess the association of medical school research funding with graduates matching in family medicine residencies and practicing primary care. Observational study of United States medical schools. One hundred twenty-one allopathic medical schools. The primary outcomes included the proportion of each school's graduates from 1999 to 2001 who were primary care physicians in 2008, and the proportion of each school's graduates who entered family medicine residencies during 2007 through 2009. The 25 medical schools with the highest levels of research funding from the National Institutes of Health in 2010 were designated as "research-intensive." Among research-intensive medical schools, the 16 private medical schools produced significantly fewer practicing primary care physicians (median 24.1% vs. 33.4%, p private schools. In contrast, the nine research-intensive public medical schools produced comparable proportions of graduates pursuing primary care careers (median 36.1% vs. 36.3%, p = 0.87) and matching in family medicine residencies (median 7.4% vs. 10.0%, p = 0.37) relative to the other 66 public medical schools. To meet the health care needs of the US population, research-intensive private medical schools should play a more active role in promoting primary care careers for their students and graduates.
Gerhardus, Ansgar; Becher, Heiko; Groenewegen, Peter; Mansmann, Ulrich; Meyer, Thorsten; Pfaff, Holger; Puhan, Milo; Razum, Oliver; Rehfuess, Eva; Sauerborn, Rainer; Strech, Daniel; Wissing, Frank; Zeeb, Hajo; Hummers-Pradier, Eva
Public health research is complex, involves various disciplines, epistemological perspectives and methods, and is rarely conducted in a controlled setting. Often, the added value of a research project lies in its inter- or trans-disciplinary interaction, reflecting the complexity of the research questions at hand. This creates specific challenges when writing and reviewing public health research grant applications. Therefore, the German Research Foundation (DFG), the largest independent research funding organization in Germany, organized a round table to discuss the process of writing, reviewing and funding public health research. The aim was to analyse the challenges of writing, reviewing and granting scientific public health projects and to improve the situation by offering guidance to applicants, reviewers and funding organizations. The DFG round table discussion brought together national and international public health researchers and representatives of funding organizations. Based on their presentations and discussions, a core group of the participants (the authors) wrote a first draft on the challenges of writing and reviewing public health research proposals and on possible solutions. Comments were discussed in the group of authors until consensus was reached. Public health research demands an epistemological openness and the integration of a broad range of specific skills and expertise. Applicants need to explicitly refer to theories as well as to methodological and ethical standards and elaborate on why certain combinations of theories and methods are required. Simultaneously, they must acknowledge and meet the practical and ethical challenges of conducting research in complex real life settings. Reviewers need to make the rationale for their judgments transparent, refer to the corresponding standards and be explicit about any limitations in their expertise towards the review boards. Grant review boards, funding organizations and research ethics committees
Full Text Available Sovereign funds are an important actor occurring on international financial markets in the last decade, being, in fact, state controlled international investments. Generally, they are financed from foreign currency reserves of the emergent countries they are constituted in, being managed apart of the official reserves and used for external expansion; they are likely to be detrimental to certain strategic interests. As public financial vehicles, they own, endorse or manage public funds of some emergent countries, freely invested by them in a great number of assets, being seen as a foreign policy element.
Zachwieja, Jeffrey; Hentges, Eric; Hill, James O.; Black, Richard; Vassileva, Maria
The global burdens of morbidity and mortality associated with obesity-related chronic diseases are crippling public health and are predicted to exponentially increase over the next 3 decades. Meanwhile, the resources necessary to conduct research that may offer solutions to the obesity epidemic continue to decline and funding has become increasingly difficult to secure. Alternative models for funding nutrition and health research are necessary to make considerable and timely progress to improve public health. Key stakeholders include, but are not limited to, government agencies, foundations, private industry, and nongovernmental organizations. PMID:24038261
Skovgaard, Marlene; Okkels, Niels; Christensen, Mette Krogh;
INTRODUCTION: In the 1990s, the publication and PhD recruitment rates following the Danish pre-graduate research programme (PGRP) in medicine were 54% and 33%, respectively. Updated estimates are unknown. METHODS: All medical students enrolled in the PGRP at the Faculty of Medicine, Aarhus......% of the overall 224 papers, and 90% were original articles. Publication was positively associated with completion of the PGRP in related to enrolment in the PGRP after fewer years in medical school. CONCLUSIONS......: Fast completion of the PGRP and early enrolment in the programme were associated with scientific publishing and PhD recruitment. The publication rate has remained stable over time. FUNDING: Authors were funded by their individual affiliations. TRIAL REGISTRATION: not relevant....
Lebeau, Yann; Stumpf, Rolf; Brown, Roger; Lucchesi, Martha Abrahao Saad; Kwiek, Marek
The aftermath of the international financial crisis of 2008/2009 and current economic downturn in the world economy has unsurprisingly put publicly-funded higher education (HE) systems under immense pressure in most parts of the world. Added to measures of the past 20 years, aiming at introducing cost effective management approaches imported from…
Wynn, Barbara O.; Kawata, Jennifer
This study analyzed issues related to estimating indirect medical education costs specific to pediatric discharges. The Children's Hospital Graduate Medical Education (CHGNE) program was established to support graduate medical education in children's hospitals. This provision authorizes payments for both direct and indirect medical education…
Pashchenko, Y.; Korin, M.
The paper found that the implementation of the priority areas of railway infrastructure, defined transport strategy Ukraine requires significant funding required amounts which are absent in Railways and the state budget of Ukraine. It was determined that one of the effective tools of financial security of railroad infrastructure is a mechanism of public-private partnerships. Based on this the essence of public-private partnership, its main characteristics and forms of implementation. Deals wi...
Knight, Andrew J.; Chopra, Hema
Community-Based Social Marketing is presented as a technique to add to Extension's community economic development toolbox by examining perceived benefits and barriers to local food procurement at publicly funded institutions. Data were gathered through 86 in-person interviews with representatives across the supply chain. The findings revealed that…
...\\ 15 U.S.C. 7217(b). \\2\\ 15 U.S.C. 78s(b)(1). \\3\\ Release No. 34-64816 (Jul. 6, 2011) [76 FR 40950 (Jul... COMMISSION Public Company Accounting Oversight Board; Order Approving Proposed Board Funding Final Rules for Allocation of the Board's Accounting Support Fee Among Issuers, Brokers, and Dealers, and Other Amendments...
Group of Eight (NJ1), 2008
This Go8 Backgrounder explores the possible uses of compacts in government financing of university activities, examines their potential costs and benefits, and outlines principles for their design and implementation. The Government has committed to compacts as an element of its future funding arrangements with public universities but has not yet…
Connolly, Mark P.; Postma, Maarten J.; Crespi, Simone; Andersen, Anders Nyboe; Ziebe, Soren
This study evaluated the fiscal impact attributed to recent policy changes that limited funding to public fertility clinics in Denmark. Taking into consideration that introducing patient co-payments will influence the numbers of couples treated, the number of children born every year from assisted r
Hallonsten, Olof; Silander, Charlotte
In many countries, current research policy is dominated by managerialism and excellence, manifesting the aim of making universities into national strategic assets in the globally competitive knowledge economy. This article discusses these policy trends and their mirror in recent developments in public funding for academic research, with special…
Connolly, Mark P; Postma, Maarten J; Crespi, Simone
This study evaluated the fiscal impact attributed to recent policy changes that limited funding to public fertility clinics in Denmark. Taking into consideration that introducing patient co-payments will influence the numbers of couples treated, the number of children born every year from assisted...
Using 1975-76 school-year data, the study describes New Mexico size adjustment factors for public school funding, compares them with the manner in which other states recognize smallness or sparsity, and delineates the impact of size adjustment factors on New Mexico school districts in terms of resources, net operational and proportionate…
Hanlon, N T
An era of managerialism in health care delivery systems is now well ensconced throughout the nations of the OECD. This development has occurred, in large part, as a response to funding pressures in institutionally based health care delivery imposed by principal third party insurers. In the case of publicly funded hospitals, the more traditional concerns for stewardship and appeasement of professional groups is being replaced by a greater emphasis on cost consciousness and corporate-style leadership as these organizations seek to reposition themselves in new funding and regulatory environments. While institutional theory and strategic management perspectives help illuminate these issues, this paper argues that a place-based perspective is also needed to understand the changes currently underway in health care delivery and publicly funded human services more generally. This is illustrated with reference to developments in the strategic management of public hospitals in the province of Ontario. Evidence from a survey of senior administrators of public hospitals, distributed at the height of these policy reform initiatives, is examined to shed light on local level management responses to changing policy and fiscal pressures. The data suggest that the latest policy directions in the province of Ontario will 'encourage' hospital executives in particular community settings to steer their organizations in very unfamiliar directions. The findings suggest a need for greater attention to context and setting in health services research and policy.
... soon after the communication as is reasonably possible but no later than three business days after the... communication as is reasonably possible but no later than three business days after the communication, unless... REGULATIONS EX PARTE COMMUNICATIONS § 201.3 Public funding, audits and litigation: Ex parte contacts...
Religious and charitable foundations are often held to have been a sub¬stantial presence in pre-industrial societies. One of their key tasks was the funding of public services, specifically social and religious services. This dissertation has tried to explain the regional variation in the extent to
Verhave, J.C.; Troyanov, S.; Mongeau, F.; Fradette, L.; Bouchard, J.; Awadalla, P.; Madore, F.
BACKGROUND AND OBJECTIVES: It is uncertain how many patients with CKD and cardiovascular risk factors in publicly funded universal health care systems are aware of their disease and how to achieve their treatment targets. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The CARTaGENE study evaluated B
Connolly, Mark P.; Postma, Maarten J.; Crespi, Simone; Andersen, Anders Nyboe; Ziebe, Soren
This study evaluated the fiscal impact attributed to recent policy changes that limited funding to public fertility clinics in Denmark. Taking into consideration that introducing patient co-payments will influence the numbers of couples treated, the number of children born every year from assisted
Rowbottom, Darrell P.; Aiston, Sarah Jane
How should educational research be contracted? And is there anything wrong with the way that public funding of educational research is currently administered? We endeavour to answer these questions by appeal to the work of two of the most prominent philosophers of science of the twentieth century, namely Popper and Kuhn. Although their normative…
Edwards, Tony; And Others
Examines government policies in England and Australia toward nongovernment schools, compares forms of direct and indirect support which such schools and their pupils receive from public funds, and looks at ways in which state aid for nonstate schools has been justified and condemned. (JHZ)
Vorstenbosch, M.A.T.M.; Bolhuis, S.; Kuppeveld, S. van; Kooloos, J.G.M.; Laan, R.F.J.M.
Publications on anatomy in medical education appear to be largely anecdotal. To explore this, we investigated the literature on anatomy in medical education, aiming first to evaluate the contribution of the literature on anatomy in medical education to "best evidence medical education" (BEME) and se
Vorstenbosch, Marc; Bolhuis, Sanneke; van Kuppeveld, Sascha; Kooloos, Jan; Laan, Roland
Publications on anatomy in medical education appear to be largely anecdotal. To explore this, we investigated the literature on anatomy in medical education, aiming first to evaluate the contribution of the literature on anatomy in medical education to "best evidence medical education" (BEME) and second to evaluate the development of this…
Catling-Paull, Christine; Dahlen, Hannah; Homer, Caroline S E; Homer, Caroline C S E
Hospital birth is commonly thought to be a safer option than homebirth, despite many studies showing similar rates of safety for low risk mothers and babies when cared for by qualified midwives with systems of back-up in place. Recently in Australia, demand has led to the introduction of a small number of publicly-funded homebirth programs. Women's confidence in having a homebirth through a publicly-funded homebirth program in Australia has not yet been explored. The aim of the study was to explore the reasons why multiparous women feel confident to have a homebirth within a publicly-funded model of care in Australia. Ten multiparous English-speaking women who chose to have a homebirth with the St George Hospital Homebirth Program were interviewed in the postnatal period using semi-structured, open-ended questions. Interviews were transcribed, then a thematic analysis was undertaken. Women, having already experienced a normal birth, demonstrated a strong confidence in their ability to give birth at home and described a confidence in their bodies, their midwives, and the health system. Women weighed up the risks of homebirth through information they gathered and integration with their previous experience of birth, their family support and self-confidence. Women choosing publicly-funded homebirth display strong confidence in both themselves to give birth at home, and their belief in the health system's ability to cope with any complications that may arise. Many women may benefit from access to publicly-funded homebirth models of care. This should be further investigated. Copyright © 2010 Australian College of Midwives. All rights reserved.
Ushang Desai; Paras Patel
Over the few years medical marijuana is growing in the United States. Because of the medical marijuana legislators able to legalized recreational marijuana in the two states in the US. Marijuana has several potential benefits that help in certain disease. The delivery of marijuana is also important because smoking marijuana has severe side effects. Physicians also play important role in medical marijuana, physicians also divided on the use of medical marijuana. Their attitude towards medical ...
Bayer, Ronald; Sampat, Bhaven N
We discuss the public and private sponsoring of university research and the issues it raises in a context of diminished federal funding. We consider research funding at schools of public health and why these schools have historically had weaker links to industry than have other academic units. We argue that the possibility of enhanced links with industry at schools of public health may raise specific concerns beyond those facing universities generally. Six issues should be considered before entering into these relationships: (1) the effects on research orientation, (2) unacceptability of some funders, (3) potential threats to objectivity and academic freedom, (4) effects on academic standards, (5) the effects on dissemination of knowledge, and (6) reputational risks.
Emery, J C Herbert
Needs for non-medical residential care services, long-term care (LTC), will increase over the next 30 years as Canada's population ages. Adams and Vanin (2016) explore four options for raising the public and private monies required to meet LTC needs. In this commentary, I raise a fifth option for finding the resources to meet emerging LTC needs. An alternative approach is to divert resources from Canada's well-resourced, but inefficient, medical treatment system. The dividend of provinces pursuing long overdue reforms to medicare is the liberation of public funds to finance emerging priorities for Canadians like LTC.
Skovgaard, Marlene; Okkels, Niels; Christensen, Mette Krogh;
INTRODUCTION: In the 1990s, the publication and PhD recruitment rates following the Danish pre-graduate research programme (PGRP) in medicine were 54% and 33%, respectively. Updated estimates are unknown. METHODS: All medical students enrolled in the PGRP at the Faculty of Medicine, Aarhus......, PGRP completion time and years in medical school at the time of PGRP initiation. Supervisors were described by sex, title, position and affiliation. Calculations were tested by the chi-squared test; p ...: Fast completion of the PGRP and early enrolment in the programme were associated with scientific publishing and PhD recruitment. The publication rate has remained stable over time. FUNDING: Authors were funded by their individual affiliations. TRIAL REGISTRATION: not relevant....
In countries where local governments are heavily involved in financing health care for the indigent, regional disparities in local revenues may adversely affect the access of the poor to medical care. It is thus important to examine how central governments provide funds for such local medical needs. In Japan, local governments finance all medical costs for the poor through their Public Assistance (PA) programs. Using the unique mechanism of the Japanese system of central grants, I construct a...
Stedrak, Luke J.
This study contains an analysis of virtual schools, public policy, and funding in the United States. The purpose of this study was to determine what public policies and legislation were in place regarding the funding models of virtual education on a state by state basis. Furthermore, this study addressed how allocations were being made by state…
Evert A. Jiménez-Cotes
Full Text Available Abstract: Objective: To evaluate the results of clinical trials financed by the pharmaceutical industries during the period 2007-2012 in a general medical journal. Materials and methods: We performed an observational cross sectional study where originals clinical trials financed by the pharmaceutical industry published between 2007 and 2012 in the journal The New England Journal of Medicine (http://www.nejm.org were reviewed. Trend Chi2 test was used to evaluate the results of studies over the years. A database was created with different variables, identifying the number of publications and the period of greater publishing negatives studies, as well as the medical specialty and pharmaceutical industry funding. Results: 321 clinical trials were analyzed. The Odds Ratio was calculated for each year evaluated, finding a Chi2 of linear trend in negatives studies of 2.91 with value p 0.08 and positive studies of 1.16 with value p 0.28. It was found that in the period 2007-2009 123 studies were published, 40 % of which presented negative results; unlike the 2010-2012 period in which 198 clinical trials where published, 142 of them, showed positive results, OR 1.68, 95 % CI (1.02-2.78 value p 0.03. The highest figures of negative results were published in 2007: 44.7 %. Conclusions: A progressive decrease in the number of publications with annual general negative results has been observed. A statistically significant difference in the publication of negative studies per year was not found between the periods 2007-2012. The medical specialty that showed the largest number of total and negative publications in both periods was cardiology. The pharmaceutical industry that sponsored most total clinical trials with negative results in both periods did so through Merck, Glaxo SmithKline, and Sanofi-Aventis. 50% of neurology publications showed negative results.
Full Text Available In the present article, an attempt was made to assess the organization of production and economic results of agricultural holdings that realized investments subsidized with public funds, from the perspective of good agricultural practice. Agricultural holdings in the Podlaskie voivodeship registered in the FADN system in 2011–2012 were investigated. Assessment accounted for crop structure, stock density, production intensity, the value and structure of capital, and profi tableness of land, capital, and labour. Analysis showed that holdings benefi ting from subsidization of investments with public funds were characterized by greater production intensity and also achieved better economic results. However, they exerted greater pressure on the environment and posed hazards that mainly resulted from high stock density.
Connolly, Mark P; Postma, Maarten J; Crespi, Simone
This study evaluated the fiscal impact attributed to recent policy changes that limited funding to public fertility clinics in Denmark. Taking into consideration that introducing patient co-payments will influence the numbers of couples treated, the number of children born every year from assisted......) and lifetime gross tax contributions to derive the discounted net tax contribution from assisted-conception singletons. An investment of €11,078 in a mother aged...
Full Text Available Large amounts of unspent funds budgeted for implementing development projects have been recovered from Nigeria’s public officials since President Yar Adua directed in 2007 that responsible Nigerian Ministries, Departments and Agencies (MDAs must refund such funds at the end of every fiscal year. While unspent funds recovery represents some progress in the “war on corruption” entrenched by previous governments in the 1980s, the current policy limited by concentrating narrowly on recovery of financial resources thereby excluding accounting for other project resources (human skills application, time management or optimization among others that are usually applied to project implementation but lost through public officers’ failure and/or delays to implement planned projects. This article examines the magnitude of unspent funds recently recovered by the government from its various ministries, departments and agencies (MDAs. The general objective of this article is to contribute towards improving the development project management culture in Nigeria. The specific objectives are: To highlight the magnitude of unspent funds in Nigeria’s MDAs; and to show some adverse consequences of failing (or delaying to spend funds allocated in the budget forimplementing projects in economic sectors and on the pursuit of development objectives. Survey and description methods were used. Data on the refund of unspent funds was obtained from secondary sources (records of MDAs and analysed using qualitative and simple quantitative techniques. Results show that a high rate of projects delay and /or abandonment was discovered shortly after the inauguration of President Yar’ Adua and his administration in May 2007. Although some project funds have been recovered, other project resources (time wasted, human skills/hours and development benefits that would have accrued from completion of the planned and financed projects have not been recovered but lost. The fact
Stagnaro-Green, Alex; Roe, David; Soto-Greene, Maria; Joffe, Russell
Increasing financial pressures, along with a desire to realign resources with institutional priorities, has resulted in the adoption of mission-based funding (MBF) at many medical schools. The lack of inclusion of quality and the time and expense in developing and implementing mission based funding are major deficiencies in the models reported to date. In academic year 2002-2003 New Jersey Medical School developed a model that included both quantity and quality in the education metric and that was departmentally based. Eighty percent of the undergraduate medical education allocation was based on the quantity of undergraduate medical education taught by the department ($7.35 million), and 20% ($1.89 million) was allocated based on the quality of the education delivered. Quality determinations were made by the educational leadership based on student evaluations and departmental compliance with educational administrative requirements. Evolution of the model has included the development of a faculty oversight committee and the integration of peer evaluation in the determination of educational quality. Six departments had a documented increase in quality over time, and one department had a transient decrease in quality. The MBF model has been well accepted by chairs, educational leaders, and faculty and has been instrumental in enhancing the stature of education at our institution.
Publication of pharmaceutical company-sponsored research in medical journals, and its presentation at conferences and meetings, is mostly governed by 'publication plans' that extract the maximum amount of scientific and commercial value out of data and analyses through carefully constructed and placed papers. Clinical research is typically performed by contract research organizations, analyzed by company statisticians, written up by independent medical writers, approved and edited by academic researchers who then serve as authors, and the whole process organized and shepherded through to journal publication by publication planners. This paper reports on a conference of an international association of publication planners. It describes and analyzes their work in an ecological framework that relates it to marketing departments of pharmaceutical companies, medical journals and publishers, academic authors, and potential audiences. The medical research described here forms a new kind of corporate science, designed to look like traditional academic work, but performed largely to market products.
Background In recent years, China has experienced tremendous growth in its pharmaceutical industry. Both the Chinese government and private investors are motivated to invest into pharmaceutical research and development (R&D). However, studies regarding the different behaviors of public and private investment in pharmaceutical R&D are scarce. Therefore, this paper aims to investigate the current situation of public funding and private investment into Chinese pharmaceutical R&D. Methods The primary data used in the research were obtained from the China High-tech Industry Statistics Yearbook (2002–2012) and China Statistical Yearbook of Science and Technology (2002–2012). We analyzed public funding and private investment in five aspects: total investment in the industry, funding sources of the whole industry, differences between provinces, difference in subsectors, and private equity/venture capital investment. Results The vast majority of R&D investment was from private sources. There is a significantly positive correlation between public funding and private investment in different provinces of China. However, public funding was likely to be invested into less developed provinces with abundant natural herbal resources. Compared with the chemical medicine subsector, traditional Chinese medicine and biopharmaceutical subsectors obtained more public funding. Further, the effect of the government was focused on private equity and venture capital investment although private fund is the mainstream of this type of investment. Conclusions Public funding and private investment play different but complementary roles in pharmaceutical R&D in China. While being less than private investment, public funding shows its significance in R&D investment. With rapid growth of the industry, the pharmaceutical R&D investment in China is expected to increase steadily from both public and private sources. PMID:24925505
Full Text Available In a market economy government resources are often insufficient to cover all the public budget needs. Public capital collecting process presents a particular interest considering the need of getting them with lower costs. The options for collecting public resources are characterized by diversity and complexity. One of them is based on municipal bonds funds. This paper explores the potential of public bonds issued at a local level in raising capital for infrastructure investments in Romanian public administration. This paper is not meant to be an empirical study at national level because sub-sovereign bonds market in Romania is not very developed. This paper is limited to a case study of public financing methods for a Romanian local public administration. Local authorities from Oradea have no other possibility without one of borrowing to achieve the objectives proposed. Thus, it resorted to a set of internal and external loans. Our study contents a comparative cost analysis of public financing by loans. The analysis lead to the result that the cheapest source of financing is the loan offered by the European Investment Bank, followed by municipal bonds issuing.
Gandré, Coralie; Prigent, Amélie; Kemel, Marie-Louise; Leboyer, Marion; Chevreul, Karine
Since 2007, actions have been undertaken in France to foster mental health research. Our objective was to assess their utility by estimating the evolution of public and non-profit funding for mental health research between 2007 and 2011, both in terms of total funding and the share of health research budgets. Public and non-profit funding was considered. Core funding from public research institutions was determined through a top-down approach by multiplying their total budget by the ratio of the number of psychiatry-related publications to the total number of publications focusing on health issues. A bottom-up method was used to estimate the amount of project-based grants and funding by non-profit organizations, which were directly contacted to obtain this information. Public and non-profit funding for mental health research increased by a factor of 3.4 between 2007 and 2011 reaching €84.8 million, while the share of health research funding allocated to mental health research nearly doubled from 2.2% to 4.1%. Public sources were the main contributors representing 94% of the total funding. Our results have important implications for policy makers, as they suggest that actions specifically aimed at prioritizing mental health research are effective in increasing research funding. There is therefore an urgent need to further undertake such actions as funding in France remains particularly low compared to the United Kingdom and the United States, despite the fact that the epidemiological and economic burden represented by mental disorders is expected to grow rapidly in the coming years.
Understanding the performance and impact of public knowledge translation funding interventions: Protocol for an evaluation of Canadian Institutes of Health Research knowledge translation funding programs
McLean Robert K D
Full Text Available Abstract Background The Canadian Institutes of Health Research (CIHR has defined knowledge translation (KT as a dynamic and iterative process that includes the synthesis, dissemination, exchange, and ethically-sound application of knowledge to improve the health of Canadians, provide more effective health services and products, and strengthen the healthcare system. CIHR, the national health research funding agency in Canada, has undertaken to advance this concept through direct research funding opportunities in KT. Because CIHR is recognized within Canada and internationally for leading and funding the advancement of KT science and practice, it is essential and timely to evaluate this intervention, and specifically, these funding opportunities. Design The study will employ a novel method of participatory, utilization-focused evaluation inspired by the principles of integrated KT. It will use a mixed methods approach, drawing on both quantitative and qualitative data, and will elicit participation from CIHR funded researchers, knowledge users, KT experts, as well as other health research funding agencies. Lines of inquiry will include an international environmental scan, document/data reviews, in-depth interviews, targeted surveys, case studies, and an expert review panel. The study will investigate how efficiently and effectively the CIHR model of KT funding programs operates, what immediate outcomes these funding mechanisms have produced, and what impact these programs have had on the broader state of health research, health research uptake, and health improvement. Discussion The protocol and results of this evaluation will be of interest to those engaged in the theory, practice, and evaluation of KT. The dissemination of the study protocol and results to both practitioners and theorists will help to fill a gap in knowledge in three areas: the role of a public research funding agency in facilitating KT, the outcomes and impacts KT funding
Full Text Available The Clinical University hospitals in European Union, including those from new European countries, are providing medical services according to high quality standards; however there are significant differences in medical service payment from the government. There are also differences in the amount of the payment for in- and outpatient services. According to World Bank’s assessment several of new European Union members are ranked as high-income countries alongside to old European member countries, but the payment gap of medical services between these countries is very relevant. Health insurance costs vary a lot across the European Union countries, with the highest percentage in Germany (15.5% and the lowest in France (100 Euro per year. In most countries the government finances the costs of surgical manipulations, but by contrast in Latvia patients have to pay fixed payment of EUR 43 for treatment even in case of malignancy and additional payments for staying in hospital. The salary of surgeons in field of gynecological oncology for the full workload ranges from 500 Euro in Macedonia to 4000 Euro in Denmark per month after the taxes. Reward from government varies a lot for the same manipulations in different countries. Despite the fact World Bank ranks new European countries as high-income countries there is tremendous difference in the manipulation costs covered by government and payment of medical stuff.
Stuckler, David; Basu, Sanjay; Gilmore, Anna; Batniji, Rajaie; Ooms, Gorik; Marphatia, Akanksha A; Hammonds, Rachel; McKee, Martin
The International Monetary Fund's recent claims concerning its impact on public health are evaluated against available data. First, the IMF claims that health spending either does not change or increases with IMF-supported programs, but there is substantial evidence to the contrary. Second, the IMF claims to have relaxed strict spending requirements in response to the 2008-9 financial crisis, but there is no evidence supporting this claim, and some limited evidence from the Center for Economic Policy Research contradicting it. Third, the IMF states that wage ceilings on public health are no longer part of its explicit conditionalities to poor countries, as governments can choose how to achieve public spending targets; but in practice, ministers are left with few viable alternatives than to reduce health budgets to achieve specific IMF-mandated targets, so the result effectively preserves former policy. Fourth, the IMF's claim that it has increased aid to poor countries also seems to be contradicted by its policies of diverting aid to reserves, as well as evidence that a very small fraction of the Fund's new lending in response to the financial crisis has reached poor countries. Finally, the IMF's claim that it follows public health standards in tobacco control contrasts with its existing policies, which fail to follow the guidelines recommended by the World Bank and World Health Organization. The authors recommend that the IMF (1) become more transparent in its policies, practices, and data to allow improved independent evaluations of its impact on public health (including Health Impact Assessment) and (2) review considerable public health evidence indicating a negative association between its current policies and public health outcomes.
In February 1998, the Government of Canada established the Climate Change Action Fund (CCAF) to assist Canada in meeting its commitments under the Kyoto Protocol for the reduction of greenhouse gas emissions. The CCAF managed a budget of 150 million dollars over three years, and the Public Education and Outreach (PEO) Block was allocated 30 million dollars of that total for its operations. Its mandate was to increase public awareness and understanding on the topic of climate change, as well as providing the required information to effect reductions in the emissions of greenhouse gases and adapt to climate change. An evaluation into this program was conducted, and it covered the period September 2000 to January 20, 2001. To date, 152 projects have been approved, which represents an investment of approximately 17.5 million dollars. Approximately 6 million dollars have been spent on the awareness component, while government communication activities used approximately 3.1 million dollars. Staff and project management fees in support of the program account for the remaining funds. This report addressed the performance to date in meeting the objectives, and also included recommendations for improved effectiveness. PEO files and records, a report entitled Interim review of the Climate Change Action Fund PEO Program, interviews with Departmental representatives, and interviews with external stakeholder groups formed the basis for the findings and recommendations. It was determined that future direction represents the most critical issue facing the PEO block. 1 tab.
From the preface: This brochure is based on an analysis study that ascertained that since 2004 the Research Council's PETROMAKS and DEMO 2000 programmes have allocated funding to more than 80 projects carried out by the research community and private industry relating to climate challenges. Once these projects have been concluded, they will have received a total of over half a billion kroner in public funding. There is no doubt that many of the measures recommended by these projects will have positive impacts on the environment. Many of these research findings can contribute to making processes more energy efficient or to directly reducing emissions of greenhouse gases. The brochure presents a selection of these projects. A complete list of projects under the PETROMAKS and DEMO 2000 programmes which address raising energy efficiency may be found at the end of the brochure.(eb)
... 42 Public Health 2 2010-10-01 2010-10-01 false Depreciation: Allowance for depreciation on assets financed with Federal or public funds. 413.149 Section 413.149 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE...
Levit, Katharine R; Kassed, Cheryl A; Coffey, Rosanna M; Mark, Tami L; Stranges, Elizabeth M; Buck, Jeffrey A; Vandivort-Warren, Rita
Spending on mental health (MH) and substance abuse (SA) treatment is expected to double between 2003 and 2014, to $239 billion, and is anticipated to continue falling as a share of all health spending. By 2014, our projections of SA spending show increasing responsibility for state and local governments (45 percent); deteriorating shares financed by private insurance (7 percent); and 42 percent of SA spending going to specialty SA centers. For MH, Medicaid is forecasted to fund an increasingly larger share of treatment costs (27 percent), and prescription medications are expected to capture 30 percent of MH spending by 2014.
Chen, Hsinchun [The University of Arizona, Department of Management Information Systems (United States); Roco, Mihail C. [National Science Foundation (United States); Son, Jaebong; Jiang, Shan, E-mail: firstname.lastname@example.org; Larson, Catherine A.; Gao, Qiang [The University of Arizona, Department of Management Information Systems (United States)
In a relatively short interval for an emerging technology, nanotechnology has made a significant economic impact in numerous sectors including semiconductor manufacturing, catalysts, medicine, agriculture, and energy production. A part of the United States (US) government investment in basic research has been realized in the last two decades through the National Science Foundation (NSF), beginning with the nanoparticle research initiative in 1991 and continuing with support from the National Nanotechnology Initiative after fiscal year 2001. This paper has two main goals: (a) present a longitudinal analysis of the global nanotechnology development as reflected in the United States Patent and Trade Office (USPTO) patents and Web of Science (WoS) publications in nanoscale science and engineering (NSE) for the interval 1991-2012; and (b) identify the effect of basic research funded by NSF on both indicators. The interval has been separated into three parts for comparison purposes: 1991-2000, 2001-2010, and 2011-2012. The global trends of patents and scientific publications are presented. Bibliometric analysis, topic analysis, and citation network analysis methods are used to rank countries, institutions, technology subfields, and inventors contributing to nanotechnology development. We then, examined how these entities were affected by NSF funding and how they evolved over the past two decades. Results show that dedicated NSF funding used to support nanotechnology R and D was followed by an increased number of relevant patents and scientific publications, a greater diversity of technology topics, and a significant increase of citations. The NSF played important roles in the inventor community and served as a major contributor to numerous nanotechnology subfields.
Chen, Hsinchun; Roco, Mihail C.; Son, Jaebong; Jiang, Shan; Larson, Catherine A.; Gao, Qiang
In a relatively short interval for an emerging technology, nanotechnology has made a significant economic impact in numerous sectors including semiconductor manufacturing, catalysts, medicine, agriculture, and energy production. A part of the United States (US) government investment in basic research has been realized in the last two decades through the National Science Foundation (NSF), beginning with the nanoparticle research initiative in 1991 and continuing with support from the National Nanotechnology Initiative after fiscal year 2001. This paper has two main goals: (a) present a longitudinal analysis of the global nanotechnology development as reflected in the United States Patent and Trade Office (USPTO) patents and Web of Science (WoS) publications in nanoscale science and engineering (NSE) for the interval 1991-2012; and (b) identify the effect of basic research funded by NSF on both indicators. The interval has been separated into three parts for comparison purposes: 1991-2000, 2001-2010, and 2011-2012. The global trends of patents and scientific publications are presented. Bibliometric analysis, topic analysis, and citation network analysis methods are used to rank countries, institutions, technology subfields, and inventors contributing to nanotechnology development. We then, examined how these entities were affected by NSF funding and how they evolved over the past two decades. Results show that dedicated NSF funding used to support nanotechnology R&D was followed by an increased number of relevant patents and scientific publications, a greater diversity of technology topics, and a significant increase of citations. The NSF played important roles in the inventor community and served as a major contributor to numerous nanotechnology subfields.
Paterson, Andrew; Oppenheim, Jerrold; Dubravka Pineda, Maria
Building a better energy future will be expensive, in part, because it will require modernizing energy infrastructure and bringing more innovative technologies to deliver energy more efficiently to consumers with less environmental impact. With the extended recession and turmoil in credit markets in 2008, some states have turned to public benefit funds to address critical risks in adopting innovative energy technologies and systems. This paper updates valuable observations for governing PBFs to promote wider adoption of innovative energy technologies enabling a better balance of risk and return in concert with other policy tools by negotiating mitigation of early adopter risks.
Davó-Blanes, M Carmen; Vives-Cases, Carmen; Barrio-Fernández, José Luis; Porta, Miquel; Benavides, Fernando G; de Miguel, Ángel Gil
To reach a consensus among public health faculty from various Spanish universities about the core public health competencies that should be integrated into undergraduate medical degrees. The 2nd Forum of University Teachers was held at the Rey Juan Carlos University (Madrid, 11-12 December 2014). Twenty-four university professors and lecturers from 19 Spanish universities imparting medical degrees participated in the forum. They were distributed in three working groups during three working sessions. In the first session, they were asked to identify and classify core public health competencies for medical degrees. In the second, they were asked to propose public health contents for the identified competencies. In the third session, the participants organized these contents in thematic blocks. The results were discussed in distinct plenary sessions. The highest number of core competencies was identified in the activities related to the public health functions «Assessment of the population's health needs» and «Developing health policies». The final programme included basic contents organised into five units: Concept of health, public health and its determinants; Epidemiology and health research; Determinants and health problems; Strategies, interventions and policies; and health systems, clinical and healthcare management. The public health core competencies and contents identified in this Forum may be considered as a starting point to improve and update public health training programmes for future medical professionals. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.
Correia, Victor; Fernandez, Isabel
The European Federation of Geologists (EFG) is based in 24 European countries and represents over 50,000 geoscientists in Europe, working in organisations dealing with many of the critical societal challenges that came with fast population growing: soils fertility; fresh water; energy; and raw materials supply. This calls for the concerted contribution of networks of geoscientists to frame and answer the global challenges we are facing. In Europe, the Research and Innovation funding program Horizon 2020 provided a unique opportunity for EFG to play an active role in this context, and this justifies the direct involvement of EFG in several funded projects, ranging from international cooperation on raw materials supply to groundwater research or combined heat, power and metal extraction from ultra-deep ore bodies. But an active participation of a not for profit organization of geoscientists in such public funded projects brings responsibilities and reputational risks. The authors will describe how EFG is taking these responsibilities and facing the correspondent risks, through the involvement of certified professionals. The authors will highlight why EFG is keen in promoting the EurGeol professional title, ensuring title holders are skilled and competent to deliver high quality services within the practice of geology, framed by a Code of Ethics and a commitment towards continuing professional development.
Full Text Available BACKGROUND: Few data are available evaluating the associations of formal public health education with long-term career choice and professional outcomes among medical school graduates. The objective of this study was to determine if formal public health education via completion of a masters of public health (MPH degree among US medical school graduates was associated with early and long-term career choice, professional satisfaction, or research productivity. METHODS: We conducted a retrospective cohort study in 1108 physicians (17.1% completed a MPH degree who had 10-20 years of follow-up post medical school graduation. Multivariable logistic regression analyses were conducted. RESULTS: Compared to their counterparts with no MPH, medical school graduates with a MPH were more likely to have completed a generalist primary care residency only [relative risk (RR 1.79, 95% confidence interval (CI 1.35-2.29], obtain employment in an academic institution (RR 1.81; 95% CI 1.33-2.37 or government agency (RR 3.26; 95% CI 1.89-5.38, and practice public health (RR 39.84; 95% CI 12.13-107.38 or primary care (RR 1.59; 95% CI 1.18-2.05. Furthermore, medical school graduates with a MPH were more likely to conduct public health research (RR 8.79; 95% CI: 5.20-13.82, receive NIH or other federal funding (RR 3.11, 95% CI 1.74-5.33, have four or more peer-reviewed publications (RR 2.07; 95% CI 1.56-2.60, and have five or more scientific presentations (RR 2.31, 95% CI 1.70-2.98. CONCLUSION: Formal public health education via a MPH was associated with career choice and professional outcomes among physicians.
Muñoz, Ana; Moreno, Carolina; Luján, José Luis
This article examines the relationship between the general public's understanding of science and the attitude towards public funding of scientific research. It applies a multivariate and discriminant analysis (Wilks' Lambda), in addition to a more commonly used bivariate analysis (Cramer's V), to data compiled from the Third National Survey on the Social Perception of Science and Technology in Spain (FECYT, 2006). The general conclusion is that the multivariate analysis produces information complementary to the bivariate analysis, and that the variables commonly applied in public perception studies have limited predictive value with respect to the attitude towards public funding of scientific research.
Reynolds, Sandra M
Since 1992 the Office of Research Integrity (ORI) had reviewed investigations of scientific misconduct in research funded by the US Public Health Service (PHS). ORI defined scientific misconduct as "fabrication, falsification, plagiarism, or other practices that seriously deviate from those that are commonly accepted within the scientific community for proposing, conducting, or reporting research". The purpose of this study was to summarize the findings and administrative actions reported in ORI notices of scientific misconduct in clinical trials occurring between May 1992 and 2002. Findings of misconduct were gathered from publicly available sources: the ORI annual reports and the NIH Guide to Grants and Contracts. Clinical trials accounted for 17 (13%) of the 136 investigations that resulted in findings of scientific misconduct, and they were noted in 12 (11%) of the 113 brief reports of investigations closed with findings of no scientific misconduct. In clinical trials, the most severe sanction, debarment from US Government funding, was applied in six (35%) of the cases of misconduct compared to 79 (66%) of 119 cases from all other types of research combined. Of individuals cited for misconduct in clinical trials, three (18%) held doctorates in contrast to 81 (68%) in other types of research. In clinical trials, junior employees may bear the burden of sanction for scientific misconduct. The most frequently applied sanction was the requirement that a plan of supervision of the sanctioned employees accompany any future application for funding which would include them. This imposition of sanction on an individual employee does not address possible causes of misconduct which may be inherent in the overall pattern of leadership, training and supervision in the trial. Furthermore, the definition of misconduct, as interpreted by the Departmental Appeals Board, excludes carelessness and other poor research practices that may lead to dissemination of more incorrect data
LaVallie Donna L
Full Text Available Abstract Background The purpose of this study is to identify publication output, and research areas, as well as descriptively and quantitatively characterize the field of medical informatics through publication trend analysis over a twenty year period (1987–2006. Methods A bibliometric analysis of medical informatics citations indexed in Medline was performed using publication trends, journal frequency, impact factors, MeSH term frequencies and characteristics of citations. Results There were 77,023 medical informatics articles published during this 20 year period in 4,644 unique journals. The average annual article publication growth rate was 12%. The 50 identified medical informatics MeSH terms are rarely assigned together to the same document and are almost exclusively paired with a non-medical informatics MeSH term, suggesting a strong interdisciplinary trend. Trends in citations, journals, and MeSH categories of medical informatics output for the 20-year period are summarized. Average impact factor scores and weighted average impact factor scores increased over the 20-year period with two notable growth periods. Conclusion There is a steadily growing presence and increasing visibility of medical informatics literature over the years. Patterns in research output that seem to characterize the historic trends and current components of the field of medical informatics suggest it may be a maturing discipline, and highlight specific journals in which the medical informatics literature appears most frequently, including general medical journals as well as informatics-specific journals.
Sobelson, Robyn K; Young, Andrea C
The Centers for Public Health Preparedness (CPHP) program was a five-year cooperative agreement funded by the Centers for Disease Control and Prevention (CDC). The program was initiated in 2004 to strengthen terrorism and emergency preparedness by linking academic expertise to state and local health agency needs. The purposes of the evaluation study were to identify the results achieved by the Centers and inform program planning for future programs. The evaluation was summative and retrospective in its design and focused on the aggregate outcomes of the CPHP program. The evaluation results indicated progress was achieved on program goals related to development of new training products, training members of the public health workforce, and expansion of partnerships between accredited schools of public health and state and local public health departments. Evaluation results, as well as methodological insights gleaned during the planning and conduct of the CPHP evaluation, were used to inform the design of the next iteration of the CPHP Program, the Preparedness and Emergency Response Learning Centers (PERLC).
