Report of the procedure of voluntary interruption of pregnancy at a university hospital in Uruguay

OpenAIRE

Bentancor, Ana; Hernández, Ana Laura; Godoy, Yamile; Dapueto, Juan J

2016-01-01

ABSTRACT OBJECTIVE To describe the constitution and operation of a voluntary interruption of pregnancy team of a university hospital, from the outlook of the mental health team. METHODS In this case study, the following aspects were analyzed: 1) historical background; 2) implementation of Law 18,897 of October 22, 2012; and 3) functioning of the program at the Hospital de Clínicas of the Facultad de Medicina (Universidad de la República, Uruguay), taking into account three dimensions: str...

Report of the procedure of voluntary interruption of pregnancy at a university hospital in Uruguay.

Science.gov (United States)

Bentancor, Ana; Hernández, Ana Laura; Godoy, Yamile; Dapueto, Juan J

2016-07-04

To describe the constitution and operation of a voluntary interruption of pregnancy team of a university hospital, from the outlook of the mental health team. In this case study, the following aspects were analyzed: 1) historical background; 2) implementation of Law 18,897 of October 22, 2012; and 3) functioning of the program at the Hospital de Clínicas of the Facultad de Medicina (Universidad de la República, Uruguay), taking into account three dimensions: structure, process, and results. Between December 2012 and November 2013, a total of 6,676 voluntary interruptions of pregnancy were reported in Uruguay; out of these, 80 were conducted at the Hospital de Clínicas. The patients' demographic data agreed with those reported at the national level: Of the total patients, 81.0% were aged over 19 years; 6.2% decided to continue with the pregnancy; and only 70.0% attended the subsequent control and received advice on contraception. In its implementation year in Uruguay, we can assess the experience as positive from the point of view of women's health. Our experience as a mental health team at the Hospital de Clínicas, inserted into the multidisciplinary voluntary interruption of pregnancy team, is in the process of assessment and reformulation of practices. Describir la conformación y funcionamiento de un equipo de interrupción voluntaria del embarazo de un hospital universitario, desde la mirada del equipo de salud mental. En este estudio de caso, se analizan los siguientes aspectos: 1) antecedentes históricos; 2) implementación de la Ley 18.897 de 22 de octubre de 2012; y 3) funcionamiento del programa en el Hospital de Clínicas de la Facultad de Medicina (Universidad de la República, Uruguay), teniendo en cuenta tres dimensiones (estructura, proceso y resultados). Entre diciembre de 2012 y noviembre de 2013, se reportaron en Uruguay un total de 6.676 interrupciones voluntarias del embarazo; de ellas, 80 se llevaron a cabo en el Hospital de Clínicas. Los

Why female sex workers participate in HIV research: the illusion of voluntariness.

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Reed, Elizabeth; Fisher, Celia B; Blankenship, Kim M; West, Brooke S; Khoshnood, Kaveh

2017-07-01

The purpose of this study was to examine factors influencing the motivation for and perceived voluntariness of participation in non-intervention HIV research among female sex workers (FSW) in India. FSW (n = 30) who participated in non-intervention HIV studies in the previous three years were recruited from a local community-based organization. Semi-structured qualitative interviews focused on women's personal and economic motivations for participation and their perceptions of the informed consent process. Interviews were audio-recorded, translated, transcribed, and reviewed for common themes. Content analysis indicated that while many women reported willing participation, reports of obligatory participation were also a common theme. Obligations included money-related pressures and coercion by other FSW, social pressures, not wanting to disappoint the researchers, and perceiving that they had a contractual agreement to complete participation as a result of signing the consent form. Findings suggest a need for additional efforts during and following informed consent to prevent obligatory participation in HIV research studies among FSW. Findings emphasize the importance of integrating ongoing participant feedback into research ethics practices to identify issues not well addressed via standard ethics protocols when conducting HIV research among vulnerable populations.

Systematic Review of Voluntary Participation in Simulation-Based Laparoscopic Skills Training: Motivators and Barriers for Surgical Trainee Attendance.

Science.gov (United States)

Gostlow, Hannah; Marlow, Nicholas; Babidge, Wendy; Maddern, Guy

To examine and report on evidence relating to surgical trainees' voluntary participation in simulation-based laparoscopic skills training. Specifically, the underlying motivators, enablers, and barriers faced by surgical trainees with regard to attending training sessions on a regular basis. A systematic search of the literature (PubMed; CINAHL; EMBASE; Cochrane Collaboration) was conducted between May and July 2015. Studies were included on whether they reported on surgical trainee attendance at voluntary, simulation-based laparoscopic skills training sessions, in addition to qualitative data regarding participant's perceived barriers and motivators influencing their decision to attend such training. Factors affecting a trainee's motivation were categorized as either intrinsic (internal) or extrinsic (external). Two randomised control trials and 7 case series' met our inclusion criteria. Included studies were small and generally poor quality. Overall, voluntary simulation-based laparoscopic skills training was not well attended. Intrinsic motivators included clearly defined personal performance goals and relevance to clinical practice. Extrinsic motivators included clinical responsibilities and available free time, simulator location close to clinical training, and setting obligatory assessments or mandated training sessions. The effect of each of these factors was variable, and largely dependent on the individual trainee. The greatest reported barrier to attending voluntary training was the lack of available free time. Although data quality is limited, it can be seen that providing unrestricted access to simulator equipment is not effective in motivating surgical trainees to voluntarily participate in simulation-based laparoscopic skills training. To successfully encourage participation, consideration needs to be given to the factors influencing motivation to attend training. Further research, including better designed randomised control trials and large

The effect of ostracism and optional participation on the evolution of cooperation in the voluntary public goods game.

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Mayuko Nakamaru

Full Text Available Not only animals, plants and microbes but also humans cooperate in groups. The evolution of cooperation in a group is an evolutionary puzzle, because defectors always obtain a higher benefit than cooperators. When people participate in a group, they evaluate group member's reputations and then decide whether to participate in it. In some groups, membership is open to all who are willing to participate in the group. In other groups, a candidate is excluded from membership if group members regard the candidate's reputation as bad. We developed an evolutionary game model and investigated how participation in groups and ostracism influence the evolution of cooperation in groups when group members play the voluntary public goods game, by means of computer simulation. When group membership is open to all candidates and those candidates can decide whether to participate in a group, cooperation cannot be sustainable. However, cooperation is sustainable when a candidate cannot be a member unless all group members admit them to membership. Therefore, it is not participation in a group but rather ostracism, which functions as costless punishment on defectors, that is essential to sustain cooperation in the voluntary public goods game.

Opt-out of voluntary HIV testing: a Singapore hospital's experience.

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Chua, Arlene C; Leo, Yee Sin; Cavailler, Philippe; Chu, Christine; Ng, Aloysius; Ng, Oon Tek; Krishnan, Prabha

2012-01-01

Since 2008, the Singapore Ministry of Health (MOH) has expanded HIV testing by increasing anonymous HIV test sites, as well as issuing a directive to hospitals to offer routine voluntary opt out inpatient HIV testing. We reviewed this program implemented at the end of 2008 at Tan Tock Seng Hospital (TTSH), the second largest acute care general hospital in Singapore. From January 2009 to December 2010, all inpatients aged greater or equal than 21 years were screened for HIV unless they declined or were not eligible for screening. We reviewed the implementation of the Opt Out testing policy. There were a total of 93,211 admissions; 41,543 patients were included based on HIV screening program eligibility criteria. Among those included, 79% (n = 32,675) opted out of HIV screening. The overall acceptance rate was 21%. Majority of eligible patients who were tested (63%) were men. The mean age of tested patients was 52 years. The opt out rate was significantly higher among females (OR: 1.5, 95%CI: 1.4-1.6), aged >60 years (OR: 2.3, 95%CI: 2.2-2.4) and Chinese ethnicity (OR: 1.7, 95%CI:1.6-1.8). The false positive rate of the HIV screening test is 0.56%. The proportion of patients with HIV infection among those who underwent HIV screening is 0.18%. All 16 confirmed HIV patients were linked to care. The default opt-in rate of inpatient HIV testing was low at Tan Tock Seng Hospital, Singapore. Efforts to address individual HIV risk perception and campaigns against HIV stigma are needed to encourage more individuals to be tested for HIV.

Voluntary Participation in Regional Fisheries Management Council Meetings

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Danielle T. Brzezinski

2010-09-01

Full Text Available Insufficient and unrepresentative participation in voluntary public hearings and policy discussions has been problematic since Aristotle's time. In fisheries, research has shown that involvement is dominated by financially resourceful and extreme-opinion stakeholders and tends to advantage groups that have a lower cost of attendance. Stakeholders may exhibit only one or all of these traits but can be still similarly advantaged. The opposites of these traits tend to characterize the disadvantaged, such as the middle-ground opinions, the less wealthy or organized, and the more remote stakeholders. Remoteness or distance is the most straightforward and objective of these characteristics to measure. We analyzed the New England Fishery Management Council's sign-in sheets for 2003-2006, estimating participants' travel distance and associations with the groundfish, scallop, and herring industries. We also evaluated the representativeness of participation by comparing attendance to landings and permit distributions. The distance analysis showed a significant correlation between attendance levels and costs via travel distance. These results suggest a potential bias toward those stakeholders residing closer to meeting locations, possibly disadvantaging parties who are further and must incur higher costs. However, few significant differences were found between the actual fishing industry and attendee distributions, suggesting that the geographical distribution of the meeting attendees is statistically similar to that of the larger fishery. The interpretation of these results must take into consideration the limited time span of the analysis, as policy changes may have altered the industry make-up and location prior to our study. Furthermore, the limited geographical input of stakeholders may lend bias to the Council's perception of ecological and social conditions throughout the spatial range of the fishery. These factors should be further considered in

Opt-out of voluntary HIV testing: a Singapore hospital's experience.

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Arlene C Chua

Full Text Available INTRODUCTION: Since 2008, the Singapore Ministry of Health (MOH has expanded HIV testing by increasing anonymous HIV test sites, as well as issuing a directive to hospitals to offer routine voluntary opt out inpatient HIV testing. We reviewed this program implemented at the end of 2008 at Tan Tock Seng Hospital (TTSH, the second largest acute care general hospital in Singapore. METHODS AND FINDINGS: From January 2009 to December 2010, all inpatients aged greater or equal than 21 years were screened for HIV unless they declined or were not eligible for screening. We reviewed the implementation of the Opt Out testing policy. There were a total of 93,211 admissions; 41,543 patients were included based on HIV screening program eligibility criteria. Among those included, 79% (n = 32,675 opted out of HIV screening. The overall acceptance rate was 21%. Majority of eligible patients who were tested (63% were men. The mean age of tested patients was 52 years. The opt out rate was significantly higher among females (OR: 1.5, 95%CI: 1.4-1.6, aged >60 years (OR: 2.3, 95%CI: 2.2-2.4 and Chinese ethnicity (OR: 1.7, 95%CI:1.6-1.8. The false positive rate of the HIV screening test is 0.56%. The proportion of patients with HIV infection among those who underwent HIV screening is 0.18%. All 16 confirmed HIV patients were linked to care. CONCLUSION: The default opt-in rate of inpatient HIV testing was low at Tan Tock Seng Hospital, Singapore. Efforts to address individual HIV risk perception and campaigns against HIV stigma are needed to encourage more individuals to be tested for HIV.

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

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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.

Factors explaining voluntary participation in PACE-Vaquita

OpenAIRE

Sara Avila

2011-01-01

Vaquita marina, a small species of porpoise endemic to the Northern Gulf of California in Mexico, is the world’s most endangered cetacean species. With the purpose of preserving vaquita, the Mexican government launched PACE-Vaquita in 2008. This voluntary program offers an innovative schedule of compensations: as in a payment for conservation program, PACE-Vaquita compensates for temporary reductions in fishing reductions in fishing effort; as in a program to accelerate technology adoption,PA...

Sociodemographic and clinical profile of patients in voluntary and involuntary psychiatric hospitalizations

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Carlos Robson Bezerra de Medeiros

2011-12-01

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 specialtytreatment, 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. Weobserved 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 tohospital by a relative, mainly due to alcohol use or drugs.

Is there a need to phase out replacement blood donors by voluntary blood donors in hospital based blood transfusion services?

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Praneeta Jaswant Singh

2017-01-01

Conclusion: Data highlight that RD contributed major source of blood supply in hospital-based blood transfusion services and the prevalence of TTI was higher among them in comparison to first-time voluntary donors. Thus, efforts should be made to increase the number of VBD.

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

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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.

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

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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.

How do voluntary organizations foster protest? The role of organizational involvement on individual protest participation.

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Somma, Nicolás M

2010-01-01

Prior research shows that members of voluntary organizations are more likely to protest than nonmembers. But why, among members, do some protest while others do not? I explore whether organizational involvement-the extent in which members engage in the "life" of their organizations-affects protest. I identify four dimensions of involvement-time and money contributions, participation in activities, psychological attachment, and embeddedness in interpersonal communication networks. Only the first dimension has robust effects on protest, and they are nonlinear: intermediate contributors have the highest protest rates. The three other dimensions substantially increase protest only under specific "involvement profiles."

Recruitment of child soldiers in Nepal: Mental health status and risk factors for voluntary participation of youth in armed groups.

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Kohrt, Brandon A; Yang, Minyoung; Rai, Sauharda; Bhardwaj, Anvita; Tol, Wietse A; Jordans, Mark J D

2016-08-01

Preventing involuntary conscription and voluntary recruitment of youth into armed groups are global human rights priorities. Pathways for self-reported voluntary recruitment and the impact of voluntary recruitment on mental health have received limited attention. The objective of this study was to identify risk factors for voluntarily joining armed groups, as well as the association of conscription status and mental health. In Nepal, interviews were conducted with 258 former child soldiers who participated in a communist (Maoist) revolution. Eighty percent of child soldiers joined 'voluntarily'. Girls were 2.07 times as likely to join voluntarily (95% CI, 1.03-4.16, p =0.04). Among girls, 51% reported joining voluntarily because of personal connections to people who were members of the armed group, compared to 22% of boys. Other reasons included escaping difficult life situations (36%), inability to achieve other goals in life (28%), and an appealing philosophy of the armed group (32%). Poor economic conditions were more frequently endorsed among boys (22%) than girls (10%). Voluntary conscription was associated with decreased risk for PTSD among boys but not for girls. Interventions to prevent voluntary association with armed groups could benefit from attending to difficulties in daily life, identifying non-violent paths to achieve life goals, and challenging the political philosophy of armed groups. Among boys, addressing economic risk factors may prevent recruitment, and prevention efforts for girls will need to address personal connections to armed groups, as it has important implications for preventing recruitment through new methods, such as social media.

Privatizing or socializing corporate responsibility: business participation in voluntary programs

NARCIS (Netherlands)

Fransen, L.W.; Burgoon, B.

2014-01-01

This article explores why companies choose some Corporate Responsibility initiatives over others. The focus is on competing voluntary programs to oversee and protect labor standards. These programs may differ with regard to two aspects: the governance of the program and the financial and managerial

Participation, public policy-making, and legitimacy in the EU Voluntary Partnership Agreement process

DEFF Research Database (Denmark)

Wodschow, Astrid; Nathan, Iben; Cerutti, Paolo

2016-01-01

This paper discusses how participatory policy-making processes such as the Voluntary Partnership Agreement (VPA) negotiations are and should be organised to foster political legitimacy and support. The VPAs are bilateral agreements between the European Union (EU) and timber producing countries....... VPAs constitute a cornerstone in EU's Forest Law Enforcement, Governance and Trade (FLEGT) programme, the most important tool for the EU to address illegal logging problems. The EU requires that national VPA negotiations include participation by the relevant stakeholders. Based on primary data, we...... compare the VPA negotiations in Cameroon (2006–2009) with three different ‘ideal’ models of participatory policy-making: the rationalist, the communicative incremental and the mixed model, which we expect have different implications for legitimacy. We conclude that the Cameroonian process is closest...

Using participant or non-participant observation to explain information behaviour. Participant observation, Non-participant observation, Information behaviour, Hospital pharmacists, Older people

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Janet Cooper

2004-01-01

Full Text Available The aim of the paper is to provide guidance on conducting participant and non-participant observation studies of information behaviour. Examines lessons learned during non-participant observation of hospital pharmacists, and participant observation with dependent older people living in their own homes. Describes the methods used in both studies, and discusses the ethical issues involved in gaining access to the subjects. In the hospital setting, professional affiliation between the researcher and the subjects (six pharmacists made access easier to obtain. In the home care setting, access to subjects (seven clients for participant observation (as a care worker was more difficult, as was withdrawal from the field study. In both studies, the observation element was triangulated with survey data. Both studies indicated the fundamental need for trust between the observer and the research subjects. In some situations, professional relations offer instant access and trust, whereas in closed and sensitive situations such as social care, time is required to build up trust. With participant observation, that trust should not be damaged by withdrawal of the researcher from the research setting.

Participant dropout as a function of survey length in internet-mediated university studies: implications for study design and voluntary participation in psychological research.

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Hoerger, Michael

2010-12-01

Internet-mediated research has offered substantial advantages over traditional laboratory-based research in terms of efficiently and affordably allowing for the recruitment of large samples of participants for psychology studies. Core technical, ethical, and methodological issues have been addressed in recent years, but the important issue of participant dropout has received surprisingly little attention. Specifically, web-based psychology studies often involve undergraduates completing lengthy and time-consuming batteries of online personality questionnaires, but no known published studies to date have closely examined the natural course of participant dropout during attempted completion of these studies. The present investigation examined participant dropout among 1,963 undergraduates completing one of six web-based survey studies relatively representative of those conducted in university settings. Results indicated that 10% of participants could be expected to drop out of these studies nearly instantaneously, with an additional 2% dropping out per 100 survey items included in the study. For individual project investigators, these findings hold ramifications for study design considerations, such as conducting a priori power analyses. The present results also have broader ethical implications for understanding and improving voluntary participation in research involving human subjects. Nonetheless, the generalizability of these conclusions may be limited to studies involving similar design or survey content.

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.

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...

Participation in voluntary organizations and volunteer work as a compensation for the absence of work or partnership? Evidence from two German samples of younger and older adults.

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Pavlova, Maria K; Silbereisen, Rainer K

2012-07-01

We tested whether formal volunteering, in terms of its associations with mental health, compensates for the absence of major work and family roles among older adults or rather complements such roles among both younger and older adults. Two cross-sectional samples of younger (aged 18-42 years, N = 2,346) and older (aged 56-75 years, N = 1,422) German adults were used. We regressed mental health indicators on control variables, 2 indicators of formal volunteering (participation in voluntary organizations and volunteer work), and their interactions with employment/partnership status. Participation in voluntary organizations was associated with higher positive affect, higher life satisfaction, and fewer depressive symptoms in younger adults. In older adults, it was related to higher life satisfaction only among working individuals, although the difference from nonworking individuals was not significant. Volunteer work was associated with higher positive affect in both age groups. In younger adults, it had no relation to life satisfaction and depressive symptoms. In older adults, it was related to higher life satisfaction among nonworking individuals and to fewer depressive symptoms among those without a steady partner. Volunteer work but not participation in voluntary organizations yielded compensatory effects on mental health among older adults.

Barriers to participation in a hospital-based falls assessment clinicprogramme

DEFF Research Database (Denmark)

Evron, Lotte; Schultz-Larsen, Kirsten; Fristrup, Tine

2009-01-01

Aims: To gain new knowledge about barriers to participation in hospital-based falls assessment. Methods: Semi-structured interviews with 20 older people referred to falls assessment at a hospital-based clinic were conducted. A convenience sample of 10 refusers and 10 accepters was collected. Those...... of knowledge were expected, owing to accepters' participation in the programme. Interview transcriptions were thematically analysed. The analysis was directed towards identification of barriers to falls assessment. Results: Barriers to participation were categorized as being either within or outside the falls...

Voluntary cognitive screening: characteristics of participants in an Asian setting

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Ho V

2015-04-01

Full Text Available Vanda Ho,1,2 Nur Hani Zainal,1 Linda Lim,1 Aloysius Ng,1 Eveline Silva,1 Nagaendran Kandiah1,3 1Department of Neurology, National Neuroscience Institute, Singapore; 2School of Clinical Medicine, University of Cambridge, Cambridge, UK; 3Duke-NUS Graduate Medical School, Singapore Background: Mild cognitive impairment (MCI and dementia are reaching epidemic proportions in Asia. Lack of awareness and late presentation are major obstacles to early diagnosis and timely intervention. Cognitive screening may be an effective method for early detection of dementia in Asia. The purpose of this work was to study the characteristics of subjects volunteering for cognitive screening in an Asian setting and to determine the prevalence of MCI.Methods: Retrospective and cross-sectional data from community subjects attending a screening program from 2008 to 2013 were analyzed. Information on demographics, vascular risk factors, subjective symptoms, and cognitive measures were analyzed over the 6-year period.Results: Over the 6 years from 2008 to 2013, 1,243 community subjects voluntarily turned up for cognitive screening (91.2% were Chinese, 5.23% were Indian, 1.37% were Malay, and 2.25% were Eurasian. The mean age of the participants was 61.3 years and the mean number of years of education was 11.0 years. A total of 71.1% of participants were living in public housing, 59.8% had at least one cardiovascular risk factor, and 56.2% reported subjective cognitive symptoms. Over a period of 6 years, no significant change in demographic or clinical variables was noted. High cholesterol and hypertension were consistently the top two risk factors found in the population screened. In total, 17.2% of the total cohort had MCI. Across the 6 years, the proportion with MCI and depression was relatively constant.Conclusion: A significant proportion of participants attending voluntary cognitive screening have MCI. Low level of education and presence of vascular risk factors are

Epidemiology of Hospital-Treated Injuries Sustained by Fitness Participants

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Gray, Shannon E.; Finch, Caroline F.

2015-01-01

Purpose: The purpose of this study was to provide an epidemiological profile of injuries sustained by participants in fitness activities in Victoria, Australia, based on hospital admissions and emergency department (ED) presentations and to identify the most common types, causes, and sites of these injuries. Method: Hospital-treated fitness…

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...

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.

Understanding hospital meal experiences by means of participant-driven-photo-elicitation.

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Justesen, Lise; Mikkelsen, Bent E; Gyimóthy, Szilvia

2014-04-01

A patients' hospital meal experiences can be complex and often difficult to capture using traditional methods. This study investigated patients' hospital meal experiences using participant-driven-photo-elicitation (PDPE). PDPE invites respondents to photograph their daily lives and combines this with interviews, which can provide deeper insight into multisensory experiences beyond verbal or written discourse. The sample consisted of eight hospitalised patients. Patients completed a photo-essay of their hospital meal experience during a single day at a Danish hospital and afterwards participated in an open-ended interview. Two inductive analytical approaches were selected to assess the patients' reflections on their hospital meal experiences. First, the interview transcripts were analysed using the Semiotic Analysis approach using qualitative data analysis software NVivo 9. Second, the 91 produced photographs and the participants' engagement with the photographs were analysed by means of a Reflexive Content Analysis. The study found that PDPE is a research method that can be used for expanding the conceptualisation of hospital meal experiences, revealing the significance of the meal context, materiality and memories beyond food per se. Copyright © 2013 Elsevier Ltd. All rights reserved.

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.

Redefining RECs: Additionality in the voluntary Renewable Energy Certificate market

Science.gov (United States)

Gillenwater, Michael Wayne

In the United States, electricity consumers are told that they can "buy" electricity from renewable energy projects, versus fossil fuel-fired facilities, through participation in a voluntary green power program. The marketing messages communicate to consumers that their participation and premium payments for a green label will cause additional renewable energy generation and thereby allow them to claim they consume electricity that is absent pollution as well as reduce pollutant emissions. Renewable Energy Certificates (RECs) and wind energy are the basis for the majority of the voluntary green power market in the United States. This dissertation addresses the question: Do project developers respond to the voluntary REC market in the United States by altering their decisions to invest in wind turbines? This question is investigated by modeling and probabilistically quantifying the effect of the voluntary REC market on a representative wind power investor in the United States using data from formal expert elicitations of active participants in the industry. It is further explored by comparing the distribution of a sample of wind power projects supplying the voluntary green power market in the United States against an economic viability model that incorporates geographic factors. This dissertation contributes the first quantitative analysis of the effect of the voluntary REC market on project investment. It is found that 1) RECs should be not treated as equivalent to emission offset credits, 2) there is no clearly credible role for voluntary market RECs in emissions trading markets without dramatic restructuring of one or both markets and the environmental commodities they trade, and 3) the use of RECs in entity-level GHG emissions accounting (i.e., "carbon footprinting") leads to double counting of emissions and therefore is not justified. The impotence of the voluntary REC market was, at least in part, due to the small magnitude of the REC price signal and lack of

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.

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...

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.

The relationship between hospital and ehr vendor market dynamics on health information organization presence and participation.

Science.gov (United States)

Lin, Sunny C; Adler-Milstein, Julia

2018-05-08

Health Information Organizations (HIOs) are third party organizations that facilitate electronic health information exchange (HIE) between providers in a geographic area. Despite benefits from HIE, HIOs have struggled to form and subsequently gain broad provider participation. We sought to assess whether market-level hospital and EHR vendor dynamics are associated with presence and level of hospital participation in HIOs. 2014 data on 4523 hospitals and their EHR vendors were aggregated to the market level. We used multivariate OLS regression to analyze the relationship between hospital and vendor dynamics and (1) probability of HIO presence and (2) percent of hospitals participating in an HIO. 298 of 469 markets (64%) had HIO presence, and in those markets, 47% of hospitals participated in an HIO on average. In multivariate analysis, four characteristics were associated with HIO presence. Markets with more hospitals, markets with more EHR vendors, and markets with an EHR vendor-led HIE approach were more likely to have an HIO. Compared to markets with low hospital competition, markets with high hospital competition had a 25 percentage point lower probability of HIO presence. Two characteristics were associated with level of hospital HIO participation. Markets with more hospitals as well as markets with high vendor competition (compared to low competition) had lower participation. Both hospital and EHR vendor dynamics are associated with whether a market has an HIO as well as the level of hospital participation in HIOs.

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.

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.

Understanding hospital meal experiences by means of Participant-Driven-Photo-Elicitation

DEFF Research Database (Denmark)

Justesen, Lise; Mikkelsen, Bent Egberg; Gyimóthy, Szilvia

2014-01-01

A patients’ hospital meal experiences can be complex and often difficult to capture using traditional methods. This study investigated patients’ hospital meal experiences using participant-driven-photo-elicitation (PDPE). PDPE invites respondents to photograph their daily lives and combines this ...

78 FR 57818 - Commission Participation and Commission Employee Involvement in Voluntary Standards Activities

Science.gov (United States)

2013-09-20

... docket number for this rulemaking. All comments received may be posted without change, including any... found in in such locations as homes, schools, and recreational areas. Voluntary standards activity is an... handled primarily by three standards development/coordinating organizations: ASTM International...

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.

A Descriptive Survey of Weight Control Participants at a U.S. Army Community Hospital.

Science.gov (United States)

1983-08-01

participation in the survey was strictly voluntary; 3. only active duty Army personnel who were on the Army’s weight control program could volunteer ...A.R. 600-9 limit 2 I was singled out because I looked overweight 3 I volunteered for the program 4 Other, specify 18. Where was your initial weight...33. Wing, Rena R., and Epstein, Leonard H. "Prescribed Level of Caloric Restriction in Bahavioral Weight Loss Programs. Addictive Behaviors 6

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

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.

Spreading the word: A process evaluation of a voluntary AOD prevention program.

Science.gov (United States)

Edelen, Maria Orlando; Tucker, Joan; D'Amico, Elizabeth

2015-06-01

Research on voluntary after-school alcohol and other drug (AOD) prevention programs is limited. It is important to increase understanding of students' motivation to attend these types of programs and their tendency to transfer program information to peers. This paper summarizes efforts to evaluate process information for CHOICE, a voluntary after-school AOD prevention program for middle-school youth. A survey administered to 1899 students aged 10-16 in seven schools assessed: (1) why students choose to attend CHOICE (2) barriers to attendance; and (3) how program information is disseminated to non-participants. Frequencies of responses from participants and non-participants were compared. Participants were motivated by several features, most notably, the demeanor of the group leaders and enjoyable curriculum content. Barriers to attendance were primarily logistic, but results also suggest that the promotion message should more effectively emphasize that CHOICE is appropriate for everyone. The majority of students knew about CHOICE, both through advertising and conversations with friends. Non-participants' detailed reports of what they heard from friends corresponded closely with what participants reported sharing. The use of dynamic group leaders is critical to engaging students in voluntary programs. Offering the program on different days of the week or at different times (e.g., before school) may improve attendance rates. Peer networks represent a critical pathway for prevention information that can help increase program impact. These results can be used to inform modifications to existing voluntary after-school AOD prevention programs to obtain higher attendance rates and more widespread dissemination of the intervention message. © American Academy of Addiction Psychiatry.

Development of hospital information systems: user participation and factors affecting it.

Science.gov (United States)

Rahimi, Bahlol; Safdari, Reza; Jebraeily, Mohamad

2014-12-01

Given the large volume of data generated in hospitals, in order to efficiently management them; using hospital information system (HIS) is critical. User participation is one of the major factors in the success of HIS that in turn leads Information needs and processes to be correctly predicted and also their commitment to the development of HIS to be augmented. The purpose of this study is to investigate the participation rate of users in different stages of HIS development as well as to identify the factors affecting it. This is a descriptive-cross sectional study which was inducted in 2014. The study population consists of 140 HIS users (from different types of job including physicians, nurses, laboratory, radiology and HIM staffs) from Teaching Hospitals Affiliated to Urmia University of Medical Sciences. Data were collected using a self-structured questionnaire which was estimated as both reliable and valid. The data were analyzed by SPSS software descriptive statistics and analytical statistics (t-test and chi-square). The highest participation rate of users in the four-stage development of the HIS was related to the implementation phase (2.88) and the lowest participation rate was related to analysis (1.23). The test results showed that the rate of user participation was not satisfactory in none of the stages of development (Psystem, and in this way, the success of the system will be assured.

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.

High hospital research participation and improved colorectal cancer survival outcomes: a population-based study.

