Science.gov

Sample records for equity waiting times

  1. The Effect of Wait-Time on Issues of Gender Equity, Academic Achievement, and Attitude toward a Course.

    ERIC Educational Resources Information Center

    Mansfield, Jim B.

    1996-01-01

    This study investigated the effect of extended wait-time versus short wait-time on ninth graders' academic achievement, as well as on gender equity and student attitudes toward a course. Surveys indicated students with more wait-time had greater gain in academic achievement. Females received longer wait-time in both experimental and control…

  2. Feedback control of waiting times

    NASA Astrophysics Data System (ADS)

    Brandes, Tobias; Emary, Clive

    2016-04-01

    Feedback loops are known as a versatile tool for controlling transport in small systems, which usually have large intrinsic fluctuations. Here we investigate the control of a temporal correlation function, the waiting-time distribution, under active and passive feedback conditions. We develop a general formalism and then specify to the simple unidirectional transport model, where we compare costs of open-loop and feedback control and use methods from optimal control theory to optimize waiting-time distributions.

  3. Feedback control of waiting times.

    PubMed

    Brandes, Tobias; Emary, Clive

    2016-04-01

    Feedback loops are known as a versatile tool for controlling transport in small systems, which usually have large intrinsic fluctuations. Here we investigate the control of a temporal correlation function, the waiting-time distribution, under active and passive feedback conditions. We develop a general formalism and then specify to the simple unidirectional transport model, where we compare costs of open-loop and feedback control and use methods from optimal control theory to optimize waiting-time distributions. PMID:27176250

  4. 46 CFR 9.10 - Waiting time.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Waiting time. 9.10 Section 9.10 Shipping COAST GUARD... § 9.10 Waiting time. The same construction should be given the act when charging for waiting time as... for duty the waiting time amounts to at least one hour....

  5. 46 CFR 9.10 - Waiting time.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Waiting time. 9.10 Section 9.10 Shipping COAST GUARD... § 9.10 Waiting time. The same construction should be given the act when charging for waiting time as... for duty the waiting time amounts to at least one hour....

  6. 46 CFR 9.10 - Waiting time.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 1 2013-10-01 2013-10-01 false Waiting time. 9.10 Section 9.10 Shipping COAST GUARD... § 9.10 Waiting time. The same construction should be given the act when charging for waiting time as... for duty the waiting time amounts to at least one hour....

  7. 46 CFR 9.10 - Waiting time.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 1 2014-10-01 2014-10-01 false Waiting time. 9.10 Section 9.10 Shipping COAST GUARD... § 9.10 Waiting time. The same construction should be given the act when charging for waiting time as... for duty the waiting time amounts to at least one hour....

  8. 46 CFR 9.10 - Waiting time.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 1 2012-10-01 2012-10-01 false Waiting time. 9.10 Section 9.10 Shipping COAST GUARD... § 9.10 Waiting time. The same construction should be given the act when charging for waiting time as... for duty the waiting time amounts to at least one hour....

  9. Advertising emergency department wait times.

    PubMed

    Weiner, Scott G

    2013-03-01

    Advertising emergency department (ED) wait times has become a common practice in the United States. Proponents of this practice state that it is a powerful marketing strategy that can help steer patients to the ED. Opponents worry about the risk to the public health that arises from a patient with an emergent condition self-triaging to a further hospital, problems with inaccuracy and lack of standard definition of the reported time, and directing lower acuity patients to the higher cost ED setting instead to primary care. Three sample cases demonstrating the pitfalls of advertising ED wait times are discussed. Given the lack of rigorous evidence supporting the practice and potential adverse effects to the public health, caution about its use is advised. PMID:23599836

  10. Two Effective Ways to Implement Wait Time. A Symposium on Wait Time.

    ERIC Educational Resources Information Center

    Swift, J. Nathan; And Others

    The effects of instructional guides and a wait time feedback device (called a "Wait Timer") on the classroom interaction of middle school science teachers are examined. The Wait Timer, an unobtrusive indicator of wait time, is an automatic device that activates a light when a person speaks. The duration of the light at the end of a question,…

  11. Organ Type and Waiting Time

    MedlinePlus

    ... with any one product nor does UNOS assume responsibility for any error, omissions or other discrepancies. Share ... your support system. You begin developing your financial strategy. Your waiting period begins. Your transplant takes place. ...

  12. Heart Surgery Waiting Time: Assessing the Effectiveness of an Action

    PubMed Central

    Badakhshan, Abbas; Arab, Mohammad; Gholipour, Mahin; Behnampour, Naser; Saleki, Saeid

    2015-01-01

    Background: Waiting time is an index assessing patient satisfaction, managerial effectiveness and horizontal equity in providing health care. Although heart surgery centers establishment is attractive for politicians. They are always faced with the question of to what extent they solve patient’s problems. Objectives: The objective of this study was to evaluate factors influencing waiting time in patients of heart surgery centers, and to make recommendations for health-care policy-makers for reducing waiting time and increasing the quality of services from this perspective. Patients and Methods: This cross-sectional study was performed in 2013. After searching articles on PubMed, Elsevier, Google Scholar, Ovid, Magiran, IranMedex, and SID, a list of several criteria, which relate to waiting time, was provided. Afterwards, the data on waiting time were collected by a researcher-structured checklist from 156 hospitalized patients. The data were analyzed by SPSS 16. The Kolmogorov Smirnov and Shapiro tests were used for determination of normality. Due to the non-normal distribution, non-parametric tests, such as Kruskal-Wallis and Mann-Whitney were chosen for reporting significance. Parametric tests also used reporting medians. Results: Among the studied variables, just economic status had a significant relation with waiting time (P = 0.37). Fifty percent of participants had diabetes, whereas this estimate was 43.58% for high blood pressure. As the cause of delay, 28.2% of patients reported financial problems, 18.6% personal problem and 13.5% a delay in providing equipment by the hospital. Conclusions: It seems the studied hospital should review its waiting time arrangements and detach them, as far as possible, from subjective and personal (specialists) decisions. On the other hand, ministries of health and insurance companies should consider more financial support. It is also recommend that hospitals should arrange preoperational psychiatric consultation for

  13. Electron waiting times for the mesoscopic capacitor

    NASA Astrophysics Data System (ADS)

    Hofer, Patrick P.; Dasenbrook, David; Flindt, Christian

    2016-08-01

    We evaluate the distribution of waiting times between electrons emitted by a driven mesoscopic capacitor. Based on a wave packet approach we obtain analytic expressions for the electronic waiting time distribution and the joint distribution of subsequent waiting times. These semi-classical results are compared to a full quantum treatment based on Floquet scattering theory and good agreement is found in the appropriate parameter ranges. Our results provide an intuitive picture of the electronic emissions from the driven mesoscopic capacitor and may be tested in future experiments.

  14. Waiting time prioritisation: Evidence from England.

    PubMed

    Gutacker, Nils; Siciliani, Luigi; Cookson, Richard

    2016-06-01

    A number of OECD countries have introduced waiting time prioritisation policies which give explicit priority to severely ill patients with high marginal disutility of waiting. There is however little empirical evidence on how patients are actually prioritised. We exploit a unique opportunity to investigate this issue using a large national dataset with accurate measures of severity on nearly 400,000 patients. We link data from a national patient-reported outcome measures survey to administrative data on all patients waiting for a publicly funded hip and knee replacement in England during the years 2009-14. We find that patients suffering the most severe pain and immobility have shorter waits than those suffering the least, by about 24% for hip replacement and 11% for knee replacement, and that the association is approximately linear. These differentials are more closely associated with pain than immobility, and are larger in hospitals with longer average waiting times. These result suggests that doctors prioritise patients according to severity even when no formal prioritisation policy is in place and average waiting times are short. PMID:27183130

  15. Waiting time for radiotherapy in women with cervical cancer

    PubMed Central

    do Nascimento, Maria Isabel; Azevedo e Silva, Gulnar

    2016-01-01

    ABSTRACT OBJECTIVE To describe the waiting time for radiotherapy for patients with cervical cancer. METHODS This descriptive study was conducted with 342 cervical cancer cases that were referred to primary radiotherapy, in the Baixada Fluminense region, RJ, Southeastern Brazil, from October 1995 to August 2010. The waiting time was calculated using the recommended 60-day deadline as a parameter to obtaining the first cancer treatment and considering the date at which the diagnosis was confirmed, the date of first oncological consultation and date when the radiotherapy began. Median and proportional comparisons were made using the Kruskal Wallis and Chi-square tests. RESULTS Most of the women (72.2%) began their radiotherapy within 60 days from the diagnostic confirmation date. The median of this total waiting time was 41 days. This median worsened over the time period, going from 11 days (1995-1996) to 64 days (2009-2010). The median interval between the diagnostic confirmation and the first oncological consultation was 33 days, and between the first oncological consultation and the first radiotherapy session was four days. The median waiting time differed significantly (p = 0.003) according to different stages of the tumor, reaching 56 days, 35 days and 30 days for women whose cancers were classified up to IIA; from IIB to IIIB, and IVA-IVB, respectively. CONCLUSIONS Despite most of the women having had access to radiotherapy within the recommended 60 days, the implementation of procedures to define the stage of the tumor and to reestablish clinical conditions took a large part of this time, showing that at least one of these intervals needs to be improved. Even though the waiting times were ideal for all patients, the most advanced cases were quickly treated, which suggests that access to radiotherapy by women with cervical cancer has been reached with equity. PMID:26786473

  16. Managing waiting times in diagnostic medical imaging

    PubMed Central

    Nuti, Sabina; Vainieri, Milena

    2012-01-01

    Objective This paper aims to analyse the variation in the delivery of diagnostic imaging services in order to suggest possible solutions for the reduction of waiting times, increase the quality of services and reduce financial costs. Design This study provides a logic model to manage waiting times in a regional context. Waiting times measured per day were compared on the basis of the variability in the use rates of CT and MRI examinations in Tuscany for the population, as well as on the basis of the capacity offered with respect to the number of radiologists available. The analysis was performed at the local health authority level to support the decision-making process of local managers. Setting Diagnostic imaging services, in particular the CT and MRI examinations. The study involved all the 12 local health authorities that provide services for 3.7 million inhabitants of the Italian Tuscany Region. Primary and secondary outcome measures Participants: the study uses regional administrative data on outpatients and survey data on inpatient diagnostic examinations in order to measure productivity. Primary and secondary outcome measures The study uses the volumes per 1000 inhabitants, the days of waiting times and the number of examinations per radiologist. Variability was measured using the traditional SD measures. Results A significant variation in areas considered homogeneous in terms of age, gender or mortality may indicate that the use of radiological services is not optimal and underuse or overuse occurs and that there is room for improvement in the service organisation. Conclusions Considering that there is a high level of variability among district use rates and waiting times, this study provides managers with a specific tool to find the cause of the problem, identify a possible solution, assess the financial impact and initiate the eventual reduction of waste. PMID:23242480

  17. Waiting time prioritisation for specialist services in Italy: the homogeneous waiting time groups approach.

    PubMed

    Mariotti, Giuliano; Siciliani, Luigi; Rebba, Vincenzo; Fellini, Rita; Gentilini, Maria; Benea, Giorgio; Bertoli, Pierpaolo; Bistolfi, Lorenzo; Brugaletta, Salvatore; Camboa, Pierluigi; Casucci, Paola; Dessi, Dino; Faronato, Pierpaolo; Galante, Mariangela; Gioffredi, Alessio; Guarino, Teresa Maria; Pofi, Enrico; Liva, Carlo

    2014-07-01

    The demand for referrals and diagnostic procedures in Italy has been rising constantly in recent years, making access to diagnostic services increasingly difficult with significant waiting times. A number of Health Authorities (known as Local Health Units) have responded by implementing formalised waiting-time prioritisation tools, giving rise to what are known as Homogeneous Waiting Groups (HWGs). The study describes the implementation of the HWG approach in Italy. This represents a promising tool for improving the prioritisation of patients waiting to see a specialist or to receive a diagnostic test. The study of the Italian HWG experience provides useful insights to improve the outpatient referral process for those countries where the demand prioritisation policies have focused more on inpatient care than outpatient specialist care and diagnostic services. PMID:24576498

  18. Quantum theory of an electron waiting time clock

    NASA Astrophysics Data System (ADS)

    Dasenbrook, David; Flindt, Christian

    2016-06-01

    The electron waiting time is the time that passes between two subsequent charge transfers in an electronic conductor. Recently, theories of electron waiting times have been devised for quantum transport in Coulomb-blockade structures and for mesoscopic conductors; however, so far a proper description of a detector has been missing. Here we develop a quantum theory of a waiting time clock capable of measuring the distribution of waiting times between electrons above the Fermi sea in a mesoscopic conductor. The detector consists of a mesoscopic capacitor coupled to a quantum two-level system whose coherent precession we monitor. Under ideal operating conditions our waiting time clock recovers the results of earlier theories without a detector. We investigate possible deviations due to an imperfect waiting time clock. As specific applications we consider a quantum point contact with a constant voltage and Lorentzian voltage pulses applied to an electrode.

  19. Waiting time at a fast-track diagnostic clinic.

    PubMed

    Basta, Y L; Tytgat, K M A J; Klinkenbijl, J H G; Fockens, P; Smets, E M A

    2016-06-13

    Purpose - Guidelines stating maximum waiting times fail to take cancer patients' expectations into account. Therefore, the purpose of this paper is to assess patients' expectations and experiences with their waiting time at a fast-track clinic. Design/methodology/approach - Patients were selected using a purposeful sampling strategy and were interviewed four times: before the visit; one day after; two weeks after the visit; and one week after starting treatment. Interviews were audiotaped and independently coded by two researchers. Findings - All patients (n=9) preferred a short waiting time before the first visit; they feared that their disease would spread and believed that cancer warrants priority treatment. Six patients experienced the waiting time as short, one had no expectations and two felt they waited longer than expected; three patients changed this evaluation during the study. Six patients received treatment - four preferred to wait before treatment and two wanted to start treatment immediately. Reasons to wait included putting one's affairs in order, or needing to adjust to the diagnosis. Practical implications - Cancer patients prefer a short waiting time before the first visit but have different expectations and needs regarding waiting time before treatment. Ideally, their expectations are managed by their treating physician to match waiting time reality. Originality/value - This is the first study to assess cancer patients' waiting time experiences and how these experiences change over time. This study paves the way for establishing a framework to better assess patient satisfaction with oncology care waiting time. An important aspect, is managing patients' expectations. PMID:27256775

  20. Waiting time distribution for continuous stochastic systems.

    PubMed

    Gernert, Robert; Emary, Clive; Klapp, Sabine H L

    2014-12-01

    The waiting time distribution (WTD) is a common tool for analyzing discrete stochastic processes in classical and quantum systems. However, there are many physical examples where the dynamics is continuous and only approximately discrete, or where it is favourable to discuss the dynamics on a discretized and a continuous level in parallel. An example is the hindered motion of particles through potential landscapes with barriers. In the present paper we propose a consistent generalization of the WTD from the discrete case to situations where the particles perform continuous barrier crossing characterized by a finite duration. To this end, we introduce a recipe to calculate the WTD from the Fokker-Planck (Smoluchowski) equation. In contrast to the closely related first passage time distribution (FPTD), which is frequently used to describe continuous processes, the WTD contains information about the direction of motion. As an application, we consider the paradigmatic example of an overdamped particle diffusing through a washboard potential. To verify the approach and to elucidate its numerical implications, we compare the WTD defined via the Smoluchowski equation with data from direct simulation of the underlying Langevin equation and find full consistency provided that the jumps in the Langevin approach are defined properly. Moreover, for sufficiently large energy barriers, the WTD defined via the Smoluchowski equation becomes consistent with that resulting from the analytical solution of a (two-state) master equation model for the short-time dynamics developed previously by us [Phys. Rev. E 86, 061135 (2012)]. Thus, our approach "interpolates" between these two types of stochastic motion. We illustrate our approach for both symmetric systems and systems under constant force. PMID:25615052