Vorstenbosch, Marc; Bolhuis, Sanneke; van Kuppeveld, Sascha; Kooloos, Jan; Laan, Roland
Publications on anatomy in medical education appear to be largely anecdotal. To explore this, we investigated the literature on anatomy in medical education, aiming first to evaluate the contribution of the literature on anatomy in medical education to "best evidence medical education" (BEME) and second to evaluate the development of this literature toward more "best evidence" between 1985 and 2009. Four databases were searched for publications on anatomy in medical education published between 1985 and 2009, resulting in 525 references. Hundred publications were characterized by five variables (journal category, paper subject, paper category, author perspective, and paper perspective). Statements from these publications were characterized by two variables (category and foundation). The publications contained 797 statements that involved the words "anatomy," "anatomical," or "anatomist." Forty-five percent of the publications contained no explicit research question. Forty percent of the statements made were about "teaching methods" and 17% about "teaching content," 8% referred to "practical value," and 10% to "side effects" of anatomy education. Ten percent of the statements were "positional," five percent "traditional," four percent "self-evident," and two percent referred to "quality of care." Fifty-six percent of the statements had no foundation, 17% were founded on empirical data, and 27% by references. These results substantiated the critical comments about the anecdotal nature of the literature. However, it is encouraging to see that between 1985 and 2009 the number of publications is rising that these publications increasingly focus on teaching methods and that an academic writing style is developing. This suggests a growing body of empirical literature about anatomy education.
Full Text Available Abstract This study analyses the priorities of public donors in funding HIV prevention by either integrated condom programming or HIV preventive microbicides and vaccines in the period between 2000 and 2008. It further compares the public funding investments of the USA government and European governments, including the EU, as we expect the two groups to invest differently in HIV prevention options, because their policies on sexual and reproductive health and rights are different. We use two existing officially UN endorsed databases to compare the public donor funding streams for HIV prevention of these two distinct contributors. In the period 2000-2008, the relative share of public funding for integrated condom programming dropped significantly, while that for research on vaccines and microbicides increased. The European public donors gave a larger share to condom programming than the United States, but exhibited a similar downward trend in favour of funding research on vaccines and microbicides. Both public donor parties invested progressively more in research on vaccines and microbicides rather than addressing the shortage of condoms and improving access to integrated condom programming in developing countries.
I show herein how to develop fundable proposals to support your research. Although the proposal strategy I discuss is commonly used in successful proposals, most junior faculty (and many senior scholars) in political science and other social sciences seem to be unaware of it. I dispel myths about funding, and discuss how to find funders and target…
... COMMISSION Public Company Accounting Oversight Board; Notice of Filing of Proposed Board Funding Final Rules for Allocation of the Board's Accounting Support Fee Among Issuers, Brokers, and Dealers, and Other... 2002 (the ``Act''), notice is hereby given that on June 21, 2011, the Public Company...
Thousands of pregnant patients and radiation workers are exposed to ionising radiation each year. Lack of knowledge is responsible for great anxiety and probably unnecessary termination of pregnancies. For many patients, the exposure is appropriate, while for others the exposure may be inappropriate, placing the unborn child at increased risk. Prenatal doses from most properly done diagnostic procedures present no measurably increased risk of prenatal death, malformation, or impairment of mental development over the background incidence of these entities. Higher doses, such as those involved in therapeutic procedures, can result in significant fetal harm. The pregnant patient or worker has a right to know the magnitude and type of potential radiation effects that might result from in utero exposure. Almost always, if a diagnostic radiology examination is medically indicated, the risk to the mother of not doing the procedure is greater than is the risk of potential harm to the fetus. Most nuclear medicine procedures do not cause large fetal doses. However, some radiopharmaceuticals that are used in nuclear medicine can pose significant fetal risks. It is important to ascertain whether a female patient is pregnant prior to radiotherapy. In pregnant patients, cancers that are remote from the pelvis usually can be heated with radiotherapy. This however requires careful planning. Cancers in the pelvis cannot be adequately treated during pregnancy without severe or lethal consequences for the fetus. The basis for the control of the occupational exposure of women who are not pregnant is the same as that for men. However, if a woman is, or may be, pregnant, additional controls have to be considered to protect the unborn child. In many countries, radiation exposure of pregnant females in biomedical research is not specifically prohibited. However, their involvement in such research is very rare and should be discouraged. Termination of pregnancy is an individual decision
Hansson, Sven Ove
In order to shorten queues to healthcare, the Swedish government has introduced a yearly "queue billion" that is paid out to the county councils in proportion to how successful they are in reducing queues. However, only the queues for first visits are covered. Evidence has accumulated that queues for return visits have become longer. This affects the chronically and severely ill. Swedish physicians, and the Swedish Medical Association, have strongly criticized the queue billion and have claimed that it conflicts with medical ethics. Instead they demand that their professional judgments on priority setting and medical urgency be respected. This discussion provides an interesting illustration of some of the limitations of new public management and also more generally of the complicated relationships between medical ethics and public policy.
Annegret F. Hannawa
Full Text Available Medical errors are not a prevalent discussion topic in the current public health literature. However, their impact on patient lives across the world is alarming. In the United States alone, more than 1.3 million patients are harmed every year by medical treatments that are intended to help them. About three quarters of these adverse events are caused by preventable human error.....
Jones, D.W.; Paik, I.K.
There are three major areas in which economics can contribute to the evaluation of federal R and D: assessment of net benefits, ex ante expected as well as ex post realized; tailoring of R and D portfolios to policy goals; and guiding the contractual organization of R and D production. Additionally, evaluation of R and D and scientific activity tend to be distinctly retrospective, principally because of the long lags between the initial production activity and the observability of consequences. Extending the purview of economic evaluation of R and D, they find ample opportunity for evaluation that can inform current R and D management practice. The conduct of R and D is organized through a series of explicit and implicit contracts designed to elicit long-term commitments by some agents while attempting to limit the commitment by others. It is natural to consider the efficiency with which R and D is conducted as a subject for economic inquiry, although in practice such inquiries generally are restricted to accounting exercises. In evaluating the efficiency with which R and D is done, the current ordinary practice is to look at labor rates and equipment and materials prices while considering quantities of those items as the principal instrument variables in an optimization problem (the authors conceptualization, not that of the typical review of an R and D project). The authors recommend the contractual structure and other elements of the incentive structure (pay and promotion) of R and D production as prime focal points for managerially useful economic evaluation. Non-economic motivations for funding public R and D, including energy R and D, are well known. The US will consider spending several billion dollars on an international space station, partly if not largely, to fund the peaceful employment of scientists from the Former Soviet Union. Nonetheless, it will be useful to understand the economics of the R and D programs even if other considerations play important
Larson, Gregg S; Carey, Cate; Grarup, Jesper; Hudson, Fleur; Sachi, Karen; Vjecha, Michael J; Gordin, Fred
Randomized clinical trials are widely recognized as essential to address worldwide clinical and public health research questions. However, their size and duration can overwhelm available public and private resources. To remain competitive in international research settings, advocates and practitioners of clinical trials must implement practices that reduce their cost. We identify approaches and practices for large, publicly funded, international trials that reduce cost without compromising data integrity and recommend an approach to cost reporting that permits comparison of clinical trials. We describe the organizational and financial characteristics of The International Network for Strategic Initiatives in Global HIV Trials, an infectious disease research network that conducts multiple, large, long-term, international trials, and examine challenges associated with simple and streamlined governance and an infrastructure and financial management model that is based on performance, transparency, and accountability. It is possible to reduce costs of participants' follow-up and not compromise clinical trial quality or integrity. The International Network for Strategic Initiatives in Global HIV Trials network has successfully completed three large HIV trials using cost-efficient practices that have not adversely affected investigator enthusiasm, accrual rates, loss-to-follow-up, adherence to the protocol, and completion of data collection. This experience is relevant to the conduct of large, publicly funded trials in other disease areas, particularly trials dependent on international collaborations. New approaches, or creative adaption of traditional clinical trial infrastructure and financial management tools, can render large, international clinical trials more cost-efficient by emphasizing structural simplicity, minimal up-front costs, payments for performance, and uniform algorithms and fees-for-service, irrespective of location. However, challenges remain. They
Karishma Rosann Pereira
Full Text Available Introduction: It is thrilling for any physician to write and publish a paper, because it reflects their study and expertise. It has become imperative in today's ever evolving world of medical science to keep abreast with academia by actively engaging in publication of scientific literature. The number of publications a physician has to his/her credit speaks volumes about their subject interest, command and passion. On the other hand, medical journals serve as sources of the most recent up-to-date information, which aids physicians in providing their patients with latest care in their specialty. Method: Having worked closely with a wide array of practicing physicians, right from fresh graduates to seasoned consultants; I have gained useful insight into the lacuna aspects when it comes to medical publications. Results: This paper aims to help every medical practitioner by bridging the gap between possessing vast amounts of data to structurally organising it and getting your information successfully published. I attempt to bring forth a ready reckoner that could serve as a step-wise checklist and guide to simplify the process of getting medical literature published; keeping in mind the time crunched and hectic schedules of medical practitioners.
Berry, Tanya R; McCarville, Ron E; Rhodes, Ryan E
The purpose of this research was to conduct a content analysis of physical activity advertisements in an effort to determine which advertisements were more likely to include features that may attract and maintain attention levels. Fifty-seven advertisements were collected from top circulation Canadian magazines. The advertisements ranged from publicly funded health promotion pieces to corporate sponsored advertisements using physical activity to sell a product. Advertisements were examined for textual and pictorial factors thought to increase attention allocated to advertising of this nature. Only two public health advertisements were found, and the majority of advertisements (57.9%) were from commercial advertisers using physical activity images to sell products or to encourage brand recognition. The advertisements originating with the private sector tended to possess most of the characteristics thought to attract the attention of readers. Once this attention was gained, however, most of these advertisements failed to highlight the benefits of physical activity. As a result, the positive effect of these advertisements may have been compromised. Public health advertisements were so infrequent that we could not compare their characteristics with those originating with the private sector. The characteristics with those we did find were inconsistent with those thought to attract and maintain attention levels. Results are discussed in terms of potential implications for promoting physical activity.
Amir Lisa H
Full Text Available Abstract Despite current scientific evidence that artificial feeding is a harmful practice, unquestioned acceptance of breastfeeding as the normal or "default" method of infant feeding remains elusive in the industrialised world. Throughout the developing world the profound consequences of the aggressive marketing strategies of the infant formula industry since the end of the Second World War is well known. A key objective of the International Breastfeeding Journal is to promote breastfeeding through addressing issues that encourage breastfeeding initiation, duration and effective management. Informing this aim is the recognition of artificial feeding as a harmful practice that places infant health at risk. From this perspective it would be unethical for this journal to accept for publication any manuscript that has received funding, sponsorship or any other means of support from infant formula manufacturers. This stance is consistent with the journal's aim of supporting, protecting and promoting breastfeeding. It will also contribute to the promotion of a breastfeeding culture.
Beasley, Annette; Amir, Lisa H
Despite current scientific evidence that artificial feeding is a harmful practice, unquestioned acceptance of breastfeeding as the normal or "default" method of infant feeding remains elusive in the industrialised world. Throughout the developing world the profound consequences of the aggressive marketing strategies of the infant formula industry since the end of the Second World War is well known. A key objective of the International Breastfeeding Journal is to promote breastfeeding through addressing issues that encourage breastfeeding initiation, duration and effective management. Informing this aim is the recognition of artificial feeding as a harmful practice that places infant health at risk. From this perspective it would be unethical for this journal to accept for publication any manuscript that has received funding, sponsorship or any other means of support from infant formula manufacturers. This stance is consistent with the journal's aim of supporting, protecting and promoting breastfeeding. It will also contribute to the promotion of a breastfeeding culture. PMID:17341315
Connolly, Mark P; Postma, Maarten J; Crespi, Simone; Andersen, Anders Nyboe; Ziebe, Søren
This study evaluated the fiscal impact attributed to recent policy changes that limited funding to public fertility clinics in Denmark. Taking into consideration that introducing patient co-payments will influence the numbers of couples treated, the number of children born every year from assisted reproductive technology will be affected. To reflect the government perspective, the model assessed the average life course of a cohort of assisted-conception singletons taking into consideration age-specific, per-capita government transfers (e.g. education, health care, family allowances, education, pensions) and lifetime gross tax contributions to derive the discounted net tax contribution from assisted-conception singletons. An investment of €11,078 in a mother aged fiscal consequences of the policy change on the government over many generations. The analytical framework discussed here estimates the net tax revenue of a cohort of assisted-conception children and the discounted net tax revenue that these children pay to the Danish government over their lifetime. The analysis illustrates that the government will save more costs than those directly related to public fertility services because fewer children are likely to be born and consequently to require government services (e.g. education, health care, family allowances). However, over time as the assisted-conception cohort matures and enters the work force. the reduced number of assisted-conception children, attributed to the funding cuts, will negatively impact government accounts due to lost tax revenue. The policy analysis described here suggests that the economic impact of the fertility policy change is dependent on the time frame over which the analysis is considered. In the short term, it is possible to save on assisted reproduction treatment costs; however, taking into consideration the life course of the diminished size of the assisted-conception cohort, this will negatively influence government accounts in
Hochrainer-Stigler, Stefan; Mechler, Reinhard; Pflug, Georg; Williges, Keith
National governments are key actors in managing climate variability and change, yet, many countries, faced with exhausted tax bases, high levels of indebtedness and limited donor assistance, have been unable to raise sufficient and timely capital to replace or repair damaged assets and restore livelihoods following major disasters exacerbating the impacts of disaster shocks on poverty and development. For weather extremes, which form a subset of the adaptation challenge and are supposed to increase in intensity and frequency with a changing climate, we conduct an assessment of the costs of managing and financing today's public sector risks on a global scale for more than 180 countries. A countries financial vulnerability is defined as a function of its financial resilience and its exposure to disaster risk. While disaster risk is estimated in terms of asset loss distributions based on catastrophe modeling approaches, financial resilience is operationalized as the public sector's ability to pay for relief to the affected population and support the reconstruction of affected assets and infrastructure for a given event. We consider governments financially vulnerable to disasters if they cannot access sufficient funding after a disaster to cover their liabilities. We operationalize this concept by the term resource gap, which we define the net loss associated with a disaster event after exhausting all possible ex-post and ex ante financing sources. Extending this approach for all possible disaster events, the risk that a resource gap will occur over a given time-span can be calculated for each country individually and dependent on the risk level different risk instruments may have to be applied. Furthermore, our estimates may inform decisions pertaining to a "climate insurance fund" absorbing "high level" country risks exceeding the ability of any given country to pay in the case of an extreme event. Our estimates relate to today's climate, yet we suggest that
Halloran, Kieran; Padwal, Raj S; Johnson-Stoklossa, Carlene; Sharma, Arya M; Birch, Dan W
Bariatric surgery has emerged as an effective and safe treatment for severe obesity and utilization rates have increased dramatically. In private health care settings, low socioeconomic status is associated with a reduced likelihood of undergoing a bariatric procedure. Whether this relationship is also present in a universally accessible, publicly funded health care system is not currently known. A retrospective analysis of the Edmonton Weight Wise obesity program clinical registry was conducted. Patients who were unemployed, on long-term disability or receiving social assistance were classified as "low income" status. The remaining patients were categorized as "regular income" status. Multivariable logistic regression analysis was used to examine the association between low income status and approval for surgery within 1 year of program entry. Thirty-three (7%) of 419 patients were ineligible for surgery or excluded because of missing income status data. Of the remaining 386 patients, 72 (19%) were of low income status and 89 (23%) were approved for surgery. Low income patients were older, heavier, and had greater comorbidity. Compared to patients of regular income status, those with low income status were less likely to be approved for surgery (15.3% versus 24.8%; adjusted OR 0.45; 95% CI 0.22 to 0.94). Within a publicly funded and universally accessible regional obesity program, lower income status patients were less likely to be approved for bariatric surgery. Further study is necessary to clarify this apparent disparity and to determine if program modifications are necessary to ensure equity across all socioeconomic strata.
Smith, Julia; Thompson, Sheryl; Lee, Kelly
This article analyzes the history of tobacco industry funding for the AIDS response – a largely ignored aspect of private donor involvement. Primary documents from the Legacy Tobacco Documents Library and from AIDS organizations are analyzed, alongside existing literature on the tobacco control and AIDS responses. Research on the tactics of transnational tobacco companies has documented how they have used various charitable causes to subvert tobacco control efforts and influence public health policy. This raises questions, which this paper seeks to answer, about if donations by tobacco companies to AIDS organizations have been used for similar means, and if so how AIDS organizations have responded to tobacco industry overtures. Two examples illustrate that tobacco companies initially tried to use the AIDS response to counter tobacco control measures: 1) During the 1990s Philip Morris, one of the largest corporate donors of the AIDS response in the US, used its connections with AIDS organizations to create competition for health resources, improve its reputation, and market tobacco products to the LGBT community; 2) In both Latin America and Sub-Saharan Africa, Philip Morris and British American Tobacco championed the AIDS response in order to delegitimize efforts to develop the WHO Framework Convention on Tobacco Control. However, from the late 1990s onwards, AIDS organizations began to refuse tobacco funding and partnerships - though these policies have been not comprehensive, as many tobacco companies still fund programs in Sub-Sahara Africa. The article concludes that tobacco companies aimed to exploit competition between health issues, and use the high profile AIDS response to improve their reputation and market access. However, AIDS organizations, adhering to broader health goals and drawing on extensive resources and networks, were able to shut the tobacco industry out of much of the response, though pockets of influence still exist. This demonstrates the
Smith, Julia; Thompson, Sheryl; Lee, Kelley
This article analyzes the history of tobacco industry funding for the AIDS response - a largely ignored aspect of private donor involvement. Primary documents from the Legacy Tobacco Documents Library and AIDS organizations are analyzed, alongside existing literature on the tobacco control and AIDS responses. Research on the tactics of transnational tobacco companies has documented how they have used various charitable causes to subvert tobacco control efforts and influence public health policy. This raises questions, which this paper seeks to answer, about if donations by tobacco companies to AIDS organizations have been used for similar means, and if so how AIDS organizations have responded to tobacco industry overtures. Two examples illustrate how tobacco companies initially tried to use the AIDS response to counter tobacco control measures: (1) During the 1990s, Philip Morris, one of the largest corporate donors of the AIDS response in the USA, used its connections with AIDS organizations to create competition for health resources, improve its reputation, and market tobacco products to the LGBT community; (2) In both Latin America and sub-Saharan Africa, Philip Morris and British American Tobacco championed the AIDS response in order to delegitimize efforts to develop the World Health Organization's Framework Convention on Tobacco Control. However, from the late 1990s onwards, AIDS organizations began to refuse tobacco funding and partnerships - though these policies have been not comprehensive, as many tobacco companies still fund programs in sub-Saharan Africa. The article concludes that tobacco companies aimed to exploit competition between health issues, and use the high-profile AIDS response to improve their reputation and market access. However, AIDS organizations, adhering to broader health goals and drawing on extensive resources and networks, were able to shut the tobacco industry out of much of the response, though pockets of influence still exist
Bonsile Rachel Ndlangamandla
Full Text Available
Couched within the context of social history of medicine, this study explores the trajectory of the Church of the Nazarene medical mission from 1911, when the Nazarene missionaries experienced their first ‘surgical’ service, to 1939 when the Church of the Nazarene had established a medical unit. The absence of large- scale biomedical facilities for the Swazi gave the Nazarene Christian missionaries the impression that they had a health burden to carry. How to fund the Nazarene frontier medical mission was the question that brought the church, the state, and the Swazi together. The study purports to discuss the tripartite funding of the Nazarene biomedical mission using information obtained from the Church of the Nazarene documents and government annual reports housed in the Swaziland National Archives. The significance of this ground- breaking study lies in its ability to evince the subtle nuances of the trajectory of multiple Christian medical mission encounters through the prism of multi- sectoral funding.
Lee, Yeh Chen; Kroon, René; Koczwara, Bogda; Haines, Ian; Francis, Kay; Millward, Michael; Kefford, Richard; Olver, Ian; Mileshkin, Linda
The completion of continuing professional development (CPD) is mandatory for medical oncologists and trainees (MO&T). Pharmaceutical companies may fund some CPD activities, but there is increasing debate about the potential for conflicts of interest (COI). To assess current practices around funding to attend CPD activities. An electronic survey was distributed to Australian MO&T. The survey asked questions about current practices, institutional policies and perceptions about attending CPD funded by pharmaceutical companies. The design looked at comparing responses between MO&T as well as their understanding of and training around institutional and ethical process. A total of 157 of 653 (24%) responses was received, the majority from MO (76%). Most CPD activities attended by MO&T were self-funded (53%), followed by funding from institutions (19%), pharmaceutical companies (16%) and salary award (16%). Most institutions allowed MO&T to receive CPD funding from professional organisations (104/157, 66%) or pharmaceutical companies (90/157, 57%). A minority of respondents (13/157, 8%) reported that the process to use pharmaceutical funds had been considered by an ethics committee. Although 103/157 (66%) had received pharmaceutical funding for CPD, most (109/157, 69%) reported never receiving training about potential COI. The lack of education was more noticeable among trainees (odds ratio (OR) 8.61, P = 0.02). MO&T acknowledged the potential bias towards a pharmaceutical product (P = 0.05) but believed there was adequate separation between themselves and pharmaceutical companies (P < 0.01). Majority of CPD attended by MO&T is self-funded. There is lack of clarity in institutional policies regarding external funding support for CPD activities. Formal education about potential COI is lacking. © 2017 Royal Australasian College of Physicians.
Walker, Steven; Gibbins, Jane; Paes, Paul; Adams, Astrid; Chandratilake, Madawa; Gishen, Faye; Lodge, Philip; Wee, Bee; Barclay, Stephen
A proportion of newly qualified doctors report feeling unprepared to manage patients with palliative care and end-of-life needs. This may be related to barriers within their institution during undergraduate training. Information is limited regarding the current organisation of palliative care teaching across UK medical schools. To investigate the evolution and structure of palliative care teaching at UK medical schools. Anonymised, web-based questionnaire. Settings/participants: Results were obtained from palliative care course organisers at all 30 UK medical schools. The palliative care course was established through active planning (13/30, 43%), ad hoc development (10, 33%) or combination of approaches (7, 23%). The place of palliative care teaching within the curriculum varied. A student-selected palliative care component was offered by 29/30 (97%). All medical schools sought student feedback. The course was reviewed in 26/30 (87%) but not in 4. Similarly, a course organiser was responsible for the palliative care programme in 26/30 but not in 4. A total of 22 respondents spent a mean of 3.9 h (median 2.5)/week in supporting/delivering palliative care education (medical schools. Funding was not universally transparent. Palliative care teaching was associated with some form of funding in 20/30 (66%). Development, organisation, course evaluation and funding for palliative care teaching at UK medical schools are variable. This may have implications for delivery of effective palliative care education for medical students.
Recent studies have identified the need to understand what shapes public attitudes toward space policy. I address this gap in the literature by developing a multivariate regression model explaining why many Americans support government spending on space exploration. Using pooled data from the 2006 and 2008 General Social Surveys, the study reveals that spending preferences on space exploration are largely apolitical and associated instead with knowledge and opinions about science. In particular, the odds of wanting to increase funding for space exploration are significantly higher for white, male Babyboomers with a higher socio-economic status, a fondness for organized science, and a post-secondary science education. As such, I argue that public support for NASA's spending epitomizes what Launius termed "Apollo Nostalgia" in American culture. That is, Americans benefitting most from the old social order of the 1960s developed a greater fondness for science that makes them more likely to lament the glory days of space exploration. The article concludes with suggestions for how to elaborate on these findings in future studies.
... into its Public Law 102-477 Plan? 26.22 Section 26.22 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF... tribe integrate Job Placement and Training funds into its Public Law 102-477 Plan? Yes, Indian tribes may integrate Job Placement and Training Program funds into their Public Law 102-477 Plan....
Hernandez-Villafuerte, Karla; Sussex, Jon; Robin, Enora; Guthrie, Sue; Wooding, Steve
Publicly funded biomedical and health research is expected to achieve the best return possible for taxpayers and for society generally. It is therefore important to know whether such research is more productive if concentrated into a small number of 'research groups' or dispersed across many. We undertook a systematic rapid evidence assessment focused on the research question: do economies of scale and scope exist in biomedical and health research? In other words, is that research more productive per unit of cost if more of it, or a wider variety of it, is done in one location? We reviewed English language literature without date restriction to the end of 2014. To help us to classify and understand that literature, we first undertook a review of econometric literature discussing models for analysing economies of scale and/or scope in research generally (not limited to biomedical and health research). We found a large and disparate literature. We reviewed 60 empirical studies of (dis-)economies of scale and/or scope in biomedical and health research, or in categories of research including or overlapping with biomedical and health research. This literature is varied in methods and findings. At the level of universities or research institutes, studies more often point to positive economies of scale than to diseconomies of scale or constant returns to scale in biomedical and health research. However, all three findings exist in the literature, along with inverse U-shaped relationships. At the level of individual research units, laboratories or projects, the numbers of studies are smaller and evidence is mixed. Concerning economies of scope, the literature more often suggests positive economies of scope than diseconomies, but the picture is again mixed. The effect of varying the scope of activities by a research group was less often reported than the effect of scale and the results were more mixed. The absence of predominant findings for or against the existence of
Schier, Joshua G; Rubin, Carol; Schwartz, Michael D; Thomas, Jerry D; Geller, Robert J; Morgan, Brent W; McGeehin, Michael A; Frumkin, Howard
In December 2002, the medical toxicology sub-board, which consists of representatives from emergency medicine, preventive medicine, and pediatrics, released revised core content for medical toxicology, aiming to better meet the academic challenges imposed by the continually expanding knowledge base of medical toxicology. These challenges included the addition of relatively new areas of interest in medical toxicology, including population health, while simultaneously ensuring that a structural framework existed to accommodate future areas of interest. There is no evidence readily available to assess how well the educational curricula of existing fellowship programs are meeting these needs. In an effort to address this, the authors describe a medical toxicology fellowship program that consists of a partnership among the Emory University School of Medicine, the Georgia Poison Control Center, and the CDC, as well as the results of a reorganization of its academic curriculum that occurred in 2006. To the best of the authors' knowledge, this is the first published report describing such a curriculum redesign. Suggestions and potential resources proposed as enhancements for the public health-associated education of medical toxicology fellows are discussed. The authors also seek to initiate a discussion among programs about how to optimally meet the new challenges developed by the medical toxicology sub-board.
Benotmane, Ilies; Glatz, Nicolas; Bihan, Solenn; Legrand, Fanny; Gosset, Didier; Boulanger, Eric
The purpose of this study was to determine the future, in terms of scientific publication, of medical thesis (MT) defended in the Medical School of Lille 2 University (MSL2U) between January 1st, 2001 and December 31st, 2007. The collection of MT published as a corresponding scientific article was realized from PubMed(®). For every corresponding article, we determined the journal Impact Factor (IF), the language of publication and the rank of the student and his MT director in the author list. Analyses were also realized according to the group of speciality of the TM. In all, 11.3% of the 2150 MT defended in the MSL2U were followed up by a scientific publication. The average IF was 2.32 with a median at 1.75 and extreme values from 0 to 14.78. Seventy percent of the articles were published in English. The rank of the student was placed before his MT director (2.06 vs. 3.15). The MT defended by students in the field of medical specialities presented the highest rate of publication (25.1%). The general medicine was the second speciality the most productive in term of number of published articles (n=49) after medical specialities (n=103). The MT director and the PhD students must be more motivated to publish their results. The value of 11.3% could be considered as weak but, because of a huge lack of references, it is impossible to compare our results to those of other French medical schools. It remains important to reform the objectives and the modalities of the writing of a MT: should we not have to turn to thesis called "on article"? Copyright © 2012. Published by Elsevier Masson SAS.
Pan, Wei; Coatrieux, Gouenou; Bouslimi, Dalel; Prigent, Nicolas
Cloud computing promises medical imaging services offering large storage and computing capabilities for limited costs. In this data outsourcing framework, one of the greatest issues to deal with is data security. To do so, we propose to secure a public cloud platform devoted to medical image sharing by defining and deploying a security policy so as to control various security mechanisms. This policy stands on a risk assessment we conducted so as to identify security objectives with a special interest for digital content protection. These objectives are addressed by means of different security mechanisms like access and usage control policy, partial-encryption and watermarking.
Whether you think of it as your image, your standing in the community, or your reputation, your medical practice is also a brand. While many organizations, companies, products, and services are known for specific attributes that make them stand out from competitors, most use a combination of marketing disciplines to communicate who and what they are to their customers, consumers, and patients. Public relations is often considered the most powerful, cost-effective, and efficacious of the marketing disciplines, surpassing advertising, promotion, and direct mail in molding and developing brands. Your practice can benefit from a well-crafted branding public relations program.
This paper shows how the different groups of managers (administrative, artistic, and technical) of a publicly funded opera company evaluate the artistic performance of their organization. Performance information of varied nature is exchanged between the internal and external stakeholders of the orga
Ryans, Cynthia C.; Shanklin, William L.
Perspectives on college and university strategic planning, marketing and public relations, and fund-raising are offered. Also included are previously published journal articles by experts in this area, annotated bibliographies of books and journal articles on these subjects, author/title and subject indexes, and a directory of publishers. Three…
The uncertain need for long-term care services is a risk best protected by insurance. However, the current funding relies heavily on personal payment and public welfare, and only lightly on social and private insurances. This method, akin to sitting on a two-legged stool, is unlikely to be sustainable. To incorporate insurance as a key component of funding and to mobilize public and private resources more effectively, we propose a three-legged-stool funding model under which social insurance would provide a basic protection, to be supplemented by private insurance and personal payment. When these sources do not provide sufficient protection for some individuals, Medicaid as public welfare would serve as a safety net. This article (a) discusses how to implement this funding model by using the trade-off principle in both the public and private sectors when resources for long-term care are scarce, and (b) analyzes several objections to this model from cognitive psychology/behavioral economics
This paper shows how the different groups of managers (administrative, artistic, and technical) of a publicly funded opera company evaluate the artistic performance of their organization. Performance information of varied nature is exchanged between the internal and external stakeholders of the
McClure, Charles R.; Ryan, Joe; Bertot, John Carlo
This study examines the role of external funding in the development of public library network resources and services, their identification, and their benefit and impact, particularly as they affect the digital divide. The study was conducted between February 2001 and January 2002, employing a range of data collection techniques, including site…
Bertot, John Carlo; McClure, Charles R.; Ryan, Joe
Describes external sources of funding for public libraries to establish and maintain their technology infrastructure, telecommunications services, and network-based resources and services. Highlights include LSTA (Library Services and Technology Act); the E-rate program; and the Bill and Melissa Gates Foundation U.S. Library Program. (LRW)
Full Text Available Abstract Background In the United States, a dedicated property tax describes the legal authority given to a local jurisdiction to levy and collect a tax for a specific purpose. We investigated for an association of locally dedicated property taxes to fund local public health agencies and improved health status in the eight states designated as the Mississippi Delta Region. Methods We analyzed the difference in health outcomes of counties with and without a dedicated public health tax after adjusting for a set of control variables using regression models for county level data from 720 counties of the Mississippi Delta Region. Results Levying a dedicated public health tax for counties with per capita income above $28,000 is associated with improved health outcomes of those counties when compared to counties without a dedicated property tax for public health. Alternatively, levying a dedicated property tax in counties with lower per capita income is associated with poor health outcomes. Conclusions There are both positive and negative consequences of using dedicated property taxes to fund public health. Policymakers should carefully examine both the positive association of improved health outcomes and negative impact of taxation on poor populations before authorizing the use of dedicated local property tax levies to fund public health agencies.
Full Text Available This paper presents the results of a bibliometric analysis of the Medical Sciences (MS domains in Iran. Totally 9047 articles indexed in ISI (Thomson Reuters Database from 1989 to 2008 in December 2008 have been extracted. HistCiteTM applications are used to discover the Iranian publication status during this period. The publication count has grown at an approximate rate of 40.5% per year. We tried to introduce the most productive authors, and cited works. Moreover, distributions of output in journals identified by ISI and research output analysis of different universities were presented. The most influential cited authors and articles in this research were drawn. Finally, the process of the evolution of the medical sciences discipline, and its shift over the period of the research was traced and shown in the map. Using HistCiteTM applications, retrieved articles were analyzed and visualized.
Dara, Ajay; Sangamwar, Abhay T
This review discusses the various drug therapeutic targets and latest technologies of anticancer patents from 10 Indian public-funded research organizations covering more than 150 esteemed institutes. We have identified and reported the leading assignee and inventors along with their collaboration network and, thereby, have analyzed the various patent trends, geographical distributions, citation maps, Derwent World Patents Index, international patent classification analysis and the like. This article provides the insights of 1905 patent documents from 191 families and discusses in-depth anticancer technology through categorization studies at the level of drug discovery, drug development and treatment and diagnosis. In addition, various cancer targets were correlated with recent technologies so as to identify the white spaces for upcoming technologies. Over a period of 13 years (1990 - 2013) the main focus of Indian cancer research was in the field of synthetic chemistry and natural extracts followed by the pharmaceutical compositions and combinations, whereas, the white spaces for future cancer remedy were identified from research in the areas of cancer stem cell lines, vaccines, gene therapy, nano formulations with targeted drug delivery systems as core and latest technologies.
Hansen, Kim Toft
Studying independent film in Denmark is a new and interesting way to analyse power relations in Danish film productions. The sheer magnitude of Danish indiefilms is in itself a very convincing voice to be heard. Throughout the past almost two decades we have seen a developing challenge to the typ......Studying independent film in Denmark is a new and interesting way to analyse power relations in Danish film productions. The sheer magnitude of Danish indiefilms is in itself a very convincing voice to be heard. Throughout the past almost two decades we have seen a developing challenge...... to the typical way of producing a film in Denmark. Small production companies shoot up everywhere. Some of them are very critical of the public Danish film funding system, while others attempt to build a career as a Danish film producer. One key inspiration for many of the directors in – what has now become...... production. This DIY-culture has very much provided Danish film subcultures with a bible and an idol to look up to....
Blieden, N; Flinders, S; Hawkins, K; Reid, M; Alphs, L D; Arfken, C L
The study examined the effect of clozapine treatment on the health care costs and health status of people with schizophrenia who are supported by public funds. Thirty-three patients with schizophrenia hospitalized in a state facility were interviewed within one week of starting clozapine and six months later. Health status was assessed with four clinical rating scales measuring severity of psychopathology, negative symptoms, depression, and quality of life. Cost and health care utilization data were collected for the six months before and after initiation of clozapine. Only 52 percent of the subjects stayed on clozapine for six months. Subjects who continued on clozapine were more likely to be discharged within six months than those who did not continue. Six months after clozapine was started, health care costs showed a sayings of $11,464 per person, even after adjustment for pretreatment costs, and health status was improved. For subjects who continued on clozapine for six months, clozapine treatment was associated with reduced days of psychiatric hospital care, reduced overall costs despite increased outpatient treatment and residential costs, and improved health status.
One function of drug formularies is to allow health care providers to exert some control over spending. Decisions about whether to include a given medication in a formulary are based on estimates of its costs and effectiveness, relative to other treatment strategies. These decisions are made from a societal perspective, as opposed to that of individual patients, which sometimes results in conflicts. The clinical response to a medication often varies widely among subjects, which means that a small subgroup of patients might benefit dramatically, while others with the same disease do not. The result would be that a drug might appear not to be cost effective in an economic analysis, even though it is of proven value for some patients. New and innovative medications are assessed according to high standards of cost effectiveness, even though established treatments are wasteful of valuable health care resources. Moreover, quality-adjusted life-years (QALYs) discriminate against certain patient groups, including those with diseases that are associated with a high morbidity but a low mortality. Such patients often incur high indirect costs, including loss of employment income and costs incurred by family caregivers that QALYs do not reflect. Therefore, even though QALYs are transparent and widely applicable, they are not necessarily appropriate in the evaluation of a particular therapeutic intervention. A new paradigm should be developed for evaluating emerging therapies. An example would be a risk-sharing approach, whereby the pharmaceutical industry and public insurers share in the costs and rewards of introducing new treatments. This would have implications for the prices charged for new medications.
Full Text Available One function of drug formularies is to allow health care providers to exert some control over spending. Decisions about whether to include a given medication in a formulary are based on estimates of its costs and effectiveness, relative to other treatment strategies. These decisions are made from a societal perspective, as opposed to that of individual patients, which sometimes results in conflicts. The clinical response to a medication often varies widely among subjects, which means that a small subgroup of patients might benefit dramatically, while others with the same disease do not. The result would be that a drug might appear not to be cost effective in an economic analysis, even though it is of proven value for some patients. New and innovative medications are assessed according to high standards of cost effectiveness, even though established treatments are wasteful of valuable health care resources. Moreover, quality-adjusted life-years (QALYs discriminate against certain patient groups, including those with diseases that are associated with a high morbidity but a low mortality. Such patients often incur high indirect costs, including loss of employment income and costs incurred by family caregivers that QALYs do not reflect. Therefore, even though QALYs are transparent and widely applicable, they are not necessarily appropriate in the evaluation of a particular therapeutic intervention. A new paradigm should be developed for evaluating emerging therapies. An example would be a risk-sharing approach, whereby the pharmaceutical industry and public insurers share in the costs and rewards of introducing new treatments. This would have implications for the prices charged for new medications.
Kim, Soo Young; Bae, Chong-Woo; Hahm, Chang Kok; Cho, Hye Min
The purpose of this study was to examine trends in duplicate publication in Korean medical articles indexed in the KoreaMed database from 2004 to 2009, before and after a campaign against scientific misconduct launched by the Korean Association of Medical Journal Editors in 2006. The study covered period from 2007 to 2012; and 5% of the articles indexed in KoreaMed were retrieved by random sampling. Three authors reviewed full texts of the retrieved articles. The pattern of duplicate publication, such as copy, salami slicing (fragmentation), and aggregation (imalas), was also determined. Before the launching ethics campaign, the national duplication rate in medical journals was relatively high: 5.9% in 2004, 6.0% in 2005, and 7.2% in 2006. However, duplication rate steadily declined to 4.5% in 2007, 2.8% in 2008, and 1.2 % in 2009. Of all duplicated articles, 53.4% were classified as copies, 27.8% as salami slicing, and 18.8% as aggregation (imalas). The decline in duplicate publication rate took place as a result of nationwide campaigns and monitoring by KoreaMed and KoreaMed Synapse, starting from 2006.
Studies show significant negative effects of smoking marijuana on physical and mental health as well as social and occupational functioning. At the same time, there are more considerations about its ability to treat a number of diseases. This review summarizes current data in scientific literature that examines the medical effects of marijuana on human health with particular emphasis on its potential in medicine. Marijuana has a range of adverse health effects, particularly relating to young people because of higher risk for psychosis, traffic accidents, and cognitive impairment. Marijuana may be helpful in relieving symptoms of nausea and vomiting, increasing appetite and pain relief for persons with cancer, AIDS and multiple sclerosis. Smoking marijuana can impose significant public health risks. If there is a medical role for using marijuana, it lies in the application of clearly defined medical protocols and chemically defined compounds, not with using the unprocessed cannabis plant.
The journal impact factor (IF) is often recognized as a symbol of scientific prestige and relevance. However it is greatly influenced by the field or scope of journals, publisher, scientific, editorial, and economic background. Although there are many suggestions to modify the most important scientometric parameter, it is widely used to compare journals, individuals, departments, scientific outputs to judge academic promotions, grant allocations, awarding appointments. Most of the researchers use international database searching relevant publication, which will be cited in their own paper. Unfortunately these international databases refer only few Hungarian journals. It is recommended to develop and maintain a Hungarian Electronic Medical Bibliography, divided by the field of scientific interest (e.g., diabetology, gastroenterology, public health, urology etc.). Authors can upload the list or full text of publications, if copyright agreements allow, and search other Hungarian papers for citation, to promote each others. Organizer, manager, host and supporters of this database are very welcomed.
Full Text Available This study analyzes funding acknowledgments in scientific papers to investigate relationships between research sponsorship and publication impacts. We identify acknowledgments to research sponsors for nanotechnology papers published in the Web of Science during a one-year sample period. We examine the citations accrued by these papers and the journal impact factors of their publication titles. The results show that publications from grant sponsored research exhibit higher impacts in terms of both journal ranking and citation counts than research that is not grant sponsored. We discuss the method and models used, and the insights provided by this approach as well as it limitations.
Kozlakidis, Zisis; Mant, Christine; Cason, John
Biobanks offer translational researchers a novel method of obtaining clinical research materials, patient data, and relevant ethical and legal permissions. However, such tissue collections are expensive to establish and maintain. Current opinion is that such initiatives can only survive with core funding from Government or major funding bodies. Given the present climate of financial austerity, funding agencies may be tempted to invest in fast-return research projects rather than in maintaining tissue collections, whose benefits will only become apparent in much longer timescales. Thus, securing additional funding for biobanks could provide a valuable boost enabling an extension of core services. Here we suggest that using biobank expertise to offer contract services to clinicians and industry may be an alternative approach to obtaining such extra funding.
Basaza, Robert; Alier, Paul Kon; Kirabira, Peter; Ogubi, David; Lako, Richard Lino Loro
This study assessed willingness to pay for National Health Insurance Fund (NHIF) among public servants in Juba City. NHIF is the proposed health insurance scheme for South Sudan and aims at achieving universal health coverage for the entire nation's population. One compounding issue is that over the years, governments' spending on healthcare has been decreasing from 8.4% of national budget in 2007 to only 2.2% in 2012. A cross-sectional study design using contingent evaluation was employed; data on willingness to pay was collected from 381 randomly selected respondents and 13 purposively selected key informants working for the national, state and Juba County in September 2015. Qualitative data were analysed using conceptual content analysis. T-tests and linear regressions were performed to determine association between WTP for NHIF and independent variables. Up to 381 public servants were interviewed, of which 68% indicated willingness to pay varying percentages of total monthly individual income for NHIF. Over two-thirds (67.8%) of those willing to pay could pay up to 5% of their total monthly income, 22.9% could pay up to 10% and the rest could pay 25%. Over 80% were willing to pay up to 50 SSP (1 USD = 10 SSP) premiums for medical consultation, laboratory services and drugs. The main factors influencing the respondents' decisions were awareness, alternative sources of income, household size, insurance cover and religion. Willingness to pay is mainly influenced by awareness, alternative sources of individual income, household size, insurance cover and religion. Most of the public servants were aware of and willing to pay for NHIF and prefer a premium of up to 5% of total monthly income. There is need to create awareness and reach out to those who do not know about the scheme in addition to a detailed analysis of other stakeholders. Consideration could be made by the Government of South Sudan to start the scheme at the earliest opportunity since the majority of
Berner, Eta S
Academic culture has a set of norms, expectations, and values that are sometimes tacit and sometimes very explicit. In medical school and other health professions educational settings, probably the most common norm includes placing a high value on peer-reviewed research publications, which are seen as the major evidence of scholarly productivity. Other features of academic culture include encouraging junior faculty and graduate students to share their research results at professional conferences and lecturing with slides as a major way to convey information. Major values that faculty share with journal editors include responsible conduct of research and proper attribution of others' words and ideas. Medical school faculty also value technology and are often quick to embrace technological advances that can assist them in their teaching and research. This article addresses the effects of technology on three aspects of academic culture: education, presentations at professional meetings, and research publications.The technologies discussed include online instruction, dissemination of conference proceedings on the Internet, plagiarism-detection software, and new technologies deployed by the National Center for Biotechnology Information, the home of PubMed. The author describes how the ease of deploying new technologies without faculty changing their norms and behavior in the areas of teaching and research can lead to conflicts of values among key stakeholders in the academic medical community, including faculty, journal editors, and professional associations. The implications of these conflicts and strategies for managing them are discussed.