Science.gov (United States)

Downing, Amy; Morris, Eva Ja; Corrigan, Neil; Sebag-Montefiore, David; Finan, Paul J; Thomas, James D; Chapman, Michael; Hamilton, Russell; Campbell, Helen; Cameron, David; Kaplan, Richard; Parmar, Mahesh; Stephens, Richard; Seymour, Matt; Gregory, Walter; Selby, Peter

2017-01-01

In 2001, the National Institute for Health Research Cancer Research Network (NCRN) was established, leading to a rapid increase in clinical research activity across the English NHS. Using colorectal cancer (CRC) as an example, we test the hypothesis that high, sustained hospital-level participation in interventional clinical trials improves outcomes for all patients with CRC managed in those research-intensive hospitals. Data for patients diagnosed with CRC in England in 2001-2008 (n=209 968) were linked with data on accrual to NCRN CRC studies (n=30 998). Hospital Trusts were categorised by the proportion of patients accrued to interventional studies annually. Multivariable models investigated the relationship between 30-day postoperative mortality and 5-year survival and the level and duration of study participation. Most of the Trusts achieving high participation were district general hospitals and the effects were not limited to cancer 'centres of excellence', although such centres do make substantial contributions. Patients treated in Trusts with high research participation (≥16%) in their year of diagnosis had lower postoperative mortality (presearch participation, with a reduction in postoperative mortality of 1.5% (6.5%-5%, pstudies for all patients with CRC treated in the hospital study participants. Improvement precedes and increases with the level and years of sustained participation. 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/.

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

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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.

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...

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.

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.

Stakeholders of Voluntary Forest Carbon Offset Projects in China: An Empirical Analysis

Directory of Open Access Journals (Sweden)

Derong Lin

2015-01-01

Full Text Available Climate change is one of the defining challenges facing the planet. Voluntary forest carbon offset project which has the potential to boost forest carbon storage and mitigate global warming has aroused the global concern. The objective of this paper is to model the game situation and analyze the game behaviors of stakeholders of voluntary forest carbon offset projects in China. A stakeholder model and a Power-Benefit Matrix are constructed to analyze the roles, behaviors, and conflicts of stakeholders including farmers, planting entities, communities, government, and China Green Carbon Foundation. The empirical analysis results show that although the stakeholders have diverse interests and different goals, a win-win solution is still possible through their joint participation and compromise in the voluntary forest carbon offset project. A wide governance structure laying emphasis on benefit balance, equality, and information exchanges and being regulated by all stakeholders has been constructed. It facilitates the agreement among the stakeholders with conflicting or different interests. The joint participation of stakeholders in voluntary forest carbon offset projects might change the government-dominated afforestation/reforestation into a market, where all participators including government are encouraged to cooperate with each other to improve the condition of fund shortage and low efficiency.

Planning for strategic change? A participative planning approach for community hospitals.

Science.gov (United States)

MacDonald, S K; Beange, J E; Blachford, P C

1992-01-01

Strategic planning is becoming to hospitals what business case analysis is to private corporations. In fact, this type of planning is becoming essential for the professional management of Ontario hospitals. The participative strategic planning process at Toronto East General Hospital (TEGH) is an example of how a professionally structured and implemented strategic planning process can be successfully developed and implemented in a community hospital. In this article, the environmental factors driving planning are reviewed and the critical success factors for the development and implementation of a strategic plan are examined in the context of TEGH's experience.

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.

Intrusive images and voluntary memory for affective pictures: contextualization and dual-task interference.

Science.gov (United States)

Krans, Julie; Langner, Oliver; Reinecke, Andrea; Pearson, David G

2013-12-01

The present study addressed the role of context information and dual-task interference during the encoding of negative pictures on intrusion development and voluntary recall. Healthy participants were shown negative pictures with or without context information. Pictures were either viewed alone or concurrently with a visuospatial or verbal task. Participants reported their intrusive images of the pictures in a diary. At follow-up, perceptual and contextual memory was tested. Participants in the context group reported more intrusive images and perceptual voluntary memory than participants in the no context group. No effects of the concurrent tasks were found on intrusive image frequency, but perceptual and contextual memory was affected according to the cognitive load of the task. The analogue method cannot be generalized to real-life trauma and the secondary tasks may differ in cognitive load. The findings challenge a dual memory model of PTSD but support an account in which retrieval strategy, rather than encoding processes, accounts for the experience of involuntary versus voluntary recall. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

Respiratory function in voluntary participating Patagonia sea lions in sternal recumbency

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Andreas Fahlman

2016-11-01

Full Text Available We measured esophageal pressures (n=4, respiratory flow rates (n=5, and expired O2 and CO2 (n=4 in five adult Patagonia sea lions (Otaria flavescens, body mass range 94.3-286.0 kg during voluntary breaths while laying down. The data were used to estimate the dynamic specific lung compliance (sCL, cmH2O-1, the O2 consumption rate (VO2 and CO2 production rates (VCO2 during rest. Our results indicate that the resting tidal volume in Patagonia sea lions is approximately 47-73% of the estimated total lung capacity. The esophageal pressures indicated that expiration is passive during voluntary breaths. The average sCL of dolphins was 0.41±0.11 cmH2O−1, which is similar to those measured in anesthetized sea lions and awake cetaceans, and significantly higher as compared with humans (0.08 cmH2O−1. The average estimated and using breath-by-breath respirometry were 1.023 ± 0.327 L O2 min-1 (range: 0.695-1.514 L O2 min−1 and 0.777 ± 0.318 L CO2 min-1, (range: 0.510-1.235 L CO2 min-1, respectively, which is similar to previously published metabolic measurements from California and Steller sea lions using conventional flow-through respirometry. Our data provide end-tidal gas composition and provide novel data for respiratory physiology in pinnpeds, which may be important for clinical medicine and conservation efforts.

School Ethical Climate and Teachers' Voluntary Absence

Science.gov (United States)

Shapira-Lishchinsky, Orly; Rosenblatt, Zehava

2010-01-01

Purpose: This paper aims to offer a theoretical framework for linking school ethical climate with teachers' voluntary absence. The paper attempts to explain this relationship using the concept of affective organizational commitment. Design/methodology/approach: Participants were 1,016 school teachers from 35 high schools in Israel. Data were…

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

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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.

Parental Intentions to Enroll Children in a Voluntary Expanded Newborn Screening Program

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Paquin, Ryan S.; Peay, Holly L.; Gehtland, Lisa M.; Lewis, Megan A.; Bailey, Donald B.

2016-01-01

Background and Objectives Nearly all babies in the United States are tested at birth for rare, serious, and treatable disorders through mandatory state newborn screening (NBS). Recently, there have been calls for an expanded, voluntary model to facilitate early diagnosis and treatment of a wider range of disorders. We applied the reasoned action framework to examine parental intentions to participate in voluntary expanded screening. Methods We recruited a national cohort of recent and expectant parents living in the U.S. who completed a self-administered online survey (N = 1,001). Using a mixed-level fractional factorial experiment, we studied parental participation intentions and preferences for timing of consent, cost, consent format, and testing options. Results We conducted a hierarchical regression analysis assessing parental intentions to participate in voluntary expanded NBS. Attitudes, perceived normative influence, and perceived behavioral control explained substantial variance in intention, with perceived normative influence emerging as the strongest predictor. We found no evidence that the manipulated program features altered mean levels of intention, but timing of parental permission, cost, and permission format moderated the relative importance of reasoned action constructs on intention. Conclusion Program design features may impact the psychological mechanisms underlying parental decision making for voluntary expanded screening. These results have important implications for parent education, outreach, and informed parental permission procedures. PMID:27526258

Parental intentions to enroll children in a voluntary expanded newborn screening program.

Science.gov (United States)

Paquin, Ryan S; Peay, Holly L; Gehtland, Lisa M; Lewis, Megan A; Bailey, Donald B

2016-10-01

Nearly all babies in the United States are tested at birth for rare, serious, and treatable disorders through mandatory state newborn screening (NBS). Recently, there have been calls for an expanded, voluntary model to facilitate early diagnosis and treatment of a wider range of disorders. We applied the reasoned action framework to examine parental intentions to participate in voluntary expanded screening. We recruited a national cohort of recent and expectant parents living in the U.S. who completed a self-administered online survey (N = 1001). Using a mixed-level fractional factorial experiment, we studied parental participation intentions and preferences for timing of consent, cost, consent format, and testing options. We conducted a hierarchical regression analysis assessing parental intentions to participate in voluntary expanded NBS. Attitudes, perceived normative influence, and perceived behavioral control explained substantial variance in intention, with perceived normative influence emerging as the strongest predictor. We found no evidence that the manipulated program features altered mean levels of intention, but timing of parental permission, cost, and permission format moderated the relative importance of reasoned action constructs on intention. Program design features may impact the psychological mechanisms underlying parental decision making for voluntary expanded screening. These results have important implications for parent education, outreach, and informed parental permission procedures. Copyright © 2016 Elsevier Ltd. All rights reserved.

Syndromic surveillance: hospital emergency department participation during the Kentucky Derby Festival.

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Carrico, Ruth; Goss, Linda

2005-01-01

Electronic syndromic surveillance may have value in detecting emerging pathogens or a biological weapons release. Hospitals that have an agile process to evaluate chief complaints of patients seeking emergency care may be able to more quickly identify subtle changes in the community's health. An easily adaptable prototype system was developed to monitor emergency department patient visits during the Kentucky Derby Festival in Louisville, Kentucky, from April 16-May 14, 2002. Use of the system was continued during the same festival periods in 2003 and 2004. Twelve area hospitals in Louisville, Kentucky, participated in a prospective analysis of the chief symptoms of patients who sought care in the emergency department during the Kentucky Derby Festival during 2002. Six hospitals were classified as computer record groups (CRG) and used their existing computerized record capabilities. The other 6 hospitals used a personal digital assistant (PDA) with customized software (PDA group). Data were evaluated by the health department epidemiologist using SaTScan, a modified version of a cancer cluster detection program, to look for clusters of cases above baseline over time and by Zip code. All 12 hospitals were able to collect and provide data elements during the study period. The 6 CRG hospitals were able to perform daily data transmission; however, 3 CRG hospitals were unable to interpret their data because it was transmitted in pure text format. In contrast, data from all 6 PDA group hospitals were interpretable. Real-time data analysis was compared with post-event data, and it was found that the real-time evaluation correctly identified no unusual disease activity during the study period. The 12 hospitals participating in this study demonstrated that community-wide surveillance using computerized data was possible and that the 6 study hospitals using a PDA could quickly interpret emergency department patients' chief complaints. The emergency department chief complaints

Towards a Long-Term Strategy for Voluntary-Based Internal Radiation Contamination Monitoring: Representativeness of the Monitoring Results in Fukushima, Japan

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Shuhei Nomura

2017-06-01

Full Text Available Following Japan’s 2011 Fukushima nuclear incident, voluntary participation, rather than mandatory, was adopted as the default scenario for individual radiation monitoring. We evaluated the representativeness of the internal monitoring results from voluntary participants in Minamisoma City, which is located 10–40 km from the Fukushima nuclear plant. Of approximately 70,000 individuals who were residing in Minamisoma City before the incident, a total of 19,263 residents (aged ≥21 years participated in the monitoring from 1 October 2011 to 31 March 2015. Based on regression projection techniques with the available data obtained from the voluntary participants, the modeled probabilities of radiocesium (Cs detection in October 2011 for Cs-137 and Cs-134 were 66.9% and 52.9%, respectively, which declined dramatically within a year following the incident. The rate of decline had stagnated since mid-2012, and the probability was close to zero after mid-2014. Sufficient agreement between the modeled probabilities of Cs detection (for the whole population versus the measured Cs levels (for voluntary participants was observed, except for Cs-134 in October 2011, indicating that the voluntary monitoring participant group was a good representative sample. Our findings affirmed the clinical importance of voluntary-based monitoring as a screening and dose-assessment tool in a post-nuclear incident. Our study informs societal decision-making regarding the long-term maintenance of the monitoring program under the current low exposure levels.

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

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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.

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

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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.

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.

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.

Urine Creatinine Concentrations in Drug Monitoring Participants and Hospitalized Patients.

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Love, Sara A; Seegmiller, Jesse C; Kloss, Julie; Apple, Fred S

2016-10-01

Urine drug testing is commonly performed in both clinical and forensic arenas for screening, monitoring and compliance purposes. We sought to determine if urine creatinine concentrations in monitoring program participants were significantly different from hospital in-patients and out-patients undergoing urine drug testing. We retrospectively reviewed urine creatinine submitted in June through December 2015 for all specimens undergoing urine drug testing. The 20,479 creatinine results were categorized as hospitalized patients (H) and monitoring/compliance groups for pain management (P), legal (L) or recovery (R). Median creatinine concentrations (interquartile range, mg/dL) were significantly different (P creatinine concentrations were significantly lower in the R vs. L group (Pcreatinine concentration and may indicate participants' attempts to tamper with their drug test results through dilution means. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

NURSES’ VIEWS ABOUT PARENT PARTICIPATION IN THE CARE OF HOSPITALIZED CHILDREN

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Sevil Ozkan

2017-12-01

Full Text Available Aim: To determine views of nurses’, who worked at pediatric clinics, about parent participation in the care of hospitalized children. Methods: This descriptive research was performed with 155 nurses who worked at pediatric clinics of four hospitals located in the city center of Konya, in March-May, 2014. Data were collected using a questionaire which was developed according to literature. Data were evaluated in terms of number, percentage, mean, standard deviation via SPSS 20 programme. Results: In study, 81.9% of nurses agreed to views about parent participation can result “reduce fear and anxiety of child" and "facilitation child's coping with painful practices". It was found that most of nurses agreed “it provides that parents know everything about child's care and treatment” (74.8% and “professional communication between nurses and families can return social communication style" (81.3. Gender of parents, comunication style, education levels, knowing caring process of children, children's disease process, age and doctor's order about parent participation were determined effective factors in parent participation. Conclusion: It was found that nurses’ views about effect of parent participation on children were mostly positive but they also had negative views about its effects on parents and nursing. [J Contemp Med 2017; 7(4.000: 355-364

Motivation and benefits of voluntary activities. Case study: EYOF 2013 Braşov

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Codruţa Adina BĂLTESCU

2016-07-01

Full Text Available Voluntary activities have become natural concerns among an increasing number of European citizens. Romania, as a member state of the EU, has a low number of participations in voluntary activities, situation partly justified by the lack of presence of our country on the map of large scale events organization which is based to a high extent, on volunteers’ involvement. The present paper presents the results of a quantitative marketing research organized among volunteers who participated at EYOF 2013 Braşov and highlights the participation’s motivations and benefits felt by volunteers at the end of the event. The authors of the article highlight the differences reported between volunteers’ expectations and their opinions after the event, the results obtained being considered useful for planning the voluntary activities in organizing future events hosted in our country.

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.

16 CFR 1031.6 - Extent and form of Commission involvement in the development of voluntary standards.

Science.gov (United States)

2010-01-01

..., engineering support, and information and education programs) and administrative assistance (e.g., travel costs... SAFETY COMMISSION GENERAL COMMISSION PARTICIPATION AND COMMISSION EMPLOYEE INVOLVEMENT IN VOLUNTARY... goals and objectives with regard to voluntary standards and improved consumer product safety; responding...

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.

Nanotechnology, voluntary oversight, and corporate social performance: does company size matter?

International Nuclear Information System (INIS)

Kuzma, Jennifer; Kuzhabekova, Aliya

2011-01-01

In this article, we examine voluntary oversight programs for nanotechnology in the context of corporate social performance (CSP) in order to better understand the drivers, barriers, and forms of company participation in such programs. At the theoretical level, we use the management framework of CSP to understand the voluntary behavior of companies. At the empirical level, we investigate nanotech industry participation in the Environmental Protection Agency’s Nanoscale Materials Stewardship Program (NMSP) as an example of CSP, in order to examine the effects of company characteristics on CSP outcomes. The analysis demonstrates that, on the average, older and larger companies for which nanotech is one of the many business activities demonstrate greater CSP as judged by company actions, declarations, and self-evaluations. Such companies tended to submit more of the requested information to the NMSP, including specific information about health and safety, and to claim fewer of the submitted items as confidential business information. They were also more likely to have on-line statements of generic and nano-specific corporate social responsibility principles, policies, and achievements. The article suggests a need to encourage smaller and younger companies to participate in voluntary oversight programs for nanotechnology and presents options for better design of these programs.

Nanotechnology, voluntary oversight, and corporate social performance: does company size matter?

Science.gov (United States)

Kuzma, Jennifer; Kuzhabekova, Aliya

2011-04-01

In this article, we examine voluntary oversight programs for nanotechnology in the context of corporate social performance (CSP) in order to better understand the drivers, barriers, and forms of company participation in such programs. At the theoretical level, we use the management framework of CSP to understand the voluntary behavior of companies. At the empirical level, we investigate nanotech industry participation in the Environmental Protection Agency's Nanoscale Materials Stewardship Program (NMSP) as an example of CSP, in order to examine the effects of company characteristics on CSP outcomes. The analysis demonstrates that, on the average, older and larger companies for which nanotech is one of the many business activities demonstrate greater CSP as judged by company actions, declarations, and self-evaluations. Such companies tended to submit more of the requested information to the NMSP, including specific information about health and safety, and to claim fewer of the submitted items as confidential business information. They were also more likely to have on-line statements of generic and nano-specific corporate social responsibility principles, policies, and achievements. The article suggests a need to encourage smaller and younger companies to participate in voluntary oversight programs for nanotechnology and presents options for better design of these programs.

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

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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.

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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

Participation of informal caregivers in the hospital care of elderly patients and their evaluations of the care given: pilot study in three different hospitals.

Science.gov (United States)

Laitinen, P

1992-10-01

This action research is an ongoing study which will last from 1991 to 1993. The main purpose of the study is to increase the participation of informal caregivers in the hospital care of elderly patients without decreasing the quality of care. The data reported here are from a pilot study. This study had three aims: (a) to test reliability and validity of the measure used, (b) to investigate the current participation of informal caregivers in the hospital care of elderly patients (aged over 75), and (c) to evaluate and compare the quality of care from both the patients' and the informal caregivers' point of view in three different hospitals. The measure of quality of care was developed on the basis of need theories, mainly those of Maslow and Alderfer. Patients and caregivers were also asked to rate the participation of the caregivers in the hospital care of elderly patients. Participation consisted of 18 activities of daily living. The pilot test with 18 elderly hospital patients and seven family members or significant others showed differences between the two groups in perception of care received. Statistically significant differences (P needs, psychic and spiritual needs and totals. The results supported earlier findings that elderly patients are satisfied with and do not criticize their care. The younger generation (i.e. their children) is more demanding and has precise perceptions about the care given. Relatives could be used more in planning, evaluation and even implementation of care; however, their current participation in patient hospital care is minimal.

42 CFR 489.34 - Allowable charges: Hospitals participating in State reimbursement control systems or...

Science.gov (United States)

2010-10-01

... reimbursement control systems or demonstration projects. 489.34 Section 489.34 Public Health CENTERS FOR... CERTIFICATION PROVIDER AGREEMENTS AND SUPPLIER APPROVAL Allowable Charges § 489.34 Allowable charges: Hospitals participating in State reimbursement control systems or demonstration projects. A hospital receiving payment for...

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.

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

Patterns of financing for the largest hospital systems in the United States.

Science.gov (United States)

Cleverley, William O; Baserman, Sarah Jane

2005-01-01

The ten large systems reviewed in this column have greater degrees of financial leverage than do most freestanding hospitals. Larger firms typically have both greater capital access and lower costs of financing. Both voluntary and IO systems make extensive use of variable rate financing, but the percentage of variable rate financing is slightly higher for voluntary systems. This difference may be attributable to larger yield curve spreads for tax-exempt versus taxable securities. Interest rate swaps were used by 70 percent of the systems, but the actual amount swapped was relatively minor. This may change in the future as financial officers become more comfortable and familiar with interest rate swap arrangements. When compared to IO systems, voluntary systems have extensive levels of cash relative to their debt positions. Cash balances are more critical in the bond-rating process for voluntary hospitals, and the ability to raise new equity is much more limited in the voluntary sector. Very little capital leasing was used in any of the systems.

Voluntary Service System (VSS)

Data.gov (United States)

Department of Veterans Affairs — Voluntary Service System (VSS) is a national-level application which replaced the site-based Voluntary Timekeeping System (VTK). VTK was used for many years at the...

PRESENT CONDITION AND MEASURES TO EXPAND OF VOLUNTARY AGREEMENT ON PLASTIC SHOPPING BAGS REDUCTION AT THE PREFECTURAL LEVEL

Science.gov (United States)

Mori, Mayuka; Kanaya, Ken

Purpose of this research is to clear present condition and measures to expand of voluntary agreement on plastic shopping bags reduction at the prefectural level. Methods of this research are questionnaire survey to prefectures implementing the agreement and survey by i town page to the number of stores of companies and the number of companies in the prefectures. Findings of this research are as follows: 1. The refusal rate of plastic shopping bags was 10-40% before the implementation of voluntary agreements. And the rate is approximately 70-90% after the implementation. Therefore, before and after the implementation of voluntary agreements, the refusal rate of plastic shopping bags is approximately 40-70% less. 2. It is suggested that the time and number of meetings from proposal to conclusion of the agreement are related in some way, to the ratio of stores participating. On the participation of administration, the ratio of stores participating in the case in which prefecture and cities participate is higher than in the case in which prefecture participates.

Job stress and burnout in hospital employees: comparisons of different medical professions in a regional hospital in Taiwan

Science.gov (United States)

Chou, Li-Ping; Li, Chung-Yi; Hu, Susan C

2014-01-01

Objectives To explore the prevalence and associated factors of burnout among five different medical professions in a regional teaching hospital. Design Cross-sectional study. Setting Hospital-based survey. Participants A total of 1329 medical professionals were recruited in a regional hospital with a response rate of 89%. These voluntary participants included 101 physicians, 68 physician assistants, 570 nurses, 216 medical technicians and 374 administrative staff. Primary and secondary outcome measures Demographic data included gender, age, level of education and marital status, and work situations, such as position, work hours and work shifts, were obtained from an electronic questionnaire. Job strain and burnout were measured by two validated questionnaires, the Chinese version of the Job Content Questionnaire and the Copenhagen Burnout Inventory. Results Among the five medical professions, the prevalence of high work-related burnout from highest to lowest was nurses (66%), physician assistants (61.8%), physicians (38.6%), administrative staff (36.1%) and medical technicians (31.9%), respectively. Hierarchical regression analysis indicated that job strain, overcommitment and low social support explained the most variance (32.6%) of burnout. Conclusions Physician assistant is an emerging high burnout group; its severity is similar to that of nurses and far more than that of physicians, administrative staff and medical technicians. These findings may contribute to the development of feasible strategies to reduce the stress which results in the burnout currently plaguing most hospitals in Taiwan. PMID:24568961

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...

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

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 risk Seeking in the Risk Society: Explaining Involvement in Edgework

NARCIS (Netherlands)

P. Mascini (Peter); P.H.J. Achterberg (Peter); D. Houtman (Dick)

2015-01-01

markdownabstract__Abstract__ How does voluntary participation in dangerous leisure activities requiring skills (‘edgework’) compare, for example, to gambling and thrill seeking and why does edgework thrive in societies preoccupied with safety and security? Lyng (1990) assumes edgework constitutes

Participation in sports clubs is a strong predictor of injury hospitalization: a prospective cohort study.

Science.gov (United States)

Mattila, V M; Parkkari, J; Koivusilta, L; Kannus, P; Rimpelä, A

2009-04-01

The aim of this prospective cohort study was to investigate the nature and risk factors of injuries leading to hospitalization. A cohort of 57 407 Finns aged 14-18 years was followed in the Hospital Discharge Register for an average of 10.6 years, totaling 608 990 person-years. We identified 5889 respondents (10.3%) with injury hospitalization. The most common anatomical location was the knee and shin (23.9%), followed by the head and neck (17.8%), and the ankle and foot (16.7%). Fractures (30.4%) and distortions (25.4%) were the most common injury types. The strongest risk factor for injury hospitalization was frequent participation in sports clubs [hazard ratio (HR) in males 1.8; 95% confidence interval (CI): 1.7-2.0 and in females 2.3; 95% CI: 1.9-2.7], followed by recurring drunkenness (HR 1.6; 95% CI: 1.4-2.7 in males and 1.4; 95% CI: 1.2-1.6 in females) and daily smoking (HR 1.4; 95% CI: 1.3-1.5 in males and 1.43 95% CI: 1.2-1.5 in females). The association between injuries and sports clubs participation remained after adjusting for sociodemographic background, health, and health behaviors. Health behavior in adolescence, particularly sports club activity, predicted injury hospitalization. Preventive interventions directed toward adolescents who participate in sports clubs may decrease injury occurrence.

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.

Barriers to participation in a hospital-based falls assessment clinic programme: an interview study with older people

DEFF Research Database (Denmark)

Evron, L.; Schultz-Larsen, K.; Fristrup, T.

2009-01-01

Aims: To gain new knowledge about barriers to participation in hospital-based falls assessment. Methods: Semi-structured interviews with 20 older people referred to falls assessment at a hospital-based clinic were conducted. A convenience sample of 10 refusers and 10 accepters was collected. Thos...... the findings of this study to a public health message, we have to consider moving the focus of falls prevention strategies from disease control to the domain of health promotion in order to engage older adults in preventive healthcare Udgivelsesdato: 2009/9......Aims: To gain new knowledge about barriers to participation in hospital-based falls assessment. Methods: Semi-structured interviews with 20 older people referred to falls assessment at a hospital-based clinic were conducted. A convenience sample of 10 refusers and 10 accepters was collected. Those...... system taking over their life. Conclusions: This study indicates that older at-risk patients acknowledge their falls problem, but refuse to participate in hospital-based assessment programmes because they expect to lose their authority and to be caught up in the healthcare system. In order to transform...

Barriers to participation in a hospital-based falls assessment clinic programme: an interview study with older people

DEFF Research Database (Denmark)

Evron, Lotte; Schultz-Larsen, Kirsten; Fristrup, Tine

2009-01-01

Aims: To gain new knowledge about barriers to participation in hospital-based falls assessment. Methods: Semi-structured interviews with 20 older people referred to falls assessment at a hospital-based clinic were conducted. A convenience sample of 10 refusers and 10 accepters was collected. Thos...... the findings of this study to a public health message, we have to consider moving the focus of falls prevention strategies from disease control to the domain of health promotion in order to engage older adults in preventive healthcare.......Aims: To gain new knowledge about barriers to participation in hospital-based falls assessment. Methods: Semi-structured interviews with 20 older people referred to falls assessment at a hospital-based clinic were conducted. A convenience sample of 10 refusers and 10 accepters was collected. Those...... system taking over their life. Conclusions: This study indicates that older at-risk patients acknowledge their falls problem, but refuse to participate in hospital-based assessment programmes because they expect to lose their authority and to be caught up in the healthcare system. In order to transform...

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.

Does outsourcing paramedical departments of teaching hospitals affect educational status of the students?

Science.gov (United States)

Moslehi, Shandiz; Atefimanesh, Pezhman; Sarabi Asiabar, Ali; Ahmadzadeh, Nahal; Kafaeimehr, Mohamadhosein; Emamgholizadeh, Saeid

2016-01-01

There is an increasing trend of outsourcing public departments. Teaching hospitals also outsourced some of their departments to private sectors. The aim of this study was to investigate and compare the educational status of students in public and outsourced departments of teaching hospitals affiliated to Iran University of Medical Sciences. This study was conducted in six teaching hospitals of Iran University of Medical Sciences, which had public and outsourced teaching departments in 2015. One hundred fifty students from the departments of radiology, physiotherapy and laboratory participated in this study and their perceptions about their educational status were assessed. A valid and reliable questionnaire was used; participation in the study was voluntary. Descriptive statistics such as mean (SD), t-test and Kolmogorov-Smirnov were used. No difference was detected between the educational status of students in public and outsourced departments of radiology, physiotherapy and laboratory (p>0.05). Based on the students' perception, the private sectors could maintain the educational level of the teaching departments similar to the public departments. It is recommended to involve all the stakeholders such as hospital administrators, academic staff and students in the decision- making process when changes in teaching environments are being considered.

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)

Implementing hospital quality assurance policies in Iran: balancing licensing, annual evaluation, inspections and quality management systems.

Science.gov (United States)

Aghaei Hashjin, Asgar; Delgoshaei, Bahram; Kringos, Dionne S; Tabibi, Seyed Jamaladin; Manouchehri, Jila; Klazinga, Niek S

2015-01-01

The purpose of this paper is to provide an overview of applied hospital quality assurance (QA) policies in Iran. A mixed method (quantitative data and qualitative document analysis) study was carried out between 1996 and 2010. The QA policy cycle forms a tight monitoring system to assure hospital quality by combining mandatory and voluntary methods in Iran. The licensing, annual evaluation and grading, and regulatory inspections statutorily implemented by the government as a national package to assure and improve hospital care quality, while implementing quality management systems (QMS) was voluntary for hospitals. The government's strong QA policy legislation role and support has been an important factor for successful QA implementation in Iran, though it may affected QA assessment independency and validity. Increased hospital evaluation independency and repositioning, updating standards, professional involvement and effectiveness studies could increase QA policy impact and maturity. The study highlights the current QA policy implementation cycle in Iranian hospitals. It provides a basis for further quality strategy development in Iranian hospitals and elsewhere. It also raises attention about finding the optimal balance between different QA policies, which is topical for many countries. This paper describes experiences when implementing a unique approach, combining mandatory and voluntary QA policies simultaneously in a developing country, which has invested considerably over time to improve hospital quality. The experiences with a mixed obligatory/voluntary approach and comprehensive policies in Iran may contain lessons for policy makers in developing and developed countries.

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

Agency problems in hospitals participating in self-management project under global budget system in Taiwan.