  1. Wait-Time and Multiple Representation Levels in Chemistry Lessons

    ERIC Educational Resources Information Center

    Li, Winnie Sim Siew; Arshad, Mohammad Yusof

    2014-01-01

    Wait-time is an important aspect in a teaching and learning process, especially after the teacher has posed questions to students, as it is one of the factors in determining quality of students' responses. This article describes the practices of wait-time one after teacher's questions at multiple representation levels among twenty three chemistry…

  2. Do waiting times affect health outcomes? Evidence from coronary bypass.

    PubMed

    Moscelli, Giuseppe; Siciliani, Luigi; Tonei, Valentina

    2016-07-01

    Long waiting times for non-emergency services are a feature of several publicly-funded health systems. A key policy concern is that long waiting times may worsen health outcomes: when patients receive treatment, their health condition may have deteriorated and health gains reduced. This study investigates whether patients in need of coronary bypass with longer waiting times are associated with poorer health outcomes in the English National Health Service over 2000-2010. Exploiting information from the Hospital Episode Statistics (HES), we measure health outcomes with in-hospital mortality and 28-day emergency readmission following discharge. Our results, obtained combining hospital fixed effects and instrumental variable methods, find no evidence of waiting times being associated with higher in-hospital mortality and weak association between waiting times and emergency readmission following a surgery. The results inform the debate on the relative merits of different types of rationing in healthcare systems. They are to some extent supportive of waiting times as an acceptable rationing mechanism, although further research is required to explore whether long waiting times affect other aspects of individuals' life. PMID:27299977

  3. Improving wait times and patient satisfaction in primary care.

    PubMed

    Michael, Melanie; Schaffer, Susan D; Egan, Patricia L; Little, Barbara B; Pritchard, Patrick Scott

    2013-01-01

    A strong and inverse relationship between patient satisfaction and wait times in ambulatory care settings has been demonstrated. Despite its relevance to key medical practice outcomes, timeliness of care in primary care settings has not been widely studied. The goal of the quality improvement project described here was to increase patient satisfaction by minimizing wait times using the Dartmouth Microsystem Improvement Curriculum (DMIC) framework and the Plan-Do-Study-Act (PDSA) improvement process. Following completion of an initial PDSA cycle, significant reductions in mean waiting room and exam room wait times (p = .001 and p = .047, respectively) were observed along with a significant increase in patient satisfaction with waiting room wait time (p = .029). The results support the hypothesis that the DMIC framework and the PDSA method can be applied to improve wait times and patient satisfaction among primary care patients. Furthermore, the pretest-posttest preexperimental study design employed provides a model for sequential repetitive tests of change that can lead to meaningful improvements in the delivery of care and practice performance in a variety of ambulatory care settings over time. PMID:23480405

  4. The Origin of the Solar Flare Waiting-Time Distribution.

    PubMed

    Wheatland

    2000-06-20

    It was recently pointed out that the distribution of times between solar flares (the flare waiting-time distribution) follows a power law for long waiting times. Based on 25 years of soft X-ray flares observed by Geostationary Operational Environmental Satellite instruments, it is shown that (1) the waiting-time distribution of flares is consistent with a time-dependent Poisson process and (2) the fraction of time the Sun spends with different flaring rates approximately follows an exponential distribution. The second result is a new phenomenological law for flares. It is shown analytically how the observed power-law behavior of the waiting times originates in the exponential distribution of flaring rates. These results are argued to be consistent with a nonstationary avalanche model for flares. PMID:10859130

  5. Wait time for treatment in hospital emergency departments: 2009.

    PubMed

    Hing, Esther; Bhuiya, Farida

    2012-08-01

    From 1999 through 2009, the number of visits to emergency departments (EDs) increased 32%, from 102.8 million visits in 1999 to 136.1 million visits in 2009 (1,2). In some hospitals, increased ED visit volume has resulted in ED crowding and increased wait times for minor and sometimes serious problems, such as myocardial infarction (3–7). This report describes the recent trend in wait times for treatment in EDs, and focuses on how wait times for treatment varied by two ED crowding measures: ambulance diversions and boarding of admitted patients. PMID:23101886

  6. [Review and evaluation of waiting time indicators used in Italy].

    PubMed

    Scanzano, Pietro; Caracci, Giovanni; De Michelis, Giulio; Casertano, Luca; Duranti, Giorgia; Mantuano, Carmen; Guasticchi, Gabriella; Splendori, Franco

    2005-01-01

    In this study, a set of 15 indicators that are used to provide information on waiting times for medical services and procedures were evaluated. Each waiting time indicator was evaluated with respect to 14 criteria and given a score. The indicator "waiting time estimated through past performance" reached the highest score with respect to all others. This indicator is calculated by dividing the total number of individuals waiting for a medical procedure by the number of procedures performed in the facility in the previous month. The result is multiplied by thirty and expressed in days. This indicator can be used even in non-computerized facilities. It allows easy data accounting (at all levels, i.e service, facility, healthcare unit, area, regional and national level) and provides useful information for citizens/users. PMID:17211958

  7. Resource Selection Using Execution and Queue Wait Time Predictions

    NASA Technical Reports Server (NTRS)

    Smith, Warren; Wong, Parkson; Biegel, Bryan (Technical Monitor)

    2001-01-01

    We developed techniques to predict application execution times for instance-based learning with an average error of 33% of average run time. We developed techniques to predict queue wait times that included a simulation of scheduling algorithms and execution time predictions. We implemented these techniques for the NAS Origin cluster.

  8. Waiting times of entangled electrons in normal-superconducting junctions

    NASA Astrophysics Data System (ADS)

    Albert, M.; Chevallier, D.; Devillard, P.

    2016-02-01

    We consider a normal-superconducting junction in order to investigate the effect of new physical ingredients on waiting times. First, we study the interplay between Andreev and specular scattering at the interface on the distribution of waiting times of electrons or holes separately. In that case the distribution is not altered dramatically compared to the case of a single quantum channel with a quantum point contact since the interface acts as an Andreev mirror for holes. We then consider a fully entangled state originating from splitting of Cooper pairs at the interface and demonstrate a significant enhancement of the probability to detect two consecutive electrons in a short time interval. Finally, we discuss the electronic waiting time distribution in the more realistic situation of partial entanglement.

  9. Wait Time for Counseling Affecting Perceived Stigma and Attitude toward the University

    ERIC Educational Resources Information Center

    Blau, Gary; DiMino, John; Sheridan, Natalie; Stein, Alexander; Casper, Steven; Chessler, Marcy; Beverly, Clyde

    2015-01-01

    A sample of 99 undergraduates in counseling was divided into two groups based on wait time from triage to intake, "less wait time" (up to two weeks) versus "more wait time" (at least two weeks). The less wait time group showed "higher willingness to recommend the university," "higher institutional…

  10. Reducing waiting time at security checkpoints

    SciTech Connect

    Landauer, E.G.; Becker, L.C.

    1988-08-01

    The authors were asked to improve the time it took a queue of cars to go through a security gate every morning and afternoon. Each individual passing through the gate was required to show a security badge to a guard. The goal was to improve processing time and to eliminate a safety problem at the gate without increasing the required resources. This problem required quick resolution. The project was initiated using queuing theory. After collecting data, the authors determined that a simulation model would be more appropriate. The study demonstrated that a significant improvement could be seen when the same number of guards worked two parallel traffic lines leading to the single gate, in place of the security guards working in a serial process from a single line of traffic. 7 tabs., 4 figs.

  11. Contract management of Ontario's cancer surgery wait times strategy.

    PubMed

    Cheng, Siu Mee; Irish, Jonathan C; Thompson, Leslee J

    2007-01-01

    The province of Ontario, as a result of the First Ministers' Meeting, was committed to addressing surgery wait times in Ontario. The Ministry of Health and Long-Term Care's response to this commitment was the Wait Times Strategy (WTS) initiative, which addressed access issues with the aim of positively impacting wait times in cancer surgery. Cancer Care Ontario (CCO) was tasked with managing the cancer surgery WTS. CCO engaged in accountability agreements with Ontario hospitals to provide incremental cancer surgery volumes, in return for one-time funding. Through the use of accountability agreements, CCO was able to tie service volume delivery, quality care initiatives and reporting requirements to funding. Other elements of the cancer surgery WTS implementation included the development of wait times definitions, guidelines and targets; the use of a performance management system; facilitation by existing regional cancer leads and continued development of regional cancer programs. Eight key lessons were learned: (1) baseline volume guarantees are critical to ensuring that wait times are positively impacted; (2) there is a need to create a balance between accountability and systems management; (3) clinical quality initiatives can be tied to funding initiatives; (4) allocations of services should be informed by many factors; (5) regional leadership is key to ensuring that local needs are met; (6) data are invaluable in improving performance; (7) there is regional disparity in service delivery, capacity and resources across the province; and (8) program sustainability is an underlying goal of the WTS for cancer surgery. The implication is that accountability agreements can be leveraged to create sustainable health management systems. PMID:18019899

  12. Resource Selection Using Execution and Queue Wait Time Predictions

    NASA Technical Reports Server (NTRS)

    Warren, Smith; Wong, Parkson; Biegel, Bryan A. (Technical Monitor)

    2002-01-01

    Computational grids provide users with many possible places to execute their applications. We wish to help users select where to run their applications by providing predictions of the execution times of applications on space shared parallel computers and predictions of when scheduling systems for such parallel computers will start applications. Our predictions are based on instance based learning techniques and simulations of scheduling algorithms. We find that our execution time prediction techniques have an average error of 37 percent of the execution times for trace data recorded from SGI Origins at NASA Ames Research Center and that this error is 67 percent lower than the error of user estimates. We also find that the error when predicting how long applications will wait in scheduling queues is 95 percent of mean queue wait times when using our execution time predictions and this is 57 percent lower than if we use user execution time estimates.

  13. Bargaining over waiting time in ultimatum game experiments.

    PubMed

    Berger, Roger; Rauhut, Heiko; Prade, Sandra; Helbing, Dirk

    2012-03-01

    While preference-based explanations play an increasing role in economics and sociology, the accurate measurement of social preferences deserves more attention. Most laboratory experiments measure social preferences by studying the division of "a cake that nobody had to bake" (Güth and Kliemt, 2003). This article reports results of the first ultimatum game experiment with bargaining over waiting time. The experiment was created to avoid effects of windfall gains. In contrast to donated money, time is not endowed by the experimenter and implies a natural loss to subjects. This allows for a better measurement of the inherent conflict in the ultimatum game. We implemented three anonymity conditions; one baseline condition, one condition with anonymity among subjects and one double-blind condition in which the experimenter did not know the division of waiting time. While we expected to observe less other-regarding behavior in ultimatum game bargaining over time, our experimental results rather confirm previous ultimatum game experiments, in which people bargained over money. The modal offer was half of the waiting time and only one offer was rejected. Interestingly, anonymity did not change the results significantly. In conclusion, our experiment confirms other-regarding behavior in the ultimatum game. PMID:23017758

  14. An accelerated failure time model for investigating pedestrian crossing behavior and waiting times at signalized intersections.

    PubMed

    Yang, Xiaobao; Abdel-Aty, Mohamed; Huan, Mei; Peng, Yichuan; Gao, Ziyou

    2015-09-01

    The waiting process is crucial to pedestrians in the street-crossing behavior. Once pedestrians terminate their waiting behavior during the red light period, they would cross against the red light and put themselves in danger. A joint hazard-based duration model is developed to investigate the effect of various covariates on pedestrian crossing behavior and to estimate pedestrian waiting times at signalized intersections. A total of 1181 pedestrians approaching the intersections during red light periods were observed in Beijing, China. Pedestrian crossing behaviors are classified into immediate crossing behavior and waiting behavior. The probability and effect of various covariates for pedestrians' immediate crossing behavior are identified by a logit model. Four accelerated failure time duration models based on the exponential, Weibull, lognormal and log-logistic distributions are proposed to examine the significant risk factors affecting duration times for pedestrians' waiting behavior. A joint duration model is developed to estimate pedestrian waiting times. Moreover, unobserved heterogeneity is considered in the proposed model. The results indicate that the Weibull AFT model with shared frailty is appropriate for modelling pedestrian waiting durations. Failure to account for heterogeneity would significantly underestimate the effects of covariates on waiting duration times. The proposed model provides a better understanding of pedestrian crossing behavior and more accurate estimation of pedestrian waiting times. It may be applicable in traffic system analysis in developing countries with high flow of mixed traffic. PMID:26072184

  15. An Investigation of the Teacher Behavior of Wait-Time During an Inquiry Science Lesson.

    ERIC Educational Resources Information Center

    Fowler, Thaddeus W.

    This study was designed to investigate the nonverbal teacher behavior of wait-time. Wait-time is the silence in a conversation following a teacher or student utterance. The primary purpose of the investigation was to document some of the behavioral and cognitive effects of wait-time and to delineate the interrelationships between the various forms…

  16. Creating Time for Equity Together

    ERIC Educational Resources Information Center

    Renée, Michelle

    2015-01-01

    Iin urban communities across the nation, a broad range of partners have committed to reinventing educational time together to ensure equitable access to rich learning opportunities for all young people. Across the nation, education partners are using their creativity, commitment, and unique resources to create new school and system designs that…

  17. An automaton approach for waiting times in DNA evolution.

    PubMed

    Behrens, Sarah; Nicaud, Cyril; Nicodème, Pierre

    2012-05-01

    In a recent article, Behrens and Vingron (J. Comput. Biol. 17/12, 2010) compute waiting times for k-mers to appear during DNA evolution under the assumption that the considered k-mers do not occur in the initial DNA sequence, an issue arising when studying the evolution of regulatory DNA sequences with regard to transcription factor (TF) binding site emergence. The mathematical analysis underlying their computation assumes that occurrences of words under interest do not overlap. We relax here this assumption by use of an automata approach. In an alphabet of size 4 like the DNA alphabet, most words have no or a low autocorrelation; therefore, globally, our results confirm those of Behrens and Vingron. The outcome is quite different when considering highly autocorrelated k-mers; in this case, the autocorrelation pushes down the probability of occurrence of these k-mers at generation 1 and, consequently, increases the waiting time for apparition of these k-mers up to 40%. An analysis of existing TF binding sites unveils a significant proportion of k-mers exhibiting autocorrelation. Thus, our computations based on automata greatly improve the accuracy of predicting waiting times for the emergence of TF binding sites to appear during DNA evolution. We do the computation in the Bernoulli or M0 model; computations in the M1 model, a Markov model of order 1, are more costly in terms of time and memory but should produce similar results. While Behrens and Vingron considered specifically promoters of length 1000, we extend the results to promoters of any size; we exhibit the property that the probability that a k-mer occurs at generation time 1 while being absent at time 0 behaves linearly with respect to the length of the promoter, which induces a hyperbolic behaviour of the waiting time of any k-mer with respect to the length of the promoter. The C code is available at www.lipn.univ-paris13.fr/∼nicodeme/ . PMID:22468677

  18. Joint optimisation of transmission and waiting times in cognitive radio

    NASA Astrophysics Data System (ADS)

    Amini, Mohammadreza; Samimi, Abouzar; Mirzavandi, Asra

    2016-04-01

    Transmission time optimisation is one of the key considerations of cognitive network design. There are many studies in cognitive radio networks (CRNs) focusing on finding the best transmission time for secondary users (SUs) to maximise transmission or energy efficiency. While longer sensing duration leads to a higher sensing accuracy and causes less interference, the SU spends less time for transmission and more energy on sensing spectrum. On the other hand, when the transmission duration becomes longer, although the SU has more opportunities to access the channel, it may encounter higher interference due to primary user (PU) returns and the probability of collision becomes higher. In this article, in a decentralised slotted protocol for CRN, the SU spectrum access is proved as a renewal process, then the interference due to PU return during SU transmission, the missed opportunities due to waiting for the channel to become idle and the energy consumed by the SU in the whole spectrum access process including idling energy, transmission energy and sensing energy consumption are formulated and integrated into newly defined efficiency to obtain the optimum transmission time and waiting time.

