A missed primary care appointment correlates with a subsequent emergency department visit among children with asthma.

Science.gov (United States)

McGovern, Colleen Marie; Redmond, Margaret; Arcoleo, Kimberly; Stukus, David R

2017-11-01

Since the Affordable Care Act's implementation, emergency department (ED) visits have increased. Poor asthma control increases the risk of acute exacerbations and preventable ED visits. The Centers for Medicare and Medicaid Services support the reduction of preventable ED visits to reduce healthcare spending. Implementation of interventions to avoid preventable ED visits has become a priority for many healthcare systems yet little data exist examining children's missed asthma management primary care (PC) appointments and subsequent ED visits. Longitudinal, retrospective review at a children's hospital was conducted for children with diagnosed asthma (ICD-9 493.xx), ages 2-18 years, scheduled for a PC visit between January 1, 2010, and June 30, 2012 (N = 3895). Records were cross-referenced with all asthma-related ED visits from January 1, 2010 to December 31, 2012. Logistic regression with maximum likelihood estimation was conducted. None of the children who completed a PC appointment experienced an ED visit in the subsequent 6 months whereas 2.7% of those with missed PC appointments had an ED visit (χ 2 = 64.28, p asthma as one mechanism for preventing ED visits was demonstrated. Interventions targeting missed visits could decrease asthma-related morbidity, preventable ED visits, and healthcare costs.

Papike appointed Director of IOM

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James Papike was appointed director of the Institute of Meteoritics in the Department of Geology and Presidential Professor at the University of New Mexico, Albuquerque, on July 1, 1990. Papike succeeded Klaus Keil, who moved to the University of Hawaii to direct the Planetary Geoscience Division at the Hawaii Institute of Geosciences.The newly constituted IOM will emphasize planetary volcanic processes through the study of achondritic meteorites, the Moon, and Earth, and the origin of primitive solar system materials and planetary formation through the study of chondritic meteorites.

Healthcare and Catholic identity in the universal Church.

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Danneels, C D

1987-10-01

Two topics that are closely related to the daily work and the primordial concern of Catholic healthcare givers are the meaning and sense of Catholic healthcare institutions, and the relationship between a particular Church and the universal Church, especially since the Second Vatican Council. Some question whether it is worthwhile to maintain independent Catholic institutions, rather than working with others in nondenominational healthcare institutions. Christian institutions are indispensable as a defense against the well-organized forces of evil in the world, and because togetherness is needed in the struggle for good and for faith. Without this togetherness, the danger exists that the power of faith will be taken over by the power of money and financial interest groups. The elements of the Catholic identity of institutions and organizations are a service to the world, the Gospel message, a balance between technology and humanism, a permanent solicitude for the whole person, and a respect for human liberty. This Catholic identity must be fostered in our institutions, especially among the laypeople working there. The relationship between the universal Church and local Churches has come under stress since the Second Vatican Council, and a balance must be found. The problem has two aspects: the theological, and the cultural and psychological. A sound communion theology must be established to provide a good perspective on the relationship. In addition, a dialogue must be established between Rome and the particular Churches to prevent the universal message of Christ in his Gospel from conflicting more and more with local styling of the message.(ABSTRACT TRUNCATED AT 250 WORDS)

Healthcare information technology infrastructures in Turkey.

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Dogac, A; Yuksel, M; Ertürkmen, G L; Kabak, Y; Namli, T; Yıldız, M H; Ay, Y; Ceyhan, B; Hülür, U; Oztürk, H; Atbakan, E

2014-05-22

The objective of this paper is to describe some of the major healthcare information technology (IT) infrastructures in Turkey, namely, Sağlık-Net (Turkish for "Health-Net"), the Centralized Hospital Appointment System, the Basic Health Statistics Module, the Core Resources Management System, and the e-prescription system of the Social Security Institution. International collaboration projects that are integrated with Sağlık-Net are also briefly summarized. The authors provide a survey of the some of the major healthcare IT infrastructures in Turkey. Sağlık-Net has two main components: the National Health Information System (NHIS) and the Family Medicine Information System (FMIS). The NHIS is a nation-wide infrastructure for sharing patients' Electronic Health Records (EHRs). So far, EHRs of 78.9 million people have been created in the NHIS. Similarly, family medicine is operational in the whole country via FMIS. Centralized Hospital Appointment System enables the citizens to easily make appointments in healthcare providers. Basic Health Statistics Module is used for collecting information about the health status, risks and indicators across the country. Core Resources Management System speeds up the flow of information between the headquarters and Provincial Health Directorates. The e-prescription system is linked with Sağlık-Net and seamlessly integrated with the healthcare provider information systems. Finally, Turkey is involved in several international projects for experience sharing and disseminating national developments. With the introduction of the "Health Transformation Program" in 2003, a number of successful healthcare IT infrastructures have been developed in Turkey. Currently, work is going on to enhance and further improve their functionality.

It Takes Two to Tango: Customization and Standardization as Colluding Logics in Healthcare Comment on "(Re) Making the Procrustean Bed Standardization and Customization as Competing Logics in Healthcare".

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Greenfield, David; Eljiz, Kathy; Butler-Henderson, Kerryn

2017-06-28

The healthcare context is characterized with new developments, technologies, ideas and expectations that are continually reshaping the frontline of care delivery. Mannion and Exworthy identify two key factors driving this complexity, 'standardization' and 'customization,' and their apparent resulting paradox to be negotiated by healthcare professionals, managers and policy makers. However, while they present a compelling argument an alternative viewpoint exists. An analysis is presented that shows instead of being 'competing' logics in healthcare, standardization and customization are long standing 'colluding' logics. Mannion and Exworthy's call for further sustained work to understand this complex, contested space is endorsed, noting that it is critical to inform future debates and service decisions. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Patenting and licensing of university research: promoting innovation or undermining academic values?

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Sterckx, Sigrid

2011-03-01

Since the 1980s in the US and the 1990s in Europe, patenting and licensing activities by universities have massively increased. This is strongly encouraged by governments throughout the Western world. Many regard academic patenting as essential to achieve 'knowledge transfer' from academia to industry. This trend has far-reaching consequences for access to the fruits of academic research and so the question arises whether the current policies are indeed promoting innovation or whether they are instead a symptom of a pro-intellectual property (IP) culture which is blind to adverse effects. Addressing this question requires both empirical analysis (how real is the link between academic patenting and licensing and 'development' of academic research by industry?) and normative assessment (which justifications are given for the current policies and to what extent do they threaten important academic values?). After illustrating the major rise of academic patenting and licensing in the US and Europe and commenting on the increasing trend of 'upstream' patenting and the focus on exclusive as opposed to non-exclusive licences, this paper will discuss five negative effects of these trends. Subsequently, the question as to why policymakers seem to ignore these adverse effects will be addressed. Finally, a number of proposals for improving university policies will be made.

New Editors Appointed for Water Resources Research

Science.gov (United States)

2009-03-01

Praveen Kumar (University of Illinois at Urbana-Champaign), the newly appointed editor in chief of Water Resources Research (WRR), heads the new team of editors for the journal. The other editors are Tom Torgersen (University of Connecticut, Groton), who continues his editorship; Tissa Illangasekare (Colorado School of Mines, Golden); Graham Sander (Loughborough University, Loughborough, UK); and John Selker (Oregon State University, Corvallis). Hoshin Gupta (University of Arizona, Tucson) will join WRR at the end of 2009. The new editors will begin receiving submissions immediately. The incoming editorial board thanks outgoing editors Marc Parlange, Brian Berkowitz, Amilcare Porporato, and Scott Tyler, all of whom will assist during the transition.

Effectiveness of mobile-phone short message service (SMS reminders for ophthalmology outpatient appointments: Observational study

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Car Josip

2008-05-01

Full Text Available Abstract Background Non-attendance for hospital outpatient appointments is a significant problem in many countries. It causes suboptimal use of clinical and administrative staff and financial losses, as well as longer waiting times. The use of Short Message Service (SMS appointment reminders potentially offers a cost-effective and time-efficient strategy to decrease non-attendance and so improve the efficiency of outpatient healthcare delivery. Methods An SMS text message was sent to patients with scheduled appointments between April and September 2006 in a hospital ophthalmology department in London, reminding them of their appointments. This group acted as the intervention group. Controls were patients with scheduled ophthalmology appointments who did not receive an SMS or any alternative reminder. Results During the period of the study, 11.2% (50/447 of patients who received an SMS appointment reminder were non-attenders, compared to 18.1% (1720/9512 who did not receive an SMS reminder. Non-attendance rates were 38% lower in patients who received an SMS reminder than in patients who did not receive a reminder (RR of non-attendance = 0.62; 95% CI = 0.48 – 0.80. Conclusion The use of SMS reminders for ophthalmology outpatient appointments was associated with a reduction of 38% in the likelihood of patients not attending their appointments, compared to no appointment reminder. The use of SMS reminders may also be more cost-effective than traditional appointment reminders and require less labour. These findings should be confirmed with a more rigorous study design before a wider roll-out.

Mentorship for newly appointed physicians: a strategy for enhancing patient safety?

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Harrison, Reema; McClean, Serwaa; Lawton, Rebecca; Wright, John; Kay, Clive

2014-09-01

Mentorship is an increasingly popular innovation from business and industry that is being applied in health-care contexts. This paper explores the concept of mentorship for newly appointed physicians in their first substantive senior post, and specifically its utilization to enhance patient safety. Semi-structured face to face and telephone interviews with Medical Directors (n = 5), Deputy Medical Directors (n = 4), and Clinical Directors (n = 6) from 9 acute NHS Trusts in the Yorkshire and Humber region in the north of England. A focused thematic analysis was used. A number of beneficial outcomes were associated with mentorship for newly appointed physicians including greater personal and professional support, organizational commitment, and general well-being. Providing newly appointed senior physicians with support through mentorship was considered to enhance the safety of patient care. Mentorship may prevent or reduce active failures, be used to identify threats in the local working environment, and in the longer term, address latent threats to safety within the organization by encouraging a healthier safety culture. Offering mentorship to all newly appointed physicians in their first substantive post in health care may be a useful strategy to support the development of their clinical, professional, and personal skills in this transitional period that may also enhance the safety of patient care.

Competing Logics and Healthcare Comment on "(Re) Making the Procrustean Bed? Standardization and Customization as Competing Logics in Healthcare".

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Saks, Mike

2017-08-20

This paper offers a short commentary on the editorial by Mannion and Exworthy. The paper highlights the positive insights offered by their analysis into the tensions between the competing institutional logics of standardization and customization in healthcare, in part manifested in the conflict between managers and professionals, and endorses the plea of the authors for further research in this field. However, the editorial is criticized for its lack of a strong societal reference point, the comparative absence of focus on hybridization, and its failure to highlight structural factors impinging on the opposing logics in a broader neo-institutional framework. With reference to the Procrustean metaphor, it is argued that greater stress should be placed on the healthcare user in future health policy. Finally, the case of complementary and alternative medicine is set out which - while not explicitly mentioned in the editorial - most effectively concretizes the tensions at the heart of this analysis of healthcare. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Predicting appointment breaking.

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Bean, A G; Talaga, J

1995-01-01

The goal of physician referral services is to schedule appointments, but if too many patients fail to show up, the value of the service will be compromised. The authors found that appointment breaking can be predicted by the number of days to the scheduled appointment, the doctor's specialty, and the patient's age and gender. They also offer specific suggestions for modifying the marketing mix to reduce the incidence of no-shows.

Primary care patients' expectations regarding medical appointments and their experiences during a visit: does age matter?

Directory of Open Access Journals (Sweden)

Jaworski M

2017-07-01

Full Text Available Mariusz Jaworski,1 Marta Rzadkiewicz,1 Miroslawa Adamus,1 Joanna Chylinska,1 Magdalena Lazarewicz,1 Gørill Haugan,2 Monica Lillefjell,3 Geir Arild Espnes,2 Dorota Wlodarczyk1 1Department of Medical Psychology, Second Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland; 2Department of Public Health and Nursing, 3Department of Neuromedicine and Movement Science, NTNU Center for Health Promotion Research, Norwegian University of Science and Technology, Trondheim, Norway Introduction: There is evidence that meeting patients’ expectations toward health care correlates with involvement in the treatment they receive. The most important patient expectations concern certain types of information: explanation of disease and treatment, health promotion, and improvement in quality of life. Other demands include proper rapport and emotional support. The aim of this paper was to examine different patient groups over the age of 50 years and their expectations toward medical visits, evaluated before a visit and after the visit.Patients and methods: The study group consisted of 4,921 primary health-care patients. The patients received self-administered questionnaires that they filled in before and after the appointment with the doctor. Interviews with patients were conducted individually by specially trained interviewers. The PRACTA Patient Expectations Scale was used to measure the appointment-related expectations of the patients.Results: We observed differences related to age in patients’ expectations before medical visits regarding the following factors: disease explanation, treatment explanation, quality of life, rapport, and emotional support. The same differences were not observed on health promotion. Evaluation of patients’ appointment-related experiences after the visit showed that there were significant differences between the age-groups regarding all types of expectations included in the study. Differences between previsit and

Reduction of missed appointments at an urban primary care clinic: a randomised controlled study

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Calmy Alexandra

2010-10-01

Full Text Available Abstract Background Missed appointments are known to interfere with appropriate care and to misspend medical and administrative resources. The aim of this study was to test the effectiveness of a sequential intervention reminding patients of their upcoming appointment and to identify the profile of patients missing their appointments. Methods We conducted a randomised controlled study in an urban primary care clinic at the Geneva University Hospitals serving a majority of vulnerable patients. All patients booked in a primary care or HIV clinic at the Geneva University Hospitals were sent a reminder 48 hrs prior to their appointment according to the following sequential intervention: 1. Phone call (fixed or mobile reminder; 2. If no phone response: a Short Message Service (SMS reminder; 3. If no available mobile phone number: a postal reminder. The rate of missed appointment, the cost of the intervention, and the profile of patients missing their appointment were recorded. Results 2123 patients were included: 1052 in the intervention group, 1071 in the control group. Only 61.7% patients had a mobile phone recorded at the clinic. The sequential intervention significantly reduced the rate of missed appointments: 11.4% (n = 122 in the control group and 7.8% (n = 82 in the intervention group (p 1year (OR 2.2; CI: 1.15-4.2, substance abuse (2.09, CI 1.21-3.61, and being an asylum seeker (OR 2.73: CI 1.22-6.09. Conclusion A practical reminder system can significantly increase patient attendance at medical outpatient clinics. An intervention focused on specific patient characteristics could further increase the effectiveness of appointment reminders.

How changes to Irish healthcare financing are affecting universal health coverage.

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Briggs, Adam D M

2013-11-01

In 2010, the World Health Organisation (WHO) published the World Health Report - Health systems financing: the path to universal coverage. The Director-General of the WHO, Dr Margaret Chan, commissioned the report "in response to a need, expressed by rich and poor countries alike, for practical guidance on ways to finance health care". Given the current context of global economic hardship and difficult budgetary decisions, the report offered timely recommendations for achieving universal health coverage (UHC). This article analyses the current methods of healthcare financing in Ireland and their implications for UHC. Three questions are asked of the Irish healthcare system: firstly, how is the health system financed; secondly, how can the health system protect people from the financial consequences of ill-health and paying for health services; and finally, how can the health system encourage the optimum use of available resources? By answering these three questions, this article argues that the Irish healthcare system is not achieving UHC, and that it is unclear whether recent changes to financing are moving Ireland closer or further away from the WHO's ambition for healthcare for all. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Personalisation - An Emergent Institutional Logic in Healthcare? Comment on "(Re) Making the Procrustean Bed? Standardization and Customization as Competing Logics in Healthcare".

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Ferlie, Ewan

2017-06-20

This commentary on the recent think piece by Mannion and Exworthy reviews their core arguments, highlighting their suggestion that recent forces for personalization have emerged which may counterbalance the strong standardization wave which has been evident in many healthcare settings and systems over the last two decades. These forces for personalization can take very different forms. The commentary explores the authors' suggestion that these themes can be fruitfully examined theoretically through an institutional logics (ILs) literature, which has recently been applied by some scholars to healthcare settings. This commentary outlines key premises of that theoretical tradition. Finally, the commentary makes suggestions for taking this IL influenced research agenda further, along with some issues to be addressed. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

(Re) Making the Procrustean Bed? Standardization and Customization as Competing Logics in Healthcare.

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Mannion, Russell; Exworthy, Mark

2017-03-28

Recent years have witnessed a parallel and seemingly contradictory trend towards both the standardization and the customization of healthcare and medical treatment. Here, we explore what is meant by 'standardization' and 'customization' in healthcare settings and explore the implications of these changes for healthcare delivery. We frame the paradox of these divergent and opposing factors in terms of institutional logics - the socially constructed rules, practices and beliefs which perpetuate institutional behaviour. As the tension between standardization and customization is fast becoming a critical fault-line within many health systems, there remains an urgent need for more sustained work exploring how these competing logics are articulated, adapted, resisted and co-exist on the front line of care delivery. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Cognitive overload and communication in two healthcare settings.

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Cicourel, Aaron V

2004-01-01

The confluence of organizational social interaction and cognitive information processing constraints create 'noisy' conditions in institutionalized settings. Attentional and memory limitations always influence the ability of participants to comprehend each other's communication. Two organizational settings (a medical specialty clinic and periodontal office) will be used to explore a few features of healthcare delivery that are often ignored in studies of such systems. Scheduling appointments, for example, creates stress for both patients and healthcare personnel but is often an unexamined aspect of healthcare delivery that has become both challenging and often irritating for all concerned. For example, when patients call, someone at a general scheduling center or the particular clinic or office of an individual physician or dentist or a group practice will answer the call with a menu of options, or the caller may be asked to leave message. When a patient leaves a clinic or surgery office after a visit, they may be allowed to make a new appointment. The term 'cognitive overload' is a ubiquitous element of all healthcare systems and refers to organizationally induced and constrained limited capacity processing inherent in the way improvised discourse practices, and annotative devices or artifacts (such as written notes or some related strategy) become an integral part of everyday healthcare delivery.

78 FR 14071 - Notice of Appointment of Members to the National Agricultural Research, Extension, Education, and...

Science.gov (United States)

2013-03-04

...,'' Charles Boyer, Dean, Jordan College of Agriculture and Technology, California State University-Fresno... DEPARTMENT OF AGRICULTURE Office of the Secretary Notice of Appointment of Members to the National... Act, 5 U.S.C. App 2, the United States Department of Agriculture announces the appointments made by...

The Indiana University Center for Healthcare Innovation and Implementation Science: Bridging healthcare research and delivery to build a learning healthcare system.

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Azar, Jose; Adams, Nadia; Boustani, Malaz

2015-01-01

In the United States, it is estimated that 75,000 deaths every year could be averted if the healthcare system implemented high quality care more effectively and efficiently. Patient harm in the hospital occurs as a consequence of inadequate procedures, medications and other therapies, nosocomial infections, diagnostic evaluations and patient falls. Implementation science, a new emerging field in healthcare, is the development and study of methods and tools aimed at enhancing the implementation of new discoveries and evidence into daily healthcare delivery. The Indiana University Center for Healthcare Innovation and Implementation Science (IU-CHIIS) was launched in September 2013 with the mission to use implementation science and innovation to produce great-quality, patient-centered and cost-efficient healthcare delivery solutions for the United States of America. Within the first 24 months of its initiation, the IU-CHIIS successfully scaled up an evidence-based collaborative care model for people with dementia and/or depression, successfully expanded the Accountable Care Unit model positively impacting the efficiency and quality of care, created the first Certificate in Innovation and Implementation Science in the US and secured funding from National Institutes of Health to investigate innovations in dementia care. This article summarizes the establishment of the IU-CHIIS, its impact and outcomes and the lessons learned during the journey. Copyright © 2015. Published by Elsevier GmbH.

Appointment breaking: causes and solutions.

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Bean, A G; Talaga, J

1992-12-01

From a review of research on health care appointment breaking, the authors find that patient demographic characteristics, psychosocial problems, previous appointment keeping, health beliefs, and situational factors predict no-show behavior. Suggestions are offered for designing the marketing mix to increase patient appointment keeping. Methods for mitigating the negative effects of no-shows on health care providers are described.

38 CFR 13.55 - Veterans Service Center Manager to select and appoint or recommend for appointment the person or...

Science.gov (United States)

2010-07-01

... Manager to select and appoint or recommend for appointment the person or legal entity to receive....55 Veterans Service Center Manager to select and appoint or recommend for appointment the person or.... The Veterans Service Center Manager is authorized to select and appoint (or in the case of a court...

Appointment reminder systems are effective but not optimal: results of a systematic review and evidence synthesis employing realist principles

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McLean SM

2016-04-01

Full Text Available Sionnadh Mairi McLean,1 Andrew Booth,2 Melanie Gee,3 Sarah Salway,2 Mark Cobb,4 Sadiq Bhanbhro,3 Susan A Nancarrow5 1Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, UK; 2School of Health and Related Research, University of Sheffield, Sheffield, UK; 3Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK; 4Therapeutics & Palliative Care, Sheffield Teaching Hospitals, Sheffield, UK; 5School of Health and Human Science, Southern Cross University, East Lismore, NSW, Australia Abstract: Missed appointments are an avoidable cost and resource inefficiency which impact upon the health of the patient and treatment outcomes. Health care services are increasingly utilizing reminder systems to manage these negative effects. This study explores the effectiveness of reminder systems for promoting attendance, cancellations, and rescheduling of appointments across all health care settings and for particular patient groups and the contextual factors which indicate that reminders are being employed sub-optimally. We used three inter-related reviews of quantitative and qualitative evidence. Firstly, using pre-existing models and theories, we developed a conceptual framework to inform our understanding of the contexts and mechanisms which influence reminder effectiveness. Secondly, we performed a review following Centre for Reviews and Dissemination guidelines to investigate the effectiveness of different methods of reminding patients to attend health service appointments. Finally, to supplement the effectiveness information, we completed a review informed by realist principles to identify factors likely to influence non-attendance behaviors and the effectiveness of reminders. We found consistent evidence that all types of reminder systems are effective at improving appointment attendance across a range of health care settings and patient populations. Reminder systems may also increase cancellation and

Enhanced Leads and Appointment System

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Social Security Administration — The data asset contains information on current or upcoming appointments, individuals who will be attending the appointment, potential intent to file a claim (lead),...

Appointment Template Redesign in a Women's Health Clinic Using Clinical Constraints to Improve Service Quality and Efficiency.

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Huang, Y; Verduzco, S

2015-01-01

Patient wait time is a critical element of access to care that has long been recognized as a major problem in modern outpatient health care delivery systems. It impacts patient and medical staff productivity, stress, quality and efficiency of medical care, as well as health-care cost and availability. This study was conducted in a Women's Health Clinic. The objective was to improve clinic service quality by redesigning patient appointment template using the clinical constraints. The proposed scheduling template consisted of two key elements: the redesign of appointment types and the determination of the length of time slots using defined constraints. The re-classification technique was used for the redesign of appointment visit types to capture service variation for scheduling purposes. Then, the appointment length was determined by incorporating clinic constraints or goals, such as patient wait time, physician idle time, overtime, finish time, lunch hours, when the last appointment was scheduled, and the desired number of appointment slots, to converge the optimal length of appointment slots for each visit type. The redesigned template was implemented and the results indicated a 73% reduction in average patient waiting from the reported 40 to 11 minutes. The patient no-show rate was reduced by 4% from 24% to 20%. The morning section on average finished about 11:50 am. The clinic day was finished around 4:45 pm. Provider average idle time was estimated to be about 5 minutes, which can be used for charting/documenting patients. This study provided an alternative method of redesigning appointment scheduling templates using only the clinical constraints rather than the traditional way that required an objective function. This paper also documented the employed methods step by step in a real clinic setting. The implementation results concluded a significant improvement on patient wait time and no-show rate.

Nonattendance to medical specialists’ appointments and its relation to regional environmental and socioeconomic indicators in the Chilean public health system

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Elizabeth Angélica Salinas Rebolledo

2014-10-01

Full Text Available INTRODUCTION Medical care provided by medical specialists is one of the scarcest resources in the public system. It is costly and difficult to access for the general population. Availability and accessibility of specialized care is related to economic, social and cultural aspects that vary among geographical areas. An aggravating factor for this situation is patients’ failure to appear on the date of their appointment, which is defined as the nonattendance of patients to medical specialist appointments without notice. OBJECTIVES To measure and analyze the phenomenon of nonattendance of patients to medical appointments with specialists in the public healthcare system of Chile and its relationship with environmental and socioeconomic regional indicators. METHODS Ecological design study, using medical care records in the public system and environmental and socioeconomic regional indicators potentially related to the absence of patients, between the years 2005-2010. Poisson regression models with random components were used for assessing associations. RESULTS There is 16.5% of nonattendance of patients, with a range between regions from 8.8 to 20.2%. Nonattendance is higher in the specialties of dermatology, geriatrics and nutrition (20.0%, in children (3.1% more than in adults, in areas with highest indigenous population (RR=1.3, in areas with low diversity of specialties (RR=1.1 and in the months of February, July, November and December (RR>1.1. CONCLUSIONS In Chile, socioeconomic factors and the management of healthcare resources have greater influence on the nonattendance of patients to medical specialists’ appointments than environmental factors; therefore, this phenomenon may be avoidable.

5 CFR 316.402 - Procedures for making temporary appointments.

Science.gov (United States)

2010-01-01

... appointments. Such appointments are not VRA appointments and do not lead to conversion to career-conditional appointment; (3) Career-conditional appointment under § 315.601, 315.604, 315.605, 315.606, 315.607, 315.608... the General Accounting Office; (6) Appointment under 28 U.S.C. 602 for current and former employees of...

Controlling cost escalation of healthcare: making universal health coverage sustainable in China

Science.gov (United States)

2012-01-01

An increasingly number of low- and middle-income countries have developed and implemented a national policy towards universal coverage of healthcare for their citizens over the past decade. Among them is China which has expanded its population coverage by health insurance from around 29.7% in 2003 to over 90% at the end of 2010. While both central and local governments in China have significantly increased financial inputs into the two newly established health insurance schemes: new cooperative medical scheme (NCMS) for the rural population, and urban resident basic health insurance (URBMI), the cost of healthcare in China has also been rising rapidly at the annual rate of 17.0%% over the period of the past two decades years. The total health expenditure increased from 74.7 billion Chinese yuan in 1990 to 1998 billion Chinese yuan in 2010, while average health expenditure per capital reached the level of 1490.1 Chinese yuan per person in 2010, rising from 65.4 Chinese yuan per person in 1990. The repaid increased population coverage by government supported health insurance schemes has stimulated a rising use of healthcare, and thus given rise to more pressure on cost control in China. There are many effective measures of supply-side and demand-side cost control in healthcare available. Over the past three decades China had introduced many measures to control demand for health care, via a series of co-payment mechanisms. The paper introduces and discusses new initiatives and measures employed to control cost escalation of healthcare in China, including alternative provider payment methods, reforming drug procurement systems, and strengthening the application of standard clinical paths in treating patients at hospitals, and analyses the impacts of these initiatives and measures. The paper finally proposes ways forward to make universal health coverage in China more sustainable. PMID:22992484

Getting patients in the door: medical appointment reminder preferences.

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Crutchfield, Trisha M; Kistler, Christine E

2017-01-01

Between 23% and 34% of outpatient appointments are missed annually. Patients who frequently miss medical appointments have poorer health outcomes and are less likely to use preventive health care services. Missed appointments result in unnecessary costs and organizational inefficiencies. Appointment reminders may help reduce missed appointments; particular types may be more effective than other types. We used a survey with a discrete choice experiment (DCE) to learn why individuals miss appointments and to assess appointment reminder preferences. We enrolled a national sample of adults from an online survey panel to complete demographic and appointment habit questions as well as a 16-task DCE designed in Sawtooth Software's Discover tool. We assessed preferences for four reminder attributes - initial reminder type, arrival of initial reminder, reminder content, and number of reminders. We derived utilities and importance scores. We surveyed 251 adults nationally, with a mean age of 43 (range 18-83) years: 51% female, 84% White, and 8% African American. Twenty-three percent of individuals missed one or more appointments in the past 12 months. Two primary reasons given for missing an appointment include transportation problems (28%) and forgetfulness (26%). Participants indicated the initial reminder type (21%) was the most important attribute, followed by the number of reminders (10%). Overall, individuals indicated a preference for a single reminder, arriving via email, phone call, or text message, delivered less than 2 weeks prior to an appointment. Preferences for reminder content were less clear. The number of missed appointments and reasons for missing appointments are consistent with prior research. Patient-centered appointment reminders may improve appointment attendance by addressing some of the reasons individuals report missing appointments and by meeting patients' needs. Future research is necessary to determine if preferred reminders used in practice

Examining Children's Healthcare Experiences through Drawings

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Burns-Nader, Sherwood

2017-01-01

This study examines children's anxieties about healthcare experiences using drawings. Fifty children, either experiencing a doctor's appointment or hospitalization, completed a drawing of a person in the hospital. Using the Child Drawing: Hospital (CD:H), drawings were scored on individual items which were summed for a total score of projected…

How can healthcare standards be standardised?

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Shaw, Charles D

2015-10-01

International travel, medical tourism and trade have created a demand for reliable assessment of healthcare provision across borders, and for information which is accessible to patients, insurers and referring institutions. External assessment schemes for healthcare providers may be clustered into three types: statutory regulation and institutional licensing, International Standardization Organisation certification, and voluntary systems such as peer review and healthcare accreditation. Increasing complexity of healthcare provision, pressures for public accountability and expectations of professional self-governance place a burden on the inspectors and the inspected. If only to contain costs of external assessment and to increase access to reliable information for patients and insurers, the three approaches must work together rather than compete. This paper summarises the origins, aims, authority and methods of the three general models, describing current pressures and opportunities for convergence (between systems and across borders) in the UK and in Europe. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Safety-evaluation report related to renewal of the operating license for the Texas A and M University Research Reactor. Docket No. 50-128, License R-83

International Nuclear Information System (INIS)

1983-03-01

This Safety Evaluation Report for the application filed by the Texas A and M University (Texas A and M) for a renewal of operating license number R-83 to continue to operate a research reactor has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is owned and operated by the Texas Engineering and Experiment Station of the Texas A and M University and is located on the campus in College Station, Brazos County, Texas. The staff concludes that the TRIGA reactor facility can continue to be operated by Texas A and M University without endangering the health and safety of the public

Appointment scheduling on computer.

Science.gov (United States)

Mercando, A D

1997-07-01

The program is well-written, intuitive, and easy to use once initial data, such as the available appointment slots, has been entered. While the effort may not seem worthwhile initially, the ability to access an office appointment book from several locations simultaneously and the reporting capabilities of the software make MEDSched a useful addition to any busy office practice or clinic. Please send your comments and suggestions to me at adm4@columbia.edu.

One-appointment endodontic therapy: biological considerations.

Science.gov (United States)

Lin, Louis M; Lin, Jarshen; Rosenberg, Paul A

2007-11-01

The authors conducted a literature review to present the best available biological evidence concerning one-appointment endodontic therapy for asymptomatic teeth with apical periodontitis. Because of recent advances in technology, such as rotary engines and nickel-titanium instruments, some practitioners are performing one-appointment endodontic therapy for asymptomatic teeth with apical periodontitis. The authors reviewed the literature, which revealed only a small number of randomized, controlled clinical trials that have been conducted on one-appointment versus multiple-appointment endodontic therapy. As the apical canal preparation is enlarged, a greater percentage of bacteria is eradicated from infected root canals. In addition, sufficiently large apical root canal enlargement facilitates the delivery of antimicrobial irrigant to the apical portion of the canal. However, an association between positive or negative preobturation root canal culture results and the outcome of endodontic treatment has not been well-established. The best available evidence, based on a systematic literature review, indicates that one-appointment endodontic therapy may be feasible in selected cases of apical periodontitis in asymptomatic teeth. However, additional randomized, controlled clinical trials are required.

25 CFR 11.610 - Appointment of guardians.

Science.gov (United States)

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Appointment of guardians. 11.610 Section 11.610 Indians... ORDER CODE Domestic Relations § 11.610 Appointment of guardians. The court shall have the jurisdiction to appoint or remove legal guardians for minors and for persons who are incapable of managing their...

Patients’ Perspective on the Value of Medication Management Appointments

Directory of Open Access Journals (Sweden)

Mario Cruz

2015-05-01

Full Text Available Objectives: There is ongoing concern that psychiatric medication management appointments add little value to care. The present study attempted to address this concern by capturing depressed patients’ views and opinions about the value of psychiatric medication management appointments. Methods: Seventy-eight semi-structured interviews were performed with white and African American depressed patients post medication management appointments. These interviews tapped patients’ views and opinions about the value of attending medication management appointments. Analysis: An iterative thematic analysis was performed. Findings: Patients reported greater appointment value when appointments included obtaining medications, discussing the need for medication changes or dose adjustments, and discussing the impact of medications on their illness. Additionally, greater appointment value was perceived by patients when there were non-medical conversations about life issues, immediate outcomes from the appointment such as motivation to continue in care, and specific qualities of providers that were appealing to patients. Conclusions: Patients’ perceived value of psychiatric medication management appointments is complex. Though important patient outcomes are obtaining medicine and perceiving improvement in their mental health, there are other valued appointment and provider factors. Some of these other valued factors embedded within medication management appointments could have therapeutic properties. These findings have implications for future clinical research and service delivery.

Licensing the Sun

Science.gov (United States)

Demski, Jennifer

2013-01-01

The University of San Diego (USD) and Point Loma Nazarene University (PLNU) are licensing the sun. Both California schools are generating solar power on campus without having to sink large amounts of capital into equipment and installation. By negotiating power purchasing agreements (PPAs) with Amsolar and Perpetual Energy Systems, respectively,…

Safety Evaluation Report related to the renewal of the operating license for the research reactor at Pennsylvania State University

International Nuclear Information System (INIS)

1986-01-01

This Safety Evaluation Report for the application filed by the Pennsylvania State University for a renewal of Operating License R-2 to continue to operate the Pennsylvania State University Breazeale Reactor (PSBR) has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is located on the campus in University Park, Pennsylvania. On the basis of its technical review, the staff concludes that the reactor facility can continue to be operated by the university without endangering the health and safety of the public or the environment

Adherence to Medical Cannabis Among Licensed Patients in Israel

OpenAIRE

Zolotov, Yuval; Baruch, Yehuda; Reuveni, Haim; Magnezi, Racheli

2016-01-01

Abstract Objectives: To evaluate adherence among Israeli patients who are licensed to use medical cannabis and to identify factors associated with adherence to medical cannabis. Methods: Ninety-five novice licensed patients were interviewed for this cross-sectional study. The questionnaire measured demographics, the perceived patient?physician relationship, and the level of patients' active involvement in their healthcare. In addition, patients were queried about adverse effect(s) and about t...

Predicting appointment misses in hospitals using data analytics

Science.gov (United States)

Karpagam, Sylvia; Ma, Nang Laik

2017-01-01

Background There is growing attention over the last few years about non-attendance in hospitals and its clinical and economic consequences. There have been several studies documenting the various aspects of non-attendance in hospitals. Project Predicting Appoint Misses (PAM) was started with the intention of being able to predict the type of patients that would not come for appointments after making bookings. Methods Historic hospital appointment data merged with “distance from hospital” variable was used to run Logistic Regression, Support Vector Machine and Recursive Partitioning to decide the contributing variables to missed appointments. Results Variables that are “class”, “time”, “demographics” related have an effect on the target variable, however, prediction models may not perform effectively due to very subtle influence on the target variable. Previously assumed major contributors like “age”, “distance” did not have a major effect on the target variable. Conclusions With the given data it will be very difficult to make any moderate/strong prediction of the Appointment misses. That being said with the help of the cut off we are able to capture all of the “appointment misses” in addition to also capturing the actualized appointments. PMID:28567409

Does leadership effectiveness correlates with leadership styles in healthcare executives of Iran University of Medical Sciences.

Science.gov (United States)

Ebadifard Azar, Farbod; Sarabi Asiabar, Ali

2015-01-01

Effective leadership is essential to passing through obstacles facing the health field.The current health care system in Iran has major problems and gaps in the field of effective leadership. The aim of this study was to evaluate hospital managers' leadership style through selfassessment and to determine the correlation between leadership styles with healthcare executives' leadership readiness and leadership effectiveness. In this cross-sectional study a self-administered questionnaire completed by all internal healthcare executives of all teaching and non-teaching hospitals affiliated to Iran University of Medical Sciences. Questionnaire was composed to determine demographic information, leadership style questions, leadership effectiveness and leadership readiness. Descriptive statistics and Pearson correlation coefficient were used for data analysis. According to the findings, the dominant style of healthcare executives was transformational leadership style (with a score of 4.34). The leadership effectiveness was estimated at about 4.36 that shows the appropriate level of leadership effectiveness. There was a significant correlation (correlation coefficient of 0.244) between leadership readiness and transformational leadership style (pleadership effectiveness with transformational (0.051) and transactional (0.216) styles. There was a correlation between leadership readiness and leadership effectiveness with leadership styles. Application of this research will be crucial to universities and healthcare executives. This study suggests that strengthening the scientific basis is essential for leadership readiness and leadership effectiveness in healthcare system.

48 CFR 1401.603-3 - Appointment.

Science.gov (United States)

2010-10-01

... Responsibilities 1401.603-3 Appointment. Purchase card holders may be appointed in writing or in accordance with the bureau/office procedures within the constraints of DOI Integrated Charge Card Program Policy Manual located at http://www.doi.gov/pam/chargecard. Additional guidance is available in the GSA Smart...

Appointment, qualifications and responsibilities of ventilation officers

International Nuclear Information System (INIS)

1981-01-01

The Code provides for the appointment of a ventilation officer when required by the appropriate authority. This guideline offers comment on the appointment, qualifications, training and responsibilities of that person

TPMG Northern California appointments and advice call center.

Science.gov (United States)

Conolly, Patricia; Levine, Leslie; Amaral, Debra J; Fireman, Bruce H; Driscoll, Tom

2005-08-01

Kaiser Permanente (KP) has been developing its use of call centers as a way to provide an expansive set of healthcare services to KP members efficiently and cost effectively. Since 1995, when The Permanente Medical Group (TPMG) began to consolidate primary care phone services into three physical call centers, the TPMG Appointments and Advice Call Center (AACC) has become the "front office" for primary care services across approximately 89% of Northern California. The AACC provides primary care phone service for approximately 3 million Kaiser Foundation Health Plan members in Northern California and responds to approximately 1 million calls per month across the three AACC sites. A database records each caller's identity as well as the day, time, and duration of each call; reason for calling; services provided to callers as a result of calls; and clinical outcomes of calls. We here summarize this information for the period 2000 through 2003.

Factors influencing non-attendance of clinic appointments in ...

African Journals Online (AJOL)

without an appointment, with an average of eight patients per day missing their appointment. The low rate of compliance with clinic appointments was of concern for the physicians at both the diabetes clinics. Prior to the current study, the reasons for non-attendance had not been examined. Materials and methods. A sample ...

Qualitative Study of Foster Caregivers’ Views on Adherence to Pediatric Appointments

Science.gov (United States)

Schneiderman, Janet U.; Kennedy, Andrea K.; Sayegh, Caitlin S.

2016-01-01

The current study is a qualitative investigation of how foster caregivers, primarily Latinos, view adherence to pediatric appointments with the purpose of identifying how the child welfare system, pediatric clinics, and pediatric health providers serving foster children might promote appointment attendance. Participants in the study had a return appointment at an outpatient pediatric clinic that only served children in the child welfare system. Twenty-eight caregivers (13 related and 15 unrelated) participated in telephone interviews after the date of their scheduled pediatric appointment (32% missed their return appointment). Semistructured interview guides included general questions about what promotes attending the pediatric appointment, what makes it difficult to attend the pediatric appointment, and how pediatric care affects the foster child. Analysis of qualitative data using content analysis identified three themes: (a) multiple methods to attend appointments, which included caregivers’ organizational and problem-solving skills; (b) positive health care experiences, which consisted of caregivers’ personal relationships with providers and staff members and clinic organization; and (c) necessity of pediatric care, which included recognition of the need for health care, especially timely immunizations. All caregivers also reported that appointments reminders would be helpful. Unrelated caregivers more often said that appointment attendance was facilitated by clinic organization compared to related caregivers. Nonadherent caregivers mentioned their need to solve problems to attend appointments or reschedule appointments more than attenders. In summary, caregivers said they valued regular pediatric health care to treat their child’s chronic conditions and prevent illnesses, but they acknowledged that their home lives were hectic and attending scheduled appointments was sometimes difficult. Foster caregivers in this study identified the ideal pediatric

Between the Cup and the Lip: Missed Dental Appointments.

Science.gov (United States)

Tandon, Sandeep; Duhan, Reena; Sharma, Meenakshi; Vasudeva, Suraj

2016-05-01

Missed appointments are an issue which have been very commonly noticed but overlooked in Indian dental society. Almost every dentist, general or specialized, private or public, has faced this problem in routine practice but very less research has been conducted on this issue in Asian countries. The aim of this study was to determine the frequency and distribution of missed dental appointments among children and the reasons behind the non-attendance in department of paediatric and preventive dentistry. Patients under 15 years of age who reported during the period March through August 2014 were included in this study. Attendance data and demographical data for patients was obtained from patient records and the hospital database. The type of treatment patients were to receive was gathered from the appointment diaries of staff, postgraduate students and undergraduates. A structured questionnaire regarding the most frequent reasons given by patients for not attending the scheduled appointment was also prepared. The data were analysed using descriptive analysis. Of the total 2294 patients 886 patients failed to come on their scheduled appointment. Percentage of patients who missed their appointments was 38.6%. A 38.2% of them required primary teeth pulp therapy. No significant differences was found between genders regarding the prevalence of missed dental appointments. Only 40% dentist witnessed that the most common reason for their patients to miss dental appointment was "no leave from school". Illness was the second frequent excuse heard by dentists (5/20= 25%) from their patients and attendants. Missed dental appointment was found to be a common issue in paediatric age group. Counseling and motivation is required to be done at first dental visit to reduce the chances of missed appointment.

Sláintecare - A ten-year plan to achieve universal healthcare in Ireland.

Science.gov (United States)

Burke, Sara; Barry, Sarah; Siersbaek, Rikke; Johnston, Bridget; Ní Fhallúin, Maebh; Thomas, Steve

2018-05-22

In May 2017, an Irish cross-party parliamentary committee published the 'Houses of the Oireachtas Committee on the Future of Healthcare "Sláintecare" report'. The report, known as 'Sláintecare', is unique and historic as it is the first time there has been a cross-party political consensus on major health reform in Ireland. Sláintecare sets out a high level policy roadmap to deliver whole system reform and universal healthcare, phased over a ten year period and costed. Sláintecare details reform proposals which, if delivered, will establish; a universal, single-tier health service where patients are treated solely on the basis of health need; the reorientation of the health system 'towards integrated primary and community care, consistent with the highest quality of patient safety in as short a time-frame as possible'. Sláintecare has five interrelated components: population health; entitlements and access to healthcare; integrated care; funding; and implementation. In this article, the authors use documents in the public domain (parliamentary reports, public hearings, submissions to the Committee, media coverage, the final report of the Committee, speeches by Committee members) to describe the policy process and the main contents of the proposed Sláintecare reforms. It is too soon tell if the political consensus in the policy formation can hold for its implementation. Copyright © 2018 The Author(s). Published by Elsevier B.V. All rights reserved.

The first antenatal appointment: An exploratory study of the experiences of women with a diagnosis of mental illness.

Science.gov (United States)

Phillips, Louise; Thomas, Dona

2015-08-01

to explore and gain insight into the expectations and experiences of women with a pre-existing diagnosis of mental illness, of their first booking appointment; to make recommendations for practice development and collaborative partnership working between healthcare professionals. a qualitative design using semi structured interviews and thematic analysis of the data. QSR NVivo 10 software is used to organise the data into themes. the interviews took place either at the women׳s homes, or within the antenatal service with the consent of the woman and relevant practitioners. twelve participants were selected from one antenatal clinic and one perinatal mental health service. the themes identified within the data included the lack of information prior to the initial midwife booking appointment; the perception of too much information at the initial booking appointment and women not being clear about their mental health needs at this time; a general positivity about disclosing mental illness diagnoses; overall positive thoughts about midwives although some midwives appeared less knowledgeable about bipolar disorder, and perceptions about a lack of joined up working between antenatal and perinatal mental health services. it is recommended that GPs receive adequate training in order to equip them with the skills needed to discuss sensitive issues around perinatal mental illness and the impact on pregnancy and childbirth. Women require more information about their booking appointment, and it would be beneficial for their emotional and physical health needs to be assessed at each follow-up antenatal appointment. Midwives need to be facilitated to receive up-to-date knowledge of antenatal and postnatal mental illness and treatments, and the referral process to perinatal mental health services. Copyright © 2015 Elsevier Ltd. All rights reserved.

Investor Response to Appointment of Female CEOs and CFOs

NARCIS (Netherlands)

Scholtens, Lambertus; Brinkhuis, Eline

2018-01-01

We study the impact of appointing women to top executive positions from an investor perspective. We analyze whether shareholders value announcement of appointment of women to top positions differently than they do appointment of men. This study uses an international sample of 100 announcements of

78 FR 29393 - University of Missouri-Columbia Facility Operating License No. R-103

Science.gov (United States)

2013-05-20

... Facility Operating License No. R-103 AGENCY: Nuclear Regulatory Commission. ACTION: License renewal... the renewal of Facility Operating License No. R-103 (``Application''), which currently authorizes the... application for the renewal of Facility Operating License No. R-103, which, currently authorizes the licensee...

Sound Exposure of Healthcare Professionals Working with a University Marching Band.

Science.gov (United States)

Russell, Jeffrey A; Yamaguchi, Moegi

2018-01-01

Music-induced hearing disorders are known to result from exposure to excessive levels of music of different genres. Marching band music, with its heavy emphasis on brass and percussion, is one type that is a likely contributor to music-induced hearing disorders, although specific data on sound pressure levels of marching bands have not been widely studied. Furthermore, if marching band music does lead to music-induced hearing disorders, the musicians may not be the only individuals at risk. Support personnel such as directors, equipment managers, and performing arts healthcare providers may also be exposed to potentially damaging sound pressures. Thus, we sought to explore to what degree healthcare providers receive sound dosages above recommended limits during their work with a marching band. The purpose of this study was to determine the sound exposure of healthcare professionals (specifically, athletic trainers [ATs]) who provide on-site care to a large, well-known university marching band. We hypothesized that sound pressure levels to which these individuals were exposed would exceed the National Institute for Occupational Safety and Health (NIOSH) daily percentage allowance. Descriptive observational study. Eight ATs working with a well-known American university marching band volunteered to wear noise dosimeters. During the marching band season, ATs wore an Etymotic ER-200D dosimeter whenever working with the band at outdoor rehearsals, indoor field house rehearsals, and outdoor performances. The dosimeters recorded dose percent exposure, equivalent continuous sound levels in A-weighted decibels, and duration of exposure. For comparison, a dosimeter also was worn by an AT working in the university's performing arts medicine clinic. Participants did not alter their typical duties during any data collection sessions. Sound data were collected with the dosimeters set at the NIOSH standards of 85 dBA threshold and 3 dBA exchange rate; the NIOSH 100% daily dose is

Behavioral changes during dental appointments in children having tooth extractions

Directory of Open Access Journals (Sweden)

Mariana Gonzalez Cademartori

2017-01-01

Full Text Available Background: Tooth extractions are associated with anxiety-related situations that can cause behavioral problems in pediatric dental clinics. Aim: We aimed to describe the behavior of children during tooth extraction appointments, compare it to their behavior in preceding and subsequent dental appointments, and assess the behavioral differences according to gender, age, type of dentition, and reason for extraction. Settings and Design: This was a retrospective study based on information obtained from records of children between 6 and 13 years of age who were cared for at the Dentistry School in Pelotas, Brazil. Materials and Methods: Child behavior was assessed during the dental appointment that preceded the tooth extraction, during the tooth extraction appointment, and in the subsequent dental appointment using the Venham Behavior Rating Scale. Statistical Analysis: Results were analyzed using the Pearson Chi-square and McNemar tests. Results: Eighty-nine children were included. Cooperative behavior prevailed in all the dental appointments. The prevalence of “mild/intense protest” was higher in the tooth extraction appointments than in the previous or subsequent dental appointments (P < 0.001. No significant differences in behavior were detected between the type of dentition (primary or permanent teeth, reason for extraction or gender. Conclusion: In this sample of children treated at a dental school, the occurrence of uncooperative behavior was higher during the tooth extraction appointments than in the preceding and subsequent dental appointments.

An introduction to intellectual property licensing for technology companies

Science.gov (United States)

Meier, Lawrence H.

2001-05-01

Intellectual property licensing is an important issue facing all technology companies. Before entering into license agreements a number of issues need to be addressed, including invention ownership, obtaining and identifying licensable subject matter, and developing a licensing strategy. There are a number of important provisions that are included in most intellectual property license agreements. These provisions include definitions, the license grant, consideration, audit rights confidentiality, warranties, indemnification, and limitation of liability. Special licensing considerations exist relative to each type of intellectual property, and when the other party is a foreign company or a university.

48 CFR 245.7001 - Selection, appointment, and termination.

Science.gov (United States)

2010-10-01

... REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE CONTRACT MANAGEMENT GOVERNMENT PROPERTY Appointment of Property... officers, the appointment authority shall consider experience, training, education, business acumen, judgment, character, and ethics. ...

Audiologist-patient communication profiles in hearing rehabilitation appointments.

Science.gov (United States)

Meyer, Carly; Barr, Caitlin; Khan, Asaduzzaman; Hickson, Louise

2017-08-01

To profile the communication between audiologists and patients in initial appointments on a biomedical-psychosocial continuum; and explore the associations between these profiles and 1) characteristics of the appointment and 2) patients' decisions to pursue hearing aids. Sixty-three initial hearing assessment appointments were filmed and audiologist-patient communication was coded using the Roter Interaction Analysis System. A hierarchical cluster analysis was conducted to profile audiologist-patient communication, after which regression modelling and Chi-squared analyses were conducted. Two distinct audiologist-patient communication profiles were identified during both the history taking phase (46=biopsychosocial profile, 15=psychosocial profile) and diagnosis and management planning phase (45=expanded biomedical profile, 11=narrowly biomedical profile). Longer appointments were significantly more likely to be associated with an expanded biomedical interaction during the diagnosis and management planning phase. No significant associations were found between audiologist-patient communication profile and patients' decisions to pursue hearing aids. Initial audiology consultations appear to remain clinician-centred. Three quarters of appointments began with a biopsychosocial interaction; however, 80% ended with an expanded biomedical interaction. Findings suggest that audiologists could consider modifying their communication in initial appointments to more holistically address the needs of patients. Copyright © 2017 Elsevier B.V. All rights reserved.

