The Trend of Voluntary Warnings in Electronic Nicotine Delivery System Magazine Advertisements

OpenAIRE

Shang, Ce; Chaloupka, Frank J.

2017-01-01

Some manufacturers of electronic nicotine delivery systems (ENDS) voluntarily carried health warnings in their advertisements. This study examined these voluntary warnings in magazine ads and plotted their trends between 2012 and early 2015. ENDS magazine ads were obtained through Kantar media and warnings were collected from the Chicago Public Library or the Trinkets and Trash surveillance system. The prevalence of voluntary warnings, warnings with the specific capitalized word “WARNING”, an...

77 FR 11120 - Patient Safety Organizations: Voluntary Relinquishment From UAB Health System Patient Safety...

Science.gov (United States)

2012-02-24

... Organizations: Voluntary Relinquishment From UAB Health System Patient Safety Organization AGENCY: Agency for... notification of voluntary relinquishment from the UAB Health System Patient Safety Organization of its status as a Patient Safety Organization (PSO). The Patient Safety and Quality Improvement Act of 2005...

Voluntary "involuntary" commitment--the briar-patch syndrome.

Science.gov (United States)

Miller, R D

1980-01-01

Szasz and others have pointed out that many so-called voluntary admissions to mental hospitals have various elements of coercion involved, and are thus not truly voluntary. The author contends that the converse situation is also true, that many patients admitted under involuntary commitment papers arrange for their own commitments. Reasons for such choices are discussed in the context of a review of the literature and several case histories.

Sociodemographic and clinical profile of patients in voluntary and involuntary psychiatric hospitalizations - doi:10.5020/18061230.2011.p361

Directory of Open Access Journals (Sweden)

Maria Selma Nogueira Oliveira

2012-01-01

Full Text Available Objective: To assess the sociodemographic and clinical profile of patients in psychiatric hospitalizations of voluntary inpatients (IPV and involuntary (IPI, in psychiatric hospitals of Fortaleza-CE, Brazil, under contract with the Unified Health System (SUS. Methods: A quantitative study, descriptive, cross-sectional and analytical. The sample comprised 393 patients, distributed among 253 IPV and 140 IPI, submitted to Psychiatry specialty treatment, in the year 2007. Results: For both patients, IPV and IPI, most were male: 185 (73.1% and 82 (58.6%; single: 181 (46.7% and 103 (26.5%; living in Fortaleza: 181 (71.5% and 95 (67.9%, respectively, and aged 20 to 60 years (mean age of 37 years. We observed significant difference between the type of hospital and patient gender (p = 0.003, which did not occur with marital status (p = 0.688 and origin (p = 0.95. The main symptom profiles which justified the clinical admission of these patients were the use of alcohol or drugs 70 (27.6%, changes in critical judgments 40 (28.6% and psychological distress 68 (26.9%. Family members were the main responsible for conducting these patients to the hospital. Conclusion: The results showed that patients on IPV and IPI, which joined in the study, had a socio-demographic and clinical profile characterized by: prevalence of male patients, from the capital Fortaleza, single, mean age of 37 years, having been brought to hospital by a relative, mainly due to alcohol use or drugs.

Voluntary agreements in environmental policy

International Nuclear Information System (INIS)

Torvanger, Asbjoern

2001-01-01

A typically voluntary agreement is signed between the authorities and an industrial sector in order to reduce the emission of environmentally harmful substances. There are many different types of agreements. Voluntary agreements are not strictly voluntary, since in the background there is often some kind of ''threat'' about taxation or fees if the industry is unwilling to cooperate. This type of agreements has become popular in many OECD countries during the last decades. In Norway there are only a few agreements of this type. Experience with the use of voluntary agreements as well as research show that they are less cost-effective than market-based instruments such as taxes and quota systems. If there are great restrictions on the use of taxes and quota systems because of information- or measurement problems, or because these instruments are not politically acceptable, then voluntary agreements may be an interesting alternative. Thus, voluntary agreements are best used as a supplement to other instruments in some niche areas of the environmental policy. In some cases, voluntary agreements may be used between two countries or at a regional level, for example within the EU

76 FR 9350 - Patient Safety Organizations: Voluntary Delisting From Rocky Mountain Patient Safety Organization

Science.gov (United States)

2011-02-17

... Organizations: Voluntary Delisting From Rocky Mountain Patient Safety Organization AGENCY: Agency for Healthcare... Organization: AHRQ has accepted a notification of voluntary relinquishment from Rocky Mountain Patient Safety Organization, a component entity of Colorado Hospital Association, of its status as a Patient Safety...

Incident Reporting in Mashhad Hospitals

Directory of Open Access Journals (Sweden)

Davoodi R

2013-10-01

Full Text Available Objectives: In this study, our aim was to evaluate and classify the voluntary error reports in the hospitals of Mashhad University of Medical Sciences. Patients have the right to receive health care in accordance to the best standards. Health care carries a risk of harm for patient safety, and with respect to today’s stressful systems with a large number of patients, it would be inevitable. The meaning of risk management is to predict adverse events and reduce their occurrence.Materials and Methods: A voluntary medical error reporting form was designed and approved by the clinical governance team of Mashhad Medical University. They were then distributed inside hospitals in the way in which everyone (health providers and patients could access them easily. The forms were collected and classified monthly in all wards. Classification was performed on the base of type, outcome and reporter. Data gathering took place from spring to autumn 2012. The data was analyzed by the SPSS software. Results: 2500 errors were extracted from 1000 voluntary error reporting forms of the 12 hospitals of Mashhad Medical University. The most frequent error type was treatment errors (36% related to drug administration, standard procedures and surgical events. Conclusions: Error reporting as a basic activity has an important role in discovering pitfalls of the health care system. To promote the reporting culture, its non punitive base must become clear for all professors and staff members, because this kind of reporting could lead to fewer medical errors and higher staff awareness about probable errors.

Comparison of seropositivity of human immunodeficiency virus, hepatitis B virus, hepatitis C virus, and syphilis among Hospital Cornea Retrieval Programme-Donors versus voluntary cornea donors at a large eye bank in Eastern India.

Science.gov (United States)

Basak, Soham; Basak, Samar K; Biswas, Bani

2017-11-01

To compare the serology profile of donors from Hospital Cornea Retrieval Programme-donors (HCRP-D) and voluntary cornea donors (VC-D) from a large eye bank in Eastern India. This is a retrospective analysis of donor details from January 2011 to December 2016. Donor demographics, cause of death, and serology reports were compiled. Postmortem blood was tested for human immunodeficiency virus 1 and 2 (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis using government-approved kits as per the National Programme for Control of Blindness Standards of Eye Banking. Donors for whom serology was not possible were excluded. A total of 4300 of 4353 donors were included of which 74.3% were hospital donors and 25.7% were voluntary donors. A total of 93 (2.2%) donors with 94 seropositive reports were noted: 79 (84.9%) from HCRP-D and 14 (15.1%) from VC-D which was statistically significantly higher (P = 0.02). Among seropositive reports, HIV, HBV, HCV, and syphilis accounted for 12 (12.8%), 38 (40.4%), 36 (38.3%), and eight (8.5%), respectively. There was no correlation between the cause of death and seropositivity. A statistically significant decreasing trend in seroprevalence among hospital donors was observed over the years (5.3% in 2011 to 1.4% in 2016; P = 0.004). Two (0.47%) of 421 hospital donors with prior negative serology were found to be seropositive. Seropositive rates are significantly higher among hospital donors in spite of medical prescreening compared to nonscreened voluntary donors. Serology should be repeated even when prior reports are available.

The Trend of Voluntary Warnings in Electronic Nicotine Delivery System Magazine Advertisements.

Science.gov (United States)

Shang, Ce; Chaloupka, Frank J

2017-01-10

Some manufacturers of electronic nicotine delivery systems (ENDS) voluntarily carried health warnings in their advertisements. This study examined these voluntary warnings in magazine ads and plotted their trends between 2012 and early 2015. ENDS magazine ads were obtained through Kantar media and warnings were collected from the Chicago Public Library or the Trinkets and Trash surveillance system. The prevalence of voluntary warnings, warnings with the specific capitalized word "WARNING", and MarkTen warnings were examined after being weighted using factors related to exposure between January 2012 and March 2015. Five brands (MarkTen, NJOY, MISTIC, and some Blu) carried warnings during the study period. The prevalence of warnings post 2012 that contained a description of nicotine did not significantly increase until the launch of MarkTen, which also happened several months before April 2014 when the U.S. food and drug administration (FDA) published its proposed deeming rule. In addition, none of these warnings met the criteria required by the FDA in the final rules. Voluntary warnings, particularly MarkTen warnings, significantly increased in ENDS magazine ads between 2014 and 2015. It is important to monitor how ENDS manufacturers will comply with the FDA regulation related to warnings and how this regulation will ultimately impact ENDS risk perceptions and use.

The Trend of Voluntary Warnings in Electronic Nicotine Delivery System Magazine Advertisements

Directory of Open Access Journals (Sweden)

Ce Shang

2017-01-01

Full Text Available Some manufacturers of electronic nicotine delivery systems (ENDS voluntarily carried health warnings in their advertisements. This study examined these voluntary warnings in magazine ads and plotted their trends between 2012 and early 2015. ENDS magazine ads were obtained through Kantar media and warnings were collected from the Chicago Public Library or the Trinkets and Trash surveillance system. The prevalence of voluntary warnings, warnings with the specific capitalized word “WARNING”, and MarkTen warnings were examined after being weighted using factors related to exposure between January 2012 and March 2015. Five brands (MarkTen, NJOY, MISTIC, and some Blu carried warnings during the study period. The prevalence of warnings post 2012 that contained a description of nicotine did not significantly increase until the launch of MarkTen, which also happened several months before April 2014 when the U.S. food and drug administration (FDA published its proposed deeming rule. In addition, none of these warnings met the criteria required by the FDA in the final rules. Voluntary warnings, particularly MarkTen warnings, significantly increased in ENDS magazine ads between 2014 and 2015. It is important to monitor how ENDS manufacturers will comply with the FDA regulation related to warnings and how this regulation will ultimately impact ENDS risk perceptions and use.

To relieve the sufferings of humanity, irrespective of party, politics or creed?: conflict, consensus and voluntary hospital provision in Edwardian South Wales.

Science.gov (United States)

Thompson, Steven

2003-08-01

This article examines the provision of voluntary hospital facilities for injured workers in the mining valleys of Edwardian South Wales. It considers the co-operation and conflict that characterized efforts to establish hospitals, and examines the attitudes and activities of workers, employers, and other interested groups. Despite certain instances of disagreement and conflict, this article demonstrates the significant levels of co-operation and consensus that characterized the efforts of employers and workers to provide communities with hospital facilities. This co-operation was perhaps surprising considering the bitter industrial conflict and social unrest of that period. The article uses this material to question assertions that hospitals reflect the social and political milieus of the communities in which they were situated and argues that the social relations produced by hospital provision sometimes coincided with wider social and industrial relations, but at other times differed from them or transcended them. Furthermore, the article demonstrates that the co-operation between employers and workers in the provision of hospitals in Edwardian South Wales did not stabilize social and industrial relations in the way that historians of associational voluntarism in other contexts have found.

Comparison of seropositivity of human immunodeficiency virus, hepatitis B virus, hepatitis C virus, and syphilis among Hospital Cornea Retrieval Programme-Donors versus voluntary cornea donors at a large eye bank in Eastern India

Directory of Open Access Journals (Sweden)

Soham Basak

2017-01-01

Full Text Available Purpose: To compare the serology profile of donors from Hospital Cornea Retrieval Programme-donors (HCRP-D and voluntary cornea donors (VC-D from a large eye bank in Eastern India. Methods: This is a retrospective analysis of donor details from January 2011 to December 2016. Donor demographics, cause of death, and serology reports were compiled. Postmortem blood was tested for human immunodeficiency virus 1 and 2 (HIV, hepatitis B virus (HBV, hepatitis C virus (HCV, and syphilis using government-approved kits as per the National Programme for Control of Blindness Standards of Eye Banking. Donors for whom serology was not possible were excluded. Results: A total of 4300 of 4353 donors were included of which 74.3% were hospital donors and 25.7% were voluntary donors. A total of 93 (2.2% donors with 94 seropositive reports were noted: 79 (84.9% from HCRP-D and 14 (15.1% from VC-D which was statistically significantly higher (P = 0.02. Among seropositive reports, HIV, HBV, HCV, and syphilis accounted for 12 (12.8%, 38 (40.4%, 36 (38.3%, and eight (8.5%, respectively. There was no correlation between the cause of death and seropositivity. A statistically significant decreasing trend in seroprevalence among hospital donors was observed over the years (5.3% in 2011 to 1.4% in 2016; P = 0.004. Two (0.47% of 421 hospital donors with prior negative serology were found to be seropositive. Conclusion: Seropositive rates are significantly higher among hospital donors in spite of medical prescreening compared to nonscreened voluntary donors. Serology should be repeated even when prior reports are available.

Voluntary euthanasia.

Science.gov (United States)

Brewin, Thurstan B

1986-05-10

Brewin comments upon James Rachels' The End of Life (Oxford University Press; 1986) and Voluntary Euthanasia (Peter Owen; 1986), a compilation edited by A.B. Downing and B. Smoker that is an expanded version of a 1969 work by Britain's Voluntary Euthanasia Society. Rachels maintains that it is illogical to distinguish between active and passive euthanasia. In Voluntary Euthanasia, 17 contributors argue the pros and cons of the issue. The Voluntary Euthanasia Society proposes that mentally competent persons be allowed by law to request euthanasia, either when taken ill or by advance directive. Brewin says he is almost but not quite convinced by the arguments for legalized voluntary euthanasia. He is concerned about the "slippery slope," the uncertainties of prognosis and quality of life judgments, the pressures to which the terminally ill or aged might be subjected, and the potentially negative impact of euthanasia on the physician patient relationship.

Voluntary certification systems in the EU wine sector: How to recognise quality and be safe from confusion

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Rolandi Silvia

2015-01-01

Full Text Available In recent years there has been a significant growth in voluntary certification schemes field in wine sector, by following a general trend that has characterised agricultural products and foodstuffs. The voluntary certification system is aimed at adding value to products, while differentiating it on the related market. The paper presents the preliminary results of a work-in-progress research on the voluntary certification schemes in the Italian wine sector. Through a case-study analysis, the paper is aimed at highlighting the emerging implementation issues. The scope of the case-studies is limited to three voluntary certification schemes, which underlie similarities with the organic wine farming and operate at business-to-consumer level. The paper is divided in three parts. Part I will examine the relevant legal framework on wine quality standards, by framing the legislation in mandatory, regulatory and voluntary. Part II will consider three case-studies of voluntary certification schemes that are implemented in the Italian wine sector. Part III will analyse the emerging issues that arise from the analysis of the case-studies. In conclusion, the paper highlights the key challenge, which concerns finding a trade-off between consumer protection and the promotion of free trade in an openly competitive market.

A Financial Analysis of Brazilian Hospitals Between 2006 and 2011

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Antônio Artur de Souza

2014-12-01

Full Text Available This paper presents the results of a research that aimed at developing a financial analysis of a sample of Brazilian hospitals between 2006 and 2011. The data were collected from financial statements of 23 hospitals and from the Database of United Health System. These secondary data were analyzed through the following techniques: descriptive statistics, Spearman’s correlation, Kolmogorov-Smirnov’s test, Kruskal-Wallis’ test and Chi-square’s test. It was verified that the sample presents unsatisfactory general results about financial performance, especially when related to financial ratios of profitability and return. However, the analysis of different categories of hospitals displays relevant and significant divergences, especially about the type of hospitals: publics and voluntaries ones. The voluntary hospitals present higher liquidity ratios and the best profitability and their capital structure usually focus on long term financing obtained from external agents. These evidences suggest that those organizations focus on financial leverage to achieve better results without deteriorate their liquidity. On the other hand, the public hospitals present lower liquidity as well as worse profitability and return ratios. It was verified that the large-sized hospitals usually present lower financial ratios (liquidity, profitability and return than the medium-sized hospitals.

HWMA/RCRA Closure Plan for the Basin Facility Basin Water Treatment System - Voluntary Consent Order NEW-CPP-016 Action Plan

International Nuclear Information System (INIS)

Evans, S. K.

2007-01-01

This Hazardous Waste Management Act/Resource Conservation and Recovery Act closure plan for the Basin Water Treatment System located in the Basin Facility (CPP-603), Idaho Nuclear Technology and Engineering Center (INTEC), Idaho National Laboratory Site, was developed to meet future milestones established under the Voluntary Consent Order. The system to be closed includes units and associated ancillary equipment included in the Voluntary Consent Order NEW-CPP-016 Action Plan and Voluntary Consent Order SITE-TANK-005 Tank Systems INTEC-077 and INTEC-078 that were determined to have managed hazardous waste. The Basin Water Treatment System will be closed in accordance with the requirements of the Hazardous Waste Management Act/Resource Conservation and Recovery Act, as implemented by the Idaho Administrative Procedures Act 58.01.05.009 and 40 Code of Federal Regulations 265, to achieve 'clean closure' of the tank system. This closure plan presents the closure performance standards and methods of achieving those standards for the Basin Water Treatment Systems

HWMA/RCRA Closure Plan for the Basin Facility Basin Water Treatment System - Voluntary Consent Order NEW-CPP-016 Action Plan

Energy Technology Data Exchange (ETDEWEB)

Evans, S. K.

2007-11-07

This Hazardous Waste Management Act/Resource Conservation and Recovery Act closure plan for the Basin Water Treatment System located in the Basin Facility (CPP-603), Idaho Nuclear Technology and Engineering Center (INTEC), Idaho National Laboratory Site, was developed to meet future milestones established under the Voluntary Consent Order. The system to be closed includes units and associated ancillary equipment included in the Voluntary Consent Order NEW-CPP-016 Action Plan and Voluntary Consent Order SITE-TANK-005 Tank Systems INTEC-077 and INTEC-078 that were determined to have managed hazardous waste. The Basin Water Treatment System will be closed in accordance with the requirements of the Hazardous Waste Management Act/Resource Conservation and Recovery Act, as implemented by the Idaho Administrative Procedures Act 58.01.05.009 and 40 Code of Federal Regulations 265, to achieve "clean closure" of the tank system. This closure plan presents the closure performance standards and methods of achieving those standards for the Basin Water Treatment Systems.

Moving from voluntary euthanasia to non-voluntary euthanasia: equality and compassion.

Science.gov (United States)

Amaraskekara, Kumar; Bagaric, Mirko

2004-09-01

The recent Dutch law legalising active voluntary euthanasia will reignite the euthanasia debate. An illuminating method for evaluating the moral status of a practice is to follow the implications of the practice to its logical conclusion. The argument for compassion is one of the central arguments in favour of voluntary active euthanasia. This argument applies perhaps even more forcefully in relation to incompetent patients. If active voluntary euthanasia is legalised, arguments based on compassion and equality will be directed towards legalising active non-voluntary euthanasia in order to make accelerated termination of death available also to the incompetent. The removal of discrimination against the incompetent has the potential to become as potent a catch-cry as the right to die. However, the legalisation of non-voluntary euthanasia is undesirable. A review of the relevant authorities reveals that there is no coherent and workable "best interests" test which can be invoked to decide whether an incompetent patient is better off dead. This provides a strong reason for not stepping onto the slippery path of permitting active voluntary euthanasia.

Differences in Voluntary Cow Traffic between Holstein and Illawarra Breeds of Dairy Cattle in a Pasture-based Automatic Milking System.

Science.gov (United States)

Clark, C E F; Kwinten, N B P; van Gastel, D A J M; Kerrisk, K L; Lyons, N A; Garcia, S C

2014-04-01

Automatic milking systems (AMS) rely upon voluntary cow traffic (the voluntary movement of cattle around a farm) for milk harvesting and feed consumption. Previous research on conventional milking systems has shown differences between dairy cow breeds for intake and milk production, however, the ability to manipulate voluntary cow traffic and milking frequency on AMS farms through breed selection is unknown. This study investigated the effect of breed (Holstein Friesian versus Illawarra) on voluntary cow traffic as determined by gate passes at the Camden AMS research farm dairy facility. Daily data on days in milk, milk yield, gate passes and milking frequency for 158 Holstein Friesian cows and 24 Illawarra cows were collated by month for the 2007 and 2008 years. Illawarra cows had 9% more gate passes/day than Holstein cows over the duration of the study; however, the milking frequency and milk yield of both breeds were similar. Gate passes were greatest for both breeds in early lactation and in the winter (June to August) and summer (December to February) seasons. These findings highlight an opportunity to translate increased voluntary cow movement associated with breed selection into increased milking frequencies, milk production and overall pasture-based AMS performance.

The role of medical abortion in the implementation of the law on voluntary termination of pregnancy in Uruguay.

Science.gov (United States)

Fiol, Verónica; Rieppi, Leticia; Aguirre, Rafael; Nozar, María; Gorgoroso, Mónica; Coppola, Francisco; Briozzo, Leonel

2016-08-01

To evaluate the implementation of the law that liberalizes voluntary abortion in Uruguay and enables health services to offer these services to the population. The legal and regulatory provisions are described and the national data-provided by the Ministry of Public Health's National Information System (SINADI)-on the number of voluntary terminations of pregnancy, the abortion method (medical or surgical), and whether it was performed as an outpatient or inpatient are analyzed. To determine complications, the number of maternal deaths and admissions to intensive care units for pregnant women was used. The study period ran from December 1, 2012, to December 31, 2014. A total of 15 996 abortions were performed during the study period; only 1.2% were surgical and 98.8% were medical. Of the latter, only 3.4% required hospitalization. Less than half of the pregnancies were terminated up to 9weeks of gestation and 54% were at 10 to 12weeks in a sample from the Pereira Rossell Hospital. The rapid nationwide rollout of voluntary termination of pregnancy services to all women was possible to a large degree thanks to the availability and broad acceptance of medical abortion, facilitated by the prior experience in applying the risk and harm reduction strategy. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Businesses' voluntary pro-health tobacco policies: a review and research agenda.

Science.gov (United States)

McDaniel, Patricia A; Malone, Ruth E

2012-01-01

Research on the role of businesses in tobacco control has focused primarily on retailers, advertising firms and the hospitality industry, all of which have tended to support tobacco industry interests and resist effective tobacco control policies. However, in several countries, businesses have a history of voluntarily adopting tobacco-related policies that may advance tobacco control objectives. These phenomena have received little research attention. Existing literature on businesses ending tobacco sales, instituting voluntary workplace smoking restrictions and establishing non-smoker only hiring policies was reviewed. A research agenda on voluntary business initiatives would enhance and complement research on mandatory tobacco control policies by identifying new advocacy opportunities; suggesting avenues for strengthening or reinforcing existing policy initiatives; laying the groundwork for new mandatory policies; helping to inform ethical debates about contentious voluntary policies; and contributing to a better understanding of how alliances between the tobacco industry and other businesses might be weakened.

Demographic Characteristics of Voluntary Donors Registered in Beijing Tongren Hospital Eye Bank of China: A Retrospective Study From 2007 to 2016.

Science.gov (United States)

Liu, Y; Zhang, Y N; Liu, Y; Zhang, J; Li, A P; Liang, Q F; Pan, Z Q

2017-10-01

Lack of willingness to pledge eyes among the general population is the main cause for the shortage of cornea tissue in China. A few studies have implied that general-population adults with specific demographics showed more willingness to donate their eyes. In this study, we analyzed the demographic characteristics of 918 voluntary donors registered in Beijing Tongren Hospital Eye Bank in the past 10 years for possible predictors that might help us to identify potential donors in Beijing and increase the donation rate. All copies of voluntary eye donation application forms filled by the registrants from 2007 to 2016 were collected. Basic demographics listed in the application form were extracted for analysis. Demographics were described as proportions and compared by means of a χ 2 test. Besides that, donor counts and proportions of combining 2 demographics from the 4 main demographics were described and compared. Voluntary donors greater than 50 years of age (n = 477, 53.0%) predominated the proportions. Regarding education level and occupation, donors with tertiary education (n = 484, 57.4%) were more numerous than donors with primary and secondary education (n = 355, 42.1%); office clerks, workers, and government officers were more willing to pledge eyes than were donors engaged in other occupations. In addition, donors of the Han race (n = 856, 94.9%) made up the majority and mainly were distributed in 5 central administrative districts of Beijing (n = 629, 77.5%). The present study suggests that older women (>50 years of age), living in a central district, with higher education level and engaged in white-collar work, were possible predictors for potential donors. Copyright © 2017 Elsevier Inc. All rights reserved.

Differences in Voluntary Cow Traffic between Holstein and Illawarra Breeds of Dairy Cattle in a Pasture-based Automatic Milking System

Directory of Open Access Journals (Sweden)

C. E. F. Clark

2014-04-01

Full Text Available Automatic milking systems (AMS rely upon voluntary cow traffic (the voluntary movement of cattle around a farm for milk harvesting and feed consumption. Previous research on conventional milking systems has shown differences between dairy cow breeds for intake and milk production, however, the ability to manipulate voluntary cow traffic and milking frequency on AMS farms through breed selection is unknown. This study investigated the effect of breed (Holstein Friesian versus Illawarra on voluntary cow traffic as determined by gate passes at the Camden AMS research farm dairy facility. Daily data on days in milk, milk yield, gate passes and milking frequency for 158 Holstein Friesian cows and 24 Illawarra cows were collated by month for the 2007 and 2008 years. Illawarra cows had 9% more gate passes/day than Holstein cows over the duration of the study; however, the milking frequency and milk yield of both breeds were similar. Gate passes were greatest for both breeds in early lactation and in the winter (June to August and summer (December to February seasons. These findings highlight an opportunity to translate increased voluntary cow movement associated with breed selection into increased milking frequencies, milk production and overall pasture-based AMS performance.

Voluntary Public Unemployment Insurance

DEFF Research Database (Denmark)

O. Parsons, Donald; Tranæs, Torben; Bie Lilleør, Helene

Denmark has drawn much attention for its active labor market policies, but is almost unique in offering a voluntary public unemployment insurance program requiring a significant premium payment. A safety net program – a less generous, means-tested social assistance plan – completes the system...

Support for Voluntary Euthanasia with No Logical Slippery Slope to Non-Voluntary Euthanasia.

Science.gov (United States)

Daskal, Steven

2018-01-01

This paper demonstrates that acceptance of voluntary euthanasia does not generate commitment to either non-voluntary euthanasia or euthanasia on request. This is accomplished through analysis of John Keown's and David Jones's slippery slope arguments, and rejection of their view that voluntary euthanasia requires physicians to judge patients as better off dead. Instead, voluntary euthanasia merely requires physicians to judge patients as within boundaries of appropriate deference. This paper develops two ways of understanding and defending voluntary euthanasia on this model, one focused on the independent value of patients' autonomy and the other on the evidence of well-being provided by patients' requests. Both avoid the purported slippery slopes and both are independently supported by an analogy to uncontroversial elements of medical practice. Moreover, the proposed analyses of voluntary euthanasia suggest parameters for the design of euthanasia legislation, both supporting and challenging elements of existing laws in Oregon and the Netherlands.

A roadmap for navigating voluntary and mandated programs for building energy efficiency

International Nuclear Information System (INIS)

Peterman, Andrew; Kourula, Arno; Levitt, Raymond

2012-01-01

Commercial building owners and managers often face the challenge of selecting the appropriate combination of voluntary and mandated programs for commercial building energy efficiency. Using a mixed-method, both quantitative and qualitative approach, this study finds that barriers to energy efficiency can be interpreted as strategic drivers for the emergence of five forms of voluntary and mandated program forms. We argue that the links between energy efficiency programs in commercial buildings should be conceptualized in a comprehensive manner by evaluating the strategic drivers that have ultimately led to the emergence of the principal forms of voluntary programs: economic incentives; certifications; alliances and partnerships; and internal company programs. We develop a conceptual framework that helps building owners and managers: identify the primary drivers for energy efficiency efforts; assess the efficacy and limitations of available program forms; apply each program form strategically in conjunction with a number of other program forms; and, ultimately, predict the emergence of new program forms. In addition to United States Department of Energy survey data, this study draws upon data collected through semi-structured interviews with experts at major U.S.-based corporations, federally funded laboratories, government agencies, and non-governmental organizations. - Highlights: ► Distills a complex system of energy efficiency programs into a single framework. ► Classify drivers, emerging forms, and shortcomings of each voluntary program form. ► Present survey and interview data from retail, real estate, and hospital experts. ► None of these programs alone meet organizational needs for energy efficiency. ► Entrepreneurs will play a key role by capitalizing on broken agency challenges.

[Adverse events self-declaration system and influenza vaccination coverage of healthcare workers in a tertiary hospital].

Science.gov (United States)

Velasco Munoz, Cesar; Sequera, Víctor-Guillermo; Vilajeliu, Alba; Aldea, Marta; Mena, Guillermo; Quesada, Sebastiana; Varela, Pilar; Olivé, Victoria; Bayas, José M; Trilla, Antoni

2016-02-19

During the influenza vaccination campaign 2011-2012 we established a self-declaration system of adverse events (AEs) in healthcare workers (HCW). The aim of this study is to describe the vaccinated population and analyse vaccination coverage and self-declared AEs after the voluntary flu vaccination in a university hospital in Barcelona. Observational study. We used the HCW immunization record to calculate the vaccination coverage. We collected AEs using a voluntary, anonymous, self-administered survey during the 2011-2012 flu vaccination campaign. We performed a logistic regression model to determine the associated factors to declare AEs. The influenza vaccination coverage in HCW was 30.5% (n=1,507/4,944). We received completed surveys from 358 vaccinated HCW (23.8% of all vaccinated). We registered AEs in 186 respondents to the survey (52.0% of all respondents). Of these, 75.3% (n=140) reported local symptoms after the flu vaccination, 9.7% (n=18) reported systemic symptoms and 15.1% (n=28) both local and systemic symptoms. No serious AEs were self-reported. Female sex and aged under 35 were both factors associated with declaring AEs. Our self-reporting system did not register serious AEs in HCW, resulting in an opportunity to improve HCW trust in flu vaccination. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Hospital Prices Increase in California, Especially Among Hospitals in the Largest Multi-hospital Systems

Directory of Open Access Journals (Sweden)

Glenn A. Melnick PhD

2016-06-01

Full Text Available A surge in hospital consolidation is fueling formation of ever larger multi-hospital systems throughout the United States. This article examines hospital prices in California over time with a focus on hospitals in the largest multi-hospital systems. Our data show that hospital prices in California grew substantially (+76% per hospital admission across all hospitals and all services between 2004 and 2013 and that prices at hospitals that are members of the largest, multi-hospital systems grew substantially more (113% than prices paid to all other California hospitals (70%. Prices were similar in both groups at the start of the period (approximately $9200 per admission. By the end of the period, prices at hospitals in the largest systems exceeded prices at other California hospitals by almost $4000 per patient admission. Our study findings are potentially useful to policy makers across the country for several reasons. Our data measure actual prices for a large sample of hospitals over a long period of time in California. California experienced its wave of consolidation much earlier than the rest of the country and as such our findings may provide some insights into what may happen across the United States from hospital consolidation including growth of large, multi-hospital systems now forming in the rest of the rest of the country.

The empirical slippery slope from voluntary to non-voluntary euthanasia.

Science.gov (United States)

Lewis, Penney

2007-01-01

This article examines the evidence for the empirical argument that there is a slippery slope between the legalization of voluntary and non-voluntary euthanasia. The main source of evidence in relation to this argument comes from the Netherlands. The argument is only effective against legalization if it is legalization which causes the slippery slope. Moreover, it is only effective if it is used comparatively-to show that the slope is more slippery in jurisdictions which have legalized voluntary euthanasia than it is in jurisdictions which have not done so. Both of these elements are examined comparatively.

ANALYSIS OF DONOR CORNEA RETRIEVAL DATA- HOSPITAL AND RESIDENCES

Directory of Open Access Journals (Sweden)

Rekha Gyanchand

2017-07-01

Full Text Available BACKGROUND The voluntary eye donation is still the most popular methods of eye donation in our country. Since last three decades, the voluntary eye donation is promoted by a number of NGOs and Government of India. The meaning of voluntary eye donation is that an individual has prior knowledge about eye donation and also has the contact number of the eye bank. When they come across any death in their community, they will contact the eye bank for eye donation. As per Eye Bank Association of India, the incidence of total blindness is 8.9 million and 1% of this is corneal blindness. Each year, 25,000 to 30,000/new corneal blind patients are added. The voluntary eye donation is not sufficient in providing transplantable corneas to the corneal blind. As our concentration is mainly on voluntary eye collections, this is one of the main reasons that we are unable reach our target of sight restoration in the management of corneal blindness. In this study, we have analysed the voluntary eye donations procured from residence and hospital. The aim of the study is to compare corneas procured by hospital eye donations and residence eye donations to look into all factors that contribute to a transplantable cornea. MATERIALS AND METHODS The donor corneas retrieved from the year 2005-2010 were analysed. The hospital eye donations and residential eye donations were divided into two study groups. The factors analysed were number of corneas collected, donor age and gender, serology test result, death to preservation time (DPT, optical grade cornea, utilisation of corneas for transplantation and role of pledging in eye donation. Study Type- Retrospective study. Study Done- At Lions International Eye Bank, Bangalore. RESULTS The total number of donor eyes collected from the year 2005-2010 were 7362 of which residence collections was 50.73% and hospital collections was 49.26%. The 5-year period between from 2005 to 2010 in spite of not conducting a Hospital Cornea

Awareness and attitude of antenatal clients towards HIV voluntary counselling and testing in Aminu Kano Teaching Hospital, Kano, Nigeria.

Science.gov (United States)

Iliyasu, Z; Kabir, M; Galadanci, H S; Abubakar, I S; Aliyu, M H

2005-01-01

Mother to child transmission accounts for the majority of HIV infections in children in the developing countries. This study assessed pregnant women's knowledge of HIV/AIDS, awareness and attitudes towards Voluntary Counselling and Testing (VCT) in a teaching hospital in northern Nigeria. A pre-tested structured interview questionnaire was administered on a cross-section of 210 antenatal clients in Aminu Kano Teaching Hospital, Nigeria. All respondents were aware of HIV/AIDS. Fifty seven percent had good knowledge, 32% had fair knowledge and the remaining 11% had poor knowledge of the infection. Most respondents were aware of VCT through health workers, mass media and friends. Similarly, most respondents (81.0%) approved of VCT, 13.0% disapproved of it and the remaining (6%) was undecided. The main reasons for disapproval were; fear of stigmatisation, isolation and effect on marriage security. Those that had tertiary level of education were three times more likely to accept VCT compared to those with lower levels of education (O.R=3.2, 95% confidence interval =1.3-8.0). Although the awareness of VCT for HIV was quite high with most antenatal clients harbouring positive attitudes towards it, there is a need to intensify health education to convince the remaining minority who are still sceptical or ignorant of the benefits of VCT.

Profiles of Attendees in Voluntary Counseling and Testing Centers of a Medical College Hospital in Coastal Karnataka

Science.gov (United States)

Jayarama, S; Shenoy, Shaliny; Unnikrishnan, B; Ramapuram, John; Rao, Manjula

2008-01-01

Research Question: What are the socio-demographic profile and risk behavior pattern of seropositive attendees in the voluntary counseling and testing center (VCTC)? Study Design: Retrospective study. Setting: VCTC in the outpatient complex of Kasturba Medical College Hospital, Mangalore, Karnataka. Subjects: Records pertaining to all the 539 and 330 seropositive attendees during the years 2005 and 2006, respectively, were included in the study besides data from 2001 onwards in order to assess the time trend of human immunodeficiency virus (HIV). Study Variables: Age, sex, marital status, religion, educational status, occupation, place of residence and pattern of risk behavior in relation to HIV/AIDS. Statistical Analysis: Analysis was done with SPSS version 11. Statistical test and Chi-square was done, and P profile, about 17-27% were housewives, 19-21% were laborers/hotel workers and 7% were entrepreneurs. About 45% were from urban area and nearly one-third hailing from other districts in the border of Karnataka. About 25% were exposed to commercial sex workers; another 21-23% were involved in premarital sex and nearly 38% were indulging in heterosexual activities. PMID:19966996

Hemochromatosis Patients as Voluntary Blood Donors

Directory of Open Access Journals (Sweden)

Tara E Power

2004-01-01

Full Text Available The present study was designed to investigate hemochromatosis patients' suitability as blood donors as well as their perceptions and experience with the current public donation system. Participants were gathered from a list of current hemochromatosis patients (n=120 and members of the Canadian Hemochromatosis Society (n=1000. Of the 1120 surveys mailed out to these groups, 801 surveys were returned completed. The sample respondents had a mean age of 57.44 years (SD=12.73; range 19 to 87 years, and 57% were men. It was found that 20% (160 of the respondents have donated blood since their diagnosis; however, only 12% of the respondents indicated that they use voluntary blood donation as a means of maintaining their iron levels. Forty per cent of the respondents indicated that they had been refused from voluntary donation. Despite the fact that in May 2001 the Canadian Blood Services, in collaboration with the Canadian Hemochromatosis Society, began a promotion campaign to encourage hemochromatosis patients to become voluntary blood donors, the present study found that 15% of the respondents reported having been refused from the voluntary blood donation service due to the diagnosis of hemochromatosis. With respect to quality of life, it was found that individuals who donate blood were generally healthier with respect to physical functioning and bodily pain, however, these findings may indicate that hemochromatosis patients who are healthier are better able to donate at public blood banks, rather than that voluntary blood donation has an effect on the donors' physical functioning over phlebotomy clinic users. These study findings suggest that although there may be other medical factors limiting individuals from donating, hemochromatosis patients are interested in being voluntary blood donors and this potential resource is currently under-used.

Balancing auditor choices during the transition from a mandatory to a voluntary joint audit system in Denmark

DEFF Research Database (Denmark)

Holm, Claus; Thinggaard, Frank

This paper examines agency explanations for choice of auditor in the context of the transition from a mandatory to a voluntary joint audit system in Denmark. Our findings suggest that companies do use auditor choices as a balancing mechanism against independence threats.More specifically, we find...... more frequent rotation when single auditor are appointed, more equal audit fee share in the year before the voluntary joint audit system took effect and higher propensity to choose non-BigN auditor (absence of dominance) when joint audits are chosen, and lower NAS increases when joint audits...... are involved. We also find that the length of relationship with prime BigN auditors are longer than for non-BigN, thus suggesting potential problem with independence in appearance consistent with the EC green paper issues raised concerning audit firm concentration. However, we do not find differences between...

Voluntary Environmental Governance Arrangements

NARCIS (Netherlands)

van der Heijden, J.

2012-01-01

Voluntary environmental governance arrangements have focal attention in studies on environmental policy, regulation and governance. The four major debates in the contemporary literature on voluntary environmental governance arrangements are studied. The literature falls short of sufficiently

Tools in a clinical information system supporting clinical trials at a Swiss University Hospital.

Science.gov (United States)

Weisskopf, Michael; Bucklar, Guido; Blaser, Jürg

2014-12-01

Issues concerning inadequate source data of clinical trials rank second in the most common findings by regulatory authorities. The increasing use of electronic clinical information systems by healthcare providers offers an opportunity to facilitate and improve the conduct of clinical trials and the source documentation. We report on a number of tools implemented into the clinical information system of a university hospital to support clinical research. In 2011/2012, a set of tools was developed in the clinical information system of the University Hospital Zurich to support clinical research, including (1) a trial registry for documenting metadata on the clinical trials conducted at the hospital, (2) a patient-trial-assignment-tool to tag patients in the electronic medical charts as participants of specific trials, (3) medical record templates for the documentation of study visits and trial-related procedures, (4) online queries on trials and trial participants, (5) access to the electronic medical records for clinical monitors, (6) an alerting tool to notify of hospital admissions of trial participants, (7) queries to identify potentially eligible patients in the planning phase as trial feasibility checks and during the trial as recruitment support, and (8) order sets to facilitate the complete and accurate performance of study visit procedures. The number of approximately 100 new registrations per year in the voluntary trial registry in the clinical information system now matches the numbers of the existing mandatory trial registry of the hospital. Likewise, the yearly numbers of patients tagged as trial participants as well as the use of the standardized trial record templates increased to 2408 documented trial enrolments and 190 reports generated/month in the year 2013. Accounts for 32 clinical monitors have been established in the first 2 years monitoring a total of 49 trials in 16 clinical departments. A total of 15 months after adding the optional feature of

International Voluntary Renewable Energy Markets (Presentation)

Energy Technology Data Exchange (ETDEWEB)

Heeter, J.

2012-06-01

This presentation provides an overview of international voluntary renewable energy markets, with a focus on the United States and Europe. The voluntary renewable energy market is the market in which consumers and institutions purchase renewable energy to match their electricity needs on a voluntary basis. In 2010, the U.S. voluntary market was estimated at 35 terawatt-hours (TWh) compared to 300 TWh in the European market, though key differences exist. On a customer basis, Australia has historically had the largest number of customers, pricing for voluntary certificates remains low, at less than $1 megawatt-hour, though prices depend on technology.

The influence of health policy and market factors on the hospital safety net.

Science.gov (United States)

Bazzoli, Gloria J; Lindrooth, Richard C; Kang, Ray; Hasnain-Wynia, Romana

2006-08-01

To examine how the financial pressures resulting from the Balanced Budget Act (BBA) of 1997 interacted with private sector pressures to affect indigent care provision. American Hospital Association Annual Survey, Area Resource File, InterStudy Health Maintenance Organization files, Current Population Survey, and Bureau of Primary Health Care data. We distinguished core and voluntary safety net hospitals in our analysis. Core safety net hospitals provide a large share of uncompensated care in their markets and have large indigent care patient mix. Voluntary safety net hospitals provide substantial indigent care but less so than core hospitals. We examined the effect of financial pressure in the initial year of the 1997 BBA on uncompensated care for three hospital groups. Data for 1996-2000 were analyzed using approaches that control for hospital and market heterogeneity. All urban U.S. general acute care hospitals with complete data for at least 2 years between 1996 and 2000, which totaled 1,693 institutions. Core safety net hospitals reduced their uncompensated care in response to Medicaid financial pressure. Voluntary safety net hospitals also responded in this way but only when faced with the combined forces of Medicaid and private sector payment pressures. Nonsafety net hospitals did not exhibit similar responses. Our results are consistent with theories of hospital behavior when institutions face reductions in payment. They raise concern given continuing state budget crises plus the focus of recent federal deficit reduction legislation intended to cut Medicaid expenditures.

Voluntary Safety Management System in the Manufacturing Industry – To What Extent does OHSAS 18001 Certification Help?

Directory of Open Access Journals (Sweden)

Paas Õnnela

2015-11-01

Full Text Available Occupational risk prevention can be managed in several ways. Voluntary safety management standard OHSAS 18001 is a tool, which is considered to give contribution in effective risk management in the manufacturing industry. The current paper examines the benefits of OHSAS 18001 based on the statistical analysis. MISHA method is used for safety audit in 16 Estonian enterprises. The results demonstrate the objectives why companies implement or are willing to implement OHSAS 18001, bring out differences in safety activities for 3 types of companies and determine correlations among different safety activity areas. The information is valuable for enterprises that are willing to improve their safety activities via a voluntary safety management system.

78 FR 69793 - Voluntary Remedial Actions and Guidelines for Voluntary Recall Notices

Science.gov (United States)

2013-11-21

...'' and ``hard copy'' as possible forms of direct voluntary recall notice. Because firms often lack... formatting of a voluntary recall notice in the form of a press release should comport with the most current... transmitted using an electronic medium and in hard copy form. Acceptable forms of, and means for...

The voluntary offset - approaches and limitations

International Nuclear Information System (INIS)

2012-06-01

After having briefly presented the voluntary offset mechanism which aims at funding a project of reduction or capture of greenhouse gas emissions, this document describes the approach to be followed to adopt this voluntary offset, for individuals as well as for companies, communities or event organisations. It describes other important context issues (projects developed under the voluntary offset, actors of the voluntary offsetting market, market status, offset labels), and how to proceed in practice (definition of objectives and expectations, search for needed requirements, to ensure the meeting of requirements with respect to expectations). It addresses the case of voluntary offset in France (difficult implantation, possible solutions)

Inpatient satisfaction and usage patterns of personalized smart bedside station system for patient-centered service at a tertiary university hospital.

Science.gov (United States)

Ryu, Borim; Kim, Seok; Lee, Kee-Hyuck; Hwang, Hee; Yoo, Sooyoung

2016-11-01

Bedside stations, also known as bedside terminals, are in place to enhance the quality and experience of a hospital's healthcare service delivery. The purpose of this study was to identify information needs and overall satisfaction with the personalized patient bedside system, called Smart Bedside Station (SBS) system, embedded in a tertiary general university hospital. End-user responses on the satisfaction survey and system usage logs of the SBS system were collected and analyzed. For the user opinion survey, 156 nurses and 1914 patients, their family members, or caregivers participated during the evaluation period of 2013 to 2014 in this study. All working nurses in the SBS-installed ward were answered the paper-based evaluation, for complete enumeration survey. Inpatients were voluntary participated to deliver the online questionnaire on the SBS menu. We also explored system log data including page calls and usage time from December 2013 to 2015. Regarding the relationship of overall satisfaction of the SBS with patient's characteristics, patient's education status and degree of familiarity with the smart device were statistically significant. From the analysis of system logs, Personalized My Menu(28.0%) was the most frequently used menu item (except for TV and Internet entertainment service use of 62.7%),it provides individual health information, such as laboratory test results, hospital fee check, message logs, daily medication information, and meal information. Next frequently used menus were information support(4.9%) which deliver hospital guide and health information and convenience service ordering(4.4%) such as meal order, bed sheet change. Satisfaction survey results and log data results show that the personalized service enhances the user satisfaction during hospital admission. Our post-implementation experience and subsequent assessment of SBS system is capable of providing insights into improving the hospital information system and service contents

Seroprevalence of human immunodeficiency virus among voluntary counseling and testing clients at the University of Gondar Teaching Hospital, Northwest Ethiopia

Directory of Open Access Journals (Sweden)

Sinku Y

2016-08-01

Full Text Available Yohannes Sinku,1,2 Takele Gezahegn,1 Yalewayiker Gashaw,1 Meseret Workineh,1 Tekalign Deressa1 1School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, 2Diagnostic Laboratory Case Team, University of Gondar Teaching Hospital, Gondar, Ethiopia Background: The epidemiology of human immunodeficiency virus (HIV infection in Ethiopia varies with regions, study population, and time. Thus, timely information on HIV epidemiology is critical for the combat of the epidemic. In this study, we aim to update HIV prevalence and risk factors among voluntary counseling and testing (VCT clients at the University of Gondar Teaching Hospital, Northwest Ethiopia.Methods: A total of 2,120 VCT clients’ records from September 2007 to August 2010 were analyzed retrospectively. Bivariate logistic regression analysis was used to identify significant predictors. Odds ratio (OR and 95% confidence intervals (CIs were calculated. Statistical significance was set at P-value <0.05.Results: Of 2,120 VCT clients, 363 (17.1% were seropositive for HIV. A higher rate of HIV positivity was observed among female clients (20.4% than that in male clients (14.0% (OR 1.58, 95% CI 1.26–1.98, P=0.00. Widowed (95% CI 10.42–34.92, P=0.00, married (95% CI 3.42–5.94, P=0.00, divorced (95% CI 2.79–5.32, P=0.00, and illiterate (95% CI 2.33–5.47, P=0.00 clients were associated with HIV infection with the odds ratios of 19.07, 4.51, 3.85, and 3.57, respectively. Clients within the age category of 35–49 years (OR 5.03, 95% CI 3.56–7.12, P=0.00 and above the age of 50 years (OR 4.99, 95% CI 2.67–9.34, P=0.00 were more likely to be infected with HIV.Conclusion: HIV is still the major concern of public health in the Gondar area as evidenced by our data. Being female, widowed, married, illiterate, and older age were the identified risk factors for HIV infection. Thus, consideration of these factors in future intervention and

Comparing Voluntary and Mandatory Gameplay

Directory of Open Access Journals (Sweden)

Esther Kuindersma

2016-09-01

Full Text Available Gameplay is commonly considered to be a voluntary activity. Game designers generally believe that voluntary gameplay is essentially different from mandatory gameplay. Such a belief may be a challenge for serious games, as instruction is usually mandatory. The article describes the outcomes of two experiments on the impact of voluntariness on the learning effect and enjoyment of a serious game. In the first experiment freedom of choosing to play a serious game was studied, with participants who had volunteered to participate. The results suggested that, contrary to the opinion of many game designers, being required to play a serious game does not automatically take the fun out of the game. The second experiment had voluntary participants and mandatory participants, who had to participate as part of a homework assignment. The outcomes show that mandatory participants enjoyed the game as much as the voluntary participants, even if they had to play the game for a minimum required time. These studies indicate that mandatory gameplay does not reduce enjoyment and learning effect.