SZNITMAN, SHARON R.; Bretteville-Jensen, Anne Line
Background Debate about medical cannabis legalization are typically informed by three beliefs: (1) cannabis has medical effects, (2) medical cannabis is addictive and (3) medical cannabis legalization leads to increased used of cannabis for recreational purposes (spillover effects). We examined how strongly these beliefs are associated with public support for medical cannabis legalization and whether this association differs across divergent medical cannabis policy regimes. Methods Robust reg...
Márcio Telles Portal
Full Text Available The present study aimed to document the effects of financial constraints on the negative relationship between cash flow and external funds, a phenomenon associated with the Pecking Order Theory. This theory suggests that companies subject to more expensive external funds (financially constrained firms should demonstrate a stronger negative relationship with cash flow than companies subject to minor financial frictions (financially unconstrained firms. The results indicate that the external funds of constrained firms consistently present less negative sensitivity to cash flow compared with those of unconstrained companies. Additionally, the internal funds of constrained companies demonstrate a positive sensitivity to cash flow, whereas those of unconstrained companies do not show any such significant behavior. These results are in accordance with the findings of Almeida and Campello (2010, who suggest the following: first, because of the endogenous nature of investment decisions in constrained companies, the complementary relationship between internal and external funds prevails over the substitutive effects suggested by the Pecking Order Theory; and second, the negative relationship between cash flow and external funds cannot be interpreted as evidence of costly external funds and therefore does not corroborate the Pecking Order Theory.
Snyder, Jeremy; Mathers, Annalise; Crooks, Valorie A
Crowdfunding involves raising money from large groups of individuals, often through the use of websites dedicated to this purpose. Crowdfunding campaigns aimed at raising money to pay for expenses related to receiving medical treatment are receiving increased media attention and there is evidence that medical crowdfunding websites are heavily used. Nonetheless, virtually no scholarly attention has been paid to these medical crowdfunding campaigns and there is no systematic evidence about how widely they are used and for what reasons, and what effects they have on the provision of medical care and individuals' relationships to their health systems. Ethical concerns have been raised in relation to these campaigns, focusing on issues for campaigners and donors such as exposure to fraudulent campaigns, loss of privacy, and fairness in how medical crowdfunding funds are distributed. Medical crowdfunding websites themselves have not been systematically studied, despite their significant influence on how these campaigns are developed and promoted. In this paper, we identify three very broad and pressing ethical questions regarding medical crowdfunding for social scientists to address and offer some preliminary insights into key issues informing future answers to each: Who benefits the most from medical crowdfunding and how does medical crowdfunding affect access to medical care; How does medical crowdfunding affect our understanding of the causes of inadequate access to medical care; and How are campaigner and donor privacy affected by website design? Our observations indicate the need for increased scholarly attention to the ethical and practical effects of medical crowdfunding for campaigners, recipients, donors, and the health system as a whole.
Bashkireva, E A; Buromskiĭ, I V
In the recent years, professional activity of forensic medical examiners has been gaining publicity which necessitates knowledge of individual psychologic personality traits, the ability to effectively communicate, and high vocational culture on the part of each specialist. The specific character of professional contacts of a forensic medical expert is self-evident taking into consideration that he (she) has to deal with a great variety of persons including law enforcement officials, law breakers and criminal offence victims, men and women, young and aged people, representatives of different social groups, subjects in a specific emotional state, etc. In order to organize efficacious cooperation with all these individuals, the expert must develop high communicative competence, possess knowledge of psychology of communication, abilities and skills necessary for the establishment and maintenance of professional and business contacts.
... Response to Hurricane Sandy: Response, Recovery & Resiliency AGENCY: Federal Transit Administration (FTA... recipients most severely affected by Hurricane Sandy: the Metropolitan Transportation Authority, New Jersey... Federal Register notice, bringing the total amount of Hurricane Sandy Emergency Relief funds allocated...
Vanstone, Meredith; Yacoub, Karima; Giacomini, Mita; Hulan, Danielle; McDonald, Sarah
Non-invasive prenatal testing (NIPT) via fetal DNA in maternal blood has been publicly funded in Ontario, Canada, for high-risk women since 2014. We solicited women's experiences and values related to this new health technology to describe how this test is currently being used in Ontario and to provide information about patient priorities to inform future policy decisions about the use of NIPT. Guided by constructivist grounded theory methodology, we interviewed 38 women who had diverse personal experiences with NIPT. Participants' accounts of their values for decision making about NIPT heavily relied on three mutually modulating factors: timing, accuracy, and risk. The values expressed by women conflict with the way that publicly funded NIPT has typically been implemented in Ontario. We offer recommendations for how NIPT might be integrated into prenatal care pathways in a way more consistent with women's values.
Ashwell, Margaret; Stone, Elaine; Mathers, John; Barnes, Stephen; Compston, Juliet; Francis, Roger M; Key, Tim; Cashman, Kevin D.; Cooper, Cyrus; Khaw, Kay Tee; Lanham-New, Susan; Macdonald, Helen; Prentice, Ann; Shearer, Martin; Stephen, Alison
The UK Food Standards Agency convened an international group of expert scientists to review the Agency-funded projects on diet and bone health in the context of developments in the field as a whole. The potential benefits of fruit and vegetables, vitamin K, early-life nutrition and vitamin D on bone health were presented and reviewed. The workshop reached two conclusions which have public health implications. First, that promoting a diet rich in fruit and vegetable intakes might be beneficial...
Full Text Available In the article the problems caused by legislative gaps and contradictions in control of procurement of goods, works and natural monopolies` services for public funds is analyzed. It is also shown that efforts of several state structures to solve evident drawbacks within their commission are unsuccessful. In order to solve the problem a package approach is suggested. The first step of this approach is adoption of earlier foreknown special laws.
Dara, Ajay; Sangamwar, Abhay T
The article reported an in-depth comparative technology analysis of 1708 Anti-cancer patents from top 20 international universities and leading 10 Indian public funded organization and research institutes. The study segregated pioneer universities vs. technologies used in the field of Anticancer research at a level of drug discovery, development, diagnosis and treatment, which are illustrated in the form of novel substantive patent landscape maps. The reported competitive intelligent maps identified genetics, composition and synthetic compounds as dominating technologies; followed by natural extracts, combination and drug delivery systems as upcoming technologies. The least number of patents were reported by surgical apparatus, targeted therapy and animal models. In addition, the study analysed the key technologies followed by Indian universities in comparison to the international universities, to identify the overlooked technologies by the Indian public funded institutes. In an ever changing competitive world, it is essential for every university to have their own research plan and thrust areas; but at the same time, it is equally important for any organisation to have an idea of their competitor's research plan as well. So, the article suggested Indian institutes to focus on the latest emerging Anti-cancer technology trends, which are in practice by the international universities. Concurrently, this study may be a landmark indication for Indian public funded universities and institutes, calling for a U-turn from their traditional approaches.
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Filtering facepiece respirator for use by the... Filtering facepiece respirator for use by the general public in public health medical emergencies. (a) Identification. A filtering facepiece respirator for use by the general public in public health...
... No. FDA-2010-N-0237] Identifying Unmet Public Health Needs and Facilitating Innovation in Medical...) is announcing a public workshop entitled ``Identifying Unmet Public Health Needs and Facilitating... identify the most important unmet public health needs, the barriers to innovative medical...
李靠队; 张华; 薛天杨; 刘丹丹; 陆莉斌; 许苗苗; 沈潇婷
The government accounting reform paves the way for medical care reform;the new medical accounting reform has become the touchstone of the government accounting reform. As the model of the government accounting, fund accounting needs further establishment and implementation, while the “New Rural Cooperative Medical System” ( NCMS) fund accounting fully reflects the characteristics of the government fund accounting. Establishing the concept of the large-scale medical accounting system to establish practical references from the “NCMS” fund accounting to the government accounting system reform will contribute to a synergistic mechanism for government accounting and public health reform.%政府会计改革为医改铺路，新《医院会计制度》是政府会计改革的试金石。基金会计作为政府会计的主要模式尚需进一步建立和完善，“新农合”基金会计则充分体现出了政府“基金会计”的特点。树立大医疗会计制度观念，将“新农合”基金会计的实践借鉴至政府会计改革将有利于政府会计与公益性医疗改革的协同机制的建立。
Full Text Available This research focuses on the interplay of politics, bureaucracies and markets in Iceland. It aims to explain theoretically how politics and bureaucracies operate when a coalition government makes and implements decisions in a policy environment in which decisions and their effects intersect public bureaucracies’ and markets’ boundaries. The decision to raise the limits of Housing Fund mortgages in 2003 is a case examined by agenda-setting theories in public policy. The research is based on the data from parliamentary Special Investigation reports on the collapse of the Icelandic banks and the Housing Fund as well as the author’s interviews home and abroad. The research shows that, when made, the decision ignited competition between the Housing Fund and the recently privatized banks and that between the banks themselves. The Independence Party’s attempts to delay implementation of the decision involved system change backed by an instrument designed to stem a run on the Fund. The impact of this instrument (a tax on pre-payments was incompatible with the Progressive Party’s political interests. In a hasty attempt to implement its election promises, the Progressive Party ignored the fact that the Fund was operating within a transformed financial system. The conclusions indicate that those who think long-term in politics make policies by changing system dynamics, those who think short-term change programmes. System dynamics, however, change the balance of power and influence between actors, leaving legacies which curb the government’s attempt at change, unless consolidated and sustained political authority and will are established to see changes through.
Full Text Available European project management is the main filed of the article. Assuming a connection between the degree of absorption of European funds and the degree of maturity of the Romanian society in terms of project management, the article seeks to identify the negative factors on accessing and carrying out European projects. The identified problem is a low degree of absorption of European funds in Romania, and the main objective of the research is to identify the problems faced by the public institutions in the Centre Region in accessing European funds and also the causes that led to the low absorption of European funds. This articleâ€™s research is based on a preliminary analysis performed by the authors on the rate of accessing of European funds published in the article called â€œThe current state of European funds absorption through funding programmes â€“ measure of the Romanian performances in the project management practiceâ€. The conclusion of this article was a low rate of absorption of European funds in Romania, a fact that reveals a poor practice of the theory on project management. This article identifies part of the causes of this situation by identifying a part of the problems that stood in the way of beneficiaries of European funds The qualitative and quantitative research methods are used in combination in the research. The investigation has however a highly quantitative character, the purpose of the qualitative research being to provide the prerequisites for achieving the quantitative research. The interview-based qualitative research enabled the researcher to get acquainted with the subjectsâ€™ problems related to the theme of investigation, the causes that have generated these problems. This preliminary investigation to the questionnaire-based research aims to provide information that would help the researcher prepare the questionnaire, so that the questions allow getting the most comprehensive information to
Camilo D. Malong Jr.
Full Text Available The study determined the utilization of the fund use of Income Generating Projects of the Surigao del Sur State University Tandag Campus relating the fiscal governance in improvement of the quality of education. A survey was conducted to among the internal stakeholders to extract perception of the effectiveness of the utilization of the fund. Results of the study showed that the earning projects among the income generating projects of the University are in the areas of selling commercial rice, grocery store, supplies for ROTC/CWTS, and livelihood assistance program. The income from the enterprise is being used to instructional development. Further, a test in perceived utilization of IGP funds has no statistical difference among the administrators, faculty, staff and students indicating a general sense of acceptability of the fiscal governance of the income generating project of the institution.
Viviane Muniz da Silva Fragoso
Full Text Available Objective: To analyse the medications used by breastfeeding women treated in the public health network, and correlated actions. Methods: Cross-sectional, quantitative and descriptive study carried out with 100 breastfeeding women, recruited through nonprobabilistic convenience sampling, at the Municipal Hospital of Duque de Caxias, RJ, in 2012. A questionnaire was applied containing the following variables: prescribed medications, unwanted effects in nursing infants, and professionals involved in guidance on the edication. The data was analysed through descriptive statistics, based on absolute and relative frequencies. Results: It was found that 46% (n=46 of the breastfeeding women were aged 21 to 30 years, 54% (n=54 were primiparae, 52% (n=52 had complete fundamental level, and 72% (n=72 received prenatal care. It was verified that 78% (n = 78 of the sample were receiving some type of medicine and, among these, a significant percentage of nonsteroidal analgesic/anti-inflammatory medication, with 61.54% (n=48 of the breastfeeding women. All the prescribed medicines were in the category of compatible use with breastfeeding. The incidence of some unwanted symptoms was evidenced in 19.2% (n=15 of the breastfeeding women. Among the women undergoing medication therapy, 76.92% (n=60 received guidance during treatment, 55% (n=33 by doctors and 45% (n=27 by nurses. In this research, 100% of the breastfeeding women were satisfied with the acquired knowledge. Conclusion: It was noted a high percentage of breastfeeding women in the sample taking medicines, all compatible with breastfeeding. It stands out the limited engagement of the multidisciplinary team in the orientations. doi:10.5020/18061230.2014.p283
Yoo, Stella K; Ahmed, Awad A; Ileto, Jan; Zaorsky, Nicholas G; Deville, Curtiland; Holliday, Emma B; Wilson, Lynn D; Jagsi, Reshma; Thomas, Charles R
To quantify and determine the relationship between oncology departmental/division heads and private industry vis-à-vis potential financial conflict of interests (FCOIs) as publicly reported by the Centers for Medicare and Medicaid Services Open Payments database. We extracted the names of the chairs/chiefs in medical oncology (MO) and chairs of radiation oncology (RO) for 81 different institutions with both RO and MO training programs as reported by the Association of American Medical Colleges. For each leader, the amount of consulting fees and research payments received in 2015 was determined. Logistic modeling was used to assess associations between the 2 endpoints of receiving a consulting fee and receiving a research payment with various institution-specific and practitioner-specific variables included as covariates: specialty, sex, National Cancer Institute designation, PhD status, and geographic region. The majority of leaders in MO were reported to have received consulting fees or research payments (69.5%) compared with a minority of RO chairs (27.2%). Among those receiving payments, the average (range) consulting fee was $13,413 ($200-$70,423) for MO leaders and $6463 ($837-$16,205) for RO chairs; the average research payment for MO leaders receiving payments was $240,446 ($156-$1,234,762) and $295,089 ($160-$1,219,564) for RO chairs. On multivariable regression when the endpoint was receipt of a research payment, those receiving a consulting fee (odds ratio [OR]: 5.34; 95% confidence interval [CI]: 2.22-13.65) and MO leaders (OR: 5.54; 95% CI: 2.62-12.18) were more likely to receive research payments. Examination of the receipt of consulting fees as the endpoint showed that those receiving a research payment (OR: 5.41; 95% CI: 2.23-13.99) and MO leaders (OR: 3.06; 95% CI: 1.21-8.13) were more likely to receive a consulting fee. Leaders in academic oncology receive consulting or research payments from industry. Relationships between oncology leaders and
Full Text Available BACKGROUND: Patents are one of the most important forms of intellectual property. They grant a time-limited exclusivity on the use of an invention allowing the recuperation of research costs. The use of patents is fiercely debated for medical innovation and especially controversial for publicly funded research, where the patent holder is an institution accountable to public interest. Despite this controversy, for the situation in Germany almost no empirical information exists. The purpose of this study is to examine the amount, types and trends of patent applications for health products submitted by German public research organisations. METHODS/PRINCIPAL FINDINGS: We conducted a systematic search for patent documents using the publicly accessible database search interface of the German Patent and Trademark Office. We defined keywords and search criteria and developed search patterns for the database request. We retrieved documents with application date between 1988 and 2006 and processed the collected data stepwise to compile the most relevant documents in patent families for further analysis. We developed a rationale and present individual steps of a systematic method to request and process patent data from a publicly accessible database. We retrieved and processed 10194 patent documents. Out of these, we identified 1772 relevant patent families, applied for by 193 different universities and non-university public research organisations. 827 (47% of these patent families contained granted patents. The number of patent applications submitted by universities and university-affiliated institutions more than tripled since the introduction of legal reforms in 2002, constituting almost half of all patent applications and accounting for most of the post-reform increase. Patenting of most non-university public research organisations remained stable. CONCLUSIONS: We search, process and analyse patent applications from publicly accessible databases
Full Text Available The aim of the nationalization of the pension fund assets expressed by treasury bonds was accounting reducing of open level of public debts and thus avoid exceeding the second prudential threshold according to national methodology to GDP. It was the easiest solution, which had immediate short-term effect. Reasoning that was conducted by government side was as follows: without necessity to fund additional borrowing needs due to OFE relation between debt and GDP would be significantly lower. Limiting or complete elimination of OFE will have positive influence on public finance also in a long-term period. The aim of the article is to demonstrate that OFE is not responsible for our public finance. The main reason for the imbalance are exceptions to the rules of the pension reform of individual governing groups. Consequently, if nationalization doesn’t solve any of the problems of structural imbalances in the polish public finance thus doesn’t close the path to re-build-up of debt. Therefore, it is necessary as soon as possible to star structural reforms and this time implementing them consistently.
The growth of private higher education has come as a surprise to most governments, which have tried to catch up in their regulatory and funding policymaking. In China, Malaysia and South Africa they have given legal recognition to previously disallowed private higher education and this has helped to fuel its subsequent growth. Some governments…
... Application Funding opportunity title (FON) Access to FOA due date Basic Center Program HHS-2012-ACF-ACYF-CY-0303. http://www.acf.hhs.gov/ 07/09/2012 grants/open/foa/view/HHS- 2012-ACF-ACYF-CY-0303. Transitional.... grants/open/foa/view/HHS- 2012-ACF-ACYF-CX-0289. Transitional Living Program and...
The growth of private higher education has come as a surprise to most governments, which have tried to catch up in their regulatory and funding policymaking. In China, Malaysia and South Africa they have given legal recognition to previously disallowed private higher education and this has helped to fuel its subsequent growth. Some governments…
Rowe, Ronald K., II
... having the intention of achieving a more just system of school funding does not guarantee that the legislature achieved its purpose with its recent action or that the legislation is consistent with the Missouri Constitution as a whole. In the 2009 case of Committee for Educational Equality v. State of Missouri, a group of students, taxpayers, and school ...
... this sub-indicator as a measure of how the PHA is using the Capital Funds to make units available to... performer. HUD considers the occupancy of units as an integral measure of a high performing PHA. Issue.... The award of 5 points is awarded as a temporary measure to address the transition to the scoring...
This study investigated various state policies to determine their impact on the state share of instruction (SSI) funding to community colleges in the state of Ohio. To complete the policy analysis, the researcher utilized three policy analysis tools, defined by Gill and Saunders (2010) as iterative processes, intuition and judgment, and advice and…
Coleman, C. Norman; Sullivan, Julie M.; Bader, Judith L.; Murrain-Hill, Paula; Koerner, John F.; Garrett, Andrew L.; Weinstock, David M.; Case, Cullen; Hrdina, Chad; Adams, Steven A.; Whitcomb, Robert C.; Graeden, Ellie; Shankman, Robert; Lant, Timothy; Maidment, Bert W.; Hatchett, Richard C.
Resilience and the ability to mitigate the consequences of a nuclear incident are enhanced by (1) effective planning, preparation and training; (2) ongoing interaction, formal exercises, and evaluation among the sectors involved; (3) effective and timely response and communication; and (4) continuous improvements based on new science, technology, experience and ideas. Public health and medical planning require a complex, multi-faceted systematic approach involving federal, state, local, tribal and territorial governments, private sector organizations, academia, industry, international partners, and individual experts and volunteers. The approach developed by the U.S. Department of Health and Human Services Nuclear Incident Medical Enterprise (NIME) is the result of efforts from government and nongovernment experts. It is a “bottom-up” systematic approach built on the available and emerging science that considers physical infrastructure damage, the spectrum of injuries, a scarce resources setting, the need for decision making in the face of a rapidly evolving situation with limited information early on, timely communication and the need for tools and just-in-time information for responders who will likely be unfamiliar with radiation medicine and uncertain and overwhelmed in the face of the large number of casualties and the presence of radioactivity. The components of NIME can be used to support planning for, response to, and recovery from the effects of a nuclear incident. Recognizing that it is a continuous work-in-progress, the current status of the public health and medical preparedness and response for a nuclear incident is provided. PMID:25551496
Lee, Jeong W.
Quantitative financial measures were applied to evaluate the performance of the North Dakota Public Employee Retirement System (NDPERS) pension fund portfolios and the Teachers Insurance and Annuity Association (TIAA)/College Retirement Equities Fund (CREF) portfolios, thus providing a relative performance assessment. Ten years of data were…
Betty Castro Maldonado
Full Text Available Introduction: The undergraduate thesis rather than a requirement to graduate, are a way of doing research. Previous studies show a thesis published between 2.7% to 17.6% in indexed journals. Objective: Describe the characteristics of the undergraduate thesis of the Faculty of a medical school. Bibliometric study. 221 theses were reviewed, collecting: Year, number of authors, advisers, and references, study population, and national priorities for health research. A search was performed on Google Scholar to assess publication. Descriptive statistics were used. Results: Being lower production in the years 2008-2010 was observed. 91.6% had one advisor, 76% descriptive, 82.8% in hospital population, and 62.4% of adults. Theses displayed between 2010-2014 72.9% did not correspond to any national health research priority. Only 6.8% was based on literature of the last five years. Only 9 (4.1% were published in a scientific journal indexed. Conclusions: The undergraduate thesis were characterized as descriptive, hospital, adults, literature based on outdated and not in line with the national priorities for health research. The publication is low.
After describing the dossier of the medical works attributed to Cleopatra in the MD. Grmek fund deposited at IMEC (Institut Mémoires de l'Edition Contemporaine, Abbaye d'Ardenne, Saint-Germain-la-Blanche-Herbe, near Caen), this paper reports some recent papyrological discoveries (P. Oxy. 71.4809, third century AD, and P. Berol. inv. 25239, BC 33), as well as some new studies in the field over the past ten years, and presents the project of the Centre de Documentation de Papyrologie Littiraire (CEDOPAL, University of Liège) for an edition of the fragments of Cleopatra's Kosmetikon.
Agyapong, Vincent Israel Opoku; McLoughlin, Declan
Objectives: Authors assessed the impact of a public-speaking competition on the level of interest in psychiatry of Ghanaian medical students. Method: An inter-medical school public-speaking competition was organized to promote psychiatry as a fulfilling career option for Ghanaian medical students. Feedback questionnaires were completed by the…
Agyapong, Vincent Israel Opoku; McLoughlin, Declan
Objectives: Authors assessed the impact of a public-speaking competition on the level of interest in psychiatry of Ghanaian medical students. Method: An inter-medical school public-speaking competition was organized to promote psychiatry as a fulfilling career option for Ghanaian medical students. Feedback questionnaires were completed by the…
Morad, Zaki; Choong, Hui Lin; Tungsanga, Kriang; Suhardjono
The provision of renal replacement therapy (RRT) in developing economies is limited by lack of financial and other resources. There are no national reimbursement policies for RRT in many countries in Asia. The Southeast Asia countries of Singapore, Malaysia, Thailand, and Indonesia have adopted a strategy of encouraging public-private partnerships to increase the RRT rates in their respective countries. The private organizations include both for-profit and philanthropic bodies. The latter raise funds from ordinary citizens, corporations, and faith-based groups, as well as receive subsidies from the government to support RRT for patients in need. The kidney foundations of these countries play a leadership role in this public-private partnership. Many of the private organizations that support RRT are providers of treatment in addition to offering financial assistance to patients, with hemodialysis being the most frequently supported modality. Public-private partnership in funding RRT is sustainable over the long term with proper organization and facilitated by support from the government. Copyright © 2015 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
De Pietro, Carlo
This study explores how Italian public hospitals can use private medical activities run by their employed physicians as a human resources management (HRM) tool. It is based on field research in two acute-care hospitals and a review of Italian literature and laws. The Italian National Health Service (NHS) allows employed physicians to run private, patient-funded activities ("private beds", surgical operations, hospital outpatient clinics, etc.). Basic regulation is set at the national level, but it can be greatly improved at the hospital level. Private activities, if poorly managed, can damage efficiency, equity, quality of care, and public trust in the NHS. On the other hand, hospitals can also use them as leverage to improve HRM, with special attention to three issues: (1) professional evaluation, development, and training; (2) compensation policies; (3) competition for, and retention of, professionals in short supply. The two case studies presented here show great differences between the two hospitals in terms of regulation and organizational solutions that have been adopted to deal with such activities. However, in both hospitals, private activities do not seem to benefit HRM. Private activities are not systematically considered in compensation policies. Moreover, private revenues are strongly concentrated in a few physicians. Hospitals use very little of the information provided by the private activities to improve knowledge management, career development, or training planning. Finally, hospitals do not use private activities management as a tool for competing in the labor market for health professionals who are in short supply.
L.A. van der Valk (Loes)
textabstractSummary The development of mutual and commercial health insurance, and state health insurance programs in particular, typically provoked much criticism from the professionals involved with them. Moreover, the efforts of the Dutch medical association, the NMG, to influence state proposals
Masoud, Ferdosi; Alireza, Jabbari; Mahmoud, Keyvanara; Zahra, Agharahimi
Medical tourism for any study area is complex. Using full articles from other databases, Institute for Scientific Information (ISI), Science Direct, Emerald, Oxford, Magiran, and Scientific Information Database (SID), to examine systematically published articles about medical tourism in the interval 2000-2011 paid. Articles were obtained using descriptive statistics and content analysis categories were analyzed. Among the 28 articles reviewed, 11 cases were a kind of research articles, three cases were case studies in Mexico, India, Hungary, Germany, and Iran, and 14 were case studies, review documents and data were passed. The main topics of study included the definition of medical tourism, medical tourists' motivation and development of medical tourism, ethical issues in medical tourism, and impact on health and medical tourism marketing. The findings indicate the definition of medical tourism in various articles, and medical tourists are motivated. However, most studies indicate the benefits of medical tourism in developing countries and more developed countries reflect the consequences of medical tourism.
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Martelli, Nicolas; van den Brink, Hélène
Financing innovative medical devices is an important challenge for national health policy makers, and a crucial issue for hospitals. However, when innovative medical devices are launched on the European market there is generally little clinical evidence regarding both efficacy and safety, both because of the flaws in the European system for regulating such devices, and because they are at an early stage of development. To manage the uncertainty surrounding the reimbursement of innovation, several European countries have set up temporary funding schemes to generate evidence about the effectiveness of devices. This article explores two different French approaches to funding innovative in-hospital devices and collecting supplementary data: the coverage with evidence development (CED) scheme introduced under Article L. 165-1-1 of the French Social Security Code; and national programs for hospital-based research. We discuss pros and cons of both approaches in the light of CED policies in Germany and the UK. The CED policies for devices share common limitations. Thus, transparency of CED processes should be enhanced and decisions need to be made in a timely way. Finally, we think that closer collaboration between manufacturers, health authorities and hospitals is essential to make CED policies more operational.
Schneider, William H
The establishment of National Institutes of Health (NIH) extramural grants in the second half of the twentieth century marked a signal shift in support for medical research in the United States and created an influential model for the rest of the world. A similar landmark development occurred in the first half of the twentieth century with the creation of the Rockefeller Foundation and its funding programs for medical research. The programs and support of the foundation had a dramatic impact on medical research in the United States and globally. This paper examines early connections between these two developments. The NIH grants have usually been seen as having their roots primarily in the government programs of the Second World War. This article finds direct and indirect influence by the Rockefeller Foundation, as well as parallel developments in these two monumental programs of support for medical research. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: email@example.com.
Congress of the U.S., Washington, DC. Senate Committee on Finance.
Hearings on the status of medical education funded under the Medicare program are presented, with attention to how the program reimburses hospitals for medical education costs. The Social Security Act Amendments of 1983 provided for a radical reform in hospital payment. By the end of a 3-year phase-in period, the program was designed to set…
Despite the centralised nature of the fiscal system in colonial India, public education expenditures varied dramatically across regions with the western and southern provinces spending three to four times as much as the eastern provinces. A significant portion of the inter-regional difference was due to historical differences in land taxes, an important source of provincial revenues in the nineteenth and early twentieth century. The large differences in public spending, however, did not produce comparable differences in enrollment rates or literacy in the colonial period. Nonetheless, public investments influenced the direction of school development and perhaps the long run trajectory of rural literacy.
Robbins, Cheryl L; Gavin, Loretta; Carter, Marion W; Moskosky, Susan B
Federal and clinical guidelines recommend integrating reproductive life plan assessments into routine family planning encounters to increase provision of preconception care. Yet, the prevalence of clinical protocols and of relevant practices at publicly funded health centers is unknown. Administrators and providers at a nationally representative sample of publicly funded health centers that provide family planning services were surveyed in 2013-2014; data from 1,039 linked pairs were used to explore the reported prevalence of reproductive life plan protocols, frequent assessment of patients' reproductive life plan and frequent provision of preconception care. Chi-square tests and multivariable general linear models were used to examine differences in reports of protocols and related practices. Overall, 58% of centers reported having reproductive life plan assessment protocols, 87% reported frequently assessing reproductive life plans and 55% reported frequently providing preconception care. The proportions reporting protocols were lower in community health centers than in other center types (32% vs. 52-91%), in primary care centers than in those with another focus (33% vs. 77-80%) and in centers not receiving Title X funding than in those with such support (36% vs. 77%). Reported existence of a written protocol was positively associated with reported frequent assessment (prevalence ratio, 1.1), and the latter was positively associated with reported frequent preconception care (1.4). Further research is needed on associations between written protocols and clinical practice, and to elucidate the preconception care services that may be associated with reproductive life plan assessment. Copyright © 2017 by the Guttmacher Institute.
Sheppard, Maria K
Despite the unproven effectiveness of many practices that are under the umbrella term 'complementary alternative medicine' (CAM), there is provision of CAM within the English National Health Service (NHS). Moreover, although the National Institute for Health and Care Excellence was established to promote scientifically validated medicine in the NHS, the paradox of publicly funded, non-evidence based CAM can be explained as linked with government policy of patient choice and specifically patient treatment choice. Patient choice is useful in the political and policy discourse as it is open to different interpretations and can be justified by policy-makers who rely on the traditional NHS values of equity and universality. Treatment choice finds expression in the policy of personalised healthcare linked with patient responsibilisation which finds resonance in the emphasis CAM places on self-care and self-management. More importantly, however, policy-makers also use patient choice and treatment choice as a policy initiative with the objective of encouraging destabilisation of the entrenched healthcare institutions and practices considered resistant to change. This political strategy of system reform has the unintended, paradoxical consequence of allowing for the emergence of non-evidence based, publicly funded CAM in the NHS. The political and policy discourse of patient choice thus trumps evidence based medicine, with patients that demand access to CAM becoming the unwitting beneficiaries.
Nigerian capital market by publicly quoted companies. These practices previously .... (proportion of profit that is not spent). External sources of ... security does not benefit from access to the Stock Exchange trading market. Also they tend to be ...
Guns, R.; Engels, T.C.E.
Publishing in the social sciences and humanities (SSH) and research evaluation practices are co-evolving. In this paper we present an analysis on how in Flanders the PRFS has shaped and influenced publication practices in the SSH. Our analysis is based on the VABB-SHW, a comprehensive database of research output in the SSH in Flanders. We find that a strong emphasis on WoS publications since 2003 has caused a growth in WoS publications, that is greater than what can be observed in other countries and other fields of science in Flanders. Other mechanisms appear to exist for book publications, which are not indexed in the WoS databases used for the PRFS. (Author)
Sobelson, Robyn K; Young, Andrea C; Wigington, Corinne J; Duncan, Heather
The Centers for Disease Control and Prevention (CDC) created the Public Health Associate Program (PHAP) to establish a continuous source of public health professionals who can deliver frontline services at the federal, state, tribal, local, and territorial levels. The article describes preliminary evaluation findings for PHAP. The evaluation's primary purposes are to assess the quality and effectiveness of PHAP, determine its value and impact, and provide information to continuously improve the program. Because the evaluation is both formative and summative and focuses on aggregate outputs and outcomes of PHAP, the methodology is complex and builds over time as different cohorts cycle into and out of the program. Results presented are outcomes of various Web-based surveys and reporting systems. Four PHAP cohorts, consisting of 579 individuals, participated in 1 or more of the evaluation activities described in this article. The majority of participants report satisfaction with their PHAP experiences, and 74% of recent graduates indicate they are continuing their careers or education in public health immediately after program completion. Seventy-eight percent of recent PHAP graduates who accept a job in public health are employed by the federal government. One year post-PHAP, 74% of alumni report that PHAP has been influential in their careers. CDC's investment in PHAP has increased the capacity and capabilities of the public health workforce. Results presented are early indicators of program quality, effectiveness, and impact. Today's public health workers are asked to do more with less, in the face of a dynamic array of complex public health challenges. PHAP offers public health agencies assistance in tackling these losses and challenges.
Objectives To investigate whether the long term lease of public hospital owned land could be an additional financing mechanism for Greek public (mental) health hospitals. Methods We performed a financial analysis of the official 2008 data of a case - study hospital (Mental Health Hospital of Chania). We used a capital budgeting approach to investigate whether value is created for the public hospital by engaging its assets in a project for the development of a private renal dialysis Unit. Results The development of the private unit in hospital owned land is a good investment decision, as it generates high project Net Present Value and Internal Rate of Return. When the project commences generating operating cash flows, nearly €400.000 will be paid annually to the Mental Health Hospital of Chania as rent, thereby gradually decreasing the annual deficit of the hospital. Conclusions Revenue generated from the long term lease of public hospital land is crucial to gradually eliminate hospital deficit. The Ministry of Health should encourage similar forms of Public Private Partnerships in order to ensure the sustainability of public (mental) hospitals. PMID:21067580
Full Text Available Abstract Objectives To investigate whether the long term lease of public hospital owned land could be an additional financing mechanism for Greek public (mental health hospitals. Methods We performed a financial analysis of the official 2008 data of a case - study hospital (Mental Health Hospital of Chania. We used a capital budgeting approach to investigate whether value is created for the public hospital by engaging its assets in a project for the development of a private renal dialysis Unit. Results The development of the private unit in hospital owned land is a good investment decision, as it generates high project Net Present Value and Internal Rate of Return. When the project commences generating operating cash flows, nearly €400.000 will be paid annually to the Mental Health Hospital of Chania as rent, thereby gradually decreasing the annual deficit of the hospital. Conclusions Revenue generated from the long term lease of public hospital land is crucial to gradually eliminate hospital deficit. The Ministry of Health should encourage similar forms of Public Private Partnerships in order to ensure the sustainability of public (mental hospitals.
McFarland, Sarah L; Meyers, Peter; Sautter, Robin; Honsvall, Amanda; Prunuske, Jacob
Few US medical school graduates receive a public health degree. We sought to identify factors involved in medical students' decisions to pursue dual medical and public health degrees and describe the decision-making process. We conducted focus group discussions and telephone interviews with medical students considering, or enrolled in, a public health degree program. Participants described early exposures to public health, perspectives on physician public health roles, advantages and disadvantages of a public health degree, and the relative importance of factors influencing their decision to pursue a public health degree. Data were coded using open codes, and thematic analysis was performed. Medical students' decisions about pursuing a public health degree are based on consideration of advantages and disadvantages of academic, personal, and financial factors. Students place weights on various factors and value guidance. Access to training and information about public health programs and career opportunities may facilitate decision-making. Knowledge of factors involved in students' decisions and the decision-making process will allow mentors, advisors, faculty, and staff working to recruit students into MPH programs to support students interested in earning dual medical and public health degrees. Future research should explore avenues for supporting medical student decision-making and further reducing barriers to public health training.
Hughes, Allen A.
Public safety can be enhanced through the development of a comprehensive medical device risk management. This can be accomplished through case studies using a framework that incorporates cost-benefit analysis in the evaluation of risk management attributes. This paper presents a framework for evaluating the risk management system for regulatory Class III medical devices. The framework consists of the following sixteen attributes of a comprehensive medical device risk management system: fault/failure analysis, premarket testing/clinical trials, post-approval studies, manufacturer sponsored hospital studies, product labeling, establishment inspections, problem reporting program, mandatory hospital reporting, medical literature surveillance, device/patient registries, device performance monitoring, returned product analysis, autopsy program, emergency treatment funds/interim compensation, product liability, and alternative compensation mechanisms. Review of performance histories for several medical devices can reveal the value of information for many attributes, and also the inter-dependencies of the attributes in generating risk information flow. Such an information flow network is presented as a starting point for enhancing medical device risk management by focusing on attributes with high net benefit values and potential to spur information dissemination.
Rovniak, Liza S; Johnson-Kozlow, Marilyn F; Hovell, Melbourne F
Tobacco use costs approximately dollar 167 billion annually in the U.S., but few tobacco education opportunities are available in schools of public health. Reasons for the discrepancy between the costs of tobacco use and the creation of tobacco training opportunities have not been well explored. Based on the Behavioral Ecological Model, we present 10 recommendations for increasing tobacco training in schools of public health. Six recommendations focus on policy changes within the educational, legislative, and health care systems that influence funds for tobacco training, and four recommendations focus on strategies to mobilize key social groups that can advocate for change in tobacco control education and related policies. In addition, we present a model tobacco control curriculum to equip public health students with the skills needed to advocate for these recommended policy changes. Through concurrent changes in the ecological systems affecting tobacco control training, and through the collaborative action of legislators, the public, the media, and health professionals, tobacco control training can be moved to a higher priority in educational settings.
Charlton, Bruce G
What kind of a thing is science and how does it work? [Kealey T. Sex, science and profits: In a recent book (Sex, science and profits: how people evolved to make money. London: William Heinemann; 2008) (p. 455)] Terence Kealey argues persuasively that the motivations driving science are widely misunderstood. Science is often assumed to be useful to the public but an economic loser for the scientist and his or her paymasters - in other words, science is supposed to be a 'public good'. The public good argument is used to support large-scale government funding of science, on the basis that if government does not fund science it will not be funded adequately. But Kealey argues that most science is profitable to commercial organizations, and other types of worthwhile science will be supported by private patronage. Yet excessive government funding tends to 'crowd-out' potential private sources of funding - both by replacing and by deterring private investment. And scientists are not primarily motivated by money, but instead by striving for status within the 'invisible college' of active researchers in their field. Kealey's take-home message is that overall and in the long-term, science neither requires nor benefits from government funding. Scientific research would be better-served by private funding from commercial organizations that are seeking profit, combined with patronage from charities and foundations that regard science as intrinsically valuable.
Pablo Aguilera, MD
Full Text Available Introduction: While a nationwide poison control registry exists in Chile, reporting to the center is sporadic and happens at the discretion of the treating physician or by patients’ self-report. Moreover, individual hospitals do not monitor accidental or intentional poisoning in a systematic manner. The goal of this study was to identify all cases of intentional medication overdose (MO that occurred over two years at a large public hospital in Santiago, Chile, and examine its epidemiologic profile. Methods: This study is a retrospective, explicit chart review conducted at Hospital Sótero del Rio from July 2008 until June 2010. We included all cases of identified intentional MO. Alcohol and recreational drugs were included only when they were ingested with other medications. Results: We identified 1,557 cases of intentional MO and analyzed a total of 1,197 cases, corresponding to 0.51% of all emergency department (ED presentations between July 2008 and June 2010. The median patient age was 25 years. The majority was female (67.6%. Two peaks were identified, corresponding to the spring of each year sampled. The rate of hospital admission was 22.2%. Benzodiazepines, selective serotonin reuptake inhibitors, and tricyclic antidepressants (TCA were the causative agents most commonly found, comprising 1,044 (87.2% of all analyzed cases. Acetaminophen was involved in 81 (6.8% cases. More than one active substance was involved in 35% of cases. In 7.3% there was ethanol co-ingestion and in 1.0% co-ingestion of some other recreational drug (primarily cocaine. Of 1,557 cases, six (0.39% patients died. TCA were involved in two of these deaths. Conclusion: Similar to other developed and developing nations, intentional MO accounts for a significant number of ED presentations in Chile. Chile is unique in the region, however, in that its spectrum of intentional overdoses includes an excess burden of tricyclic antidepressant and benzodiazepine overdoses, a
Introduction: The National Institutes of Health public access policy requires the principal investigators of any Institutes-funded research to submit their manuscript to PubMed Central, and the open access publisher Public Library of Science submits all articles to PubMed Central, irrespective of funder. Whether the investigators, who made the…
In attempting to explain state support of public higher education, this study develops a theory-driven, comprehensive conceptualization of the state political system within a larger theoretical framework that consists of state economic and demographic factors and higher education system attributes. Furthermore, although the higher education policy…
...] [FR Doc No: 2011-32947] OFFICE OF SCIENCE AND TECHNOLOGY POLICY Request for Information: Public Access... Technology Policy (OSTP) on behalf of the National Science and Technology Council (NSTC) SUPPLEMENTARY... costs. Federal science agencies already have some experience with policies to promote long- term...
Gerhardus, Ansgar; Becher, Heiko; Groenewegen, P.P.; Meyer, Thorsten; Mansmann, Ulrich; Pfaff, Holger; Puhan, Milo; Razum, Oliver; Rehfuess, Eva; Sauerborn, Rainer; Strech, Daniel; Wissing, Frank; Zeeb, Hajo; Hummers-Pradier, Eva
Public health research is complex, involves various disciplines, epistemological perspectives and methods, and is rarely conducted in a controlled setting. Often, the added value of a research project lies in its inter- or trans-disciplinary interaction, reflecting the complexity of the research que
Herwartz, Helmut; Theilen, Bernd
In this article, we examined if partisan ideology and electoral motives influence public healthcare expenditure (HCE) in countries of the Organization for Economic Cooperation and Development. We distinguished between the effects on the growth of the expenditures and its adjustment to violations of a long-run equilibrium linking HCE with macroeconomic and demographic trends. Regarding the influence of partisan ideology, we found that if governments are sufficiently long in power, right-wing governments spend less on public health than their left-wing counterparts. Furthermore, if a right-wing party governs without coalition partners, it responds more strongly to deviations from the long-run HCE equilibrium than left-wing governments. With regard to electoral motives, we found that health expenditure increases in years of elections. Independent of their partisan ideology, single-party (minority) governments induce higher (lower) growth of public HCE. Each of these political factors by its own may increase (decrease) HCE growth by approximately one percentage point. Given an average annual growth of HCE of approximately 4.1%, political factors turn out to be important determinants of trends in public HCE. Copyright © 2013 John Wiley & Sons, Ltd.