New Editors Appointed for Sections of Journal of Geophysical Research

Science.gov (United States)

2009-04-01

New editors have been appointed for the Atmospheres, Biogeosciences, and Oceans sections of the Journal of Geophysical Research (JGR). Joost de Gouw (NOAA, Boulder, Colo.) and Renyi Zhang (Texas A&M, College Station) are filling the vacancies of retiring Atmospheres section editors John Austin and Jose Fuentes. De Gouw and Zhang join the continuing editors Steven Ghan and Yinon Rudich. Sara Pryor (Indiana University, Bloomington) is joining the Atmospheres section editorial board as an associate editor now; she will transition to editor in January 2010.

25 CFR 11.706 - Appointment and duties of appraiser.

Science.gov (United States)

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Appointment and duties of appraiser. 11.706 Section 11... OFFENSES AND LAW AND ORDER CODE Probate Proceedings § 11.706 Appointment and duties of appraiser. (a) Upon ordering an estate to be probated, the court shall appoint a disinterested and competent person as an...

Shared medical appointments: improving access, outcomes, and satisfaction for patients with chronic cardiac diseases.

Science.gov (United States)

Bartley, Kelly Bauer; Haney, Rebecca

2010-01-01

Improving access to care, health outcomes, and patient satisfaction are primary objectives for healthcare practices. This article outlines benefits, concerns, and possible challenges of shared medical appointments (SMAs) for patients and providers. The SMA model was designed to support providers' demanding schedules by allowing patients with the same chronic condition to be seen in a group setting. By concentrating on patient education and disease management, interactive meetings provide an opportunity for patients to share both successes and struggles with others experiencing similar challenges. Studies demonstrated that SMAs improved patient access, enhanced outcomes, and promoted patient satisfaction. This article describes the potential benefits of SMAs for patients with chronic heart disease, which consumes a large number of healthcare dollars related to hospital admissions, acute exacerbations, and symptom management. Education for self-management of chronic disease can become repetitive and time consuming. The SMA model introduces a fresh and unique style of healthcare visits, allowing providers to devote more time and attention to patients and improve productivity. The SMA model provides an outstanding method for nurse practitioners to demonstrate their role as a primary care provider, by leading patients in group discussions and evaluating their current health status. Patient selection, preparation, and facilitation of an SMA are discussed to demonstrate the complementary nature of an SMA approach in a healthcare practice.

mHealth Clinic Appointment PC Tablet: Implementation, Challenges and Solutions

Science.gov (United States)

Smith, Carol E.; Spaulding, Ryan; Piamjariyakul, Ubolrat; Werkowitch, Marilyn; Yadrich, Donna Macan; Hooper, Dedrick; Moore, Tyson; Gilroy, Richard

2015-01-01

Background Patients requiring daily intravenous (IV) home parenteral nutrition (HPN) would benefit from in-home professional observation to improve self-care, to assess, detect and prevent serious complications. Aims The study aims are to assess the viability and utility of conducting mobile healthcare (mHealth) videoconference assessments with patients managing lifelong daily 12-hour IV nutrition infusions in their homes. The challenges and solutions to implementing mobile personal computer (PC) tablet based clinic appointments are described. Methods A wireless Apple iPad Mini™ mobile touch-screen tablet computer with 5 mega-pixel camera was loaned to patients. Each tablet had Polycom RealPresence software and a fourth generation (4G) mobile telecommunications data plan. These supported audio-visual mobile videoconferencing encrypted connections between health professionals in their offices and HPN patients and their family members in their homes. Patients’ and professionals’ evaluations of their mHealth clinic experiences are collected. Results Patients (mean age = 41.9, SD = 2.8 years) had been prescribed 12-hour home parenteral nutrition (HPN) infusions daily due short bowel disorders. Patients had been on HPN from 1 to 10 years (M=4, SD=3.6). Evaluation of clinic appointments revealed that 100% of the patients (n=45) and the professionals (n=6) indicated that they can clearly hear and easily see one another. The mHealth audio-visual interactions were highly rated by patients and family members. Professionals highly rated their ability to obtain a medical history and visual inspection of patients. Several challenges were identified and recommendations for resolutions are described. Discussion All patients and professionals highly rated the iPad mHealth clinic appointments for convenience and ease of communicating between homes and offices. An important challenge for all mHealth visits is the clinical professional’s ability to make clinically accurate

An Optimization of Inventory Demand Forecasting in University Healthcare Centre

Science.gov (United States)

Bon, A. T.; Ng, T. K.

2017-01-01

Healthcare industry becomes an important field for human beings nowadays as it concerns about one’s health. With that, forecasting demand for health services is an important step in managerial decision making for all healthcare organizations. Hence, a case study was conducted in University Health Centre to collect historical demand data of Panadol 650mg for 68 months from January 2009 until August 2014. The aim of the research is to optimize the overall inventory demand through forecasting techniques. Quantitative forecasting or time series forecasting model was used in the case study to forecast future data as a function of past data. Furthermore, the data pattern needs to be identified first before applying the forecasting techniques. Trend is the data pattern and then ten forecasting techniques are applied using Risk Simulator Software. Lastly, the best forecasting techniques will be find out with the least forecasting error. Among the ten forecasting techniques include single moving average, single exponential smoothing, double moving average, double exponential smoothing, regression, Holt-Winter’s additive, Seasonal additive, Holt-Winter’s multiplicative, seasonal multiplicative and Autoregressive Integrated Moving Average (ARIMA). According to the forecasting accuracy measurement, the best forecasting technique is regression analysis.

Effect of second timed appointments for non-attenders of breast cancer screening in England: a randomised controlled trial.

Science.gov (United States)

Allgood, Prue C; Maroni, Roberta; Hudson, Sue; Offman, Judith; Turnbull, Anne E; Peacock, Lesley; Steel, Jim; Kirby, Geraldine; Ingram, Christine E; Somers, Julie; Fuller, Clare; Threlfall, Anthony G; Gabe, Rhian; Maxwell, Anthony J; Patnick, Julietta; Duffy, Stephen W

2017-07-01

significantly higher in the intervention group (2861 [22%] of 12 807) than in the control group (1632 [12%] of 13 247); relative risk of participation 1·81 (95% CI 1·70-1·93; p<0·0001). These findings show that a policy of second appointments with fixed date and time for non-attenders of breast screening is effective in improving participation. This strategy can be easily implemented by the screening sites and, if combined with simple interventions, could further increase participation and ensure an upward shift in the participation trend nationally. Whether the policy should vary by time since last attended screen will have to be considered. National Health Service Cancer Screening Programmes and Department of Health Policy Research Programme. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Regulator process for the authorization of an amendment to the operation license of a nuclear power plant in Mexico

International Nuclear Information System (INIS)

Perez, R.; Espinosa V, J.M.; Salgado, J.R.; Mamani, Y.R.

2005-01-01

The regulator process by which an authorization is granted from an amendment to the License of Operation of a nuclear power station in Mexico is described. It makes an appointment the effective legal mark, the technical characteristics of the modification, the evaluation process and deposition upon oath of tests and finally the elaboration of the Safety report and the Technical Verdict that is a correspondent for the regulator organism to the Secretary of Energy, the one that in turn is the responsible of granting the amendment the License just as it establishes it the Law. (Author)

Medication therapy management clinic: perception of healthcare professionals in a University medical center setting

Directory of Open Access Journals (Sweden)

Shah M

2013-09-01

Full Text Available Objective: To determine the overall perception and utilization of the pharmacist managed medication therapy management (MTM clinic services, by healthcare professionals in a large, urban, university medical care setting.Methods: This was a cross-sectional, anonymous survey sent to 195 healthcare professionals, including physicians, nurses, and pharmacists at The University of Illinois Outpatient Care Center to determine their perception and utilization of the MTM clinic. The survey consisted of 12 questions and was delivered through a secure online application. Results: Sixty-two healthcare professionals (32% completed the survey. 82% were familiar with the MTM clinic, and 63% had referred patients to the clinic. Medication adherence and disease state management was the most common reason for referral. Lack of knowledge on the appropriate referral procedure was the prominent reason for not referring patients to the MTM clinic. Of the providers that were aware of MTM services, 44% rated care as ‘excellent’, 44% as ‘good’, 5% as ‘fair’, and 0% stated ‘poor’. Strengths of MTM clinic identified by healthcare providers included in-depth education to patients, close follow-up, and detailed medication reconciliation provided by MTM clinic pharmacists. Of those familiar with MTM clinic, recommendations included; increase marketing efforts to raise awareness of the MTM clinic service, create collaborative practice agreements between MTM pharmacists and physicians, and ensure that progress notes are more concise.Conclusion: In a large, urban, academic institution MTM clinic is perceived as a valuable resource to optimize patient care by providing patients with in-depth education as it relates to their prescribed medications and disease states. These identified benefits of MTM clinic lead to frequent patient referrals specifically for aid with medication adherence and disease state management.

History of the medical licensing examination (uieop in Korea’s Goryeo Dynasty (918-1392

Directory of Open Access Journals (Sweden)

Kyung-Lock Lee

2015-05-01

Full Text Available This article aims to describe the training and medical licensing system (uieop for becoming a physician officer (uigwan during Korea’s Goryeo Dynasty (918-1392. In the Goryeo Dynasty, although no license was necessary to provide medical services to the common people, there was a licensing examination to become a physician officer. No other national licensing system for healthcare professionals existed in Korea at that time. The medical licensing examination was administered beginning in 958. Physician officers who passed the medical licensing examination worked in two main healthcare institutions: the Government Hospital (Taeuigam and Pharmacy for the King (Sangyakguk. The promotion and expansion of medical education differed depending on the historical period. Until the reign of King Munjong (1046-1083, medical education as a path to licensure was encouraged in order to increase the number of physician officers qualifying for licensure by examination; thus, the number of applicants sitting for the examination increased. However, in the late Goryeo Dynasty, after the officer class of the local authorities (hyangri showed a tendency to monopolize the examination, the Goryeo government limited the examination applications by this group. The medical licensing examination was divided into two parts: medicine and ‘feeling the pulse and acupuncture’ (jugeumeop. The Goryeo Dynasty followed the Chinese Dang Dynasty’s medical system while also taking a strong interest in the Chinese Song Dynasty’s ideas about medicine.

VEHICLES LICENSED IN SWITZERLAND

CERN Multimedia

Service des Relations avec les Pays-Hôtes

2000-01-01

1.\tVehicle licensinga)\tTime limitsVehicles must have a Swiss registration document and Swiss number plates: -\tif the owner has been residing in Switzerland for more than one year without a break of more than three consecutive months and has been using it for more than one month on Swiss territory, or -\tif the vehicle itself has been on Swiss territory for more than one year without a break of more than three consecutive months. b)\tTechnical details Vehicles belonging to non-Swiss members of the personnel who hold a carte de légitimation issued by the Swiss Federal Department of Foreign Affairs (hereinafter referred to as 'DFAE') and who were not permanently resident in Switzerland before taking up their appointment may be licensed in Switzerland with virtually no restrictions provided that their owner produces: -\tthe vehicle registration document and number plates of the country in which the car was previously registered, or -\ta manufacturer's certi...

39 CFR 5.1 - Establishment and appointment.

Science.gov (United States)

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Establishment and appointment. 5.1 Section 5.1 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE COMMITTEES (ARTICLE V) § 5.1 Establishment and appointment. From time to time the Board may establish by resolution...

Collegiate Licensing in Canada and the Statutory Advantage.

Science.gov (United States)

Burshtein, Sheldon

1985-01-01

Discusses a specific provision in a Canadian statute enabling universities and other educational institutions to obtain protection and financial gain in a collegiate licensing program, an advantage not held in other countries or by other trademark licensers in Canada. (MSE)

"Nudge" and the epidemic of missed appointments.

Science.gov (United States)

Aggarwal, Ajay; Davies, Joanna; Sullivan, Richard

2016-06-20

Purpose - Missed appointments constitute a significant problem in the UK National Health Service (NHS) and this remains an area where improvements could yield substantial efficiency savings. The purpose of this paper is to suggest that nudge policies based on behavioural theories may help target interventions to improve patient motivation to attend appointments. Design/methodology/approach - The authors propose two policies to reduce missed appointments. The first attempts to empower patients through making the appointment system more individualised to them and utilising their intrinsic feelings of social responsibility. The second policy utilises a financial commitment given by the patient at the time of booking. The different mechanisms of influencing patient behaviour are based on two different views of what motivates individuals' actions. The first policy is based on individuals being "knights". They are altruistic and have well-intentioned values. The second policy option is constructed on the premise that an individual is governed by self-interest, and they are in fact "knaves". Findings - A policy, which avoids the use of financial penalties is likely to be more culturally acceptable within the NHS. It could also prevent the phenomenon of "crowding out" whereby the desire to act dutifully gets displaced by the motivation to avoid incurring a monetary fine. Originality/value - Testing both strategies would provide insight into patient attitudes towards health care and society. This would help optimise behavioural strategies which may influence not only appointment attendances but also have wider implications for encouraging rational health care consumption.

Managing patient demand: a qualitative study of appointment making in general practice.

Science.gov (United States)

Gallagher, M; Pearson, P; Drinkwater, C; Guy, J

2001-04-01

Managing patients' requests for appointments is an important general practice activity. No previous research has systematically observed how patients and receptionists negotiate appointments. To observe appointment making and investigate patients' and professionals' experiences of appointment negotiations. A qualitative study using participant observation. Three general practices on Tyneside; a single-handed practice, a practice comprising three doctors, and a seven-doctor practice. Participant observation sessions, consisting of 35 activity recordings and 34 periods of observation and 38 patient and 15 professional interviews, were set up. Seven groups of patients were selected for interview. These included patients attending an 'open access' surgery, patients who complained about making an appointment, and patients who complimented the receptionists. Appointment making is a complex social process. Outcomes are dependent on the process of negotiation and factors, such as patients' expectations and appointment availability. Receptionists felt that patients in employment, patients allocated to the practice by the Health Authority, and patients who did not comply with practice appointment rules were most demanding. Appointment requests are legitimised by receptionists enforcing practice rules and requesting clinical information. Patients volunteer information to provide evidence that their complaint is appropriate and employ strategies, such as persistence, assertiveness, and threats, to try and persuade receptionists to grant appointments. Appointment making is a complex social process where outcomes are negotiated. Receptionists have an important role in managing patient demand. Practices should be explicit about how appointments are allocated, including publishing practice criteria.

[Analysis of outpatient healthcare utilization in the context of the universal healthcare coverage reform in Mexico].

Science.gov (United States)

Bautista-Arredondo, Sergio; Serván-Mori, Edson; Colchero, M Arantxa; Ramírez-Rodríguez, Baruch; Sosa-Rubí, Sandra G

2014-01-01

Understand and quantify the relationship between socio-economic and health insurance profiles and the use of outpatient medical services in the context of universal health care in Mexico. Using ENSANUT 2012 multinomial regression models were estimated to analyze the use of outpatient services and associated factors. Population with greater poverty levels, lower educational level and living in highly marginalized areas have lower odds to use outpatient health services. In contrast, health insurance and higher income increase the odds to use health services and influence the choice of provider. Barriers to access to health care related to poverty and social protection persist. However, there is space to lower the effect of these barriers by addressing constraints linked to the supply and the perceived quality of healthcare services.

Experiences and reflections of patients with motor neuron disease on breaking the news in a two-tiered appointment: a qualitative study.

Science.gov (United States)

Seeber, Antje A; Pols, A Jeannette; Hijdra, Albert; Grupstra, Hepke F; Willems, Dick L; de Visser, Marianne

2016-02-02

Breaking bad news should be fine-tuned to the individual patient, contain intelligible information, include emotional support and offer a tailor-made treatment plan. To achieve this goal in motor neuron disease (MND), neurologists of the amyotrophic lateral sclerosis (ALS) centre Amsterdam deliver the message on 2 separate visits within 14 days. To evaluate how patients with MND react to and view disclosure of the diagnosis, in this 2-tiered approach. Non-participating observations and in-depth interviews with patients were conducted in 1 tertiary ALS referral centre. Qualitative analysis consisted of inductive analysis of observation reports and verbatim typed out interviews. 10 2-tiered appointments were observed and 21 Dutch patients with MND interviewed. They experienced the straightforward message to be suffering from a fatal disease as devastating, yet unavoidable. The prospect of a short-term second appointment offered structure for the period immediately following the diagnosis. The time between appointments provided the opportunity for a first reorientation on their changed perspective on their life. The second appointment allowed for detailed discussions about various aspects of MND and a tailor-made treatment plan. The 2-tiered approach fits well with the way in which Dutch patients with MND process the disclosure of their diagnosis, gather information and handle the changed perspective on their life. It may serve as a model for other life-limiting diseases. 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/

Appointment attendance at a remote rural dental training facility in Australia.

Science.gov (United States)

Lalloo, Ratilal; McDonald, Jenny M

2013-08-02

Non-attended appointments have impacts on the operations of dental clinics. These impacts vary from lost productivity, loss of income and loss of clinical teaching hours. Appointment data were analysed to assess the percentage of completed, failed to attend (FTA) and cancelled appointments at an Australian remote rural student dental clinic training facility. The demographic and time characteristics of FTA and cancelled appointments were analysed using simple and multivariate multinomial regression analysis, to inform interventions that may be necessary. Over the 2-year study period a total of 3,042 appointments were made. The percentage of FTA was 21.3% (N = 648) and cancelled appointments 13.7% (N = 418). The odds of an FTA were in excess of 4 times higher in patients aged 19-25 years (OR = 4.1; 95% CI = 2.3-7.3) and 26-35 years (OR = 4.4; 95% CI = 2.5-7.9) compared to patients 65 years and older. The odds of an FTA was 2.3 (95% CI = 1.8-3.1) times higher in public patients compared to private patients. The odds of a cancellation was 1.7 (95% CI = 1.1-2.6) times higher on a Friday compared to a Monday and 1.8 (95% CI = 1.1-2.9) times higher on the last appointment of the day compared to the first appointment. For cancelled appointments, 71.3% were cancelled on the day of the appointment and 16.6% on the day before. Non-attended appointments (FTA or cancelled) were common at this remote rural dental clinic training facility. Efforts to reduce these need to be implemented; including telephonic reminders, educating the community on the importance of attending their appointments, block booking school children and double booking or arranging alternative activities for the students at times when non-attendance is common.

26 CFR 25.2514-1 - Transfers under power of appointment.

Science.gov (United States)

2010-04-01

... power of appointment. (a) Introductory. (1) Section 2514 treats the exercise of a general power of... section also treats as a transfer of property the exercise or complete release of a general power of... power of appointment is not treated as a general power of appointment merely by reason of the fact that...

On appointment of Courts presidents - some open questions

Directory of Open Access Journals (Sweden)

Mijo Galiot

2014-01-01

Full Text Available In their paper, the authors analyse the legal position of the judiciary within the framework of the separation of powers in the Republic of Croatia, as well as the procedure of the election of the members and president, and the scope and manner of operation of the State Judiciary Council on a principal level. The authors especially deal with and analyse the 2010 constitutional changes and the State Judiciary Council Act from 2010 (SJCA, which introduced significant novelties in the appointment of presidents of courts in the normative and institutional sense as well as in practical applications. Separately, an integral historical overview is given of the appointment of presidents of courts from the gaining of Croatian independency until the SJCA became effective, as well as a comparative overview of the manner of appointment of presidents of courts in elected, related European legal systems. Moreover, the authors break down and analyse the procedures of the appointment of presidents of courts with a special reference to each phase. Here, special emphasis is given to the candidate valuation manner and criteria and the legal protection of candidates after the decision on appointment, both in the normative sense and in practice, all this accompanied by authors’ suggestions de lege ferenda.

Coproduction of healthcare service.

Science.gov (United States)

Batalden, Maren; Batalden, Paul; Margolis, Peter; Seid, Michael; Armstrong, Gail; Opipari-Arrigan, Lisa; Hartung, Hans

2016-07-01

Efforts to ensure effective participation of patients in healthcare are called by many names-patient centredness, patient engagement, patient experience. Improvement initiatives in this domain often resemble the efforts of manufacturers to engage consumers in designing and marketing products. Services, however, are fundamentally different than products; unlike goods, services are always 'coproduced'. Failure to recognise this unique character of a service and its implications may limit our success in partnering with patients to improve health care. We trace a partial history of the coproduction concept, present a model of healthcare service coproduction and explore its application as a design principle in three healthcare service delivery innovations. We use the principle to examine the roles, relationships and aims of this interdependent work. We explore the principle's implications and challenges for health professional development, for service delivery system design and for understanding and measuring benefit in healthcare services. 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/

Measuring Chemotherapy Appointment Duration and Variation Using Real-Time Location Systems.

Science.gov (United States)

Barysauskas, Constance M; Hudgins, Gina; Gill, Katie Kupferberg; Camuso, Kristen M; Bagley, Janet; Rozanski, Sheila; Kadish, Sarah

Clinical schedules drive resource utilization, cost, and patient wait time. Accurate appointment duration allocation ensures appropriate staffing ratios to daily caseloads and maximizes scarce resources. Dana-Farber Cancer Institute (DFCI) infusion appointment duration is adjusted by regimen using a consensus method of experts including pharmacists, nurses, and administrators. Using real-time location system (RTLS), we examined the accuracy of observed appointment duration compared with the scheduled duration. Appointment duration was calculated using RTLS at DFCI between August 1, 2013, and September 30, 2013. Duration was defined as the total time a patient occupied an infusion chair. The top 10 administered infusion regimens were investigated (n = 805). Median observed appointment durations were statistically different than the scheduled durations. Appointment durations were shorter than scheduled 98% (C), 95% (I), and 75% (F) of the time and longer than scheduled 77% (A) and 76% (G) of the time. Fifty-six percent of the longer than scheduled (A) appointments were at least 30 minute longer. RTLS provides reliable and unbiased data to improve schedule accuracy. Replacing consensus with system-based data may improve clinic flow, relieve staff stress, and increase patient satisfaction. Further investigation is warranted to elucidate factors that impact variation in appointment duration.

Safety Evaluation Report related to the renewal of the operating license for the research reactor at Purdue University: Docket No. 50-182

International Nuclear Information System (INIS)

1988-04-01

This Safety Evaluation Report for the application filed by Purdue University for a renewal of Operating License R-87 to continue to operate a research reactor has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is owned by Purdue University and is located on the campus in West Lafayette, Indiana. On the basis of its technical review, the staff concludes that the reactor facility can continue to be operated by the university without endangering the health and safety of the public or the enviroment

How much does a diabetes out-patient appointment actually cost? An argument for PLICS.

Science.gov (United States)

Grant, Paul

2015-01-01

The national tariff system for clinical processes and procedures aims to put a discrete unit cost on clinical activity. Calculating such costs can be subject to a great deal of local variation and interpretation. Given the rising costs of diabetes the purpose of this paper is to ask the question what does a diabetes outpatient appointment in the UK NHS actually cost? This is important in a time of financial austerity and healthcare rationing because it can be difficult to decipher the attribution of costs within the acute hospital setting. Exploring this question, the author considers the present cost model and analyse in terms of the language of unit model cost; the basic tariff system and how it works in diabetes and looking at internal cost information the author attempts to unbundle the cost to provide a more accurate value for the cost object. One major finding is that costs and overheads are divided arbitrarily as opposed to being distributed on the basis of measured relative consumption. Alternative costing methods are appraised to demonstrate that a patient level episodic costing approach such as patient level information and costing system (PLICS) which incorporates aspects of activity-based costing (ABC) would be far more appropriate. Using time driven ABC (TDABC), a new patient appointment costs £162 for 30 minutes and a follow-up appointment costs £81 for 15 minutes. PLICS has the added benefit of greater financial and clinical transparency and this goes some way towards the holy grail of greater engagement with the doctors delivering clinical care. It would appear that there are different purposes of different costing systems. One can argue that a costing system is there to both contain costs and divide overheads and demonstrate activity. Depending on how data are interpreted costing information can be an agent of enlightenment and behavioural modification for healthcare professionals to show them their direct and indirect costs, their capacity and

Analysis of outpatient healthcare utilization in the context of the universal healthcare coverage reform in Mexico.

Directory of Open Access Journals (Sweden)

Sergio Bautista-Arredondo

2014-01-01

Full Text Available Objective. Understand and quantify the relationship between socio-economic and health insurance profiles and the use of outpatient medical services in the context of universal health care in Mexico. Materials and methods. Using ENSANUT 2012 multinomial regression models were estimated to analyze the use of outpatient services and associated factors. Results. Population with greater poverty levels, lower educational level and living in highly marginalized areas have lower odds to use outpatient health services. In contrast, health insurance and higher income increase the odds to use health services and influence the choice of provider. Conclusions. Barriers to access to health care related to poverty and social protection persist. However, there is space to lower the effect of these barriers by addressing constraints linked to the supply and the perceived quality of healthcare services.

Improving Healthcare through Lean Management

DEFF Research Database (Denmark)

Nielsen, Anders Paarup; Edwards, Kasper

2011-01-01

The ideas and principles from lean management are now widely being adopted within the healthcare sector. The analysis in this paper shows that organizations within healthcare most often only implement a limited set of tools and methods from the lean tool-box. Departing from a theoretical analysis...... of the well-known and universal lean management principles in the context of the healthcare this paper will attempt to formulate and test four hypotheses about possible barriers to the successful implementation of lean management in healthcare. The first hypothesis states that lean management in healthcare....... The paper concludes by discussing the implications of hypothesis two, three, and four for the successful application of lean management within healthcare. Is it concluded that this requires a transformative and contingent approach to lean management where the universal principles of the lean philosophy...

38 CFR 17.100 - Refusal of treatment by unnecessarily breaking appointments.

Science.gov (United States)

2010-07-01

... and satisfactory reasons are advanced for breaking the appointment and circumstances were such that... unnecessarily breaking appointments. 17.100 Section 17.100 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Breaking Appointments § 17.100 Refusal of treatment by unnecessarily breaking...

Scheduling rules to achieve lead-time targets in outpatient appointment systems

OpenAIRE

Sivakumar, Appa Iyer; Nguyen, Thu Ba Thi; Graves, Stephen C

2015-01-01

This paper considers how to schedule appointments for outpatients, for a clinic that is subject to appointment lead-time targets for both new and returning patients. We develop heuristic rules, which are the exact and relaxed appointment scheduling rules, to schedule each new patient appointment (only) in light of uncertainty about future arrivals. The scheduling rules entail two decisions. First, the rules need to determine whether or not a patient's request can be accepted; then, if the req...

Discretionary decisions and disparities in receiving drug-eluting stents under a universal healthcare system: A population-based study.

Directory of Open Access Journals (Sweden)

Raymond N Kuo

Full Text Available One of the main objectives behind the expansion of insurance coverage is to eliminate disparities in health and healthcare. However, researchers have not yet fully elucidated the reasons for disparities in the use of high-cost treatments among patients of different occupations. Furthermore, it remains unknown whether discretionary decisions made at the hospital level have an impact on the administration of high-cost interventions in a universal healthcare system. This study investigated the adoption of drug-eluting stents (DES versus bare metal-stents (BMS among patients in different occupations and income levels, with the aim of gauging the degree to which the inclination of health providers toward treatment options could affect treatment choices at the patient-level within a universal healthcare system.We adopted a cross-sectional observational study design using hierarchical modeling in conjunction with the population-based National Health Insurance database of Taiwan. Patients who received either a BMS or a DES between 2007 and 2010 were included in the study.During the period of study, 42,124 patients received a BMS (65.3% and 22,376 received DES (34.7%. Patients who were physicians or the family members of physicians were far more likely to receive DES (OR: 3.18, CI: 2.38-4.23 than were patients who were neither physicians nor in other high-status jobs (employers, other medical professions, or public service. Similarly, patients in the top 5% income bracket had a higher probability of receiving a DES (OR: 2.23, CI: 2.06-2.47, p 50% or between 25% and 50% was shown to be strongly associated with the selection of DESs (OR: 3.64 CI: 3.24-4.09 and OR: 2.16, CI: 2.01-2.33, respectively.Even under the universal healthcare system in Taiwan, socioeconomic disparities in the use of high-cost services remain widespread. Differences in the care received by patients of lower socioeconomic status may be due to the discretionary decisions of healthcare

Horace Lamb and the circumstances of his appointment at Owens College

Science.gov (United States)

Launder, Brian

2013-01-01

This paper examines a succession of incidents at a critical juncture in the life of Professor Horace Lamb FRS, a highly regarded classical fluid mechanicist, who, over a period of some 35 years at Manchester, made notable contributions in research, in education and in wise administration at both national and university levels. Drawing on archived documents from the universities of Manchester and Adelaide, the article presents the unusual sequence of events that led to his removing from Adelaide, South Australia, where he had served for nine years as the Elder Professor of Mathematics, to Manchester. In 1885 he was initially appointed to the vacant Chair of Pure Mathematics at Owens College and then, in 1888, as an outcome of his proposal for rearranging professorial responsibilities, to the Beyer Professorship of Pure and Applied Mathematics.

Automated detection of follow-up appointments using text mining of discharge records.

Science.gov (United States)

Ruud, Kari L; Johnson, Matthew G; Liesinger, Juliette T; Grafft, Carrie A; Naessens, James M

2010-06-01

To determine whether text mining can accurately detect specific follow-up appointment criteria in free-text hospital discharge records. Cross-sectional study. Mayo Clinic Rochester hospitals. Inpatients discharged from general medicine services in 2006 (n = 6481). Textual hospital dismissal summaries were manually reviewed to determine whether the records contained specific follow-up appointment arrangement elements: date, time and either physician or location for an appointment. The data set was evaluated for the same criteria using SAS Text Miner software. The two assessments were compared to determine the accuracy of text mining for detecting records containing follow-up appointment arrangements. Agreement of text-mined appointment findings with gold standard (manual abstraction) including sensitivity, specificity, positive predictive and negative predictive values (PPV and NPV). About 55.2% (3576) of discharge records contained all criteria for follow-up appointment arrangements according to the manual review, 3.2% (113) of which were missed through text mining. Text mining incorrectly identified 3.7% (107) follow-up appointments that were not considered valid through manual review. Therefore, the text mining analysis concurred with the manual review in 96.6% of the appointment findings. Overall sensitivity and specificity were 96.8 and 96.3%, respectively; and PPV and NPV were 97.0 and 96.1%, respectively. of individual appointment criteria resulted in accuracy rates of 93.5% for date, 97.4% for time, 97.5% for physician and 82.9% for location. Text mining of unstructured hospital dismissal summaries can accurately detect documentation of follow-up appointment arrangement elements, thus saving considerable resources for performance assessment and quality-related research.

Siting Practices and Site Licensing Process for New Reactors in Canada

International Nuclear Information System (INIS)

Vos, Marcel de

2011-01-01

'Siting' in Canada is composed of Site Evaluation and Site Selection. As outlined in CNSC Regulatory Document RD-346 Site Evaluation for New Nuclear Power Plants (based on IAEA NS-R-3), prior to the triggering of the Environmental Assessment (EA) and licensing processes, the proponent is expected to use a robust process to characterize proposed sites over the full life cycle of the facility, and then develop a fully documented defense of the site selection case. This case forms the backbone for submissions in support of the EA and the application for a License to Prepare Site which will be reviewed by the CNSC and other applicable federal authorities. The Environmental Assessment process and License to Prepare Site in Canada do not require a proponent to select a specific design; however, CNSC does not accept a 'black box' approach to siting. CNSC balances the level of design information required with the extent of safety assurance desired for any designs being contemplated for the proposed site. Nevertheless, the design information submitted must be sufficient to justify the site as suitable for all future licensing stages. The depth of plant design information contributes significantly to the credibility of the applicant's case for both the EA and application for License to Prepare Site. The review process utilizes an assessment plan with defined review stages and timelines. The outcome of these reviews is a series of recommendations to a federal government appointed Joint Review Panel (which also serves as a panel of the 'Commission') which, following public hearings, renders a decision regarding the EA, and subsequently, the application for a License to Prepare Site. (author)

Multi-agent Pareto appointment exchanging in hospital patient scheduling

NARCIS (Netherlands)

I.B. Vermeulen (Ivan); S.M. Bohte (Sander); D.J.A. Somefun (Koye); J.A. La Poutré (Han)

2007-01-01

htmlabstractWe present a dynamic and distributed approach to the hospital patient scheduling problem, in which patients can have multiple appointments that have to be scheduled to different resources. To efficiently solve this problem we develop a multi-agent Pareto-improvement appointment

Multi-agent Pareto appointment exchanging in hospital patient scheduling

NARCIS (Netherlands)

Vermeulen, I.B.; Bohté, S.M.; Somefun, D.J.A.; Poutré, La J.A.

2007-01-01

We present a dynamic and distributed approach to the hospital patient scheduling problem, in which patients can have multiple appointments that have to be scheduled to different resources. To efficiently solve this problem we develop a multi-agent Pareto-improvement appointment exchanging algorithm:

25 CFR 11.704 - Appointment and duties of executor or administrator.

Science.gov (United States)

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Appointment and duties of executor or administrator. 11... executor or administrator. (a) Upon ordering the estate to be probated, the court shall appoint an... be the executor of the estate shall be so appointed, provided such person is willing to serve in such...

45 CFR 211.5 - Action under State law; appointment of guardian.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false Action under State law; appointment of guardian... Action under State law; appointment of guardian. Whenever an eligible person is incapable of giving his... appointment of a legal guardian, to ensure the proper planning for and provision of such care and treatment. ...

Safety evaluation report related to the renewal of the operating license for the University of New Mexico Research Reactor (Docket No. 50-252)

International Nuclear Information System (INIS)

1987-03-01

This Safety Evaluation Report for the application filed by the University of New Mexico (UNM) for renewal of Operating License No. R-102 to continue to operate its research reactor has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is located on the campus of the University of New Mexico in Albuquerque, New Mexico. The staff concludes that the reactor can continue to be operated by the University of New Mexico without endangering the health and safety of the public. 7 refs., 7 figs., 2 tabs

Chemotherapy appointment scheduling under uncertainty using mean-risk stochastic integer programming.

Science.gov (United States)

Alvarado, Michelle; Ntaimo, Lewis

2018-03-01

Oncology clinics are often burdened with scheduling large volumes of cancer patients for chemotherapy treatments under limited resources such as the number of nurses and chairs. These cancer patients require a series of appointments over several weeks or months and the timing of these appointments is critical to the treatment's effectiveness. Additionally, the appointment duration, the acuity levels of each appointment, and the availability of clinic nurses are uncertain. The timing constraints, stochastic parameters, rising treatment costs, and increased demand of outpatient oncology clinic services motivate the need for efficient appointment schedules and clinic operations. In this paper, we develop three mean-risk stochastic integer programming (SIP) models, referred to as SIP-CHEMO, for the problem of scheduling individual chemotherapy patient appointments and resources. These mean-risk models are presented and an algorithm is devised to improve computational speed. Computational results were conducted using a simulation model and results indicate that the risk-averse SIP-CHEMO model with the expected excess mean-risk measure can decrease patient waiting times and nurse overtime when compared to deterministic scheduling algorithms by 42 % and 27 %, respectively.

Experiences from implementing value-based healthcare at a Swedish University Hospital - an longitudinal interview study.

Science.gov (United States)

Nilsson, Kerstin; Bååthe, Fredrik; Andersson, Annette Erichsen; Wikström, Ewa; Sandoff, Mette

2017-02-28

Implementing the value-based healthcare concept (VBHC) is a growing management trend in Swedish healthcare organizations. The aim of this study is to explore how representatives of four pilot project teams experienced implementing VBHC in a large Swedish University Hospital over a period of 2 years. The project teams started their work in October 2013. An explorative and qualitative design was used, with interviews as the data collection method. All the participants in the four pilot project teams were individually interviewed three times, with interviews starting in March 2014 and ending in November 2015. All the interviews were transcribed and analyzed using qualitative analysis. Value for the patients was experienced as the fundamental drive for implementing VBHC. However, multiple understandings of what value for patients' means existed in parallel. The teams received guidance from consultants during the first 3 months. There were pros and cons to the consultant's guidance. This period included intensive work identifying outcome measurements based on patients' and professionals' perspectives, with less interest devoted to measuring costs. The implementation process, which both gave and took energy, developed over time and included interventions. In due course it provided insights to the teams about the complexity of healthcare. The necessity of coordination, cooperation and working together inter-departmentally was critical. Healthcare organizations implementing VBHC will benefit from emphasizing value for patients, in line with the intrinsic drive in healthcare, as well as managing the process of implementation on the basis of understanding the complexities of healthcare. Paying attention to the patients' voice is a most important concern and is also a key towards increased engagement from physicians and care providers for improvement work.

Bilevel Fuzzy Chance Constrained Hospital Outpatient Appointment Scheduling Model

Directory of Open Access Journals (Sweden)

Xiaoyang Zhou

2016-01-01

Full Text Available Hospital outpatient departments operate by selling fixed period appointments for different treatments. The challenge being faced is to improve profit by determining the mix of full time and part time doctors and allocating appointments (which involves scheduling a combination of doctors, patients, and treatments to a time period in a department optimally. In this paper, a bilevel fuzzy chance constrained model is developed to solve the hospital outpatient appointment scheduling problem based on revenue management. In the model, the hospital, the leader in the hierarchy, decides the mix of the hired full time and part time doctors to maximize the total profit; each department, the follower in the hierarchy, makes the decision of the appointment scheduling to maximize its own profit while simultaneously minimizing surplus capacity. Doctor wage and demand are considered as fuzzy variables to better describe the real-life situation. Then we use chance operator to handle the model with fuzzy parameters and equivalently transform the appointment scheduling model into a crisp model. Moreover, interactive algorithm based on satisfaction is employed to convert the bilevel programming into a single level programming, in order to make it solvable. Finally, the numerical experiments were executed to demonstrate the efficiency and effectiveness of the proposed approaches.

A University Engagement Model for Achieving Technology Adoption and Performance Improvement Impacts in Healthcare, Manufacturing, and Government

Science.gov (United States)

McKinnis, David R.; Sloan, Mary Anne; Snow, L. David; Garimella, Suresh V.

2014-01-01

The Purdue Technical Assistance Program (TAP) offers a model of university engagement and service that is achieving technology adoption and performance improvement impacts in healthcare, manufacturing, government, and other sectors. The TAP model focuses on understanding and meeting the changing and challenging needs of those served, always…

New appointment at the IAEA

International Nuclear Information System (INIS)

2000-01-01

The document gives short information on the biography of Professor Dr. Werner Burkart from Germany who was appointed (as of July 2000) as Deputy Director General, Head of the Department of Nuclear Sciences and Applications, IAEA

Entrepreneurship and University Licensing

NARCIS (Netherlands)

Brouwer, M.

2005-01-01

Outside invention has gained in importance as universities are actively seeking commercialization of their inventions since the passage of the Bayh-Dole Act. The paper analyzes the incentives to invent for outside and inside inventors. It is shown that outside inventors have greater incentives to

Safety-evaluation report related to the renewal of the operating license for the Cornell University TRIGA Research Reactor. Docket No. 50-157

International Nuclear Information System (INIS)

1983-08-01

This Safety Evaluation Report for the application filed by the Cornell University for a renewal of Operating License R-80 to continue to operate a research reactor has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is owned and operated by Cornell University and is located on the Cornell campus in Ithaca, New York. The staff concludes that the TRIGA reactor facility can continue to be operated by Cornell without endangering the health and safety of the public

Osteoporosis Knowledge among Future Healthcare Practitioners: Findings from a Malaysian Public University

Science.gov (United States)

Elnaem, Mohamed Hassan; Jamshed, Shazia Qasim; Elkalmi, Ramadan Mohamed; Baharuddin, Muhammad Farhan; Johari, Muhammad Afif; Aziz, Nur Ashikin Binti Ab; Sabri, Siti Farhanah Binti Ahmad; Ismail, Nur Akmal Binti

2017-01-01

Background and Objectives: Students in relevant health-care academic programs are the future professionals who should play an active role in increasing community awareness regarding chronic diseases such as osteoporosis. This research aimed to evaluate the knowledge of osteoporosis, one of the growing health-care burdens in Malaysia, among students belong to three different health occupations programs in a Malaysian University. Methods: A cross-sectional study design was conducted to assess the level of knowledge on osteoporosis and to explore the potential association between the study program and osteoporosis-related knowledge among medicine, pharmacy, and allied health sciences students in a Malaysian University. A total of 348 students were approached. The data were collected using validated revised Osteoporosis Knowledge Test questionnaire. Results: The results showed variability in knowledge score between students belonging to different study programs. allied health sciences students have the highest overall total score (median = 20) and nutrition score (median = 16), but for exercise score, both students in allied health sciences and medicine programs shared a similar median score (median = 11.5). More than half of the respondents showed adequate knowledge on osteoporosis. The students from allied health sciences exhibited more knowledge on osteoporosis compared to students in other study programs. Among the Kulliyyah of Pharmacy respondents, the majority did not manage to answer correctly on the whole scale. This was evident by total percentage of 69.91% of the respondents scored below than median score. Conclusion: There is a considerable gap of knowledge regarding osteoporosis among students in various health occupations academic programs. Pharmacy students particularly need focused learning related to exercise and nutrition in preventing osteoporosis during their academic program. PMID:28717334

Osteoporosis Knowledge among future healthcare practitioners: Findings from a Malaysian public university

Directory of Open Access Journals (Sweden)

Mohamed Hassan Elnaem

2017-01-01

Full Text Available Background and Objectives: Students in relevant health-care academic programs are the future professionals who should play an active role in increasing community awareness regarding chronic diseases such as osteoporosis. This research aimed to evaluate the knowledge of osteoporosis, one of the growing health-care burdens in Malaysia, among students belong to three different health occupations programs in a Malaysian University. Methods: A cross-sectional study design was conducted to assess the level of knowledge on osteoporosis and to explore the potential association between the study program and osteoporosis-related knowledge among medicine, pharmacy, and allied health sciences students in a Malaysian University. A total of 348 students were approached. The data were collected using validated revised Osteoporosis Knowledge Test questionnaire. Results: The results showed variability in knowledge score between students belonging to different study programs. allied health sciences students have the highest overall total score (median = 20 and nutrition score (median = 16, but for exercise score, both students in allied health sciences and medicine programs shared a similar median score (median = 11.5. More than half of the respondents showed adequate knowledge on osteoporosis. The students from allied health sciences exhibited more knowledge on osteoporosis compared to students in other study programs. Among the Kulliyyah of Pharmacy respondents, the majority did not manage to answer correctly on the whole scale. This was evident by total percentage of 69.91% of the respondents scored below than median score. Conclusion: There is a considerable gap of knowledge regarding osteoporosis among students in various health occupations academic programs. Pharmacy students particularly need focused learning related to exercise and nutrition in preventing osteoporosis during their academic program.

AVC/H.264 patent portfolio license

Science.gov (United States)

Skandalis, Dean A.

2006-08-01

MPEG LA, LLC offers a joint patent license for the AVC (a/k/a H.264) Standard (ISO/IEC IS 14496-10:2004). Like MPEG LA's other licenses, the AVC Patent Portfolio License is offered for the convenience of the marketplace as an alternative enabling users to access essential intellectual property owned by many patent holders under a single license rather than negotiating licenses with each of them individually. The AVC Patent Portfolio License includes essential patents owned by DAEWOO Electronics Corporation; Electronics and Telecommunications Research Institute (ETRI); France Telecom, societe anonyme; Fujitsu Limited; Hitachi, Ltd.; Koninklijke Philips Electronics N.V.; LG Electronics Inc.; Matsushita Electric Industrial Co., Ltd.; Microsoft Corporation; Mitsubishi Electric Corporation; Robert Bosch GmbH; Samsung Electronics Co., Ltd.; Sedna Patent Services, LLC; Sharp Kabushiki Kaisha; Siemens AG; Sony Corporation; The Trustees of Columbia University in the City of New York; Toshiba Corporation; UB Video Inc.; and Victor Company of Japan, Limited. Another is expected also to join as of August 1, 2006. MPEG LA's objective is to provide worldwide access to as much AVC essential intellectual property as possible for the benefit of AVC users. Therefore, any party that believes it has essential patents is welcome to submit them for evaluation of their essentiality and inclusion in the License if found essential.

Safety Evaluation Report related to the renewal of the operating license for the research reactor at Michigan State University (Docket No. 50-294)

International Nuclear Information System (INIS)

1984-08-01

This Safety Evaluation Report for the application filed by the Michigan State University (MSU) for a renewal of operating license number R-114 to continue to operate the TRIGA Mark I research reactor has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is owned and operated by the Michigan State University and is located on the campus of Michigan State University in East Lansing, Ingham County, Michigan. The staff concludes that the TRIGA reactor facility can continue to be operated by MSU without endangering the health and safety of the public

7 CFR 1260.145 - Appointment.

Science.gov (United States)

2010-01-01

... Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE BEEF PROMOTION AND RESEARCH Beef Promotion and Research Order Cattlemen's Beef Promotion and Research Board § 1260.145 Appointment. (a) From...

7 CFR 1221.103 - Appointment.

Science.gov (United States)

2010-01-01

... Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... INFORMATION ORDER Sorghum Promotion, Research, and Information Order Sorghum Promotion, Research, and Information Board § 1221.103 Appointment. From the nominations made pursuant to § 1221.101, the Secretary...

5 CFR 330.1106 - Appointment.

Science.gov (United States)

2010-01-01

... Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS RECRUITMENT, SELECTION, AND PLACEMENT (GENERAL) Federal Employment Priority Consideration Program for Displaced Employees of the... under Public Law 105-274. For employees appointed before October 21, 1998, the conversion will be...

Regulations concerning licensing of nuclear reactor facilities and other nuclear installations, Decree No 7/9141, 6 January 1975

International Nuclear Information System (INIS)

1975-01-01

This Decree lays down the licensing system for nuclear installations in Turkey and also sets up a Nuclear Safety Committee whose duty is to ensure that the requirements of this Decree are met. The Committee is made up of members of the Atomic Energy Commission specialized in reactors, nuclear safety, health physics, reactor physics as well as two experts respectively appointed by the Ministry of Health and Social Welfare and the Ministry of Energy and National Resources. (NEA) [fr

Improving Healthcare through Lean Management: Experiences from the Danish healthcare system

DEFF Research Database (Denmark)

Edwards, Kasper; Nielsen, Anders Paarup

still is in its infancy and it is just a matter of letting sufficient time pass in order have a successful implementation of lean in all areas of healthcare. The second hypothesis states that a major barrier to lean management in healthcare simply is lacking understanding of the lean concepts leading......The ideas and principles from lean management are now widely being adopted within the healthcare sector. The analysis in this paper shows that organizations within healthcare most often only implement a limited set of tools and methods from the lean tool-box. Departing from a theoretical analysis...... of the well-known and universal lean management principles in the context of the healthcare this paper will attempt to formulate and test four hypotheses about possible barriers to the successful implementation of lean management in healthcare. The first hypothesis states that lean management in healthcare...

Mobile health treatment support intervention for HIV and tuberculosis in Mozambique: Perspectives of patients and healthcare workers.

Directory of Open Access Journals (Sweden)

José António Nhavoto

Full Text Available Studies have been conducted in developing countries using SMS to communicate with patients to reduce the number of missed appointments and improve retention in treatment, however; very few have been scaled up. One possible reason for this could be that patients or staff are dissatisfied with the method in some way. This paper reports a study of patients' and healthcare workers' (HCW views on an mHealth intervention aiming to support retention in antiretroviral therapy (ART and tuberculosis (TB treatment in Mozambique.The study was conducted at five healthcare centres in Mozambique. Automated SMS health promotions and reminders were sent to patients in a RCT. A total of 141 patients and 40 HCWs were interviewed. Respondents rated usefulness, perceived benefits, ease of use, satisfaction, and risks of the SMS system using a Likert scale questionnaire. A semi-structured interview guide was followed. Interviews were transcribed and thematic analysis was conducted.Both patients and HCW found the SMS system useful and reliable. Most highly rated positive effects were reducing the number of failures to collect medication and avoiding missing appointments. Patients' confidence in the system was high. Most perceived the system to improve communication between health-care provider and patient and assist in education and motivation. The automatic recognition of questions from patients and the provision of appropriate answers (a unique feature of this system was especially appreciated. A majority would recommend the system to other patients or healthcare centres. Risks also were mentioned, mostly by HCW, of unintentional disclosure of health status in cases where patients use shared phones.The results suggest that SMS technology for HIV and TB should be used to transmit reminders for appointments, medications, motivational texts, and health education to increase retention in care. Measures must be taken to reduce risks of privacy intrusion, but these are

7 CFR 1280.204 - Appointment.

Science.gov (United States)

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Appointment. 1280.204 Section 1280.204 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... INFORMATION ORDER Lamb Promotion, Research, and Information Order Lamb Promotion, Research, and Information...

Safety evaluation report related to the renewal of the operating license for the Washington State University TRIGA reactor. Docket No. 50-27

International Nuclear Information System (INIS)

1982-05-01

This Safety Evaluation Report for the application filed by the Washington State University (WSU) for a renewal of operating license number R-76 to continue to operate a research reactor has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is owned and operated by the Washington State University and is located on the WSU campus in Pullman, Whitman County, Washington. The staff concludes that the TRIGA reactor facility can continue to be operated by WSU without endangering the health and safety of the public

EXTENSION EDUCATION SYMPOSIUM: Getting the most out of your extension appointment and still having a life.