Science.gov (United States)

Yan, Yu-Hua; Hsu, Shuofen; Yang, Chen-Wei; Fang, Shih-Chieh

2010-02-01

The main purposes of this study are to clarify the agency problems in the hospitals participating in self-management project within the context of Global Budgeting Payment System regulated by Taiwan government, and also to provide some suggestions for hospital administrator and health policy maker in reducing the waste of healthcare resources resulting from agency problems. For the purposes above, this study examines the relationships between two agency problems (ex ante moral hazard and ex post moral hazard) aroused among the hospitals and Bureau of National Health Insurance in Taiwan's health care sector. This study empirically tested the theoretical model at organization level. The findings suggest that the hospital's ex ante moral hazards before participating the self-management project do have some influence on its ex post moral hazards after participating the self-management project. This study concludes that the goal conflict between the agents and the principal certainly exist. The principal tries hard to control the expenditure escalation and keep the financial balance, but the agents have to subsist within limited healthcare resources. Therefore, the agency cost would definitely occur due to the conflicts between both parties. According to the results of the research, some suggestions and related management concepts were proposed at the end of the paper.

Voluntary agreements between government and business - a scoping review of the literature with specific reference to the Public Health Responsibility Deal.

Science.gov (United States)

Bryden, Anna; Petticrew, Mark; Mays, Nicholas; Eastmure, Elizabeth; Knai, Cecile

2013-05-01

A scoping review was conducted to synthesise the findings of evaluations of voluntary agreements between business and government. It aimed to summarise the types of agreements that exist, how they work in practice, the conditions for their success and how they had been evaluated. Voluntary agreements were included if they involved a transparent signing-up process and where businesses agreed to carry out specific actions or to achieve specific outcomes. Studies of any design published in English were included. 47 studies were identified. Voluntary agreements may help to improve relationships between government and business, and can help both parties agree on target-setting and data-sharing. Governments may also use the experience to help develop subsequent legislation. For voluntary agreements to be successful, targets should be ambitious and clearly defined, with robust independent monitoring. Public knowledge of agreements can help encourage participation and ensure compliance. If properly implemented and monitored, voluntary agreements can be an effective policy approach, though there is little evidence on whether they are more effective than compulsory approaches. Some of the most effective voluntary agreements include substantial disincentives for non-participation and sanctions for non-compliance. Many countries are moving towards these more formal approaches to voluntary agreements. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Assessing Dutch farmers' incentives to join a voluntary Johne's Disease programme

NARCIS (Netherlands)

Hop, G.E.; Velthuis, A.G.J.; Frankena, K.

2011-01-01

The incentives of Dutch dairy farmers to participate in a voluntary Johne's Disease (JD) control programme were investigated using a case–control design. Furthermore, farm and farmers’ characteristics of case and control farmers were compared. Dairy farmers in the northern part of the Netherlands

Consensus on the leadership of hospital CEOs and its impact on the participation of physicians in improvement projects.

Science.gov (United States)

Dückers, Michel L A; Stegeman, Inge; Spreeuwenberg, Peter; Wagner, Cordula; Sanders, Karin; Groenewegen, Peter P

2009-08-01

The success of a Dutch program to disseminate quality improvement projects depends on the participation of physicians working in program hospitals. The leadership of hospital executives (CEOs) is considered an important explanation. This study aims to determine whether the relation, between the extent to which physicians notice their CEOs stimulate improvement initiatives and the number of projects joined by physicians, is moderated by the consensus among physicians working in the same hospital. Multilevel analyses are applied on data of 286 physicians from eight hospitals to: (1) estimate whether participation depends on noticing if CEOs stimulate improvement, (2) test if an individual's participation differs when more colleagues have the same opinion (effect modification). Significant moderator effects are found. The participation of physicians, noticing that CEOs stimulate improvement is higher when more colleagues share this opinion. For physicians not knowing whether improvement is encouraged, higher consensus coincides with lower participation. Project involvement of physicians depends on their consensus about encouragement by CEOs. This confirms the importance of strategic leaders in dissemination programs. Further research is recommended into causes of CEO leadership visibility and methods to strengthen leadership climate.

Psychiatric hospital nursing staff's experiences of participating in group-based clinical supervision:

DEFF Research Database (Denmark)

Buus, Niels; Angel, Sanne; Traynor, Michael

2010-01-01

Group-based clinical supervision is commonly offered as a stress-reducing intervention in psychiatric settings, but nurses often feel ambivalent about participating. This study aimed at exploring psychiatric nurses' experiences of participating in groupbased supervision and identifying psychosocial...... reasons for their ambivalence. Semi-structured interviews were conducted with 22 psychiatric nurses at a Danish university hospital. The results indicated that participation in clinical supervision was difficult for the nurses because of an uncomfortable exposure to the professional community. The sense...... of exposure was caused by the particular interactional organisation during the sessions, which brought to light pre-existing but covert conflicts among the nurses....

Early-career registered nurses' participation in hospital quality improvement activities.

Science.gov (United States)

Djukic, Maja; Kovner, Christine T; Brewer, Carol S; Fatehi, Farida K; Bernstein, Ilya

2013-01-01

We surveyed 2 cohorts of early-career registered nurses from 15 states in the US, 2 years apart, to compare their reported participation in hospital quality improvement (QI) activities. We anticipated differences between the 2 cohorts because of the growth of several initiatives for engaging nurses in QI. There were no differences between the 2 cohorts across 14 measured activities, except for their reported use of appropriate strategies to improve hand-washing compliance to reduce nosocomial infection rates.

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

The Influence of Nurses' Demographics on Patient Participation in Hospitals: A Cross-Sectional Study.

Science.gov (United States)

Malfait, Simon; Eeckloo, Kristof; Van Hecke, Ann

2017-12-01

Patient participation is an important issue in contemporary healthcare as it improves quality of care and enhances positive health outcomes. The participation of patients is mainly initiated by the nurses' willingness to share their power and responsibility, but knowledge on nurses' demographic characteristics influencing this behavior is nonexistent. This knowledge is essential to understand and improve patient participation. To determine if nurses' demographic characteristics influence their willingness to engage in patient participation. A cross-sectional multicenter study in 22 general and three university hospitals with 997 nurses was performed. The Patient Participation Culture Tool for healthcare workers, which measures patient participation behavior, was used. Multilevel analysis, taking into account the difference in wards and hospitals, was used to identify the influence of demographic characteristics. A position as supervisor (range: p nurses seem to be more reluctant in accepting a collaborative patient role (p = .002) and coping with more active patient behavior (p nurses on geriatric wards (p = .013), who also showed less sharing of information with their patients (p nurses' willingness to share power and responsibility with their patients, perhaps indicating that patient participation behavior is an advanced nursing skill and multifaceted interventions, are needed for optimal implementation. Moreover, supervising nurses have different perceptions on patient participation and possibly regard patient participation as an easier task than their team members. This could lead to misunderstandings about the expectations toward patient participation in daily practice, leading to struggles with their nursing staff. Both findings implicate that implementing patient participation on a wide scale is more difficult than expected, which is conflicting with the widespread societal demand for more participation. © 2017 Sigma Theta Tau International.

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.

Effects of social participation and the emergence of voluntary social interactions on household power-saving practices in post-disaster Kanagawa, Japan

International Nuclear Information System (INIS)

Nakamura, Hidenori

2013-01-01

An online social survey was conducted to reveal household electricity-saving behaviour and its relationship with participation in social group activities, as well as face-to-face and online social interactions, i.e., information sources used and information dissemination through personal networks, in a disaster-affected region of Kanagawa, Japan, during the summer of 2011. The study confirms the positive contribution of respondents’ participation in social group activities to the number of power-saving practices conducted. It also reveals the emergence of voluntary social face-to-face and/or online interactions for power-saving. The study suggests it would be useful to provide effective information to proactive individuals who are closely engaged in power-saving in households and who are proactively disseminating power-saving information practices to others. Such individuals include (1) women who have school-children and who are proactively engaging in the social interactions of their children’s schools, other parents, neighbours, as well as their own parents and relatives; and (2) men and women who are using various kinds of online interaction tools and are also engaged in face-to-face social interactions

Understanding organisational development, sustainability, and diffusion of innovations within hospitals participating in a multilevel quality collaborative.

NARCIS (Netherlands)

Dückers, M.L.A.; Wagner, C.; Vos, L.; Groenewegen, P.P.

2011-01-01

BACKGROUND: Between 2004 and 2008, 24 Dutch hospitals participated in a two-year multilevel quality collaborative (MQC) comprised of (a) a leadership programme for hospital executives, (b) six quality-improvement collaboratives (QICs) for healthcare professionals and other staff, and (c) an internal

Auditory-somatosensory temporal sensitivity improves when the somatosensory event is caused by voluntary body movement

Directory of Open Access Journals (Sweden)

Norimichi Kitagawa

2016-12-01

Full Text Available When we actively interact with the environment, it is crucial that we perceive a precise temporal relationship between our own actions and sensory effects to guide our body movements.Thus, we hypothesized that voluntary movements improve perceptual sensitivity to the temporal disparity between auditory and movement-related somatosensory events compared to when they are delivered passively to sensory receptors. In the voluntary condition, participants voluntarily tapped 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 performance of temporal order judgment (TOJ in the voluntary condition (as indexed by the just noticeable difference was significantly better (M=42.5 ms ±3.8 s.e.m than that when their finger was passively stimulated (passive condition: M=66.8 ms ±6.3 s.e.m. We further examined whether the performance improvement with voluntary action can be attributed to the prediction of the timing of the stimulation from sensory cues (sensory-based prediction, kinesthetic cues contained in voluntary action, and/or to the prediction of stimulation timing from the efference copy of the motor command (motor-based prediction. When the participant’s finger was moved passively to press the button (involuntary condition and when three noise bursts were presented before the target burst with regular intervals (predictable condition, the TOJ performance was not improved from that in the passive condition. These results suggest that the improvement in sensitivity to temporal disparity between somatosensory and auditory events caused by the voluntary action cannot be attributed to sensory-based prediction and kinesthetic cues. Rather, the prediction from the efference copy of the motor command would be crucial for improving the temporal sensitivity.

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.

The role of emotions in spatial prisoner's dilemma game with voluntary participation

Science.gov (United States)

Wang, Lu; Ye, Shun-Qiang; Cheong, Kang Hao; Bao, Wei; Xie, Neng-gang

2018-01-01

This paper develops an extended emotional model in the voluntary prisoner's dilemma game. It fills a gap in the traditional imitation mechanism by assuming that players do not simply imitate pure strategies, but imitate the emotional profiles of one another instead. The relationship between emotional profiles and strategy are constructed and Monte Carlo simulations are performed on a square lattice. Simulation results reveal that with an increase in the temptation parameter T (1 ⩽ T ⩽ 2), the order-chaos-order transition occurs. When T is around 1.2, we find that a bifurcation occurs. From a social system perspective, as T increases, the system changes from a benign one (respect for the 'successful' people and sympathy towards the weak one) to one that is of vicious nature (that is, bully the weak and fear the strong).

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.

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.

Understanding organisational development, sustainability, and diffusion of innovations within hospitals participating in a multilevel quality collaborative.

Science.gov (United States)

Dückers, Michel La; Wagner, Cordula; Vos, Leti; Groenewegen, Peter P

2011-03-09

Between 2004 and 2008, 24 Dutch hospitals participated in a two-year multilevel quality collaborative (MQC) comprised of (a) a leadership programme for hospital executives, (b) six quality-improvement collaboratives (QICs) for healthcare professionals and other staff, and (c) an internal programme organisation to help senior management monitor and coordinate team progress. The MQC aimed to stimulate the development of quality-management systems and the spread of methods to improve patient safety and logistics. The objective of this study is to describe how the first group of eight MQC hospitals sustained and disseminated improvements made and the quality methods used. The approach followed by the hospitals was described using interview and questionnaire data gathered from eight programme coordinators. MQC hospitals followed a systematic strategy of diffusion and sustainability. Hospital quality-management systems are further developed according to a model linking plan-do-study-act cycles at the unit and hospital level. The model involves quality norms based on realised successes, performance agreements with unit heads, organisational support, monitoring, and quarterly accountability reports. It is concluded from this study that the MQC contributed to organisational development and dissemination within participating hospitals. Organisational learning effects were demonstrated. System changes affect the context factors in the theory of organisational readiness: organisational culture, policies and procedures, past experience, organisational resources, and organisational structure. Programme coordinator responses indicate that these factors are utilised to manage spread and sustainability. Further research is needed to assess long-term effects.

Does outsourcing paramedical departments of teaching hospitals affect educational status of the students?

Science.gov (United States)

Moslehi, Shandiz; Atefimanesh, Pezhman; Sarabi Asiabar, Ali; Ahmadzadeh, Nahal; Kafaeimehr, Mohamadhosein; Emamgholizadeh, Saeid

2016-01-01

Background: There is an increasing trend of outsourcing public departments. Teaching hospitals also outsourced some of their departments to private sectors. The aim of this study was to investigate and compare the educational status of students in public and outsourced departments of teaching hospitals affiliated to Iran University of Medical Sciences. Methods: This study was conducted in six teaching hospitals of Iran University of Medical Sciences, which had public and outsourced teaching departments in 2015. One hundred fifty students from the departments of radiology, physiotherapy and laboratory participated in this study and their perceptions about their educational status were assessed. A valid and reliable questionnaire was used; participation in the study was voluntary. Descriptive statistics such as mean (SD), t-test and Kolmogorov-Smirnov were used. Results: No difference was detected between the educational status of students in public and outsourced departments of radiology, physiotherapy and laboratory (p>0.05). Conclusion: Based on the students’ perception, the private sectors could maintain the educational level of the teaching departments similar to the public departments. It is recommended to involve all the stakeholders such as hospital administrators, academic staff and students in the decision- making process when changes in teaching environments are being considered. PMID:27683645

Effects on Student Achievement in General Chemistry Following Participation in an Online Preparatory Course. ChemPrep, a Voluntary, Self-Paced, Online Introduction to Chemistry

Science.gov (United States)

Botch, Beatrice; Day, Roberta; Vining, William; Stewart, Barbara; Rath, Kenneth; Peterfreund, Alan; Hart, David

2007-03-01

ChemPrep was developed to be a stand-alone preparatory short-course to help students succeed in general chemistry. It is Web-based and delivered using the OWL system. Students reported that the ChemPrep materials (short information pages, parameterized questions with detailed feedback, tutorials, and answers to questions through the OWL message system) permitted them to work independently without the need for textbook or lecture. On average, students who completed ChemPrep had higher grades in the subsequent GenChem, Nursing, and Honors chemistry courses, with a greater percentage achieving a grade of C- or higher. Participation in ChemPrep was voluntary, and more women than men responded. Students in the Honors course enrolled in ChemPrep in higher percentages than students in GenChem and Nursing. SAT and departmental math placement exam scores were used as proxy measures of prior achievement and ability. Based on these, Honors chemistry ChemPrep users were on par with their peers but performed better in the course than non-users. In GenChem and Nursing chemistry courses, ChemPrep helped students of high prior achievement and ability perform better than their achievement scores would predict. Weaker or less motivated students did not respond to the voluntary offerings of ChemPrep in the same numbers as stronger or more motivated students, and we are seeking alternate ways to reach this population.

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

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

Participation of the nurse manager in the process of hospital accreditation

Directory of Open Access Journals (Sweden)

Andréia Guerra Siman

Full Text Available This study's aim was to understand the role of nurse managers in the process of hospital accreditation. This qualitative case study was conducted in a large private hospital in Belo Horizonte, MG, Brazil. Five nurse managers were interviewed using a semi-structured script from April to May, 2011 and content analysis was used to interpret the data. Results show the strategic position of this professional, his/her managerial skills and participation in the implementation and maintenance of accreditation, and the importance of care management. Nurses have played managerial roles with greater autonomy, connecting inter-sector care, which contrasts with the curative model, and have established partnerships with different social and institutional segments, adopting standards for teamwork. Managerial, healthcare, and educational work is performed from a procedural and indivisible perspective.

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

Understanding organisational development, sustainability, and diffusion of innovations within the hospitals participating in a multilevel quality collaborative.

NARCIS (Netherlands)

Duckers, M.L.A.; Wagner, C.; Groenewegen, P.P.

2011-01-01

Background: Between 2004 and 2008, 24 Dutch hospitals participated in a two-year multilevel quality collaborative (MQC) comprised of (a) a leadership programme for hospital executives, (b) six quality-improvement collaboratives (QICs) for healthcare professionals and other staff, and (c) an

Moderating effects of voluntariness on the actual use of electronic health records for allied health professionals.

Science.gov (United States)

Chiu, Teresa Ml; Ku, Benny Ps

2015-02-10

Mandatory versus voluntary requirement has moderating effect on a person's intention to use a new information technology. Studies have shown that the use of technology in health care settings is predicted by perceived ease of use, perceived usefulness, social influence, facilitating conditions, and attitude towards computer. These factors have different effects on mandatory versus voluntary environment of use. However, the degree and direction of moderating effect of voluntariness on these factors remain inconclusive. This study aimed to examine the moderating effect of voluntariness on the actual use of an electronic health record (EHR) designed for use by allied health professionals in Hong Kong. Specifically, this study explored and compared the moderating effects of voluntariness on factors organized into technology, implementation, and individual contexts. Physiotherapists who had taken part in the implementation of a new EHR were invited to complete a survey. The survey included questions that measured the levels of voluntariness, technology acceptance and use, and attitude towards technology. Multiple logistic regressions were conducted to identify factors associated with actual use of a compulsory module and a noncompulsory module of the EHR. In total, there were 93 participants in the study. All of them had access to the noncompulsory module, the e-Progress Note, to record progress notes of their patients. Out of the 93 participants, 57 (62%) were required to use a compulsory module, the e-Registration, to register patient attendance. In the low voluntariness environment, Actual Use was associated with Effort Expectancy (mean score of users 3.51, SD 0.43; mean score of non-users 3.21, SD 0.31; P=.03). Effort Expectancy measured the perceived ease of use and was a variable in the technology context. The variables in the implementation and individual contexts did not show a difference between the two groups. In the high voluntariness environment, the mean

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…

Understanding organisational development, sustainability, and diffusion of innovations within hospitals participating in a multilevel quality collaborative

Directory of Open Access Journals (Sweden)

Wagner Cordula

2011-03-01

Full Text Available Abstract Background Between 2004 and 2008, 24 Dutch hospitals participated in a two-year multilevel quality collaborative (MQC comprised of (a a leadership programme for hospital executives, (b six quality-improvement collaboratives (QICs for healthcare professionals and other staff, and (c an internal programme organisation to help senior management monitor and coordinate team progress. The MQC aimed to stimulate the development of quality-management systems and the spread of methods to improve patient safety and logistics. The objective of this study is to describe how the first group of eight MQC hospitals sustained and disseminated improvements made and the quality methods used. Methods The approach followed by the hospitals was described using interview and questionnaire data gathered from eight programme coordinators. Results MQC hospitals followed a systematic strategy of diffusion and sustainability. Hospital quality-management systems are further developed according to a model linking plan-do-study-act cycles at the unit and hospital level. The model involves quality norms based on realised successes, performance agreements with unit heads, organisational support, monitoring, and quarterly accountability reports. Conclusions It is concluded from this study that the MQC contributed to organisational development and dissemination within participating hospitals. Organisational learning effects were demonstrated. System changes affect the context factors in the theory of organisational readiness: organisational culture, policies and procedures, past experience, organisational resources, and organisational structure. Programme coordinator responses indicate that these factors are utilised to manage spread and sustainability. Further research is needed to assess long-term effects.

Understanding organisational development, sustainability, and diffusion of innovations within hospitals participating in a multilevel quality collaborative

Science.gov (United States)

2011-01-01

Background Between 2004 and 2008, 24 Dutch hospitals participated in a two-year multilevel quality collaborative (MQC) comprised of (a) a leadership programme for hospital executives, (b) six quality-improvement collaboratives (QICs) for healthcare professionals and other staff, and (c) an internal programme organisation to help senior management monitor and coordinate team progress. The MQC aimed to stimulate the development of quality-management systems and the spread of methods to improve patient safety and logistics. The objective of this study is to describe how the first group of eight MQC hospitals sustained and disseminated improvements made and the quality methods used. Methods The approach followed by the hospitals was described using interview and questionnaire data gathered from eight programme coordinators. Results MQC hospitals followed a systematic strategy of diffusion and sustainability. Hospital quality-management systems are further developed according to a model linking plan-do-study-act cycles at the unit and hospital level. The model involves quality norms based on realised successes, performance agreements with unit heads, organisational support, monitoring, and quarterly accountability reports. Conclusions It is concluded from this study that the MQC contributed to organisational development and dissemination within participating hospitals. Organisational learning effects were demonstrated. System changes affect the context factors in the theory of organisational readiness: organisational culture, policies and procedures, past experience, organisational resources, and organisational structure. Programme coordinator responses indicate that these factors are utilised to manage spread and sustainability. Further research is needed to assess long-term effects. PMID:21385467

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.

9 CFR 317.343 - Significant participation for voluntary nutrition labeling.

Science.gov (United States)

2010-01-01

... allocated by type and size. (d) FSIS will find that significant participation by food retailers exists if at.... (b) FSIS will judge a food retailer to be participating at a significant level if the retailer... an approriate manner. (c) To determine whether there is significant participation by retailers under...

Barriers to participation in a hospital-based falls assessment clinic programme: an interview study with older people

DEFF Research Database (Denmark)

Evron, Lotte

2009-01-01

Aims: To gain new knowledge about barriers to participation in hospital-based falls assessment. Methods: Semi-structured interviews with 20 older people referred to falls assessment at a hospital-based clinic were conducted. A convenience sample of 10 refusers and 10 accepters was collected. Those...

Stability of participation in collective pension schemes: an option pricing approach

NARCIS (Netherlands)

Chen, D.H.J.; Beetsma, R.M.W.J.; Broeders, D.W.G.A.

2015-01-01

This paper contributes to the discussion about mandatory participation in collective funded pension schemes. It explores under what circumstances individual participants exercise the option to exit such scheme if participation is voluntary. First, we show how the willingness to participate increases

Stability of Participation in Collective Pension Schemes : An Option Pricing Approach

NARCIS (Netherlands)

Chen, Damiaan; Beetsma, Roel; Broeders, D.

2015-01-01

This paper contributes to the discussion about mandatory participation in collective funded pension schemes. It explores under what circumstances individual participants exercise the option to exit such scheme if participation is voluntary. First, we show how the willingness to participate increases

9 CFR 381.443 - Significant participation for voluntary nutrition labeling.

Science.gov (United States)

2010-01-01

... allocated by type and size. (d) FSIS will find that significant participation by food retailers exists if at... frozen. (b) FSIS will judge a food retailer to be participating at a significant level if the retailer... an appropriate manner. (c) To determine whether there is significant participation by retailers under...

A Financial Analysis of Brazilian Hospitals Between 2006 and 2011

Directory of Open Access Journals (Sweden)

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.

Voluntary self-touch increases body ownership

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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.

Trainability of muscular activity level during maximal voluntary co-contraction: comparison between bodybuilders and nonathletes.

Directory of Open Access Journals (Sweden)

Sumiaki Maeo

Full Text Available Antagonistic muscle pairs cannot be fully activated simultaneously, even with maximal effort, under conditions of voluntary co-contraction, and their muscular activity levels are always below those during agonist contraction with maximal voluntary effort (MVE. Whether the muscular activity level during the task has trainability remains unclear. The present study examined this issue by comparing the muscular activity level during maximal voluntary co-contraction for highly experienced bodybuilders, who frequently perform voluntary co-contraction in their training programs, with that for untrained individuals (nonathletes. The electromyograms (EMGs of biceps brachii and triceps brachii muscles during maximal voluntary co-contraction of elbow flexors and extensors were recorded in 11 male bodybuilders and 10 nonathletes, and normalized to the values obtained during the MVE of agonist contraction for each of the corresponding muscles (% EMGMVE. The involuntary coactivation level in antagonist muscle during the MVE of agonist contraction was also calculated. In both muscles, % EMGMVE values during the co-contraction task for bodybuilders were significantly higher (P<0.01 than those for nonathletes (biceps brachii: 66±14% in bodybuilders vs. 46±13% in nonathletes, triceps brachii: 74±16% vs. 57±9%. There was a significant positive correlation between a length of bodybuilding experience and muscular activity level during the co-contraction task (r = 0.653, P = 0.03. Involuntary antagonist coactivation level during MVE of agonist contraction was not different between the two groups. The current result indicates that long-term participation in voluntary co-contraction training progressively enhances muscular activity during maximal voluntary co-contraction.

Trainability of Muscular Activity Level during Maximal Voluntary Co-Contraction: Comparison between Bodybuilders and Nonathletes

Science.gov (United States)

Maeo, Sumiaki; Takahashi, Takumi; Takai, Yohei; Kanehisa, Hiroaki

2013-01-01

Antagonistic muscle pairs cannot be fully activated simultaneously, even with maximal effort, under conditions of voluntary co-contraction, and their muscular activity levels are always below those during agonist contraction with maximal voluntary effort (MVE). Whether the muscular activity level during the task has trainability remains unclear. The present study examined this issue by comparing the muscular activity level during maximal voluntary co-contraction for highly experienced bodybuilders, who frequently perform voluntary co-contraction in their training programs, with that for untrained individuals (nonathletes). The electromyograms (EMGs) of biceps brachii and triceps brachii muscles during maximal voluntary co-contraction of elbow flexors and extensors were recorded in 11 male bodybuilders and 10 nonathletes, and normalized to the values obtained during the MVE of agonist contraction for each of the corresponding muscles (% EMGMVE). The involuntary coactivation level in antagonist muscle during the MVE of agonist contraction was also calculated. In both muscles, % EMGMVE values during the co-contraction task for bodybuilders were significantly higher (Pbodybuilders vs. 46±13% in nonathletes, triceps brachii: 74±16% vs. 57±9%). There was a significant positive correlation between a length of bodybuilding experience and muscular activity level during the co-contraction task (r = 0.653, P = 0.03). Involuntary antagonist coactivation level during MVE of agonist contraction was not different between the two groups. The current result indicates that long-term participation in voluntary co-contraction training progressively enhances muscular activity during maximal voluntary co-contraction. PMID:24260233

Sustainability of participation in collective pension schemes : An option pricing approach

NARCIS (Netherlands)

Chen, D.H.J.; Beetsma, R.M.W.J.; Broeders, D.W.G.A.; Pelsser, A.A.J.

2017-01-01

This paper contributes to the discussion about mandatory participation in collective funded pension schemes. It explores under what circumstances individual participants exercise the option to exit such a scheme if participation is voluntary. We begin by showing how the willingness to participate

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.

Sequential voluntary cough and aspiration or aspiration risk in Parkinson's disease.

Science.gov (United States)

Hegland, Karen Wheeler; Okun, Michael S; Troche, Michelle S

2014-08-01

Disordered swallowing, or dysphagia, is almost always present to some degree in people with Parkinson's disease (PD), either causing aspiration or greatly increasing the risk for aspiration during swallowing. This likely contributes to aspiration pneumonia, a leading cause of death in this patient population. Effective airway protection is dependent upon multiple behaviors, including cough and swallowing. Single voluntary cough function is disordered in people with PD and dysphagia. However, the appropriate response to aspirate material is more than one cough, or sequential cough. The goal of this study was to examine voluntary sequential coughing in people with PD, with and without dysphagia. Forty adults diagnosed with idiopathic PD produced two trials of sequential voluntary cough. The cough airflows were obtained using pneumotachograph and facemask and subsequently digitized and recorded. All participants received a modified barium swallow study as part of their clinical care, and the worst penetration-aspiration score observed was used to determine whether the patient had dysphagia. There were significant differences in the compression phase duration, peak expiratory flow rates, and amount of air expired of the sequential cough produced by participants with and without dysphagia. The presence of dysphagia in people with PD is associated with disordered cough function. Sequential cough, which is important in removing aspirate material from large- and smaller-diameter airways, is also impaired in people with PD and dysphagia compared with those without dysphagia. There may be common neuroanatomical substrates for cough and swallowing impairment in PD leading to the co-occurrence of these dysfunctions.

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.

Searching for the majority: algorithms of voluntary control.

Directory of Open Access Journals (Sweden)

Jin Fan

Full Text Available Voluntary control of information processing is crucial to allocate resources and prioritize the processes that are most important under a given situation; the algorithms underlying such control, however, are often not clear. We investigated possible algorithms of control for the performance of the majority function, in which participants searched for and identified one of two alternative categories (left or right pointing arrows as composing the majority in each stimulus set. We manipulated the amount (set size of 1, 3, and 5 and content (ratio of left and right pointing arrows within a set of the inputs to test competing hypotheses regarding mental operations for information processing. Using a novel measure based on computational load, we found that reaction time was best predicted by a grouping search algorithm as compared to alternative algorithms (i.e., exhaustive or self-terminating search. The grouping search algorithm involves sampling and resampling of the inputs before a decision is reached. These findings highlight the importance of investigating the implications of voluntary control via algorithms of mental operations.

Consensus on the leadership of hospital CEOs and its impact on the participation of physicians in improvement projects

NARCIS (Netherlands)

Dückers, Michel L.A.; Stegeman, Inge; Spreeuwenberg, Peter; Wagner, Cordula; Sanders, Karin; Groenewegen, Peter P.

2009-01-01

Objectives: The success of a Dutch program to disseminate quality improvement projects depends on the participation of physicians working in program hospitals. The leadership of hospital executives (CEOs) is considered an important explanation. This study aims to determine whether the relation,

Consensus on the leadership of hospital CEOs and its impact on the participation of clinicians in improvement projects.

NARCIS (Netherlands)

Dückers, M.L.A.; Stegeman, I.; Spreeuwenberg, P.; Wagner, C.; Sanders, K.; Groenewegen, P.P.

2009-01-01

Objectives: The success of a Dutch program to disseminate quality improvement projects depends on the participation of physicians working in program hospitals. The leadership of hospital executives (CEOs) is considered an important explanation. This study aims to determine whether the relation,

Consensus on the leadership of hospital CEOs and its impact on the participation of physicians in improvement projects

NARCIS (Netherlands)

Duckers, M.L.A.; Stegeman, I.; Spreeuwenberg, P.; Wagner, C.; Sanders, K.; Groenewegen, P.P.

2009-01-01

OBJECTIVES: The success of a Dutch program to disseminate quality improvement projects depends on the participation of physicians working in program hospitals. The leadership of hospital executives (CEOs) is considered an important explanation. This study aims to determine whether the relation,

Consensus on the leadership of hospital CEO's and its impact on the participation of physicians in improvement projects

NARCIS (Netherlands)

Dückers, M.L.A.; Stegeman, I.; Spreeuwenberg, P.; Wagner, C.; Sanders, K.; Groenewegen, P.P.