  19. Average waiting time in FDDI networks with local priorities

    NASA Technical Reports Server (NTRS)

    Gercek, Gokhan

    1994-01-01

    A method is introduced to compute the average queuing delay experienced by different priority group messages in an FDDI node. It is assumed that no FDDI MAC layer priorities are used. Instead, a priority structure is introduced to the messages at a higher protocol layer (e.g. network layer) locally. Such a method was planned to be used in Space Station Freedom FDDI network. Conservation of the average waiting time is used as the key concept in computing average queuing delays. It is shown that local priority assignments are feasable specially when the traffic distribution is asymmetric in the FDDI network.

  20. Lean-driven solutions slash ED wait times, LOS.

    PubMed

    2012-12-01

    The ED at The Aroostook Medical Center (TAMC) in Presque Isle, ME, is a level II trauma center. It is the largest in the region, with only 89 beds. It has undergone a transformation in recent months, with average wait times to see a provider going from four to five hours down to less than five minutes, and the left-without-being-seen (LWBS) rate has been slashed from a high of 7% down to less than 1%. The hospital says the improvements are the result of lean-driven, staff-designed solutions, coupled with administrative engagement and oversight. And administrators say more improvements are on the way in 2013 when a hospital-wide workgroup will try to clear away obstacles and inefficiencies from the hospital admissions process. To tackle long wait times among patients with lower triage levels, the ED instituted a fast-track system, manned by mid-level providers and a tech or LPN. Responsibilities for charge nurses have been redesigned so that they have the power to monitor and facilitate patient flow. The ED has initiated more point-of-care testing so that nurses and techs can conduct many routine tests on their own. While the lean model relies on staff-driven solutions, administrators make the difference when it comes to sustaining changes and minimizing employee resistance. PMID:23214229

  1. Wait and consult times for primary healthcare services in central Mozambique: a time-motion study

    PubMed Central

    Wagenaar, Bradley H.; Gimbel, Sarah; Hoek, Roxanne; Pfeiffer, James; Michel, Cathy; Cuembelo, Fatima; Quembo, Titos; Afonso, Pires; Gloyd, Stephen; Lambdin, Barrot H.; Micek, Mark A.; Porthé, Victoria; Sherr, Kenneth

    2016-01-01

    Background We describe wait and consult times across public-sector clinics and identify health facility determinants of wait and consult times. Design We observed 8,102 patient arrivals and departures from clinical service areas across 12 public-sector clinics in Sofala and Manica Provinces between January and April 2011. Negative binomial generalized estimating equations were used to model associated health facility factors. Results Mean wait times (in minutes) were: 26.1 for reception; 43.5 for outpatient consults; 58.8 for antenatal visits; 16.2 for well-child visits; 8.0 for pharmacy; and 15.6 for laboratory. Mean consultation times (in minutes) were: 5.3 for outpatient consults; 9.4 for antenatal visits; and 2.3 for well-child visits. Over 70% (884/1,248) of patients arrived at the clinic to begin queuing for general reception prior to 10:30 am. Facilities with more institutional births had significantly longer wait times for general reception, antenatal visits, and well-child visits. Clinics in rural areas had especially shorter wait times for well-child visits. Outpatient consultations were significantly longer at the smallest health facilities, followed by rural hospitals, tertiary/quaternary facilities, compared with Type 1 rural health centers. Discussion The average outpatient consult in Central Mozambique lasts 5 min, following over 40 min of waiting, not including time to register at most clinics. Wait times for first antenatal visits are even longer at almost 1 h. Urgent investments in public-sector human resources for health alongside innovative operational research are needed to increase consult times, decrease wait times, and improve health system responsiveness. PMID:27580822

  2. Waiting times for elective surgery and the decision to buy private health insurance.

    PubMed

    Johar, Meliyanni; Jones, Glenn; Keane, Michael; Savage, Elizabeth; Stavrunova, Olena

    2011-09-01

    More than 45% of Australians buy health insurance for private treatment in hospital. This is despite having access to universal and free public hospital treatment. Anecdotal evidence suggests that avoidance of long waits for public treatment is one possible explanation for the high rate of insurance coverage. In this study, we investigate the effect of waiting on individual decisions to buy private health insurance. Individuals are assumed to form an expectation of their own waiting time as a function of their demographics and health status. We model waiting times using administrative data on the population hospitalised for elective procedures in public hospitals and use the parameter estimates to impute the expected waiting time and the probability of a long wait for a representative sample of the population. We find that expected waiting time does not increase the probability of buying insurance but a high probability of experiencing a long wait does. On average, waiting time has no significant impact on insurance. In addition, we find that favourable selection into private insurance, measured by self-assessed health, is no longer significant once waiting time variables are included. This result suggests that a source of favourable selection may be aversion to waiting among healthier people. PMID:21337454

  3. Spacecraft intercept using minimum control energy and wait time

    NASA Astrophysics Data System (ADS)

    Leeghim, H.

    2013-01-01

    A new approach to the minimum energy impulse intercept problem for spacecraft in orbit is explored. The types of orbits investigated in this paper are not restricted to a particular one. The constrained optimization technique is formulated with the universal variable, which is used to describe orbit information with sufficient accuracy for general types of orbits. Two optimization problems are posed. First, a problem for minimum velocity change and time of flight for intercept are investigated with the constraint on the final position of two satellites. Next, the so-called wait time is also added as an additional parameter to be determined. Although a closed-form solution is not obtained, the Newton iteration technique is successfully applicable. Finally, by numerically comparing the proposed solution to the Hohmann transfer, the suggested approach is demonstrated to be a feasible technique applicable to a broad class of orbit transfer problems.

  4. How a short stay unit can reduce children's waiting times.

    PubMed

    Gray, Constance; Christensen, Martin

    2016-06-01

    Admitting children to emergency departments (EDs) often places them in an environment better suited to the treatment of adult patients. These children are often triaged and treated as adults, resulting in children being given the wrong triage categories and having their treatment delayed. EDs have problems giving drugs to children, staff are unfamiliar with children's emergency care, and children find EDs frightening. A paediatric emergency short stay unit (PESSU) was opened at Caboolture Hospital, Queensland, Australia, in January 2014. Admission to the PESSU has significantly reduced waiting times for children arriving at the ED and enabled specialist nursing and medical care to be provided quickly. This has been supported by the development of the paediatric flow nurse role ( Gray et al 2016 ). PMID:27266752

  5. The surgical waiting time initiative: A review of the Nigerian situation

    PubMed Central

    Abdulkareem, Imran Haruna

    2014-01-01

    SUMMARY The concept of surgical waiting time initiative (SWAT) was introduced in developed countries to reduce elective surgery waiting lists and increase efficiency of care. It was supplemented by increasing popularity of day surgery, which shortens elective waiting lists and minimises cancellations. It is established in Western countries, but not in developing countries like Nigeria where it is still evolving. A search was carried out in Pub Med, Google, African journals online (AJOL), Athens and Ovid for relevant publications on elective surgery waiting list in Nigeria, published in English language. Words include waiting/wait time, waiting time initiative, time to surgery, waiting for operations, waiting for intervention, waiting for procedures and time before surgery in Nigeria. A total of 37 articles published from Nigeria in relation to various waiting times were found from the search and fulfilled the inclusion criteria. Among them, 11 publications (29.7%) were related to emergency surgery waiting times, 10 (27%) were related to clinic waiting times, 9 (24.3%) were related to day case surgery, 2 (5.5%) were related to investigation waiting times and only 5 (13.5%) articles were specifically published on elective surgery waiting times. A total of 9 articles (24.5%) were published from obstetrics and gynaecology (OG), 7 (19%) from general surgery, 5 (13.5%) from public health, 3 (8%) from orthopaedics, 3 (8%) from general practice (GP), 3 (8%) from paediatrics/paediatric surgery, 2 (5.5%) from ophthalmology, 1 (2.7%) from ear, nose and throat (ENT), 1 (2.7%) from plastic surgery, 1 (2.7%) from urology and only 1 (2.7%) article was published from dental/maxillofacial surgery. Waiting times mean different things to different health practitioners in Nigeria. There were only 5/37 articles (13.5%) specifically related to elective surgery waiting times in Nigerian hospitals, which show that the concept of the SWAT is still evolving in Nigeria. Of the 37, 11 (24

  6. Norwegian Priority Setting in Practice – an Analysis of Waiting Time Patterns Across Medical Disciplines

    PubMed Central

    Gangstøe, Jurgita Januleviciute; Heggestad, Torhild; Norheim, Ole Frithjof

    2016-01-01

    Background: Different strategies for addressing the challenge of prioritizing elective patients efficiently and fairly have been introduced in Norway. In the time period studied, there were three possible outcomes for elective patients that had been through the process of priority setting: (i) high priority with assigned individual maximum waiting time; (ii) low priority without a maximum waiting time; and (iii) refusal (not in need for specialized services). We study variation in priority status and waiting time of the first two groups across different medical disciplines. Methods: Data was extracted from the Norwegian Patient Register (NPR) and contains information on elective referrals to 41 hospitals in the Western Norway Regional Health Authority in 2010. The hospital practice across different specialties was measured by patient priority status and waiting times. The distributions of assigned maximum waiting times and the actual ones were analyzed using standard Kernel density estimation. The perspective of the planning process was studied by measuring the time interval between the actual start of healthcare and the maximum waiting time. Results: Considerable variation was found across medical specialties concerning proportion of priority patients and their maximum waiting times. The degree of differentiation in terms of maximum waiting times also varied by medical discipline. We found that the actual waiting time was very close to the assigned maximum waiting time. Furthermore, there was no clear correspondence between the actual waiting time for patients and their priority status. Conclusion: Variations across medical disciplines are often interpreted as differences in clinical judgment and capacity. Alternatively they primarily reflect differences in patient characteristics, patient case-mix, as well as capacity. One hypothesis for further research is that the introduction of maximum waiting times may have contributed to push the actual waiting time towards

  7. Classroom Interaction Patterns During Microteaching: Wait-Time As An Instructional Variable.

    ERIC Educational Resources Information Center

    Boeck, Marjorie A.; Hillenmeyer, Gale P.

    This study was designed to investigate the relationship between wait-time and two classroom interaction variables: cognitive level of teacher questions and length of student response. The interval of time between a teacher question and the next verbal response by teacher or student (wait-time) was measured using an electrocardiograph with…

  8. Models of Emergency Departments for Reducing Patient Waiting Times

    PubMed Central

    Laskowski, Marek; McLeod, Robert D.; Friesen, Marcia R.; Podaima, Blake W.; Alfa, Attahiru S.

    2009-01-01

    In this paper, we apply both agent-based models and queuing models to investigate patient access and patient flow through emergency departments. The objective of this work is to gain insights into the comparative contributions and limitations of these complementary techniques, in their ability to contribute empirical input into healthcare policy and practice guidelines. The models were developed independently, with a view to compare their suitability to emergency department simulation. The current models implement relatively simple general scenarios, and rely on a combination of simulated and real data to simulate patient flow in a single emergency department or in multiple interacting emergency departments. In addition, several concepts from telecommunications engineering are translated into this modeling context. The framework of multiple-priority queue systems and the genetic programming paradigm of evolutionary machine learning are applied as a means of forecasting patient wait times and as a means of evolving healthcare policy, respectively. The models' utility lies in their ability to provide qualitative insights into the relative sensitivities and impacts of model input parameters, to illuminate scenarios worthy of more complex investigation, and to iteratively validate the models as they continue to be refined and extended. The paper discusses future efforts to refine, extend, and validate the models with more data and real data relative to physical (spatial–topographical) and social inputs (staffing, patient care models, etc.). Real data obtained through proximity location and tracking system technologies is one example discussed. PMID:19572015

  9. Genetic progression and the waiting time to cancer.

    PubMed

    Beerenwinkel, Niko; Antal, Tibor; Dingli, David; Traulsen, Arne; Kinzler, Kenneth W; Velculescu, Victor E; Vogelstein, Bert; Nowak, Martin A

    2007-11-01

    Cancer results from genetic alterations that disturb the normal cooperative behavior of cells. Recent high-throughput genomic studies of cancer cells have shown that the mutational landscape of cancer is complex and that individual cancers may evolve through mutations in as many as 20 different cancer-associated genes. We use data published by Sjöblom et al. (2006) to develop a new mathematical model for the somatic evolution of colorectal cancers. We employ the Wright-Fisher process for exploring the basic parameters of this evolutionary process and derive an analytical approximation for the expected waiting time to the cancer phenotype. Our results highlight the relative importance of selection over both the size of the cell population at risk and the mutation rate. The model predicts that the observed genetic diversity of cancer genomes can arise under a normal mutation rate if the average selective advantage per mutation is on the order of 1%. Increased mutation rates due to genetic instability would allow even smaller selective advantages during tumorigenesis. The complexity of cancer progression can be understood as the result of multiple sequential mutations, each of which has a relatively small but positive effect on net cell growth. PMID:17997597

  10. Waiting Time as a Barrier to Treatment Entry: Perceptions of Substance Users

    PubMed Central

    Redko, Cristina; Rapp, Richard C.; Carlson, Robert G.

    2007-01-01

    Many substance users report that they experience multiple barriers that produce significant challenges to linking with treatment services. Being on a waiting list is frequently mentioned as a barrier, leading some people to give up on treatment and to continue using, while prompting others to view sobriety during the waiting period as proof they do not need treatment. This ethnographic study examines the views that 52 substance users have of the waiting time before treatment and the strategies they created to overcome it. Understanding how substance users react to waiting time itself and in relation to other barriers can lead to services that are effective in encouraging treatment linkage. PMID:18509514

  11. Spousal agreement on preferred waiting time to next birth in sub-Saharan Africa.

    PubMed

    Gebreselassie, Tesfayi; Mishra, Vinod

    2011-07-01

    This study investigates how various social, demographic and economic factors affect spousal agreement on preferred waiting time to next birth. Data for matched cohabiting couples from ten Demographic and Health Surveys in sub-Saharan Africa (Benin, Burkina Faso, Ghana, Guinea, Mali, Ethiopia, Kenya, Mozambique, Zambia and Zimbabwe), conducted between 2003 and 2006, were analysed to compare reported waiting time to next birth by the husband and the wife. Couples where the reported waiting time to next birth was the same for both partners (difference is 0 months) were defined as having agreement on waiting time to next birth. In sub-Saharan Africa, spousal agreement on waiting time to next birth was found to be associated with wanting the next child sooner. When the spouses disagree on waiting time to next birth, the wives want to wait longer than their husbands in most cases. Additionally, the study found that demographic factors are the primary determinants of spousal agreement on waiting time to next birth, not socioeconomic factors. The strongest predictors of spousal agreement on waiting time to next birth were number of living children, difference between the number of ideal and living children and wife's age. Couples with fewer children, a younger wife and those with a difference of five or more children between ideal and living number of children were more likely to agree on waiting time to next birth. Effects of socioeconomic factors, such as education and wealth status, on spousal agreement on waiting time to next birth were generally weak and inconsistent. The findings highlight some of the challenges in developing programmes to promote spousal communication and birth spacing and underscore the need for programmes to be gender-sensitive. PMID:21450119

  12. Fractional calculus and continuous-time finance II: the waiting-time distribution

    NASA Astrophysics Data System (ADS)

    Mainardi, Francesco; Raberto, Marco; Gorenflo, Rudolf; Scalas, Enrico

    2000-12-01

    We complement the theory of tick-by-tick dynamics of financial markets based on a continuous-time random walk (CTRW) model recently proposed by Scalas et al. (Physica A 284 (2000) 376), and we point out its consistency with the behaviour observed in the waiting-time distribution for BUND future prices traded at LIFFE, London.