Science.gov (United States)

Powers, W; Cockett, N; Lardy, G

2017-04-01

Managing the demands of an academic appointment in extension can be a challenging task. Demands from constituent groups, expectations of supervisors, and rigors of promotion and tenure processes can create pressures that young faculty did not expect. Throw in spousal and family duties and you have created a situation that many will find hard to navigate. However, there are ways to cope and, even better news, there are ways to excel in meeting the demands of an academic appointment and enjoying life. Because many new extension faculty members do not have prior experience in extension, best practices in documenting programs and extension scholarship over the pretenure period are provided in this paper. Appointments that include both research and extension are quite common at many land grant universities. The advantages of joint appointments are numerous and include the fact that more and more grant agencies are seeking integrated research, teaching, and/or extension projects. However, the time demands of joint appointments can be challenging. Joint appointments can be designed to help faculty members conduct important translational research and have it be applied in a production setting. By seeking commonalities in research and extension efforts, joint appointments can be very synergistic. Development of highly successful programs requires planning on the front end with an emphasis on an in-depth needs assessment to determine stakeholder needs for both research and extension. Impact assessment should be part of this planning effort. Performing as a successful extension faculty member while maintaining relationships outside of work is challenging and requires deliberate effort on the part of employees and supervisors to realize there is more to life than work. Some authors have referred to this as work-life balance, but it may be more helpful to think of it as work-life effectiveness. To do this, one needs to 1) define what success looks like, 2) set boundaries and

The licensing of nuclear power plants in Brazil

International Nuclear Information System (INIS)

Lederman, L.

1980-01-01

In Brazil the governmental organization responsible for the licensing of NPPs is the Comissao Nacional de Energia Nuclear (CNEN), the Brazilian Regulatory Body. A description of CNEN's organization, responsabilities and working methods, as well as the present situation of the Brazilian NPPs undergoing licensing, has recently been presented. In this paper the experience gained by CNEN in the course of licensing Brazilian NPPs Units I and II is discussed. CNEN's present day technical competence and its future trends are analysed with regard to in-house capacity, foreign consultants and research contracts with Brazilian Universities. Finally, the immediate need for a Safety research programm in support of licensing is discussed. Manpower needs and major areas for such a programm are also indicated. (orig./RW)

Safety Evaluation Report related to the construction permit and operating license for the research reactor at the University of Texas (Docket No. 50-602)

International Nuclear Information System (INIS)

1985-05-01

This Safety Evaluation Report for the application filed by the University of Texas for a construction permit and operating license to construct and operate a TRIGA research reactor has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is owned and operated by the University of Texas and is located at the university's Balcones Research Center, about 7 miles (11.6 km) north of the main campus in Austin, Texas. The staff concludes that the TRIGA reactor facility can be constructed and operated by the University of Texas without endangering the health and safety of the public

Information technology for competitive advantage: the case of learning and innovation in behavioural healthcare service.

Science.gov (United States)

Hsieh, Chang-tseh; Lin, Binshan

2011-01-01

The utilisation of IS/IT could offer a substantial competitive advantage to healthcare service providers through the realisation of improved clinical, financial, and administrative outcomes. In this study, 42 journal articles were reviewed and summarised with respect to identified benefits and challenges of the development and implementation of electronic medical records, tele-health, and electronic appointment reminders. Results of this study help pave the knowledge foundation for management of the behavioural healthcare to learn how to apply state-of-the-art information technology to offer higher quality, clinically proven effective services at lower costs than those of their competitors.

Oncology healthcare professionals' perspectives on the psychosocial support needs of cancer patients during oncology treatment.

Science.gov (United States)

Aldaz, Bruno E; Treharne, Gareth J; Knight, Robert G; Conner, Tamlin S; Perez, David

2017-09-01

This study explored oncology healthcare professionals' perspectives on the psychosocial support needs of diverse cancer patients during oncology treatment. Six themes were identified using thematic analysis. Healthcare professionals highlighted the importance of their sensitivity, respect and emotional tact during appointments in order to effectively identify and meet the needs of oncology patients. Participants also emphasised the importance of building rapport that recognises patients as people. Patients' acceptance of treatment-related distress and uncertainty was described as required for uptake of available psychosocial supportive services. We offer some practical implications that may help improve cancer patients' experiences during oncology treatment.

How do bioethics teachers in Japan cope with ethical disagreement among healthcare university students in the classroom? A survey on educators in charge

Science.gov (United States)

Itai, K; Asai, A; Tsuchiya, Y; Onishi, M; Kosugi, S

2006-01-01

Objective The purpose of this study was to demonstrate how educators involved in the teaching of bioethics to healthcare university students in Japan would cope with ethical disagreement in the classroom, and to identify factors influencing them. Methods A cross sectional survey was conducted using self administered questionnaires mailed to a sample of university faculty in charge of bioethics curriculum for university healthcare students. Results A total of 107 usable questionnaires were returned: a response rate of 61.5%. When facing ethical disagreement in the classroom, coping behaviour differed depending on the topic of discussion, was influenced by educators' individual clear ethical attitudes regarding the topic of discussion, and was independent of many respondents' individual and social backgrounds. Among educators, it was commonly recognised that the purpose of bioethics education was to raise the level of awareness of ethical problems, to provide information about and knowledge of those issues, to raise students' sensitivity to ethical problems, and to teach students methods of reasoning and logical argument. Yet, despite this, several respondents considered the purpose of bioethics education to be to influence students about normative ethical judgments. There was no clear relationship, however, between ways of coping with ethical disagreement and educators' sense of the purpose of bioethics education. Conclusions This descriptive study suggests that educators involved in bioethics education for healthcare university students in Japan coped in various ways with ethical disagreement. Further research concerning ethical disagreement in educational settings is needed to provide better bioethics education for healthcare students. PMID:16648283

Practical principles in appointment scheduling

NARCIS (Netherlands)

Kuiper, A.; Mandjes, M.

2015-01-01

Appointment schedules aim at achieving a proper balance between the conflicting interests of the service provider and her clients: a primary objective of the service provider is to fully utilize her available time, whereas clients want to avoid excessive waiting times. Setting up schedules that

Scheduling patient appointments via multilevel template: a case study in chemotherapy

OpenAIRE

Condotta, A; Shakhlevich, NV

2014-01-01

This paper studies a multi-criteria optimization problem which appears in the context of booking chemotherapy appointments. The main feature of the model under study is the requirement to book for each patient multiple appointments which should follow a pre-specified multi-day pattern. Each appointment involves several nurse activities which should also follow a pre-specified intra-day pattern. The main objectives are to minimize patients’ waiting times and peaks of nurses’ workload for an ou...

Carolina Care at University of North Carolina Health Care: Implementing a Theory-Driven Care Delivery Model Across a Healthcare System.

Science.gov (United States)

Tonges, Mary; Ray, Joel D; Herman, Suzanne; McCann, Meghan

2018-04-01

Patient satisfaction is a key component of healthcare organizations' performance. Providing a consistent, positive patient experience across a system can be challenging. This article describes an organization's approach to achieving this goal by implementing a successful model developed at the flagship academic healthcare center across an 8-hospital system. The Carolina Care at University of North Carolina Health Care initiative has resulted in substantive qualitative and quantitative benefits including higher patient experience scores for both overall rating and nurse communication.

Predictors of missed appointments in patients referred for congenital or pediatric cardiac magnetic resonance

Energy Technology Data Exchange (ETDEWEB)

Lu, Jimmy C.; Dorfman, Adam L. [C.S. Mott Children' s Hospital, Department of Pediatrics and Communicable Diseases, Division of Pediatric Cardiology, University of Michigan Health System, University of Michigan Congenital Heart Center, Ann Arbor, MI (United States); C.S. Mott Children' s Hospital, Department of Radiology, University of Michigan Health System, Section of Pediatric Radiology, Ann Arbor, MI (United States); Lowery, Ray; Yu, Sunkyung [C.S. Mott Children' s Hospital, Department of Pediatrics and Communicable Diseases, Division of Pediatric Cardiology, University of Michigan Health System, University of Michigan Congenital Heart Center, Ann Arbor, MI (United States); Ghadimi Mahani, Maryam [C.S. Mott Children' s Hospital, Department of Radiology, University of Michigan Health System, Section of Pediatric Radiology, Ann Arbor, MI (United States); Agarwal, Prachi P. [University of Michigan Health System, Department of Radiology, Division of Cardiothoracic Radiology, Ann Arbor, MI (United States)

2017-07-15

Congenital cardiac magnetic resonance is a limited resource because of scanner and physician availability. Missed appointments decrease scheduling efficiency, have financial implications and represent missed care opportunities. To characterize the rate of missed appointments and identify modifiable predictors. This single-center retrospective study included all patients with outpatient congenital or pediatric cardiac MR appointments from Jan. 1, 2014, through Dec. 31, 2015. We identified missed appointments (no-shows or same-day cancellations) from the electronic medical record. We obtained demographic and clinical factors from the medical record and assessed socioeconomic factors by U.S. Census block data by patient ZIP code. Statistically significant variables (P<0.05) were included into a multivariable analysis. Of 795 outpatients (median age 18.5 years, interquartile range 13.4-27.1 years) referred for congenital cardiac MR, a total of 91 patients (11.4%) missed appointments; 28 (3.5%) missed multiple appointments. Reason for missed appointment could be identified in only 38 patients (42%), but of these, 28 (74%) were preventable or could have been identified prior to the appointment. In multivariable analysis, independent predictors of missed appointments were referral by a non-cardiologist (adjusted odds ratio [AOR] 5.8, P=0.0002), referral for research (AOR 3.6, P=0.01), having public insurance (AOR 2.1, P=0.004), and having scheduled cardiac MR from November to April (AOR 1.8, P=0.01). Demographic factors can identify patients at higher risk for missing appointments. These data may inform initiatives to limit missed appointments, such as targeted education of referring providers and patients. Further data are needed to evaluate the efficacy of potential interventions. (orig.)

Approximate dynamic programming approaches for appointment scheduling with patient preferences.

Science.gov (United States)

Li, Xin; Wang, Jin; Fung, Richard Y K

2018-04-01

During the appointment booking process in out-patient departments, the level of patient satisfaction can be affected by whether or not their preferences can be met, including the choice of physicians and preferred time slot. In addition, because the appointments are sequential, considering future possible requests is also necessary for a successful appointment system. This paper proposes a Markov decision process model for optimizing the scheduling of sequential appointments with patient preferences. In contrast to existing models, the evaluation of a booking decision in this model focuses on the extent to which preferences are satisfied. Characteristics of the model are analysed to develop a system for formulating booking policies. Based on these characteristics, two types of approximate dynamic programming algorithms are developed to avoid the curse of dimensionality. Experimental results suggest directions for further fine-tuning of the model, as well as improving the efficiency of the two proposed algorithms. Copyright © 2018 Elsevier B.V. All rights reserved.

Directors General appointed

CERN Multimedia

1975-01-01

At a special session on 21 March, presided over by P. Levaux, the Council of the European Organization for Nuclear Research appointed J . B. Adams and L . Van Hove as Directors General of the Organization for a period of five years beginning 1 January 1976. Dr. Adams will be responsible for the administration of CERN, for the operation of the equipment and services and for the construction of buildings and major equipment. Professor Van Hove will be responsible for the research activities of the Organization.

Safety Evaluation Report related to renewal of the operating license for the CAVALIER Training Reactor at the University of Virginia (Docket No. 50-396)

International Nuclear Information System (INIS)

1985-05-01

This Safety Evaluation Report for the application filed by the University of Virginia for a renewal of Operating License R-123 to continue to operate the CAVALIER (Cooperatively Assembled Virginia Low Intensity Educational Reactor) has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is owned and operated by the University of Virginia and is located on the campus in Charlottesville, Virginia. Based on its technical review, the staff concludes that the reactor facility can continue to be operated by the university without endangering the health and safety of the public or the environment

Determinants of unmet needs for healthcare and sexual health counselling among Ugandan university students with same-sex sexuality experience.

Science.gov (United States)

Larsson, Markus; Ross, Michael W; Tumwine, Gilbert; Agardh, Anette

2016-01-01

Research from sub-Saharan Africa has shown that persons with same-sex sexuality experience are at elevated risk for ill health due to sexual risk taking, stigma, and discrimination. However, studies of healthcare seeking among young people in this region with same-sex sexuality experience are limited. To identify determinants of unmet healthcare and sexual health counselling needs, respectively, among Ugandan university students with experience of same-sex sexuality. In 2010, 1,954 Ugandan university students completed a questionnaire assessing socio-demographic factors, mental health, alcohol usage, sexual behaviours, and healthcare seeking. The study population consisted of those 570 who reported ever being in love with, sexually attracted to, sexually fantasised about, or sexually engaged with someone of the same sex. Findings showed that 56% and 30% reported unmet healthcare and sexual health counselling needs, respectively. Unmet healthcare needs were associated with poor mental health and exposure to sexual coercion (OR 3.9, 95% confidence intervals [CI]: 2.7-5.7; OR 2.0, 95% CI: 1.3-3.0, respectively). Unmet sexual health counselling needs were significantly associated with poor mental health (OR 3.2, 95% CI: 2.1-4.8), exposure to sexual coercion (OR 2.6, 95% CI: 1.7-3.9), frequent heavy episodic drinking (OR 3.3, 95% CI: 1.9-5.8), and number of sexual partners (OR 1.9, 95% CI: 1.04-3.3). The associations between poor mental health, sexual coercion, and unmet healthcare needs (AOR 4.2, 95% CI: 2.1-8.5; AOR 2.8, 95% CI: 1.3-5.8) and unmet needs for sexual health counselling (AOR 3.3, 95% CI: 1.6-7.1; AOR 2.7, 95% CI: 1.4-5.4) persisted after adjustment for socio-demographic factors, number of sexual partners, and frequent heavy episodic drinking. These findings indicate that exposure to sexual coercion and poor mental health may influence healthcare seeking behaviours of same-sex sexuality experienced students. Targeted interventions that integrate mental

Determinants of unmet needs for healthcare and sexual health counselling among Ugandan university students with same-sex sexuality experience

Directory of Open Access Journals (Sweden)

Markus Larsson

2016-03-01

Full Text Available Background: Research from sub-Saharan Africa has shown that persons with same-sex sexuality experience are at elevated risk for ill health due to sexual risk taking, stigma, and discrimination. However, studies of healthcare seeking among young people in this region with same-sex sexuality experience are limited. Objective: To identify determinants of unmet healthcare and sexual health counselling needs, respectively, among Ugandan university students with experience of same-sex sexuality. Design: In 2010, 1,954 Ugandan university students completed a questionnaire assessing socio-demographic factors, mental health, alcohol usage, sexual behaviours, and healthcare seeking. The study population consisted of those 570 who reported ever being in love with, sexually attracted to, sexually fantasised about, or sexually engaged with someone of the same sex. Results: Findings showed that 56% and 30% reported unmet healthcare and sexual health counselling needs, respectively. Unmet healthcare needs were associated with poor mental health and exposure to sexual coercion (OR 3.9, 95% confidence intervals [CI]: 2.7–5.7; OR 2.0, 95% CI: 1.3–3.0, respectively. Unmet sexual health counselling needs were significantly associated with poor mental health (OR 3.2, 95% CI: 2.1–4.8, exposure to sexual coercion (OR 2.6, 95% CI: 1.7–3.9, frequent heavy episodic drinking (OR 3.3, 95% CI: 1.9–5.8, and number of sexual partners (OR 1.9, 95% CI: 1.04–3.3. The associations between poor mental health, sexual coercion, and unmet healthcare needs (AOR 4.2, 95% CI: 2.1–8.5; AOR 2.8, 95% CI: 1.3–5.8 and unmet needs for sexual health counselling (AOR 3.3, 95% CI: 1.6–7.1; AOR 2.7, 95% CI: 1.4–5.4 persisted after adjustment for socio-demographic factors, number of sexual partners, and frequent heavy episodic drinking. Conclusions: These findings indicate that exposure to sexual coercion and poor mental health may influence healthcare seeking behaviours of

26 CFR 20.2041-1 - Powers of appointment; in general.

Science.gov (United States)

2010-04-01

... Powers of appointment; in general. (a) Introduction. A decedent's gross estate includes under section... beneficiary of a trust to assent to a periodic accounting, thereby relieving the trustee from further... 26 Internal Revenue 14 2010-04-01 2010-04-01 false Powers of appointment; in general. 20.2041-1...

10 CFR 1045.33 - Appointment of restricted data management official.

Science.gov (United States)

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Appointment of restricted data management official. 1045... DECLASSIFICATION Generation and Review of Documents Containing Restricted Data and Formerly Restricted Data § 1045.33 Appointment of restricted data management official. (a) Each agency with access to RD or FRD shall...

Designing cyclic appointment schedules for outpatient clinics with scheduled and unscheduled patient arrivals

NARCIS (Netherlands)

Kortbeek, Nikky; Zonderland, Maartje E.; Braaksma, Aleida; Vliegen, Ingrid M. H.; Boucherie, Richard J.; Litvak, Nelly; Hans, Erwin W.

2014-01-01

We present a methodology to design appointment systems for outpatient clinics and diagnostic facilities that offer both walk-in and scheduled service. The developed blueprint for the appointment schedule prescribes the number of appointments to plan per day and the moment on the day to schedule the

Designing cyclic appointment schedules for outpatient clinics with scheduled and unscheduled patient arrivals

NARCIS (Netherlands)

Kortbeek, Nikky; Zonderland, Maartje Elisabeth; Boucherie, Richardus J.; Litvak, Nelli; Hans, Elias W.

2011-01-01

We present a methodology to design appointment systems for outpatient clinics and diagnostic facilities that offer both walk-in and scheduled service. The developed blueprint for the appointment schedule prescribes the number of appointments to plan per day and the moment on the day to schedule the

Health Beliefs and Co-morbidities Associated with Appointment-Keeping Behavior Among HCV and HIV/HCV Patients.

Science.gov (United States)

Pundhir, Pooja; North, Carol S; Fatunde, Oluwatomilade; Jain, Mamta K

2016-02-01

Appointment-keeping behavior is an important requisite for HCV linkage and treatment initiation. In this study we examine what impact hepatitis C (HCV) knowledge and attitudes has on appointment-keeping behavior among a cohort of HCV and HCV/HIV patients. Knowledge scores and attitude scales, obtained from a cross-sectional survey, were correlated with proportion of appointments kept 1 year prior to taking the survey. Independent risk factors for missing appointments were examined by multiple regression analysis. 292 HCV patients completed the survey, and 149 (51%) were co-infected with HIV. HCV patients kept 67.5 ± 17.4% of their total appointments and a similar proportion (67 ± 38.2) of Liver Clinic appointments, but they attended a higher proportion (73 ± 24.4) of Primary Care Clinic appointments. However, certain health beliefs, psychiatric illness, and HIV co-infection were independently associated with lower levels of appointment-keeping behavior. HCV knowledge was not associated with appointment-keeping behavior. Health beliefs, psychiatric illness, and HIV co-infection are associated with missing appointments, but no link between knowledge and appointment keeping behavior is apparent. In order to increase engagement into HCV care, HCV care coordination programs need to focus on addressing health beliefs and providing resources to those at highest risk for missing appointments.

An Effective Outpatient Appointment System for General Leonard Wood Army Community Hospital

Science.gov (United States)

1990-07-13

collection, donated many hours. She asked patients about the appointment system and personally observed clinic personnel. Additionally, as a consumer ...appointment system which must satisfy both the demands 0of external ( patients ) and internal (physicians) customers . At the o0 C 0 same time, the...its health care environment. A variable that can effect patient flow is centralization or decentralization of the registration and appointment system

Assessment of equity in healthcare financing in Fiji and Timor-Leste: a study protocol.

Science.gov (United States)

Asante, Augustine D; Price, Jennifer; Hayen, Andrew; Irava, Wayne; Martins, Joao; Guinness, Lorna; Ataguba, John E; Limwattananon, Supon; Mills, Anne; Jan, Stephen; Wiseman, Virginia

2014-12-02

Equitable health financing remains a key health policy objective worldwide. In low and middle-income countries (LMICs), there is evidence that many people are unable to access the health services they need due to financial and other barriers. There are growing calls for fairer health financing systems that will protect people from catastrophic and impoverishing health payments in times of illness. This study aims to assess equity in healthcare financing in Fiji and Timor-Leste in order to support government efforts to improve access to healthcare and move towards universal health coverage in the two countries. The study employs two standard measures of equity in health financing increasingly being applied in LMICs-benefit incidence analysis (BIA) and financing incidence analysis (FIA). In Fiji, we will use a combination of secondary and primary data including a Household Income and Expenditure Survey, National Health Accounts, and data from a cross-sectional household survey on healthcare utilisation. In Timor-Leste, the World Bank recently completed a health equity and financial protection analysis that incorporates BIA and FIA, and found that the distribution of benefits from healthcare financing is pro-rich. Building on this work, we will explore the factors that influence the pro-rich distribution. The study is approved by the Human Research Ethics Committee of University of New South Wales, Australia (Approval number: HC13269); the Fiji National Health Research Committee (Approval # 201371); and the Timor-Leste Ministry of Health (Ref MS/UNSW/VI/218). Study outcomes will be disseminated through stakeholder meetings, targeted multidisciplinary seminars, peer-reviewed journal publications, policy briefs and the use of other web-based technologies including social media. A user-friendly toolkit on how to analyse healthcare financing equity will be developed for use by policymakers and development partners in the region. Published by the BMJ Publishing Group

Pengaruh Appointment Registration System terhadap Waktu Tunggu dan Kepuasan Pasien

Directory of Open Access Journals (Sweden)

Yuli Susanti

2015-02-01

Full Text Available Abstrak Peningkatan derajat kesehatan dapat dicapai melalui kemudahan akses terhadap fasilitas kesehatan. Peningkatan peserta pada program Jaminan Kesehatan Nasional (JKN mengakibatkan antrian panjang di sarana pelayanan kesehatan. Penelitian ini bertujuan untuk menganalisis pengaruh metode appointment registration system (ARS terhadap waktu tunggu dan kepuasan pasien. Metode penelitian yang digunakan adalah survei dengan sampel 380 orang dan observasi pada bulan Desember 2014 di RS Al-Islam Bandung. Analisis menggunakan structural equation modeling (SEM dan production operation management-quantitative methods (POMQM. Hasil penelitian diperoleh kondisi pelaksanaan ARS (60,7%, waktu tunggu (59,1%, dan kepuasan pasien (67,3% termasuk dalam kategori cukup. Terdapat pengaruh positif dan signifikan ARS terhadap waktu tunggu (51,84%, pengaruh positif dan signifikan waktu tunggu terhadap kepuasan pasien (25%, dan total pengaruh ARS terhadap kepuasan pasien (16,79%. ARS dapat menurunkan waktu tunggu secara efektif tetapi tidak semua metode ARS dapat menurunkan waktu tunggu. Simpulan, pasien RS Al-Islam Bandung merasa cukup puas terhadap pendaftaran appointment dan waktu tunggu. Kata kunci: Appointment registration system, kepuasan pasien, waktu tunggu   The Influence of Outpatient Appointment Registration System to Waiting Time and Patient Satisfications Abstract Health improvement can be achieved through accessibility to health services. An increased participants in the Health Insurance Program (HIP resulted in a long queue in the hospital. This research aim was to analize influence of appointment registration system (ARS to waiting time and patient satisfaction. Research method using patient satisfaction survey in 380 subjects and observation on December 2014 at Al-Islam Bandung Hospital. The result was analyzed using structural equation modeling (SEM and production operation management-quantitative methods (POMQM. The results showed that the

Leisure-time physical inactivity among healthcare workers.

Science.gov (United States)

Rocha, Saulo Vasconcelos; Barbosa, Aline Rodrigues; Araújo, Tania Maria

2018-01-15

To estimate the prevalence of leisure-time physical inactivity (LTPI) and associated factors among healthcare workers. The cross-sectional study carried out with 2684 healthcare workers from 4 municipalities from the northeast region, Brazil. The LTPI was assessed by dichotomous question. The association between LTPI and the various independent variables was examined through the multinomial logistic regression analysis (crude and adjusted). The prevalence of LTPI was 47.9% (95% confidence interval (CI): 46.01-48.80). The adjusted analysis (sociodemographic and occupational characteristics) showed that women and individuals with higher levels of education were more LTPI (p = 0.05). The prevalence of LTPI was high among the population investigated, especially among women and individuals with higher education. These results show the importance of developing actions to encourage adherence to physical activity during leisure time among workers, especially among the most vulnerable groups (people with higher education and women), given the benefits of this behavior to health. Int J Occup Med Environ Health 2018;31(3):251-260. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Safety evaluation report related to the renewal of the operating license for the Zero-Power Reactor at Cornell University, Docket No. 50-97

International Nuclear Information System (INIS)

1983-09-01

This Safety Evaluation Report for the application filed by Cornell University (CU) for a renewal of Operating License R-80 to continue to operate a zero-power reactor (ZPR) has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is owned and operated by Cornell University and is located on the Cornell campus in Ithaca, New York. The staff concludes that the ZPR facility can continue to be operated by CU without endangering the health and safety of the public

Safety Evaluation Report related to the renewal of the operating license for the training and research reactor at the University of Lowell (Docket No. 50-223)

International Nuclear Information System (INIS)

1985-11-01

This Safety Evaluation Report for the application filed by the University of Lowell (UL) for renewal of operating license number R-125 to continue to operate its research reactor has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is located on the North Campus of the University of Lowell in Lowell, Massachusetts. The staff concludes that the reactor can continue to be operated by the University of Lowell without endangering the health and safety of the public

The Interaction of Publications and Appointments: New Evidence on Academic Economists in Germany

Science.gov (United States)

Beckmann, Klaus; Schneider, Andrea

2013-01-01

Using a new panel data set comprising publication and appointment data for 889 German academic economists over a quarter of a century, we confirm the familiar hypothesis that publications are important for professorial appointments, but find only a small negative effect of appointments on subsequent research productivity, in particular if one…

Research on the actual condition on the licensed chief engineers of radiation

International Nuclear Information System (INIS)

1976-01-01

A research on the actual condition on the licensed chief engineers of radiation was performed on October, 1975. Question cards were sent to 2915 facilities in Japan, and answers came back from 2850 facilities. Answers report the size of each facility, number of employee, number of chief engineers in charge, age of chief engineers, appointment authority, responsibility, improvement of working condition of chief engineer, and assistant officer for chief engineer. The number of worker is 62,456 in 2,769 facilities. The number of chief engineer in charge is 3,286 containing 579 doctor and/or dentist. The age of chief in 80 percent facilities is above 31. System of management of radiation safety was also investigated. (Kato, T.)

Herbal remedies: issues in licensing and economic evaluation.

Science.gov (United States)

Ashcroft, D M; Po, A L

1999-10-01

In recent years, the use of alternative therapies has become widespread. In particular, there has been a resurgence in the public's demand for herbal remedies, despite a lack of high-quality evidence to support the use of many of them. Given the increasing pressures to control healthcare spending in most countries, it is not surprising that attention is being focused on the cost effectiveness of herbal remedies. We address the question of whether there is sufficient information to enable the assessment of the cost effectiveness of herbal remedies. In so doing, we discuss the current state of play with several of the more high-profile alternative herbal remedies [Chinese medicinal herbs for atopic eczema, evening primrose oil, ginkgo biloba, hypericum (St John's wort)] and some which have made the transition from being alternative to being orthodox remedies. We use historical context to discuss, on the one hand, the increasing commodification of herbal remedies and on the other, the trend towards greater regulatory control and licensing of alternative herbal remedies. We argue that unless great care is exercised, these changes are not necessarily in the best interests of patients. In order to identify cost-effective care, we need reliable information about the costs as well as the efficacy and safety of the treatments being assessed. For most alternative therapies, such data are not available. We believe that studies to gather such data are long overdue. Whilst we argue strongly in favour of control of some herbal remedies, we urge caution with the trend towards licensing of all herbal remedies. We argue that the licensing of those herbal remedies with equivocal benefits and few risks, as evidenced by a long history of safe use, increases barriers to entry and increases societal healthcare costs.

How the Spectre of Societal Homogeneity Undermines Equitable Healthcare for Refugees Comment on "Defining and Acting on Global Health: The Case of Japan and the Refugee Crisis".

Science.gov (United States)

Razum, Oliver; Wenner, Judith; Bozorgmehr, Kayvan

2016-10-17

Recourse to a purported ideal of societal homogeneity has become common in the context of the refugee reception crisis - not only in Japan, as Leppold et al report, but also throughout Europe. Calls for societal homogeneity in Europe originate from populist movements as well as from some governments. Often, they go along with reduced social support for refugees and asylum seekers, for example in healthcare provision. The fundamental right to health is then reduced to a citizens' right, granted fully only to nationals. Germany, in spite of welcoming many refugees in 2015, is a case in point: entitlement and access to healthcare for asylum seekers are restricted during the first 15 months of their stay. We show that arguments brought forward to defend such restrictions do not hold, particularly not those which relate to maintaining societal homogeneity. European societies are not homogeneous, irrespective of migration. But as migration will continue, societies need to invest in what we call "globalization within." Removing entitlement restrictions and access barriers to healthcare for refugees and asylum seekers is one important element thereof. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Catastrophic healthcare expenditure and poverty related to out-of-pocket payments for healthcare in Bangladesh-an estimation of financial risk protection of universal health coverage.

Science.gov (United States)

Khan, Jahangir A M; Ahmed, Sayem; Evans, Timothy G

2017-10-01

The Sustainable Development Goals target to achieve Universal Health Coverage (UHC), including financial risk protection (FRP) among other dimensions. There are four indicators of FRP, namely incidence of catastrophic health expenditure (CHE), mean positive catastrophic overshoot, incidence of impoverishment and increase in the depth of poverty occur for high out-of-pocket (OOP) healthcare spending. OOP spending is the major payment strategy for healthcare in most low-and-middle-income countries, such as Bangladesh. Large and unpredictable health payments can expose households to substantial financial risk and, at their most extreme, can result in poverty. The aim of this study was to estimate the impact of OOP spending on CHE and poverty, i.e. status of FRP for UHC in Bangladesh. A nationally representative Household Income and Expenditure Survey 2010 was used to determine household consumption expenditure and health-related spending in the last 30 days. Mean CHE headcount and its concentration indices (CI) were calculated. The propensity of facing CHE for households was predicted by demographic and socioeconomic characteristics. The poverty headcount was estimated using 'total household consumption expenditure' and such expenditure without OOP payments for health in comparison with the poverty-line measured by cost of basic need. In absolute values, a pro-rich distribution of OOP payment for healthcare was found in urban and rural Bangladesh. At the 10%-threshold level, in total 14.2% of households faced CHE with 1.9% overshoot. 16.5% of the poorest and 9.2% of the richest households faced CHE. An overall pro-poor distribution was found for CHE (CI = -0.064) in both urban and rural households, while the former had higher CHE incidences. The poverty headcount increased by 3.5% (5.1 million individuals) due to OOP payments. Reliance on OOP payments for healthcare in Bangladesh should be reduced for poverty alleviation in urban and rural Bangladesh in order to

Physical hazard safety awareness among healthcare workers in Tanta university hospitals, Egypt.

Science.gov (United States)

El-Sallamy, Rania M; Kabbash, Ibrahim Ali; El-Fatah, Sanaa Abd; El-Feky, Asmaa

2017-05-17

Hospital workers are exposed to many occupational hazards that may threaten their health and safety. Physical hazards encountered in hospital working environment include temperature, illumination, noise, electrical injuries, and radiation. To assess the awareness of healthcare workers (HCWs) about physical hazards in Tanta university hospitals, this cross-sectional study included 401 HCWs (physicians, nurses, technicians, and workers) from seven departments (general surgery, orthopedics, radiology, ophthalmology, kitchen, incinerator, and laundry). Data were collected through interview questionnaire to assess six types of physical hazards (noise, electric hazards, temperature, radiation, fire, and lighting,). Most of the physicians (63.7%) were aware of the level of noise. All physicians, nurses, technicians, and majority of workers reported that hearing protective devices were not available, and all HCWs reported that periodic hearing examination was not performed. Most of the nurses (75.2%) and workers (68.5%) did not attended emergency training, and more than two thirds of all HCWs were not briefed about emergency evacuation. Most HCWs were not given appropriate radiation safety training before starting work (88% of workers, 73.7% of nurses, 65.7% of physicians, and 68.3% of technicians). The majority of physicians, nurses, and technicians (70.5, 65.4, and 53.7%) denied regular environmental monitoring for radiation level inside work place. Health education programs on health and safety issues regarding physical hazards should be mandatory to all healthcare workers to improve their awareness and protect them from undue exposures they may face due to lack of adequate awareness and knowledge. There is urgent need of expanding the occupational healthcare services in Egypt to cover all the employees as indicated by the international recommendations and the Egyptian Constitution, legislation, and community necessity.

Safety Evaluation Report related to the renewal of the operating license for the training and research reactor at the University of Michigan (Docket No. 50-2)

International Nuclear Information System (INIS)

1985-07-01

This Safety Evaluation Report for the application filed by the University of Michigan (UM) for renewal of the Ford Nuclear Reactor (FNR) operating license number R-28 to continue to operate its research reactor has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is located on the North Campus of the University of Michigan in Ann Arbor, Michigan. The staff concludes that the reactor can continue to be operated by the University of Michigan without endangering the health and safety of the public

Faculty Handbook -- 1974-1976. Montana State University, Bozeman.

Science.gov (United States)

Montana State Univ., Bozeman.

The Montana State University's 1974 faculty handbook outlines the history and scope of the university within the Montana state higher education system. The document details the administrative organization; the faculty organization and operation; personnel policies including appointments, tenure, rank and titles, faculty review, promotions,…

Healthcare Engineering Defined: A White Paper.

Science.gov (United States)

Chyu, Ming-Chien; Austin, Tony; Calisir, Fethi; Chanjaplammootil, Samuel; Davis, Mark J; Favela, Jesus; Gan, Heng; Gefen, Amit; Haddas, Ram; Hahn-Goldberg, Shoshana; Hornero, Roberto; Huang, Yu-Li; Jensen, Øystein; Jiang, Zhongwei; Katsanis, J S; Lee, Jeong-A; Lewis, Gladius; Lovell, Nigel H; Luebbers, Heinz-Theo; Morales, George G; Matis, Timothy; Matthews, Judith T; Mazur, Lukasz; Ng, Eddie Yin-Kwee; Oommen, K J; Ormand, Kevin; Rohde, Tarald; Sánchez-Morillo, Daniel; Sanz-Calcedo, Justo García; Sawan, Mohamad; Shen, Chwan-Li; Shieh, Jiann-Shing; Su, Chao-Ton; Sun, Lilly; Sun, Mingui; Sun, Yi; Tewolde, Senay N; Williams, Eric A; Yan, Chongjun; Zhang, Jiajie; Zhang, Yuan-Ting

2015-01-01

Engineering has been playing an important role in serving and advancing healthcare. The term "Healthcare Engineering" has been used by professional societies, universities, scientific authors, and the healthcare industry for decades. However, the definition of "Healthcare Engineering" remains ambiguous. The purpose of this position paper is to present a definition of Healthcare Engineering as an academic discipline, an area of research, a field of specialty, and a profession. Healthcare Engineering is defined in terms of what it is, who performs it, where it is performed, and how it is performed, including its purpose, scope, topics, synergy, education/training, contributions, and prospects.

5 CFR 9901.511 - Appointing authorities.

Science.gov (United States)

2010-01-01

... 9901.511 Administrative Personnel DEPARTMENT OF DEFENSE HUMAN RESOURCES MANAGEMENT AND LABOR RELATIONS SYSTEMS (DEPARTMENT OF DEFENSE-OFFICE OF PERSONNEL MANAGEMENT) DEPARTMENT OF DEFENSE NATIONAL SECURITY... these authorities will be given career, career conditional, term or temporary appointments in the...

The nuclear licensing procedure

International Nuclear Information System (INIS)

Wagner, H.

1976-01-01

To begin with, the present nuclear licensing procedure is illustrated by a diagram. The relationship between the state and the Laender, the various experts (GRS - IRS + LRA -, TUEV, DWD, university institutes, firms of consulting engineers, etc), participation of the public, e.g. publication of the relevant documents, questions, objections (made by individuals or by groups such as citizens' initiatives), public discussion, official notice, appeals against the decision, the right of immediate execution of the decision are shortly dealt with. Finally, ways to improve the licensing procedure are discussed, from the evaluation of the documents to be submitted, published, and examined by the authorities (and their experts) up to an improvement of the administrative procedure. An improved licensing procedure should satisfy the well-founded claims of the public for more transparency as well as the equally justifiable claims of industry and utilities in order to ensure that the citizens' legal right to have safe and adequate electric power is guaranteed. The updated energy programme established by the Federal Government is mentioned along with the effectiveness of dealing with nuclear problems on the various levels of a Land government. (orig.) [de

Scientific profile and professional responsibility of Court-appointed Medical Technical Consultants in Italy: time for a specific educational curriculum?

Science.gov (United States)

Conti, Andrea Alberto

2014-08-20

Court-appointed Technical Consultants (CTCs) are fundamental figures in the Italian judicial system. CTCs are experts appointed by judges in order to supplement their activities by ascertaining, collecting and analyzing facts concerning the specific subject of a lawsuit. These experts formulate opinions, gather motivations and perform checks to provide clear, objective and irrefutable answers to the questions posed by judges. With direct reference to the medical field, while police doctors (specialists in forensic medicine) follow an academic, dedicated, well-structured educational curriculum, the University specialty school in Forensic Medicine, other medical CTCs, though not infrequently luminaries with one or many medical specialties and professional acknowledgments, may have no specific legal-medicine and juridical expertise, precisely because a similar expertise is not formally required of them. In the light of these considerations, in Italy some professionals of the legal world, and of the health context too, have proposed for medical CTCs targeted educational pathways, which would provide these experts with formal specific qualifications. In synthesis and in conclusion, a full knowledge and a rigorous respect of the rules of legal proceedings emerge as increasingly important characteristics for current and future Court-appointed Technical Consultants, together with a specific educational curriculum.

Safety evaluation report related to the renewal of the operating license for the research reactor at the University of Florida. Docket No. 50-83

International Nuclear Information System (INIS)

1982-05-01

This Safety Evaluation Report for the application filed by the University of Florida (UF) for a renewal of Operating License R-56 to continue to operate its Argonaut-type research reactor has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is owned and operated by the University of Florida and is located on the UF campus in Gainesville, Alachua County, Florida. The staff concludes that the reactor facility can continue to be operated by UF without endangering the health and safety of the public

Self-management model in the scheduling of successive appointments in rheumatology.

Science.gov (United States)

Castro Corredor, David; Cuadra Díaz, José Luis; Mateos Rodríguez, Javier José; Anino Fernández, Joaquín; Mínguez Sánchez, María Dolores; de Lara Simón, Isabel María; Tébar, María Ángeles; Añó, Encarnación; Sanz, María Dolores; Ballester, María Nieves

2018-01-08

The rheumatology service of Ciudad Real Hospital, located in an autonomous community of that same name that is nearly in the center of Spain, implemented a self-management model of successive appointments more than 10 years ago. Since then, the physicians of the department schedule follow-up visits for their patients depending on the disease, its course and ancillary tests. The purpose of this study is to evaluate and compare the self-management model for successive appointments in the rheumatology service of Ciudad Real Hospital versus the model of external appointment management implemented in 8 of the hospital's 15 medical services. A comparative and multivariate analysis was performed to identify variables with statistically significant differences, in terms of activity and/or performance indicators and quality perceived by users. The comparison involved the self-management model for successive appointments employed in the rheumatology service of Ciudad Real Hospital and the model for external appointment management used in 8 hospital medical services between January 1 and May 31, 2016. In a database with more than 100,000 records of appointments involving the set of services included in the study, the mean waiting time and the numbers of non-appearances and rescheduling of follow-up visits in the rheumatology department were significantly lower than in the other services. The number of individuals treated in outpatient rheumatology services was 7,768, and a total of 280 patients were surveyed (response rate 63.21%). They showed great overall satisfaction, and the incidence rate of claims was low. Our results show that the self-management model of scheduling appointments has better results in terms of activity indicators and in quality perceived by users, despite the intense activity. Thus, this study could be fundamental for decision making in the management of health care organizations. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de

Missed medical appointment among hypertensive and diabetic ...

African Journals Online (AJOL)

Keywords: Missed medical appointments, Hypertensive, Diabetic outpatients, Medication adherence, ... 12 weeks, at 95 % confidence level and 5 % error margin, 300 hypertensive ... monthly income and health insurance status of respondents ...

Cost-effectiveness of universal rotavirus vaccination in reducing rotavirus gastroenteritis in Ireland.

LENUS (Irish Health Repository)

Tilson, L

2011-10-06

We evaluated the cost-effectiveness of universal infant rotavirus (RV) vaccination compared to current standard of care of "no vaccination". Two RV vaccines are currently licensed in Ireland: Rotarix and RotaTeq. A cohort model used in several European countries was adapted using Irish epidemiological, resource utilisation and cost data. The base case model considers the impact of Rotarix vaccination on health-related quality of life of children under five years old from a healthcare payer perspective. Other scenarios explored the use of RotaTeq, impact on one caregiver, on societal costs and on cases that do not seek medical attention. Cost was varied between the vaccine list price (€100\\/course) in the base case and an assumed tender price (€70\\/course). One-way and probabilistic sensitivity analyses were conducted. Implementing universal RV vaccination may prevent around 1970 GP visits, 3280 A&E attendances and 2490 hospitalisations. A vaccination programme was estimated to cost approximately €6.54 million per year but €4.65 million of this would be offset by reducing healthcare resource use. The baseline ICER was €112,048\\/QALY and €72,736\\/QALY from the healthcare payer and societal perspective, respectively, falling to €68,896 and €43,916\\/QALY, respectively, if the impact on one caregiver was considered. If the price fell to €70 per course, universal RV vaccination would be cost saving under all scenarios. Results were sensitive to vaccination costs, incidence of RV infection and direct medical costs. Universal RV vaccination would not be cost-effective under base case assumptions. However, it could be cost-effective at a lower vaccine price or from a wider societal perspective.

Healthcare Engineering Defined: A White Paper

Directory of Open Access Journals (Sweden)

Ming-Chien Chyu

2015-01-01

Full Text Available Engineering has been playing an important role in serving and advancing healthcare. The term “Healthcare Engineering” has been used by professional societies, universities, scientific authors, and the healthcare industry for decades. However, the definition of “Healthcare Engineering” remains ambiguous. The purpose of this position paper is to present a definition of Healthcare Engineering as an academic discipline, an area of research, a field of specialty, and a profession. Healthcare Engineering is defined in terms of what it is, who performs it, where it is performed, and how it is performed, including its purpose, scope, topics, synergy, education/training, contributions, and prospects.

Safety Evaluation Report related to the renewal of the operating license for the TRIGA training and research reactor at the University of Arizona (Docket No. 50-113)

International Nuclear Information System (INIS)

1990-05-01

This Safety Evaluation Report for the application filed by the University of Arizona for the renewal of Operating License R-52 to continue operating its research reactor at an increased operating power level has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is located on the University of Arizona campus in Tucson, Arizona. The staff concludes that the reactor can continue to be operated by the University of Arizona without endangering the health and safety of the public. 20 refs., 8 figs., 5 tabs

Sustainability Through Technology Licensing and Commercialization: Lessons Learned from the TRIAD Project.

Science.gov (United States)

Payne, Philip R O

2014-01-01

Ongoing transformation relative to the funding climate for healthcare research programs housed in academic and non-profit research organizations has led to a new (or renewed) emphasis on the pursuit of non-traditional sustainability models. This need is often particularly acute in the context of data management and sharing infrastructure that is developed under the auspices of such research initiatives. One option for achieving sustainability of such data management and sharing infrastructure is the pursuit of technology licensing and commercialization, in an effort to establish public-private or equivalent partnerships that sustain and even expand upon the development and dissemination of research-oriented data management and sharing technologies. However, the critical success factors for technology licensing and commercialization efforts are often unknown to individuals outside of the private sector, thus making this type of endeavor challenging to investigators in academic and non-profit settings. In response to such a gap in knowledge, this article will review a number of generalizable lessons learned from an effort undertaken at The Ohio State University to commercialize a prototypical research-oriented data management and sharing infrastructure, known as the Translational Research Informatics and Data Management (TRIAD) Grid. It is important to note that the specific emphasis of these lessons learned is on the early stages of moving a technology from the research setting into a private-sector entity and as such are particularly relevant to academic investigators interested in pursuing such activities.

CNPC Appoints Chief Experts for Important Technological Projects

Institute of Scientific and Technical Information of China (English)

Zhao Jianzhong

2006-01-01

@@ On June 27th, China National Petroleum Corporation (CNPC) held a public recruitment to appoint chief experts in Beijing for its important technological projects, which is the first time for CNPC to appoint chief managers by the means of competitive recruitment. This recruitment covers four projects, such as drilling, logging, geophysical survey and ground engineering with 15 projects. Of those,there are 8 drilling projects, which make up 50 percent of all the important technological projects for public recruitment. CNPC expects to further boost the chief expert responsibility system and promote the research and development (R&D) of technological project on the basis of the public recruitment. The company completes the recruitment following the procedure of making announcement, conducting competitive recruitment and giving publicity. On July 25th, the appointment ceremony was held by CNPC and 15 experts were awarded the certificates. CNPC is entering a new stage for the implementation of the technology and talent strategy for the 11th Five-Year Plan. What's more, a new management mode is taking shape for the technological project and for the construction of technological personnel pool.

Appointment waiting times and education level influence the quality of bowel preparation in adult patients undergoing colonoscopy

Directory of Open Access Journals (Sweden)

Goh Khean-Lee

2011-07-01

Full Text Available Abstract Background Risk factors for poor bowel preparation are recognized to be independent of the type of bowel preparation method used. Patient and administrative factors influencing bowel preparation are known to vary in different healthcare systems. Methods A prospective, cross-sectional study of patients undergoing colonoscopy in an Asian tertiary centre was conducted to identify risk factors associated with poor bowel preparation, and to evaluate the impact of poor bowel preparation on technical performance and patient comfort. Results Data on 501 patients (mean age 60.1 ± 14.0 years old, 51.2% males, 60.9% with secondary education or higher was available for analysis. Poor bowel preparation was present in 151 patients (30.1%. Lower education level (OR = 2.35, 95% CI = 1.54 - 3.60, colonoscopy appointment waiting time beyond 16 weeks (OR = 1.86, 95% CI = 1.04 - 3.37 and non-adherence to bowel preparation instructions (OR = 4.76, 95% CI = 3.00 - 7.55 were identified as independent risk factors for poor bowel preparation. Poor bowel preparation was associated with a lower cecal intubation rate (78.1% versus 98.3%, p Conclusions Education levels and appointment waiting times, in addition to non-adherence to bowel preparation instructions, increase the risk of poor bowel preparation in adult patients undergoing colonoscopy. The latter has a significant impact on colonoscopy performance and patient comfort.

Access to primary care for socioeconomically disadvantaged older people in rural areas: a realist review.

Science.gov (United States)

Ford, John A; Wong, Geoff; Jones, Andy P; Steel, Nick

2016-05-17

The aim of this review is to identify and understand the contexts that effect access to high-quality primary care for socioeconomically disadvantaged older people in rural areas. A realist review. MEDLINE and EMBASE electronic databases and grey literature (from inception to December 2014). Broad inclusion criteria were used to allow articles which were not specific, but might be relevant to the population of interest to be considered. Studies meeting the inclusion criteria were assessed for rigour and relevance and coded for concepts relating to context, mechanism or outcome. An overarching patient pathway was generated and used as the basis to explore contexts, causal mechanisms and outcomes. 162 articles were included. Most were from the USA or the UK, cross-sectional in design and presented subgroup data by age, rurality or deprivation. From these studies, a patient pathway was generated which included 7 steps (problem identified, decision to seek help, actively seek help, obtain appointment, get to appointment, primary care interaction and outcome). Important contexts were stoicism, education status, expectations of ageing, financial resources, understanding the healthcare system, access to suitable transport, capacity within practice, the booking system and experience of healthcare. Prominent causal mechanisms were health literacy, perceived convenience, patient empowerment and responsiveness of the practice. Socioeconomically disadvantaged older people in rural areas face personal, community and healthcare barriers that limit their access to primary care. Initiatives should be targeted at local contextual factors to help individuals recognise problems, feel welcome, navigate the healthcare system, book appointments easily, access appropriate transport and have sufficient time with professional staff to improve their experience of healthcare; all of which will require dedicated primary care resources. Published by the BMJ Publishing Group Limited. For

New appointments at the IAEA

International Nuclear Information System (INIS)

1999-01-01

The document shortly presents the following new appointments: the Deputy Director General, Head of the Department of Safeguards (effective as of 1 May 1999), the Director of the Division of Nuclear Fuel Cycle and Waste Technology in the Department of Nuclear Energy, and the Director of the Division of Conference and Document Services in the Department of Administration (effective as of 1 April 1999)

76 FR 62868 - Washington State University; Notice of Issuance of Renewed Facility Operating License No. R-76

Science.gov (United States)

2011-10-11

...; Notice of Issuance of Renewed Facility Operating License No. R-76 AGENCY: Nuclear Regulatory Commission. ACTION: Notice of issuance of renewed facility operating license No. R- 76. ADDRESSES: You can access.... Nuclear Regulatory Commission (NRC, the Commission) has issued renewed Facility Operating License No. R-76...

Safety Evaluation Report related to the renewal of the operating license for the research reactor at the University of Kansas (Docket No. 50-148)

International Nuclear Information System (INIS)

1984-05-01

This Safety Evaluation Report for the application filed by the University of Kansas (KU) for a renewal of Operating License R-78 to continue to operate the KU 250-kW open-pool training reactor has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is owned and operated by the University of Kansas and is located on the KU campus in Lawrence, Douglas County, Kansas. The staff concludes that the reactor facility can continue to be operated by KU without endangering the health and safety of the public. 17 references, 11 figures, 4 tables

Equal Opportunity? Gender Gaps in CEO Appointments and Executive Pay

OpenAIRE

Keloharju, Matti; Knüpfer, Samuli; Tåg, Joacim

2016-01-01

This paper uses exceptionally rich data on Swedish corporate executives and their personal characteristics to study gender gaps in CEO appointments and pay. Both gaps are sizeable: 18% for CEO appointments and 27% for pay. At most one-eight of the gaps can be attributed to observable gender differences in executives' and their firms' characteristics. Further tests suggest that unobservable gender differences in characteristics are unlikely to account for the remaining gaps. Instead, our resul...