Smart information system for gachon university gil hospital.

Science.gov (United States)

Park, Dong Kyun; Jung, Eun Young; Jeong, Byung Hui; Moon, Byung Chan; Kang, Hyung Wook; Tchah, Hann; Han, Gi Seong; Cheng, Woo Sung; Lee, Young Ho

2012-03-01

In this research, the hospital information system of Gachon University Gil hospital is introduced and a future strategy for hospital information systems is proposed. This research introduces the development conditions of hospital information system at Gachon University Gil hospital, information about the development of the enterprise resource planning (ERP), a medical service process improvement system, and the personal health record (PHR) system. The medical service process and work efficiency were improved through the medical service process improvement system, which is the most common hospital information system at Gachon University Gil hospital and which includes an emergency medical service system, an online evaluation system and a round support system. Gachon University Gil hospital developed medical service improvement systems to increase work efficiency of medical team and optimized the systems to prove the availability of high-quality medical services for patients and their families. The PHR-based personalized health care solution is under development and will provide higher quality medical service for more patients in the future.

Linking mortgage finance incentives to a voluntary home energy rating system: Insight into consensus building

International Nuclear Information System (INIS)

Jenior, M.-M.

1994-01-01

A collaborative consensus process was created to implement a program linking voluntary home energy rating systems (HERS) to mortgage incentives. The participants involved many of the stakeholders or interest groups who have a role in implementing and who will be affected by energy efficiency mortgate incentive programs linked to HERS. The participants included representatives from the primary and secondary mortgage market; real estate, home building, and remodeling industries; utilities; state, local, consumer, and environmental organizations; and home energy rating providers. The participants defined the actions required to implement as well as the technical requirements of a program linking home energy ratings and mortgage finance. Building on the recommendations of the collaborative process, members of the collaborative continue to take initiatives to put a Home Energy Rating Systems Council into place, in planning pilot programs for developing and testing ways to link HERS and mortgage programs, and in making home buyers and owners aware of existing mortgage incentives. At the same time, mortgage providers are working to develop uniformity among mortgage incentive programs and with the US Department of Energy to develop procedures to verify the relative accuracy of HERS calculation tools and their application, and with the emerging HERS Council to develop the guidelines for voluntary HERS required under the Energy Policy Act of 1992

Effects of a Voluntary Front-of-Pack Nutrition Labelling System on Packaged Food Reformulation: The Health Star Rating System in New Zealand.

Science.gov (United States)

Mhurchu, Cliona Ni; Eyles, Helen; Choi, Yeun-Hyang

2017-08-22

Interpretive, front-of-pack (FOP) nutrition labels may encourage reformulation of packaged foods. We aimed to evaluate the effects of the Health Star Rating (HSR), a new voluntary interpretive FOP labelling system, on food reformulation in New Zealand. Annual surveys of packaged food and beverage labelling and composition were undertaken in supermarkets before and after adoption of HSR i.e., 2014 to 2016. Outcomes assessed were HSR uptake by food group star ratings of products displaying a HSR label; nutritional composition of products displaying HSR compared with non-HSR products; and the composition of products displaying HSR labels in 2016 compared with their composition prior to introduction of HSR. In 2016, two years after adoption of the voluntary system, 5.3% of packaged food and beverage products surveyed ( n = 807/15,357) displayed HSR labels. The highest rates of uptake were for cereals, convenience foods, packaged fruit and vegetables, sauces and spreads, and 'Other' products (predominantly breakfast beverages). Products displaying HSR labels had higher energy density but had significantly lower mean saturated fat, total sugar and sodium, and higher fibre, contents than non-HSR products (all p -values labelled products compared with their composition prior to adoption of HSR. Reformulation of HSR-labelled products was greater than that of non-HSR-labelled products over the same period, e.g., energy reduction in HSR products was greater than in non-HSR products (-1.5% versus -0.4%), and sodium content of HSR products decreased by 4.6% while that of non-HSR products increased by 3.1%. We conclude that roll-out of the voluntary HSR labelling system is driving healthier reformulation of some products. Greater uptake across the full food supply should improve population diets.

HIV/AIDS treatment in two Ghanaian hospitals : experiences of patients, nurses and doctors

NARCIS (Netherlands)

Dapaah, Jonathan Mensah

2012-01-01

This thesis is based on fifteen months of anthropological research in the voluntary counselling and testing centres and antiretroviral therapy clinics of two hospitals in Ghana, St. Patrick's Hospital at Maase-Offinso and Komfo Anokye Teaching Hospital in Kumasi, including in-depth conversations

Joint-Service Integration: An Organizational Culture Study of the United States Department of Defense Voluntary Education System

Science.gov (United States)

Benson, Martin K.

2010-01-01

The purpose of the descriptive case study with a multiple case framework was to (a) describe the organizational cultures of education programs and leaders in the United States (U.S.) Department of Defense (DoD) voluntary education system on Oahu, Hawaii; (b) determine if an overlapping common organizational culture exists; and (c) assess the…

42 CFR 419.20 - Hospitals subject to the hospital outpatient prospective payment system.

Science.gov (United States)

2010-10-01

... prospective payment system. 419.20 Section 419.20 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL... Outpatient Prospective Payment System § 419.20 Hospitals subject to the hospital outpatient prospective...

Voluntary Disclosure and Risk Sharing

NARCIS (Netherlands)

Suijs, J.P.M.

2001-01-01

This paper analyzes the disclosure strategy of firms that face uncertainty regarding the investor's response to a voluntary disclosure of the firm's private information.This paper distinguishes itself from the existing disclosure literature in that firms do not use voluntary disclosures to separate

Factors Affecting Acceptance of Hospital Information Systems Based on Extended Technology Acceptance Model: A Case Study in Three Paraclinical Departments.

Science.gov (United States)

Nadri, Hamed; Rahimi, Bahlol; Lotfnezhad Afshar, Hadi; Samadbeik, Mahnaz; Garavand, Ali

2018-04-01

 Regardless of the acceptance of users, information and communication systems can be considered as a health intervention designed to improve the care delivered to patients. This study aimed to determine the adoption and use of the extended Technology Acceptance Model (TAM2) by the users of hospital information system (HIS) in paraclinical departments including laboratory, radiology, and nutrition and to investigate the key factors of adoption and use of these systems.  A standard questionnaire was used to collect the data from nearly 253 users of these systems in paraclinical departments of eight university hospitals in two different cities of Iran. A total of 202 questionnaires including valid responses were used in this study (105 in Urmia and 97 in Khorramabad). The data were processed using LISREL and SPSS software and statistical analysis technique was based on the structural equation modeling (SEM).  It was found that the original TAM constructs had a significant impact on the staffs' behavioral intention to adopt HIS in paraclinical departments. The results of this study indicated that cognitive instrumental processes (job relevance, output quality, result demonstrability, and perceived ease of use), except for result demonstrability, were significant predictors of intention to use, whereas the result revealed no significant relationship between social influence processes (subjective norm, voluntariness, and image) and the users' behavioral intention to use the system.  The results confirmed that several factors in the TAM2 that were important in previous studies were not significant in paraclinical departments and in government-owned hospitals. The users' behavior factors are essential for successful usage of the system and should be considered. It provides valuable information for hospital system providers and policy makers in understanding the adoption challenges as well as practical guidance for the successful implementation of information

Operant Variability and Voluntary Action

Science.gov (United States)

Neuringer, Allen; Jensen, Greg

2010-01-01

A behavior-based theory identified 2 characteristics of voluntary acts. The first, extensively explored in operant-conditioning experiments, is that voluntary responses produce the reinforcers that control them. This bidirectional relationship--in which reinforcer depends on response and response on reinforcer--demonstrates the functional nature…

The determinants of voluntary traceability standards. The case of the wine sector

Directory of Open Access Journals (Sweden)

Stefanella Stranieri

2018-06-01

Full Text Available The aim of this paper is to study the determinants leading firms to choose among different kinds of voluntary traceability standards in the wine sector. To achieve this goal, we referred both to individual and institutional-level determinants, which are identified to play an important role in the literature related to the implementation of quality and safety standards. In specific, we referred to two theoretical approaches to better understand the industry behaviour towards the adoption of voluntary traceability, i.e. the Theory of Reasoned Action and the Institutional Theory. We developed a vis-à-vis survey through a questionnaire on a sample of Italian wineries approached during the most important Italian wine exhibitions in 2016. The results suggest that when wineries show positive cognitive beliefs towards voluntary traceability standards, they will probably implement complex traceability systems, which require high investments and efforts for their management. On the contrary, when the institutional environment plays a key role in the perception of wine processors, a simple and flexible traceability system seems to be preferred. Keywords: Voluntary traceability standards, Institutional determinants, Cognitive determinants

78 FR 15882 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

Science.gov (United States)

2013-03-13

... Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and... Register entitled ``Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates; Hospitals...

The architecture of enterprise hospital information system.

Science.gov (United States)

Lu, Xudong; Duan, Huilong; Li, Haomin; Zhao, Chenhui; An, Jiye

2005-01-01

Because of the complexity of the hospital environment, there exist a lot of medical information systems from different vendors with incompatible structures. In order to establish an enterprise hospital information system, the integration among these heterogeneous systems must be considered. Complete integration should cover three aspects: data integration, function integration and workflow integration. However most of the previous design of architecture did not accomplish such a complete integration. This article offers an architecture design of the enterprise hospital information system based on the concept of digital neural network system in hospital. It covers all three aspects of integration, and eventually achieves the target of one virtual data center with Enterprise Viewer for users of different roles. The initial implementation of the architecture in the 5-year Digital Hospital Project in Huzhou Central hospital of Zhejiang Province is also described.

Proprietary hospitals in cost containment.

Science.gov (United States)

Jones, D A

1985-08-23

Any effort to control the rise in health care costs must start with analyzing the causes, which are really quite simple. Most cost control efforts fail because they do not address the causes. The causes are large subsidies in several forms that send a false message that health care is free and should be used abundantly, and expansive reimbursement programs that reward inefficient providers with higher payments. This combination of demand stimulation and cost-plus reimbursement produced the world's most expensive health care delivery system and strident calls for reform. A long overdue change in public policy took effect October 1, 1983, when Medicare payments moved from cost-plus reimbursement to fixed, prospectively determined prices. Because it addressed one of the causes of medical inflation, this change has been effective in slowing the rise in Medicare expenditures. Sponsorship of a hospital is not a determinant of its cost-effectiveness. There are examples of efficient and inefficient hospitals in both the voluntary and the investor-owned or taxpaying hospitals. The determining factor is the will of management to keep costs under control.

Status and Trends in the U.S. Voluntary Green Power Market (2013 Data)

Energy Technology Data Exchange (ETDEWEB)

Heeter, J.; Belyeu, K.; Kuskova-Burns, K.

2014-11-01

Voluntary green power markets are those in which consumers and institutions voluntarily purchase renewable energy to match their electricity needs. This report surveys utilities, competitive suppliers, renewable energy certificate (REC) marketers, and, for the first time, the community choice aggregation market. This report finds that the voluntary market totaled 62 million megawatt-hours in 2013. Approximately 5.4 million customers are purchasing green power. This report presents data and analysis on voluntary market sales and customer participation, products and premiums, green pricing marketing, and administrative expenses. The report also details trends in REC tracking systems, REC pricing in voluntary and compliance markets, community and crowd-funded solar, and interest in renewable energy by the information and communication technologies sector.

Voluntary vs directed siting -- or somewhere in-between?

Energy Technology Data Exchange (ETDEWEB)

Peelle, E.B.

1994-04-01

Waste siting gridlock in the United States and Canada has led to experimentation with voluntary and hybrid or ``mixed mode`` siting. We review nuclear and hazardous waste voluntary siting (VS) results for selected cases in the U.S, and Canada. Findings indicate that VS is not a panacea, but that current siting efforts are inadequate tests of its potential. We suggest trials of improved VS protocols and more effort on hybrid approaches in which the developer chooses the site but is required to reach agreement on conditions with local stakeholders. Mixed mode siting may be better suited to the US context and its three-tiered governmental system.

Disincentives to voluntary transactions

International Nuclear Information System (INIS)

Anon.

1991-01-01

Current legal, regulatory and institutional standards and practices provide several disincentives for a utility wishing to engage in voluntary wheeling transactions, and are discussed here. These disincentives largely arise from the fact that regulation, like the transmission system itself, is based on the notion of integrated utilities engaging in transactions largely for reliability reasons. Factors which fall into this category are: a pricing regime based on embedded costs, the ratemaking treatment of revenues derived from coordination and transmission services, and several provisions in legislation and FERC regulations

77 FR 4908 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

Science.gov (United States)

2012-02-01

... Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal... the final rule entitled ``Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2012 Rates...

77 FR 65495 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

Science.gov (United States)

2012-10-29

... Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and... Federal Register entitled ``Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates...

The voluntary fulfillment of the taxes payment as reformative institution of Venezuelan tax system

Directory of Open Access Journals (Sweden)

Jose Guillermo Garcia

2007-07-01

Full Text Available A consensus between the reformers of the public administration exists on a matter that changes are not decreed, but that these require, for their effective fulfillment of certain conditions, like stimulation of actors affected by the reforms, to recognize the new scenario like favorable and therefore, to act in its name. Under this premise, this paper analyzes the voluntary fulfillment of the taxes payment as reformative institution of the Venezuelan tax system, which has implied the development of a formal incentives structure promoting the initiative of conscious tax payment.

Correlates of oncologist-issued referrals for psycho-oncology services: what we learned from the electronic voluntary screening and referral system for depression (eVSRS-D).

Science.gov (United States)

Lee, Joo-Young; Jung, Dooyoung; Kim, Won-Hyoung; Lee, Hyuk-Joon; Noh, Dong-Young; Hahm, Bong-Jin

2016-02-01

Depression in cancer patients is under-recognized and under-treated. To better identify depression, we designed a voluntary depression screening system. Based on its data, we examined trends in oncologist-issued referrals for the psycho-oncology service (POS). The Electronic Voluntary Screening and Referral System for Depression (eVSRS-D) comprises self-screening, automated reporting, and referral guidance. Using touch-screen kiosks at a tertiary hospital in Korea, participants with cancer completed the Patient Health Questionnaire-9 at their convenience, received the results, and reported their willingness to participate in POS. At oncology appointments, oncologists received the screening reports and issued referrals following pre-recommended guidelines. The correlates of actual referrals were examined across all participants and within the willing and non-willing groups. Among the 838 participants, 56.3% reported severe depression symptoms, 30.5% wanted a referral, and 14.8% were actually referred. The correlates of participants' desire for referral were more severe depression symptoms, being unmarried, and being metastasis and recurrence free. Among all participants, the correlates of actual referrals were unemployment, less severe depression symptoms, poorer performance, treatment status, and wanting a referral. The sole correlate of actual referrals within the non-willing group was poorer performance, and no significant correlates existed within the willing group. The non-referrals were mostly (87.1%) because of postponed decisions. The eVSRS-D cannot definitively diagnose major depression but may efficiently self-select a population with significant depression symptoms. The patients' willingness to engage the POS most strongly predicted the actual referrals. Oncologist reviews of screening reports may not result in further depression severity-specific referrals. Copyright © 2015 John Wiley & Sons, Ltd.

Redefining RECs: Additionality in the voluntary Renewable Energy Certificate market

Science.gov (United States)

Gillenwater, Michael Wayne

long-term contracts that would reduce the risk of relying on revenue the voluntary green power market. Although no simple solutions are identified, a proposal for integrating RECs into a load based cap-and-trade system is presented. Keywords: Renewable Energy Certificate (REC); Renewable Portfolio Standard (RPS); emission offset; additionality; attributes

Health systems: changes in hospital efficiency and profitability.

Science.gov (United States)

Büchner, Vera Antonia; Hinz, Vera; Schreyögg, Jonas

2016-06-01

This study investigates potential changes in hospital performance after health system entry, while differentiating between hospital technical and cost efficiency and hospital profitability. In the first stage we obtained (bootstrapped) data envelopment analysis (DEA) efficiency scores. Then, genetic matching is used as a novel matching procedure in this context along with a difference-in-difference approach within a panel regression framework. With the genetic matching procedure, independent and health system hospitals are matched along a number of environmental and organizational characteristics. The results show that health system entry increases hospital technical and cost efficiency by between 0.6 and 3.4 % in four alternative post-entry periods, indicating that health system entry has not a transitory but rather a permanent effect on hospital efficiency. Regarding hospital profitability, the results reveal an increase in hospital profitability only 1 year after health system entry, and the estimations suggest that this effect is a transitional phenomenon. Overall, health system entry may serve as an appropriate management instrument for decision makers to increase hospital performance.

Burrowing as a novel voluntary strength training method for mice : A comparison of various voluntary strength or resistance exercise methods

NARCIS (Netherlands)

Roemers, P; Mazzola, P N; De Deyn, P P; Bossers, W J; van Heuvelen, M J G; van der Zee, E A

2018-01-01

BACKGROUND: Voluntary strength training methods for rodents are necessary to investigate the effects of strength training on cognition and the brain. However, few voluntary methods are available. NEW METHOD: The current study tested functional and muscular effects of two novel voluntary strength

Pedagogical Aspects of Voluntary School Work

Directory of Open Access Journals (Sweden)

Mária Jármai Erzsébet

2015-03-01

Full Text Available The economic importance of voluntary work has been exceedingly appreciated in the last few decades. This is not surprising at all, because it is highly profitable according to the related estimated data. There are 115,9 million people doing voluntary work only in Europe, which means that they would create the world's 7th biggest economy with EUR 282 billion value creation if they formed an individual state. The organizations know that voluntary work has several advantages apart from the economic benefits. It is profitable both for the society and for the individuals as well. Several researches have proven that voluntary work positively influences the development of the personality, because the key-competencies - such as: co-operation, empathy, solidarity, conflict handling, problem solving, etc. - expected in the labor market can be improved.

Rethinking voluntary euthanasia.

Science.gov (United States)

Stoyles, Byron J; Costreie, Sorin

2013-12-01

Our goal in this article is to explicate the way, and the extent to which, euthanasia can be voluntary from both the perspective of the patient and the perspective of the health care providers involved in the patient's care. More significantly, we aim to challenge the way in which those engaged in ongoing philosophical debates regarding the morality of euthanasia draw distinctions between voluntary, involuntary, and nonvoluntary euthanasia on the grounds that drawing the distinctions in the traditional manner (1) fails to reflect what is important from the patient's perspective and (2) fails to reflect the significance of health care providers' interests, including their autonomy and integrity.

The relationship between the implementation of voluntary Five-Star occupational health and safety management system and the incidence of fatal and permanently disabling injury

DEFF Research Database (Denmark)

Hedlund, Frank Huess

2014-01-01

This paper examines two properties of the South African NOSA 5-Star System, a voluntary occupational health and safety (OHS) management system. The first property is the association between system implementation and final OHS outcomes measured as incidence rates of fatal and permanently disabling...... of their positive impact on OHS. It is clear though, that such systems cannot substitute authority enforcement activities.......This paper examines two properties of the South African NOSA 5-Star System, a voluntary occupational health and safety (OHS) management system. The first property is the association between system implementation and final OHS outcomes measured as incidence rates of fatal and permanently disabling...... injury. The second is the association between the Star audit rating and rates of serious occupational injury. Although there are many uncertainties involved the paper argues that companies committed to the NOSA system experienced fewer fatal and permanently disabling injuries than the general...

Factors that affect voluntary vaccination of children in Japan.

Science.gov (United States)

Shono, Aiko; Kondo, Masahide

2015-03-10

Some important vaccinations are not included in the routine childhood immunization schedule in Japan. Voluntary vaccinations are usually paid as an out-of-pocket expense. Low voluntary vaccination coverage rates and high target disease incidence are assumed to be a consequence of voluntary vaccination. Therefore, this study aimed to explore factors associated with voluntary vaccination patterns in children. We conducted an online survey of 1243 mothers from a registered survey panel who had at least one child 2 months to <3 years of age. The voluntary vaccination mainly correlated positively with annual household income and mothers' positive opinions about voluntary vaccinations, but negatively with number of children. Financial support, especially for low income households and households with more than one child, may motivate parents to vaccinate their children. Communication is also an important issue. More opportunities for education and information about voluntary vaccinations should be provided to mothers without distinguishing between voluntary and routine vaccination. Copyright © 2014 Elsevier Ltd. All rights reserved.

75 FR 34614 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and...

Science.gov (United States)

2010-06-17

... Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and Fiscal Year 2010 Rates and to the Long- Term Care Hospital Prospective Payment System and Rate Year 2010 Rates... Prospective Payment Systems for Acute Care Hospitals and Fiscal Year 2010 Rates and to the Long-Term Care...

75 FR 60640 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

Science.gov (United States)

2010-10-01

...; RIN 0938-AP33 Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System Changes and FY 2011 Rates; Provider... Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective...

The Client's Perspective on Voluntary Stuttering.

Science.gov (United States)

Byrd, Courtney T; Gkalitsiou, Zoi; Donaher, Joe; Stergiou, Erin

2016-08-01

Voluntary stuttering is a strategy that has been suggested for use in the clinical literature but has minimal empirical data regarding treatment outcomes. The purpose of the present study is to explore client perspectives regarding the impact of the use of this strategy on the affective, behavioral, and cognitive components of stuttering. The present study used an original survey designed to explore the intended purpose. A total of 206 adults who stutter were included in the final data corpus. Responses were considered with respect to the type of voluntary stuttering the participants reportedly produced and the location of use. A client perceives significantly greater affective, behavioral, and cognitive benefits from voluntary stuttering when the production is closely matched to the client's actual stutter and when it is used outside the clinical environment. To enhance client perception of associated benefits, clinicians should encourage use of voluntary stuttering that closely matches the client's own stuttering. Clinicians should also facilitate practice of voluntary stuttering outside of the therapy room. Finally, clinicians should be aware that clients, at least initially, may not perceive any benefits from the use of this strategy.

Voluntary agreements as instruments for international environmental policy; Frivillege avtaler som internasjonalt miljoepolitisk verkemiddel

Energy Technology Data Exchange (ETDEWEB)

Torvanger, Asbjoern

1997-12-31

According to this report, voluntary agreements have a potential as instruments for environmental policy. Such agreements can be national or international. Through an international voluntary agreement the authorities in one country may make contracts with factories in another country about emission reductions against some kind of compensation. A supranational organisation of voluntary agreements may ensure equal environmental political conditions for factories in different countries and be a useful means for the regulation of environmental problems of regional or global extent. It is most realistic to establish a supranational system of voluntary agreements in a group of countries that have already institutionalized their relations, such as the European Union. 14 refs., 1 table

Sociotechnical factors influencing unsafe use of hospital information systems: A qualitative study in Malaysian government hospitals.

Science.gov (United States)

Salahuddin, Lizawati; Ismail, Zuraini; Hashim, Ummi Rabaah; Raja Ikram, Raja Rina; Ismail, Nor Haslinda; Naim Mohayat, Mohd Hariz

2018-03-01

The objective of this study is to identify factors influencing unsafe use of hospital information systems in Malaysian government hospitals. Semi-structured interviews with 31 medical doctors in three Malaysian government hospitals implementing total hospital information systems were conducted between March and May 2015. A thematic qualitative analysis was performed on the resultant data to deduce the relevant themes. A total of five themes emerged as the factors influencing unsafe use of a hospital information system: (1) knowledge, (2) system quality, (3) task stressor, (4) organization resources, and (5) teamwork. These qualitative findings highlight that factors influencing unsafe use of a hospital information system originate from multidimensional sociotechnical aspects. Unsafe use of a hospital information system could possibly lead to the incidence of errors and thus raises safety risks to the patients. Hence, multiple interventions (e.g. technology systems and teamwork) are required in shaping high-quality hospital information system use.

Voluntary sway and rapid orthogonal transitions of voluntary sway in young adults, and low and high fall-risk older adults.

Science.gov (United States)

Tucker, Murray G; Kavanagh, Justin J; Morrison, Steven; Barrett, Rod S

2009-10-01

Falls amongst older people have been linked to reduced postural stability and slowed movement responses. The objective of this study was to examine differences in postural stability and the speed of response between young adults, low fall-risk older adults, and high fall-risk older adults during voluntary postural sway movements. Twenty-five young adults (25+/-4 years), and 32 low fall-risk (74+/-5 years), and 16 high fall-risk (79+/-7 years) older adults performed voluntary sway and rapid orthogonal transitions of voluntary sway between the anterior-posterior and medial-lateral directions. Measures included reaction and movement time and the amplitudes of the centre of pressure, centre of mass, and the separation distance between the centre of pressure and centre of mass. Both fall-risk groups compared to the young had slower reaction and movement time, greater centre of pressure and/or centre of mass amplitude in the orthogonal (non-target) direction during voluntary sway, and reduced anterior-posterior and medial-lateral separation between the centre of pressure and centre of mass during voluntary sway and orthogonal transitions. High compared to low fall-risk individuals had slower reaction and movement time, increased non-target centre of mass amplitude during voluntary sway, and reduced medial-lateral centre of pressure and centre of mass separation during voluntary sway and orthogonal transitions. Age-related deterioration of postural control resulted in slower reactive responses and reduced control of the direction of body movement during voluntary sway and orthogonal transitions. Slower postural reaction and movement time and reduced medial-lateral control of the centre of mass during voluntary sway movements are associated with increased fall-risk in community-living older people.

Illness, suffering and voluntary euthanasia.

Science.gov (United States)

Varelius, Jukka

2007-02-01

It is often accepted that we may legitimately speak about voluntary euthanasia only in cases of persons who are suffering because they are incurably injured or have an incurable disease. This article argues that when we consider the moral acceptability of voluntary euthanasia, we have no good reason to concentrate only on persons who are ill or injured and suffering.

37 CFR 351.2 - Voluntary negotiation period; settlement.

Science.gov (United States)

2010-07-01

... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Voluntary negotiation period... CONGRESS COPYRIGHT ROYALTY JUDGES RULES AND PROCEDURES PROCEEDINGS § 351.2 Voluntary negotiation period..., the Copyright Royalty Judges will announce the beginning of a voluntary negotiation period and will...

78 FR 38679 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

Science.gov (United States)

2013-06-27

... Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Proposed... Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and... regarding MS-DRG classifications and new technology add-on payments. Eva Fung (410) 786-7539, for...

A Computerized Hospital Patient Information Management System

Science.gov (United States)

Wig, Eldon D.

1982-01-01

The information processing needs of a hospital are many, with varying degrees of complexity. The prime concern in providing an integrated hospital information management system lies in the ability to process the data relating to the single entity for which every hospital functions - the patient. This paper examines the PRIMIS computer system developed to accommodate hospital needs with respect to a central patient registry, inpatients (i.e., Admission/Transfer/Discharge), and out-patients. Finally, the potential for expansion to permit the incorporation of more hospital functions within PRIMIS is examined.

Voluntary euthanasia: a utilitarian perspective.

Science.gov (United States)

Singer, Peter

2003-10-01

Belgium legalised voluntary euthanasia in 2002, thus ending the long isolation of the Netherlands as the only country in which doctors could openly give lethal injections to patients who have requested help in dying. Meanwhile in Oregon, in the United States, doctors may prescribe drugs for terminally ill patients, who can use them to end their life--if they are able to swallow and digest them. But despite President Bush's oft-repeated statements that his philosophy is to 'trust individuals to make the right decisions' and his opposition to 'distant bureaucracies', his administration is doing its best to prevent Oregonians acting in accordance with a law that its voters have twice ratified. The situation regarding voluntary euthanasia around the world is therefore very much in flux. This essay reviews ethical arguments regarding voluntary euthanasia and physician-assisted suicide from a utilitarian perspective. I shall begin by asking why it is normally wrong to kill an innocent person, and whether these reasons apply to aiding a person who, when rational and competent, asks to be killed or given the means to commit suicide. Then I shall consider more specific utilitarian arguments for and against permitting voluntary euthanasia.

Is the system really the solution? Operating costs in hospital systems.

Science.gov (United States)

Burns, Lawton Robert; McCullough, Jeffrey S; Wholey, Douglas R; Kruse, Gregory; Kralovec, Peter; Muller, Ralph

2015-06-01

Hospital system formation has recently accelerated. Executives emphasize scale economies that lower operating costs, a claim unsupported in academic research. Do systems achieve lower costs than freestanding facilities, and, if so, which system types? We test hypotheses about the relationship of cost with membership in systems, larger systems, and centralized and local hub-and-spoke systems. We also test whether these relationships have changed over time. Examining 4,000 U.S. hospitals during 1998 to 2010, we find no evidence that system members exhibit lower costs. However, members of smaller systems are lower cost than larger systems, and hospitals in centralized systems are lower cost than everyone else. There is no evidence that the system's spatial configuration is associated with cost, although national system hospitals exhibit higher costs. Finally, these results hold over time. We conclude that while systems in general may not be the solution to lower costs, some types of systems are. © The Author(s) 2015.

77 FR 63751 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

Science.gov (United States)

2012-10-17

... [CMS-1588-F2] RIN 0938-AR12 Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates..., 2012 Federal Register entitled ``Medicare Program; Hospital Inpatient Prospective Payment Systems for...

Voluntary Informed Consent in Paediatric Oncology Research.

Science.gov (United States)

Dekking, Sara A S; Van Der Graaf, Rieke; Van Delden, Johannes J M

2016-07-01

In paediatric oncology, research and treatments are often closely combined, which may compromise voluntary informed consent of parents. We identified two key scenarios in which voluntary informed consent for paediatric oncology studies is potentially compromised due to the intertwinement of research and care. The first scenario is inclusion by the treating paediatric oncologist, the second scenario concerns treatments confined to the research context. In this article we examine whether voluntary informed consent of parents for research is compromised in these two scenarios, and if so whether this is also morally problematic. For this, we employ the account of voluntary consent from Nelson and colleagues, who assert that voluntary consent requires substantial freedom from controlling influences. We argue that, in the absence of persuasion or manipulation, inclusion by the treating physician does not compromise voluntariness. However, it may function as a risk factor for controlling influence as it narrows the scope within which parents make decisions. Furthermore, physician appeal to reciprocity is not controlling as it constitutes persuasion. In addition, framing information is a form of informational manipulation and constitutes a controlling influence. In the second scenario, treatments confined to the research context qualify as controlling if the available options are restricted through manipulation of options. Although none of the influences is morally problematic in itself, a combination of influences may create morally problematic instances of involuntary informed consent. Therefore, safeguards should be implemented to establish an optimal environment for parents to provide voluntary informed consent in an integrated research-care context. © 2015 John Wiley & Sons Ltd.

Capital Investment by Independent and System-Affiliated Hospitals.

Science.gov (United States)

Carroll, Nathan W; Smith, Dean G; Wheeler, John R C

2015-01-01

Capital expenditures are a critical part of hospitals' efforts to maintain quality of patient care and financial stability. Over the past 20 years, finding capital to fund these expenditures has become increasingly challenging for hospitals, particularly independent hospitals. Independent hospitals struggling to find ways to fund necessary capital investment are often advised that their best strategy is to join a multi-hospital system. There is scant empirical evidence to support the idea that system membership improves independent hospitals' ability to make capital expenditures. Using data from the American Hospital Association and Medicare Cost Reports, we use difference-in-difference methods to examine changes in capital expenditures for independent hospitals that joined multi-hospital systems between 1997 and 2008. We find that in the first 5 years after acquisition, capital expenditures increase by an average of almost $16,000 per bed annually, as compared with non-acquired hospitals. In later years, the difference in capital expenditure is smaller and not statistically significant. Our results do not suggest that increases in capital expenditures vary by asset age or the size of the acquiring system. © The Author(s) 2015.

Voluntary work, a diversity of forms

NARCIS (Netherlands)

Paul Dekker; Joep de Hart

2009-01-01

Original title: Vrijwilligerswerk in meervoud. By international standards, the level of participation in voluntary work in the Netherlands is high, and the signs are that this will continue. On the other hand, the type of voluntary work and the groups in which it is concentrated are changing.

Voluntary agreement for the new energy and environmental policies goals

International Nuclear Information System (INIS)

Pesaro, G.

1998-01-01

In the field of public policies innovative instruments based on market mechanisms and voluntary action by economical subjects meet a growing favour. This emerges also from the proceedings of the recent National Conference on Energy and the Environment, held in Rome in November 1998. From a planning policy, directly implemented by public bodies and often characterised by a strong rigidity, we are now passing to a new policy style, based on main trends and principles and implemented, at least in a priority way, through a mechanism of pacts and agreements among a variety of actors. This article, starting from an introduction on the nature and the functioning limits of voluntary agreements and, on these bases, presents some hypothesis on the ways and the necessary conditions to develop a concrete system of voluntary agreements in the country, in order to reach the new energy and environmental policies goals [it

ANALISA PENGARUH TARIF DAN KUALITAS TERHADAP VOLUNTARY CHURN PRODUK FLEXI TRENDY (Studi Kasus : PT. Telkom Wilayah Kota Semarang

Directory of Open Access Journals (Sweden)

Haryo Santoso

2012-02-01

Full Text Available Pada abad 21 ini, telekomunikasi sudah berkembang dengan pesat. Perkembangan itu dibuktikan dengan munculnya teknologi-teknologi dalam bidang telekomunikasi yang semakin memudahkan manusia untuk berkomunikasi. Layanan telekomunikasi nirkabel yang dikenal saat ini di Indonesia terdiri dari 2 jenis yaitu layanan telekomunikasi Full Mobility atau Mobile Wireless Access (MWA dan Limited Mobility atau Fixed Wireless Access (FWA, sedangkan teknologi yang digunakan terdiri dari  teknologi Global System for Mobile Comunnication (GSM dan teknologi Code Division Multiple Access (CDMA. PT. TELKOM merupakan market leader dalam industri telekomunikasi seluler di Indonesia yang berlisensi FWA dengan market share mencapai 60% dari seluruh pasar FWA di Indonesia. Salah satu cara untuk mempertahankan jumlah pelanggan yaitu dengan meminimalisasi voluntary churn. Voluntary churn yaitu pelanggan yang berhenti menggunakan layanan PT TELKOM atas permintaan sendiri.  PT. TELKOM mempunyai dua produk berlisensi FWA yaitu Flexi Classy dan Flexi Trendy. Jumlah pelanggan yang melakukan voluntary churn pada Flexi Trendy jauh lebih besar daripada Flexi Classy. Menurut Mattison (2005, h.53 ada dua faktor utama yang menyebabkan voluntary churn yaitu faktor taruf yang ditawarkan dan faktor kualitas yang diberikan. Oleh karena itu pada penelitian ini menganalisa pengaruh tarif dan kualitas terhadap voluntary churn pada produk Flexi Trendy. Penelitian ini menggunakan system dynamics sebagai alat bantu (tools dalam menganalisa pengaruh tarif dan kualitas terhadap voluntary churn. Dari penelitian ini diketahui bahwa bahwa faktor tarif memiliki pengaruh dan kontribusi yang lebih besar dibandingkan dengan faktor kualitas terhadap terjadinya voluntary churn. Selain itu, faktor tarif telepon ke operator lain memiliki kontribusi terbesar terhadap tingkat voluntary churn dibandingkan dengan faktor yang lain.  Strategi terbaik yang dapat dilakukan berdasarkan tingkat churn yang

Record of hospitalizations for ambulatory care sensitive conditions: validation of the hospital information system.

Science.gov (United States)

Rehem, Tania Cristina Morais Santa Barbara; de Oliveira, Maria Regina Fernandes; Ciosak, Suely Itsuko; Egry, Emiko Yoshikawa

2013-01-01

To estimate the sensitivity, specificity and positive and negative predictive values of the Unified Health System's Hospital Information System for the appropriate recording of hospitalizations for ambulatory care-sensitive conditions. The hospital information system records for conditions which are sensitive to ambulatory care, and for those which are not, were considered for analysis, taking the medical records as the gold standard. Through simple random sampling, a sample of 816 medical records was defined and selected by means of a list of random numbers using the Statistical Package for Social Sciences. The sensitivity was 81.89%, specificity was 95.19%, the positive predictive value was 77.61% and the negative predictive value was 96.27%. In the study setting, the Hospital Information System (SIH) was more specific than sensitive, with nearly 20% of care sensitive conditions not detected. There are no validation studies in Brazil of the Hospital Information System records for the hospitalizations which are sensitive to primary health care. These results are relevant when one considers that this system is one of the bases for assessment of the effectiveness of primary health care.

Record of hospitalizations for ambulatory care sensitive conditions: validation of the hospital information system

Directory of Open Access Journals (Sweden)

Tania Cristina Morais Santa Barbara Rehem

2013-09-01

Full Text Available OBJECTIVE: to estimate the sensitivity, specificity and positive and negative predictive values of the Unified Health System's Hospital Information System for the appropriate recording of hospitalizations for ambulatory care-sensitive conditions. METHOD: the hospital information system records for conditions which are sensitive to ambulatory care, and for those which are not, were considered for analysis, taking the medical records as the gold standard. Through simple random sampling, a sample of 816 medical records was defined and selected by means of a list of random numbers using the Statistical Package for Social Sciences. RESULT: the sensitivity was 81.89%, specificity was 95.19%, the positive predictive value was 77.61% and the negative predictive value was 96.27%. In the study setting, the Hospital Information System (SIH was more specific than sensitive, with nearly 20% of care sensitive conditions not detected. CONCLUSION: there are no validation studies in Brazil of the Hospital Information System records for the hospitalizations which are sensitive to primary health care. These results are relevant when one considers that this system is one of the bases for assessment of the effectiveness of primary health care.

AN ECONOMETRIC APPROACH ABOUT VOLUNTARY TURNOVER

Directory of Open Access Journals (Sweden)

ADALET EREN

2013-06-01

Full Text Available This study analyzes individual and organizational variables that affect voluntary turnover are determined in the special defence and security companies. A binomial logistic regression model is used to estimate voluntary turnover.  Binomial Logistic regression, reliability test (scale alfa, variance (ANOVA, Post-hoc/Tukey, correlation (Pearson and other basic statistical techniques  with SPSS 13 statistical packet program was used in the analyzes ofresearch data. The study finds that; situation of suppose working, number of child, number of death child, number of home’s moving, support of rent, total monthly income of household, last work’s region, number of prizes, affect voluntary turnover are determined.

Making Sense of Voluntary Participation: A Theoretical Synthesis

Science.gov (United States)

Ryan, Vernon D.; Agnitsch, Kerry A.; Zhao, Lijun; Mullick, Rehan

2005-01-01

This paper examines the influence of community attachment on voluntary citizen participation in rural community improvement projects. We do so by modifying the original systemic model of community attachment (Kasarda and Janowitz 1974) and combining it with tenets of rational choice and social embeddedness theories. The modified model is then…

Biliary atresia: lessons learned from the voluntary German registry.

Science.gov (United States)

Leonhardt, J; Kuebler, J F; Leute, P J; Turowski, C; Becker, T; Pfister, E-D; Ure, B; Petersen, C

2011-03-01

Aim of the study was to carry out a 5-year survey of German patients with biliary atresia (BA) and to launch a discussion regarding the feasibility of voluntary registries in unregulated healthcare systems. A retrospective analysis of German BA patients born between 2001 and 2005, based on data collected from the voluntary European Biliary Atresia Registry (EBAR), was carried out and supplemented by data from all BA patients who underwent liver transplantation at the only 4 pediatric transplantation centers (pLTx) in Germany which are so far not registered at EBAR. Survival rates were calculated using Kaplan-Meier analysis and compared by Cox regression to determine the predictive value of age at surgery and the influence of the center size (fewer or more than 5 patients/study period) on overall survival and survival with native liver. A critical review of the 148 German EBAR charts revealed that 11 patients (7.4%) had no biliary atresia. The remaining 137 patients from EBAR together with 46 BA patients who underwent LTx without prior registration at EBAR were evaluated with a median follow-up of 39 months (range: 25-85 months). 29 hospitals performed a total of 159 Kasai procedures, but only 7 centers treated 5 or more patients (116 patients, range: 5-68), and 22 hospitals performed less than 5 KP (43 patients, range: 1-4). Primary LTx was performed in 21 patients (11.5%) and 3 patients died without surgical intervention. 16 patients were lost to follow-up (8.7%). Overall survival after 2 years was 83.3% (139 patients), including 105 patients (63%) who had undergone LTx and 34 patients (20.3%) with native liver. 28 patients died (16.7%), 8 after LTx (5.8%). The experience of the center was the only factor with a significant predictive value for jaundice-free survival with native liver (p=0.001). 25% of all German BA patients were not registered at EBAR, and 29 clinics were involved in the surgical management of BA patients. Therefore a new approach consisting of

Voluntary sterilization in Serbia: Unmet need?

Directory of Open Access Journals (Sweden)

Rašević Mirjana M.

2002-01-01

Full Text Available Is voluntary sterilization as a birth control method accepted in Serbia? This is certainly a question that is being imposed for research, regardless of the fact that voluntary sterilization is neither accessible nor promoted. Most importantly because there is no understanding in the social nor political sphere for legalization of voluntary sterilization as a form of birth control, apart from the clear necessity for this, first, step. They are: the recognition that voluntary sterilization is an efficient and safe birth control method, respectability of basic human as well as sexual and reproductive rights, spreading of sterilization as a form of birth control among population of both developed and developing countries and an epidemic diffusion of repeated induced abortions in Serbia. Thus individual recognition of the advantages of relying on voluntary sterilization, in a non-encouraging atmosphere, certainly represents one more argument to enable couples to prevent conception by sterilization. Since it was impossible to carry out a representative research among the population of men and women who are at risk for conception, an attempt was made to obtain a reply to the set question among women who decided to induce abortion. It was done out of at least two reasons. The first being that women with induced abortion in their reproductive history were the target group for voluntary sterilization. The second reason was based on the assumption that bringing a decision on induced abortion is preceded by the reconsideration of an earlier adopted strategy regarding children, giving birth and contraception and thus its rational component is revealed more and therefore more easily measurable. The research was carried out in the University Clinic of Obstetrics and Gynecology 'Narodni front' in Belgrade from January 21st o March 1st 2002, and included 296 women. By comparing the social and demographic characteristics of the female respondents, as well as

Factors Affecting Successful Implementation of Hospital Information Systems.

Science.gov (United States)

Farzandipur, Mehrdad; Jeddi, Fatemeh Rangraz; Azimi, Esmaeil

2016-02-01

Today, the use of information systems in health environments, like any other fields, is necessary and organizational managers are convinced to use these systems. However, managers' satisfaction is not the only factor in successfully implementing these systems and failed information technology projects (IT) are reported despite the consent of the directors. Therefore, this study aims to determine the factors affecting the successful implementation of a hospital information system. The study was carried out as a descriptive method in 20 clinical hospitals that the hospital information system (HIS) was conducted in them. The clinical and paraclinical users of mentioned hospitals are the study group. 400 people were chosen as samples in scientific method and the data was collected using a questionnaire consisted of three main human, managerial and organizational, and technological factors, by questionnaire and interview. Then the data was scored in Likert scale (score of 1 to 5) and were analyzed using the SPSS software. About 75 percent of the population were female, with average work experience of 10 years and the mean age was 30 years. The human factors affecting the success of hospital information system implementation achieved the mean score of 3.5, both organizational and managerial factors 2.9 and technological factors the mean of 3. Human factors including computer skills, perceiving usefulness and perceiving the ease of a hospital information system use are more effective on the acceptance and successful implementation of hospital information systems; then the technological factors play a greater role. It is recommended that for the successful implementation of hospital information systems, most of these factors to be considered.

PREDICTING VOLUNTARY INTAKE ON MEDIUM QUALITY ...

African Journals Online (AJOL)

found a good relationship between the rate constant for fermentation and ... By dividing voluntary feed intake into the ... voluntary feed intake will be equal to the rate at which the rumen is ... per abomosum to prevent any deficiency in protein restricting .... McDougall's saliva and was not included in the calculation of the lust ...

Voluntary inhibitory motor control over involuntary tic movements.

Science.gov (United States)

Ganos, Christos; Rothwell, John; Haggard, Patrick

2018-03-06

Inhibitory control is crucial for normal adaptive motor behavior. In hyperkinesias, such as tics, disinhibition within the cortico-striato-thalamo-cortical loops is thought to underlie the presence of involuntary movements. Paradoxically, tics are also subject to voluntary inhibitory control. This puzzling clinical observation questions the traditional definition of tics as purely involuntary motor behaviors. Importantly, it suggests novel insights into tic pathophysiology. In this review, we first define voluntary inhibitory tic control and compare it with other notions of tic control from the literature. We then examine the association between voluntary inhibitory tic control with premonitory urges and review evidence linking voluntary tic inhibition to other forms of executive control of action. We discuss the somatotopic selectivity and the neural correlates of voluntary inhibitory tic control. Finally, we provide a scientific framework with regard to the clinical relevance of the study of voluntary inhibitory tic control within the context of the neurodevelopmental disorder of Tourette syndrome. We identify current knowledge gaps that deserve attention in future research. © 2018 International Parkinson and Movement Disorder Society. © 2018 International Parkinson and Movement Disorder Society.

Capital Investment by Independent and System-Affiliated Hospitals

Science.gov (United States)

Carroll, Nathan W.; Smith, Dean G.; Wheeler, John R. C.

2015-01-01

Capital expenditures are a critical part of hospitals’ efforts to maintain quality of patient care and financial stability. Over the past 20 years, finding capital to fund these expenditures has become increasingly challenging for hospitals, particularly independent hospitals. Independent hospitals struggling to find ways to fund necessary capital investment are often advised that their best strategy is to join a multi-hospital system. There is scant empirical evidence to support the idea that system membership improves independent hospitals’ ability to make capital expenditures. Using data from the American Hospital Association and Medicare Cost Reports, we use difference-in-difference methods to examine changes in capital expenditures for independent hospitals that joined multi-hospital systems between 1997 and 2008. We find that in the first 5 years after acquisition, capital expenditures increase by an average of almost $16 000 per bed annually, as compared with non-acquired hospitals. In later years, the difference in capital expenditure is smaller and not statistically significant. Our results do not suggest that increases in capital expenditures vary by asset age or the size of the acquiring system. PMID:26105571

Managerial innovation in the hospital: an analysis of the diffusion of hospital cost-accounting systems.

Science.gov (United States)

Counte, M A; Glandon, G L

1988-01-01

Currently much interest is focused on the uses of cost-accounting systems within the hospital industry. Proponents frequently contend that such systems will help hospitals successfully adapt to new methods of financial reimbursement because they are essential to a number of major management functions, including competitive bidding, cost management, pricing, and profitability assessment. This article reports the results of a study conducted to examine the extent to which hospitals in a major market are actually beginning to use standard cost-accounting systems and identify factors that either aid or hinder the diffusion of these methods. Chief financial officers from 94 hospitals (83 percent response rate) participated in the study during the summer of 1986 where less than half of the hospitals (43 percent) had recently purchased a cost-accounting system. Detailed information about the interface of cost-accounting systems with other application systems and their specific management uses is reported.

Evaluation of a Web-based Error Reporting Surveillance System in a Large Iranian Hospital.

