WorldWideScience

Sample records for regulation prescribes policies

  1. Pharmaceutical policies: effects of financial incentives for prescribers.

    Science.gov (United States)

    Rashidian, Arash; Omidvari, Amir-Houshang; Vali, Yasaman; Sturm, Heidrun; Oxman, Andrew D

    2015-08-04

    The proportion of total healthcare expenditures spent on drugs has continued to grow in countries of all income categories. Policy-makers are under pressure to control pharmaceutical expenditures without adversely affecting quality of care. Financial incentives seeking to influence prescribers' behaviour include budgetary arrangements at primary care and hospital settings (pharmaceutical budget caps or targets), financial rewards for target behaviours or outcomes (pay for performance interventions) and reduced benefit margin for prescribers based on medicine sales and prescriptions (pharmaceutical reimbursement rate reduction policies). This is the first update of the original version of this review. To determine the effects of pharmaceutical policies using financial incentives to influence prescribers' practices on drug use, healthcare utilisation, health outcomes and costs (expenditures). We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (searched 29/01/2015); MEDLINE, Ovid SP (searched 29/01/2015); EMBASE, Ovid SP (searched 29/01/2015); International Network for Rational Use of Drugs (INRUD) Bibliography (searched 29/01/2015); National Health Service (NHS) Economic Evaluation Database (searched 29/01/2015); EconLit - ProQuest (searched 02/02/2015); and Science Citation Index and Social Sciences Citation Index, Institute for Scientific Information (ISI) Web of Knowledge (citation search for included studies searched 10/02/2015). We screened the reference lists of relevant reports and contacted study authors and organisations to identify additional studies. We included policies that intend to affect prescribing by means of financial incentives for prescribers. Included in this category are pharmaceutical budget caps or targets, pay for performance and drug reimbursement rate reductions and other financial policies, if they were specifically targeted at prescribing or drug utilisation. Policies in this review were defined as laws, rules

  2. Antibiotic prescribing policy and Clostridium difficile diarrhoea.

    LENUS (Irish Health Repository)

    O'Connor, K A

    2012-02-03

    BACKGROUND: Broad-spectrum antibiotics, particularly intravenous cephalosporins, are associated with Clostridium difficile diarrhoea. Diarrhoea due to C. difficile is a growing problem in hospitals, especially among elderly patients. AIM: To establish whether changing an antibiotic policy with the aim of reducing the use of injectable cephalosporins leads to a reduction in the incidence of C. difficile diarrhoea in elderly patients. DESIGN: Retrospective analysis. METHODS: A group of patients who were subject to the new antibiotic policy from the period following July 2000, were compared with patients who were admitted prior to July 2000 and were not subject to the new policy. Infections, antibiotic prescriptions and mortality rates were determined from case notes, and C. difficle diarrhoea rates from microbiological data. RESULTS: Intravenous cephalosporin use fell from 210 to 28 defined daily doses (p < 0.001) following the change in antibiotic policy, with a corresponding increase in piperacillin-tazobactam (p < 0.001) and moxifloxacin (p < 0.001) use. The new policy led to a significant reduction in C. difficile diarrhoea cases. The relative risk of developing C. difficile infection with the old policy compared to the new policy was 3.24 (95%CI 1.07-9.84, p = 0.03). DISCUSSION: The antibiotic policy was successfully introduced into an elderly care service. It reduced both intravenous cephalosporin use and C. difficile diarrhoea.

  3. Regulative environmental policy. Regulative Umweltpolitik

    Energy Technology Data Exchange (ETDEWEB)

    Goerlitz, A; Voigt, R [Universitaet der Bundeswehr Muenchen, Neubiberg (Germany, F.R.). Fakultaet fuer Sozialwissenschaften; eds.

    1991-01-01

    Regulative policy means those governmental attempts to steer the course of things which can fall back on a certain repertoire of instruments for actions in order to warrant the causal and temporal connection between the making available and the employment of means. The fact that environmental protection needs regulative policy is substantiated by the thesis that the market has failed; consequently only government can manage the public goods 'environment' in a suitable way, and it is a matter of fact that environmental protection at present is operated preferably via regulative policy. The problems of regulative enviromental policy are manifold. Its implementation often miscarries because of limited administrative resources on the one hand - making sufficient control impossible for instance -, and because of poor quality regulative instruments on the other hand. One way out would be to increase the efficiency of regulative policy by sophisticating judicial techniques. Other ways out point to the executing level and aim at improving implementation strategies or are concerned with post-regulative law. The latter refers to a new legal quality which demonstrates itself already in corporatistical crisis regulation or in induction programs such as pollution limits. A final way out favours deregulation strategies which includes the introduction of environmental levies or the allocation of environmental licences. An interdisciplinary discourse is to find out what would happen if these ways were taken. Pointers to solutions from varying scientific disciplines resulting from this discourse are to be found in this volume. (orig./HSCH).

  4. Association Between Academic Medical Center Pharmaceutical Detailing Policies and Physician Prescribing.

    Science.gov (United States)

    Larkin, Ian; Ang, Desmond; Steinhart, Jonathan; Chao, Matthew; Patterson, Mark; Sah, Sunita; Wu, Tina; Schoenbaum, Michael; Hutchins, David; Brennan, Troyen; Loewenstein, George

    2017-05-02

    In an effort to regulate physician conflicts of interest, some US academic medical centers (AMCs) enacted policies restricting pharmaceutical representative sales visits to physicians (known as detailing) between 2006 and 2012. Little is known about the effect of these policies on physician prescribing. To analyze the association between detailing policies enacted at AMCs and physician prescribing of actively detailed and not detailed drugs. The study used a difference-in-differences multivariable regression analysis to compare changes in prescribing by physicians before and after implementation of detailing policies at AMCs in 5 states (California, Illinois, Massachusetts, Pennsylvania, and New York) that made up the intervention group with changes in prescribing by a matched control group of similar physicians not subject to a detailing policy. Academic medical center implementation of policies regulating pharmaceutical salesperson visits to attending physicians. The monthly within-drug class market share of prescriptions written by an individual physician for detailed and nondetailed drugs in 8 drug classes (lipid-lowering drugs, gastroesophageal reflux disease drugs, diabetes drugs, antihypertensive drugs, hypnotic drugs approved for the treatment of insomnia [sleep aids], attention-deficit/hyperactivity disorder drugs, antidepressant drugs, and antipsychotic drugs) comparing the 10- to 36-month period before implementation of the detailing policies with the 12- to 36-month period after implementation, depending on data availability. The analysis included 16 121 483 prescriptions written between January 2006 and June 2012 by 2126 attending physicians at the 19 intervention group AMCs and by 24 593 matched control group physicians. The sample mean market share at the physician-drug-month level for detailed and nondetailed drugs prior to enactment of policies was 19.3% and 14.2%, respectively. Exposure to an AMC detailing policy was associated with a

  5. Gifts and influence: Conflict of interest policies and prescribing of psychotropic medications in the United States.

    Science.gov (United States)

    King, Marissa; Bearman, Peter S

    2017-01-01

    The pharmaceutical industry spends roughly 15 billion dollars annually on detailing - providing gifts, information, samples, trips, honoraria and other inducements - to physicians in order to encourage them to prescribe their drugs. In response, several states in the United States adopted policies that restrict detailing. Some states banned gifts from pharmaceutical companies to doctors, other states simply required physicians to disclose the gifts they receive, while most states allowed unrestricted detailing. We exploit this geographic variation to examine the relationship between gift regulation and the diffusion of four newly marketed medications. Using a dataset that captures 189 million psychotropic prescriptions written between 2005 and 2009, we find that uptake of new costly medications was significantly lower in states with marketing regulation than in areas that allowed unrestricted pharmaceutical marketing. In states with gift bans, we observed reductions in market shares ranging from 39% to 83%. Policies banning or restricting gifts were associated with the largest reductions in uptake. Disclosure policies were associated with a significantly smaller reduction in prescribing than gift bans and gift restrictions. In states that ban gift-giving, peer influence substituted for pharmaceutical detailing when a relatively beneficial drug came to market and provided a less biased channel for physicians to learn about new medications. Our work suggests that policies banning or limiting gifts from pharmaceutical representatives to doctors are likely to be more effective than disclosure policies alone. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Evaluating Alternative Prescribed Burning Policies to Reduce Net Economic Damages from Wildfire

    OpenAIRE

    D. Evan Mercer; Jeffrey P. Prestemon; David T. Butry; John M. Pye

    2007-01-01

    We estimate a wildfire risk model with a new measure of wildfire output, intensity-weighted risk and use it in Monte Carlo simulations to estimate welfare changes from alternative prescribed burning policies. Using Volusia County, Florida as a case study, an annual prescribed burning rate of 13% of all forest lands maximizes net welfare; ignoring the effects on wildfire intensity may underestimate optimal rates of prescribed burning. Our estimated supply function for prescribed fire services ...

  7. 30 CFR 285.103 - When may MMS prescribe or approve departures from these regulations?

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false When may MMS prescribe or approve departures... CONTINENTAL SHELF General Provisions § 285.103 When may MMS prescribe or approve departures from these regulations? (a) The MMS may prescribe or approve departures from these regulations when departures are...

  8. Evaluating alternative prescribed burning policies to reduce net economic damages from wildfire

    Science.gov (United States)

    D. Evan Mercer; Jeffrey P. Prestemon; David T. Butry; John M. Pye

    2007-01-01

    We estimate a wildfire risk model with a new measure of wildfire output, intensity-weighted risk and use it in Monte Carlo simulations to estimate welfare changes from alternative prescribed burning policies. Using Volusia County, Florida as a case study, an annual prescribed burning rate of 13% of all forest lands maximizes net welfare; ignoring the effects on...

  9. 41 CFR 102-85.5 - By what authority is the pricing policy in this part prescribed?

    Science.gov (United States)

    2010-07-01

    ... pricing policy in this part prescribed? 102-85.5 Section 102-85.5 Public Contracts and Property Management...-PRICING POLICY FOR OCCUPANCY IN GSA SPACE Pricing Policy-General § 102-85.5 By what authority is the pricing policy in this part prescribed? (a) General authority is granted in the Federal Property and...

  10. Improving antimicrobial prescribing: implementation of an antimicrobial i.v.-to-oral switch policy.

    Science.gov (United States)

    McCallum, A D; Sutherland, R K; Mackintosh, C L

    2013-01-01

    Antimicrobial stewardship programmes reduce the risk of hospital associated infections (HAI) and antimicrobial resistance, and include early intravenous-to-oral switch (IVOS) as a key stewardship measure. We audited the number of patients on intravenous antimicrobials suitable for oral switch, assessed whether prescribing guidelines were followed and reviewed prescribing documentation in three clinical areas in the Western General Hospital, Edinburgh, in late 2012. Following this, the first cycle results and local guidelines were presented at a local level and at the hospital grand rounds, posters with recommendations were distributed, joint infection consult and antimicrobial rounds commenced and an alert antimicrobial policy was introduced before re-auditing in early 2013. We demonstrate suboptimal prescribing of intravenous antimicrobials, with 43.9% (43/98) of patients eligible for IVOS at the time of auditing. Only 56.1% (55/98) followed empiric prescribing recommendations. Documentation of antimicrobial prescribing was poor with stop dates recorded in 14.3%, indication on prescription charts in 18.4% and in the notes in 90.8%. The commonest reason for deferring IVOS was deteriorating clinical condition or severe sepsis. Further work to encourage prudent antimicrobial prescribing and earlier consideration of IVOS is required.

  11. The influence of hospital drug formulary policies on the prescribing patterns of proton pump inhibitors in primary care

    DEFF Research Database (Denmark)

    Larsen, Michael Due; Schou, Mette; Kristiansen, Anja Sparre

    2014-01-01

    decreased from 33.5 to 9.4 %, corresponding to a risk ratio of 0.28. In primary care after discharge, 13.4 % of esomeprazole use was initiated in the hospital, and this was 8.4 % for PPIs in general. After the change of hospital drug policy, this decreased to 6.5 % for esomeprazole and increased......AIM: This study had two aims: Firstly, to describe how prescriptions for proton pump inhibitor (PPI) in primary care were influenced by a change of the hospital drug policy, and secondly, to describe if a large discount on an expensive PPI (esomeprazole) to a hospital would influence prescribing...... policy on prescribings in primary care was measured by the likelihood of having a high-cost PPI prescribed before and after change of drug policy. RESULTS: In total, 9,341 hospital stays in 2009 and 2010 were included. The probability of a patient to be prescribed an expensive PPI after discharge...

  12. Medical school gift restriction policies and physician prescribing of newly marketed psychotropic medications: difference-in-differences analysis.

    Science.gov (United States)

    King, Marissa; Essick, Connor; Bearman, Peter; Ross, Joseph S

    2013-01-30

    To examine the effect of attending a medical school with an active policy on restricting gifts from representatives of pharmaceutical and device industries on subsequent prescribing behavior. Difference-in-differences approach. 14 US medical schools with an active gift restriction policy in place by 2004. Prescribing patterns in 2008 and 2009 of physicians attending one of the schools compared with physicians graduating from the same schools before the implementation of the policy, as well as a set of contemporary matched controls. Probability that a physician would prescribe a newly marketed medication over existing alternatives of three psychotropic classes: lisdexamfetamine among stimulants, paliperidone among antipsychotics, and desvenlafaxine among antidepressants. None of these medications represented radical breakthroughs in their respective classes. For two of the three medications examined, attending a medical school with an active gift restriction policy was associated with reduced prescribing of the newly marketed drug. Physicians who attended a medical school with an active conflict of interest policy were less likely to prescribe lisdexamfetamine over older stimulants (adjusted odds ratio 0.44, 95% confidence interval 0.22 to 0.88; P=0.02) and paliperidone over older antipsychotics (0.25, 0.07 to 0.85; P=0.03). A significant effect was not observed for desvenlafaxine (1.54, 0.79 to 3.03; P=0.20). Among cohorts of students who had a longer exposure to the policy or were exposed to more stringent policies, prescribing rates were further reduced. Exposure to a gift restriction policy during medical school was associated with reduced prescribing of two out of three newly introduced psychotropic medications.

  13. Utility regulation and competition policy

    International Nuclear Information System (INIS)

    Robinson, Colin

    2002-03-01

    Contents: 1. The New Electricity Trading Arrangements in England and Wales: A Review - David Currie, 2. A Critique of Rail Regulation - Dieter Helm, 3. Moving to a Competitive Market in Water - Colin Robinson, 4. The New Gas Trading Arrangements - George Yarrow, 5. A Review of Privatization and Regulation Experience in Britain - Irwin M. Stelzer, 6. Converging Communications: Implications for Regulation - Mark Armstrong, 7. Opening European Electricity and Gas Markets - Graham Shuttleworth, 8. Concurrency or Convergence? Competition and Regulation Under the Competition Act 1998 - Tom Sharpe QC, 9. Ten Years of European Merger Control - Paul Seabright. (Author)

  14. Take on the issue of chronic pain with comprehensive solutions, firm policies on prescribing.

    Science.gov (United States)

    2011-08-01

    Patients who visit the ED frequently to obtain treatment for chronic pain can be frustrating and difficult to manage, but some EDs are making progress with this group by linking these patients to resources and establishing a firm policy on when narcotics will be prescribed. Experts say that while strict "no opioids" policies rarely work well, some patients can be helped when given access to more comprehensive treatment approaches. The ED at Methodist Hospital in Indianapolis has developed a multidisciplinary program that includes referrals to a primary care provider (PCP), as well as a chemical dependency specialist. All providers have access to care-management notes on the patient through the health system's electronic medical record. Patients who are non-complaint with the program risk losing access to narcotic medications when they visit the ED. The ED at Dosher Memorial Hospital in Southport, NC, has developed a policy that encourages all patients with chronic pain to seek treatment from a PCP. The hospital will help to link patients with a PCP and other resources in the region. The approach has curbed the incidence of drug-seeking behavior and helped to make the treatment of chronic pain uniform across all ED providers. Since the prevalence of pain is so high among patients in the ED, many emergency physicians are seeking added training in the treatment of pain.

  15. Public utility regulation and national energy policy

    Energy Technology Data Exchange (ETDEWEB)

    Navarro, P.

    1980-09-01

    The linkage between Public Utility Commission (PUC) regulation, the deteriorating financial health of the electric utility industry, and implementation of national energy policy, particularly the reduction of foreign petroleum consumption in the utility sector is examined. The role of the Nation's utilities in the pursuit of national energy policy goals and postulates a linkage between PUC regulation, the poor financial health of the utility industry, and the current and prospective failure to displace foreign petroleum in the utility sector is discussed. A brief history of PUC regulation is provided. The concept of regulatory climate and how the financial community has developed a system of ranking regulatory climate in the various State jurisdictions are explained. The existing evidence on the hypothesis that the cost of capital to a utility increases and its availability is reduced as regulatory climate grows more unfavorable from an investor's point of view is analyzed. The implications of this cost of capital effect on the electric utilities and collaterally on national energy policy and electric ratepayers are explained. Finally various State, regional and Federal regulatory responses to problems associated with PUC regulation are examined.

  16. REGULATION AND ENFORCEMENT OF COMPETITION POLICY

    Directory of Open Access Journals (Sweden)

    Liviana Andreea Niminet

    2014-12-01

    Full Text Available Competition policy starts by shaping a legislative framework. This is aimed to establish boundaries for conducting competition and also sets limits of licit and illicit demarcation, for competitive and anticompetitive practices. The Romanian Competition Law has a divalent approach and it aims to provide specific behavioral conditions in order to stimulate and protect free-market competition, with the ultimate goal of developing a balanced, efficient and competitive economy. Our country’s Competition policy is based on punishing the behavior. There are three such types of anti-competitive behavior, namely: agreements between undertakings, abuse of dominant position and mergers and other concentrations between undertakings. Recent Practice proved that this “enforcement-conduct-punishment” structure is not necessary the best way to address competition and it is high time for authorities to switch both regulation and enforcement of competition from the “classical perspective” towards concepts like “competition advocacy” and “soft power” and give competition policy a new, reshaped face.

  17. Regulation of Communication Policy of Modern Banks

    Directory of Open Access Journals (Sweden)

    Ketova Natalia, P.

    2016-03-01

    Full Text Available The paper shows the need for effective communication commercial banks, revealed the possibility of interaction with customers through advertising, sponsorship, philanthropy, sales promotion, lobbying of interests of banking institutions. The principles for the regulation of communications to ensure consistency of communication complex, which cause a complex effect on the external environment, the creation of adaptive system of marketing communications. It is proved that the possibilities of implementing an active communication policy of modern banks in recent years is constantly increasing. This contributes to the extension of Internet technologies, the creation of remote service channels, the emergence of new tools and technologies to attract and retain customers. On the example of JSC "Sberbank of Russia" presented the technology of using the traditional tools of ATL and BTL communications, the formation of the system CSR – corporate social responsibility, building contact with customers, enhancing their loyalty to the Bank. Reveals the areas of regulation of the savings Bank of its activities on the creation of the daily value of services based on the principles of involvement and co-operation of the system "Client - Bank", "Bank - Company", "Bank – Employees".

  18. 7 CFR 982.40 - Marketing policy and volume regulation.

    Science.gov (United States)

    2010-01-01

    ... the declared policy of the act, it shall compute and announce an inshell trade demand for that year... 7 Agriculture 8 2010-01-01 2010-01-01 false Marketing policy and volume regulation. 982.40 Section 982.40 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING...

  19. Strict Liability Versus Policy and Regulation for Environmental Protection and Agricultural Waste Management in Malaysia

    Directory of Open Access Journals (Sweden)

    Mohd Bakri Ishak

    2010-01-01

    Full Text Available Basically, strict liability is part of the mechanism for expressing judgment or sentence by using direct evidence. This principle is very useful in order to obtain remedies from any damage either directly or indirectly. The principle in Rylands v Fletcher is responsible on imposing strict liability where if something brought onto land or collected there escapes liability under this rule can include not only the owner of land but also those who control or occupation on it. However, as a matter of fact, policy and regulation are also important in taking any action against any party who are responsible for environmental pollution or damage, which may include mismanagement of waste or industrial waste or agricultural waste. There are certain policies and regulations on environmental protection such as the National Environmental Policy, certain Acts and several regulations under the Environmental Quality Act 1974 (Act 127, which are very useful for agricultural waste management inter alia: Waters Act 1920 (Act 418, Environmental Quality (Prescribed Premises (Crude Palm Oil Regulations 1977, Environmental Quality (Prescribed Premises (Raw Natural Rubber Regulations 1978, Environmental Quality (Sewage and Industrial Effluents Regulations 1979, and Environmental Quality (Compounding of Offences Rules 1978. As a matter of fact, we should realize that time is of an essence for any parties which are involved in court cases and especially in avoiding the element of externality, which is commonly suffered by the government. In making this paper, therefore, some element of comparison with certain developed jurisdiction such as in the United Kingdom and Japan could not be avoided in order to obtain better outcome and to be more practical for the purpose of environmental protection and agricultural waste management.

  20. 42 CFR 403.201 - State regulation of insurance policies.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false State regulation of insurance policies. 403.201 Section 403.201 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Medicare Supplemental Policies General Provisions...

  1. Decree 120/12. It regulate the servitudes prescribed by law 17,389

    International Nuclear Information System (INIS)

    2012-01-01

    This decree regulates the monitoring, control, maintenance and operation of the oil pipeline territory in charge of Ancap. This pipeline connects the Eastern Terminal Jose Ignacio with La Teja refinery which simultaneously is connected with La Tablada plant. The Administracion Nacional de Combustibles Alcohol y Portland (Ancap) establish the prohibitions and limitations on the land use as well as the explosive charge circulation in the zone.

  2. E-commerce and Regulation Policy

    OpenAIRE

    Dragos Vasile

    2007-01-01

    E-commerce is a relatively new business field with a high potential of growth, thanks primarily to advantages provided to companies and consumers. At the same time, e-commerce raises technical and economic issues and problems to be solved, which are a concern for businesses, states and international organizations. The growth is accompanied by a need of regulation, including the observance of competition rules. The analysis of the practice in states with developed e-commerce markets highlights...

  3. An Optimization-Based Impedance Approach for Robot Force Regulation with Prescribed Force Limits

    Directory of Open Access Journals (Sweden)

    R. de J. Portillo-Vélez

    2015-01-01

    Full Text Available An optimization based approach for the regulation of excessive or insufficient forces at the end-effector level is introduced. The objective is to minimize the interaction force error at the robot end effector, while constraining undesired interaction forces. To that end, a dynamic optimization problem (DOP is formulated considering a dynamic robot impedance model. Penalty functions are considered in the DOP to handle the constraints on the interaction force. The optimization problem is online solved through the gradient flow approach. Convergence properties are presented and the stability is drawn when the force limits are considered in the analysis. The effectiveness of our proposal is validated via experimental results for a robotic grasping task.

  4. Review of Policy Documents for Nuclear Safety and Regulation

    International Nuclear Information System (INIS)

    Kim, Woong Sik; Choi, Kwang Sik; Choi, Young Sung; Kim, Hho Jung; Kim, Ho Ki

    2006-01-01

    The goal of regulation is to protect public health and safety as well as environment from radiological hazards that may occur as a result of the use of atomic energy. In September 1994, the Korean government issued the Nuclear Safety Policy Statement (NSPS) to establish policy goals of maintaining and achieving high-level of nuclear safety and also help the public understand the national policy and a strong will of the government toward nuclear safety. It declares the importance of establishing safety culture in nuclear community and also specifies five nuclear regulatory principles (Independence, Openness, Clarity, Efficiency and Reliability) and provides the eleven regulatory policy directions. In 2001, the Nuclear Safety Charter was declared to make the highest goal of safety in driving nuclear business clearer; to encourage atomic energy- related institutions and workers to keep in mind the mission and responsibility for assuring safety; to guarantee public confidence in related organizations. The Ministry of Science and Technology (MOST) also issues Yearly Regulatory Policy Directions at the beginning of every year. Recently, the third Atomic Energy Promotion Plan (2007-2011) has been established. It becomes necessary for the relevant organizations to prepare the detailed plans on such areas as nuclear development, safety management, regulation, etc. This paper introduces a multi-level structure of nuclear safety and regulation policy documents in Korea and presents some improvements necessary for better application of the policies

  5. Review of Policy Documents for Nuclear Safety and Regulation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Woong Sik; Choi, Kwang Sik; Choi, Young Sung; Kim, Hho Jung; Kim, Ho Ki [Korea Institute of Nuclear Safety, Taejon (Korea, Republic of)

    2006-07-01

    The goal of regulation is to protect public health and safety as well as environment from radiological hazards that may occur as a result of the use of atomic energy. In September 1994, the Korean government issued the Nuclear Safety Policy Statement (NSPS) to establish policy goals of maintaining and achieving high-level of nuclear safety and also help the public understand the national policy and a strong will of the government toward nuclear safety. It declares the importance of establishing safety culture in nuclear community and also specifies five nuclear regulatory principles (Independence, Openness, Clarity, Efficiency and Reliability) and provides the eleven regulatory policy directions. In 2001, the Nuclear Safety Charter was declared to make the highest goal of safety in driving nuclear business clearer; to encourage atomic energy- related institutions and workers to keep in mind the mission and responsibility for assuring safety; to guarantee public confidence in related organizations. The Ministry of Science and Technology (MOST) also issues Yearly Regulatory Policy Directions at the beginning of every year. Recently, the third Atomic Energy Promotion Plan (2007-2011) has been established. It becomes necessary for the relevant organizations to prepare the detailed plans on such areas as nuclear development, safety management, regulation, etc. This paper introduces a multi-level structure of nuclear safety and regulation policy documents in Korea and presents some improvements necessary for better application of the policies.

  6. NPL deletion policy for RCRA-regulated TSD facilities finalized

    International Nuclear Information System (INIS)

    Anon.

    1995-01-01

    Under a new policy published by EPA on March 20, 1995, certain sites may be deleted from the National Priorities List (NPL) and deferred to RCRA corrective action. To be deleted from the NPL, a site must (1) be regulated under RCRA as a treatment, storage, or disposal (TSD) facility and (2) meet the four criteria specified by EPA. The new NPL deletion policy, which does not pertain to federal TSD facilities, became effective on April 19, 1995. 1 tab

  7. Situational analysis of antibiotic use and resistance in Ghana: policy and regulation

    Directory of Open Access Journals (Sweden)

    Saviour Kwame Yevutsey

    2017-11-01

    Full Text Available Abstract Background Antibiotics have played an essential role in decreasing morbidity and mortality from infectious diseases. However, indiscriminate use and unrestricted access is contributing to the emergence of bacterial resistance. This paper reports on a situational analysis of antimicrobial use and resistance in Ghana, with focus on policy and regulation. Methods Relevant policy documents, reports, regulations and enactments were reviewed. PubMed and Google search engines were used to extract relevant published papers. Websites of stakeholders such as Ministry of Health (MOH and its agencies were also reviewed. An interview guide was used to elicit responses from selected officials from these sectors. Results Laws and guidelines to control the use of antimicrobials in humans were available but not for animals. There was no National Antimicrobial Policy (NAP. A health practice regulatory law mandates Physicians, Physician Assistants, Midwives and trained Nurses to prescribe antimicrobials. However, antibiotics are widely prescribed and dispensed by unauthorised persons, suggesting weak enforcement of the laws. Antibiotics were also supplied to and from unapproved medicine outlets. The Standard Treatment Guidelines (STG, Essential Medicines List (EML and the National Health Insurance Scheme Medicines List (NHISML provide restrictions regarding levels of prescribing of antimicrobials. However, existing guidelines on antibiotic use are mostly not adhered to. The use of Automatic Stop Orders to avoid wastage in the hospitals is also not practiced. Data on use of antibiotics for individuals are not readily available in most facilities. Again, there are no standards or guidelines on veterinary use of antibiotics. Surveillance systems for consumption of antibiotics and resistance monitoring were not in place in most health facilities. However, there is an ongoing national action to create awareness on bacteria resistance, strengthening knowledge

  8. Liquidity regulation and the implementation of monetary policy

    OpenAIRE

    Morten L. Bech; Todd Keister

    2013-01-01

    In addition to revamping existing rules for bank capital, Basel III introduces a new global framework for liquidity regulation. One part of this framework is the liquidity coverage ratio (LCR), which requires banks to hold sufficient high-quality liquid assets to survive a 30-day period of market stress. As monetary policy typically involves targeting the interest rate on loans of one of these assets — central bank reserves — it is important to understand how this regulation may impact the ef...

  9. Expanding Access to Insurance by the Poor : Policy, Regulation and ...

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

    Expanding Access to Insurance by the Poor : Policy, Regulation and Supervision of Micro Insurance. This project aims to facilitate poor people's access to insurance products and services as a means of addressing their vulnerability to risk. It will do so by carrying out case studies in five countries. Potential candidates ...

  10. Environmental Policies, Product Market Regulation and Innovation in Renewable Energy

    International Nuclear Information System (INIS)

    Nesta, Lionel; Vona, Francesco; Nicolli, Francesco

    2012-10-01

    We investigate the effectiveness of policies in favor of innovation in renew- able energy under different levels of competition. Using information regarding renewable energy policies, product market regulation and high-quality green patents for OECD countries since the late 1970's, we develop a pre-sample mean count-data econometric specification that also accounts for the endogeneity of policies. We find that renewable energy policies are significantly more effective in fostering green innovation in countries with deregulated energy markets. We also find that public support for renewable energy is crucial only in the generation of high-quality green patents, whereas competition enhances the generation of green patents irrespective of their quality. (authors)

  11. Automated Vehicle Policy and Regulation: A State Perspective Workshop: Summary

    Energy Technology Data Exchange (ETDEWEB)

    Young, Stanley E. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Levine, Aaron [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2016-06-01

    A workshop held on May 18, 2016, at the University of Maryland focused on key principles that should govern state policy decisions intended to ensure the safe operation of autonomous vehicles (AVs). The patchwork approach taken by early state adopters had primarily addressed only testing of these vehicles. As uncertainties in technology and business models play out, and in the absence of more suitable policies and regulations, states are relying on laws created for conventional vehicles to govern AV operations. The workshop addressed these challenges with three panel discussions that examined the underpinnings of policy development, factors affecting policy decisions, and the ultimate impact of AVs in a number of areas, including economic competitiveness; quality of mobility, particularly for disabled community; and energy use and emissions.

  12. Rationalising prescribing

    DEFF Research Database (Denmark)

    Wadmann, Sarah; Bang, Lia Evi

    2015-01-01

    Initiatives in the name of 'rational pharmacotherapy' have been launched to alter what is seen as 'inappropriate' prescribing practices of physicians. Based on observations and interviews with 20 general practitioners (GPs) in 2009-2011, we explored how attempts to rationalise prescribing interac...

  13. Tobacco regulations and policies in the Eurasian Economic Union

    Directory of Open Access Journals (Sweden)

    Andrei Konstantinovich Demin

    2017-05-01

    Differences between tobacco regulations and policies in the EAEU, EU and other supranational organizations should be further researched in order to promote exchange of best practices in WHO FCTC comprehensive compliance. Implementation of WHO FCTC Article 5.3. and involvement of civil society are among priorities. The practical prospects for the supranational EAEU to become a party to the WHO FCTC should be considered in detail.

  14. National policies and regulations for decommissioning nuclear facilities

    International Nuclear Information System (INIS)

    1993-07-01

    This report, though produced as a follow-up to Safety Series No. 105, The Regulatory Process for the Decommissioning of Nuclear Facilities, is not primarily intended as guidance. Rather, its objective is to provide an overview of national decommissioning policies and regulatory practices as part of the background knowledge which is an essential precondition for good decision making. It discusses the reasons for the similarities and differences in national approach using specific examples but without giving preference to any particular scheme; it aims rather to provide factual, general information on the choices that have been or are being made, and why. As many Member States are in a transient situation between the case-by-case approach to decommissioning and the establishment of national policies, strategies and regulations, this seems the right moment to assess existing national practices worldwide and that is the purpose for which the document is issued at this time. The information gathered in this report is based on submissions by Member States which have developed or are in the process of developing decommissioning oriented policies and regulations. 29 refs

  15. Chemical regulation on fire: rapid policy advances on flame retardants.

    Science.gov (United States)

    Cordner, Alissa; Mulcahy, Margaret; Brown, Phil

    2013-07-02

    Chemicals that are widely used in consumer products offer challenges to product manufacturers, risk managers, environmental regulators, environmental scientists, and the interested public. However, the factors that cause specific chemicals to rise to the level of regulatory, scientific, and social movement concern and scrutiny are not well documented, and scientists are frequently unclear about exactly how their research impacts policy. Through a case study of advocacy around flame retardant chemicals, this paper traces the pathways through which scientific evidence and concern is marshaled by both advocacy groups and media sources to affect policy change. We focus our analysis around a broad coalition of environmental and public health advocacy organizations and an investigative journalism series published in 2012 in the Chicago Tribune. We demonstrate that the Tribune series both brought the issue to a wider public audience and precipitated government action, including state policy revisions and federal Senate hearings. We also show how a broad and successful flame retardant coalition developed, leveraged a media event, and influenced policy at multiple institutional levels. The analysis draws on over 110 in-depth interviews, literature and Web site reviews, and observations at a flame retardant manufacturing company, government offices, and scientific and advocacy conferences.

  16. Illicit drugs policy through the lens of regulation.

    Science.gov (United States)

    Ritter, Alison

    2010-07-01

    The application of regulatory theory to the problem of illicit drugs has generally been thought about only in terms of 'command and control'. The international treaties governing global illicit drug control and the use of law enforcement to dissuade and punish offenders have been primary strategies. In this paper I explore the application of other aspects of regulatory theory to illicit drugs-primarily self-regulation and market regulation. There has been an overreliance on strategies from the top of the regulatory pyramid. Two other regulatory strategies--self-regulation and market regulation--can be applied to illicit drugs. Self-regulation, driven by the proactive support of consumer groups may reduce drug-related harms. Market strategies such as pill-testing can change consumer preferences and encourage alternate seller behaviour. Regulatory theory is also concerned with partnerships between the state and third parties: strategies in these areas include partnerships between police and pharmacies regarding sale of potential precursor chemicals. Regulatory theory and practice is a rich and well-developed field in the social sciences. I argue that governments should consider the full array of regulatory strategies. Using regulatory theory provides a rationale and justification to strategies that are currently at the whim of politics, such as funding for user groups. The greater application of regulatory approaches may produce more flexible and structured illicit drug policies. Copyright (c) 2009 Elsevier B.V. All rights reserved.

  17. Oil price volatility, financial regulation and energy policy

    International Nuclear Information System (INIS)

    Chevalier, J.M.

    2010-01-01

    In October of 2009, the French Ministry of Economy asked the author to chair a work group on oil price volatility. The report resulting from that work was submitted to the minister on February 9, 2010. Based on the report, this article focuses on three major elements: (i) the operation of the oil market, with interacting physical basics and financial basics (ii) financial market regulation, more specifically commodities-derived product markets and current work in that area and (iii) the lessons one can draw from that exercise in terms of energy policy. Significant projects have been initiated on global, European and national levels. (author)

  18. E-cigarette regulation and policy: UK vapers' perspectives.

    Science.gov (United States)

    Farrimond, Hannah

    2016-06-01

    The rapid increase in use of electronic cigarettes (e-cigarettes) has created an international policy dilemma concerning how to use these products. This study assesses the types of beliefs that e-cigarette users in the United Kingdom may hold concerning regulation. Qualitative thematic analysis of written answers to open-ended questions. United Kingdom, questionnaire conducted by post, 44% recruited from online forums and 56% non-online. Fifty-five UK vapers, 55% male, mean age 46 years, 84% sole users of e-cigarettes, 95% vaping daily. Open-ended questions on regulatory and policy options. 'Protecting youth' was seen as a fundamental regulatory requirement which should be achieved through childproofing, age limits, no advertising aimed at children and health warnings about addictiveness of nicotine, but not the restriction of flavours. There was little support for regulating e-cigarettes as medicines or limiting the strength of nicotine liquids. In terms of public use, participants argued against a blanket ban on public vaping given perceptions of a lack of scientific evidence of harm. However, they supported the principle of autonomy, that individuals and organizations have the right to restrict vaping. Some participants suggested banning vaping in places such as schools, hospitals or around food, in line with current smoking norms. Vapers' regulatory positions were accompanied by political concerns about the use (and misuse) of scientific evidence. With regard to regulation of e-cigarettes, issues that are salient to UK vapers may include the need for youth protection, regulation as medicines, strength of e-liquids, bans on public vaping and concerns about the misuse of scientific evidence. © 2016 Society for the Study of Addiction.

  19. Prescribing procrastination

    Science.gov (United States)

    Thomson, George H.

    1979-01-01

    In his everyday work the family physician sees many patients whose problems have been diagnosed but for whom postponement of an active treatment plan is indicated. The physician must therefore prescribe procrastination in a carefully planned way. I describe some ideas and practical methods for doing this. PMID:529244

  20. Prescribing Antibiotics

    DEFF Research Database (Denmark)

    Pedersen, Inge Kryger; Jepsen, Kim Sune

    2018-01-01

    The medical professions will lose an indispensable tool in clinical practice if even simple infections cannot be cured because antibiotics have lost effectiveness. This article presents results from an exploratory enquiry into “good doctoring” in the case of antibiotic prescribing at a time when...... the knowledge base in the healthcare field is shifting. Drawing on in-depth interviews about diagnosing and prescribing, the article demonstrates how the problem of antimicrobial resistance is understood and engaged with by Danish general practitioners. When general practitioners speak of managing “non......-medical issues,” they refer to routines, clinical expertise, experiences with their patients, and decision-making based more on contextual circumstances than molecular conditions—and on the fact that such conditions can be hard to assess. This article’s contribution to knowledge about how new and global health...

  1. Analysis of Brazilian SHP policy and its regulation scenario

    International Nuclear Information System (INIS)

    Tiago Filho, Geraldo Lucio; Rocha Galhardo, Camila; Cassia Barbosa, Adriana de; Mambeli Barros, Regina; Gracas Braga da Silva, Fernando das

    2011-01-01

    This article presents the main regulatory changes that occurred in the Brazilian power sector in 2009, along with the impacts these changes caused on the market, especially related to small hydropower (<30 MW). This study addresses regulatory issues based on inventory studies and records of basic projects, changes related to the compensation of the assured energy of SHPs in the Brazilian energy reallocation market, the socio-economic impact resulting from the construction of SHPs, SHPs in alternative resource auctions and finally the general outlook for the growth scenario for SHPs in Brazil according to the ten-year plan (2010-2019). The overall conclusions of this investigation were that the 2008/2009 biennium was a period of great changes in the regulation of small hydropower plants in Brazil, and the SHP market has shown maturity. Additionally, despite SHP being a type of technology that is completely dominated by domestic industry, in recent years, they have experienced policy disincentives caused by changes to rules that inhibit their growth. - Highlights: → Main regulatory changes in Brazilian Power Sector that have occurred in 2009. → The impact of these changes caused on market, especially about SHPs (<30 MW). → The Brazilian growth scenario for SHPs according to the ten-year plan (2010-2019). → 2008/2009 biennium was a period of changes in the Brazilian regulation of SHPs. → SHP is a type of technology that is completely dominated by domestic industry.

  2. What Can We Learn About the Processes of Regulation of Tuberculosis Medicines From the Experiences of Health Policy and System Actors in India, Tanzania, and Zambia?

    Directory of Open Access Journals (Sweden)

    Kabir Sheikh

    2016-07-01

    Full Text Available Background: The unregulated availability and irrational use of tuberculosis (TB medicines is a major issue of public health concern globally. Governments of many low- and middle-income countries (LMICs have committed to regulating the quality and availability of TB medicines, but with variable success. Regulation of TB medicines remains an intractable challenge in many settings, but the reasons for this are poorly understood. The objective of this paper is to elaborate processes of regulation of quality and availability of TB medicines in three LMICs – India, Tanzania, and Zambia – and to understand the factors that constrain and enable these processes. Methods: We adopted the action-centred approach of policy implementation analysis that draws on the experiences of relevant policy and health system actors in order to understand regulatory processes. We drew on data from three case studies commissioned by the World Health Organization (WHO, on the regulation of TB medicines in India, Tanzania, and Zambia. Qualitative research methods were used, including in-depth interviews with 89 policy and health system actors and document review. Data were organized thematically into accounts of regulators’ authority and capacity; extent of policy implementation; and efficiency, transparency, and accountability. Results: In India, findings included the absence of a comprehensive policy framework for regulation of TB medicines, constraints of authority and capacity of regulators, and poor implementation of prescribing and dispensing norms in the majority private sector. Tanzania had a policy that restricted import, prescribing and dispensing of TB medicines to government operators. Zambia procured and dispensed TB medicines mainly through government services, albeit in the absence of a single policy for restriction of medicines. Three cross-cutting factors emerged as crucially influencing regulatory processes - political and stakeholder support for

  3. 14 CFR Section 01 - Authority Under Which Accounting and Reporting Rules and Regulations are Prescribed and Administered

    Science.gov (United States)

    2010-01-01

    ... OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS UNIFORM... all documents, papers, and correspondence, now or hereafter existing, and kept or required to be kept... necessary in the public interest. Safety, Economic and Postal Offenses Sec. 901. (a)(1) Any person who...

  4. Evolution of the policy of legal regulation on public procurement in Lithuania

    OpenAIRE

    Ambrazevičienė, Rima

    2004-01-01

    This article aims to present in overview of the evolution of the policy of legal regulations on public procurement in Lithuania in 1990-2004. The public procurement policy in this article is understood as the concept, principles and main aims of legal regulation on this sphere. According to some scientific researchers there are two major paradigm shifts of public procurement policy in the world - a shift from internal processes to value adding benefits and a shift to opening up of public purc...

  5. 78 FR 71558 - Insurance Cost Information Regulation

    Science.gov (United States)

    2013-11-29

    .... FOR FURTHER INFORMATION CONTACT: Deborah Mazyck, Office of International Policy, Fuel Economy and... Transportation prescribe regulations requiring passenger motor vehicle dealers to distribute to prospective... vehicle dealers to distribute this information to prospective buyers. The House of Representatives...

  6. The impact of the 'Better Care Better Value' prescribing policy on the utilisation of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers for treating hypertension in the UK primary care setting: longitudinal quasi-experimental design.

    Science.gov (United States)

    Baker, Amanj; Chen, Li-Chia; Elliott, Rachel A; Godman, Brian

    2015-09-10

    In April/2009, the UK National Health Service initiated four Better Care Better Value (BCBV) prescribing indicators, one of which encouraged the prescribing of cheaper angiotensin-converting enzyme inhibitors (ACEIs) instead of expensive angiotensin receptor blockers (ARBs), with 80 % ACEIs/20 % ARBs as a proposed, and achievable target. The policy was intended to save costs without affecting patient outcomes. However, little is known about the actual impact of the BCBV indicator on ACEIs/ARBs utilisation and cost-savings. Therefore, this study aimed to evaluate the impact of BCBV policy on ACEIs/ARBs utilisation and cost-savings, including exploration of regional variations of the policy's impact. This cross-sectional study used data from the UK Clinical Practice Research Datalink. Segmented time-series analysis was applied to monthly ACEIs prescription proportion, adjusted number of ACEIs/ARBs prescriptions and costs. Overall, the proportion of ACEIs prescription decreased during the study period from 71.2% in April/2006 to 70.7% in March/2012, with a small but a statistically significant pre-policy reduction in its monthly trend of 0.02% (p < 0.001). Instantly after its initiation, the policy was associated with a sudden reduction in the proportion of ACEIs prescription; however, it resulted in a statistically significant increase in the post-policy monthly trend of ACEIs prescription proportion of 0.013% (p < 0.001), resulting in an overall post-policy slope of -0.007%. Despite this post-policy induced increment, the policy failed to achieve the 80% target, which resulted in missing a potential cost-saving opportunity. The pre-policy trend of the adjusted number of ACEIs/ARBs prescriptions was increasing; however, their trends declined after the policy implementation. The policy affected neither total ACEIs/ARBs cost nor individual ACEIs or ARBs costs. ACEIs/ARBs utilisation was not affected by the BCBV policy. The small increase in post-policy ACEIs

  7. Potential impact of policy regulation and generic competition on sales of cholesterol lowering medication, antidepressants and acid blocking agents in Belgium.

    Science.gov (United States)

    Fraeyman, J; Van Hal, G; De Loof, H; Remmen, R; De Meyer, G R Y; Beutels, P

    2012-01-01

    Pharmaceutical expenditures are increasing as a proportion of health expenditures in most rich countries. Antidepressants, acid blocking agents and cholesterol lowering medication are major contributors to medicine sales around the globe. We aimed to document the possible impact of policy regulations and generic market penetration on the evolution of sales volume and average cost per unit (Defined Daily Doses and packages) of antidepressants, acid blocking agents and cholesterol lowering medication. We extracted data from the IMS health database regarding the public price and sales volume of the antidepressants (selective serotonin reuptake inhibitors (SSRI's), monoamine oxidase inhibitors (MAOl's) and tricyclic and remaining antidepressants (TCA's)), acid blocking agents (proton pump inhibitors (PPl's) and H2 receptor antagonists) and cholesterol lowering medication (statins and fibrates) in Belgium between 1995 and 2009. We describe these sales data in relation to various national policy measures which were systematically searched in official records. Our analysis suggests that particular policy regulations have had immediate impact on sales figures and expenditures on pharmaceuticals in Belgium: changes in reimbursement conditions, a public tender and entry of generic competitors in a reference pricing system. However, possible sustainable effects seem to be counteracted by other mechanisms such as marketing strategies, prescribing behaviour, brand loyalty and the entry of pseudogenerics. It is likely that demand-side measures have a more sustainable impact on expenditure. Compared with other European countries, generic penetration in Belgium remains low. Alternative policy regulations aimed at enlarging the generic market and influencing pharmaceutical expenditures deserve consideration. This should include policies aiming to influence physicians' prescribing and a shared responsibility of pharmacists, physicians and patients towards expenditures.

  8. The Interdependence of Competition Policy, Consumer Policy and Regulation in Introducing and Safeguarding Effective Competition in the EU Telecommunications Market

    OpenAIRE

    Bartels, Andreas; Pleșea, Doru Alexandru; Studeny, Michael; Just, Vanessa

    2017-01-01

    Currently, the European Union finds itself in troubled waters. It has to prove that its benefits outweigh the costs of its endeavour. In this respect, an EU competition policy that focuses on consumer welfare is one way to gain support by the citizens of its member states. The Roaming Regulation that has reduced the mobile communications costs while travelling abroad serves as a good example for this approach. The EU Commission views consumer policy as another important factor to protect and ...

  9. Renewable electricity in Sweden: an analysis of policy and regulations

    International Nuclear Information System (INIS)

    Wang Yan

    2006-01-01

    This study aims to analyse the developments in renewable energy policy making in Sweden. It assesses the energy policy context, changes in the choice of policy instruments, and provides explanations behind policy successes and failures. Swedish renewable energy policy has been developing in a context of uncertainty around nuclear issues. While there has been made a political decision to replace nuclear power with renewable s, there is a lack of consensus about the pace of phasing out nuclear power due to perceived negative impacts on industrial competitiveness. Such uncertainty had an effect in the formulation of renewable energy policy. Biomass and wind power are the main options for renewable electricity production. Throughout 1990s, the combined effect of different policy instruments has stimulated the growth of these two renewable sources. Yet, both biomass and wind power are still a minor contributor in the total electricity generation. Lack of strong government commitment due to uncertainty around nuclear issues is a crucial factor. Short-term subsidies have been preferred rather than open-ended subsidy mechanisms, causing intervals without subsidies and interruption to development. Other factors are such as lack of incentives from the major electricity companies and administrative obstacles. The taxation system has been successful in fostering an expansion of biomass for heating but hindered a similar development in the electricity sector. The quota system adopted in 2003 is expected to create high demand on biomass but does not favour wind power. The renewable energy aims are unlikely to be changed. Yet, the future development of renewable energy policies especially for high-cost technologies will again depend strongly on nuclear policies, which are still unstable and might affect the pace of renewable energy development

  10. Who regulates the disposal of low-level radioactive waste under the Low-Level Radioactive Waste Policy Act

    International Nuclear Information System (INIS)

    Mostaghel, D.M.

    1988-01-01

    The present existence of immense quantities of low-level nuclear waste, a federal law providing for state or regional control of such waste disposal, and a number of state disposal laws challenged on a variety of constitutional grounds underscore what currently may be the most serious problem in nuclear waste disposal: who is to regulate the disposal of low-level nuclear wastes. This problem's origin may be traced to crucial omissions in the Atomic Energy Act of 1946 and its 1954 amendments (AEA) that concern radioactive waste disposal. Although the AEA states that nuclear materials and facilities are affected with the public interest and should be regulated to provide for the public health and safety, the statute fails to prescribe specific guidelines for any nuclear waste disposal. The Low-Level Radioactive Waste Policy Act of 1980 (LLRWPA) grants states some control over radioactive waste disposal, an area from which they were previously excluded by the doctrine of federal preemption. This Comment discusses the question of who regulates low-level radioactive waste disposal facilities by examining the following: the constitutional doctrines safeguarding federal government authority; area of state authority; grants of specific authority delegations under the LLRWPA and its amendment; and finally, potential problems that may arise depending on whether ultimate regulatory authority is deemed to rest with single states, regional compacts, or the federal government

  11. Determinants of Renewable Energy Innovation: Environmental Policies vs. Market Regulation

    International Nuclear Information System (INIS)

    Vona, Francesco; Nesta, Lionel; Nicolli, Francesco

    2012-02-01

    This paper carries out a comprehensive analysis of renewable energy innovations considering four mechanisms suggested by innovation models: 1. policy-inducement; 2. market structure; 3. demand and social cohesion- mainly proxied by income inequality; 4. characteristics of country knowledge base. For OECD countries and years 1970-2005, we build a unique dataset containing time-varying information on quality-adjusted patent production in renewable energy, the latter being a function of environmental policies, green R and D, entry barriers, knowledge stock, knowledge diversity and income inequality. We develop count data models using the Generalized Method of Moments (GMM) to account for endogeneity of policy support. Our synthetic policy index positively affects innovations especially in countries with deregulated energy markets and low entry barriers. The effect of entry barriers and inequality is negative and of similar magnitude as that of policy. Product market liberalization positively affects green patent generation, especially so when ambitious policies are adopted, when the initial level of public R and D expenditures and when the initial share of distributed energy generation is high. Our results are robust to alternative specifications, to the inclusion of technology-specific effects and to the use of quality-adjusted patents as dependent variables. In the latter case, the estimated effect of lowering entry barriers and of knowledge diversity almost double on citation count relatively to patent count. (authors)

  12. Multiple policies to enhance prescribing efficiency for established medicines in Europe with a particular focus on demand-side measures: findings and future implications

    Directory of Open Access Journals (Sweden)

    Brian eGodman

    2014-06-01

    Full Text Available Introduction: The appreciable growth in pharmaceutical expenditure has resulted in multiple initiatives across Europe to lower generic prices and enhance their utilisation. However, considerable variation in their use and prices. Objective: Assess the influence of multiple supply and demand-side initiatives across Europe for established medicines to enhance prescribing efficiency before a decision to prescribe a particular medicine. Subsequently utilise the findings to suggest potential future initiatives that countries could consider. Method: Analysis of different methodologies involving cross national and single country retrospective observational studies on reimbursed use and expenditure of PPIs, statins and renin-angiotensin inhibitor drugs among European countries. Results: Nature and intensity of the various initiatives appreciably influenced prescribing behaviour and expenditure, e.g. multiple measures resulted in reimbursed expenditure for PPIs in Scotland in 2010 56% below 2001 levels despite a 3 fold increase in utilisation and in the Netherlands, PPI expenditure fell by 58% in 2010 vs. 2000 despite a 3-fold increase in utilisation. A similarly picture was seen with prescribing restrictions, i.e. (i more aggressive follow-up of prescribing restrictions for patented statins and ARBs resulted in a greater reduction in the utilisation of patented statins in Austria vs. Norway and lower utilisation of patented ARBs vs. generic ACEIs in Croatia than Austria. However, limited impact of restrictions on esomeprazole in Norway with the first prescription or recommendation in hospital where restrictions do not apply. Similar findings when generic losartan became available in Western Europe. Conclusions: Multiple demand-side measures are needed to influence prescribing patterns. When combined with supply-side measures, activities can realise appreciable savings. Health authorities cannot rely on a ‘spill over’ effect between classes to affect

  13. Regulation of alcohol advertising: Policy options for Australia

    Directory of Open Access Journals (Sweden)

    Sandra C. Jones

    2013-06-01

    Full Text Available A systematic search of academic databases was conducted to identify all refereed papers published between 1990 and 2012 on the regulation of alcohol advertising in Australia and three comparison countries (New Zealand, Canada and the UK. This paper reviews the codes that apply to alcohol advertising in each of the four countries, research into the effectiveness of these codes, and the small body of research into consumer attitudes towards alcohol advertising regulation. This review adduces considerable evidence that alcohol advertising influences drinking behaviours, and that current regulatory systems based on co-regulation and voluntary regulation (as is the case in Australia are ineffective. Recommendations are provided regarding the three pillars of regulation: volume restrictions, content restrictions, and infrastructure to support the regulatory environment.

  14. Prescribing Democracy?

    DEFF Research Database (Denmark)

    Bourne, Angela; Casals Bertoa, Fernando

    2017-01-01

    When democracies ban political parties, one of the central issues to usually emerge in both public and academic debate concerns the effects of proscription. Some argue that proscription may lead to radicalisation, a growth of militancy and readiness to use violence. Some also argue that, in the l......When democracies ban political parties, one of the central issues to usually emerge in both public and academic debate concerns the effects of proscription. Some argue that proscription may lead to radicalisation, a growth of militancy and readiness to use violence. Some also argue that...... of party bans on party system development has remained mostly under-researched. Trying to address this lacuna, and employing a new dataset of banned parties in Europe between 1945 and 2015, we compare the effects of party ban regulation on party system stability in three different arenas: electoral......, parliamentary and governmental. In particular, we examine the impact of party proscription on electoral volatility, fragmentation and closure in three different countries: Turkey, Germany and Spain. Using examples both at national and regional (e.g. Basque Country, Navarre, Saxony) level, and making use...

  15. A New Regulation Policy for Accounting and Control of Nuclear Material

    Energy Technology Data Exchange (ETDEWEB)

    Kim, K. H.; Kim, M. S.; Ahn, S. H. [Korea Institute of Nuclear nonproliferation and Control, Daejeon (Korea, Republic of)

    2016-05-15

    Nuclear Safety and Security Commission(NSSC) has amended two public notices about the regulation of nuclear material accounting and control(NMAC). Those notices were declared in November 2014 and entry into force since 2015. According to this legislation, a new type of NMAC inspection system was introduced and facility rules for NMAC approved by the government should be revised subsequently. These changes were one of the preemptive actions to cope with the emergence of new international safeguards policy and increasing demand on advanced nuclear technology. Generally, the regulation policy affects the nuclear business including research and development. Therefore, understanding of the new policy and its making process may help stakeholders to minimize unnecessary financial and operational burden. This study describes background, features, and institutionalization of the new regulation policy for NMAC. The new regulation policy for NMAC was established and institutionalized to preemptively cope with the internal and external demand on 'better' national system of accounting and control of nuclear material. This new policy and regulation system may call not only the regulator but also nuclear business operators for new works to make their system more effective and efficient.

  16. A New Regulation Policy for Accounting and Control of Nuclear Material

    International Nuclear Information System (INIS)

    Kim, K. H.; Kim, M. S.; Ahn, S. H.

    2016-01-01

    Nuclear Safety and Security Commission(NSSC) has amended two public notices about the regulation of nuclear material accounting and control(NMAC). Those notices were declared in November 2014 and entry into force since 2015. According to this legislation, a new type of NMAC inspection system was introduced and facility rules for NMAC approved by the government should be revised subsequently. These changes were one of the preemptive actions to cope with the emergence of new international safeguards policy and increasing demand on advanced nuclear technology. Generally, the regulation policy affects the nuclear business including research and development. Therefore, understanding of the new policy and its making process may help stakeholders to minimize unnecessary financial and operational burden. This study describes background, features, and institutionalization of the new regulation policy for NMAC. The new regulation policy for NMAC was established and institutionalized to preemptively cope with the internal and external demand on 'better' national system of accounting and control of nuclear material. This new policy and regulation system may call not only the regulator but also nuclear business operators for new works to make their system more effective and efficient

  17. South African law and policy regulating learner absenteeism

    African Journals Online (AJOL)

    Packard Bell

    Department of Psychology of Education, College of Education, University of ... Keywords: ecosystemic theory; learner absenteeism; management approach; South African law and policy ..... learners, but can also be cultural and systemic ..... tesis. Pretoria, Suid-Afrika: Universiteit van Suid-. Afrika. Beskikbaar te .... Phd thesis.

  18. South African law and policy regulating learner absenteeism

    African Journals Online (AJOL)

    Packard Bell

    Learner absenteeism often occurs involuntarily due to learners' social and economic circumstances. ..... still a child; e.g. under 18 years of age, and ... schools to take the age and maturity of the ... 5). The Policy on Learner Attendance (DBE, RSA,. 2010, para. 13(i)) allows the ..... Emotional literacy and the ecology of.

  19. Towards EU Cybersecurity Law: Regulating a New Policy Field

    NARCIS (Netherlands)

    Wessel, Ramses A.; Tsagourias, Nicholas; Buchan, Russell

    2015-01-01

    EU cybersecurity forms a prime example of an area in which both internal and external (global as well as bilateral) policies are connected and in which the different legal competences of the Union need to be combined. Over the past decade the European Union started to take its first careful steps in

  20. The cofiring problem of a power plant under policy regulations

    International Nuclear Information System (INIS)

    Kangas, Hanna-Liisa; Lintunen, Jussi; Uusivuori, Jussi

    2009-01-01

    Cofiring of fossil and renewable fuels can contribute to reaching tightening climate and renewable energy goals. The increase in biomass share in cofiring decreases the use of fossil fuel and increases renewable energy production. We study how energy and climate policies promote that increase. First, we present and solve an electricity producer's profit-maximization problem with detailed technical description of cofiring. We then study the effectiveness of policy instruments (e.g. feed-in laws and emission trading) on biomass utilization in cofiring. The study offers a novel approach to explore the cofiring problem, because of the endogenous fuel choice combined with the policy analysis. We study two different power plants that are located in two different European electricity market areas. Our analysis shows that both feed-in tariff and feed-in premium can have unexpected weaknesses, when they are introduced together with emission trading. Therefore decision-makers should be well informed and cautious when introducing these policies. (author)

  1. Radiopharmaceutical regulation and Food and Drug Administration policy.

    Science.gov (United States)

    Rotman, M; Laven, D; Levine, G

    1996-04-01

    The regulatory policy of the Food and Drug Administration (FDA) on radiopharmaceuticals flows from a rigid, traditional, drug-like interpretation of the FDC Act on the licensing of radiopharmaceuticals. This contributes to significant delays in the drug-approval process for radiopharmaceuticals, which are very costly to the nuclear medicine community and the American public. It seems that radiopharmaceuticals would be better characterized as molecular devices. Good generic rule-making principles include: use of a risk/benefit/cost analysis; intent based on sound science; performance standards prepared by outside experts; a definite need shown by the regulatory agency; to live with the consequences of any erroneous cost estimates; and design individual credential requirements so that additional training results in enhanced professional responsibility. When these common elements are applied to current FDA policy, it seems that the agency is out of sync with the stated goals for revitalizing federal regulatory policies as deemed necessary by the Clinton administration. Recent FDA rulings on positron-emission tomography, Patient Package inserts, and on medical device service accentuate the degree of such asynchronization. Radiopharmaceutical review and licensing flexibility could be dramatically improved by excluding radiopharmaceuticals from the drug category and reviewing them as separate entities. This new category would take into account their excellent record of safety and their lack of pharmacological action. Additionally, their evaluation of efficacy should be based on their ability to provide useful scintiphotos, data, or responses of the physiological system it portends to image, quantitate, or describe. To accomplish the goal of transforming the FDA's rigid, prescriptive policy into a streamlined flexible performance-based policy, the Council on Radionuclides and Radiopharmaceuticals proposal has been presented. In addition, it is suggested that the United

  2. Policy and network regulation for the integration of distribution generation and renewables for electricity supply

    International Nuclear Information System (INIS)

    Ten Donkelaar, M.; Van Oostvoorn, F.