ITER licensing

International Nuclear Information System (INIS)

Gordon, C.W.

2005-01-01

ITER was fortunate to have four countries interested in ITER siting to the point where licensing discussions were initiated. This experience uncovered the challenges of licensing a first of a kind, fusion machine under different licensing regimes and helped prepare the way for the site specific licensing process. These initial steps in licensing ITER have allowed for refining the safety case and provide confidence that the design and safety approach will be licensable. With site-specific licensing underway, the necessary regulatory submissions have been defined and are well on the way to being completed. Of course, there is still work to be done and details to be sorted out. However, the informal international discussions to bring both the proponent and regulatory authority up to a common level of understanding have laid the foundation for a licensing process that should proceed smoothly. This paper provides observations from the perspective of the International Team. (author)

[Healthcare and culture, between diversity and universality].

Science.gov (United States)

Debout, Christophe

2010-01-01

Interrelations exist between people's behaviour and the reasons for it as explained by culture. The healthcare theory put forward by the American nurse Madeleine Leininger, at the end of the 1970s, integrates anthropology Identifying and understanding the patient's culture enables nursing care to be adapted to the patient's own view of his/her disease.

The role of short messaging service in supporting the delivery of healthcare: An umbrella systematic review.

Science.gov (United States)

Househ, Mowafa

2016-06-01

Short messaging service (SMS) messages may present a convenient and cost-effective method to support healthcare interventions. This work assesses the effects of short messaging service on various healthcare interventions found in systematic reviews. The search strategy was based on two key concepts: short messaging service and healthcare delivery. The initial search was conducted in December 2012 and was updated in June 2013. Of the 550 identified references, 13 systematic reviews met the inclusion criteria, of which 8 were published in peer-reviewed journals and 5 were retrieved from the Cochrane library. Data analysis shows that low to moderate research evidence exists on the benefits of short messaging service interventions for appointment reminders, promoting health in developing countries and preventive healthcare. In many interventions, however, there were a few studies that were of high quality, and most of the studies were rated from low to moderate quality or had no rating at all. Healthcare organizations, policy makers, or clinicians using short messaging service messages to support healthcare interventions should (1) implement interventions that have been found to work in healthcare settings, (2) continue evaluating short messaging service interventions that have not been adequately assessed, and (3) improve collaboration between various healthcare entities to develop studies targeted at specific populations to evaluate the long-term impact of short messaging service on healthcare outcomes. © The Author(s) 2014.

mHealth: Knowledge and use among doctors and nurses in public secondary health-care facilities of Lagos, Nigeria

Directory of Open Access Journals (Sweden)

Bukola Samuel Owolabi

2018-01-01

Full Text Available Objectives: Mobile health (mHealth is gaining importance worldwide, changing and improving the way healthcare and services are provided, but its role is just emerging in Nigeria. This study aimed to assess the knowledge and use of mHealth among health workers and the provisions for its use in public secondary health-care facilities of Lagos State, Nigeria. Methods: The study was a descriptive cross-sectional study carried out among 65 doctors and 135 nurses selected using a two-staged sampling method. Data were collected with pretested self-administered questionnaires and analyzed with EpiInfo™ 7. Results: Majority (doctors 84.6%, nurses 91.1% had not heard of the term “mHealth,” but most (doctors 96.9%, nurses 87.4% were aware of the use of mobile phones in health-care delivery. Only three (27.3% (health call centers/health-care telephone helpline, appointment reminders, and mobile telemedicine out of 11 mHealth components listed were mostly known. Most doctors simply used patient monitoring/surveillance and mobile telemedicine, while nurses mainly used treatment compliance and appointment reminder services. Majority were willing to use more mHealth services if available in their hospital. All the doctors and 97% of nurses had mobile phones. However, only about one-quarter (27.5% had smartphones with applications used for mHealth purposes. Conclusions: Knowledge, awareness, and use of mHealth services were low. Doctors and nurses should be enlightened and trained on ways to use mHealth services to improve health-care delivery, mHealth services should be made available in the hospitals, and use of smartphones encouraged as they portend better adaptability for mHealth use.

Job and industry turnover for registered and licensed vocational nurses.

Science.gov (United States)

Spetz, Joanne; Rickles, Jordan; Chapman, Susan; Ong, Paul M

2008-09-01

Most studies of nurse turnover focus on job turnover, which could reflect nurse advancement and thus not be detrimental to the workforce. The authors discuss findings from a study that involved 2 cohorts of graduates from registered nursing and licensed vocational nursing community college programs in California. The duration of employment in the healthcare industry, as well as with specific employers, is tracked, lending a more thorough analysis of nursing job and industry turnover than found in other studies.

Text Messaging for Enhancement of Testing and Treatment for Tuberculosis, Human Immunodeficiency Virus, and Syphilis: A Survey of Attitudes Toward Cellular Phones and Healthcare

Science.gov (United States)

Person, Anna K.; Blain, Michela L.M.; Jiang, Helen; Rasmussen, Petra W.

2011-01-01

Abstract Objectives: The objective of this study was to assess knowledge, attitudes, and behaviors surrounding healthcare-related mobile phone use and text messaging among persons at risk for or infected with tuberculosis (TB) or the human immunodeficiency virus (HIV). Methods: An anonymous survey was conducted in three groups of subjects: (1) HIV-infected persons attending an HIV clinic; (2) persons with latent TB infection at a public health clinic; and (3) persons presenting for TB, HIV, and syphilis screening at a community screening site. Results: Three hundred fifteen (n  = 315) persons responded to the survey, of whom 241 (76.5%) owned a cell phone. Cell phone owners were younger and more educated than nonowners. Transportation difficulty and forgetting appointments were cited as significant barriers by 34.2% and 39.5% of respondents, respectively. Fifty-six percent of subjects felt it would be acceptable to receive text message appointment reminders, and 33% felt that text message reminders to take medications would be acceptable. Younger age and cell phone ownership were significantly associated with acceptance of text message reminders. Black and Hispanic subjects were more likely to feel that text message reminders for appointments or medications were helpful than White subjects. Further, Black and Hispanic subjects, as well as subjects with lower educational attainment, were more receptive to healthcare-related educational text messages. Conclusions: Cell phones and text messaging were prevalent among our subjects attending HIV and TB clinics, and subjects were generally receptive to text messaging for healthcare-related communication. Interventions that explore the potential for text messaging to improve clinic attendance, medication adherence, and health knowledge should be explored. PMID:21457085

45 CFR 61.7 - Reporting licensure actions taken by Federal or State licensing and certification agencies.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Reporting licensure actions taken by Federal or State licensing and certification agencies. 61.7 Section 61.7 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION HEALTHCARE INTEGRITY AND PROTECTION DATA BANK FOR FINAL ADVERSE...

[Principles of nutrition in patients with newly appointed stoma].

Science.gov (United States)

Pachocka, Lucyna Małgorzata; Urbanik, Anna

2016-01-01

The treatment of intestinal stoma is often a difficult experience for patients and results in numerous problems in the physical, psychological and social aspects. Therefore, post-operative care of the patient with the newly appointed stoma should be taken by therapeutic team consisting of doctors, nurses, physiotherapists, dieticians, psychologists and social workers. Appropriate nutritional education of patients aims to improve their quality of life and to prevent from unpleasant ailments formed after the operation. The specific type of stoma may decide about certain dietary recommendations. The presented work provides a practical dietary recommendations for patients with newly appointed stoma.

Market concentration trends in South Africa’s private healthcare sector

Directory of Open Access Journals (Sweden)

Marine Erasmus

2016-03-01

Full Text Available The Competition Commission (CC commenced with an enquiry into South Africa’s private healthcare sector at the beginning of 2014, the outcome of which could have far-reaching consequences for the medical industry in South Africa. The panel appointed to consider competition in the private healthcare sector has indicated that they are interested in understanding increased consolidation in the private hospital market and the effect this may have on competitive dynamics. This article considers historical concentration trends in the private hospital market from 2000 to 2012. In addition it also deals with changes in market structure in the medical scheme and administrator markets. These trends provide a complete picture of market structure changes and the implications for relative bargaining power of the various parties. It finds that whereas the market concentration of private hospitals has remained relatively stable since 2004, the market concentration of medical schemes and administrators has increased over this period.

Assessment of the Correlation between Appointment Scheduling and Patient Satisfaction in a Pediatric Dental Setup

Directory of Open Access Journals (Sweden)

Amar N. Katre

2014-01-01

Full Text Available Introduction. The practice of modern pediatric dentistry requires delivery of quality care in combination with adherence to excellent business as well as time management principles. A definite appointment schedule should be presented to the parents on the first or second appointment. More importantly, the prescribed schedule should be followed to the best of the professional abilities of the pediatric dentist. Aims. The aim of the study was to assess the co-relation between appointment scheduling and patient satisfaction in a pediatric dental setup with the objective of understanding the parameters related to appointment scheduling to increase patient satisfaction. Method. A total of 40 patients, who visited the Department of Pediatric and Preventive Dentistry, YMT Dental College & Hospital, for dental treatment were selected on a random basis. A questionnaire with a set of 6 questions with a rating scale of 1–5 to assess the patient satisfaction related to appointment scheduling was prepared. Results. A significant number of the patients were happy with the existing appointment scheduling system barring a few exceptions.

Prevention of healthcare-associated infections: knowledge among dental students in seven Italian universities.

Science.gov (United States)

Pasquarella, Cesira; Veronesi, Licia; Castiglia, Paolo; D'Alessandro, Daniela; Legnani, Pierpaolo; Minelli, Liliana; Montagna, Maria Teresa; Napoli, Christian; Righi, Elena; Strohmenger, Laura; Tesauro, Marina; Torre, Ida; Tanzi, Maria Luiza

2015-01-01

Lack of knowledge is the major reason for non-compliance with correct healthcare-associated infections (HAI) prevention procedures. The aim of this study was to evaluate knowledge of the Dental School (DSS) and Dental Hygiene (DHS) students with regard to the prevention of HAI, as basic knowledge for improving and harmonizing the educational content in the different Italian Universities. A cross-sectional study was carried out using an anonymous questionnaire that was completed by DSS (I, II, III, IV, and V year) in seven Universities and DHS (I, II, and III year) in three Universities. The questions dealt with three specific areas: healthcare-associated infections, standard precautions and hand hygiene. Factors associated with an unacceptable level of knowledge (score <17.5) were analyzed using a logistic regression model. A p value <0.05 was considered to be significant. Five hundred and four questionnaires were collected: 81.5% for DSS and 18.5% for DHS. Mean overall score (±DS) achieved by the total number of students was 18.2±2.93 on an overall perfect score of 25; 18.2±3.04 for DSS and 17.8±2.31 for DHS. Stratifying by area, the average score 2.7±1.07 (53%) for HAI, 10.3±1.61 (85.9%) for standard precautions, and 5.2±1.44 (64.8%) for hand hygiene was observed. A significantly different level of knowledge (p<0.001) between DSS and DHS was observed only for HAI (2.8±1.07 for DSS vs 2.1±0.96 for DHS). Significant differences among the academic years were found only for DSS concerning HAI and standard precautions. The logistic regression model showed that an age <23 years was a risk factor for lack of knowledge on HAI, but a protective factor for lack of knowledge about standard precautions and hand hygiene; attending DH degree course was associated with lack of knowledge on HAI. Although the overall score obtained both by DSS and DHS indicated an acceptable level of knowledge, lack of knowledge was highlighted, in particular, for hand hygiene. Therefore

The No-Destination Ship of Priority-Setting in Healthcare: A Call for More Democracy.

Science.gov (United States)

Seixas, Brayan V

2017-10-11

In dealing with scarcity of resources within healthcare systems, decision-makers inevitably have to make choices about which services to fund. Setting priorities represents a challenging task that requires systematic, explicit and transparent methodologies with focus on economic efficiency. In addition, the engagement of the general public in the process of decision-making has been regarded as one of the most important aspects of the management of publicly-funded health systems in liberal democracies. In the current essay, we aim to discuss the problematics of public engagement in the process of resource allocation and priority-setting within the context of publiclyfunded health systems. Our central argument is that although there may be a conflict between democratic mechanisms of citizen participation and economic efficiency, in the extra-welfarist sense, expected for/from the system, the solution for this tension does not seem to rely on more or novel authoritative technocratic approaches, but rather on the deepening and betterment of democratic participation. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Maintenance Appointments in Railway Rolling Stock Rescheduling

NARCIS (Netherlands)

J.C. Wagenaar (Joris); L.G. Kroon (Leo); M.E. Schmidt (Marie)

2016-01-01

textabstractThis paper addresses the Rolling Stock Rescheduling Problem (RSRP), while taking maintenance appointments into account. After a disruption, the rolling stock of the disrupted passenger trains has to be rescheduled in order to restore a feasible rolling stock circulation. Usually, a

77 FR 62490 - Performance Review Board Appointments

Science.gov (United States)

2012-10-15

... Board Appointments AGENCY: Office of Human Resource Management, Departmental Management. ACTION: Notice..., Director, Office of Human Resources Management, telephone: (202) 690-2994, email: [email protected] has a total of seven PRBs: The Secretary's PRB; Career Agency Head's PRB; Departmental Management and...

5 CFR 317.501 - Recruitment and selection for initial SES career appointment be achieved from the brightest and...

Science.gov (United States)

2010-01-01

.... OPM may review proposed career appointments to ensure that they comply with all merit staffing... career appointment be achieved from the brightest and most diverse pool possible. 317.501 Section 317.501... EXECUTIVE SERVICE Career Appointments § 317.501 Recruitment and selection for initial SES career appointment...

Safety evaluation report related to the construction permit and operating license for the research reactor at the University of Texas (Docket No. 50-602)

International Nuclear Information System (INIS)

1992-01-01

The Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission (NRC) has prepared Supplement 1 to NUREG-1135, ''Safety Evaluation Report Related to the Construction Permit and Operating License for the Research Reactor at the University of Texas'' (SER) May 1985. The reactor facility is owned by The University of Texas at Austin (UT, the applicant) and is located at the University's Balcones Research Center in Austin, Texas. This supplement to the SER (SSER) describes the changes to the reactor facility design from the description in the SER. The SER and SSER together reflect the facility as built. The SSER also documents the reviews that the NRC has completed regarding the applicant's emergency plan, security plan, and technical specifications that were identified as open in the SER

'1Care' and the Politics of Healthcare in Malaysia

OpenAIRE

Por Heong Hong

2014-01-01

In this article, we assess the current state of healthcare financing and the contestation surrounding it in Malaysia. The stakes are high because the system of healthcare financing in a country influences to a large extent issues of healthcare accessibility, equity and universal coverage. The taxation-based public healthcare system is a primary welfare source for the people of this country. Nevertheless, privatization of the healthcare sector, expansion of private hospitals, and increase in u...

Safety evaluation report related to the renewal of the operating license for the Research Reactor at the State University of New York at Buffalo, Docket No. 50-57

International Nuclear Information System (INIS)

1983-05-01

This Safety Evaluation Report for the application filed by the State University of New York at Buffalo for a renewal of Operating License R-77 to continue to operate a research reactor has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is owned by the State University of New York and is located on the campus in Buffalo, New York. Based on its technical review, the staff concludes that the reactor facility can continue to be operated by the University without endangering the health and safety of the public or endangering the environment

The Imminent Healthcare and Emergency Care Crisis in Japan

Directory of Open Access Journals (Sweden)

Suzuki, Tetsuji

2008-05-01

Full Text Available Objectives: Japan has a universal healthcare system, and this paper describes the reality of the healthcare services provided, as well as current issues with the system.Methods: Academic, government, and press reports on Japanese healthcare systems and healthcare guidelines were reviewed.Results: The universal healthcare system of Japan is considered internationally to be both low-cost and effective because the Japanese population enjoys good health status with a long life expectancy, while healthcare spending in Japan is below the average given by the Organization for Economic Corporation and Development (OECD. However, in many regions of Japan the existing healthcare resources are seriously inadequate, especially with regard to the number of physicians and other health professionals. Because healthcare is traditionally viewed as “sacred” work in Japan, healthcare professionals are expected to make large personal sacrifices. Also, public attitudes toward medical malpractice have changed in recent decades, and medical professionals are facing legal issues without experienced support of the government or legal professionals. Administrative response to the lack of resources and collaboration among communities are beginning, and more efficient control and management of the healthcare system is under consideration.Conclusion: The Japanese healthcare system needs to adopt an efficient medical control organization to ease the strain on existing healthcare professionals and to increase the number of physicians and other healthcare resources. Rather than continuing to depend on healthcare professionals being able and willing to make personal sacrifices, the government, the public and medical societies must cooperate and support changes in the healthcare system.

Practical quantum appointment scheduling

Science.gov (United States)

Touchette, Dave; Lovitz, Benjamin; Lütkenhaus, Norbert

2018-04-01

We propose a protocol based on coherent states and linear optics operations for solving the appointment-scheduling problem. Our main protocol leaks strictly less information about each party's input than the optimal classical protocol, even when considering experimental errors. Along with the ability to generate constant-amplitude coherent states over two modes, this protocol requires the ability to transfer these modes back-and-forth between the two parties multiple times with very low losses. The implementation requirements are thus still challenging. Along the way, we develop tools to study quantum information cost of interactive protocols in the finite regime.

Infusing an Inter-Professional and Inter-University Perspective into Healthcare Education

Science.gov (United States)

Goldberg, Lynette R.; Koontz, Jennifer Scott; Downs, David; Uhlig, Paul; Kumar, Neil G.; Shah, Sapna; Clark, Paige E.; Coiner, Christina; Crumrine, Daiquirie

2010-01-01

A national (USA) student-led, case-based CLinician/Administrator Relationship Improvement OrganizatioN (CLARION) competition focuses students in medical and related healthcare programs on the provision of healthcare that is safe, timely, equitable, patient-centred, effective and efficient. Students work in four-person, inter-professional teams to…

76 FR 78225 - Notice of Appointment of Members to the National Agricultural Research, Extension, Education, and...

Science.gov (United States)

2011-12-16

... (Appointment--3 years); Category H. ``National Food Science Organization, Dr. Mark R. McLellan, Member... specific category related to agriculture. The Board was first appointed in September 1996 and at the time... member is appointed by the Secretary of Agriculture to a specific category on the Board, including...

Adherence to Medical Cannabis Among Licensed Patients in Israel.

Science.gov (United States)

Zolotov, Yuval; Baruch, Yehuda; Reuveni, Haim; Magnezi, Racheli

2016-01-01

Objectives: To evaluate adherence among Israeli patients who are licensed to use medical cannabis and to identify factors associated with adherence to medical cannabis. Methods: Ninety-five novice licensed patients were interviewed for this cross-sectional study. The questionnaire measured demographics, the perceived patient-physician relationship, and the level of patients' active involvement in their healthcare. In addition, patients were queried about adverse effect(s) and about their overall satisfaction from this medical treatment. Results: Eighty percent ( n =76) has been identified as adherent to medical cannabis use. Variables found associated with adherence were "country of origin" (immigrant status), "type of illness" (cancer vs. non-cancer), and "experiencing adverse effect(s)." Three predictors of adherence were found significant in a logistic regression model: "type of illness" (odds ratio [OR] 0.101), patient-physician relationship (OR 1.406), and level of patient activation (OR 1.132). 71.5% rated themselves being "completely satisfied" or "satisfied" from medical cannabis use. Conclusions: Our findings show a relatively high adherence rate for medical cannabis, as well as relative safety and high satisfaction among licensed patients. Additionally indicated is the need to develop and implement standardized education about this evolving field-to both patients and physicians.

Modeling Patient No-Show History and Predicting Future Outpatient Appointment Behavior in the Veterans Health Administration.

Science.gov (United States)

Goffman, Rachel M; Harris, Shannon L; May, Jerrold H; Milicevic, Aleksandra S; Monte, Robert J; Myaskovsky, Larissa; Rodriguez, Keri L; Tjader, Youxu C; Vargas, Dominic L

2017-05-01

Missed appointments reduce the efficiency of the health care system and negatively impact access to care for all patients. Identifying patients at risk for missing an appointment could help health care systems and providers better target interventions to reduce patient no-shows. Our aim was to develop and test a predictive model that identifies patients that have a high probability of missing their outpatient appointments. Demographic information, appointment characteristics, and attendance history were drawn from the existing data sets from four Veterans Affairs health care facilities within six separate service areas. Past attendance behavior was modeled using an empirical Markov model based on up to 10 previous appointments. Using logistic regression, we developed 24 unique predictive models. We implemented the models and tested an intervention strategy using live reminder calls placed 24, 48, and 72 hours ahead of time. The pilot study targeted 1,754 high-risk patients, whose probability of missing an appointment was predicted to be at least 0.2. Our results indicate that three variables were consistently related to a patient's no-show probability in all 24 models: past attendance behavior, the age of the appointment, and having multiple appointments scheduled on that day. After the intervention was implemented, the no-show rate in the pilot group was reduced from the expected value of 35% to 12.16% (p value < 0.0001). The predictive model accurately identified patients who were more likely to miss their appointments. Applying the model in practice enables clinics to apply more intensive intervention measures to high-risk patients. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

The Impact of Health Care Appointment Non-Adherence on Graft Outcomes in Kidney Transplantation.

Science.gov (United States)

Taber, David J; Fleming, James N; Fominaya, Cory E; Gebregziabher, Mulugeta; Hunt, Kelly J; Srinivas, Titte R; Baliga, Prabhakar K; McGillicuddy, John W; Egede, Leonard E

2017-01-01

Non-adherence to medication is a well-studied and known cause of late allograft loss, but it is difficult to measure and prospectively monitor. The aim of this study was to assess if appointment non-adherence was correlated with medication non-adherence and a predictor of graft outcomes. This was a longitudinal cohort study that used the National United States Renal Data System and veterans affairs health records data with time-to-event analyses conducted to assess the impact on graft and patient survival. The number of transplants that were included in the analysis was 4,646 (3,656 with complete records); 14.6% of patients had an appointment no show rate of ≥12% (non-adherence). Appointment and medication non-adherence were highly correlated and both were significant independent predictors of outcomes. Those with appointment non-adherence had 1.5 times the risk of acute rejection (22.0 vs. 14.7%, p adherence; those with appointment and medication non-adherence were at very high risk of graft loss (aHR 4.18, 95% CI 3.39-5.15, p adherence (aHR 1.39, 95% CI 0.97-2.01, p = 0.0766) or only medication non-adherence (aHR 2.44, 95% CI 2.11-2.81, p adherence to health care appointments is a significant and independent risk factor for graft loss. © 2016 S. Karger AG, Basel.

Men's Educational Group Appointments in Rural Nicaragua.

Science.gov (United States)

Campbell, Bruce B; Gonzalez, Hugo; Campbell, McKenzie; Campbell, Kent

2017-03-01

Men's preventive health and wellness is largely neglected in rural Nicaragua, where a machismo culture prevents men from seeking health care. To address this issue, a men's educational group appointment model was initiated at a rural health post to increase awareness about hypertension, and to train community health leaders to measure blood pressure. Men's hypertension workshops were conducted with patient knowledge pretesting, didactic teaching, and posttesting. Pretesting and posttesting performances were recorded, blood pressures were screened, and community leaders were trained to perform sphygmomanometry. An increase in hypertension-related knowledge was observed after every workshop and community health leaders demonstrated proficiency in sphygmomanometry. In addition, several at-risk patients were identified and follow-up care arranged. Men's educational group appointments, shown to be effective in the United States in increasing patient knowledge and satisfaction, appear to function similarly in a resource-constrained environment and may be an effective mechanism for reaching underserved men in Nicaragua.

Court Appointed Volunteers for Abused and Neglected Children.

Science.gov (United States)

Justin, Renate G.

2002-02-01

A court appointed special advocate (CASA) volunteer is a trained citizen who is appointed by a judge to represent the best interests of an abused and neglected child in court. An independent voice, the volunteer gathers information and reports to the court. The CASA volunteer works in close cooperation with other professionals, physicians, lawyers, social workers, and teachers to find the most suitable permanent placement for a victimized child, whether it be a foster home, parental home, or adoptive home. Another function for CASA volunteers is to be supportive to the child during a time of uncertainty in his or her life and to help the youngster adjust to new and changing situations; the CASA volunteer may be the only consistent adult presence during this difficult period of transition.

License renewal

International Nuclear Information System (INIS)

Newberry, S.

1993-01-01

This article gives an overview of the process of license renewal for nuclear power plants. It explains what is meant by license renewal, the significance of license renewal, and goes over key elements involved in the process of license renewal. Those key elements are NRC requirements embodied in 10 CFR Part 54 (Reactor Safety) and 10 CFR Part 51 (Environmental Issues). In addition Industry Reports must be developed and reviewed. License renewal is essentially the process of applying for a 20 year extension to the original 40 year operating license granted for the plant. This is a very long term process, which involves a lot of preparation, and compliance with regulatory rules and guidelines. In general it is a process which is expected to begin when plants reach an operating lifetime of 20 years. It has provisions for allowing the public to become involved in the review process

Commercialization of University Research for Technology-Based Economic Development

Science.gov (United States)

Ferguson, W. Ker

2011-01-01

This empirical study investigates the hypothesized relationship between US federally funded university research and development (R&D) and its resulting economic impact, as measured by the level of licensing revenue generated by US universities. The author also examines the key operating statistics of the top-ten licensing income-producing…

Stakeholders' Perceptions on Shortage of Healthcare Workers in Primary Healthcare in Botswana: Focus Group Discussions.

Directory of Open Access Journals (Sweden)

Oathokwa Nkomazana

Full Text Available An adequate health workforce force is central to universal health coverage and positive public health outcomes. However many African countries have critical shortages of healthcare workers, which are worse in primary healthcare. The aim of this study was to explore the perceptions of healthcare workers, policy makers and the community on the shortage of healthcare workers in Botswana.Fifteen focus group discussions were conducted with three groups of policy makers, six groups of healthcare workers and six groups of community members in rural, urban and remote rural health districts of Botswana. All the participants were 18 years and older. Recruitment was purposive and the framework method was used to inductively analyse the data.There was a perceived shortage of healthcare workers in primary healthcare, which was believed to result from an increased need for health services, inequitable distribution of healthcare workers, migration and too few such workers being trained. Migration was mainly the result of unfavourable personal and family factors, weak and ineffective healthcare and human resources management, low salaries and inadequate incentives for rural and remote area service.Botswana has a perceived shortage of healthcare workers, which is worse in primary healthcare and rural areas, as a result of multiple complex factors. To address the scarcity the country should train adequate numbers of healthcare workers and distribute them equitably to sufficiently resourced healthcare facilities. They should be competently managed and adequately remunerated and the living conditions and rural infrastructure should also be improved.

Machine Learning for Healthcare: On the Verge of a Major Shift in Healthcare Epidemiology.

Science.gov (United States)

Wiens, Jenna; Shenoy, Erica S

2018-01-06

The increasing availability of electronic health data presents a major opportunity in healthcare for both discovery and practical applications to improve healthcare. However, for healthcare epidemiologists to best use these data, computational techniques that can handle large complex datasets are required. Machine learning (ML), the study of tools and methods for identifying patterns in data, can help. The appropriate application of ML to these data promises to transform patient risk stratification broadly in the field of medicine and especially in infectious diseases. This, in turn, could lead to targeted interventions that reduce the spread of healthcare-associated pathogens. In this review, we begin with an introduction to the basics of ML. We then move on to discuss how ML can transform healthcare epidemiology, providing examples of successful applications. Finally, we present special considerations for those healthcare epidemiologists who want to use and apply ML. © The Author(s) 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Prevalence and Correlates of Missed First Appointments among ...

African Journals Online (AJOL)

In Nigeria, where mental health services are poorly organized, missed appointments and its resultant consequences may be burdensome. Aim: This ... However, having received previous treatment for a psychiatric illness (P = 0.02) and having ...

Integrating empowerment evaluation and quality improvement to achieve healthcare improvement outcomes.

Science.gov (United States)

Wandersman, Abraham; Alia, Kassandra Ann; Cook, Brittany; Ramaswamy, Rohit

2015-10-01

While the body of evidence-based healthcare interventions grows, the ability of health systems to deliver these interventions effectively and efficiently lags behind. Quality improvement approaches, such as the model for improvement, have demonstrated some success in healthcare but their impact has been lessened by implementation challenges. To help address these challenges, we describe the empowerment evaluation approach that has been developed by programme evaluators and a method for its application (Getting To Outcomes (GTO)). We then describe how GTO can be used to implement healthcare interventions. An illustrative healthcare quality improvement example that compares the model for improvement and the GTO method for reducing hospital admissions through improved diabetes care is described. We conclude with suggestions for integrating GTO and the model for improvement. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Safety evaluation report related to the renewal of the operating license for the training and research reactor at the University of Maryland (Docket No. 50-166)

International Nuclear Information System (INIS)

1984-03-01

This Safety Evaluation Report for the application filed by the University of Maryland (UMD) for a renewal of operating license R-70 to continue to operate a training and research reactor facility has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is owned and operated by the University of Maryland and is located at a site in College Park, Prince Georges County, Maryland. The staff concludes that this training reactor facility can continue to be operated by UMD without endangering the health and safety of the public

Thoughts on the Italian National University Council (CUN

Directory of Open Access Journals (Sweden)

Borghetti M

2009-01-01

Full Text Available The Italian National University Council (CUN is an elected body that represents the Italian academic system and formulates proposal and gives advice to the Minister of University. The opinion is expressed that the professors who are appointed to CUN should go on sabbatical leave from their universities over the period they are part of CUN, as an important condition for carrying out better their institutional job and preventing any potential conflict of interest.

Tom Brown appointed Dean of Students

OpenAIRE

Williams, Meghan

2007-01-01

James Thomas "Tom" Brown, former senior associate dean of the Dean of Students office, has been appointed as the Dean of Students. The Dean of Students office is responsible for the coordination of student advocacy, new student orientation and parent programs, and responding to student emergencies in collaboration with Judicial Affairs, Residence Life, Cook Counseling Center, Schiffert Health Center, and other departments and agencies.

Assessment of the Correlation between Appointment Scheduling and Patient Satisfaction in a Pediatric Dental Setup

OpenAIRE

Katre, Amar N.

2014-01-01

Introduction. The practice of modern pediatric dentistry requires delivery of quality care in combination with adherence to excellent business as well as time management principles. A definite appointment schedule should be presented to the parents on the first or second appointment. More importantly, the prescribed schedule should be followed to the best of the professional abilities of the pediatric dentist. Aims. The aim of the study was to assess the co-relation between appointment schedu...

Prevalence and Correlates of Missed First Appointments among ...

African Journals Online (AJOL)

quality of care, results in poor treatment outcomes and drains financial resources. In Nigeria, where mental .... and physical aggression. Each subscale has four .... missed first appointments observed in this study falls within the range of 17 and ...

Reasons for and consequences of missed appointments in general practice in the UK: questionnaire survey and prospective review of medical records

Directory of Open Access Journals (Sweden)

Lawlor Debbie A

2005-11-01

Full Text Available Abstract Background Missed appointments are a common occurrence in primary care in the UK, yet little is known about the reasons for them, or the consequences of missing an appointment. This paper aims to determine the reasons for missed appointments and whether patients who miss an appointment subsequently consult their general practitioner (GP. Secondary aims are to compare psychological morbidity, and the previous appointments with GPs between subjects and a comparison group. Methods Postal questionnaire survey and prospective medical notes review of adult patients missing an appointment and the comparison group who attended appointments over a three week period in seven general practices in West Yorkshire. Results Of the 386 who missed appointments 122 (32% responded. Of the 386 in the comparison group 223 (58% responded, resulting in 23 case-control matched pairs with complete data collection. Over 40% of individuals who missed an appointment and participated said that they forgot the appointment and a quarter said that they tried very hard to cancel the appointment or that it was at an inconvenient time. A fifth reported family commitments or being too ill to attend. Over 90% of the patients who missed an appointment subsequently consulted within three months and of these nearly 60% consulted for the stated problem that was going to be presented in the missed consultation. The odds of missing an appointment decreased with increasing age and were greater among those who had missed at least one appointment in the previous 12 months. However, estimates for comparisons between those who missed appointments and the comparison group were imprecise due to the low response rate. Conclusion Patients who miss appointments tend to cite practice factors and their own forgetfulness as the main reasons for doing so, and most attend within three months of a missed appointment. This study highlights a number of implications for future research. More work

Regulator process for the authorization of an amendment to the operation license of a nuclear power plant in Mexico; Proceso regulador para la autorizacion de una enmienda a la licencia de operacion de una central nuclear en Mexico

Energy Technology Data Exchange (ETDEWEB)

Perez, R.; Espinosa V, J.M.; Salgado, J.R.; Mamani, Y.R. [CNSNS, Dr. Barragan 779, Col. Narvarte, 03020 Mexico D.F. (Mexico)

2005-07-01

The regulator process by which an authorization is granted from an amendment to the License of Operation of a nuclear power station in Mexico is described. It makes an appointment the effective legal mark, the technical characteristics of the modification, the evaluation process and deposition upon oath of tests and finally the elaboration of the Safety report and the Technical Verdict that is a correspondent for the regulator organism to the Secretary of Energy, the one that in turn is the responsible of granting the amendment the License just as it establishes it the Law. (Author)

Academic productivity and its relationship to physician salaries in the University of California Healthcare System.

Science.gov (United States)

Fijalkowski, Natalia; Zheng, Luo Luo; Henderson, Michael T; Moshfeghi, Andrew A; Maltenfort, Mitchell; Moshfeghi, Darius M

2013-07-01

To evaluate whether physicians with higher academic productivity, as measured by the number of publications in Scopus and the Scopus Hirsch index (h-index), earn higher salaries. This was a cross-sectional study. Participants were ophthalmologists, otolaryngologists, neurosurgeons, and neurologists classified as "top earners" (>$100,000 annually) within the University of California (UC) healthcare system in 2008. Bibliometric searches on Scopus were conducted to retrieve the total number of publications and Hirsch indices (h-index), a measure of academic productivity. The association between the number of publications and h-index on physicians' total compensation was determined with multivariate regression models after controlling for the four specialties (ophthalmology, otolaryngology, neurosurgery, and neurology), the five institutions (UC San Francisco, UC Los Angeles, UC San Diego, UC Irvine, and UC Davis), and academic rank (assistant professor, associate professor, and professor). The UC healthcare system departments reported 433 faculty physicians among the four specialties, with 71.6% (n = 310) earning more than $100,000 in 2008 and classifying as top earners. After controlling for the specialty, institution, and ranking, there was a significant association between the number of publications on salary (P Scopus number of publications and h-index were correlated (P Scopus h-index was of borderline significance in predicting physician salary (P = 0.12). Physicians with higher Scopus publications had higher total salaries across all four specialties. Every 10 publications were associated with a 2.40% increase in total salary after controlling for specialty, institution, rank, and chair. Ophthalmologists, otolaryngologists, neurosurgeons, and neurologists in the UC healthcare system who are more academically productive receive greater remuneration.

The Globalisation of Higher Education and the Sojourner Academic: Insights into Challenges Experienced by Newly Appointed International Academic Staff in a UK University

Science.gov (United States)

Walker, Patricia

2015-01-01

The increasingly diverse nature of the higher education academic community in the United Kingdom is under-researched and under-theorised. This article presents an exploratory study of the lived experiences of newly appointed international academic staff as expressed in their written reflections on their professional practice and interpreted by the…

A TIMELY APPOINTMENT – SAMA'S NEW CEO

African Journals Online (AJOL)

Nicky

Her middle name might mean 'the one who came before her time', but Dr. Aquina Motlakapele Thulare, 42, the new CEO of the South African Medical. Association, is determined to see doctors better paid and properly valued during her tenure. Ratified by the full board last month, her historic appointment follows the.

Impact of Delayed Time to Advanced Imaging on Missed Appointments Across Different Demographic and Socioeconomic Factors.

Science.gov (United States)

Daye, Dania; Carrodeguas, Emmanuel; Glover, McKinley; Guerrier, Claude Emmanuel; Harvey, H Benjamin; Flores, Efrén J

2018-05-01

The aim of this study was to investigate the impact of wait days (WDs) on missed outpatient MRI appointments across different demographic and socioeconomic factors. An institutional review board-approved retrospective study was conducted among adult patients scheduled for outpatient MRI during a 12-month period. Scheduling data and demographic information were obtained. Imaging missed appointments were defined as missed scheduled imaging encounters. WDs were defined as the number of days from study order to appointment. Multivariate logistic regression was applied to assess the contribution of race and socioeconomic factors to missed appointments. Linear regression was performed to assess the relationship between missed appointment rates and WDs stratified by race, income, and patient insurance groups with analysis of covariance statistics. A total of 42,727 patients met the inclusion criteria. Mean WDs were 7.95 days. Multivariate regression showed increased odds ratio for missed appointments for patients with increased WDs (7-21 days: odds ratio [OR], 1.39; >21 days: OR, 1.77), African American patients (OR, 1.71), Hispanic patients (OR, 1.30), patients with noncommercial insurance (OR, 2.00-2.55), and those with imaging performed at the main hospital campus (OR, 1.51). Missed appointment rate linearly increased with WDs, with analysis of covariance revealing underrepresented minorities and Medicaid insurance as significant effect modifiers. Increased WDs for advanced imaging significantly increases the likelihood of missed appointments. This effect is most pronounced among underrepresented minorities and patients with lower socioeconomic status. Efforts to reduce WDs may improve equity in access to and utilization of advanced diagnostic imaging for all patients. Copyright © 2018. Published by Elsevier Inc.

A web-based appointment system to reduce waiting for outpatients: a retrospective study.

Science.gov (United States)

Cao, Wenjun; Wan, Yi; Tu, Haibo; Shang, Fujun; Liu, Danhong; Tan, Zhijun; Sun, Caihong; Ye, Qing; Xu, Yongyong

2011-11-22

Long waiting times for registration to see a doctor is problematic in China, especially in tertiary hospitals. To address this issue, a web-based appointment system was developed for the Xijing hospital. The aim of this study was to investigate the efficacy of the web-based appointment system in the registration service for outpatients. Data from the web-based appointment system in Xijing hospital from January to December 2010 were collected using a stratified random sampling method, from which participants were randomly selected for a telephone interview asking for detailed information on using the system. Patients who registered through registration windows were randomly selected as a comparison group, and completed a questionnaire on-site. A total of 5641 patients using the online booking service were available for data analysis. Of them, 500 were randomly selected, and 369 (73.8%) completed a telephone interview. Of the 500 patients using the usual queuing method who were randomly selected for inclusion in the study, responses were obtained from 463, a response rate of 92.6%. Between the two registration methods, there were significant differences in age, degree of satisfaction, and total waiting time (P0.05). Being ignorant of online registration, not trusting the internet, and a lack of ability to use a computer were three main reasons given for not using the web-based appointment system. The overall proportion of non-attendance was 14.4% for those using the web-based appointment system, and the non-attendance rate was significantly different among different hospital departments, day of the week, and time of the day (Pweb-based appointment system could significantly increase patient's satisfaction with registration and reduce total waiting time effectively. However, further improvements are needed for broad use of the system.

A Way Forward for Healthcare in Madagascar?

Science.gov (United States)

Marks, Florian; Rabehanta, Nathalie; Baker, Stephen; Panzner, Ursula; Park, Se Eun; Fobil, Julius N; Meyer, Christian G; Rakotozandrindrainy, Raphaël

2016-03-15

A healthcare utilization survey was conducted as a component of the Typhoid Fever Surveillance in Africa Program (TSAP). The findings of this survey in Madagascar contrasted with those in other sites of the program; namely, only 30% of the population sought healthcare at the government-provided healthcare facilities for fever. These findings promoted us to determine the drivers and barriers in accessing and utilizing healthcare in Madagascar. Here we review the results of the TSAP healthcare utilization initiative and place them in the context of the current organization of the Madagascan healthcare system. Our work highlights the demands of the population for access to appropriate healthcare and the need for novel solutions that can quickly provide an affordable and sustainable basic healthcare infrastructure until a government-funded scheme is in place. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Factors deterring dentistry, medical, pharmacy, and social science undergraduates from pursuing nursing as a healthcare career: a cross-sectional study in an Asian university.

Science.gov (United States)

Wu, Ling Ting; Wang, Wenru; Holroyd, Eleanor; Lopez, Violeta; Liaw, Sok Ying

2018-01-26

Globally more registered nurses need to be recruited to meet the needs of aging populations and increased co-morbidity. Nursing recruitment remains challenging when compared to other healthcare programs. Despite healthcare students having similar motivation in joining the healthcare industry, many did not consider nursing as a career choice. This study aims to identify the deterrents to choosing nursing among healthcare undergraduates by examining the differences in the factors influencing healthcare career choices and nursing as a career choice. A cross sectional study was conducted using a 35-parallel items instrument known as Healthcare Career Choice and Nursing Career Choice scale. Six hundred and four (n = 604) first year medical, pharmacy, dentistry and social science students from a university in Singapore completed the survey. Nursing as a career was perceived by healthcare students to be more likely influenced by prior healthcare exposure, the nature of the work, job prospects, and social influences. Lack of autonomous decision making, perceived lower ability to make diagnosis, having to attend to patients' hygiene needs, engendered stigma, and lack of parental support were identified as deterring factors to choosing nursing as a career. An understanding of the deterrents to choosing nursing as career allows policy makers and educational leaders to focus on recruitment strategies. These include providing more exposure to nurses' roles in early school years, helping young people to overcome the fear of providing personal hygiene care, promoting nurses' autonomous nursing practice, addressing gender stigma, and overcoming parental objection.

78 FR 75948 - Senior Executive Service; Appointment of Members to the Performance Review Board

Science.gov (United States)

2013-12-13

... Resources Center--Sydney T. Rose Executive Secretary--Director, Executive Resources--Kim L.H. Green... H. Moore, Deputy Assistant Secretary for Operations and Analysis--appointment expires on 09/30/16..., New York--appointment expires on 09/30/16 OLMS Stephen J. Willertz, Director, Office of Enforcement...

The most influential people in healthcare

Directory of Open Access Journals (Sweden)

Robbins RA

2016-09-01

Full Text Available No abstract available. Article truncated at 150 words. Recently Modern Healthcare released the 2016 listing of their annual most influential people in Healthcare (1. Leading the list is President Barack Obama for his Affordable Care Act. The list consists of a monotonous list of bureaucrats, politicians, large healthcare chain CEOs , insurance company CEOs, health interest organizations (American Hospital Association, America's Health Insurance Plans Healthcare, etc., professional organizations (American Medical Association, American Nurses Association, etc., nongovernmental healthcare interest organizations (Joint Commission, National Quality Forum, etc. and vendors (Epic, McKesson, etc.. From the Southwest the list includes at least 11 hospital chain CEOs including 1 from Arizona, 3 from Colorado and 7 from California. Striking is the lack of influential healthcare professionals who made the list. Only two are leading academicians-Atul Gawande, a surgeon and author at Harvard, and Robert Wachter, an internist and pioneer in the hosptialist movement at University of California San Francisco. John Noseworthy (Mayo Clinic ...

License renewal process

International Nuclear Information System (INIS)

Fable, D.; Prah, M.; Vrankic, K.; Lebegner, J.

2004-01-01

The purpose of this paper is to provide information about license renewal process, as defined by Nuclear Regulatory Commission (NRC). The Atomic Energy Act and NRC regulations limit commercial power reactor licenses to an initial 40 years but also permit such licenses to be renewed. This original 40-year term for reactor licenses was based on economic and antitrust considerations not on limitations of nuclear technology. Due to this selected time period; however, some structures and components may have been engineered on the basis of an expected 40-year service life. The NRC has established a timely license renewal process and clear requirements codified in 10 CFR Part 51 and 10 CFR Part 54, that are needed to assure safe plant operation for extended plant life. The timely renewal of licenses for an additional 20 years, where appropriate to renew them, may be important to ensuring an adequate energy supply during the first half of the 21st Century. License renewal rests on the determination that currently operating plants continue to maintain adequate levels of safety, and over the plant's life, this level has been enhanced through maintenance of the licensing bases, with appropriate adjustments to address new information from industry operating experience. Additionally, NRC activities have provided ongoing assurance that the licensing bases will continue to provide an acceptable level of safety. This paper provides additional discussion of license renewal costs, as one of key elements in evaluation of license renewal justifiability. Including structure of costs, approximately value and two different approaches, conservative and typical. Current status and position of Nuclear Power Plant Krsko, related to license renewal process, will be briefly presented in this paper. NPP Krsko is designed based on NRC Regulations, so requirements from 10 CFR 51, and 10 CFR 54, are applicable to NPP Krsko, as well. Finally, this paper will give an overview of current status of

Diffusion of novel healthcare technologies to resource poor settings.

Science.gov (United States)

Malkin, Robert; von Oldenburg Beer, Kim

2013-09-01

A new product has completed clinical trials in a distant, resource poor hospital using a few dozen prototypes. The data looks great. The novel medical device solves a widely felt problem. The next goal is to integrate the device into the country's healthcare system and spread the device to other countries. But how? In order to be widely used, the device must be manufactured and distributed. One option is to license the intellectual property (IP) to an interested third party, if one can be found. However, it is possible to manage the manufacturing and distribution without licensing. There are at least two common means for manufacturing a novel medical device targeted to resource poor settings: (a) formal (contract) manufacturing and (b) informal (local) manufacturing. There are three primary routes to diffusion of novel medical devices in the developing world: (1) local distributors (2) direct international sales and (3) international donations. Perhaps surprisingly, the least effective mechanism is direct importation through donation. The most successful mechanism, the method used by nearly all working medical devices in resource-poor settings, is the use of contract manufacturing and a local distributor. This article is written for the biomedical innovator and entrepreneur who wishes to make a novel healthcare technology or product available and accessible to healthcare providers and patients in the developing world. There are very few documented cases and little formal research in this area. To this end, this article describes and explores the manufacturing and distribution options in order to provide insights into when and how each can be applied to scale up a novel technology to make a difference in a resource poor setting.

Safety Evaluation Report related to the renewal of the operating license for the TRIGA training and research reactor at the University of Utah (Docket No. 50-407)

International Nuclear Information System (INIS)

1985-03-01

This Safety Evaluation Report for the application filed by the University of Utah (UU) for a renewal of operating license R-126 to continue to operate a training and research reactor facility has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is owned and operated by the University of Utah and is located on its campus in Salt Lake City, Salt Lake County, Utah. The staff concludes that this training reactor facility can continue to be operated by UU without endangering the health and safety of the public

Healthcare-associated infections in intensive care units: epidemiology and infection control in low-to-middle income countries.

Science.gov (United States)

Alp, Emine; Damani, Nizam

2015-10-29

Healthcare-associated infections (HAIs) are major patient safety problems in hospitals, especially in intensive care units (ICUs). Patients in ICUs are prone to HAIs due to reduced host defense mechanisms, low compliance with infection prevention and control (IPC) measures due to lack of education and training, and heavy workload and low staffing levels, leading to cross-transmission of microorganisms from patient to patient. Patients with HAIs have prolonged hospital stays, and have high morbidity and mortality, thus adding economic burden on the healthcare system. For various reasons, in low-to-middle income countries (LMICs), the scale of the problem is huge; each year, many people die from HAIs. In this review, epidemiology of HAIs and infection prevention and control measures in ICUs is discussed, with especial emphasis on LMICs. High rates of HAIs caused by multidrug-resistant organisms (MDROs) are serious problems in ICUs in LMICs. In view of increasing prevalence of MDROs, LMICs should establish effective IPC infrastructure, appoint IPC teams, and provide adequate training and resources. These resources to establish and appoint IPC teams can be released by avoiding ritualistic, wasteful, and unsafe IPC practices, and by diverting resources to implement basic IPC measures, including early detection of infection, isolation of patients, application of appropriate IPC precautions, adherence to hand hygiene, and implementation of HAIs care bundles and basic evidence-based practices.

NUPLEX Licensing Subcommittee

International Nuclear Information System (INIS)

Edwards, D.W.; Allen, S.R.

1988-01-01

The NUPLEX Licensing Subcommittee was organized to seek a formal license renewal mechanism that institutionalizes the current licensing basis and consequent level of safety of a plant as the legitimate standard for acceptance and approval of an application for extended operation. Along with defining the most workable approach to and scope of review for license renewal, this paper explains the reasons why a regulatory framework is needed by the early 1990s. The initial results of development work on two key issues, licensing criteria and hearing process, are also presented. at this point six potential license renewal criteria have emerged: evaluation of existing monitoring/maintenance programs, revalidation of current licensing basis, conformance to special regulations, evaluation to a safety goal, plant performance history, and environmental assessment. The work on a hearing process has led to the development of two models for future consideration: hybrid legislative and hybrid adjudicatory

Disruption management for truck appointment system at a container terminal

DEFF Research Database (Denmark)

Li, N.; Chen, Gang; Jin, Z.

2016-01-01

-appointed arrivals at a container terminal that is running an appointment system. Second, we propose some response strategies to cope with different levels of disruptions, and evaluate their resilience ability with two Key Performance Indicators (KPIs): total waiting time of on-time trucks and total idling emissions...... of all trucks, in order to balance the service quality to punctual arrivals and green performance of the whole system. Third, we conduct a sensitivity analysis using a discrete event simulation to understand the performance of the proposed strategies. Considering both KPIs, the best strategy in most......-crane moving distance, especially when the first KPI is given lower weight than the second one....

76 FR 38348 - Notice of Appointment of Committee Members to the Advisory Committee on Biotechnology and 21st...

Science.gov (United States)

2011-06-30

... Service Notice of Appointment of Committee Members to the Advisory Committee on Biotechnology and 21st.... ACTION: Notice of Appointment of Committee Members to the Advisory Committee on Biotechnology and 21st... the appointment of members to the Advisory Committee on Biotechnology and 21st Century Agriculture...

The Development of a New Master's of Science in Healthcare Quality Program

Science.gov (United States)

Sears, Kim; Broderick, Briana; Stockley, Denise; Goldstien, D.; Egan, R.

2014-01-01

Working in silos or working within one discipline has not improved the delivery of healthcare. With a goal to advance the healthcare quality agenda and in response to an identified need within both the educational and healthcare sector, Queen's University has established a Master's degree in Healthcare Quality [MSc(HQ)]. The interprofessional…

An investigation into why patients do not attend for out-patient radiology appointments

International Nuclear Information System (INIS)

Lyon, Rebecca; Reeves, Pauline J.