  13. Waiting Endurance Time Estimation of Electric Two-Wheelers at Signalized Intersections

    PubMed Central

    Huan, Mei; Yang, Xiao-bao

    2014-01-01

    The paper proposed a model for estimating waiting endurance times of electric two-wheelers at signalized intersections using survival analysis method. Waiting duration times were collected by video cameras and they were assigned as censored and uncensored data to distinguish between normal crossing and red-light running behavior. A Cox proportional hazard model was introduced, and variables revealing personal characteristics and traffic conditions were defined as covariates to describe the effects of internal and external factors. Empirical results show that riders do not want to wait too long to cross intersections. As signal waiting time increases, electric two-wheelers get impatient and violate the traffic signal. There are 12.8% of electric two-wheelers with negligible wait time. 25.0% of electric two-wheelers are generally nonrisk takers who can obey the traffic rules after waiting for 100 seconds. Half of electric two-wheelers cannot endure 49.0 seconds or longer at red-light phase. Red phase time, motor vehicle volume, and conformity behavior have important effects on riders' waiting times. Waiting endurance times would decrease with the longer red-phase time, the lower traffic volume, or the bigger number of other riders who run against the red light. The proposed model may be applicable in the design, management and control of signalized intersections in other developing cities. PMID:24895659

  14. Effects of Wait Time When Communicating with Children Who Have Sensory and Additional Disabilities

    ERIC Educational Resources Information Center

    Johnson, Nicole; Parker, Amy T.

    2013-01-01

    Introduction: This study utilized wait-time procedures to determine if they are effective in helping children with deafblindness or multiple disabilities that include a visual impairment communicate in their home. Methods: A single subject with an alternating treatment design was used for the study. Zero- to one-second wait time was utilized…

  15. Spatial structure increases the waiting time for cancer.

    PubMed

    Martens, Erik A; Kostadinov, Rumen; Maley, Carlo C; Hallatschek, Oskar

    2011-11-01

    Cancer results from a sequence of genetic and epigenetic changes which lead to a variety of abnormal phenotypes including increased proliferation and survival of somatic cells, and thus, to a selective advantage of pre-cancerous cells. The notion of cancer progression as an evolutionary process has been experiencing increasing interest in recent years. Many efforts have been made to better understand and predict the progression to cancer using mathematical models; these mostly consider the evolution of a well-mixed cell population, even though pre-cancerous cells often evolve in highly structured epithelial tissues. In this study, we propose a novel model of cancer progression that considers a spatially structured cell population where clones expand via adaptive waves. This model is used to assess two different paradigms of asexual evolution that have been suggested to delineate the process of cancer progression. The standard scenario of periodic selection assumes that driver mutations are accumulated strictly sequentially over time. However, when the mutation supply is sufficiently high, clones may arise simultaneously on distinct genetic backgrounds, and clonal adaptation waves interfere with each other. We find that in the presence of clonal interference, spatial structure increases the waiting time for cancer, leads to a patchwork structure of non-uniformly sized clones, decreases the survival probability of virtually neutral (passenger) mutations, and that genetic distance begins to increase over a characteristic length scale L(c). These characteristic features of clonal interference may help to predict the onset of cancers with pronounced spatial structure and to interpret spatially-sampled genetic data obtained from biopsies. Our estimates suggest that clonal interference likely occurs in the progression of colon cancer, and possibly other cancers where spatial structure matters. PMID:22707911

  16. Spatial structure increases the waiting time for cancer

    PubMed Central

    Martens, Erik A.; Kostadinov, Rumen; Maley, Carlo C.; Hallatschek, Oskar

    2012-01-01

    Cancer results from a sequence of genetic and epigenetic changes which lead to a variety of abnormal phenotypes including increased proliferation and survival of somatic cells, and thus, to a selective advantage of pre-cancerous cells. The notion of cancer progression as an evolutionary process has been experiencing increasing interest in recent years. Many efforts have been made to better understand and predict the progression to cancer using mathematical models; these mostly consider the evolution of a well-mixed cell population, even though pre-cancerous cells often evolve in highly structured epithelial tissues. In this study, we propose a novel model of cancer progression that considers a spatially structured cell population where clones expand via adaptive waves. This model is used to assess two different paradigms of asexual evolution that have been suggested to delineate the process of cancer progression. The standard scenario of periodic selection assumes that driver mutations are accumulated strictly sequentially over time. However, when the mutation supply is sufficiently high, clones may arise simultaneously on distinct genetic backgrounds, and clonal adaptation waves interfere with each other. We find that in the presence of clonal interference, spatial structure increases the waiting time for cancer, leads to a patchwork structure of non-uniformly sized clones, decreases the survival probability of virtually neutral (passenger) mutations, and that genetic distance begins to increase over a characteristic length scale Lc. These characteristic features of clonal interference may help to predict the onset of cancers with pronounced spatial structure and to interpret spatially-sampled genetic data obtained from biopsies. Our estimates suggest that clonal interference likely occurs in the progression of colon cancer, and possibly other cancers where spatial structure matters. PMID:22707911

  17. Spatial structure increases the waiting time for cancer

    NASA Astrophysics Data System (ADS)

    Martens, Erik A.; Kostadinov, Rumen; Maley, Carlo C.; Hallatschek, Oskar

    2011-11-01

    Cancer results from a sequence of genetic and epigenetic changes that lead to a variety of abnormal phenotypes including increased proliferation and survival of somatic cells and thus to a selective advantage of pre-cancerous cells. The notion of cancer progression as an evolutionary process has been attracting increasing interest in recent years. A great deal of effort has been made to better understand and predict the progression to cancer using mathematical models; these mostly consider the evolution of a well-mixed cell population, even though pre-cancerous cells often evolve in highly structured epithelial tissues. In this study, we propose a novel model of cancer progression that considers a spatially structured cell population where clones expand via adaptive waves. This model is used to assess two different paradigms of asexual evolution that have been suggested to delineate the process of cancer progression. The standard scenario of periodic selection assumes that driver mutations are accumulated strictly sequentially over time. However, when the mutation supply is sufficiently high, clones may arise simultaneously on distinct genetic backgrounds, and clonal adaptation waves interfere with each other. We find that in the presence of clonal interference, spatial structure increases the waiting time for cancer, leads to a patchwork structure of non-uniformly sized clones and decreases the survival probability of virtually neutral (passenger) mutations, and that genetic distance begins to increase over a characteristic length scale Lc. These characteristic features of clonal interference may help us to predict the onset of cancers with pronounced spatial structure and to interpret spatially sampled genetic data obtained from biopsies. Our estimates suggest that clonal interference likely occurs in the progression of colon cancer and possibly other cancers where spatial structure matters.

  18. The relationship between educational attainment and waiting time among the elderly in Norway.

    PubMed

    Carlsen, Fredrik; Kaarboe, Oddvar Martin

    2015-11-01

    We investigate whether educational attainment affects waiting time of elderly patients in somatic hospitals. We consider three distinct pathways; that patients with different educational attainment have different disease patterns, that patients with different levels of education receive treatments at different hospitals, and that patient choice and supply of local health services within hospital catchment areas explain unequal waiting time of different educational groups. We find evidence of an educational gradient in waiting time for male patients, but not for female patients. Conditional on age, male patients with tertiary education wait 45% shorter than male patients with secondary or primary education. The first pathway is not quantitatively important as controlling for disease patters has little effect on relative waiting times. The second pathway is important. Relative to patients with primary education, variation in waiting time and education level across local hospitals contributes to higher waiting time for male patients with secondary education and female patients with secondary or tertiary education and lower waiting time for male patients with tertiary education. These effects are in the order of 15-20%. The third pathway is also quantitatively important. The educational gradients within catchment areas disappear when we control for travel distance and supply of private specialists. PMID:26477666

  19. Optimal epidemic spreading on complex networks with heterogeneous waiting time distribution

    NASA Astrophysics Data System (ADS)

    Yang, Guan-Ling; Yang, Xinsong

    2016-04-01

    In this paper, the effects of heterogeneous waiting time on spreading dynamics is studied based on network-dependent information. A new non-Markovian susceptible-infected-susceptible (SIS) model is first proposed, in which node's waiting time is dependent on its degree and may be different from each other. Every node tries to transmit the epidemic to its neighbors after the waiting time. Moreover, by using the mean-field theory and numerical simulations, it is discovered that the epidemic threshold is correlated to the network topology and the distribution of the waiting time. Furthermore, our results reveal that an optimal distribution of the heterogeneous waiting time can suppress the epidemic spreading.

  20. Outpatient clinic waiting time, provider communication styles and satisfaction with healthcare in India.

    PubMed

    Mehra, Payal

    2016-08-01

    Purpose - The purpose of this paper is to evaluate the impact of extended waiting time on patients' perceptions of provider communication skills and in-clinic satisfaction, in three major cities in India. Design/methodology/approach - In total, 625 patients were interviewed. The multivariate general linear model was used to determine the causality and relationship between the independent and the dependent variable. A moderation analysis was also conducted to assess waiting time role as a potential moderator in doctor-patient communication. Findings - Results show that patients with higher waiting time were less satisfied with health care quality. Male patients and patients of male providers were more affected by extended waiting time than female patients and patients of female providers. The advanced regression analysis, however, suggests weak support for waiting time and its effect on overall satisfaction with clinic quality. Waiting time did not moderate the relationship between satisfaction with dominant communication style, and overall satisfaction at the outpatient clinic. Research limitations/implications - A cross-sectional study does not easily lend itself to explaining causality with certainty. Thus, sophisticated techniques, such as structural equation modelling may also be utilized to assess the influence of extended waiting time on satisfaction with healthcare at outpatient clinics. Practical implications - Findings are relevant for providers as the onus is on them to ensure patient satisfaction. They should initiate a workable waiting time assessment model at the operational level. Originality/value - There has been a relatively lesser focus on patient waiting time in patient-provider satisfaction studies. In India, this aspect is still vastly unexplored especially in the context of outpatient clinics. Gender wise pattern of patient satisfaction and waiting time is also missing in most studies. PMID:27477932

  1. Waiting Time: The De-Subjectification of Children in Danish Asylum Centres

    ERIC Educational Resources Information Center

    Vitus, Kathrine

    2010-01-01

    This article analyses the relationship between time and subjectification, focusing on the temporal structures created within Danish asylum centres and politics, and on children's experiences of and reactions to open-ended waiting. Such waiting leads to existential boredom which manifests in the children as restlessness, fatigue and despair. The…

  2. Waiting times in the ambulatory sector - the case of chronically Ill patients

    PubMed Central

    2013-01-01

    Aims First, the influence of determinants on the waiting times of chronically ill patients in the ambulatory sector is investigated. The determinants are subdivided into four groups: (1) need, (2) socio-economic factors, (3) health system and (4) patient time pressures. Next, the influence of waiting times on the annual number of consultations is examined to assess whether the existing variation in waiting times influences the frequency of medical examinations. The waiting times of chronically ill patients are analysed since regular ambulatory care for this patient group could both improve treatment outcomes and lower costs. Data sources Individual data from the 2010 Representative Survey conducted by the National Association of Statutory Health Insurance Physicians (KBV) together with regional data from the Federal Office of Construction and Regional Planning. Study design This is a retrospective observational study. The dependent variables are waiting times in the ambulatory sector and the number of consultations of General Practitioners (GPs) and specialist physicians in the year 2010. The explanatory variables of interest are ‘need’ and ‘health system’ in the first model and ‘length of waiting times’ in the second. Negative binomial models with random effects are used to estimate the incidence rate ratios of increased waiting times and number of consultations. Subsequently, the models are stratified by urban and rural areas. Results In the pooled regression the factor ‘privately insured’ shortens the waiting time for treatment by a specialist by approximately 28% (about 3 days) in comparison with members of the statutory health insurance system. The category of insurance has no influence on the number of consultations of GPs. In addition, the regression results stratified by urban and rural areas show that in urban areas the factor ‘privately insured’ reduces the waiting time for specialists by approximately 35% (about 3.3 days) while in

  3. Age Dating Fluvial Sediment Storage Reservoirs to Construct Sediment Waiting Time Distributions

    NASA Astrophysics Data System (ADS)

    Skalak, K.; Pizzuto, J. E.; Benthem, A.; Karwan, D. L.; Mahan, S.

    2015-12-01

    Suspended sediment transport is an important geomorphic process that can often control the transport of nutrients and contaminants. The time a particle spends in storage remains a critical knowledge gap in understanding particle trajectories through landscapes. We dated floodplain deposits in South River, VA, using fallout radionuclides (Pb-210, Cs-137), optically stimulated luminescence (OSL), and radiocarbon dating to determine sediment ages and construct sediment waiting time distributions. We have a total of 14 age dates in two eroding banks. We combine these age dates with a well-constrained history of mercury concentrations on suspended sediment in the river from an industrial release. Ages from fallout radionuclides document sedimentation from the early 1900s to the present, and agree with the history of mercury contamination. OSL dates span approximately 200 to 17,000 years old. We performed a standard Weibull analysis of nonexceedance to construct a waiting time distribution of floodplain sediment for the South River. The mean waiting time for floodplain sediment is 2930 years, while the median is approximately 710 years. When the floodplain waiting time distribution is combined with the waiting time distribution for in-channel sediment storage (available from previous studies), the mean waiting time shifts to approximately 680 years, suggesting that quantifying sediment waiting times for both channel and floodplain storage is critical in advancing knowledge of particle trajectories through watersheds.

  4. Waiting time in an urban accident and emergency department--a way to improve it.

    PubMed Central

    Lau, F L; Leung, K P

    1997-01-01

    OBJECTIVE: To determine how the introduction of a new small team consultation system could reduce the average waiting time of patients in the busy accident and emergency (A&E) department of a Hong Kong hospital. METHODS: 1,264 and 1,319 A&E cases, respectively, were samples during the four months before and after the introduction of a new small team consultation system. The data collected included the average and the range of the patients' waiting time as well as the number of patients in different triage categories and their average waiting time. Also recorded in the study were the average daily attendance, the admission rate, the number of complaints, and patients reattendance rate. RESULTS: Before and after the introduction of the new system, the average waiting time of the patients was 35.19 minutes and 22.04 minutes respectively (range 0 to 134.0 minutes and 0 to 106.3 minutes, respectively). The difference of 13.15 minutes in the average waiting times was clinically and statistically significant (t = 2.81; P = 0.004). There were no significant changes in other variables affecting the patients' waiting time and the quality o service. CONCLUSIONS: A small team consultation system can reduce the average waiting time of patients without compromising the existing quality of service. Images Figure 1 PMID:9315931

  5. Improving wait times to care for individuals with multimorbidities and complex conditions using value stream mapping

    PubMed Central

    Sampalli, Tara; Desy, Michel; Dhir, Minakshi; Edwards, Lynn; Dickson, Robert; Blackmore, Gail

    2015-01-01

    Background: Recognizing the significant impact of wait times for care for individuals with complex chronic conditions, we applied a LEAN methodology, namely – an adaptation of Value Stream Mapping (VSM) to meet the needs of people with multiple chronic conditions and to improve wait times without additional resources or funding. Methods: Over an 18-month time period, staff applied a patient-centric approach that included LEAN methodology of VSM to improve wait times to care. Our framework of evaluation was grounded in the needs and perspectives of patients and individuals waiting to receive care. Patient centric views were obtained through surveys such as Patient Assessment of Chronic Illness Care (PACIC) and process engineering based questions. In addition, LEAN methodology, VSM was added to identify non-value added processes contributing to wait times. Results: The care team successfully reduced wait times to 2 months in 2014 with no wait times for care anticipated in 2015. Increased patient engagement and satisfaction are also outcomes of this innovative initiative. In addition, successful transformations and implementation have resulted in resource efficiencies without increase in costs. Patients have shown significant improvements in functional health following Integrated Chronic Care Service (ICCS) intervention. The methodology will be applied to other chronic disease management areas in Capital Health and the province. Conclusion: Wait times to care in the management of multimoribidities and other complex conditions can add a significant burden not only on the affected individuals but also on the healthcare system. In this study, a novel and modified LEAN methodology has been applied to embed the voice of the patient in care delivery processes and to reduce wait times to care in the management of complex chronic conditions. PMID:26188810