2009-01-01

Objectives: The success of a Dutch program to disseminate quality improvement projects depends on the participation of physicians working in program hospitals. The leadership of hospital executives (CEOs) is considered an important explanation. This study aims to determine whether the relation,

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.

Web sites survey for electronic public participation

International Nuclear Information System (INIS)

Park, Moon Su; Lee, Young Wook; Kang, Chang Sun

2004-01-01

Public acceptance has been a key factor in nuclear industry as well as other fields. There are many ways to get public acceptance. Public participation in making a policy must be a good tool for this purpose. Moreover, the participation by means of internet may be an excellent way to increase voluntary participation. In this paper, the level of electronic public participation is defined and how easy and deep for lay public to participate electronically is assessed for some organization's web sites

Measuring voluntary quadriceps activation: Effect of visual feedback and stimulus delivery.

Science.gov (United States)

Luc, Brittney A; Harkey, Matthew H; Arguelles, Gabrielle D; Blackburn, J Troy; Ryan, Eric D; Pietrosimone, Brian

2016-02-01

Quadriceps voluntary activation, assessed via the superimposed burst technique, has been extensively studied in a variety of populations as a measure of quadriceps function. However, a variety of stimulus delivery techniques have been employed, which may influence the level of voluntary activation as calculated via the central activation ratio (CAR). The purpose was to determine the effect of visual feedback, stimulus delivery, and perceived discomfort on maximal voluntary isometric contraction (MVIC) peak torque and the CAR. Quadriceps CAR was assessed in 14 individuals on two days using three stimulus delivery methods; (1) manual without visual feedback, (2) manual with visual feedback, and (3) automated with visual feedback. MVIC peak torque and the CAR were not different between the automated with visual feedback (MVIC=3.25, SE=0.14Nm/kg; CAR=88.63, SE=1.75%) and manual with visual feedback (MVIC=3.26, SE=0.13Nm/kg, P=0.859; CAR=89.06, SE=1.70%, P=0.39) stimulus delivery methods. MVIC (2.99, SE=0.12Nm/kg) and CAR (85.32, SE=2.10%) were significantly lower using manual without visual feedback compared to manual with visual feedback and automated with visual feedback (CAR P<0.001; MVIC P<0.001). Perceived discomfort was lower in the second session (P<0.05). Utilizing visual feedback ensures participant MVIC, and may provide a more accurate assessment of quadriceps voluntary activation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Exploring the repetition bias in voluntary task switching.

Science.gov (United States)

Mittelstädt, Victor; Dignath, David; Schmidt-Ott, Magdalena; Kiesel, Andrea

2018-01-01

In the voluntary task-switching paradigm, participants are required to randomly select tasks. We reasoned that the consistent finding of a repetition bias (i.e., participants repeat tasks more often than expected by chance) reflects reasonable adaptive task selection behavior to balance the goal of random task selection with the goals to minimize the time and effort for task performance. We conducted two experiments in which participants were provided with variable amount of preview for the non-chosen task stimuli (i.e., potential switch stimuli). We assumed that switch stimuli would initiate some pre-processing resulting in improved performance in switch trials. Results showed that reduced switch costs due to extra-preview in advance of each trial were accompanied by more task switches. This finding is in line with the characteristics of rational adaptive behavior. However, participants were not biased to switch tasks more often than chance despite large switch benefits. We suggest that participants might avoid effortful additional control processes that modulate the effects of preview on task performance and task choice.

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.

'What do I know? Should I participate?' Considerations on participation in HIV related research among HIV infected adults in Bangalore, South India.

Science.gov (United States)

Rodrigues, Rashmi J; Antony, Jimmy; Krishnamurthy, Shubha; Shet, Anita; De Costa, Ayesha

2013-01-01

India has the highest number of HIV infected persons in the world after South Africa. Much HIV related behavioral, clinical and laboratory based research is ongoing in India. Yet little is known on Indian HIV patients' knowledge of research, their processes of decision making and motives for participation. We aimed to explore these areas among HIV infected individuals to understand their reasons for participating in research. This is a cross sectional survey among 173 HIV infected adults at a tertiary level hospital in Bangalore, India, done between October 2010 and January 2011. A pre-tested questionnaire was administered to the participants by trained research assistants to assess their knowledge regarding research, willingness to participate, decision making and determinants of participation. Participants were presented with five hypothetical HIV research studies. Each study had a different level of intervention and time commitment. Of respondents, 103(60%), said that research meant 'to discover something new' and 138(80%) were willing to participate in research. A third of the respondents were unaware of their right to refuse participation. Willingness to participate in research varied with level of intervention. It was the lowest for the hypothetical study involving sensitive questions followed by the hypothetical drug trial; and was the highest for the hypothetical cross sectional questionnaire based study (pWomen were less likely to make autonomous decisions for participation in interventional studies. Despite a majority willing to participate, over a third of respondents did not have any knowledge of research or the voluntary nature of participation. This has ethical implications. Researchers need to focus on enabling potential research participants understand the concepts of research, promote autonomous decisions, especially by women and restrict therapeutic misconception.

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.

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.

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...

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.

Understanding social capital in sports clubs: participation, duration and social trust

DEFF Research Database (Denmark)

Elmose-Østerlund, Karsten; Van der Roest, Jan-Willem

2017-01-01

A central claim in Robert Putnam’s theory of social capital is that participation in voluntary organizations can foster social trust among members that are active and engaged. Based on this claim, this article examines how duration of membership and member participation impacts upon levels...... of social trust among sports club members. The results show that neither participation nor duration impacts on levels of social trust – a result found in survey studies conducted in Denmark and the Netherlands. Sophisticated participation measures and the inclusion of duration of membership set this study...... apart from previous studies on social capital. The fact that no correlation can be identified between participation and duration on one side and social trust on the other adds weight to the claim that, even though numerous studies find higher levels of social trust among members of voluntary...

Student teacher training: participant motivation.

Science.gov (United States)

Burgess, Annette; van Diggele, Christie; Mellis, Craig

2016-08-01

Teaching, assessment and feedback skills are documented globally as required graduate attributes for medical students. By integrating teacher training into curricula, the importance of teaching and educational scholarship is highlighted. In this study, we used self-determination theory (SDT) to consider medical students' motivation to voluntarily participate in a short teacher training programme. Thirty-eight senior medical students were invited to attend a teacher training programme at a major tertiary teaching hospital. Participating students were asked to respond to one question: 'Why did you volunteer to take part in the teacher training course?' Self-determination theory was used as a conceptual framework to identify and code recurrent themes in the data. In total, 23/38 (61%) of invited students chose to participate in the programme, and 21/23 (91%) of the students responded to the survey. Students' motivation to participate in the teacher training programme were related to: (1) autonomy - their enjoyment of their current voluntary involvement in teaching; (2) competence - a recognition of the need for formal training and certification in teaching, and as an essential part of their future career in medicine; (3) relatedness - the joint recognition of the importance of quality in teaching, as emphasised by their own learning experiences in the medical programme. Students reported being motivated to take part in teacher training because of their enjoyment of teaching, their desire to increase the quality of teaching within medical education, their desire for formal recognition of teaching as a learned skill, plus their recognition of teaching as a requirement within the medical profession. By integrating teacher training into curricula, the importance of teaching and educational scholarship is highlighted. © 2015 John Wiley & Sons Ltd.

Workplace violence injury in 106 US hospitals participating in the Occupational Health Safety Network (OHSN), 2012-2015.

Science.gov (United States)

Groenewold, Matthew R; Sarmiento, Raymond F R; Vanoli, Kelly; Raudabaugh, William; Nowlin, Susan; Gomaa, Ahmed

2018-02-01

Workplace violence is a substantial occupational hazard for healthcare workers in the United States. We analyzed workplace violence injury surveillance data submitted by hospitals participating in the Occupational Health Safety Network (OHSN) from 2012 to 2015. Data were frequently missing for several important variables. Nursing assistants (14.89, 95%CI 10.12-21.91) and nurses (8.05, 95%CI 6.14-10.55) had the highest crude workplace violence injury rates per 1000 full-time equivalent (FTE) workers. Nursing assistants' (IRR 2.82, 95%CI 2.36-3.36) and nurses' (IRR 1.70, 95%CI 1.45-1.99) adjusted workplace violence injury rates were significantly higher than those of non-patient care personnel. On average, the overall rate of workplace violence injury among OHSN-participating hospitals increased by 23% annually during the study period. Improved data collection is needed for OHSN to realize its full potential. Workplace violence is a serious, increasingly common problem in OHSN-participating hospitals. Nursing assistants and nurses have the highest injury risk. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

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.

Balanced performance measurement in research hospitals: the participative case study of a haematology department.

Science.gov (United States)

Catuogno, Simona; Arena, Claudia; Saggese, Sara; Sarto, Fabrizia

2017-08-03

The paper aims to review, design and implement a multidimensional performance measurement system for a public research hospital in order to address the complexity of its multifaceted stakeholder requirements and its double institutional aim of care and research. The methodology relies on a participative case study performed by external researchers in close collaboration with the staff of an Italian research hospital. The paper develops and applies a customized version of balanced scorecard based on a new set of performance measures. Our findings suggest that it can be considered an effective framework for measuring the research hospital performance, thanks to a combination of generalizable and context-specific factors. By showing how the balanced scorecard framework can be customized to research hospitals, the paper is especially of interest for complex healthcare organizations that are implementing management accounting practices. The paper contributes to the body of literature on the application of the balanced scorecard in healthcare through an examination of the challenges in designing and implementing this multidimensional performance tool. This is one of the first papers that show how the balanced scorecard model can be adapted to fit the specific requirements of public research hospitals.

Voluntary Participation in Community Economic Development in Canada: An Empirical Analysis

Directory of Open Access Journals (Sweden)

Laura Lamb

2011-01-01

Full Text Available This article is an empirical analysis of an individual's decision to participate in community economic development (CED initiatives in Canada. The objective of the analysis is to better understand how individuals make decisions to volunteer time toward CED initiatives and to determine whether the determinants of participation in CED are unique when compared to those of participation in volunteer activities in general. The dataset employed is Statistics Canada's 2004 Canada Survey of Giving, Volunteering and Participating (CSGVP. To date, there has been no prior econometric analysis of the decision to participate in community economic development initiatives in Canada. Results suggest a role for both public policymakers and practitioners in influencing participation in CED. / Cet article constitue une analyse empirique du processus de prise de décision chez les individus en ce qui a trait à la participation aux initiatives canadiennes de développement économique communautaire (DÉC. Le but de l'analyse est de mieux comprendre la façon dont les individus prennent la décision de consacrer du temps au bénévolat dans les initiatives de DÉC. Elle sert aussi à trancher la question de savoir si les facteurs de participation aux initiatives de développement économique communautaire sont uniques ou communs à la participation à des activités bénévoles en général. Les données employées dans le cadre de cette analyse sont puisées de l'Enquête canadienne sur le don, le bénévolat et la participation effectuée par Statistique Canada en 2004. À ce jour, aucune analyse économétrique n'a été menée sur la décision de participer aux initiatives canadiennes de DÉC. Les résultats suggèrent que les responsables de l'élaboration des politiques ainsi que les praticiens influencent tous deux la participation aux initiatives de DÉC.

Service users' perceptions about their hospital admission elicited by service user-researchers or by clinicians.

LENUS (Irish Health Repository)

O'Donoghue, Brian

2013-05-01

OBJECTIVE Service users may express positive, ambivalent, or negative views of their hospital admission. The objective of this study was to determine whether the background of the interviewer-service user-researcher or clinician-influences the information elicited. The primary outcome was the level of perceived coercion on admission, and secondary outcomes were perceived pressures on admission, procedural justice, perceived necessity for admission, satisfaction with services, and willingness to consent to participate in the study. METHODS Participants voluntarily and involuntarily admitted to three hospitals in Ireland were randomly allocated to be interviewed at hospital discharge by either a service user-researcher or a clinician. Interviewers used the MacArthur Admission Experience Survey and the Client Satisfaction Questionnaire. RESULTS A total of 161 participants were interviewed. No differences by interviewer status or by admission status (involuntary or voluntary) were found in levels of perceived coercion, perceived pressures, procedural justice, perceived necessity, or satisfaction with services. Service users were more likely to decline to participate if their consent was sought by a service user-researcher (24% versus 8%, p=.003). CONCLUSIONS Most interviewees gave positive accounts of their admission regardless of interviewer status. The findings indicate that clinicians and researchers can be more confident that service users\\' positive accounts of admissions are not attributable to a response bias. Researchers can also feel more confident in directly comparing the results of studies undertaken by clinicians and by service user-researchers.

Hospitals Participating In ACOs Tend To Be Large And Urban, Allowing Access To Capital And Data.

Science.gov (United States)

Colla, Carrie H; Lewis, Valerie A; Tierney, Emily; Muhlestein, David B

2016-03-01

Relationships between physicians and hospitals have changed considerably over the past decade, as hospitals and physician groups have integrated and new public and private payment policies have created financial interdependence. The extent to which accountable care organizations (ACOs) involve hospitals in their operations may prove to be vitally important, because managing hospital care is a key part of improving health care quality and lowering cost growth. Using primary data on ACO composition and capabilities paired with hospital characteristics, we found that 20 percent of US hospitals were part of an ACO in 2014. Hospitals that were in urban areas, were nonprofit, or had a smaller share of Medicare patients were more likely to participate in ACOs, compared to hospitals that were in more rural areas, were for-profit or government owned, or had a larger share of Medicare patients, respectively. Qualitative data identified the following advantages of including a hospital in an ACO: the availability of start-up capital, advanced data sharing, and engagement of providers across the care continuum. Although the 63 percent of ACOs that included hospitals offered more comprehensive services compared to ACOs without hospitals, we found no differences between the two groups in their ability to manage hospital-related aspects of patient care. Project HOPE—The People-to-People Health Foundation, Inc.

'What do I know? Should I participate?' Considerations on participation in HIV related research among HIV infected adults in Bangalore, South India.

Directory of Open Access Journals (Sweden)

Rashmi J Rodrigues

Full Text Available BACKGROUND: India has the highest number of HIV infected persons in the world after South Africa. Much HIV related behavioral, clinical and laboratory based research is ongoing in India. Yet little is known on Indian HIV patients' knowledge of research, their processes of decision making and motives for participation. We aimed to explore these areas among HIV infected individuals to understand their reasons for participating in research. METHODOLOGY/PRINCIPAL FINDINGS: This is a cross sectional survey among 173 HIV infected adults at a tertiary level hospital in Bangalore, India, done between October 2010 and January 2011. A pre-tested questionnaire was administered to the participants by trained research assistants to assess their knowledge regarding research, willingness to participate, decision making and determinants of participation. Participants were presented with five hypothetical HIV research studies. Each study had a different level of intervention and time commitment. Of respondents, 103(60%, said that research meant 'to discover something new' and 138(80% were willing to participate in research. A third of the respondents were unaware of their right to refuse participation. Willingness to participate in research varied with level of intervention. It was the lowest for the hypothetical study involving sensitive questions followed by the hypothetical drug trial; and was the highest for the hypothetical cross sectional questionnaire based study (p<0.0015. Individual health benefits and altruism were the primary motives for participation in research and indicate the presence of therapeutic misconception. Women were less likely to make autonomous decisions for participation in interventional studies. CONCLUSIONS/SIGNIFICANCE: Despite a majority willing to participate, over a third of respondents did not have any knowledge of research or the voluntary nature of participation. This has ethical implications. Researchers need to focus on

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.

[Survey of methicillin-resistant Staphylococcus aureus control measures in hospitals participating in the VINCat program].

Science.gov (United States)

Sopena-Galindo, Nieves; Hornero-Lopez, Anna; Freixas-Sala, Núria; Bella-Cueto, Feliu; Pérez-Jové, Josefa; Limon-Cáceres, Enric; Gudiol-Munté, Francesc

2016-01-01

VINCat is a nosocomial infection surveillance program in hospitals in Catalonia. The aim of the study was to determine the surveillance and control measures of methicillin-resistant Staphylococcus aureus (MRSA) in these centres. An e-mail survey was carried out from January to March 2013 with questions related to the characteristics of the hospitals and their control measures for MRSA. A response was received from 53 hospitals (>500 beds: 7; 200-500 beds: 14;prevent MRSA in hospitals participating in the VINCat program. Most of the centres have an MRSA protocol, however compliance with it should be improved, especially in areas such as active detection on admission in patients at risk, hand hygiene adherence, cleaning frequency and optimising the use of antibiotics. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Voluntary agreements with white certificates for energy efficiency improvement as a hybrid policy instrument

International Nuclear Information System (INIS)

Oikonomou, V.; Patel, M.K.; Rietbergen, M.; Van der Gaast, W.

2009-01-01

In this paper we examine the implementation of a combined policy scheme that consists of a traditional instrument, the voluntary agreements (VAs), and an innovative one, the white certificates (WhC). The basic structure of this scheme is that energy suppliers who undertake an energy efficiency obligation under a white certificate scheme can make use of voluntary actions to enhance investments in innovative energy savings projects. Energy suppliers and other market parties can additionally or in parallel participate in voluntary agreements and set energy efficiency targets. For fulfilling their voluntary agreement target, these market parties can receive tax exemptions or receive white certificates that they can sell in the market. Transaction costs and baseline definition for demonstrating energy efficiency improvement deserve special attention. This policy can assist a country to enhance energy efficiency improvement while it stimulates innovation. Cost effectiveness can be higher than the case of stand-alone policy instruments, since more financing options are available for more expensive projects. Nevertheless, the added value of the scheme lies more in the implementation of innovative measures for enhanced energy efficiency. Furthermore, market parties can discover more business opportunities in energy efficiency and establish a green image; hence an integrated scheme should achieve higher political acceptability. (author)

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

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.

Lower Limb Voluntary Movement Improvement Following a Robot-Assisted Locomotor Training in Spinal Cord Injury

Directory of Open Access Journals (Sweden)

Mirbagheri Mehdi

2011-12-01

Full Text Available Individuals with spinal cord injury (SCI suffer from severe impairments in voluntary movements. Literature reports a reduction in major kinematic and kinetic parameters of lower limbs’ joints. A body weight support treadmill training with robotic assistance has been widely used to improve lower-extremity function and locomotion in persons with SCI. Our objective was to explore the effects of 4-weeks robot-assisted locomotor training on voluntary movement of the ankle musculature in patients with incomplete SCI. In particular, we aimed to characterize the therapeutic effects of Lokomat training on kinematic measures (range of motion, velocity, smoothness during a dorsiflexion movement. We hypothesized that training would improve these measures. Preliminary results show an improvement of kinematic parameters during ankle dorsiflexion voluntary movement after a 4-weeks training in the major part of our participants. Complementary investigations are in progress to confirm these results and understand underlying mechanisms associated with the recovery.

Voluntary blood donation in a rural block of Vellore, South India: A knowledge, attitude and practice study

Directory of Open Access Journals (Sweden)

Akhil Kurup

2016-01-01

Full Text Available Context: There is a shortage of voluntary blood donors in developing countries which are, therefore, more dependent on replacement donors. Aim: To study the knowledge, attitude, and practices regarding voluntary blood donation in a rural block in Vellore, South India. Settings and Designs: A cross-sectional survey in randomly selected villages of a rural block in Vellore, South India. Materials and Methods: Knowledge, attitude, and practices were assessed using a pilot-tested, semi-structured, interviewer-administered questionnaire on randomly chosen rural adults aged between 18 and 60 years. Results: Of the 104 individuals interviewed, 90% were aware of voluntary blood donation, the main source of this awareness being television. Nearly, two-thirds of the participants felt they would fall sick by donating blood and that women and manual laborers were not capable of blood donation. Among the interviewed, 70.3% were of the opinion that blood can purchased with money. Only 44% were willing to donate blood on a voluntary basis. Perceived weakness and a misconception on the apparent lack of blood were the major reasons for unwillingness to donate blood. There was a significant association between willingness to donate blood and educational status as well as occupation, with the less educated and manual laborers unwilling to donate blood on a voluntary basis (odds ratio [OR] = 3.758, confidence interval [CI] = 1.54–9.156; OR = 5.333, CI = 1.429–19.90, respectively. Conclusions: The study found that although awareness on voluntary blood donation among individuals in the rural community was widespread, hesitancy to donate blood in real life situation was high. Since voluntary unpaid donors are the best candidates for blood donation, community being the best available source, education, and motivation of the community should play a greater role in increasing voluntary blood donation.

Participant observation of time allocation, direct patient contact and simultaneous activities in hospital physicians

Directory of Open Access Journals (Sweden)

Zupanc Andrea

2009-06-01

Full Text Available Abstract Background Hospital physicians' time is a critical resource in medical care. Two aspects are of interest. First, the time spent in direct patient contact – a key principle of effective medical care. Second, simultaneous task performance ('multitasking' which may contribute to medical error, impaired safety behaviour, and stress. There is a call for instruments to assess these aspects. A preliminary study to gain insight into activity patterns, time allocation and simultaneous activities of hospital physicians was carried out. Therefore an observation instrument for time-motion-studies in hospital settings was developed and tested. Methods 35 participant observations of internists and surgeons of a German municipal 300-bed hospital were conducted. Complete day shifts of hospital physicians on wards, emergency ward, intensive care unit, and operating room were continuously observed. Assessed variables of interest were time allocation, share of direct patient contact, and simultaneous activities. Inter-rater agreement of Kappa = .71 points to good reliability of the instrument. Results Hospital physicians spent 25.5% of their time at work in direct contact with patients. Most time was allocated to documentation and conversation with colleagues and nursing staff. Physicians performed parallel simultaneous activities for 17–20% of their work time. Communication with patients, documentation, and conversation with colleagues and nursing staff were the most frequently observed simultaneous activities. Applying logit-linear analyses, specific primary activities increase the probability of particular simultaneous activities. Conclusion Patient-related working time in hospitals is limited. The potential detrimental effects of frequently observed simultaneous activities on performance outcomes need further consideration.

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.

The impact of non-response bias due to sampling in public health studies: A comparison of voluntary versus mandatory recruitment in a Dutch national survey on adolescent health.

Science.gov (United States)

Cheung, Kei Long; Ten Klooster, Peter M; Smit, Cees; de Vries, Hein; Pieterse, Marcel E

2017-03-23

In public health monitoring of young people it is critical to understand the effects of selective non-response, in particular when a controversial topic is involved like substance abuse or sexual behaviour. Research that is dependent upon voluntary subject participation is particularly vulnerable to sampling bias. As respondents whose participation is hardest to elicit on a voluntary basis are also more likely to report risk behaviour, this potentially leads to underestimation of risk factor prevalence. Inviting adolescents to participate in a home-sent postal survey is a typical voluntary recruitment strategy with high non-response, as opposed to mandatory participation during school time. This study examines the extent to which prevalence estimates of adolescent health-related characteristics are biased due to different sampling methods, and whether this also biases within-subject analyses. Cross-sectional datasets collected in 2011 in Twente and IJsselland, two similar and adjacent regions in the Netherlands, were used. In total, 9360 youngsters in a mandatory sample (Twente) and 1952 youngsters in a voluntary sample (IJsselland) participated in the study. To test whether the samples differed on health-related variables, we conducted both univariate and multivariable logistic regression analyses controlling for any demographic difference between the samples. Additional multivariable logistic regressions were conducted to examine moderating effects of sampling method on associations between health-related variables. As expected, females, older individuals, as well as individuals with higher education levels, were over-represented in the voluntary sample, compared to the mandatory sample. Respondents in the voluntary sample tended to smoke less, consume less alcohol (ever, lifetime, and past four weeks), have better mental health, have better subjective health status, have more positive school experiences and have less sexual intercourse than respondents in the

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.

The current situation of voluntary vaccination and the factors influencing its coverage among children in Takatsuki, Japan: focus on Hib and pneumococcal vaccines.

Science.gov (United States)

Tsuda, Yuko; Watanabe, Misuzu; Tanimoto, Yoshimi; Hayashida, Itsushi; Kusabiraki, Toshiyuki; Komiyama, Maki; Kono, Koichi

2015-03-01

This study aimed to understand the current scenario of voluntary vaccination and the factors influencing its coverage among 18-month-old children of Takatsuki City, Japan. Based on 1167 parents responses, we found that voluntary vaccination coverage rates were low when compared with routine vaccination rates. The children who were not the first born of the family and who had young and poorly educated parents were less likely to receive voluntary vaccination. Japanese government-supported vaccines, such as Haemophilus influenzae type b and pneumococcal vaccine, had a higher coverage than the vaccines for which parents had to bear the entire vaccination cost. Furthermore, it was found that mass communication media and family pediatricians were effective means to disseminate voluntary vaccination-related information. We envisage that an active participation of medical professionals, easy access to vaccinations, and mass awareness programs will increase voluntary vaccination coverage in Takatsuki. © 2013 APJPH.

A Review of Economic Factors Influencing Voluntary Carbon Disclosure in the Property Sector of Developing Economies

Science.gov (United States)

Kalu, J. U.; Aliagha, G. U.; Buang, A.

2016-02-01

Global warming has consequences on the environment and economy; this led to the establishment of United Nation Framework Convention on Climate Change (UNFCCC) and the Kyoto Protocol. These two agreements were to reduce greenhouse gases (GHG) emissions which are responsible for climate change and global warming. Developing countries under the protocol are not obligated to reduce or disclosure GHG emission, so their participation in the protocol is on voluntary mitigation bases. This study intends to examine economic factors that influence voluntary carbon disclosure in the property sub-sector of developing countries based on annual report of listed property companies in Malaysia. Signaling theory addresses the problem of information asymmetry in the society. Disclosure is an effective tool to overcome information imbalance among different market participants. The study hypothesizes that the economic factors that influence voluntary carbon information disclosure in developing countries are: [1] the company's size; this is because a large-sized company have more resources to cover the cost of reducing pollution. [2] The company's gearing status; where there is no sufficient information disclosure in a highly geared company will result to an increased agency cost. [3] Profitability; profits grants companies a pool of resources for mitigation activities and environmental reporting. Also, carbon disclosure acts as a means for achieving public confidence and legitimacy. [4] Liquidity: Companies that are highly liquid will disclosure more information to distinguish themselves from other companies that are less liquidity. This is correlated to environmental disclosure. [5] Financial slack affects companies’ ability to participate in green technology projects that enable a reduction in emission.

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.

Spousal caregivers and persons with dementia: Increasing participation in shared leisure activities among hospital-based dementia support program participants.

Science.gov (United States)

DiLauro, Michelle; Pereira, Amanda; Carr, Jennifer; Chiu, Mary; Wesson, Virginia

2015-02-20

Spousal caregivers of persons with dementia often have difficulty engaging persons with dementia in leisure activities. This qualitative descriptive study identifies how caregivers perceive their spouses' participation in leisure activities since dementia onset and the professional guidance caregivers require to increase persons with dementia participation in shared leisure activities. Nine spousal caregivers from a hospital-based caregiver intervention attended one of three focus groups. Using symbolic interactionism and selective optimization with compensation theory as guiding frameworks, thematic content analysis was performed. Three major themes were identified: Recognizing and acknowledging changes, Making sense of changes and conflicts, and Embracing changes and forging ahead. Findings can be used by healthcare providers to better understand caregivers' needs for engaging persons with dementia in shared leisure activities, and inform development of feedback protocols to enhance caregiver interventions. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

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

Introduction of voluntary environmental management systems into the Spanish hospital network: current state (2015

Directory of Open Access Journals (Sweden)

Sergio García Vicente

2016-12-01

Full Text Available Hospitals produce vast amounts of waste and are large consumers of energy and natural resources. However, do they worry about environmental health? With this question in mind, and in order to approach hospital environmental practices, the introduction into the Spanish hospital network of the most accepted certified environmental management systems (CEMS, such as ISO 14001 and EMAS, was evaluated so as to obtain a point of reference for environmental practices in our National Health System as no up-to-date, specific official register exists. To this end, a list of hospitals by Spanish Autonomous Community having CEMS in force in 2015 was drawn up using official databases, evaluating information and conducting fieldwork. We found that 18.9 % of hospitals had CEMS (ISO 14001 in all cases: 149 out of 787 hospitals, in the National Hospitals Catalogue, especially in Madrid (40 and Andalusia (37. Eighty-one of the certified hospitals are private. Only 23 had EMAS: 12 are public and 11 private. The resulting “map” shows the main references in order for the need to offer citizens a balance between healthcare and environmental friendliness, to be compared and envisaged based on hospital activity, considering hospitals socially responsible, environmentally friendly organisations, that seek leadership in the field of environmental sustainability together with other sectors (environmental, engineering, industrial.

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.

Clinical risk management in hospitals: strategy, central coordination and dialogue as key enablers.

Science.gov (United States)

Briner, Matthias; Manser, Tanja; Kessler, Oliver

2013-04-01

The study aims to identify key enablers fostering clinical risk management (CRM) in hospitals to guide health care in this vital area of patient safety. A cross-sectional survey was conducted at the national level in 324 Swiss hospitals in 2007-2008 to assess the relationship between key elements and systematic CRM. Therefore, a comprehensive monitoring instrument for CRM was used for the first time. Organizational factors (e.g. strategy, coordination, resources) and structural conditions (e.g. hospital size) were tested as key elements. CRM was assessed by evaluating its maturity (i.e. the level of CRM development) by 12 theoretically derived indices joining together essential aspects of CRM at the hospital level and the service level. Chi-square measures were used to analyse the relationships between organizational factors or structural conditions and maturity of CRM. Participation in this voluntary survey was good, with CRM experts of 138 out of 324 hospitals responding (response rate 43%). Three key enablers for CRM were identified: implementing a function for central CRM coordination, assuring dialogue with and between the different hospital services, and developing strategic CRM objectives. This study offers, for the first time, an assessment of the maturity of hospitals' CRM and identifies key enablers related to CRM. This is a feasible first step in guiding hospitals to shape their CRM and presents a basis for future studies, for example, linking CRM to outcome data. © 2012 Blackwell Publishing Ltd.