2006-01-01

Introduction: Patients who do not attend (DNA) for out-patient hospital appointments cause delays in the diagnosis and subsequent treatment of their own, and other patient's, illnesses, with potentially hazardous consequences. This also impacts upon waiting lists. Failure to attend is viewed as a specific type of non-compliance and social cognition theories have been applied to previous studies in an attempt to uncover the reasons why patients choose not to keep their appointments. Methods: A case-control study was conducted throughout the X-ray departments of a District General type of NHS Trust, using telephone interview questionnaires based on the Health Belief Model, in an attempt to identify any significant differences between attenders and non-attenders, so that likely non-attenders could be targeted. Results: Principal reasons for non-attendance were that the patient forgot or that they did not receive their appointment. The results differed from previous research, in that specific health beliefs were not the primary reasons for non-attendance. Departments that gave patients the opportunity to arrange their appointments for a mutually convenient time had exceptionally low DNA rates, as did those which had rigorous confirmation systems in place

University Technology Transfer

Directory of Open Access Journals (Sweden)

Mike Cox

2004-09-01

Full Text Available This article describes the experiences and general observations of the author at Heriot-Watt University and concerns the transfer of university technology for the purposes of commercialisation. Full commercial exploitation of a university invention generally requires transferring that technology into the industrial arena, usually either by formation of a new company or licensing into an existing company. Commercialisation activities need to be carried out in unison with the prime activities of the university of research and teaching. Responsibility for commercialising university inventions generally rests with a specific group within the university, typically referred to as the technology transfer group. Each technology transfer should be considered individually and appropriate arrangements made for that particular invention. In general, this transfer process involves four stages: identification, evaluation, protection and exploitation. Considerations under these general headings are outlined from a university viewpoint. A phased approach is generally preferred where possible for the evaluation, protection and exploitation of an invention to balance risk with potential reward. Evaluation of the potential opportunity for a university invention involves essentially the same considerations as for an industrial invention. However, there are a range of commercial exploitation routes and potential deals so that only general guidelines can be given. Naturally, the final deal achieved is that which can be negotiated. The potential rewards for the university and inventor are both financial (via licensing income and equity realisation and non-financial.

Men’s Educational Group Appointments in Rural Nicaragua

Science.gov (United States)

Campbell, Bruce B.; Gonzalez, Hugo; Campbell, McKenzie; Campbell, Kent

2016-01-01

Men’s preventive health and wellness is largely neglected in rural Nicaragua, where a machismo culture prevents men from seeking health care. To address this issue, a men’s educational group appointment model was initiated at a rural health post to increase awareness about hypertension, and to train community health leaders to measure blood pressure. Men’s hypertension workshops were conducted with patient knowledge pretesting, didactic teaching, and posttesting. Pretesting and posttesting performances were recorded, blood pressures were screened, and community leaders were trained to perform sphygmomanometry. An increase in hypertension-related knowledge was observed after every workshop and community health leaders demonstrated proficiency in sphygmomanometry. In addition, several at-risk patients were identified and follow-up care arranged. Men’s educational group appointments, shown to be effective in the United States in increasing patient knowledge and satisfaction, appear to function similarly in a resource-constrained environment and may be an effective mechanism for reaching underserved men in Nicaragua. PMID:27885146

Council appoints CERN’s next Director General

CERN Multimedia

Maximilien Brice

2007-01-01

On 14 December 2007, CERN Council appointed Professor Rolf-Dieter Heuer to succeed Dr Robert Aymar as CERN Director General. Professor Heuer will serve a five-year term, taking office on 1 January 2009. From Left to right: Dr Robert Aymar, current CERN Director General, Professor Torsten Åkesson, President of CERN Council, and Professor Rolf-Dieter Heuer, CERN's next Director General.

To License or Not to License Remanufacturing Business?

Directory of Open Access Journals (Sweden)

Zu-Jun Ma

2018-01-01

Full Text Available Many original equipment manufacturers (OEMs face the choice of whether to license an independent remanufacturer (IR to remanufacture their used products. In this paper, we develop closed-loop supply chain models with licensed and unlicensed remanufacturing operations to analyze the competition and cooperation between an OEM and an IR. The OEM sells new products and collects used products through trade-ins, while the IR intercepts the OEM’s cores to produce remanufactured products and sell them in the same market. We derive optimal decisions for each of the two types of firms in licensed and unlicensed remanufacturing scenarios and identify conditions under which the OEM and the IR would be most likely to cooperate with each other in implementing remanufacturing. The results show although it is beneficial for an OEM to license an IR to remanufacture its cores, it is not always necessary for an IR to accept OEM’s authorization. Moreover, we contrast the result for licensed remanufacturing scenario in the decentralized system with that in the centrally coordinated system to quantify potential inefficiency resulting from decentralization of decision making.

Teaching at primary healthcare services within the Brazilian national health system (SUS in Brazilian healthcare professionals' training

Directory of Open Access Journals (Sweden)

Ramona Fernanda Ceriotti Toassi

2013-06-01

Full Text Available The aim of this study was to analyze the role of teaching at primary healthcare services within the Brazilian National Health System (SUS in dentists' training, at a public university in the south of Brazil. A qualitative methodological approach (case study was used. Interviews were conducted with 12 dentistry students, six dentists who were preceptors working in public primary healthcare services and three teachers connected with this curricular training. Our findings showed that the curricular training in SUS primary healthcare services had an impact on the dentists' education through establishment of bonds, autonomy in problem-solving and multiprofessional teamwork. It was seen that they learned about how healthcare services function, about healthcare and about development of cultural competence. There is a need to maintain constant questioning regarding these practices, and to ensure the presence of infrastructure and qualified professionals for teaching at these services.

Values, participatory democracy, and healthcare resource allocation: an application to a campus community.

Science.gov (United States)

Bentley, J P; Larson, L N; Brenton, M A

1995-03-01

As healthcare reform is debated, it is important that decision makers consider the values of all citizens, that is, what people find desirable or useful about healthcare services. Several states have used town meetings in an effort to determine their citizens' views on the values in the realm of healthcare. In this article, the authors describe a process in which individuals actively participate in an open discussion about issues surrounding allocation of healthcare resources in a university setting. Three different groups from the university community participated in separate, structured meetings to discuss their values concerning the allocation of scarce healthcare resources. Such meetings give participants opportunities to learn about their values and those of other persons in the community.

77 FR 21109 - Senior Executive Service; Appointment of Members to the Performance Review Board

Science.gov (United States)

2012-04-09

... DEPARTMENT OF LABOR Office of the Secretary Senior Executive Service; Appointment of Members to the Performance Review Board Title 5 U.S.C. 4314(c)(4) provides that Notice of the Appointment of an individual to serve as a member of the Performance Review Board of the Senior Executive Service shall be...

Technology licensing in China

DEFF Research Database (Denmark)

Wang, Yuandi; Li-Ying, Jason; Chen, Jin

2015-01-01

We explore the landscape of technology licensing among Chinese entities in the period 2000–12, using a unique database on technological licensing from the State Intellectual Property Office of China. We find that: first, among Chinese licensee organizations, firms have dominated in terms...... of the number of licensed technologies; second, the geographical distribution of licensed technologies among the provinces has gradually reached a new quantitative balance; third, utility models are the most popular technologies to be licensed and the majority of technology licensing in China has been between...... Chinese entities, and most transactions have been local within provinces; and finally, Chinese firms have gradually in-licensed newer and newer technologies, but the technologies in-licensed from foreign sources are by no means state-of-the-art. We make several suggestions for innovation policy...

78 FR 24749 - Health Information Technology Policy Committee Appointment

Science.gov (United States)

2013-04-26

... GOVERNMENT ACCOUNTABILITY OFFICE Health Information Technology Policy Committee Appointment AGENCY... Recovery and Reinvestment Act of 2009 (ARRA) established the Health Information Technology Policy Committee to make recommendations on the implementation of a nationwide health information technology...

Prevalence and compensation of academic leaders, professors, and trustees on publicly traded US healthcare company boards of directors: cross sectional study.

Science.gov (United States)

Anderson, Timothy S; Good, Chester B; Gellad, Walid F

2015-09-29

To identify the prevalence, characteristics, and compensation of members of the boards of directors of healthcare industry companies who hold academic appointments as leaders, professors, or trustees. Cross sectional study. US healthcare companies publicly traded on the NASDAQ or New York Stock Exchange in 2013. 3434 directors of pharmaceutical, biotechnology, medical equipment and supply, and healthcare provider companies. Prevalence, annual compensation, and beneficial stock ownership of directors with affiliations as leaders, professors, or trustees of academic medical and research institutions. 446 healthcare companies met the study search criteria, of which 442 (99%) had publicly accessible disclosures on boards of directors. 180 companies (41%) had one or more academically affiliated directors. Directors were affiliated with 85 geographically diverse non-profit academic institutions, including 19 of the top 20 National Institute of Health funded medical schools and all of the 17 US News honor roll hospitals. Overall, these 279 academically affiliated directors included 73 leaders, 121 professors, and 85 trustees. Leaders included 17 chief executive officers and 11 vice presidents or executive officers of health systems and hospitals; 15 university presidents, provosts, and chancellors; and eight medical school deans or presidents. The total annual compensation to academically affiliated directors for their services to companies was $54,995,786 (£35,836,000; €49,185,900) (median individual compensation $193,000) and directors beneficially owned 59,831,477 shares of company stock (median 50,699 shares). A substantial number and diversity of academic leaders, professors, and trustees hold directorships at US healthcare companies, with compensation often approaching or surpassing common academic clinical salaries. Dual obligations to for profit company shareholders and non-profit clinical and educational institutions pose considerable personal, financial, and

License renewal and power upgrade of the Cornell University TRIGA reactor

International Nuclear Information System (INIS)

Aderhold, Howard C.

1984-01-01

The Cornell Mark II TRIGA reactor has been a principal facility for instruction and research in nuclear science and engineering at Cornell, and it has been extensively used by other departments at Cornell and by nearby universities and industries. Initially the fuel was low hydride, 8.5w/o 19%-enriched, aluminum clad; in 1974 it was changed to high-hydride, stainless-steel-clad. The maximum power has been 100 kW, with pulses to $2, and operation has been on a one-shift demand basis. Annual energy generation of 50 MWH has been typical. Standard features include a 4-inch tangential port and our 6-inch radial ports, a thermal column with hohlraum and vertical access, a central thimble, a 'rabbit', and a set of dry irradiation tubes, replacing the 'Lazy Susan'. The license was renewed and amended in November 1983; the new limits are 500 kW and $3 pulses. Physical changes to the facility included addition of a water-to-water heat exchanger and of a diffuser at the water outlet ∼ 60 cm above the core. The flow rate is 300 liters per minute in the primary (reactor) side of the heat exchanger. The temperature of the chilled water entering the secondary of the exchanger is ∼ 12?C; its flow rate is adjusted by a servo-controlled by-pass valve to maintain the desired range of pool water temperature. Steps taken to go to higher power included rearrangement of fuel elements to increase excess reactivity, recalibration of control rods, and power vs ion chamber current calibrations at successively higher power by comparing the rate of rise of pool temperature with a known rate using electrical heating elements. Steady-state operation has been done up to 480 kW (nominal) but pulsing at the newly allowed higher levels has not been tested as yet

Lead Time to Appointment and No-Show Rates for New and Follow-up Patients in an Ambulatory Clinic.

Science.gov (United States)

Drewek, Rupali; Mirea, Lucia; Adelson, P David

High rates of no-shows in outpatient clinics are problematic for revenue and for quality of patient care. Longer lead time to appointment has variably been implicated as a risk factor for no-shows, but the evidence within pediatric clinics is inconclusive. The goal of this study was to estimate no-show rates and test for association between appointment lead time and no-show rates for new and follow-up patients. Analyses included 534 new and 1920 follow-up patients from pulmonology and gastroenterology clinics at a freestanding children's hospital. The overall rate of no-shows was lower for visits scheduled within 0 to 30 days compared with 30 days or more (23% compared with 47%, P < .0001). Patient type significantly modified the association of appointment lead time; the rate of no-shows was higher (30%) among new patients compared with (21%) follow-up patients with appointments scheduled within 30 days (P = .004). For appointments scheduled 30 or more days' lead time, no-show rates were statistically similar for new patients (46%) and follow-up patients (0.48%). Time to appointment is a risk factor associated with no-shows, and further study is needed to identify and implement effective approaches to reduce appointment lead time, especially for new patients in pediatric subspecialties.

Centre for nuclear engineering University of Toronto annual report 1984

International Nuclear Information System (INIS)

1984-12-01

The annual report of the Centre for Nuclear Engineering, University of Toronto covers the following subjects: message from the Dean; Chairman's message; origins of the centre; formation of the centre; new nuclear appointments; and activities of the centre, 1984

The healthcare costs of secondhand smoke exposure in rural China.

Science.gov (United States)

Yao, Tingting; Sung, Hai-Yen; Mao, Zhengzhong; Hu, Teh-wei; Max, Wendy

2015-10-01

The goal of this study was to assess the healthcare costs attributable to secondhand smoke (SHS) exposure among non-smoking adults (age ≥ 19) in rural China. We analysed data from the 2011 National Rural Household Survey which was conducted among adults in five provinces and one municipality in China (N=12,397). Respondents reported their smoking status, health conditions and healthcare expenditures. Relative risks were obtained from published sources. Healthcare costs included annual outpatient and inpatient hospitalisation expenditures for five SHS-related diseases: asthma, breast cancer (female only), heart disease, lung cancer and tuberculosis. SHS-attributable healthcare costs were estimated using a prevalence-based annual cost approach. The total healthcare costs of SHS exposure in rural China amounted to $1.2 billion in 2011, including $559 million for outpatient visits and $612.4 million for inpatient hospitalisations. The healthcare costs for women and men were $877.1 million and $294.3 million, respectively. Heart disease was the most costly condition for both women ($701.7 million) and men ($180.6 million). The total healthcare costs of SHS exposure in rural China accounted to 0.3% of China's national healthcare expenditures in 2011. Over one-fifth of the total healthcare costs of SHS exposure in rural China were paid by health insurance. The out-of-pocket expenditures per person accounted for almost half (47%) of their daily income. The adverse health effects of SHS exposure result in a large economic burden in China. Tobacco control policies that reduce SHS exposure could have an impact on reducing healthcare costs in China. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Licensing process in Finland

International Nuclear Information System (INIS)

Tiippana, Petteri

2011-01-01

In accordance with the Nuclear Energy Act, the use of nuclear energy constitutes operations subject to license. The licensing process and conditions for granting a license is defined in the legislation. The licenses are applied from and granted by the Government. This paper discusses briefly the licensing process in Finland and also the roles and responsibilities of main stakeholders in licensing. Licensing of a nuclear power plant in Finland has three steps. The first step is the Decision in Principle (DiP). Goal of DiP is to decide whether using nuclear power is for the overall good for the Finnish society. The second step is Construction License (CL) and the goal of CL phase is to determine whether the design of the proposed plant is safe and that the participating organisations are capable of constructing the plant to meet safety goals. The third step is the Operating License (OL) and the goal of the OL phase is to determine whether the plant operates safely and licensee is capable to operate the plant safely. Main stakeholders in the licensing process in Finland are the utility (licensee) interested in using nuclear power in Finland, Ministry of Employment and the Economy (MEE), Government, Parliament, STUK, the municipality siting the plant and the general public. Government grants all licenses, and Parliament has to ratify Government's Decision in Principle. STUK has to assess the safety of the license applications in each step and give statement to the Ministry. Municipality has to agree to site the plant. Both STUK and the municipality have a veto right in the licensing process

Perspectives on healthcare leader and leadership development

OpenAIRE

Scott, Elaine S.

2010-01-01

Elaine S ScottCollege of Nursing, Graduate Nursing Science Department, East Carolina University, Greenville, NC USAAbstract: Healthcare delivery systems are complex entities that must merge the best of administrative and clinical practices into a new model of leadership. But, despite growing recognition that healthcare organizational leaders must partner with clinical leaders to address patient safety, evidence based practice, financial sustainability, and capacity, tensions between the group...

Healthcare Finance in the Kingdom of Saudi Arabia: A Qualitative Study of Householders' Attitudes.

Science.gov (United States)

Al-Hanawi, Mohammed Khaled; Alsharqi, Omar; Almazrou, Saja; Vaidya, Kirit

2018-02-01

The public sector healthcare system in Saudi Arabia, essentially financed by oil revenues and 'free at the point of delivery', is coming under increasing strain due to escalating expenditure and an increasingly volatile oil market and is likely to be unsustainable in the medium to long term. This study examines how satisfied the Saudi people are with their public sector healthcare services and assesses their willingness to contribute to financing the system through a national health insurance scheme. The study also examines public preferences and expectations of a future national health insurance system. A total of 36 heads of households participated in face-to-face audio-recorded semi-structured interviews. The participants were purposefully selected based on different socio-economic and socio-demographic factors from urban and rural areas to represent the geographical diversity that would presumably influence individual views, expectations, preferences and healthcare experiences. The evidence showed some dissatisfaction with the provision and quality of current public sector healthcare services, including the availability of appointments, waiting times and the availability of drugs. The households indicated a willingness to contribute to a national insurance scheme, conditional upon improvements in the quality of public sector healthcare services. The results also revealed a variety of preferences and expectations regarding the proposed national health insurance scheme. Quality improvement is a key factor that could motivate the Saudi people to contribute to financing the healthcare system. A new authority, consisting of a partnership between the public and private sectors under government supervision, could represent an acceptable option for addressing the variation in public preferences.

The drive for universal healthcare in South Africa: views from private general practitioners.

Science.gov (United States)

Surender, Rebecca; Van Niekerk, Robert; Hannah, Bridget; Allan, Lucie; Shung-King, Maylene

2015-07-01

To address problems of inadequate public health services, escalating private healthcare costs and widening health inequalities, the South Africa (SA) Government has launched a bold new proposal to introduce a universal, comprehensive and integrated system for all SAs; National Health Insurance. Though attention has been devoted to the economics of universal coverage less attention has been paid to other potential challenges, in particular the important role played by the clinicians tasked with implementing the reforms. However, historical and comparative analysis reveals that whenever health systems undergo radical reform, the medical profession is instrumental in determining its nature and outcomes. Moreover, early indications suggest many SA private general practitioners (GPs) are opposed to the measures--and it is not yet known whether they will comply with the proposals. This study therefore analyses the dynamics and potential success of the reforms by directly examining the perceptions of the SA medical profession, in particular private-sector GPs. It draws on a conceptual framework which argues that understanding human motivation and behaviour is essential for the successful design of social policy. Seventy-six interviews were conducted with clinicians in the Eastern Cape Province in 2012. The findings suggest that the SA government will face significant challenges in garnering the support of private GPs. Concerns revolved around remuneration, state control, increased workload, clinical autonomy and diminished quality of care and working conditions. Although there were as yet few signs of mobilization or agency by private clinicians in the policy process, the findings suggests that it will be important for the government to directly address their concerns in order to ensure a stable transition and successful implementation of the reforms. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author

22 CFR 11.30 - Senior Foreign Service officer career candidate and limited non-career appointments.

Science.gov (United States)

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Senior Foreign Service officer career candidate... PERSONNEL APPOINTMENT OF FOREIGN SERVICE OFFICERS § 11.30 Senior Foreign Service officer career candidate and limited non-career appointments. (a) General considerations. (1) Career officers at the Senior...

Mapping healthcare systems: a policy relevant analytic tool.

Science.gov (United States)

Sekhri Feachem, Neelam; Afshar, Ariana; Pruett, Cristina; Avanceña, Anton L V

2017-07-01

In the past decade, an international consensus on the value of well-functioning systems has driven considerable health systems research. This research falls into two broad categories. The first provides conceptual frameworks that take complex healthcare systems and create simplified constructs of interactions and functions. The second focuses on granular inputs and outputs. This paper presents a novel translational mapping tool - the University of California, San Francisco mapping tool (the Tool) - which bridges the gap between these two areas of research, creating a platform for multi-country comparative analysis. Using the Murray-Frenk framework, we create a macro-level representation of a country's structure, focusing on how it finances and delivers healthcare. The map visually depicts the fundamental policy questions in healthcare system design: funding sources and amount spent through each source, purchasers, populations covered, provider categories; and the relationship between these entities. We use the Tool to provide a macro-level comparative analysis of the structure of India's and Thailand's healthcare systems. As part of the systems strengthening arsenal, the Tool can stimulate debate about the merits and consequences of different healthcare systems structural designs, using a common framework that fosters multi-country comparative analyses. © The Author 2017. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

The Development Needs of Newly Appointed Senior School Leaders in the Western Cape South Africa: A Case Study

Directory of Open Access Journals (Sweden)

Nelius Jansen van Vuuren

2017-12-01

Full Text Available The essential role that senior school leaders play in school leadership teams to ensure effective strategic leadership in schools has been the subject of intense discussion for many years. Crucial to this debate is the establishment of professional learning and leadership approaches for newly appointed senior school leaders. Recommendations for policy and practice highlight the importance of appropriate, multifaceted, developmental support initiatives for newly appointed school leaders. In many countries, including South Africa, a teaching qualification and, in most cases, extensive teaching experience is the only requirement for being appointed as a senior school leader in a school. This tends to suggest that no further professional development is required for newly appointed school leaders, the problem addressed in this paper. This paper reports on the main findings of the perceived development needs of newly appointed senior school leaders in the Western Cape, South Africa, and suggests that school leaders occupy a unique and specialist role in education, which requires relevant and specific preparation to support effective leadership. The respondents of this study report a lack of contextualised training and support before and after their appointment in their new roles creating unique development needs. This paper, therefore, employs a mixed-method approach to gather data to understand the perceived needs of twenty newly appointed senior school leaders in the Western Cape, South Africa.

Patients as story-tellers of healthcare journeys.

Science.gov (United States)

Lamprell, Klay; Braithwaite, Jeffrey

2016-09-01

There are gaps in our comprehension of patients' subjective experiences as they engage with and transit through the healthcare environments implicated in their treatment trajectories. Patients' stories, unlike patient experience data gathered in questionnaires and surveys, express the deeply personal, narrative nature of the journeys that patients take, creating opportunities for qualitative healthcare research. Yet narrative capabilities and propensities vary with individuals, and are affected by the stresses of illness and treatment. This article extends the growing interest in narrative competence training for both practitioners and patients with the investigation of a story-telling model that could facilitate patients to narrate their experiences of healthcare systems. This model is derived from the literary arts. In fiction and autobiography, the journey arc of the central character is often one in which he or she is compelled to leave the comfort of everyday life and face a series of extraordinary events involving challenge and change which forces the character towards practical, intellectual, psychological and philosophical adjustments that define, by the end of the story, the character's 'new normal'. This pattern is known as the 'hero journey'. Its parallels with patients' experiences of healthcare and the way people narrate their stories of illness have long been recognised. We present here a new idea for applying this model as a narrative structure by which patients may construct their stories about being in and moving through the healthcare system. 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/

Social Responsibility and Healthcare in Finland.

Science.gov (United States)

Ahola-Launonen, Johanna

2016-07-01

This article examines current trends and prospects in Finnish healthcare literature and discussion. The Finnish healthcare system was long considered to manifest an equal, universal, and solidaristic welfare scheme. However, recent data reveals structural inequalities in access to healthcare that result in health differences among socioeconomic groups. The political will aims at tackling these inequalities, but the ideological trend toward responsibilization of the individual taking place across political spheres elsewhere in Europe creates potential challenges to this goal. The applications of this trend have a theoretical background in the responsibility-sensitive egalitarian-or luck egalitarian-tradition. The theory, which is unfit for real-life policy applications, has explicit appeal in considerations aiming at the responsibilization of the individual within the healthcare sector. It remains to be seen in which direction the Finnish welfare schemes will continue to develop.

Libraries and licensing

Directory of Open Access Journals (Sweden)

Maja Žumer

2001-01-01

Full Text Available In the mid 90s, the abundance of various electronic publications exposed libraries to the problems of licensing electronic content. Various licensing principles have been prepared recently to help libraries in the process; it can be said that in general, the knowledge of licensing issues has improved in libraries of all types. Libraries form consortia in order to gain stronger negotiating positions and obtain better conditions.In the article, new licensing principles are presented in more detail, as well as some domestic and foreign experiences with consortia forming.

Appointment keeping for medical review among patients with selected chronic diseases in an urban area of Uganda.

Science.gov (United States)

Kalyango, Joan Nakayaga; Hall, Maurice; Karamagi, Charles

2014-01-01

Proper management of chronic diseases is important for prevention of disease complications and yet some patients miss appointments for medical review thereby missing the opportunity for proper monitoring of their disease conditions. There is limited information on missed appointments among chronic disease patients in resource limited settings. This study aimed to determine the prevalence of missed appointments for medical review and associated factors among chronic disease patients in an urban area of Uganda. Patients or caregivers of children with chronic diseases were identified as they bought medicines from a community pharmacy. They were visited at home to access their medical documents and those whose chronic disease status was ascertained were enrolled. The data was collected using: questionnaires, review of medical documents, and in-depth interviews with chronic disease patients. The prevalence of missed appointments was 42% (95%CI = 35-49%). The factors associated with missed appointments were: monthly income ≤30US Dollars (OR = 2.56, CI = 1.25-5.26), affording less than half of prescribed drugs (OR = 3.92, CI = 1.64-9.40), not experiencing adverse events (OR = 2.66, CI = 1.26-5.61), not sure if treatment helps (OR = 2.84, CI = 1.047.77), not having a medicines administration schedule (OR = 6.77, CI = 2.11-21.68), and increasing number of drugs (OR = 0.72, CI = 0.53-0.98). Patients missed appointments mainly due to: financial and health system barriers, conflicting commitments with appointments, and perceptions of the disease condition. Patients should be supported with accessible and affordable health services.

The unilateral appointment of co-arbitrators

DEFF Research Database (Denmark)

Tufte-Kristensen, Johan

2016-01-01

on some important aspects of the procedure but leaves certain aspects and arguments unconsidered. The article approaches the appointment procedure from a neutral position. It identifies and considers the relevant rules, practices, and arguments in order to discuss the procedure’s implications...... of experienced arbitration practitioners have advocated against the procedure for some of the reasons above, whereas other experienced arbitration practitioners have defended the procedure because of its practical advantages and underlying rationales. Each of the previous contributions to the debate sheds light...

Defining the role of University of Kentucky HealthCare in its medical market--how strategic planning creates the intersection of good public policy and good business practices.

Science.gov (United States)

Karpf, Michael; Lofgren, Richard; Bricker, Timothy; Claypool, Joseph O; Zembrodt, Jim; Perman, Jay; Higdon, Courtney M

2009-02-01

In response both to national pressures to reduce costs and improve health care access and outcomes and to local pressures to become a top-20 public research university, the University of Kentucky moved toward an integrated clinical enterprise, UK HealthCare, to create a common vision, shared goals, and an effective decision-making process. The leadership formed the vision and then embarked on a comprehensive and coordinated planning process that addressed financial, clinical, academic, and operational issues. The authors describe in depth the strategic planning process and specifically the definition of UK HealthCare's role in its medical marketplace. They began a rigorous process to assess and develop goals for the clinical programs and followed the progress of these programs through meetings driven by data and attended by the organization's senior leadership. They describe their approach to working with rural and community hospitals throughout central, eastern, and southern Kentucky to support the health care infrastructure of the state. They review the early successes of their strategic approach and describe the lessons they learned. The clinical successes have led to academic gains. The experience of UK HealthCare suggests that good business practices and good public policy are synergistic.

Harm reduction principles for healthcare settings

Directory of Open Access Journals (Sweden)

Mary Hawk

2017-10-01

Full Text Available Abstract Background Harm reduction refers to interventions aimed at reducing the negative effects of health behaviors without necessarily extinguishing the problematic health behaviors completely. The vast majority of the harm reduction literature focuses on the harms of drug use and on specific harm reduction strategies, such as syringe exchange, rather than on the harm reduction philosophy as a whole. Given that a harm reduction approach can address other risk behaviors that often occur alongside drug use and that harm reduction principles have been applied to harms such as sex work, eating disorders, and tobacco use, a natural evolution of the harm reduction philosophy is to extend it to other health risk behaviors and to a broader healthcare audience. Methods Building on the extant literature, we used data from in-depth qualitative interviews with 23 patients and 17 staff members from an HIV clinic in the USA to describe harm reduction principles for use in healthcare settings. Results We defined six principles of harm reduction and generalized them for use in healthcare settings with patients beyond those who use illicit substances. The principles include humanism, pragmatism, individualism, autonomy, incrementalism, and accountability without termination. For each of these principles, we present a definition, a description of how healthcare providers can deliver interventions informed by the principle, and examples of how each principle may be applied in the healthcare setting. Conclusion This paper is one of the firsts to provide a comprehensive set of principles for universal harm reduction as a conceptual approach for healthcare provision. Applying harm reduction principles in healthcare settings may improve clinical care outcomes given that the quality of the provider-patient relationship is known to impact health outcomes and treatment adherence. Harm reduction can be a universal precaution applied to all individuals regardless of

Harm reduction principles for healthcare settings.

Science.gov (United States)

Hawk, Mary; Coulter, Robert W S; Egan, James E; Fisk, Stuart; Reuel Friedman, M; Tula, Monique; Kinsky, Suzanne

2017-10-24

Harm reduction refers to interventions aimed at reducing the negative effects of health behaviors without necessarily extinguishing the problematic health behaviors completely. The vast majority of the harm reduction literature focuses on the harms of drug use and on specific harm reduction strategies, such as syringe exchange, rather than on the harm reduction philosophy as a whole. Given that a harm reduction approach can address other risk behaviors that often occur alongside drug use and that harm reduction principles have been applied to harms such as sex work, eating disorders, and tobacco use, a natural evolution of the harm reduction philosophy is to extend it to other health risk behaviors and to a broader healthcare audience. Building on the extant literature, we used data from in-depth qualitative interviews with 23 patients and 17 staff members from an HIV clinic in the USA to describe harm reduction principles for use in healthcare settings. We defined six principles of harm reduction and generalized them for use in healthcare settings with patients beyond those who use illicit substances. The principles include humanism, pragmatism, individualism, autonomy, incrementalism, and accountability without termination. For each of these principles, we present a definition, a description of how healthcare providers can deliver interventions informed by the principle, and examples of how each principle may be applied in the healthcare setting. This paper is one of the firsts to provide a comprehensive set of principles for universal harm reduction as a conceptual approach for healthcare provision. Applying harm reduction principles in healthcare settings may improve clinical care outcomes given that the quality of the provider-patient relationship is known to impact health outcomes and treatment adherence. Harm reduction can be a universal precaution applied to all individuals regardless of their disclosure of negative health behaviors, given that health

Methods of appointment and qualifications of club doctors and physiotherapists in English professional football: some problems and issues.

Science.gov (United States)

Waddington, I; Roderick, M; Naik, R

2001-02-01

To examine the methods of appointment, experience, and qualifications of club doctors and physiotherapists in professional football. Semistructured tape recorded interviews with 12 club doctors, 10 club physiotherapists, and 27 current and former players. A questionnaire was also sent to 90 club doctors; 58 were returned. In almost all clubs, methods of appointment of doctors are informal and reflect poor employment practice: posts are rarely advertised and many doctors are appointed on the basis of personal contacts and without interview. Few club doctors had prior experience or qualifications in sports medicine and very few have a written job description. The club doctor is often not consulted about the appointment of the physiotherapist; physiotherapists are usually appointed informally, often without interview, and often by the manager without involving anyone who is qualified in medicine or physiotherapy. Half of all clubs do not have a qualified (chartered) physiotherapist; such unqualified physiotherapists are in a weak position to resist threats to their clinical autonomy, particularly those arising from managers' attempts to influence clinical decisions. Almost all aspects of the appointment of club doctors and physiotherapists need careful re-examination.

Improving the resilience of the healthcare workforce.

Science.gov (United States)

Glasper, Alan

2016-11-24

Emeritus Professor Alan Glasper, from the University of Southampton, discusses government strategies to ensure a future healthcare workforce that is sustainable and does not rely on overseas recruitment.

Improving the resilience of the healthcare workforce

OpenAIRE

Glasper, Alan

2016-01-01

Emeritus Professor Alan Glasper, from the University of Southampton, discusses government strategies to ensure a future healthcare workforce that is sustainable and does not rely on overseas recruitment

Use of Six Sigma Methodology to Reduce Appointment Lead-Time in Obstetrics Outpatient Department.

Science.gov (United States)

Ortiz Barrios, Miguel A; Felizzola Jiménez, Heriberto

2016-10-01

This paper focuses on the issue of longer appointment lead-time in the obstetrics outpatient department of a maternal-child hospital in Colombia. Because of extended appointment lead-time, women with high-risk pregnancy could develop severe complications in their health status and put their babies at risk. This problem was detected through a project selection process explained in this article and to solve it, Six Sigma methodology has been used. First, the process was defined through a SIPOC diagram to identify its input and output variables. Second, six sigma performance indicators were calculated to establish the process baseline. Then, a fishbone diagram was used to determine the possible causes of the problem. These causes were validated with the aid of correlation analysis and other statistical tools. Later, improvement strategies were designed to reduce appointment lead-time in this department. Project results evidenced that average appointment lead-time reduced from 6,89 days to 4,08 days and the deviation standard dropped from 1,57 days to 1,24 days. In this way, the hospital will serve pregnant women faster, which represents a risk reduction of perinatal and maternal mortality.

Philip II’s Quest. The Appointment of Governors-General during the Dutch Revolt (1559-1598

Directory of Open Access Journals (Sweden)

V. Soen

2011-01-01

Full Text Available Philip II’s Quest: The Appointment of Governors-General during the Dutch Revolt (1559-1598Recent historiographical studies have presented the Habsburg appointment of governors-general during the Dutch Revolt as the outcome of factional infighting at the Spanish Court. While this so-called ‘faction model’ has yielded new insights, it also raises a number of problems. Firstly, in the new model, the role of the dynasty is unduly relegated to the background – even though Philip II’s appointment decisions were mainly driven by dynastic considerations. Secondly, the power struggle at the Spanish Court was not only a conflict between court factions, but also between noble houses vying for prestige and trying to secure positions for their offspring. Thirdly, there is an excessive focus on the Spanish Court, while the feuds between noble houses in the Low Countries also played a role in the interim appointments made during the Revolt. Finally, Philip II always looked for the most suitable candidate in terms of administration and warfare during the Dutch Revolt, in accordance with the constraints of the composite Spanish monarchy. Only the combination of these four (frequently contradictory motives reveals how Philip II’s appointment of governors can be seen as a quest for the right man or woman in the right place.

Factors affecting Japanese retirees' healthcare service utilisation in Malaysia: a qualitative study.

Science.gov (United States)

Kohno, Ayako; Nik Farid, Nik Daliana; Musa, Ghazali; Abdul Aziz, Norlaili; Nakayama, Takeo; Dahlui, Maznah

2016-03-22

While living overseas in another culture, retirees need to adapt to a new environment but often this causes difficulties, particularly among those elderly who require healthcare services. This study examines factors affecting healthcare service utilisation among Japanese retirees in Malaysia. We conducted 6 focus group discussions with Japanese retirees and interviewed 8 relevant medical services providers in-depth. Guided by the Andersen Healthcare Utilisation Model, we managed and analysed the data, using QSR NVivo 10 software and the directed content analysis method. We interviewed participants at Japan Clubs and their offices. 30 Japanese retirees who live in Kuala Lumpur and Ipoh, and 8 medical services providers. We identified health beliefs, medical symptoms and health insurance as the 3 most important themes, respectively, representing the 3 dimensions within the Andersen Healthcare Utilisation Model. Additionally, language barriers, voluntary health repatriation to Japan and psychological support were unique themes that influence healthcare service utilisation among Japanese retirees. The healthcare service utilisation among Japanese retirees in Malaysia could be partially explained by the Andersen Healthcare Utilisation Model, together with some factors that were unique findings to this study. Healthcare service utilisation among Japanese retirees in Malaysia could be improved by alleviating negative health beliefs through awareness programmes for Japanese retirees about the healthcare systems and cultural aspects of medical care in Malaysia. 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/

Interorganisational Integration: Healthcare Professionals’ Perspectives on Barriers and Facilitators within the Danish Healthcare System

Directory of Open Access Journals (Sweden)

Anne Marie Lyngsø

2016-03-01

Full Text Available Introduction: Despite many initiatives to improve coordination of patient pathways and intersectoral cooperation, Danish health care is still fragmented, lacking intra- and interorganisational integration. This study explores barriers to and facilitators of interorganisational integration as perceived by healthcare professionals caring for patients with chronic obstructive pulmonary disease within the Danish healthcare system. Methods: Seven focus groups were conducted in January through July 2014 with 21 informants from general practice, local healthcare centres and a pulmonary department at a university hospital in the Capital Region of Denmark. Results and discussion: Our results can be grouped into five influencing areas for interorganisational integration: communication/information transfer, committed leadership, patient engagement, the role and competencies of the general practitioner and organisational culture. Proposed solutions to barriers in each area hold the potential to improve care integration as experienced by individuals responsible for supporting and facilitating it. Barriers and facilitators to integrating care relate to clinical, professional, functional and normative integration. Especially, clinical, functional and normative integration seems fundamental to developing integrated care in practice from the perspective of healthcare professionals.

Location based mobile app for doctor's appointment inSaudi Arabia ...

African Journals Online (AJOL)

Journal of Fundamental and Applied Sciences ... Reducing waiting times and surgeon idle time improves the quality of service and efficiency ... to develop an appointment management application for mobile devices using the Android platform.

A comparative study on the level of satisfaction among regular and contractual health-care workers in a Northern city of India.

Science.gov (United States)

Dixit, Jyoti; Goel, Sonu; Sharma, Vijaylakshmi

2017-01-01

Job satisfaction greatly determines the productivity and efficiency of human resources for health. The current study aims to assess the level of satisfaction and factors influencing the job satisfaction among regular and contractual health-care workers. A cross-sectional quantitative study was conducted from January to June 2015 among health care workers ( n = 354) at all levels of public health-care facilities of Chandigarh. The correlation between variables with overall level of satisfaction was computed for regular and contractual health-care workers. Stepwise multiple linear regression was done to elucidate the major factors influencing job satisfaction. Majority of the regular health-care staff was highly satisfied (86.9%) as compared to contractual staff (10.5%), which however was moderately satisfied (55.9%). Stepwise regression model showed that work-related matters (β = 1.370, P job (β = 0.530, P satisfaction level. Under the National Rural Health Mission, contract appointments have improved the overall availability of health-care staff at all levels of public health facilities. However, there are concerns regarding their level of motivation with various aspects related to the job, which need to be urgently addressed so as to improve the effectiveness and efficiency of health services.

Technology-Based Healthcare for Nursing Education Within The Netherlands: Past, Present and Future.

Science.gov (United States)

Koster, Ybranda; van Houwelingen, Cornelis T M

2017-01-01

At the present time, nearly all Dutch nursing schools are searching for suitable ways to implement technology-based healthcare in their curriculum. Some Universities chose elective education, others a mandatory solution. Several studies were executed to determine competencies needed by nurses in order to work with technology-based healthcare. In 2016 a nationwide new curriculum for nurses has been published. Providing technology-based healthcare is included under the core competencies of this new curriculum. All baccalaureate nursing educational institutes must implement this new curriculum at the start of 2016 which will have a huge impact on the implementation of technology-based healthcare in the education programs. In the future, technology centers from Universities will collaborate and specialize, partner with technology companies and crossovers between information and communication technology and healthcare education will be expanded.

Impact of health portal enrollment with email reminders on adherence to clinic appointments: a pilot study.

Science.gov (United States)

Horvath, Monica; Levy, Janet; L'Engle, Pete; Carlson, Boyd; Ahmad, Asif; Ferranti, Jeffrey

2011-05-26

Internet portal technologies that provide access to portions of electronic health records have the potential to revolutionize patients' involvement in their care. However, relatively few descriptions of the demographic characteristics of portal enrollees or of the effects of portal technology on quality outcomes exist. This study examined data from patients who attended one of seven Duke Medicine clinics and who were offered the option of enrolling in and using the Duke Medicine HealthView portal (HVP). The HVP allows patients to manage details of their appointment scheduling and provides automated email appointment reminders in addition to the telephone and mail reminders that all patients receive. Our objective was to test whether portal enrollment with an email reminder functionality is significantly related to decreases in rates of appointment "no-shows," which are known to impair clinic operational efficiency. Appointment activity during a 1-year period was examined for all patients attending one of seven Duke Medicine clinics. Patients were categorized as portal enrollees or as nonusers either by their status at time of appointment or at the end of the 1-year period. Demographic characteristics and no-show rates among these groups were compared. A binomial logistic regression model was constructed to measure the adjusted impact of HVP enrollment on no-show rates, given confounding factors. To demonstrate the effect of HVP use over time, monthly no-show rates were calculated for patient appointment keeping and contrasted between preportal and postportal deployment periods. Across seven clinics, 58,942 patients, 15.7% (9239/58,942) of whom were portal enrollees, scheduled 198,199 appointments with an overall no-show rate of 9.9% (19,668/198,199). We found that HVP enrollees were significantly more likely to be female, white, and privately insured compared with nonusers. Bivariate no-show rate differences between portal enrollment groups varied widely according

Communication Access for Deaf People in Healthcare Settings: Understanding the Work of American Sign Language Interpreters.

Science.gov (United States)

Olson, Andrea M; Swabey, Laurie

Despite federal laws that mandate equal access and communication in all healthcare settings for deaf people, consistent provision of quality interpreting in healthcare settings is still not a reality, as recognized by deaf people and American Sign Language (ASL)-English interpreters. The purpose of this study was to better understand the work of ASL interpreters employed in healthcare settings, which can then inform on training and credentialing of interpreters, with the ultimate aim of improving the quality of healthcare and communication access for deaf people. Based on job analysis, researchers designed an online survey with 167 task statements representing 44 categories. American Sign Language interpreters (N = 339) rated the importance of, and frequency with which they performed, each of the 167 tasks. Categories with the highest average importance ratings included language and interpreting, situation assessment, ethical and professional decision making, manage the discourse, monitor, manage and/or coordinate appointments. Categories with the highest average frequency ratings included the following: dress appropriately, adapt to a variety of physical settings and locations, adapt to working with variety of providers in variety of roles, deal with uncertain and unpredictable work situations, and demonstrate cultural adaptability. To achieve health equity for the deaf community, the training and credentialing of interpreters needs to be systematically addressed.

On Engster's care-justification of the specialness thesis about healthcare.

Science.gov (United States)

Rumbold, Benedict

2017-08-01

To say health is 'special' is to say that it has a moral significance that differentiates it from other goods (cars, say or radios) and, as a matter of justice, warrants distributing it separately. In this essay, I critique a new justification for the specialness thesis about healthcare (STHC) recently put forth by Engster. I argue that, regrettably, Engster's justification of STHC ultimately fails and fails on much the same grounds as have previous justifications of STHC. However, I also argue that Engster's argument still adds something valuable to the debate around STHC insofar as it reminds us that the moral significance of healthcare may be wider than simply its effect on the incidence of disability and disease: one further reason we may think healthcare is morally significant is because it concerns the treatment and care of those who are already unwell. 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/.

Appointment reminder systems are effective but not optimal: results of a systematic review and evidence synthesis employing realist principles.

Science.gov (United States)

McLean, Sionnadh Mairi; Booth, Andrew; Gee, Melanie; Salway, Sarah; Cobb, Mark; Bhanbhro, Sadiq; Nancarrow, Susan A

2016-01-01

Missed appointments are an avoidable cost and resource inefficiency which impact upon the health of the patient and treatment outcomes. Health care services are increasingly utilizing reminder systems to manage these negative effects. This study explores the effectiveness of reminder systems for promoting attendance, cancellations, and rescheduling of appointments across all health care settings and for particular patient groups and the contextual factors which indicate that reminders are being employed sub-optimally. We used three inter-related reviews of quantitative and qualitative evidence. Firstly, using pre-existing models and theories, we developed a conceptual framework to inform our understanding of the contexts and mechanisms which influence reminder effectiveness. Secondly, we performed a review following Centre for Reviews and Dissemination guidelines to investigate the effectiveness of different methods of reminding patients to attend health service appointments. Finally, to supplement the effectiveness information, we completed a review informed by realist principles to identify factors likely to influence non-attendance behaviors and the effectiveness of reminders. We found consistent evidence that all types of reminder systems are effective at improving appointment attendance across a range of health care settings and patient populations. Reminder systems may also increase cancellation and rescheduling of unwanted appointments. "Reminder plus", which provides additional information beyond the reminder function may be more effective than simple reminders (ie, date, time, place) at reducing non-attendance at appointments in particular circumstances. We identified six areas of inefficiency which indicate that reminder systems are being used sub-optimally. Unless otherwise indicated, all patients should receive a reminder to facilitate attendance at their health care appointment. The choice of reminder system should be tailored to the individual service

Reactor licensing

International Nuclear Information System (INIS)

Harvie, J.D.

2002-01-01

This presentation discusses reactor licensing and includes the legislative basis for licensing, other relevant legislation , the purpose of the Nuclear Safety and Control Act, important regulations, regulatory document, policies, and standards. It also discusses the role of the CNSC, its mandate and safety philosophy

Strategic Planning to Advance Equity on Campus: A Case Study at Portland State University

Science.gov (United States)

Zapata, Marisa; Percy, Stephen; Andrews, Sona

2018-01-01

Propelled by many factors, including a newly appointed Board of Trustees responsible for governance of our university, resource shortages, and enrollment swings, Portland State University embarked on a strategic planning effort in 2014 with the intent of reunifying a divided campus and creating a bold vision for moving forward in the next five…

76 FR 77580 - Contemporary Healthcare Senior Lien Fund I, LP; Notice Seeking Exemption Under Section 312 of the...

Science.gov (United States)

2011-12-13

... closing costs and for working capital purposes. The financing is brought within the purview of Sec. 107... SMALL BUSINESS ADMINISTRATION [License No. 02/02-0649] Contemporary Healthcare Senior Lien Fund I, LP; Notice Seeking Exemption Under Section 312 of the Small Business Investment Act, Conflicts of...

R&D Funding Sources and University Technology Transfer: What Is Stimulating Universities to Be More Entrepreneurial?

Science.gov (United States)

Powers, Joshua B.

2004-01-01

In recent years, universities have become increasingly entrepreneurial as evidenced by their rapid escalation into technology transfer, the process by which university-developed technologies are commercialized. Stimulated in part by a favorable policy environment for patenting and licensing as well as increased competition for limited resources,…

Endodontic inter-appointment flare-ups: An example of chaos?

Directory of Open Access Journals (Sweden)

Poorya Jalali

2015-01-01

Full Text Available Introduction: Pain and/or swelling after instrumentation of a root canal constitute a significant complication during endodontic treatment. Despite a large number of articles discussing the causative factors behind endodontic flare-ups, the exact mechanism is still not understood. The Hypothesis: The seemingly irrational behavior of endodontic inter-appointment flare-ups may be due to sensitive dependence on initial conditions. A model based on Lorenz′ chaos theory is presented as a possible explanation for the sudden emergence and unpredictability of flare-ups. Evaluation of the Hypothesis: All studies agree on some common traits regarding inter-appointment flare-ups: Careful instrumentation can still cause flare-up; the host inflammatory response behaves as a complex nonlinear network; and also the poly-etiologic nature of this phenomenon all illustrate the sensitive dependence on initial conditions of the system. Integrating more variables (e.g., different species of bacteria into this already complex system will make it increasingly chaotic reflecting its unpredictable behavior.

25 CFR 291.10 - What is the role of the mediator appointed by the Secretary?

Science.gov (United States)

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false What is the role of the mediator appointed by the... ENTERPRISES CLASS III GAMING PROCEDURES § 291.10 What is the role of the mediator appointed by the Secretary? (a) The mediator must ask the Indian tribe and the State to submit their last best proposal for Class...

Nuclear reactor operator licensing

International Nuclear Information System (INIS)

Bursey, R.J.

1978-01-01

The Atomic Energy Act of 1954, which was amended in 1974 by the Energy Reorganization Act, established the requirement that individuals who had the responsibility of operating the reactors in nuclear power plants must be licensed. Section 107 of the act states ''the Commission shall (1) prescribe uniform conditions for licensing individuals; (2) determine the qualifications of such individuals; and (3) issue licenses to such individuals in such form as the Commission may prescribe.'' The article discusses the types of licenses, the selection and training of individuals, and the administration of the Nuclear Regulatory Commission licensing examinations

Operator licensing examiner standards

International Nuclear Information System (INIS)

1987-05-01

The Operator Licensing Examiner Standards provide policy and guidance to NRC examiners and establish the procedures and practices for examining and licensing of applicants for NRC operator licenses pursuant to Part 55 of Title 10 of the Code of Federal Regulations (10 CFR 55). They are intended to assist NRC examiners and facility licensees to understand the examination process better and to provide for equitable and consistent administration of examinations to all applicants by NRC examiners. These standards are not a substitute for the operator licensing regulations and are subject to revision or other internal operator examination licensing policy changes

Addressing the oral healthcare needs of special needs children: pediatric nurses' self-perceived effectiveness.

Science.gov (United States)

Parish, Carrigan L; Singer, Richard; Abel, Stephen; Metsch, Lisa R

2014-01-01

To examine the oral health knowledge and practices of pediatric nurses who coordinate healthcare services for special needs children and to identify those factors that influenced their perceived effectiveness in managing their patients' oral health needs. Self-reported data were collected from 376 nurses employed at Children's Medical Services who responded to an online survey. Likert scale scores were used to specifically assess the nurses' perceived effectiveness in addressing the oral health needs of special needs children. Characteristics significantly associated with special needs pediatric nurses who described themselves as "effective or very effective" included: the self-perception of being very knowledgeable about basic oral health, receiving four or more hours of continuing education training, and securing dental appointments for the majority of their pediatric special needs patients with minimal waiting times. Findings reveal that oral health knowledge significantly influenced nurses' perceived effectiveness in addressing the oral health needs of special needs children, as well as their ability to secure timely dental appointments. These results support the need to incorporate oral health education into nursing curricula and expand upon the dental workforce available and willing to treat disabled patients. © 2013 Special Care Dentistry Association and Wiley Periodicals, Inc.

A framework for luck egalitarianism in health and healthcare.