  6. Characterization of waiting times in a simulation of kidney paired donation.

    PubMed

    Segev, Dorry L; Gentry, Sommer E; Melancon, J Keith; Montgomery, Robert A

    2005-10-01

    A national kidney paired donation (KPD) program will substantially increase transplant opportunities for recipients with blood type incompatible or cross-match positive donors. It seems likely that donor-recipient pairs with certain blood types, races or restrictions will wait longer than others for a match, although no data exist to confirm this assumption. We simulated patients and characterized the predicted waiting times for different blood type sub-groups, as well as the effects of patient-imposed restrictions on waiting time. We also compared waiting times of different racial sub-groups. Almost all patients with panel-reactive antibody (PRA) less than 80% match within a few months in a national KPD program, with the longest waiting time seen by O recipients with AB donors. Highly sensitized patients wait considerably longer, especially those unwilling to travel or accept older donors, and those with AB or B donors may not match in a timely manner. Although patients are better served by matching in a combined pool than within their own race, racial inequalities exist and bonus points can offset some of these differences. These data provide the first waiting time predictions that can aid patients with incompatible donors in choosing between KPD and desensitization, and can also facilitate planning for a national KPD program. PMID:16162194

  7. Floquet theory of electron waiting times in quantum-coherent conductors.

    PubMed

    Dasenbrook, David; Flindt, Christian; Büttiker, Markus

    2014-04-11

    We present a Floquet scattering theory of electron waiting time distributions in periodically driven quantum conductors. We employ a second-quantized formulation that allows us to relate the waiting time distribution to the Floquet scattering matrix of the system. As an application we evaluate the electron waiting times for a quantum point contact, modulating either the applied voltage (external driving) or the transmission probability (internal driving) periodically in time. Lorentzian-shaped voltage pulses are of particular interest as they lead to the emission of clean single-particle excitations as recently demonstrated experimentally. The distributions of waiting times provide us with a detailed characterization of the dynamical properties of the quantum-coherent conductor in addition to what can be obtained from the shot noise or the full counting statistics. PMID:24766000

  8. Prognostic value of wait time in nasopharyngeal carcinoma treated with intensity modulated radiotherapy: a propensitymatched analysis

    PubMed Central

    Chen, Lei; Tang, Ling-Long; Li, Wen-Fei; Liu, Xu; Zhou, Guan-Qun; Guo, Rui; Sun, Ying; Kang, Tie-Bang; Zeng, Mu-Sheng; Ma, Jun

    2016-01-01

    The aim of this study was to determine the prognostic value of wait time from histological diagnosis to primary treatmen for nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiotherapy (IMRT). Between October 2009 and February 2012, a total of 1672 NPC patients were retrospectively analyzed. A cutoff value of > 4 weeks was used to define prolonged wait time. Matched patients according to the wait time were identified using propensity score matching (PSM), which was also used to identify matched patients for subsequent stratified analyses. Differences in progression-free survival (PFS), overall survival (OS), distant metastasis-free survival (DMFS), and locoregional relapse-free survival (LRFS) were estimated using the Kaplan–Meier method and Cox proportional hazards models. In total, 407 pairs of NPC patients were selected by PSM. The 3-year PFS rate was significantly lower for patients with a prolonged wait time (> 4 weeks) than for those with an acceptable wait time (P = 0.035). Stratified analyses revealed that the negative effects of a prolonged wait time occurred primarily in patients with advanced NPC without neoadjuvant chemotherapy (NACT; PFS:P = 0.040; DMFS:P = 0.028). In multivariate analysis, a prolonged wait time was found to be an independent unfavorable prognostic factor for PFS and DMFS in advanced-staged patients without NACT. These results suggest that a prolonged time (> 4 weeks) between diagnosis and primary radical radiotherapy is a disadvantage for NPC patients, particularly those with advanced disease receiving no NACT. Thus, it is necessary to optimize resources for decreasing this wait time, although additional studies are warranted to further clarify our findings. PMID:26942870

  9. The Effect of Preservice Laserdisc Presentation of Question Types and Wait-Time Use on Questioning and Wait-Time Use in Clinical Experiences.

    ERIC Educational Resources Information Center

    Wallace, Stephen R.; And Others

    This study explored whether the addition of visual examples through laser disc instruction influenced the learning and application of convergent and divergent questioning techniques and wait-time by preservice elementary education teachers during their clinical experience. The study compared the difference in the frequency of convergent and…

  10. Discovering the Impact of Preceding Units' Characteristics on the Wait Time of Cardiac Surgery Unit from Statistic Data

    PubMed Central

    Liu, Jiming; Tao, Li; Xiao, Bo

    2011-01-01

    Introduction Prior research shows that clinical demand and supplier capacity significantly affect the throughput and the wait time within an isolated unit. However, it is doubtful whether characteristics (i.e., demand, capacity, throughput, and wait time) of one unit would affect the wait time of subsequent units on the patient flow process. Focusing on cardiac care, this paper aims to examine the impact of characteristics of the catheterization unit (CU) on the wait time of cardiac surgery unit (SU). Methods This study integrates published data from several sources on characteristics of the CU and SU units in 11 hospitals in Ontario, Canada between 2005 and 2008. It proposes a two-layer wait time model (with each layer representing one unit) to examine the impact of CU's characteristics on the wait time of SU and test the hypotheses using the Partial Least Squares-based Structural Equation Modeling analysis tool. Results Results show that: (i) wait time of CU has a direct positive impact on wait time of SU (); (ii) capacity of CU has a direct positive impact on demand of SU (); (iii) within each unit, there exist significant relationships among different characteristics (except for the effect of throughput on wait time in SU). Conclusion Characteristics of CU have direct and indirect impacts on wait time of SU. Specifically, demand and wait time of preceding unit are good predictors for wait time of subsequent units. This suggests that considering such cross-unit effects is necessary when alleviating wait time in a health care system. Further, different patient risk profiles may affect wait time in different ways (e.g., positive or negative effects) within SU. This implies that the wait time management should carefully consider the relationship between priority triage and risk stratification, especially for cardiac surgery. PMID:21818282

  11. Using Queuing Theory and Simulation Modelling to Reduce Waiting Times in An Iranian Emergency Department

    PubMed Central

    Haghighinejad, Hourvash Akbari; Kharazmi, Erfan; Hatam, Nahid; Yousefi, Sedigheh; Hesami, Seyed Ali; Danaei, Mina; Askarian, Mehrdad

    2016-01-01

    Background: Hospital emergencies have an essential role in health care systems. In the last decade, developed countries have paid great attention to overcrowding crisis in emergency departments. Simulation analysis of complex models for which conditions will change over time is much more effective than analytical solutions and emergency department (ED) is one of the most complex models for analysis. This study aimed to determine the number of patients who are waiting and waiting time in emergency department services in an Iranian hospital ED and to propose scenarios to reduce its queue and waiting time. Methods: This is a cross-sectional study in which simulation software (Arena, version 14) was used. The input information was extracted from the hospital database as well as through sampling. The objective was to evaluate the response variables of waiting time, number waiting and utilization of each server and test the three scenarios to improve them. Results: Running the models for 30 days revealed that a total of 4088 patients left the ED after being served and 1238 patients waited in the queue for admission in the ED bed area at end of the run (actually these patients received services out of their defined capacity). The first scenario result in the number of beds had to be increased from 81 to179 in order that the number waiting of the “bed area” server become almost zero. The second scenario which attempted to limit hospitalization time in the ED bed area to the third quartile of the serving time distribution could decrease the number waiting to 586 patients. Conclusion: Doubling the bed capacity in the emergency department and consequently other resources and capacity appropriately can solve the problem. This includes bed capacity requirement for both critically ill and less critically ill patients. Classification of ED internal sections based on severity of illness instead of medical specialty is another solution. PMID:26793727

  12. Factors Associated With Waiting Time for Breast Cancer Treatment in a Teaching Hospital in Ghana.

    PubMed

    Dedey, Florence; Wu, Lily; Ayettey, Hannah; Sanuade, Olutobi A; Akingbola, Titilola S; Hewlett, Sandra A; Tayo, Bamidele O; Cole, Helen V; de-Graft Aikins, Ama; Ogedegbe, Gbenga; Adanu, Richard

    2016-08-01

    Background Breast cancer is the leading cause of cancer-related mortality among women in Ghana. Data are limited on the predictors of poor outcomes in breast cancer patients in low-income countries; however, prolonged waiting time has been implicated. Among breast cancer patients who received treatment at Korle Bu Teaching Hospital, this study evaluated duration and factors that influenced waiting time from first presentation to start of definitive treatment. Method We conducted a hospital-based retrospective study of 205 breast cancer patients starting definitive treatment at Korle Bu Teaching Hospital between May and December 2013. We used descriptive statistics to summarize patient characteristics. Mann-Whitney U and Kruskal-Wallis tests and Spearman rank correlation were performed to examine the patients, health system, and health worker factors associated with median waiting time. Poisson regression was used to examine the determinants of waiting time. Results The mean age of the patients was 51.1 ± 11.8 years. The median waiting time was 5 weeks. The determinants of waiting time were level of education, age, income, marital status, ethnicity, disease stage, health insurance status, study sites, time interval between when biopsy was requested and when results were received and receipt of adequate information from health workers. Conclusion A prolonged waiting time to treatment occurs for breast cancer patients in Ghana, particularly for older patients, those with minimal or no education, with lower income, single patients, those with late disease, those who are insured, and who did not receive adequate information from the health workers. Time to obtain biopsy reports should be shortened. Patients and providers need education on timely treatment to improve prognosis. PMID:27091222

  13. Outpatient Waiting Time in Health Services and Teaching Hospitals: A Case Study in Iran

    PubMed Central

    Mohebbifar, Rafat; Hasanpoor, Edris; Mohseni, Mohammad; Sokhanvar, Mobin; Khosravizadeh, Omid; Isfahani, Haleh Mousavi

    2014-01-01

    Background: One of the most important indexes of the health care quality is patient’s satisfaction and it takes place only when there is a process based on management. One of these processes in the health care organizations is the appropriate management of the waiting time process. The aim of this study is the systematic analyzing of the outpatient waiting time. Methods: This descriptive cross sectional study conducted in 2011 is an applicable study performed in the educational and health care hospitals of one of the medical universities located in the north west of Iran. Since the distributions of outpatients in all the months were equal, sampling stage was used. 160 outpatients were studied and the data was analyzed by using SPSS software. Results: Results of the study showed that the waiting time for the outpatients of ophthalmology clinic with an average of 245 minutes for each patient allocated the maximum time among the other clinics for itself. Orthopedic clinic had the minimal waiting time including an average of 77 minutes per patient. The total average waiting time for each patient in the educational hospitals under this study was about 161 minutes. Conclusion: by applying some models, we can reduce the waiting time especially in the realm of time and space before the admission to the examination room. Utilizing the models including the one before admission, electronic visit systems via internet, a process model, six sigma model, queuing theory model and FIFO model, are the components of the intervention that reduces the outpatient waiting time. PMID:24373277

  14. An evaluation of wait-times at an interprofessional student-run free clinic.

    PubMed

    Hu, Tina; Leung, Fok-Han

    2016-07-01

    Student-run free clinics (SRFCs) are becoming increasingly popular programmes in schools for promoting interprofessional education and service learning. Despite their prevalence, little research has been done surrounding SRFCs and wait-times. SRFCs may experience long wait-times because patients are often seen on a drop-in basis and time has to be allotted for interprofessional case discussion and teaching. The purpose of this study was to evaluate the wait-times for patients being seen at an interprofessional SRFC and determine potential improvements. Wait-times, total treatment room times, total time per patient, and whether a referral and/or prescription was given were tracked from May 2014 to July 2015 at an SRFC. A total of 268 patients were seen in 52 clinics. On average, five patients were seen per clinic. Patients waited for an average time of 21 minutes before they were seen by the team. Average treatment time per patient was 69 minutes. Patients were generally at the clinic for a total of 91 minutes before being discharged. Several improvements for managing client flow at interprofessional SRFCs are discussed. PMID:27332500

  15. Waiting Times in Emergency Department After Using the Emergency Severity Index Triage Tool

    PubMed Central

    Mahmoodian, Farzad; Eqtesadi, Razie; Ghareghani, Atefe

    2014-01-01

    Background: Hospital emergency departments (EDs) are as barometers of the health care system. Crowded EDs threaten delivery of timely care. Prolonged ED wait times reduce the quality of care and increase adverse and sometimes irreversible events. Objectives: The purpose of this study was to determine the patients' waiting time at Namazi and Shahid Faghihi hospitals in Shiraz, Iran. Patients and Methods: This analytical cross-sectional study was conducted in two phases from December 2012 to May 2013. First, the researcher attended the EDs of the two hospitals and recorded the information of 900 patients who entered the ED, including arrival time, level of triage, and time of first visit by physician. Then, among patients admitted to the ED units, 273 were followed and waiting times for the first physician order in the referral unit and the commencement of clinical interventions (defined as check time by the nurse) were recorded. Results: The median waiting time from arrival to first visit by physician for the 900 patients included in the study was 8 (5-14) minutes [median (interquartile range)]. For the patients admitted to referral units, waiting time was 84 (43-145) minutes for the physician order and 85 (45-147) minutes for the commencement of first clinical intervention; 75% of the patients in triage level I, 84.6% in triage level II, and 95.6% in triage level III were visited within the target time limit. Conclusions: Waiting time for commencement of clinical action in patients admitted to the EDs was considerably high for patients with higher priorities; so, rapid care of critically ill patients, identified during the triage process, should be emphasized. PMID:25738132

  16. Reprint of : Waiting times of entangled electrons in normal-superconducting junctions

    NASA Astrophysics Data System (ADS)

    Albert, M.; Chevallier, D.; Devillard, P.

    2016-08-01

    We consider a normal-superconducting junction in order to investigate the effect of new physical ingredients on waiting times. First, we study the interplay between Andreev and specular scattering at the interface on the distribution of waiting times of electrons or holes separately. In that case the distribution is not altered dramatically compared to the case of a single quantum channel with a quantum point contact since the interface acts as an Andreev mirror for holes. We then consider a fully entangled state originating from splitting of Cooper pairs at the interface and demonstrate a significant enhancement of the probability to detect two consecutive electrons in a short time interval. Finally, we discuss the electronic waiting time distribution in the more realistic situation of partial entanglement.

  17. On the control, stability, and waiting time in a slotted ALOHA random-access system

    NASA Technical Reports Server (NTRS)

    Ferguson, M. J.

    1975-01-01

    This paper explores some of the boundaries in performance of slotted ALOHA systems by analyzing a simple and almost optimal centrally supervised control. The control results in a very simple Markov chain model and allows an examination of stability, conditional waiting time distribution of transmitting terminals, and many other system measures. The key to the simplicity is to have a probability of successful packet transmission that is independent of the number of transmitting terminals. In considering waiting time, we calculate the mean and other moments of the waiting time of a terminal when it enters the system to find (n - 1) other terminals already there competing for the channel. Under this control, the average time is proportional to n. The control requires exact knowledge of the number of terminals contending for the channel, and hence is not implementable, except as an approximation.