Participation of the family in hospital-based palliative cancer care: perspective of nurses

Directory of Open Access Journals (Sweden)

Marcelle Miranda da Silva

Full Text Available The objective was to understand the perspective of nurses about the participation of the family in palliative cancer care and to analyze the nursing care strategies to meet their needs. Descriptive and qualitative research, conducted at the National Cancer Institute between January and March 2013, with 17 nurses. Elements of the Roy Adaptation Model were used for the interpretation of the data. Two categoriesemergedfrom the thematic analysis: perspective of nurses about the presence and valuation of family in the hospital; and appointing strategies to encourage family participation in care and meet their needs. This participation is essentialand represents a training opportunity for the purpose of homecare. Nurses create strategies to encourage it and seek to meet the needs. The results contribute to promote the family adaptation and integrity, in order to balance the dependent and independent behaviors, aimingfor quality of life and comfort. Further studies are neededdue to the challenges of the specialty.

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.

Participation of catalase in voluntary ethanol consumption in perinatally low-level lead-exposed rats.

Science.gov (United States)

Mattalloni, Mara S; De Giovanni, Laura N; Molina, Juan C; Cancela, Liliana M; Virgolini, Miriam B

2013-10-01

Environmental lead (Pb) exposure and alcohol abuse pose significant public health problems for our society. One of the proposed mechanisms of action of the developmental neurotoxicant Pb is related to its ability to affect antioxidant enzymes, including catalase (CAT). Ethanol's (EtOH) motivational effects are postulated to be mediated by the CAT-dependent acetaldehyde generated in the brain. The current study sought to investigate the role of this enzyme in the elevated EtOH intake previously reported in perinatally Pb-exposed rats. Thirty-five-day-old male Wistar rats exposed to 220 ppm Pb during gestation and lactation were offered escalating EtOH solutions (2 to 10%) or water, 2 h/d for 28 days. Once baseline 10% EtOH intake was achieved, they were injected with (i) saline (SAL), (ii) 3-amino 1,2,4 triazole (aminotriazole [AT], a CAT inhibitor, 250 mg/kg intraperitoneally [i.p.], 5 hours before the last 8 EtOH intake sessions), or (iii) 3-nitropropionic acid (3NPA; a CAT activator, 20 mg/kg subcutaneously [s.c.], 45 minutes before the last 4 EtOH intake sessions). Rats were then sacrificed, blood collected, and brain regions harvested for CAT activity determination. Additional studies evaluated EtOH intake and CAT activity in response to 10 and 30 mg/kg 3NPA. Both 3NPA and AT were evaluated for striatal cytotoxicity. We observed that AT pretreatment blunted the increased EtOH intake, as well as the elevated CAT activity in blood, cerebellum, and hippocampus evidenced in the developmentally Pb-exposed rats that have consumed EtOH. Conversely, 20 mg/kg 3NPA further increased voluntary EtOH intake in these animals as compared with controls, concomitantly with a slight elevation in CAT activity both in blood and in the striatum, associated with no changes in striatal cytotoxicity. These results suggest a participation of CAT, and possibly acetaldehyde, in Pb-induced high EtOH intake, and open up new avenues to elucidate the mechanism that underlies the Pb and Et

[Communication, participation and leadership in the perception of the emotional climate in a university hospital in Andalusia, Spain].

Science.gov (United States)

Danet, Alina; March, Joan Carles; Romera, Inmaculada García

2014-03-01

The aim of this study was to identify and analyze perceptions and opinions among health professionals in a university hospital in Andalusia, Spain, regarding the emotional climate, leadership style, quality of information, and internal communication. The study also aimed to collect health professionals' suggestions for improving these workplace characteristics. The study included 730 participants and used a quantitative and qualitative methodology. The results reflect a medium-to-low level of emotional climate, correlated with the leadership style and information and internal communication. Statistically significant differences appeared when comparing professional categories and hospital units. The health professionals provided a positive assessment of the administrators' work, although requiring more task-oriented, participative, and affiliative leadership skills.

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.

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

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.

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...

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...

Evaluation of Bias Correction Methods for "Worst-case" Selective Non-participation in NAEP

Science.gov (United States)

McLaughlin, Don; Gallagher, Larry; Stancavage, Fran

2004-01-01

With the advent of No Child Left Behind (NCLB), the context for NAEP participation is changing. Whereas in the past participation in NAEP has always been voluntary, participation is now mandatory for some grade and subjects among schools receiving Title I funds. While this will certainly raise school-level participation rates in the mandated…

The Assessment of the Applications to University Hospital Urology Outpatient Clinic

Directory of Open Access Journals (Sweden)

Adnan Gucuk

2013-04-01

Full Text Available Introduction: Provision of health care services to persons where it is needed required for the production of quality service in the organization of health services. The purpose of this study, determine the reason for admission and factors affecting admission and evaluate the current status for the patients admitted to a tertiary health care center. Materials and methods: The study was planned descriptive. Participants were determined among the patients were admitted to urology clinic between December 2011-March 2012 for any reason on a voluntary basis. Fourteen item questionnaire was completed by the physician. The survey asked the age, educational status, initial complaint, elapsed time from the beginning of complaints, whether was the previous treatment from another institution, reasons for choosing a university hospital polyclinics for participants. Results: A total of 337 participants attended, and their gender were 23.7% female, 76.3% male. 61.7% participants had received earlier medical attention because of complaints, 38.3% of had not received previously medical attention in any health institution and had to apply directly to the tertiary health care center. Apply directly to the university hospital outpatient clinic was significantly higher in men (p:0.11(table 1. Direct applications are increasing significantly in participant has higher education level. Compared to complexity of required investigations for patients had received and had not received earlier medical attention were no significant differences (p:0.134. Conclusion: For more effective use of health resources and results-oriented, training must be relevant to users of health care services to increase health literacy as well as a number of legal arrangements. [TAF Prev Med Bull 2013; 12(2.000: 165-168

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...

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.

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

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...

Knowledge concerning the nursing staff hospital-acquired infections in the prevention and transmission paths microorganisms living in the hospital environment .

Directory of Open Access Journals (Sweden)

Monika Teresa Pierzak

2017-08-01

Full Text Available Introduction: The level of knowledge in the filed of infections associated with health care is a very important element affecting the health and lives of patients and medical staff working covering the entire interdisciplinary team. In the various stages of the nursing process, which consists of diagnosis, planning, implementation and evaluation, there is the problem of hospital infections. Objectives of work: The aim of the study is to assess the level of knowledge of nursing staff in the field of hospital infections, prevention and routes of transmission of microorganisms. Material and Method: The study was conducted in the period from 01.01.2017-01.06.2017 in the Regional Hospital in Kielce. The research was voluntary and those involved agreed to participate in them. The study included 92 (100% of the nursing staff. These were women 96.65% (n = 88 and men 4.35% (n = 4. The subjects were informed about the anonymity of the research. Method was used diagnostic survey, using the author, anonymous questionnaire consisting of 26 questions, which was developed on the basis of the latest reports from scientific articles on the subject of nosocomial infections. Results: Our study showed different levels of knowledge of hospital infection among nursing staff. The respondents do not know the importance of washing hands in the prevention of nosocomial infections. Alarming is the fact that only 64.13% (n = 59 of those participating in the survey asked about the most common source of hospital-acquired infections answered that it is "direct contact, usually by hand during the performed treatments and medicines." The nursing staff involved in the study I am aware of the need for training organization to raise knowledge of hospital infections. Respondents asked about the need to provide training for the prevention of infection in the workplace 84.78% (n = 78 responded that there is such a necessity. Conclusions: The level of knowledge of nursing staff is

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

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

Voluntary GHG reduction of industrial sectors in Taiwan.

Science.gov (United States)

Chen, Liang-Tung; Hu, Allen H

2012-08-01

The present paper describes the voluntary greenhouse gas (GHG) reduction agreements of six different industrial sectors in Taiwan, as well as the fluorinated gases (F-gas) reduction agreement of the semiconductor and Liquid Crystal Display (LCD) industries. The operating mechanisms, GHG reduction methods, capital investment, and investment effectiveness are also discussed. A total of 182 plants participated in the voluntary energy saving and GHG reduction in six industrial sectors (iron and steel, petrochemical, cement, paper, synthetic fiber, and textile printing and dyeing), with 5.35 Mt reduction from 2004 to 2008, or 33% higher than the target goal (4.02 Mt). The reduction accounts for 1.6% annual emission or 7.8% during the 5-yr span. The petrochemical industry accounts for 49% of the reduction, followed by the cement sector (21%) and the iron and steel industry (13%). The total investment amounted to approximately USD 716 million, in which, the majority of the investment went to the modification of the manufacturing process (89%). The benefit was valued at around USD 472 million with an average payback period of 1.5 yr. Moreover, related energy saving was achieved through different approaches, e.g., via electricity (iron and steel), steam and oil consumption (petrochemical) and coal usage (cement). The cost for unit CO(2) reduction varies per industry, with the steel and iron industrial sector having the highest cost (USD 346 t(-1) CO(2)) compared with the average cost of the six industrial sectors (USD 134 t(-1) CO(2)). For the semiconductor and Thin-Film Transistor LCD industries, F-gas emissions were reduced from approximately 4.1 to about 1.7 Mt CO(2)-eq, and from 2.2 to about 1.1 Mt CO(2)-eq, respectively. Incentive mechanisms for participation in GHG reduction are also further discussed. Copyright © 2012 Elsevier Ltd. All rights reserved.

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.

Voluntary reduction of force variability via modulation of low-frequency oscillations.

Science.gov (United States)

Park, Seoung Hoon; Casamento-Moran, Agostina; Yacoubi, Basma; Christou, Evangelos A

2017-09-01

Visual feedback can influence the force output by changing the power in frequencies below 1 Hz. However, it remains unknown whether visual guidance can help an individual reduce force variability voluntarily. The purpose of this study, therefore, was to determine whether an individual can voluntarily reduce force variability during constant contractions with visual guidance, and whether this reduction is associated with a decrease in the power of low-frequency oscillations (0-1 Hz) in force and muscle activity. Twenty young adults (27.6 ± 3.4 years) matched a force target of 15% MVC (maximal voluntary contraction) with ankle dorsiflexion. Participants performed six visually unrestricted contractions, from which we selected the trial with the least variability. Following, participants performed six visually guided contractions and were encouraged to reduce their force variability within two guidelines (±1 SD of the least variable unrestricted trial). Participants decreased the SD of force by 45% (P  0.2). The decrease in force variability was associated with decreased low-frequency oscillations (0-1 Hz) in force (R 2  = 0.59), which was associated with decreased low-frequency oscillations in EMG bursts (R 2  = 0.35). The reduction in low-frequency oscillations in EMG burst was positively associated with power in the interference EMG from 35 to 60 Hz (R 2  = 0.47). In conclusion, voluntary reduction of force variability is associated with decreased low-frequency oscillations in EMG bursts and consequently force output. We provide novel evidence that visual guidance allows healthy young adults to reduce force variability voluntarily likely by adjusting the low-frequency oscillations in the neural drive.

Nurses' perceptions of and participation in continuing nursing education: results from a study of psychiatric hospital nurses in Bahrain.

Science.gov (United States)

Al-Majid, Sadeeka; Al-Majed, Hashmiya; Rakovski, Cyril S; Otten, Rebecca A

2012-05-01

Although many psychiatric hospital nurses in Bahrain attend at least one continuing nursing education (CNE) activity per year, many others do not. This study explored these nurses' perceptions of CNE and factors that promote or hinder participation in CNE activities. A descriptive design was used to gather data from a convenience sample of 200 nurses working at the psychiatric hospital in Bahrain. Nurses believed that CNE improved the quality of patient care and patient outcomes, increased nurses' knowledge and skills, and kept them current with advances in nursing. Participation in CNE was hindered by unavailability of CNE activities related to psychiatric nursing. The majority of nurses had positive perceptions of CNE. Their participation was hindered by unavailability of CNE activities related to psychiatric nursing. Those responsible for planning continuing education in Bahrain should consider these findings when planning future CNE activities. Copyright 2012, SLACK Incorporated.

Voluntary and involuntary emotional memory following an analogue traumatic stressor: the differential effects of communality in men and women.

Science.gov (United States)

Kamboj, Sunjeev K; Oldfield, Lucy; Loewenberger, Alana; Das, Ravi K; Bisby, James; Brewin, Chris R

2014-12-01

Men and women show differences in performance on emotional processing tasks. Sex also interacts with personality traits to affect information processing. Here we examine effects of sex, and two personality traits that are differentially expressed in men and women - instrumentality and communality - on voluntary and involuntary memory for distressing video-footage. On session one, participants (n = 39 men; 40 women) completed the Bem Sex-Role Inventory, which assesses communal and instrumental traits. After viewing film-footage of death/serious injury, participants recorded daily involuntary memories (intrusions) relating to the footage on an online diary for seven days, returning on day eight for a second session to perform a voluntary memory task relating to the film. Communality interacted with sex such that men with higher levels of communality reported more frequent involuntary memories. Alternatively, a communality × sex interaction reflected a tendency for women with high levels of communality to perform more poorly on the voluntary recognition memory task. The study involved healthy volunteers with no history of significant psychological disorder. Future research with clinical populations will help to determine the generalizability of the current findings. Communality has separate effects on voluntary and involuntary emotional memory. We suggest that high levels of communality in men and women may confer vulnerability to the negative effects of stressful events either through the over-encoding of sensory/perceptual-information in men or the reduced encoding of contextualised, verbally-based, voluntarily accessible representations in women. Copyright © 2014 Elsevier Ltd. All rights reserved.

Knowledge, Attitudes, and Practices of Voluntary HIV Counseling and Testing among Rural Migrants in Shanghai, China

Science.gov (United States)

He, Na; Zhang, Jinling; Yao, Jinjian; Tian, Xiuhong; Zhao, Genming; Jiang, Qingwu; Detels, Roger

2009-01-01

A study of knowledge, attitudes and practices (KAP) of voluntary HIV counseling and testing (VCT) among rural migrants was conducted in Shanghai, China. An anonymous questionnaire was administered face-to-face. Among 2,690 participants, 78% reported having had lifetime sexual intercourse with 41.3% of singles reporting sexual intercourse, 9.2%…

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...

Voluntary and Involuntary Singlehood and Young Adults' Mental Health: an Investigation of Mediating Role of Romantic Loneliness.

Science.gov (United States)

Adamczyk, Katarzyna

2017-01-01

The present study tested the hypothesis that single young adults who perceive their singlehood as voluntary would report a higher level of positive mental health (i.e., emotional, psychological and social well-being), lower levels of mental health illness (i.e., somatic symptoms, anxiety, social dysfunction, severe depression) and romantic loneliness in comparison to young adults who perceive their singlehood as involuntary. This paper also investigated whether romantic loneliness mediates the relationship between voluntary and involuntary singlehood, positive mental health, and mental health illness. The study sample included 151 participants (86 females and 65 males) aged 20-26 ( M  = 22.48, SD  = 2.01) from Poland. The main findings were that voluntarily single young adults reported a lower level of romantic loneliness compared to involuntarily single young adults. The two groups differed neither in regard to positive mental health nor in regard to mental health problems. In addition, gender differences were observed solely in the domain of romantic loneliness, with women reporting greater romantic loneliness than men. The mediation analysis revealed that romantic loneliness does not mediate the relationship between voluntary and involuntary singlehood, positive mental health, and mental health illness. Voluntary and involuntary singlehood was predictive of somatic symptoms, anxiety and insomnia, severe depression, and romantic loneliness.

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.

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.

Motives for Physical Activity Participation in Turkish Primary School Students

Science.gov (United States)

Saçli Uzunöz, Fatma

2015-01-01

The purpose of this study was to explore the motives for participating in physical activity, and to compare motives with respect to gender and age in pupils aged from 9 to 11 years in Turkey. The participants were 400 voluntary pupils (205 females and 195 males) from a total of four public schools in the center of Cappadocia region. Authorization…

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 Fasting to Control Post-Ramadan Weight Gain among Overweight and Obese Women

Directory of Open Access Journals (Sweden)

Suriani Ismail

2015-01-01

Full Text Available Objectives: This study aimed to examine the effectiveness of an Islamic voluntary fasting intervention to control post-Ramadan weight gain. Methods: This study was conducted between July and November 2011. Two weight loss intervention programmes were developed and implemented among groups of overweight or obese Malay women living in the Malaysian cities of Putrajaya and Seremban: a standard programme promoting control of food intake according to national dietary guidelines (group B and a faith-based programme promoting voluntary fasting in addition to the standard programme (group A. Participants’ dietary practices (i.e., voluntary fasting practices, frequency of fruit/vegetable consumption per week and quantity of carbohydrates/protein consumed per day, body mass index (BMI, blood pressure, fasting blood high-density lipoprotein cholesterol (HDL-C and total cholesterol (TC:HDL-C ratio were assessed before Ramadan and three months post-Ramadan. Results: Voluntary fasting practices increased only in group A (P <0.01. Additionally, the quantity of protein/carbohydrates consumed per day, mean diastolic pressure and TC:HDL-C ratio decreased only in group A (P <0.01, 0.05, 0.02 and <0.01, respectively. Frequency of fruit/vegetable consumption per week, as well as HDL-C levels, increased only in group A (P = 0.03 and <0.01, respectively. Although changes in BMI between the groups was not significant (P = 0.08, BMI decrease among participants in group A was significant (P <0.01. Conclusion: Control of post-Ramadan weight gain was more evident in the faith-based intervention group. Healthcare providers should consider faith-based interventions to encourage weight loss during Ramadan and to prevent post-Ramadan weight gain among patients.

Voluntary Fasting to Control Post-Ramadan Weight Gain among Overweight and Obese Women

Science.gov (United States)

Ismail, Suriani; Shamsuddin, Khadijah; Latiff, Khalib A.; Saad, Hazizi A.; Majid, Latifah A.; Othman, Fadlan M.

2015-01-01

Objectives: This study aimed to examine the effectiveness of an Islamic voluntary fasting intervention to control post-Ramadan weight gain. Methods: This study was conducted between July and November 2011. Two weight loss intervention programmes were developed and implemented among groups of overweight or obese Malay women living in the Malaysian cities of Putrajaya and Seremban: a standard programme promoting control of food intake according to national dietary guidelines (group B) and a faith-based programme promoting voluntary fasting in addition to the standard programme (group A). Participants’ dietary practices (i.e., voluntary fasting practices, frequency of fruit/vegetable consumption per week and quantity of carbohydrates/protein consumed per day), body mass index (BMI), blood pressure, fasting blood high-density lipoprotein cholesterol (HDL-C) and total cholesterol (TC):HDL-C ratio were assessed before Ramadan and three months post-Ramadan. Results: Voluntary fasting practices increased only in group A (P <0.01). Additionally, the quantity of protein/carbohydrates consumed per day, mean diastolic pressure and TC:HDL-C ratio decreased only in group A (P <0.01, 0.05, 0.02 and <0.01, respectively). Frequency of fruit/vegetable consumption per week, as well as HDL-C levels, increased only in group A (P = 0.03 and <0.01, respectively). Although changes in BMI between the groups was not significant (P = 0.08), BMI decrease among participants in group A was significant (P <0.01). Conclusion: Control of post-Ramadan weight gain was more evident in the faith-based intervention group. Healthcare providers should consider faith-based interventions to encourage weight loss during Ramadan and to prevent post-Ramadan weight gain among patients. PMID:25685394

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.

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.

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.

Bonding, Achievement, and Activities: School Bonding, Academic Achievement, and Participation in Extracurricular Activities

Science.gov (United States)

Howard, Anissa K.; Ziomek-Daigle, Jolie

2009-01-01

Utilizing a single-group interrupted time series design (Creswell, 2003), this pilot study examined the relationship between academic achievement, school bonding, and the extracurricular activity participation of "uninvolved" students (n=11) who participated in a voluntary support group at a suburban high school in the southeast. Results…

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...

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.

Voluntary organ donation system adapted to Chinese cultural values and social reality.

Science.gov (United States)

Huang, Jiefu; Millis, J Michael; Mao, Yilei; Millis, M Andrew; Sang, Xinting; Zhong, Shouxian

2015-04-01

Organ donation and transplant systems have unique characteristics based on the local culture and socioeconomic context. China's transplant and organ donation systems developed without regulatory oversight until 2006 when regulation and policy were developed and then implemented over the next several years. Most recently, the pilot project of establishing a voluntary citizen-based deceased donor program was established. The pilot program addressed the legal, financial, and cultural barriers to organ donation in China. The pilot program has evolved into a national program. Significantly, it established a uniquely Chinese donor classification system. The Chinese donor classification system recognizes donation after brain death (category I), donation after circulatory death (category II), and donation after brain death followed by circulatory death (category III). Through August 2014, the system has identified 2326 donors and provided 6416 organs that have been allocated though a transparent organ allocation system. The estimated number of donors in 2014 is 1147. As China's attitudes toward organ donation have matured and evolved and as China, as a nation, is taking its place on the world stage, it is recognizing that its past practice of using organs from executed prisoners is not sustainable. It is time to recognize that the efforts to regulate transplantation and provide voluntary citizen-based deceased organ donation have been successful and that China should use this system to provide organs for all transplants in every province and hospital in China. At the national organ transplant congress on October 30, 2014, the Chairman of the China's national organ donation and transplantation committee, Jeifu Huang required all hospitals to stop using organs from executed prisoners immediately and the civilian organ donation will be sole source for organ transplant in China starting January 2015. © 2015 American Association for the Study of Liver Diseases.

Barriers to Co-Contribution in Superannuation: a Comparative Assessment of the Financial Benefits of Scheme Participation

Directory of Open Access Journals (Sweden)

Aaron Bruhn

2013-09-01

Full Text Available Voluntary superannuation contributions provide a means for individuals to top-up their savings in a tax advantaged environment. In order to encourage voluntary contributions the government instituted the cocontribution scheme in 2003. Under the existing scheme, within a given financial year the government contributes up to a maximum of $500 when an individual on a low income makes a voluntary contribution of up to $1,000. Despite the apparent financial attractiveness of the scheme, participation among eligible persons is low. Reasons may include competing expenditure needs leading to a lack of sufficient funds for contribution, lack of trust in the system given regular changes to superannuation policy, and behavioural reasons including a short-term rather than long-term focus, procrastination from uncertainty and fear of regret, and loss aversion. In this paper we investigate another possible reason for low participation, namely poor financial opportunity cost. While an immediate 50% investment return may appear to be a ‘no-brainer’, for eligible individuals or families with mortgages, scheme participation may in fact not be optimal. We investigate the relative benefit of scheme participation versus reducing a mortgage, and conclude that while participation is sensible for those with short remaining mortgage terms, for those with longer mortgage terms the decision to participate may not be preferred unless one assumes generous long-term superannuation investment returns, or unless scheme participation is intended year on year for long durations.

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...

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.…

Barriers to voluntary participation in sport for children: a systematic review.

Science.gov (United States)

Somerset, Sarah; Hoare, Derek J

2018-02-09

Numerous studies have detailed the physical health benefits of children's participation in sport and a growing body of research also highlights the benefits for mental health. Children who participate in sport have also been shown to be advantaged academically. However, despite the benefits there is evidence that children are leading increasingly sedentary lifestyles and are at greater risk of chronic disease than those with active lifestyles. Sport provides an important means for children to achieve their recommended amount of daily physical activity. This systematic review asks 'what are those barriers to children's participation in sport?' Literature searches were carried out in June 2015 using; EMBASE, Medline, CINAHL and SportDiscus using the search terms barrier*, stop*, prevent*, participat*, taking part, Sports/, sport*, "physical education", PE, child*, young person*, adolescen*. These were supplemented with hand searches. A total of 3434 records were identified of which 22 were suitable for inclusion in the review, two additional studies were identified from Google Scholar in November 2016. Both qualitative and quantitative studies were included. Study's included in the review assessed children up to 18 years of age. Study quality was assessed using Critical Appraisal Skills Programme (CASP) tools. Studies took place in the school environment (n = 14), sports club (n = 1), community setting (n = 8) and adolescent care setting (n = 1). Frequently reported barriers across quantitative studies were 'time' (n = 4), 'cost' (n = 3), 'opportunity/accessibility' (n = 3) and 'friends' (n = 2). Frequently reported barriers across qualitative studies were 'time' (n = 6), 'cost' (n = 5), 'not being good at sport' (n = 6) and 'fear of being judged/embarrassed' (n = 6). Policy makers, parents and teachers should all be aware that 'cost' and 'time' are key barriers to participation in sport. More local sports opportunities are needed where costs are reduced. Schools

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...

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...

Relation between Peak Power Output in Sprint Cycling and Maximum Voluntary Isometric Torque Production.

Science.gov (United States)

Kordi, Mehdi; Goodall, Stuart; Barratt, Paul; Rowley, Nicola; Leeder, Jonathan; Howatson, Glyn

2017-08-01

From a cycling paradigm, little has been done to understand the relationships between maximal isometric strength of different single joint lower body muscle groups and their relation with, and ability to predict PPO and how they compare to an isometric cycling specific task. The aim of this study was to establish relationships between maximal voluntary torque production from isometric single-joint and cycling specific tasks and assess their ability to predict PPO. Twenty male trained cyclists participated in this study. Peak torque was measured by performing maximum voluntary contractions (MVC) of knee extensors, knee flexors, dorsi flexors and hip extensors whilst instrumented cranks measured isometric peak torque from MVC when participants were in their cycling specific position (ISOCYC). A stepwise regression showed that peak torque of the knee extensors was the only significant predictor of PPO when using SJD and accounted for 47% of the variance. However, when compared to ISOCYC, the only significant predictor of PPO was ISOCYC, which accounted for 77% of the variance. This suggests that peak torque of the knee extensors was the best single-joint predictor of PPO in sprint cycling. Furthermore, a stronger prediction can be made from a task specific isometric task. Copyright © 2017 Elsevier Ltd. All rights reserved.

Succumbing to Bottom-Up Biases on Task Choice Predicts Increased Switch Costs in the Voluntary Task Switching Paradigm

Science.gov (United States)

Orr, Joseph M.; Weissman, Daniel H.

2010-01-01

Bottom-up biases are widely thought to influence task choice in the voluntary task switching paradigm. Definitive support for this hypothesis is lacking, however, because task choice and task performance are usually confounded. We therefore revisited this hypothesis using a paradigm in which task choice and task performance are temporally separated. As predicted, participants tended to choose the task that was primed by bottom-up biases. Moreover, such choices were linked to increased switch costs during subsequent task performance. These findings provide compelling evidence that bottom-up biases influence voluntary task choice. They also suggest that succumbing to such biases reflects a reduction of top-down control that persists to influence upcoming task performance. PMID:21713192

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.

[Should hospitalization be required after the emergency discharge of patients with borderline personality disorder who have attempted suicide (FRENCH CRISIS cohort)?].

Science.gov (United States)

Cailhol, L; Riedi, G; Mathur, A; Czapla, P; Charpentier, S; Genestal, M; Birmes, P

2014-09-01

Borderline personality disorder (BPD) is characterized by a pervasive pattern of instability and impulsivity. There is a high prevalence of BPD patients among those admitted to the emergency department for suicide attempts. However, little empirical research exists to assist clinicians in deciding whether to hospitalize a suicidal patient. Some authors have argued that hospitalization does not prevent suicide and could actually harm these patients, thereby leading to psychosocial regression. Parasuicidal behaviors could be reinforced by the attention given during hospitalization. Our purpose was to determine whether the hospitalization of suicidal patients who have a high risk of BPD after discharge from the emergency department is associated with a recurrence of suicidal behavior at 6months. We designed a prospective study, acquiring patients from three emergency hospitals. The participants were suicidal subjects admitted for voluntary drug intoxication and were 18years of age or older. The participants completed the Personality Disorder Questionnaire (PDQ-4+) to assess BPD symptomatology. Information on the recurrence of suicidal behavior at 6months was obtained by interview of patients and the review of the charts from the 3 hospitals involved in the study. Other assessments included the BDI-13 (severity of depression), the Hopelessness Scale (hopelessness), the TAS-20 (alexythymia), the AUDIT (alcohol disorder) and the MINI (axis I disorders). A total of 606 subjects admitted for a suicide attempt participated in this study. A total of 320 (52.8 %) of the subjects completed the PDQ-4+. The sample was divided into three groups: participants at high risk of having at least one BPD (n=197), a group at high risk of having at least one non-BPD PD (n=84) and a group with low risk of having a PD (n=39). Hospitalization following an emergency was not associated with a recurrence of suicide attempts at 6months among patients at high risk of BPD. A logistical

Increasing participation in incentive programs for biodiversity conservation.

Science.gov (United States)

Sorice, Michael G; Oh, Chi-Ok; Gartner, Todd; Snieckus, Mary; Johnson, Rhett; Donlan, C Josh

2013-07-01

Engaging private landowners in conservation activities for imperiled species is critical to maintaining and enhancing biodiversity. Market-based approaches can incentivize conservation behaviors on private lands by shifting the benefit-cost ratio of engaging in activities that result in net conservation benefits for target species. In the United States and elsewhere, voluntary conservation agreements with financial incentives are becoming an increasingly common strategy. While the influence of program design and delivery of voluntary conservation programs is often overlooked, these aspects are critical to achieving the necessary participation to attain landscape-scale outcomes. Using a sample of family-forest landowners in the southeast United States, we show how preferences for participation in a conservation program to protect an at-risk species, the gopher tortoise (Gopherus polyphemus), are related to program structure, delivery, and perceived efficacy. Landowners were most sensitive to programs that are highly controlling, require permanent conservation easements, and put landowners at risk for future regulation. Programs designed with greater levels of compensation and that support landowners' autonomy to make land management decisions can increase participation and increase landowner acceptance of program components that are generally unfavorable, like long-term contracts and permanent easements. There is an inherent trade-off between maximizing participation and maximizing the conservation benefits when designing a conservation incentive program. For conservation programs targeting private lands to achieve landscape-level benefits, they must attract a critical level of participation that creates a connected mosaic of conservation benefits. Yet, programs with attributes that strive to maximize conservation benefits within a single agreement (and reduce risks of failure) are likely to have lower participation, and thus lower landscape benefits. Achieving

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

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.

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.

78 FR 23550 - Department of Energy's (DOE) Participation in Development of the International Energy...

Science.gov (United States)

2013-04-19

... building energy codes by periodically reviewing the technical and economic basis of the voluntary building... and modification of such codes. (42 U.S.C. 6836(b)) B. Background The IECC serves as a model building... building energy codes is through participation in the IECC development process. DOE participates in the ICC...

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

Directory of Open Access Journals (Sweden)

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.