Science.gov (United States)

Albertsen, Andreas; Knight, Carl

2015-02-01

Several attempts have been made to apply the choice-sensitive theory of distributive justice, luck egalitarianism, in the context of health and healthcare. This article presents a framework for this discussion by highlighting different normative decisions to be made in such an application, some of the objections to which luck egalitarians must provide answers and some of the practical implications associated with applying such an approach in the real world. It is argued that luck egalitarians should address distributions of health rather than healthcare, endorse an integrationist theory that combines health concerns with general distributive concerns and be pluralist in their approach. It further suggests that choice-sensitive policies need not be the result of applying luck egalitarianism in this context. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Licensing in an international triopoly

Science.gov (United States)

Ferreira, Fernanda A.; Ferreira, Flávio

2011-12-01

We study the effects of entry of two foreign firms on domestic welfare in the presence of licensing, when the incumbent is technologically superior to the entrants. We consider two different situations: (i) the cost-reducing innovation is licensed to both entrants; (ii) the cost-reducing innovation is licensed to just one of the entrants. We analyse three kind of license: (lump-sum) fixed-fee; (per-unit) royalty; and two-part tariff, that is a combination of a fixed-fee and a royalty. We prove that a two part tariff is never an optimal licensing scheme for the incumbent. Moreover, (i) when the technology is licensed to the two entrants, the optimal contract consists of a licensing with only output royalty; and (ii) when the technology is licensed to just one of the entrants, the optimal contract consists of a licensing with only a fixed-fee.

Healthcare financing: approaches and trends in India.

Science.gov (United States)

Bajpai, Vikas; Saraya, Anoop

2010-01-01

Despite the importance of healthcare for the well-being of society, there is little public debate in India on issues relating to it. The 'human capital approach' to finance healthcare largely relies on private investment in health, while the 'human development approach' envisages the State as the guarantorof preventive as well as curative care to achieve universalization of healthcare. The prevailing health indices of India and challenges in the field of public health require a human developmentapproach to healthcare. On the eve of independence, India adopted the human development approach, with the report of the Bhore Committee emphasizing the role of the State in the development and provision of healthcare. However, more recently, successive governments have moved towards the human capital approach. Instead of increasing state spending on health and expanding the public health infrastructure, the government has been relying more and more on the private sector. The public-private partnership has been touted as the new-age panacea for the ills of the Indian healthcare system. This approach has led to a stagnation of public health indices and a decrease in the access of the poor to healthcare.

14 CFR 431.73 - Continuing accuracy of license application; application for modification of license.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Continuing accuracy of license application; application for modification of license. 431.73 Section 431.73 Aeronautics and Space COMMERCIAL SPACE... Conditions § 431.73 Continuing accuracy of license application; application for modification of license. (a...

Are healthcare professionals working in Australia's immigration detention centres condoning torture?

Science.gov (United States)

Isaacs, David

2016-07-01

Australian immigration detention centres are in secluded locations, some on offshore islands, and are subject to extreme secrecy, comparable with 'black sites' elsewhere. There are parallels between healthcare professionals working in immigration detention centres and healthcare professionals involved with or complicit in torture. In both cases, healthcare professionals are conflicted between a duty of care to improve the health of patients and the interests of the government. While this duality of interests has been recognised previously, the full implications for healthcare professionals working in immigration detention have not been addressed. The Australian Government maintains that immigration detention is needed for security checks, but the average duration of immigration detention has increased from 10 weeks to 14 months, and detainees are not informed of the progress of their application for refugee status. Long-term immigration detention causes major mental health problems, is illegal in international law and arguably fulfils the recognised definition of torture. It is generally accepted that healthcare professionals should not participate in or condone torture. Australian healthcare professionals thus face a major ethical dilemma: patients in immigration detention have pressing mental and physical health needs, but providing healthcare might support or represent complicity in a practice that is unethical. Individual healthcare professionals need to decide whether or not to work in immigration detention centres. If they do so, they need to decide for how long and to what extent restrictive contracts and gagging laws will constrain them from advocating for closing detention centres. 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/

Why Patients Miss Follow-Up Appointments: A Prospective Control ...

African Journals Online (AJOL)

Reasons include: transport (19 responses), ill-health (6) and financial constraints (5). State transport was unavailable to almost twothirds of the responders who cited transport as a problem. Conclusions: The 17% missed appointment rate is largely due to transport constraints. The commonest time for patients to miss ...

The provincial health office as performance manager: change in the local healthcare system after Thailand's universal coverage reforms.

Science.gov (United States)

Intaranongpai, Siranee; Hughes, David; Leethongdee, Songkramchai

2012-01-01

This paper examines the implementation of Thailand's universal coverage healthcare reforms in a rural province, using data from field studies undertaken in 2003-2005 and 2008-2011. We focus on the strand of policy that aimed to develop primary care by allocating funds to contracting units for primary care (CUPs) responsible for managing local service networks. The two studies document a striking change in the balance of power in the local healthcare system over the 8-year period. Initially, the newly formed CUPs gained influence as 'power followed the money', and the provincial health offices (PHOs), which had commanded the service units, were left with a weaker co-ordination role. However, the situation changed as a new insurance purchaser, the National Health Security Office, took financial control and established regional outposts. National Health Security Office outposts worked with PHOs to develop rationalised management tools-strategic plans, targets, KPIs and benchmarking-that installed the PHOs as performance managers of local healthcare systems. New lines of accountability and changed budgetary systems reduced the power of the CUPs to control resource allocation and patterns of services within CUP networks. Whereas some CUPs fought to retain limited autonomy, the PHO has been able to regain much of its former control. We suggest that implementation theory needs to take a long view to capture the complexity of a major reform initiative and argue for an analysis that recognises the key role of policy networks and advocacy coalitions that span national and local levels and realign over time. Copyright © 2012 John Wiley & Sons, Ltd.

Solidarity, justice and unconditional access to healthcare.

Science.gov (United States)

Gheaus, Anca

2017-03-01

Luck egalitarianism provides a reason to object to conditionality in health incentive programmes in some cases when conditionality undermines political values such as solidarity or inclusiveness. This is the case with incentive programmes that aim to restrict access to essential healthcare services. Such programmes undermine solidarity. Yet, most people's lives are objectively worse, in one respect, in non-solidary societies, because solidarity contributes both instrumentally and directly to individuals' well-being. Because solidarity is non-excludable, undermining it will deprive both the prudent and the imprudent citizens of its goods. Thereby, undermining solidarity can make prudent citizens worse off than they would have otherwise been, out of no fault or choice of their own, but rather as a result of somebody else's imprudent choice. This goes against the spirit of luck egalitarianism. Therefore (luck egalitarian) justice can require us to save the imprudent and avoid conditionality in access to essential healthcare services. 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/.

Council Appointed Mayors in Spain: Effects on Local Democracy

Directory of Open Access Journals (Sweden)

María Jesús García García

2017-03-01

Full Text Available This paper deals with the influence of having council appointed mayors on local governments. Five elements of local government systems are considered: the electoral system and its influence on the political composition of the local government; the local government structure and the distribution of functions and powers between mayor and council; the role of political parties; scrutiny of the executive and accountability; and citizen participation. This analysis highlights the effect that a council appointed mayor system has in terms of accountability and legitimacy, transparency and efficiency. KEYWORDS Local government systems, directly elected mayors, local governance, council appointed mayors, Local Government Structure; Political Parties; Citizen Participation; Accountability. El presente artículo toma en consideración los efectos que el sistema de elección del Alcalde tiene sobre la democracia local, basándose en la consideración cinco aspectos: el sistema electoral y su influencia en la composición política de las administraciones locales; la estructura de la administración local y la distribución de funciones entre los alcaldes y el pleno municipal; el papel de los partidos políticos; los mecanismos de control del ejecutivo local y la participación ciudadana. El estudio subraya especialmente la incidencia que el sistema de elección del alcalde por los concejales tiene en relación con los principios de responsabilidad, legitimidad, transparencia y eficiencia de la gestión local. PALABRAS CLAVE Gobierno local, elección directa de los alcaldes, elección indirecta de los alcaldes, estructura del gobierno local, partidos políticos, participación ciudadana, responsabilidad política.

Purchasing Value: Purchasing and Supply Management's Contribution to Health Service Performance: Address delivered at the occasion of accepting the appointment of endowed professor of Purchasing & Supply Management in Healthcare on behalf of the Vereniging Trustfonds, Erasmus University Rotterdam, at Rotterdam School of Management and the institute of Health Policy & Management, Erasmus University, on Friday, 14 October 2016

OpenAIRE

Raaij, Erik

2016-01-01

textabstractMany countries across the globe face the challenge of increasing healthcare costs, often increasing faster than GDP or personal income. In an effort to manage these costs, but also to improve the quality and accessibility of healthcare, governments have introduced a purchaser-provider split in the healthcare system. Healthcare financers, such as local governments, employers and health insurers exercise the role of healthcare purchasers. They select and contract providers, and mana...

NRC's license renewal regulations

International Nuclear Information System (INIS)

Akstulewicz, Francis

1991-01-01

In order to provide for the continuity of the current generation of nuclear power plant operating licenses and at the same time ensure the health and safety of the public, and the quality of the environment, the US Nuclear Regulatory Commission (NRC) established a goal of developing and issuing regulations and regulatory guidance for license renewal in the early 1990s. This paper will discuss some of those activities underway to achieve this goal. More specifically, this paper will discuss the Commission's regulatory philosophy for license renewal and the two major license renewal rule makings currently underway. The first is the development of a new Part 54 to address procedural and technical requirements for license renewal; the second is a revision to existing Part 51 to exclude environmental issues and impacts from consideration during the license renewal process. (author)

Improving access to health care in a rural regional hospital in South Africa: Why do patients miss their appointments?

Science.gov (United States)

Frost, Lucy; Jenkins, Louis S; Emmink, Benjamin

2017-03-30

Access to health services is one of the Batho Pele ('people first') values and principles of the South African government since 1997. This necessitated some changes around public service systems, procedures, attitudes and behaviour. The challenges of providing health care to rural geographically spread populations include variations in socio-economic status, transport opportunities, access to appointment information and patient perceptions of costs and benefits of seeking health care. George hospital, situated in a rural area, serves 5000 outpatient visits monthly, with non-attendance rates of up to 40%. The aim of this research was to gain a greater understanding of the reasons behind non-attendance of outpatient department clinics to allow locally driven, targeted interventions. This was a descriptive study. We attempted to phone all patients who missed appointments over a 1-month period (n = 574). Only 20% were contactable with one person declining consent. Twenty-nine percent had no telephone number on hospital systems, 7% had incorrect numbers, 2% had died and 42% did not respond to three attempts. The main reasons for non-attendance included unaware of appointment date (16%), out of area (11%), confusion over date (11%), sick or admitted to hospital (10%), family member sick or died (7%), appointment should have been cancelled by clerical staff (6%) and transport (6%). Only 9% chose to miss their appointment. The other 24% had various reasons. Improved patient awareness of appointments, adjustments in referral systems and enabling appointment cancellation if indicated would directly improve over two-thirds of reasons for non-attendance. Understanding the underlying causes will help appointment planning, reduce wasted costs and have a significant impact on patient care.

[Today's jobs in the healthcare sector are comparable to other professions].

Science.gov (United States)

Conrad, H-J

2014-08-01

By applying current standards of job descriptions and performance profiles in the healthcare sector, this article focuses on the issue whether there are fundamental differences between physicians and other healthcare professionals compared to other professions. There are special requirements for physicians, such as a university degree, but the same also holds true for other professions. The increasing economization of the healthcare sector in recent years has led to a situation where differences in the standards for healthcare professionals when compared to other occupations are no longer apparent. Medical directors at university hospitals also have to conform to standards that are applied to executive managers in other businesses. Besides the obvious professional skills, communication with patients and collaborators, knowledge of economics and leadership competence are also mandatory. This does not exclude the impression that physicians and nurses subjectively see in their profession more than just a job but truly a vocation.

Significant Factors Related to Failed Pediatric Dental General Anesthesia Appointments at a Hospital-based Residency Program.

Science.gov (United States)

Emhardt, John R; Yepes, Juan F; Vinson, LaQuia A; Jones, James E; Emhardt, John D; Kozlowski, Diana C; Eckert, George J; Maupome, Gerardo

2017-05-15

The purposes of this study were to: (1) evaluate the relationship between appointment failure and the factors of age, gender, race, insurance type, day of week, scheduled time of surgery, distance traveled, and weather; (2) investigate reasons for failure; and (3) explore the relationships between the factors and reasons for failure. Electronic medical records were accessed to obtain data for patients scheduled for dental care under general anesthesia from May 2012 to May 2015. Factors were analyzed for relation to appointment failure. Data from 3,513 appointments for 2,874 children were analyzed. Bivariate associations showed statistically significant (Pgeneral anesthesia face specific barriers to care.

2015 Business Licenses

Data.gov (United States)

City of Jackson, Mississippi — This data displays all business license information for the year of 2015. This information details license classifications and status. This information will updated...

5 CFR 315.603 - Appointment based on former incumbency of a position brought into the competitive service.

Science.gov (United States)

2010-01-01

... OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS CAREER AND CAREER-CONDITIONAL EMPLOYMENT Career or Career-Conditional Appointment Under Special Authorities § 315.603 Appointment based on former... type of case from this requirement. (b) Review of disapproved recommendations. Agencies shall establish...

Engaging Mission: Applying the Catholic Social Tradition to Investing and Licensing

Science.gov (United States)

Purcell, Bill; Rose, Margarita

2018-01-01

Faced with economic and demographic challenges, Catholic colleges and universities use endowment and licensing revenues to supplement tuition income in order to serve their missions of educating students of all socio-economic classes to promote the common good through their professional careers and service to the community. Licensees sometimes…

Teenagers' licensing decisions and their views of licensing policies: a national survey.

Science.gov (United States)

Williams, Allan F

2011-08-01

One objective was to determine teenage licensing rates on a national basis, interest in early licensure, and reasons for delay. A second objective was to learn teenagers' opinions about licensing policies, important in states considering ways to upgrade their current licensing systems. One thousand three hundred eighty-three 15- to 18-year-olds completed an online survey in November 2010. They were drawn from a nationally representative panel of US households recruited using probability-based sampling. The panel included cell phone-only households, and Internet access was provided to those without it. Weighting procedures were applied so that the study population represented the national US population of 15- to 18-year-olds. Most teens said that they were interested in getting a license as soon as legally possible, but many had not started the process. At 16, teens were about equally divided among those who had not started, those in the learner stage, and those with a restricted or full license. At 18, 62 percent had full licenses; 22 percent had not started. For those old enough to start, lack of a car, costs, parent availability, ability to get around without a car, and being busy with other activities were leading reasons for delay. The majority of teens were not in favor of higher licensing ages. Forty-six percent thought the minimum learner age should be 16; 30 percent thought the full license age should be 18 or older. The majority approved of night (78%) and passenger (57%) restrictions, and 85 and 93 percent endorsed cell phone and texting bans, respectively. When these policies were packaged together in a single law that included an age 16 start, night, passenger, cell phone and texting bans, and a full license at age 18, 74 percent of teens were in favor. Teenagers are not as supportive of strong licensing policies as parents of teens, but there is evidence that they will support comprehensive policies likely to lead to further reductions in teen crash

Radiation control through licensing and intensive training

International Nuclear Information System (INIS)

Cheng, C.-H.; Yang, Y.-C.; Wu, T.-Y.; Weng, P.-S.

1982-01-01

Various types of intensive training courses to suit radiation workers in different fields were sponsored by both the Atomic Energy Council of Executive Yuan and the National Health Administration of Executive Yuan, Republic of China during the past seven years. During the years 1974-79, the number of radiation workers attending each training course, their age, sex and educational background are presented in detail. The typical course contents for both medical and non-medical radiation workers are given. A summary of the percentage of passes and failures of the final examination given at the end of each training course is also given. The present status of licensing for radiation facilities and workers is described, and its results are indicated. The successful control of ionizing radiation through this kind of intensive training and licensing is evidenced in the film badge records given by a centralized service laboratory located at the National Tsing Hua University. (author)

Now What? Think Fast: Using Healthcare Clinics as Universal Language to Maximize Learning for International Students in a Graduate Classroom

Directory of Open Access Journals (Sweden)

Sanda Katila

2016-12-01

Full Text Available International students in Masters programs come to the US optimistic and willing to learn. Upon arrival and entrance into programs, they often encounter unexpected environments. Culture shock and language barriers may seem like obvious hurdles, but work ethic and scope of visual knowledge also pose unique challenges for both students and design educators. Although all students share new challenges in graduate school, international students face tougher impediments in studio environments where they express themselves both visually and verbally. Additionally, much of design uses humor, idioms, and visual clues only understood in English. So how do educators help international students build on what they already know? How do educators break barriers between domestic and international students so they may teach one another through a shared language? In fall 2015, my Conceptual Development and Implementation class was struggling to exchange ideas in the classroom. We moved through that struggle by developing a shared language around each student's experiences with healthcare clinics in their country of origin. Students explained what makes healthcare clinics reputable; how people access information in India, China, small towns and larger urban areas; and where people look for trustworthy information. This paper discusses how one educator used student experience of healthcare clinics to find a universal language to maximize learning for international students in design education.

Radiopharmaceutical licensing

International Nuclear Information System (INIS)

Mather, S.J.

1992-01-01

Recent health service legislation, and especially the loss of crown immunity has once again focussed attention on the arrangements for licensing of radiopharmaceuticals. The aim of the article is to describe in general terms the UK licensing system and in particular to provide guidance to those responsible for the supply of radiopharmaceuticals in hospitals. (author)

Regulating the for-profit private healthcare providers towards universal health coverage: A qualitative study of legal and organizational framework in Mongolia.

Science.gov (United States)

Tsevelvaanchig, Uranchimeg; Narula, Indermohan S; Gouda, Hebe; Hill, Peter S

2018-01-01

Regulating the behavior of private providers in the context of mixed health systems has become increasingly important and challenging in many developing countries moving towards universal health coverage including Mongolia. This study examines the current regulatory architecture for private healthcare in Mongolia exploring its role for improving accessibility, affordability, and quality of private care and identifies gaps in policy design and implementation. Qualitative research methods were used including documentary review, analysis, and in-depth interviews with 45 representatives of key actors involved in and affected by regulations in Mongolia's mixed health system, along with long-term participant observation. There has been extensive legal documentation developed regulating private healthcare, with specific organizations assigned to conduct health regulations and inspections. However, the regulatory architecture for healthcare in Mongolia is not optimally designed to improve affordability and quality of private care. This is not limited only to private care: important regulatory functions targeted to quality of care do not exist at the national level. The imprecise content and details of regulations in laws inviting increased political interference, governance issues, unclear roles, and responsibilities of different government regulatory bodies have contributed to failures in implementation of existing regulations. Copyright © 2017 John Wiley & Sons, Ltd.

Student-led leadership training for undergraduate healthcare students.

Science.gov (United States)

Sheriff, Ibrahim Hasanyn Naim; Ahmed, Faheem; Jivraj, Naheed; Wan, Jonathan C M; Sampford, Jade; Ahmed, Na'eem

2017-10-02

Purpose Effective clinical leadership is crucial to avoid failings in the delivery of safe health care, particularly during a period of increasing scrutiny and cost-constraints for the National Health Service (NHS). However, there is a paucity of leadership training for health-care students, the future leaders of the NHS, which is due in part to overfilled curricula. The purpose of this study was to assess the impact of student-led leadership training for the benefit of fellow students. Design/methodology/approach To address this training gap, a group of multiprofessional students organised a series of large-group seminars and small-group workshops given by notable health-care leaders at a London university over the course of two consecutive years. Findings The majority of students had not previously received any formal exposure to leadership training. Feedback post-events were almost universally positive, though students expressed a preference for experiential teaching of leadership. Working with university faculty, an inaugural essay prize was founded and student members were given the opportunity to complete internships in real-life quality improvement projects. Originality/value Student-led teaching interventions in leadership can help to fill an unmet teaching need and help to better equip the next generation of health-care workers for future roles as leaders within the NHS.

Effects of shared medical appointments on quality of life and cost-effectiveness for patients with a chronic neuromuscular disease. Study protocol of a randomized controlled trial

Directory of Open Access Journals (Sweden)

van der Wilt Gert-Jan

2011-08-01

Full Text Available Abstract Background Shared medical appointments are a series of one-to-one doctor-patient contacts, in presence of a group of 6-10 fellow patients. This group visits substitute the annual control visits of patients with the neurologist. The same items attended to in a one-to- one appointment are addressed. The possible advantages of a shared medical appointment could be an added value to the present management of neuromuscular patients. The currently problem-focused one-to-one out-patient visits often leave little time for the patient's psychosocial needs, patient education, and patient empowerment. Methods/design A randomized, prospective controlled study (RCT with a follow up of 6 months will be conducted to evaluate the clinical and cost-effectiveness of shared medical appointments compared to usual care for 300 neuromuscular patients and their partners at the Radboud University Nijmegen Medical Center. Every included patient will be randomly allocated to one of the two study arms. This study has been reviewed and approved by the medical ethics committee of the region Arnhem-Nijmegen, the Netherlands. The primary outcome measure is quality of life as measured by the EQ-5D, SF-36 and the Individualized neuromuscular Quality of Life Questionnaire. The primary analysis will be an intention-to-treat analysis on the area under the curve of the quality of life scores. A linear mixed model will be used with random factor group and fixed factors treatment, baseline score and type of neuromuscular disease. For the economic evaluation an incremental cost-effectiveness analysis will be conducted from a societal perspective, relating differences in costs to difference in health outcome. Results are expected in 2012. Discussion This study will be the first randomized controlled trial which evaluates the effect of shared medical appointments versus usual care for neuromuscular patients. This will enable to determine if there is additional value of shared

Joint Optimization of Preventive Maintenance and Spare Parts Inventory with Appointment Policy

Directory of Open Access Journals (Sweden)

Jing Cai

2017-01-01

Full Text Available Under the background of the wide application of condition-based maintenance (CBM in maintenance practice, the joint optimization of maintenance and spare parts inventory is becoming a hot research to take full advantage of CBM and reduce the operational cost. In order to avoid both the high inventory level and the shortage of spare parts, an appointment policy of spare parts is first proposed based on the prediction of remaining useful lifetime, and then a corresponding joint optimization model of preventive maintenance and spare parts inventory is established. Due to the complexity of the model, the combination method of genetic algorithm and Monte Carlo is presented to get the optimal maximum inventory level, safety inventory level, potential failure threshold, and appointment threshold to minimize the cost rate. Finally, the proposed model is studied through a case study and compared with both the separate optimization and the joint optimization without appointment policy, and the results show that the proposed model is more effective. In addition, the sensitivity analysis shows that the proposed model is consistent with the actual situation of maintenance practices and inventory management.

State Licenses & Permits

Data.gov (United States)

Small Business Administration — Starting a business? Confused about whether you need a business license or permit? Virtually every business needs some form of license or permit to operate legally....

Quality of Care for Patients with Chronic Respiratory Diseases: Data for Accreditation Plan in Primary Healthcare.

Science.gov (United States)

Kurpas, Donata; Szwamel, Katarzyna; Mroczek, Bożena

There are scarce reports in the literature on factors affecting the assessment of the quality of care for patients with chronic respiratory diseases. Such information is relevant in the accreditation process on implementing the healthcare. The study group consisted of 133 adult patients with chronic respiratory diseases and 125 adult patients with chronic non-respiratory diseases. In the present study, the level of satisfaction from healthcare provided by the primary healthcare unit, disease acceptance, quality of life, health behaviors, and met needs were examined, as well as associations between variables with the use of correspondence analysis. The results are that in patients with chronic respiratory diseases an increase in satisfaction depends on the improvement of well-being in the mental sphere. The lack of problems with obtaining a referral to a specialist and a higher level of fulfilled needs also have a positive effect. Additionally, low levels of satisfaction should be expected in those patients with chronic respiratory diseases who wait for an appointment in front of the office for a long time, report problems with obtaining a referral to additional tests, present a low level of health behaviors, and have a low index of benefits.

Operator licensing examiner standards

International Nuclear Information System (INIS)

1983-10-01

The Operator Licensing Examiner Standards provide policy and guidance to NRC examiners and establish the procedures and practices for examining and licensing of applicants for NRC operator licenses pursuant to Part 55 of Title 10 of the Code of Federal Regulations (10 CFR 55). They are intended to assist NRC examiners and facility licensees to understand the examination process better and to provide for equitable and consistent administration of examinations to all applicants by NRC examiners. These standards are not a substitute for the operator licensing regulations and are subject to revision or other internal operator examination licensing policy changes. As appropriate, these standards will be revised periodically to accommodate comments and reflect new information or experience

The SLOWPOKE licensing model

Energy Technology Data Exchange (ETDEWEB)

Snell, V. G.; Takats, F.; Szivos, K.

1989-08-15

The SLOWPOKE Energy System (SES-10) is a 10 MW heating reactor that has been developed in Canada. It will be capable of running without a licensed operator in continuous attendance, and will be sited in urban areas. It has forgiving safety characteristics, including transient time-scales of the order of hours. A process called `up-front` licensing has been evolved in Canada to identify, and resolve, regulatory concerns early in the process. Because of the potential market in Hungary for nuclear district heating, a licensing plan has been developed that incorporates Canadian licensing experience, identifies specific Hungarian requirements, and reduces the risk of licensing delays by seeking agreement of all parties at an early stage in the program.

License to build

International Nuclear Information System (INIS)

Huntelaar, Mark; Vos, Renate de; Roobol, Lars

2007-01-01

Full text: A new license under the nuclear power act is applied for at the Dutch Government for the building of a High Active Repackaging Unit (HAVA-VU in Dutch) at NRG in Petten, The Netherlands. This new building is necessary to comply with our nuclear license to dispose of high active nuclear waste at Petten to the intermediate storage facility (COVRA). In the first part of this paper attention is given to the formal procedure followed by the Government, what type of documents are to be submitted, what time frames are followed, how citizen participation is organized, and as final result a new license. In the second part more detailed information is given about the present license renewal needed for the High Active Repackaging Unit

De-Internationalization of Universities

DEFF Research Database (Denmark)

Turcan, Romeo V.; Gulieva, Valeria

Alongside student and staff mobility, universities these days get also actively involved in out-ward cross-border activities, such as licensing, entering joint ventures and establishing campuses. These cross-border activities are not without pitfalls however. A large number of universities de-int...... on withdrawals from franchise, joint venture, and branch campus operations. We use the concept of de-internationalization as a theoretical lens and conduct a review of available unobtrusive data to identify reasons and patterns of universities' withdrawals from international markets....

Executive Succession and Institutional Change: A Case Study of the University of New Mexico, 1967-1972.

Science.gov (United States)

Bjork, Lars G.

The history of the University of New Mexico during 1967-1972, when a new president was appointed, is examined. Attention is focused primarily on the environmental milieu relating to federal support of university research and the president's leadership initiative in establishing the Office of the Vice President for Research. In reviewing…

Evaluation of Terminated Nuclear Material Licenses

International Nuclear Information System (INIS)

Spencer, K.M.; Zeighami, E.A.

1999-01-01

This report presents the results of a six-year project that reviewed material licenses that had been terminated during the period from inception of licensing until approximately late-1994. The material licenses covered in the review project were Part 30, byproduct material licenses; Part 40, source material licenses; and Part 70, special nuclear material licenses. This report describes the methodology developed for the project, summarizes the findings of the license file inventory process, and describes the findings of the reviews or evaluations of the license files. The evaluation identified nuclear material use sites that need review of the licensing material or more direct follow-up of some type. The review process also identified licenses authorized to possess sealed sources for which there was incomplete or missing documentation of the fate of the sources

Predictors of Missed Research Appointments in a Randomized Placebo-Controlled Trial

Directory of Open Access Journals (Sweden)

Stéphanie J.E. Becker

2014-09-01

 Younger patients with no college education, who believe their health can be controlled, are more likely to miss a research appointment when enrolled in a randomized placebo injection-controlled trial. 

77 FR 19264 - Renewal of Air University Board of Visitors

Science.gov (United States)

2012-03-30

..., management, leadership, and academia. All Board member appointments must be renewed by the Secretary of... shall serve as an ex- offico member. Board members, who are not full-time or permanent part-time Federal... processes across the University (to include the Air Force Institute of Technology (AFIT), Air War College...

Migrant women's perceptions of healthcare during pregnancy and early motherhood: addressing the social determinants of health.

Science.gov (United States)

Almeida, Lígia Moreira; Casanova, Catarina; Caldas, José; Ayres-de-Campos, Diogo; Dias, Sónia

2014-08-01

Recent guidelines from the World Health Organization emphasize the need to monitor the social determinants of health, with particular focus on the most vulnerable groups. With this in mind, we evaluated the access, use and perceived quality of care received by migrant women during pregnancy and early motherhood, in a large urban area in northern Portugal. We performed semi-structured interviews in 25 recent mothers, contacted through welfare institutions, who had immigrated from Eastern European countries, Brazil, or Portuguese-speaking African countries. Six native-Portuguese women of equal economic status were also interviewed for comparison. Misinformation about legal rights and inadequate clarification during medical appointments frequently interacted with social determinants, such as low social-economic status, unemployment, and poor living conditions, to result in lower perceived quality of healthcare. Special attention needs to be given to the most vulnerable populations in order to improve healthcare. Challenges reside not only in assuring access, but also in promoting equity in the quality of care.

Stock Market Reaction to CEO Appointment – Preliminary Results

Directory of Open Access Journals (Sweden)

Katarzyna Byrka-Kita

2017-06-01

Full Text Available Purpose: The aim of this paper is to examine shareholders’ reaction to the decision of the supervisory board to appoint a CEO in companies listed on the Warsaw Stock Exchange. Methodology: An event study and the mean-adjusted model were applied. The abnormal returns were measured as the CAAR in the entire (-60, + 60 window and selected sub-windows. Findings: The obtained values of abnormal returns indicate the shareholder’s negative reaction. Throughout the observation window, they oscillate slightly below zero, and in the window (0, +20 they are negative at -1.566%. Irrespective of the observation window, negative abnormal returns were obtained for over half of the observation (52–57%. Therefore, preliminary results indicate the predominance of the information effect over the real one. The decrease in market value as a result of the event may result from an increase in investors’ uncertainty as to the effects of changes in strategy and skills of the new CEO. Originality: The research is a unique one. To date, no one has carried out research into shareholders’ reaction to a CEO appointment in either the Polish or Central and Eastern European capital markets. They primarily bring the value of cognition of shareholders’ behaviour in the analysed event, which is reflected in share prices. They extend the literature on the signalization instruments, i.e. the activities that boards can undertake due to the new information transmitted to the capital market participants and stakeholders. The market reaction to a CEO appointment will without a doubt interest investors; the institutions responsible for supervision (which in the case of Poland is the Financial Oversight Commission and the legislator in charge of regulations that prevent insider trading while promoting corporate disclosure transparency.

Contestable Licensing

OpenAIRE

Zvika Neeman; Gerhard O. Orosel

2000-01-01

We analyze a model of repeated franchise bidding for natural monopoly with contestable licensing - a franchisee halds an (exclusive) license to operate a franchise until another rm offers to pay more for it. In a world where quality is observable but not veri able, the simple regulatory scheme we describe combines market-like incentives with regulatory oversight to generate efficient outcomes.

Predictors of full-time faculty appointment among MD–PhD program graduates: a national cohort study

Directory of Open Access Journals (Sweden)

Dorothy A. Andriole

2016-05-01

Full Text Available Purpose: The authors sought to identify variables associated with MD–PhD program graduates’ academic medicine careers. Methods: We analyzed data for a national cohort of MD–PhD program graduates from 2000 to 2005, using multivariable logistic regression to identify independent predictors of full-time academic medicine faculty appointment through 2013. Results: Of 1,860 MD–PhD program graduates in 2000–2005, we included 1,846 (99.2% who had completed residency training before 2014. Of these 1,846 graduates, 968 (52.4% held full-time faculty appointments. Graduates who attended schools with Medical Scientist Training Program (MSTP funding (vs. no MSTP funding; adjusted odds ratio [aOR], 1.41; 95% confidence interval [CI], 1.14–1.74 and participated in ≥1 year of research during residency (vs. no documented research year; aOR, 1.85; 95% CI, 1.50–2.28 were more likely to have held full-time faculty appointments. Asian/Pacific Islander (aOR, 0.74; 95% CI, 0.60–0.93 and under-represented minority (URM; aOR, 0.68; 95% CI, 0.48–0.98 graduates (each vs. white graduates, graduates who reported total debt of ≥$100,000 (vs. no debt at graduation (aOR, 0.58; 95% CI, 0.39–0.88, and graduates in surgical practice (aOR, 0.64; 95% CI, 0.48–0.84 and other practice (aOR, 0.66, 95% CI, 0.54–0.81 specialties (each vs. ‘medicine, pediatrics, pathology, or neurology’ were less likely to have held full-time faculty appointments. Gender was not independently associated with likelihood of full-time faculty appointment. Conclusions: Over half of all MD–PhD program graduates in our study had full-time faculty appointments. Our findings regarding variables independently associated with full-time faculty appointments can inform the design of strategies to promote academic medicine career choice among MD–PhD program graduates. Further research is warranted to identify other factors amenable to intervention, in addition to those included in

Safety-evaluation report related to the renewal of the operating license for the research reactor at the Iowa State University (Docket No. 50-116)

International Nuclear Information System (INIS)

1983-09-01

This Safety Evaluation Report for the application filed by the Iowa State University (ISU) for a renewal of the Class 104 Operating License R-59 to continue to operate its Argonaut-type research reactor has been prepared by the Office of Nuclear Reactor Regulation of the US Nuclear Regulatory Commission. The facility is owned and operated by the Iowa State University, and is located on the ISU campus in Ames, Story County, Iowa. The staff concludes that the reactor facility can continue to be operated by ISU without endangering the health and safety of the public. The principal matters reviewed are: design, testing, and performance of the reactor components and systems; the expected consequences of credible accidents; the licensee's management organization; the method used for the control of radiological effluents; the licensee's technical specifications; financial data and information; the physical protection program; procedures for training reactor operators; and emergency plans. 11 references, 15 figures, 13 tables

Effects of librarian-provided services in healthcare settings: a systematic review.

Science.gov (United States)

Perrier, Laure; Farrell, Ann; Ayala, A Patricia; Lightfoot, David; Kenny, Tim; Aaronson, Ellen; Allee, Nancy; Brigham, Tara; Connor, Elizabeth; Constantinescu, Teodora; Muellenbach, Joanne; Epstein, Helen-Ann Brown; Weiss, Ardis

2014-01-01

To assess the effects of librarian-provided services in healthcare settings on patient, healthcare provider, and researcher outcomes. Medline, CINAHL, ERIC, LISA (Library and Information Science Abstracts), and the Cochrane Central Register of Controlled Trials were searched from inception to June 2013. Studies involving librarian-provided services for patients encountering the healthcare system, healthcare providers, or researchers were eligible for inclusion. All librarian-provided services in healthcare settings were considered as an intervention, including hospitals, primary care settings, or public health clinics. Twenty-five articles fulfilled our eligibility criteria, including 22 primary publications and three companion reports. The majority of studies (15/22 primary publications) examined librarians providing instruction in literature searching to healthcare trainees, and measured literature searching proficiency. Other studies analyzed librarian-provided literature searching services and instruction in question formulation as well as the impact of librarian-provided services on patient length of stay in hospital. No studies were found that investigated librarians providing direct services to researchers or patients in healthcare settings. Librarian-provided services directed to participants in training programs (eg, students, residents) improve skills in searching the literature to facilitate the integration of research evidence into clinical decision-making. Services provided to clinicians were shown to be effective in saving time for health professionals and providing relevant information for decision-making. Two studies indicated patient length of stay was reduced when clinicians requested literature searches related to a patient's case. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The similarity of life across the universe.

Science.gov (United States)

Cockell, Charles S

2016-05-15

Is the hypothesis correct that if life exists elsewhere in the universe, it would have forms and structures unlike anything we could imagine? From the subatomic level in cellular energy acquisition to the assembly and even behavior of organisms at the scale of populations, life on Earth exhibits characteristics that suggest it is a universal norm for life at all levels of hierarchy. These patterns emerge from physical and biochemical limitations. Their potentially universal nature is supported by recent data on the astrophysical abundance and availability of carbon compounds and water. Within these constraints, biochemical and biological variation is certainly possible, but it is limited. If life exists elsewhere, life on Earth, rather than being a contingent product of one specific experiment in biological evolution, is likely to reflect common patterns for the assembly of living matter. © 2016 Cockell. This article is distributed by The American Society for Cell Biology under license from the author(s). Two months after publication it is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

Investigation of ELF Signals Associated with Mine Warfare: A University of Idaho and Acoustic Research Detachment Collaboration, Phase 2

Science.gov (United States)

2010-07-31

9] [14] Authorized licensed use limited to: UNIVERSITY OF IDAHO Downloaoed on Jury 27.2010 st 20:36:20 UTC from IEEE Xplore . Restrictions apply...VS25.00 © 2009 IEEE Authorized licensed use limited to: UNIVERSITY OF I3AHO. Downtoadeo on July 27.2010 a: 20:34:14 UTC Iron. IEEE Xplore . Restrictions...2010 IEEE Authorized licensed use limited to: UNIVERSITY OF IDAHO. Downloaded or, July 27.2010 at 17:15:26 UTC from IEEE Xplore . Restrictions

78 FR 33448 - Application for a License To Export High-Enriched Uranium

Science.gov (United States)

2013-06-04

... NUCLEAR REGULATORY COMMISSION Application for a License To Export High-Enriched Uranium Pursuant.... Security Complex, May 13, Uranium (93.35%). uranium-235 at the National 2013, May 21, 2013, XSNM3745, contained in 7.5 Research Universal 11006098. kilograms reactor in Canada for uranium. ultimate use in...

22 CFR 11.20 - Foreign Service specialist career candidate appointments.

Science.gov (United States)

2010-04-01

..., background investigation, and final review process required of career candidates, but normally they will not... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Foreign Service specialist career candidate... SERVICE OFFICERS § 11.20 Foreign Service specialist career candidate appointments. (a) General...

Nuclear plant license renewal

International Nuclear Information System (INIS)

Gazda, P.A.; Bhatt, P.C.

1991-01-01

During the next 10 years, nuclear plant license renewal is expected to become a significant issue. Recent Electric Power Research Institute (EPRI) studies have shown license renewal to be technically and economically feasible. Filing an application for license renewal with the Nuclear Regulatory Commission (NRC) entails verifying that the systems, structures, and components essential for safety will continue to perform their safety functions throughout the license renewal period. This paper discusses the current proposed requirements for this verification and the current industry knowledge regarding age-related degradation of structures. Elements of a license renewal program incorporating NRC requirements and industry knowledge including a schedule are presented. Degradation mechanisms for structural components, their significance to nuclear plant structures, and industry-suggested age-related degradation management options are also reviewed

76 FR 10945 - San Luis Trust Bank, FSB, San Luis Obispo, CA; Notice of Appointment of Receiver

Science.gov (United States)

2011-02-28

... DEPARTMENT OF THE TREASURY Office of Thrift Supervision San Luis Trust Bank, FSB, San Luis Obispo, CA; Notice of Appointment of Receiver Notice is hereby given that, pursuant to the authority... appointed the Federal Deposit Insurance Corporation as sole Receiver for San Luis Trust Bank, FSB, San Luis...

Healthcare Learning Community and Student Retention

Science.gov (United States)

Johnson, Sherryl W.

2014-01-01

Teaching, learning, and retention processes have evolved historically to include multifaceted techniques beyond the traditional lecture. This article presents related results of a study using a healthcare learning community in a southwest Georgia university. The value of novel techniques and tools in promoting student learning and retention…

Healthcare-associated vancomycin resistant Enterococcus faecium infections in the Mansoura University Hospitals intensive care units, Egypt

Directory of Open Access Journals (Sweden)

Dalia Moemen

2015-09-01

Full Text Available Vancomycin resistant Enterococcus faecium (VREF ia an emerging and challenging nosocomial pathogen. This study aimed to determine the prevalence, risk factors and clonal relationships between different VREF isolates in the intensive care units (ICUs of the university hospitals in our geographic location. This prospective study was conducted from July, 2012 until September, 2013 on 781 patients who were admitted to the ICUs of the Mansoura University Hospitals (MUHs, and fulfilled the healthcare-associated infection (HAI criteria. Susceptibility testing was determined using the disk diffusion method. The clonal relationships were evaluated with pulsed field gel electrophoresis (PFGE. Out of 52 E. faecium isolates, 12 (23.1% were vancomycin resistant. The significant risk factors for the VREF infections were: transfer to the ICU from a ward, renal failure, an extended ICU stay and use of third-generation cephalosporins, gentamicin, or ciprofloxacin. PFGE with the 12 isolates showed 9 different patterns; 3 belonged to the same pulsotype and another 2 carried a second pulsotypes. The similar pulsotypes isolates were isolated from ICUs of one hospital (EICUs; however, all of the isolates from the other ICUs had different patterns. Infection control policy, in conjunction with antibiotic stewardship, is important to combat VREF transmission in these high-risk patients.

Challenges of SMR licensing practices

Energy Technology Data Exchange (ETDEWEB)

Soderholm, K., E-mail: kristiina.soderholm@fortum.com [Fortum Power, Espoo (Finland)

2012-12-15

This paper aims to increase the understanding of high level Nuclear Power Plant (NPP) licensing processes in Finland, France, the UK, Canada and the USA. These countries have been selected for this study because of their different licensing processes and recent actions in new NPP construction. After discussing their similarities and differences, suitable features for Small Modular Reactor licensing can be emphasized and suggested. Some of the studied licensing processes have elements that are already quite well suited for application to SMRs, but all of these different national processes can benefit from studying and implementing lessons learned from SMR specific licensing needs. The main SMR features to take into account in licensing are standardization of the design, modularity, mass production and serial construction. Modularity can be divided into two different categories: the first category is simply a single unit facility constructed of independently engineered modules (e.g., construction process for Westinghouse AP-1000 NPP) and the second is a facility structure composed of many reactor modules where modules are manufactured in factories and installed into the facility as needed (e.g., NuScale Power SMR design). Short construction schedules will not be fully benefited from if the long licensing process prolongs the commissioning and approach to full-power operation. The focus area of this study is to better understand the possibility of SMR deployment in small nuclear countries, such as Finland, which currently has four operating NPPs. The licensing process needs to be simple and clear to make SMR deployment feasible from an economical point of view. This paper uses public information and interviews with experts to establish the overview of the different licensing processes and their main steps. A high-level comparison of the licensing steps has been carried out. Certain aspects of the aviation industry licensing process have also been studied and certain

31 CFR 596.306 - License.

Science.gov (United States)

2010-07-01

... ASSETS CONTROL, DEPARTMENT OF THE TREASURY TERRORISM LIST GOVERNMENTS SANCTIONS REGULATIONS General Definitions § 596.306 License. Except as otherwise specified, the term license means any license or...

Understanding Licensing Behavior

DEFF Research Database (Denmark)

Cabaleiro, Goretti; Moreira, Solon; Reichstein, Toke

The potential for rent dissipation has been argued to be the main cause of firms? licensing out behavior being stifled.However, this aspect has been scarcely studied empirically. We draw on rent dissipation arguments, and hypothesize that firms suffering from the not-invented-here (NIH) syndrome......, firms in competitive product markets, and firms that have incurred substantial sunk cost are associated with lower rates of technology out-licensing. We also posit that sunk costs negatively moderate the relationship between competition in the licensor?s product market, and licensing rate. We test our...

Healthcare Engagement and Encounters in a Rural State: A Focus Group Study

Directory of Open Access Journals (Sweden)

Reshmi Singh

2018-01-01

many medications, rushed encounters, and providers with poor bedside manner. ‘Engagement in Health’ dimension included the theme of Self-management Process such as taking things one day at a time, taking medication daily, and good stress management. The second theme was Barriers to Engagement and included issues regarding inclement weather, lack of sidewalks, stress, lack of time and the financial constraints for eating healthy, going to a gym, and/or problems with payer source. Participants also described a number of technological tools they utilized to engage with their healthcare including appointment reminders, health-based websites, symptom trackers, online portal systems for health care records, and online bill pay. Many used apps on smart phones to track calories and exercise as well as online community groups to encourage fitness. Conclusions: The results from this study highlighted some of the gaps in healthcare for rural areas. A large number of participants indicated a lack of trust of their providers and only a few had any communicative interaction with their pharmacist. Future studies could evaluate training designed to teach healthcare providers and pharmacists how to engage patients in their own care. Use of technology by healthcare providers might be another way to improve healthcare engagement. Conflict of Interest "We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received, employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties". Acknowledgements: This study was funded by the University of Wyoming College of Health Sciences (UW CHS Faculty Seed Grant awarded to first author Dr. Singh in April 2015. Interim results of this study have been presented at the Health Literacy Research Conference (HARC in November 2015. Treatment of Human Subjects

Nuclear power stations licensing

International Nuclear Information System (INIS)

Solito, J.

1978-04-01

The judicial aspects of nuclear stations licensing are presented. The licensing systems of the United States, Spain, France and Federal Republic of Germany are focused. The decree n 0 60.824 from July 7 sup(th), 1967 and the following legislation which define the systematic and area of competence in nuclear stations licensing are analysed [pt

76 FR 73521 - Statutory Bar to Appointment of Persons Who Fail To Register Under Selective Service Law

Science.gov (United States)

2011-11-29

... 3206-AM06 Statutory Bar to Appointment of Persons Who Fail To Register Under Selective Service Law... statutory bar on employment in an Executive agency of an individual who was required to register with the... as follows: Subpart G--Statutory Bar to Appointment of Persons Who Fail To Register Under the...

Hardships of end-of-life care with court-appointed guardians.

Science.gov (United States)

Hastings, Kylie B

2014-02-01

In the United States, the court-appointed guardians do not have the ability to make decisions regarding end-of-life (EOL) care for their clients. Additionally, the process of initiating EOL care measures can be slow and cumbersome, despite an existing process of getting approval for such care. This process has the potential to prolong suffering and delay imperative decisions. This article reviews the hardships that patients, court-appointed guardians, and health care staff endure while moving through the oppressive process of obtaining EOL care orders through the court. This article also proposes ways of tuning up the laws, regulations, and communications to make it easier and faster to obtain orders regarding EOL care to preserve the dignity of our patients and loved ones. "A guardianship is a legal relationship created when a person or institution named in a will or assigned by the court to take care of minor children or incompetent adults."

FOSS License Selection and Code Management

OpenAIRE

Vescuso, Peter

2011-01-01

With nearly 2,000 free and open source software (FLOSS) licenses, software license proliferation¿ can be a major headache for software development organizations trying to speed development through software component reuse, as well as companies redistributing software packages as components of their products. Scope is one problem: from the Free Beer license to the GPL family of licenses to platform-specific licenses such as Apache and Eclipse, the number and variety of licenses make it difficu...

Supporting nurses' transition to rural healthcare environments through mentorship.

Science.gov (United States)

Rohatinsky, Noelle K; Jahner, Sharleen

2016-01-01

The global shortage of rural healthcare professionals threatens the access these communities have to adequate healthcare resources. Barriers to recruitment and retention of nurses in rural facilities include limited resources, professional development opportunities, and interpersonal ties to the area. Mentorship programs have been used to successfully recruit and retain rural nurses. This study aimed to explore (i) employee perceptions of mentorship in rural healthcare organizations, (ii) the processes involved in creating mentoring relationships in rural healthcare organizations, and (iii) the organizational features supporting and inhibiting mentorship in rural healthcare organizations. This study was conducted in one rural health region in Saskatchewan, Canada. Volunteer participants who were employed at one rural healthcare facility were interviewed. A semi-structured interview guide that focused on exploring and gaining an understanding of participants' perceptions of mentorship in rural communities was employed. Data were analyzed using interpretive description methodology, which places high value on participants' subjective perspective and knowledge of their experience. All seven participants were female and employed as registered nurses or licensed practical nurses. Participants recognized that the rural environment offered unique challenges and opportunities for the transition of nurses new to rural healthcare. Participants believed mentorships facilitated this transition and were vital to the personal and professional success of new employees. Specifically, their insights indicated that this transition was influenced by three factors: rural community influences, organizational influences, and mentorship program influences. Facilitators for mentorships hinged on the close working relationships that facilitated the development of trust. Barriers to mentorship included low staff numbers, limited selection of volunteer mentors, and lack of mentorship

Learning-by-Licensing: How Chinese Firms Benefit From Licensing-In Technologies

DEFF Research Database (Denmark)

Wang, Yuandi; Roijakkers, N.; Vanhaverbeke, W.

2012-01-01

This paper explores how interfirm variations in their in-licensed technology portfolios influence subsequent innovation performance. Existing studies mainly assume licensed technologies are homogeneously accessible to firms, and a prevailing explanation as to why firms vary in their innovation pe...

Masculinity impediments: Internalized masculinity contributes to healthcare avoidance in men and women.

Science.gov (United States)

Himmelstein, Mary S; Sanchez, Diana T

2016-07-01

Gender beliefs contribute to men's healthcare avoidance, but little research examines these outcomes in women. This article models healthcare avoidance related to masculine contingencies of self-worth in men and women. Nested path modelling tested relationships between social role beliefs, masculine contingencies of self-worth, barriers to help seeking and avoidance of health care in university and non-university-student adult samples. Results indicated social role beliefs predicted masculine contingencies of self-worth in men but not in women. Regardless of gender, masculine contingencies of self-worth predicted barriers to help seeking, which predicted healthcare avoidance in both men and women. Thus, masculine contingencies of self-worth have downstream consequences for men and women through barriers to help seeking. © The Author(s) 2014.