Arping, S.; Lóránth, G.; Morrison, A.D.
We analyze financial support for the entrepreneurial sector. State support can raise welfare by relaxing financial constraints, but it can also reduce lending standards if entrepreneurs substitute public sources of collateral for their own assets, if it encourages excessive entrepreneurial entry, or
Driscoll, Lisa G.; Knoeppel, Robert C.; Della Sala, Matthew R.; Watson, Jim R.
As a result of the Great Recession of 2007-2009, most states experienced declines in employment, consumer spending, and economic productivity (Alm, Buschman, and Sjoquist 2011). In turn, these events led to historic declines in state tax revenues (Mikesell and Mullins 2010; Boyd and Dadayan 2009), resulting in major cuts in public spending. Local…
Wager, Elizabeth; Woolley, Karen; Adshead, Viv; Cairns, Angela; Fullam, Josh; Gonzalez, John; Grant, Tom; Tortell, Stephanie
To gather information about current practices and implementation of publication guidelines among publication professionals working in or for the pharmaceutical industry. Web-based survey publicised via email and social media to members of the International Society for Medical Publication Professionals (ISMPP) and other organisations from November 2012 to February 2013. 469 individuals involved in publishing industry-sponsored research in peer-reviewed journals, mainly working in pharmaceutical or device companies ('industry', n=144), communication agencies ('agency', n=238), contract research organisations (CRO, n=15) or as freelancers (n=34). Most respondents (78%) had worked on medical publications for ≥5 years and 62% had a PhD/MD. Over 90% of industry, agency and CRO respondents routinely refer to Good Publication Practice (GPP2) and the International Committee of Medical Journal Editors' Uniform Requirements. Most respondents (78% industry, 79% agency) received mandatory training on ethical publication practices. Over 90% of respondents' companies had publication guidelines or policies and required medical writing support to be acknowledged in publications (96% industry, 99% agency). Many industry respondents used publication management tools to monitor compliance with company guidelines and about half (46%) stated that their company had formal publication audits. Fewer agencies audited adherence to guidelines but 20% of agency respondents reported audits of employees and 6% audits of freelancers. Of concern, 37% of agency respondents reported requests from authors or sponsors that they believed were unethical, although 93% of these requests were withdrawn after respondents explained the need for compliance with guidelines. Most respondents' departments (63% industry, 58% agency, 60% CRO) had been involved in publishing studies with negative or inconclusive results. Within this sample, most publication professionals working in or for industry were aware of
Brosseau, Lisa M
Concerns about limiting pandemic infectious disease transmission when vaccines are not yet available prompted the Food and Drug Administration (FDA) to develop guidance for marketing respirators for use in public health medical emergencies. This project describes the results of filtering facepiece fit tests using 35 untrained, inexperienced subjects meeting the face size criteria of the National Institute for Occupational Safety and Health bivariate panel, in preparation for an FDA 510(k) application. Quantitative fit factors were measured for each subject on two replicates of each of two N95 filtering facepiece respirators (A and B) using the TSI Portacount Plus with N95 Companion. Subjects received no training or assistance with donning and had no prior experience with wearing respirators. The panel consisted of 20 females and 15 males; 80% were between 18 and 34 years of age. Almost all subjects properly placed the respirator on the face and formed the nose clip. Straps were improperly placed 25% of the time. Users reviewed the donning instructions 73% of the time and performed a seal check 80% of the time. Leaks were observed during 80% of the fit tests, most frequently at the chin during the head up and down exercise. For Respirator A, all but one subject had a 95% fit factor greater than 2 (the minimum required by FDA); one subject had a 95% fit factor of 1.5. All subjects had a 95% fit factor greater than 2.5 for Respirator B. Geometric mean fit factors ranged from 19-28 for these two respirators, and a majority of subjects were able to achieve a fit factor of 10 most of the time. However, fewer than 25% of subjects received the fit factor of 100 expected in workplace settings.
Masoud, Ferdosi; Alireza, Jabbari; Mahmoud, Keyvanara; Zahra, Agharahimi
Introduction: Medical tourism for any study area is complex. Materials and Methods: Using full articles from other databases, Institute for Scientific Information (ISI), Science Direct, Emerald, Oxford, Magiran, and Scientific Information Database (SID), to examine systematically published articles about medical tourism in the interval 2000-2011 paid. Articles were obtained using descriptive statistics and content analysis categories were analyzed. Results: Among the 28 articles reviewed, 11 cases were a kind of research articles, three cases were case studies in Mexico, India, Hungary, Germany, and Iran, and 14 were case studies, review documents and data were passed. The main topics of study included the definition of medical tourism, medical tourists’ motivation and development of medical tourism, ethical issues in medical tourism, and impact on health and medical tourism marketing. Conclusion: The findings indicate the definition of medical tourism in various articles, and medical tourists are motivated. However, most studies indicate the benefits of medical tourism in developing countries and more developed countries reflect the consequences of medical tourism. PMID:24251287
Stephenson, Carol; Stephenson, Erin; Chaves, Debbie
Background Multiple sclerosis (MS), a progressive demyelinating disease of the brain and spinal cord, is the leading cause of nontraumatic neurological damage in young adults. Canada has one of the highest reported incidents of MS, with estimates between 55 and 240 per 100,000 individuals. Between 2009 and 2014, the MS Society of Canada provided over Can $90 million to researchers and, since 2013, has encouraged researchers to make both current and previous research products openly available. Objective The goal of the study was to determine the open access (OA) cost implications and repository policies of journals frequently used by a sample of MS researchers. This study benchmarked current publishing preferences by MS Society of Canada researchers by examining the OA full-text availability of journal articles written by researchers funded between 2009 and 2014. Methods Researchers were identified from the 2009 to 2014 annual MS Society of Canada Research Summaries. Articles were identified through searches in Web of Science, Scopus, Medline and Embase (both via OVID). Journal level analysis included comparison of OA policies, including article processing charges (APCs) and repository policies. Data were analyzed using descriptive statistics. Results There were 758 articles analyzed in this study, of which 288 (38.0%) were OA articles. The majority of authors were still relying on journal policies for deposit in PubMed Central or availability on publisher websites for OA. Gold OA journals accounted for 10.2% of the journals in this study and were associated with significantly lower APCs (US $1900) than in hybrid journals (US $3000). Review of the journal self-archiving options highlighted the complexity of stipulations that authors would have to navigate to legally deposit a version of their article. Conclusions This study found that there are currently researcher- and publisher-imposed barriers to both the gold and green roads to OA. These results provide a
Bakker, Caitlin; Stephenson, Carol; Stephenson, Erin; Chaves, Debbie
Multiple sclerosis (MS), a progressive demyelinating disease of the brain and spinal cord, is the leading cause of nontraumatic neurological damage in young adults. Canada has one of the highest reported incidents of MS, with estimates between 55 and 240 per 100,000 individuals. Between 2009 and 2014, the MS Society of Canada provided over Can $90 million to researchers and, since 2013, has encouraged researchers to make both current and previous research products openly available. The goal of the study was to determine the open access (OA) cost implications and repository policies of journals frequently used by a sample of MS researchers. This study benchmarked current publishing preferences by MS Society of Canada researchers by examining the OA full-text availability of journal articles written by researchers funded between 2009 and 2014. Researchers were identified from the 2009 to 2014 annual MS Society of Canada Research Summaries. Articles were identified through searches in Web of Science, Scopus, Medline and Embase (both via OVID). Journal level analysis included comparison of OA policies, including article processing charges (APCs) and repository policies. Data were analyzed using descriptive statistics. There were 758 articles analyzed in this study, of which 288 (38.0%) were OA articles. The majority of authors were still relying on journal policies for deposit in PubMed Central or availability on publisher websites for OA. Gold OA journals accounted for 10.2% of the journals in this study and were associated with significantly lower APCs (US $1900) than in hybrid journals (US $3000). Review of the journal self-archiving options highlighted the complexity of stipulations that authors would have to navigate to legally deposit a version of their article. This study found that there are currently researcher- and publisher-imposed barriers to both the gold and green roads to OA. These results provide a current benchmark against which efforts to enhance
A key challenge in particle therapy today is quality assurance during treatment, which needs advanced medical imaging techniques. This issue is tackled by the EC funded project ENVISION, an R\\&D consortium of sixteen leading European research centres and one industrial partner, co-ordinated by CERN. ENVISION covers developments in Time Of Flight in-beam PET, in-beam single particle tomography, organ motion monitoring techniques, simulation, and treatment planning. Additionally, ENVISION serves as a training platform for the ENTERVISION project, a Marie-Curie Initial Training Network aimed at educating young researchers in online 3D digital imaging for hadron therapy. ENTERVISION brings together ten academic institutes and research centres of excellence and a leading European company in particle therapy, and is coordinated by CERN. Its multi-disciplinary training programme of ENTERVISION includes a diversified portfolio of scientific courses, complemented by specific courses aimed at developing soft skills...
... HUMAN SERVICES Food and Drug Administration Summit on Color in Medical Imaging; Cosponsored Public... International Color Consortium (ICC) are announcing the following public workshop entitled ``Summit on Color in... Approaches for Dealing with Color in Medical Images.'' The purpose of the workshop is to bring together...
Walwyn, David R
South Africa's expenditure on tuberculosis (TB) research and development (R&D) is insignificant relative to both its disease burden and the expenditure of some comparator countries with a minimal TB incidence. In 2010, the country had the second highest TB incidence rate in the world (796 per 100,000 population), and the third highest number of new TB cases (490,000 or 6% of the global total). Although it has a large TB treatment program (about $588 million per year), TB R&D funding is small both in absolute terms and relative to its total R&D expenditure. Given the risk and the high cost associated with drug discovery R&D, such neglect may make strategic sense. However in this analysis it is shown that TB R&D presents a unique opportunity to the national treasuries of all high-burden countries. Using two separate estimation methods (global justice and return on investment), it is concluded that most countries, including South Africa, are under-investing in TB R&D. Specific investment targets for a range of countries, particularly in areas of applied research, are developed. This work supports the outcome of the World Health Organization's Consultative Expert Working Group on Research and Development: Financing and Coordination, which has called for "a process leading to the negotiation of a binding agreement on R&D relevant to the health needs of developing countries".
For the first time, six knowledge and technology transfer activities are set to benefit from a dedicated fund made available by the Knowledge Transfer group. This initiative cements CERN’s commitment to sharing its technological knowledge and expertise with society. GEM detectors for flame detection and early earthquake prediction, radio-frequency absorbers for energy recovery, and exotic radioisotopes for medical applications are among the projects funded by the recently introduced KT Fund. “CERN’s scientific programme generates a considerable amount of intellectual property, a natural driver for innovation,” explains Giovanni Anelli, Head of the Knowledge Transfer Group. “Very often, though, financial support is needed to bring the newly-born technologies a step further and make them ready for transfer to other research institutes or to companies.” This is where the KT fund comes into play. It provides vital support in the early sta...
The benefit of good health will be even greater for the absolute poor, as they may ... There are three main types of publications – Thesis or dissertation, Book or ... of publications, identify challenges in research and publication in Nigeria and proffer some solution to .... completion of study, not only to aid advancement but.
Full Text Available Purpose: Respective European Union member states’ interest in using spending reviews varies as there are no international mandatory regulations. The EU legislation contains general indications as to maintaining a rational fscal policy, from the provisions of the TFUE, expanded in the Pact for Stability and Growth, and elaborated in 2011. Methodology: Adopting an interpretative research approach, this article elaborates a multiple explanatory case study design to discover how existing theories about public spending reviews are conceptualized by practitioners in their natural contexts. Findings: The deteriorated state of many countries’ public fnances, as a result of the global fnancial crisis, has increased the interest in advanced innovative consolidation and fscal stabilization methods. Spending reviews are among the most developed and advanced methods. Such reviews were conducted both by countries that had applied this instrument before (Netherlands, Denmark, Finland, United Kingdom, Australia, and by those that introduced them for the frst time (Ireland, Canada, France. However, reviews are applied in countries characterized by signifcant economic advancement and mature public management systems. Originality: This article analyses and draws conclusions from several selected countries’ experience to date in using spending reviews. The budget functions are compared using information from the implementation of the spending reviews. This article contributes to flling two main gaps identifed in the literature review.
Daniel Stefan DRĂGULIN
Full Text Available The major significance of the actual financing context is that, through the community budget, the rural communities can receive money in order to support development strategies, the financing under programs specific to the rural sector can be correlated to the financing programs by regional policy, environment policy, enterprise policy, education sector policy, etc. But, in order to benefit efficiently by the community interventions system, the major problem for the Romanian rural communities is related to: the identification of the different funding opportunities;the elaboration of a project portfolio adequate for the won development options; finding co-financing sources.Taking into consideration the complexity of such an approach and considering the particular situation of the Romanian rural sector it results that the key role in the rural development and use of the opportunities provided by the European context belongs to the public administration. The good information and information dissemination at the community level, possibly with best practice examples from other EU counties can have an essential role in attracting funds and projects that improve the effectiveness of the development strategies.
Vander Wekken, Suzanne; Sørensen, Susanne; Meldrum, John; Naylor, Patti-Jean
To explore industry perspectives on the transition to healthier food and beverage sales in publicly funded recreation facilities and specifically (a) the awareness of the BC provincial Guidelines and implementation supports; (b) challenges encountered in the transition to healthier products; and (c) thoughts on future trends and opportunities in the snack and beverage business. We used a qualitative research design (semi-structured interviews) with thematic analysis to explore the data collected. Overall, the industry was aware of the BC Guidelines and philosophically supported the transition to healthier choices in public recreation facilities. Main challenges in implementing the Guidelines were the: (1) perceived limitations of the Guidelines; (2) issues stocking healthy products; (3) competition in food sales environments; and (4) negative impact on profits. Interviewees believed that consumer choice is increasingly influenced by environmental and health priorities and that adapting to these trends would be important for future business success. The food and beverage industry needs time, resources and expertise to adapt their business model and to find new palatable products that meet healthy Guidelines. Strategies that strengthen accountability, provide opportunities for economic development and enhance private-public sector communication will help industry partners support implementation of nutrition policies. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Marinković, Natalija; VITALE, KSENIJA; Afrić, Ivo; Janev Holcer, Nataša
The amount of waste produced is connected with the degree of a country’s economic development; more developed countries produce more waste. This paper reviews the quantities, manipulation and treatment methods of medical waste in Croatia, as well as hazardous potentials of medical waste for human health. Medical waste must be collected and sorted in containers suitable for its characteristics, amount, means of transportation and treatment method in order to prevent contact with environment an...
... From Medical Imaging; Public Meeting; Request for Comments AGENCY: Food and Drug Administration, HHS... Medical Imaging.'' The purpose of this meeting is to discuss steps that could be taken by manufacturers of... reduce unnecessary patient exposure to ionizing radiation from these medical imaging modalities. The...
... No. FDA-2013-N-0580] Battery-Powered Medical Devices Workshop: Challenges and Opportunities; Public... entitled ``Battery-Powered Medical Devices Workshop: Challenges and Opportunities''. The purpose of this workshop is to create awareness of the challenges related to battery-powered medical devices and...
Omwami, Edith Mukudi; Keller, Edmond J.
Budgetary capacity that would allow for the public funding of the provision of universal access to primary education is lacking in many sub-Saharan economies. National revenues significantly lag behind the overall economic productivity measure of GDP. Analysis of data derived from UNESCO and UNDP for 2004 shows that governments in the region spend far less in US dollars per unit cost on primary education than do developed countries. Increasing the unit cost of education in order to enable a government to guarantee universal primary education would take away resources from other tiers of the education system in many countries in the region. The alternative is to universalise access, despite existing budget allocation constraints, and thereby further compound the problems of poor infrastructure and limited human resource capacity that continue to compromise education quality in sub-Saharan Africa.
Full Text Available This study was conducted to determine whether states with performance budgeting and funding (PBF programs had improved institutional performance of higher education over the five years (1997 through 2001 considered in this study. First Time in College (FTIC graduation rate was used as the measure of institutional performance. In this study, the unit of analysis is institution level and the study population is all public four-or-more-year institutions in the United States. To test PBF program effectiveness, Hierarchical Linear Modeling (HLM growth analysis was applied. According to the HLM analysis, the growth of graduation rates in states with PBF programs was not greater than in states without PBF programs. The lack of growth in institutional graduation rates, however, does not mean that PBF programs failed to achieve their goals. Policy-makers are advised to sustain PBF programs long enough until such programs bear their fruits or are proven ineffective.
Guerrero, Erick G; Harris, Lesley; Padwa, Howard; Vega, William A; Palinkas, Lawrence
Little is known about how the Affordable Care Act (ACA) will be implemented in publicly funded addiction health services (AHS) organizations. Guided by a conceptual model of implementation of new practices in health care systems, this study relied on qualitative data collected in 2013 from 30 AHS clinical supervisors in Los Angeles County, California. Interviews were transcribed, coded, and analyzed using a constructivist grounded theory approach with ATLAS.ti software. Supervisors expected several potential effects of ACA implementation, including increased use of AHS services, shifts in the duration and intensity of AHS services, and workforce professionalization. However, supervisors were not prepared for actions to align their programs' strategic change plans with policy expectations. Findings point to the need for health care policy interventions to help treatment providers effectively respond to ACA principles of improving standards of care and reducing disparities.
McInnes, B.; Brown, A.; Liffers, M.
Publically funded laboratories have a responsibility to generate, archive and disseminate analytical data to the research community. Laboratory managers know however, that a long tail of analytical effort never escapes researchers' thumb drives once they leave the lab. This work reports on a research data management project (Digital Mineralogy Library) where integrated hardware and software systems automatically archive and deliver analytical data and metadata to institutional and community data portals. The scientific objective of the DML project was to quantify the modal abundance of heavy minerals extracted from key lithological units in Western Australia. The selected analytical platform was a TESCAN Integrated Mineral Analyser (TIMA) that uses EDS-based mineral classification software to image and quantify mineral abundance and grain size at micron scale resolution. The analytical workflow used a bespoke laboratory information management system (LIMS) to orchestrate: (1) the preparation of grain mounts with embedded QR codes that serve as enduring links between physical samples and analytical data, (2) the assignment of an International Geo Sample Number (IGSN) and Digital Object Identifier (DOI) to each grain mount via the System for Earth Sample Registry (SESAR), (3) the assignment of a DOI to instrument metadata via Research Data Australia, (4) the delivery of TIMA analytical outputs, including spatially registered mineralogy images and mineral abundance data, to an institutionally-based data management server, and (5) the downstream delivery of a final data product via a Google Maps interface such as the AuScope Discovery Portal. The modular design of the system permits the networking of multiple instruments within a single site or multiple collaborating research institutions. Although sharing analytical data does provide new opportunities for the geochemistry community, the creation of an open data network requires: (1) adopting open data reporting
Full Text Available The Global Health 2035 report notes that the "grand convergence"--closure of the infectious, maternal, and child mortality gap between rich and poor countries--is dependent on research and development (R&D of new drugs, vaccines, diagnostics, and other health tools. However, this convergence (and the R&D underpinning it will first require an even more fundamental convergence of the different worlds of public health and innovation, where a largely historical gap between global health experts and innovation experts is hindering achievement of the grand convergence in health.
Hodgetts, Katherine; Hiller, Janet E; Street, Jackie M; Carter, Drew; Braunack-Mayer, Annette J; Watt, Amber M; Moss, John R; Elshaug, Adam G
Measures to improve the quality and sustainability of healthcare practice and provision have become a policy concern. In addition, the involvement of stakeholders in health policy decision-making has been advocated, as complex questions arise around the structure of funding arrangements in a context of limited resources. Using a case study of assisted reproductive technologies (ART), deliberative engagements with a range of stakeholder groups were held on the topic of how best to structure the distribution of Australian public funding in this domain. Deliberative engagements were carried out with groups of ART consumers, clinicians and community members. The forums were informed by a systematic review of ART treatment safety and effectiveness (focusing, in particular, on maternal age and number of treatment cycles), as well as by international policy comparisons, and ethical and cost analyses. Forum discussions were transcribed and subject to thematic analysis. Each forum demonstrated stakeholders' capacity to understand concepts of choice under resource scarcity and disinvestment, and to countenance options for ART funding not always aligned with their interests. Deliberations in each engagement identified concerns around 'equity' and 'patient responsibility', culminating in a broad preference for (potential) ART subsidy restrictions to be based upon individual factors rather than maternal age or number of treatment cycles. Community participants were open to restrictions based upon measures of body mass index (BMI) and smoking status, while consumers and clinicians saw support to improve these factors as part of an ART treatment program, as distinct from a funding criterion. All groups advocated continued patient co-payments, with measures in place to provide treatment access to those unable to pay (namely, equity of access). Deliberations yielded qualitative, socially-negotiated evidence required to inform ethical, accountable policy decisions in the specific
Henry C.H. Ko
Full Text Available There is a wealth of medical information now available to the public through various sources that are not necessarily controlled by medical or healthcare professionals. In Australia there has been a strong movement in the health consumer arena of consumer-led sharing and production of medical information and in healthcare decision-making. This has led to empowerment of the public as well as increased knowledge-sharing. There are some successful initiatives and strategies on consumer- and public-led sharing of medical information, including the formation of specialised consumer groups, independent medical information organisations, consumer peer tutoring, and email lists and consumer networking events. With well-organised public initiatives and networks, there tends to be fairly balanced information being shared. However, there needs to be caution about the use of publicly available scientific information to further the agenda of special-interest groups and lobbying groups to advance often biased and unproven opinions or for scaremongering. With the adoption of more accountability of medical research, and the increased public scrutiny of private and public research, the validity and quality of medical information reaching the public is achieving higher standards.
Marinković, Natalija; Vitale, Ksenija; Afrić, Ivo; Janev Holcer, Natasa
The amount of waste produced is connected with the degree of a country's economic development; more developed countries produce more waste. This paper reviews the quantities, manipulation and treatment methods of medical waste in Croatia, as well as hazardous potentials of medical waste for human health. Medical waste must be collected and sorted in containers suitable for its characteristics, amount, means of transportation and treatment method in order to prevent contact with environment and to protect people who are working with waste. Hazardous medical waste in Croatia is largely produced by hospitals. Even though only one hospital has a licence to incinerate infectious medical waste, many other hospitals incinerate their hazardous waste in inappropriate facilities. Healthcare institutions also store great amounts of old medical waste, mostly pharmaceutical, anti-infectious, and cytostatic drugs and chemical waste. Data on waste treatment effects on human health are scarce, while environmental problems are covered better. Croatian medical waste legislation is not being implemented. It is very important to establish a medical waste management system that would implement the existing legislation in all waste management cycles from waste production to treatment and final disposal.
The questions tackled in this paper are: How do we deal with ethically contested medical innovations?, and Can we do better? First, I analyse how we deal with these problems by a division of labour and competitive boundary work between the medical R&D system's research and technological imperative,
Tijdink, Joeri K; Verbeke, Reinout; Smulders, Yvo M
There is increasing evidence that scientific misconduct is more common than previously thought. Strong emphasis on scientific productivity may increase the sense of publication pressure. We administered a nationwide survey to Flemish biomedical scientists on whether they had engaged in scientific misconduct and whether they had experienced publication pressure. A total of 315 scientists participated in the survey; 15% of the respondents admitted they had fabricated, falsified, plagiarized, or manipulated data in the past 3 years. Fraud was more common among younger scientists working in a university hospital. Furthermore, 72% rated publication pressure as "too high." Publication pressure was strongly and significantly associated with a composite scientific misconduct severity score.
Johnston, Rory; Crooks, Valorie A; Adams, Krystyna; Snyder, Jeremy; Kingsbury, Paul
The medical tourism industry, which assists patients with accessing non-emergency medical care abroad, has grown rapidly in recent years. A lack of reliable data about medical tourism makes it difficult to create policy, health system, and public health responses to address the associated risks and shortcomings, such as spread of infectious diseases, associated with this industry. This article addresses this knowledge gap by analyzing interviews conducted with Canadian medical tourism facilitators in order to understand Canadian patients' involvement in medical tourism and the implications of this involvement for public health. Semi-structured phone interviews were conducted with 12 medical facilitators from 10 companies in 2010. An exhaustive recruitment strategy was used to identify interviewees. Questions focused on business dimensions, information exchange, medical tourists' decision-making, and facilitators' roles in medical tourism. Thematic analysis was undertaken following data collection. Facilitators helped their Canadian clients travel to 11 different countries. Estimates of the number of clients sent abroad annually varied due to demand factors. Facilitators commonly worked with medical tourists aged between 40 and 60 from a variety of socio-economic backgrounds who faced a number of potential barriers including affordability, fear of the unfamiliar, and lack of confidence. Medical tourists who chose not to use facilitators' services were thought to be interested in saving money or have cultural/familial connections to the destination country. Canadian doctors were commonly identified as barriers to securing clients. No effective Canadian public health response to medical tourism can treat medical tourists as a unified group with similar motivations for engaging in medical tourism and choosing similar mechanisms for doing so. This situation may be echoed in other countries with patients seeking care abroad. Therefore, a call for a comprehensive public
Full Text Available Abstract Background The medical tourism industry, which assists patients with accessing non-emergency medical care abroad, has grown rapidly in recent years. A lack of reliable data about medical tourism makes it difficult to create policy, health system, and public health responses to address the associated risks and shortcomings, such as spread of infectious diseases, associated with this industry. This article addresses this knowledge gap by analyzing interviews conducted with Canadian medical tourism facilitators in order to understand Canadian patients' involvement in medical tourism and the implications of this involvement for public health. Methods Semi-structured phone interviews were conducted with 12 medical facilitators from 10 companies in 2010. An exhaustive recruitment strategy was used to identify interviewees. Questions focused on business dimensions, information exchange, medical tourists' decision-making, and facilitators' roles in medical tourism. Thematic analysis was undertaken following data collection. Results Facilitators helped their Canadian clients travel to 11 different countries. Estimates of the number of clients sent abroad annually varied due to demand factors. Facilitators commonly worked with medical tourists aged between 40 and 60 from a variety of socio-economic backgrounds who faced a number of potential barriers including affordability, fear of the unfamiliar, and lack of confidence. Medical tourists who chose not to use facilitators' services were thought to be interested in saving money or have cultural/familial connections to the destination country. Canadian doctors were commonly identified as barriers to securing clients. Conclusions No effective Canadian public health response to medical tourism can treat medical tourists as a unified group with similar motivations for engaging in medical tourism and choosing similar mechanisms for doing so. This situation may be echoed in other countries with patients
Norris, Keith C.; Baker, Richard S.; Taylor, Robert; Montgomery-Rice, Valerie; Higginbotham, Eve J.; Riley, Wayne J.; Maupin, John; Drew-Ivie, Sylvia; Reede, Joan Y.; Gibbons, Gary
Substantial changes in not only access to care, cost, and quality of care, but also health professions education are needed to ensure effective national healthcare reform. Since the actionable determinants of health such as personal beliefs and behaviors, socioeconomic factors, and the environment disproportionately affect the poor (and often racial/ethnic minorities), many have suggested that focusing efforts on this population will both directly and indirectly improve the overall health of the nation. Key to the success of such strategies are the ongoing efforts by historically black medical schools (HBMSs) as well as other minority serving medical and health professional schools, who produce a disproportionate percentage of the high-quality and diverse health professionals that are dedicated to maintaining the health of an increasingly diverse nation. Despite their public mission, HBMSs receive limited public support threatening their ability to not only meet the increasing minority health workforce needs but to even sustain their existing contributions. Substantial changes in health education policy and funding are needed to ensure HBMSs as well as other minority-serving medical and health professional schools can continue to produce the diverse, high-quality health professional workforce necessary to maintain the health of an increasingly diverse nation. We explore several model initiatives including focused partnerships with legislative and business leaders that are urgently needed to ensure the ability of HBMSs to maintain their legacy of providing compassionate, quality care to the communities in greatest need. PMID:19806842
郭美亮; 厉芬芬; 郑思思; 梁雲洁; 陈浩; 曾春燕
In the context that medical and health system reform is furthering, the voice that hospitals should return to public welfare nature and embody medical humanism is growing. The investment of public hospital in charity work is also increasing. To learn the current situation of charitable medical assistance work in some public hospitals in Zhejiang and promote it to a better development, the research group has investigated Health and Family Planning Commission of Zhejiang Province and more than ten large public hospitals in Hangzhou, Wenzhou, Taizhou and some other cities. On the basis of a number of interviews records and fully understanding of the process, funding sources and rescue objects of the current public hospital charity medical assistance, main problems of current charitable medical assistance system were discussed and analyzed. Existing difficulties in the process of public hospital charitable medical assistance were summarized, such as there are many chores in assistance work and the assistance coverage is small. Several targeted suggestions were put forward from the perspective of government and public hospitals including strengthening policy guidance, refining laws and regulations, establishing a charity department and improving the management system of charity fund.
... Support Publications Fundraising News What is the Fanconi Anemia Research Fund? Fanconi anemia is an inherited disease that can lead to ... population. Lynn and Dave Frohnmayer started the Fanconi Anemia Research Fund, in 1989 to find effective treatments ...
Andersen, M S; Christensen, E F; Jepsen, S B
BACKGROUND: Emergency Medical Dispatchers make decisions based on limited information. We aimed to investigate if adding demographic and hospitalization history information to the dispatch process improved precision. METHODS: This 30-day follow-up study evaluated time-critical emergencies...
Kim, Eungdo; Kim, Soyoung; Kim, Hongbum
For decades, efforts have been made globally to measure the performance of large-scale public projects and to develop a framework to perform such measurements due to the complexity and dynamics of R&D and stakeholder interests. Still, limitations such as the use of a simply modified model and the lack of a comprehensive viewpoint are prevalent in existing approaches. In light of these research gaps, this study suggests a practical model to evaluate the performance of large-scale and publicly funded projects. The proposed model suggests a standard matrix framework of indices that evaluates the performance of particular elements in an industrial ecosystem in vertical categories and the economic and technological outcomes of those elements in horizontal categories. Based on the application of a balanced scorecard, this study uses mixed methodologies such as social network analysis, inter-industry analysis, and the analytic hierarchy process. Finally, the model evaluates the performance of Korea's Next Generation Network project as a case study.
Isnani A. Suryono
Full Text Available The objective of this study is to assess the problems encountered in the management of Medical Journal of Indonesia and whether any progress has been achieved during the past 7 years. A retrospective descriptive study was done in the MJI. Available data used as parameters were: number of articles submitted and author's home institution, number of articles submitted and rejected, cause/criteria of rejection, qualification of reviewers and editors, duration of manuscript processing, and whether pre-scheduled time is met in the Med J Indones. For this purpose, all manuscripts from January 1995- January 2001 were evaluated. In addition, recent problems encountered were noted. Problems encountered were limited supply of manuscript that might be due to language barrier, decrease in circulation due to limited budget, communication problems due to seniority, and increase in average processing time that might be due to restriction in the time allocated for MJI Number of articles submitted by authors originating from national versus foreign institutions in 1995-1997 was 101 versus 16, and in 1998 - 2000 were 124 versus 84. Articles rejected were ±26.4 % (1999-2001 and the most frequent causes of rejection were insignificancy of substance and improper data analysis. As for the qualification of editors there was an increase in the number of PhDs and professors. Average processing time is approximately 1.5 times the scheduled time. It seems that the 4 main problems encountered were (1 Language barrier, (2 Funding, (3 Communication problems and (4 Time management; and though not impressive, there are definitely positive changes in the number of manuscipts submitted, qualification of editors and peer reviewers. Average processing time is about the same, and the prescheduled time of editing is yet to be met. (Med J Indones 2001; 10: 252-8Keywords: language barrier, funding, communication problems, time management
There exists a notable structural risk in the accumulated surplus of the employee medical insurance fund.The part of one-time payment occupies 67% of the whole accumulated surplus of the fund, of which individual account funds compose 43%.As for medical consumption, the hospitalization expenditure of the retirees, who make up 36% of all the insured, accounts for 72% of the total expenditure.Provided with various risks, the connotation of development philosophy requires urgent intensification. Also, the structure of medical healthcare insurance funds ought to be optimized, and medical supervision must be strengthened.% 职工医保基金累计结余中存在的结构性风险十分突出。某市一次性趸缴基金在医保基金累计结余中占比高达67%，个人账户基金占比达43%。在医疗消费中，占参保人员总数36%的退休人员其住院统筹支出占总支出的72%。面对诸多风险，亟待增强内涵发展理念，注重基金结构优化，加强医保监管。
Full Text Available Purpose: The paper discusses issues associated with using funds that support the development of entrepreneurship – the purpose of the paper is to answer questions regarding the purposefulness and effectiveness of financial instruments from EU funds aimed at the development of emerging businesses (startups. Methodology: The paper analyzes previously conducted research studies in the fi eld of the discussed topic, it systematizes and describes the fi nancial instruments from EU funds supporting self- employment and startups in their early stages of activity. It also provides an overview of evaluation reports concerning these instruments. The paper also contains a case study: an analysis of the effectiveness of a selected project supporting the development of entrepreneurship (co-fi nanced from EU funds, in which the method of evaluating the net effect of the support in the short term has been used. Findings: An analysis of previously conducted research studies has shown that properly designed State aid targeted at those starting up their own business is sensible, as it provides them with seed capital and it helps them survive the most diffi cult period of the so-called “startup”. However, there is a lack of comprehensive studies to confirm the positive impact of business support interventions carried out using EU funds. The methodology of evaluating the net effect used by the Author in the conducted study has made it possible to identify the actual size of the – positive – impact of the selected project on the growth of self-employment. Limitations: The study revealed some limitations – the method and time of the study allow to capture the phenomenon on a micro-scale, in the short term. The institutions that are involved in the process of allocating funds should develop a comprehensive methodology that implements the idea of evaluating the net effect, allowing to assess the effectiveness of the support at regional and national level
Christiansen, Terkel; Erb, Karin; Rizvanovic, Amra
To examine the costs to the public health care system of couples in medically assisted reproduction.......To examine the costs to the public health care system of couples in medically assisted reproduction....
Christiansen, Terkel; Erb, Karin; Rizvanovic, Amra
Objective. To examine the costs to the public health care system of couples in medically assisted reproduction. Design. Longitudinal cohort study of infertile couples initiating medically assisted reproduction treatment. Setting. Specialized public fertility clinics in Denmark. Sample. Seven hund...
Vettorato, Giovanna; Hsuan, Juliana
This paper investigates design for remanufacture in terms of both detailed new product design and the environmental performance in which modularization and reversed production may operate. We examine the medical equipment industry and their potential contributions to the implementation of green...... supply chain in the healthcare sector. An exploratory case study of medical equipment supply chain is presented when considering the life cycle of the product can be managed through the modularization strategies. Preliminary findings indicate that design-for-disassembly of modules make equipment easier...
我国医疗保险基金自运行以来，有效保障了人民医疗健康需求，但长期来看我国医疗保险基金收支平衡压力较大，因此需要寻找新的途径缓解基金收支平衡压力。对此，我国社会保障基金和美国医疗保险基金市场化运营的成功经验为我国医疗保险基金的市场化运营提供了经验借鉴，但当前的基金统筹制度、基金投资制度及资本市场环境限制了医疗保险基金市场化运营，建议政府应当逐步构建医疗保险基金市场化运营的政策环境，循序渐进地对其进行市场化运作。%Since the operation of China's medical insurance fund,it has effectively protected the citizens' health, but the medical health insurance fund is facing a serious balance pressure in the long run, so it would be necessary to explore new pathway to relieve this pressure. The marketing operation of the social insurance fund of China and medical health insurance of US has provided much experience to China's health insurance fund. But there are still many problems,such as the fund coordinating system,investment system,and capital market environment,which has hindered the marketing operation of China's medical health insurance, to solve these problems, the government should create a favorable environment for the marketing operation of medical health insurance.
Kapilashrami, Anuj; McPake, Barbara
Global health initiatives (GHIs) have gained prominence as innovative and effective policy mechanisms to tackle global health priorities. More recent literature reveals governance-related challenges and their unintended health system effects. Much less attention is received by the relationship between these mechanisms, the ideas that underpin them and the country-level practices they generate. The Global Fund has leveraged significant funding and taken a lead in harmonizing disparate efforts to control HIV/AIDS. Its growing influence in recipient countries makes it a useful case to examine this relationship and evaluate the extent to which the dominant public discourse on Global Fund departs from the hidden resistances and conflicts in its operation. Drawing on insights from ethnographic fieldwork and 70 interviews with multiple stakeholders, this article aims to better understand and reveal the public and the hidden transcript of the Global Fund and its activities in India. We argue that while its public transcript abdicates its role in country-level operations, a critical ethnographic examination of the organization and governance of the Fund in India reveals a contrasting scenario. Its organizing principles prompt diverse actors with conflicting agendas to come together in response to the availability of funds. Multiple and discrete projects emerge, each leveraging control and resources and acting as conduits of power. We examine how management of HIV is punctuated with conflicts of power and interests in a competitive environment set off by the Fund protocol and discuss its system-wide effects. The findings also underscore the need for similar ethnographic research on the financing and policy-making architecture of GHIs.
Block, Robert C.; Duron, Vincent; Creigh, Peter; McIntosh, Scott
Objective: We aimed to improve the education of medical students involved in a longitudinal perinatal health improvement project in Gowa, Malawi. Design: We conducted qualitative interviews with students who participated in the project, reviewed their quantitative reports, and assessed the application of methodologies consonant with the learning…
Oscarina da Silva Ezequiel
Full Text Available Summary Objective: To evaluate the geographic distribution and career trajectory of medical graduates and the factors associated with their choice of practice location. Method: A cross-sectional study involving graduates from December 2001 to December 2010 was conducted. A self-administered questionnaire collected demographics and geographic information (place of birth, place of residence at the time of medical school admission, place of residency training and practice location, and reason for choosing the current location. Statistical analyses assessed trends in geographic distribution of graduates, and identified factors associated with location choice (through the population density of the location chosen for professional practice. Results: A total of 563 graduates completed the questionnaire. Of those, 4.3% (n=24 reported family medicine as their medical specialty, 19.9% (n=112 reported other primary care specialties (internal medicine, pediatrics, surgery and obstetrics-gynecology and the others chose subspecialties. Larger cities were more likely to be chosen for practice, particularly for newly-graduated doctors. Job invitations received during medical residency training increased the likelihood of choosing high-populated cities. In contrast, job invitations received during medical school increased the likelihood of choosing cities less populated. Amongst those in cities with lower population density, proximity to family members was an additional influencing factor; those who chose more densely populated cities did so because of better infrastructure and recreational options. Conclusion: Most of the physicians included in this study pursue subspecialties training and were practicing medicine in large cities. Knowing the multiple factors that influenced the choice of practice location can assist in planning future strategies to reduce physician workforce misdistribution.
Eva, Eliza Omar; Islam, Md Zakirul; Mosaddek, Abu Syed Md; Rahman, Md Faizur; Rozario, Rini Juliet; Iftekhar, A F Md Hassan; Ahmed, Tarafder Shahniam; Jahan, Iffat; Abubakar, Abdullahi Rabiu; Dali, Wan Putri Elena Wan; Razzaque, Mohammed S; Habib, Rahat Bin; Haque, Mainul
Throughout the world all health professionals face stress because of time-pressures, workload, multiple roles and emotional issues. Stress does not only exist among the health professionals but also in medical students. Bangladesh has currently 77 medical colleges 54 of which are private. This study was designed to collect baseline data of stress-level among Bangladeshi students, which we believe will form the basis for further in depth studies. A cross-sectional study was conducted on medical students from 2 public and 6 private medical-schools in Bangladesh. All medical schools have common curriculum formulated by the Government of Bangladesh. The study population was 1,363 medical students of Year-III and IV of academic session 2013/2014. Universal sampling technique was used. The period of study was February to June 2014. Data was collected using a validated instrument, compiled and analysed using SPSS version-20. A total of 990 (73%) out 1,363 medical students participated in the study, of which 36% were male and 64% were female. The overall prevalence of stress of the study population was 54%. 53% of male and 55% of female were reported suffering from stress. 54% of Year-III students and 55% of Year-IV were noted suffering from stress. There was statistically significant (p = 0.005) differences in the level of stress between public (2.84 ± 0.59) and private (2.73 ± 0.57) medical schools student. More than half of Bangladeshi medical students are suffering from measureable academic stress. It would be pertinent if the relevant authorities could address the issue so as to provide a conducive medical learning environment.
Stebbins, Samuel; Sanders, Jason L; Vukotich, Charles J; Mahoney, John F
Calls for more public health education for medical students date back at least 150 years. In recent years, medical schools have increased their required coursework in core public health topics such as epidemiology, biostatistics, and behavioral determinants of health. Some schools have created more in-depth alternatives, including combined or concurrent master's degrees; MD/PhD programs with a public health track; certificates in public health; or complete re-envisioning of the school into an integrated medical and public health institution. In 2009 the University of Pittsburgh School of Medicine began a Public Health Area of Concentration (AOC) that provides an optional, integrated curriculum that includes key elements of research, practice, and leadership. The AOC is a partnership between two schools at the University of Pittsburgh--Medicine and Public Health--and the local county health department. The result is a program that provides mentorship and training over 4 years of education designed to mend the long historical divide between the skills and constituencies of individual and population health. In addition, the AOC is relatively easy and inexpensive to implement and is modular in nature. The Public Health AOC is a simple model for incorporating many key aspects of public health into medical education and can be duplicated by any university that is willing to create partnerships and work across boundaries. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
The author regards development of Australia's ill-fated Research Quality Framework (RQF) as a "live experiment" in determining the most appropriate approach to evaluating the extra-academic returns, or "impact," of a nation's publicly funded research. The RQF was at the forefront of an international movement toward richer qualitative,…
Sigman, Laura J.
Patent and antitrust laws impact public access to pharmaceuticals and medical technologies. Two instancesâ€”one involving Rocheâ€™s new class of HIV/AIDS drugs, the other an antitrust action brought against Boston Scientific Corporation for violations of an anticompetitive agreement pertaining to cardiac treatment technologyâ€”illustrate the salient effects that medical products can have on public welfare. This paper provides a summary of pat...