Science.gov (United States)

Askarian, Mehrdad; Ghoreishi, Mahboobeh; Akbari Haghighinejad, Hourvash; Palenik, Charles John; Ghodsi, Maryam

2017-08-01

Proper reporting of medical errors helps healthcare providers learn from adverse incidents and improve patient safety. A well-designed and functioning confidential reporting system is an essential component to this process. There are many error reporting methods; however, web-based systems are often preferred because they can provide; comprehensive and more easily analyzed information. This study addresses the use of a web-based error reporting system. This interventional study involved the application of an in-house designed "voluntary web-based medical error reporting system." The system has been used since July 2014 in Nemazee Hospital, Shiraz University of Medical Sciences. The rate and severity of errors reported during the year prior and a year after system launch were compared. The slope of the error report trend line was steep during the first 12 months (B = 105.727, P = 0.00). However, it slowed following launch of the web-based reporting system and was no longer statistically significant (B = 15.27, P = 0.81) by the end of the second year. Most recorded errors were no-harm laboratory types and were due to inattention. Usually, they were reported by nurses and other permanent employees. Most reported errors occurred during morning shifts. Using a standardized web-based error reporting system can be beneficial. This study reports on the performance of an in-house designed reporting system, which appeared to properly detect and analyze medical errors. The system also generated follow-up reports in a timely and accurate manner. Detection of near-miss errors could play a significant role in identifying areas of system defects.

Hospital information systems: experience at the fully digitized Seoul National University Bundang Hospital.

Science.gov (United States)

Yoo, Sooyoung; Hwang, Hee; Jheon, Sanghoon

2016-08-01

The different levels of health information technology (IT) adoption and its integration into hospital workflow can affect the maximization of the benefits of using of health IT. We aimed at sharing our experiences and the journey to the successful adoption of health IT over 13 years at a tertiary university hospital in South Korea. The integrated system of comprehensive applications for direct care, support care, and smart care has been implemented with the latest IT and a rich user information platform, achieving the fully digitized hospital. The users experience design methodology, barcode and radio-frequency identification (RFID) technologies, smartphone and mobile technologies, and data analytics were integrated into hospital workflow. Applications for user-centered electronic medical record (EMR) and clinical decision support (CDS), closed loop medication administration (CLMA), mobile EMR and dashboard system for care coordination, clinical data warehouse (CDW) system, and patient engagement solutions were designed and developed to improve quality of care, work efficiency, and patient safety. We believe that comprehensive electronic health record systems and patient-centered smart hospital applications will go a long way in ensuring seamless patient care and experience.

Voluntary reporting of greenhouse gases, 1995

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-07-01

The Voluntary Reporting Program for greenhouse gases is part of an attempt by the U.S. Government to develop innovative, low-cost, and nonregulatory approaches to limit emissions of greenhouse gases. It is one element in an array of such programs introduced in recent years as part of the effort being made by the United States to comply with its national commitment to stabilize emissions of greenhouse gases under the Framework Convention on Climate Change. The Voluntary Reporting Program, developed pursuant to Section 1605(b) of the Energy Policy Act of 1992, permits corporations, government agencies, households, and voluntary organizations to report to the Energy Information Administration (EIA) on actions taken that have reduced or avoided emissions of greenhouse gases.

Participatory simulation in hospital work system design

DEFF Research Database (Denmark)

Andersen, Simone Nyholm

When ergonomic considerations are integrated into the design of work systems, both overall system performance and employee well-being improve. A central part of integrating ergonomics in work system design is to benefit from emplo y-ees’ knowledge of existing work systems. Participatory simulation...... (PS) is a method to access employee knowledge; namely employees are involved in the simulation and design of their own future work systems through the exploration of models representing work system designs. However, only a few studies have investigated PS and the elements of the method. Yet...... understanding the elements is essential when analyzing and planning PS in research and practice. This PhD study investigates PS and the method elements in the context of the Danish hospital sector, where PS is applied in the renewal and design of public hospitals and the work systems within the hospitals...

Voluntary Wheel Running in Mice.

Science.gov (United States)

Goh, Jorming; Ladiges, Warren

2015-12-02

Voluntary wheel running in the mouse is used to assess physical performance and endurance and to model exercise training as a way to enhance health. Wheel running is a voluntary activity in contrast to other experimental exercise models in mice, which rely on aversive stimuli to force active movement. This protocol consists of allowing mice to run freely on the open surface of a slanted, plastic saucer-shaped wheel placed inside a standard mouse cage. Rotations are electronically transmitted to a USB hub so that frequency and rate of running can be captured via a software program for data storage and analysis for variable time periods. Mice are individually housed so that accurate recordings can be made for each animal. Factors such as mouse strain, gender, age, and individual motivation, which affect running activity, must be considered in the design of experiments using voluntary wheel running. Copyright © 2015 John Wiley & Sons, Inc.

[Hospital clinical engineer orientation and function in the maintenance system of hospital medical equipment].

Science.gov (United States)

Li, Bin; Zheng, Yunxin; He, Dehua; Jiang, Ruiyao; Chen, Ying; Jing, Wei

2012-03-01

The quantity of medical equipment in hospital rise quickly recent year. It provides the comprehensive support to the clinical service. The maintenance of medical equipment becomes more important than before. It is necessary to study on the orientation and function of clinical engineer in medical equipment maintenance system. Refer to three grade health care system, the community doctors which is called General practitioner, play an important role as the gatekeeper of health care system to triage and cost control. The paper suggests that hospital clinical engineer should play similar role as the gatekeeper of medical equipment maintenance system which composed by hospital clinical engineer, manufacture engineer and third party engineer. The hospital clinical engineer should be responsible of guard a pass of medical equipment maintenance quality and cost control. As the gatekeeper, hospital clinical engineer should take the responsibility of "General engineer" and pay more attention to safety and health of medical equipment. The responsibility description and future transition? development of clinical engineer as "General Engineer" is discussed. More attention should be recommended to the team building of hospital clinical engineer as "General Engineer".

Changing Dynamics in the Voluntary Market (Presentation)

Energy Technology Data Exchange (ETDEWEB)

Heeter, J.

2014-12-01

Voluntary green power markets are those in which consumers and institutions voluntarily purchase renewable energy to match their electricity needs. This presentation, presented at the Renewable Energy Markets Conference in December 2014, outlines the voluntary market in 2013, including community choice aggregation and community solar.

Implementation of voluntary agreements for energy efficiency in China

International Nuclear Information System (INIS)

Hu Yuan

2007-01-01

Low-energy efficiency and environmental pollution have long been taken as key problems of Chinese industry, although a number of command-and-control and economic instruments have been adopted in the last few decades. In this paper, policy and legislation development for voluntary agreements were summarized. The voluntary agreements pilot project in two iron and steel companies in Shandong Province as well as other cases were analyzed. In order to identify the existing problems in Chinese cases, comparison was made between China and industrialized countries in the practices of energy efficiency voluntary agreements. Based on the analysis, detained recommendations, including the use of supporting policies for voluntary agreements, were raised. It is expected that voluntary agreements could play a more important role in energy efficiency improvement of Chinese industry

Towards better embedding sustainability into companies’ systems: an analysis of voluntary corporate initiatives

NARCIS (Netherlands)

Lozano, R.

2012-01-01

Corporate leaders and employees have been increasingly recognising their role in contributing to sustainability. In this context, different voluntary tools, approaches, and initiatives have been developed by and for corporations to engage with sustainability. However, there has been a lack of

Turkish nursing students' attitudes towards voluntary induced abortion.

Science.gov (United States)

Yanikkerem, Emre; Üstgörül, Sema; Karakus, Asli; Baydar, Ozge; Esmeray, Nicole; Ertem, Gül

2018-03-01

To evaluate Turkish nursing students' attitudes towards voluntary induced abortion.. This cross-sectional study was conducted between January and June 2015, comprising students of Ege University Nursing Faculty and Celal Bayar University School of Health, located in two different cities of Turkey. Data was collected with a three-part questionnaire, focussing on students' characteristics, the knowledge of abortion law in Turkey and attitudes towards voluntary induced abortion. SPSS 15 was used for data analysis.. The mean score of students' attitude towards voluntary induced abortion was 39.8±7.9 which shows that nursing students moderately support abortion. Female students, students coming from upper class in society, and students who had higher family income and sexual experiences had more supportiveness attitudes towards voluntary induced abortion (pabortion.

Ways of sampling voluntary and involuntary autobiographical memories in daily life.

Science.gov (United States)

Rasmussen, Anne S; Johannessen, Kim B; Berntsen, Dorthe

2014-11-01

Cognitive psychologists have often equaled retrieval of personal events with voluntary recall from autobiographical memory, but more recent research shows that autobiographical memories often come to mind involuntarily-that is, with no retrieval effort. Voluntary memories have been studied in numerous laboratory experiments in response to word-prompts, whereas involuntary memories primarily have been examined in an everyday living context, using a structured diary procedure. However, it remains unclear how voluntary memories sampled in the laboratory map onto self-prompted voluntary memories in daily life. Here, we used a structured diary procedure to compare different types of voluntary autobiographical memories to their involuntary counterparts. The results replicated previous findings with regard to differences between word-prompted voluntary and involuntary memories, whereas there were fewer differences between self-prompted voluntary and involuntary memories. The findings raise the question as to what is the best way of sampling voluntary memories and the best comparison for involuntary memories. Copyright © 2014 Elsevier Inc. All rights reserved.

[The professional mobility of hospital nurses].

Science.gov (United States)

Van Schingen, Édith; Ladegaillerie, Geneviève; Lefebvre, Hélène; Challier, Marie-Pierre; Rothan-Tondeur, Monique

2015-09-01

For several decades, hospitals have been faced with the voluntary departures of nurses. In parallel to this external mobility, internal mobility is also on the rise and is not always initiated by the nurse. This new mode of management has repercussions for professionals, patients as well as for the quality of care. Copyright © 2015. Published by Elsevier Masson SAS.

Final voluntary release assessment/corrective action report

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-11-12

The US Department of Energy, Carlsbad Area Office (DOE-CAO) has completed a voluntary release assessment sampling program at selected Solid Waste Management Units (SWMUs) at the Waste Isolation Pilot Plant (WIPP). This Voluntary Release Assessment/Corrective Action (RA/CA) report has been prepared for final submittal to the Environmental protection Agency (EPA) Region 6, Hazardous Waste Management Division and the New Mexico Environment Department (NMED) Hazardous and Radioactive Materials Bureau to describe the results of voluntary release assessment sampling and proposed corrective actions at the SWMU sites. The Voluntary RA/CA Program is intended to be the first phase in implementing the Resource Conservation and Recovery Act (RCRA) Facility Investigation (RFI) and corrective action process at the WIPP. Data generated as part of this sampling program are intended to update the RCRA Facility Assessment (RFA) for the WIPP (Assessment of Solid Waste Management Units at the Waste Isolation Pilot Plant), NMED/DOE/AIP 94/1. This Final Voluntary RA/CA Report documents the results of release assessment sampling at 11 SWMUs identified in the RFA. With this submittal, DOE formally requests a No Further Action determination for these SWMUs. Additionally, this report provides information to support DOE`s request for No Further Action at the Brinderson and Construction landfill SWMUs, and to support DOE`s request for approval of proposed corrective actions at three other SWMUs (the Badger Unit Drill Pad, the Cotton Baby Drill Pad, and the DOE-1 Drill Pad). This information is provided to document the results of the Voluntary RA/CA activities submitted to the EPA and NMED in August 1995.

Conocimientos de los enfermeros del Hospital del Oriente de Asturias (HOA) en reanimación cardiopulmonar

OpenAIRE

anonymous

2016-01-01

Objetive: To evaluate the level of knowledge of nurses of the Hospital of Eastern Asturias (HOA) on CPR. Knowing the degree of training in CPR. Methods: Cross-sectional study. Anonymous and voluntary survey of nurses HOA evaluating aspects related to the sociodemographic characteristics, work experience, training and knowledge in CPR, knowledge of the warning system - response in case of cardiac arrest and interest in receiving training. Results: Participation rate of 77.90%. 71% of pro...

A study on building data warehouse of hospital information system.

Science.gov (United States)

Li, Ping; Wu, Tao; Chen, Mu; Zhou, Bin; Xu, Wei-guo

2011-08-01

Existing hospital information systems with simple statistical functions cannot meet current management needs. It is well known that hospital resources are distributed with private property rights among hospitals, such as in the case of the regional coordination of medical services. In this study, to integrate and make full use of medical data effectively, we propose a data warehouse modeling method for the hospital information system. The method can also be employed for a distributed-hospital medical service system. To ensure that hospital information supports the diverse needs of health care, the framework of the hospital information system has three layers: datacenter layer, system-function layer, and user-interface layer. This paper discusses the role of a data warehouse management system in handling hospital information from the establishment of the data theme to the design of a data model to the establishment of a data warehouse. Online analytical processing tools assist user-friendly multidimensional analysis from a number of different angles to extract the required data and information. Use of the data warehouse improves online analytical processing and mitigates deficiencies in the decision support system. The hospital information system based on a data warehouse effectively employs statistical analysis and data mining technology to handle massive quantities of historical data, and summarizes from clinical and hospital information for decision making. This paper proposes the use of a data warehouse for a hospital information system, specifically a data warehouse for the theme of hospital information to determine latitude, modeling and so on. The processing of patient information is given as an example that demonstrates the usefulness of this method in the case of hospital information management. Data warehouse technology is an evolving technology, and more and more decision support information extracted by data mining and with decision-making technology is

Differences in risk factors for voluntary early retirement and disability pension: a 15-year follow-up in a cohort of nurses' aides

DEFF Research Database (Denmark)

Jensen, L. D.; Ryom, P. K.; Christensen, M. V.

2012-01-01

of nurses' aides established in 1993 with a follow-up period of 15 years. SETTING: Nurses' aides working in nursery homes, homecare or hospitals. PARTICIPANTS: 3332 gainfully employed nurses' aides at the time of inclusion in the study. OUTCOME: Disability pension or early voluntary retirement. RESULTS: 16......OBJECTIVE: To estimate the extent of early retirement and to examine risk factors for voluntary early retirement and disability pension in a cohort of nurses' aides. DESIGN: Register study including baseline questionnaire and register data covering all transfer incomes from 1991 to 2008 in a cohort.......2% of the population was granted disability pension and 27.1% entered early voluntary retirement in the follow-up period representing 11 186 lost working years with a direct cost in transfer payment amounting about euro410 million. Health-related risk factors for disability pension was long-lasting low-back pain (HR 2...

75 FR 27563 - Agency Information Collection Activities: Voluntary Customer Survey

Science.gov (United States)

2010-05-17

... Activities: Voluntary Customer Survey AGENCY: U.S. Customs and Border Protection (CBP), Department of... collection requirement concerning a Voluntary Customer Survey. This request for comment is being made... soliciting comments concerning the following information collection: Title: Voluntary Customer Survey. OMB...

Assessment of factors associated with voluntary counseling and ...

African Journals Online (AJOL)

Assessment of factors associated with voluntary counseling and testing uptake among students in Bahir Dar University: A case control study. ... Background: Voluntary counseling and testing (VCT) is one of the ... AJOL African Journals Online.

Assessment of Effective Coverage of Voluntary Counseling and ...

African Journals Online (AJOL)

Assessment of Effective Coverage of Voluntary Counseling and Testing ... The objective of this study was to assess effective coverage level for Voluntary Counseling and testing services in major health facilities ... AJOL African Journals Online.

Voluntary emission trading potential of Turkey

International Nuclear Information System (INIS)

Ari, İzzet

2013-01-01

Climate change is likely to cause serious market failures, and carbon trading as a market instrument can help correct its negative impacts. The global carbon markets established to combat climate change include regulatory and voluntary markets. Turkey cannot utilise regulatory carbon markets under the Kyoto Protocol. As a result of her unique position in the UNFCCC, some offsetting projects in Turkey have benefitted only voluntary emission trading for the reduction of GHG emissions. Due to on-going climate change negotiation under the UNFCCC, it seems that Turkey will not use the current regulatory carbon markets. Thus, Turkey should promote the use of and participation in voluntary carbon markets. In this article, emission reduction potential via energy efficiency, renewable energy and solid waste management, and corresponding offsetting of credits with their estimated prices is investigated for the period between 2013 and 2020. The emission reduction potential for energy efficiency, renewable energy and solid waste management projects are estimated at 403, 312 and 356 million tons of CO 2 equivalent emissions respectively, totalling 1,071 million tons of CO 2 equivalent. The total revenue of the carbon certificates are estimated in the range of 19,775–33,386 million US Dollars for the same period. -- Highlights: •Turkey has 1,071 million tons GHG emission reduction in three sectors for 2013–2020. •Turkey can only use voluntary emission trading for reduction of GHGs. •Total revenue estimation could be between 19,775 and 33,386 million US Dollars. •Turkey's economy and emissions have been rapidly growing. •Turkey can more easily reduce its emission by using voluntary emission trading

Status and Trends in U.S. Compliance and Voluntary Renewable Energy Certificate Markets (2010 Data)

Energy Technology Data Exchange (ETDEWEB)

Heeter, J.; Bird, L.

2011-10-01

This report documents the status and trends of 'compliance'--renewable energy certificate (REC) markets used to meet state renewable portfolio standard (RPS) requirements--and 'voluntary' markets--those in which consumers and institutions purchase renewable energy to match their electricity needs on a voluntary basis. Today, 29 states and the District of Columbia have an RPS, more than half of all U.S. electricity customers have an option to purchase some type of green power product directly from a retail electricity provider, and all consumers have the option to purchase RECs. This report documents REC activities and trends in the United States. The compliance REC market analysis includes analysis of REC trading, regional REC markets, REC tracking systems, types of compliance RECs, compliance REC pricing trends, and an overview of compliance with RPS polices. The voluntary REC analysis presents data and analysis on voluntary market sales and customer participation, products and premiums, green pricing marketing and administrative expenses, voluntary REC pricing, and the voluntary carbon offsets market. The report concludes with a discussion of upcoming guidance from the Federal Trade Commission on green marketing claims, the emergence of community solar programs, and the potential impact of Dodd-Frank regulations on the REC market.

77 FR 36566 - Agency Information Collection Activities: Voluntary Customer Survey

Science.gov (United States)

2012-06-19

... Activities: Voluntary Customer Survey AGENCY: U.S. Customs and Border Protection (CBP), Department of... requirement concerning a Voluntary Customer Survey. This request for comment is being made pursuant to the... following information collection: Title: Voluntary Customer Survey. OMB Number: 1651-0135. Abstract: Customs...

77 FR 55487 - Agency Information Collection Activities; Voluntary Customer Survey

Science.gov (United States)

2012-09-10

... Activities; Voluntary Customer Survey AGENCY: U.S. Customs and Border Protection, Department of Homeland... (OMB) for review and approval in accordance with the Paperwork Reduction Act: Voluntary Customer Survey... forms of information. Title: Voluntary Customer Survey. OMB Number: 1651-0135. Abstract: Customs and...

Models of governance in multihospital systems. Implications for hospital and system-level decision-making.

Science.gov (United States)

Morlock, L L; Alexander, J A

1986-12-01

This study utilizes data from a national survey of 159 multihospital systems in order to describe the types of governance structures currently being utilized, and to compare the policy making process for various types of decisions in systems with different approaches to governance. Survey results indicate that multihospital systems most often use one of three governance models. Forty-one percent of the systems (including 33% of system hospitals) use a parent holding company model in which there is a system-wide corporate governing board and separate governing boards for each member hospital. Twenty-two percent of systems in the sample (but 47% of all system hospitals) utilize what we have termed a modified parent holding company model in which there is one system-wide governing board, but advisory boards are substituted for governing boards at the local hospital level. Twenty-three percent of the sampled systems (including 11% of system hospitals) use a corporate model in which there is one system-wide governing board but no other governing or advisory boards at either the divisional, regional or local hospital levels. A comparison of systems using these three governance approaches found significant variation in terms of system size, ownership and the geographic proximity of member hospitals. In order to examine the relationship between alternative approaches to governance and patterns of decision-making, the three model types were compared with respect to the percentages of systems reporting that local boards, corporate management and/or system-wide corporate boards have responsibility for decision-making in a number of specific issue areas. Study results indicate that, regardless of model type, corporate boards are most likely to have responsibility for decisions regarding the transfer, pledging and sale of assets; the formation of new companies; purchase of assets greater than $100,000; changes in hospital bylaws; and the appointment of local board members. In

The value relevance of voluntary disclosure in the annual report

DEFF Research Database (Denmark)

Banghøj, Jesper; Plenborg, Thomas

2006-01-01

This paper examines if the level of voluntary disclosure affects the association between current returns and future earnings. Economic theory suggests that firms might find it advantageous to provide additional pieces of information (i.e., voluntary disclosure) to investors and analysts (Verrecchia...... 1983). Our results indicate that more voluntary disclosure does not improve the association between current returns and future earnings; i.e. current returns do not reflect more future earnings news. This finding raises the question whether voluntary information in the annual report contains value...... relevant information about future earnings or if investors are simply not capable of incorporating voluntary information in the firm value estimates. Key words: Disclosure, future earnings, informativeness...

75 FR 47607 - Agency Information Collection Activities: Voluntary Customer Survey

Science.gov (United States)

2010-08-06

... Activities: Voluntary Customer Survey AGENCY: U.S. Customs and Border Protection, Department of Homeland... review and approval in accordance with the Paperwork Reduction Act: Voluntary Customer Survey. This is a.... Title: Voluntary Customer Survey. OMB Number: Will be assigned upon approval. Form Number: None...

Current State of the Voluntary Renewable Energy Market (Presentation)

Energy Technology Data Exchange (ETDEWEB)

Heeter, J.

2013-09-01

This presentation highlights the status of the voluntary green power market in 2012. The voluntary green power market totaled more than 48 million MWh in 2012, with about 1.9 million customers participating. The supply continues to be dominated by wind, though solar is increasing its share of utility green pricing programs. Prices for voluntary renewable energy certificates (RECs) increased to above $1/MWh.

Burrowing as a novel voluntary strength training method for mice: A comparison of various voluntary strength or resistance exercise methods.

Science.gov (United States)

Roemers, P; Mazzola, P N; De Deyn, P P; Bossers, W J; van Heuvelen, M J G; van der Zee, E A

2018-04-15

Voluntary strength training methods for rodents are necessary to investigate the effects of strength training on cognition and the brain. However, few voluntary methods are available. The current study tested functional and muscular effects of two novel voluntary strength training methods, burrowing (digging a substrate out of a tube) and unloaded tower climbing, in male C57Bl6 mice. To compare these two novel methods with existing exercise methods, resistance running and (non-resistance) running were included. Motor coordination, grip strength and muscle fatigue were measured at baseline, halfway through and near the end of a fourteen week exercise intervention. Endurance was measured by an incremental treadmill test after twelve weeks. Both burrowing and resistance running improved forelimb grip strength as compared to controls. Running and resistance running increased endurance in the treadmill test and improved motor skills as measured by the balance beam test. Post-mortem tissue analyses revealed that running and resistance running induced Soleus muscle hypertrophy and reduced epididymal fat mass. Tower climbing elicited no functional or muscular changes. As a voluntary strength exercise method, burrowing avoids the confounding effects of stress and positive reinforcers elicited in forced strength exercise methods. Compared to voluntary resistance running, burrowing likely reduces the contribution of aerobic exercise components. Burrowing qualifies as a suitable voluntary strength training method in mice. Furthermore, resistance running shares features of strength training and endurance (aerobic) exercise and should be considered a multi-modal aerobic-strength exercise method in mice. Copyright © 2017 Elsevier B.V. All rights reserved.

5 CFR 630.1014 - Movement between voluntary leave bank programs.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Movement between voluntary leave bank programs. 630.1014 Section 630.1014 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS ABSENCE AND LEAVE Voluntary Leave Bank Program § 630.1014 Movement between voluntary leave bank...

Hospital System Performance within Veterans Affairs

Data.gov (United States)

Department of Veterans Affairs — Strategic Analytics for Improvement and Learning Value Model or SAIL, is a system for summarizing hospital system performance within Veterans Health Administration...

Market Brief. Status of the Voluntary Renewable Energy Certificate Market (2011 Data)

Energy Technology Data Exchange (ETDEWEB)

Heeter, Jenny [National Renewable Energy Lab. (NREL), Golden, CO (United States); Armstrong, Philip [National Renewable Energy Lab. (NREL), Golden, CO (United States); Bird, Lori [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2012-09-01

This report documents the status and trends of U.S. 'voluntary' markets -- those in which consumers and institutions purchase renewable energy to match their electricity needs on a voluntary basis. Voluntary REC markets continue to exhibit growth and spur renewable energy development. Voluntary green power markets provide an additional revenue stream for renewable energy projects and raise consumer awareness of the benefits of renewable energy. Although a full estimate of the size of the voluntary market is not available for 2011, this review uses indicative metrics to capture 2011 voluntary market trends.

Market Brief: Status of the Voluntary Renewable Energy Certificate Market (2011 Data)

Energy Technology Data Exchange (ETDEWEB)

Heeter, J.; Armstrong, P.; Bird, L.

2012-09-01

This report documents the status and trends of U.S. 'voluntary' markets -- those in which consumers and institutions purchase renewable energy to match their electricity needs on a voluntary basis. Voluntary REC markets continue to exhibit growth and spur renewable energy development. Voluntary green power markets provide an additional revenue stream for renewable energy projects and raise consumer awareness of the benefits of renewable energy. Although a full estimate of the size of the voluntary market is not available for 2011, this review uses indicative metrics to capture 2011 voluntary market trends.

Hospital Outpatient Prospective Payment System (OPPS) Lim...

Data.gov (United States)

U.S. Department of Health & Human Services — Hospital Outpatient Prospective Payment System (OPPS) Limited Data Set This file contains select claim level data and is derived from 2010 hospital outpatient PPS...

Changing patient classification system for hospital reimbursement in Romania.

Science.gov (United States)

Radu, Ciprian-Paul; Chiriac, Delia Nona; Vladescu, Cristian

2010-06-01

To evaluate the effects of the change in the diagnosis-related group (DRG) system on patient morbidity and hospital financial performance in the Romanian public health care system. Three variables were assessed before and after the classification switch in July 2007: clinical outcomes, the case mix index, and hospital budgets, using the database of the National School of Public Health and Health Services Management, which contains data regularly received from hospitals reimbursed through the Romanian DRG scheme (291 in 2009). The lack of a Romanian system for the calculation of cost-weights imposed the necessity to use an imported system, which was criticized by some clinicians for not accurately reflecting resource consumption in Romanian hospitals. The new DRG classification system allowed a more accurate clinical classification. However, it also exposed a lack of physicians' knowledge on diagnosing and coding procedures, which led to incorrect coding. Consequently, the reported hospital morbidity changed after the DRG switch, reflecting an increase in the national case-mix index of 25% in 2009 (compared with 2007). Since hospitals received the same reimbursement over the first two years after the classification switch, the new DRG system led them sometimes to change patients' diagnoses in order to receive more funding. Lack of oversight of hospital coding and reporting to the national reimbursement scheme allowed the increase in the case-mix index. The complexity of the new classification system requires more resources (human and financial), better monitoring and evaluation, and improved legislation in order to achieve better hospital resource allocation and more efficient patient care.

Information Systems Evaluation: A Study in Hospital Organizations

Directory of Open Access Journals (Sweden)

Laís Coelho Ayala

2012-06-01

Full Text Available Given increasing demand for timely and accurate information to support decision making, hospitals, a particularly complex type of service organization, have increasingly resorted to a wide range of tools such as the Clinical Information Systems (CIS. However, research has shown that such systems do not always meet hospital managers’ needs, and assessment processes are necessary both before and after CIS implementation. Aiming to identify whether the CIS do meet hospital managers’ information needs and do fit in the specificities of such organizations, this paper reports on the assessment of four CIS based on the perspective of their users in four hospitals in the Metropolitan Region of Belo Horizonte, State of Minas Gerais, Brazil. The data was collected by means of semi-structured interviews and non-obtrusive observation. On the one hand, the result shows that the four organizations have difficulties in using their systems, such as accessibility problems, inadequate training and system underutilization. On the other hand, they also benefit from such systems, as they make processes faster and enable information control. One can say that the results from this research contribute to a better understanding of evaluating information systems in hospitals. Managers of such organizations can benefit from these results when seeking to evaluate and improve their information systens.

Rules regarding voluntary contributions to the Agency

International Nuclear Information System (INIS)

1989-11-01

The texts of the following Rules Regarding Voluntary Contributions to the Agency are reproduced: 1. Rules to Govern the Acceptance of Gifts of Services, Equipment and Facilities (adopted by the Board of Governors on 13 June 1989); 2. Rules Regarding the Acceptance of Voluntary Contributions of Money to the Agency (approved by the General Conference on 29 September 1989)

15 CFR 764.8 - Voluntary self-disclosures for boycott violations.

Science.gov (United States)

2010-01-01

... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Voluntary self-disclosures for boycott... ENFORCEMENT AND PROTECTIVE MEASURES § 764.8 Voluntary self-disclosures for boycott violations. This section... provisions. Voluntary self-disclosures are a mitigating factor with respect to any enforcement action that...

Weaker Seniors Exhibit Motor Cortex Hypoexcitability and Impairments in Voluntary Activation.

Science.gov (United States)

Clark, Brian C; Taylor, Janet L; Hong, S Lee; Law, Timothy D; Russ, David W

2015-09-01

Weakness predisposes seniors to a fourfold increase in functional limitations. The potential for age-related degradation in nervous system function to contribute to weakness and physical disability has garnered much interest of late. In this study, we tested the hypothesis that weaker seniors have impairments in voluntary (neural) activation and increased indices of GABAergic inhibition of the motor cortex, assessed using transcranial magnetic stimulation. Young adults (N = 46; 21.2±0.5 years) and seniors (N = 42; 70.7±0.9 years) had their wrist flexion strength quantified along with voluntary activation capacity (by comparing voluntary and electrically evoked forces). Single-pulse transcranial magnetic stimulation was used to measure motor-evoked potential amplitude and silent period duration during isometric contractions at 15% and 30% of maximum strength. Paired-pulse transcranial magnetic stimulation was used to measure intracortical facilitation and short-interval and long-interval intracortical inhibition. The primary analysis compared seniors to young adults. The secondary analysis compared stronger seniors (top two tertiles) to weaker seniors (bottom tertile) based on strength relative to body weight. The most novel findings were that weaker seniors exhibited: (i) a 20% deficit in voluntary activation; (ii) ~20% smaller motor-evoked potentials during the 30% contraction task; and (iii) nearly twofold higher levels of long-interval intracortical inhibition under resting conditions. These findings indicate that weaker seniors exhibit significant impairments in voluntary activation, and that this impairment may be mechanistically associated with increased GABAergic inhibition of the motor cortex. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Efficiency of voluntary closing hand and hook prostheses

NARCIS (Netherlands)

Smit, G.; Plettenburg, D.H.

2010-01-01

The Delft Institute of Prosthetics and Orthotics has started a research program to develop an improved voluntary closing, body-powered hand prosthesis. Five commercially available voluntary closing terminal devices were mechanically tested: three hands [Hosmer APRL VC hand, Hosmer Soft VC Male hand,

Current concerns in involuntary and voluntary autobiographical memories

DEFF Research Database (Denmark)

Johannessen, Kim Berg; Berntsen, Dorthe

2010-01-01

Involuntary autobiographical memories are conscious memories of personal events that come to mind with no preceding attempts at retrieval. It is often assumed that such memories are closely related to current concerns - i.e., uncompleted personal goals. Here we examined involuntary versus volunta...... concern related involuntary and voluntary memories. The findings support the view that involuntary and voluntary remembering is subject to similar motivational constraints.......Involuntary autobiographical memories are conscious memories of personal events that come to mind with no preceding attempts at retrieval. It is often assumed that such memories are closely related to current concerns - i.e., uncompleted personal goals. Here we examined involuntary versus voluntary...... (deliberately retrieved) autobiographical memories in relation to earlier registered current concerns measured by the Personal Concern Inventory (PCI; Cox & Klinger, 2000). We found no differences between involuntary and voluntary memories with regard to frequency or characteristics of current concern related...

Coerced hospital admission and symptom change--a prospective observational multi-centre study.

Directory of Open Access Journals (Sweden)

Thomas W Kallert

Full Text Available INTRODUCTION: Coerced admission to psychiatric hospitals, defined by legal status or patient's subjective experience, is common. Evidence on clinical outcomes however is limited. This study aimed to assess symptom change over a three month period following coerced admission and identify patient characteristics associated with outcomes. METHOD: At study sites in 11 European countries consecutive legally involuntary patients and patients with a legally voluntary admission who however felt coerced, were recruited and assessed by independent researchers within the first week after admission. Symptoms were assessed on the Brief Psychiatric Rating Scale. Patients were re-assessed after one and three months. RESULTS: The total sample consisted of 2326 legally coerced patients and 764 patients with a legally voluntary admission who felt coerced. Symptom levels significantly improved over time. In a multivariable analysis, higher baseline symptoms, being unemployed, living alone, repeated hospitalisation, being legally a voluntary patient but feeling coerced, and being initially less satisfied with treatment were all associated with less symptom improvement after one month and, other than initial treatment satisfaction, also after three months. The diagnostic group was not linked with outcomes. DISCUSSION: On average patients show significant but limited symptom improvements after coerced hospital admission, possibly reflecting the severity of the underlying illnesses. Social factors, but not the psychiatric diagnosis, appear important predictors of outcomes. Legally voluntary patients who feel coerced may have a poorer prognosis than legally involuntary patients and deserve attention in research and clinical practice.

[Hospital information system performance for road traffic accidents analysis in a hospital recruitment based area].

Science.gov (United States)

Jannot, A-S; Fauconnier, J

2013-06-01

Road traffic accidents in France are mainly analyzed through reports completed by the security forces (police and gendarmerie). But the hospital information systems can also identify road traffic accidents via specific documentary codes of the International Classification of Diseases (ICD-10). The aim of this study was therefore to determine whether hospital stays consecutive to road traffic accident were truly identified by these documentary codes in a facility that collects data routinely and to study the consistency of results from hospital information systems and from security forces during the 2002-2008 period. We retrieved all patients for whom a documentary code for road traffic accident was entered in 2002-2008. We manually checked the concordance of documentary code for road traffic accident and trauma origin in 350 patient files. The number of accidents in the Grenoble area was then inferred by combining with hospitalization regional data and compared to the number of persons injured by traffic accidents declared by the security force. These hospital information systems successfully report road traffic accidents with 96% sensitivity (95%CI: [92%, 100%]) and 97% specificity (95%CI: [95%, 99%]). The decrease in road traffic accidents observed was significantly less than that observed was significantly lower than that observed in the data from the security force (45% for security force data against 27% for hospital data). Overall, this study shows that hospital information systems are a powerful tool for studying road traffic accidents morbidity in hospital and are complementary to security force data. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Challenges of using Hospital Information Systems by nurses: comparing academic and non-academic hospitals.

Science.gov (United States)

Ahmadian, Leila; Dorosti, Nafise; Khajouei, Reza; Gohari, Sadrieh Hajesmaeel

2017-06-01

Hospital Information Systems (HIS) are used for easy access to information, improvement of documentation and reducing errors. Nonetheless, using these systems is faced with some barriers and obstacles. This study identifies the challenges and the obstacles of using these systems in the academic and non-academic hospitals in Kerman. This is a cross-sectional study which was carried out in 2015. The statistical population in this study consisted of the nurses who had been working in the academic and non-academic hospitals in Kerman. A questionnaire consisting of two sections was used. The first section consisted of the demographic information of the participants and the second section comprised 34 questions about the challenges of HIS use. Data were analyzed by the descriptive and statistical analysis (t-test, and ANOVA) using SPSS 19 software. The most common and important challenges in the academic hospitals were about human environment factors, particularly "negative attitude of society toward using HIS". In the non-academic hospitals, the most common and important challenges were related to human factors, and among them, "no incentive to use system" was the main factor. The results of the t-test method revealed that there was a significant relationship between gender and the mean score of challenges related to the organizational environment category in the academic hospitals and between familiarity with HIS and mean score of human environment factors (pinformation systems are the factors related to the human environment and the human factors. The results of this study can bring a good perspective to the policy makers and the managers regarding obstacles of using HISs from the nurses' perspective, so that they can solve their problems and can successfully implement these systems.

Impacts of hospitals' innovativeness on information system outsourcing decisions.

Science.gov (United States)

Park, Jae Sung

2014-04-01

The purpose of this study was to identify the effects of hospitals' innovativeness on outsourcing decision-making regarding four information system (IS) functions, namely, software programs, network maintenance, hardware systems, and PC/printer maintenance. Using the 2011 roster of the Korean Hospital Association, this study selected 311 general hospitals as a study population. After identifying the managers who were in charge of outsourcing, this study administered questionnaires. A total of 103 hospitals responded. Of the responding hospitals, 55.34% outsourced at least one IS function, whereas 88.35% outsourced at least one managerial function. IS outsourcing was motivated by the need for outside experts, but other managerial functions were outsourced for cost savings. Innovative and early adopter hospitals were 4.52 and 4.91 times more likely to outsource IS functions related with work processes (i.e., software and network maintenance) than early and late majority hospitals, respectively. IT outsourcing effectiveness significantly influenced the outsourcing decisions regarding four IS functions. Hospitals that had perceived more risks of outsourcing significantly preferred non-outsourcing on their hardware systems, but the risks of outsourcing were not significant for outsourcing decisions regarding the other IS functions. Hospitals' innovativeness also significantly explained the quantity of innovation adoptions. Innovative and early adopter hospitals did more outsourcing than early and late majority hospitals. Hospitals' innovativeness influences decision-making regarding outsourcing. Innovative hospitals are more likely to outsource their work-process-related IS functions. Thus, organizational traits, especially hospitals' innovativeness, should be considered as a key success factor for IS management.

Impacts of Hospitals' Innovativeness on Information System Outsourcing Decisions

Science.gov (United States)

2014-01-01

Objectives The purpose of this study was to identify the effects of hospitals' innovativeness on outsourcing decision-making regarding four information system (IS) functions, namely, software programs, network maintenance, hardware systems, and PC/printer maintenance. Methods Using the 2011 roster of the Korean Hospital Association, this study selected 311 general hospitals as a study population. After identifying the managers who were in charge of outsourcing, this study administered questionnaires. A total of 103 hospitals responded. Results Of the responding hospitals, 55.34% outsourced at least one IS function, whereas 88.35% outsourced at least one managerial function. IS outsourcing was motivated by the need for outside experts, but other managerial functions were outsourced for cost savings. Innovative and early adopter hospitals were 4.52 and 4.91 times more likely to outsource IS functions related with work processes (i.e., software and network maintenance) than early and late majority hospitals, respectively. IT outsourcing effectiveness significantly influenced the outsourcing decisions regarding four IS functions. Hospitals that had perceived more risks of outsourcing significantly preferred non-outsourcing on their hardware systems, but the risks of outsourcing were not significant for outsourcing decisions regarding the other IS functions. Hospitals' innovativeness also significantly explained the quantity of innovation adoptions. Innovative and early adopter hospitals did more outsourcing than early and late majority hospitals. Conclusions Hospitals' innovativeness influences decision-making regarding outsourcing. Innovative hospitals are more likely to outsource their work-process-related IS functions. Thus, organizational traits, especially hospitals' innovativeness, should be considered as a key success factor for IS management. PMID:24872912

Withdrawal of voluntary inhibition unravels the off state of the spontaneous blink generator.

Science.gov (United States)

Moraitis, Timoleon; Ghosh, Arko

2014-12-01

Involuntary movements such as spontaneous eye blinks can be successfully inhibited at will. Little do we know how the voluntary motor circuits countermand spontaneous blinks. Do the voluntary inhibitory commands act to pause or to turn off the endogenous blink generator, or does inhibition intersect and counter the generator׳s excitatory outputs? In theory, the time taken for the system to generate an after-inhibition blink will reflect onto the form of inhibition. For instance, if voluntary commands were to turn the blink generator off then the after-blink latency would be fixed to the inhibition offset and reflect the time it takes for the generator to rebound and turn on. In this study we measured the after-blink latency from the offset of voluntary inhibition. Volunteers inhibited their blinks in response to sound tones of randomly varying durations. At the offset volunteers withdrew the inhibition and relaxed. Interestingly, the spontaneous after-blinks were fixed to the offset of the inhibition as if the generator rebounded from an off state. The after-blink latency was not related to the duration of the inhibition, and inhibiting even for a small fraction of the mean inter-blink interval generated an after-blink time-locked to the inhibition offset. Interestingly, the insertion of voluntary blinks after inhibition further altered the blink generator by delaying the spontaneous after-blinks. We propose that the inhibition of spontaneous blinks at the level of the generator allows for highly effective voluntary countermanding. Nevertheless, the withdrawal of such inhibition was strongly associated with motor excitation. Copyright © 2014 Elsevier Ltd. All rights reserved.

75 FR 34148 - Voluntary Private Sector Accreditation and Certification Preparedness Program

Science.gov (United States)

2010-06-16

...] Voluntary Private Sector Accreditation and Certification Preparedness Program AGENCY: Federal Emergency...) announces its adoption of three standards for the Voluntary Private Sector Accreditation and Certification... DHS to develop and implement a Voluntary Private Sector Preparedness Accreditation and Certification...

Hospital accounting and information systems: a critical assessment.

Science.gov (United States)

Macintosh, N B

1991-01-01

Public sector organisations seem to be caught up in the global wave of 'neo-Thatcherism'. As such, they are being held 'accountable' today by their respective government finance departments for the costs and benefits of the services they provide to the general public. As the public purse tightens, hospitals (and related health service units) more and more compete with other public sector organisations (old-age pensions and services, post-secondary education, day-care centres, port authorities, unemployment insurance, parks and recreation, elite sport programs, aboriginal peoples aid and development, and so on) for a diminishing piece of what seems a smaller and smaller pie. In this 'fight-for-funding', hospitals seem particularly vulnerable. Sky-rocketing costs, public resentment of doctors' high income and a deliberate restriction and limiting of medical school places, among other things, contribute to general public antagonism. The message for hospitals is that cost-effective accountability will loom large when hospitals come begging at the public trough. Even left-wing politicians today seem to be heeding the words of free-market economists like Freedman of Chicago. 'Privatisation' is the constant threat for those deemed inefficient. As a consequence, hospital administrators around the world, caught up in this trend, seem to be stampeding to 'boot-up' some kind of new accounting information system. For example, at my own university hospital (Queen's University, Kingston, Canada), the hospital administrators are in the process of introducing a version of the Johns Hopkins Hospital (Baltimore, Maryland) case-mix-loading cost-accumulation system. In other parts of the world they are known by other fancy names such as 'patient-costing', 'diagnosis-related-groups' (or DRGs). Trendy accounting systems seem to be the order of the day, a sort of panacea for the current plague of problems hospitals face. As the new systems become operational, however, traditional

Reforming voluntary drug insurance in Russian healthcare: does social solidarity matter?

Science.gov (United States)

Gerry, Christopher J; Kaneva, Maria; Zasimova, Liudmila

2017-11-01

With low take-up of both private health insurance and the existing public drug reimbursement scheme, it is thought that less than 5% of the Russian population have access to free outpatient drug treatment. This represents a major policy challenge for a country grappling with reforms of its healthcare system and experiencing low or no economic growth and significant associated reductions in spending on social services. In this paper, we draw on data from a 2011 Levada-Center survey to examine the attitudes and social solidarity of the Russian population towards drug policies in general and towards the introduction of a proposed voluntary drug insurance system in particular. In addition to being among the first to explore these important questions in the post-Communist setting, we make three important contributions to the emerging policy debates. First, we find that, if introduced immediately and without careful planning and preparation, Russia's voluntary drug insurance scheme is likely to collapse financially due to the over-representation of high-risk unhealthy individuals opting in to the scheme. Second, the negative attitude of higher income groups towards the redistribution of wealth to the poor may further impede government efforts to introduce voluntary drug insurance. Finally, we argue that Russia currently lacks the breadth and depth of social solidarity necessary for implementing this form of health financing. Copyright © 2017 Elsevier B.V. All rights reserved.

Alexithymic trait and voluntary control in healthy adults.

Directory of Open Access Journals (Sweden)

Xiaosi Gu

Full Text Available Alexithymia is a personality trait characterized by deficiency in understanding, processing, or describing emotions. Recent studies have revealed that alexithymia is associated with less activation of the anterior cingulate cortex, a brain region shown to play a role in cognitive and emotional processing. However, few studies have directly investigated the cognitive domain in relation to alexithymia to examine whether alexithymic trait is related to less efficient voluntary control.We examined the relationship between alexithymic trait and voluntary control in a group of healthy volunteers. We used the 20-item Toronto Alexithymia Scale (TAS-20 to measure alexithymic trait. Additionally, we examined state and trait voluntary control using the revised Attention Network Test (ANT-R and the Adult Temperament Questionnaire (ATQ, respectively. Alexithymic trait was positively correlated with the overall reaction time of the ANT-R, and negatively correlated with the Effortful Control factor of the ATQ.Our results suggest that alexithymic trait is associated with less efficient voluntary control.

Hospital-based school for children with chronic illness in Taiwan.

Science.gov (United States)

Chen, Der-Fang; Tsai, Tsuen-Chiuan; Su, Yu-Tsun; Lin, Chi-Wei

2015-10-01

To provide educational support and avoid unwanted damage that may impede learning for children with chronic illness, the learning environment should be friendly and safe. There is a need to establish schools inside hospitals, however, which may be neglected in a highly efficient health care system. A study was conducted to identify hospital-based schools for sick children in Taiwan, and to explore the barriers for implementation. The data were collected by structured telephone interview and retrieval of hospital web information. The study targeted social workers and nurses in the pediatric wards of 29 hospitals, plus officials from the Education Bureau in Taiwan. The interviewers inquired about the availability of a formal educational program inside hospitals and the barriers (if any) in providing educational supports. Taiwan has only one hospital-based informal school and eight hospitals with rotating bedside teachers. Education inside hospitals occurs mostly through voluntary teaching in informal education models. Information about special educational resources has not been widely distributed to patients and health care providers. Professional personnel in Taiwan are not well aware of the needs to establish a hospital-based school. The educational needs of children with chronic illness can be easily neglected even in an industrialized country. The establishment of policy and the enrichment of professional education on advocacy are necessary to eliminate educational inequities and benefit sick children. Copyright © 2014. Published by Elsevier B.V.

75 FR 60773 - Voluntary Private Sector Accreditation and Certification Preparedness Program

Science.gov (United States)

2010-10-01

...] Voluntary Private Sector Accreditation and Certification Preparedness Program AGENCY: Federal Emergency... concerns in the Voluntary Private Sector Accreditation and Certification Preparedness Program (PS-Prep...-53 (the 9/11 Act) mandated DHS to establish a voluntary private sector preparedness accreditation and...

Beliefs in and About God and Attitudes Toward Voluntary Euthanasia.

Science.gov (United States)

Sharp, Shane

2018-06-01

I use data from the General Social Survey to evaluate several hypotheses regarding how beliefs in and about God predict attitudes toward voluntary euthanasia. I find that certainty in the belief in God significantly predicts negative attitudes toward voluntary euthanasia. I also find that belief in a caring God and in a God that is the primary source of moral rules significantly predicts negative attitudes toward voluntary euthanasia. I also find that respondents' beliefs about the how close they are to God and how close they want to be with God predict negative attitudes toward voluntary euthanasia. These associations hold even after controlling for religious affiliation, religious attendance, views of the Bible, and sociodemographic factors. The findings indicate that to understand individuals' attitudes about voluntary euthanasia, one must pay attention to their beliefs in and about God.

[The development of hospital medical supplies information management system].

Science.gov (United States)

Cao, Shaoping; Gu, Hongqing; Zhang, Peng; Wang, Qiang

2010-05-01

The information management of medical materials by using high-tech computer, in order to improve the efficiency of the consumption of medical supplies, hospital supplies and develop a new technology way to manage the hospital and material support. Using C # NET, JAVA techniques to develop procedures for the establishment of hospital material management information system, set the various management modules, production of various statistical reports, standard operating procedures. The system is convenient, functional and strong, fluent statistical functions. It can always fully grasp and understand the whole hospital supplies run dynamic information, as a modern and effective tool for hospital materials management.

Evaluation of a Cyber Security System for Hospital Network.

Science.gov (United States)

Faysel, Mohammad A

2015-01-01

Most of the cyber security systems use simulated data in evaluating their detection capabilities. The proposed cyber security system utilizes real hospital network connections. It uses a probabilistic data mining algorithm to detect anomalous events and takes appropriate response in real-time. On an evaluation using real-world hospital network data consisting of incoming network connections collected for a 24-hour period, the proposed system detected 15 unusual connections which were undetected by a commercial intrusion prevention system for the same network connections. Evaluation of the proposed system shows a potential to secure protected patient health information on a hospital network.