    2005-08-01

    This study has analysed the existing policy and regulation aimed at the integration of an increased share of Distributed Generation (DG) in electricity supply systems in the European Union. It illustrates the state of the art and progress in the development of support mechanisms and network regulation for large-scale integration of DG. Through a benchmark study a systematic comparison has been made of different DG support schemes and distribution network regulation in EU Member States to a predefined standard, the level playing field. This level playing field has been defined as the situation where energy markets, policy and regulation provide neutral incentives to central versus distributed generation, which results in an economically more efficient electricity supply to the consumer. In current regulation and policy a certain discrepancy can be noticed between the actual regulation and policy support systems in a number of countries, the medium to long term targets and the ideal situation described according to the level playing field objective. Policies towards DG and RES are now mainly aimed at removing short-term barriers, increasing the production share of DG/RES, but often ignoring the more complex barriers of integrating DG/RES that is created by the economic network regulation in current electricity markets

  3. The effects of regulation, legislation and policy on consumption of edible insects in the global world

    DEFF Research Database (Denmark)

    Wilderspin, Dana Elisabeth; Halloran, Afton Marina Szasz

    2018-01-01

    With an expanding edible insect industry, regulators, legislators, and policy-makers face increasingly difficult decisions regarding trade, production, harvesting, and consumption. It is becoming clearer that no panacea or one-size-fits-all solutions exist for regulating the industry, and that so...

  4. How Does Environmental Regulation Affect Industrial Transformation? A Study Based on the Methodology of Policy Simulation

    Directory of Open Access Journals (Sweden)

    Wei Liu

    2016-01-01

    Full Text Available The difference of factor input structure determines different response to environmental regulation. This paper constructs a theoretical model including environmental regulation, factor input structure, and industrial transformation and conducts a policy simulation based on the difference of influencing mechanism of environmental regulation considering industrial heterogeneity. The findings show that the impact of environmental regulation on industrial transformation presents comparison of distortion effect of resource allocation and technology effect. Environmental regulation will promote industrial transformation when technology effect of environmental regulation is stronger than distortion effect of resource allocation. Particularly, command-control environmental regulation has a significant incentive effect and spillover effect of technological innovation on cleaning industries, but these effects do not exist in pollution-intensive industries. Command-control environmental regulation promotes industrial transformation. The result of simulation showed that environmental regulation of market incentives is similar to that of command-control.

  5. Energy policy study. Volume 10. Nuclear power regulation

    International Nuclear Information System (INIS)

    Nikodem, Z.D.; Reynolds, A.W.; Clark, R.G.

    1980-05-01

    This report examines the programs for regulating the safety, design, and operation of domestic nuclear power plants. The first part of the study describes the Federal and State regulatory procedures. It describes the legal foundations for the Federal licensing process and the associated State regulatory activities. It then analyzes the aspects of these procedures that affect the cost and supply of nuclear-generated electricity. The second part of this study examines the effects of nuclear safety regulations on the planning and construction lead time for nuclear power stations, the cost of nuclear power, and, ultimately, the decision to invest in nuclear power

  6. MODERN APPROACHES TO THE IMPLEMENTATION OF MONETARY POLICY AND THE REGULATION OF FINANCIAL SYSTEMS

    Directory of Open Access Journals (Sweden)

    Radu CUHAL

    2013-01-01

    Full Text Available This study determines the modern approaches to the implementation of monetary policy and regulation of financial systems. Set of measures to prevent and overcome the financial crisis is grounded taking into consideration different areas of research and the IMF. New tasks of monetary policy in central banks are specified and they are intended to ensure the financial stability of the state (within the common fiscal policy. The main directions of elaboration and implementation of new monetary policy mechanism, which is intended to ensure the effective solution of problems in macro prudential supervision and financial stability, are examined.

  7. Modern approaches to the implementation of monetary policy and the regulation of financial systems

    Directory of Open Access Journals (Sweden)

    Basistîi Nicolae

    2013-01-01

    Full Text Available This study determines the modern approaches to the implementation of monetary policy and regulation of financial systems. Set of measures to prevent and overcome the financial crisis is grounded taking into consideration different areas of research and the IMF.New tasks of monetary policy in central banks are specified and they are intended to ensure the financial stability of the state (within the common fiscal policy.The main directions of elaboration and implementation of new monetary policy mechanism, which is intended to ensure the effective solution of problems in macro prudential supervision and financial stability, are examined.

  8. Access to Orphan Drugs: A Comprehensive Review of Legislations, Regulations and Policies in 35 Countries

    Science.gov (United States)

    Gammie, Todd

    2015-01-01

    Objective To review existing regulations and policies utilised by countries to enable patient access to orphan drugs. Methods A review of the literature (1998 to 2014) was performed to identify relevant, peer-reviewed articles. Using content analysis, we synthesised regulations and policies for access to orphan drugs by type and by country. Results Fifty seven articles and 35 countries were included in this review. Six broad categories of regulation and policy instruments were identified: national orphan drug policies, orphan drug designation, marketing authorization, incentives, marketing exclusivity, and pricing and reimbursement. The availability of orphan drugs depends on individual country’s legislation and regulations including national orphan drug policies, orphan drug designation, marketing authorization, marketing exclusivity and incentives such as tax credits to ensure research, development and marketing. The majority of countries (27/35) had in place orphan drug legislation. Access to orphan drugs depends on individual country’s pricing and reimbursement policies, which varied widely between countries. High prices and insufficient evidence often limit orphan drugs from meeting the traditional health technology assessment criteria, especially cost-effectiveness, which may influence access. Conclusions Overall many countries have implemented a combination of legislations, regulations and policies for orphan drugs in the last two decades. While these may enable the availability and access to orphan drugs, there are critical differences between countries in terms of range and types of legislations, regulations and policies implemented. Importantly, China and India, two of the largest countries by population size, both lack national legislation for orphan medicines and rare diseases, which could have substantial negative impacts on their patient populations with rare diseases. PMID:26451948

  9. Access to Orphan Drugs: A Comprehensive Review of Legislations, Regulations and Policies in 35 Countries.

    Science.gov (United States)

    Gammie, Todd; Lu, Christine Y; Babar, Zaheer Ud-Din

    2015-01-01

    To review existing regulations and policies utilised by countries to enable patient access to orphan drugs. A review of the literature (1998 to 2014) was performed to identify relevant, peer-reviewed articles. Using content analysis, we synthesised regulations and policies for access to orphan drugs by type and by country. Fifty seven articles and 35 countries were included in this review. Six broad categories of regulation and policy instruments were identified: national orphan drug policies, orphan drug designation, marketing authorization, incentives, marketing exclusivity, and pricing and reimbursement. The availability of orphan drugs depends on individual country's legislation and regulations including national orphan drug policies, orphan drug designation, marketing authorization, marketing exclusivity and incentives such as tax credits to ensure research, development and marketing. The majority of countries (27/35) had in place orphan drug legislation. Access to orphan drugs depends on individual country's pricing and reimbursement policies, which varied widely between countries. High prices and insufficient evidence often limit orphan drugs from meeting the traditional health technology assessment criteria, especially cost-effectiveness, which may influence access. Overall many countries have implemented a combination of legislations, regulations and policies for orphan drugs in the last two decades. While these may enable the availability and access to orphan drugs, there are critical differences between countries in terms of range and types of legislations, regulations and policies implemented. Importantly, China and India, two of the largest countries by population size, both lack national legislation for orphan medicines and rare diseases, which could have substantial negative impacts on their patient populations with rare diseases.

  10. Access to Orphan Drugs: A Comprehensive Review of Legislations, Regulations and Policies in 35 Countries.

    Directory of Open Access Journals (Sweden)

    Todd Gammie

    Full Text Available To review existing regulations and policies utilised by countries to enable patient access to orphan drugs.A review of the literature (1998 to 2014 was performed to identify relevant, peer-reviewed articles. Using content analysis, we synthesised regulations and policies for access to orphan drugs by type and by country.Fifty seven articles and 35 countries were included in this review. Six broad categories of regulation and policy instruments were identified: national orphan drug policies, orphan drug designation, marketing authorization, incentives, marketing exclusivity, and pricing and reimbursement. The availability of orphan drugs depends on individual country's legislation and regulations including national orphan drug policies, orphan drug designation, marketing authorization, marketing exclusivity and incentives such as tax credits to ensure research, development and marketing. The majority of countries (27/35 had in place orphan drug legislation. Access to orphan drugs depends on individual country's pricing and reimbursement policies, which varied widely between countries. High prices and insufficient evidence often limit orphan drugs from meeting the traditional health technology assessment criteria, especially cost-effectiveness, which may influence access.Overall many countries have implemented a combination of legislations, regulations and policies for orphan drugs in the last two decades. While these may enable the availability and access to orphan drugs, there are critical differences between countries in terms of range and types of legislations, regulations and policies implemented. Importantly, China and India, two of the largest countries by population size, both lack national legislation for orphan medicines and rare diseases, which could have substantial negative impacts on their patient populations with rare diseases.

  11. The social act of electronic medication prescribing

    NARCIS (Netherlands)

    J.E.C.M. Aarts (Jos)

    2013-01-01

    markdownabstract__Abstract__ Prescribing medication is embedded in social norms and cultures. In modern Western health care professionals and policy makers have attempted to rationalize medicine by addressing cost-effectiveness of diagnostic and therapeutic treatments and the development of

  12. Limits of self-regulation in international phytosanitary policy

    NARCIS (Netherlands)

    Rau, M.L.; Bremmers, H.J.; Szajkowska, A.; Bakker, de E.; Bremmer, J.

    2012-01-01

    In accordance with international agreements, phytosanitary regulations from standard setting to conformity assessment and monitoring have been assigned a public task which is carried out by government authorities. The private sector needs to comply with these phytosanitary requirements, and it is

  13. Spatial Regulation, Politics of Access and Informal economic Policy ...

    African Journals Online (AJOL)

    ... to draw attention to the political contestation over space. The city was 'invaded' and 'conquered' by traders who were formerly excluded (Nesvag, 2000, 2001; Tsoeu, 2003). At the same time, attention is drawn to the current attempts by city managers to control and regulate this contested space in an environment of flux.

  14. CUSTOMS POLICY, CUSTOMS BUSINESS, CUSTOMS REGULATION: TO PROBLEM OF CONCEPTION CORRELATIONS

    OpenAIRE

    A. D. Molokovich; K. N. Shabeka

    2010-01-01

    Theoretical and methodological comprehension of customs regulation place and role in provision of trade and transport activity under conditions of world integration processes is considered in the paper.The essence of such economic categories as «customs policy», «customs regulation», «customs and tariff regulation», «customs business» is ascertained with the help of justified argumentation, clear conception approaches.

  15. Development and utilization of the NRC policy statement on the regulation of advanced nuclear power plants

    International Nuclear Information System (INIS)

    Williams, P.M.; King, T.L.

    1988-06-01

    On March 26, 1985, the US Nuclear Regulatory Commission issued for public comment a ''Proposed Policy for Regulation of Advanced Nuclear Power Plants'' (50 FR 11884). This report presents and discusses the Commission's final version of that policy as titled and published on July 8, 1986 ''Regulation of Advanced Nuclear Power Plants, Statement of Policy'' (51 FR 24643). It provides an overview of comments received from the public, of the significant changes from the proposed Policy Statement to the final Policy Statement, and of the Commission's response to six questions contained in the proposed Policy Statement. The report also discusses the definition for advanced reactors, the establishment of an Advanced Reactors Group, the staff review approach and information needs, and the utilization of the Policy Statement in relation to other NRC programs, including the policies for safety goals, severe accidents and standardization. In addition, guidance for advanced reactors with respect to operating experience, technology development, foreign information and data, and prototype testing is provided. Finally, a discussion on the use of less prescriptive and nonprescriptive design criteria for advanced reactors, which the Policy Statement encourages, is presented

  16. 78 FR 22771 - Statement of Policy on the Development and Review of Regulations and Policies

    Science.gov (United States)

    2013-04-17

    ... the basic principles that guide the FDIC in its promulgation and review of regulations and written... basic principles which guide the FDIC's promulgation and review of regulations and written statements of... Housing Finance Agency) has become more common. Some rulemakings also require consultation with the...

  17. Environmental policies and regulations on the electricity market in EC

    International Nuclear Information System (INIS)

    Boucher, J.

    1990-01-01

    The use of natural resources like ground and water, the emissions of noxious gases and particles, the thermal rejections, the production of waste and the noise are the main environmental impacts associated with the production of electricity. Emission regulations and standards have been selected so far by the European Community (EC) and the different Member States to deal with the abatement problem. They simply consist in defining some ceilings or regulations for the different types of noxious gases and particles which are emitted by power plants and forcing the power generation companies to comply with these norms within some pre-determined time period. They can also take the form of a general constraint on the sulfur content of the fuel, for example. Tables of emission limits for various gases from existing and new plants are presented. 3 figs., 8 tabs

  18. Nitrates in ground and drinking water: analysis of policies and regulations

    Energy Technology Data Exchange (ETDEWEB)

    Conrad, J

    1986-05-01

    On the societal level, risks are the result of collective processes of definition. Accepted risks are mainly the output and secondarily the (scientific) input of these processes. As a consequence, in this paper the question of risk management of the nitrate burden to ground and drinking water is analysed within the framework of comparative policy analysis. Various actors pursue their respective interests in different policy arenas within the given rules of the policy game. The impacts of the policy outputs on the policy addressees, namely farmers and water companies, (substantially) determine the level of actual risk. Different national regulatory styles and traditions towards nitrate regulation shape the policy outputs. Consequently, the assumption or normative postulate of a rational (scientific) risk assessment and risk management appears to be utterly heroic and, in the end, misleading.

  19. Morals or markets? Regulating assisted reproductive technologies as morality or economic policies in the states.

    Science.gov (United States)

    Heidt-Forsythe, Erin

    2017-01-01

    The availability of assisted reproductive technologies (ARTs) in the medical marketplace complicates our understanding of reproductive public policy in the United States. Political debates over ARTs often are based on fundamental moral principles of life, reproduction, and kinship, similar to other reproductive policies in the United States. However, ARTs are an important moneymaking private enterprise for the U.S. biotechnology industry. This project investigates how the U.S. states regulate these unique and challenging technologies as either moral policies or economic policies. This study employs ordinary least squares (OLS) regression to estimate the significance of morality and economic policy variables on ART policies at the state level, noting associations between state-level political, economic, and gender variables on restrictive and permissive state-level ART policies. Economic variables (reflecting the biotechnology industry) and advocacy for access to ART on behalf of infertility patients increase the chances of states passing policies that enable consumer use of ARTs. Additionally, individual ART policies are distinct from one another in the ways that morality variables increase the chances of ART regulations. Surprisingly, the role of religious adherence among state residents varied in positive and negative relationships with individual policy passage. In general, these results support the hypothesis that ART laws are associated with economic as well as moral concerns of the states-ARTs lie at the intersection of issues of life and reproduction and of scientific innovation and health. What is most striking about these results is that they do not follow patterns seen in the legislation of abortion, contraception, and sexuality in general-those reproductive policies that are considered "morality policy." Similarly, economic variables are not consistently significant in the expected direction.

  20. Impact, regulation and health policy implications of physician migration in OECD countries

    Directory of Open Access Journals (Sweden)

    Simoens Steven

    2004-07-01

    Full Text Available Abstract Background In the face of rising demand for medical services due to ageing populations, physician migration flows are increasingly affecting the supply of physicians in Organisation for Economic Co-operation and development (OECD countries. This paper offers an integrated perspective on the impact of physician migration on home and host countries and discusses international regulation and policy approaches governing physician migration. Methods Information about migration flows, international regulation and policies governing physician migration were derived from two questionnaires sent to OECD countries, a secondary analysis of EUROSTAT Labour Force Surveys, a literature review and official policy documents of OECD countries. Results OECD countries increasingly perceive immigration of foreign physicians as a way of sustaining their physician workforce. As a result, countries have entered into international agreements regulating physician migration, although their success has been limited due to the imposition of licensing requirements and the protection of vested interests by domestic physicians. OECD countries have therefore adopted specific policies designed to stimulate the immigration of foreign physicians, whilst minimising its negative impact on the home country. Measures promoting immigration have included international recruitment campaigns, less strict immigration requirements and arrangements that foster shared learning between health care systems. Policies restricting the societal costs of physician emigration from developing countries such as good practice guidelines and taxes on host countries have not yet produced their expected effect or in some cases have not been established at all. Conclusions Although OECD countries generally favour long-term policies of national self-sufficiency to sustain their physician workforce, such policies usually co-exist with short-term or medium-term policies to attract foreign physicians

  1. The Interdependence of Competition Policy, Consumer Policy and Regulation in Introducing and Safeguarding Effective Competition in the EU Telecommunications Market

    Directory of Open Access Journals (Sweden)

    Andreas Bartels

    2017-05-01

    Full Text Available Currently, the European Union finds itself in troubled waters. It has to prove that its benefits outweigh the costs of its endeavour. In this respect, an EU competition policy that focuses on consumer welfare is one way to gain support by the citizens of its member states. The Roaming Regulation that has reduced the mobile communications costs while travelling abroad serves as a good example for this approach. The EU Commission views consumer policy as another important factor to protect and benefit customers. In markets with natural monopolies, the two policies require the support of an effective regulatory policy. The research demonstrates that these three policies – if harmonised – are able to lead to an increase in consumer welfare (primarily by reducing prices and that they protect the rights and interests of consumers. In the case of telecommunications, several initiatives of the European Commission and of national regulatory authorities to falls in prices and forced operators to implement customer friendly rules and to protect customer data and privacy. The authors consider that the European Commission has tried to establish and harmonise rules across all member states in order to protect the interests and rights of consumers on the telecommunication market. The enforcement of competition and consumer policy within institutions from the telecom field certainly could promote the focus on consumers and the possibility to use a large “toolbox”. Harmonising and adjusting the policies across different countries and institutions and minimising any possible side effects is nevertheless a challenging task for the EU Commission in the future.

  2. Cognitive radio policy and regulation techno-economic studies to facilitate dynamic spectrum access

    CERN Document Server

    Holland, Oliver

    2014-01-01

    This book offers a timely reflection on how the proliferation of advanced wireless communications technologies, particularly cognitive radio (CR) can be enabled by thoroughly-considered policy and appropriate regulation. It looks at the prospects of CR from the divergent standpoints of technological development and economic market reality. The book provides a broad survey of various techno-economic and policy aspects of CR development, and provides the reader with an understanding of the complexities involved as well as a toolbox of possible solutions to enable the evolutionary leap towards successful implementation of disruptive CR technology or indeed any other novel wireless technologies. Cognitive Radio Policy and Regulation showcases the original ideas and concepts introduced into the field of CR and dynamic spectrum access policy over nearly four years of work within COST Action IC0905 TERRA, a think-tank with participants from more than 20 countries. The book’s subject matter includes: • deploymen...

  3. The European Union, Financial Crises and the Regulation of Hedge Funds: A Policy Cul-de-Sac or Policy Window?

    Directory of Open Access Journals (Sweden)

    David John Lutton

    2008-11-01

    Full Text Available A series of financial crises involving hedge funds has created a general perception that action needs to be taken. A number of key member states and political actors favour tighter regulation. Traditional bureaucratic theory suggests that the European Commission would seek to maximise this ‘policy window’, and yet there remains no single unified European Union (EU regulatory framework specifically targeting hedge funds. The nature of the regulatory regime, which has generally demanded a ‘light touch’ approach, means there are strict limits the EU’s ability to act. From an EU perspective, hedge fund regulation appears to be a policy cul-de-sac. However, the relationship between hedge funds and financial crisis is complex and less straightforward than is often portrayed. Hedge fund regulation cannot, however, be considered in isolation but should be viewed in the context of a wider programme to integrate European financial services markets. Viewed from this perspective, EU regulation is in fact changing the landscape of the hedge fund industry through a process of negative integration.

  4. Appetite self-regulation: Environmental and policy influences on eating behaviors.

    Science.gov (United States)

    Schwartz, Marlene B; Just, David R; Chriqui, Jamie F; Ammerman, Alice S

    2017-03-01

    Appetite regulation is influenced by the environment, and the environment is shaped by food-related policies. This review summarizes the environment and policy research portion of an NIH Workshop (Bethesda, MD, 2015) titled "Self-Regulation of Appetite-It's Complicated." In this paper, we begin by making the case for why policy is an important tool in efforts to improve nutrition, and we introduce an ecological framework that illustrates the multiple layers that influence what people eat. We describe the state of the science on how policies influence behavior in several key areas: the federal food programs, schools, child care, food and beverage pricing, marketing to youth, behavioral economics, and changing defaults. Next, we propose novel approaches for multidisciplinary prevention and intervention strategies to promote breastfeeding, and examine interactions between psychology and the environment. Policy and environmental change are the most distal influences on individual-level appetite regulation, yet these strategies can reach many people at once by changing the environment in which food choices are made. We note the need for more research to understand compensatory behavior, reactance, and how to effectively change social norms. To move forward, we need a more sophisticated understanding of how individual psychological and biological factors interact with the environment and policy influences. © 2017 The Obesity Society.

  5. Learning from prescribing errors

    OpenAIRE

    Dean, B

    2002-01-01

    

 The importance of learning from medical error has recently received increasing emphasis. This paper focuses on prescribing errors and argues that, while learning from prescribing errors is a laudable goal, there are currently barriers that can prevent this occurring. Learning from errors can take place on an individual level, at a team level, and across an organisation. Barriers to learning from prescribing errors include the non-discovery of many prescribing errors, lack of feedback to th...

  6. Sustainable Trade Credit and Replenishment Policies under the Cap-And-Trade and Carbon Tax Regulations

    Directory of Open Access Journals (Sweden)

    Juanjuan Qin

    2015-12-01

    Full Text Available The paper considers the sustainable trade credit and inventory policies with demand related to credit period and the environmental sensitivity of consumers under the carbon cap-and-trade and carbon tax regulations. First, the decision models are constructed under three cases: without regulation, carbon cap-and-trade regulation, and carbon tax regulation. The optimal solutions of the retailer in the three cases are then discussed under the exogenous and endogenous credit periods. Finally, numerical analysis is conducted to obtain conclusions. The retailer shortens the trade credit period as the environmental sensitivity of the consumer is enhanced. The cap has no effects on the credit period decisions under the carbon cap-and-trade regulation. Carbon trade price and carbon tax have negative effects on the credit period. The retailer under carbon cap-and-trade regulation is more motivated to obey regulations than that under carbon tax regulation when carbon trade price equals carbon tax. Carbon regulations have better effects on carbon emission reduction than with exogenous credit term when the retailer has the power to decide with regards credit policies.

  7. Broadband ICT policies in Southern Africa: Initiatives and dynamic spectrum regulation

    CSIR Research Space (South Africa)

    Olwal, T

    2013-05-01

    Full Text Available regulatory agencies. These ICT regulatory agencies had been established with the aim of liberalizing the telecommunications sector to ensure that governments are not the direct providers of telecom services, but the regulators [1]. Moreover, due to out... goals demand liberal and dynamic spectrum regulation policies designed at a country level and more importantly across a majority of countries in the same region. This paper highlights various initiatives aimed at formulating the all...

  8. Stakeholder perspectives on national policy for regulating the school food environment in Mexico.

    Science.gov (United States)

    Monterrosa, Eva C; Campirano, Fabricio; Tolentino Mayo, Lizbeth; Frongillo, Edward A; Hernández Cordero, Sonia; Kaufer-Horwitz, Martha; Rivera, Juan A

    2015-02-01

    In Mexico, the school environment has been promoting sale of unhealthy foods. There is little empirical evidence on multi-stakeholder perspectives around national school food policy to regulate this. We studied stakeholders' perspectives on the proposed regulation for school sale of unhealthy foods. Comments about the regulation were available from an open consultation process held in June 2010 before the approval and implementation of the regulation. To examine perspectives, we coded 597 comments for beliefs, expectations and demands in NVivo. We created matrices by actors: academics, parents, citizens, health professionals and food industry. For academics, citizens and health professionals, the primary issue regarding the regulation was obesity, while for parents it was health of children. Academics, citizens, health professionals and parents believed that government was responsible for health of citizens, expected that this regulation would improve eating habits and health (i.e. less obesity and chronic diseases), and demanded that unhealthy foods be removed from schools. Parents demanded immediate action for school food policy that would protect their children. Citizens and health professionals demanded nutrition education and healthy food environment. Food industry opposed the regulation because it would not solve obesity or improve diet and physical activity behaviours. Instead, industry would lose income and jobs. Food industry demanded policy aimed at families that included nutrition education and physical activity. There was substantial consensus in narratives and perspectives for most actor types, with the primary narrative being the food environment followed by shared responsibility. Food industry rejected both these narratives, espousing instead the narrative of personal responsibility. Consensus among most actor groups supports the potential success of implementation of the regulation in Mexican schools. With regard to addressing childhood obesity

  9. Understanding the determinants of antimicrobial prescribing within hospitals: the role of "prescribing etiquette".

    Science.gov (United States)

    Charani, E; Castro-Sanchez, E; Sevdalis, N; Kyratsis, Y; Drumright, L; Shah, N; Holmes, A

    2013-07-01

    There is limited knowledge of the key determinants of antimicrobial prescribing behavior (APB) in hospitals. An understanding of these determinants is required for the successful design, adoption, and implementation of quality improvement interventions in antimicrobial stewardship programs. Qualitative semistructured interviews were conducted with doctors (n = 10), pharmacists (n = 10), and nurses and midwives (n = 19) in 4 hospitals in London. Interviews were conducted until thematic saturation was reached. Thematic analysis was applied to the data to identify the key determinants of antimicrobial prescribing behaviors. The APB of healthcare professionals is governed by a set of cultural rules. Antimicrobial prescribing is performed in an environment where the behavior of clinical leaders or seniors influences practice of junior doctors. Senior doctors consider themselves exempt from following policy and practice within a culture of perceived autonomous decision making that relies more on personal knowledge and experience than formal policy. Prescribers identify with the clinical groups in which they work and adjust their APB according to the prevailing practice within these groups. A culture of "noninterference" in the antimicrobial prescribing practice of peers prevents intervention into prescribing of colleagues. These sets of cultural rules demonstrate the existence of a "prescribing etiquette," which dominates the APB of healthcare professionals. Prescribing etiquette creates an environment in which professional hierarchy and clinical groups act as key determinants of APB. To influence the antimicrobial prescribing of individual healthcare professionals, interventions need to address prescribing etiquette and use clinical leadership within existing clinical groups to influence practice.

  10. Emotion regulation as the foundation of political attitudes: does reappraisal decrease support for conservative policies?

    Directory of Open Access Journals (Sweden)

    Jooa Julia Lee

    Full Text Available Cognitive scientists, behavior geneticists, and political scientists have identified several ways in which emotions influence political attitudes, and psychologists have shown that emotion regulation can have an important causal effect on physiology, cognition, and subjective experience. However, no work to date explores the possibility that emotion regulation may shape political ideology and attitudes toward policies. Here, we conduct four studies that investigate the role of a particular emotion regulation strategy--reappraisal in particular. Two observational studies show that individual differences in emotion regulation styles predict variation in political orientations and support for conservative policies. In the third study, we experimentally induce disgust as the target emotion to be regulated and show that use of reappraisal reduces the experience of disgust, thereby decreasing moral concerns associated with conservatism. In the final experimental study, we show that use of reappraisal successfully attenuates the relationship between trait-level disgust sensitivity and support for conservative policies. Our findings provide the first evidence of a critical link between emotion regulation and political attitudes.

  11. Emotion Regulation as the Foundation of Political Attitudes: Does Reappraisal Decrease Support for Conservative Policies?

    Science.gov (United States)

    Lee, Jooa Julia; Sohn, Yunkyu; Fowler, James H.

    2013-01-01

    Cognitive scientists, behavior geneticists, and political scientists have identified several ways in which emotions influence political attitudes, and psychologists have shown that emotion regulation can have an important causal effect on physiology, cognition, and subjective experience. However, no work to date explores the possibility that emotion regulation may shape political ideology and attitudes toward policies. Here, we conduct four studies that investigate the role of a particular emotion regulation strategy – reappraisal in particular. Two observational studies show that individual differences in emotion regulation styles predict variation in political orientations and support for conservative policies. In the third study, we experimentally induce disgust as the target emotion to be regulated and show that use of reappraisal reduces the experience of disgust, thereby decreasing moral concerns associated with conservatism. In the final experimental study, we show that use of reappraisal successfully attenuates the relationship between trait-level disgust sensitivity and support for conservative policies. Our findings provide the first evidence of a critical link between emotion regulation and political attitudes. PMID:24367583

  12. Of risks and regulations: how leading U.S. nanoscientists form policy stances about nanotechnology

    Energy Technology Data Exchange (ETDEWEB)

    Corley, Elizabeth A., E-mail: elizabeth.corley@asu.ed [Arizona State University, School of Public Affairs (United States); Scheufele, Dietram A. [University of Wisconsin, Department of Life Sciences Communication (United States); Hu Qian [Arizona State University, School of Public Affairs (United States)

    2009-10-15

    Even though there is a high degree of scientific uncertainty about the risks of nanotechnology, many scholars have argued that policy-making cannot be placed on hold until risk assessments are complete (Faunce, Med J Aust 186(4):189-191, 2007; Kuzma, J Nanopart Res 9(1):165-182, 2007; O'Brien and Cummins, Hum Ecol Risk Assess 14(3):568-592, 2008; Powell et al., Environ Manag 42(3):426-443, 2008). In the absence of risk assessment data, decision makers often rely on scientists' input about risks and regulation to make policy decisions. The research we present here goes beyond the earlier descriptive studies about nanotechnology regulation to explore the heuristics that the leading U.S. nanoscientists use when they make policy decisions about regulating nanotechnology. In particular, we explore the relationship between nanoscientists' risk and benefit perceptions and their support for nanotech regulation. We conclude that nanoscientists are more supportive of regulating nanotechnology when they perceive higher levels of risks; yet, their perceived benefits about nanotechnology do not significantly impact their support for nanotech regulation. We also find some gender and disciplinary differences among the nanoscientists. Males are less supportive of nanotech regulation than their female peers and materials scientists are more supportive of nanotechnology regulation than scientists in other fields. Lastly, our findings illustrate that the leading U.S. nanoscientists see the areas of surveillance/privacy, human enhancement, medicine, and environment as the nanotech application areas that are most in need of new regulations.

  13. Of risks and regulations: how leading U.S. nanoscientists form policy stances about nanotechnology

    Science.gov (United States)

    Scheufele, Dietram A.; Hu, Qian

    2009-01-01

    Even though there is a high degree of scientific uncertainty about the risks of nanotechnology, many scholars have argued that policy-making cannot be placed on hold until risk assessments are complete (Faunce, Med J Aust 186(4):189–191, 2007; Kuzma, J Nanopart Res 9(1):165–182, 2007; O’Brien and Cummins, Hum Ecol Risk Assess 14(3):568–592, 2008; Powell et al., Environ Manag 42(3):426–443, 2008). In the absence of risk assessment data, decision makers often rely on scientists’ input about risks and regulation to make policy decisions. The research we present here goes beyond the earlier descriptive studies about nanotechnology regulation to explore the heuristics that the leading U.S. nanoscientists use when they make policy decisions about regulating nanotechnology. In particular, we explore the relationship between nanoscientists’ risk and benefit perceptions and their support for nanotech regulation. We conclude that nanoscientists are more supportive of regulating nanotechnology when they perceive higher levels of risks; yet, their perceived benefits about nanotechnology do not significantly impact their support for nanotech regulation. We also find some gender and disciplinary differences among the nanoscientists. Males are less supportive of nanotech regulation than their female peers and materials scientists are more supportive of nanotechnology regulation than scientists in other fields. Lastly, our findings illustrate that the leading U.S. nanoscientists see the areas of surveillance/privacy, human enhancement, medicine, and environment as the nanotech application areas that are most in need of new regulations. PMID:21170136

  14. Of risks and regulations: how leading U.S. nanoscientists form policy stances about nanotechnology

    International Nuclear Information System (INIS)

    Corley, Elizabeth A.; Scheufele, Dietram A.; Hu Qian

    2009-01-01

    Even though there is a high degree of scientific uncertainty about the risks of nanotechnology, many scholars have argued that policy-making cannot be placed on hold until risk assessments are complete (Faunce, Med J Aust 186(4):189-191, 2007; Kuzma, J Nanopart Res 9(1):165-182, 2007; O'Brien and Cummins, Hum Ecol Risk Assess 14(3):568-592, 2008; Powell et al., Environ Manag 42(3):426-443, 2008). In the absence of risk assessment data, decision makers often rely on scientists' input about risks and regulation to make policy decisions. The research we present here goes beyond the earlier descriptive studies about nanotechnology regulation to explore the heuristics that the leading U.S. nanoscientists use when they make policy decisions about regulating nanotechnology. In particular, we explore the relationship between nanoscientists' risk and benefit perceptions and their support for nanotech regulation. We conclude that nanoscientists are more supportive of regulating nanotechnology when they perceive higher levels of risks; yet, their perceived benefits about nanotechnology do not significantly impact their support for nanotech regulation. We also find some gender and disciplinary differences among the nanoscientists. Males are less supportive of nanotech regulation than their female peers and materials scientists are more supportive of nanotechnology regulation than scientists in other fields. Lastly, our findings illustrate that the leading U.S. nanoscientists see the areas of surveillance/privacy, human enhancement, medicine, and environment as the nanotech application areas that are most in need of new regulations.

  15. Approaches to Risk and Consumer Policy in Financial Service Regulation in the UK

    Directory of Open Access Journals (Sweden)

    Peter Lunt

    2006-01-01

    Full Text Available The financial service and communication sectors in the UK have been subject to radical re-organisation, involving the formation of sector-wide regulatory bodies (FSA and Ofcom with wide-ranging powers and statutory obligations. Although both have responsibilities for assessment and management of risk, their remits go beyond traditional approaches to regulation. Hence, although primarily oriented to economic policy, both regulators address questions of corporate responsibility, balance of stakeholder interests, the public good, consumer representation and public participation. Accordingly, they are undertaking a range of activities, including consumer education and research, public consultation and the involvement of stakeholders in policy review. Focusing on the case of financial services, this paper presents an analysis of two early speeches by FSA directors, one focused on the approach to risk adopted by the regulator and the other on consumer policy. The second part of the paper considers the conceptual issues regarding different modes of risk management in the new regulators, requiring an account of the various levels and forms of involvement by stakeholders and publics in the identification and management of risk. It follows on from the analysis of the speeches to examine the relationship between risk and consumer policy in the practices of the FSA. URN: urn:nbn:de:0114-fqs0601323

  16. Convergences and Hybridization of Educational Policies around "Post-Bureaucratic" Models of Regulation

    Science.gov (United States)

    Maroy, Christian

    2009-01-01

    Our purpose is to document convergences and divergences in the mode of institutional regulation of the education systems in five European countries (Belgium, England, France, Hungary and Portugal). On the national level, partially convergent policies create, to varying degrees and with different temporal rhythms, variants of a post-bureaucratic…

  17. Regulations, policies and practices concerning work stress in five European countries

    NARCIS (Netherlands)

    Kompier, M.; Gier, E. de; Smulders, P.; Draaisma, D.

    1994-01-01

    A comparative inventory of regulations, policies and practices in The Netherlands, Sweden, UK, Germany and France with regard to the prevention of work stress was carried out. In each country data were collected by means of interviews with key informants and through exploring relevant documents and

  18. Do as the Swedes do? Internet policy and regulation in Sweden – a snapshot

    Directory of Open Access Journals (Sweden)

    Merlin Münch

    2013-05-01

    Full Text Available When it comes to information technology Sweden is considered to be at the forefront both in terms of technological innovation, as well as in progressive policy-making, regulation and internet freedom. This article investigates the state-of-affairs in a number of fields of Swedish internet policy, such as copyright, net neutrality and censorship, in order to find out if and why the 'Swedish way' has been particularly efficient. In the course of this article it will become apparent that Swedens approach to internet policy and regulation has often been controversial, as the examples of the contested National Defence Radio Establishment law (known as the 'FRA-law', as well as the rigorous implementation of the Directive on the enforcement of intellectual property rights have shown. Also, when it comes to matters of transparency, the Swedish government has some catching up to do.

  19. Policies of Regulating Cultural and Ethnic Differences: On Concepts and How They are Used

    Directory of Open Access Journals (Sweden)

    Jadranka Čačić-Kumpes

    2004-09-01

    Full Text Available Modern societies are multicultural. This is a simple statement on a complex situation which poses many questions. One of the basic questions – how are relations between different cultures in society regulated – is the theme of this paper. By focusing on two pluralistic approaches to regulating relations between cultures – the multicultural and the intercultural approach – the author attempts to indicate the complexity of problems linked to the regulation of cultural differences in modern society. As it turns out, policies on the acceptance of cultural and ethnic differences have some common points, their concepts intertwine, but there are also significant differences between them. It also appears that one and the same policy can show different faces when it comes to its implementation in reality. By stressing interactions as a key trait of culture and cultural identity, the author wishes to emphasize their importance in cultural policies, since only by introducing interactions would these policies mean the acceptance of the real nature of cultural and social relations. The paper deals with this basic intent. In the first part, it presents the basic traits of culture and cultural identity as laid out in basic theories and their reception. Various processes and phenomena linked to them are mentioned in passing. In the second part, an overview of cultural policies is given – from assimilationist policies to pluralist ones (discussion focuses on assimilation, the “melting pot”, integration and multiculturalism and interculturalism. Concepts are treated defined critically and a partial review and evaluation of cultural policies is given. The reason for concentrating on concepts is the assumption that they imply a worldview and therefore it is not insignificant how social phenomena are defined and what names are attached to them.

  20. The Financial Policy as a Component of the State Regulation of Economy

    Directory of Open Access Journals (Sweden)

    Kravets Vladislav I.

    2017-12-01

    Full Text Available The article is aimed at disclosing the economic essence of financial policy as a component of institutional development of economy. At the current stage of improvement of financial-economic relations it is important to deepen the essence of financial policy as a component of socio-economic development, improvement of provisions on the influence of instruments of the State financial regulation on the socio-economic processes in the country taking into account the institutional peculiarities of the financial system. It is necessary to increase investment activity of economic entities with increasing the level of efficiency of capital investments, including through the use of mechanisms of the State support and the stimulating measures of both the fiscal-tax and the monetary-credit policy. The priority directions of financial policy need to be improved based on the main tasks of the socio-economic development, as well as the cyclical dynamics of the economy.

  1. Moral regulation and the presumption of guilt in Health Canada's medical cannabis policy and practice.

    Science.gov (United States)

    Lucas, Philippe

    2009-07-01

    This paper is a sociological examination of policies and practices in Health Canada's Marihuana Medical Access Division (MMAD) that presume the illicit intentions and inherent "guilt" of medical cannabis users, hampering safe access to a medicine to which many are legally entitled, and raising doubts about this federal programme's overall effectiveness and constitutional legitimacy. Beginning with a brief historical overview of Canada's federal medical cannabis programme, this paper examines the failure of the MMAD to meet the needs of many sick and suffering Canadians through Hunt's [Hunt, A. (1999). Governing morals: A social history of moral regulation. Cambridge, UK: Cambridge University Press] work on moral regulation and Wodak's [Wodak, A. (2007). Ethics and drug policy. Psychiatry, 6(2), 59-62] critique of "deontological" drug policy strategies. I then cite Tupper's [Tupper, K. W. (2007). The globalization of ayahuasca: Harm reduction or benefit maximization? International Journal of Drug Policy, doi:10.1016/j.drugpo.2006.11.001] argument that shifting to a generative metaphor that constructs certain entheogenic substances as potentially useful "tools" rather than regulating them through inherently moralistic prohibitionist policies would better serve public health, and incorporate Young's [Young, I. M. (1990). Justice and the politics of difference. Princeton, New Jersey: Princeton University Press] theories of domination and oppression to examine the rise of community-base medical cannabis dispensaries as "new social movements". First-hand accounts by medical cannabis patients, federally funded studies, and internal Health Canada communication and documents suggest that current federal policies and practices are blocking safe access to this herbal medicine. The community-based dispensary model of medical cannabis access is a patient-centered "new social movement" that mitigates the stigmatization and moral regulation of their member-clients by creating

  2. Statutory Regulation of Traditional Medicine Practitioners and Practices: The Need for Distinct Policy Making Guidelines.

    Science.gov (United States)

    Ijaz, Nadine; Boon, Heather

    2018-04-01

    The World Health Organization (WHO) has called for the increased statutory regulation of traditional and complementary medicine practitioners and practices, currently implemented in about half of nations surveyed. According to recent WHO data, however, the absence of policy guidelines in this area represents a significant barrier to implementation of such professional regulations. This commentary reviews several key challenges that distinguish the statutory regulation of traditional medicine practitioners and practices from biomedical professional regulation, providing a foundation for the development of policy making parameters in this area. Foremost in this regard are the ongoing impacts of the European colonial encounter, which reinforce biomedicine's disproportionate political dominance across the globe despite traditional medicine's ongoing widespread use (particularly in the global South). In this light, the authors discuss the conceptual and historical underpinnings of contemporary professional regulatory structures, the tensions between institutional and informal traditional medicine training pathways, and the policy challenges presented by the prospect of standardizing internally diverse indigenous healing approaches. Epistemic and evidentiary tensions, as well as the policy complexities surrounding the intersection of cultural and clinical considerations, present additional challenges to regulators. Conceptualizing professional regulation as an intellectual property claim under the law, the authors further consider what it means to protect traditional knowledge and prevent misappropriation in this context. Overall, the authors propose that innovative professional regulatory approaches are needed in this area to address safety, quality of care, and accessibility as key public interest concerns, while prioritizing the redress of historical inequities, protection of diverse indigenous knowledges, and delivery of care to underserved populations.

  3. An unhealthy public-private tension: pharmacy ownership, prescribing, and spending in the Philippines.

    Science.gov (United States)

    James, Chris D; Peabody, John; Solon, Orville; Quimbo, Stella; Hanson, Kara

    2009-01-01

    Physicians' links with pharmacies may create perverse financial incentives to overprescribe, prescribe products with higher profit margins, and direct patients to their pharmacy. Interviews with pharmacy customers in the Philippines show that those who use pharmacies linked to public-sector physicians had 5.4 greater odds of having a prescription from such physicians and spent 49.3 percent more than customers using other pharmacies. For customers purchasing brand-name medicines, switching to generics would reduce drug spending by 58 percent. Controlling out-of-pocket spending on drugs requires policies to control financial links between doctors and pharmacies, as well as tighter regulation of nongeneric prescribing.

  4. National environmental policy act disclosure of air quality impacts for prescribed fire projects in national forests in the Pacific Southwest Region

    Science.gov (United States)

    Suraj Ahuja; Laurie Perrot

    2008-01-01

    A key purpose of the National Environmental Policy Act (NEPA) is to “promote effortswhich will prevent or eliminate damage to the environment and biosphere and stimulate thehealth and welfare of man” (NEPA, Sec 2). The Council on Environmental Quality states “theNEPA process is intended to help public officials make decisions that...

  5. 77 FR 76864 - Amendment to the International Traffic in Arms Regulations: Afghanistan and Change to Policy on...

    Science.gov (United States)

    2012-12-31

    ... Belarus, Cuba, Eritrea, Iran, North Korea, Syria, and Venezuela. This policy also applies to countries... International Traffic in Arms Regulations: Afghanistan and Change to Policy on Prohibited Exports AGENCY.... Goforth, Director, Office of Defense Trade Controls Policy, U.S. Department of State, telephone (202) 663...

  6. 76 FR 44282 - Defense Federal Acquisition Regulation Supplement; Prohibition on Interrogation of Detainees by...

    Science.gov (United States)

    2011-07-25

    ...-AG88 Defense Federal Acquisition Regulation Supplement; Prohibition on Interrogation of Detainees by... prescribes policies prohibiting interrogation of detainees by contractor personnel, as required by section... ancillary positions, including as trainers of, and advisors to, interrogations, if the contractor personnel...

  7. Network Regulation and Support Schemes - How Policy Interactions Affect the Integration of Distributed Generation

    DEFF Research Database (Denmark)

    Ropenus, Stephanie; Jacobsen, Henrik; Schröder, Sascha Thorsten

    2011-01-01

    This article seeks to investigate the interactions between the policy dimensions of support schemes and network regulation and how they affect distributed generation. Firstly, the incentives of distributed generators and distribution system operators are examined. Frequently there exists a trade......-off between the incentives for these two market agents to facilitate the integration of distributed generation. Secondly, the interaction of these policy dimensions is analyzed, including case studies based on five EU Member States. Aspects of operational nature and investments in grid and distributed...

  8. Tensions between Scottish National Policies for onshore wind energy and local dissatisfaction - insights from regulation theory

    Energy Technology Data Exchange (ETDEWEB)

    Parkhill, Karen [School of Psychology, Tower Building, Cardiff University, Cardiff, (United Kingdom)

    2007-09-15

    Although best described as a meta theory addressing the endurance of capitalism, regulation theory can successfully be used to explore not only the economic dimensions, but also the political, socio-cultural and environmental dimensions of particular developmental strategies. Thus, it offers a framework for embedding abstract debates about social attitudes to new technologies within debates about real regulation - the economic, social and cultural relationships operating through particular places. This paper uses regulation theory and qualitative, interview-based data to analyse Scotland's drive for onshore wind energy. This approach teases out how responses to wind farms are bound up with wider debates about how rural spaces are, and should be, regulated; the tensions within and between national political objectives, local political objectives and local communities' dissatisfaction; and the connections between local actors and more formal dimensions of renewable energy policy. (Author)

  9. Energy efficiency optimization in distribution transformers considering Spanish distribution regulation policy

    International Nuclear Information System (INIS)

    Pezzini, Paola; Gomis-Bellmunt, Oriol; Frau-Valenti, Joan; Sudria-Andreu, Antoni

    2010-01-01

    In transmission and distribution systems, the high number of installed transformers, a loss source in networks, suggests a good potential for energy savings. This paper presents how the Spanish Distribution regulation policy, Royal Decree 222/2008, affects the overall energy efficiency in distribution transformers. The objective of a utility is the maximization of the benefit, and in case of failures, to install a chosen transformer in order to maximize the profit. Here, a novel method to optimize energy efficiency, considering the constraints set by the Spanish Distribution regulation policy, is presented; its aim is to achieve the objectives of the utility when installing new transformers. The overall energy efficiency increase is a clear result that can help in meeting the requirements of European environmental plans, such as the '20-20-20' action plan.

  10. Energy efficiency optimization in distribution transformers considering Spanish distribution regulation policy

    Energy Technology Data Exchange (ETDEWEB)

    Pezzini, Paola [Centre d' Innovacio en Convertidors Estatics i Accionaments (CITCEA-UPC), E.T.S. Enginyeria Industrial Barcelona, Universitat Politecnica Catalunya, Diagonal, 647, Pl. 2, 08028 Barcelona (Spain); Gomis-Bellmunt, Oriol; Sudria-Andreu, Antoni [Centre d' Innovacio en Convertidors Estatics i Accionaments (CITCEA-UPC), E.T.S. Enginyeria Industrial Barcelona, Universitat Politecnica Catalunya, Diagonal, 647, Pl. 2, 08028 Barcelona (Spain); IREC Catalonia Institute for Energy Research, Josep Pla, B2, Pl. Baixa, 08019 Barcelona (Spain); Frau-Valenti, Joan [ENDESA, Carrer Joan Maragall, 16 07006 Palma (Spain)

    2010-12-15

    In transmission and distribution systems, the high number of installed transformers, a loss source in networks, suggests a good potential for energy savings. This paper presents how the Spanish Distribution regulation policy, Royal Decree 222/2008, affects the overall energy efficiency in distribution transformers. The objective of a utility is the maximization of the benefit, and in case of failures, to install a chosen transformer in order to maximize the profit. Here, a novel method to optimize energy efficiency, considering the constraints set by the Spanish Distribution regulation policy, is presented; its aim is to achieve the objectives of the utility when installing new transformers. The overall energy efficiency increase is a clear result that can help in meeting the requirements of European environmental plans, such as the '20-20-20' action plan. (author)

  11. Advanced policy options to regulate sugar-sweetened beverages to support public health.

    Science.gov (United States)

    Pomeranz, Jennifer L

    2012-02-01

    Consumption of sugar-sweetened beverages (SSBs) has increased worldwide. As public health studies expose the detrimental impact of SSBs, consumer protection and public health advocates have called for increased government control. A major focus has been on restricting marketing of SSBs to children, but many innovative policy options--legally defensible ways to regulate SSBs and support public health--are largely unexplored. We describe the public health, economic, and retail marketing research related to SSBs (including energy drinks). We review policy options available to governments, including mandatory factual disclosures, earmarked taxation, and regulating sales, including placement within retail and food service establishments, and schools. Our review describes recent international initiatives and classifies options available in the United States by jurisdiction (federal, state, and local) based on legal viability.

  12. Smokers' attitudes and support for e-cigarette policies and regulation in the USA.

    Science.gov (United States)

    Wackowski, Olivia A; Delnevo, Cristine D

    2015-11-01

    In April 2014, the Food and Drug Administration (FDA) proposed a rule to extend its tobacco regulatory authority to e-cigarettes, which have been unregulated and growing in use since their 2006-2007 US introduction. The FDA will issue a final rule based on comments and data received from researchers, tobacco companies and the public. We aimed to present data about current smokers' awareness of and attitudes towards potential e-cigarette regulation and various policies in the USA. We conducted a cross-sectional online e-cigarette focused survey of 519 adult current smokers in April 2014, before the FDA's proposed rule was announced. Participants were recruited from a private research panel (GFK's Knowledge Networks) designed to be representative of the US population. The majority of respondents (62.5%) did not know that e-cigarettes are unregulated by the FDA but agreed that e-cigarettes should be regulated by the FDA for safety and quality (83.5%), carry warning labels about their potential risks (86.6%) and have the same legal age of sale as other tobacco (87.7%). Support was similarly high among current e-cigarette users. Support was substantial though lower overall for policies to restrict e-cigarette indoor use (41.2%), flavouring (44.3%) and advertising (55.5%), and was negatively associated with current e-cigarette use. Support for many e-cigarette regulatory policies is strong among smokers, including for policies that the FDA has recently proposed and potential future regulations. States considering indoor e-cigarette restrictions should know that a substantial number of current smokers support such regulations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  13. The Policy Maker's Anguish: Regulating Personal Data Behavior Between Paradoxes and Dilemmas

    Science.gov (United States)

    Compañó, Ramón; Lusoli, Wainer

    Regulators in Europe and elsewhere are paying great attention to identity, privacy and trust in online and converging environments. Appropriate regulation of identity in a ubiquitous information environment is seen as one of the major drivers of the future Internet economy. Regulation of personal identity data has come to the fore including mapping conducted on digital personhood by the OECD; work on human rights and profiling by the Council of Europe andmajor studies by the European Commission with regard to self-regulation in the privacy market, electronic identity technical interoperability and enhanced safety for young people. These domains overlap onto an increasingly complex model of regulation of individuals' identity management, online and offline. This chapter argues that policy makers struggle to deal with issues concerning electronic identity, due to the apparently irrational and unpredictable behavior of users when engaging in online interactions involving identity management. Building on empirical survey evidence from four EU countries, we examine the first aspect in detail - citizens' management of identity in a digital environment. We build on data from a large scale (n = 5,265) online survey of attitudes to electronic identity among young Europeans (France, Germany, Spain, UK) conducted in August 2008. The survey asked questions about perceptions and acceptance of risks, general motivations, attitudes and behaviors concerning electronic identity. Four behavioral paradoxes are identified in the analysis: a privacy paradox (to date well known), but also a control paradox, a responsibility paradox and an awareness paradox. The chapter then examines the paradoxes in relation of three main policy dilemmas framing the debate on digital identity. The paper concludes by arguing for an expanded identity debate spanning policy circles and the engineering community.

  14. On Sharing and Quasi-Sharing : The Tension between Sharing-Economy Practices, Public Policy, and Regulation

    NARCIS (Netherlands)

    Ranchordás, Sofia; Albinsson, Pia A.; Perera, B. Yasanthi

    2018-01-01

    This paper offers a critical and comparative overview of the main regulatory and policy challenges faced by regulators in the context of the sharing economy. The regulation of the sharing economy has been particularly challenging as regulators are being asked to balance the interests protected by

  15. Adaptive dynamic programming for discrete-time linear quadratic regulation based on multirate generalised policy iteration

    Science.gov (United States)

    Chun, Tae Yoon; Lee, Jae Young; Park, Jin Bae; Choi, Yoon Ho

    2018-06-01

    In this paper, we propose two multirate generalised policy iteration (GPI) algorithms applied to discrete-time linear quadratic regulation problems. The proposed algorithms are extensions of the existing GPI algorithm that consists of the approximate policy evaluation and policy improvement steps. The two proposed schemes, named heuristic dynamic programming (HDP) and dual HDP (DHP), based on multirate GPI, use multi-step estimation (M-step Bellman equation) at the approximate policy evaluation step for estimating the value function and its gradient called costate, respectively. Then, we show that these two methods with the same update horizon can be considered equivalent in the iteration domain. Furthermore, monotonically increasing and decreasing convergences, so called value iteration (VI)-mode and policy iteration (PI)-mode convergences, are proved to hold for the proposed multirate GPIs. Further, general convergence properties in terms of eigenvalues are also studied. The data-driven online implementation methods for the proposed HDP and DHP are demonstrated and finally, we present the results of numerical simulations performed to verify the effectiveness of the proposed methods.

  16. Nurse prescribing ethics and medical marketing.

    Science.gov (United States)

    Adams, J

    This article suggests that nurse prescribers require an awareness of key concepts in ethics, such as deontology and utilitarianism to reflect on current debates and contribute to them. The principles of biomedical ethics have also been influential in the development of professional codes of conduct. Attention is drawn to the importance of the Association of the British Pharmaceutical Industry's code of practice for the pharmaceutical industry in regulating marketing aimed at prescribers.

  17. Environmental policy and industrialization: The politics of regulation in Puerto Rico

    International Nuclear Information System (INIS)

    Concepcion, C.M.

    1990-01-01

    The effects of economic development on environmental regulation in Puerto Rico are examined. In particular, the research analyzes how the Puerto Rican industrialization process has affected implementation of the environmental-review process. Puerto Rico exemplifies an acute conflict between an industrialization process based on capital-intensive, highly polluting industries, and a regulatory framework of insular and US environmental laws and regulations. While industrialization has not solved unemployment problems on the island, environmental and health hazards have increased significantly, despite environmental regulations. The study focuses on a change in the environmental review process in response to economic development concerns. In particular, it examines the growth and extensive use of a new environmental review document, the Environmental Assessment. This study explains this policy shift and, more fundamentally, analyzes how and under what circumstances this change came about

  18. A structured policy review of the principles of professional self-regulation.

    Science.gov (United States)

    Benton, D C; González-Jurado, M A; Beneit-Montesinos, J V

    2013-03-01

    The International Council of Nurses (ICN) has, for many years, based its work on professional self-regulation on a set of 12 principles. These principles are research based and were identified nearly three decades ago. ICN has conducted a number of reviews of the principles; however, changes have been minimal. In the past 5-10 years, a number of authors and governments, often as part of the review of regulatory systems, have started to propose principles to guide the way regulatory frameworks are designed and implemented. These principles vary in number and content. This study examines the current policy literature on principle-based regulation and compares this with the set of principles advocated by the ICN. A systematic search of the literature on principle-based regulation is used as the basis for a qualitative thematic analysis to compare and contrast the 12 principles of self-regulation with more recently published work. A mapping of terms based on a detailed description of the principles used in the various research and policy documents was generated. This mapping forms the basis of a critique of the current ICN principles. A professional self-regulation advocated by the ICN were identified. A revised and extended set of 13 principles is needed if contemporary developments in the field of regulatory frameworks are to be accommodated. These revised principles should be considered for adoption by the ICN to underpin their advocacy work on professional self-regulation. © 2013 The Authors. International Nursing Review © 2013 International Council of Nurses.

  19. Opioid Prescribing PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    This 60 second public service announcement is based on the July 2017 CDC Vital Signs report. Higher opioid prescribing puts patients at risk for addiction and overdose. Learn what can be done about this serious problem.

  20. Claims in vapour device (e-cigarette) regulation: A Narrative Policy Framework analysis.

    Science.gov (United States)

    O'Leary, Renée; Borland, Ron; Stockwell, Tim; MacDonald, Marjorie

    2017-06-01

    The electronic cigarette or e-cigarette (vapour device) is a consumer product undergoing rapid growth, and governments have been adopting regulations on the sale of the devices and their nicotine liquids. Competing claims about vapour devices have ignited a contentious debate in the public health community. What claims have been taken up in the state arena, and how have they possibly influenced regulatory outcomes? This study utilized Narrative Policy Framework to analyze the claims made about vapour devices in legislation recommendation reports from Queensland Australia, Canada, and the European Union, and the 2016 deeming rule legislation from the United States, and examined the claims and the regulatory outcomes in these jurisdictions. The vast majority of claims in the policy documents represented vapour devices as a threat: an unsafe product harming the health of vapour device users, a gateway product promoting youth tobacco uptake, and a quasi-tobacco product impeding tobacco control. The opportunity for vapour devices to promote cessation or reduce exposure to toxins was very rarely presented, and these positive claims were not discussed at all in two of the four documents studied. The dominant claims of vapour devices as a public health threat have supported regulations that have limited their potential as a harm reduction strategy. Future policy debates should evaluate the opportunities for vapour devices to decrease the health and social burdens of the tobacco epidemic. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Adopting local alcohol policies: a case study of community efforts to regulate malt liquor sales.

    Science.gov (United States)

    McKee, Patricia A; Nelson, Toben F; Toomey, Traci L; Shimotsu, Scott T; Hannan, Peter J; Jones-Webb, Rhonda J

    2012-01-01

    To learn how the local context may affect a city's ability to regulate alcohol products such as high-alcohol-content malt liquor, a beverage associated with heavy drinking and a spectrum of nuisance crimes in urban areas. An exploratory, qualitative case study comparing cities that adopted policies to restrict malt liquor sales with cities that considered, but did not adopt policies. Nine large U.S. cities in seven states. City legislators and staff, alcohol enforcement personnel, police, neighborhood groups, business associations, alcohol retailers, and industry representatives. Qualitative data were obtained from key informant interviews (n = 56) and media articles (n = 360). The data were coded and categorized. Similarities and differences in major themes among and across Adopted and Considered cities were identified. Cities faced multiple barriers in addressing malt liquor-related problems, including a lack of enforcement tools, alcohol industry opposition, and a lack of public and political will for alcohol control. Compared to cities that did not adopt malt liquor sales restrictions, cities that adopted restrictions appeared to have a stronger public mandate for a policy and were less influenced by alcohol industry opposition and lack of legislative authority for alcohol control. Strategies common to successful policymaking efforts are discussed. Understanding the local context may be a critical step in winning support for local alcohol control policies.

  2. Decree 284/12. It regulate the servitudes prescribed by decree law 10.383 referring of UTE conduction lines energy

    International Nuclear Information System (INIS)

    2012-01-01

    This decree is about the UTE transmission line which integrate the Uruguayan National Electricity System. This regulation are able to allow an increasing energy demand as well as a better public service, a main purpose of UTE.

  3. Equity, tariffing, regulation: analysis of the cost allocation policies of an electric utility industry

    International Nuclear Information System (INIS)

    Bezzina, J.

    1998-01-01

    In this work, an analysis in terms of equity of policies of tariffing regulation and cost allocation of a multi-products electric company (organized as a natural monopoly) is proposed. The goal is double. In a standard point of view, the first goal is to show that today's literature in the domains of public economy, industrial organization and regulation (traditionally based on efficiency considerations) is able to supply reading keys for the analysis of moral philosophy problems. In a positive point of view, the second goal is to demonstrate that the equity criterion is operational enough to judge tariffing management practices in a particular industrial environment and can be used as a regulatory instrument by an ethics-concerned authority. The document is organized in two parts. An ethical and economical analysis of the equity concepts between allocation efficiency, production efficiency and tariffing practices of companies is proposed first. A particular equity concept is considered which is ready to be implemented for the regulation of a public utility, and the ins and outs expected with an equity theory of tariffing practices are evoked. In a second part, an analysis of goal conflicts between the authority and the regulated company is made in a point of view of equity regulation and cost allocation. An improved equity criterion is defined first, from which a measure is built and becomes a tool for the regulatory authority. Then, its use by a regulatory authority fully informed or encountering information asymmetry problems are analyzed in order to show its stakes on the cost allocation and tariffing policies of the company. (J.S.)

  4. 48 CFR 3004.470-2 - Policy.

    Science.gov (United States)

    2010-10-01

    ... unclassified information. MD 4300.1, entitled Information Technology Systems Security, and the DHS Sensitive Systems Handbook, prescribe the policies and procedures on security for Information Technology resources... 3004.470-2 Federal Acquisition Regulations System DEPARTMENT OF HOMELAND SECURITY, HOMELAND SECURITY...