[Participation of one children hospital residents in scientific and training activities of Sociedad Argentina de Pediatría].

Science.gov (United States)

Davenport, María Carolina; Domínguez, Paula Alejandra; Martins, Andrea Elizabeth

2012-04-01

The Sociedad Argentina de Pediatría, SAP (Argentine Society of Pediatrics) offers courses and scientific activities for pediatricians and residents. We evaluated the participation of Pedro de Elizalde Hospital residents in the scientific and training activities of SAP and assessed the trend of participation throughout the residency; 107 residents were surveyed; 48% were members, and the participation increased significantly throughout the residence (p <0.01). None of the surveyed residents were part of any association; 84% did not know the "Pediatricians in Training Group"; 49% participated in continued training programs, with a growing tendency to participation through-out the residency (p <0.01); 80% considered that the SAP is a friendly entity. We concluded that participation of residents in the SAP is scarce during the first two years of training, and that it shows a growth in the senior residents' group. Encouraging the interest of first and second year residents in the activities is necessary.

Voluntary Youth-Serving Organizations: Responding to the Needs of Young People and Society in the Last Century

OpenAIRE

Suzanne M. LeMenestrel; Lisa A. Lauxman

2011-01-01

As many national youth-serving organizations have either celebrated their 100th anniversaries or are approaching their centennials, we take a step back to celebrate these organizations’ accomplishments, but also to examine how youth organizations have responded positively to the youth development philosophy and approach to programming. The focus of this paper is on those organizations in which participation by youth is voluntary.

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

High participation rate among 25 721 patients with broad age range in a hospital-based research project involving whole-genome sequencing - the Lausanne Institutional Biobank.

Science.gov (United States)

Bochud, Murielle; Currat, Christine; Chapatte, Laurence; Roth, Cindy; Mooser, Vincent

2017-10-24

We aimed to evaluate the interest of adult inpatients and selected outpatients in engaging in a large, real-life, hospital-based, genomic medicine research project and in receiving clinically actionable incidental findings. Within the framework of the cross-sectional Institutional Biobank of Lausanne, Switzerland, a total of 25721 patients of the CHUV University Hospital were systematically invited to grant researchers access to their biomedical data and to donate blood for future analyses, including whole-genome sequencing. Multivariable logistic regression analysis was used to identify personal factors, including age, gender, religion, ethnicity, citizenship, education level and mode of admission, associated with willingness to participate in this genomic research project and with interest in receiving clinically actionable incidental findings. The overall participation rate was 79% (20343/25721). Participation rate declined progressively with age, averaging 83%, 75%, 67% and 62% in patients aged rate, but not with higher willingness to receive incidental findings within the population who had agreed to participate. A large proportion of adult patients, even among the elderly, are willing to actively participate and receive incidental findings in this systematic hospital-based precision and genomic medicine research program with broad consent.

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

20 CFR 655.1111 - Element I-What hospitals are eligible to participate in the H-1C program?

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Element I-What hospitals are eligible to participate in the H-1C program? 655.1111 Section 655.1111 Employees' Benefits EMPLOYMENT AND TRAINING... Internet website at http://www.access.gpo.gov. (d) To make a determination about information in the settled...

Barriers to Participation in an Online Nursing Journal Club at a Community Teaching Hospital.

Science.gov (United States)

Rodriguez, Christopher; Victor, Carol; Leonardi, Nathaniel; Sulo, Suela; Littlejohn, Gina

2016-12-01

HOW TO OBTAIN CONTACT HOURS BY READING THIS ISSUE Instructions: 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded after you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. In order to obtain contact hours you must: 1. Read the article, "Barriers to Participation in an Online Nursing Journal Club at a Community Teaching Hospital," found on pages 536-542, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website to register for contact hour credit. You will be asked to provide your name, contact information, and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until November 30, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. OBJECTIVES Describe the benefits and barriers to participating in an online nursing journal club (ONJC) over a

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.

Do Payments Pay Off? Evidence from Participation in Costa Rica's PES Program.

Directory of Open Access Journals (Sweden)

R A Arriagada

Full Text Available Payments for environmental services (PES are often viewed as a way to simultaneously improve conservation outcomes and the wellbeing of rural households who receive the payments. However, evidence for such win-win outcomes has been elusive. We add to the growing literature on conservation program impacts by using primary household survey data to evaluate the socioeconomic impacts of participation in Costa Rica's PES program. Despite the substantial cash transfers to voluntary participants in this program, we do not detect any evidence of impacts on their wealth or self-reported well-being using a quasi-experimental design. These results are consistent with the common claim that voluntary PES do not harm participants, but they beg the question of why landowners participate if they do not benefit. Landowners in our sample voluntarily renewed their contracts after five years in the program and thus are unlikely to have underestimated their costs of participation. They apparently did not invest additional income from the program in farm inputs such as cattle or hired labor, since both decreased as a result of participation. Nor do we find evidence that participation encouraged moves off-farm. Instead, semi-structured interviews suggest that participants joined the program to secure their property rights and contribute to the public good of forest conservation. Thus, in order to understand the social impacts of PES, we need to look beyond simple economic rationales and material outcomes.

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.

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

Directory of Open Access Journals (Sweden)

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.

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.

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

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.

Voluntary Youth-Serving Organizations: Responding to the Needs of Young People and Society in the Last Century

Directory of Open Access Journals (Sweden)

Suzanne M. LeMenestrel

2011-09-01

Full Text Available As many national youth-serving organizations have either celebrated their 100th anniversaries or are approaching their centennials, we take a step back to celebrate these organizations’ accomplishments, but also to examine how youth organizations have responded positively to the youth development philosophy and approach to programming. The focus of this paper is on those organizations in which participation by youth is voluntary.

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...

Plyometric training improves voluntary activation and strength during isometric, concentric and eccentric contractions.

Science.gov (United States)

Behrens, Martin; Mau-Moeller, Anett; Mueller, Karoline; Heise, Sandra; Gube, Martin; Beuster, Nico; Herlyn, Philipp K E; Fischer, Dagmar-C; Bruhn, Sven

2016-02-01

This study investigated effects of plyometric training (6 weeks, 3 sessions/week) on maximum voluntary contraction (MVC) strength and neural activation of the knee extensors during isometric, concentric and eccentric contractions. Twenty-seven participants were randomly assigned to the intervention or control group. Maximum voluntary torques (MVT) during the different types of contraction were measured at 110° knee flexion (180°=full extension). The interpolated twitch technique was applied at the same knee joint angle during isometric, concentric and eccentric contractions to measure voluntary activation. In addition, normalized root mean square of the EMG signal at MVT was calculated. The twitch torque signal induced by electrical nerve stimulation at rest was used to evaluate training-related changes at the muscle level. In addition, jump height in countermovement jump was measured. After training, MVT increased by 20Nm (95% CI: 5-36Nm, P=0.012), 24Nm (95% CI: 9-40Nm, P=0.004) and 27Nm (95% CI: 7-48Nm, P=0.013) for isometric, concentric and eccentric MVCs compared to controls, respectively. The strength enhancements were associated with increases in voluntary activation during isometric, concentric and eccentric MVCs by 7.8% (95% CI: 1.8-13.9%, P=0.013), 7.0% (95% CI: 0.4-13.5%, P=0.039) and 8.6% (95% CI: 3.0-14.2%, P=0.005), respectively. Changes in the twitch torque signal of the resting muscle, induced by supramaximal electrical stimulation of the femoral nerve, were not observed, indicating no alterations at the muscle level, whereas jump height was increased. Given the fact that the training exercises consisted of eccentric muscle actions followed by concentric contractions, it is in particular relevant that the plyometric training increased MVC strength and neural activation of the quadriceps muscle regardless of the contraction mode. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

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.

Voluntary pulmonary function screening with GOLD standard: an effective and simple approach to detect lung obstruction.

Science.gov (United States)

Wang, Shengyu; Gong, Wei; Tian, Yao; Yang, Min

2015-11-01

The prevalence of lung obstruction is probably underestimated. Early detection and screening may alter the course and prognosis associated with lung disease. We investigated the effectiveness of voluntary lung function screening program and the agreement between the Global Initiative for Chronic Obstructive Lung Disease (GOLD) and the lower limit of normal (LLN) standard for public screening in Xi'an China. Pulmonary function testing was conducted on volunteers recruited from eight community centers in Xi'an, China between July and August 2012. Participants underwent three forced vital capacity (FVC) maneuvers. The maneuver with the best FEV1 was retained. Participants filled out a medical history survey before undergoing pulmonary function testing. Patients that self-reported lung disease on the health survey were excluded from the analysis. A total of 803 volunteers participated in this study. And 722 participants (93.8%) did not self-report chronic lung disease and were analyzed. Of these participants, 143 subjects (19.8%) were diagnosed by GOLD standard and 134 subjects (18.6%) had obstruction with LLN definition. GOLD definition can identify more asymptomatic subjects (19.1%) with respect to LLN. GOLD definition can detect more lung obstruction in elder subjects compared with young people, the difference is significant (P=0.0007). The overall agreement between the 2 methods was good: the kappa estimate was 0.822. The agreement in subjects aged 40-49, 50-59 and 60-69 years was good: the kappa estimate was 0.82, 0.936 and 0.907 respectively and the agreement in subjects aged 18-29 was inferior: the kappa estimate was only 0.555. Voluntary lung function screening program with GOLD standard may be a simple and effective approach to ensuring high yield detection of lung obstruction in subjects aged 40-69.

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

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.

Findings from non-participant observational data concerning health promoting nursing practice in the acute hospital setting focusing on generalist nurses.

Science.gov (United States)

Casey, Dympna

2007-03-01

This paper reports on the non-participant observational findings from a study, which examined hospital-based nurses' health promoting nursing practice in an acute setting. Nurses are considered to have a key role in health promotion. However, the development of the role of the generalist hospital-based nurse in health promotion has been slow and is not well-understood. The conceptual framework used was based on the Ottawa Charter (WHO 1986). A single qualitative embedded case study, employing data source and methodological triangulation was used. A framework for identifying nurse's use of health promotion methods was developed and used to collect non-participant observations on a purposive sample of eight nurses working on an acute hospital ward. Following the observations a semi structured one-to-one interview was conducted with each observed nurse. One randomly selected patient that the observed nurse had cared for during the observations was also interviewed. Qualitative data analysis based on the work of Miles and Huberman was employed. Two categories were identified 'health promotion strategies and content' and 'patient participation'. The findings indicated that, overall, the strategies used by nurses to promote health were prescriptive and individualistic. The main strategy observed was information giving and the content was 'preparatory information'. Predominantly, nurses practised traditional health education. Overall, patient participation was limited to minor personal aspects of care as nurses focused on the routine and getting the tasks completed. There was no evidence of a ward culture which valued health promotion. Ward managers are key in creating a culture for health promotion. A review of the methods of organizing nursing care is warranted. Nursing programmes must highlight health promotion as integral to practice and emphasis the socio-political dimensions of health promotion.

Gender Differences on Attitudes and Participation in an Extracurricular Gymnastics Course among Greek University Students

Science.gov (United States)

Milosis, Dimitrios; Papaioannou, Athanasios G.; Siatras, Theophanis A.; Proios, Miltiadis; Proios, Michael

2015-01-01

The aims of the study were (a) to test the effectiveness of the theory of planned behavior (TPB) to predict Greek university students' voluntary participation in an extracurricular gymnastics course, and (b) to evaluate gender differences. Two hundred sixty-three (127 female, 136 male) students participated in the study. Students' attitudes,…

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, ...

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.

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....

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.

Grow Rich while you sleep: Selection in Experiments with Voluntary Participation

NARCIS (Netherlands)

Gautier, Pieter; Klaauw, van der Bas

2006-01-01

We use data from a promotion campaign of NH-Hoteles to study self-selection of participants in a gift-exchange experiment. The promotion campaign allowed guests to pay any non negative amount of money for a stay in one of 36 hotels in Belgium and the Netherlands. The data allow us to distinguish

Task Irrelevant External Cues Can Influence Language Selection in Voluntary Object Naming: Evidence from Hindi-English Bilinguals.

Directory of Open Access Journals (Sweden)

Divya Bhatia

Full Text Available We examined if external cues such as other agents' actions can influence the choice of language during voluntary and cued object naming in bilinguals in three experiments. Hindi-English bilinguals first saw a cartoon waving at a color patch. They were then asked to either name a picture in the language of their choice (voluntary block or to name in the instructed language (cued block. The colors waved at by the cartoon were also the colors used as language cues (Hindi or English. We compared the influence of the cartoon's choice of color on naming when speakers had to indicate their choice explicitly before naming (Experiment 1 as opposed to when they named directly on seeing the pictures (Experiment 2 and 3. Results showed that participants chose the language indicated by the cartoon greater number of times (Experiment 1 and 3. Speakers also switched significantly to the language primed by the cartoon greater number of times (Experiment 1 and 2. These results suggest that choices leading to voluntary action, as in the case of object naming can be influenced significantly by external non-linguistic cues. Importantly, these symbolic influences can work even when other agents are merely indicating their choices and are not interlocutors in bilingual communication.

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.

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...

Rehabilitation through the Arts: Impact on Participants' Engagement in Educational Programs

Science.gov (United States)

Halperin, Ronnie; Kessler, Suzanne; Braunschweiger, Dana

2012-01-01

Educational achievement has been shown to be negatively correlated with recidivism among those released from prison (Nuttall, Hollmen, and Staley, 2003). The purpose of this study was to examine the impact of a prison art rehabilitation program, Rehabilitation Through the Arts (RTA), on inmate participation in voluntary educational programs. RTA…

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

Policy uncertainty and corporate performance in government-sponsored voluntary environmental programs.

Science.gov (United States)

Liu, Ning; Tang, Shui-Yan; Zhan, Xueyong; Lo, Carlos Wing-Hung

2018-08-01

This study combines insights from the policy uncertainty literature and neo-institutional theory to examine corporate performance in implementing a government-sponsored voluntary environmental program (VEP) during 2004-2012 in Guangzhou, China. In this regulatory context, characterized by rapid policy changes, corporate performance in VEPs is affected by government surveillance, policy uncertainty, and peer pressures. Specifically, if VEP participants have experienced more government surveillance, they tend to perform better in program implementation. Such positive influence of government surveillance is particularly evident among those joining under high and low, rather than moderate uncertainty. Participants also perform better if they belong to an industry with more certified VEP firms, but worse if they are located in a regulatory jurisdiction with more certified VEP firms. At a moderate level of policy uncertainty, within-industry imitation is most likely to occur but within-jurisdiction imitation is least likely to occur. Copyright © 2018 Elsevier Ltd. All rights reserved.

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

Expectations and voluntary attrition in nursing students.

Science.gov (United States)

O'Donnell, Hugh

2011-01-01

This paper presents a series of findings generated during a larger study which aimed to develop a theoretical understanding of the reasons why nursing students voluntarily leave pre-registration nursing programmes. In this study, significant incongruence was found to exist between student expectations of pre-registration nursing programmes and the reality of these programmes following entry. The resulting dissonance was identified as an important factor in student decisions to voluntarily withdraw. A single case study design was selected to explore the causes of voluntary attrition in nursing students within a School of Nursing and Midwifery. The study population was obtained through purposeful sampling and consisted of 15 students who had previously voluntarily withdrawn from pre-registration nursing programmes. A semi-structured interview method was used to collect data from study participants. The interview schedule developed for use in the study reflected the key components of the conceptual model of higher education (HE) student attrition (Tinto, 1975, 1987, 1993). All interviews were tape recorded to facilitate later transcription. The Cyclical or Interactive Model of Qualitative Research (Miles and Huberman, 1994) was used to analyse data collected from study participants. This paper describes the unrealistic range of expectations which nursing students have of nursing, the information sources and experiences which inform student expectations and how ambiguous expectations contributed to voluntarily attrition. Copyright © 2010 Elsevier Ltd. All rights reserved.

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

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.

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

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.

Enhancing voluntary imitation through attention and motor imagery.

Science.gov (United States)

Bek, Judith; Poliakoff, Ellen; Marshall, Hannah; Trueman, Sophie; Gowen, Emma

2016-07-01

Action observation activates brain areas involved in performing the same action and has been shown to increase motor learning, with potential implications for neurorehabilitation. Recent work indicates that the effects of action observation on movement can be increased by motor imagery or by directing attention to observed actions. In voluntary imitation, activation of the motor system during action observation is already increased. We therefore explored whether imitation could be further enhanced by imagery or attention. Healthy participants observed and then immediately imitated videos of human hand movement sequences, while movement kinematics were recorded. Two blocks of trials were completed, and after the first block participants were instructed to imagine performing the observed movement (Imagery group, N = 18) or attend closely to the characteristics of the movement (Attention group, N = 15), or received no further instructions (Control group, N = 17). Kinematics of the imitated movements were modulated by instructions, with both Imagery and Attention groups being closer in duration, peak velocity and amplitude to the observed model compared with controls. These findings show that both attention and motor imagery can increase the accuracy of imitation and have implications for motor learning and rehabilitation. Future work is required to understand the mechanisms by which these two strategies influence imitation accuracy.

The Influence of Low-Barrier and Voluntary Service Policies on Survivor Empowerment in a Domestic Violence Housing Organization.

Science.gov (United States)

Nnawulezi, Nkiru; Godsay, Surbhi; Sullivan, Cris M; Marcus, Suzanne; Hacskaylo, Margaret

2018-01-18

The purpose of community-based domestic violence crisis housing programs (e.g., shelters) is to provide a safe setting that promotes empowerment for survivors of intimate partner violence. For staff to reach this aim, the program must have formal structures and processes in place to support such efforts. This study explored how low-barrier and voluntary service policies influenced staff practices and survivor empowerment. Low-barrier policies require that programs remove barriers that prevent survivors, particularly those who have mental health concerns and/or addictions, from being able to access services. A voluntary service policy states that survivors have the right to choose which services, if any, they would like to engage in during their stay at the program. Survivors' ability to stay at the housing program is not contingent on their participation in program services. This exploratory-sequential (QUAL→ quan) mixed-method study examined how low-barrier and voluntary service policies influenced staff behavior and how these behaviors then related to survivor empowerment. Qualitative results revealed that low-barrier and voluntary service were guided by cultural values of justice and access, encouraged survivor-centered practices among staff, and were believed to promote survivor autonomy. Quantitative results suggested that when survivors perceived they had a choice to engage in program services or meet with an advocate, their empowerment increased. This study has implications for domestic violence organizational practice and provides evidence about the contextual factors that support individual empowerment. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Restoring voluntary grasping function in individuals with incomplete chronic spinal cord injury: pilot study.

Science.gov (United States)

Kapadia, Naaz; Zivanovic, Vera; Popovic, Milos R

2013-01-01

Functional electrical stimulation (FES) therapy has been shown to be one of the most promising approaches for improving voluntary grasping function in individuals with subacute cervical spinal cord injury (SCI). To determine the effectiveness of FES therapy, as compared to conventional occupational therapy (COT), in improving voluntary hand function in individuals with chronic (≥24 months post injury), incomplete (American Spinal Injury Association Impairment Scale [AIS] B-D), C4 to C7 SCI. Eight participants were randomized to the intervention group (FES therapy; n = 5) or the control group (COT; n = 3). Both groups received 39 hours of therapy over 13 to 16 weeks. The primary outcome measure was the Toronto Rehabilitation Institute-Hand Function Test (TRI-HFT), and the secondary outcome measures were Graded Redefined Assessment of Strength Sensibility and Prehension (GRASSP), Functional Independence Measure (FIM) self-care subscore, and Spinal Cord Independence Measure (SCIM) self-care subscore. Outcome assessments were performed at baseline, after 39 sessions of therapy, and at 6 months following the baseline assessment. After 39 sessions of therapy, the intervention group improved by 5.8 points on the TRI-HFT's Object Manipulation Task, whereas the control group changed by only 1.17 points. Similarly, after 39 sessions of therapy, the intervention group improved by 4.6 points on the FIM self-care subscore, whereas the control group did not change at all. The results of the pilot data justify a clinical trial to compare FES therapy and COT alone to improve voluntary hand function in individuals with chronic incomplete tetraplegia.

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...

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...

Design, implementation and scaling up of the balanced scorecard for hospitals in Lebanon: policy coherence and application lessons for low and middle income countries.

Science.gov (United States)

El-Jardali, Fadi; Saleh, Shadi; Ataya, Nour; Jamal, Diana

2011-12-01

This paper describes the development and implementation of the first national hospital performance indicators in Lebanon including its institutionalization within existing policy framework and the initiation of independent governance structure for sustainability. Guided by the Ontario Acute Care Balanced Scorecard framework, a step-wise approach was used. Guiding principles were non-punitive reporting, anonymity, voluntary participation, stakeholder involvement, consensus and feasibility. Modified Delphi technique was used, readiness assessment surveys in 52 hospitals were conducted, pilot testing and evaluation were completed in 14 hospitals. Initial balanced set of 21 indicators were selected. Findings showed wide variations in indicators' measurement in hospitals including formulas and tools. Barriers to measurement included lack of quality culture, physician resistance and resources. A gradual implementation strategy was developed and selected indicators were divided into two levels. Most piloted indicators proved to be valid, feasible and reliable. The initiative was linked to the national hospital accreditation system resulting in a balanced set of 40 indicators. An independent, not-for-profit, arm's-length organization was established. This is among the first attempts made in the East Mediterranean Region to adapt the BSC approach and translate the experience of its development to addresses local needs and contextual reality. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

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.

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.

Developing control algorithms of a voluntary cough for an artificial bioengineered larynx using surface electromyography of chest muscles: A prospective cohort study.

Science.gov (United States)

Banus, M S; Birchall, M A; Graveston, J A

2018-04-01

This prospective cohort study investigates the prediction of a voluntary cough using surface electromyography (EMG) of intercostal and diaphragm muscles, to develop control algorithms for an EMG-controlled artificial larynx. The Ear Institute, London. Electromyography onset compared to voluntary cough exhalation onset and to 100 ms (to give the artificial larynx the time to close the bioengineered vocal cords) before voluntary cough exhalation onset, in twelve healthy participants. In the 189 EMG of intercostal muscle-detected voluntary coughs, 172 coughs (91% CI 70-112) were detected before onset of cough exhalation and 128 coughs (67.6% CI 33.7-101.7) 100 ms before onset of cough exhalation. In the 158 EMG of diaphragm muscle-detected voluntary coughs, 149 coughs (94.3% CI 76.3-112.3) were detected before onset of cough exhalation and 102 coughs (64.6% CI 26.6-102.6) 100 ms before onset of cough exhalation. More coughs were detected before onset of cough exhalation when combining EMG activity of intercostal and diaphragm muscles and comparing this to intercostal muscle activity alone (183 coughs [96.8% CI 83.8-109.8] vs 172 coughs, P = .0294). When comparing the mentioned combination to diaphragm muscle activity alone, the higher percentage of detected coughs before cough exhalation onset was not found to be significant (183 coughs vs 149 coughs, P = .295). In addition, more coughs were detected 100 ms before onset of cough exhalation with the mentioned combination of EMG activity and comparing this to intercostal muscles alone (149 coughs [78.8% CI 48.8-108.8] vs 128 coughs, P = .0198) and to diaphragm muscles alone (149 coughs vs 102 coughs, P = .0038). Most voluntary coughs can be predicted based on combined EMG signals of intercostal and diaphragm muscles, and therefore, these two muscle groups will be useful in controlling the bioengineered vocal cords within the artificial larynx during a voluntary cough. © 2017 John Wiley & Sons Ltd.

Activation properties of trigeminal motoneurons in participants with and without bruxism

Science.gov (United States)

D'Amico, Jessica M.; Yavuz, Ş. Utku; Saraçoğlu, Ahmet; Atiş, Elif Sibel; Türker, Kemal S.

2013-01-01

In animals, sodium- and calcium-mediated persistent inward currents (PICs), which produce long-lasting periods of depolarization under conditions of low synaptic drive, can be activated in trigeminal motoneurons following the application of the monoamine serotonin. Here we examined if PICs are activated in human trigeminal motoneurons during voluntary contractions and under physiological levels of monoaminergic drive (e.g., serotonin and norepinephrine) using a paired motor unit analysis technique. We also examined if PICs activated during voluntary contractions are larger in participants who demonstrate involuntary chewing during sleep (bruxism), which is accompanied by periods of high monoaminergic drive. In control participants, during a slowly increasing and then decreasing isometric contraction, the firing rate of an earlier-recruited masseter motor unit, which served as a measure of synaptic input to a later-recruited test unit, was consistently lower during derecruitment of the test unit compared with at recruitment (ΔF = 4.6 ± 1.5 imp/s). The ΔF, therefore, is a measure of the reduction in synaptic input needed to counteract the depolarization from the PIC to provide an indirect estimate of PIC amplitude. The range of ΔF values measured in the bruxer participants during similar voluntary contractions was the same as in controls, suggesting that abnormally high levels of monoaminergic drive are not continually present in the absence of involuntary motor activity. We also observed a consistent “onion skin effect” during the moderately sized contractions (motor units discharged at slower rates (by 4–7 imp/s) compared with motor units with relatively lower thresholds. The presence of lower firing rates in the more fatigue-prone, higher threshold trigeminal motoneurons, in addition to the activation of PICs, likely facilitates the activation of the masseter muscle during motor activities such as eating, nonnutritive chewing, clenching, and yawning

42 CFR 482.30 - Condition of participation: Utilization review.

Science.gov (United States)

2010-10-01

... circumstances: (1) A Utilization and Quality Control Quality Improvement Organization (QIO) has assumed binding... HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION CONDITIONS OF PARTICIPATION FOR HOSPITALS Basic Hospital Functions § 482.30 Condition of participation: Utilization review. The hospital must have in...

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...

[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.

The effect of nursing participation in the design of a critical care information system: a case study in a Chinese hospital.

Science.gov (United States)

Qin, Yanhong; Zhou, Ranyun; Wu, Qiong; Huang, Xiaodi; Chen, Xinli; Wang, Weiwei; Wang, Xun; Xu, Hua; Zheng, Jing; Qian, Siyu; Bai, Changqing; Yu, Ping

2017-12-06

Intensive care information systems (ICIS) are continuously evolving to meet the ever changing information needs of intensive care units (ICUs), providing the backbone for a safe, intelligent and efficient patient care environment. Although beneficial for the international advancement in building smart environments to transform ICU services, knowledge about the contemporary development of ICIS worldwide, their usage and impacts is limited. This study aimed to fill this knowledge gap by researching the development and implementation of an ICIS in a Chinese hospital, nurses' use of the system, and the impact of system use on critical care nursing processes and outcomes. This descriptive case study was conducted in a 14-bed Respiratory ICU in a tertiary hospital in Beijing. Participative design was the method used for ICU nurses, hospital IT department and a software company to collaboratively research and develop the ICIS. Focus group discussions were conducted to understand the subjective perceptions of the nurses toward the ICIS. Nursing documentation time and quality were compared before and after system implementation. ICU nursing performance was extracted from the annual nursing performance data collected by the hospital. A participative design process was followed by the nurses in the ICU, the hospital IT staff and the software engineers in the company to develop and implement a highly useful ICIS. Nursing documentation was fully digitized and was significantly improved in quality and efficiency. The wrong data, missing data items and calculation errors were significantly reduced. Nurses spent more time on direct patient care after the introduction of the ICIS. The accuracy and efficiency of medication administration was also improved. The outcome was improvement in ward nursing performance as measured by ward management, routine nursing practices, disinfection and isolation, infection rate and mortality rate. Nurses in this ICU unit in China actively

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.

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...

Onset of posttraumatic stress disorder and major depression among refugees and voluntary migrants to the United States.

Science.gov (United States)

Rasmussen, Andrew; Crager, Mia; Baser, Ray E; Chu, Tracy; Gany, Francesca

2012-12-01

Although refugees are generally thought to be at increased risk for posttraumatic stress disorder (PTSD) and major depressive episode (MDE), few studies have compared onset of PTSD and MDE between refugees and voluntary migrants. Given differences in migration histories, onset should differ pre- and postmigration. The National Latino and Asian American Survey (NLAAS) is a national representative, complex dataset measuring psychiatric morbidity, mental health service use, and migration history among Latino and Asian immigrants to the United States. Of the 3,260 foreign-born participants, 660 were refugees (a weighted proportion of 9.52%). Refugees were more likely to report a history of war-related trauma, but reports of other traumatic events were similar. Premigration onset of PTSD was statistically higher for refugees than voluntary migrants, odds ratio (OR) = 4.86, 95% confidence interval (CI) [2.01, 11.76], where postmigration onset for PTSD was not, OR = 0.61, 95% CI [0.29, 1.28]; a similar pattern was found for MDE, OR = 1.98, 95% CI [1.11, 3.51]; and OR = 1.02, 95% CI [0.65, 1.62], respectively. Although refugees arrive in host countries with more pressing psychiatric needs, onset is comparable over time, suggesting that postmigration refugees and voluntary migrants may be best served by similar programs. Copyright © 2012 International Society for Traumatic Stress Studies.

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...

Difficulties experienced by migrant physicians working in German hospitals: a qualitative interview study.

Science.gov (United States)

Klingler, Corinna; Marckmann, Georg

2016-09-23

With Germany facing a shortage of doctors, hospitals have been increasingly recruiting physicians from abroad. Studies in other countries have shown that migrant physicians experience various difficulties in their work, which might impact the quality of patient care, physician job satisfaction, and, accordingly, retention. The experiences of migrant doctors in Germany have not been systematically studied so far and will likely differ from experiences migrant physicians make in other contexts. A thorough understanding of challenges faced by this group, however, is needed to develop adequate support structures-as required by the WHO Global Code of Practice on the International Recruitment of Health Personnel. A qualitative study was conducted to give an overview of the multifaceted difficulties migrant physicians might face in German hospitals. Twenty semi-structured interviews with foreign-born and foreign-trained physicians were conducted in German. Participants were recruited via the State Chambers of Physicians and snowballing based on a maximum variation sampling strategy varying purposefully by source country and medical specialty. The interviews were recorded, transcribed verbatim, and analysed using qualitative content analysis. Participants described difficulties relating to healthcare institutions, own competencies, and interpersonal interactions. Participants experienced certain legal norms, the regulation of licensure and application for work, and the organization of the hospital environment as inadequate. Most struggled with their lack of setting-specific (language, cultural, clinical, and system) knowledge. Furthermore, behaviour of patients and co-workers was perceived as discriminating or inadequate for other reasons. This is the first study to describe the broad range of issues migrant physicians experience in Germany. Based on this information, institutional actors should devise support structures to ensure quality of care, physician wellbeing, and

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

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...