Cost effectiveness of facility and home based HIV voluntary ...

African Journals Online (AJOL)

Cost effectiveness of facility and home based HIV voluntary counseling and ... Background: In Uganda, the main stay for provision of human immunodeficiency virus (HIV) voluntary counseling and testing (VCT) ... AJOL African Journals Online.

ASPECTS REGARDING CORPORATE MANDATORY AND VOLUNTARY DISCLOSURE

Directory of Open Access Journals (Sweden)

Popa Adina

2008-05-01

Full Text Available The paper highlights theoretical aspects regarding corporate mandatory and voluntary disclosure. Since financial and business reporting are important information sources for different stakeholders, especially for publicly traded companies, the business reporting is increasingly oriented to the need of different users. In order to make rational investment decisions, users of corporate annual and interim reports require an extensive range of information. The increasing needs of the users persuade different international bodies and researchers to investigate the improvements that can be done in business reporting. The results of those studies usually were different reporting models. Because voluntary dimension of corporate disclosure involve the manifestation of free choice of the firm and its managers, we have considered as necessary to achieve a theoretical analysis of the main costs and profits of the voluntary disclosure policy.

Voluntary self-touch increases body ownership

Directory of Open Access Journals (Sweden)

Masayuki eHara

2015-10-01

Full Text Available Experimental manipulations of body ownership have indicated that multisensory integration is central to forming bodily self-representation. Voluntary self-touch is a unique multisensory situation involving corresponding motor, tactile and proprioceptive signals. Yet, even though self-touch is frequent in everyday life, its contribution to the formation of body ownership is not well understood. Here we investigated the role of voluntary self-touch in body ownership using a novel adaptation of the rubber hand illusion (RHI, in which a robotic system and virtual reality allowed participants self-touch of real and virtual hands. In the first experiment, active and passive self-touch were applied in the absence of visual feedback. In the second experiment, we tested the role of visual feedback in this bodily illusion. Finally, in the third experiment, we compared active and passive self-touch to the classical RHI in which the touch is administered by the experimenter. We hypothesized that active self-touch would increase ownership over the virtual hand through the addition of motor signals strengthening the bodily illusion. The results indicated that active self-touch elicited stronger illusory ownership compared to passive self-touch and sensory only stimulation, and indicate an important role of active self-touch in the formation of bodily self.

Turnover of nursing employees in a Gauteng hospital group

Directory of Open Access Journals (Sweden)

Japie Greyling

2010-11-01

Research purpose: The purpose of this study was to investigate individual determinants of voluntary turnover to identify a risk-group profile. Motivation for the study: Nursing employers should have a clearer understanding of the dynamics around nurses’ turnover behaviour and embark on strategies to retain their talent. Research design, approach and method: A survey measuring voluntary turnover was conducted among 262 professional and assistant nurses in three selected hospitals in Gauteng province using the McCarthy, Tyrrell and Cronin (2002 instrument. Pearson’s chi square with Yates’s continuity correction tested the relationship among the variables presented in a contingency table, in other words the risk group and each of the individual determinants. Main findings: Discontent with salaries was the major determinant of the nurses’ resignation. Organisational causes were nursing practices, the work environment, physical-emotional costs and employment opportunities after resignation. Practical/managerial implications: Hospital management could indeed establish a good rapport with nursing staff while facilitating respectful and ethical conduct by doctors towards nursing staff. Putting into place effective labour practices and business strategies could improve job satisfaction in the workplace. Contribution/value-add: This study contributed to a greater understanding of the personal and organisational determinants of the turnover of nurses in South African hospitals.

Interaction of Compliance and Voluntary Renewable Energy Markets

Energy Technology Data Exchange (ETDEWEB)

Bird, L.; Lokey, E.

2007-10-01

In recent years, both compliance and voluntary markets have emerged to help support the development of renewable energy resources. Both of these markets are growing rapidly and today about half of U.S. states have RPS policies in place, with a number of these policies adopted in the last several years. In addition, many states have recently increased the stringency of their RPS policies. This paper examines key market interaction issues between compliance and voluntary renewable energy markets. It provides an overview of both the compliance and voluntary markets, addressing each market's history, purpose, size, scope, and benefits while addressing issues, including double counting.

Mandatory cost and other cost coming from the adoption of quality certifications in the hospitality business

OpenAIRE

Sanchez Rebull, M. Victoria; Hernandez, Ana Betriz; Banchieri, Lucia; Campa Planas, Fernando; Ginieis, Matias

2011-01-01

The adaptation to the regulation of hospitality business implies a relevant cost in the profit and loss account. Additionally, some companies in this business decide to add some voluntary quality and environmental certification systems, which also yields to increased costs. The purpose of this paper is to quantify these costs and to analyse if the hotel size influences them. A total of 67 different costs were considered in hotels of all sizes, in the region of Catalonia as one of the most rel...

Biofeedback, voluntary control, and human potential.

Science.gov (United States)

Norris, P

1986-03-01

This paper examines some of the philosophical and scientific relationships involving self-control, voluntary control, and psychophysiologic self-regulation. The role of biofeedback in mediating conscious and unconscious processes is explored. Demonstrations of superior voluntary control and its relationship to belief, confidence, and expectation are examined. Biofeedback demonstrates the potential of control to oneself, creating confidence in one's ability to establish enhanced and peak performance in athletics, education, and psychophysiologic therapy. Emphasis is placed on the power of images in all human functioning, and in enhancing human potential.

A Free Market Requires Voluntary Actions

DEFF Research Database (Denmark)

Sløk-Madsen, Stefan Kirkegaard

and not consumer sovereignty. I argue that asset ownership is less important than true consumer sovereignty, which again is the essential argument for why capitalism is the superior mode of resource allocation and social organization. The paper analyzes how our understanding of markets and voluntary actions...... are essential to the construct of consumer sovereignty. Understanding the degree of voluntary actions in a given commercial setting has implications for both business strategy and policy making. This paper thus aims to contribute to explain why restricted markets become crony capitalism....

Voluntary non-monetary approaches for implementing conservation

OpenAIRE

Santangeli, Andrea; Arroyo, Beatriz; Dicks, Lynn V.; Herzon, Irina; Kukkala, Aija S.; Sutherland, William J.; Moilanen, Atte

2016-01-01

The voluntary non-monetary approach to conservation refers to actions that citizens or organizations could voluntarily implement in their area of influence without the incentive of monetary compensations. To be effectively implemented by untrained actors, actions should be clearly defined, straightforward to implement and not require specific scientific knowledge. The costs of actions should also be sufficiently affordable to be widely applied without monetary incentives. A voluntary non-mone...

Rules regarding voluntary contributions to the Agency

International Nuclear Information System (INIS)

2004-01-01

The texts of the following Rules Regarding Voluntary Contributions to the Agency are reproduced for the information of all Members of the Agency. Rules to Govern the Acceptance of Gifts of Services, Equipment and Facilities - adopted by the Board of Governors on 10 March 2004; Rules Regarding the Acceptance of Voluntary Contributions of Money to the Agency - approved by the General Conference on 21 September 2001 (GC (45)/RES/9)

Rules regarding voluntary contributions to the Agency

International Nuclear Information System (INIS)

2001-01-01

The texts of the following Rules Regarding Voluntary Contributions to the Agency are reproduced for the information of all Members of the Agency. Rules to Govern the Acceptance of Gifts of Services, Equipment and Facilities - adopted by the Board of Governors on 13 June 2001; Rules Regarding the Acceptance of Voluntary Contributions of Money to the Agency - approved by the General Conference on 21 September 2001 (GC(45)/RES/9)

KEBERADAAN CORPORATE GOVERNANCE DAN KONDISI FINANCIAL DISTRESSED TERHADAP VOLUNTARY DISCLOSURE

Directory of Open Access Journals (Sweden)

Riesanti Edie Wijaya

2017-03-01

Full Text Available Voluntary disclosure meant giving information to public either about fi nancial or non-fi -nancial regarding the fi rm’s operations without any legal requirement (Fishman and Hagerty, 1997.Giving information about voluntary disclosure enables all the concerned parties obtaining more relevantinformation about the strategies and critical elements of the fi rms. In this study, we examinedthe impact of corporate governance and fi nancial distress condition on the level of voluntary informationdisclosure. This research used a sample of manufacture fi rms listed in Indonesian stockexchange. Based on data processing using sample above, we found that corporate governance andfi nancial distress could be associated with the voluntary disclosure level.

Neglected roots of regionalism? The Commissioners for the special areas and grants to hospital services in the 1930s.

Science.gov (United States)

Mohan, J

1997-08-01

The inter-war years in the UK were notable for debates about the extent to which an extension of state intervention in hospital provision was desirable and necessary, and about the limits to and future of the voluntary hospital system which relied largely on various forms of private charity. These themes were intertwined in the UK's 'Special Areas', locations recognized as having suffered adversely from the inter-war depression, with consequent effects on their ability to finance desirable investments in social infrastructures. Grant aid was offered to hospitals in these locations under the terms of the Special Areas legislation of 1934, but there were extensive debates about the principle and practice of such subsidies to hospital development. This paper reviews these debates and considers whether the measures taken by the Commissioners can be seen as neglected antecedents of the regionalism detected in British hospital policy by several commentators.

Quality Management Systems Implementation Compared With Organizational Maturity in Hospital.

Science.gov (United States)

Moradi, Tayebeh; Jafari, Mehdi; Maleki, Mohammad Reza; Naghdi, Seyran; Ghiasvand, Hesam

2015-07-27

A quality management system can provide a framework for continuous improvement in order to increase the probability of customers and other stakeholders' satisfaction. The test maturity model helps organizations to assess the degree of maturity in implementing effective and sustained quality management systems; plan based on the current realities of the organization and prioritize their improvement programs. We aim to investigate and compare the level of organizational maturity in hospitals with the status of quality management systems implementation. This analytical cross sectional study was conducted among hospital administrators and quality experts working in hospitals with over 200 beds located in Tehran. In the first step, 32 hospitals were selected and then 96 employees working in the selected hospitals were studied. The data were gathered using the implementation checklist of quality management systems and the organization maturity questionnaire derived from ISO 10014. The content validity was calculated using Lawshe method and the reliability was estimated using test - retest method and calculation of Cronbach's alpha coefficient. The descriptive and inferential statistics were used to analyze the data using SPSS 18 software. According to the table, the mean score of organizational maturity among hospitals in the first stage of quality management systems implementation was equal to those in the third stage and hypothesis was rejected (p-value = 0.093). In general, there is no significant difference in the organizational maturity between the first and third level hospitals (in terms of implementation of quality management systems). Overall, the findings of the study show that there is no significant difference in the organizational maturity between the hospitals in different levels of the quality management systems implementation and in fact, the maturity of the organizations cannot be attributed to the implementation of such systems. As a result, hospitals

27 CFR 25.221 - Voluntary destruction of beer.

Science.gov (United States)

2010-04-01

... beer. 25.221 Section 25.221 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS BEER Voluntary Destruction § 25.221 Voluntary destruction of beer. (a) On brewery premises. (1) A brewer may destroy, at the brewery, beer on which the tax has not...

Maturity of hospital information systems: Most important influencing factors.

Science.gov (United States)

Vidal Carvalho, João; Rocha, Álvaro; Abreu, António

2017-07-01

Maturity models facilitate organizational management, including information systems management, with hospital organizations no exception. This article puts forth a study carried out with a group of experts in the field of hospital information systems management with a view to identifying the main influencing factors to be included in an encompassing maturity model for hospital information systems management. This study is based on the results of a literature review, which identified maturity models in the health field and relevant influencing factors. The development of this model is justified to the extent that the available maturity models for the hospital information systems management field reveal multiple limitations, including lack of detail, absence of tools to determine their maturity and lack of characterization for stages of maturity structured by different influencing factors.

Hospital profitability and capital structure: a comparative analysis.

Science.gov (United States)

Valvona, J; Sloan, F A

1988-08-01

This article compares the financial performance of hospitals by ownership type and of five publicly traded hospital companies with other industries, using such indicators as profit margins, return on equity (ROE) and total capitalization, and debt-to-equity ratios. We also examine stock returns to investors for the five hospital companies versus other industries, as well as the relative roles of debt and equity in new financing. Investor-owned hospitals had substantially greater margins and ROE than did other hospital types. In 1982, investor-owned chain hospitals had a ROE of 26 percent, 18 points above the average for all hospitals. Stock returns on the five selected hospital companies were more than twice as large as returns on other industries between 1972 and 1983. However, after 1983, returns for these companies fell dramatically in absolute terms and relative to other industries. We also found investor-owned hospitals to be much more highly levered than their government and voluntary counterparts, and more highly levered than other industries as well.

Voluntariness of consent to HIV clinical research: A conceptual and empirical pilot study.

Science.gov (United States)

Mamotte, Nicole; Wassenaar, Douglas

2017-09-01

Obtaining voluntary informed consent for research participation is an ethical imperative, yet there appears to be little consensus regarding what constitutes a voluntary consent decision. An instrument to assess influences on participants' consent decision and perceived voluntariness was developed and piloted in two South African HIV clinical trials. The pilot study found high levels of perceived voluntariness. The feeling of having no choice but to participate was significantly associated with lower perceived voluntariness. Overall the data suggest that it is possible to obtain voluntary and valid consent for research participants in ethically complex HIV clinical trials in a developing country context.

Mitigating greenhouse gas emissions: Voluntary reporting

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-10-01

The Voluntary Reporting Program, developed pursuant to Section 1605(b) of the Energy Policy Act of 1992, permits corporations, government agencies, households, and voluntary organizations to report on their emissions of greenhouse gases, and on actions taken that have reduced or avoided emissions or sequestered carbon, to the Energy Information Administration (EIA). This, the second annual report of the Voluntary Reporting Program, describes information provided by the participating organizations on their aggregate emissions and emissions reductions, as well as their emissions reduction or avoidance projects, through 1995. This information has been compiled into a database that includes reports from 142 organizations and descriptions of 967 projects that either reduced greenhouse gas emissions or sequestered carbon. Fifty-one reporters also provided estimates of emissions, and emissions reductions achieved, for their entire organizations. The projects described actions taken to reduce emissions of carbon dioxide from energy production and use; to reduce methane and nitrous oxide emissions from energy use, waste management, and agricultural processes; to reduce emissions of halocarbons, such as CFCs and their replacements; and to increase carbon sequestration.

Keberadaan Corporate Governance Dan Kondisi Financial Distressed Terhadap Voluntary Disclosure

OpenAIRE

Wijaya, Riesanti Edie

2009-01-01

Voluntary disclosure meant giving information to public either about fi nancial or non-fi -nancial regarding the fi rm's operations without any legal requirement (Fishman and Hagerty, 1997).Giving information about voluntary disclosure enables all the concerned parties obtaining more relevantinformation about the strategies and critical elements of the fi rms. In this study, we examinedthe impact of corporate governance and fi nancial distress condition on the level of voluntary informationdi...

Performance of interventional procedures in a day-hospital system

International Nuclear Information System (INIS)

Bae, Jae Ik; Park, Auh Whan; Cho, Hye Seon; Park, Eun Hee; Choi, Gap Suk; Lee, Seon Ju; Kim, Yong Woo; Juhn, Je Ryang

2007-01-01

We wanted to describe the practice and results of applying the day-hospital system in an interventional radiology clinic. From Oct. 2004 to Dec. 2005, the day-hospital system was applied to various interventional procedures with using a part of the recovery room of an angiography suite as a facility for hospital admission. The study included 91 cases in 73 patients. The source of the patient referral, the procedures, hospital courses and complications were analyzed and questionnaire surveys were conducted for the available 55 patients. Among the patients, 70% (n=64) were referred form other departments, 5% (n=5) from other hospitals, 5% (n=4) were new patients and 20% (n=18) were re-admissions. The procedures included gastrointestinal, biliary, urinary, hemodialysis related-and implantable port related interventions. 96% (n=87) of the patients were successfully discharged in a day and admission to the general ward was only 4% (n=4). Minor complications occurred after discharges in 3% (n=3). The questionnaire survey revealed that 96% (n=53) of the patients were satisfied with the service and they were not anxious after discharge. Most of common interventional procedures were safely done under the day-hospital system with the patients being highly satisfied. The day-hospital system can be a good tool for establishing admitting privileges for an interventional radiology clinic

Priming voluntary autobiographical memories: Implications for the organisation of autobiographical memory and voluntary recall processes.

Science.gov (United States)

Mace, John H; Clevinger, Amanda M

2013-01-01

The goal of this study was to show that voluntary autobiographical memories could be primed by the prior activation of autobiographical memories. Three experiments demonstrated voluntary memory priming with three different approaches. In Experiment 1 primed participants were asked to recall memories from their elementary school years. In a subsequent memory task primed participants were asked to recall memories from any time period, and they produced significantly more memories from their elementary school years than unprimed participants. In Experiment 2 primed participants were asked to recall what they were doing when they had heard various news events occurring between 1998 and 2005. Subsequently these participants produced significantly more memories from this time period than unprimed participants. In Experiment 3 primed participants were asked to recall memories from their teenage years. Subsequently these participants were able to recall more memories from ages 13-15 than unprimed participants, where both had only 1 second to produce a memory. We argue that the results support the notion that episodic memories can activate one another and that some of them are organised according to lifetime periods. We further argue that the results have implications for the reminiscence bump and voluntary recall of the past.

Voluntary Becomes Mandatory?

Science.gov (United States)

Kates, William

Voluntary bench-bar press guidelines have evolved over the past 15 years as a way of resolving the conflict between the right of the accused to a fair trial and the right of the press to cover such a trial. In 1980, however, a Washington state judge required reporters to sign an affidavit stating that they would follow the state's guidelines.…

Adoption of medication alert systems in hospital outpatient departments in Taiwan.

Science.gov (United States)

Kuo, Yu-Chun; Cheng, Shou-Hsia

2017-06-01

The adoption of medication alert systems in the health care sector varies among regions. In Taiwan, the health authority introduced policies in 2005 to encourage the adoption of medication alert systems in hospitals. This study aimed to understand the adoption of medication alert systems in the outpatient departments of hospitals in Taiwan using a nationwide survey. A questionnaire was developed and mailed to 380 accredited general hospitals in Taiwan in 2013. The information collected from the questionnaire concerning the outpatient department included (1) the time of adoption of a medication alert system; (2) the operation of individual alert functions: availability, management, and stability; and (3) hospital characteristics: accreditation level, teaching status, ownership, and number of beds. A total of 216 hospitals completed and returned the questionnaire, corresponding to a response rate of 56.8%. The adoption rate of medication alert systems in hospital outpatient departments increased from less than 10% in 1997-95.83% in 2012. Approximately two-thirds of the hospitals developed and maintained the alert systems independently or collaboratively with vendors. Teaching and large hospitals tended to develop more advanced alert functions such as drug-drug interaction functions. Improving the safety and quality of pharmaceutical services and meeting the policy requirements are reasons for hospitals to establish medication alert systems. The adoption rate of medication alert systems reached 95% in accredited general hospitals in Taiwan. Government policy and available health information professionals and vendors may somewhat contribute to the high adoption rate. Copyright © 2017 Elsevier B.V. All rights reserved.

Nonpoint source water pollution abatement and the feasibility of voluntary programs

Science.gov (United States)

Sawicki, David S.; Judd, Lynne B.

1983-09-01

This article details a case study of a voluntary, decentralized institutional arrangement for nonpint source water pollution control used in the Root River watershed in southeastern Wisconsin. This watershed was chosen because of its mix of urban, agricultural, and urbanizing land uses. The project objectives were to monitor and draw conclusions about the effectiveness of a voluntary, decentralized institutional system, to specify deficiencies of the approach and suggest means to correct them, and to use the conclusions to speculate about the need for regulations regarding nonpoint source pollution control or the appropriateness of financial incentives for nonpoint source control. Institutional factors considered include diversity of land uses in the watershed, educational needs, economic conditions, personality, water quality, number of agencies involved, definition of authority, and bureaucratic requirements

Impacts of Hospitals' Innovativeness on Information System Outsourcing Decisions

OpenAIRE

Park, Jae Sung

2014-01-01

Objectives The purpose of this study was to identify the effects of hospitals' innovativeness on outsourcing decision-making regarding four information system (IS) functions, namely, software programs, network maintenance, hardware systems, and PC/printer maintenance. Methods Using the 2011 roster of the Korean Hospital Association, this study selected 311 general hospitals as a study population. After identifying the managers who were in charge of outsourcing, this study administered questio...

Evaluation of real-time location systems in their hospital contexts.

Science.gov (United States)

Fisher, Jill A; Monahan, Torin

2012-10-01

The purpose of the research was to assess real-time location systems (RTLS) that have been implemented in U.S. hospitals. We examined the type of uses to which RTLS have been put, the degree of functionality of the various technologies and software, and the organizational effects of implementing RTLS. The project was a 3-year qualitative study of 23 U.S. hospitals that had implemented RTLS for the purpose of tracking assets, personnel, and/or patients. We observed the systems in use and conducted 80 semi-structured interviews with hospital personnel and vendors. In order to protect the confidentiality of the hospitals and vendors in our sample, we conducted an aggregate analysis of our findings rather than providing evaluations of specific technologies or hospital case studies. The most important findings from our research were (1) substandard functionality of most real-time location systems in use and (2) serious obstacles to effective deployment of the systems due to the material and organizational constraints of the hospitals themselves. We found that the current best use of RTLS is for asset tracking, but importantly it requires whole-hospital deployment as well as centralized control of the system, preferably by materials management or biomedical engineering departments. There are serious technological, material, and organizational barriers to the implementation of RTLS, and these barriers need to be overcome if hospitals are to maximize the potential benefits of these systems. In addition to considering the available technological options, hospitals must assess their unique environments, including the myriad material and organizational constraints that will affect the success of RTLS implementation. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Grazing Soybean to Increase Voluntary Cow Traffic in a Pasture-based Automatic Milking System

Directory of Open Access Journals (Sweden)

C. E. F. Clark

2014-03-01

Full Text Available Pasture-based automatic milking systems (AMS require cow traffic to enable cows to be milked. The interval between milkings can be manipulated by strategically allocating pasture. The current experiment investigated the effect of replacing an allocation of grazed pasture with grazed soybean (Glycine max with the hypothesis that incorporating soybean would increase voluntary cow traffic and milk production. One hundred and eighty mixed age, primiparous and multiparous Holstein-Friesian/Illawarra cows were randomly assigned to two treatment groups (n = 90/group with a 2×2 Latin square design. Each group was either offered treatments of kikuyu grass (Pennisetum clandestinum Hoach ex Chiov. pasture (pasture or soybean from 0900 h to 1500 h during the experimental period which consisted of 2 periods of 3 days following 5 days of training and adaptation in each period with groups crossing over treatments after the first period. The number of cows trafficking to each treatment was similar together with milk yield (mean ≈18 L/cow/d in this experiment. For the cows that arrived at soybean or pasture there were significant differences in their behaviour and consequently the number of cows exiting each treatment paddock. There was greater cow traffic (more cows and sooner exiting pasture allocations. Cows that arrived at soybean stayed on the allocation for 25% more time and ate more forage (8.5 kg/cow/d/allocation relative to pasture (4.7 kg/cow/d/allocation. Pasture cows predominantly replaced eating time with rumination. These findings suggest that replacing pasture with alternative grazeable forages provides no additional incentive to increase voluntary cow traffic to an allocation of feed in AMS. This work highlights the opportunity to increase forage intakes in AMS through the incorporation of alternative forages.

SEA Screening of voluntary Climate Change Plans

DEFF Research Database (Denmark)

Kørnøv, Lone; Wejs, Anja

2013-01-01

that discretionary judgement takes place and will impact on the screening decision. This article examines the results of discretion involved in screening of climate change plans (CCPs) in a Danish context. These years voluntary CCPs are developed as a response to the global and local emergence of both mitigation...... rests upon a docu- mentary study of Danish CCPs, interviews with a lawyer and ministerial key person and informal discussions between researchers, practitioners and lawyers on whether climate change plans are covered by SEA legislation and underlying reasons for the present practice. Based on a critical...... and adap- tation, and the voluntary commitment by the local authorities is an indication of an emerging norm of climate change as an important issue. This article takes its point of departure in the observation that SEA is not undertaken for these voluntary CCPs. The critical analysis of this phenomenon...

Hospital Based Customization of a Medical Information System

Science.gov (United States)

Rath, Marilyn A.; Ferguson, Julie C.

1983-01-01

A Medical Information System must be current if it is to be a viable adjunct to patient care within a hospital setting. Hospital-based customization provides a means of achieving this timeliness with maximum user satisfaction. It, however, requires a major commitment in personnel time as well as additional software and training expenses. The enhanced control of system modifications and overall flexibility in planning the change process result in enthusiastic support of this approach by many hospitals. The key factors for success include careful selection of local personnel with adequate vendor support, extensive QA control, thorough auditing/validation and direct user involvement.

Voluntary Imitation in Alzheimer’s Disease Patients

Science.gov (United States)

Bisio, Ambra; Casteran, Matthieu; Ballay, Yves; Manckoundia, Patrick; Mourey, France; Pozzo, Thierry

2016-01-01

Although Alzheimer’s disease (AD) primarily manifests as cognitive deficits, the implicit sensorimotor processes that underlie social interactions, such as automatic imitation, seem to be preserved in mild and moderate stages of the disease, as is the ability to communicate with other persons. Nevertheless, when AD patients face more challenging tasks, which do not rely on automatic processes but on explicit voluntary mechanisms and require the patient to pay attention to external events, the cognitive deficits resulting from the disease might negatively affect patients’ behavior. The aim of the present study was to investigate whether voluntary motor imitation, i.e., a volitional mechanism that involves observing another person’s action and translating this perception into one’s own action, was affected in patients with AD. Further, we tested whether this ability was modulated by the nature of the observed stimulus by comparing the ability to reproduce the kinematic features of a human demonstrator with that of a computerized-stimulus. AD patients showed an intact ability to reproduce the velocity of the observed movements, particularly when the stimulus was a human agent. This result suggests that high-level cognitive processes involved in voluntary imitation might be preserved in mild and moderate stages of AD and that voluntary imitation abilities might benefit from the implicit interpersonal communication established between the patient and the human demonstrator. PMID:27014056

Voluntary imitation in Alzheimer’s disease patients

Directory of Open Access Journals (Sweden)

Ambra eBisio

2016-03-01

Full Text Available Although Alzheimer's disease (AD primarily manifests as cognitive deficits, the implicit sensorimotor processes that underlie social interactions, such as automatic imitation, seem to be preserved in mild and moderate stages of the disease, as is the ability to communicate with other persons. Nevertheless, when AD patients face more challenging tasks, which do not rely on automatic processes but on explicit voluntary mechanisms and require the patient to pay attention to external events, the cognitive deficits resulting from the disease might negatively affect patients’ behaviour. The aim of the present study was to investigate whether voluntary motor imitation, i.e. a volitional mechanism that involves observing another person’s action and translating this perception into one’s own action, was affected in patients with Alzheimer’s disease. Further, we tested whether this ability was modulated by the nature of the observed stimulus by comparing the ability to reproduce the kinematic features of a human demonstrator with that of a computerized-stimulus. AD patients showed an intact ability to reproduce the velocity of the observed movements, particularly when the stimulus was a human agent. This result suggests that high-level cognitive processes involved in voluntary imitation might be preserved in mild and moderate stages of AD and that voluntary imitation abilities might benefit from the implicit interpersonal communication established between the patient and the human demonstrator.

78 FR 27485 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

Science.gov (United States)

2013-05-10

... Readmission 5. MDC 8 (Diseases and Disorders of the Musculoskeletal System and Connective Tissue) a. Reverse... hospitals, PPS-exempt cancer hospitals, LTCHs, and inpatient psychiatric facilities (IPFs)) that are..., (410) 786-2261, PPS-Exempt Cancer Hospital Quality Reporting Issues. Allison Lee, (410) 786-8691 and...

Hospital charitable lotteries: taking a gamble on systems thinking.

Science.gov (United States)

Reynolds, Jennifer

2013-12-01

The presence of lotteries can be witnessed worldwide. Charitable lotteries are often portrayed as 'good works', and recently, hospitals have utilized them as a popular fundraising vehicle to raise necessary funds to help achieve organizational goals and objectives. Research indicates that lotteries contribute to gambling-related harms; however, research into charitable lotteries has been underdeveloped. Both the gambling and the health care industries are complex and evolving, consisting of many interacting stakeholders with often different and competing interests. This article seeks to present systems thinking as a conceptual framework to help fill the gap in understanding the use of gambling within hospitals and its possible benefits and unforeseen negative consequences. Addressing the gap in knowledge is important to help inform decision making aimed at reducing gambling-related harms. This article proposes how the school of systems thinking, specifically framing hospitals as complex adaptive systems and system dynamics modelling, can be utilized to understand the policy implications of the adoption of lotteries as a revenue source for hospitals. Hospitals have a duty to care, inform and protect. Hospital charitable lotteries have become big business; however, its incorporation into critical funding strategies needs to be carefully understood. Systems thinking theory and methodologies provide an integrated approach to examine this dynamic and evolving fundraising initiative. Findings from this article can inform the development of action strategies, including policy development at multiple levels. © 2013 John Wiley & Sons Ltd.

Hospital Quality Systems - working mechanisms unraveled.

NARCIS (Netherlands)

Schoten, S. van; Groenewegen, P.; Wagner, C.

2015-01-01

Context: Quality systems were implemented in healthcare institutions to assure and improve the quality of care. Despite the fact that all Dutch hospitals have implemented a quality system, incidents persist to surface. How could this be explained? The current research was set out to gain thorough

STUDY ON WASTEWATER TREATMENT SYSTEMS IN HOSPITALS OF IRAN

Directory of Open Access Journals (Sweden)

M. Majlesi Nasr, A. R. Yazdanbakhsh

2008-07-01

Full Text Available Nowadays, water resources shortage is one of the most important issues for environmental engineers and managers as well as its conservation due to population growth and ever-increasing water demands. Besides, hospital wastewater has the same quality as municipal wastewater, but may also potentially contain various hazardous components. In this paper, physical and chemical specifications of produced wastewater in hospitals of Iran were investigated experiments. Results were compared with the effluent parameters of wastewater standards of Iranian Department of the Environment. 70 governmental hospitals from different provinces of Iran were selected by purposive (non-random sampling method. For data analysis, SPSS and EXCEL softwares were applied. The findings of the study showed that 52% of the surveyed hospitals were not equipped and 48% were equipped with wastewater treatment systems. The mean of Biochemical Oxygen Demand, Chemical Oxygen Demand and Total Suspended Solids of the effluent of wastewater treatment systems were reported as 113, 188 and 99 mg/L respectively. Comparison of the indicators between effluents of wastewater treatment systems and the standards of Departments of the Environment, showed the inefficiency in these systems and it was concluded that despite the recent improvements in hospital wastewater treatment systems, they should be upgraded based on the remarks in this paper.

Delivery mechanisms: voluntary vs command and control

International Nuclear Information System (INIS)

Kierans, T.

1997-01-01

The success of Canada's Voluntary Challenge and Registry (VCR) program was debated. The generally accepted view is that the voluntary program to stabilize greenhouse gas emissions at 1990 levels by year 2000 has failed. However, the author suggested that the issues and processes are complicated and that we should not give up too soon. Time is needed to refine the market instruments that we are dealing with. Also, there are substantial economic barriers to fully meet target figures, among them the fact that municipalities, universities, social services and health care industries are chronically capital rationed and don't have the money to respond to the VCR program. Other sectors of the economy capitalized and regulated by government, have not seen much success in the VCR program either. The central argument is that while voluntary programs are probably not the answer, binding agreements or government-run schemes are even less likely to succeed

[Development of Hospital Equipment Maintenance Information System].

Science.gov (United States)

Zhou, Zhixin

2015-11-01

Hospital equipment maintenance information system plays an important role in improving medical treatment quality and efficiency. By requirement analysis of hospital equipment maintenance, the system function diagram is drawed. According to analysis of input and output data, tables and reports in connection with equipment maintenance process, relationships between entity and attribute is found out, and E-R diagram is drawed and relational database table is established. Software development should meet actual process requirement of maintenance and have a friendly user interface and flexible operation. The software can analyze failure cause by statistical analysis.

The voluntary safeguards offer of the United States

International Nuclear Information System (INIS)

Houck, F.S.

1985-01-01

During negotiations of the Treaty on the Non-Proliferation of Nuclear Weapons (NPT) concerns were expressed by non-nuclear-weapon States that their acceptance of Agency safeguards would put them at a disadvantage vis-a-vis the nuclear-weapon States. To allay these concerns, the United States and the United Kingdom in December 1967 made voluntary offers to accept Agency safeguards on their peaceful nuclear activities. Subsequently, France made a voluntary offer, the safeguards agreement for which was approved by the IAEA Board of Governors in February 1978, with a view to encouraging acceptance of Agency safeguards by additional States. More recently, in February 1985 the Board approved the safeguards agreement for the voluntary offer of the USSR, made inter alia to encourage further acceptance of Agency safeguards. These safeguards agreements with nuclear-weapon-States have two important features in common: Namely, they result from voluntary offers to accept safeguards rather than from multilateral or bilateral undertakings, and they give the Agency the right but generally not an obligation to apply its safeguards. The agreements differ in certain respects, the most noteworthy of which is the scope of the nuclear activities covered by each offer. The agreements of the United States and United Kingdom are the broadest, covering all peaceful nuclear activities in each country. The safeguards agreement for the US voluntary offer has been in force since December 1980. Now is an appropriate time to review the experience with the agreement's implementation during its first four years, as well as its history and salient features

Haemoglobin variants among voluntary blood donors in Jos, Nigeria ...

African Journals Online (AJOL)

This study aimed to determine the haemoglobin variants among voluntary blood donors in Jos. METHOD: Records of the age, sex, Haemoglobin level, and the haemoglobin genotype of all voluntary blood donors who donated blood at the National Blood Transfusion Service Centre, Jos, Nigeria between January 2011 and ...

Belief in Life After Death and Attitudes Toward Voluntary Euthanasia.

Science.gov (United States)

Sharp, Shane

2017-01-01

Research has documented associations among religious affiliation, religious practice, and attitudes toward voluntary euthanasia, yet very few studies have investigated how particular religious beliefs influence these attitudes. I use data from the General Social Survey (GSS; N = 19,967) to evaluate the association between the belief in life after death and attitudes toward voluntary euthanasia. I find that those who believe in life after death are significantly less likely than those who do not believe in life after death or those who doubt the existence of life after death to have positive attitudes toward voluntary euthanasia. These associations hold even after controlling for religious affiliation, religious attendance, views of the Bible, and sociodemographic factors. The findings indicate that to understand individuals' views about voluntary euthanasia, one must pay attention to individuals' particular religious beliefs.

'These schemes will win for themselves the confidence of the people': irish independence, poor law reform and hospital provision.

Science.gov (United States)

Lucey, Donnacha Seán

2014-01-01

This article examines hospital provision in Ireland during the early twentieth century. It examines attempts by the newly independent Irish Free State to reform and de-stigmatise medical relief in former workhouse infirmaries. Such reforms were designed to move away from nineteenth century welfare regimes which were underpinned by principles of deterrence. The reform initiated in independent Ireland - the first attempted break-up of the New Poor Law in Great Britain or Ireland - was partly successful. Many of the newly named County and District Hospitals provided solely for medical cases and managed to dissociate such health care provision from the relief of poverty. However, some hospitals continued to act as multifunctional institutions and provided for various categories including the sick, the aged and infirm, 'unmarried mothers' and 'harmless lunatics'. Such institutions often remained associated with the relief of poverty. This article also examines patient fee-payment and outlines how fresh terms of entitlement and means-testing were established. Such developments were even more pronounced in voluntary hospitals where the majority of patients made a financial contribution to their treatment. The article argues that the ability to pay at times determined the type of provision, either voluntary or rate-aided, available to the sick. However, it concludes that the clinical condition of patients often determined whether they entered a more prestigious voluntary hospital or the former workhouse. Although this article concentrates on two Irish case studies, County Kerry and Cork City; it is conceptualised within wider developments with particular reference to the British context.

Review of antenatal-linked voluntary counseling and HIV testing in ...

African Journals Online (AJOL)

Review of antenatal-linked voluntary counseling and HIV testing in Sub-Saharan Africa: lessons and options for Ghana. ... Voluntary counselling and HIV testing has become an integral part of HIV prevention ... AJOL African Journals Online.

Integrated processing of ECG's in a hospital information system

NARCIS (Netherlands)

Helder, J.C.; Schram, P.H.; Verwey, H.; Meijler, F.L.; Robles de Medina, E.O.

The ECG handling in the University Hospital of Utrecht is composed by a system consisting of acquisition and storage of ECG signals, computer analysis, data management, and storage of readings in a patient data base. The last two modules are part of a Hospital Information System (HIS). The modular

An energy saving system for hospital laundries

Energy Technology Data Exchange (ETDEWEB)

Katsanis, J.S.; Tsarabaris, P.T.; Polykrati, A.D.; Proios, A.N. [National Technical Univ. of Athens, Athens (Greece). School of Electrical and Computer Engineering; Koufakis, E.I. [Public Power Corp. S.A., Crete (Greece)

2009-07-01

Hospital laundries are one of the largest consumers of water and electrical and thermal energy. This paper examined the energy savings achieved by a system using the hot wastewater from the washing process. Hospital laundries consume thermal energy using steam, which is produced in boilers by burning diesel oil or natural gas. Electrical energy for the mechanical drives, ventilation and also the lighting required in the laundry area are big consumers of energy. The paper presented the proposed system and discussed the parameters of the system and system dimensioning. The paper also provided and discussed an interpretation of steam and energy savings. The proposed system was considered to be economically viable, simple in its construction, installation and operation. From the application of the suggested system, the cost savings resulted in a satisfactory payback period for the capital invested of approximately three to five years. 14 refs., 4 tabs., 2 figs.

Development of certified environmental management in hospital and outpatient haemodialysis units.

Science.gov (United States)

García Vicente, Sergio; Morales Suárez-Varela, María; Martí Monrós, Anna; Llopis González, Agustín

2015-01-01

The environmental impact of haemodialysis is very high. Institutional activity in this sense is important, even in the production of references. Voluntary environmental management systems (EMS), environmental management and auditing systems (EMAS) and the International Organization for Standardization standards (ISO 14001) are important tools for environmental protection, together with legislation, taxation and tax benefits. To determine the degree of implementation of EMS in hospital units and outpatient haemodialysis in the Spanish National Health System to provide a group of reference centres in environmental management in this healthcare activity. Development of a list by autonomous communities showing hospital and outpatient dialysis units using an EMAS and/or ISO 14001 in 2012-2013. The sources of information were the Spanish National Catalogue of Hospitals, Spanish Registry of Healthcare Certification and Accreditation, European and regional EMAS records, world ISO registrations, dialysis centre lists from scientific societies and patients, responses from accredited entities in Spain for environmental certification and the institutional website of each haemodialysis centre identified. Of the 210 hospitals with a dialysis unit, 53 (25%) have the ISO 14001 and 15 of these also have an EMAS). This constitutes 30% of all hospital dialysis chairs in Spain: 1,291 (of 4,298). Only 11 outpatient clinics are recorded, all with the ISO 14001. There is no official documentation of the implementation of EMS in dialysis units. Making this list provides an approach to the situation, with special reference to haemodialysis because of its significant environmental impact. Copyright © 2015 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

Voluntary counseling and testing for HIV among high school

African Journals Online (AJOL)

abp

2012-09-24

Sep 24, 2012 ... Page number not for citation purposes. 1. Voluntary .... cigarettes, alcohol or going to night clubs before their majority and these activities are associated with sexual activity. ... Ngwakongnwi E, Quan H. Sex differentials in the use of centres for voluntary counseling and testing for HIV in Cameroon. Afr J AIDS ...

Assessment of the knowledge, attitude and practice of voluntary non ...

African Journals Online (AJOL)

Assessment of the knowledge, attitude and practice of voluntary ... The commonest reason for not donating blood was fear to damage of health as reported in ... to arouse the interest of the general public in voluntary blood donation exercises.

Market Motivations for Voluntary Carbon Disclosure in Real Estate Industry

Science.gov (United States)

Ufere, Kalu Joseph; Alias, Buang; Godwin Uche, Aliagha

2016-07-01

Climate change mitigation in developing economies is a balancing act, between economic development and environmental sustainability. The need for market friendly determinants for low carbon economy, without compromising economic development is of essence. The aim of the study is to determine market friendly factors, which motivates voluntary carbon information disclosure, in the real estate industry. The study modeled economic factor with three variables and financial market factor with three variables against voluntary carbon information disclosure in the real estate industry. Structural equation modeling was used for the modeling and content analysis was used to collect data on the level of voluntary carbon information disclosure, from 2013 annual reports of 126 real estate sector companies listed in the Kuala Lumpur Stock Exchange (KLSE). The model achieved a good fit, and was acceptable prediction. The results show that financial market factor has a significant predictive influence on voluntary carbon disclosure. The application of the result is that financial market factor is has a significantly positive influence on companies’ willingness to make voluntary carbon disclosure in the real estate industry. The result may be limited to the real estate industry that is highly leveraged on syndicated fund.

Voluntary health insurance in the European Union: a critical assessment.

Science.gov (United States)

Mossialos, Elias; Thomson, Sarah M S

2002-01-01

The authors examine the role and nature of the market for voluntary health insurance in the European Union and review the impact of public policy, at both the national and E.U. levels, on the development of this market in recent years. The conceptual framework, based on a model of industrial analysis, allows a wide range of policy questions regarding market structure, conduct, and performance. By analyzing these three aspects of the market for voluntary health insurance, the authors are also able to raise questions about the equity and efficiency of voluntary health insurance as a means of funding health care in the European Union. The analysis suggests that the market for voluntary health insurance in the European Union suffers from significant information failures that seriously limit its potential for competition or efficiency and also reduce equity. Substantial deregulation of the E.U. market for voluntary health insurance has stripped regulatory bodies of their power to protect consumers and poses interesting challenges for national regulators, particularly if the market is to expand in the future. In a deregulated environment, it is questionable whether this method of funding health care will encourage a more efficient and equitable allocation of resources.

An Evaluation of the Management Information System and Technology in Hospitals (GESITI/Hospitals

Directory of Open Access Journals (Sweden)

Antonio José Balloni

2017-02-01

Full Text Available The research project "Management of System and Information Technology in Hospitals" (GESITI/Hospitals has the purpose of mapping out the management of Information Systems (IS and Information Technology (IT in hospitals. By applying a multifocal prospective questionnaire in hospitals, the research aims to identify the hospitals need and demand, prospecting for unfolding, and generate a public integrated research report for supporting public and/or private decisions-makings. The ultimate result from this GESITI/Health research project should be a significant improvement on the hospital management and on the decisions-makings, which must reflect on peoples more satisfied regarding a better health care. Therefore, this paper aims to publish the main ideas of the GESITI/Health project i.e., its "Methodology & original Prospective Questionnaire (PQ". The methodology used is the Interpretative (or Introspective. About the PQ, we do not known, up to this date, who have developed a multifocal broad field tool -the PQ-, aiming wide hospitals management-. From 2010-16 the "methodology and PQ" have been implemented by about forty -40- universities -and increasing-, from Brazil and Abroad and, forty local research reports were generated. A book, published by the Brazilian Minister of Health [1], presents the results of a pilot project carried out by nineteen -19- out of these forty -40- universities, to know: sixteen Brazilian, one Mexican, one Argentina, one from Slovakia and one from Portugal. The chapter 25 of this book [1.A] presents an integrated research from all nineteen chapters -an integrated research report-. Finally, in the oral presentation, we will briefly present the "Methodology and the PQ" presented in this paper and, also, we will present an integrated comparative analyzes -main results got with the field application of the PQ- regarding the case studies accomplished by the universities from Brazil and Abroad.

On voluntariness of the withdrawal from the commitment of the criminal offence

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Đokić Ivan

2015-01-01

Full Text Available Serbian Criminal Code (CC provides in art. 32 that offender who voluntary withdraws from an attempted offence can be released from punishment. CC distinguishes between two different types of attempt, unfinished and finished attempt. For both types CC prescribes that withdrawal must be voluntary. In earlier theory the distinction between voluntariness and involuntariness was made on the basis of the so-called Frank's Formula (the withdrawal is voluntary if the perpetrator says: I don't wish to complete the offence if I could, whereas it will be involuntary if he thinks: I cannot complete the offence if I wanted to. This theory has been abandoned in the modern criminal law doctrine. The requirement of voluntariness is usually interpreted according to psychological and normative approach. According to art. 32 (2 CC there is no voluntariness if it is impossible for the offender to commit the offence or if there are some obstacles which make significantly difficult the commitment of the criminal offence. Serbian jurisprudence holds a restrictive approach to the requirement of voluntariness despite the fact that CC unlike the law of some other countries doesn't prescribe that withdrawal leads to a full acquittal from the charge based on the attempted offence.

Voluntary Exercise Improves Performance of a Discrimination Task through Effects on the Striatal Dopamine System

Science.gov (United States)

Eddy, Meghan C.; Stansfield, Katherine J.; Green, John T.

2014-01-01

We have previously demonstrated that voluntary exercise facilitates discrimination learning in a modified T-maze. There is evidence implicating the dorsolateral striatum (DLS) as the substrate for this task. The present experiments examined whether changes in DLS dopamine receptors might underlie the exercise-associated facilitation. Infusing a…

Voluntary business activities to mitigate climate change: Case studies in Japan

International Nuclear Information System (INIS)

Wakabayashi, Masayo

2013-01-01

Voluntary business activities, such as the voluntary action plans conducted by comprehensive business associations in Japan to reduce environmental damage, are viable policy instruments alongside regulations and economic incentives (e.g. taxes and emissions trading schemes). This paper examines three case studies in which voluntary activities have played a successful role in mitigating climate change. Based on interviews with business organisations together with a literature review and data analysis, we show why businesses are motivated to take socially responsible actions and describe the major benefits of such activities. One of the important benefits of voluntary activities is their flexibility in phasing measures. This flexibility is greatly appreciated, since industries are able to retain control of their responses to future uncertainties, which allows them to tackle climate change issues aggressively. We conclude that voluntary activities have been more environmentally effective than alternative policy measures under a proper institutional framework, which consists of effective motivation mechanisms for businesses, governmental measures to encourage their compliance, and capable industrial associations that can lessen the transaction costs both of the government and of industry. - Highlights: • Businesses are well motivated to take suitable, technologically feasible actions. • Capability of industrial associations is a key to successful voluntary activities. • Flexibility allows businesses to manage uncertainty and aim for ambitious goals

Hospital information system utilization in Iran: a qualitative study.

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Mohammad Ali Abbasi Moghadam

2014-11-01

Full Text Available Hospital information system (HIS should ideally allow different forms of data to be stored and used for decision making by clinicians and managers alike. This system has been developed since the early 1980's, and many hospitals gradually converted from an unrelated system into an integrated one. In successful implementation of HIS plans, the role of human factors, either individually or as a group, is expected to be very important and decisive. In this phenomenological qualitative research, in-depth personal interviews were conducted with the hospital's senior managers, and discussions were conducted in six to eight member focus groups. To include participants for interviews, purposive sampling was used in an Iranian hospital among doctors, nurses and other healthcare providers who had experience in using HIS. Data collection continued until saturation stage. The meetings took about 90 to 120 minutes, in which the participants were asked about discovering needs as well as facilitating and inhibiting factors regarding HIS application. Two members of the research team independently analyzed the interview transcripts.  As a result, problems in HIS isolation were reported to be related to the following: software, hardware, manpower, management and training. About the last point, it was stated that adequate continuing professional development programs did not exist for proper use of computers in the hospital. To achieve the ultimate goal of HISs (e.g. increasing patient satisfaction and decreasing hospital costs, it is necessary to create basic changes in the training system, and to get feedback from hospital personnel. Other steps include addressing software and hardware shortcomings as well as moving towards reinforcing the facilitating factors and refraining from inhibiting ones discovered in this study.