  18. Equity and working time: a challenge to achieve.

    PubMed

    Fischer, Frida Marina; Rotenberg, Lúcia; de Castro Moreno, Claudia Roberta

    2004-01-01

    Equity is a humanitarian issue that gained strength during the transition from the 20th to the 21st century due to the mounting global discussion and social crisis involving human rights, health, and work. This article aims at (1) introducing the concept of equity as it applies to work environments, particularly to situations involving demanding work schedules, (2) discussing the role of science in equity issues related to work, (3) introducing a new scientific society dedicated to working-time issues, and (4) presenting an overview of new research on working time and health as addressed by the series of manuscripts published in this special issue of Chronobiology International devoted to the XVIth International Symposium on Night and Shiftwork, held in Santos, Brazil, November 2003. The concept of equity has a political as a well as a scientific dimension. Many worldwide organizations, e.g., civil society, academia, and occupational health research institutions, advocate prompt actions toward equity as a strategy to attain sustainable development and to reduce poverty. The analyses of current tendencies in work settings reveal a general situation of disrespect for equity principles, which is expressed by heavy workloads, long work hours, poor work conditions, and deregulation of established labor laws, mainly in (but not restricted to) developing countries. In spite of the great contribution of science in the past five decades, obstacles stand in the way of effectively improving good working conditions, particularly in times of precarious employment. The Working Time Society is a new scientific society that aims at promoting research into working time and health and offers practical advice on how to minimize adverse effects of working hours on workers' health and well-being. An updated view of the research on working times and health includes studies on the relationship between work schedules, worker health, and well-being; effects of night and shiftwork on the

  19. Estimating the waiting time of multi-priority emergency patients with downstream blocking.

    PubMed

    Lin, Di; Patrick, Jonathan; Labeau, Fabrice

    2014-03-01

    To characterize the coupling effect between patient flow to access the emergency department (ED) and that to access the inpatient unit (IU), we develop a model with two connected queues: one upstream queue for the patient flow to access the ED and one downstream queue for the patient flow to access the IU. Building on this patient flow model, we employ queueing theory to estimate the average waiting time across patients. Using priority specific wait time targets, we further estimate the necessary number of ED and IU resources. Finally, we investigate how an alternative way of accessing ED (Fast Track) impacts the average waiting time of patients as well as the necessary number of ED/IU resources. This model as well as the analysis on patient flow can help the designer or manager of a hospital make decisions on the allocation of ED/IU resources in a hospital. PMID:23690253

  20. Non-Markovian theory for the waiting time distributions of single electron transfers.

    PubMed

    Welack, Sven; Yan, YiJing

    2009-09-21

    We derive a non-Markovian theory for waiting time distributions of consecutive single electron transfer events. The presented microscopic Pauli rate equation formalism couples the open electrodes to the many-body system, allowing to take finite bias and temperature into consideration. Numerical results reveal transient oscillations of distinct system frequencies due to memory in the waiting time distributions. Memory effects can be approximated by an expansion in non-Markovian corrections. This method is employed to calculate memory landscapes displaying preservation of memory over multiple consecutive electron transfers. PMID:19778104

  1. Universal law for waiting internal time in seismicity and its implication to earthquake network

    NASA Astrophysics Data System (ADS)

    Abe, Sumiyoshi; Suzuki, Norikazu

    2012-02-01

    In their paper (Europhys. Lett., 71 (2005) 1036), Carbone, Sorriso-Valvo, Harabaglia and Guerra showed that the "unified scaling law" for conventional waiting times of earthquakes claimed by Bak et al. (Phys. Rev. Lett., 88 (2002) 178501) is actually not universal. Here, instead of the conventional time, the concept of the internal time termed the event time is considered for seismicity. It is shown that, in contrast to the conventional waiting time, the waiting event time obeys a power law. This implies the existence of temporal long-range correlations in terms of the event time with no sharp decay of the crossover type. The discovered power-law waiting event-time distribution turns out to be universal in the sense that it takes the same form for seismicities in California, Japan and Iran. In particular, the parameters contained in the distribution take the common values in all these geographical regions. An implication of this result to the procedure of constructing earthquake networks is discussed.

  2. WAITING TIME DISTRIBUTION OF SOLAR ENERGETIC PARTICLE EVENTS MODELED WITH A NON-STATIONARY POISSON PROCESS

    SciTech Connect

    Li, C.; Su, W.; Fang, C.; Zhong, S. J.; Wang, L.

    2014-09-10

    We present a study of the waiting time distributions (WTDs) of solar energetic particle (SEP) events observed with the spacecraft WIND and GOES. The WTDs of both solar electron events (SEEs) and solar proton events (SPEs) display a power-law tail of ∼Δt {sup –γ}. The SEEs display a broken power-law WTD. The power-law index is γ{sub 1} = 0.99 for the short waiting times (<70 hr) and γ{sub 2} = 1.92 for large waiting times (>100 hr). The break of the WTD of SEEs is probably due to the modulation of the corotating interaction regions. The power-law index, γ ∼ 1.82, is derived for the WTD of the SPEs which is consistent with the WTD of type II radio bursts, indicating a close relationship between the shock wave and the production of energetic protons. The WTDs of SEP events can be modeled with a non-stationary Poisson process, which was proposed to understand the waiting time statistics of solar flares. We generalize the method and find that, if the SEP event rate λ = 1/Δt varies as the time distribution of event rate f(λ) = Aλ{sup –α}exp (– βλ), the time-dependent Poisson distribution can produce a power-law tail WTD of ∼Δt {sup α} {sup –3}, where 0 ≤ α < 2.

  3. Burst wait time simulation of CALIBAN reactor at delayed super-critical state

    SciTech Connect

    Humbert, P.; Authier, N.; Richard, B.; Grivot, P.; Casoli, P.

    2012-07-01

    In the past, the super prompt critical wait time probability distribution was measured on CALIBAN fast burst reactor [4]. Afterwards, these experiments were simulated with a very good agreement by solving the non-extinction probability equation [5]. Recently, the burst wait time probability distribution has been measured at CEA-Valduc on CALIBAN at different delayed super-critical states [6]. However, in the delayed super-critical case the non-extinction probability does not give access to the wait time distribution. In this case it is necessary to compute the time dependent evolution of the full neutron count number probability distribution. In this paper we present the point model deterministic method used to calculate the probability distribution of the wait time before a prescribed count level taking into account prompt neutrons and delayed neutron precursors. This method is based on the solution of the time dependent adjoint Kolmogorov master equations for the number of detections using the generating function methodology [8,9,10] and inverse discrete Fourier transforms. The obtained results are then compared to the measurements and Monte-Carlo calculations based on the algorithm presented in [7]. (authors)

  4. Practical solutions for reducing container ships' waiting times at ports using simulation model

    NASA Astrophysics Data System (ADS)

    Sheikholeslami, Abdorreza; Ilati, Gholamreza; Yeganeh, Yones Eftekhari

    2013-12-01

    The main challenge for container ports is the planning required for berthing container ships while docked in port. Growth of containerization is creating problems for ports and container terminals as they reach their capacity limits of various resources which increasingly leads to traffic and port congestion. Good planning and management of container terminal operations reduces waiting time for liner ships. Reducing the waiting time improves the terminal's productivity and decreases the port difficulties. Two important keys to reducing waiting time with berth allocation are determining suitable access channel depths and increasing the number of berths which in this paper are studied and analyzed as practical solutions. Simulation based analysis is the only way to understand how various resources interact with each other and how they are affected in the berthing time of ships. We used the Enterprise Dynamics software to produce simulation models due to the complexity and nature of the problems. We further present case study for berth allocation simulation of the biggest container terminal in Iran and the optimum access channel depth and the number of berths are obtained from simulation results. The results show a significant reduction in the waiting time for container ships and can be useful for major functions in operations and development of container ship terminals.

  5. Optimum waiting time for acquisition of return link PN signals

    NASA Technical Reports Server (NTRS)

    Kolata, W.

    1982-01-01

    The subject of this paper is a model that takes into account the effect that acquisition of a PN signal on the forward link has on the acquisition of a PN signal on the return link. The model is used to determine how long the start of the PN search on the return link should be delayed in order to minimize the combined acquisition time (delay + acquisition time) as a function of desired acquisition probability. It is assumed that the return link a-priori epoch uncertainty information is available. Software has been developed that models the return link PN receiver and incorporates in it the effect of forward link PN acquisition statistics in assessing performance.

  6. WAITING TIMES OF QUASI-HOMOLOGOUS CORONAL MASS EJECTIONS FROM SUPER ACTIVE REGIONS

    SciTech Connect

    Wang Yuming; Liu Lijuan; Shen Chenglong; Liu Rui; Ye Pinzhong; Wang, S.

    2013-02-01

    Why and how do some active regions (ARs) frequently produce coronal mass ejections (CMEs)? These are key questions for deepening our understanding of the mechanisms and processes of energy accumulation and sudden release in ARs and for improving our space weather prediction capability. Although some case studies have been performed, these questions are still far from fully answered. These issues are now being addressed statistically through an investigation of the waiting times of quasi-homologous CMEs from super ARs in solar cycle 23. It is found that the waiting times of quasi-homologous CMEs have a two-component distribution with a separation at about 18 hr. The first component is a Gaussian-like distribution with a peak at about 7 hr, which indicates a tight physical connection between these quasi-homologous CMEs. The likelihood of two or more occurrences of CMEs faster than 1200 km s{sup -1} from the same AR within 18 hr is about 20%. Furthermore, the correlation analysis among CME waiting times, CME speeds, and CME occurrence rates reveals that these quantities are independent of each other, suggesting that the perturbation by preceding CMEs rather than free energy input is the direct cause of quasi-homologous CMEs. The peak waiting time of 7 hr probably characterizes the timescale of the growth of the instabilities triggered by preceding CMEs. This study uncovers some clues from a statistical perspective for us to understand quasi-homologous CMEs as well as CME-rich ARs.

  7. Factors Associated with Waiting Time for Breast Cancer Treatment in a Teaching Hospital in Ghana

    ERIC Educational Resources Information Center

    Dedey, Florence; Wu, Lily; Ayettey, Hannah; Sanuade, Olutobi A.; Akingbola, Titilola S.; Hewlett, Sandra A.; Tayo, Bamidele O.; Cole, Helen V.; de-Graft Aikins, Ama; Ogedegbe, Gbenga; Adanu, Richard

    2016-01-01

    Background: Breast cancer is the leading cause of cancer-related mortality among women in Ghana. Data are limited on the predictors of poor outcomes in breast cancer patients in low-income countries; however, prolonged waiting time has been implicated. Among breast cancer patients who received treatment at Korle Bu Teaching Hospital, this study…

  8. Development and Field Testing of a Wait Time Feedback Device for Monitoring and Improving Classroom Interaction.

    ERIC Educational Resources Information Center

    Gooding, C. Thomas; And Others

    Studies of the pauses between teachers' questions and students' responses have indicated that lengthening wait-time produces significant improvement in intellectual performance. Two types of pauses have been identified: the pause after teachers pose questions and students respond, and the pause that takes place when students hesitate momentarily…

  9. Decreasing Psychiatric Admission Wait Time in the Emergency Department by Facilitating Psychiatric Discharges.

    PubMed

    Stover, Pamela R; Harpin, Scott

    2015-12-01

    Limited capacity in a psychiatric unit contributes to long emergency department (ED) admission wait times. Regulatory and accrediting agencies urge hospitals nationally to improve patient flow for better access to care for all types of patients. The purpose of the current study was to decrease psychiatric admission wait time from 10.5 to 8 hours and increase the proportion of patients discharged by 11 a.m. from 20% to 50%. The current study compared pre- and post-intervention data. Plan-Do-Study-Act cycles aimed to improve discharge processes and timeliness through initiation of new practices. Admission wait time improved to an average of 5.1 hours (t = 3.87, p = 0.006). The proportion of discharges occurring by 11 a.m. increased to 46% (odds ratio = 3.42, p < 0.0001). Improving discharge planning processes and timeliness in a psychiatric unit significantly decreased admission wait time from the ED, improving access to psychiatric care. PMID:26505524

  10. Public involvement in the priority setting activities of a wait time management initiative: a qualitative case study

    PubMed Central

    Bruni, Rebecca A; Laupacis, Andreas; Levinson, Wendy; Martin, Douglas K

    2007-01-01

    Background As no health system can afford to provide all possible services and treatments for the people it serves, each system must set priorities. Priority setting decision makers are increasingly involving the public in policy making. This study focuses on public engagement in a key priority setting context that plagues every health system around the world: wait list management. The purpose of this study is to describe and evaluate priority setting for the Ontario Wait Time Strategy, with special attention to public engagement. Methods This study was conducted at the Ontario Wait Time Strategy in Ontario, Canada which is part of a Federal-Territorial-Provincial initiative to improve access and reduce wait times in five areas: cancer, cardiac, sight restoration, joint replacements, and diagnostic imaging. There were two sources of data: (1) over 25 documents (e.g. strategic planning reports, public updates), and (2) 28 one-on-one interviews with informants (e.g. OWTS participants, MOHLTC representatives, clinicians, patient advocates). Analysis used a modified thematic technique in three phases: open coding, axial coding, and evaluation. Results The Ontario Wait Time Strategy partially meets the four conditions of 'accountability for reasonableness'. The public was not directly involved in the priority setting activities of the Ontario Wait Time Strategy. Study participants identified both benefits (supporting the initiative, experts of the lived experience, a publicly funded system and sustainability of the healthcare system) and concerns (personal biases, lack of interest to be involved, time constraints, and level of technicality) for public involvement in the Ontario Wait Time Strategy. Additionally, the participants identified concern for the consequences (sustainability, cannibalism, and a class system) resulting from the Ontario Wait Times Strategy. Conclusion We described and evaluated a wait time management initiative (the Ontario Wait Time Strategy

  11. Modeling of waiting times and price changes in currency exchange data

    NASA Astrophysics Data System (ADS)

    Repetowicz, Przemysław; Richmond, Peter

    2004-11-01

    A theory which describes the share price evolution at financial markets as a continuous-time random walk (Physica A 287 (2000) 468, Physica A 314 (2002) 749, Eur. Phys. J. B 27 (2002) 273, Physica A 376 (2000) 284) has been generalized in order to take into account the dependence of waiting times t on price returns x. A joint probability density function (pdf) φ(x,t) which uses the concept of a Lévy stable distribution is worked out. The theory is fitted to high-frequency US $/Japanese Yen exchange rate and low-frequency 19th century Irish stock data. The theory has been fitted both to price return and to waiting time data and the adherence to data, in terms of the χ2 test statistic, has been improved when compared to the old theory.

  12. The Impact of Waiting Time on Health Gains from Surgery: Evidence from a National Patient-reported Outcome Dataset.

    PubMed

    Nikolova, Silviya; Harrison, Mark; Sutton, Matt

    2016-08-01

    Reducing waiting times has been a major focus of the English National Health Service for many years, but little is known about the impact on health outcomes. The collection of data on patient-reported outcome measures for all patients undergoing four large-volume procedures facilitates analysis of the impact of waiting times on patient outcomes. The availability of patient-reported outcome measures before and after surgery allows us to estimate the impact of waiting times on the effectiveness of treatment, controlling for pre-surgery health and the endogeneity of waiting times caused by prioritisation with respect to pre-intervention health. We find that waiting time has a negative and statistically significant impact on the health gain from hip and knee replacement surgery and no impact on the effectiveness of varicose vein and hernia surgery. The magnitude of this effect at patient level is small, 0.1% of the outcome measure range for each additional week of waiting. However, the value of this effect is substantially larger than existing estimates of the disutility experienced during the waiting period. The health losses associated with an additional week of waiting for annual populations of hip and knee replacement patients are worth £11.1m and £11.5m, respectively. Copyright © 2015 John Wiley & Sons, Ltd. PMID:26013773

  13. Origins of concentration dependence of waiting times for single-molecule fluorescence binding.

    PubMed

    Yang, Jin; Pearson, John E

    2012-06-28

    Binary fluorescence time series obtained from single-molecule imaging experiments can be used to infer protein binding kinetics, in particular, association and dissociation rate constants from waiting time statistics of fluorescence intensity changes. In many cases, rate constants inferred from fluorescence time series exhibit nonintuitive dependence on ligand concentration. Here, we examine several possible mechanistic and technical origins that may induce ligand dependence of rate constants. Using aggregated Markov models, we show under the condition of detailed balance that non-fluorescent bindings and missed events due to transient interactions, instead of conformation fluctuations, may underly the dependence of waiting times and thus apparent rate constants on ligand concentrations. In general, waiting times are rational functions of ligand concentration. The shape of concentration dependence is qualitatively affected by the number of binding sites in the single molecule and is quantitatively tuned by model parameters. We also show that ligand dependence can be caused by non-equilibrium conditions which result in violations of detailed balance and require an energy source. As to a different but significant mechanism, we examine the effect of ambient buffers that can substantially reduce the effective concentration of ligands that interact with the single molecules. To demonstrate the effects by these mechanisms, we applied our results to analyze the concentration dependence in a single-molecule experiment EGFR binding to fluorophore-labeled adaptor protein Grb2 by Morimatsu et al. [Proc. Natl. Acad. Sci. U.S.A. 104, 18013 (2007)]. PMID:22755586