  5. Department of Defense Financial Management Regulation. Volume 13. Nonappropriated Funds Policy and Procedures

    National Research Council Canada - National Science Library

    1994-01-01

    .... In addition, it directs statutory and regulatory financial reporting requirements. This Volume prescribes standard accounting principles and practices for all DoD nonappropriated fund instrumentalities (NAFIs...

  6. Governmental Forest Policy for Sustainable Forest Management in Costa Rica, Guatemala, and Nicaragua: Regulation, Implementation, and Impact

    Science.gov (United States)

    Kathleen A. McGinley; Frederick W. Cubbage

    2012-01-01

    We evaluated how governmental forest regulation in Costa Rica, Guatemala, and Nicaragua has succeeded or failed in fostering changes in forest owner and user behavior that enhance the sustainability of tropical forest management. As expected, sufficient resources and capacity for forest policy implementation are crucial for attaining governmental forest policy...

  7. Decision support tool to evaluate alternative policies regulating wind integration into autonomous energy systems

    International Nuclear Information System (INIS)

    Zouros, N.; Contaxis, G.C.; Kabouris, J.

    2005-01-01

    Integration of wind power into autonomous electricity systems strongly depends on the specific technical characteristics of these systems; the regulations applied should take into account physical system constraints. Introduction of market rules makes the issue even more complicated since the interests of the market participants often conflict each other. In this paper, an integrated tool for the comparative assessment of alternative regulatory policies is presented along with a methodology for decision-making, based on alternative scenarios analysis. The social welfare concept is followed instead of the traditional Least Cost Planning

  8. Proceedings of the 8. Brazilian congress on energy: energy policy, regulation and sustainable development. v. 2: energy planning and policy, energy conservation and rational use

    International Nuclear Information System (INIS)

    1999-01-01

    The theme energy policy, regulation and sustainable development chosen for the 8. Brazilian congress on energy to be held in Rio de Janeiro from 30 November of 1999 to 02 December of 1999, specifically means the contribution of energy to a satisfactory quality of life for everyone. Within such a context, the congress technical programme theme has been structured around six different divisions: energy, environment and development; energy sector regulation; energy policy and planning; technology innovation; energy conservation; and renewable energy sources and rural areas energy supply

  9. Policy Approaches for Regulating Alcohol Marketing in a Global Context: A Public Health Perspective.

    Science.gov (United States)

    Esser, Marissa B; Jernigan, David H

    2018-04-01

    Alcohol consumption is responsible for 3.3 million deaths globally or nearly 6% of all deaths. Alcohol use contributes to both communicable and noncommunicable diseases, as well as violence and injuries. The purpose of this review is to discuss, in the context of the expansion of transnational alcohol corporations and harms associated with alcohol use, policy options for regulating exposure to alcohol marketing. We first provide an overview of the public health problem of harmful alcohol consumption and describe the association between exposure to alcohol marketing and alcohol consumption. We then discuss the growth and concentration of global alcohol corporations and their marketing practices in low- and middle-income countries, as well as in higher-income societies. We review the use and effectiveness of various approaches for regulating alcohol marketing in various countries before discussing challenges and opportunities to protect public health.

  10. Electronic prescribing reduces prescribing error in public hospitals.

    Science.gov (United States)

    Shawahna, Ramzi; Rahman, Nisar-Ur; Ahmad, Mahmood; Debray, Marcel; Yliperttula, Marjo; Declèves, Xavier

    2011-11-01

    To examine the incidence of prescribing errors in a main public hospital in Pakistan and to assess the impact of introducing electronic prescribing system on the reduction of their incidence. Medication errors are persistent in today's healthcare system. The impact of electronic prescribing on reducing errors has not been tested in developing world. Prospective review of medication and discharge medication charts before and after the introduction of an electronic inpatient record and prescribing system. Inpatient records (n = 3300) and 1100 discharge medication sheets were reviewed for prescribing errors before and after the installation of electronic prescribing system in 11 wards. Medications (13,328 and 14,064) were prescribed for inpatients, among which 3008 and 1147 prescribing errors were identified, giving an overall error rate of 22·6% and 8·2% throughout paper-based and electronic prescribing, respectively. Medications (2480 and 2790) were prescribed for discharge patients, among which 418 and 123 errors were detected, giving an overall error rate of 16·9% and 4·4% during paper-based and electronic prescribing, respectively. Electronic prescribing has a significant effect on the reduction of prescribing errors. Prescribing errors are commonplace in Pakistan public hospitals. The study evaluated the impact of introducing electronic inpatient records and electronic prescribing in the reduction of prescribing errors in a public hospital in Pakistan. © 2011 Blackwell Publishing Ltd.

  11. Nurse practitioner prescribing: an international perspective

    Directory of Open Access Journals (Sweden)

    Fong J

    2015-10-01

    financial conditions/climate in which NPs prescribe. Such research may give a better understanding of not only NP's true prescribing capacity currently but also inform future NP prescribing policy. Keywords: nurse practitioner, prescribing

  12. The social act of electronic medication prescribing.

    Science.gov (United States)

    Aarts, Jos

    2013-01-01

    Prescribing medication is embedded in social norms and cultures. In modern Western health care professionals and policy makers have attempted to rationalize medicine by addressing cost-effectiveness of diagnostic and therapeutic treatments and the development of guidelines and protocols based on the outcomes of clinical studies. These notions of cost-effectiveness and evidence-based medicine have also been embedded in technology such as electronic prescribing systems. Such constraining systems may clash with the reality of clinical practice, where formal boundaries of responsibility and authorization are often blurred. Such systems may therefore even impede patient care. Medication is seen as the essence of medical practice. Prescribing is a social act. In a hospital medications may be aimed at treating a patient for a specific condition, in primary care the professional often meets the patient with her or his social and cultural notions of a health problem. The author argues that the design and implementation of electronic prescribing systems should address the social and cultural context of prescribing. Especially in primary care, where health problems are often ill defined and evidence-based medicine guidelines do not always work as intended, studies need to take into account the sociotechnical character of electronic prescribing systems.

  13. A pilot qualitative study to explore stakeholder opinions regarding prescribing quality indicators

    NARCIS (Netherlands)

    Martirosyan, L.; Markhorst, J.; Denig, P.; Haaijer-Ruskamp, F.M.; Braspenning, J.C.

    2012-01-01

    BACKGROUND: Information on prescribing quality of diabetes care is required by health care providers, insurance companies, policy makers, and the public. Knowledge regarding the opinions and preferences of all involved parties regarding prescribing quality information is important for effective use

  14. A pilot qualitative study to explore stakeholder opinions regarding prescribing quality indicators

    NARCIS (Netherlands)

    Martirosyan, Liana; Markhorst, Joekie; Denig, Petra; Haaijer-Ruskamp, Flora M.; Braspenning, Joze

    2012-01-01

    Background: Information on prescribing quality of diabetes care is required by health care providers, insurance companies, policy makers, and the public. Knowledge regarding the opinions and preferences of all involved parties regarding prescribing quality information is important for effective use

  15. 25 CFR 900.5 - Effect of these regulations on Federal program guidelines, manual, or policy directives.

    Science.gov (United States)

    2010-04-01

    ... SELF-DETERMINATION AND EDUCATION ASSISTANCE ACT General Provisions § 900.5 Effect of these regulations... 25 Indians 2 2010-04-01 2010-04-01 false Effect of these regulations on Federal program guidelines, manual, or policy directives. 900.5 Section 900.5 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE...

  16. Municipal Risk Atlases in Mexico as policy instruments for territorial regulation

    Directory of Open Access Journals (Sweden)

    Naxhelli Ruiz Rivera

    2015-12-01

    Full Text Available Municipal Risk Atlases are one of the policy instruments that Mexican government has prioritized in the last few years in order to consolidate the territorial regulation of human settlements in the country. This paper reviews the legal, institutional conceptual and methodological developments of these documents and analyzes its current scope and limitations within the Program of Risk Prevention in Human Settlements (PRAH, which had been designed and implemented by the Ministry of Social Development (SEDESOL between 2010 and 2012, and by the Ministry of Urban, Territorial and Agrarian Development (SEDATU from 2013. The objective of the paper is to understand the conditions under which the Municipal Risk Atlases have been produced to regulate human settlements in risk-prone areas, as one of many juridical instruments that operate in the fields of land use planning and natural hazards provisions. In the first place, we review different approaches that have been used by different agents within the federal government to produce cartographic information to identify and reduce disaster risk. That includes the different concepts and methodologies used to identify different risk components (such as ‘vulnerability’, ‘affected systems’, ‘disturbances’ but also under which institutional context each of them emerge, how they relate to each other and how are they integrated with other policy devices.

  17. The Rise of the Crime Victim and Punitive Policies? Changes to the Legal Regulation of Intimate Partner Violence in Finland.

    Science.gov (United States)

    Kotanen, Riikka

    2017-10-01

    This article examines intimate partnership violence as a question of criminal justice policy in Finland, and contributes to criminological discussions regarding oft-stated connections between the politicization of the victim, the treatment of offenders, and repressive criminal justice policies. In this discussion, legislation aiming to regulate and prevent violence against women has often been utilized as an example of such punitive policies. Although criminal policies in Nordic countries differ significantly from more punitive Anglophone policies, punitive tendencies, it has been argued, have increased in the former, too. This article analyzes the change in legal regulations and the criminal political status of intimate partner violence in Finland between 1990 and 2004, while examining the juxtaposition of victims and offenders alongside repressive demands.

  18. The Monetary Policy in the System of State Regulation of the Indian Economy

    Directory of Open Access Journals (Sweden)

    Natalia V. Galistcheva

    2015-01-01

    Full Text Available The main task of this research is the analysis of India's monetary policy and its place in the system of state regulation of the economy. The article highlights the main directions of the Indian monetary policy in 1990-2000s aiming to raise competitiveness of the Indian goods on the foreign markets as well as stimulating the inflow of foreign capital in necessary volumes into the national economy. The author focuses on the main instruments of the modern Indian monetary policy, pursued in line with providing the undervalued rupee, which include the manipulating of the bank rate and currency interventions, directed mainly at sterilization of excessive inflow of foreign currency to the country. The article also underlines all the advantages and costs of the monetary policy. One of its main advantages is stimulation of national production's exports and among costs there are difficulties of importing machines and equipment into the country, increase of inflation rate as a result of massive inflow of export revenue, difficulties at external debt's service. The author notes the gradual nature of introduction of current account rupee convertibility and reasons for delay in achieving its full convertibility. Among them there are rather high level of fiscal deficit of the consolidated budget, essential average annual level of inflation, problems of non-performed assets in the economy, high liquidity ratio for commercial banks. The article also presents statistical data on the present state of the Indian foreign exchange reserves as well as dynamics in nominal and real effective exchange rate of rupee in 2005/06 - 2013/14 fiscal year.

  19. Opioid Prescribing PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2017-07-06

    This 60 second public service announcement is based on the July 2017 CDC Vital Signs report. Higher opioid prescribing puts patients at risk for addiction and overdose. Learn what can be done about this serious problem.  Created: 7/6/2017 by Centers for Disease Control and Prevention (CDC).   Date Released: 7/6/2017.

  20. Matrix with Prescribed Eigenvectors

    Science.gov (United States)

    Ahmad, Faiz

    2011-01-01

    It is a routine matter for undergraduates to find eigenvalues and eigenvectors of a given matrix. But the converse problem of finding a matrix with prescribed eigenvalues and eigenvectors is rarely discussed in elementary texts on linear algebra. This problem is related to the "spectral" decomposition of a matrix and has important technical…

  1. Prescribers and pharmaceutical representatives: why are we still meeting?

    Science.gov (United States)

    Fischer, Melissa A; Keough, Mary Ellen; Baril, Joann L; Saccoccio, Laura; Mazor, Kathleen M; Ladd, Elissa; Von Worley, Ann; Gurwitz, Jerry H

    2009-07-01

    Research suggests that pharmaceutical marketing influences prescribing and may cause cognitive dissonance for prescribers. This work has primarily been with physicians and physician-trainees. Questions remain regarding why prescribers continue to meet with pharmaceutical representatives (PRs). To describe the reasons that prescribers from various health professions continue to interact with PRs despite growing evidence of the influence of these interactions. Multi-disciplinary focus groups with 61 participants held in practice settings and at society meetings. Most prescribers participating in our focus groups believe that overall PR interactions are beneficial to patient care and practice health. They either trust the information from PRs or feel that they are equipped to evaluate it independently. Despite acknowledgement of study findings to the contrary, prescribers state that they are able to effectively manage PR interactions such that their own prescribing is not adversely impacted. Prescribers describe few specific strategies or policies for these interactions, and report that policies are not consistently implemented with all members of a clinic or institution. Some prescribers perceive an inherent contradiction between academic centers and national societies receiving money from pharmaceutical companies, and then recommending restriction at the level of the individual prescriber. Prescribers with different training backgrounds present a few novel reasons for these meetings. Despite evidence that PR detailing influences prescribing, providers from several health professions continue to believe that PR interactions improve patient care, and that they can adequately evaluate and filter information presented to them by PRs. Focus group comments suggest that cultural change is necessary to break the norms that exist in many settings. Applying policies consistently, considering non-physician members of the healthcare team, working with trainees, restructuring

  2. Proceedings of the 8. Brazilian congress on energy: energy policy, regulation and sustainable development. v. 1: energy, environment and energy sector regulation

    International Nuclear Information System (INIS)

    1999-01-01

    The theme energy policy, regulation and sustainable development chosen for the 8. Brazilian congress on energy to be held in Rio de Janeiro from 30 November of 1999 to 02 December of 1999, specifically means the contribution of energy to a satisfactory quality of life for everyone. Within such a context, the congress technical programme theme has been structured around six different divisions: energy, environment and development; energy sector regulation; energy policy and planning; technology innovation; energy conservation; and renewable energy sources and rural areas energy supply

  3. Policy for introduction of risk-informed regulation for nuclear facilities in Japan

    International Nuclear Information System (INIS)

    Akihide Hidaka; Shoichiro Sakaguchi; Toshihiro Bannai; Kunihiro Matsui

    2005-01-01

    The nuclear safety regulations in Japan place a basis on the deterministic approach with the defence-in-depth philosophy and engineering judgments. However, as the development of PSA (Probabilistic Safety Assessment) technologies in recent years, the Nuclear Safety Commission (NSC) began to consider that the utilization of risk information in addition to the traditional deterministic approach could be very effective for the safety regulations to improve rationality, consistency, transparency and efficiency by appropriate allocation of limited resources for the regulatory activities. In order to show the basic strategy, the NSC published the policy for introduction of Risk-Informed Regulation (RIR) in November 2003. The safety goals that play an important role in RIR were tentatively established in December 2003 while the performance goals are under development as of May, 2005. It is expected that RIR be gradually introduced from the applicable area. The NSC is now examining what the RIR system in Japan should be by making each role and incentive of the competent organizations clear. In the future, when the experiences on application of the safety goals are accumulated, RIR will be consistently applied from design to operational area. This paper describes the recent activities of the NSC for introduction of RIR in Japan and development of the safety goals including the performance goals. (authors)

  4. Pharmaceutical marketing research and the prescribing physician.

    Science.gov (United States)

    Greene, Jeremy A

    2007-05-15

    Surveillance of physicians' prescribing patterns and the accumulation and sale of these data for pharmaceutical marketing are currently the subjects of legislation in several states and action by state and national medical associations. Contrary to common perception, the growth of the health care information organization industry has not been limited to the past decade but has been building slowly over the past 50 years, beginning in the 1940s when growth in the prescription drug market fueled industry interest in understanding and influencing prescribing patterns. The development of this surveillance system was not simply imposed on the medical profession by the pharmaceutical industry but was developed through the interactions of pharmaceutical salesmen, pharmaceutical marketers, academic researchers, individual physicians, and physician organizations. Examination of the role of physicians and physician organizations in the development of prescriber profiling is directly relevant to the contemporary policy debate surrounding this issue.

  5. Effects of agriculture upon the air quality and climate: research, policy, and regulations.

    Science.gov (United States)

    Aneja, Viney P; Schlesinger, William H; Erisman, Jan Willem

    2009-06-15

    compounds, volatile organic compounds, greenhouse gases, odor and pathogens, the quantification of landscape processes, and the primary and secondary emissions of PM. Given the serious concerns raised regarding the amount and the impacts of agricultural air emissions, policies must be pursued and regulations must be enacted in orderto make real progress in reducing these emissions and their associated environmental impacts.

  6. Economic regulation of Canada's natural gas delivery industry : policy and regulatory principles

    International Nuclear Information System (INIS)

    Gormley, B.

    2006-03-01

    This policy paper demonstrated how restoring balance and clarity to Canada's regulatory environment will ensure the continued strength of the economy, environment, and communities. It was noted that regulatory outcomes that reflect the broad public interest can be achieved if 4 basic principles for economic regulation are pursued. These principles include strength, balance, efficiency, and clarity. In particular, this paper addressed the challenge facing Canada's natural gas delivery industry in terms of increased energy demand, tight supply, ageing infrastructure and increasing cost pressures on the energy system. It emphasized that transparent, efficient energy policy developed through informed debate can provide the foundation for a reliable, environmentally acceptable and sustainable energy future. It was suggested that immediate attention be given to rebalancing the regulatory processes that have placed short term considerations above the longer term strength of the natural gas system; improving the support for new natural gas supply development; reconsidering pricing in some energy markets where information has been distorted; and revisiting the regulatory processes that have become inefficient

  7. Changing doctor prescribing behaviour

    DEFF Research Database (Denmark)

    Gill, P.S.; Mäkelä, M.; Vermeulen, K.M.

    1999-01-01

    Collaboration on Effective Professional Practice. This register is kept up to date by searching the following databases for reports of relevant research: DHSS-DATA; EMBASE; MEDLINE; SIGLE; Resource Database in Continuing Medical Education (1975-1994), along with bibliographies of related topics, hand searching......The aim of this overview was to identify interventions that change doctor prescribing behaviour and to derive conclusions for practice and further research. Relevant studies (indicating prescribing as a behaviour change) were located from a database of studies maintained by the Cochrane...... of key journals and personal contact with content area experts. Randomised controlled trials and non-equivalent group designs with pre- and post-intervention measures were included. Outcome measures were those used by the study authors. For each study we determined whether these were positive, negative...

  8. An Evaluation of the Cybersecurity Policies for the United States Health & Human Services Department: Criteria, Regulations, and Improvements

    OpenAIRE

    Derek Mohammed; Ronda Mariani

    2014-01-01

    This paper examines the criteria necessary for the evaluation of the cybersecurity policies for the United States Health and Human Services Department of the Federal Government. The overall purpose of cybersecurity policies and procedures is supported through compliance with Federal mandated regulation and standards, which serve to protect the organizational services and goals of the United States Health and Human Services Department, and to promote the best possible security practices in the...

  9. The impact of policies regulating alcohol trading hours and days on specific alcohol-related harms: a systematic review.

    Science.gov (United States)

    Sanchez-Ramirez, Diana C; Voaklander, Donald

    2018-02-01

    Evidence supports the expectation that changes in time of alcohol sales associate with changes in alcohol-related harm in both directions. However, to the best of our knowledge, no comprehensive systematic reviews had examined the effect of policies restricting time of alcohol trading on specific alcohol-related harms. To compile existing evidence related to the impact of policies regulating alcohol trading hours/days of on specific harm outcomes such as: assault/violence, motor vehicle crashes/fatalities, injury, visits to the emergency department/hospital, murder/homicides and crime. Systematic review of literature studying the impact of policies regulation alcohol trading times in alcohol-related harm, published between January 2000 and October 2016 in English language. Results support the premise that policies regulating times of alcohol trading and consumption can contribute to reduce injuries, alcohol-related hospitalisations/emergency department visits, homicides and crime. Although the impact of alcohol trading policies in assault/violence and motor vehicle crashes/fatalities is also positive, these associations seem to be more complex and require further study. Evidence suggests a potential direct effect of policies that regulate alcohol trading times in the prevention of injuries, alcohol-related hospitalisations, homicides and crime. The impact of these alcohol trading policies in assault/violence and motor vehicle crashes/fatalities is less compelling. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. Prescribed fire research in Pennsylvania

    Science.gov (United States)

    Patrick Brose

    2009-01-01

    Prescribed fire in Pennsylvania is a relatively new forestry practice because of the State's adverse experience with highly destructive wildfires in the early 1900s. The recent introduction of prescribed fire raises a myriad of questions regarding its correct and safe use. This poster briefly describes the prescribed fire research projects of the Forestry Sciences...

  11. Nuclear regulation in the United States : Policy directions and future prospects

    International Nuclear Information System (INIS)

    Shirley, Ann Jackson

    1996-01-01

    Just before leaving the United States to come to Korea, I addressed the U. S. Nuclear Regulatory Commission (NRC) annual regulatory information conference, with which some of you might be familiar. The overall theme this year focused on enhancing and promoting a better understanding of future trends for improving nuclear safety. Specific sessions addressed an array of nuclear safety topics including: dry cask storage of spent fuel; performance-based changes in the inspection program; core performance and reactor fuel issues; the revised decommissioning rule; utility restructuring and NRC licensing activities; steam generators; implementation of the maintenance rule; an update on license renewal; the shutdown rule; and spent fuel pool issues. The number and range of topics addressed tells US that the nuclear field is by no means static. On the contrary. there are numerous areas in which regulatory policy is evolving in response to technological, governmental, and other developments. while not all nations with nuclear programs face the same issues at the same time, there is enough overlap from one nation to another that it may be useful to describe the challenges facing the NRC today. the nuclear regulatory policy is moving. The challenges that we are dealing with at the NRC today may well be those which other nations will be confronting shortly? of they are not doing so already. In addressing the question of my vision for the NRC, I am sometimes asked whether it is possible to have a vision for the agency, given that no new nuclear plants are being built in the U. S. and none are on the immediate horizon. The answer, of course, is that the original licensing of nuclear power plants is only a part of the job of the NRC? an important part, to be sure, be but because safety must be built into nuclear plants from the beginning -- but nevertheless just one part. The task of the nuclear regulator is to ensure not only that plants are designed and constructed safely, but

  12. An Evaluation of the Cybersecurity Policies for the United States Health & Human Services Department: Criteria, Regulations, and Improvements

    Directory of Open Access Journals (Sweden)

    Derek Mohammed

    2014-04-01

    Full Text Available This paper examines the criteria necessary for the evaluation of the cybersecurity policies for the United States Health and Human Services Department of the Federal Government. The overall purpose of cybersecurity policies and procedures is supported through compliance with Federal mandated regulation and standards, which serve to protect the organizational services and goals of the United States Health and Human Services Department, and to promote the best possible security practices in the protection of information systems from unauthorized actors and cyber-threats. The criteria of the cybersecurity evaluation is identified and analyzed for quality, strengths, weaknesses, and future applicability. Topics within the criteria include organizational operation, regulations and industrial standards compliance, service delivery to national customers, and the prevention and mitigation of IT system and security failure. This analysis determines the strengths and weaknesses, and makes recommendations for revising the cybersecurity policies within the United States Health and Human Services Department.

  13. The Radiation Oncology Job Market: The Economics and Policy of Workforce Regulation

    Energy Technology Data Exchange (ETDEWEB)

    Falit, Benjamin P., E-mail: bfalit2@allianceoncology.com [Pacific Cancer Institute, Wailuku, Hawaii (United States); Pan, Hubert Y.; Smith, Benjamin D. [MD Anderson Cancer Center, Houston, Texas (United States); Alexander, Brian M. [Dana Farber Cancer Institute, Boston, Massachusetts (United States); Zietman, Anthony L. [Massachusetts General Hospital, Boston, Massachusetts (United States)

    2016-11-01

    Examinations of the US radiation oncology workforce offer inconsistent conclusions, but recent data raise significant concerns about an oversupply of physicians. Despite these concerns, residency slots continue to expand at an unprecedented pace. Employed radiation oncologists and professional corporations with weak contracts or loose ties to hospital administrators would be expected to suffer the greatest harm from an oversupply. The reduced cost of labor, however, would be expected to increase profitability for equipment owners, technology vendors, and entrenched professional groups. Policymakers must recognize that the number of practicing radiation oncologists is a poor surrogate for clinical capacity. There is likely to be significant opportunity to augment capacity without increasing the number of radiation oncologists by improving clinic efficiency and offering targeted incentives for geographic redistribution. Payment policy changes significantly threaten radiation oncologists' income, which may encourage physicians to care for greater patient loads, thereby obviating more personnel. Furthermore, the implementation of alternative payment models such as Medicare's Oncology Care Model threatens to decrease both the utilization and price of radiation therapy by turning referring providers into cost-conscious consumers. Medicare funds the vast majority of graduate medical education, but the extent to which the expansion in radiation oncology residency slots has been externally funded is unclear. Excess physician capacity carries a significant risk of harm to society by suboptimally allocating intellectual resources and creating comparative shortages in other, more needed disciplines. There are practical concerns associated with a market-based solution in which medical students self-regulate according to job availability, but antitrust law would likely forbid collaborative self-regulation that purports to restrict supply. Because Congress is unlikely

  14. The Radiation Oncology Job Market: The Economics and Policy of Workforce Regulation

    International Nuclear Information System (INIS)

    Falit, Benjamin P.; Pan, Hubert Y.; Smith, Benjamin D.; Alexander, Brian M.; Zietman, Anthony L.

    2016-01-01

    Examinations of the US radiation oncology workforce offer inconsistent conclusions, but recent data raise significant concerns about an oversupply of physicians. Despite these concerns, residency slots continue to expand at an unprecedented pace. Employed radiation oncologists and professional corporations with weak contracts or loose ties to hospital administrators would be expected to suffer the greatest harm from an oversupply. The reduced cost of labor, however, would be expected to increase profitability for equipment owners, technology vendors, and entrenched professional groups. Policymakers must recognize that the number of practicing radiation oncologists is a poor surrogate for clinical capacity. There is likely to be significant opportunity to augment capacity without increasing the number of radiation oncologists by improving clinic efficiency and offering targeted incentives for geographic redistribution. Payment policy changes significantly threaten radiation oncologists' income, which may encourage physicians to care for greater patient loads, thereby obviating more personnel. Furthermore, the implementation of alternative payment models such as Medicare's Oncology Care Model threatens to decrease both the utilization and price of radiation therapy by turning referring providers into cost-conscious consumers. Medicare funds the vast majority of graduate medical education, but the extent to which the expansion in radiation oncology residency slots has been externally funded is unclear. Excess physician capacity carries a significant risk of harm to society by suboptimally allocating intellectual resources and creating comparative shortages in other, more needed disciplines. There are practical concerns associated with a market-based solution in which medical students self-regulate according to job availability, but antitrust law would likely forbid collaborative self-regulation that purports to restrict supply. Because Congress is unlikely to create

  15. Solution scanning as a key policy tool: identifying management interventions to help maintain and enhance regulating ecosystem services

    Directory of Open Access Journals (Sweden)

    William J. Sutherland

    2014-06-01

    Full Text Available The major task of policy makers and practitioners when confronted with a resource management problem is to decide on the potential solution(s to adopt from a range of available options. However, this process is unlikely to be successful and cost effective without access to an independently verified and comprehensive available list of options. There is currently burgeoning interest in ecosystem services and quantitative assessments of their importance and value. Recognition of the value of ecosystem services to human well-being represents an increasingly important argument for protecting and restoring the natural environment, alongside the moral and ethical justifications for conservation. As well as understanding the benefits of ecosystem services, it is also important to synthesize the practical interventions that are capable of maintaining and/or enhancing these services. Apart from pest regulation, pollination, and global climate regulation, this type of exercise has attracted relatively little attention. Through a systematic consultation exercise, we identify a candidate list of 296 possible interventions across the main regulating services of air quality regulation, climate regulation, water flow regulation, erosion regulation, water purification and waste treatment, disease regulation, pest regulation, pollination and natural hazard regulation. The range of interventions differs greatly between habitats and services depending upon the ease of manipulation and the level of research intensity. Some interventions have the potential to deliver benefits across a range of regulating services, especially those that reduce soil loss and maintain forest cover. Synthesis and applications: Solution scanning is important for questioning existing knowledge and identifying the range of options available to researchers and practitioners, as well as serving as the necessary basis for assessing cost effectiveness and guiding implementation strategies. We

  16. Energy policy conference on the regulation of energy industries; Conference de politique energetique sur la regulation des industries energetiques

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-11-01

    This document is the report of the conference meeting jointly organized by the French general plan commission and the general direction of energy and raw materials on the regulation of energy industries: 1 - the changes in the regulation of public utilities in competition: harmonization, respect of impartiality and social cohesion, organization of a loyal competition, specialized regulation and regulation of competition, open debates; 2 - towards an homogenous model of regulatory authority?: the US model (collegial and hybrid organizations), the UK model (individual and independent), missions of regulation and institutional 'meccano', theory and practice, draft classification of the institutional approaches of IEA countries (role of ministries and regulatory agencies), independent regulatory authorities or not, significant differences in converging models, dominant types of regulation in the different sectors, situation of the French energy regulatory system (institutional plan, regulation processes, relations of the regulation authority with the government), reasons of the differences between different countries, expected evolution of the regulation systems in the coming years. (J.S.)

  17. Energy policy conference on the regulation of energy industries; Conference de politique energetique sur la regulation des industries energetiques

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-11-01

    This document is the report of the conference meeting jointly organized by the French general plan commission and the general direction of energy and raw materials on the regulation of energy industries: 1 - the changes in the regulation of public utilities in competition: harmonization, respect of impartiality and social cohesion, organization of a loyal competition, specialized regulation and regulation of competition, open debates; 2 - towards an homogenous model of regulatory authority?: the US model (collegial and hybrid organizations), the UK model (individual and independent), missions of regulation and institutional 'meccano', theory and practice, draft classification of the institutional approaches of IEA countries (role of ministries and regulatory agencies), independent regulatory authorities or not, significant differences in converging models, dominant types of regulation in the different sectors, situation of the French energy regulatory system (institutional plan, regulation processes, relations of the regulation authority with the government), reasons of the differences between different countries, expected evolution of the regulation systems in the coming years. (J.S.)

  18. Economic and institutional dynamics of electricity markets deregulation: the interaction between sectoral regulation and antitrust policy

    International Nuclear Information System (INIS)

    Fontanel, B.

    2009-01-01

    The purpose of this study is to define regulatory intervention as a part of a global monitoring procedure allowing the definition and adaptation of market structures and rules, given the observed behavior of market participants. Nevertheless, the possible inefficiency in its (decisional) coordination with competition authorities implies further analysis. We thus adopt a comparative methodology based on the studying PJM and NETA wholesale markets. This analysis enables us to stress two possible 'models' in the distribution and coordination of monitoring powers. The first one privileges a strong 'informational coordination' between the sectoral regulator and the Transmission System Operator. By contrast, the second model is characterized by a constrained informational coordination, leading to a greater 'decisional convergence' between regulatory intervention and antitrust policy. Lastly, we put these conclusions into perspective with the specific issue of the achievement of an efficient and integrated European market for electricity. In particular, we stress the need for a single regulatory agency, which should be given autonomous decisional powers in the adoption of regional markets reform initiatives (author)

  19. Regulation of Ocean Iron Fertilization (OIF): a Model for Balancing Research, Environmental and Policy Concerns

    Science.gov (United States)

    Leinen, M.; Lamotte, R.

    2008-12-01

    The potential of enhancing carbon sequestration by the biosphere for climate mitigation often raises questions of offsetting effects. These questions become more important as the scale of the enhancement increases. Ocean iron fertilization is accompanied by additional questions related to use of the ocean commons. The London Convention (LC) and London Protocol (LP), international treaties adopted in 1972 and 1996 respectively, were designed to prevent use of the ocean for disposal of toxic, harmful and radioactive pollutants. Recently the LC/LP has been called upon to decide whether climate mitigation activities, such as subseafloor injection of CO2 and OIF, are legal under the framework and, if so, how they should be regulated. The broad consultation with the science community by the LC/LP in developing their perspective, and the involvement of the NGO community in these deliberations, provides a model for the process that the international policy community can use to develop science-based regulatory guidelines for carbon mitigation projects involving the commons. And the substance of that emerging regulatory framework -- built on a national-level permitting process informed by internationally agreed guidelines and standards -- may also serve as a model for the oversight of other emerging technologies that take place in the global commons.

  20. Opposite Trends in the Regulation of Pornography? Policy Differentiation and Policy Convergence Across 26 Countries Between 1960 and 2010.

    Science.gov (United States)

    Person, Christian; Hurka, Steffen; Knill, Christoph

    2016-09-01

    In recent decades, the regulation of pornography has been confronted with challenges emerging from cultural change, economic interests, and technological progress. As a result, the respective regulatory frameworks have changed substantially in many countries. These changes have been accompanied by fierce political struggles and societal value conflicts. However, there are few comparative studies on the reactions of national governments to these problems. In this article, we present new empirical data on the regulation of pornography in 26 countries between 1960 and 2010. To assess regulatory change, we rely on a new measurement approach that considers the extent to which governments intervene into individual freedoms and the degree to which noncompliance with these rules is actually sanctioned. Our analysis reveals a trend toward more permissive styles of pornography regulation. However, this trend is accompanied by growing regulatory specialization and a convergence toward more interventionist regimes for special types of pornography.

  1. Transformation and Regulation: A Century of Continuity in Nursery School and Welfare Policy Rhetoric

    Science.gov (United States)

    Read, Jane

    2015-01-01

    This article explores policy development for under-fives and its implementation in nursery schools in the first two decades of the twentieth century and draws parallels with current policy initiatives such as Sure Start and the "Troubled Families" programme. It interrogates how discourse on British racial health shaped policy and…

  2. What Factors Affect Physicians’ Decisions to Prescribe Opioids in Emergency Departments?

    Directory of Open Access Journals (Sweden)

    Lauren E. Sinnenberg BA

    2017-01-01

    Full Text Available Objective: With 42% of all emergency department visits in the United States related to pain, physicians who work in this setting are tasked with providing adequate pain management to patients with varying primary complaints and medical histories. Complicating this, the United States is in the midst of an opioid overdose epidemic. State governments and national organizations have developed guidelines and legislation to curtail opioid prescriptions in acute care settings, while also incentivizing providers for patient satisfaction and completeness of pain control. In order to inform future policies that focus on provider pain medication prescribing, we sought to characterize the factors physicians weigh when considering treating pain with opioids in the emergency department. Methods: We conducted and transcribed open-ended, semistructured qualitative interviews with 52 physicians at a national emergency medicine conference. Results: Participants reported a wide range of factors contributing to their opioid prescribing patterns related to three domains: 1 provider assessment of pain characteristics, 2 patient-based considerations, and 3 practice environment. Pain characteristics include the characteristics of various acute and chronic pain syndromes, including physicians’ empathy due to their own experiences with pain. Patient characteristics include “trustworthiness,” race and ethnicity, and the concern for risk of misuse. Factors related to the practice environment include hospital policy, legislation/regulation, and guidelines. Conclusion: The decision to prescribe opioids to patients in the emergency department is complex and nuanced. Physicians are interested in guidance and are concerned about the competing pressures placed on their opioid prescribing due to incentives related to patient satisfaction scores on one hand and inflexible policies that do not allow for individualized, patient-centered decisions on the other.

  3. Social determinants of prescribed and non-prescribed medicine use

    Directory of Open Access Journals (Sweden)

    García-Altés Anna

    2010-05-01

    Full Text Available Abstract Background The aim of the present study was to describe the use of prescribed and non prescribed medicines in a non-institutionalised population older than 15 years of an urban area during the year 2000, in terms of age and gender, social class, employment status and type of Primary Health Care. Methods Cross-sectional study. Information came from the 2000 Barcelona Health Interview Survey. The indicators used were the prevalence of use of prescribed and non-prescribed medicines in the two weeks prior to the interview. Descriptive analyses, bivariate and multivariate logistic regression analyses were carried out. Results More women than men took medicines (75.8% vs. 60% respectively. The prevalence of use of prescribed medicines increased with age while the prevalence of non-prescribed use decreased. These age differences are smaller among those with poor perceived health. In terms of social class, a higher percentage of men with good health in the more advantaged classes took non-prescribed medicines compared with disadvantaged classes (38.7% vs 31.8%. In contrast, among the group with poor health, more people from the more advantaged classes took prescribed medicines, compared with disadvantaged classes (51.4% vs 33.3%. A higher proportion of people who were either retired, unemployed or students, with good health, used prescribed medicines. Conclusion This study shows that beside health needs, there are social determinants affecting medicine consumption in the city of Barcelona.

  4. Best available control measures for prescribed burning

    International Nuclear Information System (INIS)

    Smith, A.M.; Stoneman, C.S.

    1992-01-01

    Section 190 of the Clean Air Act (CAA) as amended in 1990 requires the US Environmental Protection Agency (EPA) to issue guidance on Best Available Control Measures (BACM) of PM 10 (particulate matter with a nominal aerodynamic diameter less than or equal to 10 micrometers) from urban fugitive dust, residential wood combustion, and prescribed silvicultural and agricultural burning (prescribed burning). The purpose of this guidance is to assist states (especially, but not exclusively, those with PM 10 nonattainment areas which have been classified as serious) in developing a control measure for these three source categories. This guidance is to be issued no later than May 15, 1992 as required under the CAA. The guidance will be issued in the form of a policy guidance generic to all three BACM and in the form of Technical Information Documents (TIDs) for each of the three source categories. The policy guidance will provide the analytical approach for determining BACM and the TID will provide the technical information. The purpose of this paper is to present some insight from the forthcoming TID on what BACM might entail for prescribed burning in a serious PM 10 nonattainment area

  5. Society of Behavioral Medicine's (SBM) position on emerging policy issues regarding electronic nicotine delivery systems (ENDS): A need for regulation.

    Science.gov (United States)

    Rojewski, Alana M; Coleman, Nortorious; Toll, Benjamin A

    2016-09-01

    Electronic nicotine delivery systems (ENDS), commonly known as electronic cigarettes (or e-cigarettes), are widely available in the USA, yet almost entirely unregulated on a national level. Researchers are currently gathering data to understand the individual and public health effects of ENDS, as well as the role that ENDS may play in tobacco treatment. Given these uncertainties, regulatory efforts should be aimed at understanding and minimizing any potential harms of ENDS. The Society of Behavioral Medicine (SBM) supports stronger regulation of ENDS, incorporation of ENDS into clean air policies, and special consideration of safety standards to protect vulnerable populations. SBM also supports research on ENDS to guide policy decisions.

  6. Evaluation of a diabetes nurse specialist prescribing project.

    Science.gov (United States)

    Wilkinson, Jill; Carryer, Jenny; Adams, Jeffery

    2014-08-01

    To evaluate the diabetes nurse specialist prescribing project with the aim of determining whether diabetes nurse specialist prescribing is safe and effective and to inform the implementation and extension of registered nurse prescribing. Registered nurses in many countries are able to prescribe medicines, but in New Zealand, prior to the diabetes nurse specialist project, nurse practitioners were the only nurses who could prescribe medicines. New regulations allowed the nurses to prescribe a limited number of prescription medicines. The study was a process and outcome clinical programme evaluation. The project took place between April-September 2011 and involved 12 diabetes nurse specialist in four localities. Quantitative data were collected from clinical records maintained by the diabetes nurse specialist for the project (1274 patients and 3402 prescribing events), from surveys with stakeholders (general practitioners, n = 30; team members, n = 19; and patients, n = 89) and audits from patient notes (n = 117) and prescriptions (n = 227), and qualitative data from interviews with project participants (n = 18) and patients (n = 19). All data were analysed descriptively. Diabetes nurse specialist prescribing was determined to be safe, of high quality and appropriate. It brought important benefits to the effectiveness of specialist diabetes services, was acceptable to patients and was supported by the wider healthcare team. These findings are consistent with the findings reported in the international literature about nurse prescribing in a range of different practice areas. Clarification of the education and competence requirements and resourcing for the ongoing supervision of nurses is recommended if the prescribing model is to be extended. Diabetes nurse specialist prescribing improved access to medicines by providing a more timely service. Nurses felt more satisfied with their work because they could independently provide a complete episode of care

  7. 76 FR 70037 - Federal Regulations; OMB Circulars, OFPP Policy Letters, and CASB Cost Accounting Standards...

    Science.gov (United States)

    2011-11-10

    ... Circulars, OFPP Policy Letters, and CASB Cost Accounting Standards Included in the Semiannual Agenda of..., and Cost Accounting Standards Board (CASB) Cost Accounting Standards. DATES: The withdrawal is...

  8. Regulation of distributed generation. A European Policy Paper on the Integration of Distributed Generation in the Internal Electricity Market

    International Nuclear Information System (INIS)

    Van Sambeek, E.J.W.; Scheepers, M.J.J.

    2004-06-01

    In the SUSTELNET project criteria and guidelines have been developed that can create a level playing field in electricity markets between distributed generation (DG) and large scale power generation and will improve the network and market access of DG and electricity supply from renewable energy resources (RES). This report focuses on the European dimensions of DG regulation. The key findings of the SUSTELNET project are compared with the EU legislation, i.e. the current Electricity, Renewables and CHP Directives. Additional EU policy, regulation and initiatives are identified that can help Member States in developing future economically efficient and sustainable electricity supply systems

  9. On policies to regulate long-term risks from hazardous waste disposal sites under both intergenerational equity and intragenerational equity

    Science.gov (United States)

    Shu, Zhongbin

    In recent years, it has been recognized that there is a need for a general philosophic policy to guide the regulation of societal activities that involve long-term and very long-term risks. Theses societal activities not only include the disposal of high-level radioactive wastes and global warming, but also include the disposal of non-radioactive carcinogens that never decay, such as arsenic, nickel, etc. In the past, attention has been focused on nuclear wastes. However, there has been international recognition that large quantities of non-radioactive wastes are being disposed of with little consideration of their long-term risks. The objectives of this dissertation are to present the significant long-term risks posed by non-radioactive carcinogens through case studies; develop the conceptual decision framework for setting the long-term risk policy; and illustrate that certain factors, such as discount rate, can significantly influence the results of long-term risk analysis. Therefore, the proposed decision-making framework can be used to systematically study the important policy questions on long-term risk regulations, and then subsequently help the decision-maker to make informed decisions. Regulatory disparities between high-level radioactive wastes and non-radioactive wastes are summarized. Long-term risk is rarely a consideration in the regulation of disposal of non-radioactive hazardous chemicals; and when it is, the matter has been handled in a somewhat perfunctory manner. Case studies of long-term risks are conducted for five Superfund sites that are contaminated with one or more non-radioactive carcinogens. Under the same assumptions used for the disposal of high-level radioactive wastes, future subsistence farmers would be exposed to significant individual risks, in some cases with lifetime fatality risk equal to unity. The important policy questions on long-term risk regulation are identified, and the conceptual decision-making framework to regulate

  10. An audit of generic prescribing in a general surgical department.

    LENUS (Irish Health Repository)

    Gleeson, M

    2013-01-17

    BACKGROUND: The Health Service Executive introduced a generic prescription policy to reduce costs. Despite this, generic prescription rates remain low. AIM: To audit in-patient prescription practice in a single surgical department and identify potential savings which could be realised by adherence to the generic prescribing policy. METHODS: Surgical in-patient charts were obtained at the point of discharge and their drug prescription information was recorded. RESULTS: 51 % of prescriptions involved a trade-name prescription where an appropriate generic equivalent existed. The cost implications for hospital and community patients were found to be greatly affected by substitution policies that exist at hospital pharmacy level. CONCLUSION: There is a need to promote greater adherence to generic prescribing amongst hospital doctors in line with international best practice. It can have a positive impact in terms of safe prescribing and can have cost implications at both hospital and community level.

  11. Quantitative Analysis of the Impact of Changes in Policies and Regulations for Electricity and Town Gas Supply Industries (Japanese)

    OpenAIRE

    KAINOU Kazunari

    2005-01-01

    In the 1990s, a series of changes were made to policies and regulations governing electricity and town gas supply industries in Japan. To evaluate how such regulatory changes, channeled through the behavior of power/gas companies, have affected the economic welfare of the electricity and town gas markets, it is necessary to first quantitatively analyze how the power/gas companies reacted to the regulatory changes in terms of management behavior. Specifically, it must be examined what decision...

  12. Sports policy systems in regulated Rhineland welfare states : Differences in financial structures of sports clubs?

    NARCIS (Netherlands)

    Pamela Wicker; Jeroen Scheerder; Steven Vos; Christoph Breuer

    2013-01-01

    This article addresses the resource dependencies of voluntary sports club in two Rhineland welfare states with differences in their organizational arrangements of sports (e.g. the centralization of the Sport for All policy). On the basis of the VOCASPORT typology of sports policy systems and the

  13. 76 FR 60357 - Federal Regulations; OMB Circulars, OFPP Policy Letters, and CASB Cost Accounting Standards...

    Science.gov (United States)

    2011-09-29

    ... derived from 41 U.S.C. 1501. Cost Accounting Standards are rules governing the measurement, assignment... Circulars, OFPP Policy Letters, and CASB Cost Accounting Standards Included in the Semiannual Agenda of..., and Cost Accounting Standards Board (CASB) Cost Accounting Standards. OMB Circulars and OFPP Policy...

  14. THE REGULATION OF MONEY CIRCULATION ON THE BASIS OF USING METHODS AND INSTRUMENTS OF MONETARY POLICY

    OpenAIRE

    S. Mishchenko; S. Naumenkova

    2013-01-01

    In the article it was researched the instruments and mechanism of safeguarding stability of money market on the basis of implementing the optimal monetary policy regime. It was determined the main directions of appliance the monetary policy methods and instruments to guiding money market stability and it was also investigated the influence of transmission mechanism on providing the soundness of money circulations.

  15. Prescribing safety, negotiating expertise

    International Nuclear Information System (INIS)

    Rolina, Gregory

    2010-01-01

    Owing to their presumed impact on the safety of high-risk installations, the interactions between regulators and the regulated are a major but seldom explored subject of research in risk management. A study by experts on human and organizational factors in nuclear safety sheds light on the various phases (and their effects) of the process whereby experts produce assessments. Light is shed on a 'negotiated expertise' typical of the French style of safety regulations in nuclear installations. It is based on an ongoing technical dialog between experts and operators ('French cooking' for Anglo-Saxons). This analysis of 'expertise' and thus of the 'logics of action' implemented by experts proposes a typology of actions that can be transposed to other sorts of risk or other fields of activity. It hands us the keys for understanding a very contemporary activity. (author)

  16. Prescribing antibiotics in general practice:

    DEFF Research Database (Denmark)

    Sydenham, Rikke Vognbjerg; Pedersen, Line Bjørnskov; Plejdrup Hansen, Malene

    Objectives The majority of antibiotics are prescribed from general practice. The use of broad-spectrum antibiotics increases the risk of development of bacteria resistant to antibiotic treatment. In spite of guidelines aiming to minimize the use of broad-spectrum antibiotics we see an increase...... in the use of these agents. The overall aim of the project is to explore factors influencing the decision process and the prescribing behaviour of the GPs when prescribing antibiotics. We will study the impact of microbiological testing on the choice of antibiotic. Furthermore the project will explore how...... the GPs’ prescribing behaviour is influenced by selected factors. Method The study consists of a register-based study and a questionnaire study. The register-based study is based on data from the Register of Medicinal Product Statistics (prescribed antibiotics), Statistics Denmark (socio-demographic data...

  17. A review of building energy regulation and policy for energy conservation in developing countries

    International Nuclear Information System (INIS)

    Iwaro, Joseph; Mwasha, Abraham

    2010-01-01

    The rapid growth of energy use, worldwide, hfs raised concerns over problems of energy supply and exhaustion of energy resources. Most of the developed countries are implementing building energy regulations such as energy standards, codes etc., to reduce building energy consumption. The position of developing countries with respect to energy regulations implementation and enforcement is either poorly documented or not documented at all. In addition, there is a lack of consistent data, which makes it difficult to understand the underlying changes that affect energy regulation implementation in developing countries. In that respect, this paper investigates the progress of building energy regulations in developing countries and its implication for energy conservation and efficiency. The present status of building energy regulations in 60 developing countries around the world was analysed through a survey of building energy regulations using online survey. The study revealed the present progress made on building energy regulations in relation to implementation, development and compliance; at the same time the study recommends possible solutions to the barriers facing building energy regulation implementation in the developing world. - Research Highlights: →Progress and implications of energy regulations in developing countries. →Investigation assessed the progress made on energy regulations using online survey. →Energy regulation activities is progressively increasing in developing countries. →The study identified 25 developing countries without energy regulatory standards. →The study shows relationship between energy regulation and energy consumption.

  18. Protocol: mixed-methods study to evaluate implementation, enforcement, and outcomes of U.S. state laws intended to curb high-risk opioid prescribing.

    Science.gov (United States)

    McGinty, Emma E; Stuart, Elizabeth A; Caleb Alexander, G; Barry, Colleen L; Bicket, Mark C; Rutkow, Lainie

    2018-02-26

    The U.S. opioid epidemic has been driven by the high volume of opioids prescribed by healthcare providers. U.S. states have recently enacted four types of laws designed to curb high-risk prescribing practices, such as high-dose and long-term opioid prescribing, associated with opioid-related mortality: (1) mandatory Prescription Drug Monitoring Program (PDMP) enrollment laws, which require prescribers to enroll in their state's PDMP, an electronic database of patients' controlled substance prescriptions, (2) mandatory PDMP query laws, which require prescribers to query the PDMP prior to prescribing an opioid, (3) opioid prescribing cap laws, which limit the dose and/or duration of opioid prescriptions, and (4) pill mill laws, which strictly regulate pain clinics to prevent nonmedical opioid prescribing. Some pain experts have expressed concern that these laws could negatively affect pain management among patients with chronic non-cancer pain. This paper describes the protocol for a mixed-methods study analyzing the independent effects of these four types of laws on opioid prescribing patterns and chronic non-cancer pain treatment, accounting for variation in implementation and enforcement of laws across states. Many states have enacted multiple opioid prescribing laws at or around the same time. To overcome this issue, our study focuses on 18 treatment states that each enacted a single law of interest, and no other potentially confounding laws, over a 4-year period (2 years pre-/post-law). Qualitative interviews with key leaders in each of the 18 treatment states will characterize the timing, scope, and strength of each state law's implementation and enforcement. This information will inform the design and interpretation of synthetic control models analyzing the effects of each of the two types of laws on two sets of outcomes: measures of (1) high-risk opioid prescribing and (2) non-opioid treatments for chronic non-cancer pain. Study of mandatory PDMP enrollment

  19. Policy options for alcohol price regulation: the importance of modelling population heterogeneity.

    Science.gov (United States)

    Meier, Petra Sylvia; Purshouse, Robin; Brennan, Alan

    2010-03-01

    Context and aims Internationally, the repertoire of alcohol pricing policies has expanded to include targeted taxation, inflation-linked taxation, taxation based on alcohol-by-volume (ABV), minimum pricing policies (general or targeted), bans of below-cost selling and restricting price-based promotions. Policy makers clearly need to consider how options compare in reducing harms at the population level, but are also required to demonstrate proportionality of their actions, which necessitates a detailed understanding of policy effects on different population subgroups. This paper presents selected findings from a policy appraisal for the UK government and discusses the importance of accounting for population heterogeneity in such analyses. Method We have built a causal, deterministic, epidemiological model which takes account of differential preferences by population subgroups defined by age, gender and level of drinking (moderate, hazardous, harmful). We consider purchasing preferences in terms of the types and volumes of alcoholic beverages, prices paid and the balance between bars, clubs and restaurants as opposed to supermarkets and off-licenses. Results Age, sex and level of drinking fundamentally affect beverage preferences, drinking location, prices paid, price sensitivity and tendency to substitute for other beverage types. Pricing policies vary in their impact on different product types, price points and venues, thus having distinctly different effects on subgroups. Because population subgroups also have substantially different risk profiles for harms, policies are differentially effective in reducing health, crime, work-place absence and unemployment harms. Conclusion Policy appraisals must account for population heterogeneity and complexity if resulting interventions are to be well considered, proportionate, effective and cost-effective.

  20. THE REGULATION OF MONEY CIRCULATION ON THE BASIS OF USING METHODS AND INSTRUMENTS OF MONETARY POLICY

    Directory of Open Access Journals (Sweden)

    S. Mishchenko

    2013-05-01

    Full Text Available In the article it was researched the instruments and mechanism of safeguarding stability of money market on the basis of implementing the optimal monetary policy regime. It was determined the main directions of appliance the monetary policy methods and instruments to guiding money market stability and it was also investigated the influence of transmission mechanism on providing the soundness of money circulations.

  1. SURROGACY POLICY IN INDIA AND NEED OF ACTS TO REGULATE COMMERCIAL SURROGACY

    OpenAIRE

    Chaturvedi; Garg; Abha; Vidya; Praveen

    2014-01-01

    Surrogacy is an arrangement by which a woman, called as surrogate, carries and delivers the offspring of the commissioning parents and it has been recognized in India under the ART treatment. For commercial surrogacy, there is no any uniform law in India or there is no law that binds or regulates this industry. In this paper, we have focused our attention on the present existing laws or guidelines regulating surrogacy with emphasis on need for stringent laws to regulate co...

  2. Corporate coalitions and policy making in the European Union: how and why British American Tobacco promoted "Better Regulation".

    Science.gov (United States)

    Smith, Katherine Elizabeth; Fooks, Gary; Gilmore, Anna B; Collin, Jeff; Weishaar, Heide

    2015-04-01

    Over the past fifteen years, an interconnected set of regulatory reforms, known as Better Regulation, has been adopted across Europe, marking a significant shift in the way that European Union policies are developed. There has been little exploration of the origins of these reforms, which include mandatory ex ante impact assessment. Drawing on documentary and interview data, this article discusses how and why large corporations, notably British American Tobacco (BAT), worked to influence and promote these reforms. Our analysis highlights (1) how policy entrepreneurs with sufficient resources (such as large corporations) can shape the membership and direction of advocacy coalitions; (2) the extent to which "think tanks" may be prepared to lobby on behalf of commercial clients; and (3) why regulated industries (including tobacco) may favor the use of "evidence tools," such as impact assessments, in policy making. We argue that a key aspect of BAT's ability to shape regulatory reform involved the deliberate construction of a vaguely defined idea that could be strategically adapted to appeal to diverse constituencies. We discuss the theoretical implications of this finding for the Advocacy Coalition Framework, as well as the practical implications of the findings for efforts to promote transparency and public health in the European Union. Copyright © 2015 by Duke University Press.

  3. Toward a more consistent combined approach of reduction targets and climate policy regulations

    DEFF Research Database (Denmark)

    Caro, Dario; Frederiksen, Pia; Thomsen, Marianne

    2017-01-01

    In this paper we discuss how targets, policy instruments and accounting frameworks for greenhouse gas (GHG) reduction need to be complemented and aligned, to achieve a more effective road to reduce the GHG emission. We focus on gaps in the policy framework presently adopted by countries that are ...... level. We argue that to reveal the effect of policy instruments such as a meat tax, on GHG emissions reduced, an alternative consumption-based accounting could favorably complement the traditional GHG accounting.......In this paper we discuss how targets, policy instruments and accounting frameworks for greenhouse gas (GHG) reduction need to be complemented and aligned, to achieve a more effective road to reduce the GHG emission. We focus on gaps in the policy framework presently adopted by countries...... that are parties to the UNFCCC, using as illustrative case study the meat tax recently proposed in Denmark. We argue that when the GHG reduction targets for individual countries are based on a territorial approach alone (such as in the UNFCCC framework), i.e. sum of emissions from production inside the country...

  4. Regulations, guidelines, standards, and policies pertaining to decontamination and decommissioning activities: A literature review

    International Nuclear Information System (INIS)

    Cowgill, M.G.

    1993-09-01

    A literature review has been conducted of the existing rules, regulations, and guidelines pertaining to the decontamination and decommissioning of nuclear facilities. Included in the survey are US Government documents, national (industrial) standards, international standards and guidelines, and the regulations issued by various national governments, such as the United Kingdom, Canada, and Germany

  5. Prescribed burning: a topical issue

    Directory of Open Access Journals (Sweden)

    Bovio G

    2013-11-01

    Full Text Available Prescribed burning is a promising technique for the prevention of forest fires in Italy. The research deepened several ecological and operative aspects. However, legal issues need to be thoroughly investigated.

  6. Soil heating and impact of prescribed burning

    Science.gov (United States)

    Stoof, Cathelijne

    2016-04-01

    Prescribed burning is highly uncommon in the Netherlands, where wildfire awareness is increasing but its risk management does not yet include fuel management strategies. A major exception is on two military bases, that need to burn their fields in winter and spring to prevent wildfires during summer shooting practice. Research on these very frequent burns has so far been limited to effects on biodiversity, yet site managers and policy makers have questions regarding the soil temperatures reached during these burns because of potential impact on soil properties and soil dwelling fauna. In March 2015, I therefore measured soil and litter temperatures under heath and grass vegetation during a prescribed burn on military terrain in the Netherlands. Soil and litter moisture were sampled pre- and post-fire, ash was collected, and fireline intensity was estimated from flame length. While standing vegetation was dry (0.13 g water/g biomass for grass and 0.6 g/g for heather), soil and litter were moist (0.21 cm3/cm3 and 1.6 g/g, respectively). Soil heating was therefore very limited, with maximum soil temperature at the soil-litter interface remaining being as low as 6.5 to 11.5°C, and litter temperatures reaching a maximum of 77.5°C at the top of the litter layer. As a result, any changes in physical properties like soil organic matter content and bulk density were not significant. These results are a first step towards a database of soil heating in relation to fuel load and fire intensity in this temperate country, which is not only valuable to increase understanding of the relationships between fire intensity and severity, but also instrumental in the policy debate regarding the sustainability of prescribed burns.

  7. Safe prescribing: a titanic challenge.

    Science.gov (United States)

    Routledge, Philip A

    2012-10-01

    The challenge to achieve safe prescribing merits the adjective 'titanic'. The organisational and human errors leading to poor prescribing (e.g. underprescribing, overprescribing, misprescribing or medication errors) have parallels in the organisational and human errors that led to the loss of the Titanic 100 years ago this year. Prescribing can be adversely affected by communication failures, critical conditions, complacency, corner cutting, callowness and a lack of courage of conviction, all of which were also factors leading to the Titanic tragedy. These issues need to be addressed by a commitment to excellence, the final component of the 'Seven C's'. Optimal prescribing is dependent upon close communication and collaborative working between highly trained health professionals, whose role is to ensure maximum clinical effectiveness, whilst also protecting their patients from avoidable harm. Since humans are prone to error, and the environments in which they work are imperfect, it is not surprising that medication errors are common, occurring more often during the prescribing stage than during dispensing or administration. A commitment to excellence in prescribing includes a continued focus on lifelong learning (including interprofessional learning) in pharmacology and therapeutics. This should be accompanied by improvements in the clinical working environment of prescribers, and the encouragement of a strong safety culture (including reporting of adverse incidents as well as suspected adverse drug reactions whenever appropriate). Finally, members of the clinical team must be prepared to challenge each other, when necessary, to ensure that prescribing combines the highest likelihood of benefit with the lowest potential for harm. © 2012 The Author. British Journal of Clinical Pharmacology © 2012 The British Pharmacological Society.

  8. Safe prescribing: a titanic challenge

    Science.gov (United States)

    Routledge, Philip A

    2012-01-01

    The challenge to achieve safe prescribing merits the adjective ‘titanic’. The organisational and human errors leading to poor prescribing (e.g. underprescribing, overprescribing, misprescribing or medication errors) have parallels in the organisational and human errors that led to the loss of the Titanic 100 years ago this year. Prescribing can be adversely affected by communication failures, critical conditions, complacency, corner cutting, callowness and a lack of courage of conviction, all of which were also factors leading to the Titanic tragedy. These issues need to be addressed by a commitment to excellence, the final component of the ‘Seven C's’. Optimal prescribing is dependent upon close communication and collaborative working between highly trained health professionals, whose role is to ensure maximum clinical effectiveness, whilst also protecting their patients from avoidable harm. Since humans are prone to error, and the environments in which they work are imperfect, it is not surprising that medication errors are common, occurring more often during the prescribing stage than during dispensing or administration. A commitment to excellence in prescribing includes a continued focus on lifelong learning (including interprofessional learning) in pharmacology and therapeutics. This should be accompanied by improvements in the clinical working environment of prescribers, and the encouragement of a strong safety culture (including reporting of adverse incidents as well as suspected adverse drug reactions whenever appropriate). Finally, members of the clinical team must be prepared to challenge each other, when necessary, to ensure that prescribing combines the highest likelihood of benefit with the lowest potential for harm. PMID:22738396

  9. The domestic supply outlook, how the producing industry is reacting, and the challenge to regulators and policy makers

    International Nuclear Information System (INIS)

    Jordan, C.A.