Voluntary reporting of greenhouse gases 1997

Energy Technology Data Exchange (ETDEWEB)

NONE

1999-05-01

The Voluntary Reporting of Greenhouse Gases Program, required by Section 1605(b) of the Energy Policy Act of 1992, records the results of voluntary measures to reduce, avoid, or sequester greenhouse gas emissions. In 1998, 156 US companies and other organizations reported to the Energy information Administration that, during 1997, they had achieved greenhouse gas emission reductions and carbon sequestration equivalent to 166 million tons of carbon dioxide, or about 2.5% of total US emissions for the year. For the 1,229 emission reduction projects reported, reductions usually were measured by comparing an estimate of actual emissions with an estimate of what emissions would have been had the project not been implemented.

Imaging the heart: cardiac scintigraphy and echocardiography in US hospitals (1983)

International Nuclear Information System (INIS)

McPhee, S.J.; Garnick, D.W.

1986-01-01

The rapid growth of cardiac catheterization has raised questions about the availability of less costly, noninvasive tests such as cardiac scintigraphy and echocardiography. To assess their availability and rates of use, we surveyed 3778 non-federal short-term US hospitals in June, 1983. Overall, 2605 hospitals (69%) offered 201 Tl myocardial perfusion scans, 2580 (68%) 99mTc equilibrium gated blood pool scans, and 2483 (67%) cardiac shunt scans; 1679 hospitals (44%) offered M-mode and/or 2-dimensional echocardiography, and 768 (20%) pulsed Doppler echocardiography. Volumes of procedures varied enormously among hospitals capable of performing them. High volumes of both scintigraphy and echocardiography were performed in a small number of hospitals. Larger, voluntary, and teaching hospitals performed higher volumes of both procedures. Despite widespread availability of these noninvasive technologies, high volumes of both cardiac scintigraphy and echocardiography procedures are concentrated in a small number of US hospitals

Death AND DIGNITY. WHY VOLUNTARY EUTHANASIA IS A QUESTION OF CHOICE.

Science.gov (United States)

Denton, Andrew

2016-12-01

The prospect of voluntary euthanasia has created strong debate for decades and provoked passionate opinions from both sides of the fence. While not legal in Australia, a recent revived push for national voluntary euthanasia legislation has once again opened up the conversation and nurses have been encouraged to join the debate. Robert Fedele investigates the latest thinking and why more people are supporting voluntary euthanasia and the right to die with dignity.

Costly Disclosures in a Voluntary Disclosure Model with an Opponent

NARCIS (Netherlands)

Suijs, J.P.M.

1999-01-01

This paper analyzes voluntary disclosure equilibria when the voluntary disclosure model presented inWAGENHOFER (1990) is modified so as to include fixed disclosure costs as used in VERRECCHIA (1983). It turns out that incorporating both disclosure and proprietary costs rules out full disclosure

Reducing information asymmetry in the power industry: Mandatory and voluntary information disclosure regulations of sulfur dioxide emission

International Nuclear Information System (INIS)

Zhu Xufeng; Zhang Chao

2012-01-01

This paper focuses on the institutional framework for sulfur dioxide emission information disclosure (SDEID) in power industries. The authors argue that mandatory and voluntary SDEID are two complementary regulatory instruments for emission reduction in the power industry. An analytical framework of SDEID with six facets is suggested in this paper to demonstrate relevant legal provisions and regulatory policies of mandatory and voluntary SDEID of power industries in the US. Empirical research shows that mandatory and voluntary SDEID of the power industry have been regulated simultaneously in the US. The foundation of power companies' willingness to disclose emission information voluntarily is the combination of mandatory scientific monitoring with market regulation in the current SDEID system in the US. In comparison, the SDEID of power industries has yet to be widely implemented in developing countries. Finally, the paper provides some implications to developing countries that plan to learn institutional arrangements from developed countries. - Highlights: ► Mandatory and voluntary SDEID are two complementary regulatory instruments. ► An analytical framework is suggested to demonstrate SDEID of power industry in the US. ► Voluntary disclosure can be attributed to scientific monitoring and market regulation. ► We provide implications to developing countries learning from developed countries.

Acceptance model of a Hospital Information System.

Science.gov (United States)

Handayani, P W; Hidayanto, A N; Pinem, A A; Hapsari, I C; Sandhyaduhita, P I; Budi, I

2017-03-01

The purpose of this study is to develop a model of Hospital Information System (HIS) user acceptance focusing on human, technological, and organizational characteristics for supporting government eHealth programs. This model was then tested to see which hospital type in Indonesia would benefit from the model to resolve problems related to HIS user acceptance. This study used qualitative and quantitative approaches with case studies at four privately owned hospitals and three government-owned hospitals, which are general hospitals in Indonesia. The respondents involved in this study are low-level and mid-level hospital management officers, doctors, nurses, and administrative staff who work at medical record, inpatient, outpatient, emergency, pharmacy, and information technology units. Data was processed using Structural Equation Modeling (SEM) and AMOS 21.0. The study concludes that non-technological factors, such as human characteristics (i.e. compatibility, information security expectancy, and self-efficacy), and organizational characteristics (i.e. management support, facilitating conditions, and user involvement) which have level of significance of p<0.05, significantly influenced users' opinions of both the ease of use and the benefits of the HIS. This study found that different factors may affect the acceptance of each user in each type of hospital regarding the use of HIS. Finally, this model is best suited for government-owned hospitals. Based on the results of this study, hospital management and IT developers should have more understanding on the non-technological factors to better plan for HIS implementation. Support from management is critical to the sustainability of HIS implementation to ensure HIS is easy to use and provides benefits to the users as well as hospitals. Finally, this study could assist hospital management and IT developers, as well as researchers, to understand the obstacles faced by hospitals in implementing HIS. Copyright © 2016

Building the adult protective services system of tomorrow: The role of the APS national voluntary consensus guidelines.

Science.gov (United States)

Bobitt, Julie; Kuhne, Jamie; Carter, Julie; Whittier Eliason, Stephanie; Twomey, Mary

2018-01-01

In 2015, the Administration for Community Living (ACL) established the first federal "home" for Adult Protective Services (APS). This leadership has included working collaboratively with state Adult Protective Service systems to ensure that older adults and adults with disabilities are afforded the same protections against abuse, neglect, and financial exploitation regardless of where in the country they live. As part of that leadership, ACL created draft Voluntary Consensus Guidelines for State APS Systems. ACL undertook a process of public and stakeholder engagement and analyzed the resulting comments to improve upon the initial draft of the draft to arrive at the final version. This article examines the comments, including the concerns raised by the commenters about specific areas of the Guidelines, areas identified for future research, and reflections and opinions on the role of the federal government in guiding the development of the field of adult protection.

Status and Trends in the U.S. Voluntary Green Power Market (2015 Data)

Energy Technology Data Exchange (ETDEWEB)

O' Shaughnessy, Eric [National Renewable Energy Lab. (NREL), Golden, CO (United States); Liu, Chang [National Renewable Energy Lab. (NREL), Golden, CO (United States); Heeter, Jenny [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2016-10-01

The voluntary green power market refers to the sale and procurement of renewable energy for voluntary purposes by residential and commercial customers. This report reviews seven green power procurement mechanisms: utility green pricing programs, utility green tariffs, voluntary unbundled renewable energy certificates, competitive supplier green power, community choice aggregations, voluntary power purchase agreements (PPAs), and community solar. This report details the status of trends of those seven green power procurement mechanisms in 2015. Three trends -- significant growth of the voluntary PPA project pipeline, innovative green power mechanisms developed by utilities, and geographic expansion of green power mechanisms -- suggest that the green power market is likely to continue to grow in coming years.

Stuttering Frequency, Speech Rate, Speech Naturalness, and Speech Effort During the Production of Voluntary Stuttering.

Science.gov (United States)

Davidow, Jason H; Grossman, Heather L; Edge, Robin L

2018-05-01

Voluntary stuttering techniques involve persons who stutter purposefully interjecting disfluencies into their speech. Little research has been conducted on the impact of these techniques on the speech pattern of persons who stutter. The present study examined whether changes in the frequency of voluntary stuttering accompanied changes in stuttering frequency, articulation rate, speech naturalness, and speech effort. In total, 12 persons who stutter aged 16-34 years participated. Participants read four 300-syllable passages during a control condition, and three voluntary stuttering conditions that involved attempting to produce purposeful, tension-free repetitions of initial sounds or syllables of a word for two or more repetitions (i.e., bouncing). The three voluntary stuttering conditions included bouncing on 5%, 10%, and 15% of syllables read. Friedman tests and follow-up Wilcoxon signed ranks tests were conducted for the statistical analyses. Stuttering frequency, articulation rate, and speech naturalness were significantly different between the voluntary stuttering conditions. Speech effort did not differ between the voluntary stuttering conditions. Stuttering frequency was significantly lower during the three voluntary stuttering conditions compared to the control condition, and speech effort was significantly lower during two of the three voluntary stuttering conditions compared to the control condition. Due to changes in articulation rate across the voluntary stuttering conditions, it is difficult to conclude, as has been suggested previously, that voluntary stuttering is the reason for stuttering reductions found when using voluntary stuttering techniques. Additionally, future investigations should examine different types of voluntary stuttering over an extended period of time to determine their impact on stuttering frequency, speech rate, speech naturalness, and speech effort.

Study of Development for RFID System to Hospital Environment.

Science.gov (United States)

Hong, Seung Kwon; Sung, Myung-Whun

2015-01-01

RFID/USN develops information systems for anytime, anywhere to anybody access Electronic Medical Records (EMR). The goal of the present study is to develop a RFID/USN-based information system for the hospital environment. First, unable to recognize, second, able to recognize as a pursuit of place and suppose the time of medical examination. A retrospective analysis of 235 RFID monitoring results, from four ENT ambulatory clinics of Seoul National University Hospital were extracted by a reader program and monitoring of RFID tag (2006.11.16~2006.12.16). RFID detection for sensing reader of this study has been put into representing "place" and "spending time" of patients for medical history taking and examination. Through the RFID of detection for specific place and spending time of medical examination, RFID/USN develops information system progressing in the EMR of hospital system.

The bible and attitudes towards voluntary euthanasia.

Science.gov (United States)

Sharp, Shane

2018-03-15

Are beliefs about and behaviors towards the Bible associated with voluntary euthanasia attitudes? Using General Social Survey data and multivariate logistic regression, I find that individuals' views of the authorship and epistemological status of the Bible; the importance of the Bible in making decisions; and the frequency in which individuals read the Bible are associated with negative voluntary euthanasia attitudes, even when controlling for other religiosity and sociodemographic predictors. I find that the importance of the Bible in making decisions accounts for the effect of frequency of reading the Bible and viewing the Bible as the inspired word of God.

The challenges of adopting voluntary health, safety and environment measures for manufactured nanomaterials

DEFF Research Database (Denmark)

Hansen, Steffen Foss; Tickner, J.

2007-01-01

to participate for various stakeholders, agency guidance and technical assistance, and transparency both in design, reporting and evaluation. The authors also recommend that any voluntary program become mandatory after 3 no more than three years to motivate voluntary participation.......This article explores the use of voluntary environmental programs in the United States in the past, and applies the lessons learned from these experiences to the regulation of nanomaterials. The authors found that the key elements of any voluntary environmental program should be incentives...

WATER TEMPERATURE, VOLUNTARY DRINKING AND FLUID BALANCE IN DEHYDRATED TAEKWONDO ATHLETES

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Saeed Khamnei

2011-12-01

Full Text Available Voluntary drinking is one of the major determiners of rehydration, especially as regards exercise or workout in the heat. The present study undertakes to search for the effect of voluntary intake of water with different temperatures on fluid balance in Taekwondo athletes. Six young healthy male Taekwondo athletes were dehydrated by moderate exercise in a chamber with ambient temperature at 38-40°C and relative humidity between 20-30%. On four separate days they were allowed to drink ad libitum plane water with the four temperatures of 5, 16, 26, and 58°C, after dehydration. The volume of voluntary drinking and weight change was measured; then the primary percentage of dehydration, sweat loss, fluid deficit and involuntary dehydration were calculated. Voluntary drinking of water proved to be statistically different in the presented temperatures. Water at 16°C involved the greatest intake, while fluid deficit and involuntary dehydration were the lowest. Intake of water in the 5°C trial significantly correlated with the subject's plasma osmolality change after dehydration, yet it showed no significant correlation with weight loss. In conclusion, by way of achieving more voluntary intake of water and better fluid state, recommending cool water (~16°C for athletes is in order. Unlike the publicly held view, drinking cold water (~5°C does not improve voluntary drinking and hydration status.

Implementation of an advanced clinical and administrative hospital information system.

Science.gov (United States)

Vegoda, P R; Dyro, J F

1986-01-01

Over the last six years since University Hospital opened, the University Hospital Information System (UHIS) has continued to evolve to what is today an advanced administrative and clinical information system. At University Hospital UHIS is the way of conducting business. A wide range of patient care applications are operational including Patient Registration, ADT for Inpatient/Outpatient/Emergency Room visits, Advanced Order Entry/Result Reporting, Medical Records, Lab Automated Data Acquisition/Quality Control, Pharmacy, Radiology, Dietary, Respiratory Therapy, ECG, EEG, Cardiology, Physical/Occupational Therapy and Nursing. These systems and numerous financial systems have been installed in a highly tuned, efficient computer system. All applications are real-time, on-line, and data base oriented. Each system is provided with multiple data security levels, forward file recovery, and dynamic transaction backout of in-flight tasks. Sensitive medical information is safeguarded by job function passwords, identification codes, need-to-know master screens and terminal keylocks. University Hospital has an IBM 3083 CPU with five 3380 disk drives, four dual density tape drives, and a 3705 network controller. The network of 300 terminals and 100 printers is connected to the computer center by an RF broadband cable. The software is configured around the IBM/MVS operating system using CICS as the telecommunication monitor, IMS as the data base management system and PCS/ADS as the application enabling tool. The most extensive clinical system added to UHIS is the Physiological Monitoring/Patient Data Management System with serves 92 critical care beds. In keeping with the Hospital's philosophy of integrated computing, the PMS/PDMS with its network of minicomputers was linked to the UHIS system. In a pilot program, remote access to UHIS through the IBM personal computer has been implemented in several physician offices in the local community, further extending the communications

Long-term consequences of youth volunteering: Voluntary versus involuntary service.

Science.gov (United States)

Kim, Jinho; Morgül, Kerem

2017-09-01

Despite the renewed interest in youth volunteering in recent years, there remain major gaps in our knowledge of its consequences. Drawing data from the National Longitudinal Study of Adolescent to Adult Health, we examine the long-term effects of youth volunteering on the civic and personal aspects of volunteers' lives. Our results suggest that youth volunteering has a positive return on adult volunteering only when it is voluntary, and that net of contextual factors neither voluntary nor involuntary youth service has a significant effect on adult voting. Regarding personal outcomes, our findings indicate that the psychological benefits of youth volunteering accrue only to voluntary participants, whereas both voluntary and involuntary youth service are positively associated with educational attainment and earnings in young adulthood. Taken together, these results lend support to the case for youth volunteer programs, though the civic benefits of these programs appear to be less dramatic than generally suggested. Copyright © 2017 Elsevier Inc. All rights reserved.

Perceptions of hospital CEOs about the effects of CEO turnover.

Science.gov (United States)

Khaliq, Amir A; Thompson, David M; Walston, Stephen L

2006-01-01

Empirical evidence is scarce on chief executive officer (CEO) turnover in U.S. hospitals, with potentially serious implications for many of these organizations. This study, based on a nationwide survey of CEOs at non-federal general surgical and medical community hospitals conducted in the spring of 2004, reports the perceptions of hospital CEOs regarding the circumstances and impact of CEO turnover on U.S. hospitals. In the opinion of the respondents, the impact includes competitors taking advantage of turnover by luring employees and physicians away from the target hospital, significantly increasing the likelihood of other senior executives leaving the hospital, and many of the important strategic activities being delayed or cancelled altogether. Interestingly, the perceptions of CEOs regarding the effects of turnover do not seem to differ regardless of voluntary or involuntary circumstances of turnover. However, there is a notable bias in emphasizing the perceived negative implications of respondents' own departures and allegedly positive effects of their predecessors' departures.

Board diversity and corporate voluntary disclosure (CVD in the annual reports of Bangladesh

Directory of Open Access Journals (Sweden)

Md. Abdur Rouf

2016-10-01

Full Text Available This is an exploratory study designed to investigate the extant and nature of corporate voluntary disclosure (CVD in corporate annual reports of Bangladesh. Specifically, examine the relationship between board diversity and corporate voluntary disclosures. The paper is based on a sample of 106 listed non-financial companies in Dhaka Stock Exchanges (DSE from the period 2007-2011 and all the companies are selected by Judgment Sampling. The study is used ordinary least squares regression model to examine the relationship between explanatory variables and voluntary disclosure. Using an unweighted relative disclosure index for measuring voluntary disclosure, the empirical results indicate that Percentage Female Director (PFD, Board Leadership Structure (BLS and Total Assets (TA are positively association with corporate voluntary disclosure (CVD. In contrast, the extent of corporate voluntary disclosure is negatively associated with a Percentage of equity owned by the insiders to all equity of the firm higher management ownership

Effect of emotional picture viewing on voluntary eyeblinks.

Directory of Open Access Journals (Sweden)

Suvi Karla

Full Text Available Eyeblinks, whether reflexive or voluntary, play an important role in protecting our vision. When viewing pictures, reflexive eyeblinks are known to be modulated by the emotional state induced thereby. More specifically, the hedonic valence (unpleasantness-pleasantness induced by the picture has been shown to have a linear relationship with the amplitude of a startle blink elicited during picture viewing. This effect has been attributed to congruence between an ongoing state and task demands: an unpleasant emotional state is assumed to bias our attention towards potentially harmful stimuli, such as startle tones. However, recent research suggests that the valence-specific modulation may not be limited to the sensory parts of the reflexive pathway related to startle responses. Here, we examined the effect of emotional picture viewing on voluntary (in response to a written command eyeblinks in adult humans. Emotional modulation of startle blinks was also evaluated. We found that when viewing unpleasant pictures, the amplitude of reflexive eyeblinks was augmented, but the amplitude of voluntary eyeblinks was unaffected. Nevertheless, the response latencies of voluntary eyeblinks were found to be delayed during the viewing of pleasant and unpleasant relative to neutral pictures. We conclude that these results support the theory that emotional experience augments sensory processing specific to potentially harmful stimuli. Further, the emotional state seems not to exert an effect on voluntarily elicited motor activity.

37 CFR 1.221 - Voluntary publication or republication of patent application publication.

Science.gov (United States)

2010-07-01

... filing system requirements and be accompanied by the publication fee set forth in § 1.18(d) and the..., the Office will not publish the application and will refund the publication fee. (b) The Office will... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Voluntary publication or...

Between voluntary agreement and legislation

DEFF Research Database (Denmark)

Gwozdz, Wencke; Hedegaard, Liselotte; Reisch, Lucia

2009-01-01

Voluntary agreements and self-imposed standards are broadly applied to restrict the influence food advertising exerts on children’s food choices – yet their effects are unknown. The current project will therefore investigate whether and, if yes, how the Danish Code for Responsible Food Marketing...

Teleradiology service for mission hospitals: initial experiences in Ethiopia and Kenya

Directory of Open Access Journals (Sweden)

Matthew Larrison

2016-01-01

Full Text Available Throughout their history, mission hospitals have provided high quality and lifesaving medical care to regions of the world where medical care is sparse. These hospitals are generally built and equipped through a combination of governmental and non-governmental sources. As advances in diagnostic medical imaging have progressed and become mainstream in the developed world, mission hospitals have adopted advanced imaging modalities. These modalities provide early diagnosis and treatment options for their patients. In addition to the installation and operation of advanced imaging equipment, the need for professional expert interpretation of these studies remains a challenge for mission hospitals. Historically these hospitals have used either voluntary services on site or paid for interpretations from local radiologists; however, with the introduction of high speed internet, teleradiology has become a possibility. This article describes the teleradiology experience of two mission hospitals in rural Africa.

Availability of software services for a hospital information system.

Science.gov (United States)

Sakamoto, N

1998-03-01

Hospital information systems (HISs) are becoming more important and covering more parts in daily hospital operations as order-entry systems become popular and electronic charts are introduced. Thus, HISs today need to be able to provide necessary services for hospital operations for a 24-h day, 365 days a year. The provision of services discussed here does not simply mean the availability of computers, in which all that matters is that the computer is functioning. It means the provision of necessary information for hospital operations by the computer software, and we will call it the availability of software services. HISs these days are mostly client-server systems. To increase availability of software services in these systems, it is not enough to just use system structures that are highly reliable in existing host-centred systems. Four main components which support availability of software services are network systems, client computers, server computers, and application software. In this paper, we suggest how to structure these four components to provide the minimum requested software services even if a part of the system stops to function. The network system should be double-protected in stratus using Asynchronous Transfer Mode (ATM) as its base network. Client computers should be fat clients with as much application logic as possible, and reference information which do not require frequent updates (master files, for example) should be replicated in clients. It would be best if all server computers could be double-protected. However, if that is physically impossible, one database file should be made accessible by several server computers. Still, at least the basic patients' information and the latest clinical records should be double-protected physically. Application software should be tested carefully before introduction. Different versions of the application software should always be kept and managed in case the new version has problems. If a hospital

Design of the Hospital Integrated Information Management System Based on Cloud Platform.

Science.gov (United States)

Aijing, L; Jin, Y

2015-12-01

At present, the outdated information management style cannot meet the needs of hospital management, and has become the bottleneck of hospital's management and development. In order to improve the integrated management of information, hospitals have increased their investment in integrated information management systems. On account of the lack of reasonable and scientific design, some hospital integrated information management systems have common problems, such as unfriendly interface, poor portability and maintainability, low security and efficiency, lack of interactivity and information sharing. To solve the problem, this paper carries out the research and design of a hospital information management system based on cloud platform, which can realize the optimized integration of hospital information resources and save money.

Hospital information system institutionalization processes in indonesian public, government-owned and privately owned hospitals.

Science.gov (United States)

Handayani, P W; Hidayanto, A N; Ayuningtyas, Dumilah; Budi, Indra

2016-11-01

The Hospital Information System (HIS) could help hospitals as a public entity to provide optimal health services. One of the main challenges of HIS implementation is an institutional change. Using institutional theory as the analytical lens, this study aims to explain the institutionalization of HIS as an instance of e-health initiatives in Indonesia. Furthermore, this paper aims for hospital management and researchers to improve the understanding of the social forces that influence hospital personnel's HIS acceptance within an organizational context. We use case studies from four public, government-owned hospitals and four privately owned (public and specialty) hospitals to explain the HIS institutionalization process by exploring the three concepts of institutional theory: institutional isomorphism, institutional logic, and institutional entrepreneurship. This study reveals that differences exist between public, government-owned and private hospitals with regard to the institutionalization process: public, government-owned hospitals' management is more motivated to implement HIS to comply with the regulations, while private hospitals' management views HIS as an urgent requirement that must be achieved. The study findings also reveal that various institutional isomorphism mechanisms and forms of institutional logic emerge during the process. Finally, three factors-self-efficacy, social influence, and management support-have a significant influence on the individual acceptance of HIS. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The deployment of information systems and information technology in field hospitals.

Science.gov (United States)

Crowe, Ian R J; Naguib, Raouf N G

2010-01-01

Information systems and related technologies continue to develop and have become an integral part of healthcare provision and hospital care in particular. Field hospitals typically operate in the most austere and difficult of conditions and have yet to fully exploit related technologies. This paper addresses those aspects of healthcare informatics, healthcare knowledge management and lean healthcare that can be applied to field hospitals, with a view to improving patient care. The aim is to provide a vision for the deployment of information systems and information technology in field hospitals, using the British Army's field hospital as a representative model.

Airflow and Contaminant Distribution in Hospital Wards with a Displacement Ventililation System

DEFF Research Database (Denmark)

Qian, H.; Nielsen, Peter Vilhelm; Li, Y.

2004-01-01

Airflow and Contaminant Distribution in Hospital Wards with a Displacement Ventilalation System. The 2nd International Conference on Build Environment and Public Health, BEPH 2004, Shenzhen , China . ABSTRACT Displacement ventilation has not been considered to be an applicable system for hospital...... to accurately predict three-dimensional distribution of air velocity, temperature, and contaminant concentration in the ward. Indoor airflow in a displacement ventilation system involves a combination of different flow streams such as the gravity currents and thermal plumes. It is important to choose...... ventilation system in hospital wards. It is for this purpose that we study the performance of displacement ventilation in hospital wards as one of the steps to optimize the ventilation design. When the prospect of applying displacement ventilation system in a hospital ward is examined, it should be necessary...

Comparative Research of Navy Voluntary Education at Operational Commands

Science.gov (United States)

2017-03-01

into a national and international market. This is especially effects land-grant institutions who can educate the citizens within their state by...RESEARCH OF NAVY VOLUNTARY EDUCATION AT OPERATIONAL COMMANDS by Christopher B. Veenhuis March 2017 Thesis Co-Advisors: William Hatch Chad...COVERED Master’s thesis 4. TITLE AND SUBTITLE COMPARATIVE RESEARCH OF NAVY VOLUNTARY EDUCATION AT OPERATIONAL COMMANDS 5. FUNDING NUMBERS 6. AUTHOR(S

Depiction of Trends in Administrative Healthcare Data from Hospital Information System.

Science.gov (United States)

Kalankesh, Leila R; Pourasghar, Faramarz; Jafarabadi, Mohammad Asghari; Khanehdan, Negar

2015-06-01

administrative healthcare data are among main components of hospital information system. Such data can be analyzed and deployed for a variety of purposes. The principal aim of this research was to depict trends of administrative healthcare data from HIS in a general hospital from March 2011 to March 2014. data set used for this research was extracted from the SQL database of the hospital information system in Razi general hospital located in Marand. The data were saved as CSV (Comma Separated Values) in order to facilitate data cleaning and analysis. The variables of data set included patient's age, gender, final diagnosis, final diagnosis code based on ICD-10 classification system, date of hospitalization, date of discharge, LOS(Length of Stay), ward, and survival status of the patient. Data were analyzed and visualized after applying appropriate cleansing and preparing techniques. morbidity showed a constant trend over three years. Pregnancy, childbirth and the puerperium were the leading category of final diagnosis (about 32.8 %). The diseases of the circulatory system were the second class accounting for 13 percent of the hospitalization cases. The diseases of the digestive system had the third rank (10%). Patients aged between 14 and 44 constituted a higher proportion of total cases. Diseases of the circulatory system was the most common class of diseases among elderly patients (age≥65). The highest rate of mortality was observed among patients with final diagnosis of the circulatory system diseases followed by those with diseases of the respiratory system, and neoplasms. Mortality rate for the ICU and the CCU patients were 62% and 33% respectively. The longest average of LOS (7.3 days) was observed among patients hospitalized in the ICU while patients in the Obstetrics and Gynecology ward had the shortest average of LOS (2.4 days). Multiple regression analysis revealed that LOS was correlated with variables of surgery, gender, and type of payment, ward, the

Picture archiving and communication systems (PACS) for hospitals, a survey

International Nuclear Information System (INIS)

Haar Romeny, B.M. ter; Graaf, C.N. de; Waes, P.F.G.M. van; Rijk, P.P. van; Helder, J.C.; Valk, J.P.J. de

1985-01-01

In this article a survey is given for Picture Archiving and Communication Systems (PACS). Several aspects of PACS are treated, as image management, the introduction of the system, expenses etc. Special reference is made to the component parts of PACS: image stations, memory, network, software and coupling to the hospital information system. The introduction of PACS in Dutch hospitals is described. (Auth.)

Application of two neural network paradigms to the study of voluntary employee turnover.

Science.gov (United States)

Somers, M J

1999-04-01

Two neural network paradigms--multilayer perceptron and learning vector quantization--were used to study voluntary employee turnover with a sample of 577 hospital employees. The objectives of the study were twofold. The 1st was to assess whether neural computing techniques offered greater predictive accuracy than did conventional turnover methodologies. The 2nd was to explore whether computer models of turnover based on neural network technologies offered new insights into turnover processes. When compared with logistic regression analysis, both neural network paradigms provided considerably more accurate predictions of turnover behavior, particularly with respect to the correct classification of leavers. In addition, these neural network paradigms captured nonlinear relationships that are relevant for theory development. Results are discussed in terms of their implications for future research.

Data that drive: Closing the loop in the learning hospital system.

Science.gov (United States)

Liu, Vincent X; Morehouse, John W; Baker, Jennifer M; Greene, John D; Kipnis, Patricia; Escobar, Gabriel J

2016-11-01

The learning healthcare system describes a vision of US healthcare that capitalizes on science, information technology, incentives, and care culture to drive improvements in the quality of health care. The inpatient setting, one of the most costly and impactful domains of healthcare, is an ideal setting in which to use data and information technology to foster continuous learning and quality improvement. The rapid digitization of inpatient medicine offers incredible new opportunities to use data from routine care to generate new discovery and thus close the virtuous cycle of learning. We use an object lesson-sepsis care within the 21 hospitals of the Kaiser Permanente Northern California integrated healthcare delivery system-to offer insight into the critical elements necessary for developing a learning hospital system. We then describe how a hospital-wide data-driven approach to inpatient care can facilitate improvements in the quality of hospital care. Journal of Hospital Medicine 2016;11:S11-S17. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

Human dignity and the future of the voluntary active euthanasia ...

African Journals Online (AJOL)

The issue of voluntary active euthanasia was thrust into the public policy arena by the Stransham-Ford lawsuit. The High Court legalised voluntary active euthanasia – however, ostensibly only in the specific case of Mr Stransham-Ford. The Supreme Court of Appeal overturned the High Court judgment on technical grounds, ...

A Survey on Physical Factors and Compressed Breast Thickness in Voluntary Mammography Screening Using FFDM System in Malaysia: Preliminary Results

International Nuclear Information System (INIS)

Noriah Jamal; Humairah Samad Cheung; Siti Kamariah Che Mohamad; Ellyda Muhamad Nordin

2013-01-01

This paper aims at presenting preliminary results of a survey on physical factors, namely tube potential (kV), tube current exposure time product (mAs) and compressed breast thickness (CBT) during voluntary mammography screening using Full-Field Digital Mammography (FFDM) System in Malaysia. Retrospective data were collected from 1128 FFDM images of 282 women from three major ethnic groups (Malay, Chinese and Indian) who underwent voluntary screening mammography at Breast Centre, International Islamic University Malaysia from January to March 2008. Results from the present study were then compared with results from the previous study on Screen-Film Mammography System (SFM) according to the ethnic group for both Cranio-caudal (CC) and Mediol-Lateral (MLO) views. We found that the mean kV for CC view for the three ethnic groups are Malay (28), Chinese (28) and Indian (28), and for MLO view are Malay (29), Chinese (28) and Indian (29). These values are higher than the kV for SFM which were Malay (26), Chinese (27) and Indian (26) for CC and Malay (26), Chinese (27) and Indian (26) for CC and MLO views respectively. The mean mAs for CC and MLO views for FFDM were lower compared to SFM systems. These values were Malay (104), Chinese (108) and Indian (91) for CC views and Malay (106), Chinese (105), and Indian (94) for MLO views for the FFDM system. The values for SFM system are for CC and MLO views were Malay (120), Chinese (106) and Indian (126), and Malay (166), Chinese (132), Indian (183) respectively. The median CBT for CC and MLO views increased by 27 % and 7 % respectively on the FFDM compared to the SFM system. In conclusion, the FFDM operates with higher kV, lower mAs, and higher CBT when compared with SFM system. Median CBT on CC and MLO view with FFDM system are 27 % and 7 % higher respectively compared to the SFM. We are currently collecting data on mean glandular dose with FFDM systems to assess how the change in local mammography practice influences this

A comparison of mandatory and voluntary approaches to the implementation of Globally Harmonized System of Classification and Labelling of Chemicals (GHS) in the management of hazardous chemicals.

Science.gov (United States)

Ta, Goh Choo; Mokhtar, Mazlin Bin; Peterson, Peter John; Yahaya, Nadzri Bin

2011-01-01

The European Union (EU) and the World Health Organization (WHO) have applied different approaches to facilitate the implementation of the UN Globally Harmonized System of Classification and Labelling of Chemicals (GHS). The EU applied the mandatory approach by gazetting the EU Regulation 1272/2008 incorporating GHS elements on classification, labelling and packaging of substances and mixtures in 2008; whereas the WHO utilized a voluntary approach by incorporating GHS elements in the WHO guidelines entitled 'WHO Recommended Classification of Pesticides by Hazard' in 2009. We report on an analysis of both the mandatory and voluntary approaches practised by the EU and the WHO respectively, with close reference to the GHS 'purple book'. Our findings indicate that the mandatory approach practiced by the EU covers all the GHS elements referred to in the second revised edition of the GHS 'purple book'. Hence we can conclude that the EU has implemented the GHS particularly for industrial chemicals. On the other hand, the WHO guidelines published in 2009 should be revised to address concerns raised in this paper. In addition, both mandatory and voluntary approaches should be carefully examined because the classification results may be different.

INTOXICACIÓN VOLUNTARIA POR ESTRICNINA VOLUNTARY POISONING BY STRYCHNINE

Directory of Open Access Journals (Sweden)

Jesús Albero Boadas Morales

2018-04-01

Full Text Available The strychnine is a stimulating alkaloid of the central nervous system of restricted use in Venezuela for the elimination of dogs by the Coordination of Zoonosis of the Ministry of the Popular Power for the Health. In this paper a case is described of a patient with voluntary poisoning with a greater than lethal dose of strychnine. The opportune diagnosis and the satisfactory response to the treatment allowed to preserve the life of the patient and to limit the complications.

Circulating levels of endocannabinoids respond acutely to voluntary exercise, are altered in mice selectively bred for high voluntary wheel running, and differ between the sexes.

Science.gov (United States)

Thompson, Zoe; Argueta, Donovan; Garland, Theodore; DiPatrizio, Nicholas

2017-03-01

The endocannabinoid system serves many physiological roles, including in the regulation of energy balance, food reward, and voluntary locomotion. Signaling at the cannabinoid type 1 receptor has been specifically implicated in motivation for rodent voluntary exercise on wheels. We studied four replicate lines of high runner (HR) mice that have been selectively bred for 81 generations based on average number of wheel revolutions on days five and six of a six-day period of wheel access. Four additional replicate lines are bred without regard to wheel running, and serve as controls (C) for random genetic effects that may cause divergence among lines. On average, mice from HR lines voluntarily run on wheels three times more than C mice on a daily basis. We tested the general hypothesis that circulating levels of endocannabinoids (i.e., 2-arachidonoylglycerol [2-AG] and anandamide [AEA]) differ between HR and C mice in a sex-specific manner. Fifty male and 50 female mice were allowed access to wheels for six days, while another 50 males and 50 females were kept without access to wheels (half HR, half C for all groups). Blood was collected by cardiac puncture during the time of peak running on the sixth night of wheel access or no wheel access, and later analyzed for 2-AG and AEA content by ultra-performance liquid chromatography coupled to tandem mass spectrometry. We observed a significant three-way interaction among sex, linetype, and wheel access for 2-AG concentrations, with females generally having lower levels than males and wheel access lowering 2-AG levels in some but not all subgroups. The number of wheel revolutions in the minutes or hours immediately prior to sampling did not quantitatively predict plasma 2-AG levels within groups. We also observed a trend for a linetype-by-wheel access interaction for AEA levels, with wheel access lowering plasma concentrations of AEA in HR mice, while raising them in C mice. In addition, females tended to have higher AEA

Propensity for Voluntary Travel Behavior Changes: An Experimental Analysis

DEFF Research Database (Denmark)

Meloni, Italo; Sanjust, Benedetta; Sottile, Eleonora

2013-01-01

In this paper we analyze individual propensity to voluntary travel behavior change combining concepts from theory of change with the methodologies deriving from behavioral models. In particular, following the theory of voluntary changes, we set up a two-week panel survey including soft measure...... implementation, which consisted of providing car users with a personalized travel plan after the first week of observation (before) and using the second week to monitoring the post-behavior (after). These data have then been used to estimate a Mixed Logit for the choice to use a personal vehicle or a light metro......; and a Multinomial Logit for the decision to change behavior. Results from both models show the relevance of providing information about available alternatives to individuals while promoting voluntary travel behavioral change....

Hospital managers need management information systems.

Science.gov (United States)

Davis, S; Freeman, J R

1976-01-01

A new hospital director seeking to bring his institution to the brink of solvency found himself with ten pounds of data but no "information"--at least, not the kind of information he could use as a basis for management decisions. What he needed was a system that would not only present data, but the meaning of the data. Such a system is the integrated MIS.

Improved voluntary cough immediately following office-based vocal fold medialization injections.

Science.gov (United States)

Ruddy, Bari H; Pitts, Teresa E; Lehman, Jeff; Spector, Brian; Lewis, Vicki; Sapienza, Christine M

2014-07-01

This study examined changes in voluntary cough airflow measures immediately following in-office injection of Radiesse in patients diagnosed with glottic insufficiency. Due to significant comorbidities, these patients were poor candidates for medialization under general anesthesia. Each patient presented with dysphonia and dysphagia and ineffective voluntary cough, resulting in a poor clearing of secretions and a presence of ingested fluids on examination. Prospective cohort and case series study. Three patients with a diagnosis of glottic insufficiency were included for study based on flexible endoscopy and laryngostroboscopic examination. Voluntary cough airflow measures were obtained approximately 30 minutes before and after the Radiesse injections. The airflow measures were: compression phase duration (CPD), expiratory rise time (EPRT), expiratory phase peak airflow (EPPF), and cough volume acceleration (CVA). Injection of Radiesse was found to improve voluntary cough airflow measures. The immediate increase in the objective airflow measures obtained from voluntary cough production after Radiesse injections can be used to document airway protection improvements. Cough airflow is a straightforward measure to obtain and is considered an objective measure of cough function. 4. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

What happens in hospitals does not stay in hospitals: antibiotic-resistant bacteria in hospital wastewater systems.

Science.gov (United States)

Hocquet, D; Muller, A; Bertrand, X

2016-08-01

Hospitals are hotspots for antimicrobial-resistant bacteria (ARB) and play a major role in both their emergence and spread. Large numbers of these ARB will be ejected from hospitals via wastewater systems. In this review, we present quantitative and qualitative data of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli, vancomycin-resistant enterococci and Pseudomonas aeruginosa in hospital wastewaters compared to community wastewaters. We also discuss the fate of these ARB in wastewater treatment plants and in the downstream environment. Published studies have shown that hospital effluents contain ARB, the burden of these bacteria being dependent on their local prevalence. The large amounts of antimicrobials rejected in wastewater exert a continuous selective pressure. Only a few countries recommend the primary treatment of hospital effluents before their discharge into the main wastewater flow for treatment in municipal wastewater treatment plants. Despite the lack of conclusive data, some studies suggest that treatment could favour the ARB, notably ESBL-producing E. coli. Moreover, treatment plants are described as hotspots for the transfer of antibiotic resistance genes between bacterial species. Consequently, large amounts of ARB are released in the environment, but it is unclear whether this release contributes to the global epidemiology of these pathogens. It is reasonable, nevertheless, to postulate that it plays a role in the worldwide progression of antibiotic resistance. Antimicrobial resistance should now be seen as an 'environmental pollutant', and new wastewater treatment processes must be assessed for their capability in eliminating ARB, especially from hospital effluents. Copyright © 2016. Published by Elsevier Ltd.

Hospitals as a 'risk environment': an ethno-epidemiological study of voluntary and involuntary discharge from hospital against medical advice among people who inject drugs.

Science.gov (United States)

McNeil, Ryan; Small, Will; Wood, Evan; Kerr, Thomas

2014-03-01

People who inject drugs (PWID) experience high levels of HIV/AIDS and hepatitis C (HCV) infection that, together with injection-related complications such as non-fatal overdose and injection-related infections, lead to frequent hospitalizations. However, injection drug-using populations are among those most likely to be discharged from hospital against medical advice, which significantly increases their likelihood of hospital readmission, longer overall hospital stays, and death. In spite of this, little research has been undertaken examining how social-structural forces operating within hospital settings shape the experiences of PWID in receiving care in hospitals and contribute to discharges against medical advice. This ethno-epidemiological study was undertaken in Vancouver, Canada to explore how the social-structural dynamics within hospitals function to produce discharges against medical advice among PWID. In-depth interviews were conducted with thirty PWID recruited from among participants in ongoing observational cohort studies of people who inject drugs who reported that they had been discharged from hospital against medical advice within the previous two years. Data were analyzed thematically, and by drawing on the 'risk environment' framework and concepts of social violence. Our findings illustrate how intersecting social and structural factors led to inadequate pain and withdrawal management, which led to continued drug use in hospital settings. In turn, diverse forms of social control operating to regulate and prevent drug use in hospital settings amplified drug-related risks and increased the likelihood of discharge against medical advice. Given the significant morbidity and health care costs associated with discharge against medical advice among drug-using populations, there is an urgent need to reshape the social-structural contexts of hospital care for PWID by shifting emphasis toward evidence-based pain and drug treatment augmented by harm

An empirical comparison of voluntary and mandatory building energy performance disclosure outcomes

International Nuclear Information System (INIS)

Gabe, Jeremy

2016-01-01

In 2010, the federal Australian government mandated the disclosure of energy performance ratings in advertisements for sale or lease of large commercial office properties. Prior to 2010, participation in the rating scheme was voluntary. This study first develops a theoretical model of mandatory disclosure policy effectiveness. Then, with a dataset of all ratings since inception of the voluntary regime in 1999, it tests the expectation that initial voluntary adopters have a greater tendency towards environmental stewardship and are more likely to manage and invest in environmental performance improvements, potentially dampening the effectiveness of mandatory disclosure policy. However, multiple statistical models of certification are unable to reject the null hypothesis that there is no difference in energy efficiency outcomes between the mandatory and voluntary adopters at equivalent stages. For urban policymakers, the extrapolation of voluntary adopter performance appears to be a good – perhaps even conservative – estimation of mandatory energy performance disclosure outcomes. - Highlights: •A theoretical model of building energy disclosure policy effectiveness is proposed. •Mandatory disclosure adopters reduce consumption similar to voluntary adopters. •Mandatory building energy disclosure in Australia has been effective. •Early adopters creating a market for energy retrofits is a likely reason for success.

Performance Based Supplementary Payment System at University Hospitals in Turkey

Directory of Open Access Journals (Sweden)

Vahit YÝÐÝT

2017-06-01

Results: The result of the analysis has revealed that PBSP system encourage physicians who would like to receive financial incentives. PBSP system supports the individual performance, reduces waiting times in patients, increases revenues and decreases expenditures and increases in efficiency of department. However, this payment system increases work load, number of examinations and provokes the conflict among personals. Conclusions: University hospitals are academic institutions that perform important missions such as research, medical education and health services provision. Therefore, PBSP system should be revised so as to encourage performing these missions at university hospitals. There is also shortage of financial resources at the university hospitals. This situation leads to less additional payments to physicians. [J Contemp Med 2017; 7(2.000: 126-131

Status and Trends in the U.S. Voluntary Green Power Market (2014 Data)

Energy Technology Data Exchange (ETDEWEB)

O' Shaughnessy, Eric [National Renewable Energy Lab. (NREL), Golden, CO (United States); Heeter, Jenny [National Renewable Energy Lab. (NREL), Golden, CO (United States); Liu, Chang [National Renewable Energy Lab. (NREL), Golden, CO (United States); Nobler, Erin [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2015-10-16

NREL's annual report on green power markets summarizes status and trends in the voluntary demand for renewable energy. U.S. green power markets have become more complex over time as state-level policies have enabled more avenues for green power purchases. In recent years, community solar, community choice aggregation (CCA), and voluntary power purchase agreements (PPAs) have significantly increased the number of U.S. voluntary green power customers. The community solar model has grown rapidly with 90 projects in 25 states by 2015. Renewable energy sales in CCAs declined slightly in 2014 in response to less favorable economic conditions in Illinois. At the same time, several California CCAs continued to grow, and many more communities are planning to pursue green power through aggregation. Voluntary green power purchasing through bi-lateral PPAs took off in 2014 due to several large-scale agreements signed by information and communication technology firms. Traditional green power options, such as utility green pricing programs and voluntary RECs markets, also grew in 2014. Current trends suggest strong continued growth in U.S. voluntary green power markets.

Design of a robotic automation system for transportation of goods in hospitals

DEFF Research Database (Denmark)

Özkil, Ali Gürcan; Sørensen, Torben; Fan, Zhun

2007-01-01

Hospitals face with heavy traffic of goods everyday, where transportation tasks are mainly carried by human. Analysis of the current situation of transportation in a typical hospital showed several transportation tasks are suitable for automation. This paper presents a system, consisting of a fleet...... of robot vehicles, automatic stations and smart containers for automation of transportation of goods in hospitals. Design of semi-autonomous robot vehicles, containers and stations are presented and the overall system architecture is described. Implementing such a system in an existing hospital showed...

Exploring information systems outsourcing in U.S. hospital-based health care delivery systems.

Science.gov (United States)

Diana, Mark L

2009-12-01

The purpose of this study is to explore the factors associated with outsourcing of information systems (IS) in hospital-based health care delivery systems, and to determine if there is a difference in IS outsourcing activity based on the strategic value of the outsourced functions. IS sourcing behavior is conceptualized as a case of vertical integration. A synthesis of strategic management theory (SMT) and transaction cost economics (TCE) serves as the theoretical framework. The sample consists of 1,365 hospital-based health care delivery systems that own 3,452 hospitals operating in 2004. The findings indicate that neither TCE nor SMT predicted outsourcing better than the other did. The findings also suggest that health care delivery system managers may not be considering significant factors when making sourcing decisions, including the relative strategic value of the functions they are outsourcing. It is consistent with previous literature to suggest that the high cost of IS may be the main factor driving the outsourcing decision.

Analysis of the quality of hospital information systems in Isfahan teaching hospitals based on the DeLone and McLean model.

Science.gov (United States)

Saghaeiannejad-Isfahani, Sakineh; Saeedbakhsh, Saeed; Jahanbakhsh, Maryam; Habibi, Mahboobeh

2015-01-01

Quality is one of the most important criteria for the success of an information system, which refers to its desirable features of the processing system itself. The aim of this study was the analysis of system quality of hospital information systems (HIS) in teaching hospitals of Isfahan based on the DeLone and McLean model. This research was an applied and analytical-descriptive study. It was performed in teaching hospitals of Isfahan in 2010. The research population consisted of the HIS's users, system designers and hospital information technology (IT) authorities who were selected by random sampling method from users' group (n = 228), and system designers and IT authorities (n = 52) using census method. The data collection tool was two researcher-designed questionnaires. Questionnaires' reliability was estimated by using Cronbach's alpha was calculated. It was 97.1% for the system designers and IT authorities' questionnaire and 92.3% for system users' questionnaire. Findings showed that the mean of system quality score in a variety of HIS and among different hospitals was significantly different and not the same (P value ≥ 0.05). In general, Kosar (new version) system and Rahavard Rayaneh system have dedicated the highest and the lowest mean scores to themselves. The system quality criterion overall mean was 59.6% for different HIS and 57.5% among different hospitals respectively. According to the results of the research, it can be stated that based on the applied model, the investigated systems were relatively desirable in terms of quality. Thus, in order to achieve a good optimal condition, it is necessary to pay particular attention to the improving factors of system quality, type of activity, type of specialty and hospital ownership type.

75 FR 67992 - Voluntary Private Sector Accreditation and Certification Preparedness Program

Science.gov (United States)

2010-11-04

... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID FEMA-2008-0017] Voluntary Private Sector Accreditation and Certification Preparedness Program AGENCY: Federal Emergency... on an initial small business plan to address small business concerns in the Voluntary Private Sector...

The German clinical risk management survey for hospitals: Implementation levels and areas for improvement in 2015.