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...

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...

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.

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

VOLUNTARY NOISE MAPPING FOR SMART CITY

Directory of Open Access Journals (Sweden)

V. Poslončec-Petrić

2016-09-01

Full Text Available One of the main concept objectives of smart cities is to create a quality living environment that is long-term sustainable and economically justified. In that context, modern cities are aware of the exposure to various forms of physical and non-physical pollution that needs to be remediated, eliminated or reduced. To achieve that it is necessary to quality determine the sources and reasons of each pollution. The most prominent examples of physical pollution that affects the quality of life of citizens in cities are light and noise pollution. Noise pollution or noise, is mostly the consequence of road and rail traffic in cities and it directly affects the health of citizens. Traffic control, reduction of peak congestion, dispersion and traffic redirection or building protective barriers, are ways that cities use to reduce the amount of noise or its effects. To make these measures efficient it is necessary to obtain the information related to the level of noise in certain areas, streets, cities. To achieve this, smart cities use noise mapping. The city of Zagreb since 2012, participates in the i-SCOPE project (interoperable Smart City services trough Open Platform for urban Ecosystems. i-SCOPE delivers an open platform on top of which it develops, three "smart city" services: optimization of energy consumption through a service for accurate assessment of solar energy potential and energy loss at building level, environmental monitoring through a real-time environmental noise mapping service leveraging citizen's involvement will who act as distributed sensors city-wide measuring noise levels through an application on their mobile phones and improved inclusion and personal mobility of aging and diversely able citizens through an accurate personal routing service. The students of Faculty of Geodesy University of Zagreb, who enrolled in the course Thematic Cartography, were actively involved in the voluntary data acquisition in order to monitor the

Voluntary Noise Mapping for Smart City

Science.gov (United States)

Poslončec-Petrić, V.; Vuković, V.; Frangeš, S.; Bačić, Ž.

2016-09-01

One of the main concept objectives of smart cities is to create a quality living environment that is long-term sustainable and economically justified. In that context, modern cities are aware of the exposure to various forms of physical and non-physical pollution that needs to be remediated, eliminated or reduced. To achieve that it is necessary to quality determine the sources and reasons of each pollution. The most prominent examples of physical pollution that affects the quality of life of citizens in cities are light and noise pollution. Noise pollution or noise, is mostly the consequence of road and rail traffic in cities and it directly affects the health of citizens. Traffic control, reduction of peak congestion, dispersion and traffic redirection or building protective barriers, are ways that cities use to reduce the amount of noise or its effects. To make these measures efficient it is necessary to obtain the information related to the level of noise in certain areas, streets, cities. To achieve this, smart cities use noise mapping. The city of Zagreb since 2012, participates in the i-SCOPE project (interoperable Smart City services trough Open Platform for urban Ecosystems). i-SCOPE delivers an open platform on top of which it develops, three "smart city" services: optimization of energy consumption through a service for accurate assessment of solar energy potential and energy loss at building level, environmental monitoring through a real-time environmental noise mapping service leveraging citizen's involvement will who act as distributed sensors city-wide measuring noise levels through an application on their mobile phones and improved inclusion and personal mobility of aging and diversely able citizens through an accurate personal routing service. The students of Faculty of Geodesy University of Zagreb, who enrolled in the course Thematic Cartography, were actively involved in the voluntary data acquisition in order to monitor the noise in real time

Employees' Perceptions of Barriers to Participation in Training and Development in Small Engineering Businesses

Science.gov (United States)

Susomrith, Pattanee; Coetzer, Alan

2015-01-01

Purpose: This paper aims to investigate barriers to employee participation in voluntary formal training and development opportunities from the perspective of employees in small engineering businesses. Design/methodology/approach: An exploratory qualitative methodology involving data collection via site visits and in-depth semi-structured…

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.

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

Voluntary eye movements direct attention on the mental number space.

Science.gov (United States)

Ranzini, Mariagrazia; Lisi, Matteo; Zorzi, Marco

2016-05-01

Growing evidence suggests that orienting visual attention in space can influence the processing of numerical magnitude, with leftward orienting speeding up the processing of small numbers relative to larger ones and the converse for rightward orienting. The manipulation of eye movements is a convenient way to direct visuospatial attention, but several aspects of the complex relationship between eye movements, attention orienting and number processing remain unexplored. In a previous study, we observed that inducing involuntary, reflexive eye movements by means of optokinetic stimulation affected number processing only when numerical magnitude was task relevant (i.e., during magnitude comparison, but not during parity judgment; Ranzini et al., in J Cogn Psychol 27, 459-470, (2015). Here, we investigated whether processing of task-irrelevant numerical magnitude can be modulated by voluntary eye movements, and whether the type of eye movements (smooth pursuit vs. saccades) would influence this interaction. Participants tracked with their gaze a dot while listening to a digit. The numerical task was to indicate whether the digit was odd or even through non-spatial, verbal responses. The dot could move leftward or rightward either continuously, allowing tracking by smooth pursuit eye movements, or in discrete steps across a series of adjacent locations, triggering a sequence of saccades. Both smooth pursuit and saccadic eye movements similarly affected number processing and modulated response times for large numbers as a function of direction of motion. These findings suggest that voluntary eye movements redirect attention in mental number space and highlight that eye movements should play a key factor in the investigation of number-space interactions.

Political participation as an integral part of individuals’ identity

Directory of Open Access Journals (Sweden)

G. G. Udzhmadzhuridze

2014-07-01

Author examined the main types and forms of political participation. The most common types are involved in the elections, the relationship with political organizations and visiting congresses of political organizations. It is established that political participation of individuals across the all variety of its manifestations, is an expression of civic culture of a particular society. In many states for citizens there is the usual practice of political participation, but only in democratic countries individuals will do this voluntarily and without coercion. Only voluntary political participation and awareness of it, is a manifestation of personal attitudes and beliefs. The author traced that political participation as an integral part of political culture is transmitted from generation to generation through the institutions of socialization in society. The most effective institutions of socialization influence on young people. The political socialization research has revealed the transfer of political ideals and habits between generations.

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 ...

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

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

Enhancing field GP engagement in hospital-based studies. Rationale, design, main results and participation in the diagest 3-GP motivation study

Directory of Open Access Journals (Sweden)

Berkhout Christophe

2012-06-01

Full Text Available Abstract Background Diagest 3 was a study aimed at lowering the risk of developing type 2 diabetes within 3 years after childbirth. Women with gestational diabetes were enrolled in the study. After childbirth, the subjects showed little interest in the structured education programme and did not attend workshops. Their general practitioners (GPs were approached to help motivate the subjects to participate in Diagest 3, but the GPs were reluctant. The present study aimed to understand field GPs’ attitudes towards hospital-based studies, and to develop strategies to enhance their involvement and reduce subject drop-out rates. Methods We used a three-step process: step one used a phenomenological approach exploring the beliefs, attitudes, motivations and environmental factors contributing to the GPs’ level of interest in the study. Data were collected in face-to-face interviews and coded by hand and with hermeneutic software to develop distinct GP profiles. Step two was a cross-sectional survey by questionnaire to determine the distribution of the profiles in the GP study population and whether completion of an attached case report form (CRF was associated with a particular GP profile. In step three, we assessed the impact of the motivation study on participation rates in the main study. Results Fifteen interviews were conducted to achieve data saturation. Theorisation led to the definition of 4 distinct GP profiles. The response rate to the questionnaire was 73%, but dropped to 52% when a CRF was attached. The link between GP profiles and the rate of CRF completion remains to be verified. The GPs provided data on the CRF that was of comparable quality to those collected in the main trial. Our analysis showed that the motivation study increased overall participation in the main study by 23%, accounting for 16% (24/152 of all final visits for 536 patients who were initially enrolled in the Diagest 3 study. Conclusions When a hospital-led study

Enhancing field GP engagement in hospital-based studies. Rationale, design, main results and participation in the Diagest 3-GP motivation study.

Science.gov (United States)

Berkhout, Christophe; Vandaele-Bétancourt, Marie; Robert, Stéphane; Lespinasse, Solène; Mitha, Gamil; Bradier, Quentin; Vambergue, Anne; Fontaine, Pierre

2012-06-21

Diagest 3 was a study aimed at lowering the risk of developing type 2 diabetes within 3 years after childbirth. Women with gestational diabetes were enrolled in the study. After childbirth, the subjects showed little interest in the structured education programme and did not attend workshops. Their general practitioners (GPs) were approached to help motivate the subjects to participate in Diagest 3, but the GPs were reluctant. The present study aimed to understand field GPs' attitudes towards hospital-based studies, and to develop strategies to enhance their involvement and reduce subject drop-out rates. We used a three-step process: step one used a phenomenological approach exploring the beliefs, attitudes, motivations and environmental factors contributing to the GPs' level of interest in the study. Data were collected in face-to-face interviews and coded by hand and with hermeneutic software to develop distinct GP profiles. Step two was a cross-sectional survey by questionnaire to determine the distribution of the profiles in the GP study population and whether completion of an attached case report form (CRF) was associated with a particular GP profile. In step three, we assessed the impact of the motivation study on participation rates in the main study. Fifteen interviews were conducted to achieve data saturation. Theorisation led to the definition of 4 distinct GP profiles. The response rate to the questionnaire was 73%, but dropped to 52% when a CRF was attached. The link between GP profiles and the rate of CRF completion remains to be verified. The GPs provided data on the CRF that was of comparable quality to those collected in the main trial. Our analysis showed that the motivation study increased overall participation in the main study by 23%, accounting for 16% (24/152) of all final visits for 536 patients who were initially enrolled in the Diagest 3 study. When a hospital-led study explores issues in primary care, its design must anticipate GP

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

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)

Research participation by people with intellectual disability and mental health issues: an examination of the processes of consent.

Science.gov (United States)

Taua, Chris; Neville, Christine; Hepworth, Julie

2014-12-01

Balancing the demands of research and ethics is always challenging, and even more so when recruiting vulnerable groups. Within the context of current legislation and international human rights declarations, it is strongly advocated that research can and must be undertaken with all recipients of health-care services. Research in the field of intellectual disability presents particular challenges in regards to consenting processes. This paper is a reflective overview and analysis of the complex processes undertaken, and events that occurred in gaining informed consent from people with intellectual disability to participate in a study exploring their experiences of being an inpatient in mental health hospitals within Aotearoa/New Zealand. A framework based on capacity, information, and voluntariness is presented, with excerpts from the field provided to explore consenting processes. The practical implications of the processes utilized are then discussed in order to stimulate debate regarding clearer and enhanced methods of gaining informed consent from people with intellectual disability. © 2014 Australian College of Mental Health Nurses Inc.

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

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

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

Anxiety in voluntary HIV-antibody testing in pregnancy and its implications for preventive strategies.

Science.gov (United States)

Foldspang, A; Hedegaard, M

1991-06-01

During a three-month period in 1989, 820 pregnant women attending the antenatal clinic of the Aarhus University Hospital, Denmark, were offered a HIV-antibody test and asked to fill out an anonymous questionnaire about attitudes to HIV-antibody testing; 779 (95.0%) agreed to do so. One hundred and fifty-six women (20.0% of the participants) had been tested on a previous occasion, and 629 (80.7%) accepted the present offer to be tested. The most prevalent reasons to decline testing were indifference to the epidemic (45.3% of those declining), refusal of (further) blood testing (34.7%) and fear of being infected (16.7%). Women who consented to be tested most often expressed fear of being infected (21.8%). Fear of registration worried less than 5% of study group members; only 1% declined to be tested because of such worry. The pattern of worries expressed by the pregnant women is interpreted as one of anxiety and, in part at least, perplexity as concerns how to take rational consequences of public messages about the HIV epidemic. It is suggested that future surveillance be based primarily on voluntary testing and, whenever needed and possible, supplied with anonymous unlinked testing of existing blood samples from groups and persons declining to be tested. Such surveillance strategies should be supported in individual patient contacts and public health educational campaigns underscoring the risk of heterosexual transmission of HIV and the need for repeated HIV-antibody testing of selected groups and individuals.

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.

76 FR 62 - Interpretive Standards for Systemic Compensation Discrimination and Voluntary Guidelines for Self...

Science.gov (United States)

2011-01-03

... 1250-ZA00 Interpretive Standards for Systemic Compensation Discrimination and Voluntary Guidelines for... Order 11246 with respect to Systemic Compensation Discrimination (Standards) and Voluntary Guidelines... Compensation Discrimination [[Page 63

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.

What is the job satisfaction and active participation of medical staff in public hospital reform: a study in Hubei province of China.

Science.gov (United States)

Fang, Pengqian; Luo, Zhenni; Fang, Zi

2015-05-16

In China, public hospital reform has been underway for almost 5 years, and 311 pilot county hospitals are the current focus. This study aimed to assess the job satisfaction and active participation of medical staff in the reform. A total of 2268 medical staff members in pilot and non-pilot county hospitals in Hubei, China, were surveyed. Questionnaires were used to collect data. The Pearson chi-square statistical method was used to assess the differences between pilot and non-pilot county hospitals and identify the factors related to job satisfaction as well as the understanding and perception of the reform. Binary logistic regression was performed to determine the significant factors that influence the job satisfaction of medical staff in pilot county hospitals. Medical staff members in pilot county hospitals expressed higher satisfaction on current working situation, performance appraisal system, concern showed by leaders, hospital management, and compensation packages (P job and they have evidently less satisfaction on compensation packages and learning and training opportunities. The working hours and work stress were negatively related to the job satisfaction (P Satisfaction on the performance appraisal system, hospital management, compensation packages, and learning and training opportunities were positively related to job satisfaction (P pay attention to influencing factors of job satisfaction and focus on the reasonable demands of medical staff. In addition, the medical staff in pilot county hospitals exhibited a better understanding of the public hospital reform programme and showed more firm confidence, but there still were some medical staff members who hold negative attitude. The publicity and education of the public hospital reform still need improvement.

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.

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...

The importance of communication in promoting voluntary participation in an experimental trial: A qualitative study based on the assessment of the gamma-interferon test for the diagnosis of bovine tuberculosis in France.

Directory of Open Access Journals (Sweden)

Clémence Boireau

Full Text Available Understanding the factors leading each stakeholder to participate in an experimental trial is a key element for improving trial set-up and for identifying selection bias in statistical analyses. An experimental protocol, validated by the European Commission, was developed in France to assess the ability of the gamma-interferon test in terms of accuracy to replace the second intradermal skin test in cases of suspected bovine tuberculosis. Implemented between 2013 and 2015, this experimental trial was based on voluntary participation. To determine and understand the motivation or reluctance of farmers to take part in this trial, we carried out a sociological survey in France. Our study was based on semi-structured interviews with the farmers and other stakeholders involved. The analysis of findings demonstrated that shortening the lock-up period during tuberculosis suspicion, following the use of a gamma-interferon test, was an important aim and a genuine challenge for the animal health stakeholders. However, some farmers did not wish to continue the trial because it could potentially have drastic consequences for them. Moreover, misunderstandings and confusion concerning the objectives and consequences of the trial led stakeholders to reject it forcefully. Based on our results, we offer some recommendations: clear and appropriate communication tools should be prepared to explain the protocol and its aims. In addition, these types of animal health trials should be designed with the stakeholders' interests in mind. This study provides a better understanding of farmer motivations and stakeholder influences on trial participation and outcomes. The findings can be used to help design trials so that they promote participation by farmers and by all animal health stakeholders in general.

Hospital safety culture in Taiwan: a nationwide survey using Chinese version Safety Attitude Questionnaire.

Science.gov (United States)

Lee, Wui-Chiang; Wung, Hwei-Ying; Liao, Hsun-Hsiang; Lo, Chien-Ming; Chang, Fei-Ling; Wang, Pa-Chun; Fan, Angela; Chen, Hsin-Hsin; Yang, Han-Chuan; Hou, Sheng-Mou

2010-08-10

Safety activities have been initiated at many hospitals in Taiwan, but little is known about the safety culture at these hospitals. The aims of this study were to verify a safety culture survey instrument in Chinese and to assess hospital safety culture in Taiwan. The Taiwan Patient Safety Culture Survey was conducted in 2008, using the adapted Safety Attitude Questionnaire in Chinese (SAQ-C). Hospitals and their healthcare workers participated in the survey on a voluntary basis. The psychometric properties of the five SAQ-C dimensions were examined, including teamwork climate, safety climate, job satisfaction, perception of management, and working conditions. Additional safety measures were asked to assess healthcare workers' attitudes toward their collaboration with nurses, physicians, and pharmacists, respectively, and perceptions of hospitals' encouragement of safety reporting, safety training, and delivery delays due to communication breakdowns in clinical areas. The associations between the respondents' attitudes to each SAQ-C dimension and safety measures were analyzed by generalized estimating equations, adjusting for the clustering effects at hospital levels. A total of 45,242 valid questionnaires were returned from 200 hospitals with a mean response rate of 69.4%. The Cronbach's alpha was 0.792 for teamwork climate, 0.816 for safety climate, 0.912 for job satisfaction, 0.874 for perception of management, and 0.785 for working conditions. Confirmatory factor analyses demonstrated a good model fit for each dimension and the entire construct. The percentage of hospital healthcare workers holding positive attitude was 48.9% for teamwork climate, 45.2% for perception of management, 42.1% for job satisfaction, 37.2% for safety climate, and 31.8% for working conditions. There were wide variations in the range of SAQ-C scores in each dimension among hospitals. Compared to those without positive attitudes, healthcare workers with positive attitudes to each SAQ

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

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...

The effects of stimulus competition and voluntary attention on colour-graphemic synaesthesia.

Science.gov (United States)

Rich, Anina N; Mattingley, Jason B

2003-10-06

Colour-graphemic synaesthetes experience vivid colours when reading letters, digits and words. We examined the effect of stimulus competition and attention on these unusual colour experiences in 14 synaesthetes and 14 non-synaesthetic controls. Participants named the colour of hierarchical local-global stimuli in which letters at each level elicited synaesthetic colours that were congruent or incongruent with the display colour. Synaesthetes were significantly slower to name display colours when either level was incongruent than when both levels were congruent. This effect was significantly reduced when synaesthetes focused attention on one level while the congruency of letters at the ignored level was varied. These findings suggest that competition between multiple inducers and mechanisms of voluntary attention influence colour-graphemic synaesthesia.

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

42 CFR 482.62 - Condition of participation: Special staff requirements for psychiatric hospitals.

Science.gov (United States)

2010-10-01

... requirements for psychiatric hospitals. 482.62 Section 482.62 Public Health CENTERS FOR MEDICARE & MEDICAID... staff requirements for psychiatric hospitals. The hospital must have adequate numbers of qualified...) Standard: Director of inpatient psychiatric services; medical staff. Inpatient psychiatric services must be...

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 Information Retrieval Tool to Find Hospital Care Team Members: Development and Usability Study.

Science.gov (United States)

Morawski, Kyle; Monsen, Craig; Takhar, Sukhjit; Landman, Adam

2018-04-16

Hospital communication among members of a patient's care team is a central part of clinical workflow and consumes a large amount of a health care provider's time. Oftentimes the complexity of hospital care leads to difficulty in finding the appropriate contact, which can lead to inefficiencies and frustration. Squire is a Web-based information retrieval app created to improve the speed and efficiency in reaching the appropriate team member during the care of a hospitalized patient. The objective of the study was to design and develop Squire and to evaluate the usage, usability, and perceived effect of the app on finding the correct contact within a hospital. We used a mixed-methods design using a before-after survey methodology combined with one-on-one interviews to understand the perceived effect of Squire. The study took place at an academic medical center with internal medicine resident physicians. We surveyed residents on demographics, as well as time and efficiency of hospital communication before and after the use of Squire. After using Squire, participants were also asked to evaluate Squire's Net Promoter Score (NPS). A subset of voluntary participants participated in one-on-one interviews and completed the System Usability Scale (SUS). We performed descriptive statistics on participant characteristics, app usage data, and responses to surveys. Survey results were compared before and after Squire adoption using the Wilcoxon rank-sum test and a general linear model. Interview data were analyzed using content analysis with a qualitative description approach to review and categorize feedback from participants. There was a 67.9% (74/109) response rate to the pre-Squire survey and 89.9% (98/109) response rate to the post-Squire survey. At baseline, there was an average of 22.2 (95% CI 18.4-26.0) minutes/day spent searching for the right contact, and this decreased to 16.3 (95% CI 13.9-18.7) minutes/day after Squire was launched (P=.01). There were favorable

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.

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.

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.

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.

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.

An emotive subject: insights from social, voluntary and healthcare professionals into the feelings of family carers for people with mental health problems.

Science.gov (United States)

Gray, Ben; Robinson, Catherine A; Seddon, Diane; Roberts, Angela

2009-03-01

Caring for people with mental health problems can generate a whole range of positive and negative emotions, including fear, disbelief, guilt and chaos as well as a sense of purpose, pride and achievement. This paper explores the emotions of family carers from the perspectives of social, voluntary and healthcare professionals. Sixty-five participants were interviewed, the sample included directors, managers and senior staff from social, voluntary and healthcare organisations. Participants were encouraged to talk in detail about their understanding of the emotions of family carers. Findings highlight a rich understanding of the broad spectrum of carer emotions and the huge emotional adjustments that are often involved. Diagnosis was seen to be imbued with negative emotions, such as fear, anger and denial. However, feelings of hopelessness and desolation were often counterbalanced by feelings of hope, satisfaction and the emotional rewards of caring for a loved one. Participants noted a clear lack of emotional support for family carers, with accompanying feelings of marginalisation, particularly during transitions and especially involving young carers as well as ethnic minorities. By way of contrast, carer support groups were suggested by professionals to be a holistic, effective and economical way of meeting carers' emotional needs. This paper explores the challenge of family carer emotions from the perspective of managers and practitioners and draws out implications for research, policy and practice.

Voluntary exercise contributed to an amelioration of abnormal feeding behavior, locomotor activity and ghrelin production concomitantly with a weight reduction in high fat diet-induced obese rats.

Science.gov (United States)

Mifune, Hiroharu; Tajiri, Yuji; Nishi, Yoshihiro; Hara, Kento; Iwata, Shimpei; Tokubuchi, Ichiro; Mitsuzono, Ryouichi; Yamada, Kentaro; Kojima, Masayasu

2015-09-01

In the present study, effects of voluntary exercise in an obese animal model were investigated in relation to the rhythm of daily activity and ghrelin production. Male Sprague-Dawley rats were fed either a high fat diet (HFD) or a chow diet (CD) from four to 16 weeks old. They were further subdivided into either an exercise group (HFD-Ex, CD-Ex) with a running wheel for three days of every other week or sedentary group (HFD-Se, CD-Se). At 16 weeks old, marked increases in body weight and visceral fat were observed in the HFD-Se group, together with disrupted rhythms of feeding and locomotor activity. The induction of voluntary exercise brought about an effective reduction of weight and fat, and ameliorated abnormal rhythms of activity and feeding in the HFD-Ex rats. Wheel counts as voluntary exercise was greater in HFD-Ex rats than those in CD-Ex rats. The HFD-obese had exhibited a deterioration of ghrelin production, which was restored by the induction of voluntary exercise. These findings demonstrated that abnormal rhythms of feeding and locomotor activity in HFD-obese rats were restored by infrequent voluntary exercise with a concomitant amelioration of the ghrelin production and weight reduction. Because ghrelin is related to food anticipatory activity, it is plausible that ghrelin participates in the circadian rhythm of daily activity including eating behavior. A beneficial effect of voluntary exercise has now been confirmed in terms of the amelioration of the daily rhythms in eating behavior and physical activity in an animal model of obesity. Copyright © 2015 Elsevier Inc. All rights reserved.

Hospital boards and hospital strategic focus: the impact of board involvement in strategic decision making.

Science.gov (United States)

Ford-Eickhoff, Karen; Plowman, Donde Ashmos; McDaniel, Reuben R

2011-01-01

Despite pressures to change the role of hospital boards, hospitals have made few changes in board composition or director selection criteria. Hospital boards have often continued to operate in their traditional roles as either "monitors" or "advisors." More attention to the direct involvement of hospital boards in the strategic decision-making process of the organizations they serve, the timing and circumstances under which board involvement occurs, and the board composition that enhances their abilities to participate fully is needed. We investigated the relationship between broader expertise among hospital board members, board involvement in the stages of strategic decision making, and the hospital's strategic focus. We surveyed top management team members of 72 nonacademic hospitals to explore the participation of critical stakeholder groups such as the board of directors in the strategic decision-making process. We used hierarchical regression analysis to explore our hypotheses that there is a relationship between both the nature and involvement of the board and the hospital's strategic orientation. Hospitals with broader expertise on their boards reported an external focus. For some of their externally-oriented goals, hospitals also reported that their boards were involved earlier in the stages of decision making. In light of the complex and dynamic environment of hospitals today, those charged with developing hospital boards should match the variety in the external issues that the hospital faces with more variety in board makeup. By developing a board with greater breadth of expertise, the hospital responds to its complex environment by absorbing that complexity, enabling a greater potential for sensemaking and learning. Rather than acting only as monitors and advisors, boards impact their hospitals' strategic focus through their participation in the strategic decision-making process.

Maximal Voluntary Activation of the Elbow Flexors Is under Predicted by Transcranial Magnetic Stimulation Compared to Motor Point Stimulation Prior to and Following Muscle Fatigue

Directory of Open Access Journals (Sweden)

Edward W. J. Cadigan

2017-09-01

Full Text Available Transcranial magnetic (TMS and motor point stimulation have been used to determine voluntary activation (VA. However, very few studies have directly compared the two stimulation techniques for assessing VA of the elbow flexors. The purpose of this study was to compare TMS and motor point stimulation for assessing VA in non-fatigued and fatigued elbow flexors. Participants performed a fatigue protocol that included twelve, 15 s isometric elbow flexor contractions. Participants completed a set of isometric elbow flexion contractions at 100, 75, 50, and 25% of maximum voluntary contraction (MVC prior to and following fatigue contractions 3, 6, 9, and 12 and 5 and 10 min post-fatigue. Force and EMG of the bicep and triceps brachii were measured for each contraction. Force responses to TMS and motor point stimulation and EMG responses to TMS (motor evoked potentials, MEPs and Erb's point stimulation (maximal M-waves, Mmax were also recorded. VA was estimated using the equation: VA% = (1−SITforce/PTforce × 100. The resting twitch was measured directly for motor point stimulation and estimated for both motor point stimulation and TMS by extrapolation of the linear regression between the superimposed twitch force and voluntary force. MVC force, potentiated twitch force and VA significantly (p < 0.05 decreased throughout the elbow flexor fatigue protocol and partially recovered 10 min post fatigue. VA was significantly (p < 0.05 underestimated when using TMS compared to motor point stimulation in non-fatigued and fatigued elbow flexors. Motor point stimulation compared to TMS superimposed twitch forces were significantly (p < 0.05 higher at 50% MVC but similar at 75 and 100% MVC. The linear relationship between TMS superimposed twitch force and voluntary force significantly (p < 0.05 decreased with fatigue. There was no change in triceps/biceps electromyography, biceps/triceps MEP amplitudes, or bicep MEP amplitudes throughout the fatigue protocol at

Hospital board effectiveness: relationships between board training and hospital financial viability.

Science.gov (United States)

Molinari, C; Morlock, L; Alexander, J; Lyles, C A

1992-01-01

This study examined whether hospital governing boards that invest in board education and training are more informed and effective decision-making bodies. Measures of hospital financial viability (i.e., selected financial ratios and outcomes) are used as indicators of hospital board effectiveness. Board participation in educational programs was significantly associated with improved profitability, liquidity, and occupancy levels, suggesting that investment in the education of directors is likely to enhance hospital viability and thus increase board effectiveness.

Benzyl alcohol increases voluntary ethanol drinking in rats.

Science.gov (United States)

Etelälahti, T J; Eriksson, C J P

2014-09-01

The anabolic steroid nandrolone decanoate has been reported to increase voluntary ethanol intake in Wistar rats. In recent experiments we received opposite results, with decreased voluntary ethanol intake in both high drinking AA and low drinking Wistar rats after nandrolone treatment. The difference between the two studies was that we used pure nandrolone decanoate in oil, whereas in the previous study the nandrolone product Deca-Durabolin containing benzyl alcohol (BA) was used. The aims of the present study were to clarify whether the BA treatment could promote ethanol drinking and to assess the role of the hypothalamic-pituitary-adrenal-gonadal axes (HPAGA) in the potential BA effect. Male AA and Wistar rats received subcutaneously BA or vehicle oil for 14 days. Hereafter followed a 1-week washout and consecutively a 3-week voluntary alcohol consumption period. The median (± median absolute deviation) voluntary ethanol consumption during the drinking period was higher in BA-treated than in control rats (4.94 ± 1.31 g/kg/day vs. 4.17 ± 0.31 g/kg/day, p = 0.07 and 1.01 ± 0.26 g/kg/day vs. 0.38 ± 0.27 g/kg/day, p = 0.05, for AA and Wistar rats, respectively; combined effect p < 0.01). The present results can explain the previous discrepancy between the two nandrolone studies. No significant BA effects on basal and ethanol-mediated serum testosterone and corticosterone levels were observed in blood samples taken at days 1, 8 and 22. However, 2h after ethanol administration significantly (p = 0.02) higher frequency of testosterone elevations was detected in high drinking AA rats compared to low drinking Wistars, which supports our previous hypotheses of a role of testosterone elevation in promoting ethanol drinking. Skin irritation and dermatitis were shown exclusively in the BA-treated animals. Altogether, the present results indicate that earlier findings obtained with Deca-Durabolin containing BA need to be re-evaluated. Copyright © 2014 Elsevier Inc. All

Implementation of a standardized out-of-hospital management method for Parkinson dysphagia

OpenAIRE

Wei, Hongying; Sun, Dongxiu; Liu, Meiping

2017-01-01

Summary Objective: Our objective is to explore the effectiveness and feasibility of establishing a swallowing management clinic to implement out-of-hospital management for Parkinson disease (PD) patients with dysphagia. Method: Two-hundred seventeen (217) voluntary PD patients with dysphagia in a PD outpatient clinic were divided into a control group with 100 people, and an experimental group with 117 people. The control group was given dysphagia rehabilitation guidance. The experimental gr...