    1992-01-01

    This paper addresses three main topics which include an overview of the nation's natural gas reserves; a discussion of the challenges the natural gas industry faces in extracting these reserves in the realm of regulations and cost-effective extraction; and a discussion on how the industry, regulators, and policy makers can work together to extract these reserves in an economic manner while effectively operating within existing regulations. The paper also promotes methods to update and change regulations when necessary as a result of technological change or advancement. The results of the reserve study have shown that there are over 2,000 trillion cubic feet of natural gas still available in the US and Canada, not including undiscovered or additional extraction brought about by new technology. The paper goes on to discuss the historical wellhead pricing of natural gas and what these new reserve figures mean to future natural gas costs. The paper then discusses the adequacy of current distribution systems to meet an increasing demand for natural gas. Finally the paper discusses the need for more deregulation of the gas industry to make it more competitive and keep the development of these resources alive in this country. The author presents information on the decline of exploration and development in this country as a result of increased regulation

  10. A 5-year retrospective audit of prescribing by a critical care outreach team.

    Science.gov (United States)

    Wilson, Mark

    2018-05-01

    UK prescribing legislation changes made in 2006 and 2012 enabled appropriately qualified nurses to prescribe any licensed medication, and all controlled drugs in schedule 2-5 of the Misuse of Drugs Regulations 2001, for any medical condition within their clinical competence. Critical Care Outreach nurses who are independent nurse prescribers are ideally placed to ensure that acutely ill patients receive treatment without delay. The perceived challenge was how Critical Care Outreach nurses would be able to safely prescribe for a diverse patient group. This study informs this developing area of nurse prescribing in critical care practice. The aims of the audit were to: identify which medications were prescribed; develop a critical care outreach formulary; identify the frequency, timing and number of prescribing decisions being made; identify if prescribing practice changed over the years and provide information for our continuing professional development. This article reports on data collected from a 5-year retrospective audit; of prescribing activity undertaken by nine independent nurse prescribers working in a 24/7 Critical Care Outreach team of a 600-bedded district general hospital in the UK. In total, 8216 medication items were prescribed, with an average of 2·6 prescribed per shift. The most commonly prescribed items were intravenous fluids and analgesia, which were mostly prescribed at night and weekends. The audit has shown that Critical Care Outreach nurse prescribing is feasible in a whole hospital patient population. The majority of prescribing occurred after 16:00 and at night. Further research would be beneficial, particularly looking at patient outcomes following reviews from prescribing critical care outreach nurses. The audit is one of the only long-term studies that describes prescribing practice in Critical Care Outreach teams in the UK. © 2017 British Association of Critical Care Nurses.

  11. Proceedings of the 8. Brazilian congress on energy: energy policy, regulation and sustainable development. v. 3: technological innovation, renewable sources and rural energization

    International Nuclear Information System (INIS)

    1999-01-01

    These proceedings cover the papers presented in the 8. Brazilian congress on energy held at Rio de Janeiro from November, 30 to December, 02, 1999, focusing energy policy, regulation and sustainable development, specifically the contribution of energy to a satisfactory quality of life for everyone. Within such a context, the congress technical programme has been structured around six different divisions: energy, environment and development; energy sector regulation; energy policy and planning; technology innovation; energy conservation; renewable energy sources and rural areas energy supply

  12. Introduction to prescribed fires in Southern ecosystems

    Science.gov (United States)

    Thomas A. Waldrop; Scott L. Goodrick

    2012-01-01

    This publication is a guide for resource managers on planning and executing prescribed burns in Southern forests and grasslands. It includes explanations of reasons for prescribed burning, environmental effects, weather, and techniques as well as general information on prescribed burning.

  13. Assessment of policy issues in nuclear safety regulation according to circumstantial changes

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Soon Heung; Lee, Byong Ho; Baek, Woon Pil; Lee, Seong Wook; Choi, Seong Soo; Roh, Chang Hyun; Lee, Kwang Gu [Korea Advanced Institute of Scienc and Technology, Taejon (Korea, Republic of)

    1998-03-15

    The objective of the work is to assess various issues in nuclear safety regulation in consideration of circumstantial changes. Emphasis is given to the safety of operating NPPs. The derivation of an effective regulation system considering 'Rhodic Safety Review (PSR)', 'operating License Renewal (LR)', 'backfitting' and 'maintenance rule' is the main objective of the first two years. It is found that those approaches should be introduced in Korea as soon as possible, with cross lingkage to maximize the effectiveness of regulation. In particular, the approaches for PSR are discussed with consultation of IAEA document and foreign practices.

  14. Assessment of policy issues in nuclear safety regulation according to circumstantial changes

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Soon Heung; Lee, Byong Ho; Baek, Won Pil; Lee, Kwang Gu; Huh, Gyun Young; Hahn, Young Tae [Korea Advanced Institute of Science and Technology, Taejon (Korea, Republic of)

    2000-03-15

    The objective of the work is to assess various issues in nuclear safety regulation in consideration of circumstantial changes. Emphasis is given to the safety of operating NPPs. It is concluded that the Periodic Safety Review (PSR) should be implemented in Korea as soon as possible, in harmonization with the regulation for life extension of NPPs. The IAEA guidelines, including 10 year intervals and 11 safety factors, should be used as the basic guidelines. The approach to improve regulatory effectiveness is also reviewed and a transition to 'knowledge-based regulation' is suggested.

  15. Assessment of policy issues in nuclear safety regulation according to circumstantial changes

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Soon Heung; Chang, Soon Heung; Lee, Byong Ho; Baek, Won Pil; Roh, Chang Hyun; Lee, Kwang Gu; Kim, Hong Chae; Lee, Yong Ho [Korea Advanced Institute of Science and Technology, Taejon (Korea, Republic of)

    1999-03-15

    The objective of the work is to assess various issues in nuclear safety regulation in consideration of circumstantial changes. Emphasis is given to the safety of operating NPPs. It is concluded that the Periodic Safety Review (PSR) should be implemented in Korea as soon as possible, in harmonization with the regulation for life extension of NPPs. The IAEA guidelines, including 10 year intervals and 11 safety factors, should be used as the basic guidelines. Efforts are also required to cope with other circumstantial changes such as the establishment of International Nuclear Regulators Association (INRA)

  16. 42 CFR 52b.14 - Other federal laws, regulations, executive orders, and policies that apply.

    Science.gov (United States)

    2010-10-01

    ... exposure to hazardous chemicals in laboratories. 36 CFR part 1190—Minimum guidelines and requirements for... Department of Health and Human Services—effectuation of title VI of the Civil Rights Act of 1964. 45 CFR part.... (1) Design Policy and Guidelines (1996). Division of Engineering Services, National Institutes of...

  17. 76 FR 47990 - Amendment to the International Traffic in Arms Regulations: Updates to Country Policies, and...

    Science.gov (United States)

    2011-08-08

    ... ambiguity, minimize litigation, establish clear legal standards, and reduce burden. Paperwork Reduction Act... of Haiti, in coordination with the U.S. Government. * * * * * (l) Vietnam. It is the policy of the... services destined for or originating in Vietnam, except that a license or other approval may be issued, on...

  18. Soft regulations in pharmaceutical policy making : an overview of current approaches and their consequences

    NARCIS (Netherlands)

    Wettermark, B.; Godman, B.; Jacobsson, B.; Haaijer-Ruskamp, F.M.

    2009-01-01

    It is a challenge to improve public health within limited resources. Pharmaceutical policy making is a greater challenge due to conflicting interests between key stakeholder groups. This paper reviews current and future strategies to help improve the quality and efficiency of care, with special

  19. Environmental policy and technological change: The effects of economic incentives and direct regulation on energy-saving innovation

    Science.gov (United States)

    Newell, Richard G., Jr.

    Over the long run, the impacts of environmental policies will be greatly affected by the influence these policies have on the rate and direction of technological change. In particular, the roles played by energy prices and product regulation in energy-saving technology innovation are exceptionally important considerations in modeling climate change and evaluating alternative policy options. We analyze the effects of energy prices and energy-efficiency regulations on the menu of air conditioner and water heater models available on the market over a period of more than three decades, measuring their innovation in terms of improvements in the products' underlying characteristics. Through estimation of a series of "characteristics transformation surfaces," we find that during less than four decades, substantial innovation in these products reduced the total capital and operating costs of air conditioning by one-half and water heating by more than one-fifth. Although the overall rate of innovation in these products appears to be independent of energy prices and regulations, the evidence suggests that the direction of innovation may be responsive to energy price changes. This would imply that energy price increases induced innovation in a direction that lowered the capital cost tradeoffs inherent in producing more energy-efficient products. The evidence supporting "regulation-induced" changes in these tradeoffs is much weaker. Our estimates indicate that about one- to two-fifths of the energy-efficiency improvements in these products from 1973 to 1993 were associated with historical changes in energy prices. We also find that this responsiveness to price changes increased substantially after product labeling requirements came into effect, and that minimum efficiency standards had a significant positive effect on average efficiency levels. Nonetheless, a sizeable portion of historical efficiency improvements in these technologies is associated with the products' overall

  20. Re-Engineering Biosafety Regulations In India: Towards a Critique of Policy, Law and Prescriptions

    Directory of Open Access Journals (Sweden)

    A. Damodaran

    2005-06-01

    Full Text Available This article surveys the structure and essence of India’s biosafety regulations from an evolutionary perspective. After detailing the processes associated with the biosafety law and guidelines in the country, this article looks critically at recent efforts to re-engineer the regulations. It is argued that India’s biosafety regulations should move towards a more inclusive approach, which will facilitate transparent and informed decision-making, based on stakeholder-convergence. It is also suggested that the entire spectrum of laws and regulations that have a direct or indirect bearing on biosafety in India, need to be explored so that greater coherence could be secured in the management of biotechnology products that are sensitive to the environment. Drawing from the experience of the Bt cotton case, the article advocates a greater role for civil society and grassroots organizations.

  1. Impact of policies regulating foreign physician migration to Switzerland: a modelling case study in anaesthesia.

    Science.gov (United States)

    Haller, Guy; Combescure, Christophe; Mamie, Chantal; Zoccatelli, Davide; Clergue, François

    2015-05-22

    Several countries have developed policies that restrict or limit duration of stay, clinical privileges or the number of residency permits allocated to migrating physicians. Switzerland is currently preparing a new law limiting overall foreign immigration. The impact of such restrictive policies is currently unknown. In a case study of anaesthesia care in Switzerland we modelled, trends in the size of physicians' workforce until 2024, following the implementation of a strict quota policy for foreign medical trainees. We developed a computer-based Markov model with Monte-Carlo simulations to project, in the context of a strict quota policy for foreign trainees, supply and demand for anaesthesia positions until 2024. We used data from a cross-sectional study performed in the French- and Italian-speaking cantons of Switzerland and the Health dataset from the OECD. With 8 to 12 (95% CI 4-20) anaesthetists retiring per year, the implementation of strict quotas of foreign graduates would result in a 38% decrease in the number of anaesthetists in intermediary (senior registrars) positions by 2024. This decrease would be particularly important in district hospitals where nearly half (49%) of the non-Swiss anaesthetists are practising. Swiss graduates are unlikely to balance the shortage. Despite efforts by Swiss universities to increase the number of medical graduates, their number has dropped from 10.5 to 9.7/100 000 inhabitants between 2000 and 2012, due to the growth of the population. This case study in Latin Switzerland shows that a restrictive policy limiting foreign immigration of trainees would result in a major deficit in the number of anaesthetists available to meet population needs. These aspects should be carefully considered when countries develop restrictions and limitations of foreign immigration.

  2. Inappropriate prescribing in the elderly.

    LENUS (Irish Health Repository)

    Gallagher, P

    2012-02-03

    BACKGROUND AND OBJECTIVE: Drug therapy is necessary to treat acute illness, maintain current health and prevent further decline. However, optimizing drug therapy for older patients is challenging and sometimes, drug therapy can do more harm than good. Drug utilization review tools can highlight instances of potentially inappropriate prescribing to those involved in elderly pharmacotherapy, i.e. doctors, nurses and pharmacists. We aim to provide a review of the literature on potentially inappropriate prescribing in the elderly and also to review the explicit criteria that have been designed to detect potentially inappropriate prescribing in the elderly. METHODS: We performed an electronic search of the PUBMED database for articles published between 1991 and 2006 and a manual search through major journals for articles referenced in those located through PUBMED. Search terms were elderly, inappropriate prescribing, prescriptions, prevalence, Beers criteria, health outcomes and Europe. RESULTS AND DISCUSSION: Prescription of potentially inappropriate medications to older people is highly prevalent in the United States and Europe, ranging from 12% in community-dwelling elderly to 40% in nursing home residents. Inappropriate prescribing is associated with adverse drug events. Limited data exists on health outcomes from use of inappropriate medications. There are no prospective randomized controlled studies that test the tangible clinical benefit to patients of using drug utilization review tools. Existing drug utilization review tools have been designed on the basis of North American and Canadian drug formularies and may not be appropriate for use in European countries because of the differences in national drug formularies and prescribing attitudes. CONCLUSION: Given the high prevalence of inappropriate prescribing despite the widespread use of drug-utilization review tools, prospective randomized controlled trials are necessary to identify useful interventions. Drug

  3. Regulation of Islamic art in confessional policy of Catherine II (on materials of the Tyumen region

    Directory of Open Access Journals (Sweden)

    Yulia A. Bortnikova

    2016-06-01

    Full Text Available Prevention of the religious conflicts and Islamic extremism, education of confessional tolerance, – these and other questions became the most actual political and scientific problem now. Art reflects outlook of people and is an ideological lever on society. In article the policy on use of Islamic art for education of confessional tolerance is analyzed. This policy began by Catherine II in 1773, had the content of reform and extended on religious art and architecture of all gentiles in the Russian Empire. Article is written on the basis of materials of the Central historical archive of the Republic of Bashkortostan and exhibits of the museums. The Tyumen region (the South of the modern Tyumen region was an optimum basis for carrying out this policy because of the mixed option of Islam which arose there. Muslim art included a complex of the subjects intended for execution of a religious cult. It reflected elements of Shamanism and Tengriism, and after carrying out reform – Judaism and Christianity. Thus, at it there were forms and images of all religions of the Tyumen region. Syncretism of Islamic art was shown in a typology of cult objects, their ornament and mission. The most unusual phenomenon was existence of a religious sculpture which was forbidden in Islam and Orthodoxy, but existed in both religions, and also in Catholicism, Tengriism and Shamanism. In article ways of impact on Muslim art which were used by the Orenburg Mohammedan spiritual meeting are considered. It didn't interfere in preservation of religious syncretism, and also executed orders of the government on Christianization of Islamic art. Authors come to a conclusion that reform carried lines of policy of multiculturalism for gentiles.

  4. Policy Instruments for Irigation Water Management: Flat Pricing, Volumetric Pricing and Quota Regulations

    OpenAIRE

    Pinheiro, António C.; Saraiva, João Paulo

    2009-01-01

    In the fifty years since the foundation of the European Community, Europe has evolved in many fields. From being exclusively concerned with economic integration – reflected by policies to increase agricultural productivity and improvement of intra-communitarian trade –, nowadays, the European Union is gradually advancing towards a political integration, in the direction of common environmental values and towards the sustainability of natural resources. While in the Treaties of the European Co...

  5. Nuclear export policy and regulation for non-proliferation: Federal Republic of Germany

    International Nuclear Information System (INIS)

    Boulanger, Werner.

    1978-01-01

    The nuclear export policy of the Federal Republic of Germany complies with the principle of non-proliferation of nuclear weapons. Already in 1967 the Federal Government stated in a Peace Note that no export was authorised to countries (outside Euratom) which did not comply with the IAEA Safeguards. In the bilateral agreement the Federal Republic signed with Brasil in 1975, emphasis was put on international safeguards and the control exercised on exported materials to avoid any diversion for military purposes. (NEA) [fr

  6. Market Regulators of Service Spheres Innovative Development as a Tool of Regional Socio-Economic Policy

    OpenAIRE

    Pugacheva, Anna S.; Filippova, Viktoriya P.; Kon, Andrei Y.; Dorzhieva, Lyudmila B.; Silchenok, Igor S.; Pugacheva, Natalya B.; Lunev, Alexander N.; Mustafina, Alfiya A.

    2016-01-01

    The relevance of the study is conditioned by the innovative development of service spheres as the reduction of territorial social and economic differentiation to the level, due to objective differences of the regions and to balance of their revenue base and expenditure commitments. The service sector is one of the most dynamic and growing segments of regional markets and one of the characteristics of effective socio-economic policy in the region. Innovative development of service spheres as a...

  7. A Deterrence Approach to Regulate Nurses' Compliance with Electronic Medical Records Privacy Policy.

    Science.gov (United States)

    Kuo, Kuang-Ming; Talley, Paul C; Hung, Ming-Chien; Chen, Yen-Liang

    2017-11-03

    Hospitals have become increasingly aware that electronic medical records (EMR) may bring about tangible/intangible benefits to managing institutions, including reduced medical errors, improved quality-of-care, curtailed costs, and allowed access to patient information by healthcare professionals regardless of limitations. However, increased dependence on EMR has led to a corresponding increase in the influence of EMR breaches. Such incursions, which have been significantly facilitated by the introduction of mobile devices for accessing EMR, may induce tangible/intangible damage to both hospitals and concerned individuals. The purpose of this study was to explore factors which may tend to inhibit nurses' intentions to violate privacy policy concerning EMR based upon the deterrence theory perspective. Utilizing survey methodology, 262 responses were analyzed via structural equation modeling. Results revealed that punishment certainty, detection certainty, and subjective norm would most certainly and significantly reduce nurses' intentions to violate established EMR privacy policy. With these findings, recommendations for health administrators in planning and designing effective strategies which may potentially inhibit nurses from violating EMR privacy policy are discussed.

  8. IVF policy and global/local politics: the making of multiple-embryo transfer regulation in Taiwan.

    Science.gov (United States)

    Wu, Chia-Ling

    2012-08-01

    This paper analyzes the regulatory trajectory of multiple-embryo transfer in in-vitro fertilization (IVF) in Taiwan. Taking a latecomer to policy-making as the case, it argues the importance of conceptualizing the global/local dynamics in policy-making for assisted reproductive technology (ART). The conceptual framework is built upon recent literature on standardization, science policy, and global assemblage. I propose three interrelated features that reveal the "global in the local": (1) the power relationships among stakeholders, (2) the selected global form that involved actors drew upon, and (3) the re-contextualized assemblage made of local networks. Data included archives, interviews, and participant observation. In different historical periods the specific stakeholders selected different preferred global forms for Taiwan, such as Britain's code of ethics in the 1990s, the American guideline in the early 2000s, and the European trend in the mid-2000s. The global is heterogeneous. The failure to transfer the British regulation, the revision of the American guideline by adding one more embryo than it specified, and the gap between the cited European trend and the "no more than four" in Taiwan's 2007 Human Reproduction Law all show that the local network further transforms the selected global form, confining it to rhetoric only or tailoring it to local needs. Overall, Taiwanese practitioners successfully maintained their medical autonomy to build a 'flexible standardization'. Multiple pregnancy remains the most common health risk of IVF in Taiwan. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. An evaluation of prescribing trends and patterns of claims within the Preferred Drugs Initiative in Ireland (2011-2016): an interrupted time-series study.

    LENUS (Irish Health Repository)

    McDowell, Ronald

    2018-04-20

    To examine the impact of the Preferred Drugs Initiative (PDI), an Irish health policy aimed at enhancing evidence-based cost-effective prescribing, on prescribing trends and the cost of prescription medicines across seven medication classes.

  10. Changes in Policy and Market and Network Regulation to Increase Power Generation by Renewables and DG in the EU

    International Nuclear Information System (INIS)

    Van Oostvoorn, F.; Van der Welle, A.

    2009-01-01

    Recently the importance of 'Large scale DER integration' has increased as means to meet the ambitious 2020 EU policy objectives and targets for RES, emissions reductions and energy efficiency. Increasing the role of RES and DG (Renewable Energy Sources and Distributed Generation or DER) in supply is also highly beneficial for reducing EU dependency on gas and oil imports. In this EU context, it is important to review the current barriers, support policies and network regulation for integration of more DG, RES and small scale CHP (Combined Heat and Power) in the power systems. Several studies conducted for the EU and led by the ECN (Energy research Centre of the Netherlands) reveal that currently, in some, mainly new, Member States, the contribution of RES and DG is still very low. However, in coming decades the share of variable RES-E sources should become much larger in many EU countries. Note that 20% RES in a country in 2020 implies a share of electricity supply by RES of about 30% or more. Currently, countries like Denmark and Spain, already experience such a large contribution of (mostly intermittent type) renewables and this is already negatively impacting power system costs. Now the question arises whether or not we can increase the contribution of RES to the power supply beyond 20-30% without raising system inefficiency and what changes in system conditions and market and network regulation are necessary to efficiently absorb large volumes of so called intermittent RES supply resources. Based on findings from several large EU projects promoting the role of RES and DG in the power supply, the authors discuss and present the different barriers and solutions that should facilitate meeting the ambitious EU policy targets for RES in 2020

  11. A study of antibiotic prescribing

    DEFF Research Database (Denmark)

    Jaruseviciene, L.; Radzeviciene-Jurgute, R.; Jurgutis, A.

    2012-01-01

    Background. Globally, general practitioners (GPs) write more than 90% of all antibiotic prescriptions. This study examines the experiences of Lithuanian and Russian GPs in antibiotic prescription for upper respiratory tract infections, including their perceptions of when it is not indicated...... clinically or pharmacologically. Methods. 22 Lithuanian and 29 Russian GPs participated in five focus group discussions. Thematic analysis was used to analyse the data. Results. We identified four main thematic categories: patients' faith in antibiotics as medication for upper respiratory tract infections......; patient potential to influence a GP's decision to prescribe antibiotics for upper respiratory tract infections; impediments perceived by GPs in advocating clinically grounded antibiotic prescribing with their patients, and strategies applied in physician-patient negotiation about antibiotic prescribing...

  12. ELECTORAL PRESCRIBERS. WHO ARE THEY?

    Directory of Open Access Journals (Sweden)

    Constantin SASU

    2016-12-01

    Full Text Available The decision to vote and choosing among the candidates is an extremely important one with repercussions on everyday life by determining, in global mode, its quality for the whole society. Therefore the whole process by which the voter decides becomes a central concern. Prescribers, supposed to have a big influence on the electoral market, are a component of the microenvironment political organizations. These are people who occupy important positions that can influence the behavior of others. In the political environment, prescribers are known under the name of "opinion formers", "opinion leaders", "mediators" (Beciu, 2009 or "influencers" (Keller and Berry, 2003 Weimann, 1994. This paper aims to review the central opinions on what is the influence prescribers, opinion makers on voting behavior, voting and decisions on whether and how they act?

  13. 76 FR 71926 - Defense Federal Acquisition Regulation Supplement: Applicability of Hexavalent Chromium Policy to...

    Science.gov (United States)

    2011-11-21

    ... 0750-AH39 Defense Federal Acquisition Regulation Supplement: Applicability of Hexavalent Chromium... the use of materials containing hexavalent chromium. DATES: Comment Date: Comments on the proposed... human health and environmental risks related to the use of hexavalent chromium. Hexavalent chromium is a...

  14. The public’s voice about healthcare quality regulation policies: a population-based survey.

    NARCIS (Netherlands)

    Bouwman, R.; Bomhoff, M.; Jong, J.D. de; Robben, P.; Friele, R.

    2015-01-01

    Background: In the wake of various high-profile incidents in a number of countries, regulators of healthcare quality have been criticised for their ‘soft’ approach. In politics, concerns were expressed about public confidence. It was claimed that there are discrepancies between public opinions

  15. To prescribe codeine or not to prescribe codeine?

    Science.gov (United States)

    Fleming, Marc L; Wanat, Matthew A

    2014-09-01

    A recently published study in Pediatrics by Kaiser et al. (2014; Epub April 21, DOI: 10.1542/peds.2013-3171) reported that on average, over the past decade, children aged 3 to 17 were prescribed approximately 700,000 prescriptions for codeine-containing products each year in association with emergency department (ED) visits. Although, guidelines from the American Academy of Pediatrics issued warnings in 1997 and reaffirmed their concerns regarding the safety and effectiveness of codeine in 2006, it is still often prescribed for pain and cough associated with upper respiratory infection. With the impending rescheduling of hydrocodone combination products to Schedule II, physicians and mid-level prescribers may be compelled to prescribe codeine-containing products (e.g., with acetaminophen) due to reduced administrative burden and limits on Schedule II prescriptive authority for nurse practitioners and physician assistants in some states. This commentary expounds on the safety and effectiveness concerns of codeine, with a primary focus on patients in the ED setting.

  16. Psychologists' right to prescribe – should prescribing privileges be ...

    African Journals Online (AJOL)

    Current changes in legislation regarding prescription rights increase the possibility of non-medical practitioners being authorised to presctibe medication. There has been ongoing debate about granting psychologists in South Africa a limited right to prescribe (RTP) psychotropic medication. The main reasons advanced for ...

  17. Determinants of the range of drugs prescribed in general practice: a cross-sectional analysis.

    NARCIS (Netherlands)

    Bakker, D.H. de; Coffie, D.S.V.; Heerdink, E.R.; Dijk, L. van; Groenewegen, P.P.

    2007-01-01

    BACKGROUND: Current health policies assume that prescribing is more efficient and rational when general practitioners (GPs) work with a formulary or restricted drugs lists and thus with a limited range of drugs. Therefore we studied determinants of the range of drugs prescribed by general

  18. Shift in antibiotic prescribing patterns in relation to antibiotic expenditure in paediatrics

    NARCIS (Netherlands)

    Kimpen, JLL; van Houten, M.A.

    In paediatrics, antibiotics are among the most commonly prescribed drugs. Because of an overall rise in health care costs, lack of uniformity in drug prescribing and the emergence of antibiotic resistance, monitoring and control of antibiotic use is of growing concern and strict antibiotic policies

  19. Regulating compassion: an overview of Canada's federal medical cannabis policy and practice

    Directory of Open Access Journals (Sweden)

    Lucas Philippe G

    2008-01-01

    Full Text Available Abstract Background In response to a number of court challenges brought forth by Canadian patients who demonstrated that they benefited from the use of medicinal cannabis but remained vulnerable to arrest and persecution as a result of its status as a controlled substance, in 1999 Canada became the second nation in the world to initiate a centralized medicinal cannabis program. Over its six years of existence, this controversial program has been found unconstitutional by a number of courts, and has faced criticism from the medical establishment, law enforcement, as well as the patient/participants themselves. Methods This critical policy analysis is an evidence-based review of court decisions, government records, relevant studies and Access to Information Act data related to the three main facets of Health Canada's medicinal cannabis policy – the Marihuana Medical Access Division (MMAD; the Canadians Institute of Health Research Medical Marijuana Research Program; and the federal cannabis production and distribution program. This analysis also examines Canada's network of unregulated community-based dispensaries. Results There is a growing body of evidence that Health Canada's program is not meeting the needs of the nation's medical cannabis patient community and that the policies of the Marihuana Medical Access Division may be significantly limiting the potential individual and public health benefits achievable though the therapeutic use of cannabis. Canada's community-based dispensaries supply medical cannabis to a far greater number of patients than the MMAD, but their work is currently unregulated by any level of government, leaving these organizations and their clients vulnerable to arrest and prosecution. Conclusion Any future success will depend on the government's ability to better assess and address the needs and legitimate concerns of end-users of this program, to promote and fund an expanded clinical research agenda, and to work in

  20. Regulating compassion: an overview of Canada's federal medical cannabis policy and practice

    Science.gov (United States)

    Lucas, Philippe G

    2008-01-01

    Background In response to a number of court challenges brought forth by Canadian patients who demonstrated that they benefited from the use of medicinal cannabis but remained vulnerable to arrest and persecution as a result of its status as a controlled substance, in 1999 Canada became the second nation in the world to initiate a centralized medicinal cannabis program. Over its six years of existence, this controversial program has been found unconstitutional by a number of courts, and has faced criticism from the medical establishment, law enforcement, as well as the patient/participants themselves. Methods This critical policy analysis is an evidence-based review of court decisions, government records, relevant studies and Access to Information Act data related to the three main facets of Health Canada's medicinal cannabis policy – the Marihuana Medical Access Division (MMAD); the Canadians Institute of Health Research Medical Marijuana Research Program; and the federal cannabis production and distribution program. This analysis also examines Canada's network of unregulated community-based dispensaries. Results There is a growing body of evidence that Health Canada's program is not meeting the needs of the nation's medical cannabis patient community and that the policies of the Marihuana Medical Access Division may be significantly limiting the potential individual and public health benefits achievable though the therapeutic use of cannabis. Canada's community-based dispensaries supply medical cannabis to a far greater number of patients than the MMAD, but their work is currently unregulated by any level of government, leaving these organizations and their clients vulnerable to arrest and prosecution. Conclusion Any future success will depend on the government's ability to better assess and address the needs and legitimate concerns of end-users of this program, to promote and fund an expanded clinical research agenda, and to work in cooperation with community

  1. Conceptual Principles for Developing and Regulating the Energy Policy of Ukraine at a Competitive Level

    Directory of Open Access Journals (Sweden)

    Klymchuk Oleksandr V.

    2016-02-01

    Full Text Available The article is aimed at studying the current trends of regulatory policy in the global energy market and identifying potent ways for energy efficiency growth in terms of the Ukrainian economy. An analysis of the main trends of energy policy development in the world has been carried out and a priority direction for the development of Ukrainian energy on the basis of the biofuel industry has been determined. The article substantiates actuality of the matter that one of the main directions of overcoming the energy crisis in Ukraine, along with ensuring recovery and sustainable growth of the gross domestic product, is transition to the industrial use of biofuels. The process of production and consumption of biofuels must be seen as a means to raise the level of decentralization, while ensuring energy sources. It is determined that the State must provide information support for producers of biofuels, defining their market range and encouraging beneficial business partners. Increased production of biofuels in Ukraine will serve as a fundamental factor in achieving international competitiveness of the national economy, as well as its growth on innovation basis.

  2. Policies and regulations in Mexico with regard to genetic technology and food security

    OpenAIRE

    Colmenarez Ortiz, Claudia; Ortiz Garcia, Sol

    2016-01-01

    In 1988 the first application for field trials of a GMO was formally received in Mexico. Since then a Biosafety law, few bylaws and national official standards were enacted in order to regulate the safe use of GMOs and to evaluate, control and avoid adverse effects to human health and the environment. The Law on Biosafety of Genetically Modified Organisms was enacted in 2005 in order to comply with international obligations derived from the Cartagena Protocol on Biosafety signed by Mexico in ...

  3. The UK health and safety executive's policies on information relating to nuclear safety regulation

    International Nuclear Information System (INIS)

    Williams, L.

    1994-01-01

    How a message is transmitted can be as important as what is said. To be effective a message has to be timely, targeted and clear. People do not always remember what was said, by how and when it was said. This paper discusses some of the tools which the Nuclear Safety Division (NSD), the UK's nuclear regulator, has used and emphasizes the need to recognize the importance of a recipient interest in attempting to transmit a message. (author). 4 refs

  4. Prescribed burning for understory restoration

    Science.gov (United States)

    Kenneth W. Outcalt

    2006-01-01

    Because the longleaf ecosystem evolved with and is adapted to frequent fire, every 2 to 8 years, prescribed burning is often useful for restoring understory communities to a diverse ground layer of grasses, herbs, and small shrubs. This restoration provides habitat for a number of plant and animal species that are restricted to or found mostly in longleaf pine...

  5. Comparison of the Canadian and US Laws, Regulations, Policies, and Systems of Oversight for Animals in Research.

    Science.gov (United States)

    Griffin, Gilly; Locke, Paul

    2016-05-01

    The Canadian and United States' approaches to oversight of animals in research are both based on the "3Rs" principles outlined in Russell and Burch's classic text, The Principles of Humane Experimental Technique. Each country seeks to protect the welfare of animals, while permitting the legitimate goals of scientific research to be attained according to the legal principles, cultures, and strengths and constraints of their jurisprudential and societal traditions. Canada is one of the most decentralized federations in the world, and regulation of activities is based to a great extent on custom and practice. The United States is more hierarchical and, at least with respect to laws governing animal research, more centralized. Accordingly, the Canadian approach is rooted in the concepts of social contracts, with a greater emphasis on guidance and policy and less reliance on legislation. No federal (national) direct legislation of laboratory animal welfare exists, although the federal government uses its criminal and spending authorities to shape behavior. The central feature of the Canadian system is the Canadian Council on Animal Care, which was formed to support universities and government departments involved in animal-based science. Animal care committees play a central role in implementing the guidelines and policies in facilities that carry out animal research. The United States has enacted two federal (national) laws applicable to animals in research. The Animal Welfare Act is a more traditional, command-and-control law that gives authority to the US Department of Agriculture to promulgate regulations, inspect facilities, and enforce violations. The Health Research Extension Act, which amended the US Public Health Services (PHS) Act, applies to any activity conducted or supported by the PHS, including research efforts supported by the US National Institutes of Health. It is largely nonregulatory and establishes a system of assurances and policies that covered

  6. Automation bias in electronic prescribing.

    Science.gov (United States)

    Lyell, David; Magrabi, Farah; Raban, Magdalena Z; Pont, L G; Baysari, Melissa T; Day, Richard O; Coiera, Enrico

    2017-03-16

    Clinical decision support (CDS) in e-prescribing can improve safety by alerting potential errors, but introduces new sources of risk. Automation bias (AB) occurs when users over-rely on CDS, reducing vigilance in information seeking and processing. Evidence of AB has been found in other clinical tasks, but has not yet been tested with e-prescribing. This study tests for the presence of AB in e-prescribing and the impact of task complexity and interruptions on AB. One hundred and twenty students in the final two years of a medical degree prescribed medicines for nine clinical scenarios using a simulated e-prescribing system. Quality of CDS (correct, incorrect and no CDS) and task complexity (low, low + interruption and high) were varied between conditions. Omission errors (failure to detect prescribing errors) and commission errors (acceptance of false positive alerts) were measured. Compared to scenarios with no CDS, correct CDS reduced omission errors by 38.3% (p < .0001, n = 120), 46.6% (p < .0001, n = 70), and 39.2% (p < .0001, n = 120) for low, low + interrupt and high complexity scenarios respectively. Incorrect CDS increased omission errors by 33.3% (p < .0001, n = 120), 24.5% (p < .009, n = 82), and 26.7% (p < .0001, n = 120). Participants made commission errors, 65.8% (p < .0001, n = 120), 53.5% (p < .0001, n = 82), and 51.7% (p < .0001, n = 120). Task complexity and interruptions had no impact on AB. This study found evidence of AB omission and commission errors in e-prescribing. Verification of CDS alerts is key to avoiding AB errors. However, interventions focused on this have had limited success to date. Clinicians should remain vigilant to the risks of CDS failures and verify CDS.

  7. Nurse prescribing as an aspect of future role expansion: the views of Irish clinical nurse specialists.

    LENUS (Irish Health Repository)

    Lockwood, Emily B

    2008-10-01

    AIM: Nurses and midwives are expanding the scope of their professional practice, assuming additional responsibilities including the management and prescribing of medications. The aim of the study was to discover the attitudes of clinical nurse specialists (CNSs) in Ireland to nurse prescribing and to examine perceived barriers to engaging in this aspect of future role expansion. BACKGROUND: The expansion of the nursing role in relation to nurse prescribing is an ongoing process and is subject to incremental iterations of legislation and professional policy. Nurse prescribing as an expanded role function has become a reality in many countries. Ireland has addressed the matter in a formal and systematic way through legislation. METHOD: A questionnaire was administered to a sample of 283 CNSs practising in a variety of care settings in Ireland. Attitudes were measured using Likert-type attitudinal scales, designed specifically for the study. RESULTS AND CONCLUSIONS: Findings indicate that the majority of clinical nurse specialists were positively disposed toward nurse prescribing as a future role expansion. The fear of litigation was identified as the most significant barrier to nurse prescribing. The majority of respondents equated nurse prescribing with increased autonomy and holistic care. The findings indicate that there is a need for further examination of the educational requirements of the CNS in relation to nurse prescribing. The legislative implications for nurse prescribing and fear of legal consequences need to be considered prior to any implementation of nurse prescribing. IMPLICATIONS FOR NURSING MANAGEMENT: While senior clinicians are willing to embrace future role expansion in the area of nurse prescribing, their Nurse Managers should recognize that facilitation of nurse prescribing needs to address the legal and educational requirements for such activity. Failure to address these requirements can represent a barrier to role expansion. This paper offers

  8. Nurse prescribing as an aspect of future role expansion: the views of Irish clinical nurse specialists.

    Science.gov (United States)

    Lockwood, Emily B; Fealy, Gerard M

    2008-10-01

    Nurses and midwives are expanding the scope of their professional practice, assuming additional responsibilities including the management and prescribing of medications. The aim of the study was to discover the attitudes of clinical nurse specialists (CNSs) in Ireland to nurse prescribing and to examine perceived barriers to engaging in this aspect of future role expansion. The expansion of the nursing role in relation to nurse prescribing is an ongoing process and is subject to incremental iterations of legislation and professional policy. Nurse prescribing as an expanded role function has become a reality in many countries. Ireland has addressed the matter in a formal and systematic way through legislation. A questionnaire was administered to a sample of 283 CNSs practising in a variety of care settings in Ireland. Attitudes were measured using Likert-type attitudinal scales, designed specifically for the study. Findings indicate that the majority of clinical nurse specialists were positively disposed toward nurse prescribing as a future role expansion. The fear of litigation was identified as the most significant barrier to nurse prescribing. The majority of respondents equated nurse prescribing with increased autonomy and holistic care. The findings indicate that there is a need for further examination of the educational requirements of the CNS in relation to nurse prescribing. The legislative implications for nurse prescribing and fear of legal consequences need to be considered prior to any implementation of nurse prescribing. While senior clinicians are willing to embrace future role expansion in the area of nurse prescribing, their Nurse Managers should recognize that facilitation of nurse prescribing needs to address the legal and educational requirements for such activity. Failure to address these requirements can represent a barrier to role expansion. This paper offers new understandings on the views of senior clinicians concerning nurse prescribing at a

  9. Liberalisation and Market Opening Versus Energy Policy and Regulation Proposals: the German Experiences

    International Nuclear Information System (INIS)

    Wieners, J.

    2001-01-01

    In 1998 the German electricity market became fully liberalised for competition. Prices for all consumer groups recorded a considerable drop. Service centres accepted measures for cost reduction, new strategies resulted in mergers. However, in view of economic efficiency, the German Government set life surroundings as the primary task. With new electricity market regulation numerous grants were introduced into renewable energy sources as well as the combined production of heat and electricity, which had a destabilising effect on all price savings on the part of the competition.(author)

  10. S.Yu. Witte's Customs Policy and Regulation of State Import of Industrial Equipment

    Directory of Open Access Journals (Sweden)

    Антон Юрьевич Петров

    2013-12-01

    Full Text Available The article considers state import of industrial equipment in the context of the customs regulation of Russia’s foreign trade under S.Yu. Witte as the Minister of Finance (1892–1903. The analysis of archival data reveals the motives which drove various ministries of the Russian empire when they gave preference to foreign producers rather than domestic ones. In the 1890s the Ministry of Finance, on the one hand, and other ministries, on the other hand, were debating the necessity of orders for foreign industrial equipment made by the Russian governmental bodies. The article studies the course and results of this interdepartmental struggle.

  11. Generic medicine and prescribing: A quick assessment

    Directory of Open Access Journals (Sweden)

    Mainul Haque

    2017-01-01

    Full Text Available Generic drugs are copies of brand-name drugs that have exactly the same dosage, intended use, effects, side effects, route of administration, risks, safety, and strength as the original drug. In other words, their pharmacological effects are exactly the same as those of their brand-name counterparts. The Food and Drug Administration (FDA describes that generic drugs are essential possibilities that allow better access to healthcare for all Americans. They are replicas of brand-name drugs and are the identical as those of brand-name drugs in dosage form, safety, strength, route of administration, quality, performance features, and anticipated to use. Healthcare authorities and users can be guaranteed that FDA-approved generic drug products have met the same stiff principles as the innovator drug. The company that made Bayer aspirin fought in court enthusiastically to keep generic versions off the shelves, in the 1920s. The company lost in court, and consumers suddenly had an array of choices in generic aspirin. The Supreme Court of India uttering ‘the Supreme Court's ruling will prevent companies from further seeking unwarranted patents on HIV and other essential medicines.’ Generic medicine cannot be sold at a price higher than the branded medicine, so it is regularly a low-priced option. Thereafter, both the end user and the government who pay for part of the price of the medicine under the Pharmaceutical Benefits Scheme in Australia are benefitted. The treatment of diseases using essential drugs, prescribed by their generic names, has been emphasised by the WHO and many national health policies. Although there are some improvements in generic medicine prescribing, it has been advised by the WHO that ‘countries should intensify efforts to measure and regularly monitor medicine prices and availability, and adopt policy measures to address the issues identified.’

  12. Pharmaceutical policies in European countries.

    Science.gov (United States)

    Barros, Pedro Pita

    2010-01-01

    Pharmaceutical expenditures have an important role in Europe. The attempts to control expenditure have used a wide range of policy measures. We reviewed the main measures adopted by the European Union countries, especially in countries where governments are the largest third-party payers. To complement a literature review on the topic, data was gathered from national reviews of health systems and direct inquiries to several government bodies. Almost all countries regulate prices of pharmaceutical products. Popular policy measures include international referencing to set prices (using as benchmark countries that have set lower prices), internal reference pricing systems to promote price competition in domestic markets, and positive lists for reimbursement to promote consumption of generics (including in some cases substitution by pharmacists of drugs prescribed by physicians). Despite the wide range of policy measures, it is not possible to identify a "silver bullet" to control pharmaceutical expenditures. We also identified two main policy challenges: policy coordination among countries within the European Union to maintain incentives for R&D at the global level, and the development of new relationships with the pharmaceutical industry; namely, the so-called risk-sharing agreements between the pharmaceutical industry and governments/regulators (or large third-party payers).

  13. Marketing alcohol to young people: implications for industry regulation and research policy.

    Science.gov (United States)

    Jackson, M C; Hastings, G; Wheeler, C; Eadie, D; Mackintosh, A M

    2000-12-01

    This paper focuses on the marketing of alcohol to young people in the United Kingdom, but the lessons that emerge have international significance. Alcohol is a global enterprise and recent consolidation means that it is controlled by a decreasing number of expanding multi-nationals. Alcohol companies are able to allocate significant resources to researching consumer preferences, developing new products and promoting them on an international level. Recent years have seen a growth in the value that youth culture attaches to brand labels and symbols and a move away from the healthy-living ethos. The alcohol industry's response to these trends has been to design alcoholic beverages that appeal to young people, using well-informed and precisely targeted marketing strategies. This has led to growing concerns about the implications for public health and a demand for tighter controls to regulate alcohol marketing practices. In the United Kingdom, controls on alcohol are piecemeal and reactive and the current system of voluntary regulation appears ineffective. This paper argues for more research to establish current industry practice and inform the development of a comprehensive regulatory structure and system of monitoring.

  14. Chronic viral hepatitis: policy, regulation, and strategies for its control and elimination in Ethiopia

    Directory of Open Access Journals (Sweden)

    Fassil Shiferaw

    2016-08-01

    Full Text Available Abstract Background Hepatitis B and C are silent killers not yet recognized as major public health challenges in many developing countries with huge disease burden. In Ethiopia, Hepatitis B is endemic with an average prevalence of 10.8 %, and the prevalence of Hepatitis C is 2 %. The prevalence of both infections, however, is likely to be underreported due to the lack of diagnostic facilities and appropriate surveillance systems. Ethiopia is also among the many Sub-Sahara African countries lacking a coordinated and systematic national response to chronic viral hepatitis. The objective of this study is to examine the current level of response to viral Hepatitis B & C in Ethiopia with the aim to bring identified gaps to the attention of relevant stakeholders and policy makers. Methods This cross-sectional qualitative study was based on semi-structured in-depth interviews with 21 key informants from health facilities, health offices, pharmaceutical companies, regulatory bodies, professional association and blood bank units. Participants were selected purposively based on their role in the national hepatitis response. The investigators also reviewed available policy and strategy documents, standards of practice and surveys, and paid visits to pharmaceutical premises to check the availability of antiviral drugs. Thematic analysis was employed to make sense of the data. During the data analysis process, all the authors critically read the materials, and data was triangulated by source, interpreter view and thematic perspective to ensure accurate representation and comprehensiveness, and validation of the interviewees’ responses. Once each investigator reviewed the data independently, the team reached a common understanding of the scope and contexts of the information attained. Data were subsequently reduced to key concepts, and case stories were taken with successive revisions. The key concepts were later coded into most basic meaningful

  15. Chronic viral hepatitis: policy, regulation, and strategies for its control and elimination in Ethiopia.

    Science.gov (United States)

    Shiferaw, Fassil; Letebo, Mekitew; Bane, Abate

    2016-08-11

    Hepatitis B and C are silent killers not yet recognized as major public health challenges in many developing countries with huge disease burden. In Ethiopia, Hepatitis B is endemic with an average prevalence of 10.8 %, and the prevalence of Hepatitis C is 2 %. The prevalence of both infections, however, is likely to be underreported due to the lack of diagnostic facilities and appropriate surveillance systems. Ethiopia is also among the many Sub-Sahara African countries lacking a coordinated and systematic national response to chronic viral hepatitis. The objective of this study is to examine the current level of response to viral Hepatitis B & C in Ethiopia with the aim to bring identified gaps to the attention of relevant stakeholders and policy makers. This cross-sectional qualitative study was based on semi-structured in-depth interviews with 21 key informants from health facilities, health offices, pharmaceutical companies, regulatory bodies, professional association and blood bank units. Participants were selected purposively based on their role in the national hepatitis response. The investigators also reviewed available policy and strategy documents, standards of practice and surveys, and paid visits to pharmaceutical premises to check the availability of antiviral drugs. Thematic analysis was employed to make sense of the data. During the data analysis process, all the authors critically read the materials, and data was triangulated by source, interpreter view and thematic perspective to ensure accurate representation and comprehensiveness, and validation of the interviewees' responses. Once each investigator reviewed the data independently, the team reached a common understanding of the scope and contexts of the information attained. Data were subsequently reduced to key concepts, and case stories were taken with successive revisions. The key concepts were later coded into most basic meaningful categories. The World Health Organization (WHO) global

  16. Essays on the comparison of climate change policies: Land use regulations, taxes, and tradable permits

    Science.gov (United States)

    Heres Del Valle, David R.

    The California Global Warming Solutions Act of 2006 requires year 2020 greenhouse gas (GHG) emissions in the state to be reduced back to 1990 levels. Several mitigation strategies have been explored and are expected to be implemented over the next few years. Among others, land use policies have been advocated as an important means to curb GHG emissions through the reduction of vehicle miles traveled (VMT), while an economy-wide cap and trade system would ensure that a certain level of GHG reductions is achieved although at unknown costs. The first essay of this dissertation aims to contribute to the ongoing discussion over the impact of land use policies by implementing a modified two-part model (M2PM) with instrumental variables (IV), a procedure that respectively takes into account the large mass of observations with zero car travel, and the possibility of residential self-selection, both of which could otherwise bias the estimates. The analysis takes advantage of a large dataset on travel patterns and socio-economic characteristics of more than 7,000 households across the 58 counties in the state of California. Results show that although VMT elasticities with respect to residential density are larger than others found in the recent econometric literature, the actual impact of residential density on VMT would not be as large unless very large increases in residential density occur. On the other hand, recent estimates of the elasticity of VMT with respect to the price of gasoline imply that moderate increases in the price of gasoline would suffice to reduce travel by similar magnitudes. The second essay reconsiders the debate over quantity (e.g., tradable permits) and price (e.g., taxes) controls by introducing uncertainty in the damage from the externality under a controlled environment. Economic theory predicts that quantity and price instruments for the control of externalities will produce identical outcomes as long as certain conditions obtain - namely

  17. Arianespace Launch Service Operator Policy for Space Safety (Regulations and Standards for Safety)

    Science.gov (United States)

    Jourdainne, Laurent

    2013-09-01

    Since December 10, 2010, the French Space Act has entered into force. This French Law, referenced as LOS N°2008-518 ("Loi relative aux Opérations Spatiales"), is compliant with international rules. This French Space Act (LOS) is now applicable for any French private company whose business is dealing with rocket launch or in orbit satellites operations. Under CNES leadership, Arianespace contributed to the consolidation of technical regulation applicable to launch service operators.Now for each launch operation, the operator Arianespace has to apply for an authorization to proceed to the French ministry in charge of space activities. In the files issued for this purpose, the operator is able to justify a high level of warranties in the management of risks through robust processes in relation with the qualification maintenance, the configuration management, the treatment of technical facts and relevant conclusions and risks reduction implementation when needed.Thanks to the historic success of Ariane launch systems through its more than 30 years of exploitation experience (54 successes in a row for latest Ariane 5 launches), Arianespace as well as European public and industrial partners developed key experiences and knowledge as well as competences in space security and safety. Soyuz-ST and Vega launch systems are now in operation from Guiana Space Center with identical and proved risks management processes. Already existing processes have been slightly adapted to cope with the new roles and responsibilities of each actor contributing to the launch preparation and additional requirements like potential collision avoidance with inhabited space objects.Up to now, more than 12 Ariane 5 launches and 4 Soyuz-ST launches have been authorized under the French Space Act regulations. Ariane 5 and Soyuz- ST generic demonstration of conformity have been issued, including exhaustive danger and impact studies for each launch system.This article will detail how Arianespace

  18. Late-stage pharmaceutical R&D and pricing policies under two-stage regulation.

    Science.gov (United States)

    Jobjörnsson, Sebastian; Forster, Martin; Pertile, Paolo; Burman, Carl-Fredrik

    2016-12-01

    We present a model combining the two regulatory stages relevant to the approval of a new health technology: the authorisation of its commercialisation and the insurer's decision about whether to reimburse its cost. We show that the degree of uncertainty concerning the true value of the insurer's maximum willingness to pay for a unit increase in effectiveness has a non-monotonic impact on the optimal price of the innovation, the firm's expected profit and the optimal sample size of the clinical trial. A key result is that there exists a range of values of the uncertainty parameter over which a reduction in uncertainty benefits the firm, the insurer and patients. We consider how different policy parameters may be used as incentive mechanisms, and the incentives to invest in R&D for marginal projects such as those targeting rare diseases. The model is calibrated using data on a new treatment for cystic fibrosis. Copyright © 2016 Elsevier B.V. All rights reserved.

  19. Attitudes of physicians and pharmacists towards International Non-proprietary Name prescribing in Belgium.

    Science.gov (United States)

    Van Bever, Elien; Elseviers, Monique; Plovie, Marijke; Vandeputte, Lieselot; Van Bortel, Luc; Vander Stichele, Robert

    2015-03-01

    International Non-proprietary Name (INN) prescribing is the use of the name of the active ingredient(s) instead of the brand name for prescribing. In Belgium, INN prescribing began in 2005 and a major policy change occurred in 2012. The aim was to explore the opinions of Dutch-speaking general practitioners (GPs) and pharmacists. An electronic questionnaire with 39 five-point Likert scale statements and one open question was administered in 2013. Multivariate analysis was performed with multiple linear regression on a sum score for benefit statements and for drawback statements. Answers to the open question were qualitatively analysed. We received 745 valid responses with a representable sample for both subgroups. Participants perceived the motives to introduce INN prescribing as purely economic (to reduce pharmaceutical expenditures for the government and the patient). Participants accepted the concept of INN prescribing, but 88% stressed the importance of guaranteed treatment continuity, especially in older, chronic patients, to prevent patient confusion, medication non-adherence and erroneous drug use. In conclusion, the current way in which INN prescribing is applied in Belgium leads to many concerns among primary health professionals about patient confusion and medication adherence. Slightly adapting the current concept of INN prescribing to these concerns can turn INN prescribing into one of the major policies in Belgium to reduce pharmaceutical expenditures and to stimulate rational drug prescribing. © 2014 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

  20. Multi - party Game Analysis of Coal Industry and Industry Regulation Policy Optimization

    Science.gov (United States)

    Jiang, Tianqi

    2018-01-01

    In the face of the frequent occurrence of coal mine safety accidents, this paper analyses the relationship between central and local governments, coal mining enterprises and miners from the perspective of multi - group game. In the actual production, the decision of one of the three groups can affect the game strategy of the other of the three, so we should assume the corresponding game order. In this order, the game analysis of the income and decision of the three is carried out, and the game decision of the government, the enterprise and the workers is obtained through the establishment of the benefit matrix and so on. And then on the existing system to optimize the coal industry regulation proposed practical recommendations to reduce the frequency of industry safety accidents, optimize the industry production environment.

  1. Electronic prescribing in pediatrics: toward safer and more effective medication management.

    Science.gov (United States)

    Johnson, Kevin B; Lehmann, Christoph U

    2013-04-01

    This technical report discusses recent advances in electronic prescribing (e-prescribing) systems, including the evidence base supporting their limitations and potential benefits. Specifically, this report acknowledges that there are limited but positive pediatric data supporting the role of e-prescribing in mitigating medication errors, improving communication with dispensing pharmacists, and improving medication adherence. On the basis of these data and on the basis of federal statutes that provide incentives for the use of e-prescribing systems, the American Academy of Pediatrics recommends the adoption of e-prescribing systems with pediatric functionality. This report supports the accompanying policy statement from the American Academy of Pediatrics recommending the adoption of e-prescribing by pediatric health care providers.

  2. Can we influence prescribing patterns?

    Science.gov (United States)

    Sbarbaro, J A

    2001-09-15

    A variety of programming techniques and methods of training have been employed to change physician behavior. Didactic continuing medical education lectures and clinical guidelines have had minimal impact, although endorsement of national professional guidelines by local opinion leaders appears to have a positive influence on the impact of professional guidelines. Interactive, hands-on workshops, performance reporting, and peer/patient feedback are also effective. Changing prescribing habits has been equally difficult. Drug utilization letters involving both pharmacist and physician have more impact than do letters sent only to the physician. Academic detailing, when properly executed, has been consistently effective. When combined with these strategies, closed formularies become a powerful tool in changing prescribing behavior.

  3. Policy and Regulation in the Media Landscape: the Greek Paradigm Concentration of Media Ownership Versus the Right to Information

    Directory of Open Access Journals (Sweden)

    Anastasia Veneti

    2014-02-01

    Full Text Available By outlining the long-lasting peculiarities of the Greek media landscape, this paper aims to make us reflect on how the political system affects their development and role. Particularly, through analyzing the policy and regulating frames applied to Greek communication field, we try to shed light on the degree and shapes of media concentration and control as well as on the effects of this widespread phenomenon. Special emphasis is placed on the illicit interweaving of political and media interests, giving rise to a media system which has great difficulties in following constructively the technological developments in the field and challenges the active participation of citizens in the public affairs. In the contemporary society of digital revolution market values continue to be dominant. Those who control the private media outweigh the political figures and as a result any attempts to regulate the communication field are always implemented for the benefit of the private capital. Under these circumstances the question of whether the media can act as amplifiers of the democratic practices is more crucial than ever. This is the central question posed by the paper, arguing that the evolution of the Greek media system is inundated with evidence supporting the view that the particular voice of citizen as well as his right to information is under threat.

  4. Hawaii Integrated Energy Assessment. Volume V. Rules, regulations, permits and policies affecting the development of alternate energy sources in Hawaii

    Energy Technology Data Exchange (ETDEWEB)

    1980-01-01

    A comprehensive presentaton of the major permits, regulations, rules, and controls which are likely to affect the development of alternate energy sources in Hawaii is presented. An overview of the permit process, showing the major categories and types of permits and controls for energy alternatives is presented. This is followed by a brief resume of current and projected changes designed to streamline the permit process. The permits, laws, regulations, and controls that are applicable to the development of energy alternatives in Hawaii are described. The alternate energy technologies affected, a description of the permit or control, and the requirements for conformance are presented for each applicable permit. Federal, state, and county permits and controls are covered. The individual energy technologies being considered as alternatives to the State's present dependence on imported fossil fuels are emphasized. The alternate energy sources covered are bioconversion, geothermal, ocean thermal, wind, solar (direct), and solid waste. For each energy alternative, the significant permits are summarized with a brief explanation of why they may be necessary. The framework of policy development at each of the levels of government with respect to the alternate energy sources is covered.

  5. When renewable portfolio standards meet cap-and-trade regulations in the electricity sector: Market interactions, profits implications, and policy redundancy

    International Nuclear Information System (INIS)

    Tsao, C.-C.; Campbell, J.E.; Chen, Yihsu

    2011-01-01

    Emission trading programs (C and T) and renewable portfolio standards (RPS) are two common tools used by policymakers to control GHG emissions in the energy and other energy-intensive sectors. Little is known, however, as to the policy implications resulting from these concurrent regulations, especially given that their underlying policy goals and regulatory schemes are distinct. This paper applies both an analytical model and a computational model to examine the short-run implications of market interactions and policy redundancy. The analytical model is used to generate contestable hypotheses, while the numerical model is applied to consider more realistic market conditions. We have two central findings. First, lowering the CO 2 C and T cap might penalize renewable units, and increasing the RPS level could sometimes benefit coal and oil and make natural gas units worse off. Second, making one policy more stringent would weaken the market incentive, which the other policy relies upon to attain its intended policy target. - Highlights: → Lowering the CO 2 C and T cap might penalize renewable units, and increasing the RPS level could sometimes benefit coal and oil and make natural gas units worse off. → Making one policy more stringent would weaken the market incentive, which the other policy relies upon to attain its intended policy target. → The market-wise average emissions could increase when increasing RPS requirement.

  6. From Impact Assessment to the Policy Cycle: Drawing Lessons from the EU’S Better-Regulation Agenda

    Directory of Open Access Journals (Sweden)

    Andrea Renda

    2016-10-01

    Full Text Available The European Union launched its first comprehensive better-regulation agenda in 2002 and has since then been constantly modifying and improving its toolkit aimed at guaranteeing the quality of its legislation. The first better-regulation agenda followed the pioneering experience of some of its member states and introduced a formal procedure of ex ante impact assessment (IA as well as minimum criteria for stakeholder consultation.1 Different variables explain the rise of EU-level IA, such as reactions to the overuse of the precautionary principle in risk analysis and health policy (especially in chemicals and tobacco;2 pressure from finance ministers in countries such as the U.K. and the Netherlands to introduce evidence-based procedures in policy formulation, thus increasing accountability;3 and organizational developments within the European Commission, with an expansion to regulatory policy of tools originally crafted for sustainable development policies.4 The EU IA model was introduced together with a communication aimed at simplifying and improving the regulatory environment and promoting “a culture of dialogue and participation” within the EU legislative process.5 As a result, the commission decided to integrate all forms of ex ante evaluation and various tests by building an integrated impact-assessment model, to enter into force on Jan. 1, 2003.6 This model was tasked with the heavy responsibility of ensuring that adequate account was taken, at an early stage of the regulatory process, of both the competitiveness and sustainable-development goals, which ranked among the top priorities on the EU agenda. Over the past 14 years, the better-regulation toolkit of the European Commission has been strengthened from a methodological standpoint, and expanded into a more comprehensive system that involves ex ante IAs, ex post evaluations, “fitness checks” focused on clusters of laws, and cumulative cost assessments that address specific

  7. Which prosthetic foot to prescribe?

    OpenAIRE

    De Asha, AR; Barnett, CT; Struchkov, V; Buckley, JG

    2017-01-01

    Introduction: \\ud Clinicians typically use findings from cohort studies to objectively inform judgements regarding the potential (dis)advantages of prescribing a new prosthetic device. However, before finalising prescription a clinician will typically ask a patient to 'try out' a change of prosthetic device while the patient is at the clinic. Observed differences in gait when using the new device should be the result of the device’s mechanical function, but could also conceivably be due to pa...

  8. Prescribing patterns in premenstrual syndrome

    Directory of Open Access Journals (Sweden)

    Jones Paul W

    2002-06-01

    Full Text Available Abstract Background Over 300 therapies have been proposed for premenstrual syndrome. To date there has been only one survey conducted in the UK of PMS treatments prescribed by GPs, a questionnaire-based study by the National Association of Premenstrual Syndrome in 1989. Since then, selective serotonin re-uptake inhibitors have been licensed for severe PMS/PMDD, and governmental recommendations to reduce the dosage of vitamin B6 (the first choice over-the-counter treatment for many women with PMS have been made. This study investigates the annual rates of diagnoses and prescribing patterns for premenstrual syndrome (1993–1998 within a computerised general practitioner database. Methods Retrospective survey of prescribing data for premenstrual syndrome between 1993–1998 using the General Practice Research Database for the West Midlands Region which contains information on 282,600 female patients Results Overall the proportion of women with a prescription-linked diagnosis of premenstrual syndrome has halved over the five years. Progestogens including progesterone were the most commonly recorded treatment for premenstrual syndrome during the whole study period accounting for over 40% of all prescriptions. Selective serotonin-reuptake inhibitors accounted for only 2% of the prescriptions in 1993 but rose to over 16% by 1998, becoming the second most commonly recorded treatment. Vitamin B6 accounted for 22% of the prescriptions in 1993 but dropped markedly between 1997 and 1998 to 11%. Conclusions This study shows a yearly decrease in the number of prescriptions linked to diagnoses for premenstrual syndrome. Progestogens including progesterone, is the most widely prescribed treatment for premenstrual syndrome despite the lack of evidence demonstrating their efficacy.