Science.gov (United States)

Manser, Tanja; Frings, Janina; Heuser, Gregory; Mc Dermott, Fiona

2016-01-01

Despite the growing recognition of the need to implement systematic approaches for managing the risks associated with healthcare, few studies have investigated the level of implementation for clinical risk management (CRM) at a national level. Therefore, this study aimed to assess the current level of CRM implementation in German hospitals and to explore differences across hospital types. From March to June 2015, persons responsible for CRM in 2,617 hospitals and rehabilitation clinics in Germany were invited to participate in a voluntary online survey assessing the level of implementation for various aspects of CRM: CRM strategy, structures and processes; risk assessment (risk identification, risk analysis, risk evaluation) with a focus on incident reporting systems; risk mitigation measures; and risk monitoring and reporting. 572 hospitals participated in the survey (response rate 22 %). Most of these hospitals had a formalised, binding CRM strategy (72 %). 66 % had a centralised and 34 % a decentralised CRM structure. We also found that, despite a broad range of risk assessment methods being applied, there was a lack of integration of risk information from different data sources. Hospitals also reported a high level of implementation of critical incident reporting systems with a strong preference for local (74 %) over transorganisational systems. This study provides relevant data to inform targeted interventions concerning CRM implementation at a national level and to consider the specific context of different types of hospitals more carefully in this process. The approach to CRM assessment illustrated in this article could be the basis of a system for monitoring CRM over time and, thus, for evaluating the impact of strategy decisions at the policy level on CRM development. Copyright © 2016. Published by Elsevier GmbH.

Sensitivity of the Dengue Surveillance System in Brazil for Detecting Hospitalized Cases

Science.gov (United States)

2016-01-01

We evaluated the sensitivity of the dengue surveillance system in detecting hospitalized cases in ten capital cities in Brazil from 2008 to 2013 using a probabilistic record linkage of two independent information systems hospitalization (SIH-SUS) adopted as the gold standard and surveillance (SINAN). Sensitivity was defined as the proportion of cases reported to the surveillance system amid the suspected hospitalized cases registered in SIH-SUS. Of the 48,174 hospitalizations registered in SIH-SUS, 24,469 (50.7%) were reported and registered in SINAN, indicating an overall sensitivity of 50.8% (95%CI 50.3–51.2). The observed sensitivity for each of the municipalities included in the study ranged from 22.0% to 99.1%. The combination of the two data sources identified 71,161 hospitalizations, an increase of 97.0% over SINAN itself. Our results allowed establishing the proportion of underreported dengue hospitalizations in the public health system in Brazil, highlighting the use of probabilistic record linkage as a valuable tool for evaluating surveillance systems. PMID:27192405

Efficiency and hospital effectiveness in improving Hospital Consumer Assessment of Healthcare Providers and Systems ratings.

Science.gov (United States)

Al-Amin, Mona; Makarem, Suzanne C; Rosko, Michael

2016-01-01

Efficiency has emerged as a central goal to the operations of health care organizations. There are two competing perspectives on the relationship between efficiency and organizational performance. Some argue that organizational slack is a waste and that efficiency contributes to organizational performance, whereas others maintain that slack acts as a buffer, allowing organizations to adapt to environmental demands and contributing to organizational performance. As value-based purchasing becomes more prevalent, health care organizations are incented to become more efficient and, at the same time, improve their patients' experiences and outcomes. Unused slack resources might facilitate the timely implementation of these improvements. Building on previous research on organizational slack and inertia, we test whether efficiency and other organizational factors predict organizational effectiveness in improving Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) ratings. We rely on data from the American Hospital Association and HCAHPS. We estimate hospital cost-efficiency by Stochastic Frontier Analysis and use regression analysis to determine whether efficiency, competition, hospital size, and other organizational factors are significant predictors of hospital effectiveness. Our findings indicate that efficiency and hospital size have a significant negative association with organizational ability to improve HCAHPS ratings. Although achieving organizational efficiency is necessary for health care organizations, given the changes that are currently occurring in the U.S. health care system, it is important for health care managers to maintain a certain level of slack to respond to environmental demands and have the resources needed to improve their performance.

Are hospitals ready to response to disasters? Challenges, opportunities and strategies of Hospital Emergency Incident Command System (HEICS).

Science.gov (United States)

Yarmohammadian, Mohammad Hossein; Atighechian, Golrokh; Shams, Lida; Haghshenas, Abbas

2011-08-01

Applying an effective management system in emergency incidents provides maximum efficiency with using minimum facilities and human resources. Hospital Emergency Incident Command System (HEICS) is one of the most reliable emergency incident command systems to make hospitals more efficient and to increase patient safety. This research was to study requirements, barriers, and strategies of HEICS in hospitals affiliated to Isfahan University of Medical Sciences (IUMS). This was a qualitative research carried out in Isfahan Province, Iran during 2008-09. The study population included senior hospital managers of IUMS and key informants in emergency incident management across Isfahan Province. Sampling method was in non-random purposeful form and snowball technique was used. The research instrument for data collection was semi-structured interview; collected data was analyzed by Colaizzi Technique. Findings of study were categorized into three general categories including requirements (organizational and sub-organizational), barriers (internal and external) of HEICS establishment, and providing short, mid and long term strategies. These categories are explained in details in the main text. Regarding the existing barriers in establishment of HEICS, it is recommended that responsible authorities in different levels of health care system prepare necessary conditions for implementing such system as soon as possible via encouraging and supporting systems. This paper may help health policy makers to get reasonable framework and have comprehensive view for establishing HEICS in hospitals. It is necessary to consider requirements and viewpoints of stakeholders before any health policy making or planning.

Which wider social roles? : An analysis of social roles ascribed to voluntary sports clubs

NARCIS (Netherlands)

Waardenburg, M.

2016-01-01

It has long been established that voluntary sports clubs (VSCs) are ascribed a prominent social role by governments. Several scholars highlight the ascribed social values in sport policy to voluntary sports clubs and their possible implications for these voluntary organizations. Most of these

Front-Line Physicians' Satisfaction with Information Systems in Hospitals.

Science.gov (United States)

Peltonen, Laura-Maria; Junttila, Kristiina; Salanterä, Sanna

2018-01-01

Day-to-day operations management in hospital units is difficult due to continuously varying situations, several actors involved and a vast number of information systems in use. The aim of this study was to describe front-line physicians' satisfaction with existing information systems needed to support the day-to-day operations management in hospitals. A cross-sectional survey was used and data chosen with stratified random sampling were collected in nine hospitals. Data were analyzed with descriptive and inferential statistical methods. The response rate was 65 % (n = 111). The physicians reported that information systems support their decision making to some extent, but they do not improve access to information nor are they tailored for physicians. The respondents also reported that they need to use several information systems to support decision making and that they would prefer one information system to access important information. Improved information access would better support physicians' decision making and has the potential to improve the quality of decisions and speed up the decision making process.

Domestic and International Nuclear Energy Voluntary Consensus Standards Needs

International Nuclear Information System (INIS)

Hopper, Calvin Mitchell

2013-01-01

This report introduces the reader to the domestic and international standards development organizations (SDOs) and their structures and operations. It also identifies some of the support and subject matter needs for the development of standards on the subject of nuclear energy. The support needs are described with regard to organizational structure and subject-matter-expert (SME) participation that is required for producing voluntary consensus standards. The subject matter needs are described with regard to growing technologies and objectives that approach the boundaries of existing standards; implementation of knowledge; and safety of people, facilities, and the environment. Standards are proposed, developed, and produced by SMEs with the support of industry and government organizations. The voluntary consensus standards development process is, as its name implies, a voluntary effort. The problem in today's competitive market, impacted by global economic uncertainty, is that the voluntary participation is shifting from a collaborative industry and SME effort to a nearly SME-only one. This shift places a financial and/or time burden on the SMEs to the point that they are purposely withdrawing from the standards development process, both domestically and internationally. The standards development process desperately needs participation from more and younger SMEs. The report includes several suggestions on how this can be addressed.

Board composition, mimetic behaviour and corporate voluntary disclosures

Directory of Open Access Journals (Sweden)

Roshayani Arshad

2008-11-01

Full Text Available This study examines the effects of board composition and mimetic behaviour on the extent and credibility of corporate voluntary disclosure. The investigation is based on the annual reports of 155 Malaysian listed companies during the period when these companies faced new corporate governance regulation. This study provides evidence that under the influence of dominant owners on board, management voluntary disclosure decisions are driven by incentives to conform when their company is structured to meet expectations of good corporate governance. Such incentive seems to override incentives to disclose credible information to outside investors

The Frequency of Voluntary and Involuntary Autobiographical Memories across the Lifespan

Science.gov (United States)

Rubin, David C.; Berntsen, Dorthe

2011-01-01

Ratings of the memory of an important event from the last week on the frequency of voluntary and involuntary retrieval, belief in its accuracy, visual imagery, auditory imagery, setting, emotional intensity, valence, narrative coherence, and centrality to the life story were obtained from 988 adults whose age ranged from 15 to over 90. Another 992 adults provided the same ratings for a memory from their confirmation day when they were about age 14. The frequencies of involuntary and voluntary retrieval were similar. Both frequencies were predicted by emotional intensity and centrality to the life story. The results from this study, which is the first to measure the frequency of voluntary and involuntary retrieval for the same events, are counter to both cognitive and clinical theories, which consistently claim that involuntary memories are infrequent compared to voluntary memories. Age and gender differences are noted. PMID:19487759

Digestive system complications among hospitalized children with ...

African Journals Online (AJOL)

USER

least common complication, occurring in one (3.3%) of the cases studied. Conclusion: Acute ... Keywords: Acute abdominal crisis, children, haemoglobin, hospitalization, multi-systemic ... improvement of the management of such children.

Combined PACS and intranet information system in a University Hospital

International Nuclear Information System (INIS)

Heiss, D.; Pfluger, T.; Pfeifer, K.J.; Hahn, K.; Koenig, A.; Endres, S.

2000-01-01

Purpose: The Department of Radiology at the University Hospital Innenstadt Munich provides all clinical departments of a large university hospital with several radiology units at different locations. During the last four years all units have been fully digitalized with a stepwise installation of a PACS. The PACS also processes images from the Nuclear Medicine Department. Methods: As image modalities, archive systems and review workstations, we use devices from multiple vendors, which are integrated into a consistent system using the DICOM standard. The hospital has developed its own RIS and an intranet information system, which provides access to all reports and images from radiology for all clinical departments inside the hospital. Additionally, other clinical information such as laboratory results or ECG examinations are available through the system. Results: After one year of operation, the system succeeded in the clinical routine work as the primary source for radiological reports and images as well as for laboratory values. Conclusion: The advantages of digitalization were, besides reduction of film cost, especially optimizations of work flow with access to digital images from every where at any time. (orig.) [de

Implementation of quality management systems: the role of hospital (management) boards.

NARCIS (Netherlands)

Botje, D.; Klazinga, N.S.; Suñol, R.; Wagner, C.

2013-01-01

Objectives: Hospitals are putting tremendous efforts in implementing evidence-based management systems and organisational innovations for patient-centred care. Having a hospital quality management system is a prerequisite to successfully implement these innovations. Previous studies showed that the

Status and Trends in the U.S. Voluntary Green Power Market (2012 Data)

Energy Technology Data Exchange (ETDEWEB)

Heeter, J.; Nicholas, T.

2013-10-01

Voluntary green power markets are those in which consumers and institutions voluntarily purchase renewable energy to match their electricity needs. Voluntary action provides a revenue stream for renewable energy projects and raises consumer awareness of the benefits of renewable energy. These markets continued to exhibit growth and stimulate renewable energy development in 2012. This paper reviews the voluntary market and identifies market trends.

Applied patent RFID systems for building reacting HEPA air ventilation system in hospital operation rooms.

Science.gov (United States)

Lin, Jesun; Pai, Jar-Yuan; Chen, Chih-Cheng

2012-12-01

RFID technology, an automatic identification and data capture technology to provide identification, tracing, security and so on, was widely applied to healthcare industry in these years. Employing HEPA ventilation system in hospital is a way to ensure healthful indoor air quality to protect patients and healthcare workers against hospital-acquired infections. However, the system consumes lots of electricity which cost a lot. This study aims to apply the RFID technology to offer a unique medical staff and patient identification, and reacting HEPA air ventilation system in order to reduce the cost, save energy and prevent the prevalence of hospital-acquired infection. The system, reacting HEPA air ventilation system, contains RFID tags (for medical staffs and patients), sensor, and reacting system which receives the information regarding the number of medical staff and the status of the surgery, and controls the air volume of the HEPA air ventilation system accordingly. A pilot program was carried out in a unit of operation rooms of a medical center with 1,500 beds located in central Taiwan from Jan to Aug 2010. The results found the air ventilation system was able to function much more efficiently with less energy consumed. Furthermore, the indoor air quality could still keep qualified and hospital-acquired infection or other occupational diseases could be prevented.

Enhanced voluntary wheel running in GPRC6A receptor knockout mice

DEFF Research Database (Denmark)

Clemmensen, Christoffer; Pehmøller, Christian; Klein, Anders B

2013-01-01

to voluntary wheel running and forced treadmill exercise. Moreover, we assessed energy expenditure in the basal state, and evaluated the effects of wheel running on food intake, body composition, and a range of exercise-induced central and peripheral biomarkers. We found that adaptation to voluntary wheel...... running is affected by GPRC6A, as ablation of the receptor significantly enhances wheel running in KO relative to WT mice. Both genotypes responded to voluntary exercise by increasing food intake and improving body composition to a similar degree. In conclusion, these data demonstrate that the GPRC6A...

Managing voluntary turnover through challenging assignments

NARCIS (Netherlands)

Preenen, P.T.Y.; de Pater, I.E.; van Vianen, A.E.M.; Keijzer, L.

2011-01-01

This study examines employees’ challenging assignments as manageable means to reduce turnover intentions, job search behaviors, and voluntary turnover. Results indicate that challenging assignments are negatively related to turnover intentions and job search behaviors and that these relationships

Managing voluntary turnover through challenging assignments

NARCIS (Netherlands)

Preenen, P.T.Y.; Pater, I.E. de; Vianen, A.E.M. van; Keijzer, L.

2011-01-01

This study examines employees' challenging assignments as manageable means to reduce turnover intentions, job search behaviors, and voluntary turnover. Results indicate that challenging assignments are negatively related to turnover intentions and job search behaviors and that these relationships

Surgical Quality in Rectal Cancer Management: What Can Be Achieved by a Voluntary Observational Study?

Science.gov (United States)

Dziki, Łukasz; Otto, Ronny; Lippert, Hans; Mroczkowski, Paweł; Jannasch, Olof

2018-01-01

Countries with nationwide quality programmes in colorectal cancer report an improved outcome. In Germany, a self-organized and self-financed observational quality assurance project exists, based on voluntary participation. The object of the present study was to ascertain whether this nationwide project also improves the outcome of colorectal cancer. The German Quality Assurance in Colorectal Cancer Project started in 2000 and by 2012 contained 85,000 patients. Inclusion criteria for the study were participation for the entire period of 13 years and treatment of rectal cancer. The following parameters were analysed: (1) patient related: age, gender, ASA classification, T-stage, and N-stage, (2) system related: frequency of preoperative CT and MRI, and (3) outcome related: CRM status, complications, and hospital mortality. Forty-one of the 345 hospitals treating 11,597 patients fulfilled the inclusion criteria. The median age increased from 67 to 69 years ( p = 0.002). ASA stages III and IV increased from 32.0% to 37.6% ( p = 0.005) and from 2.0% to 3.3% ( p = 0.022), respectively. The use of CT rose from 67.2% to 88.8% ( p < 0.001) and that of MRI from 5.0% to 35.2% ( p < 0.001). The proportion of patients suffering from complications decreased from 7.9% to 5.3% ( p < 0.001) for intraoperative and from 28.0% to 18.6% ( p < 0.001) for postoperative surgical complications, but general postoperative complications increased from 25.8% to 29.5% ( p = 0.006). The distribution of histopathological stage, anastomotic leakage, and in-hospital mortality did not change significantly. Participation in a quality assurance project improves compliance with treatment standards, especially for diagnostic procedures. An improvement of surgical results will require further investment in training.

Surgical Quality in Rectal Cancer Management: What Can Be Achieved by a Voluntary Observational Study?

Directory of Open Access Journals (Sweden)

Łukasz Dziki

2018-01-01

Full Text Available Purpose. Countries with nationwide quality programmes in colorectal cancer report an improved outcome. In Germany, a self-organized and self-financed observational quality assurance project exists, based on voluntary participation. The object of the present study was to ascertain whether this nationwide project also improves the outcome of colorectal cancer. Methods. The German Quality Assurance in Colorectal Cancer Project started in 2000 and by 2012 contained 85,000 patients. Inclusion criteria for the study were participation for the entire period of 13 years and treatment of rectal cancer. The following parameters were analysed: (1 patient related: age, gender, ASA classification, T-stage, and N-stage, (2 system related: frequency of preoperative CT and MRI, and (3 outcome related: CRM status, complications, and hospital mortality. Results. Forty-one of the 345 hospitals treating 11,597 patients fulfilled the inclusion criteria. The median age increased from 67 to 69 years (p=0.002. ASA stages III and IV increased from 32.0% to 37.6% (p=0.005 and from 2.0% to 3.3% (p=0.022, respectively. The use of CT rose from 67.2% to 88.8% (p<0.001 and that of MRI from 5.0% to 35.2% (p<0.001. The proportion of patients suffering from complications decreased from 7.9% to 5.3% (p<0.001 for intraoperative and from 28.0% to 18.6% (p<0.001 for postoperative surgical complications, but general postoperative complications increased from 25.8% to 29.5% (p=0.006. The distribution of histopathological stage, anastomotic leakage, and in-hospital mortality did not change significantly. Conclusion. Participation in a quality assurance project improves compliance with treatment standards, especially for diagnostic procedures. An improvement of surgical results will require further investment in training.

Voluntary Smoke-Free Measures Among Oklahoma Nightlife Owners: Barriers and Facilitators.

Science.gov (United States)

Benowitz-Fredericks, Carson; McQuoid, Julia; Sheon, Nicolas; Olson, Sarah; Ling, Pamela M

2018-03-01

Smoke-free policies prevent exposure to secondhand smoke and encourage tobacco cessation. Local smoke-free policies that are more comprehensive than statewide policies are not allowed in states with preemption, including Oklahoma, which has the sixth highest smoking prevalence in the United States. In states with preemption, voluntary smoke-free measures are encouraged, but little research exists on venue owners' and managers' views of such measures, particularly in nightlife businesses such as bars and nightclubs. This article draws from semistructured interviews with 23 Oklahoma bar owners and managers, examining perceived risks and benefits of adopting voluntary smoke-free measures in their venues. No respondents expressed awareness of preemption. Many reported that smoke-free bars and nightclubs were an inevitable societal trend, particularly as younger customers increasingly expected smoke-free venues. Business benefits such as decreased operating and cleaning costs, improved atmosphere, and employee efficiency were more convincing than improved employee health. Concerns that voluntary measures created an uneven playing field among venues competing for customers formed a substantial barrier to voluntary measures. Other barriers included concerns about lost revenue and fear of disloyalty to customers, particularly older smokers. Addressing business benefits and a level playing field may increase support for voluntary smoke-free nightlife measures.

Corporate governance, cultural factors and voluntary disclosure: Evidence from selected companies in Bangladesh

Directory of Open Access Journals (Sweden)

M. Akhtaruddin

2012-01-01

Full Text Available This research aims to test empirically the relationship between corporate governance, cultural factors and voluntary disclosure by the listed companies in Bangladesh. The corporate governance factors examined are proportion of independent non-executive directors (INDs, board leadership structure, management ownership, board size and audit committee size. The extent of voluntary disclosure level is measured using 68 items of information. Data are taken from annual reports of the listed companies in Bangladesh. The result shows a positive association between board size, board leadership structure, audit committee size and voluntary disclosure. However, no evidence is found to support the contention that independent directors are associated with increased disclosure, consistent with previous studies. Higher education of the CEO and CFO is positively related to the level of voluntary disclosure. The result also indicates that the extent of voluntary disclosures is negatively associated with a higher management ownership.

Knowledge of HIV/AIDS and Attitude Toward Voluntary Counselling and Testing Among Antenatal Clinic Attendees at a Tertiary Care Hospital in India.

Science.gov (United States)

Sagili, H; Kumar, S; Lakshminarayanan, S; Papa, D; Abi, C

2015-04-01

Maternal to child transmission (MTCT) is responsible for over 90 % of all childhood HIV infections. Lack of awareness regarding HIV and preventive practices against MTCT maybe one of the reasons behind high HIV transmission rates. In our study, we assessed the knowledge of HIV/AIDS in antenatal women, attending a tertiary care hospital in India as well as their attitude toward voluntary counseling and testing (VCT) for HIV. This was a cross-sectional descriptive study carried out from May-July 2012 using a pretested interview-based questionnaire given to 386 antenatal women after obtaining consent. Data were abstracted for knowledge of HIV, MTCT, and attitude toward VCT. Results were expressed as percentages using SPSS v.16 software. Amongst the respondents, 92.5 % had heard of HIV and in 41 % of them, the source of information was through mass media. 81 % were aware of sexual intercourse as a mode of transmission of HIV while 55 % knew that sharing sharp objects and infected blood products can spread HIV. 37.6 % of respondents were aware of MTCT and 44 % heard of antiretroviral therapy as a method of prevention of MTCT. While 68 % were willing to get tested for HIV, 18.9 % knew about the steps involved and 44 % knew where to get VCT. There exists a lack of adequate knowledge regarding HIV and preventive practices against MTCT. Health education and awareness campaigns on MTCT prevention and VCT promotion should target women in their antenatal period in order to increase acceptability and accessibility of these services.

31 CFR 353.64 - Payment, reinvestment, or exchange-voluntary guardian of an incapacitated person.

Science.gov (United States)

2010-07-01

...-voluntary guardian of an incapacitated person. 353.64 Section 353.64 Money and Finance: Treasury Regulations..., Incompetents, Aged Persons, Absentees, et al. § 353.64 Payment, reinvestment, or exchange—voluntary guardian of... recognition as voluntary guardian for the purpose of redeeming the owner's bonds, if the total redemption...

31 CFR 315.64 - Payment, reinvestment, or exchange-voluntary guardian of an incapacitated person.

Science.gov (United States)

2010-07-01

...-voluntary guardian of an incapacitated person. 315.64 Section 315.64 Money and Finance: Treasury Regulations... exchange—voluntary guardian of an incapacitated person. (a) Payment of bonds. When an adult owner of bonds... an application for recognition as voluntary guardian for the purpose of redeeming the owner's bonds...

76 FR 41178 - Medicare Program; Proposed Changes to the Hospital Inpatient Prospective Payment Systems for...

Science.gov (United States)

2011-07-13

... Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment...; Proposed Changes to the Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2012 Rates'' which appeared in the...

13 CFR 108.585 - Voluntary decrease in NMVC Company's Regulatory Capital.

Science.gov (United States)

2010-01-01

...'s Regulatory Capital. 108.585 Section 108.585 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION NEW MARKETS VENTURE CAPITAL (âNMVCâ) PROGRAM Managing the Operations of a NMVC Company Voluntary Decrease in Regulatory Capital § 108.585 Voluntary decrease in NMVC Company's Regulatory Capital. You must...

Are hospitals ready to response to disasters? Challenges, opportunities and strategies of Hospital Emergency Incident Command System (HEICS

Directory of Open Access Journals (Sweden)

Mohammad Hossein Yarmohammadian

2011-01-01

Full Text Available Background: Applying an effective management system in emergency incidents provides maximum efficiency with using minimum facilities and human resources. Hospital Emergency Incident Command System (HEICS is one of the most reliable emergency incident command systems to make hospitals more efficient and to increase patient safety. This research was to study requirements, barriers, and strategies of HEICS in hospitals affiliated to Isfahan University of Medical Sciences (IUMS. Methods: This was a qualitative research carried out in Isfahan Province, Iran during 2008-09. The study population included senior hospital managers of IUMS and key informants in emergency incident management across Isfahan Province. Sampling method was in non-random purposeful form and snowball technique was used. The research in-strument for data collection was semi-structured interview; collected data was analyzed by Colaizzi Technique. Results: Findings of study were categorized into three general categories including requirements (organizational and sub-organizational, barriers (internal and external of HEICS establishment, and providing short, mid and long term strategies. These categories are explained in details in the main text. Conclusions: Regarding the existing barriers in establishment of HEICS, it is recommended that responsible authori-ties in different levels of health care system prepare necessary conditions for implementing such system as soon as possible via encouraging and supporting systems. This paper may help health policy makers to get reasonable frame-work and have comprehensive view for establishing HEICS in hospitals. It is necessary to consider requirements and viewpoints of stakeholders before any health policy making or planning.

Vietnam seeks help expanding voluntary surgical contraception.

Science.gov (United States)

Piet-pelon, N J; Sukop, S

1992-07-01

Recent surveys by the Vietnamese Ministry of Health suggest that 60% of married women desire no more children. Yet only 2% of currently married women and less than 1/2 of 1% of their partners use sterilization. Underscoring the high unmet need for effective family planning, over 1 million abortions (legal in Vietnam for the past 20 years) are performed annually. This rate corresponds to 1 abortion for every live birth. The Ministry of Health has recently welcomed a variety of organizations, including AVSC, whose assistance can help expand the country's family planning programs. Sorely lacking in supplies, equipment, and trained personnel, Vietnam has merited priority status--2nd only to China and India--from the UNFPA, which has committed $36 million over the next 4 years. Other organizations currently working in Vietnam include the Population Council, the Population Crisis Committee, and the International Planned Parenthood Federation. Despite enormous casualties during the war years, and a decrease since the 1970s in average family size from 6 to 4 children, the population of Vietnam has continued to grow rapidly, far outpacing economic growth. Currently 67 million, the population is expected to reach 80 million by the year 2000. The average Vietnamese annual income is only $195, among the lowest in the world. Doi moi, the process of economic reform begun in 1986, coupled with new government incentives for families who have no more than 2 children, is changing the face of family planning in Vietnam. Newly opened pharmacies sell imported birth control pills and condoms (to those who can afford them), while government hospitals and health clinics provide mainly IUDs, in addition to limited supplies of pills and condoms. Throughout the country, some 8000 community-level health centers are staffed by nurse-midwives trained in family planning. Voluntary sterilization is available at the district, provincial, and national hospitals. All married women may obtain family

HWMA/RCRA Closure Plan for the Fluorinel Dissolution Process Makeup and Cooling and Heating Systems Voluntary Consent Order SITE-TANK-005 Action Plan Tank Systems INTEC-066, INTEC-067, INTEC-068, and INTEC-072

International Nuclear Information System (INIS)

M.E. Davis

2007-01-01

This Hazardous Waste Management Act/Resource Conservation and Recovery Act closure plan for the fluorinel dissolution process makeup and cooling and heating systems located in the Fluorinel Dissolution Process and Fuel Storage Facility (CPP-666), Idaho Nuclear Technology and Engineering Center, Idaho National Laboratory Site, was developed to meet milestones established under the Voluntary Consent Order. The systems to be closed include waste piping associated with the fluorinel dissolution process makeup systems. This closure plan presents the closure performance standards and methods of achieving those standards

HWMA/RCRA Closure Plan for the Fluorinel Dissolution Process Makeup and Cooling and Heating Systems Voluntary Consent Order SITE-TANK-005 Action Plan Tank Systems INTEC-066, INTEC-067, INTEC-068, and INTEC-072

Energy Technology Data Exchange (ETDEWEB)

M.E. Davis

2007-05-01

This Hazardous Waste Management Act/Resource Conservation and Recovery Act closure plan for the fluorinel dissolution process makeup and cooling and heating systems located in the Fluorinel Dissolution Process and Fuel Storage Facility (CPP-666), Idaho Nuclear Technology and Engineering Center, Idaho National Laboratory Site, was developed to meet milestones established under the Voluntary Consent Order. The systems to be closed include waste piping associated with the fluorinel dissolution process makeup systems. This closure plan presents the closure performance standards and methods of achieving those standards.

Enrollment in mental health courts: voluntariness, knowingness, and adjudicative competence.

Science.gov (United States)

Redlich, Allison D; Hoover, Steven; Summers, Alicia; Steadman, Henry J

2010-04-01

Mental health courts (MHCs) are rapidly expanding as a form of diversion from jails and prisons for persons with mental illness charged with crimes. Although intended to be voluntary, little is known about this aspect of the courts. We examined perceptions of voluntariness, and levels of knowingness and legal competence among 200 newly enrolled clients of MHCs at two courts. Although most clients claimed to have chosen to enroll, at the same time, most claimed not to have been told the court was voluntary or told of the requirements prior to entering. The majority knew the "basics" of the courts, but fewer knew more nuanced information. A minority also were found to have impairments in legal competence. Implications are discussed.

Is the Australian hospital system adequately prepared for terrorism?

Science.gov (United States)

Rosenfeld, Jeffrey V; Fitzgerald, Mark; Kossmann, Thomas; Pearce, Andrew; Joseph, Anthony; Joseph, Andrew; Tan, Gim; Gardner, Michele; Shapira, Shmuel

Australian hospitals need to be prepared to deal with mass casualties from terrorist strikes, including bomb blasts and chemical, biological and radiation injury. Injuries from bomb explosions are more severe than those commonly seen in Australian hospitals. In disasters involving mass casualties in urban areas, many of the injured make their own way to hospital, often arriving before the more seriously injured casualties. Major hospitals in Australia should plan for large numbers of undifferentiated and potentially contaminated casualties arriving with minimal warning. It is critical that experienced and trained senior medical officers perform the triage of casualties in emergency departments, with frequent reassessment to detect missed injuries (especially pulmonary blast injury). Hospitals require well developed standard operating procedures for mass casualty events, reinforced by regular drills. Preparing for a major event includes training staff in major incident management, setting up an operational/control unit, nominating key personnel, ensuring there is an efficient intra-hospital communication system, and enhancing links with other emergency services and hospitals.

A chain-retrieval model for voluntary task switching.

Science.gov (United States)

Vandierendonck, André; Demanet, Jelle; Liefooghe, Baptist; Verbruggen, Frederick

2012-09-01

To account for the findings obtained in voluntary task switching, this article describes and tests the chain-retrieval model. This model postulates that voluntary task selection involves retrieval of task information from long-term memory, which is then used to guide task selection and task execution. The model assumes that the retrieved information consists of acquired sequences (or chains) of tasks, that selection may be biased towards chains containing more task repetitions and that bottom-up triggered repetitions may overrule the intended task. To test this model, four experiments are reported. In Studies 1 and 2, sequences of task choices and the corresponding transition sequences (task repetitions or switches) were analyzed with the help of dependency statistics. The free parameters of the chain-retrieval model were estimated on the observed task sequences and these estimates were used to predict autocorrelations of tasks and transitions. In Studies 3 and 4, sequences of hand choices and their transitions were analyzed similarly. In all studies, the chain-retrieval model yielded better fits and predictions than statistical models of event choice. In applications to voluntary task switching (Studies 1 and 2), all three parameters of the model were needed to account for the data. When no task switching was required (Studies 3 and 4), the chain-retrieval model could account for the data with one or two parameters clamped to a neutral value. Implications for our understanding of voluntary task selection and broader theoretical implications are discussed. Copyright © 2012 Elsevier Inc. All rights reserved.

Knowledge and behavior towards voluntary blood donation among students of a tertiary institution in Nigeria.

Science.gov (United States)

Salaudeen, A G; Odeh, E

2011-01-01

Blood donation is the only way of acquiring blood to meet emergency requirements in cases of road traffic accidents, complications of pregnancy and childbirth, various anemic disorders and surgical emergencies among others. Globally, 80 million units of blood are donated each year, but only two million units are donated in sub-Saharan Africa where the need is enormous. The objective of this study was to determine the behavior of the students of a tertiary institution in Nigeria towards voluntary blood donation. This is a descriptive cross-sectional study, which involved students of a tertiary institution in Nigeria. A multistage sampling technique was employed in selecting the participants for this study. A semi-structured self-administered questionnaire was used to collect information on socio-demographic characteristics, knowledge, attitude and factors affecting voluntary blood donation. The data obtained were analyzed using EPI-INFO 2005 software Version 3.3.2. Less than two-thirds (61%) of total respondents had good knowledge of blood donation. More than three quarters (85%) of the respondents had never donated blood. Of the 15% that had donated, only 3% donated voluntarily. Among those that had ever donated, males (57%) were more than females. Many of the donors donated for relatives (57%). The majority of the respondents were compelled to donate because of emergency situations (75%). The reasons why many did not donate were lack of opportunity (45%) due to tight lecture schedule and inadequate knowledge (24%). Gift items such as hematinics, T-shirts and wrist bands (29%) would motivate respondents to donate. The Students' Union body and other Organizations in the University should include a blood donation drive in their monthly/annual activities. The University authorities, the University health service centre and the Hematology Department of the Teaching hospital should collaborate in promoting voluntary blood donation among the students.

21 CFR 515.23 - Voluntary revocation of medicated feed mill license.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Voluntary revocation of medicated feed mill... SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS MEDICATED FEED MILL LICENSE Administrative Actions on Licenses § 515.23 Voluntary revocation of medicated feed mill license. A license issued under...

Comparing systems for costing hospital treatments. The case of stable angina pectoris.

Science.gov (United States)

Larsen, Jytte; Skjoldborg, Ulla Slothuus

2004-03-01

This paper demonstrates the basic properties in the systems most commonly considered for costing treatments in the Danish hospitals. The differences between the traditional charge system, the DRG system and the ABC system are analysed, and difficulties encountered in comparing these systems are discussed. A sample of patients diagnosed with stable angina pectoris (SAP) at Odense University Hospital was used to compare the three systems when costing an entire treatment path, costing single hospitalisations and studying the effects of length of stay. Furthermore, it is illustrated that the main idea behind each system is reflected in how the systems over- or underestimate costs. Implications when managing the hospitals, particularly reimbursement, are discussed.

Voluntary Cough Production and Swallow Dysfunction in Parkinson’s Disease

Science.gov (United States)

Bolser, Donald; Rosenbek, John; Troche, Michelle; Sapienza, Christine

2014-01-01

Cough is important for airway clearance, particularly if penetration/aspiration of foreign material occurs during swallow. Measures of voluntary cough production from ten male participants with stage II–III Parkinson’s disease (PD) who showed no videofluorographic evidence of penetration/aspiration (Group 1) were examined and compared with those of ten male participants with stage II–III PD who showed videofluorographic evidence of penetration/aspiration (Group 2). The degree of penetration/ aspiration was expertly judged from the videofluorographic examinations of the participants’ sequential swallow of a thin, 30-cc bolus. Measured cough parameters included inspiratory phase duration, inspiratory peak flow, compression phase duration, expiratory peak flow, expiratory rise time, and cough volume acceleration. Results indicated significant group differences for the majority of cough measures, except for inspiratory phase duration and inspiratory peak flow. A modest relationship existed between voluntary cough parameters and penetration/aspiration scores. Decreased ability to adequately clear material from the airway with voluntary cough may exacerbate symptoms resulting from penetration/aspiration, particularly for those with neurodegenerative disease. Measurement of voluntary cough may be useful for the evaluation of airway clearance ability. PMID:18483823

Towards State Hegemony Over Agricultural Certification: From Voluntary Private to Mandatory State Regimes on Palm Oil in Indonesia

Directory of Open Access Journals (Sweden)

Muhammad Alif Kaimuddin Sahide

2015-12-01

Full Text Available Previous work on certification of palm oil has reported on a trend toward a change, from failed state regulation to voluntary, private governance. However, recent observations suggest a trend, moving from voluntary, private governance to mandatory state governance in palm oil certification in Indonesia, a move in which the state is reclaiming authority.In thislight, the aims of ourresearch are (1 to identify the main actorsinvolved in certification politics, (2 to explain this trend in terms of the actors' interests and whatever benefits may result for them. We developed our research questions based on bureaucratic politics and power theory. A mix of document analysis, interviews, and observations are applied for addressing the questions. The results answer our research questions, i.e., that (1 the state claims back its authority over certification from private actors and contributed to the complex meta governance of palm oil certification, the state mandatory scheme that is supported by states' bureaucracies in charge reducesthe influence of non-government or private actors. (2 Thistrend is due to a coalition ofspecific state bureaucracies and big industry interests, which grant privileges to industry that are denied to small producers. Unexpectedly, all Indonesian bureaucracies associated with this trend support mandatory state certification, which indicates that palm oil has been elevated in importance to become a matter of national, rather than mere bureaucratic interest.Making certificationmandatory through coercive regulatory poweristhe main toolwithwhich state power can challenge voluntary implementation and reclaim authority. Furthermore, the state needs the voluntary system to exist as well in order to strengthen its position. Therefore, the voluntary and the compulsory systems collaborate to attract global initiatives,which is contributing to the high complex of meta governance.

A cardiorespiratory classifier of voluntary and involuntary electrodermal activity

Directory of Open Access Journals (Sweden)

Sejdic Ervin

2010-02-01

Full Text Available Abstract Background Electrodermal reactions (EDRs can be attributed to many origins, including spontaneous fluctuations of electrodermal activity (EDA and stimuli such as deep inspirations, voluntary mental activity and startling events. In fields that use EDA as a measure of psychophysiological state, the fact that EDRs may be elicited from many different stimuli is often ignored. This study attempts to classify observed EDRs as voluntary (i.e., generated from intentional respiratory or mental activity or involuntary (i.e., generated from startling events or spontaneous electrodermal fluctuations. Methods Eight able-bodied participants were subjected to conditions that would cause a change in EDA: music imagery, startling noises, and deep inspirations. A user-centered cardiorespiratory classifier consisting of 1 an EDR detector, 2 a respiratory filter and 3 a cardiorespiratory filter was developed to automatically detect a participant's EDRs and to classify the origin of their stimulation as voluntary or involuntary. Results Detected EDRs were classified with a positive predictive value of 78%, a negative predictive value of 81% and an overall accuracy of 78%. Without the classifier, EDRs could only be correctly attributed as voluntary or involuntary with an accuracy of 50%. Conclusions The proposed classifier may enable investigators to form more accurate interpretations of electrodermal activity as a measure of an individual's psychophysiological state.

[Evolution and follow-up of hunger strikers: experience from an interregional hospital secured unit].

Science.gov (United States)

Dubois, F; Sudre, E; Porte, A; Bédry, R; Gromb, S

2011-11-01

A hunger strike is a voluntary fast, performed to protest publicly against an issue deemed unfair. In the case of French prisoners, hospitalization in an interregional hospital secured units (UHSI) may be necessary. A retrospective epidemiological study based on one UHSI medical records was performed on the period of May, 2006 to December, 2008, and focused on symptoms, outcomes and ethical problems encountered. Seven men and one woman with a mean age of 32.6 years were hospitalized in an UHSI, with nine episodes of hunger strike of a median duration of 57 days. Clinical symptoms began after two weeks of voluntary deprivation in the form of dizziness, weakness, muscle pain and headache. Laboratory tests showed hypoglycemia (hunger strikes. All hunger strikes were respected by medical staff, and treatment was based upon surveillance of symptoms, vitamin B and sweetened drinks administration and explanations of the clinical hazards on a daily basis. The special problem encountered in the medical management of these strikers was to convince them to accept treatments in order to avoid a coercive life-saving treatment as requested by French law. Copyright © 2011 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Information system maturity and the hospitality enterprise performance

Directory of Open Access Journals (Sweden)

Daniela Garbin Pranicevic

2015-01-01

Full Text Available The purpose of this paper is to empirically evaluate the relationship between the maturity of hotels’ information systems and their performance. This study uses customized models of information system (IS maturity and hotel performance measurement. Since we wanted to include the intangible aspects of performance, we opted for an adapted application of the Balanced Scorecard model. In the empirical part of the paper, fundamental constructs of the model are verified, while the individual items are further evaluated by employing discriminant analysis to distinguish hotels with relatively low and high performance levels. The findings demonstrate the existence of a significant and positive relationship between IS maturity and two dimensions of performance in the hospitality industry – process quality and guest relationships. The level of employee development and financial performance do not seem to be related to IS maturity. Although representative, the sample is relatively small, and the primary data were collected in a single country. The paper provides a framework of IS maturity items in the hospitality industry which seem to contribute to hotels’ business performances. As such, it can serve as a practical framework relevant for IT management in tourism and hospitality. The paper addresses a topic already discussed in a range of industries, although it does not seem to have been empirically evaluated by many studies of the tourism and hospitality industry. In addition, a new theoretical model of IT maturity in tourism and hospitality is proposed.

42 CFR 412.20 - Hospital services subject to the prospective payment systems.

Science.gov (United States)

2010-10-01

... payment systems. 412.20 Section 412.20 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Hospital Services Subject to and Excluded From the Prospective Payment Systems for Inpatient...

The optimality of hospital financing system: the role of physician-manager interactions.

Science.gov (United States)

Crainich, David; Leleu, Hervé; Mauleon, Ana

2008-12-01

The ability of a prospective payment system to ensure an optimal level of both quality and cost reducing activities in the hospital industry has been stressed by Ma (Ma, J Econ Manage Strategy 8(2):93-112, 1994) whose analysis assumes that decisions about quality and costs are made by a single agent. This paper examines whether this result holds when the main decisions made within the hospital are shared between physicians (quality of treatment) and hospital managers (cost reduction). Ma's conclusions appear to be relevant in the US context (where the hospital managers pay the whole cost of treatment). Nonetheless, when physicians partly reimburse hospitals for the treatment cost as it is the case in many European countries, we show that the ability of a prospective payment system to achieve both objectives is sensitive to the type of interaction (simultaneous, sequential or joint decision-making) between the agents. Our analysis suggests that regulation policies in the hospital sector should not be exclusively focused on the financing system but should also take the interaction between physicians and hospital managers into account.

Reducing replacement donors in Sub-Saharan Africa: challenges and affordability.

Science.gov (United States)

Bates, I; Manyasi, G; Medina Lara, A

2007-12-01

In 1975, the World Health Assembly recommended that blood for transfusion should come from voluntary, non-remunerated donors; yet, in Africa, 75-80% of blood for transfusion still comes from hospital-based replacement donors. Although comprehensive economic data are scarce, evidence indicates that blood from voluntary donors recruited and screened at centralized transfusion centres, costs four to eight times as much as blood from a hospital-based, replacement donor system. Donor recruitment, quality assurance systems and distribution mechanisms in the centralized system are major reasons for the cost difference. There are concerns about the sustainability of centralized voluntary donor systems and their compatibility with the levels of health care that exist in many poor countries yet burdening patients' families with the responsibility of finding replacement blood donors will exacerbate poverty and reduce the safety of the blood supply. There are measures that can be introduced into hospital-based systems to improve safe blood supply in Africa but their effectiveness in different contexts needs to be evaluated.

Conditioned taste avoidance induced by forced and voluntary wheel running in rats.

Science.gov (United States)

Forristall, J R; Hookey, B L; Grant, V L

2007-03-01

Voluntary exercise by rats running in a freely rotating wheel (free wheel) produces conditioned taste avoidance (CTA) of a flavored solution consumed before running [e.g., Lett, B.T., Grant, V.L., 1996. Wheel running induces conditioned taste aversion in rats trained while hungry and thirsty. Physiol. Behav. 59, 699-702]. Forced exercise, swimming or running, also produces CTA in rats [e.g., Masaki, T., Nakajima, S., 2006. Taste aversion induced by forced swimming, voluntary running, forced running, and lithium chloride injection treatments. Physiol. Behav. 88, 411-416]. Energy expenditure may be the critical factor in producing such CTA. If so, forced running in a motorized running wheel should produce CTA equivalent to that produced by a similar amount of voluntary running. In two experiments, we compared forced running in a motorized wheel with voluntary running in a free wheel. Mean distance run over 30 min was equated as closely as possible in the two apparatuses. Both types of exercise produced CTA relative to sedentary, locked-wheel controls. However, voluntary running produced greater CTA than forced running. We consider differences between running in the free and motorized wheels that may account for the differences in strength of CTA.

Onboard measurement system of atmospheric carbon monoxide in the Pacific by voluntary observing ships

Directory of Open Access Journals (Sweden)

H. Nara

2011-11-01

Full Text Available Long-term monitoring of carbon monoxide (CO mixing ratios in the atmosphere over the Pacific Ocean is being carried out on commercial cargo vessels participating in the National Institute for Environmental Studies Voluntary Observing Ships program. The program provides a regular platform for measurement of atmospheric CO along four cruise routes: from Japan to Oceania, the United States, Canada, and Southeast Asia. Flask samples are collected during every cruise for subsequent analysis in the laboratory, and in 2005, continuous shipboard CO measurements were initiated on three of the routes. Here, we describe the system we developed for onboard measurement of CO mixing ratios with a commercially available gas filter correlation CO analyzer. The fully automated system measures CO in ambient air, and the detector sensitivity and background signals are calibrated by referencing the measurements to a CO-in-air standard gas (~1 ppmv and to CO-free air scrubbed with a catalyst, respectively. We examined the artificial production of CO in the high-pressure working gas standards during storage by referencing the measurements to CO standard gases maintained as our primary scale before and after use on the ships. The onboard performance of the continuous CO measurement system was evaluated by comparing its data with data from laboratory analyses of flask samples using gas chromatography with a reduction gas detector. The reasonably good consistency between the two independent measurement methods demonstrated the good performance of both methods over the course of 3–5 years. The continuous measurement system was more useful than the flask sampling method for regionally polluted air masses, which were often encountered on Southeast Asian cruises.

Onboard measurement system of atmospheric carbon monoxide in the Pacific by voluntary observing ships

Science.gov (United States)

Nara, H.; Tanimoto, H.; Nojiri, Y.; Mukai, H.; Machida, T.; Tohjima, Y.

2011-11-01

Long-term monitoring of carbon monoxide (CO) mixing ratios in the atmosphere over the Pacific Ocean is being carried out on commercial cargo vessels participating in the National Institute for Environmental Studies Voluntary Observing Ships program. The program provides a regular platform for measurement of atmospheric CO along four cruise routes: from Japan to Oceania, the United States, Canada, and Southeast Asia. Flask samples are collected during every cruise for subsequent analysis in the laboratory, and in 2005, continuous shipboard CO measurements were initiated on three of the routes. Here, we describe the system we developed for onboard measurement of CO mixing ratios with a commercially available gas filter correlation CO analyzer. The fully automated system measures CO in ambient air, and the detector sensitivity and background signals are calibrated by referencing the measurements to a CO-in-air standard gas (~1 ppmv) and to CO-free air scrubbed with a catalyst, respectively. We examined the artificial production of CO in the high-pressure working gas standards during storage by referencing the measurements to CO standard gases maintained as our primary scale before and after use on the ships. The onboard performance of the continuous CO measurement system was evaluated by comparing its data with data from laboratory analyses of flask samples using gas chromatography with a reduction gas detector. The reasonably good consistency between the two independent measurement methods demonstrated the good performance of both methods over the course of 3-5 years. The continuous measurement system was more useful than the flask sampling method for regionally polluted air masses, which were often encountered on Southeast Asian cruises.

Mobilising voluntary contributions in public urban regeneration – a review

DEFF Research Database (Denmark)

Larsen, Jacob Norvig; Jensen, Jesper Ole; Agger, Annika

Research on volunteerism indicates that one third of all adults in Denmark regularly contribute with voluntary labour in social relief work, community-based organizations, non-governmental organizations, or otherwise. In this paper we ask if and how urban regeneration might benefit from...... in relation to public policy arenas and activities, particularly within urban policy and the community development fields. A categorization is proposed as regards different ways and models of civic engagement and major challenges are outlined. The paper is first step of a research project exploring potential...... the apparently strong growth in voluntarism. Although there seems to be a large potential for involving volunteers and voluntary organisations, systematic analysis of recent years’ urban regeneration projects in Denmark shows that the sustainability of voluntary contributions is limited. While initial enrolling...

How should Australia regulate voluntary euthanasia and assisted suicide?

Science.gov (United States)

White, Ben; Willmott, Lindy

2012-12-01

This article invites consideration of how Australia should regulate voluntary euthanasia and assisted suicide. It attempts to pose this question as neutrally as possible, acknowledging that both prohibition and legalisation of such conduct involve decisions about regulation. It begins by charting the wider field of law at the end of life, before considering the repeated, but ultimately unsuccessful, attempts at law reform in Australia. The situation in Australia is contrasted with permissive jurisdictions overseas where voluntary euthanasia and/or assisted suicide are lawful. The authors consider the arguments for and against legalisation of such conduct along with the available empirical evidence as to what happens in practice both in Australia and overseas. The article concludes by outlining a framework for deliberating on how Australia should regulate voluntary euthanasia and assisted suicide. It asks a threshold question of whether such conduct should be criminal acts (as they presently are), the answer to which then leads to a range of possible regulatory options.