  14. Reliability of electronic recording of waiting times in the emergency department: a prospective multicenter study.

    PubMed

    Gorlicki, Judith; Raynal, Pierre-Alexis; Leleu, Agathe; Riou, Bruno; Ray, Patrick; Freund, Yonathan

    2015-10-01

    We aimed to evaluate the reliability of waiting times (WT) measures electronically retrieved. We prospectively collected true WT in four emergency departments during 20 predefined 2-h inclusion periods, and compared them with the electronically retrieved waiting time (ERWT). We assessed agreement with calculation of rate of outliers (difference exceeding 20 min), bias, and its 95% limits of agreements, and associated Bland and Altman plot. We analyzed 274 patients. The mean difference was -2 min (SD 13) between ERWT and true WT, with a 95% limits of agreements (-28 to 24 min). Bland and Altman plot showed a good agreement, and we report 7% of outliers. Using ERWT, 14 patients (5%) were misclassified as having their target WT exceeded or not. ERWT agree well with the true WT, although the significant rate of outlier and misclassification calls for caution in their interpretation. PMID:25564458

  15. Emergency department overcrowding and long wait times: taking a corporate approach to improving patient flow.

    PubMed

    Bandiera, Glen; Gaunt, Karen; Sinclair, Douglas; Trafford, Anne

    2014-01-01

    Emergency department (ED) overcrowding and long wait times are major concerns in health systems the world over. Many ED-focused innovations--such as revising staff mix, improving internal processes and exploiting decision-support software--have been implemented to address these complex problems, often with limited success. Beginning in 2008, St. Michael's Hospital in Toronto, which had some of the most challenging ED overcrowding and longest wait times in Ontario, has charted a different course. By taking an organization-wide corporate approach to the challenge of patient flow throughout the hospital, St. Michael's has significantly improved key ED flow metrics for both its admitted and non-admitted patients. PMID:25906463

  16. Breastfeeding and waiting time to conception for Malay women: a tale of two surveys.

    PubMed

    VanLandingham, M

    1993-01-01

    This study investigates the unusual relationship between breastfeeding and waiting time to conception in Malaysia as reported in Goldman et al. (1987). Using data from the Malaysian World Fertility Survey (MWFS), Goldman and her colleagues (1987) find that noncontracepting Malaysian women have an unusually long waiting time to conception, given their relatively short durations of breastfeeding. This study provides a similar analysis using data from the Malaysian Family Life Survey (MFLS) and finds a more typical relationship. I conclude that the distinction between full and partial breastfeeding made to respondents of the MFLS probably led to more reliable responses to questions about breastfeeding duration, especially for women who breastfeed for long durations. PMID:8178190

  17. Radical radiotherapy for cervix cancer: The effect of waiting time on outcome

    SciTech Connect

    Choan, E. . E-mail: ce@ottawahospital.on.ca; Dahrouge, Simone; Samant, Rajiv; Mirzaei, Ameneh; Price, Julie

    2005-03-15

    Purpose: To assess the effect of treatment waiting time on clinical outcome for patients with cervix cancers treated with radical radiotherapy. Methods and materials: A retrospective analysis was conducted on all cervix cancer patients treated with radical radiotherapy between 1990 and 2001 at the Ottawa Regional Cancer Centre. Analyses were performed according to the three following separate definitions of waiting times: interval from start of radiotherapy to (1) date of initial biopsy (2) date of examination under anesthesia, and (3) date of radiation oncology consultation. Associations between waiting times and patient characteristics and disease control were investigated using t-tests, analyses of variance, and Cox regression analyses. Results: A total of 195 patients were studied. The vast majority of patients were treated within 5, 6, and 8 weeks of their consultation (91%), examination under anesthesia (88%), and biopsy (81%), respectively. On average, delays between initial biopsy and treatment start were greater for older patients (p = 0.025) (5.8 weeks for <40 years old vs. 6.6 weeks for >70 years old) and those with smaller tumors (p < 0.001) (5.0 weeks for >4 cm vs. 6.3 weeks for {<=}4 cm). Univariate analysis revealed no adverse effect of treatment delay on tumor control. Multivariate analysis, with the inclusion of multiple prognostic tumor and treatment parameters, revealed an adverse effect of treatment delay on survival outcomes. Conclusions: Longer radiotherapy waiting times were found to be associated with diminished survival outcomes for patients treated radically for cervix cancer. The significance of this observed association requires further investigation.

  18. The effect of superfluid hydrodynamics on pulsar glitch sizes and waiting times

    NASA Astrophysics Data System (ADS)

    Haskell, B.

    2016-09-01

    Pulsar glitches, sudden jumps in frequency observed in many radio pulsars, may be the macroscopic manifestation of superfluid vortex avalanches on the microscopic scale. Small-scale quantum mechanical simulations of vortex motion in a decelerating container have shown that such events are possible and predict power-law distributions for the size of the events, and exponential distributions for the waiting time. Despite a paucity of data, this prediction is consistent with the size and waiting time distributions of most glitching pulsars. Nevertheless, a few object appear to glitch quasi-periodically, and exhibit many large glitches, while a recent study of the Crab pulsar has suggested deviations from a power-law distribution for smaller glitches. In this Letter, we incorporate the results of quantum mechanical simulations in a macroscopic superfluid hydrodynamics simulation. We show that the effect of vortex coupling to the neutron and proton fluids in the star naturally leads to deviations from power-law distributions for sizes, and from exponential distributions for waiting times, and we predict a cutoff in the size distribution for small glitches.

  19. Probabilistic model of waiting times between large failures in sheared media

    NASA Astrophysics Data System (ADS)

    Brinkman, Braden A. W.; LeBlanc, Michael P.; Uhl, Jonathan T.; Ben-Zion, Yehuda; Dahmen, Karin A.

    2016-01-01

    Using a probabilistic approximation of a mean-field mechanistic model of sheared systems, we analytically calculate the statistical properties of large failures under slow shear loading. For general shear F (t ) , the distribution of waiting times between large system-spanning failures is a generalized exponential distribution, ρT(t ) =λ ( F (t ) ) P ( F (t ) ) exp[-∫0td τ λ ( F (τ ) ) P ( F (τ ) ) ] , where λ ( F (t )) is the rate of small event occurrences at stress F (t ) and P ( F (t )) is the probability that a small event triggers a large failure. We study the behavior of this distribution as a function of fault properties, such as heterogeneity or shear rate. Because the probabilistic model accommodates any stress loading F (t ) , it is particularly useful for modeling experiments designed to understand how different forms of shear loading or stress perturbations impact the waiting-time statistics of large failures. As examples, we study how periodic perturbations or fluctuations on top of a linear shear stress increase impact the waiting-time distribution.

  20. The effect of in-office waiting time on physician visit frequency among working-age adults.

    PubMed

    Tak, Hyo Jung; Hougham, Gavin W; Ruhnke, Atsuko; Ruhnke, Gregory W

    2014-10-01

    Disparities in unmet health care demand resulting from socioeconomic, racial, and financial factors have received a great deal of attention in the United States. However, out-of-pocket costs alone do not fully reflect the total opportunity cost that patients must consider as they seek medical attention. While there is an extensive literature on the price elasticity of demand for health care, empirical evidence regarding the effect of waiting time on utilization is sparse. Using the nationally representative 2003 Community Tracking Study Household Survey, the most recent iteration containing respondents' physician office visit frequency and estimated in-office waiting time in the United States (N = 23,484), we investigated the association between waiting time and calculated time cost with the number of physician visits among a sample of working-age adults. To avoid the bias that literature suggests would result from excluding respondents with zero physician visits, we imputed waiting time for the essential inclusion of such individuals. On average, respondents visited physician offices 3.55 times, during which time they waited 28.7 min. The estimates from a negative binomial model indicated that a doubling of waiting time was associated with a 7.7 percent decrease (p-value < 0.001) in physician visit frequency. For women and unemployed respondents, who visited physicians more frequently, the decrease was even larger, suggesting a stronger response to greater waiting times. We believe this finding reflects the discretionary nature of incremental visits in these groups, and a consequent lower perceived marginal benefit of additional visits. The results suggest that in-office waiting time may have a substantial influence on patients' propensity to seek medical attention. Although there is a belief that expansions in health insurance coverage increase health care utilization by reducing financial barriers to access, our results suggest that unintended consequences

  1. The influence of insurance status on waiting times in German acute care hospitals: an empirical analysis of new data

    PubMed Central

    2009-01-01

    Background There is an ongoing debate in Germany about the assumption that patients with private health insurance (PHI) benefit from better access to medical care, including shorter waiting times (Lüngen et al. 2008), compared to patients with statutory health insurance (SHI). Problem Existing analyses of the determinants for waiting times in Germany are a) based on patient self-reports and b) do not cover the inpatient sector. This paper aims to fill both gaps by (i) generating new primary data and (ii) analyzing waiting times in German hospitals. Methods We requested individual appointments from 485 hospitals within an experimental study design, allowing us to analyze the impact of PHI versus SHI on waiting times (Asplin et al. 2005). Results In German acute care hospitals patients with PHI have significantly shorter waiting times than patients with SHI. Conclusion Discrimination in waiting times by insurance status does occur in the German acute hospital sector. Since there is very little transparency in treatment quality in Germany, we do not know whether discrimination in waiting times leads to discrimination in the quality of treatment. This is an important issue for future research. PMID:20025744

  2. Transition in the waiting-time distribution of price-change events in a global socioeconomic system

    NASA Astrophysics Data System (ADS)

    Zhao, Guannan; McDonald, Mark; Fenn, Dan; Williams, Stacy; Johnson, Nicholas; Johnson, Neil F.

    2013-12-01

    The goal of developing a firmer theoretical understanding of inhomogeneous temporal processes-in particular, the waiting times in some collective dynamical system-is attracting significant interest among physicists. Quantifying the deviations between the waiting-time distribution and the distribution generated by a random process may help unravel the feedback mechanisms that drive the underlying dynamics. We analyze the waiting-time distributions of high-frequency foreign exchange data for the best executable bid-ask prices across all major currencies. We find that the lognormal distribution yields a good overall fit for the waiting-time distribution between currency rate changes if both short and long waiting times are included. If we restrict our study to long waiting times, each currency pair’s distribution is consistent with a power-law tail with exponent near to 3.5. However, for short waiting times, the overall distribution resembles one generated by an archetypal complex systems model in which boundedly rational agents compete for limited resources. Our findings suggest that a gradual transition arises in trading behavior between a fast regime in which traders act in a boundedly rational way and a slower one in which traders’ decisions are driven by generic feedback mechanisms across multiple timescales and hence produce similar power-law tails irrespective of currency type.

  3. Analyzing patient's waiting time in emergency & trauma department in public hospital - A case study

    NASA Astrophysics Data System (ADS)

    Roslan, Shazwa; Tahir, Herniza Md; Nordin, Noraimi Azlin Mohd; Zaharudin, Zati Aqmar

    2014-09-01

    Emergency and Trauma Department (ETD) is an important element for a hospital. It provides medical service, which operates 24 hours a day in most hospitals. However overcrowding is not exclusion for ETD. Overflowing occurs due to affordable services provided by public hospitals, since it is funded by the government. It is reported that a patient attending ETD must be treated within 90 minutes, in accordance to achieve the Key Performance Indicator (KPI). However, due to overcrowd situations, most patients have to wait longer than the KPI standard. In this paper, patient's average waiting time is analyzed. Using Chi-Square Test of Goodness, patient's inter arrival per hour is also investigated. As conclusion, Monday until Wednesday was identified as the days that exceed the KPI standard while Chi-Square Test of Goodness showed that the patient's inter arrival is independent and random.

  4. Toward systematic reviews to understand the determinants of wait time management success to help decision-makers and managers better manage wait times

    PubMed Central

    2013-01-01

    Background Long waits for core specialized services have consistently been identified as a key barrier to access. Governments and organizations at all levels have responded with strategies for better wait list management. While these initiatives are promising, insufficient attention has been paid to factors influencing the implementation and sustainability of wait time management strategies (WTMS) implemented at the organizational level. Methods A systematic review was conducted using the main electronic databases, such as CINAHL, MEDLINE, and Cochrane Database of Systematic Reviews, to identify articles published between 1990 and 2011 on WTMS for scheduled care implemented at the organizational level or higher and on frameworks for analyzing factors influencing their success. Data was extracted on governance, culture, resources, and tools. We organized a workshop with Canadian healthcare policy-makers and managers to compare our initial findings with their experience. Results Our systematic review included 47 articles: 36 related to implementation and 11 to sustainability. From these, we identified a variety of WTMS initiated at the organizational level or higher, and within these, certain factors that were specific to either implementation or sustainability and others common to both. The main common factors influencing success at the contextual level were stakeholder engagement and strong funding, and at the organizational level, physician involvement, human resources capacity, and information management systems. Specific factors for successful implementation at the contextual level were consultation with front-line actors and common standards and guidelines, and at the organizational level, financial incentives and dedicated staffing. For sustainability, we found no new factors. The workshop participants identified the same major factors as found in the articles and added others, such as information sharing between physicians and managers. Conclusions Factors

  5. Medical Team Evaluation: Effect on Emergency Department Waiting Time and Length of Stay

    PubMed Central

    Lauks, Juliane; Mramor, Blaz; Baumgartl, Klaus; Maier, Heinrich; Nickel, Christian H.; Bingisser, Roland

    2016-01-01

    Emergency Departments (ED) are trying to alleviate crowding using various interventions. We assessed the effect of an alternative model of care, the Medical Team Evaluation (MTE) concept, encompassing team triage, quick registration, redesign of triage rooms and electronic medical records (EMR) on door-to-doctor (waiting) time and ED length of stay (LOS). We conducted an observational, before-and-after study at an urban academic tertiary care centre. On July 17th 2014, MTE was initiated from 9:00 a.m. to 10 p.m., 7 days a week. A registered triage nurse was teamed with an additional senior ED physician. Data of the 5-month pre-MTE and the 5-month MTE period were analysed. A matched comparison of waiting times and ED LOS of discharged and admitted patients pertaining to various Emergency Severity Index (ESI) triage categories was performed based on propensity scores. With MTE, the median waiting times improved from 41.2 (24.8–66.6) to 10.2 (5.7–18.1) minutes (min; P < 0.01). Though being beneficial for all strata, the improvement was somewhat greater for discharged, than for admitted patients. With a reduction from 54.3 (34.2–84.7) to 10.5 (5.9–18.4) min (P < 0.01), in terms of waiting times, MTE was most advantageous for ESI4 patients. The overall median ED LOS increased for about 15 min (P < 0.01), increasing from 3.4 (2.1–5.3) to 3.7 (2.3–5.6) hours. A significant increase was observed for all the strata, except for ESI5 patients. Their median ED LOS dropped by 73% from 1.2 (0.8–1.8) to 0.3 (0.2–0.5) hours (P < 0.01). In the same period the total orders for diagnostic radiology increased by 1,178 (11%) from 10,924 to 12,102 orders, with more imaging tests being ordered for ESI 2, 3 and 4 patients. Despite improved waiting times a decrease of ED LOS was only seen in ESI level 5 patients, whereas in all the other strata ED LOS increased. We speculate that this was brought about by the tendency of triage physicians to order more diagnostic radiology

  6. Convergence dynamics of the Bak Sneppen model: Activity rate and waiting time distribution

    NASA Astrophysics Data System (ADS)

    Tirnakli, Ugur; Lyra, Marcelo L.

    2007-02-01

    In this work, we study the convergence dynamics of two independent random configurations of the Bak-Sneppen model of self-organized criticality evolving under the same external noise. A recently proposed measure of the Hamming distance which considers the minimum difference between displaced configurations is used. The displacement evolves in time intermittently. We compute the jump activity rate and waiting time distribution and report on their asymptotic power-law scaling which characterizes the slow relaxation and the absence of typical length and time scales typical of critical dynamical systems.