  9. Designers' enactment of the policy intentions. An ethnographic study of the adoption of energy regulations in England and Wales

    International Nuclear Information System (INIS)

    Zapata-Lancaster, Gabriela; Tweed, Chris

    2014-01-01

    The United Kingdom is aspiring to reduce the carbon emissions in the building sector, aiming to achieve nearly zero carbon buildings by 2020. The policy models in England and Wales rely on three strands: regulations; financial incentives and educational schemes. A growing body of literature suggests that the building industry is facing several barriers that hinder the delivery of the expected carbon targets outlined at policy level. This research explores the enactment of the policy aspirations by building designers using a bottom-up approach. An ethnographic study was conducted to analyse the design process of six non-domestic buildings. The work identified the designers' responses to adopt the policy agenda in routine design and overcome the challenges that emerged during the design process. The understanding of the designers' responses could inform the policy model and suggest areas that need attention for the timely delivery of the expected carbon reductions. - Highlights: • Designers' compliance of regulations may not conform to performance-driven processes. • Stakeholders' expectations and poor awareness of performance hinder compliance. • Designers implement flexible responses to adopt the low carbon policy agenda. • The engagement of the stakeholders enables the continuity of energy aspirations. • Policies may benefit from understanding the bottom-up responses in routine design

  10. A proactive public information policy: a key element for regulator independence and credibility

    International Nuclear Information System (INIS)

    Kindelan, J.M.

    2001-01-01

    The future of the nuclear industry will depend to a large extent on the perception that the members of the public have of it. However, our mission as regulatory bodies is not to change the pro-or anti- nuclear feelings of the public, but to set in them the confidence that the use currently made of nuclear energy is carried out with the greatest guarantees of safety. We should continue to avoid their feeling of fear without reasons or their perception of uncertainty regarding processes that are duly controlled and supervised. I am convinced that whatever progress we make in increasing transparency will lead to an increase in the public credibility of the organisations that we represent. The reason underlying our need for this credibility, this reputation for autonomy and efficiency, for good performance, is that without it we will not have sufficient authority in the eyes of the regulated sector or other private political and economic interests, and will not, therefore, be in a position to provide a sensation of confidence to the members of the public, whose tranquillity and interests are our obligation. (author)

  11. Policy and technical matters for the application of ICRP 1977 recommendations to Japanese radiation protection regulations

    International Nuclear Information System (INIS)

    Hamada, Tatsuji

    1987-01-01

    Tens years has passed since 1977 when the ICRP recommendations were made, and the work of revising the Japanese radiation regulations in response to the recommendations is almost completed. The work has been conducted mainly by an elemental group established under the Radiation Council. The elemental group submitted the first interim report to the Council in 1980, which presented recommendations on the objectives of radiation protection, dose equivalent limits for the general public, facilities inspection and products testing, medical surveillance, etc. After making deliberations in response to studies by the ICRP working group, the elemental group compiled the second interim report in July 1981. Further studies were conducted and the final report was submitted to the Council in March 1983. The final report covered the definitions of such terms as 'dose equivalent', dose equivalent limit for workers, exposure dose in the event of emergency, dose equivalent limit for the general public, various standards for protection, classification of workers by working conditions, classification of work sites monitoring of exposure dose, and implementation of medical surveillance. After making deliberations, the Council submitted a report in 1986 to government agencies concerned, whose contents are almost the same as those of the above final report except for some amendments. (Nogami, K.)

  12. Hospital staff views of prescribing and discharge communication before and after electronic prescribing system implementation.

    Science.gov (United States)

    Mills, Pamela Ruth; Weidmann, Anita Elaine; Stewart, Derek

    2017-12-01

    Background Electronic prescribing system implementation is recommended to improve patient safety and general practitioner's discharge information communication. There is a paucity of information about hospital staff perspectives before and after system implementation. Objective To explore hospital staff views regarding prescribing and discharge communication systems before and after hospital electronic prescribing and medicines administration (HEPMA) system implementation. Setting A 560 bed United Kingdom district general hospital. Methods Semi-structured face-to-face qualitative interviews with a purposive sample of hospital staff involved in the prescribing and discharge communication process. Interviews transcribed verbatim and coded using the Framework Approach. Behavioural aspects mapped to Theoretical Domains Framework (TDF) to highlight associated behavioural change determinants. Main outcome measure Staff perceptions before and after implementation. Results Nineteen hospital staff (consultant doctors, junior doctors, pharmacists and advanced nurse practitioners) participated before and after implementation. Pre-implementation main themes were inpatient chart and discharge letter design and discharge communication process with issues of illegible and inaccurate information. Improved safety was anticipated after implementation. Post-implementation themes were improved inpatient chart clarity and discharge letter quality. TDF domains relevant to staff behavioural determinants preimplementation were knowledge (task or environment); skills (competence); social/professional roles and identity; beliefs about capabilities; environmental context and resources (including incidents). An additional two were relevant post-implementation: social influences and behavioural regulation (including self-monitoring). Participants described challenges and patient safety concerns pre-implementation which were mostly resolved post-implementation. Conclusion HEPMA implementation

  13. Ethical attitudes on human cloning among professionals in Taiwan and the policy implications for regulation.

    Science.gov (United States)

    Yang, Che-Ming; Chung, Chun-Chih; Lu, Meei-Shiow; Lin, Chiou-Fen; Chen, Jiun-Shyan

    2005-01-01

    This research focused on understanding the attitudes toward human cloning in Taiwan among professionals in healthcare, law, and religion. The study was conducted utilizing a structured questionnaire. 220 healthcare professionals from two regional hospitals located in Taipei, 351 religious professionals in the northern Taiwan and 711 legal professionals were selected by to receive questionnaires. The valid response rate is 42.1% The questions were generated by an expert panel and represented major arguments in the human cloning debate. There were a total of six Likert scaled questions in the questionnaire. The responses were coded from 1 to 5 with 1 representing strong opposition to human cloning, 3 representing a neutral attitude; and 5 representing a strong favorable attitude toward human cloning. Healthcare professionals had the highest overall average score of 2.14 and the religious professionals had the lowest average at 1.58. All three categories of respondents' attitude toward cloning ranged from mild opposition to strong opposition to human cloning. The religious professionals were more strongly opposed to cloning. Age, education, and religion significantly influenced attitudes toward cloning. Professionals between fifty-one and sixty years old, those with less education, and Roman Catholic professionals were more strongly opposed to cloning. Religious professionals were more strongly opposed to human cloning than professionals in healthcare or law. Younger professionals as an age group demonstrated less opposition to human cloning. Regulation of human cloning will be influenced by professionals in healthcare, law, and religion, and the regulatory environment chosen now will play a pivotal role in influencing the acceptance of human cloning in the future.

  14. The Regulation of Multi-Age Groupings in Canadian Centre-based Child Care Settings: An Analysis of Provincial and Territorial Policies, Legislation and Regulations.

    Science.gov (United States)

    Bernhard, Judith; Pollard, June; Chud, Gyda; Vukelich, Goranka; Pacini-Ketchabaw, Veronica

    2000-01-01

    Examined the ways Canadian provincial and territorial policies address the inclusion of infants in multi-age early childhood education settings and the ways practitioners and licensing personnel interpret these policies. Noted policy patterns that affect the inclusion of infants and older children. Derived recommendations for policymakers and…

  15. Prescribing under the Influence: The Business of Breastmilk Substitutes

    Directory of Open Access Journals (Sweden)

    Rosa Rios

    2016-09-01

    Full Text Available This study draws on a general theoretical framework comprising of a decision maker (a doctor, perceived moral intensity of the issue (breastfeeding substitute prescription, and the situational environment (hospital policy, pharma company promotions, and mother’s beliefs regarding breastfeeding to explain the physician’s role and influence on mothers’ infant feeding choices when prescribing infant formula in Kuwait, Middle East. Moral intensity is an issue-contingent model that suggests ethical decisions vary in terms of how much a moral imperative is present in a situation. The moral intensity of the issue is assessed using six components. Path Least Squares results indicate the following moral intensity components have significant impact on prescription behavior: magnitude of consequences, probability of effect, and temporal immediacy. Company promotion and hospital policy also significantly influence doctor’s prescription of infant formula. Doctors appear to disengage from the consequences of over prescribing infant formula.

  16. The legal environment for forestry prescribed burning in the South: regulatory programs and voluntary guidelines

    Science.gov (United States)

    Terry K. Haines; David A. Cleaves

    1999-01-01

    Southern States vary widely in their approaches to regulation and liability protection for prescribed burning. Most State air quality laws exempt prescribed burning from many open burning rules; however, monetary penalties are established for the rules that do apply. Forest protection laws address escaped fire and require permits or notification in all but two States....

  17. Medicare Provider Data - Part D Prescriber

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Part D Prescriber Public Use File (PUF) provides information on prescription drugs prescribed by individual physicians and other health care providers and paid...

  18. Dutch Travel Health Nurses: Prepared to Prescribe?

    NARCIS (Netherlands)

    Overbosch, Femke W.; Koeman, Susan C.; van den Hoek, Anneke; Sonder, Gerard J. B.

    2012-01-01

    Background. In travel medicine, as in other specialties, independent prescribing of medication has traditionally been the domain of practitioners like physicians, dentists, and midwives. However, a 2011 ruling in the Netherlands expands independent prescribing and introduces supplementary

  19. The quality of outpatient antimicrobial prescribing

    DEFF Research Database (Denmark)

    Malo, Sara; Bjerrum, Lars; Feja, Cristina

    2013-01-01

    The aim of the study was to analyse and compare the quality of outpatient antimicrobial prescribing in Denmark and Aragón (in northeastern Spain), with the objective of assessing inappropriate prescribing....

  20. Impact of the changing European Union regulations on Estonian accounting policies. Euroopa finantsaruandluse muudatuste sobivus Eestis

    Directory of Open Access Journals (Sweden)

    Maret Güldenkoh

    2014-12-01

    Full Text Available Financial reporting and audit activities are the areas to ensure the legitimacy of the everyday economic activities of the accounting entities. Financial reporting provides information on the past periods of the accounting entities; the audit activity is used to verify the accuracy of the recorded information and an assessment is given to the financial position of the audited entities. Auditing of financial statements prepared on the basis of historical financial information, results in increased reliability of the economic environment and stability of the financial environment of the state. The objective of this research was to assess the suitability of the European Union reporting principles for the auditing activity in Estonia. This objective was achieved with the following research tasks: 1 to provide an overview of the legal framework of the EU financial reporting and auditing activities; 2 to assess the problems related to the transposition of the legal framework in Estonia. The article consists of two parts, the first part provides an overview of the regulation of financial reporting and auditing activities in the European Union. The second part assess the impact of the European Union legislation on financial reporting and audit activities for the activities of the corresponding areas in Estonia. The research method used was a combined method, in the course of which legal acts were collected and analyzed, analysis of the data obtained from the commercial register was carried out and the impact of the Directive 2013/34 / EC to the accounting area of Estonia was assessed. Upon application of the Directive 2013/34/EU to the Estonia's legal framework, one cannot be sure that the desired administrative burden is reduced, rather it could bring along growth of the administrative burden for the accounting entities, which comprises the obligation of submission of additional reporting to various authorities. The reporting process could become more

  1. Prescribing Oxygen for Cluster Headache: A Guide for the Provider.

    Science.gov (United States)

    Tepper, Stewart J; Duplin, Jessica; Nye, Barbara; Tepper, Deborah E

    2017-10-01

    Oxygen is the standard of care for acute treatment of cluster headache. CMS, the US Centers for Medicaid and Medicare Services, has made the indefensible decision to not cover oxygen for cluster headache for patients with Medicaid and Medicare insurance, despite the evidence and professional guidelines. Commercial insurance generally covers oxygen for cluster headache. This is a "how-to" guide for successfully prescribing oxygen in the US. Prescription information is provided that can be incorporated as dot phrases, smart sets, or other standard templates for prescribing oxygen for cluster patients. In many states, oxygen is affordable and can be prescribed for Medicaid and Medicare patients who wish to pay cash. Welding or nonmedical grade industrial oxygen is almost the same cost as medical oxygen. However, it is less pure, lacks the same inspection of tanks, and is delivered without regulators to provide appropriate flow rates. Patients who pay cash should be strongly encouraged to buy medical oxygen. © 2017 American Headache Society.

  2. Potential impact of a US climate policy and air quality regulations on future air quality and climate change

    Science.gov (United States)

    Lee, Yunha; Shindell, Drew T.; Faluvegi, Greg; Pinder, Rob W.

    2016-04-01

    We have investigated how future air quality and climate change are influenced by the US air quality regulations that existed or were proposed in 2013 and a hypothetical climate mitigation policy that aims to reduce 2050 CO2 emissions to be 50 % below 2005 emissions. Using the NASA GISS ModelE2 general circulation model, we look at the impacts for year 2030 and 2055. The US energy-sector emissions are from the GLIMPSE project (GEOS-Chem LIDORT Integrated with MARKAL (MARKet ALlocation) for the Purpose of Scenario Exploration), and other US emissions data sets and the rest of the world emissions data sets are based on the RCP4.5 scenario. The US air quality regulations are projected to have a strong beneficial impact on US air quality and public health in year 2030 and 2055 but result in positive radiative forcing. Under this scenario, no more emission constraints are added after 2020, and the impacts on air quality and climate change are similar between year 2030 and 2055. Surface particulate matter with a diameter smaller than 2.5 µm (PM2.5) is reduced by ˜ 2 µg m-3 on average over the USA, and surface ozone by ˜ 8 ppbv. The improved air quality prevents about 91 400 premature deaths in the USA, mainly due to the PM2.5 reduction (˜ 74 200 lives saved). The air quality regulations reduce the light-reflecting aerosols (i.e., sulfate and organic matter) more than the light-absorbing species (i.e., black carbon and ozone), leading to a strong positive radiative forcing (RF) over the USA by both aerosols' direct and indirect forcing: the total RF is ˜ 0.04 W m-2 over the globe, and ˜ 0.8 W m-2 over the USA. Under the hypothetical climate policy, a future CO2 emissions cut is achieved in part by relying less on coal, and thus SO2 emissions are noticeably reduced. This provides air quality co-benefits, but it could lead to potential climate disbenefits over the USA. In 2055, the US mean total RF is +0.22 W m-2 due to positive aerosol direct and indirect forcing

  3. Potential impact of a US climate policy and air quality regulations on future air quality and climate change

    Directory of Open Access Journals (Sweden)

    Y. Lee

    2016-04-01

    Full Text Available We have investigated how future air quality and climate change are influenced by the US air quality regulations that existed or were proposed in 2013 and a hypothetical climate mitigation policy that aims to reduce 2050 CO2 emissions to be 50 % below 2005 emissions. Using the NASA GISS ModelE2 general circulation model, we look at the impacts for year 2030 and 2055. The US energy-sector emissions are from the GLIMPSE project (GEOS-Chem LIDORT Integrated with MARKAL (MARKet ALlocation for the Purpose of Scenario Exploration, and other US emissions data sets and the rest of the world emissions data sets are based on the RCP4.5 scenario. The US air quality regulations are projected to have a strong beneficial impact on US air quality and public health in year 2030 and 2055 but result in positive radiative forcing. Under this scenario, no more emission constraints are added after 2020, and the impacts on air quality and climate change are similar between year 2030 and 2055. Surface particulate matter with a diameter smaller than 2.5 µm (PM2.5 is reduced by ∼ 2 µg m−3 on average over the USA, and surface ozone by ∼ 8 ppbv. The improved air quality prevents about 91 400 premature deaths in the USA, mainly due to the PM2.5 reduction (∼ 74 200 lives saved. The air quality regulations reduce the light-reflecting aerosols (i.e., sulfate and organic matter more than the light-absorbing species (i.e., black carbon and ozone, leading to a strong positive radiative forcing (RF over the USA by both aerosols' direct and indirect forcing: the total RF is  ∼ 0.04 W m−2 over the globe, and ∼ 0.8 W m−2 over the USA. Under the hypothetical climate policy, a future CO2 emissions cut is achieved in part by relying less on coal, and thus SO2 emissions are noticeably reduced. This provides air quality co-benefits, but it could lead to potential climate disbenefits over the USA. In 2055, the US mean total RF is +0.22

  4. Potential Impact of a US Climate Policy and Air Quality Regulations on Future Air Quality and Climate Change

    Science.gov (United States)

    Lee, Y. H.; Faluvegi, Gregory S.

    2016-01-01

    We have investigated how future air quality and climate change are influenced by the US air quality regulations that existed or were proposed in 2013 and a hypothetical climate mitigation policy that aims to reduce 2050 CO2 emissions to be 50% below 2005 emissions. Using the NASA GISS ModelE2 general circulation model, we look at the impacts for year 2030 and 2055. The US energy-sector emissions are from the GLIMPSE project (GEOS-Chem LIDORT Integrated with MARKAL (MARKet ALlocation) for the Purpose of Scenario Exploration), and other US emissions data sets and the rest of the world emissions data sets are based on the RCP4.5 scenario. The US air quality regulations are projected to have a strong beneficial impact on US air quality and public health in year 2030 and 2055 but result in positive radiative forcing. Under this scenario, no more emission constraints are added after 2020, and the impacts on air quality and climate change are similar between year 2030 and 2055. Surface particulate matter with a diameter smaller than 2.5 micron PM(sub 2:5) is reduced by 2 approximately µg/m(sup -3) on average over the USA, and surface ozone by approximately 8 ppbv. The improved air quality prevents about 91 400 premature deaths in the USA, mainly due to the PM(sub 2:5) reduction approximately (74 200 lives saved). The air quality regulations reduce the light-reflecting aerosols (i.e., sulfate and organic matter) more than the light-absorbing species (i.e., black carbon and ozone), leading to a strong positive radiative forcing (RF) over the USA by both aerosols' direct and indirect forcing: the total RF is approximately 0.04 W m(sup -2) over the globe, and approximately 0.8 W m(sup -2) over the USA. Under the hypothetical climate policy, a future CO2 emissions cut is achieved in part by relying less on coal, and thus SO2 emissions are noticeably reduced. This provides air quality co-benefits, but it could lead to potential climate disbenefits over the USA. In 2055, the US

  5. Inappropriate prescribing: criteria, detection and prevention.

    LENUS (Irish Health Repository)

    O'Connor, Marie N

    2012-06-01

    Inappropriate prescribing is highly prevalent in older people and is a major healthcare concern because of its association with negative healthcare outcomes including adverse drug events, related morbidity and hospitalization. With changing population demographics resulting in increasing proportions of older people worldwide, improving the quality and safety of prescribing in older people poses a global challenge. To date a number of different strategies have been used to identify potentially inappropriate prescribing in older people. Over the last two decades, a number of criteria have been published to assist prescribers in detecting inappropriate prescribing, the majority of which have been explicit sets of criteria, though some are implicit. The majority of these prescribing indicators pertain to overprescribing and misprescribing, with only a minority focussing on the underprescribing of indicated medicines. Additional interventions to optimize prescribing in older people include comprehensive geriatric assessment, clinical pharmacist review, and education of prescribers as well as computerized prescribing with clinical decision support systems. In this review, we describe the inappropriate prescribing detection tools or criteria most frequently cited in the literature and examine their role in preventing inappropriate prescribing and other related healthcare outcomes. We also discuss other measures commonly used in the detection and prevention of inappropriate prescribing in older people and the evidence supporting their use and their application in everyday clinical practice.

  6. Regulations, policies and practices concerning work stress prevention and improving well-being at work in Sweden, Great-Britain, Germany, France and the Netherlands

    NARCIS (Netherlands)

    Gier, E. de; Kompier, M.; Draaisma, D.; Smulders, P.

    1994-01-01

    At the request of the Dutch Ministry of Social Affairs and Employment, the TNO Institute of Preventive Health Care (NIPG) carried out a comparative survey of regulations, policies and practices in the Netherlands, Sweden, the United Kingdom, Germany and France with regard to the prevention of work

  7. Effects of prescribed fires on soil properties: A review.

    Science.gov (United States)

    Alcañiz, M; Outeiro, L; Francos, M; Úbeda, X

    2018-02-01

    Soils constitute one of the most valuable resources on earth, especially because soil is renewable on human time scales. During the 20th century, a period marked by a widespread rural exodus and land abandonment, fire suppression policies were adopted facilitating the accumulation of fuel in forested areas, exacerbating the effects of wildfires, leading to severe degradation of soils. Prescribed fires emerged as an option for protecting forests and their soils from wildfires through the reduction of fuels levels. However such fires can serve other objectives, including stimulating the regeneration of a particular plant species, maintaining biological diversity or as a tool for recovering grasslands in encroached lands. This paper reviews studies examining the short- and long- term impacts of prescribed fires on the physical, chemical and biological soil properties; in so doing, it provides a summary of the benefits and drawbacks of this technique, to help determine if prescribed fires can be useful for managing the landscape. From the study conducted, we can affirm that prescribed fires affects soil properties but differ greatly depending on soil initial characteristics, vegetation or type of fire. Also, it is possible to see that soil's physical and biological properties are more strongly affected by prescribed fires than are its chemical properties. Finally, we conclude that prescribed fires clearly constitute a disturbance on the environment (positive, neutral or negative depending on the soil property studied), but most of the studies reviewed report a good recovery and their effects could be less pronounced than those of wildfires because of the limited soil heating and lower fire intensity and severity. Copyright © 2017. Published by Elsevier B.V.

  8. Collaborative, cross-national studies on health and safety in seafaring for evidence-based Maritime policy and regulations.

    Science.gov (United States)

    Jensen, Olaf C

    2009-01-01

    Until recently, maritime health and safety policies and regulations were sparsely based on health and safety research, and only a small number of countries contributed to new research. To strengthen maritime health and safety research activities by presenting a study example and discussing the possibilities and needs for more national and cross-national research. In a cross-national epidemiological study example, the seafarers from eleven countries completed small, anonymous questionnaires concerning the working conditions on their latest tours at sea while waiting for their health examinations. Significant disparities were pointed out among the nationalities, e.g., the length of the tours at sea, the proportional distribution of officers and non-officers, the mean age structure, the injury incidence rates, and the differences of occupational safety standards. The analysis of all data together increased the statistical strength of the multivariate analyses and allowed for valid comparisons among the nationalities. The questionnaire data was used successfully in the collaborative study example, but other data sources and methods are useful for health and safety research in seafaring as well. More national and cross-national research on maritime health and safety is warranted.

  9. Evaluation of Joint Regulation of the Minister of Religion and Minister of Home Affairs No. 9 and 8 of 2006: Study on Maintenance of Religious Harmony Policy

    Directory of Open Access Journals (Sweden)

    Herman Ya'arozatulo Harefa

    2016-05-01

    Full Text Available This study aims to evaluate the implementation of the regulation in the province of East Java. The method used in this study is naturalistic or qualitative with a descriptive explanation. The study result shows that in general, the implementation of the regulation in the province of East Java has not been effective. Factors that affect, among others, are the lack of commitment of in implementing the regulation, weak socialization of the regulation, weak law enforcement,and the lack of multicultural education to the community. The policy that needs to be implemented is mainly of the regulation needs to be improved to become a Law. The approval of the existing Draft Law on the Protection of Religious Community needs to be accelerated.

  10. Nurse prescribing for inpatient pain in the United Kingdom: a national questionnaire survey.

    Science.gov (United States)

    Stenner, Karen L; Courtenay, Molly; Cannons, Karin

    2011-07-01

    Nurses make a valuable contribution to pain services and have the potential to improve the safety and effectiveness of pain management. A recent addition to the role of the specialist pain nurse in the United Kingdom has been the introduction of prescribing rights, however there is a lack of literature about their role in prescribing pain medication. The aim of this study was to develop a profile of the experience, role and prescribing practice of these nurses. A descriptive questionnaire survey. 192 National Health Service public hospital inpatient pain services across the United Kingdom. 161 qualified nurse prescribers were invited to participate, representing 98% of known nurse prescribers contributing to inpatient pain services. The survey was completed in November 2009 by 137 nurses; a response rate of 85%. Compared with nurse prescribers in the United Kingdom in general, participants were highly qualified and experienced pain specialists. Fifty-six percent had qualified as a prescriber in the past 3 years and 22% reported that plans were underway for more nurses to undertake a nurse prescribing qualification. Although all participants worked in inpatient pain services, 35% also covered chronic pain (outpatient) services and 90% treated more than one pain type. A range of pain medications were prescribed, averaging 19.5 items per week. The role contained a strong educational component and contributed to informing organisational policy on pain management. Prescribing was said to improve nurses' ability to promote evidence-based practice but benefits were limited by legislation on prescribing controlled drugs. Findings demonstrate that pain nurses are increasingly adopting prescribing as part of their advanced nurse role. This has implications for the development needs of pain nurses in the United Kingdom and the future role development of nurses in other countries. Copyright © 2011 Elsevier Ltd. All rights reserved.

  11. Stakeholders' views on granting prescribing authority to pharmacists in Nigeria: a qualitative study.

    Science.gov (United States)

    Auta, Asa; Strickland-Hodge, Barry; Maz, Julia

    2016-08-01

    Background In Nigeria, only medical doctors, dentists and some nurses in primary care facilities have the legal right to prescribe medicines to patients. Patients' access to prescription medicines can be seriously affected by the shortage of prescribers leading to longer waiting times in hospitals. Objective This research was carried out to investigate stakeholders' views on granting prescribing authority to pharmacists in Nigeria. Setting The study was conducted in Nigeria. Methods Qualitative, semi-structured interviews were conducted with 43 Nigerian stakeholders including policymakers, pharmacists, doctors and patient group representatives. Transcribed interviews were entered into the QSR NVivo 10 software and analysed using a thematic approach. Main outcome measure Stakeholders' perception on the granting of prescribing authority to pharmacists in Nigeria. Results Three major themes emerged from the interviews: (1) prescribing as a logical role for pharmacists, (2) pharmacist prescribing- an opportunity or a threat and (3) the potential barriers to pharmacist prescribing. Many non-medical stakeholders including pharmacists and patient group representatives supported an extended role for pharmacists in prescribing while the majority of medical doctors including those in policy making were reluctant to do so. Generally, all stakeholders perceived that pharmacist prescribing represents an opportunity to increase patients' access to medicines, reduce doctors' workload and promote the utilisation of pharmacists' skills. However, many stakeholders including pharmacists and doctors commonly identified pharmacists' inadequate skills in diagnosis, medical resistance and shortage of pharmacists as potential barriers to the introduction of pharmacist prescribing in Nigeria. Conclusion The present study showed a split of opinion between participants who were medical doctors and those who were non-doctors in their support for pharmacist prescribing. However, all

  12. Inappropriate prescribing in geriatric patients.

    LENUS (Irish Health Repository)

    Barry, Patrick J

    2012-02-03

    Inappropriate prescribing in older people is a common condition associated with significant morbidity, mortality, and financial costs. Medication use increases with age, and this, in conjunction with an increasing disease burden, is associated with adverse drug reactions. This review outlines why older people are more likely to develop adverse drug reactions and how common the problem is. The use of different tools to identify and measure the problem is reviewed. Common syndromes seen in older adults (eg, falling, cognitive impairment, sleep disturbance) are considered, and recent evidence in relation to medication use for these conditions is reviewed. Finally, we present a brief summary of significant developments in the recent literature for those caring for older people.

  13. Nurse prescribing in dermatology: doctors' and non-prescribing nurses' views.

    Science.gov (United States)

    Stenner, Karen; Carey, Nicola; Courtenay, Molly

    2009-04-01

    This paper is a report of a study conducted to explore doctor and non-prescribing nurse views about nurse prescribing in the light of their experience in dermatology. The cooperation of healthcare professionals and peers is of key importance in enabling and supporting nurse prescribing. Lack of understanding of and opposition to nurse prescribing are known barriers to its implementation. Given the important role they play, it is necessary to consider how the recent expansion of nurse prescribing rights in England impacts on the views of healthcare professionals. Interviews with 12 doctors and six non-prescribing nurses were conducted in 10 case study sites across England between 2006 and 2007. Participants all worked with nurses who prescribed for patients with dermatological conditions in secondary or primary care. Thematic analysis was conducted on the interview data. Participants were positive about their experiences of nurse prescribing having witnessed benefits from it, but had reservations about nurse prescribing in general. Acceptance was conditional upon the nurses' level of experience, awareness of their own limitations and the context in which they prescribed. Fears that nurses would prescribe beyond their level of competence were expected to reduce as understanding and experience of nurse prescribing increased. Indications are that nurse prescribing can be acceptable to doctors and nurses so long as it operates within recommended parameters. Greater promotion and assessment of standards and criteria are recommended to improve understanding and acceptance of nurse prescribing.

  14. Prescribing Safety in Ambulatory Care: Physician Perspectives

    National Research Council Canada - National Science Library

    Rundall, Thomas G; Hsu, John; Lafata, Jennifer E; Fung, Vicki; Paez, Kathryn A; Simpkins, Jan; Simon, Steven R; Robinson, Scott B; Uratsu, Connie; Gunter, Margaret J; Soumerai, Stephen B; Selby, Joseph V

    2005-01-01

    .... We asked about current safety practices, perceptions of ambulatory prescribing safety. Using a content analysis approach, three investigators independently coded responses into thematic categories...

  15. Good things do not always come in threes: On the excess cost of overlapping regulation in EU climate policy

    International Nuclear Information System (INIS)

    Böhringer, Christoph; Keller, Andreas; Bortolamedi, Markus; Rahmeier Seyffarth, Anelise

    2016-01-01

    Since the mid-1990's the European Union (EU) aims at pushing global climate policy. The objective is to promote international cooperation by the adoption of substantial EU-wide greenhouse gas emission reduction targets and their least-cost implementation. Our quantitative impact assessment of the EU Climate and Energy Package shows that the myriad of instruments used in the EU to curb greenhouse gas emissions is doomed to generate substantial excess cost. We conclude that EU climate and energy policy should better disentangle its choices of objectives, targets, and policy instruments on rigorous economic grounds in order to improve the coherence and overall cost-effectiveness of policy initiatives. - Highlights: •EU Climate and Energy Package almost quintuples costs for EU-wide emission abatement. •The main source of excess cost of EU climate policy are energy efficiency mandates.

  16. A Descriptive Longitudinal Study of Changes in Vape Shop Characteristics and Store Policies in Anticipation of the 2016 FDA Regulations of Tobacco Products, Including E-Cigarettes

    Directory of Open Access Journals (Sweden)

    Sheila Yu

    2018-02-01

    Full Text Available After proposing the “Deeming Rule” in 2014, the U.S. Food and Drug Administration (FDA began regulating the manufacturing, marketing, and sales of electronic cigarette (e-cigarette products as tobacco products in 2016. The current study conducted vape shop store observations and surveyed Los Angeles–area shop employees (assessing their beliefs, awareness, and perceptions of e-cigarettes and related FDA regulations at two time points one year apart to better understand what vape shop retailers would do given FDA’s soon-to-be-enacted Deeming Rule. The study also compared retailer beliefs/awareness/actions and store characteristics immediately after the Deeming Rule proposal versus a year after the Rule had been proposed, right before its enactment. Two data collection waves occurred before the Deeming Rule enactment, with Year 1 surveying 77 shops (2014 and Year 2 surveying 61 shops (2015–2016. Between the data collection points, 16 shops had closed. Among the shops that were open at both time points, the majority (95% in Year 1; 74% in Year 2 were aware of some FDA regulations or other policies applying to vape shops. However, overall awareness of FDA regulations and state/local policies governing e-cigarettes significantly decreased from Year 1 to Year 2. At both time points, all shops offered customers free puffs of nicotine-containing e-liquids (prohibited by the then upcoming Deeming Rule. Perceptions of e-cigarette safety also significantly decreased between the years. Exploring vape shop retailer perceptions and store policies (i.e., free puffs/samples displays, perceptions of e-cigarette safety, etc. over time will help the FDA assess the needs of the vape shop community and develop more effective retailer education campaigns and materials targeted to increase compliance with the newly enacted regulations.

  17. A Descriptive Longitudinal Study of Changes in Vape Shop Characteristics and Store Policies in Anticipation of the 2016 FDA Regulations of Tobacco Products, Including E-Cigarettes.

    Science.gov (United States)

    Yu, Sheila; Escobedo, Patricia; Garcia, Robert; Cruz, Tess Boley; Unger, Jennifer B; Baezconde-Garbanati, Lourdes; Meza, Leah; Sussman, Steve

    2018-02-11

    After proposing the "Deeming Rule" in 2014, the U.S. Food and Drug Administration (FDA) began regulating the manufacturing, marketing, and sales of electronic cigarette (e-cigarette) products as tobacco products in 2016. The current study conducted vape shop store observations and surveyed Los Angeles-area shop employees (assessing their beliefs, awareness, and perceptions of e-cigarettes and related FDA regulations) at two time points one year apart to better understand what vape shop retailers would do given FDA's soon-to-be-enacted Deeming Rule. The study also compared retailer beliefs/awareness/actions and store characteristics immediately after the Deeming Rule proposal versus a year after the Rule had been proposed, right before its enactment. Two data collection waves occurred before the Deeming Rule enactment, with Year 1 surveying 77 shops (2014) and Year 2 surveying 61 shops (2015-2016). Between the data collection points, 16 shops had closed. Among the shops that were open at both time points, the majority (95% in Year 1; 74% in Year 2) were aware of some FDA regulations or other policies applying to vape shops. However, overall awareness of FDA regulations and state/local policies governing e-cigarettes significantly decreased from Year 1 to Year 2. At both time points, all shops offered customers free puffs of nicotine-containing e-liquids (prohibited by the then upcoming Deeming Rule). Perceptions of e-cigarette safety also significantly decreased between the years. Exploring vape shop retailer perceptions and store policies (i.e., free puffs/samples displays, perceptions of e-cigarette safety, etc.) over time will help the FDA assess the needs of the vape shop community and develop more effective retailer education campaigns and materials targeted to increase compliance with the newly enacted regulations.

  18. Reflections on the international climate change negotiations: A synthesis of a working group on carbon emission policy and regulation in Brazil

    International Nuclear Information System (INIS)

    Lucon, Oswaldo; Romeiro, Viviane; Pacca, Sergio

    2013-01-01

    This short communication presents a synthesis of a Working Group on Carbon Emission Policy and Regulation held at the University of Sao Paulo, in Brazil. The document looked at the problems with the international negotiations, the options for Brazil as it attempts to control emissions, and ways to leverage the mitigation process. Several options are currently being proposed, but these are neither clear in order to support a solid polycentric approach with adequate metrics, nor a robust international coordination and a sound scientific communication. Brazil has a central role in this process, for having successful initiatives on renewable energy and deforestation control. Its leadership can demonstrate how such policies might take shape. However, the country´s future is uncertain in terms of low carbon development. Although the country is still well positioned among BRICS to find practical solutions to the stalemate in international cooperation, several internal challenges need to be harmonized. - Highlights: • The work presents results of a recent climate change mitigation policies workshop. • It assesses Brazil's potential role in shaping future policies and negotiations. • Policies are evaluated based on domestic and international effects. • Suggests how Brazil's national effort could leverage the international processes

  19. Prevalence and Predictors of Inappropriate Medications Prescribing ...

    African Journals Online (AJOL)

    Data analysis involved use of World Health Organization (WHO) prescribing indicators, Updated 2002 Beer's criteria and DRUG-REAX® system software package of MICROMEDEX (R) Healthcare Series to assess the prescribing pattern, identify potentially inappropriate medications and potential drug-drug interactions, ...

  20. Medication errors: prescribing faults and prescription errors.

    Science.gov (United States)

    Velo, Giampaolo P; Minuz, Pietro

    2009-06-01

    1. Medication errors are common in general practice and in hospitals. Both errors in the act of writing (prescription errors) and prescribing faults due to erroneous medical decisions can result in harm to patients. 2. Any step in the prescribing process can generate errors. Slips, lapses, or mistakes are sources of errors, as in unintended omissions in the transcription of drugs. Faults in dose selection, omitted transcription, and poor handwriting are common. 3. Inadequate knowledge or competence and incomplete information about clinical characteristics and previous treatment of individual patients can result in prescribing faults, including the use of potentially inappropriate medications. 4. An unsafe working environment, complex or undefined procedures, and inadequate communication among health-care personnel, particularly between doctors and nurses, have been identified as important underlying factors that contribute to prescription errors and prescribing faults. 5. Active interventions aimed at reducing prescription errors and prescribing faults are strongly recommended. These should be focused on the education and training of prescribers and the use of on-line aids. The complexity of the prescribing procedure should be reduced by introducing automated systems or uniform prescribing charts, in order to avoid transcription and omission errors. Feedback control systems and immediate review of prescriptions, which can be performed with the assistance of a hospital pharmacist, are also helpful. Audits should be performed periodically.

  1. Psychiatric Prescribers' Experiences With Doctor Shoppers.

    Science.gov (United States)

    Worley, Julie; Johnson, Mary; Karnik, Niranjan

    2015-01-01

    Doctor shopping is a primary method of prescription medication diversion. After opioids, benzodiazepines and stimulants are the next most common prescription medications used nonmedically. Studies have shown that patients who engage in doctor shopping find it fun, exciting, and easy to do. There is a lack of research on the prescriber's perspective on the phenomenon of doctor shopping. This study investigates the experiences of prescribers in psychiatry with patients who engage in doctor shopping. Fifteen prescribers including psychiatrists and psychiatric nurse practitioners working in outpatient psychiatry were interviewed to elicit detailed information about their experiences with patients who engage in doctor shopping. Themes found throughout the interview were that psychiatric prescribers' experience with patients who engage in doctor shopping includes (a) detecting red flags, (b) negative emotional responding, (c) addressing the patient and the problem, and (d) inconsistently implementing precautions. When red flags were detected when prescribing controlled drugs, prescribers in psychiatry experienced both their own negative emotional responses such as disappointment and resentment as well as the negative emotions of the patients such as anger and other extreme emotional responses. Psychiatric prescribers responded to patient's doctor shopping in a variety of ways such as changing their practice, discharging the patients or taking steps to not accept certain patients identified as being at risk for doctor shopping, as well as by talking to the patient and trying to offer them help. Despite experiencing doctor shopping, the prescribers inconsistently implemented precautionary measures such as checking prescription drug monitoring programs. © The Author(s) 2015.

  2. Influences on the prescribing of new drugs.

    Science.gov (United States)

    Tobin, Luke; de Almedia Neto, Abelio C; Wutzke, Sonia; Patterson, Craig; Mackson, Judith; Weekes, Lynn; Williamson, Margaret

    2008-01-01

    The aim of this study was to identify the factors that influence prescribing of new drugs among general practitioners, endocrinologists and psychiatrists. Four focus groups were conducted with GPs, endocrinologists and psychiatrists on sources of awareness and influences on prescribing of new drugs. Pharmaceutical companies were the most important source for becoming aware of new drugs. There were many influences on the decision to prescribe a new drug, the most important being efficacy, safety, cost and advantage over existing therapies. Endocrinologists placed greater emphasis on evidence from clinical trials and scientific conferences, and psychiatrists and GPs placed more weight on pharmaceutical representatives, colleagues and specialists. New drug prescribing occurs in a complex environment with many influences. Effective interventions to promote rational, safe and effective prescribing of new drugs will need to be cognisant of these factors.

  3. What do providers want to know about opioid prescribing? A qualitative analysis of their questions.

    Science.gov (United States)

    Cushman, Phoebe A; Liebschutz, Jane M; Hodgkin, Joseph G; Shanahan, Christopher W; White, Julie L; Hardesty, Ilana; Alford, Daniel P

    2017-01-01

    In 2012, the US Food and Drug Administration (FDA) responded to the opioid crisis with a Risk Evaluation and Mitigation Strategy, requiring manufacturers of extended-release/long-acting opioids to fund continuing medical education based on the "FDA Blueprint for Prescriber Education." Topics in the Blueprint are "Assessing Patients for Treatment," "Initiating Therapy, Modifying Dosing, and Discontinuing Use," "Managing Therapy," "Counseling Patients and Caregivers about Safe Use," "General Drug Information," and "Specific Drug Information." Based on the FDA Blueprint, Boston University School of Medicine's "Safe and Competent Opioid Prescribing Education" (SCOPE of Pain) offers live trainings for physicians and other prescribers. During trainings, participants submit written questions about the curriculum and/or their clinical experiences. The objective was to compare themes that arose from questions asked by SCOPE of Pain participants with content of the FDA Blueprint in order to evaluate how well the Blueprint answers prescribers' concerns. The authors conducted qualitative analyses of all 1309 questions submitted by participants in 29 trainings across 16 states from May 2013 to May 2015, using conventional content analysis to code the questions. Themes that emerged from participants' questions were then compared with the Blueprint. Most themes fell into the topic categories of the Blueprint. Five main themes diverged: Participants sought information on (1) safe alternatives to opioids, (2) overcoming barriers to safe opioid prescribing, (3) government regulations of opioid prescribing, (4) the role of marijuana in opioid prescribing, and (5) maintaining a positive provider-patient relationship while prescribing opioids. In addition to learning the mechanics of safe opioid prescribing, providers want to understand government regulations and effective patient communication skills. Aware of the limitations of opioids in managing chronic pain, providers seek advice

  4. Antipsychotic prescribing in older people.

    Science.gov (United States)

    Neil, Wendy; Curran, Stephen; Wattis, John

    2003-09-01

    older people. There is a need to redress this balance to ensure that the prescribing of antipsychotics in older people is evidence based.

  5. Regulation

    International Nuclear Information System (INIS)

    Ballereau, P.

    1999-01-01

    The different regulations relative to nuclear energy since the first of January 1999 are given here. Two points deserve to be noticed: the decree of the third august 1999 authorizing the national Agency for the radioactive waste management to install and exploit on the commune of Bures (Meuse) an underground laboratory destined to study the deep geological formations where could be stored the radioactive waste. The second point is about the uranium residues and the waste notion. The judgment of the administrative tribunal of Limoges ( 9. july 1998) forbidding the exploitation of a storage installation of depleted uranium considered as final waste and qualifying it as an industrial waste storage facility has been annulled bu the Court of Appeal. It stipulated that, according to the law number 75663 of the 15. july 1965, no criteria below can be applied to depleted uranium: production residue (possibility of an ulterior enrichment), abandonment of a personal property or simple intention to do it ( future use aimed in the authorization request made in the Prefecture). This judgment has devoted the primacy of the waste notion on this one of final waste. (N.C.)

  6. Early responses to zebra mussels in the Great Lakes: a journey from information vacuum to policy and regulation

    Science.gov (United States)

    Griffiths, Ronald W.; Schloesser, Don W.; Kovalak, William P.

    2013-01-01

    Invasive species such as zebra mussels pose a threat to the economies and environments of coastal and fresh-water habitats around the world. Consequently, it is important that government policies and programs be adequate to protect these waters from invaders. This chapter documents key events that took place in the early years (1988-1991) of zebra mussel colonization of the Laurentian Great Lakes and evaluates government responses (policies and programs) to this disruptive, invasive, freshwater species.

  7. Drug prescribing and use among elderly people in Spain.

    Science.gov (United States)

    Mas, X; Laporte, J R; Frati, M E; Busquet, L; Arnau, J M; Ibañez, L; Séculi, E; Capellà, D; Arbonés, G

    1983-05-01

    As a result of the lack of an adequate regulation, the supply and the use of medicines is irrational in Spain. In order to know the characteristics of the prescription and use of drugs among the elderly, two drug utilization studies were carried out. The first study was an analysis of 981 prescriptions from an outpatient clinic of the Spanish Social Security. The results show that a high proportion of fixed-dose combinations were prescribed and that drugs without any demonstrated therapeutic value are often prescribed for the elderly. The second study was a survey of 389 individuals randomly chosen among people affiliated with a pensioners' club. The results show that drug use is highly prevalent among the elderly, that many medicines without any demonstrated benefit are being taken, and that potentially harmful drugs were being used by a high proportion of patients without medical follow-up. The prevalence of the use of some particular groups of drugs is also presented.

  8. Neuropharmacology and mental health nurse prescribers.

    Science.gov (United States)

    Skingsley, David; Bradley, Eleanor J; Nolan, Peter

    2006-08-01

    To outline the development and content of a 'top-up' neuropharmacology module for mental health nurse prescribers and consider how much pharmacology training is required to ensure effective mental health prescribing practice. Debate about the content of prescribing training courses has persisted within the United Kingdom since the mid-1980s. In early 2003 supplementary prescribing was introduced and gave mental health nurses the opportunity to become prescribers. The challenge of the nurse prescribing curriculum for universities is that they have only a short time to provide nurses from a range of backgrounds with enough knowledge to ensure that they meet agreed levels of competency for safe prescribing. There is growing concern within mental health care that the prescribing of medication in mental health services falls short of what would be deemed good practice. Over the past two decades, nurse training has increasingly adopted a psychosocial approach to nursing care raising concerns that, although nurses attending prescribing training may be able to communicate effectively with service users, they may lack the basic knowledge of biology and pharmacology to make effective decisions about medication. Following the completion of a general nurse prescribing course, mental health nurses who attended were asked to identify their specific needs during the evaluation phase. Although they had covered basic pharmacological principles in their training, they stated that they needed more specific information about drugs used in mental health; particularly how to select appropriate drug treatments for mental health conditions. This paper describes how the nurses were involved in the design of a specific module which would enable them to transfer their theoretical leaning to practice and in so doing increase their confidence in their new roles. The findings of this study suggest that the understanding and confidence of mental health nurse prescribers about the drugs they

  9. Antibiotic prescribing in dental practice in Belgium.

    Science.gov (United States)

    Mainjot, A; D'Hoore, W; Vanheusden, A; Van Nieuwenhuysen, J-P

    2009-12-01

    To assess the types and frequency of antibiotic prescriptions by Belgian dentists, the indications for antibiotic prescription, and dentists' knowledge about recommended practice in antibiotic use. In this cross-sectional survey, dental practitioners were asked to record information about all antibiotics prescribed to their patients during a 2-week period. The dental practitioners were also asked to complete a self-administered questionnaire regarding demographic data, prescribing practices, and knowledge about antibiotic use. A random sample of 268 Belgian dentists participated in the survey. During the 2-week period, 24 421 patient encounters were recorded; 1033 patients were prescribed an antibiotic (4.2%). The median number of prescriptions per dentist for the 2 weeks was 3. Broad spectrum antibiotics were most commonly prescribed: 82% of all prescriptions were for amoxycillin, amoxycillin-clavulanic acid and clindamycin. Antibiotics were often prescribed in the absence of fever (92.2%) and without any local treatment (54.2%). The most frequent diagnosis for which antibiotics were prescribed was periapical abscess (51.9%). Antibiotics were prescribed to 63.3% of patients with periapical abscess and 4.3% of patients with pulpitis. Patterns of prescriptions were confirmed by the data from the self-reported practice. Discrepancies between observed and recommended practice support the need for educational initiatives to promote rational use of antibiotics in dentistry in Belgium.

  10. 49 CFR 40.307 - What is the SAP's function in prescribing the employee's follow-up tests?

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false What is the SAP's function in prescribing the... the Return-to-Duty Process § 40.307 What is the SAP's function in prescribing the employee's follow-up tests? (a) As a SAP, for each employee who has committed a DOT drug or alcohol regulation violation, and...

  11. Nurse prescribing in general practice: a qualitative study of job satisfaction and work-related stress.

    Science.gov (United States)

    Cousins, Rosanna; Donnell, Christine

    2012-04-01

    Studies examining the impact nurse prescribing have largely focused on the efficacy of the service. It was suggested in pro-prescribing policy arguments that extending the nursing role to include prescribing would increase job satisfaction. This assertion has not been fully explored. To investigate the impact of independent prescribing for experienced nurse practitioners (NPs) working in general practice. In-depth interviews were conducted with six NPs who each had at least 3 years experience of independent prescribing in a busy inner city general practice. Analysis of interview data yielded two main themes: as independent prescribers NPs experienced increased levels of both job satisfaction and work-related stress. Increased satisfaction was associated with having greater autonomy and being able to provide more holistic care. Increased work-related stress emerged from greater job demands, perceived insufficient support and perceived effort-reward imbalance that centred upon the enhanced role not being recognized in terms of an increase in grade and pay. Independent prescribing increases job satisfaction for NPs in general practice, but there is also evidence of stressors associated with the role. It is important that NPs in general practice are encouraged and supported towards providing the effective patient-centred care in the community envisaged by current UK government. We acknowledge that the results presented in this paper are based on a sample limited to one city; however, it provides information that has important implications for the well being of NPs and ultimately patient care.

  12. Regulation of genomic and biobanking research in Africa: a content analysis of ethics guidelines, policies and procedures from 22 African countries.

    Science.gov (United States)

    de Vries, Jantina; Munung, Syntia Nchangwi; Matimba, Alice; McCurdy, Sheryl; Ouwe Missi Oukem-Boyer, Odile; Staunton, Ciara; Yakubu, Aminu; Tindana, Paulina

    2017-02-02

    The introduction of genomics and biobanking methodologies to the African research context has also introduced novel ways of doing science, based on values of sharing and reuse of data and samples. This shift raises ethical challenges that need to be considered when research is reviewed by ethics committees, relating for instance to broad consent, the feedback of individual genetic findings, and regulation of secondary sample access and use. Yet existing ethics guidelines and regulations in Africa do not successfully regulate research based on sharing, causing confusion about what is allowed, where and when. In order to understand better the ethics regulatory landscape around genomic research and biobanking, we conducted a comprehensive analysis of existing ethics guidelines, policies and other similar sources. We sourced 30 ethics regulatory documents from 22 African countries. We used software that assists with qualitative data analysis to conduct a thematic analysis of these documents. Surprisingly considering how contentious broad consent is in Africa, we found that most countries allow the use of this consent model, with its use banned in only three of the countries we investigated. In a likely response to fears about exploitation, the export of samples outside of the continent is strictly regulated, sometimes in conjunction with regulations around international collaboration. We also found that whilst an essential and critical component of ensuring ethical best practice in genomics research relates to the governance framework that accompanies sample and data sharing, this was most sparingly covered in the guidelines. There is a need for ethics guidelines in African countries to be adapted to the changing science policy landscape, which increasingly supports principles of openness, storage, sharing and secondary use. Current guidelines are not pertinent to the ethical challenges that such a new orientation raises, and therefore fail to provide accurate guidance

  13. Regulating genetically modified food. Policy trajectories, political culture, and risk perceptions in the U.S., Canada, and EU.

    Science.gov (United States)

    Wohlers, Anton E

    2010-09-01

    This paper examines whether national differences in political culture add an explanatory dimension to the formulation of policy in the area of biotechnology, especially with respect to genetically modified food. The analysis links the formulation of protective regulatory policies governing genetically modified food to both country and region-specific differences in uncertainty tolerance levels and risk perceptions in the United States, Canada, and European Union. Based on polling data and document analysis, the findings illustrate that these differences matter. Following a mostly opportunistic risk perception within an environment of high tolerance for uncertainty, policymakers in the United States and Canada modified existing regulatory frameworks that govern genetically modified food in their respective countries. In contrast, the mostly cautious perception of new food technologies and low tolerance for uncertainty among European Union member states has contributed to the creation of elaborate and stringent regulatory policies governing genetically modified food.

  14. Designing an EU energy and climate policy portfolio for 2030: Implications of overlapping regulation under different levels of electricity demand

    International Nuclear Information System (INIS)

    Flues, Florens; Löschel, Andreas; Lutz, Benjamin Johannes; Schenker, Oliver

    2014-01-01

    The European Union's current climate and energy policy has to operate under an ex ante unforeseen economic crisis. As a consequence prices for carbon emission allowances in the EU Emissions Trading System collapsed. However, this price collapse may be amplified by the interaction of a carbon emission cap with supplementary policy targets such as minimum shares for renewables in the power sector. The static interaction between climate and renewable policies has been discussed extensively. This paper extends this debate by analysing the efficiency and effectiveness of a policy portfolio containing a cap and trade scheme and a target for a minimum renewable share in different states of aggregate electricity demand. Making use of a simple partial equilibrium model of the power sector we identify an asymmetric interaction of emissions trading and renewable quotas with respect to different states of aggregate electricity demand. The results imply that unintended consequences of the policy interaction may be particularly severe and costly when aggregate electricity demand is low and that carbon prices are more sensitive to changes in economic activity if they are applied in combination with renewable energy targets. Our analysis of the policy interaction focuses on the EU, yet the conclusions may also be of relevance for fast growing emerging economies like China. - Highlights: • A minimum renewable quota that is added to an existing emissions trading system causes excess costs. • Excess costs depend on electricity demand and are highest when electricity demand is low. • Excess costs can reach up to 1.2 Billion Euro annually in the European Union in 2030. • CO 2 prices are more sensitive to changes in electricity demand if combined with minimum renewable quota

  15. Legal and administrative regulation of the petroleum industry in Trinidad and Tobago: a study of law and policy in petroleum development

    Energy Technology Data Exchange (ETDEWEB)

    Khan, K I.F.

    1984-01-01

    This work has, through an in-depth assessment of the law and institutions employed in the petroleum industry in Trinidad and Tobago, evaluated their viability in achieving declared state objectives and in providing a legal and administrative framework for regulating this industry. After considering the evolution of laws, policies, and institutions, the work focuses mainly on the petroleum contract, the national oil company, taxation of petroleum operations, and the ways of integrating the industry into the national economy and achieving an effective transfer of technology. These central areas are examined from a policy perspective which looks at their role, inter alia, as instruments of development, for securing active state participation, in the creation of an efficient and effective regulatory infrastructure and in allowing an optimum development of the resources, in the interest of the state. Further this examination provides the basis for suggested reforms and improvements to the existing model.

  16. Modeling of outpatient prescribing process in iran: a gateway toward electronic prescribing system.

    Science.gov (United States)

    Ahmadi, Maryam; Samadbeik, Mahnaz; Sadoughi, Farahnaz

    2014-01-01

    Implementation of electronic prescribing system can overcome many problems of the paper prescribing system, and provide numerous opportunities of more effective and advantageous prescribing. Successful implementation of such a system requires complete and deep understanding of work content, human force, and workflow of paper prescribing. The current study was designed in order to model the current business process of outpatient prescribing in Iran and clarify different actions during this process. In order to describe the prescribing process and the system features in Iran, the methodology of business process modeling and analysis was used in the present study. The results of the process documentation were analyzed using a conceptual model of workflow elements and the technique of modeling "As-Is" business processes. Analysis of the current (as-is) prescribing process demonstrated that Iran stood at the first levels of sophistication in graduated levels of electronic prescribing, namely electronic prescription reference, and that there were problematic areas including bottlenecks, redundant and duplicated work, concentration of decision nodes, and communicative weaknesses among stakeholders of the process. Using information technology in some activities of medication prescription in Iran has not eliminated the dependence of the stakeholders on paper-based documents and prescriptions. Therefore, it is necessary to implement proper system programming in order to support change management and solve the problems in the existing prescribing process. To this end, a suitable basis should be provided for reorganization and improvement of the prescribing process for the future electronic systems.

  17. Prescribing Practices and Polypharmacy in Kitovu Hospital

    African Journals Online (AJOL)

    admin

    1Division of Medicine and Therapeutics, Centre for Medical Education, The Queen's ... This audit of prescribing practices explores recent trends at Kitovu Hospital, Uganda ..... This creates a cycle of poor ... interventions to remedy these is vital.

  18. Customization in prescribing for bipolar disorder.

    Science.gov (United States)

    Hodgkin, Dominic; Volpe-Vartanian, Joanna; Merrick, Elizabeth L; Horgan, Constance M; Nierenberg, Andrew A; Frank, Richard G; Lee, Sue

    2012-06-01

    For many disorders, patient heterogeneity requires physicians to customize their treatment to each patient's needs. We test for the existence of customization in physicians' prescribing for bipolar disorder, using data from a naturalistic clinical effectiveness trial of bipolar disorder treatment (STEP-BD), which did not constrain physician prescribing. Multinomial logit is used to model the physician's choice among five combinations of drug classes. We find that our observed measure of the patient's clinical status played only a limited role in the choice among drug class combinations, even for conditions such as mania that are expected to affect class choice. However, treatment of a patient with given characteristics differed widely depending on which physician was seen. The explanatory power of the model was low. There was variation within each physician's prescribing, but the results do not suggest a high degree of customization in physicians' prescribing, based on our measure of clinical status. Copyright © 2011 John Wiley & Sons, Ltd.

  19. Prevalence of inappropriate prescribing in primary care

    DEFF Research Database (Denmark)

    Bregnhøj, Lisbeth; Thirstrup, Steffen; Kristensen, Mogens Brandt

    2007-01-01

    to the patients. Topical, dermatological medications and medications not used regularly were excluded. RESULTS: 212 patients were prescribed 1621 medications by their GPs at baseline. In all, 640 (39.5%) of the medications had one or more inappropriate ratings in the 10 criteria making up the MAI. The main part...... is good. However, the majority of patients used one or more medications with inappropriate ratings. The inappropriate prescribing relates to specific therapeutic groups and criteria, which should be targeted in future interventions....

  20. 75 FR 52385 - Bureau of Political-Military Affairs; Lifting of Policy of Denial Regarding ITAR Regulated...

    Science.gov (United States)

    2010-08-25

    ... DEPARTMENT OF STATE [Public Notice 7128] Bureau of Political-Military Affairs; Lifting of Policy... Controls Compliance, Bureau of Political-Military Affairs, Department of State, (202) 663-2980..., identify compliance problems, and resolve alleged violations. Xe replaced senior management; established...

  1. A qualitative study of GPs' and PCO stakeholders' views on the importance and influence of cost on prescribing.

    Science.gov (United States)

    Prosser, Helen; Walley, Tom

    2005-03-01

    With prescribing expenditure rising and evidence of prescribing costs variation, general practitioners (GPs) in the UK are under increasing pressure to contain spending. The introduction of cash-limited, unified budgets and increased monitoring of prescribing within Primary Care Organizations (PCO) are intended to increase efficiency and enhance GPs financial responsibility. Whilst GPs regularly receive data on the costs of their prescribing and also performance against a set prescribing budget, little is known about the extent to which GPs take cost into account in their prescribing decisions. This study undertook a qualitative exploration of the attitudes of various stakeholders on the relative importance and influence of cost on general practice prescribing. In order to explore a plurality of perspectives, data were obtained from focus groups and a series of individual semi-structured interviews with GPs and key PCO stakeholders. The data suggest that although almost all GPs believed costs should be taken into account when prescribing, there was great variation in the extent to which this was applied and to how sensitive GPs were to costs. Cost was secondary to clinical effectiveness and safety, whilst individual patient need was emphasized above other forms of rationality or notions of opportunity costs. Conflict was apparent between a PCO policy of cost-containment and GPs' resistance to cost-cutting. GPs largely applied simple cost-minimization while cost-consideration was undermined by contextual factors. Implications for research and policy are discussed.

  2. Nurse prescribing in Spain: The law and the curriculum.

    Science.gov (United States)

    Romero-Collado, Angel; Raurell-Torreda, Marta; Zabaleta-Del-Olmo, Edurne; Rascon-Hernan, Carolina; Homs-Romero, Erica

    2017-09-01

    In this cross-sectional study, we explored course content related to pharmacology and/or healthcare products and supplies in all nursing degree programs in Spain. Changes in nurse-prescribing legislation in Spain require that nurses take a certification course before prescribing over-the-counter products and medications. Using a cross-sectional descriptive study, between July and September 2014, the degree programs of all centers that offer a degree in nursing in Spain were examined, selecting those with course information available online. All centers offered at least one pharmacology course. One-third of the required courses had content related to pharmacology and healthcare products/supplies. The analysis showed that the course content and training received during the current nursing degree program provides the knowledge and skills needed to prescribe healthcare products/supplies and medications that do not now require a doctor's prescription, without the need for additional training and certification. It is essential that government regulation of nursing education be aligned with nursing competencies, curriculum standards, clinical practice, and evidence-based research to provide the maximum level of confidence for nursing professionals and their patients. © 2017 John Wiley & Sons Australia, Ltd.

  3. Translating Scientific Judgment, Technological Insight and Economic Theory Into Practical Policy Lessons: The Case of Climate Regulation in the United States

    Science.gov (United States)

    Mignone, B. K.