Sheringham, J; Lyon, A; Jones, A; Strobl, J; Barratt, H
The value of e-learning in medical education is widely recognized but there is little evidence of its value in teaching medical students about public health. Such evidence is needed because medical students' engagement with public health has been low. We present three recent case studies from UK medical schools to illustrate diverse ways in which online approaches can increase medical students' engagement with learning public health. A comparative case study approach was used applying quantitative and qualitative data to examine engagement in terms of uptake/use amongst eligible students, acceptability and perceived effectiveness using an analytic framework based on Seven Principles of Effective Teaching. Across the three case studies, most (67-85%) eligible students accessed online materials, and rated them more favourably than live lectures. Students particularly valued opportunities to use e-learning flexibly in terms of time and place. Online technologies offered new ways to consolidate learning of key public health concepts. Although students found contributing to online discussions challenging, it provided opportunities for students to explore concepts in depth and enabled students that were uncomfortable speaking in face-to-face discussions to participate. E-learning can be applied in diverse ways that increase medical student engagement with public health teaching. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Teixeira, Renan Kleber Costa; Botelho, Nara Macedo; Petroianu, Andy
To assess whether there is a preference for international journal citation to the detriment of national ones in ten Brazilian medical journals, in two different periods. All references in the articles published in Arquivos Brasileiros de Oftalmologia, Revista Brasileira de Cirurgia Cardiovascular, Revista da Associação Médica Brasileira, São Paulo Medical Journal, Arquivos Brasileiros de Endocrinologia e Metabologia, Clinics, Jornal Brasileiro de Pneumologia, Revista da Sociedade Brasileira de Medicina Tropical, Revista Brasileira de Psiquiatria e Acta Ortopédica Brasileira in the years 2011 and 2007 were analyzed, assessing the number of articles published in national and international journals. A total of 36,125 references from 1,462 articles published in the 10 aforementioned journals were analyzed. Of the total number, 4.242 (11.74%) were from Brazilian journals. There was no significant difference between the two analyzed periods. A total of 453 (30,98%) of the articles studied non-cited brazilian papers,and 81 (5.54%) articles had more Brazilian than international references. Of total references analyzed, 11.74% were related to articles published in Brazilian journals. This number, when compared to the percentage of Brazilian articles published in the medical area, demonstrates a good number of citations of national articles. Copyright © 2012 Elsevier Editora Ltda. All rights reserved.
Muideen O. Bakare
Full Text Available Sub-Saharan African (SSA population consists of about 45% children, while in Europe and North America children population is 10- 15%. Lately, attention has been directed at mitigating childhood infectious and communicable diseases to reduce under-five mortality. As the under-five mortality index in Sub-Saharan Africa has relatively improved over the last two decades, more Sub-Saharan African children are surviving beyond the age of five and, apparently, a sizeable percentage of this population would be living with one or more childhood neurodevelopmental disorders (NDD. The distribution of child mental health service resources across the world is unequal. This manifests in the treatment gap of major childhood onset mental health problems in SSA, with the gap being more pronounced for childhood NDD. It is important to balance the public health focus and research funding priorities in Sub-Saharan Africa. We urgently need to define the burden of childhood NDD in the region for healthcare planning and policy formulation.
Ashwell, Margaret; Stone, Elaine; Mathers, John; Barnes, Stephen; Compston, Juliet; Francis, Roger M; Key, Tim; Cashman, Kevin D; Cooper, Cyrus; Khaw, Kay Tee; Lanham-New, Susan; Macdonald, Helen; Prentice, Ann; Shearer, Martin; Stephen, Alison
The UK Food Standards Agency convened an international group of expert scientists to review the Agency-funded projects on diet and bone health in the context of developments in the field as a whole. The potential benefits of fruit and vegetables, vitamin K, early-life nutrition and vitamin D on bone health were presented and reviewed. The workshop reached two conclusions which have public health implications. First, that promoting a diet rich in fruit and vegetable intakes might be beneficial to bone health and would be very unlikely to produce adverse consequences on bone health. The mechanism(s) for any effect of fruit and vegetables remains unknown, but the results from these projects did not support the postulated acid-base balance hypothesis. Secondly, increased dietary consumption of vitamin K may contribute to bone health, possibly through its ability to increase the gamma-carboxylation status of bone proteins such as osteocalcin. A supplementation trial comparing vitamin K supplementation with Ca and vitamin D showed an additional effect of vitamin K against baseline levels of bone mineral density, but the benefit was only seen at one bone site. The major research gap identified was the need to investigate vitamin D status to define deficiency, insufficiency and depletion across age and ethnic groups in relation to bone health.
Bruno, Denise Marie; Imperato, Pascal James
The School of Public Health at the State University of New York, Downstate Medical Center has sponsored a 6-8 week global health elective for fourth year medical students since 1980. The purpose of this elective is to provide students with an opportunity to observe the health care and public health delivery systems in low-income countries, provide medical service and have a cross-cultural experience. Over the course of the past 35 years, 388 students have participated in this global health elective in more than 41 low-income countries. The most popular sites include the Dominican Republic, Guatemala, India, Kenya and Thailand. Overall, interest in this elective has persisted throughout the course of time, sometimes temporarily increasing or decreasing with outside factors, such as the events of 11 September 2001 and the outbreak of Severe Acute Respiratory Syndrome in Asia. Recent annual applications for this elective have been as high as 44 out of a class of 200 students. Over the past 10 years, annual acceptance rates have varied, ranging from a low of 32 % in 2007-2008 to a high of 74 % in 2010-2011 and 2013-2014. Careful screening, including a written application, review of academic records and personal interviews has resulted in the selection of highly mature, adaptable and dedicated students who have performed well at overseas sites. Student rated satisfaction levels with this elective are almost universally high, with most rating it the best experience of their medical school years. Students undergo extensive preparation prior to their travel overseas, including a review of individual health and safety issues, travel and lodging, and the nature of the host country culture, health care system and assignment site. Downstate medical students are especially experienced in cross-cultural understanding because of the unusual diversity of the patient population in Brooklyn, and the diversity of local hospital staff and the medical school class. The Alumni Fund of
Full Text Available The efficacy of antidepressant medication has been shown empirically to be overestimated due to publication bias, but this has only been inferred statistically with regard to psychological treatment for depression. We assessed directly the extent of study publication bias in trials examining the efficacy of psychological treatment for depression.We identified US National Institutes of Health grants awarded to fund randomized clinical trials comparing psychological treatment to control conditions or other treatments in patients diagnosed with major depressive disorder for the period 1972-2008, and we determined whether those grants led to publications. For studies that were not published, data were requested from investigators and included in the meta-analyses. Thirteen (23.6% of the 55 funded grants that began trials did not result in publications, and two others never started. Among comparisons to control conditions, adding unpublished studies (Hedges' g = 0.20; CI95% -0.11~0.51; k = 6 to published studies (g = 0.52; 0.37~0.68; k = 20 reduced the psychotherapy effect size point estimate (g = 0.39; 0.08~0.70 by 25%. Moreover, these findings may overestimate the "true" effect of psychological treatment for depression as outcome reporting bias could not be examined quantitatively.The efficacy of psychological interventions for depression has been overestimated in the published literature, just as it has been for pharmacotherapy. Both are efficacious but not to the extent that the published literature would suggest. Funding agencies and journals should archive both original protocols and raw data from treatment trials to allow the detection and correction of outcome reporting bias. Clinicians, guidelines developers, and decision makers should be aware that the published literature overestimates the effects of the predominant treatments for depression.
Driessen, Ellen; Hollon, Steven D.; Bockting, Claudi L. H.; Cuijpers, Pim; Turner, Erick H.
Background The efficacy of antidepressant medication has been shown empirically to be overestimated due to publication bias, but this has only been inferred statistically with regard to psychological treatment for depression. We assessed directly the extent of study publication bias in trials examining the efficacy of psychological treatment for depression. Methods and Findings We identified US National Institutes of Health grants awarded to fund randomized clinical trials comparing psychological treatment to control conditions or other treatments in patients diagnosed with major depressive disorder for the period 1972–2008, and we determined whether those grants led to publications. For studies that were not published, data were requested from investigators and included in the meta-analyses. Thirteen (23.6%) of the 55 funded grants that began trials did not result in publications, and two others never started. Among comparisons to control conditions, adding unpublished studies (Hedges’ g = 0.20; CI95% -0.11~0.51; k = 6) to published studies (g = 0.52; 0.37~0.68; k = 20) reduced the psychotherapy effect size point estimate (g = 0.39; 0.08~0.70) by 25%. Moreover, these findings may overestimate the "true" effect of psychological treatment for depression as outcome reporting bias could not be examined quantitatively. Conclusion The efficacy of psychological interventions for depression has been overestimated in the published literature, just as it has been for pharmacotherapy. Both are efficacious but not to the extent that the published literature would suggest. Funding agencies and journals should archive both original protocols and raw data from treatment trials to allow the detection and correction of outcome reporting bias. Clinicians, guidelines developers, and decision makers should be aware that the published literature overestimates the effects of the predominant treatments for depression. PMID:26422604
Chatterjee, Pranab; Biswas, Tamoghna
With the ubiquitous connectivity offered by the Internet, social media sites (like Twitter and Facebook) and personal publishing platforms (blogs) are proliferating rapidly. In this new, evolving scenario of social media, these tools become an important medium to disseminate information at a lightning speed. However, the conventional medical publication model is less than eager to regard them as equivalent to traditional modes of information dissemination. In this article we examine the role played by social media as a critic of the medical publication system, and how it acts as a safeguard by building a platform for post-publication peer review.
Stremikis, Kristof; Schoen, Cathy; Fryer, Ashley-Kay
More than seven of 10 adults believe the U.S. health system needs fundamental change or complete rebuilding. Most adults surveyed reported difficulties accessing care, poor care coordination, and struggles with the costs and administrative hassles of health insurance. In addition, the survey finds substantial evidence of inefficient and wasteful delivery of health services. When looking toward the future, nearly three of four adults worry about getting high-quality care or paying medical bills. Respondents favor policies that encourage more patient-centered and integrated care, and nearly nine of 10 think it is important for private and public payers to work together to negotiate prices and improve quality. These experiences attest to the value of reforms aimed at stimulating and supporting the spread of more patient-centered, accountable care organizations. To the extent reforms succeed, patients and their families stand to gain from more accessible, safer, responsive, and less wasteful care.
The construction of public cultural service is a practical way that safeguard people’s basic cultural rights and interests,which is a upper design to construct a powerful cul-ture of socialist country. It is of great significance to build a whole well-off society. The arti-cle is based on some cases of National Social Science Fund on the aspects of Public Cultural Service Project during 1994 to 2015 and put forward some advice and ideas in order to offer reference and lessons for the theoretical research and exploration of our country’s Public Cul-tural Service.
Developmental disabilities: request for public comments on proposed developmental disabilities funding priorities for Projects of National Significance for Fiscal Year 1998--Administration on Developmental Disabilities, HHS. Notice of request for public comments on developmental disabilities tentative funding priority for Projects of National Significance for Fiscal Year 1998.
The Administration on Developmental Disabilities (ADD) announced that public comments are being requested on tentative funding priorities for Fiscal Year 1998 Projects of National Significance prior to being announced in its final form. We welcome comments and suggestions on this proposed announcement and funding priority which will assist in bringing about the increased independence, productivity, integration, and inclusion into the community of individuals with developmental disabilities.
Ku, You Jin [Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, 445 Gil-dong Kangdong-Gu, Seoul 134-701 (Korea, Republic of); Yoon, Dae Young, E-mail: email@example.com [Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, 445 Gil-dong Kangdong-Gu, Seoul 134-701 (Korea, Republic of); Yun, Eun Joo [Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, 445 Gil-dong Kangdong-Gu, Seoul 134-701 (Korea, Republic of); Baek, Sora [Department of Nuclear Medicine, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, 445 Gil-dong Kangdong-Gu, Seoul 134-701 (Korea, Republic of); Lim, Kyoung Ja; Seo, Young Lan; Choi, Chul Soon; Bae, Sang Hoon [Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, 445 Gil-dong Kangdong-Gu, Seoul 134-701 (Korea, Republic of)
Highlights: ► Radiologists published only 0.2% of articles in five general medical journals. ► Most original articles from radiologists were funded and were prospective studies. ► Radiology researchers from only 11 countries published at least one original article. -- Abstract: Objective: To evaluate scientific papers published by radiologists in high impact general medical journals between 1996 and 2010. Methods: A MEDLINE search was performed in five high impact general medical journals (AIM, BMJ, JAMA, Lancet, and NEJM) for all articles of which a radiologist was the first author between 1996 and 2010. The following information was abstracted from the original articles: radiological subspecialty, imaging technique used, type of research, sample size, study design, statistical analysis, study outcome, declared funding, number of authors, collaboration, and country of the first author. Results: Of 216 (0.19%) articles were published by radiologists in five general medical journals between 1996 and 2010, 83 were original articles. Fifteen (18.1%) original articles were concerned with the field of vascular/interventional radiology, 24 (28.9%) used combined imaging techniques, 76 (91.6%) were clinical research, 63 (75.9%) had a sample size of >50, 65 (78.3%) were prospective, 78 (94.0%) performed statistical analysis, 83 (100%) showed positive study outcomes, 57 (68.7%) were funded, 49 (59.0%) had from four to seven authors, and 79 (95.2%) were collaborative studies. Conclusions: A very small number (0.19%) in five high impact general medical journals was published by radiologists between 1996 and 2010.
Ong, Marcus Eng Hock; Chung, Wan Ling; Mei, Jeanette Sng Ee
To compare the attitudes of the public attending at a local Emergency Department and the medical staff towards witnessed resuscitation. Over a 2-week period in April 2006, we conducted an interview survey on the relatives of patients attending at the Emergency Department of Singapore General Hospital (SGH) via a convenience sampling. We approached 156 people with a response rate of 93.5%. We compared the results with a similar study conducted on the medical staff in the Emergency Department in the same hospital. Should relatives be present during resuscitation? We found that 73.1% of the public supported witnessed resuscitation compared to only 10.6% of the medical staff (Padvantage for witnessed resuscitation cited by both groups was that relatives would then have assurance that everything possible had been done for the patient. While 68.8% of the public felt that being allowed into the resuscitation area would help in their grieving processes, only 35.6% of the medical staff shared the same point of view (P<0.001). Medical staff were less likely to agree that witnessed resuscitation would strengthen the bonds between themselves and the public (P<0.001). Medical staff were however, more inclined towards the opinion that relatives would have a traumatic experience in witnessing resuscitation of their loved ones (P<0.001) and that the presence of relatives would cause stress to the medical staff performing resuscitation (P<0.001). Locally, we find a discrepancy between healthcare workers and the public towards the concept of witnessed resuscitation. More research is needed on the attitudes of the Asian public and medical staff.
Full Text Available Abstract Background Application of virtual slides (VS, the digitalization of complete glass slides, is in its infancy to be implemented in routine diagnostic surgical pathology and to issues that are related to tissue-based diagnosis, such as education and scientific publication. Approach Electronic publication in Pathology offers new features of scientific communication in pathology that cannot be obtained by conventional paper based journals. Most of these features are based upon completely open or partly directed interaction between the reader and the system that distributes the article. One of these interactions can be applied to microscopic images allowing the reader to navigate and magnify the presented images. VS and interactive Virtual Microscopy (VM are a tool to increase the scientific value of microscopic images. Technology and Performance The open access journal Diagnostic Pathology http://www.diagnosticpathology.org has existed for about five years. It is a peer reviewed journal that publishes all types of scientific contributions, including original scientific work, case reports and review articles. In addition to digitized still images the authors of appropriate articles are requested to submit the underlying glass slides to an institution (DiagnomX.eu, and Leica.com for digitalization and documentation. The images are stored in a separate image data bank which is adequately linked to the article. The normal review process is not involved. Both processes (peer review and VS acquisition are performed contemporaneously in order to minimize a potential publication delay. VS are not provided with a DOI index (digital object identifier. The first articles that include VS were published in March 2011. Results and Perspectives Several logistic constraints had to be overcome until the first articles including VS could be published. Step by step an automated acquisition and distribution system had to be implemented to the corresponding
Rouvillain, J-L; Derancourt, C; Moore, N; Devos, P
SIGAPS is a bibliometric software tool developed in France to identify and analyze Medline-indexed publications that are produced by a researcher or research group. This measurement takes into account the author's ranking on the paper along with the journal's prestige according to its impact factor within the research field. However, use of this impact factor is the primary limitation of SIGAPS. SIGAPS analysis results are used to assign a financial value to hospital facilities. The impact of the journal Revue de Chirurgie Orthopédique and its successor-Orthopaedics & Traumatology: Surgery & Research-was compared using the Medline-based ISI (SIGAPS) and SCOPUS-based SCImago journal rankings. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
Davidovitch, Nadav; Seidelman, Rhona
In this article we explore how the vision uniting Zionism, science, medicine and public health is depicted in Herzl's novel Altneuland (Old-New Land). Altneuland, which belongs to the genre of fin-de-siècle utopian novels, presents a modernistic vision of progress, integrating science with a humanistic society of equals. The remedy for the "psychopathology of the Jew" was believed by many Zionists to be a return to Palestine, and the establishment there of a healthy national Jewish home. Yet, Herzl's utopia, as depicted in Altneuland, is homogeneous, not allowing for other voices to be expressed, such as those of women and Arabs. Moreover, the belief that science and technology could solve social problems did not take into account the tensions that they would create in the society and environment. This vision of science and society, with its inherent tensions, will continue to inform the Zionist discourse of our present day.
Hepp, Shelanne L; Tarraf, Rima C; Birney, Arden; Arain, Mubashir Aslam
Electronic health records are becoming increasingly common in the health care industry. Although information technology (IT) poses many benefits to improving health care and ease of access to information, there are also security and privacy risks. Educating health care providers is necessary to ensure proper use of health information systems and IT and reduce undesirable outcomes. This study evaluated employees' awareness and perceptions of the effectiveness of two IT educational training modules within a large publicly funded health care system in Canada. Semi-structured interviews and focus groups included a variety of professional roles within the organisation. Participants also completed a brief demographic data sheet. With the consent of participants, all interviews and focus groups were audio recorded. Thematic analysis and descriptive statistics were used to evaluate the effectiveness of the IT security training modules. Five main themes emerged: (i) awareness of the IT training modules, (ii) the content of modules, (iii) staff perceptions about differences between IT security and privacy issues, (iv) common breaches of IT security and privacy, and (v) challenges and barriers to completing the training program. Overall, nonclinical staff were more likely to be aware of the training modules than were clinical staff. We found e-learning was a feasible way to educate a large number of employees. However, health care providers required a module on IT security and privacy that was relatable and applicable to their specific roles. Strategies to improve staff education and mitigate against IT security and privacy risks are discussed. Future research should focus on integrating health IT competencies into the educational programs for health care professionals.
Ruis, A R; Golden, Robert N
The separation of "medicine" and "public health" in academic institutions limits the potential synergies that an integrated educational model could offer. The roots of this separation are deeply imbedded in history. During the past two centuries, there have been repeated efforts to integrate public health education into the core training of physicians, usually in response to a perceived short-term crisis, and without widespread, lasting success. The cost of additional public health instruction and the "overcrowding" of the medical curriculum have been cited as obstacles for creating an integrated medical/public health curriculum for more than a century. Several thoughtful and prescient proposals for integration were developed at a conference convened by the Rockefeller Foundation in the early 20th century, but not all were implemented. Today, there is growing recognition of the considerable value afforded by the integration of medicine and public health education. Many schools have responded to a national call for a renewed relationship between medicine and public health by increasing the availability of MD/MPH programs and/or by incorporating one or more public health courses into the basic medical curriculum. A few schools have created more substantial and innovative changes. Review and consideration of the history and politics of past efforts may serve as a guide for the development of successful new approaches to creating a clinical workforce that incorporates the principles of both clinical medicine and public health.
Doerr, H W; Cinatl, J
A look back is done to some clinical and basic research activities recently published in medical microbiology and immunology. The review covers clinical experiences and in vitro experiments to understand the emergency, pathogenicity, epidemic spread, and vaccine-based prevention of avian and swine-origin flu. Some new developments and concepts in diagnosis, (molecular) epidemiology, and therapy of AIDS, viral hepatitis C, and herpesvirus-associated diseases are outlined. Regulation of immune system has been discussed in a special issue 2010 including some aspects of CNS affections (measles). Mycobacterial infection and its prevention by modern recombinant vaccines have reached new interest, as well as new concepts of vaccination and prophylaxis against several other bacteria. Adaptation to host niches enables immune escape (example brucella) and determines virulence (example N. meningitidis). Chlamydia pneumoniae, previously considered to trigger atherosclerosis, is hypothetically associated to Alzheimer disease, while CMV, another putative trigger of atherosclerosis, gains evidence of oncomodulation in CNS tumor diseases. In terms of globalization, exotic virus infections are increasingly imported from southern countries.
Full Text Available In this study, we attempted to determine the frequency and types of metaphors in a corpus of titles from a single medical journal collected over one year. The frequency of metaphor tokens (4.6% was highest among editorials and other opinion articles and consisted predominantly of primary metaphors, which require explanation using a visual, cultural or other physical vehicle. When the metaphor was used only in the title and not in the body of the text, as was common in letters to the editor or in editorials, the metaphor may constitute a para-textual device used for engaging the reader. Other metaphors among research article titles were present not only in the title, but also used repeatedly in the body of the text. Among these research articles, metaphors were frequently used to endow the focus words of the metaphor with a precise and meaningful significance which, when used repeatedly in the text, may constitute a mechanism by which sub-technical language or internal jargon may arise. Being syntactically simple but endowed with a high communicative import, titles as a text type may help improve academic literacy, among beginners.
Salamat, Fatemeh; Sobhani, Abdol-Rasoul; Mallaei, Mahin
Providing a perfect instruction to authors can prevent most potential publication ethics errors. This study was conducted to determine the quality of ethical considerations in the instructions to the authors of Iranian research scientific journals of medical sciences (accredited by the Commission for Accreditation and Improvement of Iranian Medical Journals) in October 2011. Checklist items (n=15) were extracted from the national manual of ethics in medical research publications, and the validity of the manual of ethics was assessed. All the accredited Iranian journals of medical sciences (n=198) were entered into the study. The instructions to the authors of 160 accredited Iranian journals were available online and were reviewed. The ANOVA and Kendall Correlation coefficient were performed to analyze the results. A total of 76 (47.5%) of the 160 journals were in English and 84 (52.5%) were in Farsi. The most frequently mentioned items related to publication ethics comprised "commitment not to send manuscripts to other journals and re-publish manuscripts" (85%, 83.8%), "aim and scope" of the journal (81.9%), "principles of medical ethics in the use of human samples" (74.4%), and "review process" (74.4%). On the other hand, the items of "principles of advertising" (1.2%), "authorship criteria" (15%), and "integrity in publication of clinical trial results" (30.6%) were the least frequently mentioned ones. Based on the study findings, the quality of publication ethics, as instructed to the authors, can improve the quality of the journals.
By selecting proper indexes for the evaluation of medical service quality, and taking the index changes after the initiation of prepaid total insurance fund in the General Hospital of Shenyang Military Region as an example, we analyze its effects, therefore to provide a basis for hospital medical service quality evaluation after the implementation of medical insurance fund budget control.%本文通过筛选出比较合理的医疗服务质量评价指标，以沈阳军区总医院实行总额预付后的指标变化情况为例，分析总控后的效果，从而为实行医保总额控制之后的医院医疗服务质量评价提供依据。
Hassan, Wafa; Ahmad, Farah; Malik, Aisha; Ali, Saba
To assess the awareness about and perception of euthanasia among medical students of Karachi. The cross-sectional study was conducted from December 2011 to March 2012 among students of private-sector and one public-sector medical college in Karachi. Data was analysed using SPSS version 17, and associations were worked out using chi-square test. Out of the 493 students, 226 (46%) were from the matriculation system and 194 (39%) from the Cambridge system, while the remaining 15% were from the American High School. The male-female ratio was 1:3. There were 284 (58%) students from the private medical college. Majority of the private medical school students (n = 284; 99.6%) knew about euthanasia, compared to the public-sector facility where only 161 (77%) knew of it. Of the total, 405 (82%) students agreed that it is physician-assisted suicide; 255 (52%) agreed to the idea of palliative care, claiming it was sufficient to maintain life; 226 (54%) disagreed that a doctor should not be allowed to administer a lethal dose while only 162 (33%) agreed to the idea of it; 285 (58%) disagreed that a law regarding the practice of euthanasia should not be introduced, whereas 134 (27%) agreed to it; 70 (14%) agreed to the practice of euthanasia, while 311 (63%) disagreed, mostly for religious reasons. The awareness of euthanasia was high, but a very small proportion of students approved of it. There is need to include palliative care and euthanasia in the Behavioural Science module in the under-graduation programme of both public and private medical schools.
Stone, Geren S; Tarus, Titus; Shikanga, Mainard; Biwott, Benson; Ngetich, Thomas; Andale, Thomas; Cheriro, Betsy; Aruasa, Wilson
Observational data in the United States suggests that those without health insurance have a higher mortality and worse health outcomes. A linkage between insurance coverage and outcomes in hospitalized patients has yet to be demonstrated in resource-poor settings. To determine whether uninsured patients admitted to the public medical wards at a Kenyan referral hospital have any difference in in-hospital mortality rates compared to patients with insurance, we performed a retrospective observational study of all inpatients discharged from the public medical wards at Moi Teaching and Referral Hospital in Eldoret, Kenya, over a 3-month study period from October through December 2012. The primary outcome of interest was in-hospital death, and the primary explanatory variable of interest was health insurance status. During the study period, 201 (21.3%) of 956 patients discharged had insurance. The National Hospital Insurance Fund was the only insurance scheme noted. Overall, 211 patients (22.1%) died. The proportion who died was greater among the uninsured compared to the insured (24.7% vs. 11.4%, Chi-square = 15.6, phospital mortality with insurance. After adjusting for comorbid illness, employment status, age, HIV status, and gender, the association between insurance status and mortality remained statistically significant (adjusted odds ratio (AOR) = 0.40, 95% CI 0.24-0.66) and similar in magnitude to the association between HIV status and mortality (AOR = 2.45, 95% CI 1.56-3.86). Among adult patients hospitalized in a public referral hospital in Kenya, insurance coverage was associated with decreased in-hospital mortality. This association was comparable to the relationship between HIV and mortality. Extension of insurance coverage may yield substantial benefits for population health.
Academic medical libraries have a responsibility to inform library users regarding retracted publications. Many have created policies and procedures that identify flawed journal articles. A questionnaire was sent to the 129 academic medical libraries in the United States and Canada to find out how many had policies and procedures for identifying retracted publications. Of the returned questionnaires, 59% had no policy and no practice for calling the attention of the library user to retracted publications. Forty-one percent of the libraries called attention to retractions with or without a formal policy for doing so. Several responding libraries included their policy statement with the survey. The increasing number of academic medical libraries that realize the importance of having policies and practices in place highlights the necessity for this procedure.
Alkabba, Abdulaziz F; Hussein, Ghaiath M A; Kasule, Omar H; Jarallah, Jamal; Alrukban, Mohamed; Alrashid, Abdulaziz
Saudi Arabia is considered one of the most influential Muslim countries being as the host of the two most holy places for Muslims, namely Makkah and Madina. This was reflected in the emphasis on teaching medical ethics in a lecture-based format as a part of the subject of Islamic culture taught to medical students. Over the last few years, both teaching and evaluation of medical ethics have been changing as more Saudi academics received specialized training and qualifications in bioethics from western universities. This study aims at studying the current teaching methods and evaluation tools used by the Saudi public medical schools. It is done using a self-administered online questionnaire. Out of the 14 medical schools that responded, the majority of the responding schools (6; 42.8%), had no ethics departments; but all schools had a curriculum dedicated to medical ethics. These curricula were mostly developed by the faculty staff (12; 85.7%). The most popular teaching method was lecturing (13; 92.8%). The most popular form of student assessment was a paper-based final examination (6; 42.8%) at the end of the course that was allocated 40% or more of the total grade of the ethics course. Six schools (42.8%) allocated 15-30% of the total grade to research. Although there is a growing interest and commitment in teaching ethics to medical students in Saudi schools; there is lack of standardization in teaching and evaluation methods. There is a need for a national body to provide guidance for the medical schools to harmonize the teaching methods, particularly introducing more interactive and students-engaging methods on the account of passive lecturing.
Background Saudi Arabia is considered one of the most influential Muslim countries being as the host of the two most holy places for Muslims, namely Makkah and Madina. This was reflected in the emphasis on teaching medical ethics in a lecture-based format as a part of the subject of Islamic culture taught to medical students. Over the last few years, both teaching and evaluation of medical ethics have been changing as more Saudi academics received specialized training and qualifications in bioethics from western universities. Methods This study aims at studying the current teaching methods and evaluation tools used by the Saudi public medical schools. It is done using a self-administered online questionnaire. Results Out of the 14 medical schools that responded, the majority of the responding schools (6; 42.8%), had no ethics departments; but all schools had a curriculum dedicated to medical ethics. These curricula were mostly developed by the faculty staff (12; 85.7%). The most popular teaching method was lecturing (13; 92.8%). The most popular form of student assessment was a paper-based final examination (6; 42.8%) at the end of the course that was allocated 40% or more of the total grade of the ethics course. Six schools (42.8%) allocated 15-30% of the total grade to research. Conclusion Although there is a growing interest and commitment in teaching ethics to medical students in Saudi schools; there is lack of standardization in teaching and evaluation methods. There is a need for a national body to provide guidance for the medical schools to harmonize the teaching methods, particularly introducing more interactive and students-engaging methods on the account of passive lecturing. PMID:24020917
Cheong Ai Theng; Tong Seng Fah; Khoo Ee Ming
Abstract Background Identification of pregnant women susceptible to rubella is important as vaccination can be given postpartum to prevent future risks of congenital rubella syndrome. However, in Malaysia, rubella antibody screening is not offered routinely to pregnant women in public funded health clinics due to cost constraint. Instead, a history of rubella vaccination is asked to be provided to establish the women’s risk for rubella infection. The usefulness of this history, however, is no...
Mery, Gustavo; Wodchis, Walter P; Laporte, Audrey
The role of Home Care (HC) services for the elderly will be increasingly important in meeting populations' future needs for care. HC services include Home Health Care (HHC) and Homemaking/Personal Support (HMPS), distinction rarely seen in the literature. This paper argues that it is important to distinguish between these types of HC, since the factors that drive the likelihood of the receipt of each type of care may differ, and also to investigate the interrelationship between them. We explored the interrelationship between receipt of publicly funded HMPS and HHC, and the determinants of the receipt of each type of services. A Panel Two-Stage Residual Inclusion approach was applied to estimate the likelihood of the receipt of HC services using data for those aged 65 and over from 9 biannual waves of the Canadian National Population Health Survey (1994-95 to 2010-11). We found that there are in fact differences in the determinants of the likelihood of HHC and HMPS receipt. Moreover, receipt of publicly funded HMPS was found to be complementary with receipt of publicly funded HHC services after adjusting for functional and health status. Dependence on help with activities of daily living, health status, household arrangement, and income were found to be determinants of the propensity to receive both publicly funded HHC and HMPS services. This study aims to contribute to the existent literature by taking a step toward explicitly modelling the potential interaction between the determinants of the receipt of different types of HC services simultaneously, as a system. Our methodological approach, a Panel Two-Stage Residual Inclusion method, seems to effectively address problems that are known to be a source of bias in the literature.
Tahin, E; Morava, E
The science of public health of the XVIIIth century named politia medica together with medicina forensis became an independent obligatory subject in 1793 at the Medical Faculty of the Hungarian Royal University of Science. The independent Public Health Institute of the Medical Faculty was established in 1874. The first professor of public health was József Fodor who attained international reputation during his professorship. He organized training for school physicians and health teachers first in Europe and he organized courses for medical officers and for military doctors. He held courses for law-, engineer- and architect-students. He promoted all fields of the public health. His research on the bactericide effect of serum places him among the founders of immunology. Fodor's successors at the Chair of Public Health were Leó Liebermann whose research activities included physico-chemistry, biochemistry, microbiology and social hygiene; Gusztáv Rigler who focused on the epidemiology of communicable diseases, on the health effects of spa treatment and mineral waters. The next famous professor was Gyula Darányi. His scientific field was public health bacteriology and public health chemistry. They were followed by József Melly and László Dabis (Scheff). After the Second World War fundamental changes took place in the life of the university. The Faculty of Medicine was separated from the University of Science on February 1, 1951 and became an independent university under the control of the Ministry of Health. In 1953 the Institute of Public Health was cut into two separate institutes: Institute of Public Health and Institute for the Organization of Health Service. The Institute of Public Health was transformed to Institute of Public Health and Epidemiology in 1973. The Institute for the Organization of Health Service was transformed into Institute of Social Medicine and History of Medicine in 1985 and later into Institute of History of Medicine and Social Medicine
Barnieh, Lianne; Clement, Fiona; Harris, Anthony; Blom, Marja; Donaldson, Cam; Klarenbach, Scott; Husereau, Don; Lorenzetti, Diane; Manns, Braden
Background Publicly-funded drug plans vary in strategies used and policies employed to reduce continually increasing pharmaceutical expenditures. We systematically reviewed the utilization of cost-sharing strategies and physician-directed prescribing regulations in publicly-funded formularies within member nations of the Organization of Economic Cooperation and Development (OECD). Methods & Findings Using the OECD nations as the sampling frame, a search for cost-sharing strategies and physician-directed prescribing regulations was done using published and grey literature. Collected data was verified by a system expert within the prescription drug insurance plan in each country, to ensure the accuracy of key data elements across plans. Significant variation in the use of cost-sharing mechanisms was seen. Copayments were the most commonly used cost-containment measure, though their use and amount varied for those with certain conditions, most often chronic diseases (in 17 countries), and by socio-economic status (either income or employment status), or with age (in 15 countries). Caps and deductibles were only used by five systems. Drug cost-containment strategies targeting physicians were also identified in 24 countries, including guideline-based prescribing, prescription monitoring and incentive structures. Conclusions There was variable use of cost-containment strategies to limit pharmaceutical expenditures in publicly funded formularies within OECD countries. Further research is needed to determine the best approach to constrain costs while maintaining access to pharmaceutical drugs. PMID:24618721
Full Text Available BACKGROUND: Publicly-funded drug plans vary in strategies used and policies employed to reduce continually increasing pharmaceutical expenditures. We systematically reviewed the utilization of cost-sharing strategies and physician-directed prescribing regulations in publicly-funded formularies within member nations of the Organization of Economic Cooperation and Development (OECD. METHODS & FINDINGS: Using the OECD nations as the sampling frame, a search for cost-sharing strategies and physician-directed prescribing regulations was done using published and grey literature. Collected data was verified by a system expert within the prescription drug insurance plan in each country, to ensure the accuracy of key data elements across plans. Significant variation in the use of cost-sharing mechanisms was seen. Copayments were the most commonly used cost-containment measure, though their use and amount varied for those with certain conditions, most often chronic diseases (in 17 countries, and by socio-economic status (either income or employment status, or with age (in 15 countries. Caps and deductibles were only used by five systems. Drug cost-containment strategies targeting physicians were also identified in 24 countries, including guideline-based prescribing, prescription monitoring and incentive structures. CONCLUSIONS: There was variable use of cost-containment strategies to limit pharmaceutical expenditures in publicly funded formularies within OECD countries. Further research is needed to determine the best approach to constrain costs while maintaining access to pharmaceutical drugs.
Full Text Available A característica comum a todas as crises financeiras dos últimos trinta anos é o comparecimento do fundo público para socorrer instituições financeiras falidas durante as crises bancárias, à custa dos impostos pagos pelos cidadãos. Com a financeirização da riqueza, os mercados financeiros passam a disputar cada vez mais recursos do fundo público, impedindo a expansão dos direitos sociais. Este artigo tem por objetivo discutir a crise do capital a partir do papel exercido pelo fundo público e seus rebatimentos no financiamento da seguridade social no Brasil.The characteristic that has been common to all financial crises in the last 30 years is the appearance of the public fund to bail out bankrupt financial institutions during the banking crises, at the expense of taxes paid by the citizens. Financing wealth, financial markets dispute resources from the public fund more and more, which impedes the expansion of social rights. This article aims to discuss the crisis of the capital from the role played by public funds and their impact on the financing of social security in Brazil.
Ebi, Kristie L; Semenza, Jan C; Rocklöv, Joacim
Three major international agreements signed in 2015 are key milestones for transitioning to more sustainable and resilient societies: the UN 2030 Agenda for Sustainable Development; the Sendai Framework for Disaster Risk Reduction; and the Paris Agreement under the United Nations Framework Convention on Climate Change. Together, these agreements underscore the critical importance of understanding and managing the health risks of global changes, to ensure continued population health improvements in the face of significant social and environmental change over this century. BODY: Funding priorities of major health institutions and organizations in the U.S. and Europe do not match research investments with needs to inform implementation of these international agreements. In the U.S., the National Institutes of Health commit 0.025 % of their annual research budget to climate change and health. The European Union Seventh Framework Programme committed 0.08 % of the total budget to climate change and health; the amount committed under Horizon 2020 was 0.04 % of the budget. Two issues apparently contributing to this mismatch are viewing climate change primarily as an environmental problem, and therefore the responsibility of other research streams; and narrowly framing research into managing the health risks of climate variability and change from the perspective of medicine and traditional public health. This reductionist, top-down perspective focuses on proximate, individual level risk factors. While highly successful in reducing disease burdens, this framing is insufficient to protect health and well-being over a century that will be characterized by profound social and environmental changes. International commitments in 2015 underscored the significant challenges societies will face this century from climate change and other global changes. However, the low priority placed on understanding and managing the associated health risks by national and international research
Aki, Ozlem Erden; Ak, Sertac; Sonmez, Yunus Emre; Demir, Basaran
Electroconvulsive therapy (ECT) is safe and effective for the treatment of various psychiatric disorders. Despite being a well-known treatment method among health care professionals, lay people generally have a negative opinion of ECT. The present study aimed to examine knowledge of and attitudes toward ECT among medical students, psychology students, and the general public. Psychology students were included because they are among the important groups in mental health care in Turkey. A Likert-type questionnaire was administered to fifth-year medical students (n = 28), master of science and doctor of philosophy clinical psychology students (n = 35), and a sample of the general public (n = 26). The questionnaire included questions about the general principles of and indications for ECT, and sources of knowledge of and attitudes toward ECT. The medical students were the most knowledgeable about ECT, as expected. The medical students also had a more positive attitude toward ECT than the other 2 groups. More psychology students had negative attitudes on some aspects than general public sample, despite being more knowledgeable. Medical school theoretical and practical training in ECT played an important role in increasing the level of knowledge of and decreasing the prevalence of negative attitudes toward ECT among the medical students; similar training for psychology students is required to achieve similar results.
Heinig, Stephen J; Dev, Anurupa; Bonham, Ann C
Medical researchers and their institutions are operating under extraordinary financial stress. More than a decade after completion of the 5-year doubling of the National Institutes of Health budget, the medical research community must confront a significant loss in National Institutes of Health purchasing power and downward pressures in federal discretionary spending. In part, this trend results from a federal budget stalemate over the growth in entitlement programs, particularly spending on medical care. This article considers the changing nature of the federal investment in medical research and the potential for medical researchers and institutions conducting the full spectrum of research to improve health system performance and health equity. In our view, continued federal investments reflect an evolving social contract for research serving the public good; the term contract is used metaphorically to represent a figurative, implicit agreement between the scientific community and the public's representatives in government. Under this conceptual contract, the American people--who are ultimately the funders of research, research training and infrastructure--expect outcomes that lead to better health, security or other benefits. The evolving contract includes expectations for more accountability, transparency, sharing of results and resources, and better integration of research systems and cultures that used to take pride in boundaries and distinctions. We outline here some of the major movements of organizations realigning to social support, which are increasingly essential to sustain public investment in medical research.
Full Text Available The International Auditing and Assurance Standards Board (IAASB of the International Federation of Accountants (IFAC is the international organism of standardization in the auditing field . In our opinion, the theories, the methodologies and the standards issued by the mentioned organism, are still the paradigms with the most significant impact on audit rules and practices. Since some theorists define accounting as a social applied science, we can also affirm that the audit activity has a social role . We intend to treat the mentioned subject not only from gnoseological point of view, in other words, we won’t just broaden the current theories and practices. In research, beside the theoretical analysis work, we intend to have a critical attitude both regarding previous research and defining and spreading innovative ideas relating to the suggested topic, as well. We may say that studying theorists work who are linked to the field news, in order to formulate the rules of good practice is an epistemological matter. From the epistemological point of view, in auditing, we operate with valuable judgments, namely evaluations or practical assessments of the phenomenon which our work can influence by adopting an approval or disapproval attitude. Improving the audit of operations financed from external grants can and should be a leverage of the utmost importance for their strategic absorption, implementation according to the agreements signed with the European Commission under the full protection of EU financial interests. The present project is focused on increasing the optimization of audit procedures and techniques as regards grants audit operations so that their implementation to be transparent, effective, efficient and economic for the national economy, and complying with the financial interests of the European Union. The challenge of this approach is caused by the fact that the external public audit of the external funded grants should fully
Survey design and observations relating to cancer education funding. Cancer Education Survey II: cancer education in United States medical schools (conducted by The American Association for Cancer Education with the support of the American Cancer Society).
Bakemeier, R F; Kupchella, C E; Chamberlain, R M; Gallagher, R E; O'Donnell, J F; Parker, J A; Hill, G J; Brooks, C M
A survey has been conducted of cancer education programs for medical students in United States medical schools by the American Association for Cancer Education with grant support from the Department of Detection and Treatment of the American Cancer Society (formerly the Professional Education Department). Two questionnaires were used, an Educational Resources Questionnaire (ERQ), which 126 of the 128 medical schools completed and returned, and a Faculty and Curriculum Questionnaire (FCQ), which was completed and returned by 1,035 faculty members who had been named as active in undergraduate medical student cancer education by respondents in each school who had been designated by the Dean's Office to complete the ERQ. Overall conclusions included: (1) increased coordination of cancer education activities is a major need in many schools; (2) there is widespread interest in the further development of cancer education objectives; (3) development of a national cancer education curriculum is needed; (4) there is interest in the development of improved instructional materials and methods; (5) development of evaluation methods is needed for cancer education programs; and (6) an ongoing funding process is needed to provide support for interdepartmental coordination of cancer education activities. Cancer prevention and detection topics were ranked above cancer treatment in plans for future curriculum emphasis. More detailed conclusions and recommendations are provided in this publication and three subsequent articles in this issue of the Journal of Cancer Education.