Financial and Transactional Bylaw of Universities and Faculties of Medical Sciences: Opportunities and Threats

Directory of Open Access Journals (Sweden)

Masoud Abolhallaje

2013-12-01

Full Text Available Background and purpose: According to developments related to the relative autonomy of universities and acquired extensive powers by the board of trustees of universities of medical sciences and healthcare services in a twenty-year perspective of country and in the context of the fourth and fifth socio-economic cultural development of country, necessity of developing financial and transactional bylaw of universities of medical sciences has become increasingly clear throughout country. Materials and Methods: Grounded theory is the qualitative methodology used for this study in order to identify the threats and opportunities of new financial tax bylaw of universities and faculties of medical sciences and through the study of documents, surveys of experts and beneficiaries and elites by Delphi method. Results: Releasing potential of public administration in order to control sources and uses, increasing management confidence in documented decision making, establishing organizational concentration on controlling costs, providing conditions of decision-making according to financial reports, independency in firing and hiring manpower by adopting specific provisions and creating independency in method of keeping accounts are among the most important opportunities. While poor organizational structure, lack of knowledge and skills in the existing structure, mental processes caused by reactions and incompatibility of staff, lack of criteria and rules in selection appointment and dismissal of managers and employees, lack of discipline and proper mechanisms in order to pursue the purposes, calculating financial burden and human resources required and finally, passing through traditional thinking and management system are among the most threats. Conclusion: Considering the mentioned threats and opportunities, financial and transactional bylaw of universities and faculties of medical sciences was basically revised and modified in January 2006, and then after

Approaches taken by South African advertisers to select and appoint ...

African Journals Online (AJOL)

Pitch and industry guidelines play an important role in awarding advertising agency contracts, but agencies must take into account that not all advertisers will adhere to these guidelines. The exploratory research study on which this article reports provides insight into the appointment process and selection criteria applied ...

How 'healthy' are healthcare organizations? Exploring employee healthcare utilization rates among Dutch healthcare organizations.

Science.gov (United States)

Bronkhorst, Babette

2017-08-01

Occupational health and safety research rarely makes use of data on employee healthcare utilization to gain insight into the physical and mental health of healthcare staff. This paper aims to fill this gap by examining the prevalence of two relevant types of healthcare utilization among staff working in healthcare organizations: physical therapy and mental healthcare utilization. The paper furthermore explores what role employee and organizational characteristics play in explaining differences in healthcare utilization between organizations. A Dutch healthcare insurance company provided healthcare utilization records for a sample of 417 organizations employing 136,804 healthcare workers in the Netherlands. The results showed that there are large differences between and within healthcare industries when it comes to employee healthcare utilization. Multivariate regression analyses revealed that employee characteristics such as age and gender distributions, and healthcare industry, explain some of the variance between healthcare organizations. Nevertheless, the results of the analyses showed that for all healthcare utilization indicators there is still a large amount of unexplained variance. Further research into the subject of organizational differences in employee healthcare utilization is needed, as finding possibilities to influence employee health and subsequent healthcare utilization is beneficial to employees, employers and society as a whole.

41 CFR 102-3.130 - What policies apply to the appointment, and compensation or reimbursement of advisory committee...

Science.gov (United States)

2010-07-01

... committee staff person who is not a current Federal employee serving under an assignment must be appointed... the appointment, and compensation or reimbursement of advisory committee members, staff, and experts... compensation or reimbursement of advisory committee members, staff, and experts and consultants? In developing...

The attitudes of healthcare professionals towards women using illicit substances in pregnancy: A cross-sectional study.

Science.gov (United States)

Fonti, Siobhan; Davis, Deborah; Ferguson, Sally

2016-08-01

To assess the attitudes of healthcare professionals towards women who use substances in the maternity setting. Illicit drug use in pregnancy leads to poor maternal and neonatal outcomes. Early access to antenatal care has been shown to improve outcomes however women who use substances in pregnancy have statistically low attendance rates to appointments. Fear of stigma from healthcare professionals is a commonly stated reason for not accessing maternity health services or not disclosing substance use to care givers, however little research has been conducted which assesses stigma from a healthcare perspective. A cross-sectional quantitative research design was implemented using a previously validated attitudinal survey tool to assess the attitudes of healthcare practitioners and final year midwifery students. Ethics approval was sought and granted by the relevant institutions. A total of 147 completed questionnaires were returned. Data was analysed using the Statistical Package for the Social Sciences and parametric testing was undertaken. Participants had largely positive or neutral attitudes towards women who use substances in pregnancy. Most participants agreed or strongly agreed that the care they provide to can make a real difference to outcomes. Midwifery students had significantly lower mean attitude scores, showing more positive attitudes, than any other group tested. This research provides useful insight into the attitudes of healthcare professionals. While larger scale research is needed, the positive findings of this study may work towards reducing fear of stigma as a barrier to care for women. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Operator licensing examiner standards

International Nuclear Information System (INIS)

1993-01-01

The Operator Licensing Examiner Standards provide policy and guidance to NRC examiners and establish the procedures and practices for examining licensees and applicants for reactor operator and senior reactor operator licenses at power reactor facilities pursuant to Part 55 of Title 10 of the Code of Federal Regulations (10 CFR 55). The Examiner Standards are intended to assist NRC examiners and facility licensees to better understand the initial and requalification examination processes and to ensure the equitable and consistent administration of examinations to all applicants. These standards are not a substitute for the operator licensing regulations and are subject to revision or other internal operator licensing policy changes

Flexible licensing

Directory of Open Access Journals (Sweden)

Martyn Jansen

2012-07-01

Full Text Available The case is presented for a more flexible approach to licensing online library resources. Today's distributed education environment creates pressure for UK higher and further education institutions (HEI/FEIs to form partnerships and to develop educational products and roll them out across the globe. Online library resources are a key component of distributed education and yet existing licensing agreements struggle to keep pace with the increasing range of users and purposes for which they are required. This article describes the process of developing a flexible approach to licensing and proposes a new model licence for online library resources which has the adaptability needed in this new global educational landscape. These ideas have been presented and discussed at various workshops across Eduserv's and JISC Collections' higher education and publisher communities, and further consultation is ongoing.

31 CFR 370.5 - How can I appoint a financial institution to receive payments on my behalf?

Science.gov (United States)

2010-07-01

... Entries § 370.5 How can I appoint a financial institution to receive payments on my behalf? You must name a financial institution to receive payments through credit entries using the ACH method. You also... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false How can I appoint a financial...

Trends in nuclear licensing

Energy Technology Data Exchange (ETDEWEB)

Dalton, N W [Council for Nuclear Safety, Hennopsmeer, Pretoria (South Africa)

1990-06-01

The development of nuclear safety and licensing is briefly reviewed in four stages namely: The Formative Period (1946-1959), The Expansive Period (1960-1969), The Mature Period (1970-1979) and the Apprehensive Period (1980-1989). Particular safety issues in the respective periods are highlighted to indicate the changing emphasis of nuclear licensing over the past thirty years or so. Against this background, nuclear licensing. (author)

Trends in nuclear licensing

International Nuclear Information System (INIS)

Dalton, N.W.

1990-01-01

The development of nuclear safety and licensing is briefly reviewed in four stages namely: The Formative Period (1946-1959), The Expansive Period (1960-1969), The Mature Period (1970-1979) and the Apprehensive Period (1980-1989). Particular safety issues in the respective periods are highlighted to indicate the changing emphasis of nuclear licensing over the past thirty years or so. Against this background, nuclear licensing. (author)

University museums: problems, policy and progress

Directory of Open Access Journals (Sweden)

Nick Merriman

2001-10-01

Full Text Available There are some 400 university museums and collections in the United Kingdom. During the 1990s their often neglected state came under close scrutiny and as a result their future role is now being re-assessed. A member of the Institute's staff has recently been appointed to the new position of Curator of UCL Museums and Collections, and he comments here on the national situation and describes some of the initiatives under way at UCL.

Healthcare-associated infections in a tunisian university hospital: from analysis to action

Science.gov (United States)

Mahjoub, Mohamed; Bouafia, Nebiha; Bannour, Waadia; Masmoudi, Tasnim; Bouriga, Rym; Hellali, Radhia; Cheikh, Asma Ben; Ezzi, Olfa; Abdeljellil, Amel Ben; Mansour, Njah

2015-01-01

Introduction Our study was conducted, in university hospital center (UHC) Farhat Hached of Sousse (city in Tunisian center-east), within healthcare-associated infections (HAI) epidemiological surveillance (ES) program, based, among others, on HAI regular prevalence surveys. Our objectives are to resituate HAI prevalence rate and to identify their risk factors (RF) in order to adjust, in our hospital, prevention programs. Methods It is a transversal descriptive study, including all patients who had been hospitalized for at least 48 hours, measuring prevalence of HAI a “given day”, with only one passage by service. Risk factors were determined using Epiinfo 6.0, by uni-varied analysis, then, logistic regression stepwise descending for the variables whose p Results The study focused on 312 patients. Infected patients prevalence was 12.5% and that of HAI was 14.5%. Infections on peripheral venous catheter (PVC) dominated (42.2%) among all HAI identified. HAI significant RF were neutropenia (p < 10−4) for intrinsic factors, and PVC for extrinsic factors (p = 0,003). Conclusion Predominance of infections on PVC should be subject of specific prevention actions, including retro-information strategy, prospective ES, professional practices evaluation and finally training and increasing awareness of health personnel with hygiene measures. Finally, development of a patient safety culture with personnel ensures best adherence to hygiene measures and HAI prevention. PMID:26113928

Streamlining the license renewal review process

International Nuclear Information System (INIS)

Dozier, J.; Lee, S.; Kuo, P.T.

2001-01-01

The staff of the NRC has been developing three regulatory guidance documents for license renewal: the Generic Aging Lessons Learned (GALL) report, Standard Review Plan for License Renewal (SRP-LR), and Regulatory Guide (RG) for Standard Format and Content for Applications to Renew Nuclear Power Plant Operating Licenses. These documents are designed to streamline the license renewal review process by providing clear guidance for license renewal applicants and the NRC staff in preparing and reviewing license renewal applications. The GALL report systematically catalogs aging effects on structures and components; identifies the relevant existing plant programs; and evaluates the existing programs against the attributes considered necessary for an aging management program to be acceptable for license renewal. The GALL report also provides guidance for the augmentation of existing plant programs for license renewal. The revised SRP-LR allows an applicant to reference the GALL report to preclude further NRC staff evaluation if the plant's existing programs meet the criteria described in the GALL report. During the review process, the NRC staff will focus primarily on existing programs that should be augmented or new programs developed specifically for license renewal. The Regulatory Guide is expected to endorse the Nuclear Energy Institute (NEI) guideline, NEI 95-10, Revision 2, entitled 'Industry Guideline for Implementing the Requirements of 10 CFR Part 54 - The License Renewal Rule', which provides guidance for preparing a license renewal application. This paper will provide an introduction to the GALL report, SRP-LR, Regulatory Guide, and NEI 95-10 to show how these documents are interrelated and how they will be used to streamline the license renewal review process. This topic will be of interest to domestic power utilities considering license renewal and international ICONE participants seeking state-of-the-art information about license renewal in the United States

The Monticello license renewal project

International Nuclear Information System (INIS)

Clauss, J.M.; Harrison, D.L.; Pickens, T.A.

1993-01-01

Today, 111 nuclear power plants provide over 20 percent of the electrical energy generated in the United States. The operating license of the oldest operating plant will expire in 2003, one-third of the existing operating licenses will expire by 2010 and the newest plant's operating license will expire in 2033. The National Energy Strategy (NES) prepared by the Department of Energy (DOE) assumes that 70 percent of the current operating plants will continue to operate beyond their current license expiration. Power from current operating plants can assist in ensuring an adequate, diverse, and environmentally acceptable energy supply for economic growth and improved U.S. competitiveness. In order to preserve this energy resource, three major tasks must be successfully completed: (1) establishment of regulations, technical standards, and procedures for the preparation and review of License Renewal Applications (LRAs); (2) development of technical criteria and bases for monitoring, refurbishing or replacing plant equipment; and (3) demonstration of the regulatory process by a plant obtaining a renewed license. Since 1986, the DOE has been working with the nuclear industry and the Nuclear Regulatory Commission (NRC) to establish and demonstrate the option to extend the life of a nuclear power plant by renewing the operating license. The Monticello Lead Plant demonstration project was initiated in September 1988, following the Pilot Plant studies. This paper is primarily focused on the status and insights gained from the Northern States Power Company (NSP) Monticello Lead Plant demonstration project. The following information is included: (1) Current Status - Monticello License Renewal Application; (2) Economic Analysis; (3) License Renewal Regulatory Uncertainty Issues; (4) Key Decisions; (5) Management Structure; (6) Technical and Licensing Perspective; (7) NRC Interactions; (8) Summary

26 CFR 25.2523(e)-1 - Marital deduction; life estate with power of appointment in donee spouse.

Science.gov (United States)

2010-04-01

... satisfied and S is treated as having a general power to appoint 100/250 of the entire interest in the 250... 26 Internal Revenue 14 2010-04-01 2010-04-01 false Marital deduction; life estate with power of... Deductions § 25.2523(e)-1 Marital deduction; life estate with power of appointment in donee spouse. (a) In...

Medication supply, healthcare outcomes and healthcare expenses: longitudinal analyses of patients with type 2 diabetes and hypertension.

Science.gov (United States)

Chen, Chi-Chen; Blank, Robert H; Cheng, Shou-Hsia

2014-09-01

Patients with chronic conditions largely depend on proper medications to maintain health. This study aims to examine, for patients with diabetes and hypertension, whether the appropriateness of the quantity of drug obtained is associated with favorable healthcare outcomes and lower expenses. This study utilized a longitudinal design with a seven-year follow-up period from 2002 to 2009 under a universal health insurance program in Taiwan. The patients under study were those aged 18 years or older and newly diagnosed with type 2 diabetes or hypertension in 2002. Generalized estimating equations were performed to examine the relationship between medication supply and health outcomes as well as expenses. The results indicate that while compared with patients with an appropriate medication supply, patients with either an undersupply or an oversupply of medications tended to have poorer healthcare outcomes. The study also found that an excess supply of medications for patients with diabetes or hypertension resulted in higher total healthcare expenses. Either an undersupply or an oversupply of medication was associated with unfavorable healthcare outcomes, and that medication oversupply was associated with the increased consumption of health resources. Our findings suggest that improving appropriate medication supply is beneficial for the healthcare system. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Measuring and improving quality in university hospitals in Canada: The Collaborative for Excellence in Healthcare Quality.

Science.gov (United States)

Backman, Chantal; Vanderloo, Saskia; Forster, Alan John

2016-09-01

Measuring and monitoring overall health system performance is complex and challenging but is crucial to improving quality of care. Today's health care organizations are increasingly being held accountable to develop and implement actions aimed at improving the quality of care, reducing costs, and achieving better patient-centered care. This paper describes the development of the Collaborative for Excellence in Healthcare Quality (CEHQ), a 5-year initiative to achieve higher quality of patient care in university hospitals across Canada. This bottom-up initiative took place between 2010 and 2015, and was successful in engaging health care leaders in the development of a common framework and set of performance measures for reporting and benchmarking, as well as working on initiatives to improve performance. Despite its successes, future efforts are needed to provide clear national leadership on standards for measuring performance. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Servant as leader: Critical requirements for the appointment and training of retirement fund trustees

Directory of Open Access Journals (Sweden)

L.M. Magda Hewitt

2017-09-01

Full Text Available Orientation: The South African retirement fund industry ranks among the 15 largest retirement fund industries internationally, with some 8 million members and assets under management of close to R2 trillion. However, to be successful, retirement funds need good governance. Research purpose: To explore the most critical servant leadership qualities required that can serve as profile in the selection, appointment and training of retirement fund trustees (RFTs to serve on boards of trustees of retirement funds in the South African context. Motivation for the study: The South African National Treasury’s retirement reform proposal clearly articulates government’s concern for the poor governance of retirement fund assets by appointed boards of trustees and the broader implications on social and economic security in retirement. It promotes the regulation of standards relating to the minimum qualifications and expertise needed to be appointed to serve on a board of trustees (BoTs. Although the measures proposed by government to improve fund governance and the role of the RFTs are sound in principle, it does not inform the character, leadership qualities or leadership competence desired for RFTs, thus leaving the management of funds in the hands of people who must make investment decisions when they themselves are not fully committed. Research design, approach and method: The research question was addressed through an extensive literature review and a qualitative methodology using a semi-structured interview; fieldwork that included personal observations; and notes with six active, high-profile, respected, purposefully selected RFTs. An interpretive approach was adopted to provide elaborative interpretations of phenomena without having to rely on numerical measurement. Main findings: A strong similitude exists between servant leader qualities, as found in the literature, and those qualities identified and required to be appointed as a RFT. Literature

Cogeneration : A Regulatory Guide to Leasing, Permitting, and Licensing in Idaho, Montana, Oregon, and Washington.

Energy Technology Data Exchange (ETDEWEB)

Deshaye, Joyce; Bloomquist, R. Gordon

1992-12-01

This guidebook focuses on cogeneration development. It is one of a series of four guidebooks recently prepared to introduce the energy developer to the federal, state and local agencies that regulate energy facilities in Idaho, Montana, Oregon, and Washington (the Bonneville Power Administration Service Territory). It was prepared specifically to help cogeneration developers obtain the permits, licenses and approvals necessary to construct and operate a cogeneration facility. The regulations, agencies and policies described herein are subject to change. Changes are likely to occur whenever energy or a project becomes a political issue, a state legislature meets, a preexisting popular or valuable land use is thought threatened, elected and appointed officials change, and new directions are imposed on states and local governments by the federal government. Accordingly, cogeneration developers should verify and continuously monitor the status of laws and rules that might affect their plans. Developers are cautioned that the regulations described herein may only be a starting point on the road to obtaining all the necessary permits.

The effectiveness of SMS Reminders and the impact of patient characteristics on missed appointments in a public dental outpatient clinic

OpenAIRE

Emilia Bellucci; Lasitha Dharmasena; Lemai Nguyen; Hanny Calache

2017-01-01

This paper reports on the Failure To Attend (FTA) rate of appointments as well as patients following the implementation of SMS reminders in a public dental outpatient service.  Given the ineffectiveness of the intervention and a highly representative patient’s profile, this paper identifies the demographic characteristics of patients who miss all of their appointments.  Data on appointment attendance, patient demographics and dental service type was collected over a time period of 46 consecut...

Integration of healthcare rehabilitation in chronic conditions

Directory of Open Access Journals (Sweden)

Anne Frølich

2010-02-01

Full Text Available Introduction: Quality of care provided to people with chronic conditions does not often fulfil standards of care in Denmark and in other countries. Inadequate organisation of healthcare systems has been identified as one of the most important causes for observed performance inadequacies, and providing integrated healthcare has been identified as an important organisational challenge for healthcare systems. Three entities—Bispebjerg University Hospital, the City of Copenhagen, and the GPs in Copenhagen—collaborated on a quality improvement project focusing on integration and implementation of rehabilitation programmes in four conditions. Description of care practice: Four multidisciplinary rehabilitation intervention programmes, one for each chronic condition: chronic obstructive pulmonary disease, type 2 diabetes, chronic heart failure, and falls in elderly people were developed and implemented during the project period. The chronic care model was used as a framework for support of implementing and integration of the four rehabilitation programmes. Conclusion and discussion: The chronic care model provided support for implementing rehabilitation programmes for four chronic conditions in Bispebjerg University Hospital, the City of Copenhagen, and GPs' offices. New management practices were developed, known practices were improved to support integration, and known practices were used for implementation purposes. Several barriers to integrated care were identified.

New Provider Models for Sweden and Spain: Public, Private or Non-profit? Comment on "Governance, Government, and the Search for New Provider Models".

Science.gov (United States)

Jeurissen, Patrick P T; Maarse, Hans

2016-06-29

Sweden and Spain experiment with different provider models to reform healthcare provision. Both models have in common that they extend the role of the for-profit sector in healthcare. As the analysis of Saltman and Duran demonstrates, privatisation is an ambiguous and contested strategy that is used for quite different purposes. In our comment, we emphasize that their analysis leaves questions open on the consequences of privatisation for the performance of healthcare and the role of the public sector in healthcare provision. Furthermore, we briefly address the absence of the option of healthcare provision by not-for-profit providers in the privatisation strategy of Sweden and Spain. © 2016 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

[Ophthalmological service quality offered to outpatients of the Public Healthcare System].

Science.gov (United States)

Santos Hercos, Benigno Vicente; Berezovsky, Adriana

2006-01-01

To identify the perception of the ophthalmic service quality provided for outpatients of the public healthcare system as well as to detect which actions should be considered necessary and priority in order to improve its quality. A quantitative descriptive study was carried out on 100 outpatients of the public healthcare system which were submitted to ophthalmic tests at Fundação Hilton Rocha--Belo Horizonte-MG, from July 1st-July 30th 2004. Individual interviews were carried out by giving the interviewees two structured questionnaires adapted from the modified SERVQUAL. This scale is in agreement with the reality of the studied institute. The adapted SERVQUAL scale was submitted to statistical validation and it showed a suitable internal consistency index. In general terms, a slight general dissatisfaction was detected regarding ophthalmological service quality. The interviewees cared more about safety and reliability. A higher degree of dissatisfaction was detected mainly concerning fulfillment of procedures at scheduled appointments related to the execution of services within due time-limits. The institute is supposed to plan as well as carry out actions which lead to a general improvement in the patient's satisfaction regarding service quality and mainly reliability. Service quality monitoring through periodic use of the SERVQUAL scale will not only make it possible to plan highly precise and effective intervention strategies in these and in other healthcare services but it will also allow monitoring the responses to these actions. All these actions will contribute to the improvement of the service in the system as a whole.

Office of Energy Research collaborative research programs administered by Oak Ridge Associated Universities: Annual report, FY 1987

International Nuclear Information System (INIS)

1988-02-01

The US Department of Energy's (DOE) Office of Energy Research (OER) sponsors programs designed to encourage and support interaction between US colleges and universities and DOE research facilities. Faculty members, graduate students, undergraduates, and recent postgraduates participate in research and receive advanced training at DOE laboratories. Staff members from DOE laboratories visit campuses to deliver energy-related lectures and participate in seminars and classroom discussions. Oak Ridge Associated Universities (ORAU) has been involved in the developemnt and administration of these collaborative research programs since their inception. During FY 1987, ORAU administered appointments for the Office of Energy Research under the following two umbrella programs: University/DOE Laboratory Cooperative Program (Lab Co-op); Science and Engineering Research Semester (SERS). In addition, ORAU participated in a project to collect and assess information from individuals who had held research appointment as undergraduate students during a four-year period from 1979 to 1982. All of these activities are summarized in this report

Tuberculosis among Healthcare Workers at Chiang Mai University Hospital, Thailand: Clinical and Microbiological Characteristics and Treatment Outcomes.

Science.gov (United States)

Inchai, Juthamas; Liwsrisakun, Chalerm; Bumroongkit, Chaiwat; Euathrongchit, Juntima; Tajarernmuang, Pattraporn; Pothirat, Chaicharn

2018-05-24

Tuberculosis (TB) among healthcare workers (HCWs) highly affects morbidity and TB transmission in hospitals. A retrospective cohort study of TB among HCWs (HCW-TB) was conducted using a registered database from 2003 to 2016 at Chiang Mai University Hospital to determine clinical and microbiological characteristics and treatment outcomes of HCW-TB. A total of 76 patients comprising 54 nurses (71.1%), 12 physicians (15.8%), and 10 paramedics (13.2%) were diagnosed with TB disease. The men to women ratio was 25:51, with a mean age of 37.0±11.6 years, a median work duration of 12.0 years (5-20) and a body mass index of 19.4±2.5 kg/m 2 . Within the HCW-TB group, 28 (36.8%) worked in the Medical Department, 12 (15.8%) worked in the Outpatient Department/Emergency Room, and 9 (11.8%) worked in the Surgical Department. Pulmonary TB (PTB) was the most common manifestation of HCW-TB (92.1%). Sputum acid-fast stains were positive among 28 (40.0%) HCWs with PTB. Mycobacterium tuberculosis cultures were positive in 26 (34.2%) patients. Drug susceptibility testing showed sensitivity to all first-line drugs (75.0%), resistance to any one first-line drug (20.8%), and multidrug-resistant TB comprised 4.2%. The end-of-treatment success rate was 100%. Therefore, TB control guidelines should be strictly implemented to prevent TB transmission in healthcare settings.

Gender Inequality in University Administration and Services

OpenAIRE

Estelles Miguel, Sofia; NAVARRO GARCÍA, ANTONIO; Palmer Gato, Marta Elena; Albarracín Guillem, José Miguel

2014-01-01

This work is licensed under a Creative Commons Attribution 3.0 License. This article addresses inequalities between men and women at work. Inequalities in job access and career progression are addressed. The article reviews literature on equal opportunities at work. A case study of administrative and services staff at a public university in Valencia (Spain) is then presented. The case study assesses the current reality of gender inequality in Spanish public institutions. Spanish public uni...

University Technology Transfer: In Tough Economic Times

Science.gov (United States)

Powers, Joshua B.; Campbell, Eric G.

2009-01-01

In 1907, Frederick Cottrell, professor of chemistry at the University of California-Berkeley and father of the modern academic patent, worried that if universities became too directly involved in patenting and licensing operations, their thirst for profits could lead to the erosion of the openness necessary for academic science to flourish. For…

NUMARC view of license renewal criteria

International Nuclear Information System (INIS)

Edwards, D.W.

1989-01-01

The Atomic Energy Act and the implementing regulations of the US Nuclear Regulatory Commission (NRC) permit the renewal of nuclear plant operating licenses upon expiration of their 40-year license term. However, the regulatory process by which license renewal may be accomplished and the requirements for the scope and content of renewal applications are yet to be established. On August 29, 1988, the NRC published an Advanced Notice of Proposed Rulemaking regarding the subject of license renewal. This Advanced Notice and the NUREG which it references, NUREG-1317, Regulatory Options for Nuclear Plant License Renewal, provide the most recent regulatory thought on this issue. The basic issue addressed by NUREG-1317 is the definition of an adequate licensing basis for the renewal of a plant license. The report contemplates three alternatives in this regard. This paper discusses each of these three proposals. The NUMARC NUPLEX Working Group endorses a license renewal process based on a plant's current licensing basis along with an evaluation of the pertinent components, systems, and structures affected by age-related degradation. The NUMARC NUPLEX Working group believes that an appropriate scope for NRC review of the license renewal application should focus on those safety-significant structures systems, and components subject to significant age-related degradation that are not subject to existing recognized effective replacement, refurbishment, or inspection programs. The paper also briefly discusses NUMARC's view of the role of the Backfit Rule in the license renewal process

Perceptions of music therapy for older people among healthcare professionals.

Science.gov (United States)

Khan, Waqas Ullah; Mohamad Onn Yap, Irin Arina; O'Neill, Desmond; Moss, Hilary

2016-03-01

To investigate the perceptions of healthcare providers on music therapy and their recommendations on wider adoption in a hospital setting. A qualitative exploratory study employing short semistructured interviews using a thematic analysis method of data analysis. A qualitative exploratory study, employing short semistructured interviews was conducted in March 2015 in an urban teaching hospital to explore healthcare providers' attitudes towards and recommendations on music therapy. Convenience sampling was used for recruitment of hospital staff from a multidisciplinary geriatric unit. Only staff who had exposure, awareness, or participated in the hospital music therapy programme were asked to partake in an in-depth qualitative interview. Themes emerging reflected a belief among hospital staff that music therapy was of benefit to patients and staff; perceptions of how a hospital music therapy programme should be implemented and a desire for expansion of the music therapy programme throughout the hospital setting. Music therapy is of great importance to patients and healthcare professionals, and thus more attention is warranted to better integrate and advance this programme. This study is important because although numerous studies have examined music therapy from a patient health perspective, no report has analysed the perceptions of healthcare providers on this intervention and their recommendations on further development of music therapy services. 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/

Return Migrants’ Experience of Access to Care in Corrupt Healthcare Systems

DEFF Research Database (Denmark)

Handlos, Line Neerup; Olwig, Karen Fog; Bygbjerg, Ib Christian

2016-01-01

unstudied, even though return migrants may be particularly vulnerable to problems related to corruption due to their period of absence from their country of origin. This article investigates how corruption in the healthcare sector affects access to healthcare for refugees who repatriated to Bosnia......Equal and universal access to healthcare services is a core priority for a just health system. A key societal determinant seen to create inequality in access to healthcare is corruption in the healthcare system. How return migrants’ access to healthcare is affected by corruption is largely......, a country with a high level of corruption, from Denmark, a country with a low level of corruption. The study is based on 18 semi-structured interviews with 33 refugees who returned after long-term residence in Denmark. We found that the returned refugees faced greater problems with corruption than...

Graduated driver licensing and differential deterrence: The effect of license type on intentions to violate road rules.

Science.gov (United States)

Poirier, Brigitte; Blais, Etienne; Faubert, Camille

2018-01-01

In keeping with the differential deterrence theory, this article assesses the moderating effect of license type on the relationship between social control and intention to violate road rules. More precisely, the article has two objectives: (1) to assess the effect of license type on intentions to infringe road rules; and (2) to pinpoint mechanisms of social control affecting intentions to violate road rules based on one's type of driver license (a restricted license or a full license). This effect is examined among a sample of 392 young drivers in the province of Quebec, Canada. Drivers taking part in the Graduated Driver Licensing (GDL) program have limited demerit points and there is zero tolerance for drinking-and-driving. Propensity score matching techniques were used to assess the effect of the license type on intentions to violate road rules and on various mechanisms of social control. Regression analyses were then conducted to estimate the moderating effect of license type. Average treatment effects from propensity score matching analyses indicate that respondents with a restricted license have lower levels of intention to infringe road rules. While moral commitment and, to a lesser extent, the perceived risk of arrest are both negatively associated with intentions to violate road rules, the license type moderates the relationship between delinquent peers and intentions to violate road rules. The effect of delinquent peers is reduced among respondents with a restricted driver license. Finally, a diminished capability to resist peer pressure could explain the increased crash risk in months following full licensing. Copyright © 2017 Elsevier Ltd. All rights reserved.

Economic analysis of an epilepsy outreach model of care in a university hospital setting.

Science.gov (United States)

Maloney, Eimer; McGinty, Ronan N; Costello, Daniel J

2017-07-01

The prevalence of epilepsy in people with intellectual disability is higher than in the general population and prevalence rates increase with increasing levels of disability. Prevalence rates of epilepsy are highest among those living in residential care. The healthcare needs of people with intellectual disability and epilepsy are complex and deserve special consideration in terms of healthcare provision and access to specialist epilepsy clinics, which are usually held in acute hospital campuses. This patient population is at risk of suboptimal care because of significant difficulties accessing specialist epilepsy care which is typically delivered in the environs of acute hospitals. In 2014, the epilepsy service at Cork University Hospital established an Epilepsy Outreach Service providing regular, ambulatory outpatient follow up at residential care facilities in Cork city and county in an effort to improve access to care, reduce the burden and expense of patient and carer travel to hospital outpatient appointments, and to provide a dedicated specialist phone service for epilepsy related queries in order to reduce emergency room visits when possible. We present the findings of an economic analysis of the outreach service model of care compared to the traditional hospital outpatient service and demonstrate significant cost savings and improved access to care with this model. Ideally these cost savings should be used to develop novel ways to enhance epilepsy care for persons with disability. We propose that this model of care can be more suitable for persons with disability living in residential care who are at risk of losing access to specialist epilepsy care. Copyright © 2017 Elsevier Inc. All rights reserved.

Morality and Values in Support of Universal Healthcare Must be Enshrined in Law; Comment on “Morality and Markets in the NHS”

Directory of Open Access Journals (Sweden)

Allyson M Pollock

2015-06-01

Full Text Available This is a commentary on Gilbert and colleagues’ (1 paper on morality and markets in the National Health Service (NHS. Morality and values are not ephemeral qualities and universal healthcare is not simply an aspiration; it has to be enshrined in law. The creation of the UK NHS in 1948 was underpinned by core legal duties which required a system of public funding and delivery to follow. The moral values of the citizens in support of social solidarity were thus transformed into a political and legal contract for citizens. The NHS still survives in Scotland, Wales and Northern Ireland but the coalition government abolished it in England in 2012, reducing the NHS to a funding stream, a logo and a set of market regulators. This paper describes and explains the Health and Social Care (HSC Act 2012 in England and how the NHS is withering away and health services are being remodeled along US Health Maintenance Organization (HMO lines. There was nothing moral about this extraordinary act of savagery and violence against the public in England, and against common values and widely held beliefs in public ownership funding and provision of universal healthcare. The public health consequences will be catastrophic which is why after the election on May seventh a new Bill is required to Reinstate the NHS and the Secretary of State’s legal duty to provide listed health services throughout England.

Healthcare reforms in Cyprus 2013-2017: Does the crisis mark the end of the healthcare sector as we know it?

Science.gov (United States)

Petrou, Panagiotis; Vandoros, Sotiris

2018-02-01

As part of a bailout agreement with the International Monetary Fund, the European Commission and the European Central Bank (known as the Troika), Cyprus had to achieve a fiscal surplus through budget constraints and efficiency enhancement. As a result, a number of policy changes were implemented, including a reform of the healthcare sector, and major healthcare reforms are planned for the upcoming years, mainly via the introduction of a National Health System. This paper presents the healthcare sector, provides an overview of recent reforms, assesses the recently implemented policies and proposes further interventions. Recent reforms targeting the demand and supply side included the introduction of clinical guidelines, user charges, introduction of coding for Diagnosis Related Groups (DRGs) and the revision of public healthcare coverage criteria. The latter led to a reduction in the number of people with public healthcare coverage in a time of financial crises, when this is needed the most, while co-payments must be reassessed to avoid creating barriers to access. However, DRGs and clinical guidelines can help improve performance and efficiency. The changes so far are yet to mark the end of the healthcare sector as we know it. A universal public healthcare system must remain a priority and must be introduced swiftly to address important existing coverage gaps. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

Establishing a safety and licensing basis for generation IV advanced reactors. License by test

International Nuclear Information System (INIS)

Kadak, Andrew C.

2001-01-01

The license by test approach to licensing is a novel method of licensing reactors. It provides an opportunity to deal with innovative non-water reactors in a direct way on a time scale that could permit early certification based on tests of a demonstration reactor. The uncertainties in the design and significant contributors to risk would be identified in the PRA during the design. Deterministic analysis computer codes could be tested on a real reactor. Scaling effects and associated uncertainties would be minimized. License by test is an approach that has sufficient merit to be developed and tested

22 CFR 96.30 - State licensing.

Science.gov (United States)

2010-04-01

... Licensing and Corporate Governance § 96.30 State licensing. (a) The agency or person is properly licensed or... person follows applicable State licensing and regulatory requirements in all jurisdictions in which it provides adoption services. (c) If it provides adoption services in a State in which it is not itself...

Operating reactors licensing actions summary

International Nuclear Information System (INIS)

1982-07-01

The operating reactors licensing actions summary is designed to provide the management of the Nuclear Regulatory Commission (NRC) with an overview of licensing actions dealing with operating power and nonpower reactors. These reports utilize data collected from the Division of Licensing in the Office of Nuclear Reactor Regulation and are prepared by the Office of Management and Program Analysis. This summary report is published primarily for internal NRC use in managing the operating reactors licensing actions program. Its content will change based on NRC management informational requirements

Operating reactors licensing actions summary

International Nuclear Information System (INIS)

1982-05-01

The operating reactors licensing actions summary is designed to provide the management of the Nuclear Regulatory Commission (NRC) with an overview of licensing actions dealing with operating power and nonpower reactors. These reports utilize data collected from the Division of Licensing in the Office of Nuclear Reactor Regulation and are prepared by the Office of Management and Program Analysis. This summary report is published primarily for internal NRC use in managing the operating reactors licensing actions program. Its content will change based on NRC management informational requirements

Operating reactors licensing actions summary

International Nuclear Information System (INIS)

1983-01-01

The operating reactors licensing actions summary is designed to provide the management of the Nuclear Regulatory Commission (NRC) with an overview of licensing actions dealing with operating power and nonpower reactors. These reports utilize data collected from the Division of Licensing in the Office of Nuclear Reactor Regulation and are prepared by the Office of Management and Program Analysis. This summary report is published primarily for internal NRC use in managing the operating reactors licensing actions program. Its content will change based on NRC management informational requirements

Operating reactors licensing actions summary

International Nuclear Information System (INIS)

1983-03-01

The operating reactors licensing actions summary is designed to provide the management of the Nuclear Regulatory Commission (NRC) with an overview of licensing actions dealing with operating power and nonpower reactors. These reports utilize data collected from the Division of Licensing in the Office of Nuclear Reactor Regulation and are prepared by the Office of Management and Program Analysis. This summary report is published primarily for internal NRC use in managing the operating reactors licensing actions program. Its content will change based on NRC management informational requirements

Operating reactors licensing actions summary

International Nuclear Information System (INIS)

1982-11-01

The operating reactors licensing actions summary is designed to provide the management of the Nuclear Regulatory Commission (NRC) with an overview of licensing actions dealing with operating power and nonpower reactors. These reports utilize data collected from the Division of Licensing in the Office of Nuclear Reactor Regulation and are prepared by the Office of Management and Program Analysis. This summary report is published primarily for internal NRC use in managing the operating reactors licensing actions program. Its content will change based on NRC management informational requirements

Operating reactors licensing actions summary

International Nuclear Information System (INIS)

1982-10-01

The operating reactors licensing actions summary is designed to provide the management of the Nuclear Regulatory Commission (NRC) with an overview of licensing actions dealing with operating power and nonpower reactors. These reports utilize data collected from the Division of Licensing in the Office of Nuclear Reactor Regulation and are prepared by the Office of Management and Program Analysis. This summary report is published primarily for internal NRC use in managing the operating reactors licensing actions program. Its content will change based on NRC management informational requirements

Operating reactors licensing actions summary

International Nuclear Information System (INIS)

1982-08-01

The operating reactors licensing actions summary is designed to provide the management of the Nuclear Regulatory Commission (NRC) with an overview of licensing actions dealing with operating power and nonpower reactors. These reports utilize data collected from the Division of Licensing in the Office of Nuclear Reactor Regulation and are prepared by the Office of Management and Program Analysis. This summary report is published primarily for internal NRC use in managing the operating reactors licensing actions program. Its content will change based on NRC management informational requirements

Operating reactors licensing actions summary

International Nuclear Information System (INIS)

1982-09-01

The operating reactors licensing actions summary is designed to provide the management of the Nuclear Regulatory Commission (NRC) with an overview of licensing actions dealing with operating power and nonpower reactors. These reports utilize data collected from the Division of Licensing in the Office of Nuclear Reactor Regulation and are prepared by the Office of Management and Program Analysis. This summary report is published primarily for internal NRC use in managing the operating reactors licensing actions program. Its content will change based on NRC management informational requirements

Supreme Court Appointment Process: Roles of the President, Judiciary Committee, and Senate

National Research Council Canada - National Science Library

Rutkus, Denis S

2007-01-01

.... Under the Constitution, Justices on the Supreme Court receive lifetime appointments. Such job security in the government has been conferred solely on judges and, by constitutional design, helps insure the Court's independence from the President...

6 CFR 37.17 - Requirements for the surface of the driver's license or identification card.

Science.gov (United States)

2010-01-01

... Driver's license or identification card number. This cannot be the individual's SSN, and must be unique... University Street, Montreal, Quebec, Canada H3C 5H7, e-mail: [email protected] You may inspect a copy of the...

Operator licensing examiner standards

International Nuclear Information System (INIS)

1994-06-01

The Operator Licensing Examiner Standards provide policy and guidance to NRC examiners and establish the procedures and practices for examining licensees and applicants for reactor operator and senior reactor operator licenses at power reactor facilities pursuant to Part 55 of Title 10 of the Code of Federal Regulations (10 CFR 55). The Examiner Standards are intended to assist NRC examiners and facility licensees to better understand the initial and requalification examination processes and to ensure the equitable and consistent administration of examinations to all applicants. These standards are not a substitute for the operator licensing regulations and are subject to revision or other internal operator licensing policy changes. Revision 7 was published in January 1993 and became effective in August 1993. Supplement 1 is being issued primarily to implement administrative changes to the requalification examination program resulting from the amendment to 10 CFR 55 that eliminated the requirement for every licensed operator to pass an NRC-conducted requalification examination as a condition for license renewal. The supplement does not substantially alter either the initial or requalification examination processes and will become effective 30 days after its publication is noticed in the Federal Register. The corporate notification letters issued after the effective date will provide facility licensees with at least 90 days notice that the examinations will be administered in accordance with the revised procedures

University Technology Transfer Information Processing from the Attention Based View

Science.gov (United States)

Hamilton, Clovia

2015-01-01

Between 2005 and 2011, there was no substantial growth in licenses executed by university technology transfer offices. Since the passage of the Bayh Dole Act of 1980, universities have owned technological inventions afforded by federal research funding. There are still university technology transfer offices that struggle with increasing their…

75 FR 9747 - Promoting Excellence, Innovation, and Sustainability at Historically Black Colleges and Universities

Science.gov (United States)

2010-03-03

... Part V The President Executive Order 13532--Promoting Excellence, Innovation, and Sustainability..., Innovation, and Sustainability at Historically Black Colleges and Universities By the authority vested in me... the Secretary shall appoint a senior official to report directly to the department or agency head with...

Licensing in an International Market

Science.gov (United States)

Ferreira, Fernanda A.

2008-09-01

We study the effects of entry of a foreign firm on domestic welfare in the presence of licensing, when the entrant is technologically superior to the incumbent. We show that foreign entry increases domestic welfare for sufficiently large technological differences between the firms under both fixed-fee licensing and royalty licensing.

22 CFR 120.20 - License.

Science.gov (United States)

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false License. 120.20 Section 120.20 Foreign Relations DEPARTMENT OF STATE INTERNATIONAL TRAFFIC IN ARMS REGULATIONS PURPOSE AND DEFINITIONS § 120.20 License. License means a document bearing the word “license” issued by the Directorate of Defense Trade...

Lean healthcare from a change management perspective.

Science.gov (United States)

van Rossum, Lisa; Aij, Kjeld Harald; Simons, Frederique Elisabeth; van der Eng, Niels; Ten Have, Wouter Dirk

2016-05-16

Purpose - Lean healthcare is used in a growing number of hospitals to increase efficiency and quality of care. However, healthcare organizations encounter problems with the implementation of change initiatives due to an implementation gap: the gap between strategy and execution. From a change management perspective, the purpose of this paper is to increase scientific knowledge regarding factors that diminish the implementation gap and make the transition from the "toolbox lean" toward an actual transformation to lean healthcare. Design/methodology/approach - A cross-sectional study was executed in an operating theatre of a Dutch University Medical Centre. Transformational leadership was expected to ensure the required top-down commitment, whereas team leadership creates the required active, bottom-up behavior of employees. Furthermore, professional and functional silos and a hierarchical structure were expected to impede the workforce flexibility in adapting organizational elements and optimize the entire process flow. Findings - The correlation and regression analyses showed positive relations between the transformational leadership and team leadership styles and lean healthcare implementation. The results also indicated a strong relation between workforce flexibility and the implementation of lean healthcare. Originality/value - With the use of a recently developed change management model, the Change Competence Model, the authors suggest leadership and workforce flexibility to be part of an organization's change capacity as crucial success factor for a sustainable transformation to lean healthcare.

48 CFR 227.7203-4 - License rights.

Science.gov (United States)

2010-10-01

... Software and Computer Software Documentation 227.7203-4 License rights. (a) Grant of license. The... license, under an irrevocable license granted or obtained by the contractor which developed the software... granted to the Government. The scope of a computer software license is generally determined by the source...

Current status of construction license of PEFP

International Nuclear Information System (INIS)

Kim, J. Y.; Cho, J. S.; Min, Y. S.; Nam, J. M.; Jeon, G. P.; Park, S. S.; Jo, J. H.; Song, I. T.

2012-01-01

Since 2010 August, PEFP(Proton Engineering Frontier Project)'s Proton Accelerator Research Center has been under construction so far. Generally, in advance of construction startup, many kinds of licenses should be acquired along with the types of construction works. To acquire a license in time, each item should meet the standard by the related regulation, including not only procedural but also content aspect. In the advent of internet era, electronic government system has been adopted in many governmental functions: So is the national construction license acquisition system. Owing to the system, both approval and documentation functions in licensing are integrated in online computer network which provide us simplification in process and easy accessibility to license data. However, aside from these construction licenses, other types of licenses still remain separately managed: Machinery, electric facilities, and so on. Moreover, all the licenses have the priority order and take legal term in processing. So, to avoid any time delay in license acquisition, we organized license hierarchy and found out the priority among them. Thereafter, according to their legal term in approval and acquisition, whole license acquisition schedule was arranged and we completed all the necessary licenses acquisition in time In this study, we summarize the current status of license acquisition on Proton Accelerator Research Center Construction, and manifest how they have been and will be managed systematically

Current status of construction license of PEFP

Energy Technology Data Exchange (ETDEWEB)

Kim, J. Y.; Cho, J. S.; Min, Y. S.; Nam, J. M.; Jeon, G. P.; Park, S. S.; Jo, J. H.; Song, I. T. [KAERI, Daejeon (Korea, Republic of)

2012-10-15

Since 2010 August, PEFP(Proton Engineering Frontier Project)'s Proton Accelerator Research Center has been under construction so far. Generally, in advance of construction startup, many kinds of licenses should be acquired along with the types of construction works. To acquire a license in time, each item should meet the standard by the related regulation, including not only procedural but also content aspect. In the advent of internet era, electronic government system has been adopted in many governmental functions: So is the national construction license acquisition system. Owing to the system, both approval and documentation functions in licensing are integrated in online computer network which provide us simplification in process and easy accessibility to license data. However, aside from these construction licenses, other types of licenses still remain separately managed: Machinery, electric facilities, and so on. Moreover, all the licenses have the priority order and take legal term in processing. So, to avoid any time delay in license acquisition, we organized license hierarchy and found out the priority among them. Thereafter, according to their legal term in approval and acquisition, whole license acquisition schedule was arranged and we completed all the necessary licenses acquisition in time In this study, we summarize the current status of license acquisition on Proton Accelerator Research Center Construction, and manifest how they have been and will be managed systematically.

Technology Licensing and Firm Innovation

DEFF Research Database (Denmark)

Moreira, Solon

acquisition. The findings indicate that technology licensing is positively related to the number of inventions produced by the licensee in the years subsequent to the licensing deal. Subsequently, I investigate the moderating effect that organizational slack and myopia have on this main relationship....... The findings also suggest that high levels of Organizational Slack (available financial resources) strengthen the positive effect of licensing on innovation. However, higher levels of Organizational Myopia (the extent to which a firm draws on its own knowledge) can decrease the main effect of licensing....

Case Study: Developing, Implementing, and Evaluating a One-Day Leadership Conference to Foster Women's Leadership in Healthcare

OpenAIRE

Kerry K. Fierke; Margarette L. Kading

2014-01-01

Despite women increasingly entering the healthcare field, they still face barriers to advancing in leadership ranks within healthcare. To address the need for leadership development among women in healthcare, the Center for Leading Healthcare Change (CLHC) at the University of Minnesota College of Pharmacy piloted a one-day conference in November 2012 entitled "Women Impacting Healthcare: Decide to Make a Difference." This conference utilized an interactive agenda: each speaker's presentation...

Nutritional status of undergraduate healthcare students at the ...

African Journals Online (AJOL)

Nutritional status of undergraduate healthcare students at the University of the ... to evaluate the lifestyle habits of South African students preparing for careers in ... Fifty-nine per cent were active and 39% were very active owing to busy class ...

Video observation of hand hygiene practices during routine companion animal appointments and the effect of a poster intervention on hand hygiene compliance

Science.gov (United States)

2014-01-01

Background Hand hygiene is considered one of the most important infection control measures in human healthcare settings, but there is little information available regarding hand hygiene frequency and technique used in veterinary clinics. The objectives of this study were to describe hand hygiene practices associated with routine appointments in companion animal clinics in Ontario, and the effectiveness of a poster campaign to improve hand hygiene compliance. Results Observation of hand hygiene practices was performed in 51 clinics for approximately 3 weeks each using 2 small wireless surveillance cameras: one in an exam room, and one in the most likely location for hand hygiene to be performed outside the exam room following an appointment. Data from 38 clinics were included in the final analysis, including 449 individuals, 1139 appointments before and after the poster intervention, and 10894 hand hygiene opportunities. Overall hand hygiene compliance was 14% (1473/10894), while before and after patient contact compliance was 3% (123/4377) and 26% (1145/4377), respectively. Soap and water was used for 87% (1182/1353) of observed hand hygiene attempts with a mean contact time of 4 s (median 2 s, range 1-49 s), while alcohol-based hand rub (ABHR) was used for 7% (98/1353) of attempts with a mean contact time of 8 s (median 7 s, range 1-30 s). The presence of the posters had no significant effect on compliance, although some staff reported that they felt the posters did increase their personal awareness of the need to perform hand hygiene, and the posters had some effect on product contact times. Conclusions Overall hand hygiene compliance in veterinary clinics in this study was low, and contact time with hand hygiene products was frequently below current recommendations. Use of ABHR was low despite its advantages over hand washing and availability in the majority of clinics. The poster campaign had a limited effect on its own, but could still be used as a

75 FR 8731 - Proposed Appointment to the National Indian Gaming Commission

Science.gov (United States)

2010-02-25

... National Indian Gaming Commission ACTION: Notice. SUMMARY: The Indian Gaming Regulatory Act provides for a three-person National Indian Gaming Commission. One member, the chairman, is appointed by the President... as an associate member of the National Indian Gaming Commission for a term of 3 years. DATES...

12 CFR 509.101 - Appointment of Office of Financial Institution Adjudication.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Appointment of Office of Financial Institution... Office of Financial Institution Adjudication. Unless otherwise directed by the Office, all hearings under... direction of the Office of Financial Institution Adjudication, 1700 G Street NW., Washington, DC 20552. ...

31 CFR 596.309 - Specific license.

Science.gov (United States)

2010-07-01

... FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY TERRORISM LIST GOVERNMENTS SANCTIONS REGULATIONS General Definitions § 596.309 Specific license. The term specific license means any license or...

Online driver's license renewal.

Science.gov (United States)

2015-09-01

The Kentucky Department of Vehicle Regulation is exploring the possibility of developing and implementing online : drivers license renewal. The objective of this project was to: 1) evaluate online drivers license and REAL ID renewal : programs ...

The need for legislative framework (licensing)

International Nuclear Information System (INIS)

Krech, H.