    2008-12-01

    Effective solutions to the climate change problem will require unprecedented cooperation across space, continuity across time and coordination between disciplines. One well-known methodology for synthesizing the lessons of physical science, energy engineering and economics is integrated assessment. Typically, integrated assessment models use scientific and technological relationships as physical constraints in a larger macroeconomic optimization that is designed to either balance the costs and benefits of climate change mitigation or find the least-cost path to an exogenously prescribed endpoint (e.g. atmospheric CO2 stabilization). The usefulness of these models depends to a large extent on the quality of the assumptions and the relevance of the outcome metrics chosen by the user. In this study, I show how a scientifically-based emissions reduction scenario can be combined with engineering-based assumptions about the energy system (e.g. estimates of the marginal cost premium of carbon-free technology) to yield insights about the price path of CO2 under a future regulatory regime. I then show how this outcome metric (carbon price) relates to key decisions about the design of a future cap-and-trade system and the way in which future carbon markets may be regulated.

  4. Impact of smoke from prescribed burning: Is it a public health concern?

    Science.gov (United States)

    Haikerwal, Anjali; Reisen, Fabienne; Sim, Malcolm R; Abramson, Michael J; Meyer, Carl P; Johnston, Fay H; Dennekamp, Martine

    2015-05-01

    Given the increase in wildfire intensity and frequency worldwide, prescribed burning is becoming a more common and widespread practice. Prescribed burning is a fire management tool used to reduce fuel loads for wildfire suppression purposes and occurs on an annual basis in many parts of the world. Smoke from prescribed burning can have a substantial impact on air quality and the environment. Prescribed burning is a significant source of fine particulate matter (PM2.5 aerodynamic diameterprescribed burning on air quality particularly focussing on PM2.5. We have summarised available case studies from Australia including a recent study we conducted in regional Victoria, Australia during the prescribed burning season in 2013. The studies reported very high short-term (hourly) concentrations of PM2.5 during prescribed burning. Given the increase in PM2.5 concentrations during smoke events, there is a need to understand the influence of prescribed burning smoke exposure on human health. This is important especially since adverse health impacts have been observed during wildfire events when PM2.5 concentrations were similar to those observed during prescribed burning events. Robust research is required to quantify and determine health impacts from prescribed burning smoke exposure and derive evidence based interventions for managing the risk. Given the increase in PM2.5 concentrations during PB smoke events and its impact on the local air quality, the need to understand the influence of PB smoke exposure on human health is important. This knowledge will be important to inform policy and practice of the integrated, consistent, and adaptive approach to the appropriate planning and implementation of public health strategies during PB events. This will also have important implications for land management and public health organizations in developing evidence based objectives to minimize the risk of PB smoke exposure.

  5. Wildland fires and dwarf mistletoes: A literature review of ecology and prescribed burning

    Science.gov (United States)

    Martin E. Alexander; Frank G. Hawksworth

    1975-01-01

    Wildfires play a multiple role in the distribution of dwarf mistletoes - they may either inhibit or encourage these parasites depending primarily on the size and intensity of the burn. Many reports suggest that fire exclusion policies of the past half century have resulted in increased dwarf mistletoe levels as, well as increased fire behavior potential. Prescribed...

  6. Should we use a direct regulation to implement the Healthy Prisons Agenda in England? A qualitative study among prison key policy makers.

    Science.gov (United States)

    Ismail, N; de Viggiani, N

    2017-08-31

    The Healthy Prisons Agenda seeks to reduce prisoners' health risks, balance prisoners' rights with a security regime, ensure equivalent prison health service provisions to community health services, and facilitate the whole-prison approach. There is an established assumption that legislation will ensure better implementation of health promotion programmes. This study aimed to examine whether a legislative framework, via a direct regulation, could lead to enhanced implementation of the Healthy Prisons Agenda in England. A qualitative study design was conducted using semi-structured interviews with 30 key prison policy makers in England. Our findings contradict the established assumption that legislation improves the implementation of health promotion programmes. A direct regulation was perceived as restrictive, manifesting excessive compliance and encouraging a risk-averse culture, whilst preoccupation with security, order and discipline amongst prison governors and custody staff was deemed an internal institutional barrier to implementing the Healthy Prisons Agenda. External barriers included diminishing resources, lengthier or delayed sentencing, and an unsympathetic public and political stance towards prisoner rehabilitation. A direct regulation should not be used to operationalize the Healthy Prisons Agenda. Rather, self-regulation, along with proactive solutions for the identified barriers to implementing the Agenda, is the most appropriate path forward. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  7. The Influence of the Chicago School on the Commission's Guidelines, Notices and Block Exemption Regulations in EU Competition Policy

    DEFF Research Database (Denmark)

    Bartalevich, Dzmitry

    2016-01-01

    Antitrust rules are fundamentally informed and shaped by economic theories. Given the significance of EU competition policy for the European integration process, it is essential to disentangle the economic theories underlying EU competition law. There is abundant theoretical and empirical...... theory. The elements of the Chicago School theory hold strongest in vertical practices; they are somewhat weaker in horizontal practices and in unilateral exclusionary conduct....

  8. Does regulation stimulate productivity? The effect of air quality policies on the efficiency of US power plants

    International Nuclear Information System (INIS)

    Fleishman, Rachel; Alexander, Rob; Bretschneider, Stuart; Popp, David

    2009-01-01

    This research examines the effect of air quality regulations on the productivity of US power plants based on both economic and environmental outputs. Using data envelopment analysis (DEA) to estimate an efficiency measure incorporating both economic and environmental outcomes, we look at changes in efficiency in US power plants over an eleven-year time period (1994-2004) during which several different regulations were implemented for the control of nitrogen oxides (NO x ) and sulfur dioxide (SO 2 ). The paper then models how estimated efficiency behaves over time as a function of regulatory changes. Findings suggest mixed effects of regulations on power plant efficiency when pollution abatement and electricity generation are both included as outputs.

  9. Hybrid Security Policies

    Directory of Open Access Journals (Sweden)

    Radu CONSTANTINESCU

    2006-01-01

    Full Text Available Policy is defined as the rules and regulations set by the organization. They are laid down by management in compliance with industry regulations, law and internal decisions. Policies are mandatory. Security policies rules how the information is protected against security vulnerabilities and they are the basis for security awareness, training and vital for security audits. Policies are focused on desired results. The means of achieving the goals are defined on controls, standards and procedures.

  10. Non- medical prescribing in Australasia and the UK: the case of podiatry.

    Science.gov (United States)

    Borthwick, Alan M; Short, Anthony J; Nancarrow, Susan A; Boyce, Rosalie

    2010-01-05

    The last decade has witnessed a rapid transformation in the role boundaries of the allied health professions, enabled through the creation of new roles and the expansion of existing, traditional roles. A strategy of health care 'modernisation' has encompassed calls for the redrawing of professional boundaries and identities, linked with demands for greater workforce flexibility. Several tasks and roles previously within the exclusive domain of medicine have been delegated to, or assumed by, allied health professionals, as the workforce is reshaped to meet the challenges posed by changing demographic, social and political contexts. The prescribing of medicines by non-medically qualified healthcare professionals, and in particular the podiatry profession, reflects these changes. Using a range of key primary documentary sources derived from published material in the public domain and unpublished material in private possession, this paper traces the development of contemporary UK and Australasian podiatric prescribing, access, supply and administration of medicines. Documentary sources include material from legislative, health policy, regulatory and professional bodies (including both State and Federal sources in Australia). Tracing a chronological, comparative, socio-historical account of the emergence and development of 'prescribing' in podiatry in both Australasia and the UK enables an analysis of the impact of health policy reforms on the use of, and access to, medicines by podiatrists. The advent of neo-liberal healthcare policies, coupled with demands for workforce flexibility and role transfer within a climate of demographic, economic and social change has enabled allied health professionals to undertake an expanding number of tasks involving the sale, supply, administration and prescription of medicines. As a challenge to medical dominance, these changes, although driven by wider healthcare policy, have met with resistance. As anticipated in the theory of

  11. Qualitative analysis of multi-disciplinary round-table discussions on the acceleration of benefits and data analytics through hospital electronic prescribing (ePrescribing) systems.

    Science.gov (United States)

    Cresswell, Kathrin; Coleman, Jamie; Smith, Pam; Swainson, Charles; Slee, Ann; Sheikh, Aziz

    2016-07-04

    Electronic systems that facilitate prescribing, administration and dispensing of medicines (ePrescribing systems) are at the heart of international efforts to improve the safety, quality and efficiency of medicine management. Considering the initial costs of procuring and maintaining ePrescribing systems, there is a need to better understand how to accelerate and maximise the financial benefits associated with these systems. We sought to investigate how different sectors are approaching the realisation of returns on investment from ePrescribing systems in U.K. hospitals and what lessons can be learned for future developments and implementation strategies within healthcare settings. We conducted international, multi-disciplinary, round-table discussions with 21 participants from different backgrounds including policy makers, healthcare organisations, academic researchers, vendors and patient representatives. The discussions were audio-recorded, transcribed and then thematically analysed with the qualitative analysis software NVivo10. There was an over-riding concern that realising financial returns from ePrescribing systems was challenging. The underlying reasons included substantial fixed costs of care provision, the difficulties in radically changing the medicines management process and the lack of capacity within NHS hospitals to analyse and exploit the digital data being generated. Any future data strategy should take into account the need to collect and analyse local and national data (i.e. within and across hospitals), setting comparators to measure progress (i.e. baseline measurements) and clear standards guiding data management so that data are comparable across settings. A more coherent national approach to realising financial benefits from ePrescribing systems is needed as implementations progress and the range of tools to collect information will lead to exponential data growth. The move towards more sophisticated closed-loop systems that integrate

  12. Air Pollution Episodes Associated with Prescribed Burns

    Science.gov (United States)

    Hart, M.; Di Virgilio, G.; Jiang, N.

    2017-12-01

    Air pollution events associated with wildfires have been associated with extreme health impacts. Prescribed burns are an important tool to reduce the severity of wildfires. However, if undertaken during unfavourable meteorological conditions, they too have the capacity to trigger extreme air pollution events. The Australian state of New South Wales has increased the annual average area treated by prescribed burn activities by 45%, in order to limit wildfire activity. Prescribed burns need to be undertaken during meteorological conditions that allow the fuel load to burn, while still allowing the burn to remain under control. These conditions are similar to those that inhibit atmospheric dispersion, resulting in a fine balance between managing fire risk and managing ambient air pollution. During prescribed burns, the Sydney air shed can experience elevated particulate matter concentrations, especially fine particulates (PM2.5) that occasionally exceed national air quality standards. Using pollutant and meteorological data from sixteen monitoring stations in Sydney we used generalized additive model and CART analyses to profile the meteorological conditions influencing air quality during planned burns. The insights gained from this study will help improve prescribed burn scheduling in order to reduce the pollution risk to the community, while allowing fire agencies to conduct this important work.

  13. Control of invasive weeds with prescribed burning

    Science.gov (United States)

    DiTomaso, Joseph M.; Brooks, Matthew L.; Allen, Edith B.; Minnich, Ralph; Rice, Peter M.; Kyser, Guy B.

    2006-01-01

    Prescribed burning has primarily been used as a tool for the control of invasive late-season annual broadleaf and grass species, particularly yellow starthistle, medusahead, barb goatgrass, and several bromes. However, timely burning of a few invasive biennial broadleaves (e.g., sweetclover and garlic mustard), perennial grasses (e.g., bluegrasses and smooth brome), and woody species (e.g., brooms and Chinese tallow tree) also has been successful. In many cases, the effectiveness of prescribed burning can be enhanced when incorporated into an integrated vegetation management program. Although there are some excellent examples of successful use of prescribed burning for the control of invasive species, a limited number of species have been evaluated. In addition, few studies have measured the impact of prescribed burning on the long-term changes in plant communities, impacts to endangered plant species, effects on wildlife and insect populations, and alterations in soil biology, including nutrition, mycorrhizae, and hydrology. In this review, we evaluate the current state of knowledge on prescribed burning as a tool for invasive weed management.

  14. Policy and strategy of the Cuban Regulatory Organization for the establishment of the legal and regulation frame

    International Nuclear Information System (INIS)

    Arnau F, A.; Alonso G, I.; Sarabia M, I.

    2006-01-01

    The National Center of Nuclear Security, Cuban entity authorized to exercise the regulation functions and control of the security of the use of the nuclear energy and the accounting and control of the nuclear materials, has among its functions, to elaborate and to propose for its approval to the corresponding instances, the juridical, technical dispositions and of procedure in its competition sphere, what demands that in this sense clear guidelines exist to carry out this social mission. The fact of assuming this function demands the necessity of a Politics for the establishment of the legal and regulation frame that expresses in a coherent way the general lines on those that it behaves the elaboration of the standards that govern this activity, to reach the end in an efficient and effective way and consequently the adoption of a Strategy that frames the necessary actions that assure the one execution and development of the politics and the pursuit of the precise rules for an optimal result. The Politics for the establishment of the legal and regulation frame of the National Center of Nuclear Security is based on a group of general principles that mark the guidelines so that this activity is chord to the national juridical system, to the good ones international practices and the recommendations of the International Atomic Energy Agency appropriated to the national experience and the daily reality, being this a transparent and reconciled process in such a way that the addressee of these standards can contribute their recommendations to the ends of achieving an effective applicability of the legal and regulation frame that governs this activity in the country. The development and pursuit of these principles is sustained in a group of actions to the help of the strategy for the establishment of the legal and regulation frame, embracing the actions so much during the process of elaboration of the legal frame, its systematic revision, the publication and distribution

  15. The extent to which school district competitive food and beverage policies align with the 2010 Dietary Guidelines for Americans: implications for federal regulations.

    Science.gov (United States)

    Schneider, Linda M; Schermbeck, Rebecca M; Chriqui, Jamie F; Chaloupka, Frank J

    2012-06-01

    The Healthy, Hunger-Free Kids Act of 2010 authorized the Secretary of the US Department of Agriculture to establish science-based nutrition standards for competitive foods and beverages sold in school that are, at a minimum, aligned with the 2010 Dietary Guidelines for Americans (DGA), while still providing districts with discretion in regulating the competitive food and beverage environment. The objective of this study was to examine the extent to which district competitive food and beverage policies had specific and required limits aligned with 2010 DGA recommendations, and to inform US Department of Agriculture efforts as they develop competitive food and beverage standards. Competitive food and beverage policies were compiled for the 2009-2010 school year from a nationally representative sample of 622 districts. Each policy was double-coded for compliance with selected 2010 DGA recommendations (ie, restrictions on sugars, fats, trans fats, and sodium in foods and restrictions on regular soda, other sugar-sweetened beverages, and fat content of milk). Descriptive statistics were computed, clustered to account for the sample design, and weighted to account for districts nationwide. District nutrition policies were strongest for elementary schools. Nationwide, content of foods and soda availability were more commonly addressed. Areas that require attention include stronger nutrition standards at the secondary level, limits on trans fats, sodium, sugar-sweetened beverages other than soda, and fat content of milk, and greater availability of produce and whole grains at all sale locations. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  16. Antibiotic Use in Cold and Flu Season and Prescribing Quality: A Retrospective Cohort Study.

    Science.gov (United States)

    Alsan, Marcella; Morden, Nancy E; Gottlieb, Joshua D; Zhou, Weiping; Skinner, Jonathan

    2015-12-01

    Excessive antibiotic use in cold and flu season is costly and contributes to antibiotic resistance. The study objective was to develop an index of excessive antibiotic use in cold and flu season and determine its correlation with other indicators of prescribing quality. We included Medicare beneficiaries in the 40% random sample denominator file continuously enrolled in fee-for-service benefits for 2010 or 2011 (7,961,201 person-years) and extracted data on prescription fills for oral antibiotics that treat respiratory pathogens. We collapsed the data to the state level so they could be merged with monthly flu activity data from the Centers for Disease Control and Prevention. Linear regression, adjusted for state-specific mean antibiotic use and demographic characteristics, was used to estimate how antibiotic prescribing responded to state-specific flu activity. Flu-activity associated antibiotic use varied substantially across states-lowest in Vermont and Connecticut, highest in Mississippi and Florida. There was a robust positive correlation between flu-activity associated prescribing and use of medications that often cause adverse events in the elderly (0.755; Pantibiotic use was positively correlated with prescribing high-risk medications to the elderly and negatively correlated with beta-blocker use after myocardial infarction. These findings suggest that excessive antibiotic use reflects low-quality prescribing. They imply that practice and policy solutions should go beyond narrow, antibiotic specific, approaches to encourage evidence-based prescribing for the elderly Medicare population.

  17. The use of prescribed and non-prescribed medication by Dutch children.

    NARCIS (Netherlands)

    Dijk, L. van; Lindert, H. van

    2002-01-01

    Background: Most research on the use of medication focuses on adults. Children, however, use medication too, most of which is prescribed by GP's. Children also use non-prescribed medication (f.e. bought in the drugstore), but the extent to which is not known. Moreover, it is not known to what extent

  18. Auditing GPs' prescribing habits : Cardiovascular prescribing frequently continues medication initiated by specialists

    NARCIS (Netherlands)

    de Vries, C.S; van Diepen, N.M; de Jong-van den Berg, L T W

    Objective: To determine to what extent general practitioners' (GPs) prescribing behaviour is a result of repeat prescribing of medication which has been initiated by specialists. Method: During a 4-week period, pharmacists identified GPs' prescriptions for a large group of cardiovascular drugs.

  19. The Quality of Prescribing for Psychiatric Patients

    DEFF Research Database (Denmark)

    Soerensen, A L; Nielsen, L P; Poulsen, B K

    2014-01-01

    The Quality of Prescribing for Psychiatric PatientsSoerensen AL1,2, Nielsen LP3,4, Poulsen BK3, Lisby M3,5, Mainz J6,7 1Danish Center for Healthcare Improvements, Faculty of Social Sciences and Faculty of Health Sciences, Aalborg University, Denmark; 2University College of Northern Denmark; 3......, Aalborg; Denmark OBJECTIVES: Prescribing for adult psychiatric patients is often highly complex due to the nature of psychiatric conditions, but also due to somatic comorbidity. Therefore, the aim of this study was to identify prevalence and types of potential inappropriate prescribing (PIP), asses...... the severity of potential clinical consequences and identify possible predictive factors of PIP.METHODS: The study was designed as a prospective study of PIP using medication reviews. Patients who were admitted during a 4 month period (August 2013 - November 2013) to a psychiatric university hospital were...

  20. The Quality of Prescribing for Psychiatric Patients

    DEFF Research Database (Denmark)

    Sørensen, Ann Lykkegaard; Nielsen, Lars Peter; Poulsen, Birgitte Klindt

    2014-01-01

    The Quality of Prescribing for Psychiatric Patients Soerensen AL1,2, Nielsen LP3,4, Poulsen BK3, Lisby M3,5, Mainz J6,7 1Danish Center for Healthcare Improvements, Faculty of Social Sciences and Faculty of Health Sciences, Aalborg University, Denmark; 2University College of Northern Denmark; 3......, Aalborg; Denmark OBJECTIVES: Prescribing for adult psychiatric patients is often highly complex due to the nature of psychiatric conditions, but also due to somatic comorbidity. Therefore, the aim of this study was to identify prevalence and types of potential inappropriate prescribing (PIP), asses...... the severity of potential clinical consequences and identify possible predictive factors of PIP. METHODS: The study was designed as a prospective study of PIP using medication reviews. Patients who were admitted during a 4 month period (August 2013 - November 2013) to a psychiatric university hospital were...

  1. e-Learning initiatives to support prescribing.

    Science.gov (United States)

    Maxwell, Simon; Mucklow, John

    2012-10-01

    Preparing medical students to prescribe is a major challenge of undergraduate education. They must develop an understanding of clinical pharmacology and acquire knowledge about drugs and therapeutics, as well as the skills to prescribe for individual patients in the face of multiple variables. The task of delivering the learning required to achieve these attributes relies upon limited numbers of teachers, who have increasingly busy clinical commitments. There is evidence that training is currently insufficient to meet the demands of the workplace. e-Learning provides an opportunity to improve the learning experience. The advantages for teachers are improved distribution of learning content, ease of update, standardization and tracking of learner activities. The advantages for learners are ease of access, greater interactivity and individual choice concerning the pace and mix of learning. Important disadvantages are the considerable resource required to develop e-Learning projects and difficulties in simulating some aspects of the real world prescribing experience. Pre-requisites for developing an e-Learning programme to support prescribing include academic expertise, institutional support, learning technology services and an effective virtual learning environment. e-Learning content might range from complex interactive learning sessions through to static web pages with links. It is now possible to simulate and provide feedback on prescribing decisions and this will improve with advances in virtual reality. Other content might include a student formulary, self-assessment exercises (e.g. calculations), a glossary and an on-line library. There is some evidence for the effectiveness of e-Learning but better research is required into its potential impact on prescribing. © 2012 The Authors. British Journal of Clinical Pharmacology © 2012 The British Pharmacological Society.

  2. e-Learning initiatives to support prescribing

    Science.gov (United States)

    Maxwell, Simon; Mucklow, John

    2012-01-01

    Preparing medical students to prescribe is a major challenge of undergraduate education. They must develop an understanding of clinical pharmacology and acquire knowledge about drugs and therapeutics, as well as the skills to prescribe for individual patients in the face of multiple variables. The task of delivering the learning required to achieve these attributes relies upon limited numbers of teachers, who have increasingly busy clinical commitments. There is evidence that training is currently insufficient to meet the demands of the workplace. e-Learning provides an opportunity to improve the learning experience. The advantages for teachers are improved distribution of learning content, ease of update, standardization and tracking of learner activities. The advantages for learners are ease of access, greater interactivity and individual choice concerning the pace and mix of learning. Important disadvantages are the considerable resource required to develop e-Learning projects and difficulties in simulating some aspects of the real world prescribing experience. Pre-requisites for developing an e-Learning programme to support prescribing include academic expertise, institutional support, learning technology services and an effective virtual learning environment. e-Learning content might range from complex interactive learning sessions through to static web pages with links. It is now possible to simulate and provide feedback on prescribing decisions and this will improve with advances in virtual reality. Other content might include a student formulary, self-assessment exercises (e.g. calculations), a glossary and an on-line library. There is some evidence for the effectiveness of e-Learning but better research is required into its potential impact on prescribing. PMID:22509885

  3. Evoking prescribed spike times in stochastic neurons

    Science.gov (United States)

    Doose, Jens; Lindner, Benjamin

    2017-09-01

    Single cell stimulation in vivo is a powerful tool to investigate the properties of single neurons and their functionality in neural networks. We present a method to determine a cell-specific stimulus that reliably evokes a prescribed spike train with high temporal precision of action potentials. We test the performance of this stimulus in simulations for two different stochastic neuron models. For a broad range of parameters and a neuron firing with intermediate firing rates (20-40 Hz) the reliability in evoking the prescribed spike train is close to its theoretical maximum that is mainly determined by the level of intrinsic noise.

  4. Blueprint for prescriber continuing education program.

    Science.gov (United States)

    2012-06-01

    On October 25, 2011, the Center for Drug Evaluation and Research (CDER) of the Food and Drug Administration (FDA) posted online this Blueprint for Prescriber Continuing Education, labeled "final," relating to extended-release and long-acting opioids. The pending FDA Risk Evaluation Management Strategy (REMS) requires prescriber education. This document provides guidance to sponsors of these dosage forms in developing the prescvriber education component of their REMS. This report was posted online by the federal agency on October 25, 2011 at: http://www.fda.gov/downloads/drugs/drugsafety/informationbydrugclass/ucm277916.pdf. It is in the public domain.

  5. Conference on natural gas use state regulation and market dynamics in the Post 636/Energy Policy Act Era: Proceedings

    International Nuclear Information System (INIS)

    1993-01-01

    Reports in this Record of Proceedings explore a wide variety of issues related to the regulation of natural gas and its future role as one of the critical fuels that powers the economy of the United States. The focus is mainly on problems, obstacles, barriers, and the incredibly complex system created to bring a fuel from wellhead to burner tip. Individual papers have been cataloged separately

  6. Conference on natural gas use state regulation and market dynamics in the Post 636/Energy Policy Act Era: Proceedings

    Energy Technology Data Exchange (ETDEWEB)

    1993-08-01

    Reports in this Record of Proceedings explore a wide variety of issues related to the regulation of natural gas and its future role as one of the critical fuels that powers the economy of the United States. The focus is mainly on problems, obstacles, barriers, and the incredibly complex system created to bring a fuel from wellhead to burner tip. Individual papers have been cataloged separately.

  7. A UK guide to intake fish-screening regulations, policy and best practice with particular reference to hydroelectric power schemes

    Energy Technology Data Exchange (ETDEWEB)

    Turnpenny, A W.H.; Struthers, G; Hanson, P

    1998-07-01

    A review of fish screening regulations in England, Wales, Scotland, and Northern Ireland is presented, and a summary of findings on screening legislation is given. The views of hydroelectric scheme developers, owners and operators are considered, and recommendations including the development of a risk assessment procedure are discussed. Fish screening technology, bypasses and other escape routes, and common fault in screen design and operation are examined, and guidance to Best Practice is given. (UK)

  8. The impact of marketing practices and its regulation policies on childhood obesity. Opinions of stakeholders in Spain

    OpenAIRE

    Davó-Blanes, M. Carmen; Ortiz-Moncada, Rocío; Gil-González, Diana; Álvarez-Dardet, Carlos; Lobstein, Tim

    2013-01-01

    The aim of this study was to identify Spanish stakeholders’ views on the relationship between childhood obesity and the marketing and advertising of food and beverages aimed at children in Spain, as well as on the corresponding of regulations. We performed a qualitative study based on semi-structured interviews with Stakeholders/Key Informants (KI) from 13 organisations: experts (2), consumer advocates (1), public health advocates (2), food manufacturers (2), advertising advocates (1), govern...

  9. Preschool and School Meal Policies: An Overview of What We Know about Regulation, Implementation, and Impact on Diet in the UK, Sweden, and Australia

    Science.gov (United States)

    Sacks, Gary; Billich, Natassja; Evans, Charlotte Elizabeth Louise

    2017-01-01

    School meals make significant contributions to healthy dietary behaviour, at a time when eating habits and food preferences are being formed. We provide an overview of the approaches to the provision, regulation, and improvement of preschool and primary school meals in the UK, Sweden, and Australia, three countries which vary in their degree of centralisation and regulation of school meals. Sweden has a centralised approach; all children receive free meals, and a pedagogical approach to meals is encouraged. Legislation demands that meals are nutritious. The UK system is varied and decentralised. Meals in most primary schools are regulated by food-based standards, but preschool-specific meal standards only exist in Scotland. The UK uses food groups (starchy foods, fruit and vegetables, proteins and dairy) in a healthy plate approach. Australian States and Territories all employ guidelines for school canteen food, predominantly using a “traffic light” approach outlining recommended and discouraged foods; however, most children bring food from home and are not covered by this guidance. The preschool standards state that food provided should be nutritious. We find that action is often lacking in the preschool years, and suggest that consistent policies, strong incentives for compliance, systematic monitoring, and an acknowledgement of the broader school eating environment (including home provided food) would be beneficial. PMID:28696403

  10. Vulnerability to alcohol-related problems: a policy brief with implications for the regulation of alcohol marketing.

    Science.gov (United States)

    Babor, Thomas F; Robaina, Katherine; Noel, Jonathan K; Ritson, E Bruce

    2017-01-01

    The concern that alcohol advertising can have detrimental effects on vulnerable viewers has prompted the development of codes of responsible advertising practices. This paper evaluates critically the concept of vulnerability as it applies to (1) susceptibility to alcohol-related harm and (2) susceptibility to the effects of marketing, and describes its implications for the regulation of alcohol marketing. We describe the findings of key published studies, review papers and expert reports to determine whether these two types of vulnerability apply to population groups defined by (1) age and developmental history; (2) personality characteristics; (3) family history of alcoholism; (4) female sex and pregnancy risk; and (5) history of alcohol dependence and recovery status. Developmental theory and research suggest that groups defined by younger age, incomplete neurocognitive development and a history of alcohol dependence may be particularly vulnerable because of the disproportionate harm they experience from alcohol and their increased susceptibility to alcohol marketing. Children may be more susceptible to media imagery because they do not have the ability to compensate for biases in advertising portrayals and glamorized media imagery. Young people and people with a history of alcohol dependence appear to be especially vulnerable to alcohol marketing, warranting the development of new content and exposure guidelines focused on protecting those groups to improve current self-regulation codes promoted by the alcohol industry. If adequate protections cannot be implemented through this mechanism, statutory regulations should be considered. © 2016 Society for the Study of Addiction.

  11. The impact of marketing practices and its regulation policies on childhood obesity. Opinions of stakeholders in Spain.

    Science.gov (United States)

    Davó-Blanes, M Carmen; Ortiz-Moncada, Rocío; Gil-González, Diana; Alvarez-Dardet, Carlos; Lobstein, Tim

    2013-03-01

    The aim of this study was to identify Spanish stakeholders' views on the relationship between childhood obesity and the marketing and advertising of food and beverages aimed at children in Spain, as well as on the corresponding of regulations. We performed a qualitative study based on semi-structured interviews with Stakeholders/Key Informants (KI) from 13 organisations: experts (2), consumer advocates (1), public health advocates (2), food manufacturers (2), advertising advocates (1), government representatives (1), child/family/school advocates (2) and media (1). The variables studied were Prevalence of childhood obesity and its relationship to marketing/advertising and Regulation of marketing. In order to identify the most relevant arguments (pearls) in the discourses, a blind independent analysis by four members of the research team was performed. We found that the prevalence of childhood obesity was perceived to be higher than the European average. Self-regulation was identified as the main form of marketing control. Only food manufacturers and advertising agencies considered voluntary action and supervisory procedures to be effective. The other stakeholders advocated state control through legislation and non-state actions such as external assessment and sanctions. Despite the divergence of opinion between stakeholders, there was agreement on the need to improve supervision and to ensure compliance with current self-regulatory codes in Spain. Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. 69-74 A Retrospective Analysis of Prescribing Prac

    African Journals Online (AJOL)

    user

    A Retrospective Analysis of Prescribing Practice Based on WHO Prescribing Indicators at Four. Selected Hospitals of West ... Key words: World Health Organization, prescribing indicators, rational drug use. INTRODUCTION. Indicators of ... factors, the risk of irrational prescribing could raise several folds. Irrational use of ...

  13. Antimalarial prescribing patterns in state hospitals and selected ...

    African Journals Online (AJOL)

    slowdown of progression to resistance could be achieved by improving prescribing practice, drug quality, and patient compliance. Objective: To determine the antimalarial prescribing pattern and to assess rational prescribing of chloroquine by prescribers in government hospitals and parastatals in Lagos State. Methods: ...

  14. Determinants associated with veterinary antimicrobial prescribing in farm animals in the Netherlands: a qualitative study.

    Science.gov (United States)

    Speksnijder, D C; Jaarsma, A D C; van der Gugten, A C; Verheij, T J M; Wagenaar, J A

    2015-04-01

    Antimicrobial use in farm animals might contribute to the development of antimicrobial resistance in humans and animals, and there is an urgent need to reduce antimicrobial use in farm animals. Veterinarians are typically responsible for prescribing and overseeing antimicrobial use in animals. A thorough understanding of veterinarians' current prescribing practices and their reasons to prescribe antimicrobials might offer leads for interventions to reduce antimicrobial use in farm animals. This paper presents the results of a qualitative study of factors that influence prescribing behaviour of farm animal veterinarians. Semi-structured interviews with eleven farm animal veterinarians were conducted, which were taped, transcribed and iteratively analysed. This preliminary analysis was further discussed and refined in an expert meeting. A final conceptual model was derived from the analysis and sent to all the respondents for validation. Many conflicting interests are identifiable when it comes to antimicrobial prescribing by farm animal veterinarians. Belief in the professional obligation to alleviate animal suffering, financial dependency on clients, risk avoidance, shortcomings in advisory skills, financial barriers for structural veterinary herd health advisory services, lack of farmers' compliance to veterinary recommendations, public health interests, personal beliefs regarding the veterinary contribution to antimicrobial resistance and major economic powers are all influential determinants in antimicrobial prescribing behaviour of farm animal veterinarians. Interventions to change prescribing behaviour of farm animal veterinarians could address attitudes and advisory skills of veterinarians, as well as provide tools to deal with (perceived) pressure from farmers and advisors to prescribe antimicrobials. Additional (policy) measures could probably support farm animal veterinarians in acting as a more independent animal health consultant. © 2014 Blackwell

  15. Regulating technological change - The strategic reactions of utility companies towards subsidy policies in the German, Spanish and UK electricity markets

    International Nuclear Information System (INIS)

    Stenzel, Till; Frenzel, Alexander

    2008-01-01

    This paper focuses on how incumbent electric utilities strategically react to subsidy schemes supporting renewable energy technologies in the UK, Germany, and Spain. Firms coordinate the development of their technological capabilities and their political activities to shape their regulatory environment. Analysing the diffusion of wind power in these countries, we show that the different ways, in which firms coordinate their technological and political strategies, lead to very different market outcomes, both for the firms' market share and the size of the overall market. Although incumbents are usually seen as being resistant to change in energy systems, we show that Spanish utilities proactively drive the diffusion of wind power. We speculate about the relation between the ownership structure of the energy system and its inertia with respect to the integration of new technologies. We derive novel policy implications that explicitly take into account the strategic actions of incumbent firms shaping the technological and regulatory system

  16. Vulnerable children, stigmatised smokers: The social construction of target audiences in media debates on policies regulating smoking in vehicles

    Science.gov (United States)

    Bain, Josh; Weishaar, Heide; Semple, Sean; Duffy, Sheila; Hilton, Shona

    2016-01-01

    Following restrictions on smoking in vehicles carrying children in several countries, legislation to safeguard minors from second-hand smoke exposure in vehicles is under-consideration or has been implemented across the United Kingdom. This article presents the first investigation into social constructions of children, smokers and smoking parents in newsprint media and coverage of debates about protecting children from exposure to second-hand smoke in vehicles. Using Scotland as an example, articles on children’s exposure to second-hand smoke published between 1 January 2004 and 16 February 2014 in three Scottish newspapers were identified using Nexis UK. In all, 131 articles were thematically coded and analysed. Children were portrayed as vulnerable and requiring protection, with few articles highlighting children’s ability to voice concerns about the dangers of smoking. Smokers and smoking parents were mainly portrayed in a factual manner, but also frequently as irresponsible and, in some cases, intentionally imposing harm. Individual smokers were blamed for their recklessness, with only a small number of articles mentioning the need to assist smokers in quitting. Supporters of legislation focused on corresponding discourse, whereas critics directed debates towards established arguments against policy, including individual freedom, privacy and problems of enforcement. Focusing on children’s vulnerability to second-hand smoke might have increased support for legislation but risked a side effect of smokers being stigmatised. The media and supporters of public health policy are encouraged to consider appropriate approaches to raise awareness of the health harms of second-hand smoke to children while avoiding unintended stigmatisation of those in which they want to encourage behaviour change. PMID:27457688

  17. Vulnerable children, stigmatised smokers: The social construction of target audiences in media debates on policies regulating smoking in vehicles.

    Science.gov (United States)

    Bain, Josh; Weishaar, Heide; Semple, Sean; Duffy, Sheila; Hilton, Shona

    2017-11-01

    Following restrictions on smoking in vehicles carrying children in several countries, legislation to safeguard minors from second-hand smoke exposure in vehicles is under-consideration or has been implemented across the United Kingdom. This article presents the first investigation into social constructions of children, smokers and smoking parents in newsprint media and coverage of debates about protecting children from exposure to second-hand smoke in vehicles. Using Scotland as an example, articles on children's exposure to second-hand smoke published between 1 January 2004 and 16 February 2014 in three Scottish newspapers were identified using Nexis UK. In all, 131 articles were thematically coded and analysed. Children were portrayed as vulnerable and requiring protection, with few articles highlighting children's ability to voice concerns about the dangers of smoking. Smokers and smoking parents were mainly portrayed in a factual manner, but also frequently as irresponsible and, in some cases, intentionally imposing harm. Individual smokers were blamed for their recklessness, with only a small number of articles mentioning the need to assist smokers in quitting. Supporters of legislation focused on corresponding discourse, whereas critics directed debates towards established arguments against policy, including individual freedom, privacy and problems of enforcement. Focusing on children's vulnerability to second-hand smoke might have increased support for legislation but risked a side effect of smokers being stigmatised. The media and supporters of public health policy are encouraged to consider appropriate approaches to raise awareness of the health harms of second-hand smoke to children while avoiding unintended stigmatisation of those in which they want to encourage behaviour change.

  18. Learning from escaped prescribed fire reviews

    Science.gov (United States)

    Anne E. Black; Dave Thomas; James Saveland; Jennifer D. Ziegler

    2011-01-01

    The U.S. wildland fire community has developed a number of innovative methods for conducting a review following escape of a prescribed fire (expanding on the typical regional or local reviews, to include more of a learning focus - expanded After Action Reviews, reviews that incorporate High Reliability Organizing, Facilitated Learning Analyses, etc). The stated purpose...

  19. Optimization of electronic prescribing in pediatric patients

    NARCIS (Netherlands)

    Maat, B.

    2014-01-01

    Improving pediatric patient safety by preventing medication errors that may result in adverse drug events and consequent healthcare expenditure,is a worldwide challenge to healthcare. In pediatrics, reported medication error rates in general, and prescribing error rates in particular, vary between

  20. Prescribing Behavior of General Practitioners : Competition Matters!

    NARCIS (Netherlands)

    Schaumans, C.B.C.

    2014-01-01

    Background: General Practitioners have limited means to compete. As quality is hard to observe by patients, GPs have incentives to signal quality by using instruments patients perceive as quality. Objectives: We investigate whether GPs exhibit different prescribing behavior (volume and value of

  1. Prescribing behavior of general practitioners : Competition matters!

    NARCIS (Netherlands)

    Schaumans, C.B.C.

    Background General Practitioners (GP) have limited means to compete. As quality is hard to observe by patients, GPs have incentives to signal quality by using instruments patients perceive as quality. Objectives I investigate whether GPs prescribe more units when confronted with more competition. As

  2. Antimalarial Drugs for Pediatrics - Prescribing and Dispensing ...

    African Journals Online (AJOL)

    Purpose: To assess dispensing and prescribing practices with regard to antimalarial drugs for pediatrics in private pharmacies and public hospitals in Dar es Salaam, Tanzania. Methods: This was a cross-sectional, descriptive study that assessed the knowledge and practice of 200 drug dispensers in the private community ...

  3. Cost Evaluation of Commonly Prescribed Antihypertensive Drugs ...

    African Journals Online (AJOL)

    It was also concluded that generic prescription should be encouraged among prescribers to lessen the financial burden of patients because drugs marketed under generic names are usually cheaper than those with brand names. Key words: Brand, Generic,Prescription, Antihypertensives,Cost. [Nig. Jnl Health & Biomedical ...

  4. PRESCRIBING PATTERN OF NON-STEROIDAL ANTI ...

    African Journals Online (AJOL)

    2015-03-01

    Mar 1, 2015 ... Design: A total of 3800 prescriptions containing. NSAIDs were analyzed for information on drug name, the number of NSAIDs per prescription, the presence of ACE inhibitors and diuretics alongside. NSAIDs and NSAIDs prescribed in generic or brand names. Results: The results showed that Aspirin was ...

  5. Prescribing Patterns of Methylphenidate and Atomoxetine for ...

    African Journals Online (AJOL)

    Purpose: To determine the prescribing pattern of methylphenidate and atomoxetine to patients with. Attention-Deficit/Hyperactivity Disorder (ADHD) in South Africa. Methods: A retrospective, cross-sectional pharmacoepidemiological study was conducted based on the data from a medical aid administrator in South Africa for ...

  6. Prescribing Patterns of Methylphenidate and Atomoxetine for ...

    African Journals Online (AJOL)

    Purpose: To determine the prescribing pattern of methylphenidate and atomoxetine to patients with Attention-Deficit/Hyperactivity Disorder (ADHD) in South Africa. Methods: A retrospective, cross-sectional pharmacoepidemiological study was conducted based on the data from a medical aid administrator in South Africa for ...

  7. An atmospheric dispersion index for prescribed burning

    Science.gov (United States)

    Leonidas G. Lavdas

    1986-01-01

    A numerical index that estimates the atmosphere's capacity to disperse smoke from prescribed burning is described. The physical assumptions and mathematical development of the index are given in detail. A preliminary interpretation of dispersion index values is offered. A FORTRAN subroutine package for computing the index is included.

  8. [Prescribing, the perspectives of health professionals].

    Science.gov (United States)

    Debout, Christophe; Lescot, Thomas; Loyer, Frédérique; Ambrosino, Florence

    2016-10-01

    While, in France, various health professionals are authorised to prescribe, they approach this activity in a different way, depending on the professional category to which they belong. The areas and products concerned are specific to each profession, and inevitably evolve. This article presents the different perspectives of a doctor, a midwife and a nurse. Copyright © 2016. Published by Elsevier Masson SAS.

  9. Regulations, guidelines, standards, and policies pertaining to decontamination and decommissioning activities: A literature review. Informal report, Revision 1

    International Nuclear Information System (INIS)

    Cowgill, M.G.

    1994-09-01

    A literature review of the existing rules, regulations, and guidelines pertaining to the decontamination and decommissioning of nuclear facilities has been updated. Included in the survey are US Government documents, national (industrial) standards, international standards and guidelines, and the regulations issued by various national governments, such as the United Kingdom, Canada, and Germany. The Department of Energy (DOE) complex contains within it almost 1,000 nuclear facilities which will require decommissioning in the coming years. This action will entail activities in many different areas, one of which will involve the development of the basic safety principles to be applied to the process as a whole. These principles will be used to guide personnel in the development of safety assessment procedures for decontamination and decommissioning (D and D) activities and in conducting safety assessments of such activities at the facilities themselves. The present report represents an updating of the original report. It retains all the information that appeared in the original report with the new material integrated into the applicable sections. Future revisions will be made as additional information becomes available

  10. Beyond the basics: refills by electronic prescribing.

    Science.gov (United States)

    Goldman, Roberta E; Dubé, Catherine; Lapane, Kate L

    2010-07-01

    E-prescribing is part of a new generation of electronic solutions for the medical industry that may have great potential for improving work flow and communication between medical practices and pharmacies. In the US, it has been introduced with minimal monitoring of errors and general usability. This paper examines refill functionality in e-prescribing software. A mixed method study including focus groups and surveys was conducted. Qualitative data were collected in on-site focus groups or individual interviews with clinicians and medical office staff at 64 physician office practices. Focus group participants described their experiences with the refill functionality of e-prescribing software, provided suggestions for improving it, and suggested improvements in office procedures and software functionality. Overall, approximately 50% reduction in time spent each day on refills was reported. Overall reports of refill functionality were positive; but clinicians and staff identified numerous difficulties and glitches associated managing prescription refills. These glitches diminished over time. Benefits included time saved as well as patient convenience. Potential for refilling without thought because of the ease of use was noted. Clinicians and staff appreciated the ability to track whether patients are filling and refilling prescriptions. E-prescribing software for managing medication refills has not yet reached its full potential. To reduce work flow barriers and medication errors, software companies need to develop error reporting systems and response teams to deal effectively with problems experienced by users. Examining usability issues on both the medical office and pharmacy ends is required to identify the behavioral and cultural changes that accompany technological innovation and ease the transition to full use of e-prescribing software. 2010 Elsevier Ireland Ltd. All rights reserved.

  11. Environmental policy in Japan

    Energy Technology Data Exchange (ETDEWEB)

    Tsuru, Shigeto; Weidner, H. (eds.)

    1989-01-01

    This book deals in English with the most important features of Japanese environmental policy in a number of individual articles by different authors. The various sections report on: 1. History and organization of environmental policy; 2. The role of non-governmental actors in environmental policy (large industries); 3. Special features of environmental policies and problems; 4. Classical pollution control areas: Regulations and effects; 5. Environmental problems in a broader perspective (nature conservation); 6. Policy areas with influence on environmental quality; 7. Environmental monitoring and reporting; 8. Japanese environmental policy in an international perspective (preventive policies, developing countries). (HSCH).

  12. OpenPrescribing: normalised data and software tool to research trends in English NHS primary care prescribing 1998-2016.

    Science.gov (United States)

    Curtis, Helen J; Goldacre, Ben

    2018-02-23

    We aimed to compile and normalise England's national prescribing data for 1998-2016 to facilitate research on long-term time trends and create an open-data exploration tool for wider use. We compiled data from each individual year's national statistical publications and normalised them by mapping each drug to its current classification within the national formulary where possible. We created a freely accessible, interactive web tool to allow anyone to interact with the processed data. We downloaded all available annual prescription cost analysis datasets, which include cost and quantity for all prescription items dispensed in the community in England. Medical devices and appliances were excluded. We measured the extent of normalisation of data and aimed to produce a functioning accessible analysis tool. All data were imported successfully. 87.5% of drugs were matched exactly on name to the current formulary and a further 6.5% to similar drug names. All drugs in core clinical chapters were reconciled to their current location in the data schema, with only 1.26% of drugs not assigned a current chemical code. We created an openly accessible interactive tool to facilitate wider use of these data. Publicly available data can be made accessible through interactive online tools to help researchers and policy-makers explore time trends in prescribing. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  13. Time series analysis of forest carbon dynamics: recovery of Pinus palustris physiology following a prescribed fire

    Science.gov (United States)

    G. Starr; C. L. Staudhammer; H. W. Loescher; R. Mitchell; A. Whelan; J. K. Hiers; J. J. O’Brien

    2015-01-01

    Frequency and intensity of fire determines the structure and regulates the function of savanna ecosystems worldwide, yet our understanding of prescribed fire impacts on carbon in these systems is rudimentary. We combined eddy covariance (EC) techniques and fuel consumption plots to examine the short-term response of longleaf pine forest carbon dynamics to one...

  14. Inappropriate prescribing and prescribing omissions among drug-related problems using STOPP-START criteria

    NARCIS (Netherlands)

    Verdoorn, M.A.; Kwint, H.-F.; Faber, A.; L. Bouvy, M.

    2013-01-01

    Background and objectives: Medication review has been suggested as a way to prevent drug related problems (DRPs). Screening tools have been formulated to identify potentially inappropriate medicines (PIMs) and potential prescribing omissions (PPOs) respectively called Screening Tool of Older

  15. Accounting for medical variation: the case of prescribing activity in a New Zealand general practice sample.

    Science.gov (United States)

    Davis, P B; Yee, R L; Millar, J

    1994-08-01

    Medical practice variation is extensive and well documented, particularly for surgical interventions, and raises important questions for health policy. To date, however, little work has been carried out on interpractitioner variation in prescribing activity in the primary care setting. An analytical model of medical variation is derived from the literature and relevant indicators are identified from a study of New Zealand general practice. The data are based on nearly 9,500 completed patient encounter records drawn from over a hundred practitioners in the Waikato region of the North Island, New Zealand. The data set represents a 1% sample of all weekday general practice office encounters in the Hamilton Health District recorded over a 12-month period. Overall levels of prescribing, and the distribution of drug mentions across diagnostic groupings, are broadly comparable to results drawn from international benchmark data. A multivariate analysis is carried out on seven measures of activity in the areas of prescribing volume, script detail, and therapeutic choice. The analysis indicates that patient, practitioner and practice attributes exert little systematic influence on the prescribing task. The principal influences are diagnosis, followed by practitioner identity. The pattern of findings suggests also that the prescribing task cannot be viewed as an undifferentiated activity. It is more usefully considered as a process of decision-making in which 'core' judgements--such as the decision to prescribe and the choice of drug--are highly predictable and strongly influenced by diagnosis, while 'peripheral' features of the task--such as choosing a combination drug or prescribing generically--are less determinate and more subject to the exercise of clinical discretion.(ABSTRACT TRUNCATED AT 250 WORDS)

  16. Uganda; Financial System Stability Assessment, including Reports on the Observance of Standards and Codes on the following topics: Monetary and Financial Policy Transparency, Banking Supervision, Securities Regulation, and Payment Systems

    OpenAIRE

    International Monetary Fund

    2003-01-01

    This paper presents findings of Uganda’s Financial System Stability Assessment, including Reports on the Observance of Standards and Codes on Monetary and Financial Policy Transparency, Banking Supervision, Securities Regulation, Insurance Regulation, Corporate Governance, and Payment Systems. The banking system in Uganda, which dominates the financial system, is fundamentally sound, more resilient than in the past, and currently poses no threat to macroeconomic stability. A major disruption ...

  17. 75 deaths in asthmatics prescribed home nebulisers.

    Science.gov (United States)

    Sears, M R; Rea, H H; Fenwick, J; Gillies, A J; Holst, P E; O'Donnell, T V; Rothwell, R P

    1987-02-21

    The circumstances surrounding the deaths of 75 asthmatic patients who had been prescribed a domiciliary nebuliser driven by an air compressor pump for administration of high dose beta sympathomimetic drugs were investigated as part of the New Zealand national asthma mortality study. Death was judged unavoidable in 19 patients who seemed to have precipitous attacks despite apparently good long term management. Delays in seeking medical help because of overreliance on beta agonist delivered by nebuliser were evident in 12 cases and possible in a further 11, but these represented only 8% of the 271 verified deaths from asthma in New Zealanders aged under 70 during the period. Evidence for direct toxicity of high dose beta agonist was not found. Nevertheless, the absence of serum potassium and theophylline concentrations and of electrocardiographic monitoring in the period immediately preceding death precluded firm conclusions whether arrhythmias might have occurred due to these factors rather than to hypoxia alone. In most patients prescribed domiciliary nebulisers death was associated with deficiencies in long term and short term care similar to those seen in patients without nebulisers. Discretion in prescribing home nebulisers, greater use of other appropriate drugs, including adequate corticosteroids, and careful supervision and instruction of patients taking beta agonist by nebuliser should help to reduce the mortality from asthma.

  18. What Does ePrescribing Mean for Patients? A Case Study of the Perspectives of Hospital Renal Patients

    Directory of Open Access Journals (Sweden)

    Lisa Lee

    2015-11-01

    Full Text Available BACKGROUND: Hospital ePrescribing systems are expected to improve quality of care for patients, yet the perspectives of patients themselves have seldom been explored in the context of ePrescribing deployments.OBJECTIVE: We sought to understand the significance of ePrescribing for patients through a case study of renal in-patients on a hospital ward, before and after the introduction of an ePrescribing system.METHODS: Three data sources were drawn on as part of the case study: interviews with representatives from national patient groups (n = 10, in-patients on a renal ward (n = 11 pre-implementation; n = 12 post-implementation and fieldnotes (n = 25 of observations made on the case study ward. Data were analysed thematically focusing on: (1 perceived benefits of ePrescribing; (2 patient awareness and understanding of the medications prescribed and (3 patient views on medicines reconciliation at admission and discharge.RESULTS: While ePrescribing was viewed positively overall, its implementation in the case study site failed to address the lack of patient involvement in the prescribing process and poor medication counselling upon discharge. Importantly, the limited impact of the ePrescribing system in these particular areas appeared to be the result of institutional and cultural practices rather than solely technological factors.CONCLUSIONS: The introduction of ePrescribing systems offers new opportunities to improve sharing of knowledge and communication with all those involved in the patient’s care pathways, including patients, carers and healthcare professionals across diverse care settings. Achieving this will, first and foremost, require significant cultural and policy shifts in how the patient’s role is perceived by clinicians in relation to medicines management.

  19. Prescriber and staff perceptions of an electronic prescribing system in primary care: a qualitative assessment

    Directory of Open Access Journals (Sweden)

    Sittig Dean F

    2010-11-01

    Full Text Available Abstract Background The United States (US Health Information Technology for Economic and Clinical Health Act of 2009 has spurred adoption of electronic health records. The corresponding meaningful use criteria proposed by the Centers for Medicare and Medicaid Services mandates use of computerized provider order entry (CPOE systems. Yet, adoption in the US and other Western countries is low and descriptions of successful implementations are primarily from the inpatient setting; less frequently the ambulatory setting. We describe prescriber and staff perceptions of implementation of a CPOE system for medications (electronic- or e-prescribing system in the ambulatory setting. Methods Using a cross-sectional study design, we conducted eight focus groups at three primary care sites in an independent medical group. Each site represented a unique stage of e-prescribing implementation - pre/transition/post. We used a theoretically based, semi-structured questionnaire to elicit physician (n = 17 and staff (n = 53 perceptions of implementation of the e-prescribing system. We conducted a thematic analysis of focus group discussions using formal qualitative analytic techniques (i.e. deductive framework and grounded theory. Two coders independently coded to theoretical saturation and resolved discrepancies through discussions. Results Ten themes emerged that describe perceptions of e-prescribing implementation: 1 improved availability of clinical information resulted in prescribing efficiencies and more coordinated care; 2 improved documentation resulted in safer care; 3 efficiencies were gained by using fewer paper charts; 4 organizational support facilitated adoption; 5 transition required time; resulted in workload shift to staff; 6 hardware configurations and network stability were important in facilitating workflow; 7 e-prescribing was time-neutral or time-saving; 8 changes in patient interactions enhanced patient care but required education; 9 pharmacy

  20. Secular trends in opioid prescribing in the USA

    Directory of Open Access Journals (Sweden)

    Pezalla EJ

    2017-02-01

    Full Text Available Edmund J Pezalla,1 David Rosen,2 Jennifer G Erensen,2 J David Haddox,2,3 Tracy J Mayne2 1Bioconsult, LLC, Wethersfield, 2Purdue Pharma L.P., Stamford, CT, 3Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA Abstract: Opioid abuse and misuse in the USA is a public health crisis. The use of prescription opioid analgesics increased substantially from 2002 through 2010, then plateaued and began to decrease in 2011. This study examined prescriptions of branded and generic immediate- and extended-release opioid analgesics from 1992 to 2016. This was juxtaposed against state and federal policies designed to decrease overutilization and abuse, as well as the launch of new opioid products, including opioids with abuse-deterrent properties (OADPs. The data indicate that these health policies, including the utilization and reimbursement of OADPs, have coincided with decreased opioid utilization. The hypothesis that OADPs will paradoxically increase opioid prescribing is not supported. Keywords: OADP, prescription, utilization trends, legislation, opioids

  1. Ministerial Decree of 26 October 1966 concerning Regulations governing the procedure for granting of the clearance certificate prescribed by Section 34 of the Decree of the President of the Republic No. 185 of 13 February 1964 for category B commercial operations concerning ores, source materials and radioactive materials within the meaning of Section 4 of Act No. 1860 of 31 December 1962

    International Nuclear Information System (INIS)

    1966-01-01

    This Decree was made in implementation of DPR No. 185 which prescribes that a clearance certificate will be required from the Ministry of Industry within 30 days of the conclusion of the enquiry concerning the application for such a certificate. (NEA) [fr

  2. 48 CFR 2001.301 - Policy.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Policy. 2001.301 Section 2001.301 Federal Acquisition Regulations System NUCLEAR REGULATORY COMMISSION GENERAL NUCLEAR REGULATORY COMMISSION ACQUISITION REGULATION SYSTEM Agency Acquisition Regulations 2001.301 Policy. Policy...

  3. Does non-medical prescribing make a difference to patients?

    Science.gov (United States)

    Carey, Nicola; Stenner, Karen

    This article examines the literature on non-medical prescribing to establish its impact on UK healthcare. It discusses how better access to medication through non-medical prescribing can improve patient safety and patient-centred care, and how nurse prescribing can help ensure quality of care in the NHS during the current financial crisis.

  4. Antibiotic Utilization and Prescribing Patterns in a Nigerian ...

    African Journals Online (AJOL)

    The study of prescribing pattern seeks to monitor, evaluate and suggest a modification in prescriber's prescribing habits so as to make medical care rational and cost effective. Information about antibiotic use pattern is necessary for a constructive approach to problems that arise from multiple antibiotics available. To identify ...

  5. Out-Patient Prescribing Practices at Mbagathi District Hospital ...

    African Journals Online (AJOL)

    On average, each patient was prescribed 3.85 types of drugs. A total of 835 drugs were prescribed by generic name, accounting for 25.6% of total number of drugs prescribed (1,506). Out of 391 sampled prescriptions, 266 had antibiotics accounting for (68.0%). A relatively small proportion of the prescriptions, 9.5% had an ...

  6. Using relative humidity to predict spotfire probability on prescribed burns

    Science.gov (United States)

    John R. Weir

    2007-01-01

    Spotfires have and always will be a problem that burn bosses and fire crews will have to contend with on prescribed burns. Weather factors (temperature, wind speed and relative humidity) are the main variables burn bosses can use to predict and monitor prescribed fire behavior. At the Oklahoma State University Research Range, prescribed burns are conducted during...

  7. The policy-practice gap: describing discordances between regulation on paper and real-life practices among specialized drug shops in Kenya.

    Science.gov (United States)

    Wafula, Francis; Abuya, Timothy; Amin, Abdinasir; Goodman, Catherine

    2014-09-16

    Specialized drug shops (SDSs) are popular in Sub-Saharan Africa because they provide convenient access to medicines. There is increasing interest in how policymakers can work with them, but little knowledge on how their operation relates to regulatory frameworks. This study sought to describe characteristics and predictors of regulatory practices among SDSs in Kenya. The regulatory framework governing the Kenya pharmaceutical sector was mapped, and a list of regulations selected for inclusion in a survey questionnaire. An SDS census was conducted, and survey data collected from 213 SDSs from two districts in Western Kenya. The majority of SDSs did not comply with regulations, with only 12% having a refrigerator and 22% having a separate dispensing area for instance. Additionally, less than half had at least one staff with pharmacy qualification (46%), with less than a third of all interviewed operators knowing the name of the law governing pharmacy.Regulatory infringement was more common among SDSs in rural locations; those that did not have staff with pharmacy qualifications; and those whose operator did not know the name of the pharmacy law. Compliance was not significantly associated with the frequency of inspections, with over 80% of both rural and urban SDSs reporting an inspection in the past year. While compliance was low overall, it was particularly poor among SDSs operating in rural locations, and those that did not have staff with pharmacy qualification. This suggested the need for policy to introduce levels of practice in recognition of the variations in resource availability. Under such a system, rural SDSs operating in low-resource setting, and selling a limited range of medicines, may be exempted from certain regulatory requirements, as long as their scope of practice is limited to certain essential services only. Future research should also explore why regulatory compliance is poor despite regular inspections.

  8. EU Competition Policy Since 1990

    DEFF Research Database (Denmark)

    Bartalevich, Dzmitry

    2013-01-01

    in anticartel enforcement policies, antimonopoly regulation, and the regulation of mergers and acquisitions. The purpose of this article is to fill the gap by attempting to link EU competition policy with U.S. antitrust, provide a critical overview of the most important elements of European competition policy......, and merger control....

  9. A methodological protocol for selecting and quantifying low-value prescribing practices in routinely collected data: an Australian case study.

    Science.gov (United States)

    Brett, Jonathan; Elshaug, Adam G; Bhatia, R Sacha; Chalmers, Kelsey; Badgery-Parker, Tim; Pearson, Sallie-Anne

    2017-05-03

    Growing imperatives for safety, quality and responsible resource allocation have prompted renewed efforts to identify and quantify harmful or wasteful (low-value) medical practices such as test ordering, procedures and prescribing. Quantifying these practices at a population level using routinely collected health data allows us to understand the scale of low-value medical practices, measure practice change following specific interventions and prioritise policy decisions. To date, almost all research examining health care through the low-value lens has focused on medical services (tests and procedures) rather than on prescribing. The protocol described herein outlines a program of research funded by Australia's National Health and Medical Research Council to select and quantify low-value prescribing practices within Australian routinely collected health data. We start by describing our process for identifying and cataloguing international low-value prescribing practices. We then outline our approach to translate these prescribing practices into indicators that can be applied to Australian routinely collected health data. Next, we detail methods of using Australian health data to quantify these prescribing practices (e.g. prevalence of low-value prescribing and related costs) and their downstream health consequences. We have approval from the necessary Australian state and commonwealth human research ethics and data access committees to undertake this work. The lack of systematic and transparent approaches to quantification of low-value practices in routinely collected data has been noted in recent reviews. Here, we present a methodology applied in the Australian context with the aim of demonstrating principles that can be applied across jurisdictions in order to harmonise international efforts to measure low-value prescribing. The outcomes of this research will be submitted to international peer-reviewed journals. Results will also be presented at national and

  10. Risk evaluation and mitigation strategies (REMS): educating the prescriber.

    Science.gov (United States)

    Nicholson, Susan C; Peterson, Janet; Yektashenas, Behin

    2012-02-01

    The US FDA Amendments Act of 2007 was signed into law on 27 September 2007. A provision of this law granted the FDA new powers to enhance drug safety by requiring the pharmaceutical industry to develop Risk Evaluation and Mitigation Strategies (REMS). REMS are deemed necessary when a question exists as to whether the benefits of a drug outweigh its risks. REMS constitute a safety plan with several potential components, including a medication guide, a communication plan, elements to ensure safe use and an implementation system to help guide the prescribers, pharmacists and patients. This applies to existing drugs on the market, new drug applications (NDAs), abbreviated NDAs (generics) and biologics licence applications. REMS represent an 'upgrade' from previously required risk minimization action plans, based on the strengthening of FDA powers of authority and enforceability to incur monetary penalties against individuals representing the pharmaceutical industry who fail to comply. For illustrative purposes, we chose the drug romiplostim (Nplate®) to present an REMS, as all components were utilized to help assuage risks associated with the drug. Romiplostim is an FDA-approved drug used to treat thrombocytopenia in patients with chronic immune (idiopathic) thrombocytopenic purpura that has a significant adverse safety profile based on the risk of changes in bone marrow reticulin formation and bone marrow fibroses, and other associated risks. This review of current REMS policy is intended to provide the prescriber with a better understanding of current modalities in FDA-mandated drug safety programmes, which will impact day-to-day healthcare provider practices.