Tunia Gil Hernández
Full Text Available This article analyzes the historical evolution of the Cuban medical publications over time, from its appearance in print to the digital age. Reference is made to the first forms of scientific communication in the world, the advent of printing in America and the historical and social events that favored the birth and development of printed publications on the island of Cuba, as well as its development in the digital age.
Texas Higher Education Coordinating Board, 2009
All public institutions of higher education except community colleges and the Texas A&M University System College of Dentistry receive funding for construction and other capital purposes from the Permanent University Fund (PUF) or the Higher Education Fund (HEF) (sometimes referred to as the Higher Education Assistance Fund or HEAF). The…
Full Text Available Abstract Background An ongoing evaluation system is essential to determine if the academic system in place has worked to produce a better product, hence the objective of our study was to evaluate the satisfaction level among medical students regarding their academic teaching and assessment method and what measures will they suggest for the future to rectify the current situation. This questionnaire based cross sectional study was conducted in a public sector medical university from February to July 2010. A well structured questionnaire was administered to a random sample of 375 final year medical students. However 292 of the students provided informed consent and filled in the questionnaire which included their demographic profile as well as questions in line with the study objective. Data was entered in a Statistical Package for Social Sciences (SPSS version.16 and analyzed using descriptive statistics. Findings The male to female ratio in our study was 1:2. Most of the students (57.2% were dissatisfied with the quality of teaching in the university. Fifty-seven percent of the participants believed that the current standard of their institute were not at par with those of international medical universities. BCQ's were the mode of examination questions preferred by the majority of the students. Most of the students (66.1% wanted the university to conduct career planning seminars to help them plan their career. Conclusions These results suggest that the students of public sector medical universities are unsatisfied from current academic facilities and teaching activities. Students recommend increased emphasis on better lectures and practical training as well as a need to incorporate career planning sessions for the students to help plan them their future career paths.
Riegelman, Richard K; Garr, David R
The Institute of Medicine has recommended that all undergraduates have access to public health education. An evidence-based public health framework including curricula such as "Public Health 101" and "Epidemiology 101" was recommended for all colleges and universities by arts and sciences, public health, and clinical health professions educators as part of the Consensus Conference on Undergraduate Public Health Education. These courses should foster critical thinking whereby students learn to broadly frame options, critically analyze data, and understand the uncertainties that remain. College-level competencies or learning outcomes in research literature reading, determinants of health, basic understanding of health care systems, and the synergies between health care and public health can provide preparation for medical education. Formally tested competencies could substitute for a growing list of prerequisite courses. Grounded in principles similar to those of evidence-based medicine, evidence-based public health includes problem description, causation, evidence-based recommendations for intervention, and implementation considering key issues of when, who, and how to intervene. Curriculum frameworks for structuring "Public Health 101" and "Epidemiology 101" are provided by the Consensus Conference that lay the foundation for teaching evidence-based public health as well as evidence-based medicine. Medical school preparation based on this foundation should enable the Clinical Prevention and Population Health Curriculum Framework, including the evidence base for practice and health systems and health policy, to be fully integrated into the four years of medical school. A faculty development program, curriculum guide, interest group, and clear student interest are facilitating rapid acceptance of the need for these curricula.
Background In recent years, there has been a massive growth in the private medical education sector in South Asia. India’s large private medical education sector reflects the market driven growth in private medical education. Admission criteria to public medical schools are based on qualifying examination scores, while admission into private institutions is often dependent on relative academic merit, but also very much on the ability of the student to afford the education. This paper from Madhya Pradesh province in India aims to study and compare between first year medical students in public and private sector medical schools (i) motives for choosing a medical education (ii) career aspirations on completion of a medical degree (iii) willingness to work in a rural area in the short and long terms. Methods Cross sectional survey of 792 first year medical students in 5 public and 4 private medical schools in the province. Results There were no significant differences in the background characteristics of students in public and private medical schools. Reasons for entering medical education included personal ambition (23%), parental desire (23%), prestigious/secure profession (25%) or a service motive (20%). Most students wished to pursue a specialization (91%) and work in urban areas (64%) of the country. A small proportion (7%) wished to work abroad. There were no differences in motives or career aspirations between students of public or private schools. 40% were willing to work in a rural area for 2 years after graduating; public school students were more willing to do so. Conclusion There was little difference in background characteristics, motives for entering medicine or career aspirations between medical students in from public and private sector institutions. PMID:24034988
Diwan, Vishal; Minj, Christie; Chhari, Neeraj; De Costa, Ayesha
In recent years, there has been a massive growth in the private medical education sector in South Asia. India's large private medical education sector reflects the market driven growth in private medical education. Admission criteria to public medical schools are based on qualifying examination scores, while admission into private institutions is often dependent on relative academic merit, but also very much on the ability of the student to afford the education. This paper from Madhya Pradesh province in India aims to study and compare between first year medical students in public and private sector medical schools (i) motives for choosing a medical education (ii) career aspirations on completion of a medical degree (iii) willingness to work in a rural area in the short and long terms. Cross sectional survey of 792 first year medical students in 5 public and 4 private medical schools in the province. There were no significant differences in the background characteristics of students in public and private medical schools. Reasons for entering medical education included personal ambition (23%), parental desire (23%), prestigious/secure profession (25%) or a service motive (20%). Most students wished to pursue a specialization (91%) and work in urban areas (64%) of the country. A small proportion (7%) wished to work abroad. There were no differences in motives or career aspirations between students of public or private schools. 40% were willing to work in a rural area for 2 years after graduating; public school students were more willing to do so. There was little difference in background characteristics, motives for entering medicine or career aspirations between medical students in from public and private sector institutions.
... actions and alternatives were evaluated within several environmental resource areas: Geology, topography... Department of the Navy Notice of Public Hearings for the Draft Environmental Impact Statement for Medical... Environmental Policy Act (NEPA) and the Council on Environmental Quality Regulations for implementing the...
... workshop will be held at the Rockville Hilton Hotel, 1750 Rockville Pike, Rockville, MD 20852. Contact...) leveraging new technologies to develop pediatric medical countermeasures; and (4) risk communication related... at the cost of 10 cents per page. A transcript of the public workshop will be available on the...
Sumner, Walton, II; Schootman, Mario; Asaro, Philip; Yan, Yan; Hagen, Michael D.
Introduction: Medical education topics might be locally prioritized using public health data on health outcomes and risk factors unrelated to quality of care. Methods: The Missouri Information for Community Assessment (MICA) supplied preventable hospitalization rates (PHRs) for asthma, chronic obstructive pulmonary disease (COPD), diabetes, heart…
Frasca, Dominic R
The Secretary of the Department of Health and Human Services (HHS), through the Office of the Assistant Secretary for Preparedness and Response (ASPR), coordinates federal Emergency Support Function (ESF) #8 preparedness, response, and recovery actions. To address these needs, the ASPR can draw on trained personnel from a variety of sources, both from within and outside HHS. Among the resources under the domain of HHS is the Medical Reserve Corps (MRC), directed by the Office of the Civilian Volunteer Medical Reserve Corps (OCVMRC) in the Office of the Surgeon General. MRC units are community based and function as a way to locally organize and utilize medical and public health professionals, such as physicians, nurses, pharmacists, dentists, veterinarians, and epidemiologists. Nonclinical volunteers, such as interpreters, chaplains, office workers, legal advisors, and others, can fill logistical and support roles in MRC units. This article discusses locally controlled (Hurricanes Gustav and Ike) and federalized (Hurricanes Katrina and Rita) MRC activations, and it describes the advantages of using medical volunteers in a large-scale disaster response setting.
Kamarudin, M. K.; Yahya, Z.; Harun, R.; Jaapar, A.
In Malaysia, the government agencies that handle the management of historical buildings are finding themselves facing a shortage of funds to provide the necessary work on digitalising management works. Due to the rising cost of management, which also covers maintenance and infrastructure works, there is a need for a paradigm shift from public sector to private sector provision on infrastructure and management works. Therefore the government agencies need to find the suitable mechanism to encourage private sector especially the private property and developers to take part in it. This scenario has encouraged the authorities to look new ways of entering into partnership and collaboration with the private sector to secure the continuity of provision and funding. The paper first reviews the different approach to facilitate off-site local management system of historical buildings and then examines options for both private and public funding in digitalising the historical buildings management works by interviewing government officer, conservator and member of nongovernment agencies. It then explores how the current system of management may adopt the shift to avoid any vulnerability and threat to the existing historical buildings. This paper concludes with a short summary of key issues in management works of historical buildings and recommendations.
Full Text Available Tolling is an age long revenue collection system institutionalised by public authorities for accumulating funds required for roads and bridges construction, maintenance and management. In spite of the merits of tolling as a major source of revenue in Nigeria, it was abruptly abrogated by the government few years ago because of reasons linked to ineffective governance, endemic corruption and lack of probity. The purpose of this paper is to make a case for responsible investment as an alternative funding mechanism for roads-bridges management (RBM in Nigeria under a Public-Private Partnership (PPP framework. The paper adopts a discursive approach, relying on government policy documents, journal articles, online resources, working papers and reports on tolling best practices. The numerical and non-numerical data were critically analysed using content analysis enriched by tables and figures. The first finding indicates there are enormous potentials in tolls collection from privately funded roads and bridges for responsible investors in Nigeria under the PPP framework. The second finding identifies eight (8 PPP typologies that could be explored by investors under government’s new tolling policy. The paper concludes that the success of any tolls collection systems depend largely on effectiveness of governance, probity and accountability, which are core elements of responsible investment in the contemporary times
Wells, Rebecca; Cilenti, Dorothy; Issel, L Michele
Throughout the United States, public health leaders are experimenting with how best to integrate services for individuals with complex needs. To that end, North Carolina implemented a policy incorporating both local public health departments and other providers into medical homes for low income pregnant women and young children at risk of developmental delays. To understand how this transition occurred within local communities, a pre-post comparative case study was conducted. A total of 42 people in four local health departments across the state were interviewed immediately before the 2011 policy change and six months later: 32 professionals (24 twice) and 10 pregnant women receiving case management at the time of the policy implementation. We used constant comparative analysis of interview and supplemental data to identify three key consequences of the policy implementation. One, having medical homes increased the centrality of other providers relative to local health departments. Two, a shift from focusing on personal relationships toward medical efficiency diverged in some respects from both case managers' and mothers' goals. Three, health department staff re-interpreted state policies to fit their public health values. Using a political economy perspective, these changes are interpreted as reflecting shifts in public health's broader ideological environment. To a large extent, the state successfully induced more connection between health department-based case managers and external providers. However, limited provider engagement may constrain the implementation of the envisioned medical homes. The increased focus on medical risk may also undermine health departments' role in supporting health over time by attenuating staff relationships with mothers. This study helps clarify how state public health policy innovations unfold at local levels, and why front line practice may in some respects diverge from policy intent.
Full Text Available Providing a perfect instruction to authors can prevent most potential publication ethics errors. This study was conducted to determine the quality of ethical considerations in the instructions to the authors of Iranian research scientific journals of medical sciences (accredited by the Commission for Accreditation and Improvement of Iranian Medical Journals in October 2011. Checklist items (n=15 were extracted from the national manual of ethics in medical research publications, and the validity of the manual of ethics was assessed. All the accredited Iranian journals of medical sciences (n=198 were entered into the study. The instructions to the authors of 160 accredited Iranian journals were available online and were reviewed. The ANOVA and Kendall Correlation coefficient were performed to analyze the results. A total of 76 (47.5% of the 160 journals were in English and 84 (52.5% were in Farsi. The most frequently mentioned items related to publication ethics comprised “commitment not to send manuscripts to other journals and re-publish manuscripts” (85%, 83.8%, “aim and scope” of the journal (81.9%, “principles of medical ethics in the use of human samples” (74.4%, and “review process” (74.4%. On the other hand, the items of “principles of advertising” (1.2%, “authorship criteria” (15%, and “integrity in publication of clinical trial results” (30.6% were the least frequently mentioned ones. Based on the study findings, the quality of publication ethics, as instructed to the authors, can improve the quality of the journals.
When veteran educator Dr. N. Joyce Payne handed the reins of the organization she founded, the Thurgood Marshall College Fund, to entertainment lawyer and board member Johnny Taylor, Taylor began pursuing a remake of the prestigious group that has turned it on its head in just a matter of months. Today, with just more than a year of leading the…
Courtois, Cedric; Ongena, Guido; Cannie, Hannes
Traditionally, the debate regarding PSB funding consists of a division between culture and commerce. This discussion has been amplified by the recent trend of digitisation. Yet, this evolution’s reach stretches beyond the application of supplementary platforms and channels. In line with the digitisa
Wiesmüller, G A; Etschenberg, W; Koch, T; Konteye, C; Zahmel, J
Since November, 1999 environmental medical advice is offered to interested citizens in the Aachen district at the District Aachen Public Health Office in cooperation with the outpatient unit of environmental medicine (UEM) of the Institute of Hygiene and Environmental Medicine of the University Hospital at Aachen, Germany. Advisory cases are documented in a data bank of Microsoft(R) Access 97. Until now, all advisory cases between November, 1999 and March, 2001 have been descriptively analysed. In this period, 34 personal and two telephonic advices were performed. The frequency of advisory activities is in the lower rang of published experiences in environmental medicine. Age distribution, more frequent advice utilization by women than by men and predominance of unspecific health disorders are comparable with published environmental medical experiences. However, in respect of suspected exposures, unspecific indoor-related environmental factors are predominant. In the past this was true for wood preservatives. Judgement about possible relationships between suspected environmental factors and health disorders or diseases was positive among 11.8 % of the persons seeking advice. This percentage is higher than published experiences which mostly show values below 10 %. It must be considered that this judgement depends primarily on the physician. Other reasons may be the too small number of advice seeking persons and selective influences. Furthermore, a definite judgement can be made only after environmental medical diagnostics (biological monitoring, local inspection, ambient monitoring) and differential diagnostics. Conspicuously, 76.5 % of the advisory cases had no contact to environmental medicine prior to the environmental medical advice at the Aachen District Public Health Office. This points to an information deficit about possibilities to clarify questions concerning environmental medicine in the population. In this context a regional guide on environmental
Beidas, Rinad S; Stewart, Rebecca E; Adams, Danielle R; Fernandez, Tara; Lustbader, Susanna; Powell, Byron J; Aarons, Gregory A; Hoagwood, Kimberly E; Evans, Arthur C; Hurford, Matthew O; Rubin, Ronnie; Hadley, Trevor; Mandell, David S; Barg, Frances K
Our goal was to identify barriers and facilitators to the implementation of evidence-based practices from the perspectives of multiple stakeholders in a large publicly funded mental health system. We completed 56 interviews with three stakeholder groups: treatment developers (n = 7), agency administrators (n = 33), and system leadership (n = 16). The three stakeholder groups converged on the importance of inner (e.g., agency competing resources and demands, therapist educational background) and outer context (e.g., funding) factors as barriers to implementation. Potential threats to implementation and sustainability included the fiscal landscape of community mental health clinics and an evolving workforce. Intervention characteristics were rarely endorsed as barriers. Inner context, outer context, and intervention characteristics were all seen as important facilitators. All stakeholders endorsed the importance of coordinated collaboration across stakeholder groups within the system to successfully implement evidence-based practices.
Beidas, Rinad S; Marcus, Steven; Wolk, Courtney Benjamin; Powell, Byron; Aarons, Gregory A; Evans, Arthur C; Hurford, Matthew O; Hadley, Trevor; Adams, Danielle R; Walsh, Lucia M; Babbar, Shaili; Barg, Frances; Mandell, David S
Staff turnover rates in publicly-funded mental health settings are high. We investigated staff and organizational predictors of turnover in a sample of individuals working in an urban public mental health system that has engaged in a system-level effort to implement evidence-based practices. Additionally, we interviewed staff to understand reasons for turnover. Greater staff burnout predicted increased turnover, more openness toward new practices predicted retention, and more professional recognition predicted increased turnover. Staff reported leaving their organizations because of personal, organizational, and financial reasons; just over half of staff that left their organization stayed in the public mental health sector. Implications include an imperative to focus on turnover, with a particular emphasis on ameliorating staff burnout.
Marcus, Steven; Wolk, Courtney Benjamin; Powell, Byron; Aarons, Gregory A.; Evans, Arthur C.; Hurford, Matthew O.; Hadley, Trevor; Adams, Danielle R.; Walsh, Lucia M.; Babbar, Shaili; Barg, Frances; Mandell, David S.
Staff turnover rates in publicly-funded mental health settings are high. We investigated staff and organizational predictors of turnover in a sample of individuals working in an urban public mental health system that has engaged in a system-level effort to implement evidence-based practices. Additionally, we interviewed staff to understand reasons for turnover. Greater staff burnout predicted increased turnover, more openness toward new practices predicted retention, and more professional recognition predicted increased turnover. Staff reported leaving their organizations because of personal, organizational, and financial reasons; just over half of staff that left their organization stayed in the public mental health sector. Implications include an imperative to focus on turnover, with a particular emphasis on ameliorating staff burnout. PMID:26179469
Background/Aims The cost of caring for patients with inflammatory bowel disease (IBD) is high. Without government support, the cost burden will unavoidably rest on the patients and their family. However, the government providing full support will place a large financial burden on the health-care systems of a country. The aim of this study is to understand the current status of public medical insurance systems in caring for IBD patients among Asian countries. Methods Questionnaires inquiring about the availability of public health systems; medical, diagnostic, and endoscopy costs; and coverage rate of biologics use were designed and sent to IBD experts in each of the Asian countries studied. The results were summarized according to the feedback from the responders. Results The public health insurance coverage rate is high in Taiwan, Japan, South Korea, China, Hong Kong, and Singapore; but low in Malaysia and India. This probably affected the use of expensive medications mostly, such as biologics, as we found that the percentage of Crohn's disease (CD) treated with biologics were as high as 30%–40% in Japan, where the government covers all expenses for IBD patients. In India, the percentage maybe as low as 1% for CD patients, most of whom need to pay for the biologics themselves. Conclusions There were differences in the public health insurance systems among the Asian countries studied. This reportprovidesthe background information to understand the differences in the treatment of IBD patients among Asian countries. PMID:27433143
Zhang, Luying; Cheng, Xiaoming; Liu, Xiaoyun; Zhu, Kun; Tang, Shenglan; Bogg, Lennart; Dobberschuetz, Karin; Tolhurst, Rachel
In recent years, the central government in China has been leading the re-establishment of its rural health insurance system, but local government institutions have considerable flexibility in the specific design and management of schemes. Maintaining a reasonable balance of funds is critical to ensure that the schemes are sustainable and effective in offering financial protection to members. This paper explores the financial management of the NCMS in China through a case study of the balance of funds and the factors influencing this, in six counties in two Chinese provinces. The main data source is NCMS management data from each county from 2003 to 2005, supplemented by: a household questionnaire survey, qualitative interviews and focus group discussions with all local stakeholders and policy document analysis. The study found that five out of six counties held a large fund surplus, whilst enrolees obtained only partial financial protection. However, in one county greater risk pooling for enrolees was accompanied by relatively high utilisation levels, resulting in a fund deficit. The opportunities to sustainably increase the financial protection offered to NCMS enrolees are limited by the financial pressures on local government, specific political incentives and low technical capacities at the county level and below. Our analysis suggests that in the short term, efforts should be made to improve the management of the current NCMS design, which should be supported through capacity building for NCMS offices. However, further medium-term initiatives may be required including changes to the design of the schemes. Copyright (c) 2009 John Wiley & Sons, Ltd.
Vitor Laerte Pinto Junior
Full Text Available Health surveillance (HS is one of the key components of the Brazilian Unified Health System (SUS. This article describes recent changes in health surveillance funding models and the role these changes have had in the reorganization and decentralization of health actions. Federal law no. 8.080 of 1990 defined health surveillance as a fundamental pillar of the SUS, and an exclusive fund with equitable distribution criteria was created in the Basic Operational Norm of 1996 to pay for health surveillance actions. This step facilitated the decentralization of health care at the municipal level, giving local authorities autonomy to plan and provide services. The Health Pact of 2006 and its regulation under federal decree No. 3252 in 2009 bolstered the processes of decentralization, regionalization and integration of health care. Further changes in the basic concepts of health surveillance around the world and in the funding policies negotiated by different spheres of government in Brazil have been catalysts for the process of HS institutionalization in recent years.
... ``Global Quality Systems--An Integrated Approach to Improving Medical Product Safety.'' This 2-day public... HUMAN SERVICES Food and Drug Administration Global Quality Systems--An Integrated Approach To Improving Medical Product Safety; Public Workshop AGENCY: Food and Drug Administration, HHS. ACTION: Notice of...
Full Text Available Background: The thesis is an integral part of postgraduate medical education in India. Publication of the results of the thesis in an indexed journal is desirable; it validates the research and makes results available to researchers worldwide. Aims: To determine publication rates in indexed journals, of works derived from theses, and factors affecting publication. Settings and Design: Postgraduate theses submitted over a five-year period (2001-05 in a university medical college were analyzed in a retrospective, observational study. Materials and Methods: Data retrieved included name and gender of postgraduate student, names, department and hierarchy of supervisor and co-supervisor(s, year submitted, study design, sample size, and statistically significant difference between groups. To determine subsequent publication in an indexed journal, Medline search was performed up to December 2007. Statistical Analysis: Chi square test was used to compare publication rates based on categorical variables; Student′s t-test was used to compare differences based on continuous variables. Results: One hundred and sixty theses were retrieved, forty-eight (30% were published. Papers were published 8-74 (33.7 ± 17.33 months after thesis submission; the postgraduate student was first author in papers from 26 (54% of the published theses. Gender of the student, department of origin, year of thesis submission, hierarchy of the supervisor, number and department of co-supervisors, and thesis characteristics did not influence publication rates. Conclusions: Rate of publication in indexed journals, of papers derived from postgraduate theses is 30%. In this study we were unable to identify factors that promote publication.
Egypt's medical tourism industry has been experiencing tremendous growth. However, Egypt continues to lack the necessary investment in its public health system to effectively care for its population. Current policy and the emergence of medical tourism have led to unequal health care access, resulting in high a prevalence of infectious diseases and lack of resources for its most vulnerable populations. As a new Egyptian government emerges, it is important for policymakers to understand the critical issues and ethical concerns of existing health policy. This understanding may be used to propose new policy that more effectively allocates to care for Egypt's population.
Tan, Ngiap Chuan; Mitesh, Shah; Koh, Yi Ling Eileen; Ang, Seng Bin; Chan, Hian Hui Vincent; How, Choon How; Tay, Ee Guan; Hwang, Siew Wai
INTRODUCTION It is uncommon for medical students to deliver public health talks as part of their medical education curriculum. This study evaluated the effectiveness of a novel training programme that required medical students to deliver public health talks during their family medicine (FM) clerkship in a Singapore primary care institution. METHODS The FM faculty staff guided teams of third-year medical students to select appropriate topics for health talks that were to be conducted at designated polyclinics. The talks were video-recorded and appraised for clarity, content and delivery. The appraisal was done by the student’s peers and assigned faculty staff. The audience was surveyed to determine their satisfaction level and understanding of the talks. The students also self-rated the effectiveness of this new teaching activity. RESULTS A total of 120 medical students completed a questionnaire to rate the effectiveness of the new teaching activity. 85.8% of the students felt confident about the delivery of their talks, 95.8% reported having learnt how to deliver talks and 92.5% perceived this new training modality as useful in their medical education. Based on the results of the audience survey, the speakers were perceived as knowledgeable (53.1%), confident (51.3%) and professional (39.0%). Assessment of 15 video-recorded talks showed satisfactory delivery of the talks by the students. CONCLUSION The majority of the students reported a favourable overall learning experience under this new training programme. This finding is supported by the positive feedback garnered from the audience, peers of the medical students and the faculty staff. PMID:26891745
Mitrakrishnan Rayno Navinan
Full Text Available Background: The Faculty of Medicine, University of Colombo, has an integrated curriculum in which teaching of public health takes place through a series of modules which span the full five-year study programme. Aim: To assess final year medical student perceptions regarding the public health curriculum and to identify factors which influence this. Materials and Methods: The study was cross sectional. Convenience sampling was utilized on final-year students of the Faculty of Medicine, University of Colombo, Sri Lanka. A self-administered 4-point Likert scale questionnaire covered general opinion on public healthcare and perceptions about the curriculum. Data were analyzed using descriptive statistics and Chi-square tests. Results: One hundred and eighty four students (94% participated in the study. Eighty-two percent (148 viewed public health as an important field. Only 9% (16 were interested in a career in public health. A significant association was found between choosing public health as career and the following: perception of public health as an important field; holding a good opinion about public health prior to commencement of the course; having found the field-based experience enjoyable and beneficial to the community; and feeling competent to work in the community at the end of the course (P < 0.01. With regard to teaching methods, group activities and discussion-centered activities were identified positively (153, 83% and 125, 68% respectively. The majority of students indicated that they were not stimulated to read more on the subject or regularly revise what they have learnt, both during the introductory public health programme and during the final year. Conclusions: The curriculum has been able to create a positive opinion about public health. However, students lack enthusiasm to learn independently. Experiential, group-centered teaching activities and a constructivist approach may be more effective in promoting independent learning
Verstegen, Deborah A.
This research investigates state finance policies for public education using survey methodology. The purpose is to update previous work and the existing knowledge base in the field as well as to provide a compendium of finance and policy options that are used across the states to finance public elementary and secondary schools. Chief state school…
In order to effectively prevent corruption, Ministry of Finance issued Norms for Internal Control in Public Institutions (trial version). Currency funds, as the key aspect of internal control, are the assets with the strongest mobility and highest risk. Meanwhile, it's the key aspect which gives rise to violations such as corruption. Therefore, to improve the system of internal control of currency funds and to strengthen internal control for key aspects are quite important for reducing payment risks and guaranteeing currency funds safe and sound.%为有效防范舞弊和预防腐败，财政部颁发了《行政事业单位内部控制规范（试行）》。作为内部控制的关键环节--货币资金是单位流动性最强、控制风险最高的资产，也是最容易出现贪污等违法行为的重点领域。因此，建立健全单位货币资金内部控制制度，加强关键环节内控管理，对降低支付风险，保证货币资金的安全、完整尤为重要。
Ebi, Kristie L; Balbus, John; Kinney, Patrick L; Lipp, Erin; Mills, David; O'Neill, Marie S; Wilson, Mark L
The need to identify and try to prevent adverse health impacts of climate change has risen to the forefront of climate change policy debates and become a top priority of the public health community. Given the observed and projected changes in climate and weather patterns, their current and anticipated health impacts, and the significant degree of regulatory discussion underway in the U.S. government, it is reasonable to determine the extent of federal investment in research to understand, avoid, prepare for, and respond to the human health impacts of climate change in the United States. In this commentary we summarize the health risks of climate change in the United States and examine the extent of federal funding devoted to understanding, avoiding, preparing for, and responding to the human health risks of climate change. Future climate change is projected to exacerbate various current health problems, including heat-related mortality, diarrheal diseases, and diseases associated with exposure to ozone and aeroallergens. Demographic trends and geophysical and socioeconomic factors could increase overall vulnerability. Despite these risks, extramural federal funding of climate change and health research is estimated to be climate change poses for U.S. populations, the National Institutes of Health, Centers for Disease Control and Prevention, U.S. Environmental Protection Agency, and other agencies need to have robust intramural and extramural programs, with funding of > $200 million annually. Oversight of the size and priorities of these programs could be provided by a standing committee within the National Academy of Sciences.
This paper traces the integration of human genetics with Soviet public health science after the Lysenko era. For nearly three decades, USSR biology pursued its own version of anti-bourgeois, Soviet 'creative Darwinism', departing from western, post-WWII scientific developments. After Lysenko was suspended, research niches of immunology, biophysics and mutation research formed the basis of new departments at the Institute of Medical Genetics, which was founded in 1969 as part of the Soviet Academy of Medical Sciences. Focussing on early research activities and collaborations at the institute, I show how the concept of mutagenesis, a pivotal issue during the Cold War, became mobilized from Drosophila genetics to human heredity and to society as a whole. This mode of scaling up and down through population studies shaped not only Soviet human biology and genetics; it also brought about changes in clinical practice and public health as well as in the monitoring and regulation of mutagenic agents in the environment.
Han, M C; Lee, C S
To identify where the quality research activity has been and is carried out in Korea, and to examine to what extents Korean medical colleges play leading roles in the production of international research papers, we investigated the publication productivity of Korean medical colleges and their medical departments as measured by the number of papers published in foreign journals indexed in MEDLINE. The 12-year period from 1988 to 1999 is covered. A total of 4,881 papers is published in MEDLINE foreign journals by the researchers in Korean medical colleges during the period. The production of MEDLINE papers are concentrated in a few universities. More than 60% of MEDLINE foreign journal papers is published by top five universities 25% by Seoul National University, and 15% by Yonsei University. The newly established medical colleges at the University of Ulsan and Sungkyunkwan University produced outstanding numbers of papers in less than ten years. Radiology has led the internationalization of Korean medical papers. It was the most productive specialty identified in this study. The productivity of Internal medicine is on the rise from the mid-1 990s, and the field began to produce the most number of papers since then.
Verghini, Emanuele; Di Pietro, Maria Luisa; Virdis, Andrea; De Luca, Daniele
A case of congenital rubella syndrome has been the reason to seek damages but a Civil Court of Rome sentenced against this and in favor of sued doctors. We discussed the high level of social attention and the feeling present in our western culture behind the request for damages. Legal considerations above the Italian abortion Law is provided to understand the framework of the court decision. Ethical, medical, and public health issues are commented and compared with the Perruche's case.
Yergens, D W; Tam-Tham, H; Minty, E P
The last 25 years have been a period of innovation in the area of medical informatics. The International Medical Informatics Association (IMIA) has published, every year for the last quarter century, the Yearbook of Medical Informatics, collating selected papers from various journals in an attempt to provide a summary of the academic medical informatics literature. The objective of this paper is to visualize the evolution of the medical informatics field over the last 25 years according to the frequency of word occurrences in the papers published in the IMIA Yearbook of Medical Informatics. A literature review was conducted examining the IMIA Yearbook of Medical Informatics between 1992 and 2015. These references were collated into a reference manager application to examine the literature using keyword searches, word clouds, and topic clustering. The data was considered in its entirety, as well as segregated into 3 time periods to examine the evolution of main trends over time. Several methods were used, including word clouds, cluster maps, and custom developed web-based information dashboards. The literature search resulted in a total of 1210 references published in the Yearbook, of which 213 references were excluded, resulting in 997 references for visualization. Overall, we found that publications were more technical and methods-oriented between 1992 and 1999; more clinically and patient-oriented between 2000 and 2009; and noted the emergence of "big data", decision support, and global health in the past decade between 2010 and 2015. Dashboards were additionally created to show individual reference data, as well as, aggregated information. Medical informatics is a vast and expanding area with new methods and technologies being researched, implemented, and evaluated. Determining visualization approaches that enhance our understanding of literature is an active area of research, and like medical informatics, is constantly evolving as new software and algorithms
Garavelli, E; Marcantoni, C; Costantino, C; Tedesco, D; Burrai, V; Giraldi, G; D'Andrea, E
The postgraduate medical Schools in Public Health (locally known as School of Hygiene and Preventive Medicine) should ensure adequate scientific and technical knowledge and professional skills in preventive medicine, health promotion and healthcare planning as provided by Ministerial Decree 285/2005. The Italian Committee of Medical Residents in Hygiene, Preventive Medicine and Public Health of the Italian Society of Hygiene, Public Health and Preventive Medicine - S.It.I. (Consulta Nazionale dei medici in formazione specialistica S.It.I.) has always been engaged in monitoring activities on public health teaching, guaranteeing the homogeneity of educational proposals among all national Schools in Public Health. The purpose of this study is to provide a 'snapshot' of public health education and training in Italy and to identify the improvement actions needed for implementing an innovative and homogeneous public health training. A cross-sectional study was carried out over a period of three months (March to May 2013). A self-administered questionnaire was e-mailed to local Committee's delegates of all 32 postgraduate medical Schools in Public Health in Italy. The questionnaire was structured in four sections: general information, University education and training, extra-University training, interdisciplinary activities. The majority of local Committee's delegates have agreed to be enrolled in the survey. A total of 28 questionnaires were returned (88% response rate). The number of residents in each Italian School in Public Health ranged from 7 to 31. The distribution of professors in relation to residents is not similar for each University Schools. The ratio professors/residents spanning from 0.2 to 2. About teaching, only 4 University Schools offered all courses requested by Ministerial Decree 285/2005. Most of them offered at least 75% of the requested courses, but there were Schools in which the courses were less than 50%. The vast majority of schools held more
Cascón-Pereira, Rosalía; Kirkpatrick, Ian; Exworthy, Mark
This article aims to assess if the status of the medical profession has been reinforced or weakened with the new public management. With this purpose, it collects the opinion of two international experts regarding situation in the United Kingdom, in order to apply some lessons to the Spanish case. Both agree that, far from losing status and power with the healthcare reform, the medical profession has protected its status and autonomy against other social agents such as managers, politicians and patients. However, the maintenance of the status quo has been at the expense of an intra-professional stratification that has caused status inequalities linked to social class within the medical profession. Copyright © 2016 SESPAS. All rights reserved.
公共产品理论、外部性理论、高等教育成本分担理论、公平性理论等经济学、管理学基本理论从必要性、合理性、合法性等方面为公共财政资助民办高等教育提供了较为充分的理论依据，但出于技术上的、战略上的、观念上的种种原因，至今仍存在着诸多对公共财政资助民办高等教育必要性和合理性的质疑与反对。尽管目前针对公共财政资助民办高等教育的政策讨论还存在不可避免的反对意见，但公共财政的使命和民办高等教育的属性已经充分说明了公共财政资助民办高等教育的必要性与正当性，那些关于公共财政不应当资助民办高等教育的种种理由都是站不住脚的。%The basic theories in economics and management such as public goods theory, externality theory, cost sharing theory of higher education, equity theory provide sufficient theoretical basis for the necessity, rationality and legitimacy of private higher education funded by public finance. But for technical, strategic, ideological reasons, there are still a lot of controversies against its necessity and rationality. Although, there are inevitable oppositions in current policy discussions, the mission of public finance and the property of private higher education have fully demonstrated the necessity and legitimacy of private higher education funded by public finance, and those various reasons that public finance should not fund private higher education are untenable.
Stark, James F
Although historians have shown that there has been a complex and multi-layered relationship between the body, medicine and the force of electricity, many avenues remain to be explored. One of the most prominent of these is the way in which electrotherapy technologies were marketed to a wide variety of different end users and intermediaries. This paper offers the first historical analysis of one such device - the Overbeck Rejuvenator - a 1920s electrotherapy machine designed for use by the general public. Its inventor, Otto Overbeck, was not a medical man and this enabled him to use aggressive strategies of newspaper advertising, using testimonials to market his product alongside appeals to his own scientific authority. He commissioned the prestigious Ediswan Company to manufacture the Rejuvenator on a large scale, and took out patents in eleven countries to persuade users of the efficacy of the device. In response to Overbeck's activities, the British Medical Association enlisted an electrical engineer to examine the Rejuvenator, contacted practitioners whose endorsements were being used in publicity material, and denied Overbeck permission to advertise in the British Medical Journal. Despite this, the Rejuvenator brought its inventor wealth and notoriety, and helped redefine the concept of 'rejuvenation', even if the professional reception of such a device was almost universally hostile. This paper shows how the marketing, patenting and publishing of Overbeck combined to persuade members of the laity to try the Rejuvenator as an alternative form of therapy, bypassing the medical profession in the process.
Oliver, L D
The Australasian Physical & Engineering Sciences in Medicine Journal (APESM) is an avenue for the profession to report scientific work in medicine; provide a facility for the publication of current work, new research and new techniques developed or reviewed; report on professional news from elsewhere and; publish the Australasian College of Physical Scientists and Engineers in Medicine (ACPSEM) policies and protocols. The journal is a vital instrument within the ACPSEM organisation with a worldwide circulation. This review of APESM on medical physics in radiation oncology is meant to be a progress summary of work in that specialty. Even so, it has become a lengthy appraisal due to the many years involved. In considering publications related to medical physics in radiation oncology, this review has shown the progression of the College journal to an international journal. There is an increase in the number of papers contributed from Asia and other countries world wide for this discipline. Growth in the number of contributions should continue to rise. In order to provide some appreciation of where the present medical physics activity arose from, this article commences its discussion in 1959 and progresses towards the present, describing along the way, from radiation oncology papers published in APESM, the use of linear accelerators, brachytherapy, the medical physics workforce, the formation of the ACPSEM, and the more modern developments in radiotherapy such as 3-D treatment planning and IMRT.
Full Text Available Background: To prevent medication errors in prescribing, one needs to know their types and relative occurrence. Such errors are a great cause of concern as they have the potential to cause patient harm. The aim of this study was to determine the nature and types of medication prescribing errors in an Indian setting.Methods: The medication errors were analyzed in a prospective observational study conducted in 3 medical wards of a public teaching hospital in India. The medication errors were analyzed by means of Micromedex Drug-Reax database.Results: Out of 312 patients, only 304 were included in the study. Of the 304 cases, 103 (34% cases had at least one error. The total number of errors found was 157. The drug-drug interactions were the most frequently (68.2% occurring type of error, which was followed by incorrect dosing interval (12% and dosing errors (9.5%. The medication classes involved most were antimicrobial agents (29.4%, cardiovascular agents (15.4%, GI agents (8.6% and CNS agents (8.2%. The moderate errors contributed maximum (61.8% to the total errors when compared to the major (25.5% and minor (12.7% errors. The results showed that the number of errors increases with age and number of medicines prescribed.Conclusion: The results point to the establishment of medication error reporting at each hospital and to share the data with other hospitals. The role of clinical pharmacist in this situation appears to be a strong intervention; and the clinical pharmacist, initially, could confine to identification of the medication errors.
Purcărea, V L; Coculescu, B I; Coculescu, E C
During the transition period, the Romanian medical system, subject (like other areas) to a process of reform, had to go through a difficult path, not without obstacles (malpractice, underfunding, embezzlement scandals in the media etc.). Consequently, Romania has faced (and unfortunately still is still facing) the massive exodus of health professionals to countries where they can benefit from better working conditions and payment, and those who suffer from health care crisis are the patients. Reform means "the people in the system for the people", which requires a change of mindset within the medical staff, especially in the continuous professional development. However, to talk about the quality of the medical act requires that all those involved in the medical system should create appropriate conditions - i.e. advanced technical equipment and appropriate salaries. In addition, as underfunding is the main cause of failure in the health system, that management remains the only tool that can lead to the appropriate use of the existing resources and the quality of health services. Therefore, the idea of public-private partnership - which occurred as a challenge, especially after the EU accession - can be considered a solution designed to improve the quality and cost of health services. In other words, the cooperation of the private sector with the public authority means increasing the rigor of the medical equipment performance, fostering professional competition, and an increased attention to the patient, in a word: performance. Currently, more and more frequently, the management has studied to identify opportunities for innovation in health care services in an attempt to bring together patients and practitioners in the field by resorting to the identification of the ways they can receive health care services promptly, fairly and efficiently. Therefore, a clear and responsible design in the spirit of ethics and medical ethic will help the marketing manager solve many
Field, Karl; Bailey, Michele; Foresman, Larry L; Harris, Robert L; Motzel, Sherri L; Rockar, Richard A; Ruble, Gaye; Suckow, Mark A
Medical records are considered to be a key element of a program of adequate veterinary care for animals used in research, teaching, and testing. However, prior to the release of the public statement on medical records by the American College of Laboratory Animal Medicine (ACLAM), the guidance that was available on the form and content of medical records used for the research setting was not consistent and, in some cases, was considered to be too rigid. To address this concern, ACLAM convened an ad hoc Medical Records Committee and charged the Committee with the task of developing a medical record guideline that was based on both professional judgment and performance standards. The Committee provided ACLAM with a guidance document titled Public Statements: Medical Records for Animals Used in Research, Teaching, and Testing, which was approved by ACLAM in late 2004. The ACLAM public statement on medical records provides guidance on the definition and content of medical records, and clearly identifies the Attending Veterinarian as the individual who is charged with authority and responsibility for oversight of the institution's medical records program. The document offers latitude to institutions in the precise form and process used for medical records but identifies typical information to be included in such records. As a result, the ACLAM public statement on medical records provides practical yet flexible guidelines to assure that documentation of animal health is performed in research, teaching, and testing situations.
Crowe, Remle P; Bentley, Melissa A; Levine, Roger
Crowe RP , Bentley MA , Levine R . The Longitudinal Emergency Medical Technician (EMT) Attributes and Demographics Study (LEADS): the first 10 years and a look at public perception of Emergency Medical Services (EMS). Prehosp Disaster Med. 2016;31(Suppl. 1):s1-s6.