1977-01-01

For reasons of public acceptance the basis of a licensing system should be laid down in a law, details can be fixed in regulations below the law-level. The competence for licensing nuclear installations should be attributed to one body, which is not a the same time charged with the promotion of nuclear energy. The licensing authority has to be provided with sufficient technical advice, given by experts organized in advisory bodies. Normally a licensing procedure is split into several steps (site approval, construction permit, operation licence), each step can be subdivided. Some general aspects of licensing conditions (personal, technical and financial) as well as of the licensing procedure are outlined. The participation of the public is of particular importance but also involves most intricate problems. The paper concludes with some critical remarks on the role of administrative courts with respect to the licensing of nuclear power plants. (orig.) [de

American Sign Language Interpreters Perceptions of Barriers to Healthcare Communication in Deaf and Hard of Hearing Patients.

Science.gov (United States)

Hommes, Rachel E; Borash, Amy I; Hartwig, Kari; DeGracia, Donna

2018-04-25

Communication barriers between healthcare providers and patients contribute to health disparities and the effectiveness of health promotion messages. This is especially true regarding communication between providers and deaf and hard of hearing (HOH) patients due to lack of understanding of cultural and linguistic differences, ineffectiveness of various means of communication and level of health literacy within that population. This research aimed to identify American Sign Language (ASL) interpreters' perceptions of barriers to effective communication between deaf and HOH patients and healthcare providers. We conducted a survey of ASL interpreters attending the 2015 National Symposium on Healthcare Interpreting with an overall response rate of 25%. Results indicated a significant difference (p communication between providers and deaf/HOH patients as perceived by interpreters. ASL interpreters observed that patients did not understand provider instructions in nearly half of appointments. Eighty-one percent of interpreters said that providers "hardly ever" use "teach-back" methods with patients to ensure understanding. A focus on improving health care and health promotion efforts in the deaf/HOH community depends on improving communication, health literacy, and patient empowerment and involves holding health care organizations accountable for assuring adequate staffing of ASL interpreters and communication resources in order to reduce health disparities in this population.

31 CFR 596.305 - General license.

Science.gov (United States)

2010-07-01

... FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY TERRORISM LIST GOVERNMENTS SANCTIONS REGULATIONS General Definitions § 596.305 General license. The term general license means any license or authorization...

'Kids need to talk too': inclusive practices for children's healthcare education and participation.

Science.gov (United States)

Koller, Donna

2017-09-01

To examine how children with chronic medical conditions view healthcare education and decision-making and to propose the application of the universal design for learning in paediatric settings. Children and adolescents with chronic medical conditions tend to be excluded from healthcare decision-making. In schools, the universal design for learning promotes access to education and participation in school communities for all children, regardless of their disabilities or medical needs, rendering it an appropriate model for children's participation in healthcare decision-making. This article presents findings from a qualitative study with 26 children and adolescents with chronic medical conditions about their views and experiences with healthcare education and decision-making. Twenty-six children and adolescents with chronic medical conditions were interviewed using semi-structured interviews. Findings provide evidence that clinical practices often fail to provide equal opportunities for paediatric patients to understand their condition, share their views and/or participate in decisions regarding their care. In response to ongoing concerns about paediatric decision-making, we propose that the universal design for learning be adapted in paediatrics. The model presents exemplary programmes as inclusive, accounting for the needs of all children through multiple means of engagement and expression. A discussion of how the principles of universal design for learning could be applied in paediatric settings is offered for the purpose of advancing ethical and psychosocial care for all children regardless of their age, developmental capacity or condition. © 2016 John Wiley & Sons Ltd.

[Judicial and medical/legal aspects of the responsibility of workers appointed to carry out first aid].

Science.gov (United States)

Caprioli, L C; Ciavarella, M; Sacco, A

2005-01-01

One of the innovations introduced by law 626/94 [the Italian law on occupational health and safety of workers] is the obligation of the employer to designate workers responsible for first aid. To identify and discuss the duties, the role and the medical and legal responsibility of workers appointed to carry out first aid measures. Analysis of legislation and current practice concerning medical and legal responsibility in first aid procedures. The worker appointed to carry out first aid measures is, by virtue of his appointment, obliged to take action. Therefore, he could commit an illegitimate act both by "acting" and by "omitting" to carry out a duty that is his responsibility. In the first case the worker could be accused of committing an unpremeditated criminal offence when his actions involve negligence, imprudence, inexperience or violation of regulations concerning his duties. A "serious criminal offence" is committed when the most elementary rules of diligence, prudence and skill are violated; the offence is "slight" when negligence, imprudence or inexperience are involved in particularly complex situations. The reference parameter for inexperience is not a first aid volunteer, nor a member of the public, but a worker designated to carry out first aid possessing "average" attitudes, training and ability. Briefly, a guilty error by the appointed worker consists of the following: i) the professional conduct of the operator was clearly wrong, serious and unjustifiable; ii) the operator clearly omitted doing his/her duty; iii) the consequence of the error is physical personal damage. The observations made clearly illustrate the delicacy of the tasks of the worker appointed to carry out first aid measures. Essential elements for minimizing wrong and/or negligent conduct are appropriate choice of the designated workers and their adequate training.

Improving and analyzing signage within a healthcare setting.

Science.gov (United States)

Rousek, J B; Hallbeck, M S

2011-11-01

Healthcare facilities are increasingly utilizing pictograms rather than text signs to help direct people. The purpose of this study was to analyze a wide variety of standardized healthcare pictograms and the effects of color contrasts and complexity for participants with both normal and impaired vision. Fifty (25 males, 25 females) participants completed a signage recognition questionnaire and identified pictograms while wearing vision simulators to represent specific visual impairment. The study showed that certain color contrasts, complexities and orientations can help or hinder comprehension of signage for people with and without visual impairment. High contrast signage with consistent pictograms involving human figures (not too detailed or too abstract) is most identifiable. Standardization of healthcare signage is recommended to speed up and aid the cognitive thought process in detecting signage and determining meaning. These fundamental signage principles are critical in producing an efficient, universal wayfinding system for healthcare facilities. Copyright © 2011 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Mixed enrichment core design for the NC State University PULSTAR Reactor

International Nuclear Information System (INIS)

Mayo, C.W.; Verghese, K.; Huo, Y.G.

1997-12-01

The North Carolina State University PULSTAR Reactor license was renewed for an additional 20 years of operation on April 30, 1997. The relicensing period added additional years to the facility operating time through the end of the second license period, increasing the excess reactivity needs as projected in 1988. In 1995, the Nuclear Reactor Program developed a strategic plan that addressed the future maintenance, development, and utilization of the facility. Goals resulting from this plan included increased academic utilization of the facility in accordance with its role as a university research facility, and increased industrial service use in accordance with the mission of a land grant university. The strategic plan was accepted, and it is the intent of the College of Engineering to operate the PULSTAR Reactor as a going concern through at least the end of the current license period. In order to reach the next relicensing review without prejudice due to low excess reactivity, it is desired to maintain sufficient excess reactivity so that, if relicensed again, the facility could continue to operate without affecting users until new fuel assistance was provided. During the NC State University license renewal, the operation of the PULSTAR Reactor at the State University of New York at Buffalo (SUNY Buffalo) was terminated. At that time, the SUNY Buffalo facility had about 240 unused PULSTAR Reactor fuel pins with 6% enrichment. The objective of the work reported here was to develop a mixed enrichment core design for the NC State University PULSTAR reactor which would: (1) demonstrate that 6% enriched SUNY buffalo fuel could be used in the NC State University PULSTAR Reactor within the existing technical specification safety limits for core physics parameters; (2) show that use of this fuel could permit operating the NC State University PULSTAR Reactor to 2017 with increased utilization; and (3) assure that the decision whether or not to relicense the facility would

Licensing an assured isolation facility for low-level radioactive waste. Volume 1: Licensing strategy and issues

International Nuclear Information System (INIS)

Silverman, D.J.; Bauser, M.A.; Baird, R.D.

1998-07-01

This report provides a detailed set of proposed criteria and guidance for the preparation of a license application for an assured isolation facility (AIF). The report is intended to provide a detailed planning basis upon which a prospective applicant may begin pre-licensing discussions with the Nuclear Regulatory Commission and initiate development of a license application. The report may also be useful to the NRC or to state regulatory agencies that may be asked to review such an application. Volume 1 of this report provides background information, and describes the licensing approach and methodology. Volume 2 identifies specific information that is recommended for inclusion in a license application

EMPIRICAL STUDY OF CAR LICENSE PLATES RECOGNITION

Directory of Open Access Journals (Sweden)

Nasa Zata Dina

2015-01-01

Full Text Available The number of vehicles on the road has increased drastically in recent years. The license plate is an identity card for a vehicle. It can map to the owner and further information about vehicle. License plate information is useful to help traffic management systems. For example, traffic management systems can check for vehicles moving at speeds not permitted by law and can also be installed in parking areas to se-cure the entrance or exit way for vehicles. License plate recognition algorithms have been proposed by many researchers. License plate recognition requires license plate detection, segmentation, and charac-ters recognition. The algorithm detects the position of a license plate and extracts the characters. Various license plate recognition algorithms have been implemented, and each algorithm has its strengths and weaknesses. In this research, I implement three algorithms for detecting license plates, three algorithms for segmenting license plates, and two algorithms for recognizing license plate characters. I evaluate each of these algorithms on the same two datasets, one from Greece and one from Thailand. For detecting li-cense plates, the best result is obtained by a Haar cascade algorithm. After the best result of license plate detection is obtained, for the segmentation part a Laplacian based method has the highest accuracy. Last, the license plate recognition experiment shows that a neural network has better accuracy than other algo-rithm. I summarize and analyze the overall performance of each method for comparison.

University Technology Transfer Factors as Predictors of Entrepreneurial Orientation

Science.gov (United States)

Kirkman, Dorothy M.

2011-01-01

University technology transfer is a collaborative effort between academia and industry involving knowledge sharing and learning. Working closely with their university partners affords biotechnology firms the opportunity to successfully develop licensed inventions and gain access to novel scientific and technological discoveries. These factors may…

Operating reactors licensing actions summary

International Nuclear Information System (INIS)

1982-04-01

The operating reactors licensing actions summary is designed to provide the management of the Nuclear Regulatory Commission (NRC) with an overview of licensing actions dealing with operating power and nonpower reactors. These reports utilize data collected from the Division of Licensing in the Office of Nuclear Reactor Regulation and are prepared by the Office of Management and Program Analysis

78 FR 18363 - Proposed Appointment to the National Indian Gaming Commission

Science.gov (United States)

2013-03-26

... Gaming Commission AGENCY: Office of the Secretary, Interior. ACTION: Notice. SUMMARY: Before appointing a member to the National Indian Gaming Commission, the Secretary must provide public notice and allow a... member of the National Indian Gaming Commission for a term of 3 years. DATES: Comments must be received...

Healthcare quality management in Switzerland--a survey among providers.

Science.gov (United States)

Kaderli, Reto; Pfortmueller, Carmen A; Businger, Adrian P

2012-04-27

In the last decade assessing the quality of healthcare has become increasingly important across the world. Switzerland lacks a detailed overview of how quality management is implemented and of its effects on medical procedures and patients' concerns. This study aimed to examine the systematics of quality management in Switzerland by assessing the providers and collected parameters of current quality initiatives. In summer 2011 we contacted all of the medical societies in Switzerland, the Federal Office of Public Health, the Swiss Medical Association (FMH) and the head of Swiss medical insurance providers, to obtain detailed information on current quality initiatives. All quality initiatives featuring standardised parameter assessment were included. Of the current 45 initiatives, 19 were powered by medical societies, five by hospitals, 11 by non-medical societies, two by the government, two by insurance companies or related institutions and six by unspecified institutions. In all, 24 medical registers, five seals of quality, five circles of quality, two self-assessment tools, seven superior entities, one checklist and one combined project existed. The cost of treatment was evaluated by four initiatives. A data report was released by 24 quality initiatives. The wide variety and the large number of 45 recorded quality initiatives provides a promising basis for effective healthcare quality management in Switzerland. However, an independent national supervisory authority should be appointed to provide an effective review of all quality initiatives and their transparency and coordination.

Is there an agreement among the items of the Korean physical therapist licensing examination, learning objectives of class subjects, and physical therapists' job descriptions?

Science.gov (United States)

Kang, Min-Hyeok; Kwon, Oh-Yun; Kim, Yong-Wook; Kim, Ji-Won; Kim, Tae-Ho; Oh, Tae-Young; Weon, Jong-Hyuk; Lee, Tae-Sik; Oh, Jae-Seop

2016-01-01

To determine the agreement among the items of the Korean physical therapist licensing examination, learning objectives of class subjects, and physical therapists' job descriptions. The main tasks of physical therapists were classified, and university courses related to the main tasks were also classified. Frequency analysis was used to determine the proportions of credits for the classified courses out of the total credits of major subjects, exam items related to the classified courses out of the total number of exam items, and universities that offer courses related to the Korean physical therapist licensing examination among the surveyed universities. The proportions of credits for clinical decision making and physical therapy diagnosis-related courses out of the total number credits for major subjects at universities were relatively low (2.06% and 2.58%, respectively). Although the main tasks of physical therapists are related to diagnosis and evaluation, the proportion of physiotherapy intervention-related items (35%) was higher than that of examination and evaluation-related items (25%) on the Korean physical therapist licensing examination. The percentages of universities that offer physical therapy diagnosis and clinical decision making-related courses were 58.62% and 68.97%, respectively. Both the proportion of physiotherapy diagnosis and evaluation-related items on the Korean physical therapist licensing examination, and the number of subjects related to clinical decision making and physical therapy diagnosis in the physical therapy curriculum, should be increased to ensure that the examination items and physical therapy curriculum reflect the practical tasks of physical therapists.

Optimal healthcare delivery to care homes in the UK: a realist evaluation of what supports effective working to improve healthcare outcomes.

Science.gov (United States)

Gordon, Adam L; Goodman, Claire; Davies, Sue L; Dening, Tom; Gage, Heather; Meyer, Julienne; Schneider, Justine; Bell, Brian; Jordan, Jake; Martin, Finbarr C; Iliffe, Steve; Bowman, Clive; Gladman, John R F; Victor, Christina; Mayrhofer, Andrea; Handley, Melanie; Zubair, Maria

2018-01-05

care home residents have high healthcare needs not fully met by prevailing healthcare models. This study explored how healthcare configuration influences resource use. a realist evaluation using qualitative and quantitative data from case studies of three UK health and social care economies selected for differing patterns of healthcare delivery to care homes. Four homes per area (12 in total) were recruited. A total of 239 residents were followed for 12 months to record resource-use. Overall, 181 participants completed 116 interviews and 13 focus groups including residents, relatives, care home staff, community nurses, allied health professionals and General Practitioners. context-mechanism-outcome configurations were identified explaining what supported effective working between healthcare services and care home staff: (i) investment in care home-specific work that legitimises and values work with care homes; (ii) relational working which over time builds trust between practitioners; (iii) care which 'wraps around' care homes; and (iv) access to specialist care for older people with dementia. Resource use was similar between sites despite differing approaches to healthcare. There was greater utilisation of GP resource where this was specifically commissioned but no difference in costs between sites. activities generating opportunities and an interest in healthcare and care home staff working together are integral to optimal healthcare provision in care homes. Outcomes are likely to be better where: focus and activities legitimise ongoing contact between healthcare staff and care homes at an institutional level; link with a wider system of healthcare; and provide access to dementia-specific expertise. © The Author(s) 2018. Published by Oxford University Press on behalf of the British Geriatrics Society.

Licensing aspects regarding the RBMN project

International Nuclear Information System (INIS)

Cuccia, Valeria; Sacramento, Arivaldo M.; Aleixo, Bruna L.; Ferreira, Vinicius V.M.

2013-01-01

The licensing process of a waste disposal facility is a complex and demanding undertaking. It proceeds in phases, starting with the site selection and ending many decades later, when the radionuclides decayed and no longer offer possible hazard. That is one of the reasons why the licensing process for the Brazilian repository for low and intermediate level radioactive waste (RBMN Project) is a challenge for all the technicians involved. Besides that, the only national experience associated to this subject arose after a radiological accident in the State of Goias, in 1987. Two different institutions are involved in this licensing process: IBAMA, for environmental licensing, and CNEN, for nuclear licensing. Both of them will evaluate the possible impacts caused by the waste disposal, so it is essential to avoid conflicts and duplications of activities. The RBMN project has different teams for each main activity, and one of them is the Licensing group. This team has been planning the licensing activities for the repository, studying the legal framework and estimating costs and execution time for each step. This paper presents the status of the licensing activities regarding to the RBMN project done by the CNEN staff. (author)

The reason for appointing more women to top positions

OpenAIRE

Hansson, Martina; Kalantari, Leila

2015-01-01

Objective: Our main objective is to identify why the executive management positions of most companies in Europe are not moderately genders diverse. Within this objective we study the pattern of gender representation and diversity in a specific company (named Company A) and investigate theoretically why more women should be appointed to the top positions. Research and practical implications: This thesis contributes to a better understanding of the reason behind not having moderately gender div...

Managing Licensing in a Market for Technology

DEFF Research Database (Denmark)

Arora, Ashish; Rønde, Thomas; Fosfuri, Andrea

the technology makes licensing decisions—to centralized licensing. The business unit has superior information about licensing opportunities but may not have the appropriate incentives because its rewards depend upon product market performance. If licensing is decentralized, the business unit forgoes valuable...... licensing opportunities since the rewards for licensing are (optimally) weaker than those for product market profits. This distortion is stronger when production-based incentives are more powerful, making centralization more attractive. Growth of technology markets favors centralization and drives higher...

Some remarks regarding the procedure of the appointment of the secretary general of the United Nations

OpenAIRE

Novaković Marko

2016-01-01

Appointing Secretary-General is a process that has always been enshrined in secrecy. In 2016, due to reforms in the appointment process instigated by the president of the Security Council Mogens Lykketoft, more inclusion and transparency have been achieved, with the non-state actors being much more involved in the process. In the procedure itself, first five straw polls suggested that Antonio Guterres will be the new Secretary-General and this proved to be truth. Will this more transparent sy...

Extension Education Symposium: Getting the Most Out of Your Extension Appointment and Still Having a Life

OpenAIRE

Powers, W.; Cockett, Noelle E.; Lardy, Gregory P.

2017-01-01

Managing the demands of an academic appointment in extension can be a challenging task. Demands from constituent groups, expectations of supervisors, and rigors of promotion and tenure processes can create pressures that young faculty did not expect. Throw in spousal and family duties and you have created a situation that many will find hard to navigate. However, there are ways to cope and, even better news, there are ways to excel in meeting the demands of an academic appointment and enjoyin...

Department of Energy licensing strategy

International Nuclear Information System (INIS)

Frei, M.W.

1984-01-01

The Department of Energy (DOE) is authorized by the Nuclear Waste Policy Act of 1982 (Act) to site, design, construct, and operate mined geologic repositories for high-level radioactive wastes and is required to obtain licenses from the Nuclear Regulatory Commission (NRC) to achieve that mandate. To this end the DOE has developed a licensing approach which defines program strategies and which will facilitate and ease the licensing process. This paper will discuss the regulatory framework within which the repository program is conducted, the DOE licensing strategy, and the interactions between DOE and NRC in implementing the strategy. A licensing strategy is made necessary by the unique technical nature of the repository. Such a facility has never before been licensed; furthermore, the duration of isolation of waste demanded by the proposed EPA standard will require a degree of reliance on probabilistic performance assessment as proof of compliance that is a first of a kind for any industry. The licensing strategy is also made necessary by the complex interrelationships among the many involved governmental agencies and even within DOE itself, and because these relationships will change with time. Program activities which recognize these relationships are essential for implementing the Act. The guiding principle in this strategy is an overriding commitment to safeguarding public health and safety and to protecting the environment

Business challenges in the universities. Panel Discussion

International Nuclear Information System (INIS)

Klein, Andrew; Lee, John C.; Peterson, Per; Simard, Ron; Gates, W. Gary

2001-01-01

Full text of publication follows: University nuclear science and engineering programs in the United States currently operate in a business climate that involves serious and dramatic change. The number of degree-granting nuclear engineering programs within the nation's universities has declined over the past two decades to approximately 25. More than two-thirds of the faculty in these programs are 45 yr or older. Recruiting and retaining the best faculty and students continue to be vital to the continued success and existence of these programs. Many universities are also experiencing difficulty in finding support for their research and training reactors. There are currently only 28 university research reactors remaining across the United States. Many of these reactors were initially established with 30- to 40-yr operating licenses and will require re-licensing in the next several years. Combined, the university nuclear engineering educational programs and the university research reactors form a fundamental and vital component in a broad spectrum of our national research and education infrastructure and are critical to many national priorities such as energy, health care, education, environment, and technology transfer. Speakers have been selected from various universities, the Nuclear Energy Institute, and industry to address problems related to workforce forecasting, student recruiting and retention, research reactor operation and financing, academic accreditation, and other current issues relevant to nuclear engineering education and research. (authors)

Application of up-front licensing

Energy Technology Data Exchange (ETDEWEB)

Grant, S D [Atomic Energy of Canada Ltd., Saskatoon, SK (Canada); Snell, V G [Atomic Energy of Canada Ltd., Mississauga, ON (Canada)

1996-12-31

AECL has been pioneering `up-front` licensing of new reactor designs. The CANDU 3 design has been formally reviewed by AECB staff for a number of years. The CANDU 9 design has just started the up-front licensing process. The process gives designers, regulators and potential customers early confidence in the licensability of future plants. (author). 4 refs., 2 tabs.

Application of up-front licensing

International Nuclear Information System (INIS)

Grant, S.D.; Snell, V.G.

1995-01-01

AECL has been pioneering 'up-front' licensing of new reactor designs. The CANDU 3 design has been formally reviewed by AECB staff for a number of years. The CANDU 9 design has just started the up-front licensing process. The process gives designers, regulators and potential customers early confidence in the licensability of future plants. (author). 4 refs., 2 tabs

Regulatory systems-based licensing guidance documentation

International Nuclear Information System (INIS)

Delligatti, M.S.

1991-01-01

The US Nuclear Regulatory Commission (NRC) has developed a series of licensing guidance documents based on the regulatory requirements in Part 60 of Title 10 of the Code of Federal Regulations (10 CFR Part 60). This regulatory systems-based approach to licensing guidance documentation relies on the definition of the high-level waste repository in 10 CFR Part 60. A document which is important for the frame-work it gives to other programmatic licensing guidance is the Draft Regulatory Guide open-quotes Format and Content for the License Application for the High-Level Waste Repositoryclose quotes (FCRG). The FCRG describes a format and content acceptable to NRC for a high-level waste repository license application pursuant to the requirements of 10 CFR Part 60. Other licensing guidance documents will be compatible with the FCRG

License renewal in the United States

International Nuclear Information System (INIS)

Brons, Jack

2002-01-01

Full text: Nuclear plants in the United States are licensed for 40 years, a length specified in the Atomic Energy Act of 1954, which laid out much of the regulatory basis for the commercial nuclear industry. The Act, however, made provision for license renewal. The original 40-year license period was chosen arbitrarily by the U.S. Congress because it was the typical period over which utilities recovered their investment in electricity generating plants. Nuclear plants, however, are subject to a rigorous program of Nuclear Regulatory Commission oversight, maintenance and equipment replacement. In effect, they must be in the same operating condition on the last day of their licenses as they were on the first. As the industry matured, it became apparent that there was no physical limitation on the continued operation of nuclear plants past 40 years. The industry turned its attention toward license renewal. When the issue was first raised, the NRC considered stringent process equivalent to seeking a new operating license for each plant. The complexity, length and cost of the process made it unlikely that many nuclear plants would seek license renewal. The nuclear industry worked successfully with NRC on the application of generic principles to license renewal, however, and in 1995, the NRC issued an efficient, tightly-focused rule that made license renewal a safe, viable option. To extend the operating license for a reactor, a company must demonstrate to the NRC that aging effects will be adequately managed during the renewal terms, thus ensuring equipment functionality. The rule allows licensees to apply for extensions of up to 20 years. The first license renewal application was filed in 1998 by the owner of the two-unit Calvert Cliffs plant. Shortly thereafter, an application was filed for the three-unit Oconee Nuclear Station. The NRC renewed the licenses for all five units in 2000, and since then, five more licenses have been renewed. The NRC has received 37

Application of the transtheoretical model of behaviour change for identifying older clients' readiness for hearing rehabilitation during history-taking in audiology appointments.

Science.gov (United States)

Ekberg, Katie; Grenness, Caitlin; Hickson, Louise

2016-07-01

The transtheoretical model (TTM) of behaviour change focuses on clients' readiness for adopting new health behaviours. This study explores how clients' readiness for change can be identified through their interactions with audiologists during history-taking in initial appointments; and whether clients' readiness has consequences for the rehabilitation decisions they make within the initial appointment. Conversation analysis (CA) was used to examine video-recorded initial audiology appointments with older adults with hearing impairment. The data corpus involved 62 recorded appointments with 26 audiologists and their older adult clients (aged 55+ years). Companions were present in 17 appointments. Clients' readiness for change could be observed through their interaction with the audiologist. Analysis demonstrated that the way clients described their hearing in the history-taking phase had systematic consequences for how they responded to rehabilitation recommendations (in particular, hearing aids) in the management phase of the appointment. In particular, clients identified as being in a pre-contemplation stage-of-change were more likely to display resistance to a recommendation of hearing aids (80% declined). The transtheoretical model of behaviour change can be useful for helping audiologists individualize management planning to be congruent with individual clients' needs, attitudes, desires, and psychological readiness for action in order to optimize clients' hearing outcomes.

Interest in Use of Technology for Healthcare Among Veterans Receiving Treatment for Mental Health.

Science.gov (United States)

Miller, Christopher J; McInnes, D Keith; Stolzmann, Kelly; Bauer, Mark S

2016-10-01

There is great interest in leveraging technology, including cell phones and computers, to improve healthcare. A range of e-health applications pertaining to mental health such as messaging for prescription refill or mobile device videoconferencing are becoming more available, but little is known about the mental health patient's interest in using these newer applications. We mailed a survey to 300 patients seen in the general mental health clinic of a local Veterans Affairs Medical Center. Survey questions focused on interest in use of cell phones, tablets, and other computers in patients' interactions with the healthcare system. A total of 74 patients, primarily treated for depression, post-traumatic stress disorder, or anxiety disorders, returned completed surveys. Nearly all reported having a cell phone (72/74, 97%), but fewer than half reported having a smartphone (35/74, 47%). Overall, a substantial majority (64/74, 86%) had access to an Internet-capable device (smartphone or computer, including tablets). Respondents appeared to prefer computers to cell phones for some health-related communications, but did not express differential interest for other tasks (such as receiving appointment reminders). Interest in use was higher among younger veterans. Most veterans with a mental health diagnosis have access to technology (including cell phones and computers) and are interested in using that technology for some types of healthcare-related communications. While there is capacity to utilize information technology for healthcare purposes in this population, interests vary widely, and a substantial minority does not have access to relevant devices. Although interest in using computers for health-related communication was higher than interest in using cell phones, single-platform technology-based interventions may nonetheless exclude crucial segments of the population.

The construction of a public key infrastructure for healthcare information networks in Japan.

Science.gov (United States)

Sakamoto, N

2001-01-01

The digital signature is a key technology in the forthcoming Internet society for electronic healthcare as well as for electronic commerce. Efficient exchanges of authorized information with a digital signature in healthcare information networks require a construction of a public key infrastructure (PKI). In order to introduce a PKI to healthcare information networks in Japan, we proposed a development of a user authentication system based on a PKI for user management, user authentication and privilege management of healthcare information systems. In this paper, we describe the design of the user authentication system and its implementation. The user authentication system provides a certification authority service and a privilege management service while it is comprised of a user authentication client and user authentication serves. It is designed on a basis of an X.509 PKI and is implemented with using OpenSSL and OpenLDAP. It was incorporated into the financial information management system for the national university hospitals and has been successfully working for about one year. The hospitals plan to use it as a user authentication method for their whole healthcare information systems. One implementation of the system is free to the national university hospitals with permission of the Japanese Ministry of Education, Culture, Sports, Science and Technology. Another implementation is open to the other healthcare institutes by support of the Medical Information System Development Center (MEDIS-DC). We are moving forward to a nation-wide construction of a PKI for healthcare information networks based on it.

Self-medication among non-healthcare students of the University of Sharjah, United Arab Emirates

Directory of Open Access Journals (Sweden)

Suleiman Ibrahim Sharif

2014-01-01

Full Text Available Objectives: The objective of the following study is to estimate the prevalence of self-medication among university students and evaluate factors associated with the practice. Materials and Methods: This study was conducted during May, 2012 using a pre-validated questionnaire distributed to 250 students of the 4 years of study at the college of business administration. Data were analyzed using PASW Statistics for Windows, Version 18.0. Chicago: SPSS Inc and results are expressed as counts and percentages. Chi-square test was used to evaluate significant association among the study variables and P < 0.05 were considered to be statistically significant. Results: The response rate was 80% and all respondents were Arabs with 114 (57% females and 86 (43% males. Self-medication was practiced by 118 (59% students and most (88.1% of them obtained medications from pharmacies. About 21 (11% respondents self-medicated with antibiotics. Only 34 (17% and 16 (8% of respondents were aware of bacterial resistance and rational drug use respectively. The most common reasons for self-medication were seeking quick relief (134, 67%, physician′s advice of self-management (100, 50%, illness is minor (91, 45.5%. Common reasons against self-medication include risk of misdiagnosis of illness (160, 80%, risk of using the wrong medication (154, 77%, risk of adverse effects (140, 70%. Self-medication was practiced for headache or mild pain, eye and ear symptoms, gastric problems, cold, fever and allergy. Conclusion: Self-medication among non-healthcare students is common with high prevalence. Knowledge of students of reasons for and against self-medication was adequate, but awareness of respondents of rational drug use and risk of bacterial resistance in response to misuse was poor. Orientation courses/workshops directed to university students would be beneficial.

Evaluation of safety climate and employee injury rates in healthcare.

Science.gov (United States)

Cook, Jacqueline M; Slade, Martin D; Cantley, Linda F; Sakr, Carine J

2016-09-01

Safety climates that support safety-related behaviour are associated with fewer work-related injuries, and prior research in industry suggests that safety knowledge and motivation are strongly related to safety performance behaviours; this relationship is not well studied in healthcare settings. We performed analyses of survey results from a Veterans Health Administration (VHA) Safety Barometer employee perception survey, conducted among VHA employees in 2012. The employee perception survey assessed 6 safety programme categories, including management participation, supervisor participation, employee participation, safety support activities, safety support climate and organisational climate. We examined the relationship between safety climate from the survey results on VHA employee injury and illness rates. Among VHA facilities in the VA New England Healthcare System, work-related injury rate was significantly and inversely related to overall employee perception of safety climate, and all 6 safety programme categories, including employee perception of employee participation, management participation, organisational climate, supervisor participation, safety support activities and safety support climate. Positive employee perceptions of safety climate in VHA facilities are associated with lower work-related injury and illness rates. Employee perception of employee participation, management participation, organisational climate, supervisor participation, safety support activities and safety support climate were all associated with lower work-related injury rates. Future implications include fostering a robust safety climate for patients and healthcare workers to reduce healthcare worker injuries. 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/

Assessing the Knowledge Level, Attitudes, Risky Behaviors and Preventive Practices on Sexually Transmitted Diseases among University Students as Future Healthcare Providers in the Central Zone of Malaysia: A Cross-Sectional Study

OpenAIRE

Folasayo, Adigun Temiloluwa; Oluwasegun, Afolayan John; Samsudin, Suhailah; Saudi, Siti Nor Sakinah; Osman, Malina; Hamat, Rukman Awang

2017-01-01

This study was done to assess the knowledge, attitudes, risky behaviors and preventive practices related to sexually-transmitted diseases (STDs) among health and non-health sciences university students as future healthcare providers in Malaysia. A total of 700 health and non-health sciences university students (255 male; 445 female) aged between 17 and 30 years were surveyed by using a self-administered questionnaire. The majority (86.6%) had heard of STDs, and 50.4% knew STDs could present w...

Licensing of away-from-reactor (AFR) installations

International Nuclear Information System (INIS)

Gray, P.L.

1980-01-01

Storage of spent fuel at Away-From-Reactor (AFR) installations will allow reactors to continue to operate until reprocessing or other fuel disposal means are available. AFR installations must be licensed by the Nuclear Regulatory Commission (NRC). Although wide experience in licensing reactors exists, the licensing of an AFR installation is a relatively new activity. Only one has been licensed to date. This paper delineates the requirements for licensing an AFR installation and projects a licensing schedule. Because the NRC is developing specific AFR requirements, this schedule is based primarily on draft NRC documents. The major documents needed for an AFR license application are similar to those for a reactor. They include: a Safety Analysis Report (SAR), and Environmental Report (ER), safeguards and security plans, decommissioning plans, proposed technical specifications, and others. However, the licensing effort has one major difference in that for AFR installations it will be a one-step effort, with follow-up, rather than the two-step process used for reactors. The projected licensing schedule shows that the elapsed time between filing an application and issuance of a license will be about 32 months, assuming intervention. The legal procedural steps will determine the time schedule and will override considerations of technical complexity. A license could be issued in about 14 months in the absence of intervention

Advancing adolescent health and health services in Saudi Arabia: exploring health-care providers' training, interest, and perceptions of the health-care needs of young people

Directory of Open Access Journals (Sweden)

AlBuhairan FS

2014-09-01

Full Text Available Fadia S AlBuhairan,1–3 Tina M Olsson3,4 1Department of Pediatrics, King Abdulaziz Medical City, Riyadh, Saudi Arabia; 2King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 3King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; 4School of Social Work, Lund University, Lund, Sweden Background: Adolescent health is regarded as central to global health goals. Investments made in adolescent health and health services protect the improvements witnessed in child health. Though Saudi Arabia has a large adolescent population, adolescent health-care only began to emerge in recent years, yet widespread uptake has been very limited. Health-care providers are key in addressing and providing the necessary health-care services for adolescents, and so this study was conducted with the aim of identifying opportunities for the advancement of knowledge transfer for adolescent health services in Saudi Arabia. Methods: This Web-based, cross-sectional study was carried out at four hospitals in Saudi Arabia. Physicians and nurses were invited to participate in an online survey addressing their contact with adolescent patients, and training, knowledge, and attitudes towards adolescent health-care. Results: A total of 232 professionals participated. The majority (82.3% reported sometimes or always coming into contact with adolescent patients. Less than half (44%, however, had received any sort of training on adolescent health during their undergraduate or postgraduate education, and only 53.9% reported having adequate knowledge about the health-care needs of adolescents. Nurses perceived themselves as having more knowledge in the health-care needs of adolescents and reported feeling more comfortable in communicating with adolescents as compared with physicians. The majority of participants were interested in gaining further skills and knowledge in adolescent health-care and agreed or strongly agreed that adolescents have

The Student Newspaper; Report of the Special Commission on the Student Press to the President of the University of California.

Science.gov (United States)

American Council on Education, Washington, DC.

The Commission on the Student Press was appointed by the President of the University of California to assess the nature, role and quality of student newspapers at the University of California's campuses and ascertain their degree of effectiveness in meeting student needs. The Commission also considered such issues as (1) how should the student…

Sports Direct to appoint full-time nurse after inquiry into employment practices.

Science.gov (United States)

2016-09-14

Retailer Sports Direct is to appoint a full-time nurse at its vast warehouse in response to concerns about health and safety. The firm was the subject of a House of Commons business, innovation and skills select committee inquiry into its employment practices.

Barriers faced by healthcare professionals when managing falls in older people in Kuala Lumpur, Malaysia: a qualitative study.

Science.gov (United States)

Loganathan, Annaletchumy; Ng, Chirk Jenn; Tan, Maw Pin; Low, Wah Yun

2015-11-05

To explore the barriers faced by healthcare professionals (HCPs) in managing falls among older people (aged above 60 years) who have a high risk of falling. The study used a qualitative methodology, comprising 10 in-depth interviews and two focus group discussions. A semistructured topic guide was used to facilitate the interviews, which were audio recorded, transcribed verbatim and checked for accuracy. Data were analysed thematically using WeftQDA software. 20 HCPs who managed falls in older people. This study was conducted at the Primary Care Clinic in the University Malaya Medical Centre (UMMC), Malaysia. Four categories of barriers emerged-these were related to perceived barriers for older people, HCPs' barriers, lack of caregiver support and healthcare system barriers. HCPs perceived that older people normalised falls, felt stigmatised, were fatalistic, as well as in denial regarding falls-related advice. HCPs themselves trivialised falls and lacked the skills to manage falls. Rehabilitation was impeded by premature decisions to admit older people to nursing homes. Lastly, there was a lack of healthcare providers as well as a dearth of fall education and training on fall prevention for HCPs. This study identified barriers that explain poor fall management in older people with a high risk of falls. The lack of structured fall prevention guidelines and insufficient training in fall management made HCPs unable to advise patients on how to prevent falls. The findings of this study warrant evidence-based structured fall prevention intervention targeted to patients as well as to HCPs. 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/

Issues to Consider before Licensing Technology to a Start-Up: Mitigating Risk with Early Planning for the Entire Business Cycle

Science.gov (United States)

LaBarge, Jeffrey H.

2005-01-01

If done correctly, licensing technology to a start-up company provides a great opportunity for a university to commercialize its technology and generate good will. If done incorrectly, however, the venture may jeopardize the technology's value and adversely affect the university's reputation within the business and academic communities. Before…

Free Software Licenses and Other Free Licenses: Genetic Code of Digital Common Goods

OpenAIRE

Marco Ciurcina

2017-01-01

This article explores the history and describes the main features of free software licenses and other free licenses in an attempt to shed light on the reasons for their success in promoting individual behaviors converging towards the collective construction of digital commons.

Safety evaluation report related to the renewal of the operating license for the research reactor at North Carolina State University

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-04-01

This safety evaluation report (SER) summarizes the findings of a safety review conducted by the staff of the U.S. Nuclear Regulatory Commission (NRC), Office of Nuclear Reactor Regulation (NRR). The staff conducted this review in response to a timely application filed by North Carolina State University (the licensee or NCSU) for a 20-year renewal of Facility Operating License R-120 to continue to operate the NCSU PULSTAR research reactor. The facility is located in the Burlington Engineering Laboratory complex on the NCSU campus in Raleigh, North Carolina. In its safety review, the staff considered information submitted by the licensee (including past operating history recorded in the licensee`s annual reports to the NRC), as well as inspection reports prepared by NRC Region H personnel and first-hand observations. On the basis of this review, the staff concludes that NCSU can continue to operate the PULSTAR research reactor, in accordance with its application, without endangering the health and safety of the public. 16 refs., 31 figs., 7 tabs.

Safety evaluation report related to the renewal of the operating license for the research reactor at North Carolina State University

International Nuclear Information System (INIS)

1997-04-01

This safety evaluation report (SER) summarizes the findings of a safety review conducted by the staff of the U.S. Nuclear Regulatory Commission (NRC), Office of Nuclear Reactor Regulation (NRR). The staff conducted this review in response to a timely application filed by North Carolina State University (the licensee or NCSU) for a 20-year renewal of Facility Operating License R-120 to continue to operate the NCSU PULSTAR research reactor. The facility is located in the Burlington Engineering Laboratory complex on the NCSU campus in Raleigh, North Carolina. In its safety review, the staff considered information submitted by the licensee (including past operating history recorded in the licensee's annual reports to the NRC), as well as inspection reports prepared by NRC Region H personnel and first-hand observations. On the basis of this review, the staff concludes that NCSU can continue to operate the PULSTAR research reactor, in accordance with its application, without endangering the health and safety of the public. 16 refs., 31 figs., 7 tabs

Factors related to missing and rescheduling pharmaceutical care appointments by aged outpatients in a Brazilian public health setting

Directory of Open Access Journals (Sweden)

Thiago Vinícius Nadaleto Didone

2015-12-01

Full Text Available Objectives: To uncover reasons why patients missed pharmaceutical care (PC appointments, identify predictive factors to miss at least one appointment and to reschedule after a miss, and compare the rescheduling behavior of patients receiving different types of PC. Methods: All elderly patients who had at least one scheduled appointment in the PC service of a health setting of São Paulo city, Brazil, from January to December/2011 were included. Chi-square analysis compared categorical data between groups; multivariate logistic regression models predicted attendance and rescheduling behavior. Results: We identified 421 patients, being 221 (52.5% non-attenders. Forgetting the appointment was the most common patient-related reason (56.3%. Illiteracy was a risk factor to be a non-attender [OR(95%CI=2.27(1.17:4.40, p=0.015]. Patients having previous knowledge of the pharmacist presented more chance to rescheduled an appointment after the first miss compared to those who had not [OR(95%CI=3.57(1.90:6.71, p<0.001]. Further, non-attenders who had knowledge of the pharmacist and received Medication Review with Follow-up rescheduled more than the ones receiving other types of PC (p=0.035. Conclusion: Illiteracy predicted non-attendance in PC to aged outpatients and forgetfulness was the main reason for that. The previous acquaintance of the pharmacist and the provision of pharmaceotherapeutic follow-up explained the rescheduling behavior, which indicates the establishment of a patient-centered patient-pharmacist relationship plays a pivotal role in the continuity of the PC.

Managing Licensing in a Market for Technology

DEFF Research Database (Denmark)

Arora, Ashish; Fosfuri, Andrea; Rønde, Thomas

2013-01-01

, we find that interdependency across business units may result in more, not less, decentralization. Furthermore, even though centralization results in less information, centralized licensing deals are larger. Our model conforms to the existing evidence that reports heterogeneity across firms in both......Technology licensing is an important means for companies to extract more value from their intellectual assets. We build a model that helps understand how licensing activity should be organized within large corporations. More specifically, we compare decentralization—where the business unit using...... the technology makes licensing decisions—to centralized licensing. The business unit has superior information about licensing opportunities but may not have the appropriate incentives because its rewards depend on product market performance. If licensing is decentralized, the business unit forgoes valuable...

Effect of an evidence-based website on healthcare usage: an interrupted time-series study.

Science.gov (United States)

Spoelman, Wouter A; Bonten, Tobias N; de Waal, Margot W M; Drenthen, Ton; Smeele, Ivo J M; Nielen, Markus M J; Chavannes, Niels H

2016-11-09

Healthcare costs and usage are rising. Evidence-based online health information may reduce healthcare usage, but the evidence is scarce. The objective of this study was to determine whether the release of a nationwide evidence-based health website was associated with a reduction in healthcare usage. Interrupted time series analysis of observational primary care data of healthcare use in the Netherlands from 2009 to 2014. General community primary care. 912 000 patients who visited their general practitioners 18.1 million times during the study period. In March 2012, an evidence-based health information website was launched by the Dutch College of General Practitioners. It was easily accessible and understandable using plain language. At the end of the study period, the website had 2.9 million unique page views per month. Primary outcome was the change in consultation rate (consultations/1000 patients/month) before and after the release of the website. Additionally, a reference group was created by including consultations about topics not being viewed at the website. Subgroup analyses were performed for type of consultations, sex, age and socioeconomic status. After launch of the website, the trend in consultation rate decreased with 1.620 consultations/1000 patients/month (pHealthcare usage decreased by 12% after providing high-quality evidence-based online health information. These findings show that e-Health can be effective to improve self-management and reduce healthcare usage in times of increasing healthcare costs. 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/.

78 FR 70077 - Issuance of Materials License for U.S. Army Installation Management Command

Science.gov (United States)

2013-11-22

... the Hilo Campus of the University of Hawaii on the island of Hawaii. On February 24, 2010, the ASLB... installations in Hawaii. The Army informed the NRC in November 2006 that it had discovered DU fragments at the... Barracks and Pohakuloa Training Area installations in Hawaii. Materials License SUC-1593 authorizes...

International vision requirements for driver licensing and disability pensions: using a milestone approach in characterization of progressive eye disease

Directory of Open Access Journals (Sweden)

Alain M Bron

2010-11-01

Full Text Available Alain M Bron1, Ananth C Viswanathan2, Ulrich Thelen3, Renato de Natale4, Antonio Ferreras5, Jens Gundgaard6, Gail Schwartz7, Patricia Buchholz81Department of Ophthalmology, University Hospital, Dijon, France; 2Glaucoma Research Unit, Moorfields Eye Hospital NHS Foundation Trust and Department of Genetics, University College of London Institute of Ophthalmology, London, UK; 3Private Practice, Munster, Germany; 4Ospedale Civile di Monselice, Monselice, Italy; 5Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain; 6COWI, Kolding, Denmark; 7Wilmer Eye Institute, Johns Hopkins University, Glaucoma Consultants, Baltimore, MD, USA; 8Patricia Buchholz Consulting, Karlsruhe, GermanyObjective: Low vision that causes forfeiture of driver’s licenses and collection of disability pension benefits can lead to negative psychosocial and economic consequences. The purpose of this study was to review the requirements for holding a driver’s license and rules for obtaining a disability pension due to low vision. Results highlight the possibility of using a milestone approach to describe progressive eye disease.Methods: Government and research reports, websites, and journal articles were evaluated to review rules and requirements in Germany, Spain, Italy, France, the UK, and the US.Results: Visual acuity limits are present in all driver’s license regulations. In most countries, the visual acuity limit is 0.5. Visual field limits are included in some driver’s license regulations. In Europe, binocular visual field requirements typically follow the European Union standard of ≥120°. In the US, the visual field requirements are typically between 110° and 140°. Some countries distinguish between being partially sighted and blind in the definition of legal blindness, and in others there is only one limit.Conclusions: Loss of driving privileges could be used as a milestone to monitor progressive eye disease. Forfeiture could be standardized as a

7 CFR 6.28 - Transfer of license.

Science.gov (United States)

2010-01-01

... Licensing Authority will transfer to such other person the historical, nonhistorical or designated license... escrow with the sole condition for return of escrow being that the Licensing Authority determines that... to whom the historical licenses were issued during the quota year in which the sale or conveyance...

Free Software Licenses and Other Free Licenses: Genetic Code of Digital Common Goods

Directory of Open Access Journals (Sweden)

Marco Ciurcina

2017-06-01

Full Text Available This article explores the history and describes the main features of free software licenses and other free licenses in an attempt to shed light on the reasons for their success in promoting individual behaviors converging towards the collective construction of digital commons.

Treatment dropout and missed appointments among adults with attention-deficit/hyperactivity disorder: associations with patient- and disorder-related factors.

Science.gov (United States)

Soendergaard, Helle M; Thomsen, Per H; Pedersen, Pernille; Pedersen, Erik; Poulsen, Agnethe E; Nielsen, Jette M; Winther, Lars; Henriksen, Anne; Rungoe, Berit; Soegaard, Hans J

2016-02-01

Knowledge of factors associated with treatment dropout and missed appointments in adults with attention-deficit/hyperactivity disorder (ADHD) is very limited. On the basis of proposed hypotheses that past behavior patterns are more predictive of current behaviors of treatment dropout and missed appointments than are sociodemographic and clinical characteristics, we examined the associations of sociodemographic variables, clinical variables, risk-taking behavior, educational and occupational instability, and behaviors during mandatory schooling with the primary outcome measures of treatment dropout and missed appointments. In a naturalistic cohort study of 151 adult outpatients with ADHD initiating assessment in a Danish ADHD unit from September 1, 2010, to September 1, 2011, the Adult ADHD Self-Report Scale v1.1 symptom checklist (ASRS) and a thorough clinical interview were used to assess ADHD according to DSM-IV-TR criteria. Stepwise logistic regression analysis was used to estimate reported associations. A total of 27% of patients dropped out of treatment and a total of 42% had ≥ 3 missed appointments during treatment. Mood and anxiety disorders significantly lowered the odds of treatment dropout (odds ratio [OR] = 0.18; 95% confidence interval [CI], 0.05-0.65), whereas having started but not completed 2 or more educational programs apart from mandatory schooling significantly increased the odds of dropout (OR = 3.01; 95% CI, 1.32-6.89). Variables significantly associated with most missed appointments were low educational level (OR = 2.19; 95% CI, 1.12-4.31), 3 or more employments of less than 3 months' duration (OR = 2.86; 95% CI, 1.30-6.28), and having skipped class often/very often during mandatory schooling (OR = 2.65; 95% CI, 1.29-5.43). Additionally, the predominantly inattentive ADHD (ADHD-I) subtype lowered the odds of missed appointments (OR = 0.17; 95% CI, 0.05-0.62). Our results suggest that past behavior in terms of highest dropout rates in the

5 CFR 315.705 - Employees serving under transitional or veterans recruitment appointments.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Employees serving under transitional or veterans recruitment appointments. 315.705 Section 315.705 Administrative Personnel OFFICE OF PERSONNEL...-Conditional Employment From Other Types of Employment § 315.705 Employees serving under transitional or...

Implementing a Universal Well-Being Assessment to Mitigate Barriers to Resident Utilization of Mental Health Resources.

Science.gov (United States)

Sofka, Sarah; Grey, Carl; Lerfald, Nathan; Davisson, Laura; Howsare, Janie

2018-02-01

Physician utilization of well-being resources remains low despite efforts to promote use of these resources. We implemented a well-being assessment for internal medicine residents to improve access and use of mental health services. We scheduled all postgraduate year 1 (PGY-1) and PGY-2 residents at West Virginia University for the assessment at our faculty and staff assistance program (FSAP). While the assessment was intended to be universal (all residents), we allowed residents to "opt out." The assessment visit consisted of an evaluation by a licensed therapist, who assisted residents with a wellness plan. Anonymous surveys were distributed to all residents, and means were compared by Student's t test. Thirty-eight of 41 PGY-1 and PGY-2 residents (93%) attended the scheduled appointments. Forty-two of 58 residents (72%, including PGY-3s) completed the survey. Of 42 respondents, 28 (67%) attended the assessment sessions, and 14 (33%) did not. Residents who attended the sessions gave mean ratings of 7.8 for convenience (1, not convenient, to 9, very convenient), and 7.9 for feeling embarrassed if colleagues knew they attended (1, very embarrassed, to 9, not embarrassed). Residents who attended the assessment sessions reported they were more likely to use FSAP services in the future, compared with those who did not attend ( P  barriers to using counseling resources. The majority of residents who participated had a positive view of the program and indicated they would return to FSAP if they felt they needed counseling.

Licensing Teachers: Lessons from Other Professions.

Science.gov (United States)

Haberman, Martin

1986-01-01