  11. Assessing predictors of intention to prescribe sick leave among primary care physicians using the theory of planned behaviour.

    Science.gov (United States)

    Swarna Nantha, Yogarabindranath; Wee, Lei Hum; Chan, Caryn Mei-Hsien

    2018-01-16

    Providing sickness certification is a decision that primary care physicians make on a daily basis. The majority of sickness certification studies in the literature involve a general assessment of physician or patient behaviour without the use of a robust psychological framework to guide research accuracy. To address this deficiency, this study utilized the Theory of Planned Behaviour (TPB) to specifically gauge the intention and other salient predictors related to sickness certification prescribing behaviour amongst primary care physicians. A cross-sectional study was conducted among N = 271 primary care physicians from 86 primary care practices throughout two states in Malaysia. Questionnaires used were specifically developed based on the TPB, consisting of both direct and indirect measures related to the provision of sickness leave. Questionnaire validity was established through factor analysis and the determination of internal consistency between theoretically related constructs. The temporal stability of the indirect measures was determined via the test-retest correlation analysis. Structural equation modelling was conducted to determine the strength of predictors related to intentions. The mean scores for intention to provide patients with sickness was low. The Cronbach α value for the direct measures was good: overall physician intent to provide sick leave (0.77), physician attitude towards prescribing sick leave for patients (0.77) and physician attitude in trusting the intention of patients seeking sick leave (0.83). The temporal stability of the indirect measures of the questionnaire was satisfactory with significant correlation between constructs separated by an interval of two weeks (p sick leave to patients. An integrated behavioural model utilizing the TPB could help fully explain the complex act of providing sickness leave to patients. Findings from this study could assist relevant agencies to facilitate the creation of policies that may help

  12. [Prescribed drugs - a new crime field?].

    Science.gov (United States)

    Schwarzenbrunner, Thomas

    2014-12-01

    The first chapter of the following article discusses measures in terms of substitution treatment of a program of the Austrian Minister of the Interior. The relevance of psychosocial measures and aims of substitution treatment for opioid-dependent patients is illuminated. The abstinence as the only goal definition is modified and by the results of the study PREMOS a target differentiation at addiction work is illustrated. The second chapter addresses the misuse of prescribed drugs. Thereby police report data will be analyzed and the market situation of opioids will be outlined.

  13. How to prescribe physical exercise in rheumatology

    Directory of Open Access Journals (Sweden)

    S. Maddali Bongi

    2011-06-01

    Full Text Available Physical exercise, aiming to improve range of movement, muscle strength and physical well being, lately substituted the immobilization previously prescribed in rheumatic diseases. International guidelines, recommendations of Scientific Societies, and structured reviews regard physical exercise as of pivotal importance in treating rheumatoid arthritis, ankylosing spondylitis, osteoarthritis, fibromyalgia syndrome, osteoporosis, and to be considered in connective tissue diseases. Therapeutic exercise should: aim to improve firstly local symptoms and then general health; respect the pain threshold; be a part of a treatment including pharmacological therapies and other rehabilitation techniques, be administered by skilled physiotherapist under the guide of a rheumatologist, be different according to different diseases, disease phases and patient expectations.

  14. Prescribing tests must have curriculum support

    Directory of Open Access Journals (Sweden)

    Lemon TI

    2013-05-01

    Full Text Available Rupali D Shah, Thomas I LemonSchool of Medicine, Cardiff University, University Hospital of Wales, Cardiff, WalesGordon, Catchpole and Baker1 have discussed and investigated a very interesting, currently relevant, subject in medical education; particularly with the introduction of the prescribing test for undergraduates trialled in the UK this year and set to become a fully-fledged part of the curriculum and assessment criteria for 2014 graduates.2 It would of course be of great interest to compare the themes discussed in this paper and see they how would compare to recent graduates in late 2014.View original paper by Gordon and colleagues.

  15. CEP energy policy : Policy 917

    International Nuclear Information System (INIS)

    2002-10-01

    Some of the environmental challenges facing the world in the twenty-first century are energy and global warming. Vital human needs such as warmth, light and transportation require energy, which is also required in the production of goods. Absent from the debate concerning the energy industry and its efforts to stop climate change is the voice of energy workers. Previous policies from the Communications, Energy and Paperworkers Union of Canada (CEP) were replaced by this policy document. After providing a brief introduction, the document tackled global challenge: climate change. The following section dealt with global challenge: corporate rule. Canada's energy industries were examined from the workers' perspective, and the state of Canada's energy reserves was discussed. From national policies to national betrayal was the title of the following section of the document. Energy de-regulation and privatization was discussed, and an argument was made for a Canadian energy policy. The industrial policy was explored, as was the environment. A transition to sustainability was examined. refs

  16. Qualitative analysis of multi-disciplinary round-table discussions on the acceleration of benefits and data analytics through hospital electronic prescribing (ePrescribing systems

    Directory of Open Access Journals (Sweden)

    Kathrin Cresswell

    2016-07-01

    Full Text Available Background: Electronic systems that facilitate prescribing, administration and dispensing of medicines (ePrescribing systems are at the heart of international efforts to improve the safety, quality and efficiency of medicine management. Considering the initial costs of procuring and maintaining ePrescribing systems, there is a need to better understand how to accelerate and maximise the financial benefits associated with these systems. Objectives: We sought to investigate how different sectors are approaching the realisation of returns on investment from ePrescribing systems in U.K. hospitals and what lessons can be learned for future developments and implementation strategies within healthcare settings. Methods: We conducted international, multi-disciplinary, round-table discussions with 21 participants from different backgrounds including policy makers, healthcare organisations, academic researchers, vendors and patient representatives. The discussions were audio-recorded, transcribed and then thematically analysed with the qualitative analysis software NVivo10. Results: There was an over-riding concern that realising financial returns from ePrescribing systems was challenging. The underlying reasons included substantial fixed costs of care provision, the difficulties in radically changing the medicines management process and the lack of capacity within NHS hospitals to analyse and exploit the digital data being generated. Any future data strategy should take into account the need to collect and analyse local and national data (i.e. within and across hospitals, setting comparators to measure progress (i.e. baseline measurements and clear standards guiding data management so that data are comparable across settings. Conclusions: A more coherent national approach to realising financial benefits from ePrescribing systems is needed as implementations progress and the range of tools to collect information will lead to exponential data growth. The

  17. The assessment on impact of essential drugs policy on primary health care system in rural areas of Shandong Province policy and regulation division of the Health Department of Shandong Province.

    Science.gov (United States)

    Li, Zhuge; Shu, Defeng; Xia, Mei; Gao, Dehai; Lu, Dan; Huang, Ning; Tian, Xiaoqing; An, Limei; Li, Shixue; Li, Sheng

    2015-01-01

    At present, China has achieved an initial establishment and gradual implementation of a framework for national essential drugs policy. With the further implementation of the national essential drugs policy, it is not clear how the policy works, whether it achieves the original intention of essential drugs policy, and what impact essential drugs policy exerts on the primary health care system. In view of it, we conducted a field research on sample areas of Shandong Province to understand the conditions of the implementation of the essential drugs policy in Shandong Province. From three perspectives of medical institutions, patients and medical staff, this thesis analyzes the impact of essential drugs policy on village-level and township-level health service system, summarizes the effectiveness of implementing essential drugs policy, discovers the problems of various aspects and conducts an in-depth analysis of the causes, and puts forward feasible suggestions to provide reference for improving the essential drugs policy. The assessment results show that the implementation of essential drugs policy in Shandong Province has played a positive role in promoting the sound development of the primary health care system, changed the situation of covering hospital expenses with medicine revenue in the past, contributed to the return of medical institutions to public welfare, and reduced the patient's economic burden of disease. But there emerge many problems as follows: impact on the doctor's diagnosis and treatment due to incompleteness of drug types, and distribution not in place, patient loss and operational difficulty of village clinic. Thus, this thesis makes recommendations of drugs catalog formulation, drug procurement, sales and use, and meanwhile points out that the supporting financial compensation policy and performance appraisal policy and other measures in place are a prerequisite for a positive role of essential drugs policy.

  18. A new approach to formulating and appraising drug policy: A multi-criterion decision analysis applied to alcohol and cannabis regulation

    NARCIS (Netherlands)

    Rogeberg, Ole; Bergsvik, Daniel; Phillips, Lawrence D.; van Amsterdam, Jan; Eastwood, Niamh; Henderson, Graeme; Lynskey, Micheal; Measham, Fiona; Ponton, Rhys; Rolles, Steve; Schlag, Anne Katrin; Taylor, Polly; Nutt, David

    2018-01-01

    Drug policy, whether for legal or illegal substances, is a controversial field that encompasses many complex issues. Policies can have effects on a myriad of outcomes and stakeholders differ in the outcomes they consider and value, while relevant knowledge on policy effects is dispersed across

  19. Controlled Substance Prescribing Patterns--Prescription Behavior Surveillance System, Eight States, 2013.

    Science.gov (United States)

    Paulozzi, Leonard J; Strickler, Gail K; Kreiner, Peter W; Koris, Caitlin M

    2015-10-16

    or benzodiazepine of choice is unexplained. Most opioid prescribing occurs among a small minority of prescribers. Most of the prescriptions by top-decile prescribers probably are written by general, family medicine, internal medicine, and midlevel practitioners. The source of payment varied by state, for reasons that are unclear. Persons who are prescribed opioids also are commonly prescribed benzodiazepine sedatives despite the risk for additive depressant effects. States can use their prescription drug monitoring programs to generate population-based measures for the prescribing of controlled substances and for behaviors that suggest their misuse. Comparing data with other states and tracking changes in these measures over time can be useful in measuring the effect of policies designed to reduce prescription drug misuse.

  20. “Comprehensive emission measurements from prescribed ...

    Science.gov (United States)

    Simultaneous aerial- and ground-based emission sampling was conducted during prescribed burns at Eglin Air Force Base in November 2012 on a short grass/shrub field and a pine forest. Cumulative emission samples for volatile organic comounds, elemental carbon, organic carbon, chlorinated dioxins and furans, and PM2.5 and continuous samples for black carbon, particle size, and CO2 were taken. Aerial instruments were lofted using a 5 m diameter, helium-filled aerostat that was maneuvered with two remotely-controlled tethers mounted on all-terrain vehicles. A parallel set of instruments on the ground made simultaneous measurements, allowing for a comparison of ground level versus elevated measurements. Ground instruments were supplemented by additional measurements of polycyclic aromatic hydrocarbons and particle aerosol absorption and light scattering. Raw biomass was also gathered on site and tested in a laboratory combustion facility using the same array of instruments. This work compares emissions derived from aerial and ground sampling as well as field and laboratory results. This abstract will likely be the first ever prescribed burn study to compare laboratory and field emission results with results from aerial and and ground sampling. As such it will inform sampling methods for future events and determine the ability of laboratory simulations to mimic events inthe field.

  1. Personal and professional challenges of nurse prescribing in Ireland.

    Science.gov (United States)

    McBrien, Barry

    This article presents the challenges regarding the development of a collaborative practice agreement in order to undertake nurse prescribing in an emergency department in a large teaching hospital. Nurse prescribing has been introduced quite recently in Ireland. Although there is a plethora of knowledge regarding the topic, there are many personal and professional challenges in relation to this emerging role. The nurse prescribing initiative in Ireland is continually developing and many nurses now have the authority to prescribe from almost the same range of medicines as doctors. Prescribing has the potential to improve job satisfaction, autonomy and ultimately improves patient outcomes. However, nurses need to be cognisant of the impact it can have on the dynamics of the healthcare team. An analysis of some complexities of nurse prescribing is given, in conjunction with reflective thoughts on a clinical incident in the area of morphine prescribing.

  2. Non- medical prescribing in Australasia and the UK: the case of podiatry

    Directory of Open Access Journals (Sweden)

    Nancarrow Susan A

    2010-01-01

    Full Text Available Abstract Background The last decade has witnessed a rapid transformation in the role boundaries of the allied health professions, enabled through the creation of new roles and the expansion of existing, traditional roles. A strategy of health care 'modernisation' has encompassed calls for the redrawing of professional boundaries and identities, linked with demands for greater workforce flexibility. Several tasks and roles previously within the exclusive domain of medicine have been delegated to, or assumed by, allied health professionals, as the workforce is reshaped to meet the challenges posed by changing demographic, social and political contexts. The prescribing of medicines by non-medically qualified healthcare professionals, and in particular the podiatry profession, reflects these changes. Methods Using a range of key primary documentary sources derived from published material in the public domain and unpublished material in private possession, this paper traces the development of contemporary UK and Australasian podiatric prescribing, access, supply and administration of medicines. Documentary sources include material from legislative, health policy, regulatory and professional bodies (including both State and Federal sources in Australia. Results Tracing a chronological, comparative, socio-historical account of the emergence and development of 'prescribing' in podiatry in both Australasia and the UK enables an analysis of the impact of health policy reforms on the use of, and access to, medicines by podiatrists. The advent of neo-liberal healthcare policies, coupled with demands for workforce flexibility and role transfer within a climate of demographic, economic and social change has enabled allied health professionals to undertake an expanding number of tasks involving the sale, supply, administration and prescription of medicines. Conclusion As a challenge to medical dominance, these changes, although driven by wider healthcare

  3. Implementing nurse prescribing: a case study in diabetes.

    Science.gov (United States)

    Stenner, Karen; Carey, Nicola; Courtenay, Molly

    2010-03-01

    This paper is a report of a study exploring the views of nurses and team members on the implementation of nurse prescribing in diabetes services. Nurse prescribing is adopted as a means of improving service efficiency, particularly where demand outstretches resources. Although factors that support nurse prescribing have been identified, it is not known how these function within specific contexts. This is important as its uptake and use varies according to mode of prescribing and area of practice. A case study was undertaken in nine practice settings across England where nurses prescribed medicines for patients with diabetes. Thematic analysis was conducted on qualitative data from 31 semi-structured interviews undertaken between 2007 and 2008. Participants were qualified nurse prescribers, administrative staff, physicians and non-nurse prescribers. Nurses prescribed more often following the expansion of nurse independent prescribing rights in 2006. Initial implementation problems had been resolved and few current problems were reported. As nurses' roles were well-established, no major alterations to service provision were required to implement nurse prescribing. Access to formal and informal resources for support and training were available. Participants were accepting and supportive of this initiative to improve the efficiency of diabetes services. The main factors that promoted implementation of nurse prescribing in this setting were the ability to prescribe independently, acceptance of the prescribing role, good working relationships between doctors and nurses, and sound organizational and interpersonal support. The history of established nursing roles in diabetes care, and increasing service demand, meant that these diabetes services were primed to assimilate nurse prescribing.

  4. Growth of nurse prescribing competence: facilitators and barriers during education.

    Science.gov (United States)

    Hopia, Hanna; Karhunen, Anne; Heikkilä, Johanna

    2017-10-01

    To describe facilitators and barriers in relation to the growth of nurse prescribing competence from the perspective of the nurses studying in a prescribing programme. The number of nurses enrolled in a nurse prescribing programme is rapidly increasing in Finland. However, few studies on nurse prescribing education are available and therefore research is needed, particularly from the point of view of nurses studying in the programme. The descriptive, qualitative study used the text of student online learning diaries as data during a 14-month prescribing programme. The sample consisted of 31 nurses, public health nurses or midwives enrolled in a prescribing programme at a university of applied sciences. The data were analysed using the inductive analysis method. The growth of nurses' prescribing competence was facilitated by learning clinical examination of the patient, networking with peers, receiving support from the workplace and supervisors, doctors' positive attitude towards nurse prescribing and being able to apply competencies directly to nursing practice. The barriers to the growth of nurses' prescribing competence were unclear job description, incomplete care plans and concerns about how consultation with doctors will be organised and realised. The results show that, for the purpose of developing the new role and position of nurse prescribers, educators and nursing managers must invest more in staff awareness of nurse prescribing education and also offer more support to nurse prescribers in their workplaces. The results of this study can be used especially in countries where nurse prescribing education is only in the process of being planned or has just been started. Heads of nursing and educators in prescribing education will benefit from the results when creating expanded job descriptions for nurses and supporting networking between students during the period of training. © 2016 John Wiley & Sons Ltd.

  5. Regulating Internalities

    OpenAIRE

    Sunstein, Cass Robert; Allcott, Hunt

    2015-01-01

    This paper offers a framework for regulating internalities. Using a simple economic model, we provide four principles for designing and evaluating behaviorally-motivated policy. We then outline rules for determining which contexts reliably reflect true preferences and discuss empirical strategies for measuring internalities. As a case study, we focus on energy efficiency policy, including Corporate Average Fuel Economy (CAFE) standards and appliance and lighting energy efficiency standards.

  6. Access to essential medicines in Pakistan: policy and health systems research concerns.

    Directory of Open Access Journals (Sweden)

    Shehla Zaidi

    Full Text Available INTRODUCTION: Inadequate access to essential medicines is a common issue within developing countries. Policy response is constrained, amongst other factors, by a dearth of in-depth country level evidence. We share here i gaps related to access to essential medicine in Pakistan; and ii prioritization of emerging policy and research concerns. METHODS: An exploratory research was carried out using a health systems perspective and applying the WHO Framework for Equitable Access to Essential Medicine. Methods involved key informant interviews with policy makers, providers, industry, NGOs, experts and development partners, review of published and grey literature, and consultative prioritization in stakeholder's Roundtable. FINDINGS: A synthesis of evidence found major gaps in essential medicine access in Pakistan driven by weaknesses in the health care system as well as weak pharmaceutical regulation. 7 major policy concerns and 11 emerging research concerns were identified through consultative Roundtable. These related to weaknesses in medicine registration and quality assurance systems, unclear and counterproductive pricing policies, irrational prescribing and sub-optimal drug availability. Available research, both locally and globally, fails to target most of the identified policy concerns, tending to concentrate on irrational prescriptions. It overlooks trans-disciplinary areas of policy effectiveness surveillance, consumer behavior, operational pilots and pricing interventions review. CONCLUSION: Experience from Pakistan shows that policy concerns related to essential medicine access need integrated responses across various components of the health systems, are poorly addressed by existing evidence, and require an expanded health systems research agenda.

  7. Interactions management in environmental policy

    NARCIS (Netherlands)

    Krozer, Yoram; Franco Garcia, Maria Maria; Micallef, David

    2013-01-01

    Purpose: The paper aims to address regulator-management interactions in environmental policy with reference to direct regulations, social regulations and market-based regulation. Design/methodology/approach: Revision of literature to identify the European Union regulations for companies producing

  8. Evaluating efficacy of an environmental policy to prevent biological invasions.

    Science.gov (United States)

    Bailey, Sarah A; Deneau, Matthew G; Jean, Laurent; Wiley, Chris J; Leung, Brian; MacIsaac, Hugh J

    2011-04-01

    Enactment of any environmental policy should be followed by an evaluation of its efficacy to ensure optimal utilization of limited resources, yet measuring the success of these policies can be a challenging task owing to a dearth of data and confounding factors. We examine the efficacy of ballast water policies enacted to prevent biological invasions in the Laurentian Great Lakes. We utilize four criteria to assess the efficacy of this environmental regulation: (1) Is the prescribed management action demonstrably effective? (2) Is the management action effective under operational conditions? (3) Can compliance be achieved on a broad scale? (4) Are desired changes observed in the environment? The four lines of evidence resulting from this analysis indicate that the Great Lakes ballast water management program provides robust, but not complete, protection against ship-mediated biological invasions. Our analysis also indicates that corresponding inspection and enforcement efforts should be undertaken to ensure that environmental policies translate into increased environmental protection. Similar programs could be implemented immediately around the world to protect the biodiversity of the many freshwater ecosystems which receive ballast water discharges by international vessels. This general framework can be extended to evaluate efficacy of other environmental policies.

  9. Drug use evaluation of antibiotics prescribed in a Jordanian hospital outpatient and emergency clinics using WHO prescribing indicators

    International Nuclear Information System (INIS)

    Al-Niemat, Sahar I.; Bloukh, Diana T.; Al-Harasis, Manal D.; Al-Fanek, Alen F.; Salah, Rehab K.

    2008-01-01

    Objective was to evaluate the use of antibiotics prescribed in hospital outpatient and emergency clinics in King Hussein Medical Centre (KHMC) using WHO prescribing indicators in an attempt to rationalize the use of antibiotics in the Royal Medical Services. We retrospectively surveyed a sample of 187,822 antibiotic prescriptions obtained from 5 outpatient pharmacies in KHMC written over the period of 3 consecutive months May 2007 to July 2007. The percentage of encounters of an antibiotic prescribed was calculated using the methodology recommended by the WHO. An additional indicator, the percentage share of different antibiotics was also included to identify the frequency prescribed from those antibiotics. The average percentage of prescriptions involving antibiotics was 35.6% out of 187,822 prescriptions surveyed. From these, 65,500 antibiotic prescriptions were observed. Penicillins most frequently amoxcillins and Quinolones most frequently ciprofloxacinllin and norfloxacillin were the most commonly prescribed antibiotics with an average percentage of 31.8% and 27.5%. The average prescribing rate for the other antibiotic categories was as follows: macrolides 5.2%, cephalosporins 16% and amoxcillins/clavulanate 5.4%. The high percentage of prescriptions involving antibiotics observed in KHMC pharmacies requires rational use of antibiotics and judicious prescribing by Military prescribers. An insight into factors influencing antibiotic prescribing patterns and adherence to antibiotic prescribing guidelines by the Military prescribers is warranted. (author)

  10. Radiation Control Regulation 1993

    International Nuclear Information System (INIS)

    1993-01-01

    This Regulation (No. 434-1993) was made in pursuance of the Radiation Control Act 1990 and replaces the Active Substances Regulations 1959 repealed by the Act. It entered into force on 1 September 1993. The Regulation specifies that the technical radiation protection definitions have the same meaning as in the 1990 recommendations. The Regulation provides for the licensing of persons to use radioactive substances and radiation apparatus. It prescribes activities which may only be carried out by an accredited radiation expert and regulates the use of radiation apparatus and radioactive substances as well as the disposal and transport of radiation apparatus and radioactive substances. (NEA)

  11. Receptionist input to quality and safety in repeat prescribing in UK general practice: ethnographic case study.

    Science.gov (United States)

    Swinglehurst, Deborah; Greenhalgh, Trisha; Russell, Jill; Myall, Michelle

    2011-11-03

    To describe, explore, and compare organisational routines for repeat prescribing in general practice to identify contributors and barriers to safety and quality. Ethnographic case study. Four urban UK general practices with diverse organisational characteristics using electronic patient records that supported semi-automation of repeat prescribing. 395 hours of ethnographic observation of staff (25 doctors, 16 nurses, 4 healthcare assistants, 6 managers, and 56 reception or administrative staff), and 28 documents and other artefacts relating to repeat prescribing locally and nationally. Potential threats to patient safety and characteristics of good practice. Observation of how doctors, receptionists, and other administrative staff contributed to, and collaborated on, the repeat prescribing routine. Analysis included mapping prescribing routines, building a rich description of organisational practices, and drawing these together through narrative synthesis. This was informed by a sociological model of how organisational routines shape and are shaped by information and communications technologies. Results Repeat prescribing was a complex, technology-supported social practice requiring collaboration between clinical and administrative staff, with important implications for patient safety. More than half of requests for repeat prescriptions were classed as "exceptions" by receptionists (most commonly because the drug, dose, or timing differed from what was on the electronic repeat list). They managed these exceptions by making situated judgments that enabled them (sometimes but not always) to bridge the gap between the idealised assumptions about tasks, roles, and interactions that were built into the electronic patient record and formal protocols, and the actual repeat prescribing routine as it played out in practice. This work was creative and demanded both explicit and tacit knowledge. Clinicians were often unaware of this input and it did not feature in policy

  12. [Prescribing medication in 2013: legal aspects].

    Science.gov (United States)

    Berland-Benhaïm, C; Bartoli, C; Karsenty, G; Piercecchi-Marti, M-D

    2013-11-01

    To describe the legal framework of medicine prescription in France in 2013. With the assistance of lawyer and forensic pathologist, consultation (legifrance.gouv.fr), analysis, summary of French laws and rules surrounding drugs prescriptions to humans for medical purpose. Free medicine prescription is an essential feature of a doctor's action. To prescribe involve his responsibility at 3 levels: deontological, civilian and penal. Aim of the rules of medicine prescription is to preserve patient's safety and health. Doctors are encouraged to refer to recommendations and peer-reviewed publication every time the prescriptions go out of the case planned by law. Knowledge and respect of medicine prescription legal rules is essential for a good quality practice. Medical societies have a major role to improve medicine use among practitioners. Copyright © 2013. Published by Elsevier Masson SAS.

  13. Designing magnets with prescribed magnetic fields

    International Nuclear Information System (INIS)

    Liu Liping

    2011-01-01

    We present a novel design method capable of finding the magnetization densities that generate prescribed magnetic fields. The method is based on the solution to a simple variational inequality and the resulting designs have simple piecewise-constant magnetization densities. By this method, we obtain new designs of magnets that generate commonly used magnetic fields: uniform magnetic fields, self-shielding fields, quadrupole fields and sextupole fields. Further, it is worth noting that this method is not limited to the presented examples, and in particular, three-dimensional designs can be constructed in a similar manner. In conclusion, this novel design method is anticipated to have broad applications where specific magnetic fields are important for the performance of the devices.

  14. Ibuprofen in paediatrics: pharmacology, prescribing and controversies.

    Science.gov (United States)

    Moriarty, Camilla; Carroll, Will

    2016-12-01

    Ibuprofen, a propionic acid derivative, is a non-steroidal anti-inflammatory drug. The oral formulation is widely used in paediatric practice and after paracetamol it is one of the most common drugs prescribed for children in hospital. The treatment of fever with antipyretics such as ibuprofen is controversial as fever is the normal response of the body to infection and unless the child becomes distressed or symptomatic, fever alone should not be routinely treated. Combined treatment with paracetamol and ibuprofen is commonly undertaken but almost certainly is not helpful. This article aims to describe the indications and mode of action of the drug, outline its pharmacokinetics and highlight the important key messages regarding its use in clinical practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  15. Population policy.

    Science.gov (United States)

    1987-03-01

    Participants in the Seminar on Population Policies for Top-level Policy Makers and Program Managers, meeting in Thailand during January 1987, examined the challenges now facing them regarding the implementation of fertility regulation programs in their respective countries -- Bangladesh, China, India, Indonesia, Malaysia, Nepal, Pakistan, the Philippines, the Republic of Korea, and Thailand. This Seminar was organized to coincide with the completion of an Economic and Social Commission for Asia and the Pacific (ESCAP) study investigating the impact and efficiency of family planning programs in the region. Country studies were reviewed at the Seminar along with policy issues about the status of women, incentive and disincentive programs, and socioeconomic factors affecting fertility. In Bangladesh the government recognizes population growth as its top priority problem related to the socioeconomic development of the country and is working to promote a reorientation strategy from the previous clinic-oriented to a multidimensional family welfare program. China's family planning program seeks to postpone marraige, space the births of children between 3-5 years, and promote the 1-child family. Its goal is to reduce the rate of natural increase from 12/1000 in 1978 to 5/1000 by 1985 and 0 by 2000. India's 7th Five-Year-Plan (1986-90) calls for establishing a 2-child family norm by 2000. In Indonesia the government's population policy includes reducing the rate of population growth, achieving a redistribution of the population, adjusting economic factors, and creating prosperous families. The government of Indonesia reversed its policy to reduce the population growth rate in 1984 and announced its goal of achieving a population of 70 million by 2100 in order to support mass consumption industries. It has created an income tax deduction system favoring large families and maternity benefits for women who have up to 5 children as incentives. Nepal's official policy is to

  16. Separation of prescribing and dispensing in Malaysia: the history and challenges.

    Science.gov (United States)

    Tiong, John Jeh Lung; Mai, Chun Wai; Gan, Pou Wee; Johnson, James; Mak, Vivienne Sook Li

    2016-08-01

    This article serves as an update to the work by Shafie et al. (2012) which previously reviewed the benefits of policies separating prescribing and dispensing in various countries to advocate its implementation in Malaysia. This article seeks to strengthen the argument by highlighting not only the weaknesses of the Malaysian health care system from the historical, professional and economic viewpoints but also the shortcomings of both medical and pharmacy professions in the absence of separation of dispensing. It also provides a detailed insight into the ongoing initiatives taken to consolidate the role of pharmacists in the health care system in the advent of separation of dispensing. Under the two tier system in Malaysia at present, the separation of prescribing and dispensing is implemented only in government hospitals. The absence of this separation in the private practices has led to possible profit-oriented medical and pharmacy practices which hinder safe and cost-effective delivery of health services. The call for separation of dispensing has gained traction over the years despite various hurdles ranging from the formidable resistance from the medical fraternity to the public's scepticism towards the new policy. With historical testament and present evidence pointing towards the merits of a system in which doctors prescribe and pharmacists dispense, the implementation of this health care model is justified. © 2016 The Authors. IJPP © 2016 Royal Pharmaceutical Society.

  17. The Formation of Accounting Policies for Processing Enterprises in the Context of Adaptation of National Regulations to the International Standards of Accounting and Reporting

    OpenAIRE

    Rozheliuk Viktoriia M.; Denchuk Pavlo N.

    2017-01-01

    The article defines principles for preparation of accounting policies using both domestic and foreign experience, generalizes scientific and theoretical approaches, and improves the wordings of the concept of «accounting policy». The feasibility of conducting a preliminary assessment of efficiency of organizational activities through the use of the criteria generalized in the accounting policy has been substantiated, the legal and regulatory levels have been highlighted, taking into considera...

  18. Contribution to the economic impact assessment of policy options to regulate animal cloning for food production with an economic simulation model

    OpenAIRE

    Koen Dillen; Emanuele Ferrari; Pascal Tillie; George Philippidis; Sophie Helaine

    2013-01-01

    The EU is currently evaluating different policy options towards the use of cloning or products derived from cloned animals in the food chain. This study presents a first attempt to quantify the likely effects of different policy scenarios on international trade and EU domestic production. In the context of the Impact Asessment process the JRC was requested to simulate via a modelling study the economic impact of selected policy options. Based on a literature review and the specific constra...

  19. A Technological Innovation to Reduce Prescribing Errors Based on Implementation Intentions: The Acceptability and Feasibility of MyPrescribe.

    Science.gov (United States)

    Keyworth, Chris; Hart, Jo; Thoong, Hong; Ferguson, Jane; Tully, Mary

    2017-08-01

    Although prescribing of medication in hospitals is rarely an error-free process, prescribers receive little feedback on their mistakes and ways to change future practices. Audit and feedback interventions may be an effective approach to modifying the clinical practice of health professionals, but these may pose logistical challenges when used in hospitals. Moreover, such interventions are often labor intensive. Consequently, there is a need to develop effective and innovative interventions to overcome these challenges and to improve the delivery of feedback on prescribing. Implementation intentions, which have been shown to be effective in changing behavior, link critical situations with an appropriate response; however, these have rarely been used in the context of improving prescribing practices. Semistructured qualitative interviews were conducted to evaluate the acceptability and feasibility of providing feedback on prescribing errors via MyPrescribe, a mobile-compatible website informed by implementation intentions. Data relating to 200 prescribing errors made by 52 junior doctors were collected by 11 hospital pharmacists. These errors were populated into MyPrescribe, where prescribers were able to construct their own personalized action plans. Qualitative interviews with a subsample of 15 junior doctors were used to explore issues regarding feasibility and acceptability of MyPrescribe and their experiences of using implementation intentions to construct prescribing action plans. Framework analysis was used to identify prominent themes, with findings mapped to the behavioral components of the COM-B model (capability, opportunity, motivation, and behavior) to inform the development of future interventions. MyPrescribe was perceived to be effective in providing opportunities for critical reflection on prescribing errors and to complement existing training (such as junior doctors' e-portfolio). The participants were able to provide examples of how they would use

  20. Legitimizing policies

    DEFF Research Database (Denmark)

    Jørgensen, Martin Bak

    2012-01-01

    The focus of this article is on representations of irregular migration in a Scandinavian context and how irregular migrants are constructed as a target group. A common feature in many (Western-)European states is the difficult attempt to navigate between an urge for control and respecting......, upholding and promoting humanitarian aspects of migration management. Legitimizing policies therefore become extremely important as governments have to appease national voters to remain in power and have to respect European regulations and international conventions. Doing so raises questions of social...

  1. Antiepileptic drug prescribing before, during and after pregnancy

    DEFF Research Database (Denmark)

    Charlton, Rachel; Garne, Ester; Wang, Hao

    2015-01-01

    and after pregnancy were identified in each of the databases. AED prescribing patterns were analysed, and the choice of AEDs and co-prescribing of folic acid were evaluated. Results In total, 978 957 women with 1 248 713 deliveries were identified. In all regions, AED prescribing declined during pregnancy...... co-prescribed with high-dose folic acid: ranging from 1.0% (CI950.3–1.8%) in Emilia Romagna to 33.5% (CI9528.7–38.4%) in Wales. Conclusion The country's differences in prescribing patterns may suggest different use, knowledge or interpretation of the scientific evidence base. The low co......-prescribing of folic acid indicates that more needs to be done to better inform clinicians and women of childbearing age taking AEDs about the need to offer and receive complete preconception care....

  2. Prescribing practices amid the OxyContin crisis: examining the effect of print media coverage on opioid prescribing among physicians.

    Science.gov (United States)

    Borwein, Alexandra; Kephart, George; Whelan, Emma; Asbridge, Mark

    2013-12-01

    The pain medication OxyContin (hereafter referred to as oxycodone extended release) has been the subject of sustained, and largely negative, media attention in recent years. We sought to determine whether media coverage of oxycodone extended release in North American newspapers has led to changes in prescribing of the drug in Nova Scotia, Canada. An interrupted time-series design examined the effect of media attention on physicians' monthly prescribing of opioids. The outcome measures were, for each physician, the monthly proportions of all opioids prescribed and the proportion of strong opioids prescribed that were for oxycodone extended release. The exposure of interest was media attention defined as the number of articles published each month in 27 North American newspapers. Variations in media effects by provider characteristics (specialty, prescribing volume, and region) were assessed. Within-provider changes in the prescribing of oxycodone extended release in Nova Scotia were observed, and they followed changes in media coverage. Oxycodone extended release prescribing rose steadily prior to receiving media attention. Following peak media attention in the United States, the prescribing of oxycodone extended release slowed. Likewise, following peak coverage in Canadian newspapers, the prescribing of oxycodone extended release declined. These patterns were observed across prescriber specialties and by prescriber volume, though the magnitude of change in prescribing varied. This study demonstrates that print media reporting of oxycodone extended release in North American newspapers, and its continued portrayal as a social problem, coincided with reductions in the prescribing of oxycodone extended release by physicians in Nova Scotia. Copyright © 2013 American Pain Society. Published by Elsevier Inc. All rights reserved.

  3. Assessing the contribution of prescribing in primary care by nurses and professionals allied to medicine: a systematic review of literature

    Directory of Open Access Journals (Sweden)

    Bhanbhro Sadiq

    2011-12-01

    Full Text Available Abstract Background Safe and timely access to effective and appropriate medication through primary care settings is a major concern for all countries addressing both acute and chronic disease burdens. Legislation for nurses and other professionals allied to medicine to prescribe exists in a minority of countries, with more considering introducing legislation. Although there is variation in the range of medicines permitted to be prescribed, questions remain as to the contribution prescribing by nurses and professionals allied to medicine makes to the care of patients in primary care and what is the evidence on which clinicians, commissioners of services and policy makers can consider this innovation. Methods A integrative review of literature on non-medical prescribing in primary care was undertaken guided by dimensions of health care quality: effectiveness, acceptability, efficiency and access. Results 19 papers of 17 empirical studies were identified which provided evidence of patient outcome of non medical prescribing in primary care settings. The majority were undertaken in the UK with only one each from the USA, Canada, Botswana and Zimbabwe. Only two studies investigated clinical outcomes of non-medical prescribing. Seven papers reported on qualitative designs and four of these had fewer than ten participants. Most studies reported that non medical prescribing was widely accepted and viewed positively by patients and professionals. Conclusions Primary health care is the setting where timely access to safe and appropriate medicines is most critical for the well-being of any population. The gradual growth over time of legislative authority and in the numbers of non-medical prescribers, particularly nurses, in some countries suggests that the acceptability of non-medical prescribing is based on the perceived value to the health care system as a whole. Our review suggests that there are substantial gaps in the knowledge base to help evidence

  4. Competition Policy in Malaysia

    OpenAIRE

    Lee, Cassey

    2004-01-01

    Malaysia does not have a national competition law. Competition is regulated at the sectoral level in the country. Two economic sectors have legal provisions for competition law but these have been relatively ineffectively enforced. The benefits of Malaysia's industrial policy as well as the policy reforms in regulation and trade have been compromised by the lack of a formal institution to address competition related issues. Hence, the future priority and direction of regulatory reform is obvi...

  5. Factor analysis improves the selection of prescribing indicators

    DEFF Research Database (Denmark)

    Rasmussen, Hanne Marie Skyggedal; Søndergaard, Jens; Sokolowski, Ineta

    2006-01-01

    OBJECTIVE: To test a method for improving the selection of indicators of general practitioners' prescribing. METHODS: We conducted a prescription database study including all 180 general practices in the County of Funen, Denmark, approximately 472,000 inhabitants. Principal factor analysis was us...... appropriate and inappropriate prescribing, as revealed by the correlation of the indicators in the first factor. CONCLUSION: Correlation and factor analysis is a feasible method that assists the selection of indicators and gives better insight into prescribing patterns....

  6. A RCT evaluating the effectiveness and cost-effectiveness of academic detailing versus postal prescribing feedback in changing GP antibiotic prescribing.

    LENUS (Irish Health Repository)

    Naughton, Corina

    2009-10-01

    The aim of this study is to evaluate the effectiveness of academic detailing (AD) plus postal prescribing feedback versus postal prescribing feedback alone in reducing: (i) the overall rate of antibiotic; and (ii) proportion of second-line antibiotic prescribing. In addition, the cost-effectiveness of an outreach prescriber adviser service versus a postal prescribing feedback service was evaluated.

  7. [Generic drugs: good or bad? Physician's knowledge of generic drugs and prescribing habits].

    Science.gov (United States)

    García, A J; Martos, F; Leiva, F; Sánchez de la Cuesta, F

    2003-01-01

    In this article we analyze the responses of 1220 Spanish physicians who participated in a survery about generic drugs. A previously validated questionnaire was sent to physicians through the Spanish Medical Councils of the different provinces. Four items were analyzed: what doctors know about generic drugs (knowledge); physicians' prescribing habits concerning these drugs (attitude and professional competence); how prescription of generic drugs effects pharmaceutical costs amd, finally, what doctors believe a generic drug should be. The influence of physician-related variables (age, type of contract, specialty, workload, etc.) on prescribing of generic drugs was also analyzed. In view of the results, we believe that to rationalize expenditure through and appropriate policy on generic drugs Spanish health authorities should offer more and better training and information (clear and independent) about what generic drugs are.

  8. Prescribed Travel Schedules for Fatigue Management

    Science.gov (United States)

    Whitmire, Alexandra; Johnston, Smith; Lockley, Steven

    2011-01-01

    The NASA Fatigue Management Team is developing recommendations for managing fatigue during travel and for shift work operations, as Clinical Practice Guidelines for the Management of Circadian Desynchrony in ISS Operations. The Guidelines provide the International Space Station (ISS ) flight surgeons and other operational clinicians with evidence-based recommendations for mitigating fatigue and other factors related to sleep loss and circadian desynchronization. As much international travel is involved both before and after flight, the guidelines provide recommendations for: pre-flight training, in-flight operations, and post-flight rehabilitation. The objective of is to standardize the process by which care is provided to crewmembers, ground controllers, and other support personnel such as trainers, when overseas travel or schedule shifting is required. Proper scheduling of countermeasures - light, darkness, melatonin, diet, exercise, and medications - is the cornerstone for facilitating circadian adaptation, improving sleep, enhancing alertness, and optimizing performance. The Guidelines provide, among other things, prescribed travel schedules that outline the specific implementation of these mitigation strategies. Each travel schedule offers evidence based protocols for properly using the NASA identified countermeasures for fatigue. This presentation will describe the travel implementation schedules and how these can be used to alleviate the effects of jet lag and/or schedule shifts.

  9. Impact of generic substitution decision support on electronic prescribing behavior.

    Science.gov (United States)

    Stenner, Shane P; Chen, Qingxia; Johnson, Kevin B

    2010-01-01

    To evaluate the impact of generic substitution decision support on electronic (e-) prescribing of generic medications. The authors analyzed retrospective outpatient e-prescribing data from an academic medical center and affiliated network for July 1, 2005-September 30, 2008 using an interrupted time-series design to assess the rate of generic prescribing before and after implementing generic substitution decision support. To assess background secular trends, e-prescribing was compared with a concurrent random sample of hand-generated prescriptions. Proportion of generic medications prescribed before and after the intervention, evaluated over time, and compared with a sample of prescriptions generated without e-prescribing. The proportion of generic medication prescriptions increased from 32.1% to 54.2% after the intervention (22.1% increase, 95% CI 21.9% to 22.3%), with no diminution in magnitude of improvement post-intervention. In the concurrent control group, increases in proportion of generic prescriptions (29.3% to 31.4% to 37.4% in the pre-intervention, post-intervention, and end-of-study periods, respectively) were not commensurate with the intervention. There was a larger change in generic prescribing rates among authorized prescribers (24.6%) than nurses (18.5%; adjusted OR 1.38, 95% CI 1.17 to 1.63). Two years after the intervention, the proportion of generic prescribing remained significantly higher for e-prescriptions (58.1%; 95% CI 57.5% to 58.7%) than for hand-generated prescriptions ordered at the same time (37.4%; 95% CI 34.9% to 39.9%) (p<0.0001). Generic prescribing increased significantly in every specialty. Implementation of generic substitution decision support was associated with dramatic and sustained improvements in the rate of outpatient generic e-prescribing across all specialties.

  10. Planned development and coordination of public policies as a starting point in the harmonization of national regulations with the EU aquis

    Directory of Open Access Journals (Sweden)

    Jovanić Tatjana

    2014-01-01

    Full Text Available One of the most important aspects of harmonizing Serbian legislation with the EU law, however still neglected in Serbia, is the mutual relationship between the design and coordination of public policies on the one hand, and the harmonization of legislation in the course of negotiations for EU accession, on the other hand. This aspect has been largely neglected because of the misuse of emergency procedure for adopting legislation in order to assure compatibility with the EU law, but also due to underdeveloped regulatory policies, which has been reduced to the guillotine of legislation, instead of developing a cycle of policy and analytical phase that precedes the drafting of legislation. Although the negotiating structure of European integration has been improved, the Negotiation Team and Coordination Body certainly can not replace the role of policy makers in their creation. Since the new Law on Ministries envisaged the creation of the Secretariat for the coordination of public policies, an institutional prerequisite for the implementation of the function of harmonizing public policy proposals has been put forward, but is not yet clear what powers in the policy cycle this institution would have. In any case, this administrative body will certainly complement Serbian coordination structure in the negotiation process.

  11. Renewable Energy Policy Fact sheet - France

    International Nuclear Information System (INIS)

    2017-07-01

    The EurObserv'ER policy profiles give a snapshot of the renewable energy policy in the EU Member States. Main support scheme: for RES-E a new support scheme based on a premium in addition to the market price is in place since 2016, whereby the generators sell their electricity directly in the market. For RES-H and C the Heat Fund support is the main tool for collective buildings. For individual housing, a tax credit is the main support scheme. The promotion of bio-fuels in France is mainly provided through fiscal regulation mechanisms. On the one hand, the lower competitiveness of bio-fuels compared to conventional fuels is improved through a partial exemption of the domestic consumption tax. On the other hand, the tax on polluting activities prescribes higher rates for companies trading fuel for consumption, in case they do not respect the national quota of bio-fuels to be blended within conventional fuels, which is defined for each fuel type

  12. Electronic prescribing: criteria for evaluating handheld prescribing systems and an evaluation of a new, handheld, wireless wide area network (WWAN) prescribing system.

    Science.gov (United States)

    Goldblum, O M

    2001-02-01

    The objectives of this study were: 1) to establish criteria for evaluating handheld computerized prescribing systems; and 2) to evaluate out-of-box performance and features of a new, Palm Operating System (OS)-based, handheld, wireless wide area network (WWAN) prescribing system. The system consisted of a Palm Vx handheld organizer, a Novatel Minstrel V wireless modem, OmniSky wireless internet access and ePhysician ePad 1.1, the Palm OS electronic prescribing software program. A dermatologist familiar with healthcare information technology conducted an evaluation of the performance and features of a new, handheld, WWAN electronic prescribing system in an office practice during a three-month period in 2000. System performance, defined as transmission success rate, was determined from data collected during the three-month trial. Evaluation criteria consisted of an analysis of features found in electronic prescribing systems. All prescriptions written for all patients seen during a three-month period (August - November, 2000) were eligible for inclusion. Prescriptions written for patients who intended to fill them at pharmacies without known facsimile receiving capabilities were excluded from the study. The performance of the system was evaluated using data collected during the study. Criteria for evaluating features of electronic prescribing systems were developed and used to analyze the system employed in this study. During this three-month trial, 200 electronic prescriptions were generated for 132 patients included in the study. Of these prescriptions, 92.5 percent were successfully transmitted to pharmacies. Transmission failures resulted from incorrect facsimile numbers and non-functioning facsimile machines. Criteria established for evaluation of electronic prescribing systems included System (Hardware & Software), Costs, System Features, Printing & Transmission, Formulary & Insurance, Customization, Drug Safety and Security. This study is the first effort to

  13. The Challenges of Electronic Health Records and Diabetes Electronic Prescribing: Implications for Safety Net Care for Diverse Populations

    Directory of Open Access Journals (Sweden)

    Neda Ratanawongsa

    2017-01-01

    Full Text Available Widespread electronic health record (EHR implementation creates new challenges in the diabetes care of complex and diverse populations, including safe medication prescribing for patients with limited health literacy and limited English proficiency. This review highlights how the EHR electronic prescribing transformation has affected diabetes care for vulnerable patients and offers recommendations for improving patient safety through EHR electronic prescribing design, implementation, policy, and research. Specifically, we present evidence for (1 the adoption of RxNorm; (2 standardized naming and picklist options for high alert medications such as insulin; (3 the widespread implementation of universal medication schedule and language-concordant labels, with the expansion of electronic prescription 140-character limit; (4 enhanced bidirectional communication with pharmacy partners; and (5 informatics and implementation research in safety net healthcare systems to examine how EHR tools and practices affect diverse vulnerable populations.

  14. Operational use of prescribed fire in southern California chaparral

    Science.gov (United States)

    Ron Dougherty; Philip J. Riggan

    1982-01-01

    The use of prescribed fire in the chaparral could reduce the incidence and impacts of severe wildfires and enhance watershed re-sources. This paper describes the operational planning needed for a successful prescribed fire and discusses the recent experience with this technique on the Cleveland National Forest.

  15. Proton pump inhibitors: potential cost reductions by applying prescribing guidelines.

    LENUS (Irish Health Repository)

    Cahir, Caitriona

    2012-01-01

    There are concerns that proton pump inhibitors (PPI) are being over prescribed in both primary and secondary care. This study aims to establish potential cost savings in a community drug scheme for a one year period according to published clinical and cost-effective guidelines for PPI prescribing.

  16. Estimating fuel consumption during prescribed fires in Arkansas

    Science.gov (United States)

    Virginia L. McDaniel; James M. Guldin; Roger W. Perry

    2012-01-01

    While prescribed fire is essential to maintaining numerous plant communities, fine particles produced in smoke can impair human health and reduce visibility in scenic areas. The Arkansas Smoke Management Program was established to mitigate the impacts of smoke from prescribed fires. This program uses fuel loading and consumption estimates from standard fire-behavior...

  17. Prescribing style and variation in antibiotic prescriptions for sore throat

    DEFF Research Database (Denmark)

    Cordoba Currea, Gloria Cristina; Siersma, Volkert Dirk; Lopez-Valcarcel, Beatriz Gonzalez

    2015-01-01

    never did. After adjusting for patient and GP characteristics, prescribing style in the group of GPs from Russia was about three times more heterogeneous than the prescribing style in the group of GPs from Denmark – Median Odds Ratio ( 6.8, 95%CI 3.1;8.8 ) and ( 2.6, 95%CI 2.2;4.4 ) respectively...

  18. Benefits of nurse prescribing for patients in pain: nurses' views.

    Science.gov (United States)

    Stenner, Karen; Courtenay, Molly

    2008-07-01

    This paper is a report of a study to explore nurses' views on the benefits of adopting the role of prescribing for patients with acute and chronic pain. It was envisioned that the advent of nurse prescribing would be beneficial to the efficiency and effectiveness of the United Kingdom National Health Service. Research to date does indeed indicate that nurse prescribing can be beneficial to patients, nurses and the health service in general. Despite the expansion of nurse prescribing, there is little evidence of its impact according to nurses working in specialist areas, such as with patients in acute and chronic pain. Interviews were conducted during 2006 and 2007 with 26 nurses qualified to prescribe medicines for patients in acute and chronic pain. This was a qualitative study and a thematic analysis was conducted. Nurses reported a number of benefits, including faster access to treatment, improved quality of care, more appropriate prescribing of medication, improved safety, improved relations and communication with patients, greater efficiency and cost effectiveness. Nurses benefited from increased job satisfaction, credibility with patients and healthcare professionals and also gained knowledge through prescribing. There is potential for the benefits of nurse prescribing to be expanded beyond the United Kingdom in settings where nurses hold similar roles in the treatment of pain, although further research using a wider range of research methods is recommended to substantiate these findings.

  19. Impacts of prescribed fire on Pinus rigida Mill

    Science.gov (United States)

    Nicholas J. Carlo; Heidi J. Renninger; Kenneth L. Clark; Karina V.R. Schäfer

    2016-01-01

    A comparative analysis of the impacts of prescribed fire on three upland forest stands in the Northeastern Atlantic Plain, NJ, USA, was conducted. Effects of prescribed fire on water use and gas exchange of overstory pines were estimated via sap-flux rates and photosynthetic measurements on Pinus rigida Mill. Each study site had two sap-flux plots...

  20. Forum: Psychotropic prescribing in HIV | Reid | Southern African ...

    African Journals Online (AJOL)

    We provide a brief guide to the diagnosis and treatment of common mental disorders in people living with HIV/AIDS, including: prescribing psychotropics in HIV; neuropsychiatric side-effects of ARVs and other medications commonly prescribed in HIV; and the diagnosis and treatment of depression, anxiety, psychosis, ...

  1. Seed bank response to prescribed fire in the central Appalachians.

    Science.gov (United States)

    Thomas M. Schuler; Melissa Thomas Van-Gundy; Mary B. Adams; W. Mark. Ford

    2010-01-01

    Pre- and post-treatment seed-bank characteristics of woody species were compared after two prescribed fires in a mesic mixed-oak forest in the central Appalachians. Nineteen woody species were identified from soil samples. Mean species richness declined but evenness did not after prescribed burning. The...

  2. Prescribed burning in the South: trends, purpose, and barriers

    Science.gov (United States)

    Terry K. Haines; Rodney L. Busby; David A. Cleaves

    2001-01-01

    The results of a survey of fire management officials concerning historical and projected prescribed burning activity in the South are reported. Prescribed burning programs on USDA Forest Service and private and State-owned lands are described in terms of area burned by ownership and State, intended resource benefits, barriers to expanded burning, and optimum burning...

  3. Computational opioid prescribing: a novel application of clinical pharmacokinetics.

    Science.gov (United States)

    Linares, Oscar A; Linares, Annemarie L

    2011-01-01

    We implemented a pharmacokinetics-based mathematical modeling technique using algebra to assist prescribers with point-of-care opioid dosing. We call this technique computational opioid prescribing (COP). Because population pharmacokinetic parameter values are needed to estimate drug dosing regimen designs for individual patients using COP, and those values are not readily available to prescribers because they exist scattered in the vast pharmacology literature, we estimated the population pharmacokinetic parameter values for 12 commonly prescribed opioids from various sources using the bootstrap resampling technique. Our results show that opioid dosing regimen design, evaluation, and modification is feasible using COP. We conclude that COP is a new technique for the quantitative assessment of opioid dosing regimen design evaluation and adjustment, which may help prescribers to manage acute and chronic pain at the point-of-care. Potential benefits include opioid dose optimization and minimization of adverse opioid drug events, leading to potential improvement in patient treatment outcomes and safety.

  4. Medication discussion between nurse prescribers and people with diabetes

    DEFF Research Database (Denmark)

    Sibley, Andrew; Latter, Sue; Richard, Claude

    2011-01-01

    Aim. This paper is a report of a study to identify the content of, and participation in, medicine discussion between nurse prescribers and people with diabetes in England. Background. Diabetes affects 246 million people worldwide and effective management of medicines is an essential component...... of successful disease control. There are now over 20,000 nurse independent prescribers in the UK, many of whom frequently prescribe for people with diabetes. With this responsibility comes a challenge to effectively communicate with patients about medicines. National guidelines on medicines communication have...... recently been issued, but the extent to which nurse prescribers are facilitating effective medicine-taking in diabetes remains unknown. Methods. A purposive sample of 20 nurse prescribers working with diabetes patients audio-recorded 59 of their routine consultations and a descriptive analysis...

  5. Switching statins in Norway after new reimbursement policy: a nationwide prescription study.

    Science.gov (United States)

    Sakshaug, Solveig; Furu, Kari; Karlstad, Øystein; Rønning, Marit; Skurtveit, Svetlana

    2007-10-01

    To assess the changes in prescribing of statins in Norway after implementation of the new reimbursement regulations for statins in June 2005. Data were retrieved from the Norwegian Prescription Database covering the total population in Norway (4.6 million). Outcome measures were the proportion of atorvastatin users switching to simvastatin and changes in the proportion of new statin users receiving simvastatin. Based on retail costs for all statin prescriptions dispensed in Norway, expenditure was measured in Norwegian currency. One-year prevalences of statin use increased from 6.3 to 6.8% for women and from 7.5 to 8.1% for men from the year before to the year after the new statin regulations. Of atorvastatin users (N = 131,222), 39% switched to simvastatin during the 13-month period after the implementation. The proportion of switching was higher in women (41%) than in men (36%). In May 2005, 48% of the new statin users received simvastatin. The proportion of new users receiving simvastatin increased rapidly after implementation of the new regulations to 68% in June 2005 and reached 92% in June 2006. Expenditure was reduced from 120 million to 95 million Euro when comparing the year before with the year after the new statin regulations. The new reimbursement policy for statins has had a great impact on physicians' prescribing of statins in Norway. Physicians in Norway acknowledge the importance of contributing to cost containment.

  6. 7 CFR 948.20 - Marketing policy.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Marketing policy. 948.20 Section 948.20 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Order Regulating Handling Regulation § 948.20 Marketing policy. (a) General cull regulation. (1) It...

  7. Occupational PAH Exposures during Prescribed Pile Burns

    Science.gov (United States)

    Robinson, M. S.; Anthony, T. R.; Littau, S. R.; Herckes, P.; Nelson, X.; Poplin, G. S.; Burgess, J. L.

    2008-01-01

    Wildland firefighters are exposed to particulate matter and gases containing polycyclic aromatic hydrocarbons (PAHs), many of which are known carcinogens. Our objective was to evaluate the extent of firefighter exposure to particulate and PAHs during prescribed pile burns of mainly ponderosa pine slash and determine whether these exposures were correlated with changes in urinary 1-hydroxypyrene (1-HP), a PAH metabolite. Personal and area sampling for particulate and PAH exposures were conducted on the White Mountain Apache Tribe reservation, working with 21 Bureau of Indian Affairs/Fort Apache Agency wildland firefighters during the fall of 2006. Urine samples were collected pre- and post-exposure and pulmonary function was measured. Personal PAH exposures were detectable for only 3 of 16 PAHs analyzed: naphthalene, phenanthrene, and fluorene, all of which were identified only in vapor-phase samples. Condensed-phase PAHs were detected in PM2.5 area samples (20 of 21 PAHs analyzed were detected, all but naphthalene) at concentrations below 1 μg m−3. The total PAH/PM2.5 mass fractions were roughly a factor of two higher during smoldering (1.06 ± 0.15) than ignition (0.55 ± 0.04 μg mg−1). There were no significant changes in urinary 1-HP or pulmonary function following exposure to pile burning. In summary, PAH exposures were low in pile burns, and urinary testing for a PAH metabolite failed to show a significant difference between baseline and post-exposure measurements. PMID:18515848

  8. Analysis of Out Door Patients' Prescriptions According to World Health Organization (WHO) Prescribing Indicators Among Private Hospitals in Western India.

    Science.gov (United States)

    Shelat, Prakash R; Kumbar, Shivaprasad Kalakappa

    2015-03-01

    Prescription is document through which doctor, patient and pharmacist are communicated. Many a times if these documents are not properly written or misinterpreted it can affect management of patients. WHO established prescribing indicators to analyse prescription and promoted rational use of drugs and better management of patients. To study the prescription pattern according to WHO prescribing indicators among private hospitals. The observational, prospective study carried out at different private hospitals at metro city in Western India to study the prescription pattern among private hospital. Study was conducted at different private hospitals of metro city. A total of 250 prescriptions of outdoor patients from various departments of private hospitals were collected for a period of three months (August to October) 2012 and evaluated. The study was analysed using Z-test. Patient details like age and gender was not written in all (100%) prescriptions. It was noticed that dose, direction of drug and duration of treatment was not completely written in 90%, 74% and 80% of prescriptions respectively. Abbreviations were used in all (100%) prescriptions. Doctor's medical registration number was mentioned in 0% prescriptions. Total 869 drugs were prescribed in 250 prescriptions. Average number of drug prescribed was 3.38±1.79 (Mean±SD). It was reported that Group II (3 to 4 encoutner) was significantly higher as compared to Group I (less than or equal to 2 encoutner) and Group III( more than four encounter). It was significantly (pprivate hospitals and antibiotics was commonly prescribed in private sector. Therefore, strict policy to good prescribing practice and strict antibiotic policy in outdoor patients are required to promote rational use of drugs.

  9. Cannabis Impairment in the Workplace: A Jurisdictional Analysis of Drug Testing Policies and Recommendations in the Context of Canadian Legalization and Regulation

    OpenAIRE

    Van Pelt, Kelsey

    2017-01-01

    Cannabis impairment can affect safety in the workplace. However, the proposed Cannabis Act does not include a framework for cannabis impairment in the workplace, as workplace health and safety in Canada is a provincial jurisdiction for most industries. In British Columbia, workplace health and safety is regulated by the Occupational Health and Safety Regulations (OHSR) under the Workers Compensation Act (WCA). Part 4 – General Conditions of the OHSR contains regulations for impairment in the ...

  10. Manual on service business for policy research

    International Nuclear Information System (INIS)

    1999-01-01

    The contents of this book are summary of service business for policy research : conception classification and ways of service business for policy research, propel procedure of service business for policy research on system of committee, management, choice, contract, evaluation and post management, related regulation on service business for policy research : management regulation on service business for policy research, guide of evaluation for service business for policy research, estimation standard of policy research cost, law arrangement of national contract, required document on service business for policy research, and application manual for PRISM.