Frequency of HCV infection and its genotypes among patients attending a liver clinic and voluntary blood donors in a rural area of Pakistan

International Nuclear Information System (INIS)

Abbas, S.Z.; Ali, M.; Muhammad, A.H.; Shaw, S.; Abbas, S.Q.

2009-01-01

Objectives: To determine the frequency of Hepatitis C virus (HCV) infection and its genotypic distribution in a rural area of Sindh, Pakistan. Methodology: Retrospective study of patients attending the Free Liver Clinic (FLC), and investigated for detectable HCV antibodies (n=1638), and those screened for HCV infection prior to voluntary blood donation (n=804) at a teaching hospital, located in rural Sindh. All patients had HCV antibodies tested by ELISA. A total of 1022 patients, who tested 'reactive' to HCV antibodies, and who could financially afford to have HCV RNA tested by PCR, had their results analysed. A total of 200 patients also had their HCV genotyped and analysed. Results: Patients at FLC had a higher chance of being reactive for HCV antibodies, compared to voluntary blood donors (20% VS 14% - p = 0.004). HCV RNA was detectable in 904/1022 (88%) patients. Among type able genotypes, 125/166 (75%) had a single genotype, and 7 patients (4%) were infected with genotype 1, either alone (n=4) or in combination with 3a. Conclusions: One out of every five people tested in our FLC, and 14% of 'healthy' voluntary blood donors were seropositive for HCV antibodies. Genotype 1 is very rare in our region. (author)

78 FR 60020 - Proposed Collection: Comment Request for Voluntary Customer Satisfaction Surveys

Science.gov (United States)

2013-09-30

... Voluntary Customer Satisfaction Surveys ACTION: Notice and request for comments. SUMMARY: The Department of... Treasury is soliciting comments concerning the Customer Satisfaction Survey. DATES: Written comments should..., WV 26106-1328, (304) 480- 8150. SUPPLEMENTARY INFORMATION: Title: Voluntary Customer Satisfaction...

27 CFR 5.32a - Voluntary disclosure of major food allergens.

Science.gov (United States)

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Voluntary disclosure of major food allergens. 5.32a Section 5.32a Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX... Labeling Requirements for Distilled Spirits § 5.32a Voluntary disclosure of major food allergens. (a...

27 CFR 7.22a - Voluntary disclosure of major food allergens.

Science.gov (United States)

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Voluntary disclosure of major food allergens. 7.22a Section 7.22a Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX... Labeling Requirements for Malt Beverages § 7.22a Voluntary disclosure of major food allergens. (a...

Automated surveillance system for hospital-acquired urinary tract infections in Denmark

DEFF Research Database (Denmark)

Condell, Orla; Gubbels, Sophie; Nielsen, J

2016-01-01

BACKGROUND: The Danish Hospital-Acquired Infections Database (HAIBA) is an automated surveillance system using hospital administrative, microbiological, and antibiotic medication data. AIM: To define and evaluate the case definition for hospital-acquired urinary tract infection (HA-UTI) and to de......BACKGROUND: The Danish Hospital-Acquired Infections Database (HAIBA) is an automated surveillance system using hospital administrative, microbiological, and antibiotic medication data. AIM: To define and evaluate the case definition for hospital-acquired urinary tract infection (HA-UTI......) and to describe surveillance data from 2010 to 2014. METHODS: The HA-UTI algorithm defined a laboratory-diagnosed UTI as a urine culture positive for no more than two micro-organisms with at least one at ≥10(4)cfu/mL, and a probable UTI as a negative urine culture and a relevant diagnosis code or antibiotic...... treatment. UTI was considered hospital-acquired if a urine sample was collected ≥48h after admission and UTI was calculated per 10,000 risk-days. For validation, prevalence was calculated for each day and compared to point prevalence survey (PPS) data. FINDINGS: HAIBA...

An investigation on physicians' acceptance of hospital information systems: a case study.

Science.gov (United States)

Chen, Rai-Fu; Hsiao, Ju-Ling

2012-12-01

Information technology is used to support a wide range of highly specified healthcare tasks and services. There is, therefore, a need to understand the factors affecting the acceptance of this technology by healthcare professionals. Physicians are key providers of healthcare services and are among the principal users of hospital information systems. Their acceptance of hospital information systems is hence of great significance when evaluating the success of those systems. The survey methodology was employed to targeted physicians in the selected case hospital for investigating factors affecting physicians' acceptance of hospital information systems. A total of 202 questionnaires were sent out, with 124 completed copies returned, indicating a valid response rate of 61.4%. We used structural equation modeling to analyze the data. The results indicated that top management support (γ=0.431, psystem quality (γ=0.369, pinformation systems. Physicians' perceptions of the usefulness (β=0.132, pinformation systems had a significant impact on the acceptance of the systems, accounting for 81.4% of total explained variance. Through the understanding of the identified critical factors affecting physicians' HIS acceptance, the planners and managers should ensure that hospital information systems to be introduced into a hospital are useful and ease to use. Effort should be focuses on providing sufficient top management support, selecting qualified project team members, and delivering higher system quality in addressing physicians' clinical needs. Thus, our research results can help planners and managers understand key considerations affecting HIS development and use, and may be used as a reference for system design, development and implementation. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Voluntary Medication Error Reporting by ED Nurses: Examining the Association With Work Environment and Social Capital.

Science.gov (United States)

Farag, Amany; Blegen, Mary; Gedney-Lose, Amalia; Lose, Daniel; Perkhounkova, Yelena

2017-05-01

Medication errors are one of the most frequently occurring errors in health care settings. The complexity of the ED work environment places patients at risk for medication errors. Most hospitals rely on nurses' voluntary medication error reporting, but these errors are under-reported. The purpose of this study was to examine the relationship among work environment (nurse manager leadership style and safety climate), social capital (warmth and belonging relationships and organizational trust), and nurses' willingness to report medication errors. A cross-sectional descriptive design using a questionnaire with a convenience sample of emergency nurses was used. Data were analyzed using descriptive, correlation, Mann-Whitney U, and Kruskal-Wallis statistics. A total of 71 emergency nurses were included in the study. Emergency nurses' willingness to report errors decreased as the nurses' years of experience increased (r = -0.25, P = .03). Their willingness to report errors increased when they received more feedback about errors (r = 0.25, P = .03) and when their managers used a transactional leadership style (r = 0.28, P = .01). ED nurse managers can modify their leadership style to encourage error reporting. Timely feedback after an error report is particularly important. Engaging experienced nurses to understand error root causes could increase voluntary error reporting. Published by Elsevier Inc.

25 CFR 38.14 - Voluntary services.

Science.gov (United States)

2010-04-01

... INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION EDUCATION PERSONNEL § 38.14 Voluntary services. (a... receiving credit for their work (i.e., student teaching) from an education institution, the agreement will... Regulations Governing Responsibilities and Conduct. (e) Travel and other expenses. The decision to reimburse...

Voluntary Community Organisations in Metropolitan Development

DEFF Research Database (Denmark)

Larsen, Jacob Norvig

that voluntary community work in relation to public urban regeneration is much more than the public’s engagement in project planning processes. Contrary to temporary urban regeneration projects, VCOs are much more permanently embedded in the neighbourhood, and volunteers are motivated by both self-interest...

Equality, self‐respect and voluntary separation

NARCIS (Netherlands)

Merry, M.S.

2012-01-01

This paper argues that self‐respect constitutes an important value, and further, an important basis for equality. It also argues that under conditions of inequality‐producing segregation, voluntary separation in schooling may be more likely to provide the resources necessary for self‐respect. A

Application of Kanban System on a hospital pharmacy.

Science.gov (United States)

Mitka, Eleftheria

2015-01-01

This is a brief overview of principles, views and methods, of the Kanban System for the pharmacy of a general hospital. The main goal is the reduction of stores managed by the pharmacy, as well as improvement of the mode of operation. Solutions to problems, such as inadequate storage space, the delay in serving patients or clinics and the expiration of various pharmaceutical formulations, stored for so long time, are provided. The philosophy behind the Kanban procurement System and specifically its applicability to a pharmacy underperforming in terms of efficiency, in Greece, are described. Based on the analysis of stock requirement, item stock prices and demand, it is concluded that a significant percentage of the stocked drugs can be procured using the Kanban System. Significant cost savings and operational advantages following the Kanban System will take place. The challenging endeavor is the analysis, design and application of a system that supports the proposed procurement method. Hospital pharmacies in Greece and in other countries that face an economic crisis may largely benefit after using the Kanban System.

Hospital System Readmissions: A Care Cycle Approach

Directory of Open Access Journals (Sweden)

Cody Mullen

2012-01-01

Full Text Available Hospital readmission rates can be used as an indicator of the quality of health care services and can highlight high-priority research areas to ensure better health. A readmission is defined as when a patient is discharged from an acute care hospital and is admitted back to an acute care hospital in a set amount of days, with 30 days being the current national standard. On average, 19.6% of Medicare patients are readmitted to the hospital within 30 days of discharge and 56.1% within a year (Jencks, Williams, & Coleman, 2009. The hypothesis of this study was that the discharge location, or where a patient went immediately after discharge, would not have a significant effect on readmissions. A data set with all admission records was obtained from a major health provider. These data contain all hospital patients’ demographic and diagnosis information. General, women’s, and children’s hospitals were looked at from a system perspective to study the discharge location of patients as well as the effects of patient demographics on discharge location. By using a z-significance test in Microsoft Excel and SAS 9.2, it was discovered that patients discharged to home have a significantly lower likelihood of readmission. Generally, patients who are discharged to an extended care or intermediate care facility or patients with home health carerelated services had a significantly higher likelihood of being readmitted. The findings may indicate a possible need for an institution-to-institution intervention as well as institution-to-patient intervention. Future work will develop potential interventions in partnership with hospital staff.

Voluntary CSR vs. mandatory CSR : the sound of employees

OpenAIRE

Sarna, Bhavesh

2016-01-01

Corporate Social Responsibility (CSR) laws are an area of exploration and there is debate over preference to voluntary CSR laws or to mandatory CSR laws. The objective is to con-duct a micro-level study to explore the employee’s preferences for mandatory CSR laws or voluntary CSR laws. There is some existing literature on this topic at the macro-level and goal is to extend and contribute to the literature about this topic by studying the pref-erence at the micro-level. A qualitative study bas...

The Improved Sensitivity to Crossmodal Asynchrony Caused by Voluntary Action: Comparing Combinations of Sensory Modalities

Directory of Open Access Journals (Sweden)

Norimichi Kitagawa

2011-10-01

Full Text Available The brain has to assess the fine temporal relationship between voluntary actions and their sensory effects to achieve precise spatiotemporal control of body movement. Recently we found that voluntary action improved the subsequent perceptual temporal discrimination between somatosensory and auditory events. In voluntary condition, participants actively pressed a button and a noise burst was presented at various onset asynchronies relative to the button press. The participants made either ‘sound-first’ or ‘touch-first’ responses. We found that the temporal order judgment performance in the voluntary condition (as indexed by just noticeable difference was significantly better than that when their finger was passively stimulated (passive condition. Temporal attention and comparable involuntary movement did not explain the improvement caused by the voluntary action. The results suggest that predicting sensory consequences via a ‘forward’ model enhances perceptual temporal resolution for precise control of the body. The present study examined whether this improved temporal sensitivity caused by the voluntary action is also observed for the other combinations of sensory modalities. We compared the effects of voluntary action on the temporal sensitivity between auditory-somatosensory, visual-somatosensory, and somatosensory-somatosensory stimulus pairs.

27 CFR 4.32a - Voluntary disclosure of major food allergens.

Science.gov (United States)

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Voluntary disclosure of major food allergens. 4.32a Section 4.32a Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX... Requirements for Wine § 4.32a Voluntary disclosure of major food allergens. (a) Definitions. For purposes of...

Medicare program; hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system and Fiscal Year 2014 rates; quality reporting requirements for specific providers; hospital conditions of participation; payment policies related to patient status. Final rules.

Science.gov (United States)

2013-08-19

We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems. Some of the changes implement certain statutory provisions contained in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable Care Act) and other legislation. These changes will be applicable to discharges occurring on or after October 1, 2013, unless otherwise specified in this final rule. We also are updating the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits. The updated rate-of-increase limits will be effective for cost reporting periods beginning on or after October 1, 2013. We also are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) and implementing certain statutory changes that were applied to the LTCH PPS by the Affordable Care Act. Generally, these updates and statutory changes will be applicable to discharges occurring on or after October 1, 2013, unless otherwise specified in this final rule. In addition, we are making a number of changes relating to direct graduate medical education (GME) and indirect medical education (IME) payments. We are establishing new requirements or have revised requirements for quality reporting by specific providers (acute care hospitals, PPS-exempt cancer hospitals, LTCHs, and inpatient psychiatric facilities (IPFs)) that are participating in Medicare. We are updating policies relating to the Hospital Value-Based Purchasing (VBP) Program and the Hospital Readmissions Reduction Program. In addition, we are revising the conditions of participation (CoPs) for hospitals relating to the

76 FR 7853 - Patient Safety Organizations: Voluntary Delisting From Apollo Publishing, Inc.

Science.gov (United States)

2011-02-11

... notification of voluntary relinquishment from Apollo Publishing, Inc., of its status as a Patient Safety... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations: Voluntary Delisting From Apollo Publishing, Inc. AGENCY: Agency for Healthcare Research and...

A problem for the idea of voluntary euthanasia.

Science.gov (United States)

Campbell, N

1999-01-01

I question whether, in those cases where physician-assisted suicide is invoked to alleviate unbearable pain and suffering, there can be such a thing as voluntary euthanasia. The problem is that when a patient asks to die under such conditions there is good reason to think that the decision to die is compelled by the pain, and hence not freely chosen. Since the choice to die was not made freely it is inadvisable for physicians to act in accordance with it, for this may be contrary to the patient's genuine wishes. Thus, what were thought to be cases of voluntary euthanasia might actually be instances of involuntary euthanasia. PMID:10390679

Kinematic Modeling of Normal Voluntary Mandibular Opening and Closing Velocity-Initial Study.

Science.gov (United States)

Gawriołek, Krzysztof; Gawriołek, Maria; Komosa, Marek; Piotrowski, Paweł R; Azer, Shereen S

2015-06-01

Determination and quantification of voluntary mandibular velocity movement has not been a thoroughly studied parameter of masticatory movement. This study attempted to objectively define kinematics of mandibular movement based on numerical (digital) analysis of the relations and interactions of velocity diagram records in healthy female individuals. Using a computerized mandibular scanner (K7 Evaluation Software), 72 diagrams of voluntary mandibular velocity movements (36 for opening, 36 for closing) for women with clinically normal motor and functional activities of the masticatory system were recorded. Multiple measurements were analyzed focusing on the curve for maximum velocity records. For each movement, the loop of temporary velocities was determined. The diagram was then entered into AutoCad calculation software where movement analysis was performed. The real maximum velocity values on opening (Vmax ), closing (V0 ), and average velocity values (Vav ) as well as movement accelerations (a) were recorded. Additionally, functional (A1-A2) and geometric (P1-P4) analysis of loop constituent phases were performed, and the relations between the obtained areas were defined. Velocity means and correlation coefficient values for various velocity phases were calculated. The Wilcoxon test produced the following maximum and average velocity results: Vmax = 394 ± 102, Vav = 222 ± 61 for opening, and Vmax = 409 ± 94, Vav = 225 ± 55 mm/s for closing. Both mandibular movement range and velocity change showed significant variability achieving the highest velocity in P2 phase. Voluntary mandibular velocity presents significant variations between healthy individuals. Maximum velocity is obtained when incisal separation is between 12.8 and 13.5 mm. An improved understanding of the patterns of normal mandibular movements may provide an invaluable diagnostic aid to pathological changes within the masticatory system. © 2014 by the American College of Prosthodontists.

Neural mechanisms of voluntary and involuntary recall: a PET study.

Science.gov (United States)

Hall, Nicoline Marie; Gjedde, Albert; Kupers, Ron

2008-01-25

Neuropsychological and neuroimaging studies on episodic memory retrieval have primarily focused on volitional memory tasks. However, some conscious memories arise involuntarily, i.e. without a strategic retrieval attempt, yet little is known about the neural network underlying involuntary episodic memory. The aim of this study was to determine whether voluntary and involuntary recall are mediated by separate cortical networks. We used positron emission tomography (PET) to measure changes in regional cerebral blood flow (rCBF) in 12 healthy subjects during voluntary and involuntary cued recall of pictures and a control condition with no episodic memory requirements. Involuntary recall was elicited by using an incidental memory task. Compared to the control condition, voluntary and involuntary recall were both associated with significant regional cerebral blood flow (rCBF) increases in posterior cingulate gyrus (PCG; BA 23), left precuneus (BA 7), and right parahippocampal gyrus (BA 35/36). In addition, rCBF in right dorsolateral prefrontal cortex (PFC; BA 8/9) and left precuneus (BA 7) was significantly larger during voluntary compared to involuntary recall, while rCBF was enhanced in left dorsolateral PFC (BA 9) during involuntary recall. The findings corroborate an association of the right PFC with a strategic component of episodic memory retrieval. Moreover, they show for the first time that it is possible to activate the medial temporal lobe, the PCG, and the precuneus, regions normally associated with retrieval success, without this strategic element. The relatively higher activity in precuneus during voluntary compared to involuntary recall suggests that activity in this region co-varies not only with retrieval success but also with retrieval intentionality.

The Role of Hospital Information Systems in Universal Health Coverage Monitoring in Rwanda.

Science.gov (United States)

Karara, Gustave; Verbeke, Frank; Nyssen, Marc

2015-01-01

In this retrospective study, the authors monitored the patient health coverage in 6 Rwandan hospitals in the period between 2011 and 2014. Among the 6 hospitals, 2 are third level hospitals, 2 district hospitals and 2 private hospitals. Patient insurance and financial data were extracted and analyzed from OpenClinic GA, an open source hospital information system (HIS) used in those 6 hospitals. The percentage of patients who had no health insurer globally decreased from 35% in 2011 to 15% in 2014. The rate of health insurance coverage in hospitals varied between 75% in private hospitals and 84% in public hospitals. The amounts paid by the patients for health services decreased in private hospitals to 25% of the total costs in 2014 (-7.4%) and vary between 14% and 19% in public hospitals. Although the number of insured patients has increased and the patient share decreased over the four years of study, the patients' out-of-pocket payments increased especially for in-patients. This study emphasizes the value of integrated hospital information systems for this kind of health economics research in developing countries.

Assessing Performance of Botswana’s Public Hospital System: The Use of the World Health Organization Health System Performance Assessment Framework

Directory of Open Access Journals (Sweden)

Onalenna Seitio-Kgokgwe

2014-09-01

Full Text Available Background Very few studies have assessed performance of Botswana public hospitals. We draw from a large research study assessing performance of the Botswana Ministry of Health (MoH to evaluate the performance of public hospital system using the World Health Organization Health Systems Performance Assessment Framework (WHO HSPAF. We aimed to evaluate performance of Botswana public hospital system; relate findings of the assessment to the potential for improvements in hospital performance; and determine the usefulness of the WHO HSPAF in assessing performance of hospital systems in a developing country. Methods This article is based on data collected from document analysis, 54 key informants comprising senior managers and staff of the MoH (N= 40 and senior officers from stakeholder organizations (N= 14, and surveys of 42 hospital managers and 389 health workers. Data from documents and transcripts were analyzed using content and thematic analysis while data analysis for surveys was descriptive determining proportions and percentages. Results The organizational structure of the Botswana’s public hospital system, authority and decision-making are highly centralized. Overall physical access to health services is high. However, challenges in the distribution of facilities and inpatient beds create inequities and inefficiencies. Capacity of the hospitals to deliver services is limited by inadequate resources. There are significant challenges with the quality of care. Conclusion While Botswana invested considerably in building hospitals around the country resulting in high physical access to services, the organization and governance of the hospital system, and inadequate resources limit service delivery. The ongoing efforts to decentralize management of hospitals to district level entities should be expedited. The WHO HSPAF enabled us to conduct a comprehensive assessment of the public hospital system. Though relatively new, this approach proved

Premium Collection and the Problem of Voluntary Enrolment in China’s New Rural Cooperative Medical System

Directory of Open Access Journals (Sweden)

Armin Müller

2016-01-01

Full Text Available In late 2002, the Chinese government launched an initiative to extend the coverage of health insurance in rural China with the New Rural Cooperative Medical System (NRCMS. It covered all of rural China by 2008 and is being continuously adapted and developed. This study explores two conflicting goals in the policy design: universal coverage and voluntary enrolment. Local governments often faced the problem that only insufficient numbers of villagers were enrolling voluntarily. They developed different strategies to cope with it: Complementary outpatient reimbursement via medical savings accounts (MSAs effectively transferred villagers’ premiums back to them, thus making the NRCMS more attractive. Adapting the premium-collection process to the local context or utilising collusive practices allowed them to pay premiums on behalf of the villagers from the insurance funds. These strategies undermine the effectiveness of the NRCMS as a risk-pooling mechanism, facilitate latent coverage gaps and turn it into a tax-funded service.

Implementation of a radiology information system in an University Hospital

International Nuclear Information System (INIS)

Marques, Paulo Mazzoncini de Azevedo; Santos, Antonio Carlos; Elias Junior, Jorge; Trad, Clovis Simao; Goes, Wilson Moraes; Castro, Carlos Roberto de

2000-01-01

This paper describes a radiology information system (RIS) developed and in the process of implementation in an University Hospital (Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto - Universidade de Sao Paulo) which integrates a plan for a 'filmless' radiology facility. (author)

An evaluation of systemic reforms of public hospitals: the Sanming model in China.

Science.gov (United States)

Fu, Hongqiao; Li, Ling; Li, Mingqiang; Yang, Chunyu; Hsiao, William

2017-10-01

Low- and middle-income countries (LMICs) have been searching for effective strategies to reform their inefficient and wasteful public hospitals. Recently, China developed a model of systemic reforms called the Sanming model to address the inefficiency and waste at public hospitals. In this article, we explain and evaluate how the Sanming model reformed its 22 public hospitals in 2013 by simultaneously restructuring the hospital governance structure, altering the payment system to hospitals, and realigning physicians' incentives. By employing the difference-in-difference (DID) method and using the hospital-level data from 187 public hospitals in Fujian province, we find that the Sanming model has reduced medical costs significantly without measurably sacrificing clinical quality and productive efficiency. The systemic reform, on average, has reduced the medical care cost per outpatient visit and per inpatient admission by 6.1% (P-value = 0.0445) and 15.4% (P-value transformation of public hospitals, where the governance structure, payment system and physician compensation methods are aligned, are crucial to improving their performance; it holds critical lessons for China and other LMICs. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

[Voluntary postural control learning with a use of visual bio-feedback in patients with spinocerebellar degenerations].

Science.gov (United States)

Ustinova, K I; Ioffe, M E; Chernikova, L A; Kulikov, M A; Illarioshkin, S N; Markova, E D

2004-01-01

The study aimed at evaluation of possibility and features of voluntary postural control learning using biofeedback from a force platform in patients with spinocerebellar ataxias. Thirty-seven patients with different forms of spinocerebellar degenerations and 13 age-matched healthy subjects were trained to shift the center of pressure (CP) during several stabilographic computer games which tested an ability to learn 2 different types of voluntary postural control: general strategy and precise coordination of CP shifting. Despite the disturbances of static posture and ability for voluntary control of CP position, patients with spinocerebellar degenerations can learn to control a vertical posture using biofeedback on stabilogram. In contrast to healthy subjects, improvement of coordination in the training process does not exert a significant influence on the static posture characteristics, in particular on lateral CP oscillations. The results obtained suggest involvement of the cerebellum in both types of postural control that distinguishes them from pathology caused by motor cortex and nigro-striatal system involved only in one type of postural control.

[Relationship between cost systems and hospital expenditure].

Science.gov (United States)

García-Cornejo, Beatriz; Pérez-Méndez, José A

To analyze the relationship between the degree of development of hospital cost systems (CS) implemented by the regional health services (RHS) and the variation in unit cost of hospitals in Spanish National Health Service (NHS) between 2010 and 2013 and to identify other explanatory factors of this variation. A database of NHS hospitals was constructed from exclusively public sources. Using a multilevel regression model, explaining factors of the variation in unit cost (cost per weighted unit of activity [WAU]) of a sample of 170 hospitals were analyzed. The variables representative of the degree of development of CS are associated in a negative and significant way with the variation of the cost per WAU. It is observed that if a high-level development CS is used the cost variation per WAU would be reduced by close to 3.2%. There is also a negative and significant relationship between the variation in the cost per WAU and the variations in the percentage of high technology and the hospital occupancy rate. On the other hand, the variations in the average cost of personnel and in the number of workers per 100 beds are associated in a positive and significant way with the variation of the cost per WAU. In the period analysed, during which the main health expenditure adjustment was made, the control in hospital unit cost is associated not only with spending cuts but also with aspects related to their management, such as the implementation of more developed CS. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Hospital medication errors in a pharmacovigilance system in Colombia

Directory of Open Access Journals (Sweden)

Jorge Enrique Machado-Alba

2015-11-01

Full Text Available Objective: this study analyzes the medication errors reported to a pharmacovigilance system by 26 hospitals for patients in the healthcare system of Colombia. Methods: this retrospective study analyzed the medication errors reported to a systematized database between 1 January 2008 and 12 September 2013. The medication is dispensed by the company Audifarma S.A. to hospitals and clinics around Colombia. Data were classified according to the taxonomy of the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP. The data analysis was performed using SPSS 22.0 for Windows, considering p-values < 0.05 significant. Results: there were 9 062 medication errors in 45 hospital pharmacies. Real errors accounted for 51.9% (n = 4 707, of which 12.0% (n = 567 reached the patient (Categories C to I and caused harm (Categories E to I to 17 subjects (0.36%. The main process involved in errors that occurred (categories B to I was prescription (n = 1 758, 37.3%, followed by dispensation (n = 1 737, 36.9%, transcription (n = 970, 20.6% and administration (n = 242, 5.1%. The errors in the administration process were 45.2 times more likely to reach the patient (CI 95%: 20.2–100.9. Conclusions: medication error reporting systems and prevention strategies should be widespread in hospital settings, prioritizing efforts to address the administration process.

Improving voluntary medical male circumcision standards ...

African Journals Online (AJOL)

Voluntary medical male circumcision (VMMC) has been demonstrated to reduce the transmission of HIV by 60%. Scaling up VMMC services requires that they be of high quality, socially accepted, and effective. We evaluated an intervention aimed at improving VMMC standards adherence and patient follow-up rates in nine ...

A Comprehensive Quality Assurance Program for Personnel and Procedures in Radiation Oncology: Value of Voluntary Error Reporting and Checklists

International Nuclear Information System (INIS)

Kalapurakal, John A.; Zafirovski, Aleksandar; Smith, Jeffery; Fisher, Paul; Sathiaseelan, Vythialingam; Barnard, Cynthia; Rademaker, Alfred W.; Rave, Nick; Mittal, Bharat B.

2013-01-01

Purpose: This report describes the value of a voluntary error reporting system and the impact of a series of quality assurance (QA) measures including checklists and timeouts on reported error rates in patients receiving radiation therapy. Methods and Materials: A voluntary error reporting system was instituted with the goal of recording errors, analyzing their clinical impact, and guiding the implementation of targeted QA measures. In response to errors committed in relation to treatment of the wrong patient, wrong treatment site, and wrong dose, a novel initiative involving the use of checklists and timeouts for all staff was implemented. The impact of these and other QA initiatives was analyzed. Results: From 2001 to 2011, a total of 256 errors in 139 patients after 284,810 external radiation treatments (0.09% per treatment) were recorded in our voluntary error database. The incidence of errors related to patient/tumor site, treatment planning/data transfer, and patient setup/treatment delivery was 9%, 40.2%, and 50.8%, respectively. The compliance rate for the checklists and timeouts initiative was 97% (P<.001). These and other QA measures resulted in a significant reduction in many categories of errors. The introduction of checklists and timeouts has been successful in eliminating errors related to wrong patient, wrong site, and wrong dose. Conclusions: A comprehensive QA program that regularly monitors staff compliance together with a robust voluntary error reporting system can reduce or eliminate errors that could result in serious patient injury. We recommend the adoption of these relatively simple QA initiatives including the use of checklists and timeouts for all staff to improve the safety of patients undergoing radiation therapy in the modern era

Improving the composition of voluntary programs in the category of Women in fitness

Directory of Open Access Journals (Sweden)

Iryna Bilenka

2018-04-01

Full Text Available Purpose: to reveal the basic directions of perfection of construction of compositions of voluntary programs in the category of Women in fitness. Material & Methods: judges-experts analyzed the structure and content of voluntary competitive programs of performances of six female athletes'-finalists of the championship of Ukraine on bodybuilding and fitness in 2016. Results: voluntary programs include elements of structural groups of varying complexity: "acrobatic", "choreographic", "strength" and "flexibility"; female athletes with better indicators in the quantitative analysis of competitive compositions received higher grades for performance; the results of athletes for an arbitrary program are directly proportional to the number of complex elements in the composition. Conclusions: in an voluntary program in women's fitness for a competitive result affects the saturation of the program, the variety and complexity of the elements.

Voluntary compliance beyond the letter of the Law : Reciprocity and fair play

NARCIS (Netherlands)

Gribnau, Hans; Peeters, B.; Gribnau, H.; Badisco, J.

2017-01-01

This chapter deals with the obligation to pay taxes. It starts from the idea of voluntary taxation. In ancient Athens, the wealthy had a moral obligation to pay a periodic voluntary contribution (‘liturgy’). They paid for religious festivals and military expeditions which benefited society. This

Residential response to voluntary time-of-use electricity rates

Energy Technology Data Exchange (ETDEWEB)

Mostafa Baladi, S. [Laurits R. Christensen Associates, Inc. Ames, IA 50011-1070 (United States); Herriges, Joseph A. [Iowa State University, 280D Heady Hall, Department of Economics, Iowa State University, Ames, IA 50011-1070 (United States); Sweeney, Thomas J. [MidAmerican Energy, Des Moines, Iowa (United States)

1998-09-01

The response of residential households to voluntary Time-of-Use (TOU) electricity rates is estimated using data from a recent experiment at Midwest Power Systems of Iowa. The study`s design allows us to examine both the participation decision and the customer`s load pattern changes once the TOU rate structure was in effect. Substitution elasticities between on-peak and off-peak electricity usage are estimated and compared to those obtained in earlier mandatory programs, indicating whether program volunteers are more responsive to TOU pricing than the typical household. Attitudinal questionnaires allow us to examine the role of usage perceptions in program participation

[Monitoring evaluation system for high-specialty hospitals].

Science.gov (United States)

Fajardo Dolci, Germán; Aguirre Gas, Héctor G; Robledo Galván, Héctor

2011-01-01

Hospital evaluation is a fundamental process to identify medical units' objective compliance, to analyze efficiency of resource use and allocation, institutional values and mission alignment, patient safety and quality standards, contributions to research and medical education, and the degree of coordination among medical units and the health system as a whole. We propose an evaluation system for highly specialized regional hospitals through the monitoring of performance indicators. The following are established as base thematic elements in the construction of indicators: safe facilities and equipment, financial situation, human resources management, policy management, organizational climate, clinical activity, quality and patient safety, continuity of care, patients' and providers' rights and obligations, teaching, research, social responsibility, coordination mechanisms. Monitoring refers to the planned and systematic evaluation of valid and reliable indicators, aimed at identifying problems and opportunity areas. Moreover, evaluation is a powerful tool to strengthen decision-making and accountability in medical units.

Do Robotic Surgical Systems Improve Profit Margins? A Cross-Sectional Analysis of California Hospitals.

Science.gov (United States)

Shih, Ya-Chen Tina; Shen, Chan; Hu, Jim C

2017-09-01

The aim of this study was to examine the association between ownership of robotic surgical systems and hospital profit margins. This study used hospital annual utilization data, annual financial data, and discharge data for year 2011 from the California Office of Statewide Health Planning and Development. We first performed bivariate analysis to compare mean profit margin by hospital and market characteristics and to examine whether these characteristics differed between hospitals that had one or more robotic surgical systems in 2011 and those that did not. We applied the t test and the F test to compare mean profit margin between two groups and among three or more groups, respectively. We then conducted multilevel logistic regression to determine the association between ownership of robotic surgical systems and having a positive profit margin after controlling for other hospital and market characteristics and accounting for possible correlation among hospitals located within the same market. The study sample included 167 California hospitals with valid financial information. Hospitals with robotic surgical systems tended to report more favorable profit margins. However, multilevel logistic regression showed that this relationship (an association, not causality) became only marginally significant (odds ratio [OR] = 6.2; P = 0.053) after controlling for other hospital characteristics, such as ownership type, teaching status, bed size, and surgical volumes, and market characteristics, such as total number of robotic surgical systems owned by other hospitals in the same market area. As robotic surgical systems become widely disseminated, hospital decision makers should carefully evaluate the financial and clinical implications before making a capital investment in this technology. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

The effects of for-profit multihospital system ownership on hospital financial and operating performance.

Science.gov (United States)

Lynch, J R; McCue, M J

1990-11-01

The financial and operating performance of independent not-for-profit hospitals acquired by US for-profit multi-hospital systems in 10 Southern states between the years 1978 and 1982 was explored. The impact of system ownership on acquired hospitals was investigated by comparing the average financial performance of hospitals in the two years immediately prior to acquisition to the average for 1984 and 1985 and by comparing changes in the performance of acquired hospitals with changes in matched independent facilities. Findings suggest that for-profit multi-hospital systems were able to improve many of the financial and operating problems of acquired facilities. In comparison to independent not-for-profit hospitals, acquired hospitals were found to increase access to long-term debt, make improvements to plant and equipment, improve profitability, and increase efficiency to a greater extent. Prices in acquired hospitals rose more than those in independents and liquidity decreased to a greater extent.

Characterization of hospitalizations due to external causes in the public health system, Brazil, 2011.

Science.gov (United States)

Mascarenhas, Márcio Dênis Medeiros; Barros, Marilisa Berti de Azevedo

2015-01-01

The aim of this work is to describe the characteristics of hospital admissions owing to external causes in the public health system in Brazil in 2011. Data from the Hospital Information System of the Unified Health System (SIH/SUS) were analyzed to obtain the frequency, coefficient of hospitalization, and hospital morbidity indicators. Of the 973,015 admissions, falls (38.4%) predominated, followed by traffic accidents (15.8%). The estimated coefficient of hospitalization owing to external causes increased with the age, and it was higher in male patients and in the midwest region of the country. The average stay was higher in hospitalizations for traffic accidents (6.1 days) and assaults (6.0 days), while the hospital mortality rate reached higher values in hospitalizations for assaults (4.7%) and self-harms (4.0%). It is evident from the knowledge of the characteristics described the usefulness of hospital morbidity data for planning care actions and prevention of the external causes.

Hip orthosis powered by pneumatic artificial muscle: voluntary activation in absence of myoelectrical signal.

Science.gov (United States)

do Nascimento, Breno Gontijo; Vimieiro, Claysson Bruno Santos; Nagem, Danilo Alves Pinto; Pinotti, Marcos

2008-04-01

Powered orthosis is a special class of gait assist device that employs a mechanical or electromechanical actuator to enhance movement of hip, knee, or ankle articulations. Pneumatic artificial muscle (PAM) has been suggested as a pneumatic actuator because its performance is similar to biological muscle. The electromyography (EMG) signal interpretation is the most popular and simplest method to establish the patient voluntary control of the orthosis. However, this technique is not suitable for patients presenting neurological lesions causing absence or very low quality of EMG signal. For those cases, an alternative control strategy should be provided. The aim of the present study is to develop a gait assistance orthosis for lower limb powered by PAMs controlled by a voluntary activation method based on the angular behavior of hip joint. In the present study, an orthosis that has been molded in a patient was employed and, by taking her anthropometric parameters and movement constraints, the adaptation of the existing orthosis to the powered orthosis was planned. A control system was devised allowing voluntary control of a powered orthosis suitable for patients presenting neurological lesions causing absence or very low quality of EMG signal. A pilot clinical study was reported where a patient, victim of poliovirus, successfully tested a hip orthosis especially modified for the gait test evaluation in the parallel bar system. The hip orthosis design and the control circuitry parameters were able to be set to provide satisfactory and comfortable use of the orthosis during the gait cycle.

Knowledge, attitude and practices of people towards voluntary blood donation in Uttarakhand.

Science.gov (United States)

Agrawal, Amit; Tiwari, Aseem K; Ahuja, Alok; Kalra, Rakesh

2013-01-01

Blood transfusions form a crucial and irreplaceable part in the medical management of many diseases. The collection of blood from voluntary, non-remunerated blood donors from low risk populations is an important measure for ensuring the availability and safety of blood transfusion. In a state like Uttarakhand which is visited by lakhs of visitors during pilgrimage season and where natural calamities and accidents are very common, the availability of blood is of utmost importance. To find out knowledge, attitude and practices of people towards voluntary blood donation to comprehend the situation and find ways to enhance voluntary blood donation in the state of Uttarakhand. Multi stage methodology was designed to target population including general population, influencers (doctors) and supporting organizations (camp organizers, State AIDS Control Society Officials) who were subjected to in-depth interview using pre-structured questionnaires to assess knowledge/awareness about voluntary blood donation, factors preventing and source of knowledge about voluntary blood donation. The sample population consisted of mostly men (67%) in the age-group of 26-35 years. Requirement of blood and the measures to promote voluntary blood donation have a direct relationship with the total population and literacy level of the population. Awareness about blood donation, source of knowledge about blood donation, reasons for not donating blood are particularly stressed. With increase in educational level, the awareness level was also found to increase. While among illiterates 81 percent of the respondents knew about blood donation, among the post graduates the same ratio was found to be almost cent-percent. Among various reasons cited for not donating blood, lack of awareness being the most common reason. People gathered information about blood donation from several different sources with electronic media being the most prominent. This study illustrates how increasing awareness and

Knowledge, attitude and practices of people towards voluntary blood donation in Uttarakhand

Directory of Open Access Journals (Sweden)

Amit Agrawal

2013-01-01

Full Text Available Introduction: Blood transfusions form a crucial and irreplaceable part in the medical management of many diseases. The collection of blood from voluntary, non-remunerated blood donors from low risk populations is an important measure for ensuring the availability and safety of blood transfusion. In a state like Uttarakhand which is visited by lakhs of visitors during pilgrimage season and where natural calamities and accidents are very common, the availability of blood is of utmost importance. Aim: To find out knowledge, attitude and practices of people towards voluntary blood donation to comprehend the situation and find ways to enhance voluntary blood donation in the state of Uttarakhand. Materials and Methods: Multi stage methodology was designed to target population including general population, influencers (doctors and supporting organizations (camp organizers, State AIDS Control Society Officials who were subjected to in-depth interview using pre-structured questionnaires to assess knowledge/awareness about voluntary blood donation, factors preventing and source of knowledge about voluntary blood donation. Result: The sample population consisted of mostly men (67% in the age-group of 26-35 years. Requirement of blood and the measures to promote voluntary blood donation have a direct relationship with the total population and literacy level of the population. Awareness about blood donation, source of knowledge about blood donation, reasons for not donating blood are particularly stressed. With increase in educational level, the awareness level was also found to increase. While among illiterates 81 percent of the respondents knew about blood donation, among the post graduates the same ratio was found to be almost cent-percent. Among various reasons cited for not donating blood, lack of awareness being the most common reason. People gathered information about blood donation from several different sources with electronic media being the most

Physician practice management companies: implications for hospital-based integrated delivery systems.

Science.gov (United States)

Burns, L R; Robinson, J C

1997-01-01

Physician practice management companies (PPMCs) are one of the most visible entrants into the industry of managing physician practices, and anywhere from 100-150 are already in operation. Although PPMCs and hospital-based integrated delivery systems (IDSs) differ from each other in many ways, they share a number of common features, including the pursuit of capitation contracts from payors. As a result, PPMCs pose a growing, direct threat to hospital systems in competing for managed care contracts that cover physician service. PPMCs also provide an alternative to hospital-based IDSs at the local market level for physician group consolidation. This article looks at the structure, operation, and strategy of PPMCs and examines what implications their growth will have for hospital-based IDSs.

Opportunities and criticisms of voluntary emission reduction projects developed by Public Administrations: Analysis of 143 case studies implemented in Italy

International Nuclear Information System (INIS)

Gallo, Michela; Del Borghi, Adriana; Strazza, Carlo; Parodi, Lara; Arcioni, Livia; Proietti, Stefania

2016-01-01

Highlights: • 143 voluntary emission reduction projects have been analysed. • The projects belong to renewable energy, energy efficiency and transport sectors. • Voluntary emission reduction standards and methodologies have been applied. • The paper identified the main criticisms for each sector. • Energy efficiency projects are the most promising for public entities. - Abstract: The United Nations Framework Convention on Climate Change (UNFCCC) sets an overall framework for intergovernmental efforts to tackle the challenge posed by climate change. Besides the “flexibility mechanisms” defined by the Kyoto Protocol to lower the overall costs of achieving their emissions targets, The Voluntary Green House Gases (GHG) reduction projects can have a lead role in GHG reduction in “non Emissions Trading System ETS sectors”. Nowadays, the voluntary market is characterised by critical aspects, such as fragmentation, lack of accounting, monitoring and validation rules that have led to the low spread of voluntary emission reduction projects developed by local authorities in the European Union despite their high potentiality. The aim of this paper is to test the applicability of voluntary emission reduction projects in the public sector following a homogeneous and consistent pattern. A research has been performed at local level on 143 voluntary emission reduction projects implemented by Public Administrations in Northern and Central Italy in renewable energy, energy efficiency and transport sectors. The applicable standards and methodologies have been checked and the case studies have been analysed though a three-step process: Preliminary additionality assessment; Projects selection; Validation of the selected project. The assessment shows that energy efficiency projects, once overcoming additionality issues, are the most promising for public entities while renewable energy and transport projects resulted to be mainly affected by double counting problems and

The effect of health insurance and health facility-upgrades on hospital deliveries in rural Nigeria: a controlled interrupted time-series study.

Science.gov (United States)

Brals, Daniëlla; Aderibigbe, Sunday A; Wit, Ferdinand W; van Ophem, Johannes C M; van der List, Marijn; Osagbemi, Gordon K; Hendriks, Marleen E; Akande, Tanimola M; Boele van Hensbroek, Michael; Schultsz, Constance

2017-09-01

Access to quality obstetric care is considered essential to reducing maternal and new-born mortality. We evaluated the effect of the introduction of a multifaceted voluntary health insurance programme on hospital deliveries in rural Nigeria. We used an interrupted time-series design, including a control group. The intervention consisted of providing voluntary health insurance covering primary and secondary healthcare, including antenatal and obstetric care, combined with improving the quality of healthcare facilities. We compared changes in hospital deliveries from 1 May 2005 to 30 April 2013 between the programme area and control area in a difference-in-differences analysis with multiple time periods, adjusting for observed confounders. Data were collected through household surveys. Eligible households ( n = 1500) were selected from a stratified probability sample of enumeration areas. All deliveries during the 4-year baseline period ( n = 460) and 4-year follow-up period ( n = 380) were included. Insurance coverage increased from 0% before the insurance was introduced to 70.2% in April 2013 in the programme area. In the control area insurance coverage remained 0% between May 2005 and April 2013. Although hospital deliveries followed a common stable trend over the 4 pre-programme years ( P = 0.89), the increase in hospital deliveries during the 4-year follow-up period in the programme area was 29.3 percentage points (95% CI: 16.1 to 42.6; P health insurance but who could make use of the upgraded care delivered significantly more often in a hospital during the follow-up period than women living in the control area ( P = 0.04). Voluntary health insurance combined with quality healthcare services is highly effective in increasing hospital deliveries in rural Nigeria, by improving access to healthcare for insured and uninsured women in the programme area. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and

Study on the standardization of hospital information system for medical image information sharing

International Nuclear Information System (INIS)

Kim, Seon Chil; Kwon, Su Ja

2001-01-01

As the adoption of PACS and hospital information system among university hospitals and hospital level institutions grows bigger, the need of sharing and transferring medical information among medical institutions is rising. For the medical information, which is saved in the hospital medical system, to be transferred within the same hospital, domestic, or foreign medical institutions, a standard protocol is necessary. But realistically, most of the domestic hospitals do not abide by H7L which is the HIS standard and so, information transferring is not possible as of present. As such, the purpose of this research is to implement the information between HIS and PACS to an international standard by constructing HL7 messages through HL7 Interface, which will eventually make possible information transferring between different hospitals. Our research team has developed a method which will make the PACS equip hospitals that do not follow HL7 standard which will make possible to transfer information between HIS and PACS through HL7 Message. By constructing message files, which follow the form of HL7 Message in the HL7 Interface, they can be transferred to PACS through the ftp protocol. The realization of the HIS/OCS Interface through HL7 enables data transferring between domestic and foreign medical institutions possible by implementing the international standard in the PACS and HIS data transferring process. The HL7 that our research team has developed made patient data transfer between medical institutions possible. The Interface is for a specific system model and in order for the data transfer between different systems to be realized, interfaces that are fit for each system must be needed. If the Interface is improvised and implemented to each hospital's information system, the data sharing among medical institutions can be broadened

A Hospital Nursing Adverse Events Reporting System Project: An Approach Based on the Systems Development Life Cycle.

Science.gov (United States)

Cao, Yingjuan; Ball, Marion

2017-01-01

Based on the System Development Life Cycle, a hospital based nursing adverse event reporting system was developed and implemented which integrated with the current Hospital Information System (HIS). Besides the potitive outcomes in terms of timeliness and efficiency, this approach has brought an enormous change in how the nurses report, analyze and respond to the adverse events.

From Voluntary Collective Action to Organized Collaboration?

DEFF Research Database (Denmark)

Hattke, Fabian; Blaschke, Steffen; Frost, Jetta

2016-01-01

Our study examines the relationship between voluntary collective action, organized collaboration, and the provision of public goods in pluralistic organizations. Using German higher education as a context, we investigate whether specialized central support structures contribute to performance...

Contemplated Suicide Among Voluntary and Involuntary Retirees

Science.gov (United States)

Peretti, Peter O.; Wilson, Cedric

1978-01-01

This study explored anomic and egoistic dimensions of contemplated suicide among voluntary and involuntary retired males. Results indicated a direct relationship between anomie and egoism on the one hand, and contemplation of suicide on the other. (Author)

HOSPITAL KANBAN SYSTEM IMPLEMENTATION: EVALUATING SATISFACTION OF NURSING PERSONNEL

Directory of Open Access Journals (Sweden)

Aguilar-Escobar, Víctor G.

2015-09-01

Full Text Available Literature on healthcare supply chain management has shown that the kanban system can provide significant benefits. However, very few benefits have been empirically demonstrated and the extent of each remains unknown. This study aims to measure nurses’ satisfaction with kanban systems in logistics of medical consumables and assesses possible advantages and differences among user groups through an anonymous survey at Hospital Universitario Virgen Macarena of Seville, Spain. Treatment of responses included an exploratory factor analysis, and a CAPTCA analysis. The results showed a high level of satisfaction for each aspect of the kanban system. Moreover, it highlighted the differences of opinion between groups of individuals according to workplace, nursing units, job category, seniority, age and kanban training. The exploratory factor analysis revealed that two factors underlie the collected assessments: the inherent advantages of a kanban system, and the logistics system performance as a whole. Thus, hospital managers should promote the implementation of kanban systems, since it increases nurses’ satisfaction and provides significant benefits.

Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Short Inpatient Hospital Stays; Transition for Certain Medicare-Dependent, Small Rural Hospitals Under the Hospital Inpatient Prospective Payment System; Provider Administrative Appeals and Judicial Review. Final rule with comment period; final rule.

Science.gov (United States)

2015-11-13

This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2016 to implement applicable statutory requirements and changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. In addition, this final rule with comment period updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program. Further, this document includes certain finalized policies relating to the hospital inpatient prospective payment system: Changes to the 2-midnight rule under the short inpatient hospital stay policy; and a payment transition for hospitals that lost their status as a Medicare-dependent, small rural hospital (MDH) because they are no longer in a rural area due to the implementation of the new Office of Management and Budget delineations in FY 2015 and have not reclassified from urban to rural before January 1, 2016. In addition, this document contains a final rule that finalizes certain 2015 proposals, and addresses public comments received, relating to the changes in the Medicare regulations governing provider administrative appeals and judicial review relating to appropriate claims in provider cost reports.