Budko, A A; Chigareva, N G
The Military Medical Museum, where concentrated materials reflecting the multifaceted activities of the medical service at the front of the bloodiest war in human history, was established in the midst of the Great Patriotic War. For targeted collection of materials were formed special front brigades, which included artists, photographers, a pathologist, a spokesman for the museum. Thanks to their work, the museum has a collection of unique materials--genuine evidence of war, reflecting all aspects of the health departments of fronts, armies, parts and cities in the form of drawings, products, models, models, photographs, charts, medical supplies, documents, etc. On the basis of materials of the museum was prepared 35-volume work Great Patriotic War of 1941-1945.
de Castro-Santos, L A
Since George Herbert Mead studied "the social self" and the interactionists went further in distinguishing "images of self", a lecture on the building up of a Brazilian medical identity should try to focus on the patterns of self-images, presented images, and aspired-to images among the Brazilian medical elites during the First Republic (1889-1930). In no other period of Brazilian history were those "images" of professional identity so close--in contrast, later periods of Brazilian history witnessed an almost permanent "collision" or the clashing of such images among public health specialists. Oswaldo Cruz, Carlos Chagas, Artur Neiva and Belisário Pena are perhaps the best examples of successful careers as "sanitarians" (to recall John Duffy's historical work on luminaries before and after the "New Public Health" in the United States), and as important political actors during Brazil's First Republic. In light of the prominent political, policy-oriented, and scientific roles public health professionals played in Brazil, it is interesting to suggest that in large part such prominence resulted from the symbolic impact of the ideologies of sanitary reform on the political agenda of that period of Brazilian history. Where many studies look for personal rivalries and disputes around Chagas and Neiva as public figures, we may also see the importance of finding identity-building processes among public health specialists as an integrated group (e.g., trying to appear as "significant others" for the new generations of medical graduates in the country), regardless of existing rivalries. Cruz and Chagas, especially, were names with great impact in the Brazilian press (pro and con), a circumstance made possible largely by their easy and direct access to the Brazilian presidents Rodrigues Alves and Epitácio Pessoa, and, most clearly, by public health being one of Brazil's political priorities to find a place among the "civilized nations" of the world. A task that further
高臻耀; 张敬谊; 林志杰; 熊赟; 朱扬勇
Aiming at the key steps of medical insurance fund management and the major factors of fund risks and deriving from practical medical insurance businesses, the authors have designed a corresponding data mining algorithm and constructed medical insurance fund risk prevention and control model base and method base to prevent and control political risks, operational risks, supplier-demander contradictory risks and fraud violation risks; then through the validation-revision-application cycle to influence the medical insurance business system in order to perfectly build a medical insurance fund risk prevention and control mechanism in accordance with the medical insurance revolution and management and then co-construct a healthy circulation with the daily medical insurance business system on fund operation and surveillance which is instructive to the foundation construction of the building and operation of the medical insurance fund risk prevention and control system.%针对医保基金管理的关键环节和基金风险的主要因素,从医保业务出发,开发了相应的数据挖掘算法,构建医保基金风险防控的模型库和方法库,实现政策风险、运营风险、供需矛盾风险和违规欺诈风险防控.通过实施验证,不断修正并应用,从而全面建立与医保改革和管理相适应的医保基金风险防控机制,与日常运行的医保业务系统共同构成了基金运营、监控的良性循环,为医保基金风险防控系统的建设、实施奠定基础并提供借鉴意义.
Budgeting, a set of steps taken by state competent bodies in order to materialize the financial policy applied by governmental authority, takes place in the following stages: setting out the budget statement, approving the budget, budget execution, budget execution completion, controlling and approving budget execution completion. Budget execution is described in specialized literature especially as a stage in the budgeting process in the components of the national public budget (public budge...
Davis, Ronald M; Neale, Anne Victoria; Monsur, Joseph C
The purpose of the study was to assess medical journals' conflicts of interest in the publication of book reviews. We examined book reviews published in 1999, 2000, and 2001 (N = 1,876) in five leading medical journals: Annals of Internal Medicine, British Medical Journal (BMJ), Journal of the American Medical Association (JAMA), Lancet, and New England Journal of Medicine. The main outcome measure was journal publication of reviews of books that had been published by the journal's own publisher, that had been edited or authored by a lead editor of the journal, or that posed another conflict of interest. We also surveyed the editors-in-chief of the five journals about their policies on these conflicts of interests. During the study period, four of the five journals published 30 book reviews presenting a conflict of interest: nineteen by the BMJ, five by the Annals, four by JAMA, and two by the Lancet. These reviews represent 5.8%, 2.7%, 0.7%, and 0.7%, respectively, of all book reviews published by the journals. These four journals, respectively, published reviews of 11.9%, 25.0%, 0.9%, and 1.0% of all medical books published by the journals' publishers. Only one of the 30 book reviews included a disclosure statement addressing the conflict of interest. None of the journals had a written policy pertaining to the conflicts of interest assessed in this study, although four reported having unwritten policies. We recommend that scientific journals and associations representing journal editors develop policies on conflicts of interest pertaining to book reviews.
Koh, Yang Huang; Wong, Mee Lian; Lee, Jeanette Jen-Mai
Medical educators constantly face the challenge of preparing students for public health practice. This study aimed to analyze students' reflections to gain insight into their task-based experiences in the public health communication selective. We have also examined their self-reported learning outcomes and benefits with regard to application of public health communication. Each student wrote a semi-structured reflective journal about his or her experiences leading to the delivery of a public health talk by the group. Records from 41 students were content-analyzed for recurring themes and sub-themes. Students reported a wide range of personal and professional issues. Their writings were characterized by a deep sense of self-awareness and social relatedness such as increased self-worth, communications skills, and collaborative learning. The learning encounter challenged assumptions, and enhanced awareness of the complexity of behaviour change Students also wrote about learning being more enjoyable and how the selective had forced them to adopt a more thoughtful stance towards knowledge acquisition and assimilation. Task-based learning combined with a process for reflection holds promise as an educational strategy for teaching public health communication, and cultivating the habits of reflective practice.
Full Text Available Abstract Background Public drug insurance plans provide limited reimbursement for Alzheimer's disease (AD medications in many jurisdictions, including Canada and the United Kingdom. This study was conducted to assess Canadians' level of support for an increase in annual personal income taxes to fund a public program of unrestricted access to AD medications. Methods A telephone survey was administered to a national sample of 500 adult Canadians. The survey contained four scenarios describing a hypothetical, new AD medication. Descriptions varied across scenarios: the medication was alternatively described as being capable of treating the symptoms of cognitive decline or of halting the progression of cognitive decline, with either no probability of adverse effects or a 30% probability of primarily gastrointestinal adverse effects. After each scenario, participants were asked whether they would support a tax increase to provide unrestricted access to the drug. Participants who responded affirmatively were asked whether they would pay an additional $75, $150, or $225 per annum in taxes. Multivariable logistic regression analysis was conducted to examine the determinants of support for a tax increase. Results Eighty percent of participants supported a tax increase for at least one scenario. Support was highest (67% for the most favourable scenario (halt progression - no adverse effects and lowest (49% for the least favourable scenario (symptom treatment - 30% chance of adverse effects. The odds of supporting a tax increase under at least one scenario were approximately 55% less for participants who attached higher ratings to their health state under the assumption that they had moderate AD and almost five times greater if participants thought family members or friends would somewhat or strongly approve of their decision to support a tax increase. A majority of participants would pay an additional $150 per annum in taxes, regardless of scenario. Less
... the universal resource locator (URL) link included in the synopsis, or by visiting ETA's Web site at.... ETA's policies currently provide for publication of notices of SGAs in the Federal Register. In... Administration (ETA) will no longer publish the full text of Solicitation of Grant Applications (SGAs) in...
Ruben, R.; Schulpen, L.W.M.
The Dutch co-financing system for nongovernmental development organizations (NGDOs) is unique in Europe. Almost a quarter of public development aid is channeled through a selective group of NGDOs that have to satisfy a broad range of institutional and operational criteria. The procedures for definin
Manavi, Sahar; Nedjat, Saharnaz; Pasalar, Parvin; Majdzadeh, Reza
Nearly three decades ago, the Master of Public Health (MPH) academic degree was introduced to Tehran University of Medical Sciences' School of Public Health, Tehran, Iran. A new program for simultaneous education of medical, pharmaceutical and dental students was initiated in 2006. Talented students had the opportunity to study MPH simultaneously. There were some concerns about this kind of admission; as to whether these students who were not familiar with the health system had the appropriate attitude and background for this field of education. And with the present rate of brain drain, is this just a step towards their immigration without the fulfillment of public health? This qualitative study was conducted in 2012 where 26 students took part in focused group discussions and individual interviews. The students were questioned about their motivation and the program's impact on their future career. The participants' statements were analyzed using thematic analysis. THE PRIMARY MOTIVATIONS OF STUDENTS WHO ENTERED THIS PROGRAM WERE: learning health knowledge related issues, gaining a perspective beyond clinical practice, obtaining a degree to strengthen their academic résumé, immigration, learning academic research methods and preparing for the management of health systems in the future. Apparently, there was no considerable difference between the motivation of students and the program planners. The students' main motivation for studying MPH was a combination of various interests in research and health sciences issues. Therefore, considering the potential of this group of students, effective academic investment on MPH can have positive impact.
Kim, Hyunmin; Paige Powell, M; Bhuyan, Soumitra S; Bhuyan, Soumitra Sudip
Family caregivers play an important role to care cancer patients since they exchange medical information with health care providers. However, relatively little is known about how family caregivers seek medical information using mobile apps and the Internet. We examined factors associated with medical information seeking by using mobile apps and the Internet among family caregivers and the general public using data from the 2014 Health Information National Trends Survey 4 Cycle 1. The study sample consisted of 2425 family caregivers and 1252 non-family caregivers (the general public). Guided by Comprehensive Model of Information Seeking (CMIS), we examined related factors' impact on two outcome variables for medical information seeking: mobile apps use and Internet use with multivariate logistic regression analyses. We found that online medical information seeking is different between family caregivers and the general public. Overall, the use of the Internet for medical information seeking is more common among family caregivers, while the use of mobile apps is less common among family caregivers compared with the general public. Married family caregivers were less likely to use mobile apps, while family caregivers who would trust cancer information were more likely to use the Internet for medical information seeking as compared to the general public. Medical information seeking behavior among family caregivers can be an important predictor of both their health and the health of their cancer patients. Future research should explore the low usage of mobile health applications among family caregiver population.
朱殿月; 魏景沛; 冯冰丹
The medical insurance fund collection efifciency is to make the premium receivable through the effective allocation of premium collection resources, such as the number of insured, the social insurance base, the proportion of payment and the level of precise management of the premium collection agencies. To improve the fund collection effectively, more attentions must be paid on the variable factors, such as insured number, social insurance base and on the precise comparison of insurance data. The policy design for the resident health insurance cannot be affected by the employee health insurance. Based on the provisions of the social insurance law, the premium should be collected as a whole.%医疗保险基金征缴效率就是通过对参保人数、缴费基数、缴费比例及征缴机构精确化管理水平等征缴资源的有效配置，实现应收尽收。提升征缴效率要在参保人数、缴费基数等可变量上下功夫，在数据比对等精确化管理上下功夫。居民医保政策设计不能影响职工医保，而且要按照社会保险法的规定，实行社会保险费统一征收。
Full Text Available BACKGROUND: Information on factors that influence parental decisions for actual human papillomavirus (HPV vaccine receipt in publicly funded, school-based HPV vaccine programs for girls is limited. We report on the level of uptake of the first dose of the HPV vaccine, and determine parental factors associated with receipt of the HPV vaccine, in a publicly funded school-based HPV vaccine program in British Columbia, Canada. METHODS AND FINDINGS: All parents of girls enrolled in grade 6 during the academic year of September 2008-June 2009 in the province of British Columbia were eligible to participate. Eligible households identified through the provincial public health information system were randomly selected and those who consented completed a validated survey exploring factors associated with HPV vaccine uptake. Bivariate and multivariate analyses were conducted to calculate adjusted odds ratios to identify the factors that were associated with parents' decision to vaccinate their daughter(s against HPV. 2,025 parents agreed to complete the survey, and 65.1% (95% confidence interval [CI] 63.1-67.1 of parents in the survey reported that their daughters received the first dose of the HPV vaccine. In the same school-based vaccine program, 88.4% (95% CI 87.1-89.7 consented to the hepatitis B vaccine, and 86.5% (95% CI 85.1-87.9 consented to the meningococcal C vaccine. The main reasons for having a daughter receive the HPV vaccine were the effectiveness of the vaccine (47.9%, advice from a physician (8.7%, and concerns about daughter's health (8.4%. The main reasons for not having a daughter receive the HPV vaccine were concerns about HPV vaccine safety (29.2%, preference to wait until the daughter is older (15.6%, and not enough information to make an informed decision (12.6%. In multivariate analysis, overall attitudes to vaccines, the impact of the HPV vaccine on sexual practices, and childhood vaccine history were predictive of parents having
Background Building on an approach developed to assess the economic returns to cardiovascular research, we estimated the economic returns from UK public and charitable funded cancer-related research that arise from the net value of the improved health outcomes. Methods To assess these economic returns from cancer-related research in the UK we estimated: 1) public and charitable expenditure on cancer-related research in the UK from 1970 to 2009; 2) net monetary benefit (NMB), that is, the health benefit measured in quality adjusted life years (QALYs) valued in monetary terms (using a base-case value of a QALY of GB£25,000) minus the cost of delivering that benefit, for a prioritised list of interventions from 1991 to 2010; 3) the proportion of NMB attributable to UK research; 4) the elapsed time between research funding and health gain; and 5) the internal rate of return (IRR) from cancer-related research investments on health benefits. We analysed the uncertainties in the IRR estimate using sensitivity analyses to illustrate the effect of some key parameters. Results In 2011/12 prices, total expenditure on cancer-related research from 1970 to 2009 was £15 billion. The NMB of the 5.9 million QALYs gained from the prioritised interventions from 1991 to 2010 was £124 billion. Calculation of the IRR incorporated an estimated elapsed time of 15 years. We related 17% of the annual NMB estimated to be attributable to UK research (for each of the 20 years 1991 to 2010) to 20 years of research investment 15 years earlier (that is, for 1976 to 1995). This produced a best-estimate IRR of 10%, compared with 9% previously estimated for cardiovascular disease research. The sensitivity analysis demonstrated the importance of smoking reduction as a major source of improved cancer-related health outcomes. Conclusions We have demonstrated a substantive IRR from net health gain to public and charitable funding of cancer-related research in the UK, and further validated the
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Xu, Judy; Liu, Gordon; Deng, Guoying; Li, Lin; Xiong, Xianjun; Basu, Kisalaya
The growth of healthcare expenditure provokes constant comments and discussions, as countries battle the issues on cost containment and cost effectiveness. Prior to 1978, medical institutions in China were either state-owned or were collective public hospitals. Since 1978, China has been trying to rebuild its healthcare system, which was destroyed during the 'cultural revolution', allowing private medical institutions to deliver healthcare services. As a result, private medical institutions have grown from 0% to 28.57% between 1978 and 2010. In this context, we compare outpatient healthcare expenditures between public and private medical institutions. The central problem of this comparison is that the choice of medical institution is endogenous. So we apply an instrumental variable (IV) framework utilizing geographic information (whether the closest medical institution is private) as the instrument while controlling for severity of health and other relevant confounding factors. Using China's Urban Resident Basic Medical Insurance Survey 2008-2010, we found that there is no difference in expenditure between public and private medical institutions when IV framework is used. Our econometric tests suggest that our IV model is specified appropriately. However, the ordinary least square model, which is inconsistent in the presence of endogenous regressor(s), reveals that public medical institutions are more expensive. Copyright © 2013 John Wiley & Sons, Ltd.
Nélisse, C; Uribé, I
The new Public Curator Act systematically requires medical and psychosocial evaluations. In confronting the letter and the spirit of the law to its regulations and operating procedures (and inversely), this article outlines the various tasks that will fall under the responsibility of health and social service professionals. Following a brief presentation of the law, the authors describe how the role of these professionals is limited to evaluations for the purpose of conducting expert appraisements, a matter which raises a great deal of concern. In addition, the two key notions of "inaptitude" and "need" are discussed in their legal sense, along with their consequences from the medical evaluation and psychosocial standpoints. The latter in particular will be analyzed regarding implementation difficulties. The authors conclude with a general commentary that is likely to give meaning to that simple and sometimes routine gesture consisting of "completing a form".
Smith, Saxon; Werren, Julia
This article focuses on the ethical, social and liability implications of patients obtaining unsolicited medical advice over the phone. The ethical discussion centres on the demise of paternalism and the increase in patient autonomy and individualism and the growing public expectations of health professionals. The article then discusses the advantages and disadvantages of telephone consultations from a social and policy perspective. In light of these considerations it considers what the liability implications are for phone consultations. It argues that the ethic of individualism, coupled with recent Australian tort reforms, suggests that only in limited circumstances would a doctor be found liable for negligence in relation to telephone consultations. However, the increasing expectations being placed on medical personnel, as evidenced by the increase in unsolicited telephone consultations, if left untempered, may lead to a situation with which the health care system is ill equipped to deal.
Paulo Roberto Caldart
Full Text Available The research presented herein has two objectives. First, this study will test whether actuarial assumptions for public sector pension schemes in Brazil adhere to reality and whether changing these assumptions might affect the results, particularly with respect to life tables and wage growth assumptions. The paper shows that the best fit life table is AT 2000 for males aggregated by one year, which involves a longer life expectancy than the life table proposed under current legislation (IBGE 2009. The data also show that actual wage growth was 4.59% per year from 2002 to 2012, as opposed to the 1% wage increase proposed by the same legislation. Changing these two assumptions increases the actuarial imbalance for a representative individual by 18.17% after accounting for the adjusted life table or by 98.30% after revising the wage growth assumption. With respect to its second objective, this paper proposes alternative funding mechanisms in which the local pension scheme will provide the funded component of the benefit that would be complemented by local government in a pay-as-you-go manner. The database utilized was for the state of Rio Grande do Sul in the month of November 2011. The results are thus restricted to Rio Grande do Sul.
Sanni, S A; Zainab, A N
We analysed 580 articles (original articles only) published in Medical Journal of Malaysia between 2004 and 2008, the resources referenced by the articles and the citations and impact received. Our aim was to examine article and author productivity, the age of references used and impact of the journal. Publication data was obtained from MyAIS database and Google Scholar provided the citation data. From the 580 articles analyzed, contributors mainly come from the hospitals, universities and clinics. Contributions from foreign authors are low. The useful lives of references cited were between 3 to 11 years. ISI derived Impact factor for MJM ranged between 0.378 to 0.616. Journal self-citation is low. Out of the 580 sampled articles, 76.8% have been cited at least once over the 5 years and the ratio of total publications to citations is 1: 2.6.
Full Text Available Aim: This paper refers to the decision made by the Greek Government to publish photographs and personal data of HIV positive sex workers on the grounds of protecting public health. Method: Initially, the law and theoretical background of medical confidentiality and its break were reviewed and then the conditions and data that led to the specific decision made by the Greek Authorities were investigated. Also the contribution of NGOs in the prevention of Public Health was studied. Conclusion: The survey showed that in this particular case the break of confidentiality was excessive and biased due to the origin and illegal activity of the women. A proper solution to the HIV/AIDS outbreak would be the intensification of prevention. In this sector, NGOs can and should play an active role considering that the primary care in Greece, especially during the economic crisis, shows organizational and operational weaknesses.
Mohamed Azmi Hassali; Shafie, Asrul A.; Fahad Saleem; Harith Al-Qazaz; Imran Masood; Muhammad Atif; Hisham Aljadhey
Context: A better understanding of medication safety ensures better health state among healthcare consumers. Aim: The study aims to assess general public awareness toward issues related to medication safety. Settings and Design: A cross-sectional study was conducted among general public selected conveniently in the state of Penang, Malaysia. Materials and methods: A total of 500 respondents were approached and 476 consumers participated in the survey giving a response rate of 95.2%. Statistic...
Drawing on interviews with English primary care doctors (GPs), this paper examines GP responses to reforms intended to introduce a market in primary health care. GPs' reactions are conceptualised in terms of a GP habitus, which takes for granted the superiority of 'public' providers (i.e. GP partnerships) in the provision of care. GPs are actively involved in the defence of the public sphere, which is neither a neo-liberal minimalist market state, nor a wholly altruistic state, responding to consumers' wants. The public sphere they defend is one in which boundaries are drawn about entitlements and GPs are actively engaged in defining and policing these boundaries. The GP habitus can be seen as shaping responses in ways which serve GP interests. In the context of struggles involving various social actors (e.g. private providers, third-party payers, patients) with different stakes in the field of general medical practice; this public service orientation may enable GPs to reap cultural capital. At the same time, the habitus constrains action in a way which limits resistance to reforms threatening GPs' interests, with GPs responding by coping, rather than downing tools or engaging in active confrontation.
挪用公款罪是单行为犯，实行行为只有“挪”，“挪而未用”成立，其他活动型挪用公款罪既遂；“归个人使用”的本质是违背单位意志将公款非法置于自己的控制支配下，可根据是否体现单位意思、为单位打算、尽到善良管理人义务等进行判断；包括“挪新还旧”在内的多次挪用，无论案发时是否归还，均应根据各自的用途累计计算，然后按照“举轻以明重”原理计算挪用数额；挪用公款罪虽然也可谓片面对向犯，但使用者既不是被害人，亦不缺乏期待可能性，故要求、提议挪用公款的成立共犯，挪出之后仅参与使用公款的成立赃物犯罪；挪用公款罪不是继续犯而是状态犯，追诉期限均应从挪用行为完成之日起计算。%The crime of embezzlement is a single crime,act only"moved","moved without using"the establishment of other activity type embezzlement crime;the essence of"personal use"is against the will of unit of public funds under their control of illegal disposal,according to whether the unit of meaning,as a unit intend to do to good management duty to judge;including"move the new old", misappropriation,regardless of whether the return time of the incident,according to their respective purposes shall be cumulative,and then according to" give light to clear heavy"principle to calculate the amount of misappropriation;crime of misappropriating public funds is to make the face piece though however,the user is not the victim,nor the lack of anticipated possibility,therefore,proposed the establishment of embezzlement accomplice,moving out only after the use of public funds to the establishment of the crime in the crime of misappropriating public funds;and is not to make state crime,we should calculate the prosecution period from the date of completion of embezzlement.
Gurpinar, Erol; Musal, Berna; Aksakoglu, Gazanfer; Ucku, Reyhan
Background: The purpose of the study was to compare the knowledge scores of medical students in Problem-based Learning and traditional curriculum on public health topics. Methods: We planned a cross-sectional study including the fifth and sixth year medical students of Dokuz Eylul University in Turkey. The fifth year students (PBL group, n = 56)…
Saldaña-Gastulo, J Jhan C; Quezada-Osoria, C Claudia; Peña-Oscuvilca, Américo; Mayta-Tristán, Percy
An observational study was conducted to describe the presence of plagiarism in medical thesis in 2008 performed at a public university in Peru. Search for plagiarism in 33 thesis introductions using a Google search algorithm, characterizes of the study type and we search in electronic form if the thesis mentor have published articles in scientific journals. We found evidence of plagiarism in 27/33 introductions, 37.3% (171/479) of all the paragraphs analyzed had some degree of plagiarism, literal plagiarism was the most frequent (20/27) and journals were the most common sources of plagiarism (19/27). The characteristics of the studies were observational (32/33), cross-sectional (30/33), descriptive (25/33) and retrospective (19/33). None of the authors had published in a scientific journal, and only nine of his tutors of them had at least one publication. No association was found between the characteristics of the thesis and the presence of plagiarism. In conclusion, we found a high frequency of plagiarism in theses analyzed. Is responsibility of medical schools take the necessary actions to detect and avoid plagiarism among their students.
Wojtall, Mariola; Kurpas, Donata; Sochocka, Lucyna; Seń, Mariola; Steciwko, Andrzej
Making conditional on the smoking is making the essential problem of the contemporary society. Conducted examinations are pointing in Poland and in the world that the number of young people which are reaching for the first cigarette is soaring together with age. The aim of the study was an analysis of smoking amongst students of the Public Higher Medical Professional School in Opole. Group of 290 stationary and non-stationary students of the Nursing Institute and the Obstetrics Institute of the Public Higher Medical Professional School in Opole was put through an examination. Out of polled --72 students (24.8%) is smoking cigarettes but 218 students (75.2%) are non-smoking persons. 13.8% of the examined group of non-stationary students is smoking cigarettes, however smoking cigarettes is declaring 29% of the examined on stationary studies. Polled the most, well as far as 70.8%, began smoking cigarettes during the secondary school. 62.5% smoking persons tried to give up smoking having the harmfulness of smoking in mind. Unfortunately these attempts ended in failure. The students would expect the biggest support from close persons (the husband, the wife) during giving up smoking, 93.1% of examined is confirming such an opinion.
Public Health Service (DHEW), Arlington, VA. Home Economics Branch.
The first volume of a continuing series reporting research in progress in health economics and medical care organization and administration was compiled by contacting (1) graduate schools offering degrees in the health professions, sociology, economics, public administration, and public health, (2) charitable foundations indicating an interest in…
Ausserer, J; Schwamberger, J; Preloznik, R; Klimek, M; Paal, P; Wenzel, V
Tragic accidents, e.g. involving celebrity patients or severe incidents in hospital occur suddenly without any advance warning, often produce substantial interest by the media and quickly overburden management personnel involved in both hospitals and emergency medical services. While doctors, hospitals and emergency medical services desire objective media reports, the media promote emotionalized and dramatized reports to ensure maximum attention and circulation. When briefing the media, the scales may quickly tilt from professional, well-deliberated information to unfortunate, often unintended disinformation. Such phenomena may result in continuing exaggerated reports in the tabloid press, which in the presence of aggressive lawyers and a competitive hospital environment can turn into image and legal problems. In this article, several aspects are discussed in order to achieve successful public relations.Interviews should be given only after consultation with the responsible press officer and the director of the respective department or hospital director. Requests for information by the media should always be answered as otherwise one-sided, unintentional publications can result that are extremely difficult to correct later. One should be available to be contacted easily by journalists, regular press conferences should be held and critics should be taken seriously and not be brushed off. Questions by journalists should be answered in a timely manner as journalists are continuously under time pressure and do not understand unnecessary delays. Information for the media should always be provided at the same time, no publication should be given preference and an absolutely current list of E-mail contacts is required. When facing big events a press conference is preferred as many questions can be answered at once. Always be well prepared for an interview or even for just a statement. Each interview should be regarded as an opportunity to put a story forward which you
Interconnections between the faith-based and medical sectors are multifaceted and have existed for centuries, including partnerships that have evolved over the past several decades in the U.S. This paper outlines ten points of intersection that have engaged medical and healthcare professionals and institutions across specialties, focusing especially on primary care, global health, and community-based outreach to underserved populations. In a time of healthcare resource scarcity, such partnerships-involving religious congregations, denominations, and communal and philanthropic agencies-are useful complements to the work of private-sector medical care providers and of federal, state, and local public health institutions in their efforts to protect and maintain the health of the population. At the same time, challenges and obstacles remain, mostly related to negotiating the complex and contentious relations between these two sectors. This paper identifies pressing legal/constitutional, political/policy, professional/jurisdictional, ethical, and research and evaluation issues that need to be better addressed before this work can realize its full potential.
Full Text Available Interconnections between the faith-based and medical sectors are multifaceted and have existed for centuries, including partnerships that have evolved over the past several decades in the U.S. This paper outlines ten points of intersection that have engaged medical and healthcare professionals and institutions across specialties, focusing especially on primary care, global health, and community-based outreach to underserved populations. In a time of healthcare resource scarcity, such partnerships—involving religious congregations, denominations, and communal and philanthropic agencies—are useful complements to the work of private-sector medical care providers and of federal, state, and local public health institutions in their efforts to protect and maintain the health of the population. At the same time, challenges and obstacles remain, mostly related to negotiating the complex and contentious relations between these two sectors. This paper identifies pressing legal/constitutional, political/policy, professional/jurisdictional, ethical, and research and evaluation issues that need to be better addressed before this work can realize its full potential.
Full Text Available Abstract Background Although eponyms are widely used in medicine, they arbitrarily alternate between the possessive and nonpossessive forms. As very little is known regarding extent and distribution of this variation, the present study was planned to assess current use of eponymous term taking "Down syndrome" and "Down's syndrome" as an example. Methods This study was carried out in two phases – first phase in 1998 and second phase in 2008. In the first phase, we manually searched the terms "Down syndrome" and "Down's syndrome" in the indexes of 70 medical books, and 46 medical journals. In second phase, we performed PubMed search with both the terms, followed by text-word search for the same. Results In the first phase, there was an overall tilt towards possessive form – 62(53.4% "Down's syndrome" versus 54(46.6% "Down syndrome." However, the American publications preferred the nonpossesive form when compared with their European counterpart (40/50 versus 14/66; P Conclusion Inconsistency in the use of medical eponyms remains a major problem in literature search. Because of linguistic simplicity and technical advantages, the nonpossessive form should be used uniformly worldwide.
Christiansen, Terkel; Erb, Karin; Rizvanovic, Amra
Objective. To examine the costs to the public health care system of couples in medically assisted reproduction. Design. Longitudinal cohort study of infertile couples initiating medically assisted reproduction treatment. Setting. Specialized public fertility clinics in Denmark. Sample. Seven...... were abstracted from medical records. Flow diagrams were drawn for different standard treatment cycles and direct costs at each stage in the flow charts were measured and valued by a bottomup procedure. Indirect costs were distributed to each treatment cycle on the basis of number of visits as basis...
Burgun, Anita; Oksen, Dina V; Kuchinke, Wolfgang; Prokosch, Hans-Ulrich; Ganslandt, Thomas; Buchan, Iain; van Staa, Tjeerd; Cunningham, James; Gjerstorff, Marianne L; Dufour, Jean-Charles; Gibrat, Jean-Francois; Nikolski, Macha; Verger, Pierre; Cambon-Thomsen, Anne; Masella, Cristina; Lettieri, Emanuele; Bertele, Paolo; Salokannel, Marjut; Thiebaut, Rodolphe; Persoz, Charles; Chêne, Geneviève; Ohmann, Christian
In Europe, health and medical administrative data is increasingly accumulating on a national level. Looking further than re-use of this data on a national level, sharing health and medical administrative data would enable large-scale analyses and European-level public health projects. There is currently no research infrastructure for this type of sharing. The PHRIMA consortium proposes to realise the Public Health Research Infrastructure for Sharing of health and Medical Administrative data (PHRIMA) which will enable and facilitate the efficient and secure sharing of healthcare data.
Dejong, W; Wolf, R C; Austin, S B
This article reports a content analysis of 56 English-language public service announcements (PSAs) for HIV/AIDS prevention produced since 1987 by the U.S. federal government for television broadcast. These PSAs do not lead target audiences through a logical sequence from awareness to motivation, skill building, and maintenance. The PSAs underutilize a strategy of "strategic ambiguity" to craft individual PSAs that can address the needs of and appeal to multiple target audiences, thereby directing information not only to heterosexuals, the primary target of these PSAs, but also to homosexuals and bisexuals. The PSAs largely ignore issues related to injection drug use and needle sharing. What drug-related portrayals there are focus on African American street junkies, which perpetuates racial stereotypes and fails to address occasional injection drug use. The PSAs exploit fear of HIV/AIDS to discourage drug use but do not offer drug treatment or counseling information. PSAs produced by the Clinton administration to promote condom use do not fully address key reasons why people fail to use condoms: concern about sexual pleasure, embarrassment about obtaining condoms, and lack of skills to negotiate condom use with sexual partners. Implications of these conclusions for the future of U.S. HIV/AIDS prevention are discussed.
Newman, John H; Rich, Stuart; Abman, Steven H; Alexander, John H; Barnard, John; Beck, Gerald J; Benza, Raymond L; Bull, Todd M; Chan, Stephen Y; Chun, Hyung J; Doogan, Declan; Dupuis, Jocelyn; Erzurum, Serpil C; Frantz, Robert P; Geraci, Mark; Gillies, Hunter; Gladwin, Mark; Gray, Michael P; Hemnes, Anna R; Herbst, Roy S; Hernandez, Adrian F; Hill, Nicholas S; Horn, Evelyn M; Hunter, Kendall; Jing, Zhi-Cheng; Johns, Roger; Kaul, Sanjay; Kawut, Steven M; Lahm, Tim; Leopold, Jane A; Lewis, Greg D; Mathai, Stephen C; McLaughlin, Vallerie V; Michelakis, Evangelos D; Nathan, Steven D; Nichols, William; Page, Grier; Rabinovitch, Marlene; Rich, Jonathan; Rischard, Franz; Rounds, Sharon; Shah, Sanjiv J; Tapson, Victor F; Lowy, Naomi; Stockbridge, Norman; Weinmann, Gail; Xiao, Lei
The Division of Lung Diseases of the NHLBI and the Cardiovascular Medical Education and Research Fund held a workshop to discuss how to leverage the anticipated scientific output from the recently launched "Redefining Pulmonary Hypertension through Pulmonary Vascular Disease Phenomics" (PVDOMICS) program to develop newer approaches to pulmonary vascular disease. PVDOMICS is a collaborative, protocol-driven network to analyze all patient populations with pulmonary hypertension to define novel pulmonary vascular disease (PVD) phenotypes. Stakeholders, including basic, translational, and clinical investigators; clinicians; patient advocacy organizations; regulatory agencies; and pharmaceutical industry experts, joined to discuss the application of precision medicine to PVD clinical trials. Recommendations were generated for discussion of research priorities in line with NHLBI Strategic Vision Goals that include: (1) A national effort, involving all the stakeholders, should seek to coordinate biosamples and biodata from all funded programs to a web-based repository so that information can be shared and correlated with other research projects. Example programs sponsored by NHLBI include PVDOMICS, Pulmonary Hypertension Breakthrough Initiative, the National Biological Sample and Data Repository for PAH, and the National Precision Medicine Initiative. (2) A task force to develop a master clinical trials protocol for PVD to apply precision medicine principles to future clinical trials. Specific features include: (a) adoption of smaller clinical trials that incorporate biomarker-guided enrichment strategies, using adaptive and innovative statistical designs; and (b) development of newer endpoints that reflect well-defined and clinically meaningful changes. (3) Development of updated and systematic variables in imaging, hemodynamic, cellular, genomic, and metabolic tests that will help precisely identify individual and shared features of PVD and serve as the basis of novel
Full Text Available Irrational antibiotic use has led society to antibiotic resistance—a serious health problem worldwide. This study aimed to assess public knowledge, beliefs, and behavior concerning antibiotic use and self-medication in Lithuania. The cross-sectional survey method was processed using a validated questionnaire in different regions of Lithuania. In total, 1005 adults completed the questionnaire and were included in the study. More than half of the respondents (61.1% had poor knowledge of antibiotics. Almost half of the respondents incorrectly identified antibiotics as being effective either against viral (26.0% or mixed (bacterial and viral infections (21.7%. The respondents with lower educational qualifications (OR = 2.515; 95% CI 1.464–4.319; p = 0.001 and those from rural areas (OR = 1.765; 95% CI 1.041–2.991; p = 0.035 were significantly less knowledgeable of antibiotics. There was no significant difference between genders, different age groups, or different parenthood status. The determined level of self–medication with antibiotics was 31.0%. The men (OR = 1.650; 95% CI 1.120–2.430; p = 0.011, the respondents from rural areas (OR = 2.002; 95% CI 1.343–2.985; p = 0.001, and those without children (OR = 2.428; 95% CI 1.477–3.991; p < 0.001 were more likely to use antibiotics in self-medication. Lithuanian residents’ knowledge of antibiotics is insufficient. More information about antibiotic use should be provided by physicians and pharmacists. Self-medication with antibiotics is a serious problem in Lithuania and requires considerable attention.
Cheng, Ping; Gilchrist, Annette; Robinson, Kerin M; Paul, Lindsay
As coded clinical data are used in a variety of areas (e.g. health services funding, epidemiology, health sciences research), coding errors have the potential to produce far-reaching consequences. In this study the causes and consequences of miscoding were reviewed. In particular, the impact of miscoding due to inadequate medical documentation on hospital funding was examined. Appropriate reimbursement of hospital revenue in the casemix-based (output-based) funding system in the state of Victoria, Australia relies upon accurate, comprehensive, and timely clinical coding. In order to assess the reliability of these data in a Melbourne tertiary hospital, this study aimed to: (a) measure discrepancies in clinical code assignment; (b) identify resultant Diagnosis Related Group (DRG) changes; (c) identify revenue shifts associated with the DRG changes; (d) identify the underlying causes of coding error and DRG change; and (e) recommend strategies to address the aforementioned. An internal audit was conducted on 752 surgical inpatient discharges from the hospital within a six-month period. In a blind audit, each episode was re-coded. Comparisons were made between the original codes and the auditor-assigned codes, and coding errors were grouped and statistically analysed by categories. Changes in DRGs and weighted inlier-equivalent separations (WIES) were compared and analysed, and underlying factors were identified. Approximately 16% of the 752 cases audited reflected a DRG change, equating to a significant revenue increase of nearly AU$575,300. Fifty-six percent of DRG change cases were due to documentation issues. Incorrect selection or coding of the principal diagnosis accounted for a further 13% of the DRG changes, and missing additional diagnosis codes for 29%. The most significant of the factors underlying coding error and DRG change was poor quality of documentation. It was concluded that the auditing process plays a critical role in the identification of causes
创新一直是英国经济政策关注的焦点,直接公共资金支持是英国支持创新的政策之一.直接公共资金支持的使用涉及到公共/ 私人部门,需要仔细分析相关政策措施的合理性、作用和效果.本研究系统介绍了对英国政府利用公共资金直接支持企业创新活动的影响评估情况,为国内创新政策的效果评价和决策提供参考.%Innovation has always been the focus of UK's economic policy, thus the support to innovation from direct public funds is part of the UK's innovation policy. The use of direct public funds covers both public and private sectors, so it is necessary to analyze the rationality, function and effects of relevant policies on the use of public funds. t. This paper highlights the practice of UK government on using direct public funds to support innovation of enterprises and its achievements, trying to provide a reference for China's decision-making and effects evaluation on innovation policies.
一次性趸缴医保基金保障的是长期权益，承载的医疗保险责任是长期性、持续性的，而医疗保险责任又与后续支出密不可分，必须对“未了责任”支付下的医保基金进行科学测算。本文从“未了责任”来源和现状入手，提出测算一次性趸缴人员应缴纳的医保基金、一次性趸缴医保基金分摊方法及相应的解决对策，以应对可能出现的风险。%The one-time payment can be the safeguard of long-term interests of medical insurance fund, carrying on the responsibility of protecting function constantly and persistently. While the medical insurance liabilities cannot be separated from the after-payment, therefore medical insurance fund with outstanding liabilities payment must be calculated scientifically. Based on the origin and current situation of outstanding liabilities, this paper proposed the related solution of how to calculate the amount and distribute the proportion of medical insurance fund for the one-time insured payers to deal with the possible risk in insurance fund collection.
Toussaint, Nigel D; McMahon, Lawrence P; Dowling, Gregory; Holt, Stephen G; Smith, Gillian; Safe, Maria; Knight, Richard; Fair, Kathleen; Linehan, Leanne; Walker, Rowan G; Power, David A
♦ BACKGROUND: Increased demand for treatment of end-stage kidney disease has largely been accommodated by a costly increase in satellite hemodialysis (SHD) in most jurisdictions. In the Australian State of Victoria, a marked regional variation in the uptake of home-based dialysis suggests that use of home therapies could be increased as an alternative to SHD. An earlier strategy based solely on increased remuneration had failed to increase uptake of home therapies. Therefore, the public dialysis funder adopted the incidence and prevalence of home-based dialysis therapies as a key performance indicator (KPI) for its health services to encourage greater uptake of home therapies. ♦ METHODS: A KPI data collection and bench-marking program was established in 2012 by the Victorian Department of Health and Human Services, with data provided monthly by all renal units in Victoria using a purpose-designed website portal. A KPI Working Group was responsible for analyzing data each quarter and ensuring indicators remained accurate and relevant and each KPI had clear definitions and targets. We present a prospective, observational study of all dialysis patients in Victoria over a 4-year period following the introduction of the renal KPI program, with descriptive analyses to evaluate the proportion of patients using home therapies as well as home dialysis modality survival. ♦ RESULTS: Following the introduction of the KPI program, the net growth of dialysis patient numbers in Victoria remained stable over 4 years, at 75 - 80 per year (approximately 4%). However, unlike the previous decade, about 40% of this growth was through an increase in home dialysis, which was almost exclusively peritoneal dialysis (PD). The increase was identified particularly in the young (20 - 49) and the elderly (> 80). Disappointingly, however, 67% of these incident patients ceased PD within 2 years of commencement, 46% of whom transferred to SHD. ♦ CONCLUSIONS: Introduction of a KPI program
The South African traditional health practitioner as a beneficiary of and provider to medical funds and schemes through the traditional health practitioners Act (Act No 22, 2007: A present-day perspective
Full Text Available Background Payments to traditional health practitioners for services rendered from medical funds and schemes, as envisaged by the Traditional Health Practitioners Act (Act No 22, 2007, is controversial and a point of contention. Such policy was followed before in South Africa in the 1990s when some funds and schemes offered limited alternative healthcare benefits for members consulting traditional healers. Aims The study aimed to offer a contemporary view of the South African traditional health practitioner as a provider to and beneficiary of the medical funds and schemes through the Traditional Health Practitioners Act (No 22, 2007. Methods This is an exploratory and descriptive study that makes use of an historical approach by means of investigation and a literature review. The emphasis is on using current documentation like articles, books and newspapers as primary sources to reflect on the South African traditional health practitioner as a provider to and beneficiary of the medical schemes and funds through the Traditional Health Practitioners Act (No 22, 2007. The findings are offered in narrative form. Results It seems as if the South African authorities completely misunderstand the future implications of the Traditional Health Practitioners Act (No 22, 2007 on healthcare. This is specifically true when it comes to the right to claim from medical funds and schemes for services rendered by traditional health practitioners and the possible extra costs for these medical schemes and funds. Conclusion The implications of Section 42(2 of the Traditional Health Practitioners Act (No 22, 2007 which aims to set up a claiming process for traditional health practitioners, seems to be very problematic. The fact that Act No 22 (2007 has not been enacted properly nine years after its promulgation has put a halt on the professionalization of traditional healers until 2015. This also affected their status as a beneficiary of and service provider to the
Full Text Available Abstract There is growing evidence of the public health and community harms associated with crack cocaine smoking, particularly the risk of blood-borne transmission through non-parenteral routes. In response, community advocates and policy makers in Vancouver, Canada are calling for an exemption from Health Canada to pilot a medically supervised safer smoking facility (SSF for non-injection drug users (NIDU. Current reluctance on the part of health authorities is likely due to the lack of existing evidence surrounding the extent of related harm and potential uptake of such a facility among NIDUs in this setting. In November 2004, a feasibility study was conducted among 437 crack cocaine smokers. Univariate analyses were conducted to determine associations with willingness to use a SSF and logistic regression was used to adjust for potentially confounding variables (p
O'Brien, Timothy L
This paper uses data from the US General Social Survey to examine public support for scientists in policy contexts and its link to scientific disciplines. An analysis of attitudes about the amount of influence that environmental scientists, two kinds of medical researchers, and economists should have over policy decisions reveals that in each discipline the extent to which scientists are thought to serve the nation's best interests is the strongest determinant of attitudes about scientists as policy advisors. Perceptions of scientists' technical knowledge and the level of consensus in the scientific community also have direct, albeit weaker effects on opinions about scientists' appropriate roles in policy settings. Whereas previous research has stressed the importance of local variability in understanding the transfer of scientific authority across institutional boundaries, these results point to considerable homogeneity in the social bases of scientific authority in policy contexts.