Benchmarking of Percutaneous Injuries at the Ministry of Health Hospitals of Saudi Arabia in Comparison with the United States Hospitals Participating in Exposure Prevention Information Network (EPINet™

Directory of Open Access Journals (Sweden)

ZA Memish

2015-01-01

Full Text Available Background: Exposure to blood-borne pathogens from needle-stick and sharp injuries continues to pose a significant risk to health care workers. These events are of concern because of the risk to transmit blood-borne diseases such as hepatitis B virus, hepatitis C virus, and the human immunodeficiency virus. Objective: To benchmark different risk factors associated with needle-stick incidents among health care workers in the Ministry of Health hospitals in the Kingdom of Saudi Arabia compared to the US hospitals participating in Exposure Prevention Information Network (EPINet ™. Methods: Prospective surveillance of needle-stick and sharp incidents carried out during the year 2012 using EPINet™ ver 1.5 that provides uniform needle stick and sharp injury report form. Results: The annual percutaneous incidents (PIs rate per 100 occupied beds was 3.2 at the studied MOH hospitals. Nurses were the most affected job category by PIs (59.4%. Most PIs happened in patients' wards in the Ministry of Health hospitals (34.6%. Disposable syringes were the most common cause of PIs (47.20%. Most PIs occurred during use of the syringes (36.4%. Conclusion: Among health care workers, nurses and physicians appear especially at risk of exposure to PIs. Important risk factors of injuries include working in patient room, using disposable syringes, devices without safety features. Preventive strategies such as continuous training of health care workers with special emphasis on nurses and physicians, encouragement of reporting of such incidents, observation of sharp handling, their use and implementation of safety devices are warranted.

31 CFR 360.64 - Payment or reinvestment-voluntary guardian of an incapacitated person.

Science.gov (United States)

2010-07-01

... guardian of an incapacitated person. 360.64 Section 360.64 Money and Finance: Treasury Regulations Relating..., Absentees, et al. § 360.64 Payment or reinvestment—voluntary guardian of an incapacitated person. (a..., responsible for the owner's care and support may submit an application for recognition as voluntary guardian...

Voluntary Exercise Improves Estrous Cyclicity in Prenatally Androgenized Female Mice Despite Programming Decreased Voluntary Exercise: Implications for Polycystic Ovary Syndrome (PCOS).

Science.gov (United States)

Homa, Lori D; Burger, Laura L; Cuttitta, Ashley J; Michele, Daniel E; Moenter, Suzanne M

2015-12-01

Prenatal androgen (PNA) exposure in mice produces a phenotype resembling lean polycystic ovary syndrome. We studied effects of voluntary exercise on metabolic and reproductive parameters in PNA vs vehicle (VEH)-treated mice. Mice (8 wk of age) were housed individually and estrous cycles monitored. At 10 weeks of age, mice were divided into groups (PNA, PNA-run, VEH, VEH-run, n = 8-9/group); those in the running groups received wheels allowing voluntary running. Unexpectedly, PNA mice ran less distance than VEH mice; ovariectomy eliminated this difference. In ovary-intact mice, there was no difference in glucose tolerance, lower limb muscle fiber types, weight, or body composition among groups after 16 weeks of running, although some mitochondrial proteins were mildly up-regulated by exercise in PNA mice. Before running, estrous cycles in PNA mice were disrupted with most days in diestrus. There was no change in cycles during weeks 1-6 of running (10-15 wk of age). In contrast, from weeks 11 to 16 of running, cycles in PNA mice improved with more days in proestrus and estrus and fewer in diestrus. PNA programs reduced voluntary exercise, perhaps mediated in part by ovarian secretions. Exercise without weight loss improved estrous cycles, which if translated could be important for fertility in and counseling of lean women with polycystic ovary syndrome.

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.

Decentralized trade with bargaining and voluntary matching

DEFF Research Database (Denmark)

Tranæs, Torben; Sloth, Birgitte; Hendon, Ebbe

1994-01-01

Rubinstein and Wolinsky (1990) study a market with one seller, two buyers, and voluntary matching. Both the competitive outcomepc and the bilateral bargaining outcomepb are possible in subgame perfect equilibrium. We consider two variations. First, if there is a cost larger thanpc−pc to the seller...

The Voluntary Euthanasia (Legalization) Bill (1936) revisited.

OpenAIRE

Helme, T

1991-01-01

In view of the continuing debate on euthanasia, the restrictions and safeguards which were introduced into the Voluntary Euthanasia (Legislation) Bill 1936 are discussed. Proposals for a new Terminal Care and Euthanasia Bill are suggested, based on some of the principles of the Mental Health Act 1983.

Rules Regarding Voluntary Contributions to the Agency

Energy Technology Data Exchange (ETDEWEB)

NONE

1959-11-06

The texts of the following rules are reproduced in this document for the information of all Members of the Agency: I. Rules to Govern the Acceptance of Gifts of Services, Equipment and Facilities; II. Rules Regarding the Acceptance of Voluntary Contributions of Money to the Agency.

15 CFR 30.74 - Voluntary self-disclosure.

Science.gov (United States)

2010-01-01

..., or any other agency of the United States Government, has learned the same or substantially similar... be deemed to have made a voluntary self-disclosure under this section unless the individual making... disclosure subsequently completes the narrative account required by paragraph (c)(3) of this section, the...

Voluntary intake, nitrogen metabolism and rumen fermentation ...

African Journals Online (AJOL)

Voluntary intake, nitrogen metabolism and rumen fermentation patterns in sheep given cowpea, silverleaf desmodium and fine-stem stylo legume hays as ... utilisation, the negative nitrogen retentions might indicate the inadequacy of the specific legume hays used as nitrogen supplementary feeds to sheep fed a basal diet

Rules Regarding Voluntary Contributions to the Agency

International Nuclear Information System (INIS)

1959-01-01

The texts of the following rules are reproduced in this document for the information of all Members of the Agency: I. Rules to Govern the Acceptance of Gifts of Services, Equipment and Facilities; II. Rules Regarding the Acceptance of Voluntary Contributions of Money to the Agency

Employee pathway to voluntary turnover: Testing the direct and ınteractive roles of work family conflict and work family facilitation

OpenAIRE

Okechukwu Ethelbert Amah

2009-01-01

The direct effect of work family conflict on turnover has received much attention in organizational studies. However, neither the direct effect of work family facilitation on turnover nor the effect of its interaction with work family conflict on voluntary turnover has received similar attention. This has resulted in low explained variance in turnover in models that excluded these relationships. Using 450 participants drawn from employees in Nigeria, I found significant direct and interaction...

Elders and patient participation revisited - a discourse analytic approach to older persons' reflections on patient participation.

Science.gov (United States)

Foss, Christina

2011-07-01

This study focuses on how older persons' accounts of participation might be framed and constructed based on their social and historical situatedness. The picture emerging from contemporary research tends to portray older people as a group who prefer to leave decisions to the professionals during a hospital stay. Through an approach that sought to contextualise the respondents' accounts of participation, different features of patient participation became visible. The study is based on a postmodern framework using a discursive approach, informed by the works of Foucault and on works that have been developed in line with his main ideas. Eighteen individual in-depth interviews with older people (age 80+) were conducted between one to two weeks after discharge from hospital. Findings indicate that older people actively position themselves in relation to various discourses at play in the hospital, and display a wide variety of strategies aimed at gaining influence. To the older persons in this study, participation was practised in a subtle and discreet way, as a matter of choosing a good strategy to interact with the personnel. Participation was also seen as a matter of balancing their own needs against the needs of others and as a behaviour that required self-confidence. The accounts of patient participation given by the older persons differed from the dominant and taken-for-granted discourse of patient participation as a right. As the older persons' understanding and practice of patient participation do not 'fit' the contemporary idea of participation, it is in danger of being ignored or overlooked by care-givers as well as by researchers. To identify older patients' wish to participate, one must actively search for it. © 2011 Blackwell Publishing Ltd.

The impacts of product market competition on the quantity and quality of voluntary disclosures

Directory of Open Access Journals (Sweden)

Mojgan Saeidi

2015-06-01

Full Text Available This paper presents an empirical investigation to study the relationship between product market competition and voluntary disclosure among 124 selected firms listed on Tehran Stock Exchange over the period 2004-2013. The study uses Herfindahl–Hirschman Index (HHI and Lerner (LLIA index to measure competition in terms of capacity and price, respectively. In addition, the study uses the questionnaire developed by Botosan (1997 [Botosan, C. A. (1997. Disclosure level and the cost of equity capital. Accounting Review, 72(3, 323-349.] to measure voluntary disclosure. Using linear regression technique, the study has determined that there was a meaningful, direct and positive relationship between voluntary disclosure and competition in terms of price (LLIA. In addition, the results indicate that there was a meaningful and reverse relationship between voluntary disclosure and competition in terms of capacity (HHI.

The effects of patterned electrical stimulation combined with voluntary contraction on spinal reciprocal inhibition in healthy individuals

DEFF Research Database (Denmark)

Takahashi, Yoko; Fujiwara, Toshiyuki; Yamaguchi, Tomofumi

2017-01-01

The aim of this study was to examine the effects of voluntary contraction (VC) on the modulation of reciprocal inhibition induced by patterned electrical stimulation (PES) in healthy individuals. Twelve healthy volunteers participated in this study. PES was applied to the common peroneal nerve...... a soleus H-reflex conditioning-test paradigm at the time points of before, immediately after, 10 min after, 20 min after, and 30 min after the tasks. PES+VC increased the amount of reciprocal inhibition, with after-effects lasting up to 20 min. PES alone increased reciprocal inhibition and maintained...

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

Energy Technology Data Exchange (ETDEWEB)

Heeter, J. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Nicholas, T. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2013-10-01

The "voluntary" or "green power" market is that in which consumers and institutions voluntarily purchase renewable energy to match all or part of their electricity needs. Voluntary action provides a revenue stream for renewable energy projects and raises consumer awareness of the benefits of renewable energy. There are numerous ways consumers and institutions can purchase renewable energy. Historically, the voluntary market has consisted of three market sectors: (1) utility green pricing programs (in states with regulated electricity markets), (2) competitive suppliers (in states with restructured electricity markets), and (3) unbundled renewable electricity certificate (REC) markets, where RECs are purchased by consumers separately from electricity ("unbundled").

Status and Trends in the U.S. Voluntary Green Power Market (2016 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); Cook, Jeff [National Renewable Energy Lab. (NREL), Golden, CO (United States); Volpi, Christina [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2017-10-01

The "voluntary" or "green power" market is that in which consumers and institutions voluntarily purchase renewable energy to match all or part of their electricity needs. Voluntary action provides a revenue stream for renewable energy projects and raises consumer awareness of the benefits of renewable energy. There are numerous ways consumers and institutions can purchase renewable energy. Historically, the voluntary market has consisted of three market sectors: (1) utility green pricing programs (in states with regulated electricity markets), (2) competitive suppliers (in states with restructured electricity markets), and (3) unbundled renewable electricity certificate (REC) markets, where RECs are purchased by consumers separately from electricity ("unbundled").

Assessment of factors associated with voluntary counseling and ...

African Journals Online (AJOL)

admin

Tsehaye Tewabe1, Bikes Destaw2, Mengesha Admassu2, Bayeh Abera3. Abstract. Background: Voluntary counseling and testing (VCT) is one of the cornerstones for successful implementation of .... mosquito bites and sharing toilets. Correct ...

ENHANCING VOLUNTARY COMPLIANCE BY REDUCING COMPLIANCE COSTS: A TAXPAYER SERVICE APPROACH

OpenAIRE

Glenn Jenkins; EDWIN FORLEMU

1993-01-01

In this paper an overview is made of the determinants of voluntary tax compliance. Unlike previous treatments of this subject, the cost of taxpayer compliance is considered as an important determinant of overall level of voluntary compliance in a country. A number of ways that tax authorities reduce compliance are discussed, and the most common uses of information technology in providing taxpayer service is described. Finally, the paper considers some of the ways that such activities might be...

Construct validation of an instrument to measure patient satisfaction with pharmacy services in Nigerian hospitals.

Science.gov (United States)

Afolabi, M O; Afolabi, E R I; Faleye, B A

2012-12-01

Patient satisfaction is a multidimensional construct that reflects the type and quality of service provided by healthcare providers, how well it is delivered, and the extent to which the expectations and needs of patients are met. As a performance measure, patient satisfaction has been defined as the personal evaluation of health care services and providers. To develop a patient satisfaction scale, that could be used to assess the quality of pharmacy services provided in Nigerian hospitals and to determine the construct validity of the scale with a view to identifying the factors that may be considered relevant to the target users. The questionnaire was a 35-item inventory titled "Patient Satisfaction Survey (PSS)". This study was carried out in three university teaching hospitals located in Southwestern Nigeria. The patient satisfaction survey instrument (PSS) was administered on 506 clinic outpatients who patronised the hospital pharmacies. Participation in the study was voluntary with appropriate informed consent. Ethical approval was obtained for this study from the Medical and Ethics Committee of Obafemi Awolowo University Teaching Hospital Complex (OAUTHC). Patients with post secondary education were in the majority with a frequency of 224 (44.3%) subjects. This was followed by a frequency of 116 (22.9%) for those with secondary education. Eighty-seven (17.2%) of those included in the main study had primary education 64 (12.7%) did not receive any formal education. Fifteen (3%) out of the 506 sampled did not indicate their level of education. This study developed a scale to measure patient satisfaction with pharmaceutical services in selected Nigerian university teaching hospitals. The final 25 item scale presents significant and stable coefficients of correlation and yielded six derived dimensions of patient satisfaction.

High spatial validity is not sufficient to elicit voluntary shifts of attention.

Science.gov (United States)

Pauszek, Joseph R; Gibson, Bradley S

2016-10-01

Previous research suggests that the use of valid symbolic cues is sufficient to elicit voluntary shifts of attention. The present study interpreted this previous research within a broader theoretical context which contends that observers will voluntarily use symbolic cues to orient their attention in space when the temporal costs of using the cues are perceived to be less than the temporal costs of searching without the aid of the cues. In this view, previous research has not addressed the sufficiency of valid symbolic cues, because the temporal cost of using the cues is usually incurred before the target display appears. To address this concern, 70%-valid spatial word cues were presented simultaneously with a search display. In addition, other research suggests that opposing cue-dependent and cue-independent spatial biases may operate in these studies and alter standard measures of orienting. After identifying and controlling these opposing spatial biases, the results of two experiments showed that the word cues did not elicit voluntary shifts of attention when the search task was relatively easy but did when the search task was relatively difficult. Moreover, the findings also showed that voluntary use of the word cues changed over the course of the experiment when the task was difficult, presumably because the temporal cost of searching without the cue lessened as the task got easier with practice. Altogether, the present findings suggested that the factors underlying voluntary control are multifaceted and contextual, and that spatial validity alone is not sufficient to elicit voluntary shifts of attention.

The Voluntary Euthanasia (Legalization) Bill (1936) revisited.

Science.gov (United States)

Helme, T

1991-01-01

In view of the continuing debate on euthanasia, the restrictions and safeguards which were introduced into the Voluntary Euthanasia (Legislation) Bill 1936 are discussed. Proposals for a new Terminal Care and Euthanasia Bill are suggested, based on some of the principles of the Mental Health Act 1983. PMID:2033626

1. Transfusion Transmissible Infections among Voluntary Blood ...

African Journals Online (AJOL)

Esem

ABSTRACT. Background: HIV1&2, HBsAg, anti-HCV and syphilis antibody are mandatory disease marker tests of Transfusion Transmissible Infections (TTIs) conducted on every donated unit of blood in Zambia. Blood is donated by first time voluntary donors and repeat/regular donors ofages between 16 and 65 years.

7 CFR Exhibit E to Subpart A of... - Voluntary National Model Building Codes

Science.gov (United States)

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Voluntary National Model Building Codes E Exhibit E... National Model Building Codes The following documents address the health and safety aspects of buildings and related structures and are voluntary national model building codes as defined in § 1924.4(h)(2) of...

Classification of voluntary coughs applied to the screening of respiratory disease.

Science.gov (United States)

Infante, Christian; Chamberlain, Daniel B; Kodgule, Rahul; Fletcher, Richard Ribon

2017-07-01

Pulmonary and respiratory diseases (e.g. asthma, COPD, allergies, pneumonia, tuberculosis, etc.) represent a large proportion of the global disease burden, mortality, and disability. In this context of creating automated diagnostic tools, we explore how the analysis of voluntary cough sounds may be used to screen for pulmonary disease. As a clinical study, voluntary coughs were recorded using a custom mobile phone stethoscope from 54 patients, of which 7 had COPD, 15 had asthma, 11 had allergic rhinitis, 17 had both asthma and allergic rhinitis, and four had both COPD and allergic rhinitis. Data were also collected from 33 healthy subjects. These patients also received full auscultation at 11 sites, given a clinical questionnaire, and underwent full pulmonary function testing (spirometer, body plethysmograph, DLCO) which culminated in a diagnosis provided by an experienced pulmonologist. From machine learning analysis of these data, we show that it is possible to achieve good classification of cough sounds in terms of Wet vs Dry, yielding an ROC curve with AUC of 0.94, and show that voluntary coughs can serve as an effective test for determining Healthy vs Unhealthy (sensitivity=35.7% specificity=100%). We also show that the use of cough sounds can enhance the performance of other diagnostic tools such as a patient questionnaire and peak flow meter; however voluntary coughs alone provide relatively little value in determining specific disease diagnosis.

42 CFR 482.42 - Condition of participation: Infection control.

Science.gov (United States)

2010-10-01

... Hospital Functions § 482.42 Condition of participation: Infection control. The hospital must provide a... be an active program for the prevention, control, and investigation of infections and communicable... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Infection control. 482...

Electrical stimulation superimposed onto voluntary muscular contraction.

Science.gov (United States)

Paillard, Thierry; Noé, Frédéric; Passelergue, Philippe; Dupui, Philippe

2005-01-01

Electrical stimulation (ES) reverses the order of recruitment of motor units (MU) observed with voluntary muscular contraction (VOL) since under ES, large MU are recruited before small MU. The superimposition of ES onto VOL (superimposed technique: application of an electrical stimulus during a voluntary muscle action) can theoretically activate more motor units than VOL performed alone, which can engender an increase of the contraction force. Two superimposed techniques can be used: (i) the twitch interpolation technique (ITT), which consists of interjecting an electrical stimulus onto the muscle nerve; and (ii) the percutaneous superimposed electrical stimulation technique (PST), where the stimulation is applied to the muscle belly. These two superimposed techniques can be used to evaluate the ability to fully activate a muscle. They can thus be employed to distinguish the central or peripheral nature of fatigue after exhausting exercise. In general, whatever the technique employed, the superimposition of ES onto volitional exercise does not recruit more MU than VOL, except with eccentric actions. Nevertheless, the neuromuscular response associated with the use of the superimposed technique (ITT and PST) depends on the parameter of the superimposed current. The sex and the training level of the subjects can also modify the physiological impact of the superimposed technique. Although the motor control differs drastically between training with ES and VOL, the integration of the superimposed technique in training programmes with healthy subjects does not reveal significant benefits compared with programmes performed only with voluntary exercises. Nevertheless, in a therapeutic context, training programmes using ES superimposition compensate volume and muscle strength deficit with more efficiency than programmes using VOL or ES separately.

Analysis of the German market for voluntary carbon offsetting; Analyse des deutschen Marktes zur freiwilligen Kompensation von Treibhausgasemissionen

Energy Technology Data Exchange (ETDEWEB)

Kind, Christian; Duwe, Sebastian; Taenzler, Dennis; Reuster, Lena [adelphi research gGmbH, Berlin (Germany); Kleemann, Max; Krebs, Jan-Marten [sustainable AG, Muenchen (Germany)

2010-12-15

In the past years the market for voluntary carbon offsetting has developed rapidly. Certificates sold on this market originate partly from the compliance market, i.e. from projects of the Clean Development Mechanism and the Joint Implementation. Mostly, however, certificates stem from projects of the voluntary carbon market. Voluntary carbon offsetting can serve as another mechanism to efficiently prevent emissions, while at the same time achieving co-benefits. Very little is known however of the exact state of the voluntary carbon market, e.g. factors like business volume, market actors, origin of certificates or the efficacy of the voluntary market. Analyses of the market on the global market for voluntary offsetting do exist (ENDS, Hamilton et al. 2007, 2008, 2009); however they do not allow any conclusions for the market situation in Germany. This study aims at closing this gap. From the end of 2009 until the beginning of 2010 adelphi and sustainable interviewed providers of offset services, intermediaries, certifiers and consumers like businesses and public institutions on their activities in the voluntary carbon offset market in Germany. (orig.)

Determining firm characteristics and the level of voluntary corporate governance disclosures among Malaysian listed property companies

Directory of Open Access Journals (Sweden)

Talpur Shabana

2018-01-01

Full Text Available This study examined the level of voluntary corporate governance disclosures and the influence of firm characteristics (i.e., firm size, firm age, and firm market listing on the level of these disclosures among Malaysian property listed companies. The check-list to measure the voluntary corporate governance disclosures was adopted from Malaysian corporate governance index 2011 by Minority Shareholder Watchdog Group (MSWG. The voluntary corporate governance disclosure practices and firm specific characteristics were obtained from annual reports of property listed companies on Bursa Malaysia for the period of 2012 to 2015. The findings suggested an improving voluntary corporate governance reforms in Malaysia. However, the firm size was found as an inflicting factor in determining the level and quality of voluntary corporate governance disclosure practices. On the contrary, the results found were contradicting the hypothesis related to firm age and firm market listing, as no relation of voluntary corporate governance disclosures and firm age and firm market listing. The study has made an interesting contribution toward the disclosure and corporate governance by contributing in understanding the importance of quality disclosure and good governance practices.

Implementation of Couples' Voluntary HIV Counseling and Testing ...

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

Couples' Voluntary HIV Counseling and Testing (CVCT) is an effective HIV ... Through this project, the Rwanda Zambia HIV Research Group will apply more than ... to provide support, training, and technical assistance to pilot the expansion of ...

Factors Affecting the Decision to Quit Smoking of the Participants of a Hospital-Based Smoking Cessation Program in Greece

Directory of Open Access Journals (Sweden)

Charikleia Georgiadou

2015-03-01

Full Text Available Introduction: The purpose of this study was to investigate the factors that affect people who are in the process of quitting smoking. Methods: A randomly selected sample of 110 participants in a smoking cessation program (SCP of a hospital in Thessaloniki Greece. Instruments of data collection were: i the Demographic Data Lifestyle Questionnaire and ii the Fragerstrom Tolerance Questionnaire. ANOVA tests between the Demographic Data Lifestyle Questionnaire and the Fagerstrom Tolerance Questionnaire relating to the smokers’ determination to quit smoking applied. Results: Work satisfaction was related to whether the participants had difficulty to smoke in places that prohibited smoking and to how many cigarettes they smoked per day. If a non-smoker partner was urging the participant to quit smoking, it affected the hours of the day when the respondents smoked more cigarettes. Pressure from a non-smoking spouse was a deterrent from smoking many cigarettes during morning hours. Those participants who consumed alcohol smoked cigarettes containing higher levels of nicotine. Conclusion: Smoking cessation is a difficult process which is influenced by many factors such as educational level, work satisfaction and the presence of a partner.

Online identity: constructing interpersonal trust and openness through participating in hospitality social networks

Directory of Open Access Journals (Sweden)

Alexander Ronzhyn

2013-06-01

Full Text Available The present article describes the results of research on online identity construction during the participation in the hospitality social networks. Specifically the user references are analysed to understand patterns that form the image of a member. CouchSurfing service (couchsurfing.org allows users to leave short texts where the experience of hosting/being hosted by a CS member is described, is an evaluation of the CS members of each other’s personal traits, skills and common experience. Therefore references can become a good instrument for portraying a CouchSurfing member and understanding his or her particular traits. References form an important part of a user’s virtual identity in the network. Using a sample of references of Spanish CouchSurfing users, the research established main characteristics of the references, which are the openness, readiness to share ideas and experiences and trustworthiness. These concepts illustrate the typical traits associated with a user of the network and also shed light on the activities common during offl ine CS meetings

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...

75 FR 28780 - Proposed Information Collection; Comment Request; Procedure for Voluntary Self-Disclosure of...

Science.gov (United States)

2010-05-24

... Request; Procedure for Voluntary Self-Disclosure of Violations of the Export Administration Regulations... violators. Voluntary self-disclosure of EAR violations strengthens BIS's enforcement efforts by allowing BIS... detect the violations without such disclosures. BIS evaluates the seriousness of the violation and either...

Do Additional Inputs Change Maximal Voluntary Motor Unit Firing Rates After Spinal Cord Injury?

NARCIS (Netherlands)

Zijdewind, Inge; Gant, Katie; Bakels, Rob; Thomas, Christine K.

Background. Motor unit firing frequencies are low during maximal voluntary contractions (MVCs) of human thenar muscles impaired by cervical spinal cord injury (SCI). Objective. This study aimed to examine whether thenar motor unit firing frequencies increase when driven by both maximal voluntary

Using the Hospital Nutrition Environment Scan to Evaluate Health Initiative in Hospital Cafeterias.

Science.gov (United States)

Derrick, Jennifer Willahan; Bellini, Sarah Gunnell; Spelman, Julie

2015-11-01

Health-promoting environments advance health and prevent chronic disease. Hospitals have been charged to promote health and wellness to patients, communities, and 5.3 million adults employed in United States health care environments. In this cross-sectional observational study, the Hospital Nutrition Environment Scan (HNES) was used to measure the nutrition environment of hospital cafeterias and evaluate the influence of the LiVe Well Plate health initiative. Twenty-one hospitals in the Intermountain West region were surveyed between October 2013 and May 2014. Six hospitals participated in the LiVe Well Plate health initiative and were compared with 15 hospitals not participating. The LiVe Well Plate health initiative identified and promoted a healthy meal defined as health initiative branding were also posted at point of purchase. Hospital cafeterias were scored on four subcategories: facilitators and barriers, grab-and-go items, menu offerings, and selection options at point of purchase. Overall, hospitals scored 35.3±13.7 (range=7 to 63) points of 86 total possible points. Cafeterias in health initiative hospitals had significantly higher mean nutrition composite scores compared with non-health initiative hospitals (49.2 vs 29.7; Penvironment of hospital cafeterias. Additional research is needed to quantify and strategize ways to improve nutrition environments within hospital cafeterias and assess the influence on healthy lifestyle behaviors. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Implementation of Couples' Voluntary HIV Counseling and Testing ...

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

Couples' Voluntary HIV Counseling and Testing (CVCT) is an effective HIV ... Through this project, the Rwanda Zambia HIV Research Group will apply more than 20 ... training, and technical assistance to pilot the expansion of CVCT in local ...

Gamma loop contributing to maximal voluntary contractions in man.

Science.gov (United States)

Hagbarth, K E; Kunesch, E J; Nordin, M; Schmidt, R; Wallin, E U

1986-01-01

A local anaesthetic drug was injected around the peroneal nerve in healthy subjects in order to investigate whether the resulting loss in foot dorsiflexion power in part depended on a gamma-fibre block preventing 'internal' activation of spindle end-organs and thereby depriving the alpha-motoneurones of an excitatory spindle inflow during contraction. The motor outcome of maximal dorsiflexion efforts was assessed by measuring firing rates of individual motor units in the anterior tibial (t.a.) muscle, mean voltage e.m.g. from the pretibial muscles, dorsiflexion force and range of voluntary foot dorsiflexion movements. The tests were performed with and without peripheral conditioning stimuli, such as agonist or antagonist muscle vibration or imposed stretch of the contracting muscles. As compared to control values of t.a. motor unit firing rates in maximal isometric voluntary contractions, the firing rates were lower and more irregular during maximal dorsiflexion efforts performed during subtotal peroneal nerve blocks. During the development of paresis a gradual reduction of motor unit firing rates was observed before the units ceased responding to the voluntary commands. This change in motor unit behaviour was accompanied by a reduction of the mean voltage e.m.g. activity in the pretibial muscles. At a given stage of anaesthesia the e.m.g. responses to maximal voluntary efforts were more affected than the responses evoked by electric nerve stimuli delivered proximal to the block, indicating that impaired impulse transmission in alpha motor fibres was not the sole cause of the paresis. The inability to generate high and regular motor unit firing rates during peroneal nerve blocks was accentuated by vibration applied over the antagonistic calf muscles. By contrast, in eight out of ten experiments agonist stretch or vibration caused an enhancement of motor unit firing during the maximal force tasks. The reverse effects of agonist and antagonist vibration on the

Effects of acute voluntary loaded wheel running on BDNF expression in the rat hippocampus.

Science.gov (United States)

Lee, Minchul; Soya, Hideaki

2017-12-31

Voluntary loaded wheel running involves the use of a load during a voluntary running activity. A muscle-strength or power-type activity performed at a relatively high intensity and a short duration may cause fewer apparent metabolic adaptations but may still elicit muscle fiber hypertrophy. This study aimed to determine the effects of acute voluntary wheel running with an additional load on brain-derived neurotrophic factor (BDNF) expression in the rat hippocampus. Ten-week old male Wistar rats were assigned randomly to a (1) sedentary (Control) group; (2) voluntary exercise with no load (No-load) group; or (3) voluntary exercise with an additional load (Load) group for 1-week (acute period). The expression of BDNF genes was quantified by real-time PCR. The average distance levels were not significantly different in the No-load and Load groups. However, the average work levels significantly increased in the Load group. The relative soleus weights were greater in the No-load group. Furthermore, loaded wheel running up-regulated the BDNF mRNA level compared with that in the Control group. The BDNF mRNA levels showed a positive correlation with workload levels (r=0.75), suggesting that the availability of multiple workload levels contributes to the BDNF-related benefits of loaded wheel running noted in this study. This novel approach yielded the first set of findings showing that acute voluntary loaded wheel running, which causes muscular adaptation, enhanced BDNF expression, suggesting a possible role of high-intensity short-term exercise in hippocampal BDNF activity. ©2017 The Korean Society for Exercise Nutrition

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.