Three-tiered integration of PACS and HIS toward next generation total hospital information system.

Science.gov (United States)

Kim, J H; Lee, D H; Choi, J W; Cho, H I; Kang, H S; Yeon, K M; Han, M C

1998-01-01

The Seoul National University Hospital (SNUH) started a project to innovate the hospital information facilities. This project includes installation of high speed hospital network, development of new HIS, OCS (order communication system), RIS and PACS. This project aims at the implementation of the first total hospital information system by seamlessly integrating these systems together. To achieve this goal, we took three-tiered systems integration approach: network level, database level, and workstation level integration. There are 3 loops of networks in SNUH: proprietary star network for host computer based HIS, Ethernet based hospital LAN for OCS and RIS, and ATM based network for PACS. They are linked together at the backbone level to allow high speed communication between these systems. We have developed special communication modules for each system that allow data interchange between different databases and computer platforms. We have also developed an integrated workstation in which both the OCS and PACS application programs run on a single computer in an integrated manner allowing the clinical users to access and display radiological images as well as textual clinical information within a single user environment. A study is in progress toward a total hospital information system in SNUH by seamlessly integrating the main hospital information resources such as HIS, OCS, and PACS. With the three-tiered systems integration approach, we could successfully integrate the systems from the network level to the user application level.

The Use of Hospital Information Systems Data Base with Word Processing and Other Medical Records System Applications

OpenAIRE

Rusnak, James E.

1982-01-01

The approach frequently used to introduce computer technology into a hospital Medical Records Department is to implement a Word Processing System. Word processing is a form of computer system application that is intended to improve the department's productivity by improving the medical information transcription process. The effectiveness of the Word Processing System may be further enhanced by installing system facilities to provide access to data processing file information in the Hospital's...

Intra-hospital use of a telepathology system.

Science.gov (United States)

Ongürü, O; Celasun, B

2000-01-01

Utilization of telepathology systems to cover distant geographical areas has increased recently. However, the potential usefulness of similar systems for closer distances does not seem to be widely appreciated. In this study, we present data on the use of a simple telepathology system connecting the pathology department and the intra-operative consultation room within the operating theaters of the hospital. Ninety-eight frozen section cases from a past period have been re-evaluated using a real-time setup. Forty-eight of the cases have been re-evaluated in the customary fashion; allowing both ends to communicate and cooperate freely. Fifty of the cases, however, were evaluated by the consultant while the operating room end behaved like a robot; moving the stage of the microscope, changing and focusing the objectives. The deferral rate was lower than the original frozen section evaluations. Overall, the sensitivity was 100%, specificity 98%, negative predictive value 96, 5% and positive predictive value 100%. No significant difference was found for the diagnostic performances between the cooperative and robotic simulation methods.Our results strengthen the belief that telepathology is a valuable tool in offering pathology services to remote areas. The far side of a hospital building can also be a remote area and a low cost system can be helpful for intraoperative consultations. Educational value of such a system is also commendable.

A Comprehensive Program to Reduce Rates of Hospital-Acquired Pressure Ulcers in a System of Community Hospitals.

Science.gov (United States)

Englebright, Jane; Westcott, Ruth; McManus, Kathryn; Kleja, Kacie; Helm, Colleen; Korwek, Kimberly M; Perlin, Jonathan B

2018-03-01

The prevention of hospital-acquired pressure ulcers (PrUs) has significant consequences for patient outcomes and the cost of care. Providers are challenged with evaluating available evidence and best practices, then implementing programs and motivating change in various facility environments. In a large system of community hospitals, the Reducing Hospital Acquired-PrUs Program was developed to provide a toolkit of best practices, timely and appropriate data for focusing efforts, and continuous implementation support. Baseline data on PrU rates helped focus efforts on the most vulnerable patients and care situations. Facilities were empowered to use and adapt available resources to meet local needs and to share best practices for implementation across the system. Outcomes were measured by the rate of hospital-acquired PrUs, as gathered from patient discharge records. The rate of hospital-acquired stage III and IV PrUs decreased 66.3% between 2011 and 2013. Of the 149 participating facilities, 40 (27%) had zero hospital-acquired stage III and IV PrUs and 77 (52%) had a reduction in their PrU rate. Rates of all PrUs documented as present on admission did not change during this period. A comparison of different strategies used by the most successful facilities illustrated the necessity of facility-level flexibility and recognition of local workflows and patient demographics. Driven by the combination of a repository of evidence-based tools and best practices, readily available data on PrU rates, and local flexibility with processes, the Reducing Hospital Acquired-PrUs Program represents the successful operationalization of improvement in a wide variety of facilities.

VOLUNTARY INTEREST ARBITRATION IN THE ETHIOPIAN ...

African Journals Online (AJOL)

*Birhanu is currently working as the Manager of the Legal Research and Advisory Division ... forth voluntary interest arbitration to the attention of lawyers, employees, .... being selective is a poor design since the basic rules of this law are not .... courts to review interest arbitrators decision on the merit by way of appeal.

Patient, hospital, and local health system characteristics associated with the use of observation stays in veterans health administration hospitals, 2005 to 2012.

Science.gov (United States)

Wright, Brad; OʼShea, Amy M J; Glasgow, Justin M; Ayyagari, Padmaja; Vaughan-Sarrazin, Mary

2016-09-01

Recent studies have documented that a significant increase in the use of observation stays along with extensive variation in patterns of use across hospitals.The objective of this longitudinal observational study was to examine the extent to which patient, hospital, and local health system characteristics explain variation in observation stay rates across Veterans Health Administration (VHA) hospitals.Our data came from years 2005 to 2012 of the nationwide VHA Medical SAS inpatient and enrollment files, American Hospital Association Survey, and Area Health Resource File. We used these data to estimate linear regression models of hospitals' observation stay rates as a function of hospital, patient, and local health system characteristics, while controlling for time trends and Veterans Integrated Service Network level fixed effects.We found that observation stay rates are inversely related to hospital bed size and that hospitals with a greater proportion of younger or rural patients have higher observation stay rates. Observation stay rates were nearly 15 percentage points higher in 2012 than 2005.Although we identify several characteristics associated with variation in VHA hospital observation stay rates, many factors remain unmeasured.

The growth of corporate private hospitals in Malaysia: policy contradictions in health system pluralism.

Science.gov (United States)

Barraclough, S

1997-01-01

The rapid growth of corporate investment in the Malaysian private hospital sector has had a considerable impact on the health care system. Sustained economic growth, the development of new urban areas, an enlarged middle class, and the inclusion of hospital insurance in salary packages have all contributed to a financially lucrative investment environment for hospital entrepreneurs. Many of Malaysia's most technologically advanced hospitals employing leading specialists are owned and operated as corporate business ventures. Corporate hospital investment has been actively encouraged by the government, which regards an expanded private sector as a vital complement to the public hospital system. Yet this rapid growth of corporately owned private hospitals has posed serious contradictions for health care policy in terms of issues such as equity, cost and quality, the effect on the wider health system, and the very role of the state in health care provision. This article describes the growth of corporate investment in Malaysia's private hospital sector and explores some of the attendant policy contradictions.

Partial phenotyping in voluntary blood donors of Gujarat State

Directory of Open Access Journals (Sweden)

Maitrey Gajjar

2016-01-01

Full Text Available Introduction: Partial phenotyping of voluntary blood donors has vital role in transfusion practice, population genetic study and in resolving legal issues.The Rh blood group is one of the most complex and highly immunogenic blood group known in humans. The Kell system, discovered in 1946, is the third most potent system at triggering hemolytic transfusion reactions and consists of 25 highly immunogenic antigens. Knowledge of Rh & Kell phenotypes in given population is relevant for better planning and management of blood bank; the main goal is to find compatible blood for patients needing multiple blood transfusions. The aim of this study was to evaluate the frequency of Rh & Kell phenotype of voluntary donors in Gujarat state. Materials and Methods: The present study was conducted by taking 5670 samples from random voluntary blood donors coming in blood donation camp. Written consent was taken for donor phenotyping. The antigen typing of donors was performed by Qwalys-3(manufacturer: Diagast by using electromagnetic technology on Duolys plates. Results: Out of 5670 donors, the most common Rh antigen observed in the study population was e (99.07% followed by D (95.40%, C (88.77%, c (55.89% and E (17.88%. The frequency of the Kell antigen (K was 1.78 %. Discussion: The antigen frequencies among blood donors from Gujarat were compared with those published for other Indian populations. The frequency of D antigen in our study (95.4% and north Indian donors (93.6 was significantly higher than in the Caucasians (85% and lower than in the Chinese (99%. The frequencies of C, c and E antigens were dissimilar to other ethnic groups while the ′e′ antigen was present in high frequency in our study as also in the other ethnic groups. Kell antigen (K was found in only 101 (1.78 % donors out of 5670. Frequency of Kell antigen in Caucasian and Black populations is 9% & 2% respectively. The most common Kell phenotype was K-k+, not just in Indians (96.5% but

The relationship between social capital and quality management systems in European hospitals: a quantitative study.

Science.gov (United States)

Hammer, Antje; Arah, Onyebuchi A; Dersarkissian, Maral; Thompson, Caroline A; Mannion, Russell; Wagner, Cordula; Ommen, Oliver; Sunol, Rosa; Pfaff, Holger

2013-01-01

Strategic leadership is an important organizational capability and is essential for quality improvement in hospital settings. Furthermore, the quality of leadership depends crucially on a common set of shared values and mutual trust between hospital management board members. According to the concept of social capital, these are essential requirements for successful cooperation and coordination within groups. We assume that social capital within hospital management boards is an important factor in the development of effective organizational systems for overseeing health care quality. We hypothesized that the degree of social capital within the hospital management board is associated with the effectiveness and maturity of the quality management system in European hospitals. We used a mixed-method approach to data collection and measurement in 188 hospitals in 7 European countries. For this analysis, we used responses from hospital managers. To test our hypothesis, we conducted a multilevel linear regression analysis of the association between social capital and the quality management system score at the hospital level, controlling for hospital ownership, teaching status, number of beds, number of board members, organizational culture, and country clustering. The average social capital score within a hospital management board was 3.3 (standard deviation: 0.5; range: 1-4) and the average hospital score for the quality management index was 19.2 (standard deviation: 4.5; range: 0-27). Higher social capital was associated with higher quality management system scores (regression coefficient: 1.41; standard error: 0.64, p=0.029). The results suggest that a higher degree of social capital exists in hospitals that exhibit higher maturity in their quality management systems. Although uncontrolled confounding and reverse causation cannot be completely ruled out, our new findings, along with the results of previous research, could have important implications for the work of

76 FR 71345 - Patient Safety Organizations: Voluntary Relinquishment From Emergency Medicine Patient Safety...

Science.gov (United States)

2011-11-17

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations: Voluntary Relinquishment From Emergency Medicine Patient Safety Foundation AGENCY: Agency for... notification of voluntary relinquishment from Emergency Medicine Patient Safety Foundation of its status as a...

Taxation as metaphor. The hospital and public responsibility.

Science.gov (United States)

Friedman, E

1992-01-01

In the debate over the tax status of voluntary hospitals, most hospital executives and trustees do not seem to comprehend--or want to comprehend--the underlying issues. First, the terror of being associated with a tax hike has led many politicians to seek other "revenue enhancements" that are more ingenious than they are honest. On the other hand, many of these governments have legitimate financial problems and are seeking new sources of revenue. A second, related issue is uncertainty over what should be done about the uninsured and Medicaid populations. In the absence of an acceptable solution, we will continue to provide direct public support to public hospitals and indirect public support to private providers--including charitable tax exemptions. The third underlying issue is hospitals' curiously narrow view of their private-sector status. Most of the functions hospitals provide are not only publicly funded; they are, in fact, public functions. Finally, hospitals believe they are inherently moral organizations because they provide an inherently moral service. But hospitals grew to their present role in society almost by accident; their services are neither unique nor ethically superior. It is in how hospitals provide care that their morality can be measured, not in the fact that they provide some kind of care to somebody. An honest appraisal of these issues will help each hospital answer the basic question: As an ethical and moral matter, should this organization be paying taxes? But is this fight really about taxes? I believe society and government are using taxation as a metaphor for trust in hospitals.

Frequency of legionella contamination in conditional & water distribution systems of Tehran hospitals

Directory of Open Access Journals (Sweden)

Davod Esmaieli

2008-09-01

Full Text Available Background: Legionella species are ubiquitous in natural aquatic environments, capable of existing in waters with varied temperatures, PH levels, and nutrient and oxygen contents. Of 49 known legionella species, 20 species have been linked to pneumonia in humans. Contamination by legionella has occurred in the distribution systems of many hospitals. Aerosol-generating systems such as faucets, showerheads, cooling towers, and nebulizers are responsible for their transmission from water to air. Methods: A total of 113 water samples were gathered from different wards of 32 hospitals in different geographical regions of Tehran city. These samples were concentrated by filtration, treated with the acid and temperature buffers, and isolated on a BCYE agar culture medium. Results: A total of 22 hospitals out of 33 (26.5% were contaminated by legionella species, and 30 samples (26.5% out of 113 were positive. Chlorine concentration and pH level of the water samples were 0.18-2.2 mg/l and 6.6-7.6, respectively. Conclusion: The high rate of waste water contamination in Tehran hospitals with Legionella indicates the resistance of this microorganism to chlorine and other disinfectants, or inadequate disinfection process, representing the insufficiency of the current decontamination of hospital water distribution system. Thus identifying legionella species and their controlling in water distribution system of hospitals is of great importance.

A Comprehensive Evaluation System for Military Hospitals' Response Capability to Bio-terrorism.

Science.gov (United States)

Wang, Hui; Jiang, Nan; Shao, Sicong; Zheng, Tao; Sun, Jianzhong

2015-05-01

The objective of this study is to establish a comprehensive evaluation system for military hospitals' response capacity to bio-terrorism. Literature research and Delphi method were utilized to establish the comprehensive evaluation system for military hospitals' response capacity to bio-terrorism. Questionnaires were designed and used to survey the status quo of 134 military hospitals' response capability to bio-terrorism. Survey indicated that factor analysis method was suitable to for analyzing the comprehensive evaluation system for military hospitals' response capacity to bio-terrorism. The constructed evaluation system was consisted of five first-class and 16 second-class indexes. Among them, medical response factor was considered as the most important factor with weight coefficient of 0.660, followed in turn by the emergency management factor with weight coefficient of 0.109, emergency management consciousness factor with weight coefficient of 0.093, hardware support factor with weight coefficient of 0.078, and improvement factor with weight coefficient of 0.059. The constructed comprehensive assessment model and system are scientific and practical.

Determinants and features of voluntary disclosure in the Chinese stock market

Directory of Open Access Journals (Sweden)

Yang Lan

2013-12-01

Full Text Available This paper offers in-depth analysis of the determinants and features of voluntary disclosure based on information in the annual reports of 1066 Chinese firms listed on the Shanghai and Shenzhen Stock Exchanges. This extensive sample represents about 80% of all public companies in China. Our findings suggest that voluntary disclosure in China is positively related to firm size, leverage, assets-in-place, and return on equity and is negatively related to auditor type and the level of maturity or sophistication of the intermediary and legal environments. We also find some evidence to suggest a quadratic convex association between state ownership and voluntary disclosure. However, our analysis provides no evidence that extensive disclosure benefits public companies in China in the form of a lower cost of equity.

Workarounds to hospital electronic prescribing systems: a qualitative study in English hospitals.

Science.gov (United States)

Cresswell, Kathrin M; Mozaffar, Hajar; Lee, Lisa; Williams, Robin; Sheikh, Aziz

2017-07-01

Concerns with the usability of electronic prescribing (ePrescribing) systems can lead to the development of workarounds by users. To investigate the types of workarounds users employed, the underlying reasons offered and implications for care provision and patient safety. We collected a large qualitative data set, comprising interviews, observations and project documents, as part of an evaluation of ePrescribing systems in five English hospitals, which we conceptualised as case studies. Data were collected at up to three different time points throughout implementation and adoption. Thematic analysis involving deductive and inductive approaches was facilitated by NVivo 10. Our data set consisted of 173 interviews, 24 rounds of observation and 17 documents. Participating hospitals were at various stages of implementing a range of systems with differing functionalities. We identified two types of workarounds: informal and formal. The former were informal practices employed by users not approved by management, which were introduced because of perceived changes to professional roles, issues with system usability and performance and challenges relating to the inaccessibility of hardware. The latter were formalised practices that were promoted by management and occurred when systems posed threats to patient safety and organisational functioning. Both types of workarounds involved using paper and other software systems as intermediaries, which often created new risks relating to a lack of efficient transfer of real-time information between different users. Assessing formal and informal workarounds employed by users should be part of routine organisational implementation strategies of major health information technology initiatives. Workarounds can create new risks and present new opportunities for improvement in system design and integration. 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/.

Reliability Electrical Power System of Hospital as Cold Standby System

Directory of Open Access Journals (Sweden)

Grabski Franciszek

2016-07-01

Full Text Available The probabilistic model of a hospital electrical power system consisting of mains, an emergency power system and the automatic transfer switch with the generator starter are discussed in this paper. The reliability model is semi-Markov process describing two different units renewable cold standby system and switch. The embedded Semi-Markov processes concept is applied for description of the system evolution. Time to failure of the system is represented by a random variable denoting the first passage time of the process from the given state to the subset of states. The appropriate theorems of the Semi-Markov processes theory allow us to evaluate the reliability function and some reliability characteristics.

Reorganization of a hospital catering system increases food intake in patients with inadequate intake

DEFF Research Database (Denmark)

Freil, M.; Nielsen, M. A.; Biltz, C.

2006-01-01

Background: Low food intake is a frequent problem in undernourished hospital patients. Objective: To study whether a reorganization of a hospital catering system enabling patients to choose their evening meal individually, in combination with an increase in the energy density of the food, increases......: Reorganization of a hospital catering system can increase energy and protein intake and reduce waste substantially. Keywords: hospital food; nutritional risk; undernutrition...

The Emotional Response to Everyday Involuntary and Voluntary Memories in Dysphoria and Non-Dysphoria

DEFF Research Database (Denmark)

del Palacio Gonzalez, Adriana; Watson, Lynn; Berntsen, Dorthe

Retrieving personal memories may cause emotional reactions and thus a need for emotion regulation. Past research indicates that involuntary memories have a greater effect on mood that the voluntary counterparts. However, different dimensions of the emotional response (i.e., intensity and regulation...... regulation strategies in response to both involuntary and voluntary memories. The between-group differences were not accounted for by the individuals’ mood preceding memory retrieval or the valence of the remembered events. The results suggest an important effect of retrieval mode in the emotion regulation......) upon retrieval of both involuntary and voluntary personal memories have not been thoroughly examined. We examined individuals’ emotional intensity and regulation of everyday involuntary and voluntary memories during dysphoria and non-depression. Twenty dysphoric individuals and 23 non...

Hospital information system: reusability, designing, modelling, recommendations for implementing.

Science.gov (United States)

Huet, B

1998-01-01

The aims of this paper are to precise some essential conditions for building reuse models for hospital information systems (HIS) and to present an application for hospital clinical laboratories. Reusability is a general trend in software, however reuse can involve a more or less part of design, classes, programs; consequently, a project involving reusability must be precisely defined. In the introduction it is seen trends in software, the stakes of reuse models for HIS and the special use case constituted with a HIS. The main three parts of this paper are: 1) Designing a reuse model (which objects are common to several information systems?) 2) A reuse model for hospital clinical laboratories (a genspec object model is presented for all laboratories: biochemistry, bacteriology, parasitology, pharmacology, ...) 3) Recommendations for generating plug-compatible software components (a reuse model can be implemented as a framework, concrete factors that increase reusability are presented). In conclusion reusability is a subtle exercise of which project must be previously and carefully defined.

Voluntary activation of the sympathetic nervous system and attenuation of the innate immune response in humans.

Science.gov (United States)

Kox, Matthijs; van Eijk, Lucas T; Zwaag, Jelle; van den Wildenberg, Joanne; Sweep, Fred C G J; van der Hoeven, Johannes G; Pickkers, Peter

2014-05-20

Excessive or persistent proinflammatory cytokine production plays a central role in autoimmune diseases. Acute activation of the sympathetic nervous system attenuates the innate immune response. However, both the autonomic nervous system and innate immune system are regarded as systems that cannot be voluntarily influenced. Herein, we evaluated the effects of a training program on the autonomic nervous system and innate immune response. Healthy volunteers were randomized to either the intervention (n = 12) or control group (n = 12). Subjects in the intervention group were trained for 10 d in meditation (third eye meditation), breathing techniques (i.a., cyclic hyperventilation followed by breath retention), and exposure to cold (i.a., immersions in ice cold water). The control group was not trained. Subsequently, all subjects underwent experimental endotoxemia (i.v. administration of 2 ng/kg Escherichia coli endotoxin). In the intervention group, practicing the learned techniques resulted in intermittent respiratory alkalosis and hypoxia resulting in profoundly increased plasma epinephrine levels. In the intervention group, plasma levels of the anti-inflammatory cytokine IL-10 increased more rapidly after endotoxin administration, correlated strongly with preceding epinephrine levels, and were higher. Levels of proinflammatory mediators TNF-α, IL-6, and IL-8 were lower in the intervention group and correlated negatively with IL-10 levels. Finally, flu-like symptoms were lower in the intervention group. In conclusion, we demonstrate that voluntary activation of the sympathetic nervous system results in epinephrine release and subsequent suppression of the innate immune response in humans in vivo. These results could have important implications for the treatment of conditions associated with excessive or persistent inflammation, such as autoimmune diseases.

Use of Nutrition Standards to Improve Nutritional Quality of Hospital Patient Meals: Findings from New York City's Healthy Hospital Food Initiative.

Science.gov (United States)

Moran, Alyssa; Lederer, Ashley; Johnson Curtis, Christine

2015-11-01

Most hospital patient meals are considered regular-diet meals; these meals are not required to meet comprehensive nutrition standards for a healthy diet. Although programs exist to improve nutrition in hospital food, the focus is on retail settings such as vending machines and cafeterias vs patient meals. New York City's Healthy Hospital Food Initiative (HHFI) provides nutrition standards for regular-diet meals that hospitals can adopt, in addition to retail standards. This study was undertaken to describe regular-diet patient menus before and after implementation of the HHFI nutrition standards. The study involved pre- and post- menu change analyses of hospitals participating in the HHFI between 2010 and 2014. Eight New York City hospitals, selected based on voluntary participation in the HHFI, were included in the analyses. Nutritional content of regular-diet menus were compared with the HHFI nutrition standards. Nutrient analysis and exact Wilcoxon signed-rank tests were used for the analysis of the data. At baseline, no regular-diet menu met all HHFI standards, and most exceeded the daily limits for percentage of calories from fat (n=5), percentage of calories from saturated fat (n=5), and milligrams of sodium (n=6), and they did not meet the minimum grams of fiber (n=7). Hospitals met all key nutrient standards after implementation, increasing fiber (25%, Pfood service operations, indicating feasibility of this framework in a range of hospital settings. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Job characteristics and voluntary mobility in The Netherlands: Differential education and gender patterns?

NARCIS (Netherlands)

Gesthuizen, M.J.W.

2009-01-01

Purpose - The purpose of this paper is to address the impact of the subjective evaluation of job characteristics on voluntary mobility, the impact of voluntary mobility on changes in these job characteristics, and differential education and gender patterns. Design/methodology/approach - Ordered and

[Hospitalizations for ambulatory care-sensitive conditions: validation study at a Hospital Information System (SIH) in the Federal District, Brazil, in 2012].

Science.gov (United States)

Cavalcante, Danyelle Monteiro; de Oliveira, Maria Regina Fernandes; Rehem, Tânia Cristina Morais Santa Bárbara

2016-03-01

This study analyzes hospitalizations due to ambulatory care-sensitive conditions with a focus on infectious and parasitic diseases (IPDs) and validates the Hospital Information System, Brazilian Unified National Health System (SIH/SUS) for recording hospitalizations due to ambulatory care-sensitive conditions in a hospital in the Federal District, Brazil, in 2012. The study estimates the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the SIH for recording hospitalizations due to ambulatory care-sensitive conditions, with the patient's medical file as the gold standard. There were 1,604 hospitalizations for hospitalizations due to ambulatory care-sensitive conditions (19.6%, 95%CI: 18.7-20.5), and the leading IPDs were renal and urinary tract infection, infection of the skin and subcutaneous tissue, and infectious gastroenteritis. IPDs were the leading cause of hospitalization in the 20 to 29-year age bracket and caused 28 deaths. Sensitivity was 70.1% (95%CI: 60.5-79.7), specificity 88.4% (95%CI: 85.6-91.2), PPV = 51.7% (95%CI: 42.7-60.7), and NPV = 94.3% (95%CI: 92.2-96.4). The findings for admissions due to ACSCs in this hospital were similar to those of other studies, featuring admissions for IPDs. The SIH/SUS database was more specific than sensitive.

45 CFR 33.8 - Voluntary repayment agreement in lieu of salary offset.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Voluntary repayment agreement in lieu of salary... SALARY OFFSET § 33.8 Voluntary repayment agreement in lieu of salary offset. (a)(1) In response to the... notice of intent to offset. An employee who wishes to repay the debt without salary offset shall also...

A Qualitative Study into Dependent Relationships and Voluntary Informed Consent for Research in Pediatric Oncology.

Science.gov (United States)

Dekking, Sara A S; van der Graaf, Rieke; Schouten-van Meeteren, Antoinette Y N; Kars, Marijke C; van Delden, Johannes J M

2016-04-01

In pediatric oncology, many oncologists invite their own patients to participate in research. Inclusion within a dependent relationship is considered to potentially compromise voluntariness of consent. Currently, it is unknown to what extent those involved in pediatric oncology experience the dependent relationship as a threat to voluntary informed consent, and what they see as safeguards to protect voluntary informed consent within a dependent relationship. We performed a qualitative study among key actors in pediatric oncology to explore their experiences with the dependent relationship and voluntary informed consent. We conducted three focus groups and 25 semi-structured, in-depth interviews with pediatric oncologists, research coordinators, Research Ethics Committee members, parents of children with cancer, and adolescents with cancer. Professionals regarded the dependent relationship both as a potential threat to and as a positive influence on voluntary decision making. Parents and adolescents did not feel as though dependency upon the oncologist influenced their decisions. They valued the involvement of their own physician in the informed consent process. The professionals suggested three strategies to protect voluntariness: emphasizing voluntariness; empowering families; involvement of an independent person. Although the dependent relationship between pediatric oncologists, patients and parents may be problematic for voluntary informed consent, this is not necessarily the case. Moreover, the involvement of treating physicians may even have a positive impact on the informed consent process. Although we studied pediatric oncology, our results may also apply to many other fields of pediatric medicine where research and care are combined, for example, pediatric rheumatology, neurology and nephrology. Clinical trials in these fields are inevitably often designed, initiated and conducted by medical specialists closely involved in patient care.

Voluntary Work: Between Citizenship and Ideology

Directory of Open Access Journals (Sweden)

Luís Barreiro Carballal

2009-01-01

Full Text Available The purpose of this study is to analyze the appearance of a series of new political subjects in democratic society at the change of the millennium, political subjects that the author considers of substantial importance in the realm of Constitutional Law. These include National Law 6/1996 concerning voluntary work, the variety of laws concerning voluntary work and finally the Organic Law, which regulates the Right to Association of March 7 2002. These are all clear examples of the recent and intense interest by the part of the administration in colonizing this until recently ignored territory. In Spain, it has been curious to note how the protagonists have changed in the debate about political participation. In the 1970s, it was seen that only parties and unions could transform society. In the 1980s, the new social movements were the only voices capable of correcting savage capitalism. Since the 1990s, only volunteers are understood to be capable of offering a bit of hope to the cloudy realm of social and political participation.

The Crowding-Out Effects of Garbage Fees and Voluntary Source Separation Programs on Waste Reduction: Evidence from China

Directory of Open Access Journals (Sweden)

Hongyun Han

2016-07-01

Full Text Available This paper examines how and to what degree government policies of garbage fees and voluntary source separation programs, with free indoor containers and garbage bags, can affect the effectiveness of municipal solid waste (MSW management, in the sense of achieving a desirable reduction of per capita MSW generation. Based on city-level panel data for years 1998–2012 in China, our empirical analysis indicates that per capita MSW generated is increasing with per capita disposable income, average household size, education levels of households, and the lagged per capita MSW. While both garbage fees and source separation programs have separately led to reductions in per capita waste generation, the interaction of the two policies has resulted in an increase in per capita waste generation due to the following crowding-out effects: Firstly, the positive effect of income dominates the negative effect of the garbage fee. Secondly, there are crowding-out effects of mandatory charging system and the subsidized voluntary source separation on per capita MSW generation. Thirdly, small subsidies and tax punishments have reduced the intrinsic motivation for voluntary source separation of MSW. Thus, compatible fee charging system, higher levels of subsidies, and well-designed public information and education campaigns are required to promote household waste source separation and reduction.

75 FR 14245 - Voluntary Intermodal Sealift Agreement

Science.gov (United States)

2010-03-24

... measures so that Contingency planning information can be shared with Participants to enable them to plan... Intermodal Sealift Agreement (VISA) Table of Contents Abbreviations Definitions Preface I. Purpose II... of VISA Contingency Provisions A. General B. Notification of Activation C. Voluntary Capacity D...

Implications of an emerging EHR monoculture for hospitals and healthcare systems.

Science.gov (United States)

Koppel, Ross; Lehmann, Christoph U

2015-03-01

In many hospitals and health systems, a 'new' electronic health record means a shift to one vendor: Epic, a vendor that dominates in large and medium hospital markets and continues its success with smaller institutions and ambulatory practices. Our paper examines the implications of this emerging monoculture: its advantages and disadvantages for physicians and hospitals and its role in innovation, professional autonomy, implementation difficulties, workflow, flexibility, cost, data standards, interoperability, and interactions with other information technology (IT) systems. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A Planning Study for the Enhancement of National Nuclear Transparency through the Voluntary Contribution to IAEA

Energy Technology Data Exchange (ETDEWEB)

Yang, Maeng Ho; Oh, K. B.; Lee, H. M. (and others)

2006-12-15

This study investigated the experts' opinions and a case study of typical country in order to enhance international transparency and confidence for national nuclear policy and its activities. And direction and strategies for strengthening cooperation with IAEA through various voluntary contribution into IAEA activities, was also investigated as well as long term strategic road map. It is important to strengthen the nuclear diplomacy in order to increase transparency of Korean nuclear activities through the establishment of nation-wide collaborative systems as well as systematic and long term based implementation of positive measures and actions. At the same time, it is also required to strengthen cooperation with IAEA through voluntary contribution program into relevant IAEA activities as well as establishing national long term strategies and road map.

A Planning Study for the Enhancement of National Nuclear Transparency through the Voluntary Contribution to IAEA

International Nuclear Information System (INIS)

Yang, Maeng Ho; Oh, K. B.; Lee, H. M.

2006-12-01

This study investigated the experts' opinions and a case study of typical country in order to enhance international transparency and confidence for national nuclear policy and its activities. And direction and strategies for strengthening cooperation with IAEA through various voluntary contribution into IAEA activities, was also investigated as well as long term strategic road map. It is important to strengthen the nuclear diplomacy in order to increase transparency of Korean nuclear activities through the establishment of nation-wide collaborative systems as well as systematic and long term based implementation of positive measures and actions. At the same time, it is also required to strengthen cooperation with IAEA through voluntary contribution program into relevant IAEA activities as well as establishing national long term strategies and road map

5 CFR 630.1015 - Movement between voluntary leave bank and leave transfer programs.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Movement between voluntary leave bank and leave transfer programs. 630.1015 Section 630.1015 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS ABSENCE AND LEAVE Voluntary Leave Bank Program § 630.1015 Movement...

76 FR 71345 - Patient Safety Organizations: Voluntary Relinquishment From Child Health Patient Safety...

Science.gov (United States)

2011-11-17

... Organizations: Voluntary Relinquishment From Child Health Patient Safety Organization, Inc. AGENCY: Agency for... notification of voluntary relinquishment from Child Health Patient Safety Organization, Inc. of its status as a Patient Safety Organization (PSO). The Patient Safety and Quality Improvement Act of 2005 (Patient Safety...

76 FR 60495 - Patient Safety Organizations: Voluntary Relinquishment From the Patient Safety Group

Science.gov (United States)

2011-09-29

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations: Voluntary Relinquishment From the Patient Safety Group AGENCY: Agency for Healthcare Research and... voluntary relinquishment from The Patient Safety Group of its status as a Patient Safety Organization (PSO...

76 FR 79192 - Patient Safety Organizations: Voluntary Relinquishment From HSMS Patient Safety Organization

Science.gov (United States)

2011-12-21

... Organizations: Voluntary Relinquishment From HSMS Patient Safety Organization AGENCY: Agency for Healthcare... voluntary relinquishment from the HSMS Patient Safety Organization of its status as a Patient Safety Organization (PSO). The Patient Safety and Quality Improvement Act of 2005 (Patient Safety Act), Public Law 109...

Voluntary Truck and Bus Fuel-Economy-Program marketing plan. Final technical report, September 29, 1980-January 29, 1982

Energy Technology Data Exchange (ETDEWEB)

None

1982-01-01

The aim of the program is to improve the utilization of fuel by commercial trucks and buses by updating and implementing specific approaches for educating and monitoring the trucking industry on methods and means of conserving fuels. The following outlines the marketing plan projects: increase use of program logo by voluntary program members and others; solicit trade publication membership and support; brief Congressional delegations on fuel conservation efforts; increase voluntary program presence before trade groups; increase voluntary program presence at truck and trade shows; create a voluntary program display for use at trade shows and in other areas; review voluntary program graphics; increase voluntary program membership; and produce placemats carrying fuel conservation messages; produce a special edition of Fuel Economy News, emphasizing the driver's involvement in fuel conservation; produce posters carrying voluntary program fuel conservation message. Project objectives, activities, and results for each project are summarized.

A novel system to tackle hospital acquired pressure ulcers.

Science.gov (United States)

Renganathan, B S; Preejith, S P; Nagaiyan, Sridhar; Joseph, Jayaraj; Sivaprakasam, Mohanasankar

2016-08-01

Hospital acquired pressure ulcers (HAPUs) is a major problem that affects around one in twenty patients who are admitted in hospital with sudden illness. These ulcers often occur when patients have limited mobility and cannot change positions in bed on their own. Traditionally, the occurrence of HAPUs has been minimized by turning the patient every 2 hours to alternating lateral and supine positions, and by using pressure redistributing mattresses. In many healthcare facilities, such a patient repositioning schedule is not always maintained owing to low caregiver compliance to turning protocols. Difficulty in monitoring patient position continuously, lack of turn reminders/alerts and suboptimal caregiver staffing ratio increases the occurrence of HAPUs. A novel method to address the need for improved pressure ulcer prevention is presented. The proposed method consists of a wearable device which continuously monitors the patient's position and communicates wirelessly with a tablet which enables alerts to be sent to the caregiver when a patient turn is due in accordance with the protocol adopted by the hospital. The patient's position is continuously monitored and the turning procedure carried out is logged and updated on the hospital's cloud system, thereby enabling centralized monitoring. Under a controlled setting, system was able to continuously monitor patient's position and can accurately detect standard patient positions.

An analysis of the adoption of managerial innovation: cost accounting systems in hospitals.

Science.gov (United States)

Glandon, G L; Counte, M A

1995-11-01

The adoption of new medical technologies has received significant attention in the hospital industry, in part, because of its observed relation to hospital cost increases. However, few comprehensive studies exist regarding the adoption of non-medical technologies in the hospital setting. This paper develops and tests a model of the adoption of a managerial innovation, new to the hospital industry, that of cost accounting systems based upon standard costs. The conceptual model hypothesizes that four organizational context factors (size, complexity, ownership and slack resources) and two environmental factors (payor mix and interorganizational dependency) influence hospital adoption of cost accounting systems. Based on responses to a mail survey of hospitals in the Chicago area and AHA annual survey information for 1986, a sample of 92 hospitals was analyzed. Greater hospital size, complexity, slack resources, and interorganizational dependency all were associated with adoption. Payor mix had no significant influence and the hospital ownership variables had a mixed influence. The logistic regression model was significant overall and explained over 15% of the variance in the adoption decision.

Voluntary activation of biceps-to-triceps and deltoid-to-triceps transfers in quadriplegia.

Science.gov (United States)

Peterson, Carrie L; Bednar, Michael S; Bryden, Anne M; Keith, Michael W; Perreault, Eric J; Murray, Wendy M

2017-01-01

The biceps or the posterior deltoid can be transferred to improve elbow extension function for many individuals with C5 or C6 quadriplegia. Maximum strength after elbow reconstruction is variable; the patient's ability to voluntarily activate the transferred muscle to extend the elbow may contribute to the variability. We compared voluntary activation during maximum isometric elbow extension following biceps transfer (n = 5) and deltoid transfer (n = 6) in three functional postures. Voluntary activation was computed as the elbow extension moment generated during maximum voluntary effort divided by the moment generated with full activation, which was estimated via electrical stimulation. Voluntary activation was on average 96% after biceps transfer and not affected by posture. Individuals with deltoid transfer demonstrated deficits in voluntary activation, which differed by posture (80% in horizontal plane, 69% in overhead reach, and 70% in weight-relief), suggesting inadequate motor re-education after deltoid transfer. Overall, individuals with a biceps transfer better activated their transferred muscle than those with a deltoid transfer. This difference in neural control augmented the greater force-generating capacity of the biceps leading to increased elbow extension strength after biceps transfer (average 9.37 N-m across postures) relative to deltoid transfer (average 2.76 N-m across postures) in our study cohort.

Assessment of Pharmacy Information System Performance in Three Hospitals in Eastern Province, Saudi Arabia.

Science.gov (United States)

El Mahalli, Azza; El-Khafif, Sahar H; Yamani, Wid

2016-01-01

The pharmacy information system is one of the central pillars of a hospital information system. This research evaluated a pharmacy information system according to six aspects of the medication process in three hospitals in Eastern Province, Saudi Arabia. System administrators were interviewed to determine availability of functionalities. Then, system users within the hospital were targeted to evaluate their level of usage of these functionalities. The study was cross-sectional. Two structured surveys were designed. The overall response rate of hospital users was 31.7 percent. In all three hospitals studied, the electronic health record is hybrid, implementation has been completed and the system is running, and the systems have computerized provider order entry and clinical decision support. Also, the pharmacy information systems are integrated with the electronic health record, and computerized provider order entry and almost all prescribing and transcription functionalities are available; however, drug dispensing is a mostly manual process. However, the study hospitals do not use barcode-assisted medication administration systems to verify patient identity and electronically check dose administration, and none of them have computerized adverse drug event monitoring that uses the electronic health record. The numbers of users who used different functionalities most or all of the time was generally low. The highest frequency of utilization was for patient administration records (56.8 percent), and the lowest was for linkage of the pharmacy information system to pharmacy stock (9.1 percent). Encouraging users to use different functionalities was highly recommended.

The Voluntary Nature of Decision-Making in Addiction: Static Metaphysical Views Versus Epistemologically Dynamic Views.

Science.gov (United States)

Racine, Eric; Rousseau-Lesage, Simon

2017-06-01

The degree of autonomy present in the choices made by individuals with an addiction, notably in the context of research, is unclear and debated. Some have argued that addiction, as it is commonly understood, prevents people from having sufficient decision-making capacity or self-control to engage in choices involving substances to which they have an addiction. Others have criticized this position for being too radical and have counter-argued in favour of the full autonomy of people with an addiction. Aligning ourselves with middle-ground positions between these two extremes, we flesh out an account of voluntary action that makes room for finer-grained analyses than the proposed all-or-nothing stances, which rely on a rather static metaphysical understanding of the nature of the voluntariness of action. In contrast, a dynamic concept of voluntary action better accounts for varying levels of voluntariness of the person with an addiction which takes into consideration internal (e.g. cravings) and external (e.g. perceptions of degrees of freedom related to different options) determinants of choice. Accordingly, like other components of autonomous choices such as level of information, voluntariness can fluctuate. Therefore, there are important implications for research and clinical ethics in matters of consent, recruitment, and therapeutic approaches. Overall, our proposal is inspired by a pragmatist understanding of voluntary action, notably with respect to how voluntariness is both informed by actions and experiences that shape one's view of the world. © 2017 John Wiley & Sons Ltd.

The effects of ownership and system affiliation on the economic performance of hospitals.

Science.gov (United States)

Renn, S C; Schramm, C J; Watt, J M; Derzon, R A

1985-01-01

We investigated differences among five types of hospitals, defined by ownership (investor-owned or not-for-profit), system affiliation (system-affiliated or freestanding), and government sponsorship on 24 measures of economic performance. Using multivariate analysis of 1980 Medicare cost report and other data from a national sample of 561 hospitals, we found that investor-owned chain hospitals charged significantly more, and were more profitable, than all other types of hospitals except freestanding for-profits; there were no differences in productive efficiency that could be attributed to ownership or affiliation; the investor-owned hospitals had higher debt-to-asset ratios, less-capital-intensive plants, and greater capital costs as a percentage of operating costs than the not-for-profits; and there were no consistent case-mix differences among the hospitals.

Voluntary Certification of Agricultural Products in Competitive Markets: The Consideration of Boundedly Rational Consumers

Directory of Open Access Journals (Sweden)

Xujin Pu

2016-09-01

Full Text Available Market competition creates strategic incentives for firms to communicate private information about their own product quality through certification. Although voluntary certification has recently gained importance in the agricultural industry, information asymmetry is not always completely addressed. This study analyzes how the relative proportion of boundedly rational consumers in the market influences the effectiveness of voluntary certification mechanisms by using a duopoly game model of high- and low-quality firms. The presented results show that a change in the proportion of boundedly rational consumers leads to different certification behaviors and a different market equilibrium. We also find that the existence of boundedly rational consumers is an important factor in the failure of voluntary certification. Indeed, when the relative proportion of such consumers is very high, voluntary certification is ineffective at improving market efficiency.

Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2018 Rates; Quality Reporting Requirements for Specific Providers; Medicare and Medicaid Electronic Health Record (EHR)

Science.gov (United States)

2017-08-14

We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2018. Some of these changes implement certain statutory provisions contained in the Pathway for Sustainable Growth Rate (SGR) Reform Act of 2013, the Improving Medicare Post-Acute Care Transformation Act of 2014, the Medicare Access and CHIP Reauthorization Act of 2015, the 21st Century Cures Act, and other legislation. We also are making changes relating to the provider-based status of Indian Health Service (IHS) and Tribal facilities and organizations and to the low-volume hospital payment adjustment for hospitals operated by the IHS or a Tribe. In addition, we are providing the market basket update that will apply to the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits for FY 2018. We are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) for FY 2018. In addition, we are establishing new requirements or revising existing requirements for quality reporting by specific Medicare providers (acute care hospitals, PPS-exempt cancer hospitals, LTCHs, and inpatient psychiatric facilities). We also are establishing new requirements or revising existing requirements for eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) participating in the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. We are updating policies relating to the Hospital Value-Based Purchasing (VBP) Program, the Hospital Readmissions Reduction Program, and the Hospital-Acquired Condition (HAC) Reduction Program. We also are making changes relating to transparency of accrediting organization survey

Job characteristics and voluntary mobility in the Netherlands : differential education and gender patterns?

NARCIS (Netherlands)

Gesthuizen, M.

2009-01-01

Purpose – The purpose of this paper is to address the impact of the subjective evaluation of job characteristics on voluntary mobility, the impact of voluntary mobility on changes in these job characteristics, and differential education and gender patterns. Design/methodology/approach – Ordered and

Staff's perceptions of voluntary assertiveness skills training.

Science.gov (United States)

McVanel, Sarah; Morris, Beth

2010-01-01

Clinicians' ability to be assertive when unsure or concerned about procedures, treatment modalities, or patients' symptoms is key in reducing risk and preventing sentinel events. In this article, the authors provide a framework for generic, voluntary assertiveness communication skills workshops that any educator can implement.

The Relationship between Social Capital and Quality Management Systems in European Hospitals: A Quantitative Study

Science.gov (United States)

Hammer, Antje; Arah, Onyebuchi A.; DerSarkissian, Maral; Thompson, Caroline A.; Mannion, Russell; Wagner, Cordula; Ommen, Oliver; Sunol, Rosa; Pfaff, Holger

2013-01-01

Background Strategic leadership is an important organizational capability and is essential for quality improvement in hospital settings. Furthermore, the quality of leadership depends crucially on a common set of shared values and mutual trust between hospital management board members. According to the concept of social capital, these are essential requirements for successful cooperation and coordination within groups. Objectives We assume that social capital within hospital management boards is an important factor in the development of effective organizational systems for overseeing health care quality. We hypothesized that the degree of social capital within the hospital management board is associated with the effectiveness and maturity of the quality management system in European hospitals. Methods We used a mixed-method approach to data collection and measurement in 188 hospitals in 7 European countries. For this analysis, we used responses from hospital managers. To test our hypothesis, we conducted a multilevel linear regression analysis of the association between social capital and the quality management system score at the hospital level, controlling for hospital ownership, teaching status, number of beds, number of board members, organizational culture, and country clustering. Results The average social capital score within a hospital management board was 3.3 (standard deviation: 0.5; range: 1-4) and the average hospital score for the quality management index was 19.2 (standard deviation: 4.5; range: 0-27). Higher social capital was associated with higher quality management system scores (regression coefficient: 1.41; standard error: 0.64, p=0.029). Conclusion The results suggest that a higher degree of social capital exists in hospitals that exhibit higher maturity in their quality management systems. Although uncontrolled confounding and reverse causation cannot be completely ruled out, our new findings, along with the results of previous research, could

Association of bond, market, operational, and financial factors with multi-hospital system bond issues.

Science.gov (United States)

Carpenter, C E; McCue, M J; Hossack, J B

2001-01-01

Despite the growth of multi-hospital systems in the 1990s, their performance in the tax-exempt bond market has not been adequately evaluated. The purpose of this study is to compare bonds issued by multi-hospital systems to those issued by individual hospitals in terms of bond, market, operational, and financial characteristics. The study sample includes 2,078 newly issued, tax-exempt, revenue bonds between 1991 and 1997. The findings indicate that multi-hospital systems issued larger amounts of debt at a lower cost, were more likely to be insured, had higher debt service coverage and higher operating margins.

The Strategy of Voluntary Certification in Italian Olive Oil Industry: Who and Why?

Science.gov (United States)

Riganelli, Chiara; Marchini, Andrea

2016-01-01

The phenomenon of asymmetric information is central in the agri-food sector, in which often there is not full information transparency about product quality. This condition is particularly complex considering the high-end products. In particular, there are specific attributes (credence attributes) that are not assessable by consumers. For these reasons, a clear information about certification can give to consumers the possibility to make a rational choice. A company can choose voluntarily to participate in certification programs that can be viewed also as a simplification of some organization issues. Often the incentives to participate in voluntary programs arise from the need to have a positive economic performance of the firm. On the one hand, the firm may have benefits from the technical assistance of the certification, which allows it to reduce costs of controlling particular sensible steps of the process. On the other hand, the firm may provide a new certification label, in order to ensure a greater transparency of its processes. The research aims to understand the characteristics of firms oriented to use voluntary certifications as a tool to reduce information asymmetries between producers and final consumers. In particular, we want to consider two contexts of analysis: a structural one, considering some specific internal aspects and investment choices of the firms (typology, size, extraction system, storage system, material investments, immaterial investments); a second one that takes into account some decisions related to market relationships (sale to consumers, sale to HoReCa, sale to wholesalers, sale to purchasing groups, sale to GDO, export activity). The study concerns small and medium olive oil company of Southern Italy. We apply two logit models in order to show the determinants in the choice to introduce a voluntary certification. The results show significant values in both the two dimensions considered. Among the first one, there are significances

Mount Sinai Hospital's approach to Ontario's Health System Funding Reform.