  11. POPULATION POLICY OR SOCIAL POLICY?

    Directory of Open Access Journals (Sweden)

    ANDREI STANOIU

    2011-04-01

    Full Text Available After 1989, the demographic situation of Romania population experienced a dramatic, very concerning and dangerous evolution trend. One of the first measures of the new political power was to abolish the very restrictive, anti-human and abusive legal regulation adopted in 1966 by the communist regime concerning abortion and the whole old demographic policy. As a result of this measure and of the worsening economic and social situation of the great majority of Romanian population, the birth rate declined sharply and, from 1992, the natural demographic growth rate became a negative one. The absolute number of Romanian population decreased more and more and, if nothing changes, in the next few decades it will be no bigger than 15 million people. At the same time, the process of demographic ageing of population will accentuate, generating serious problems from demographic and social-economic point of view, Taking into account the present demographic situation and, especially, the foreseen trend of evolution, it is more than clear that there should be taken some urgent, coherent and consistent measures in order to stop this dangerous demographic evolution, until it is not too late, and to avoid, as much as possible, a potential demographic disaster. The problem is: what kind of measures should be taken and what kind of policy should be adopted? Some social scientists believe that a new population policy should be adopted; some others believe that rather a social policy should be adopted. The purpose of my paper is to analyze this different opinions and to show that, behind the dispute on the terminology, should be taken consistent measures, at governmental level, in order to assure a substantial improvement of demographic situation, not only from a quantitative, but from a qualitative point of view as well, and to identify some of these kind of measures.

  12. 38 CFR 6.15 - Cash value; special endowment at age 96 plan policy.

    Science.gov (United States)

    2010-07-01

    ... policy year; all values and net single premiums are as prescribed by the Secretary and published in VA... thereafter shall be the reserve as set forth in the policy together with any dividend accumulations. For each month after the first policy year the reserve at the end of the preceding policy year shall be increased...

  13. A new approach to formulating and appraising drug policy: A multi-criterion decision analysis applied to alcohol and cannabis regulation.

    Science.gov (United States)

    Rogeberg, Ole; Bergsvik, Daniel; Phillips, Lawrence D; van Amsterdam, Jan; Eastwood, Niamh; Henderson, Graeme; Lynskey, Micheal; Measham, Fiona; Ponton, Rhys; Rolles, Steve; Schlag, Anne Katrin; Taylor, Polly; Nutt, David

    2018-02-16

    Drug policy, whether for legal or illegal substances, is a controversial field that encompasses many complex issues. Policies can have effects on a myriad of outcomes and stakeholders differ in the outcomes they consider and value, while relevant knowledge on policy effects is dispersed across multiple research disciplines making integrated judgements difficult. Experts on drug harms, addiction, criminology and drug policy were invited to a decision conference to develop a multi-criterion decision analysis (MCDA) model for appraising alternative regulatory regimes. Participants collectively defined regulatory regimes and identified outcome criteria reflecting ethical and normative concerns. For cannabis and alcohol separately, participants evaluated each regulatory regime on each criterion and weighted the criteria to provide summary scores for comparing different regimes. Four generic regulatory regimes were defined: absolute prohibition, decriminalisation, state control and free market. Participants also identified 27 relevant criteria which were organised into seven thematically related clusters. State control was the preferred regime for both alcohol and cannabis. The ranking of the regimes was robust to variations in the criterion-specific weights. The MCDA process allowed the participants to deconstruct complex drug policy issues into a set of simpler judgements that led to consensus about the results. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

  14. Prescribing smoked cannabis for chronic noncancer pain

    Science.gov (United States)

    Kahan, Meldon; Srivastava, Anita; Spithoff, Sheryl; Bromley, Lisa

    2014-01-01

    Objective To offer preliminary guidance on prescribing smoked cannabis for chronic pain before the release of formal guidelines. Quality of evidence We reviewed the literature on the analgesic effectiveness of smoked cannabis and the harms of medical and recreational cannabis use. We developed recommendations on indications, contraindications, precautions, and dosing of smoked cannabis, and categorized the recommendations based on levels of evidence. Evidence is mostly level II (well conducted observational studies) and III (expert opinion). Main message Smoked cannabis might be indicated for patients with severe neuropathic pain conditions who have not responded to adequate trials of pharmaceutical cannabinoids and standard analgesics (level II evidence). Smoked cannabis is contraindicated in patients who are 25 years of age or younger (level II evidence); who have a current, past, or strong family history of psychosis (level II evidence); who have a current or past cannabis use disorder (level III evidence); who have a current substance use disorder (level III evidence); who have cardiovascular or respiratory disease (level III evidence); or who are pregnant or planning to become pregnant (level II evidence). It should be used with caution in patients who smoke tobacco (level II evidence), who are at increased risk of cardiovascular disease (level III evidence), who have anxiety or mood disorders (level II evidence), or who are taking higher doses of opioids or benzodiazepines (level III evidence). Cannabis users should be advised not to drive for at least 3 to 4 hours after smoking, for at least 6 hours after oral ingestion, and for at least 8 hours if they experience a subjective “high” (level II evidence). The maximum recommended dose is 1 inhalation 4 times per day (approximately 400 mg per day) of dried cannabis containing 9% delta-9-tetrahydrocannabinol (level III evidence). Physicians should avoid referring patients to “cannabinoid” clinics (level

  15. A meta-synthesis study of literature review and systematic review published in nurse prescribing.

    Science.gov (United States)

    Darvishpour, Azar; Joolaee, Soodabeh; Cheraghi, Mohammad Ali

    2014-01-01

    Prescribing represents a new aspect of practice for nurses. To make qualitative results more accessible to clinicians, researchers, and policy makers, individuals are urged to synthesize findings from related studies. Therefore this study aimed to aggregate and interpret existing literature review and systematic studies to obtain new insights on nurse prescription. This was a qualitative meta synthesis study using Walsh and Downe process. In order to obtain data all Digital National Library of Medicine's databases, search engines and several related sites were used. Full texts with "review and nurs* prescri* " words in the title or abstract in English language and published without any time limitation were considered. After eliminating duplicate and irrelevant studies, 11 texts were selected. Data analysis was conducted using qualitative content analysis. Multiple codes were compared based on the differences and similarities and divided to the categories and themes. The results from the meta synthesis of the 11 studies revealed 8 themes namely: leading countries in prescribing, views, features, infrastructures, benefits, disadvantages, facilitators and barriers of nursing prescription that are discussed in this article. The results led to a schematic model. Despite the positive view on nurse prescribing, there are still issues such as legal, administrative, weak research and educational deficiencies in academic preparation of nurses that needs more effort in these areas and requires further research.

  16. [Access to medicines prescribed for acute health conditions in adults in South and Northeast Brazil].

    Science.gov (United States)

    Paniz, Vera Maria Vieira; Cechin, Isabel Carolina Coelho Flores; Fassa, Anaclaudia Gastal; Piccini, Roberto Xavier; Tomasi, Elaine; Thumé, Elaine; Silveira, Denise Silva da; Facchini, Luiz Augusto

    2016-01-01

    This was a cross-sectional study within Brazil's Project for the Expansion and Consolidation of Family Health, 2005, with the objective of universal and free access to the medication prescribed in the last medical appointment for acute health problems and to estimate the degree to which access may have improved with inclusion of the medicines in prevailing policies and programs. The sample included 4,060 adults living in the area of primary health care units in 41 municipalities in South and Northeast Brazil. Access was greater in the South (83.2%) than in the Northeast (71%), and free access was similar (37%), with a greater share by the Family Health Program (FHP) when compared to the traditional model, especially in the Northeast. Some 60% of prescribed medicines and 50% of those on the National List of Essential Medicines (RENAME) were paid for. No variation was observed in the proportion of medicines present on the prevailing RENAME list and access. However, 40% of the medicines that were paid for can currently be obtained through the Popular Pharmacy Program. The latter program appears to emerge as a new way to guarantee access to medicines prescribed in the health system.

  17. Prokinetics prescribing in paediatrics: evidence on cisapride, domperidone, and metoclopramide.

    Science.gov (United States)

    Mt-Isa, Shahrul; Tomlin, Stephen; Sutcliffe, Alastair; Underwood, Martin; Williamson, Paula; Croft, Nicholas M; Ashby, Deborah

    2015-04-01

    Domperidone and metoclopramide are prokinetics commonly prescribed off-label to infants and younger children in an attempt to treat gastro-oesophageal reflux symptoms. Another prokinetic drug, cisapride, was used but withdrawn in 2000 in the United Kingdom because of serious arrhythmic adverse events. Medicines and Healthcare Products Regulatory Agency issued safety warnings for domperidone in May 2012 and restricted its indications. We report here national primary care prescribing trends and safety signals of these drugs in children. We used data from the General Practice Research Database between 1990 and 2006 for children <18 years. Descriptive statistics and Poisson regressions were performed to characterise prescribing trends. We examined safety signals in nested case-control studies. The proportion of children <2 years old being prescribed one of the medications doubled during the study period. Prescriptions of domperidone increased 10-fold, mainly following the withdrawal of cisapride in 2000. Prescriptions of metoclopramide did not change significantly. Despite the increase in prescriptions of domperidone, no new safety signals were identified. These data showed dramatic changes in prescribing of cisapride and domperidone despite the lack of good-quality supporting evidence. It is possible that these prescribing trends were influenced by published guidelines. Even if produced without robust efficacy and safety evidence, published guidelines can influence clinicians and consequently affect prescribing. Therefore, improving the evidence base on prokinetics to inform future guidelines is vital. The lack of new safety signals during this period would support the development of suitable powered clinical studies.

  18. Simple Macroeconomic Policies and Welfare: A Quantitative Assessment

    Directory of Open Access Journals (Sweden)

    Eurilton Araújo

    2014-09-01

    Full Text Available We quantitatively compare three macroeconomic policies in a cash-credit goods framework. The policies are: the optimal one; another one that fully smoothes out oscillations in output; and a simple one that prescribes constant values for tax and monetary growth rates. As often found in the related literature, the welfare gains or losses from changing from a given policy to another are small. We also show that the simple policy dominates the one that leads to constant output.

  19. Antimicrobial prescribing behaviour in dogs and cats by Belgian veterinarians.

    Science.gov (United States)

    Van Cleven, Alexia; Sarrazin, Steven; de Rooster, Hilde; Paepe, Dominique; Van der Meeren, Sofie; Dewulf, Jeroen

    2018-03-17

    The objective of this study is to survey general prescribing behaviour by Belgian companion animal veterinarians and to assess agreement of these practices with current treatment guidelines. Therefore an online survey was administered with five realistic and frequently occurring first-line cases to primary-care veterinary practitioners. For each case a predefined pattern of questions were asked about whether or not they would prescribe antimicrobials, if they would prescribe a non-antimicrobial treatment and if they would perform additional diagnostic steps. The responses were compared with recommendations in national guidelines and recent literature. The overall most prescribed antimicrobials were potentiated amoxicillin (43.0 per cent), fluoroquinolones (14.7 per cent), third-generation and fourth-generation cephalosporins (10.9 per cent) and tetracyclines (10.9 per cent). Only 48.3 per cent of the veterinarians complied with the guidelines in nearly all of the clinical scenarios (ie, prescribing antimicrobials when indicated, not prescribing antimicrobials when it is not indicated). Moreover, when prescribing highest priority critically important antimicrobials, susceptibility testing on bacterial cultures was performed in only 12.4 per cent of the prescriptions. The results showed that the prescribing behaviour of antimicrobial compounds by primary-care veterinary practitioners in dogs and cats is often not in agreement with national guidelines. Focus in improvement of this prescribing behaviour should be on performing the appropriate diagnostic steps and decreasing the use of highest priority critically important antimicrobials. © British Veterinary Association (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. Too Few, Too Weak: Conflict of Interest Policies at Canadian Medical Schools

    Science.gov (United States)

    Shnier, Adrienne; Lexchin, Joel; Mintzes, Barbara; Jutel, Annemarie; Holloway, Kelly

    2013-01-01

    Introduction The education of medical students should be based on the best clinical information available, rather than on commercial interests. Previous research looking at university-wide conflict of interest (COI) policies used in Canadian medical schools has shown very poor regulation. An analysis of COI policies was undertaken to document the current policy environment in all 17 Canadian medical schools. Methods A web search was used to initially locate COI policies supplemented by additional information from the deans of each medical school. Strength of policies was rated on a scale of 0 to 2 in 12 categories and also on the presence of enforcement measures. For each school, we report scores for all 12 categories, enforcement measures, and summative scores. Results COI policies received summative scores that ranged from 0 to 19, with 0 the lowest possible score obtainable and 24 the maximum. The highest mean scores per category were for disclosure and ghostwriting (0.9) and for gifts and scholarships (0.8). Discussion This study provides the first comprehensive evaluation of all 17 Canadian medical school-specific COI policies. Our results suggest that the COI policy environment at Canadian medical schools is generally permissive. Policy development is a dynamic process. We therefore encourage all Canadian medical schools to develop restrictive COI policies to ensure that their medical students are educated based on the best clinical evidence available, free of industry biases and COI relationships that may influence the future medical thinking and prescribing practices of medical students in Canada once they graduate. PMID:23861928

  1. Dispensing of non-prescribed antibiotics in Jordan

    Directory of Open Access Journals (Sweden)

    Almaaytah A

    2015-09-01

    without prescription in Jordan in violation with national regulations regarding this practice. The findings of this study could provide a layout for governmental health authorities to implement strict enfrorcment of national regulations regarding antibiotic dispensing in order to avoid the serious complications that could arise in the future as a result of such practices. Keywords: pharmacy, pharmacy practice, non-prescribed antibiotics, microbial resistance, Jordan

  2. Effect of a drug allergy educational program and antibiotic prescribing guideline on inpatient clinical providers' antibiotic prescribing knowledge.

    Science.gov (United States)

    Blumenthal, Kimberly G; Shenoy, Erica S; Hurwitz, Shelley; Varughese, Christy A; Hooper, David C; Banerji, Aleena

    2014-01-01

    Inpatient providers have varying levels of knowledge in managing patients with drug and/or penicillin (PCN) allergy. Our objectives were (1) to survey inpatient providers to ascertain their baseline drug allergy knowledge and preparedness in caring for patients with PCN allergy, and (2) to assess the impact of an educational program paired with the implementation of a hospital-based clinical guideline. We electronically surveyed 521 inpatient providers at a tertiary care medical center at baseline and again 6 weeks after an educational initiative paired with clinical guideline implementation. The guideline informed providers on drug allergy history taking and antibiotic prescribing for inpatients with PCN or cephalosporin allergy. Of 323 unique responders, 42% (95% CI, 37-48%) reported no prior education in drug allergy. When considering those who responded to both surveys (n = 213), we observed a significant increase in knowledge about PCN skin testing (35% vs 54%; P allergy over time (54% vs 80%; P allergy was severe significantly improved (77% vs 92%; P = .03). Other areas, including understanding absolute contraindications to receiving a drug again and PCN cross-reactivity with other antimicrobials, did not improve significantly. Inpatient providers have drug allergy knowledge deficits but are interested in tools to help them care for inpatients with drug allergies. Our educational initiative and hospital guideline implementation were associated with increased PCN allergy knowledge in several crucial areas. To improve care of inpatients with drug allergy, more research is needed to evaluate hospital policies and sustainable educational tools. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  3. The Supply of Prescription Opioids: Contributions of Episodic-Care Prescribers and High-Quantity Prescribers.

    Science.gov (United States)

    Schneberk, Todd; Raffetto, Brian; Kim, David; Schriger, David L

    2018-06-01

    We determine episodic and high-quantity prescribers' contribution to opioid prescriptions and total morphine milligram equivalents in California, especially among individuals prescribed large amounts of opioids. This was a cross-sectional descriptive analysis of opioid prescribing patterns during an 8-year period using the de-identified Controlled Substance Utilization Review and Evaluation System (CURES) database, the California subsection of the prescription drug monitoring program. We took a 10% random sample of all patients and stratified them by the amount of prescription opioids obtained during their maximal 90-day period. We identified "episodic prescribers" as those whose prescribing pattern included short-acting opioids on greater than 95% of all prescriptions, fewer than or equal to 31 pills on 95% of all prescriptions, only 1 prescription in the database for greater than 90% of all patients to whom they gave opioids, fewer than 6 prescriptions in the database to greater than 99% of patients given opioids, and fewer than 540 prescriptions per year. We identified top 5% prescribers by their morphine milligram equivalents per day in the database. We examined the relationship between patient opioid prescriptions and provider type, with the primary analysis performed on the patient cohort who received only short-acting opioids in an attempt to avoid guideline-concordant palliative, oncologic, and addiction care, and a secondary analysis performed on all patients. Among patients with short-acting opioid only, episodic prescribers (14.6% of 173,000 prescribers) wrote at least one prescription to 25% of 2.7 million individuals but were responsible for less than 9% of the 10.5 million opioid prescriptions and less than 3% of the 3.9 billion morphine milligram equivalents in our sample. Among individuals with high morphine milligram equivalents use, episodic prescribers were responsible for 2.8% of prescriptions and 0.6% of total morphine milligram equivalents

  4. Competition between bank regulators

    OpenAIRE

    Schindler, Dirk; Eggert, Wolfgang

    2004-01-01

    This paper examines competition between bank regulators in open economies. We use a model where credit demand of firms is endogenous and show any tendency for downward competition in regulation policy is limited by the effect of regulation on profits of nonfinancial firms. Moreover, perfect mobility on loans and deposit markets fully eliminates the incentives of regulators to set bank regulation at ine±cient low levels.

  5. Non-medical prescribing of chemotherapy: engaging stakeholders to maximise success?

    Science.gov (United States)

    Lennan, Elaine

    2014-01-01

    introduced over the past decade.Little research has been conducted in acute care and none in the chemotherapy setting.Cancer policy recommends the introduction of nurse-led chemotherapy clinics.What this paper addsNon-medical prescribing (NMP) in chemotherapy is appropriate with the right model of practice.Well-established professional relationships are a key to success.NMP is not appropriate in isolation of the multidisciplinary team (MDT).Implications for practice and/or policyNurses need to demonstrate the value of non-medical prescribing in chemotherapy using available metrics.Models of practice need to ensure good communication channels, MDT working, and transparency of prescribing.

  6. The role of national policies intended to regulate adolescent smoking in explaining the prevalence of daily smoking: a study of adolescents from 27 European countries

    DEFF Research Database (Denmark)

    Schnohr, Christina W; Kreiner, Svend; Rasmussen, Mette

    2008-01-01

    AIMS: This study seeks to examine whether contextual factors influence adolescents' daily smoking. A focus was placed on three modifiable policies operating at a national level, non-smoking policy at educational facilities, price and minimum age for buying tobacco. DESIGN: This study is based...... on a merged data set consisting of the 2001/02 Health Behavior in School-aged Children (HBSC) study and national-level data collected from the 2003 WHO European Tobacco Control Database and the World Development Indicators Database. HBSC is an international study including adolescents from 32 countries...

  7. Proceedings of the 8. Brazilian congress on energy: energy policy, regulation and sustainable development. v. 3: technological innovation, renewable sources and rural energization; Anais do 8. Congresso brasileiro de energia: politica energetica, regulamentacao e desenvolvimento sustentavel. v. 3: inovacao tecnologica, fontes renovaveis e energizacao rural

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-07-01

    These proceedings cover the papers presented in the 8. Brazilian congress on energy held at Rio de Janeiro from November, 30 to December, 02, 1999, focusing energy policy, regulation and sustainable development, specifically the contribution of energy to a satisfactory quality of life for everyone. Within such a context, the congress technical programme has been structured around six different divisions: energy, environment and development; energy sector regulation; energy policy and planning; technology innovation; energy conservation; renewable energy sources and rural areas energy supply.

  8. Prescribing in prison: minimizing psychotropic drug diversion in correctional practice.

    Science.gov (United States)

    Pilkinton, Patricia D; Pilkinton, James C

    2014-04-01

    Correctional facilities are a major provider of mental health care throughout the United States. In spite of the numerous benefits of providing care in this setting, clinicians are sometimes concerned about entering into correctional care because of uncertainty in prescribing practices. This article provides an introduction to prescription drug use, abuse, and diversion in the correctional setting, including systems issues in prescribing, commonly abused prescription medications, motivation for and detection of prescription drug abuse, and the use of laboratory monitoring. By understanding the personal and systemic factors that affect prescribing habits, the clinician can develop a more rewarding correctional practice and improve care for inmates with mental illness.

  9. Compliance. Regulatory policy P-211

    International Nuclear Information System (INIS)

    2001-05-01

    This regulatory policy describes the basic principles and directives for establishing and conducting the Canadian Nuclear Safety Commission (CNSC) Compliance Program. The program is aimed at securing compliance by regulated persons with regulatory requirements made under the Nuclear Safety and Control Act ('the Act'). The policy applies to persons who are regulated by the CNSC through the Act, regulations and licences, as well as by decisions and orders made under the Act. The policy applies to officers and employees of the CNSC, and its authorized representatives or agents, who are involved in developing and carrying out compliance activities. Compliance, in the context of this policy, means conformity by regulated persons with the legally binding requirements of the Act, and the CNSC regulations, licences, decisions, and orders made under the Act. Compliance activities are CNSC measures of promotion, verification and enforcement aimed at securing compliance by regulated person with the applicable legally binding requirements. (author)

  10. Pharmacy and primary care perspectives on e-prescribing in a rural community: A focused ethnography.

    Science.gov (United States)

    Kooienga, Sarah; Singh, Reshmi L

    , technological and communication dimensions are essential in understanding e-prescribing across settings and addressing digital divides in our health care system. Implications for interprofessional pharmacy education were addressed. Understanding the rural context and the need for role adaptability has implications for health care policy. Additional research is needed on the role of the rural pharmacist and how best to interact with primary care providers and patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Essential medicine policy in China: pros and cons.

    Science.gov (United States)

    Hu, Shanlian

    2013-01-01

    To analyze the achievements, issues and policy recommendations for implementing essential medicine system in China after a 3-year effort. Policy documents analysis and Literature reviews are conducted. From 2009-2011, a series of national essential medicine (EM) policies has been established which contain EM list, organizing production, quality assurance, pricing, tendering and procurement, distribution, rational use, monitoring and evaluation, etc. About 98.8% government-run primary healthcare institutions and 41.5% village health posts are conducting zero-mark-up policy while buying EMs. The average cost per visit, per admission, and per description in outpatient and inpatient departments has declined. The issues with the national EM list cannot meet the requirements of clinical practice at the local level, all provinces have to increase additional 64-455 EMs in their local supplementary list; the limitation of EML in primary healthcare institutions causes patients to transfer directly to secondary or tertiary hospitals to search appropriate treatment; there is no defined regulation or legislation regarding the responsibility and accountability of government to compensate for the financial loss after implementing a zero mark-up policy in primary healthcare institutions. In the future, some innovative reform should be taken into account, such as revising EML, quality assurance, control margins within the distribution system, differential pricing and internal reference-based pricing, waive taxes and import duties of EMs, and separation between prescribing and dispensing in public hospital reform. Establishing a national essential medicine system is a difficult task to accomplish. The role of the zero-mark-up policy of EMs is to cut off the economic profit chain among different stakeholders. Using pharmaceutical profit to subsidize hospital revenue will be gradually eliminated in China.

  12. Learning curves, taking instructions, and patient safety: using a theoretical domains framework in an interview study to investigate prescribing errors among trainee doctors

    Directory of Open Access Journals (Sweden)

    Duncan Eilidh M

    2012-09-01

    Full Text Available Abstract Background Prescribing errors are a major source of morbidity and mortality and represent a significant patient safety concern. Evidence suggests that trainee doctors are responsible for most prescribing errors. Understanding the factors that influence prescribing behavior may lead to effective interventions to reduce errors. Existing investigations of prescribing errors have been based on Human Error Theory but not on other relevant behavioral theories. The aim of this study was to apply a broad theory-based approach using the Theoretical Domains Framework (TDF to investigate prescribing in the hospital context among a sample of trainee doctors. Method Semistructured interviews, based on 12 theoretical domains, were conducted with 22 trainee doctors to explore views, opinions, and experiences of prescribing and prescribing errors. Content analysis was conducted, followed by applying relevance criteria and a novel stage of critical appraisal, to identify which theoretical domains could be targeted in interventions to improve prescribing. Results Seven theoretical domains met the criteria of relevance: “social professional role and identity,” “environmental context and resources,” “social influences,” “knowledge,” “skills,” “memory, attention, and decision making,” and “behavioral regulation.” From critical appraisal of the interview data, “beliefs about consequences” and “beliefs about capabilities” were also identified as potentially important domains. Interrelationships between domains were evident. Additionally, the data supported theoretical elaboration of the domain behavioral regulation. Conclusions In this investigation of hospital-based prescribing, participants’ attributions about causes of errors were used to identify domains that could be targeted in interventions to improve prescribing. In a departure from previous TDF practice, critical appraisal was used to identify additional domains

  13. Learning curves, taking instructions, and patient safety: using a theoretical domains framework in an interview study to investigate prescribing errors among trainee doctors.

    Science.gov (United States)

    Duncan, Eilidh M; Francis, Jill J; Johnston, Marie; Davey, Peter; Maxwell, Simon; McKay, Gerard A; McLay, James; Ross, Sarah; Ryan, Cristín; Webb, David J; Bond, Christine

    2012-09-11

    Prescribing errors are a major source of morbidity and mortality and represent a significant patient safety concern. Evidence suggests that trainee doctors are responsible for most prescribing errors. Understanding the factors that influence prescribing behavior may lead to effective interventions to reduce errors. Existing investigations of prescribing errors have been based on Human Error Theory but not on other relevant behavioral theories. The aim of this study was to apply a broad theory-based approach using the Theoretical Domains Framework (TDF) to investigate prescribing in the hospital context among a sample of trainee doctors. Semistructured interviews, based on 12 theoretical domains, were conducted with 22 trainee doctors to explore views, opinions, and experiences of prescribing and prescribing errors. Content analysis was conducted, followed by applying relevance criteria and a novel stage of critical appraisal, to identify which theoretical domains could be targeted in interventions to improve prescribing. Seven theoretical domains met the criteria of relevance: "social professional role and identity," "environmental context and resources," "social influences," "knowledge," "skills," "memory, attention, and decision making," and "behavioral regulation." From critical appraisal of the interview data, "beliefs about consequences" and "beliefs about capabilities" were also identified as potentially important domains. Interrelationships between domains were evident. Additionally, the data supported theoretical elaboration of the domain behavioral regulation. In this investigation of hospital-based prescribing, participants' attributions about causes of errors were used to identify domains that could be targeted in interventions to improve prescribing. In a departure from previous TDF practice, critical appraisal was used to identify additional domains that should also be targeted, despite participants' perceptions that they were not relevant to

  14. A drug utilisation study investigating prescribed daily doses of ...

    African Journals Online (AJOL)

    and drug groups. Design. Retrospective drug utilisation study using data .... drugs that were prescribed 20 or fewer times during the period under ... occurs in women and men at different ages and with different severity. group. On average, men ...

  15. Prescribing psychotropic drugs to adults with an intellectual disability

    Science.gov (United States)

    Trollor, Julian N; Salomon, Carmela; Franklin, Catherine

    2016-01-01

    SUMMARY Mental illness is common in people with intellectual disability. They may also have physical health problems which can affect their mental state. Difficulties in communication can contribute to mental health problems being overlooked. These may present with changes in behaviour. Psychological management is usually preferable to prescribing psychotropic drugs. Behavioural approaches are the most appropriate way to manage challenging behaviour. If a drug is considered, prescribers should complete a thorough diagnostic assessment, exclude physical and environmental contributions to symptoms, and consider medical comorbidities before prescribing. Where possible avoid psychotropics with the highest cardiometabolic burden. Prescribe the minimum effective dose and treatment length, and regularly monitor drug efficacy and adverse effects. There is insufficient evidence to support the use of psychotropics for challenging behaviour. They should be avoided unless the behaviour is severe and non-responsive to other treatments. PMID:27756975

  16. Retrospective evaluation of antimicrobial prescribing pattern in a ...

    African Journals Online (AJOL)

    Retrospective evaluation of antimicrobial prescribing pattern in a tertiary hospital in Nigeria. ... Annals of Biomedical Sciences ... prescription in University of Benin Teaching Hospital, Benin City, Nigeria over a period of seven years. Materials ...

  17. On a class of graphs with prescribed mean curvature

    International Nuclear Information System (INIS)

    Duong Minh Duc; Costa Salavessa, I.M. de

    1989-11-01

    We study a class of quasilinear elliptic equations on the unit ball of R n and apply these results to get the existence of graphs with prescribed mean curvature on n-hyperbolic spaces. (author). 18 refs

  18. Potentially inappropriate prescribing in older patients admitted to psychiatric hospital

    NARCIS (Netherlands)

    Rongen, S.; Kramers, C.; O'Mahony, D.; Feuth, T.; Olde Rikkert, M.G.M.; Ahmed, A.I.A.

    2016-01-01

    OBJECTIVES: The objectives of this study are to determine the prevalence of potentially inappropriate prescribing including potentially inappropriate medications (PIMs) and potential prescription omissions (PPOs) and to assess related risk factors in older people with major psychiatric illness.

  19. Medicare Part D Prescriber Look-up Tool

    Data.gov (United States)

    U.S. Department of Health & Human Services — This look-up tool is a searchable database that allows you to look up a Medicare Part D prescriber by National Provider Identifier (NPI), or by name and location....

  20. Research Article Antimalarial Drugs for Pediatrics - Prescribing and ...

    African Journals Online (AJOL)

    Erah

    2011-03-23

    Mar 23, 2011 ... is a need to institute measures to ensure rational prescribing, dispensing and use of antimalarial drugs in pediatrics. ... facilities, strategies to control behaviour in the private sector are ..... changes were implemented in 2006 in.

  1. Antibiotic prescribing practice and adherence to guidelines in ...

    African Journals Online (AJOL)

    clinical outcomes, including death, and consume more healthcare resources.[2] Globally 700 ... Individual prescribing decisions affect the population level of resistance. .... professionals (doctors, nurses, dentists and primary care drug therapist ...

  2. Trends in Antibiotic Prescribing in Adults in Dutch General Practice

    NARCIS (Netherlands)

    M.B. Haeseker (Michiel); N.H.T.M. Dukers-Muijrers (Nicole); C.J.P.A. Hoebe (Christian); C.A. Bruggeman (Cathrien); J.W.L. Cals (Jochen); A. Verbon (Annelies)

    2012-01-01

    textabstractBackground: Antibiotic consumption is associated with adverse drug events (ADE) and increasing antibiotic resistance. Detailed information of antibiotic prescribing in different age categories is scarce, but necessary to develop strategies for prudent antibiotic use. The aim of this

  3. Evaluation of a medication order writing standards policy in a regional health authority

    Science.gov (United States)

    Raymond, Colette B.; Coates, Jan; Woloschuk, Donna M. M.

    2013-01-01

    Background: The Winnipeg Regional Health Authority (WRHA) implemented a medication order writing standards (MOWS) policy (including banned abbreviations) to improve patient safety. Widespread educational campaigns and direct prescriber feedback were implemented. Methods: We audited orders within the WRHA from 2005 to 2009 and surveyed all WRHA staff in 2011 about the policy and suggestions for improving education and compliance. Results: Overall, orders containing banned abbreviations, acronyms or symbols numbered 2261/8565 (26.4%) preimplementation. After WRHA-wide didactic education, the proportion declined to 1358/5461 (24.9%) (p = 0.043) and then, with targeted prescriber feedback, to 1186/6198 (19.1%) (p < 0.0001). A survey of 723 employees showed frequent violations of the MOWS, despite widespread knowledge of the policy. Respondents supported ongoing efforts to enforce the policy within the WRHA. Nonprescribers were significantly more likely than prescribers to agree with statements regarding enhancing compliance by defining prescriber/transcriber responsibilities and placing sanctions on noncompliant prescribers. Discussion: Education, raising general awareness and targeted feedback to prescribers alone are insufficient to ensure compliance with MOWS policies. WRHA staff supported ongoing communication, improved tools such as compliant preprinted orders and reporting and feedback about medication incidents. A surprising number of respondents supported placing sanctions on noncompliant prescribers. Conclusion: Serial audits and targeted interventions such as direct prescriber feedback improve prescription quality in inpatient hospital settings. Education plus direct prescriber feedback had a greater impact than education alone on improving compliance with a MOWS policy. Future efforts at the WRHA to improve compliance will require an expanded focus on incentives, resources and development of action plans that involve all affected staff, not just prescribers

  4. 7 CFR 989.54 - Marketing policy.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Marketing policy. 989.54 Section 989.54 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... CALIFORNIA Order Regulating Handling Marketing Policy § 989.54 Marketing policy. (a) Trade demand. On or...

  5. 7 CFR 993.41 - Marketing policy.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Marketing policy. 993.41 Section 993.41 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Order Regulating Handling Marketing Policy § 993.41 Marketing policy. (a) On or before the first Tuesday...

  6. Existence of conformal metrics on spheres with prescribed Paneitz curvature

    International Nuclear Information System (INIS)

    Ben Ayed, Mohamed; El Mehdi, Khalil

    2003-07-01

    In this paper we study the problem of prescribing a fourth order conformal invariant (the Paneitz curvature) on the n-spheres, with n ≥ 5. Using tools from the theory of critical points at infinity, we provide some topological conditions on the level sets of a given function defined on the sphere, under which we prove the existence of conformal metric with prescribed Paneitz curvature. (author)

  7. Nurse prescriber-patient consultations: a case study in dermatology.

    Science.gov (United States)

    Courtenay, Molly; Carey, Nicola; Stenner, Karen

    2009-06-01

    This paper is a report of a study exploring the content and processes in consultations between nurse prescribers and patients with dermatological conditions. Communication skills, consultation time, information and follow-up are central to the treatment and management of patients with dermatological conditions. The contribution nurses make to the care of these patients has great potential. A multiple case study was conducted with 10 practice settings across England in which nurses prescribed medicines for patients with dermatological conditions. Data were collected between June 2006 and September 2007 using semi-structured interviews (n = 40), patient questionnaires (n = 165/200) and videotaped observations of nurse consultations (n = 40). Data analysis included thematic analysis, descriptive statistics, chi-square and non-parametric tests. Nurses believed that their holistic approach to assessment, combined with their prescribing knowledge, improved prescribing decisions. Listening and explanation of treatments were aspects of nurse communication that were rated highly by patients. Listening and dealing sensitively with emotions were also aspects of the videotaped consultations that were rated highly by assessors. Nurses were less consistent in providing information about medicines. Triangulated data from this study suggest that nurse prescribing enhances the care of patients with dermatological conditions through improved prescribing decisions. If patients are to be more involved in this decision-making, nurses must give them more information about their medicines. The benefits of prescribing were most evident in the practices of dermatology specialist nurses. Further evidence is required to identify whether prescribing by specialist nurses offers similar benefits in other therapeutic areas.

  8. Existence of conformal metrics on spheres with prescribed Paneitz curvature

    CERN Document Server

    Ben-Ayed, M

    2003-01-01

    In this paper we study the problem of prescribing a fourth order conformal invariant (the Paneitz curvature) on the n-spheres, with n >= 5. Using tools from the theory of critical points at infinity, we provide some topological conditions on the level sets of a given function defined on the sphere, under which we prove the existence of conformal metric with prescribed Paneitz curvature.

  9. Sorafenib prescribed by gastroenterologists and hepatologists for hepatocellular carcinoma

    Science.gov (United States)

    Kaplan, David E.; Mehta, Rajni; D’Addeo, Kathryn; Valderrama, Adriana; Taddei, Tamar H.

    2018-01-01

    Abstract Sorafenib is the only Food and Drug Administration (FDA)-approved first-line therapy shown to have survival benefit for patients with advanced hepatocellular carcinoma (HCC). Patients with advanced HCC are often but not exclusively transferred from non-oncologists to oncologists to initiate systemic therapy. The objective of this study was to assess whether sorafenib prescribing by non-oncologists has any impact on utilization, adverse effects, cost or outcome. This was a retrospective cohort study utilizing data from patients prescribed sorafenib for HCC within Veterans Health Administration hospitals with 100% chart abstraction to confirm HCC diagnosis, identify prescribing provider specialty (oncology versus gastroenterology/hepatology), and obtain data required for cancer staging by the Barcelona Clinic Liver Cancer (BCLC) system. The primary outcome was overall survival from the time of sorafenib prescription. A total of 4903 patients who prescribed sorafenib for HCC were identified, for whom 340 patients (6.9%) were prescribed drug by a non-oncologist (Onc). BCLC Stage, age, Child–Turcotte–Pugh score, and comorbidity indices were similar between patients prescribed sorafenib by oncologists and non-oncologists. Oncologists more often discontinued sorafenib due to progression, whereas non-oncologists were more likely to continue sorafenib until death resulting in greater pill utilization and cost. Overall survival in both unadjusted and multivariable models showed no significant impact of prescriber type on survival (222 vs 217 days, P = .96), confirmed with propensity-matched subcohorts. Similar survival outcomes were observed for patients with HCC prescribed sorafenib by non-oncologists and oncologists, suggesting that non-oncologists with expertise in the management of HCC can safely and effectively administer sorafenib. PMID:29369224

  10. Prescribing the behavior of early terminating GMRES and Arnoldi iterations

    Czech Academy of Sciences Publication Activity Database

    Duintjer Tebbens, Jurjen; Meurant, G.

    2014-01-01

    Roč. 65, č. 1 (2014), s. 69-90 ISSN 1017-1398 R&D Projects: GA AV ČR IAA100300802 Grant - others:GA AV ČR(CZ) M100301201 Institutional research plan: CEZ:AV0Z10300504 Keywords : Arnoldi process * early termination * GMRES method * prescribed GMRES convergence * Arnoldi method * prescribed Ritz values Subject RIV: BA - General Mathematics Impact factor: 1.417, year: 2014

  11. Assessment of antibiotic prescribing in Latvian general practitioners

    Directory of Open Access Journals (Sweden)

    Dumpis Uga

    2013-01-01

    Full Text Available Abstract Background Though general antibiotic consumption data is available, information on the actual patterns of prescribing antibiotics locally is difficult to obtain. An easy to use methodology was designed to assess ambulatory management of infections by Latvian general practitioners (GPs. Methods GPs were asked to record data in a patient data collection form for every patient that received antibiotics. Study period – (7 days one week in November, 2008. Data recorded included the following details: an antibiotic, the prescribed dose, dosing interval, route of administration combined with the demographic factors of the patient and clinical diagnosis based on a pre-defined list. Results Two hundred forty eight forms out of the 600 (41% were returned by post. Antibiotics were prescribed in 6.4% (1711/26803 of outpatient consultations. In total, 1763 antibiotics were prescribed during the study period. Ninety seven percent of the patients received monotherapy and only 47 (2.7% patients were prescribed two antibiotics. The most commonly prescribed antibiotics were amoxicillin (33.9% of prescribed, amoxicillin/clavulanate (18,7% and clarithromycin (7.6%. The most commonly treated indications were pharyngitis (29.8%, acute bronchitis (25.3% and rhinosinusitis (10.2%. Pneumonia was mostly treated with amoxicillin/clavulanate (25,7%, amoxicillin (15.7% and clarithromycin (19.3%. Conclusions Methodology employed provided useful additional information on ambulatory practice of prescribing antibiotics and could be used in further assessment studies. Educational interventions should be focused on treatment of acute pharyngitis and bronchitis in children and unnecessary use of quinolones in adults for uncomplicated urinary tract infection.

  12. Alinhamento entre a regulação sanitária e as políticas públicas de medicamentos no Brasil | Alignment between sanitary regulation and drug policies in Brazil

    Directory of Open Access Journals (Sweden)

    Rodrigo Abrão Veloso Taveira

    2015-02-01

    Full Text Available Objetivos: Avaliar a produção normativa da ANVISA referente a medicamentos e verificar o seu alinhamento à Política Nacional de Medicamentos e à Política Nacional de Assistência Farmacêutica. Métodos: Trata-se de estudo descritivo, do tipo levantamento de dados, baseado no método de pesquisa quantitativa e utilizando-se elementos da pesquisa documental. As resoluções da ANVISA publicadas entre 1999 e 2012 foram classificadas em “normativas” e “não normativas” e agrupadas em 12 temas. Aquelas relacionadas a medicamentos foram organizadas em 24 categorias. Ao final, analisou-se a correlação entre essas normas e as diretrizes definidas pelas Políticas Nacionais de Medicamentos e Assistência Farmacêutica. Resultados: Das 2367 resoluções identificadas, 43% possuem caráter “normativo”. As demais (57% não foram consideradas na análise. O principal objeto regulamentado pela ANVISA foi medicamentos (37%, seguido por alimentos (22%. Todas as resoluções sobre medicamentos estão alinhadas à Política Nacional de Medicamentos e à Política Nacional de Assistência Farmacêutica. Conclusões: A atuação regulatória da ANVISA na área de medicamentos está alinhada aos principais instrumentos políticos do governo federal brasileiro nesse setor. Pode-se afirmar que a Agência contribui para a execução das políticas estudadas, fornecendo subsídios para a garantia da segurança, eficácia e qualidade dos medicamentos e serviços farmacêuticos disponibilizados à população. ---------------------------------------------------------------------------------------------- Objectives: Assess the production of Anvisa´s regulations regarding medications and check your alignment to the National Drug Policy and the National Policy of Pharmaceutical Assistance. Methods: This is a descriptive study, the type of data collection, based on quantitative research method and also using elements of documentary research. We used the

  13. 32 CFR 172.3 - Policy.

    Science.gov (United States)

    2010-07-01

    ... SALES OF SURPLUS PERSONAL PROPERTY § 172.3 Policy. (a) Cash or cash equivalents in the prescribed amounts shall accompany bid deposits for a bid to be considered responsive. Similarly, cash or cash...-level costs incurred in operation of the recyclable program. (2) After reimbursement of the cost...

  14. [Antibiotic prescribing in acute respiratory tract infections in general practice].

    Science.gov (United States)

    Malo, S; Bjerrum, L; Feja, C; Lallana, M J; Poncel, A; Rabanaque, M J

    2015-06-01

    Antimicrobial resistance is a worldwide threat to public health. Acute respiratory tract infections are the main reason for antibiotic prescribing in the Spanish paediatric population. The aim of the study was to describe the frequency of antibiotic prescription and their pattern of use in acute respiratory tract infections diagnosed in children in Primary Care in Aragón (Spain). A study was conducted over a 1-year period on children between 0 and 14 years-old, recording all episodes of acute otitis, acute pharyngotonsillitis, non-specific upper respiratory infection, and acute bronchitis. The proportion of episodes within each diagnosis receiving an antibiotic prescription was calculated, and the prescribing pattern was determined. Half (50%) of the children in Aragón were diagnosed with a respiratory tract infection during the study period. Non-specific upper respiratory infection was the most frequent diagnosis. An antibiotic was prescribed in 75% of pharyngotonsillitis episodes, 72% of otitis, 27% of bronchitis, and 16% of non-specific upper respiratory infections. Broad spectrum antibiotics, mainly amoxicillin and amoxicillin-clavulanic, were predominantly prescribed. Antibiotic prescribing in respiratory tract infections in children was generally high, and the choice of antibiotics was probably inappropriate in a high percentage of cases. Therefore an improvement in antibiotic prescribing in children appears to be needed. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  15. Governmental oversight of prescribing medications: history of the US Food and Drug Administration and prescriptive authority.

    Science.gov (United States)

    Plank, Linda S

    2011-01-01

    The evolution of drug regulation and awarding of prescriptive authority is a complex and sometimes convoluted process that can be confusing for health care providers. A review of the history of how drugs have been manufactured and dispensed helps explain why this process has been so laborious and complicated. Because the federal and state governments have the responsibility for protecting the public, most regulations have been passed with the intentions of ensuring consumer safety. The current system of laws and regulations is the result of many years of using the legal system to correct drug marketing that had adverse health consequences. Government oversight will continue as prescribing medications transitions to an electronic form and as health care professionals in addition to physicians seek to gain prescriptive authority. © 2011 by the American College of Nurse-Midwives.

  16. A survey of the criteria for prescribing in cases of borderline refractive errors

    Directory of Open Access Journals (Sweden)

    Einat Shneor

    2016-01-01

    Conclusions: The prescribing criteria found in this study are broadly comparable with those in previous studies and with published prescribing guidelines. Subtle indications suggest that optometrists may become more conservative in their prescribing criteria with experience.

  17. Drug prescribing pattern in three levels of health care facilities in the ...

    African Journals Online (AJOL)

    tabulation and goodness of fit. Results showed that there is significant statistical differences in the number of drugs prescribed per patient encounter, percentage of encounter with an injection prescribed, in adherence to WHO prescribing ...

  18. Understanding the culture of antimicrobial prescribing in agriculture: a qualitative study of UK pig veterinary surgeons

    Science.gov (United States)

    Coyne, L. A.; Latham, S. M.; Williams, N. J.; Dawson, S.; Donald, I. J.; Pearson, R. B.; Smith, R. F.; Pinchbeck, G. L.

    2016-01-01

    Objectives The use of antimicrobials in food-producing animals has been linked with the emergence of antimicrobial resistance in bacterial populations, with consequences for animal and public health. This study explored the underpinning drivers, motivators and reasoning behind prescribing decisions made by veterinary surgeons working in the UK pig industry. Methods A qualitative interview study was conducted with 21 veterinary surgeons purposively selected from all UK pig veterinary surgeons. Thematic analysis was used to analyse transcripts. Results Ensuring optimum pig health and welfare was described as a driver for antimicrobial use by many veterinary surgeons and was considered a professional and moral obligation. Veterinary surgeons also exhibited a strong sense of social responsibility over the need to ensure that antimicrobial use was responsible. A close relationship between management practices, health and economics was evident, with improvements in management commonly identified as being potential routes to reduce antimicrobial usage; however, these were not always considered economically viable. The relationship with clients was identified as being a source of professional stress for practitioners due to pressure from farmers requesting antimicrobial prescriptions, and concern over poor compliance of antimicrobial administration by some farmers. Conclusions The drivers behind prescribing decisions by veterinary surgeons were complex and diverse. A combination of education, improving communication between veterinary surgeons and farmers, and changes in regulations, in farm management and in consumer/retailer demands may all be needed to ensure that antimicrobial prescribing is optimal and to achieve significant reductions in use. PMID:27516473

  19. Prescribing Optimization Method for Improving Prescribing in Elderly Patients Receiving Polypharmacy Results of Application to Case Histories by General Practitioners

    NARCIS (Netherlands)

    Drenth-van Maanen, A. Clara; van Marum, Rob J.; Knol, Wilma; van der Linden, Carolien M. J.; Jansen, Paul A. F.

    2009-01-01

    Background: Optimizing polypharmacy is often difficult, and critical appraisal of medication use often leads to one or more changes. We developed the Prescribing Optimization Method (POM) to assist physicians, especially general practitioners (GPs), in their attempts to optimize polypharmacy in

  20. Getting value today and incentivising for the future: Pharmaceutical development and healthcare policies

    Directory of Open Access Journals (Sweden)

    Kasper Munk Johannesen

    2015-05-01

    Full Text Available To manage the challenge of limited healthcare resources and unlimited demand for healthcare, decision makers utilise a variety of demand side policies, such as health technology appraisals and international reference pricing to regulate price and utilisation. By controlling price and utilisation demand side policies determine the earnings potential, and hence the incentives to invest in research and development (R&D of new technologies. However, the impact of demand side policies on R&D incentives is seldom formally assessed.Based on the key assumption that intellectual property rights, i.e. patents, and expected rent are key drivers of pharmaceutical R&D, this work outlines a framework illustrating the link between demand side policies and pharmaceutical R&D incentives. By analysing how policies impact expected rent and consumer surplus, the framework is used to understand how commonly used demand side policies (including timing and length of reimbursement process, international reference pricing, parallel trade, and sequential adoption into clinical practice may influence R&D incentives.The analysis demonstrates that delayed reimbursement decisions as well as sequential adoption into clinical practise may in fact reduce both expected rent and consumer surplus. It is also demonstrated how international reference pricing is likely to increase consumer surplus at the expense of lower rent and thus lower R&D incentives.Although this work illustrates the importance of considering how demand side policies may impact long-term R&D incentives, it is important to note that the purpose has not been to prescribe which demand side policies should be utilised or how. Rather, the main contribution is to illustrate the need for a structured approach to the analysis of the complex, and at times highly politicised question of how demand side policies ultimately influence population health, both in the short and in the long term. 

  1. "What they see is what you get": Prescribing antibiotics for respiratory tract infections in primary care: Do high prescribers diagnose differently? An analysis of German routine data.

    Science.gov (United States)

    Hueber, Susann; Kuehlein, Thomas; Gerlach, Roman; Tauscher, Martin; Schedlbauer, Angela

    2017-01-01

    Characteristics of high and low prescribers of antibiotics in German primary care were analysed using population data. We aimed to evaluate differences in prescribing rates and factors being associated with high prescribing, and whether high prescribers made the diagnosis of perceived bacterial infections more often. Routine data were provided by the Bavarian Association of Statutory Health Insurance Physicians. Routine data are delivered by primary care practices on a quarterly basis. We analysed data from 2011 and 2012. Patients older than 15 years with respiratory tract infections consulting a primary care physician were selected (6.647 primary care practices). Patient and physician characteristics associated with high prescribing were identified using stepwise logistic regression. Mean prescribing rate of antibiotics was 24.9%. Prescribing rate for high prescribers was 43.5% compared to 8.5% for low prescribers. High prescribers made the diagnosis of perceived bacterial infections more often (Mhigh = 64.5%, Mlow = 45.2%). In the adjusted regression model, perceived bacterial infections were strongly associated with high prescribing (OR = 13.9, 95% CI [10.2, 18.8]). Treating patients with comorbidities was associated with lower prescribing of antibiotics (OR = 0.6, 95% CI [0.4, 0.8]). High prescribers had a higher practice volume, a higher degree of prescribing dominance, and were situated more often in deprived areas and in rural settings. Compared to findings of studies in other European countries, prescribing rates were low. There was a considerable difference between prescribing rates of high and low prescribers. Diagnostic labelling was the best predictor for high prescribing. Current guidelines recommend considering antibiotic treatment for patients with co-morbidities. In our study, treating a large number of high-risk patients was not associated with high prescribing.

  2. Application of laws, policies, and guidance from the United States and Canada to the regulation of food and feed derived from genetically modified crops: interpretation of composition data.

    Science.gov (United States)

    Price, William D; Underhill, Lynne

    2013-09-04

    With the development of recombinant DNA techniques for genetically modifying plants to exhibit beneficial traits, laws and regulations were adopted to ensure the safety of food and feed derived from such plants. This paper focuses on the regulation of genetically modified (GM) plants in Canada and the United States, with emphasis on the results of the compositional analysis routinely utilized as an indicator of possible unintended effects resulting from genetic modification. This work discusses the mandate of Health Canada and the Canadian Food Inspection Agency as well as the U.S. Food and Drug Administration's approach to regulating food and feed derived from GM plants. This work also addresses how publications by the Organisation for Economic Co-operation and Development and Codex Alimentarius fit, particularly with defining the importance and purpose of compositional analysis. The importance of study design, selection of comparators, use of literature, and commercial variety reference values is also discussed.

  3. Implementation of a financial guarantee policy at the CNSC

    International Nuclear Information System (INIS)

    Barker, R.

    2011-01-01

    The Canadian Nuclear Safety Commission (CNSC) was established in 2000 under the Nuclear Safety and Control Act (NSCA) to replace the Atomic Energy Control Board (AECB). Prior to the coming in force of the NSCA, financial guarantees associated with licensed activities were not prescribed in the Atomic Energy Control Act or its regulations. Under the NSCA, the Commission Tribunal 'the Commission' was given authority to impose conditions in licences requiring financial guarantees from licensees. Other provisions of the NSCA provided information on the application of financial guarantees and for refunds when decommissioning obligations had been met. Since 2000, the application of financial guarantees has been primarily focussed on licences issued pursuant to the Class I Nuclear Facilities Regulations and the Uranium Mines and Mills Regulations. This was to assure that the requirements for financial guarantees were initially directed at the high risk, complex facilities licensed by the CNSC. However, all licensees have not yet been required to provide a financial guarantee for all licensed facilities, activities or licence types. Additionally, CNSC expectations in relation to when financial guarantees, associated decommissioning plans and cost estimates need to be reviewed, updated and submitted, and what they should entail have been evolving, indicating a need for a clear CNSC policy on the subject. Consequently, the CNSC is proceeding with the development of a financial guarantee policy and implementation plan to assure that generators of nuclear waste will have the financial resources available to decommission nuclear facilities, operations and devices and that this activity will not fall to government as a future liability. This program will require approval by the Commission, planned for 2012. This paper will further describe this policy and its possible outcomes. (author)

  4. 7 CFR 923.50 - Marketing policy.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Marketing policy. 923.50 Section 923.50 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... COUNTIES IN WASHINGTON Order Regulating Handling Regulations § 923.50 Marketing policy. (a) Each season...

  5. 7 CFR 905.50 - Marketing policy.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Marketing policy. 905.50 Section 905.50 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... TANGELOS GROWN IN FLORIDA Order Regulating Handling Regulations § 905.50 Marketing policy. (a) Before...

  6. 7 CFR 946.50 - Marketing policy.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Marketing policy. 946.50 Section 946.50 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Order Regulating Handling Regulation § 946.50 Marketing policy. (a) Prior to each marketing season, the...

  7. 7 CFR 927.50 - Marketing policy.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Marketing policy. 927.50 Section 927.50 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Order Regulating Handling Regulation of Shipments § 927.50 Marketing policy. (a) It shall be the duty of...

  8. 7 CFR 953.40 - Marketing policy.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Marketing policy. 953.40 Section 953.40 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... STATES Order Regulating Handling Regulations § 953.40 Marketing policy. Prior to or at the same time...

  9. 7 CFR 966.50 - Marketing policy.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Marketing policy. 966.50 Section 966.50 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Regulation § 966.50 Marketing policy. Prior to or at the same time as initial...

  10. 7 CFR 922.50 - Marketing policy.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Marketing policy. 922.50 Section 922.50 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... IN WASHINGTON Order Regulating Handling Regulations § 922.50 Marketing policy. (a) Each season prior...

  11. 7 CFR 906.38 - Marketing policy.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Marketing policy. 906.38 Section 906.38 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... RIO GRANDE VALLEY IN TEXAS Order Regulating Handling Regulation § 906.38 Marketing policy. Prior to or...

  12. 7 CFR 929.46 - Marketing policy.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Marketing policy. 929.46 Section 929.46 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... LONG ISLAND IN THE STATE OF NEW YORK Order Regulating Handling Regulations § 929.46 Marketing policy...

  13. 7 CFR 916.50 - Marketing policy.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Marketing policy. 916.50 Section 916.50 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Regulations § 916.50 Marketing policy. (a) Each season prior to making any...

  14. 7 CFR 959.50 - Marketing policy.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Marketing policy. 959.50 Section 959.50 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Regulations § 959.50 Marketing policy. (a) At the beginning of each season, and as the...

  15. 48 CFR 4.302 - Policy.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Policy. 4.302 Section 4.302 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL ADMINISTRATIVE MATTERS Paper Documents 4.302 Policy. When electronic commerce methods (see 4.502) are not being used, a...

  16. 48 CFR 232.702 - Policy.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Policy. 232.702 Section 232.702 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE GENERAL CONTRACTING REQUIREMENTS CONTRACT FINANCING Contract Funding 232.702 Policy. Fixed-price...

  17. 48 CFR 22.1401 - Policy.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Policy. 22.1401 Section 22.1401 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SOCIOECONOMIC PROGRAMS APPLICATION OF LABOR LAWS TO GOVERNMENT ACQUISITIONS Employment of Workers with Disabilities 22.1401 Policy...

  18. Contraceptive Provision to Adolescent Females Prescribed Teratogenic Medications.

    Science.gov (United States)

    Stancil, Stephani L; Miller, Melissa; Briggs, Holley; Lynch, Daryl; Goggin, Kathy; Kearns, Gregory

    2016-01-01

    Rates of adult women receiving contraceptive provision when simultaneously prescribed a known teratogen are alarmingly low. The prevalence of this behavior among pediatric providers and their adolescent patients is unknown. The objective of this study was to describe pediatric provider behaviors for prescribing teratogens concurrently with counseling, referral, and/or prescribing of contraception (collectively called contraceptive provision) in the adolescent population. A retrospective review was conducted examining visits in 2008-2012 by adolescents aged 14 to 25 years in which a known teratogen (US Food and Drug Administration pregnancy risk category D or X) was prescribed. The electronic medical records were queried for demographic information, evidence of contraceptive provision, and menstrual and sexual histories. The data were analyzed using standard statistical methods. Within 4172 clinic visits, 1694 females received 4506 prescriptions for teratogenic medications. The most commonly prescribed teratogens were topiramate, methotrexate, diazepam, isotretinoin, and enalapril. The subspecialties prescribing teratogens most frequently were neurology, hematology-oncology, and dermatology. Overall, contraceptive provision was documented in 28.6% of the visits. Whites versus nonwhites and older versus younger girls were more likely to receive contraceptive provision. The presence of a federal risk mitigation system for the teratogen also increased the likelihood of contraceptive provision. Our data demonstrate female adolescents prescribed teratogens receive inadequate contraception provision, which could increase their risk for negative pregnancy outcomes. Although the presence of a federal risk mitigation system appears to improve contraceptive provision, these systems are costly and, in some instances, difficult to implement. Efforts to improve provider practices are needed. Copyright © 2016 by the American Academy of Pediatrics.

  19. A Validation Study of Homeopathic Prescribing and Patient Care Indicators

    Directory of Open Access Journals (Sweden)

    Munmun Koley

    2014-10-01

    Full Text Available A preliminary version of the homeopathic prescribing and patient care indicators was available. The instrument was modified further in this study with an intention to address formally its validity and reliability, audit prescriptions, identify areas of sub-optimal prescribing, and highlight target areas for improving the quality of practices. A cross-sectional study with record analysis was conducted on systematically sampled 377 patients of Mahesh Bhattacharyya Homeopathic Medical College and Hospital (MBHMC and H, Howrah, West Bengal, India. The outcome measures were homeopathic prescribing indicators (6 items and patient care indicators (5 items. Individualized homeopathic prescriptions predominated in the encounters. Areas demanding immediate attention were extremely poor labeling of drugs dispensed from the hospital pharmacy, improper record of case history and disease diagnosis, ongoing therapies, and investigational findings in the prescriptions. Internal consistency of the overall instrument was estimated to be good (Cronbach's alpha: Prescribing indicators 0.752 and patient care indicators 0.791. The prescribing indicators, except items 1 and 3, reflected acceptable item-corrected total correlations – Pearson's r from 0.58 (95% CI: 0.52-0.65 to 0.74 (95% CI: 0.69-0.78. The patient care indicators, except item 2, showed acceptable correlations – Pearson's r from 0.40 (95% CI: 0.31-0.48 to 0.82 (95% CI: 0.78-0.85. The instrument also showed high discriminant validity (prescribing indicators P<0.0001 and patient care indicators P<0.0001. Improper prescribing practice was quite rampant and corrective measures are warranted. The developed indicators appeared to be validated and reliable; however, they are amendable for further development.

  20. A Validation Study of Homeopathic Prescribing and Patient Care Indicators

    Science.gov (United States)

    Koley, Munmun; Saha, Subhranil; Ghosh, Shubhamoy; Nag, Goutam; Kundu, Monojit; Mondal, Ramkumar; Purkait, Rajib; Patra, Supratim

    2014-01-01

    A preliminary version of the homeopathic prescribing and patient care indicators was available. The instrument was modified further in this study with an intention to address formally its validity and reliability, audit prescriptions, identify areas of sub-optimal prescribing, and highlight target areas for improving the quality of practices. A cross-sectional study with record analysis was conducted on systematically sampled 377 patients of Mahesh Bhattacharyya Homeopathic Medical College and Hospital (MBHMC and H), Howrah, West Bengal, India. The outcome measures were homeopathic prescribing indicators (6 items) and patient care indicators (5 items). Individualized homeopathic prescriptions predominated in the encounters. Areas demanding immediate attention were extremely poor labeling of drugs dispensed from the hospital pharmacy, improper record of case history and disease diagnosis, ongoing therapies, and investigational findings in the prescriptions. Internal consistency of the overall instrument was estimated to be good (Cronbach's alpha: Prescribing indicators 0.752 and patient care indicators 0.791). The prescribing indicators, except items 1 and 3, reflected acceptable item-corrected total correlations – Pearson's r from 0.58 (95% CI: 0.52-0.65) to 0.74 (95% CI: 0.69-0.78). The patient care indicators, except item 2, showed acceptable correlations – Pearson's r from 0.40 (95% CI: 0.31-0.48) to 0.82 (95% CI: 0.78-0.85). The instrument also showed high discriminant validity (prescribing indicators P < 0.0001 and patient care indicators P < 0.0001). Improper prescribing practice was quite rampant and corrective measures are warranted. The developed indicators appeared to be validated and reliable; however, they are amendable for further development. PMID:25379474