Cobb, Enesha M; Gebremariam, Achamyeleh; Singer, Dianne; Davis, Matthew M
We determined national levels of public participation in medical research study design. We compared public interest in medical research participation (MRP) in studies overall, versus studies explicitly designed with public involvement. Cross-sectional household survey of US population in June 2013. Descriptive statistics estimated participation in medical research study design. Chi-square test compared levels of interest in MRP if respondent knew patients or community members helped design the study. Of 2,048 respondents (participation rate 60%), 5% knew someone who had helped design a medical research study. There was no association between having known someone or personal participation in study design and willingness to engage in MRP. Although the overall proportion of respondents who would consider MRP initially (51%) was similar to the proportion who would consider MRP with community member involvement in study design (49%), the changes in respondents' views across the different scenarios were significantly greater than what would have been expected by chance. We found similar levels of interest in MRP whether or not the public is involved in medical research study design. This finding may indicate that public involvement in study design, like community-based participatory research, may not affect overall rates of MRP. © 2015 Wiley Periodicals, Inc.
Toccaceli, Virgilia; Fagnani, Corrado; Stazi, Maria Antonietta
In a time when Europe is preparing to introduce new regulations on privacy protection, we conducted a survey among 1700 twins enrolled in the Italian Twin Register about the access and use of their medical records for public health research without explicit informed consent. A great majority of respondents would refuse or are doubtful about the access and use of hospital discharge records or clinical data without their explicit consent. Young and female individuals represent the modal profile of these careful people. As information retrieved from medical records is crucial for progressing knowledge, it is important to promote a better understanding of the value of public health research activities among the general population. Furthermore, public opinions are relevant to policy making, and concerns and preferences about privacy and confidentiality in research can contribute to the design of procedures to exploit medical records effectively and customize the protection of individuals' medical data. Significance for public healthInformation retrieved from medical records is critical for public health research and policy. In particular, large amounts of individual health data are needed in an epidemiological setting, where methodological constraints (e.g. follow-up update) and quality control procedures very often require data to be re-identifiable. Concern about European regulation affecting access to medical records seems to be widespread in the scientific community. Highlighting individuals' concerns and preferences about privacy and informed consent regarding the use of health data can support policy making for public health research. It can contribute to the design of procedures aiming to extract the greatest value from medical records and, more importantly, to create a system for the protection of personal data tailored to the needs of different people.
The 2006 Annual Report of the Pension Fund, which was approved by Council at its session of 22 June 2007, is now available from Departmental secretariats. Pension beneficiaries who wish to obtain this document should contact the Administration of the Fund (tel. 004122 767 9194/8798), bldg 5, 1-030.
The 2005 Annual Report of the Pension Fund, which was approved by Council at its session of 23 June 2006, is now available from Departmental secretariats. Pension beneficiaries who wish to obtain this document should contact the Administration of the Fund (tel. 00 41 22 767 91 94), bldg 5, 1-030.
The 2006 Annual Report of the Pension Fund, which was approved by Council at its Session of 22 June 2007, is now available from Departmental secretariats. Pension beneficiaries who wish to obtain this document should contact the Administration of the Fund (tel. 004122 767 9194/8798), Bldg 5, 1-030.
The 2004 Annual Report of the Pension Fund, which was approved by Council at its session of 17 June 2004, will be available as of beginning of July from Department secretariats. Pension beneficiaries who wish to obtain this document should contact the Administration of the Fund (tel. 004122 767 9194), bldg 5, 1-030.
... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Funding. 330.7 Section 330.7... § 330.7 Funding. (a) Section 330.3(c) sets forth the maximum authorized funds for law enforcement contracting in FY 1978 and FY 1979. The Division funding levels for FY 1978 are based on information...
In line with the decisions concerning the new governance of the Pension Fund taken by the Council in June and September 2007, amendments to Section 2 "Structure and Functions" of the Rules of the Fund (Article I 2.08 – Composition of the Investment Committee and Article I 2.08b – Chairman of the Investment Committee) entered into force on 1st January 2009. These articles replace the provisions of the existing Regulations of the Investment Committee of the Pension Fund relating to the composition and chairman of the Investment Committee. Amendment No. 27 (PDF document) may be downloaded directly from the Pension Fund website: http://pensions.web.cern.ch/Pensions/statuts___rules.htm or obtained from the Administration of the Fund (Tel. 022 7672742, mailto:Barbara.Bordjah@cern.ch).
Pavydė, Eglė; Veikutis, Vincentas; Mačiulienė, Asta; Mačiulis, Vytautas; Petrikonis, Kęstutis; Stankevičius, Edgaras
Irrational antibiotic use has led society to antibiotic resistance-a serious health problem worldwide. This study aimed to assess public knowledge, beliefs, and behavior concerning antibiotic use and self-medication in Lithuania. The cross-sectional survey method was processed using a validated questionnaire in different regions of Lithuania. In total, 1005 adults completed the questionnaire and were included in the study. More than half of the respondents (61.1%) had poor knowledge of antibiotics. Almost half of the respondents incorrectly identified antibiotics as being effective either against viral (26.0%) or mixed (bacterial and viral) infections (21.7%). The respondents with lower educational qualifications (OR = 2.515; 95% CI 1.464-4.319; p = 0.001) and those from rural areas (OR = 1.765; 95% CI 1.041-2.991; p = 0.035) were significantly less knowledgeable of antibiotics. There was no significant difference between genders, different age groups, or different parenthood status. The determined level of self-medication with antibiotics was 31.0%. The men (OR = 1.650; 95% CI 1.120-2.430; p = 0.011), the respondents from rural areas (OR = 2.002; 95% CI 1.343-2.985; p = 0.001), and those without children (OR = 2.428; 95% CI 1.477-3.991; p Lithuania and requires considerable attention.
Botelho, Stephanie Ferreira; Reis, Adriano Max Moreira
Risk mitigation plans (RMP) are an innovative and important strategy for monitoring the sanitary risks of medication. The scope of the study was to identify RMPs for drugs registered with the Food and Drug Administration (FDA) and the actions to minimize risks established by the Brazilian Health Surveillance Agency (Anvisa) and the manufacturers of these drugs. This is a quantitative and descriptive study including a survey together with the pharmaceutical industries and research on sites and databases of Anvisa, the FDA and pharmaceutical industries. Forty drugs with RMPs filed with the FDA were also registered with Anvisa. Only 4 laboratories (10f%) reported RMPs developed in Brazil. Safety information for 15 drugs (37.5%) were located on the Anvisa site. In 91.4% of Brazilian user package leaflets there is safety information equivalent to actions to promote safe use described in RMPs available on the FDA website. The actions of communication on drug safety and sanitary risk of drugs needs to be expanded by Anvisa. The RMP is an important strategy in public health for managing new risks, monitoring known risks and, especially, for promoting the safe use of medication.
Imperatore, Giuseppina; Pinsky, Linda E; Motulsky, Arno; Reyes, Michele; Bradley, Linda A; Burke, Wylie
Hereditary hemochromatosis (HHC) is a condition characterized by excess iron in body tissues, resulting in complications such as cirrhosis, cardiomyopathy, diabetes, and arthritis. These complications usually manifest during adulthood. Two methods of screening for the detection of early stage of HHC are available: serum iron measures and molecular testing to detect mutations in the gene. These phenotypic and genotypic screening tests are of particular interest because a simple treatment-periodic phlebotomy-can be used to prevent iron accumulation and clinical complications. HHC might represent the first adult-onset genetic disorder for which universal population-based screening would be appropriate. Therefore, HHC has been proposed as a paradigm for the introduction of adult genetic diseases into clinical and public health practice. However, universal screening for HHC has not been recommended because of the uncertainty about the natural history of the iron overload or HHC and, in particular, uncertainty about the prevalence of asymptomatic iron overload and the likelihood that it will progress to clinical complications. If universal screening is not appropriate based on current data, what other measures might reduce the disease burden of iron overload? New studies provide more systematic information about the penetrance of the C282Y mutation and shed further light on the natural history of the disorder. The authors review these data and consider their implications for public health, medical genetics, and primary care.
Goldstein, Peggy; Warde, Beverly; Peluso, Paul
Background: Many states provide public funding to facilitate school readiness for community-based pre-K and preschool programs for 4 year old children and "at risk" 3 year old children. Little research exists on the school readiness gains of children participating in these "garden variety" community-based programs. Objective:…
Objective To explore the effective countermeasures for the Scientific research funds auditing in medical schools.Methods Political-Economic-Social Technological (PEST) method was used to analyze the macro environment changes for research funding audit,including policy,economics,social,technology..We described the situation in the research funds auditing,based on the model of Strengths-Weaknesses Opportunities-Threats (SWOT).Results Some counter-measures in the research funds auditing are recommeded for solution.Conclusions The PEST-SWOT model could provide effective countermeasures for the research funds auditing in medical schools.%目的 探索医学院校科研经费审计有效对策.方法 通过PEST方法,分析我国科研经费审计政策、经济、社会、科技等宏观环境变化;基于SWOT视角,阐述医学院校科研经费审计工作优劣态势.结果 探讨做好医学院校科研经费审计对策.结论 PEST SWOT模型分析,可为做好医学院校科研经费审计提供有效对策.
With the deepening reform of government management philosophy and medical insurance,medical insurance fund accounting should be based on different business,take the cash basis and accrual basis combining accounting basis,in order to accurately,compre-hensively reflect the actual operation of the medical insurance fund,is conducive to the budget management.% 随着政府管理理念的变化和医疗保险体制改革的不断深化，医疗保险基金核算应根据不同的业务，采取收付实现制和权责发生制相结合的会计核算基础，以便准确、全面地反映医疗保险基金的实际运行情况，有利于预算管理。
Full Text Available Thoai D Ngo,1,2 Caroline Free,1 Hoan T Le,3 Phil Edwards,1 Kiet HT Pham,4 Yen BT Nguyen,4 Thang H Nguyen5 1Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK; 2Research, Monitoring and Evaluation Team, Health System Department, Marie Stopes International, London, UK; 3Department of Environmental Health, 4Department of Health Economics, Hanoi Medical University, 5Research and Metrics Team, Marie Stopes International Vietnam, Hanoi, Vietnam Background: The purpose of this study was to investigate attributes of public service providers associated with the provision of medical abortion in Vietnam. Methods: We conducted a cross-sectional study via interviewer-administered questionnaire among abortion providers from public health facilities in Hanoi, Khanh Hoa, and Ho Chi Minh City in Vietnam between August 2011 and January 2012. We recruited abortion providers at all levels of Vietnam's public health service delivery system. Participants were questioned about their medical abortion provision practices and perspectives regarding abortion methods. Results: A total of 905 providers from 62 health facilities were included, comprising 525 (58.0% from Hanoi, 122 (13.5% from Khanh Hoa, and 258 (28.5% from Ho Chi Minh City. The majority of providers were female (96.7%, aged ≥25 years (94%, married (84.4%, and had at least one child (89%; 68.9% of providers offered only manual vacuum aspiration and 31.1% performed both medical abortion and manual vacuum aspiration. Those performing both methods included physicians (74.5%, midwives (21.7%, and nurses (3.9%. Unadjusted analyses showed that female providers (odds ratio 0.1; 95% confidence interval 0.01–0.30 and providers in rural settings (odds ratio 0.3; 95% confidence interval 0.08–0.79 were less likely to provide medical abortion than their counterparts. Obstetricians and gynecologists were more likely to provide medical abortion than providers with
Kraschnewski, Jennifer L.; Rovniak, Liza S.
There are currently 7175 farmers’ markets in the United States, and these organizations are increasingly viewed as one facet of the solution to national health problems. There has been a recent trend toward establishing markets on medical center campuses, and such partnerships can augment a medical center's ability to serve community health. However, to our knowledge no studies have described the emergence of a market at a medical center, the barriers and challenges such an initiative has faced, or the nature of programming it may foster. We provide a qualitative description of the process of starting a seasonal, once-a-week, producers-only market at the Pennsylvania State Hershey Medical Center, and we call for greater public health attention to these emerging community spaces. PMID:22021298
George, Daniel R; Kraschnewski, Jennifer L; Rovniak, Liza S
There are currently 7175 farmers' markets in the United States, and these organizations are increasingly viewed as one facet of the solution to national health problems. There has been a recent trend toward establishing markets on medical center campuses, and such partnerships can augment a medical center's ability to serve community health. However, to our knowledge no studies have described the emergence of a market at a medical center, the barriers and challenges such an initiative has faced, or the nature of programming it may foster. We provide a qualitative description of the process of starting a seasonal, once-a-week, producers-only market at the Pennsylvania State Hershey Medical Center, and we call for greater public health attention to these emerging community spaces.
Biomedical imaging, and in particular MRI and CT, is often identified as among the top 10 most significant advances in healthcare in the 20th century. This presentation will describe some of the recent advances in medical physics and imaging being funded by NIH in this century and current funding opportunities. The presentation will also highlight the role of multidisciplinary research in bringing concepts from the physical sciences and applying them to challenges in biological and biomedical research.. NIH Funding for Biomedical Imaging.
... Information for the Public / Hearing and Balance Ototoxic Medications (Medication Effects) By Barbara Cone, Patricia Dorn, Dawn Konrad- ... Audiology Information Series [PDF]. What Is Ototoxicity? Certain medications can damage the ear, resulting in hearing loss, ...
The International Monetary Fund's response to evidence on the impact of its programs on public health fails to address the fundamental criticisms about its policies. The IMF's demand for borrowers to achieve extremely low inflation targets is founded on very little empirical evidence in the peer-reviewed literature. The low-inflation policies privilege international creditors over domestic debtors and short-term priorities over long-term development goals, and contain high social costs, referred to by economists as a "sacrifice ratio." For example, governments' raising of interest rates to bring down inflation undermines the ability of domestic firms to expand production and employment and thus "sacrifices" higher economic growth and higher tax revenues and unnecessarily constrains domestic health spending. During financial crisis, most countries seek to lower interest rates to stimulate the economy, the opposite of the IMF's general advice. Perversely, compliance with IMF policies has become a prerequisite for receiving donor aid. Critiques of the IMF express significant concerns that IMF fiscal and monetary policies are unduly restrictive. Health advocates must weigh in on such matters and pressure their finance ministries, particularly in the G7, to take steps at the level of the IMF Executive Board to revisit and modify its policy framework on deficits and inflation. Such reforms are crucial to enable countries to generate more domestic resources while the global health community searches for ways to support strengthening health system capacity.
Full Text Available Introduction: Integration of public health and medical education has been thought to have an important role in medical students’ training. Shiraz University of Medical Sciences has developed an MD/MPH dual degree educational program for the talented volunteer students. The aim of this study was to assess the students’ viewpoints about various aspects of Shiraz MD/MPH program. Methods: This cross-sectional study was conducted on Shiraz undergraduate medical students, who were enrolled in MD/MPH program. A self-structured questionnaire in Persian consisting of 4 parts was used; it included demographic factors including 16 questions which evaluated the students’ perspective of the goals, content, skill development, applicability and meeting their expectations; 7 questions evaluating the self-reported increase of knowledge; and 3 multiple choice questions to assess the students’ motivations and opinions on the impact of the program on their future career. Descriptive statistics was used for data analysis. Results: All MD/MPH students (89 with a mean age of 21.4±1.34 participated in this study. Forty one of the students (46.1% were male and 48 (53.9% female. Overall, 86.1% of them had positive views about the goals of the program; also, 83.5%, 81.2% and 81.9% of them reported a positive viewpoint about the contents, the applicability and development of specific skills, and meeting their expectations, respectively. The students’ most frequent motivation was “learning how to research systematically” (73%. The majority of the students reported this program to be moderately to highly effective in increasing their knowledge in the provided courses. Conclusion: The students had a positive view about almost all of the aspects of the MD/MPH program; this may be indicative of the program being successful in delivering the goals, increasing the students’ knowledge and skills, and meeting their expectations to date. Students’ enthusiasm for
Farahangiz, Saman; Salehi, Alireza; Rezaee, Rita; Imanieh, Mohammad Hadi
Integration of public health and medical education has been thought to have an important role in medical students' training. Shiraz University of Medical Sciences has developed an MD/MPH dual degree educational program for the talented volunteer students. The aim of this study was to assess the students' viewpoints about various aspects of Shiraz MD/MPH program. This cross-sectional study was conducted on Shiraz undergraduate medical students, who were enrolled in MD/MPH program. A self-structured questionnaire in Persian consisting of 4 parts was used; it included demographic factors including 16 questions which evaluated the students' perspective of the goals, content, skill development, applicability and meeting their expectations; 7 questions evaluating the self-reported increase of knowledge; and 3 multiple choice questions to assess the students' motivations and opinions on the impact of the program on their future career. Descriptive statistics was used for data analysis. All MD/MPH students (89) with a mean age of 21.4±1.34 participated in this study. Forty one of the students (46.1%) were male and 48 (53.9%) female. Overall, 86.1% of them had positive views about the goals of the program; also, 83.5%, 81.2% and 81.9% of them reported a positive viewpoint about the contents, the applicability and development of specific skills, and meeting their expectations, respectively. The students' most frequent motivation was "learning how to research systematically" (73%). The majority of the students reported this program to be moderately to highly effective in increasing their knowledge in the provided courses. The students had a positive view about almost all of the aspects of the MD/MPH program; this may be indicative of the program being successful in delivering the goals, increasing the students' knowledge and skills, and meeting their expectations to date. Students' enthusiasm for the educational program may lead to their motivation for better learning and
Woolley, Karen L; Lew, Rebecca A; Stretton, Serina; Ely, Julie A; Bramich, Narelle J; Keys, Janelle R; Monk, Julie A; Woolley, Mark J
The primary objective of this study was to quantify how many publications retracted because of misconduct involved declared medical writers (i.e., not ghostwriters) or declared pharmaceutical industry support. The secondary objective was to investigate factors associated with misconduct retractions. A systematic, controlled, retrospective, bibliometric study. Retracted publications dataset in the MEDLINE database. PubMed was searched (Limits: English, human, January 1966 - February 2008) to identify publications retracted because of misconduct. Publications retracted because of mistake served as the control group. Standardized definitions and data collection tools were used, and data were analyzed by an independent academic statistician. Of the 463 retracted publications retrieved, 213 (46%) were retracted because of misconduct. Publications retracted because of misconduct rarely involved declared medical writers (3/213; 1.4%) or declared pharmaceutical industry support (8/213; 3.8%); no misconduct retractions involved both declared medical writers and the industry. Retraction because of misconduct, rather than mistake, was significantly associated with: absence of declared medical writers (odds ratio: 0.16; 95% confidence interval: 0.05-0.57); absence of declared industry involvement (0.25; 0.11-0.58); single authorship (2.04; 1.01-4.12); first author having at least one other retraction (2.05; 1.35-3.11); and first author affiliated with a low/middle income country (2.34; 1.18-4.63). The main limitations of this study were restricting the search to English-language and human research articles. Publications retracted because of misconduct rarely involved declared medical writers or declared pharmaceutical industry support. Increased attention should focus on factors that are associated with misconduct retractions.
Christopher E. McCoy
Full Text Available The 25th known outbreak of the Ebola Virus Disease (EVD is now a global public health emergency and the World Health Organization (WHO has declared the epidemic to be a Public Health Emergency of International Concern (PHEIC. Since the first cases of the West African epidemic were reported in March 2014, there has been an increase in infection rates of over 13,000% over a 6-month period. The Ebola virus has now arrived in the United States and public health professionals, doctors, hospitals, Emergency Medial Services Administrators, Medical Directors, and policy makers have been working with haste to develop strategies to prevent the disease from reaching epidemic proportions. Prehospital care providers (emergency medical technicians and paramedics and medical first responders (including but not limited to firefighters and law enforcement are the healthcare systems front lines when it comes to first medical contact with patients outside of the hospital setting. Risk of contracting Ebola can be particularly high in this population of first responders if the appropriate precautions are not implemented. This article provides a brief clinical overview of the Ebola Virus Disease and provides a comprehensive summary of the Center for Disease Control and Prevention’s Interim Guidance for Emergency Medical Services (EMS Systems and 9-1-1 Public Safety Answering Points (PSAPS for Management of Patients with Known of Suspected Ebola Virus Disease in the United States. [West J Emerg Med. 2014;15(7:-0.
Amendment No 21 to the Rules and Regulations of the Pension Fund has just been published and can be obtained from Department/Unit secretariats or, in the case of pensioners, directly from the Administration of the Fund (tel. 767-91 94/27 38), bldg 5, 1-030. This Amendment, which entered into force on 17.03.2005, concerns Article I 2.05 (Composition of the Governing Board) and Article I 2.06 (Chairman and Vice-Chairmen of the Governing Board) of the Rules of the Pension Fund.
Sipahi, Oğuz Reşat; Caglayan Serin, Derya; Pullukcu, Hüsnü; Tasbakan, Meltem; Köseli Ulu, Demet; Yamazhan, Tansu; Arda, Bilgin; Sipahi, Hilal; Ulusoy, Sercan
Writing a thesis is mandatory for getting a postgraduate medical degree in Turkey. Publication of the results of the thesis in an indexed journal makes the results available to researchers, however publication rate is usually low. The aim of this retrospective observational study was to investigate the publication rate of Turkish Infectious Diseases and Clinical Microbiology, Medical Microbiology specialty theses and Microbiology doctorate theses in international peer-review journals. On August 17th 2007, the thesis database of the Council of Higher Education of the Republic of Turkey (YOK) where all specialization and doctorate theses are recorded obligatorily, was searched for Infectious Diseases and Clinical Microbiology and Medical Microbiology specialty and Microbiology doctorate theses. Assuming that publication of a thesis would last at least six months, theses dated to February 2007 and after were excluded. The publication rate of those theses was found out by searching Science Citation Index-Expanded database for thesis author and supervisor between August 17-September 12, 2007. Chi-square test was used for statistical analysis. Our search yielded a total of 834 theses dated from 1997 to 2007, however 10 of them were excluded, since they were dated to February 2007 or after. It was found that the overall publication rate was 11.4% (94/824). The publication rates for Microbiology doctorate, Medical Microbiology and Infectious Diseases and Clinical Microbiology specialty theses were 13.7% (34/249), 10.7% (33/309) and 10.2% (27/266), respectively, with no statistical significance (p> 0.05). It was determined that nine (9.6%) of the 94 published theses belonged to 1997-2001 period, whereas 85 (80.4%) were in 2002-2007 period (pThesis is an important part of specialty and doctorate education and necessitates intense work. The created knowledge usually contains important data about the country and the world. Publication of the theses supplies dissemination of
Taylor, Beverly D; Buckner, Ayanna V; Walker, Carla Durham; Blumenthal, Daniel S
Faith-based organizations can be strategic partners in addressing the needs of low-income and underserved individuals and communities. The Morehouse School of Medicine (MSM) Public Health/Preventive Medicine Residency Program (PH/PMR) collaborates with faith-based organizations for the purpose of resident education, community engagement, and service. These partners provide guidance for the program's community initiatives and health promotion activities designed to address health inequities. Residents complete a longitudinal community practicum experience with a faith-based organization over the 2-year training period. Residents conduct a community health needs assessment at the organization and design a health intervention that addresses the identified needs. The faith-based community practicum also serves as a vehicle for achieving skills in all eight domains of the Public Health Competencies developed by the Council on Linkages and all six Accreditation Council for Graduate Medical Education (ACGME) Core Competencies. The MSM PH/PMR Program has engaged in faith-based partnerships for 7 years. This article discusses the structure of these partnerships, how partners are identified, funding sources for supporting resident projects, and examples of resident health needs assessment and intervention activities. The MSM PH/PMR Program may serve as a model to other residency and fellowship programs that may have an interest in developing partnerships with faith-based organizations.
In line with the decisions taken by the Council in June and September 2007 concerning the new governance of the Pension Fund, amendments to Section 2 (Structure and Functions) of the Rules of the Fund entered into force on 1st November 2007 (Article I 2.05 – Composition of the Governing Board and Article I 2.06 – Chairman and Vice-Chairman of the Governing Board). The Rules, updated to include all the amendments introduced since 1st January 2007, may be downloaded in A4 format (PDF document) directly from the Pension Fund website or obtained from the Administration of the Fund (Tel. 022 767 2742, Sophia.Revol@cern.ch).
In line with the decisions taken by the Council in June and September 2007 concerning the new governance of the Pension Fund, amendments to Section 2 «Structure and Functions» of the Rules of the Fund entered into force on 1st January 2009 (Article I 2.08 – Composition of the Investment Committee and Article I 2.08bis – Chairman of the Investment Committee). Amendment n°27 may be downloaded (PDF document) directly from the Pension Fund website: http://pensions.web.cern.ch/Pensions/statuts___rules.htm or obtained from the Administration of the Fund (Tel. 022 767 2742, mailto:Barbara.Bordjah@cern.ch).
As announced in the Bulletin during the summer, the Pension Fund has published a complete new version of the Fund's Rules and Regulations incorporating all amendments up to 1 November 2006, following the decisions of the CERN Council. This new version of the Rules and Regulations can be downloaded in A4 format (pdf document) directly from the Pension Fund's website (http://pensions.web.cern.ch/Pensions/statuts___rules.htm for the Rules and http://pensions.web.cern.ch/Pensions/règlements___regulations.htm for the Regulations) or obtained from the Fund Administration (Tel. 022 767 27 42, Building 5, 1-030, or by e-mail Sophia.Revol@cern.ch).
Montanari, Katia; Cucchi, Alessandro; Tessari, Gianni; Turri, Valentina; Gregorio, Pasquale
It is difficult to identify, from a regulatory point of view, the actual competencies of medical directors of public hospitals in Italy. A questionnaire survey was therefore conducted to identify which are the activities actually performed by this professional. One hundred twenty local health authorities participated in the survey. Findings reveal that many activities conducted by the hospital medical director, such a mediation with the local health authorities, are not formally recognized and that the medical director actually conducts more complex activities than those formally pertaining to his role.
... Clinical Practice Guidelines Resources Continuing Education Funding Training & Career Development Division of Intramural Research Research Resources Scientific Reports Technology Transfer What are Clinical Trials? Children & Clinical Studies NHLBI Trials Clinical Trial Websites Press ...
Amendment No 17 to the Rules and Regulations of the Pension Fund relating to the technical adjustment of the coefficients C made necessary by the integration of the members of the CERN personnel into the new career structure on 1.9.2001 can be obtained from Divisional secretariats or, in the case of pensioners, directly from the Administration of the Fund (tel. 767-91 94/27 38), bldg 5, 1-030.
The 2007 Annual Report and Accounts of the Pension Fund which was approved by Council at its session of 20 June 2008, is now available from the Departmental secretariats. Pension beneficiaries who wish to obtain this document should contact Emilie Clerc (Tel. + 41 22 767 87 98), building 5-5/017. It is also available on the Pension fund site: http://pensions.web.cern.ch/Pensions/
The 2007 Annual Report and Accounts of the Pension Fund which was approved by Council at its session of 20 June 2008, is now available from the Departmental secretariats. Pension beneficiaries who wish to obtain this document should contact Emilie Clerc (Tel. + 41 22 767 87 98), building 5-5/017. It is also available on the Pension fund site: http://pensions.web.cern.ch/Pensions/
Amendment No 20 to the Rules and Regulations of the Pension Fund has just been published and can be obtained from Department/Unit secretariats or, in the case of pensioners, directly from the Administration of the Fund (tel. 767-91 94/27 38), bldg 5, 1-030. This Amendment, which entered into force on 1.1.2004, concerns the fixed sums and allowances adjusted at same date (Annex B).
The Pension Fund Governing Board (PFGB) held two meetings over the summer, the first on 9 June and the second on 1st September. The agendas of the two meetings had several items in common, including progress reports on the work of the four working groups. Group 1, which is responsible for the revision of Chapter I, Section 2 of the Rules of the Fund, has made good progress but will need more time to complete its terms of reference in view of the number and complexity of the articles to be amended. In parallel, the Group has approved a code of conduct for the Pension Fund, which is based, in particular, on the new charter introduced for Swiss pension funds by the Swiss Association of Provident Institutions (ASIP) and the CFA (Chartered Financial Analyst) code of ethics applicable to members of pension fund bodies. The PFGB took note that the Group had also been working on the rules relating to the status of the personnel of the Fund and the composition of the Investment Committee. The work of Group 2, responsi...
At its June 2006 meeting, the Finance Committee approved the following amendment to Article 6a of the Regulations for elections to the Governing Board of the Pension Fund, which will enter into force on 1.7.2006: Current text New text ... 6a. The Administrator of the Fund shall be responsible for holding the elections and for issuing all relevant information. ... ... 6a. The Administrator of the Fund shall be responsible for holding the elections by electronic voting or, if this method cannot be used, following the procedure outlined in Articles 6i., 6j. and 6k. below. He shall issue to the members of the Pension Fund all relevant information concerning the elections. The deadlines mentioned in paragraphs 6i. and 6j. below shall apply mutatis mutandis to electronic voting. ... The amendment will allow the Pension Fund to use an electronic voting procedure for the election of elected members to the Governing Board of the Fund. It will be included in a complete new edition of the Rules and Regulatio...
Cárdenas-Perea, María Elena; Gómez-Conde, Eduardo; Santos-López, Gerardo; Pérez-Contreras, Irma; Díaz-Orea, María Alicia; Gándara-Ramírez, José Luís; Cruz Y López, Othón Rafael; Márquez-Domínguez, Luis; Sosa-Jurado, Francisca
Although preventable with vaccination, Hepatitis B virus (HBV) infection is a major health concern, with ∼400 million people at risk of developing the chronic form of the disease worldwide. The anti-HBV vaccine consists of a recombinant HBV surface antigen (HBsAg), which induces specific anti-HBs antibodies and confers 95% protection for >20 y. The aim of the present study was to analyze the response to HBV vaccination by measuring anti-HBs antibodies in serum samples from medical students of a public university in Puebla, Mexico. HBV infection markers HBsAg and anti-HBs, were also determined. A total of 201 students were included and vaccination coverage was found at 54%. Overall seropositivity for HBsAg, anti-HBc and anti-HBs determined by ELISA was 0.5%, 1.0% and 47%, respectively. Protective levels of anti-HBs >10 mIU/mL were found in 93.2% of subjects vaccinated with 2 or 3 doses and in 40% of those vaccinated with a single dose; while only 4.8% of unvaccinated subjects were anti-HBs positive. The response to the HBV vaccine was different in each participant, despite similar vaccination scheme. A history of blood transfusion/organ transplant or more than 2 sexual partners was significantly associated with anti-HBc positivity, OR = 399 (p = 0.010) and OR = 19.9 (p = 0.044), respectively. HBV immunization coverage was low in our sample compared with reports from countries with similar HBV prevalence, but anti-HBs in vaccinated individuals were in the expected range. It is important to promote HBV vaccination and awareness among medical students, due to their exposure risk.
Full Text Available Introduction: Problem-based learning (PBL method has progressed as an alternative to lecture-based learning (LBL method in recent decades. Benefits of PBL clearly supported by researches however several items remain unclear especially in Iranian medical universities. The aim of this paper is to compare the learning outputs of PBL and LBL methods. Methods: In this cross- sectional study public health course was prepared for three groups of students. Group 1 included medical students (n=101, Group 2 dentistry students (n=54, and Group 3 was formed of pharmacy students (n=112. Scores of final exam as well as 10 similar- root questions as a short-term outcome, scores in national basic science exam, recent similar informal exam as a mid-term output in addition to course evaluation by students, and assessment of attitude about PBL were compared between groups. Data analysis was performed by SPSS-11 using means’ comparison. Results: Scores of students in PBL group was significantly higher in final exam (P<0.001. The percentage of correct responses to 10 same- root questions in PBL (M= 6.68 were significantly higher (M=6.54. Faculty members were evaluated better in PBL group (P<0.001 in all aspects of teaching. Totally, the students who evaluated teachers in PBL group had 2 points more than LBL group (P<0.001. Scores of students in national exam (after two years and the recent survey (in the third year were higher in PBL group (P<0.001. Conclusion: Results of using PBL method indicated the higher rate of scores and better recalling of learned materials in this method.
Mohamed Azmi Hassali
Full Text Available Context: A better understanding of medication safety ensures better health state among healthcare consumers. Aim: The study aims to assess general public awareness toward issues related to medication safety. Settings and Design: A cross-sectional study was conducted among general public selected conveniently in the state of Penang, Malaysia. Materials and methods: A total of 500 respondents were approached and 476 consumers participated in the survey giving a response rate of 95.2%. Statistical analysis: Data were analyzed by using SPSS version 12.0 and descriptive statistics were reported where appropriate. Results: Majority of the respondents (n=292, 61.3% stated that they were well aware of the possible side effects of their current medications. A total of 196 respondents (41.17% believed that all medicines registered in Malaysia are safe to use as these medicines have no side effects. About 40.33% (n=192 of the respondents claimed that they share their unused medicines with family and friends who are having similar illness. Majority of respondents 57.7% (n=275 were satisfied with the drug information provided by the healthcare professionals. This study also found that more than 80% of the respondents (n=409 did report that they read the labels of their medication before using. Conclusions: In this study, it was revealed that there is a moderate level of public knowledge regarding medication safety. It is evident that public underestimates the risk of their medications. There is a general lack of awareness and understanding among the public especially toward side effects.
de la Calle Guillermo
Full Text Available Abstract Background Over the past years, the number of available informatics resources in medicine has grown exponentially. While specific inventories of such resources have already begun to be developed for Bioinformatics (BI, comparable inventories are as yet not available for the Medical Informatics (MI field, so that locating and accessing them currently remains a difficult and time-consuming task. Description We have created a repository of MI resources from the scientific literature, providing free access to its contents through a web-based service. We define informatics resources as all those elements that constitute, serve to define or are used by informatics systems, ranging from architectures or development methodologies to terminologies, vocabularies, databases or tools. Relevant information describing the resources is automatically extracted from manuscripts published in top-ranked MI journals. We used a pattern matching approach to detect the resources’ names and their main features. Detected resources are classified according to three different criteria: functionality, resource type and domain. To facilitate these tasks, we have built three different classification schemas by following a novel approach based on folksonomies and social tagging. We adopted the terminology most frequently used by MI researchers in their publications to create the concepts and hierarchical relationships belonging to the classification schemas. The classification algorithm identifies the categories associated with resources and annotates them accordingly. The database is then populated with this data after manual curation and validation. Conclusions We have created an online repository of MI resources to assist researchers in locating and accessing the most suitable resources to perform specific tasks. The database contains 609 resources at the time of writing and is available at http://www.gib.fi.upm.es/eMIR2. We are continuing to expand the number
Background Over the past years, the number of available informatics resources in medicine has grown exponentially. While specific inventories of such resources have already begun to be developed for Bioinformatics (BI), comparable inventories are as yet not available for the Medical Informatics (MI) field, so that locating and accessing them currently remains a difficult and time-consuming task. Description We have created a repository of MI resources from the scientific literature, providing free access to its contents through a web-based service. We define informatics resources as all those elements that constitute, serve to define or are used by informatics systems, ranging from architectures or development methodologies to terminologies, vocabularies, databases or tools. Relevant information describing the resources is automatically extracted from manuscripts published in top-ranked MI journals. We used a pattern matching approach to detect the resources’ names and their main features. Detected resources are classified according to three different criteria: functionality, resource type and domain. To facilitate these tasks, we have built three different classification schemas by following a novel approach based on folksonomies and social tagging. We adopted the terminology most frequently used by MI researchers in their publications to create the concepts and hierarchical relationships belonging to the classification schemas. The classification algorithm identifies the categories associated with resources and annotates them accordingly. The database is then populated with this data after manual curation and validation. Conclusions We have created an online repository of MI resources to assist researchers in locating and accessing the most suitable resources to perform specific tasks. The database contains 609 resources at the time of writing and is available at http://www.gib.fi.upm.es/eMIR2. We are continuing to expand the number of available resources by
Full Text Available In 1985 the Australian Government sought to delete circumcision of infants from the benefits payable under its newly established universal health scheme, Medicare. Although the decision had been recommended by the government's health advisers and was welcomed by medical authorities, it was soon reversed after protests from Jewish community leaders. I present a detailed narrative of this affair and explain why a decision based on sound medical knowledge advice was rescinded after quite mild objections. The answer is found to lie partly in contingent factors, such as the details of the policy change, the personalities of the government figures involved, and problems with implementation and communication; and partly in the sensibilities of the ethnic/religious communities most directly affected. I dispel the misconception that the original decision aroused widespread opposition and show, on the contrary, that it was based on good advice, represented sound public policy, and was widely supported. I conclude that the episode may have useful lessons for other governments seeking to implement or resist policy changes that affect the sensitivities of cultural minorities.
Wang, Hung-Yuan; Liang, Jyh-Chong; Tsai, Chin-Chung
The purpose of this study is two-fold: to explore the differences in online medical information searching behaviors, including evaluative standards and search strategies, of the general public (general group) and those of hospital patients and their relatives (hospital group); and to compare the predictive relationship between the evaluative…
Examines the relations among self-consciousness, attribution of responsibility, and differentiation of emotions by interviewing 30 Israeli medical students. Finds that in terms of student-patient interactions, students high in public self-consciousness made more internal attributions while students high in private self-consciousness made more…
Los beneficios de la gestión activa de carteras. Una propuesta de reforma para la Dirección de Pensiones Civiles del Estado de Michoacán, México/The benefits of active portfolio management. A reform proposal to Michoacan State's Public Pension Fund Office
Oscar V De La Torre Torres; Ma Isabel Martínez Torre-Enciso
..., como consecuencia, el periodo de suficiencia financiera del plan de pensiones. Abstract: The present paper studies one of the most politically relevant public pension funds in Mexico: the Michoacan State Public Pension Fund Office. As a result of this review, we propose an investment policy along with its related portfolio management struc...
Full Text Available Seilin Uhm1, Kristin Liabo1, Ruth Stewart1,2, Rebecca Rees1, Sandy Oliver11Social Science Research Unit, Institute of Education, University of London, London, UK; 2The Centre for Language and Culture, University of Johannesburg, Johannesburg, South AfricaAbstract: This paper explores the role of patient panels for shaping research for health, scientific research about health and illness, and applied medical research. After examining the history and purposes of involving patients in discussions and decision making for research, it outlines the expertise and skills required if panels are to be successful. The paper also analyses existing guidance for panels that include patients. Panels benefit from the experiential knowledge of panel members, craft knowledge of panel facilitators, and organizational knowledge gained through previous experience of hosting panels. Guidance is available that addresses structures and resources (for panel funders and interpersonal communication and group dynamics (for panel members and facilitators. This guidance is most comprehensive when it has itself been developed by all these types of stakeholders.Keywords: public involvement, patient panels, expert panels, guidelines, guidance
Célia Cristina Fornaziero
Full Text Available The aim of this research was to understand the reasoning developed by medical students in a public university in Brazil. This research on education included semi-structured interviews and film recordings of interns discussing 10 clinical cases. A sample of 16 interns analyzed cases presented on a notebook computer with a webcam. They were instructed to verbalize all their thoughts on the procedures they would use. The film recordings and transcripts of the interviews were analyzed. Quantitative data was evaluated using Yates' chi-squared test and speech analysis was used to evaluate the transcripts. The theme worked on in the practice of reasoning was: the student's perceptions of their clinical practice. Of the 160 diagnoses, 57% were done with analytical reasoning and 43% with non-analytical reasoning. The hypothetical deductive method was employed by 31% of the interns and the inductive method was employed by 69%. The diagnostic accuracy was 81% correct for easy cases and 85% correct for difficult cases. We observed two empirical categories: the cognitive universe of the student and the patient's context.
Knebel, Ann R; Sharpe, Virginia A; Danis, Marion; Toomey, Lauren M; Knickerbocker, Deborah K
During catastrophic disasters, government leaders must decide how to efficiently and effectively allocate scarce public health and medical resources. The literature about triage decision making at the individual patient level is substantial, and the National Response Framework provides guidance about the distribution of responsibilities between federal and state governments. However, little has been written about the decision-making process of federal leaders in disaster situations when resources are not sufficient to meet the needs of several states simultaneously. We offer an ethical framework and logic model for decision making in such circumstances. We adapted medical triage and the federalism principle to the decision-making process for allocating scarce federal public health and medical resources. We believe that the logic model provides a values-based framework that can inform the gestalt during the iterative decision process used by federal leaders as they allocate scarce resources to states during catastrophic disasters.
This article considers the medical measures of the 1920 Aliens Order barring aliens from Britain. Building on existing local and port public health inspection, the requirement for aliens to be medically inspected before landing significantly expanded the duties of these state agencies and necessitated the creation of a new level of physical infrastructure and administrative machinery. This article closely examines the workings and limitations of alien medical inspection in two of England’s major ports—Liverpool and London—and sheds light on the everyday working of the Act. In doing so it reflects on the ambitions, actions and limitations of the state and so extends research by historians of the nineteenth and early twentieth century on the disputed histories of public health and the complexities of statecraft. Overall it suggests the importance of developing nuanced understandings of the gaps and failures arising from the translation of legislation into practice. PMID:27482146
The PFGB held two meetings over the summer, the first on 9 June and the second on 1st September. The agendas of the two meetings had several items in common, including progress reports on the work of the four working groups. Group 1, which is responsible for the revision of Chapter I, Section 2 of the Rules of the Fund, has made good progress but will need more time to complete its terms of reference in view of the number and complexity of the articles to be amended. In parallel, the Group has approved a code of conduct for the Pension Fund, which is based, in particular, on the new charter introduced for Swiss pension funds by the Swiss Association of Provident Institutions (ASIP) and the CFA (Chartered Financial Analyst) code of ethics applicable to members of pension fund bodies. The PFGB took note that the Group had also been working on the rules relating to the status of the personnel of the Fund and the composition of the Investment Committee. The work of Group 2, resp...
The Governing Board of the Pension Fund held its first three meetings of the year on 2 February, 2 March and 13 April.At the first of these meetings the Board first heard a presentation by Mrs H. Richmond of JP Morgan on the results of the currency overlay programme applied to the Fund's assets. Thanks to the policy pursued by this company, volatility, i.e. portfolio risk for assets denominated in currencies other than the Swiss franc, has been reduced. However, despite the fact that JP Morgan has considerable expertise in this field, no gain has been achieved over the past year. The Governing Board heard a report by the Investment Committee Chairman G. Maurin on the meetings of 21-22 and 28 January at which the Pension Fund's various fund managers had been interviewed on their results. Decisions were taken on benchmarks aimed at optimising management and on the terms of reference of the Internal Management Unit. It was also decided to place two fund managers on a watching list and to request them to make eve...