  7. Parallel-Batch Scheduling and Transportation Coordination with Waiting Time Constraint

    PubMed Central

    Gong, Hua; Chen, Daheng; Xu, Ke

    2014-01-01

    This paper addresses a parallel-batch scheduling problem that incorporates transportation of raw materials or semifinished products before processing with waiting time constraint. The orders located at the different suppliers are transported by some vehicles to a manufacturing facility for further processing. One vehicle can load only one order in one shipment. Each order arriving at the facility must be processed in the limited waiting time. The orders are processed in batches on a parallel-batch machine, where a batch contains several orders and the processing time of the batch is the largest processing time of the orders in it. The goal is to find a schedule to minimize the sum of the total flow time and the production cost. We prove that the general problem is NP-hard in the strong sense. We also demonstrate that the problem with equal processing times on the machine is NP-hard. Furthermore, a dynamic programming algorithm in pseudopolynomial time is provided to prove its ordinarily NP-hardness. An optimal algorithm in polynomial time is presented to solve a special case with equal processing times and equal transportation times for each order. PMID:24883385

  8. An Estimation Method of Waiting Time for Health Service at Hospital by Using a Portable RFID and Robust Estimation

    NASA Astrophysics Data System (ADS)

    Ishigaki, Tsukasa; Yamamoto, Yoshinobu; Nakamura, Yoshiyuki; Akamatsu, Motoyuki

    Patients that have an health service by doctor have to wait long time at many hospitals. The long waiting time is the worst factor of patient's dissatisfaction for hospital service according to questionnaire for patients. The present paper describes an estimation method of the waiting time for each patient without an electronic medical chart system. The method applies a portable RFID system to data acquisition and robust estimation of probability distribution of the health service and test time by doctor for high-accurate waiting time estimation. We carried out an health service of data acquisition at a real hospital and verified the efficiency of the proposed method. The proposed system widely can be used as data acquisition system in various fields such as marketing service, entertainment or human behavior measurement.

  9. Waiting time to conception among the Igbo women of Enugu, Nigeria.

    PubMed

    Onah, H E; Obi, S N; Akogu, S P O

    2009-07-01

    The objective of this study was to determine the waiting time to conception among a sample of pregnant Igbo women resident in an urban area of South-east Nigeria. This was a cross-sectional questionnaire study of antenatal clinic attendees at four major health institutions within Enugu, South-eastern Nigeria. The time to conception showed a pattern closer to that of the USA than that of the UK and is consistent with high fertility previously recorded in the Igbo population. We conclude that the data will be useful in counselling women who present with difficulty in conception. PMID:19603320

  10. Prognostic value of wait time in nasopharyngeal carcinoma treated with intensity modulated radiotherapy: a propensity matched analysis.

    PubMed

    Chen, Yu-Pei; Mao, Yan-Ping; Zhang, Wen-Na; Chen, Lei; Tang, Ling-Long; Li, Wen-Fei; Liu, Xu; Zhou, Guan-Qun; Guo, Rui; Sun, Ying; Kang, Tie-Bang; Zeng, Mu-Sheng; Ma, Jun

    2016-03-22

    The aim of this study was to determine the prognostic value of wait time from histological diagnosis to primary treatmen for nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiotherapy (IMRT). Between October 2009 and February 2012, a total of 1672 NPC patients were retrospectively analyzed. A cutoff value of > 4 weeks was used to define prolonged wait time. Matched patients according to the wait time were identified using propensity score matching (PSM), which was also used to identify matched patients for subsequent stratified analyses. Differences in progression-free survival (PFS), overall survival (OS), distant metastasis-free survival (DMFS), and locoregional relapse-free survival (LRFS) were estimated using the Kaplan-Meier method and Cox proportional hazards models. In total, 407 pairs of NPC patients were selected by PSM. The 3-year PFS rate was significantly lower for patients with a prolonged wait time (> 4 weeks) than for those with an acceptable wait time (P = 0.035). Stratified analyses revealed that the negative effects of a prolonged wait time occurred primarily in patients with advanced NPC without neoadjuvant chemotherapy (NACT; PFS:P = 0.040; DMFS:P = 0.028). In multivariate analysis, a prolonged wait time was found to be an independent unfavorable prognostic factor for PFS and DMFS in advanced-staged patients without NACT. These results suggest that a prolonged time (> 4 weeks) between diagnosis and primary radical radiotherapy is a disadvantage for NPC patients, particularly those with advanced disease receiving no NACT. Thus, it is necessary to optimize resources for decreasing this wait time, although additional studies are warranted to further clarify our findings. PMID:26942870

  11. Modeling share price evolution as a continuous time random walk (CTRW) with non-independent price changes and waiting times

    NASA Astrophysics Data System (ADS)

    Repetowicz, Przemysław; Richmond, Peter

    2004-12-01

    A theory which describes the share price evolution at financial markets as a continuous time random walk has been generalized in order to take into account the dependence of waiting times t on price returns x. A joint probability density function φ(x,t), which uses the concept of a Lévy stable distribution, is worked out. The evolution equation is formulated and it is shown that the process is non-Markovian. Finally, the theory is fitted to market data.

  12. Delay decomposition at a single server queue with constant service time and multiple inputs. [Waiting time on computer network

    NASA Technical Reports Server (NTRS)

    Ziegler, C.; Schilling, D. L.

    1977-01-01

    Two networks consisting of single server queues, each with a constant service time, are considered. The external inputs to each network are assumed to follow some general probability distribution. Several interesting equivalencies that exist between the two networks considered are derived. This leads to the introduction of an important concept in delay decomposition. It is shown that the waiting time experienced by a customer can be decomposed into two basic components called self delay and interference delay.

  13. Wait times for prostate cancer treatment and patient perceptions of care in Canada: a mixed-methods report

    PubMed Central

    Tran, K.; Sandoval, C.; Rahal, R.; Porter, G.; Siemens, R.; Hernandez, J.; Fung, S.; Louzado, C.; Liu, J; Bryant, H.

    2015-01-01

    Background Access to cancer care is a significant concern for Canadians. Prolonged delays between cancer diagnosis and treatment have been associated with anxiety, stress, and perceived powerlessness for patients and their family members. Longer wait times can also be associated with poorer prognosis, although the evidence is inconclusive. Here, we report national wait times for radiation therapy and surgery for localized prostate cancer (pca) and the effect of wait time on patient perceptions of their care. Results Treatment wait times showed substantial interprovincial variation. The longest 90th percentile wait times for radiation therapy and surgery were, respectively, 40 days and 105 days. In all provinces, waits for radiation therapy were longer for pca patients than for patients with breast, colorectal, or lung cancer. In the focus groups and interviews conducted with 47 men treated for pca, many participants did not perceive that wait times for treatment were prolonged. Those who experienced delays between diagnosis and treatment voiced issues with a lack of communication about when they would receive treatment and a lack of support or information to make an informed decision about treatment. Minimizing treatment delays was an aspect of the cancer journey that participants would like to change because of the stress it caused. Conclusions Although wait time statistics are useful, a review of cancer control in Canada cannot be considered complete unless an effort is made to give voice to the experiences of individuals with cancer. The findings presented here are intended to provide a snapshot of national care delivery for localized pca and to identify opportunities for improvement in clinical practice. PMID:26628869

  14. Numerical Simulations of Nanoflares: PDFs of Released Energy, Waiting Times and Quiet- Sun Magnetic Field Elements

    NASA Astrophysics Data System (ADS)

    Egidi, A.; Viticchie`, B.; Berrilli, F.; Del Moro, D.

    2007-12-01

    A numerical model for nanoflares is proposed to describe probability density functions (PDF) and waiting time statistics of the emitted magnetic energy and to guess PDF of quiet-Sun magnetic field strength. In the simulation, footpoints of reconnecting magnetic loops are advected by photospheric flows computed via a n-body algorithm. The model simulates a system whose behavior is characterized by small scale (i.e., granulation) flows that interact to develop large organization scales (i.e., mesogranulation). Such spatio-temporal correlated flows, incessantly supply , remove and convey the passive magnetic footpoints onto the photospheric surface, triggering reconnections and magnetic field reconfigurations.

  15. Impact of Lean on patient cycle and waiting times at a rural district hospital in KwaZulu-Natal

    PubMed Central

    Naidoo, Logandran

    2016-01-01

    Background Prolonged waiting time is a source of patient dissatisfaction with health care and is negatively associated with patient satisfaction. Prolonged waiting times in many district hospitals result in many dissatisfied patients, overworked and frustrated staff, and poor quality of care because of the perceived increased workload. Aim The aim of the study was to determine the impact of Lean principles techniques, and tools on the operational efficiency in the outpatient department (OPD) of a rural district hospital. Setting The study was conducted at the Catherine Booth Hospital (CBH) – a rural district hospital in KwaZulu-Natal, South Africa. Methods This was an action research study with pre-, intermediate-, and post-implementation assessments. Cycle and waiting times were measured by direct observation on two occasions before, approximately two-weekly during, and on two occasions after Lean implementation. A standardised data collection tool was completed by the researcher at each of the six key service nodes in the OPD to capture the waiting times and cycle times. Results All six service nodes showed a reduction in cycle times and waiting times between the baseline assessment and post-Lean implementation measurement. Significant reduction was achieved in cycle times (27%; p < 0.05) and waiting times (from 11.93 to 10 min; p = 0.03) at the Investigations node. Although the target reduction was not achieved for the Consulting Room node, there was a significant reduction in waiting times from 80.95 to 74.43 min, (p < 0.001). The average efficiency increased from 16.35% (baseline) to 20.13% (post-intervention). Conclusion The application of Lean principles, tools and techniques provides hospital managers with an evidence-based management approach to resolving problems and improving quality indicators. PMID:27543283

  16. Improving equitable access to imaging under universal-access medicine: the ontario wait time information program and its impact on hospital policy and process.

    PubMed

    Kielar, Ania Z; El-Maraghi, Robert H; Schweitzer, Mark E

    2010-08-01

    In Canada, equal access to health care is the goal, but this is associated with wait times. Wait times should be fair rather than uniform, taking into account the urgency of the problem as well as the time an individual has already waited. In November 2004, the Ontario government began addressing this issue. One of the first steps was to institute benchmarks reflecting "acceptable" wait times for CT and MRI. A public Web site was developed indicating wait times at each Local Health Integration Network. Since starting the Wait Time Information Program, there has been a sustained reduction in wait times for Ontarians requiring CT and MRI. The average wait time for a CT scan went from 81 days in September 2005 to 47 days in September 2009. For MRI, the resulting wait time was reduced from 120 to 105 days. Increased patient scans have been achieved by purchasing new CT and MRI scanners, expanding hours of operation, and improving patient throughput using strategies learned from the Lean initiative, based on Toyota's manufacturing philosophy for car production. Institution-specific changes in booking procedures have been implemented. Concurrently, government guidelines have been developed to ensure accountability for monies received. The Ontario Wait Time Information Program is an innovative first step in improving fair and equitable access to publicly funded imaging services. There have been reductions in wait times for both CT and MRI. As various new processes are implemented, further review will be necessary for each step to determine their individual efficacy. PMID:20678727

  17. Waiting time reduction in intravitreal clinics by optimization of appointment scheduling: balancing demand and supply

    PubMed Central

    Ugarte, Marta

    2015-01-01

    This study was designed guided by the Model for Improvement framework to reduce waiting times and visit duration in the intravitreal therapy clinic, while improving patient and staff experience. In our aim to provide good quality, patient-centred care and constantly improve, we optimised the appointment profile and patient flow. We involved a multidisciplinary team (one consultant, junior doctors, staff nurses, technicians, and receptionist), as well as patients and relatives, to try to understand the main delays in the clinic. Process mapping, a fishbone diagram, run charts, together with feedback from patients and staff, provided an insight on the possible roots of the delays experienced by our patients. The results of the inquiry led us to take actions focused on optimising appointment scheduling. After implementing the new scheduling profile (with a gap in the middle of the session), various cycles of plan-do-study-act and a comparative, qualitative study by interviewing 10 patients demonstrated that the waiting times decreased, and patients and staff experience improved. PMID:26734454

  18. Waiting time reduction in intravitreal clinics by optimization of appointment scheduling: balancing demand and supply.

    PubMed

    Ugarte, Marta

    2015-01-01

    This study was designed guided by the Model for Improvement framework to reduce waiting times and visit duration in the intravitreal therapy clinic, while improving patient and staff experience. In our aim to provide good quality, patient-centred care and constantly improve, we optimised the appointment profile and patient flow. We involved a multidisciplinary team (one consultant, junior doctors, staff nurses, technicians, and receptionist), as well as patients and relatives, to try to understand the main delays in the clinic. Process mapping, a fishbone diagram, run charts, together with feedback from patients and staff, provided an insight on the possible roots of the delays experienced by our patients. The results of the inquiry led us to take actions focused on optimising appointment scheduling. After implementing the new scheduling profile (with a gap in the middle of the session), various cycles of plan-do-study-act and a comparative, qualitative study by interviewing 10 patients demonstrated that the waiting times decreased, and patients and staff experience improved. PMID:26734454

  19. Beat the clock! Wait times and the production of 'quality' in emergency departments.

    PubMed

    Melon, Karen A; White, Deborah; Rankin, Janet

    2013-07-01

    Emergency care in large urban hospitals across the country is in the midst of major redesign intended to deliver quality care through improved access, decreased wait times, and maximum efficiency. The central argument in this paper is that the conceptualization of quality including the documentary facts and figures produced to substantiate quality emergency care is socially organized within a powerful ruling discourse that inserts the interests of politics and economics into nurses' work. The Canadian Triage and Acuity Scale figures prominently in the analysis as a high-level organizer of triage work and knowledge production that underpins the way those who administer the system define, measure and evaluate emergency care processes, and then use this information for restructuring. Managerial targets and thinking not only dominate the way emergency work is understood, determined, and controlled but also subsume the actual work of health-care providers in spaces called 'wait times', where it is systematically rendered 'unknowable'. The analysis is supported with evidence from an extensive institutional ethnography that shows what nurses actually do to manage the safe passage of patients through their emergency care process starting with the work of triage nurses. PMID:23745663

  20. Public reporting on quality, waiting times and patient experience in 11 high-income countries.

    PubMed

    Rechel, Bernd; McKee, Martin; Haas, Marion; Marchildon, Gregory P; Bousquet, Frederic; Blümel, Miriam; Geissler, Alexander; van Ginneken, Ewout; Ashton, Toni; Saunes, Ingrid Sperre; Anell, Anders; Quentin, Wilm; Saltman, Richard; Culler, Steven; Barnes, Andrew; Palm, Willy; Nolte, Ellen

    2016-04-01

    This article maps current approaches to public reporting on waiting times, patient experience and aggregate measures of quality and safety in 11 high-income countries (Australia, Canada, England, France, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland and the United States). Using a questionnaire-based survey of key national informants, we found that the data most commonly made available to the public are on waiting times for hospital treatment, being reported for major hospitals in seven countries. Information on patient experience at hospital level is also made available in many countries, but it is not generally available in respect of primary care services. Only one of the 11 countries (England) publishes composite measures of overall quality and safety of care that allow the ranking of providers of hospital care. Similarly, the publication of information on outcomes of individual physicians remains rare. We conclude that public reporting of aggregate measures of quality and safety, as well as of outcomes of individual physicians, remain relatively uncommon. This is likely to be due to both unresolved methodological and ethical problems and concerns that public reporting may lead to unintended consequences. PMID:26964783

  1. Wait Times for Publicly Funded Outpatient and Community Physiotherapy and Occupational Therapy Services: Implications for the Increasing Number of Persons with Chronic Conditions in Ontario, Canada

    PubMed Central

    Passalent, Laura A.; Landry, Michel D.

    2009-01-01

    ABSTRACT Background: Timely access to publicly funded health services has emerged as a priority policy issue across the continuum of care from hospitals to the home and community sector. The purpose of this study was to examine wait lists and wait times for publicly funded outpatient and community occupational therapy (OT) and physical therapy (PT) services. Methods: A mailed self-administered questionnaire was sent in December 2005 to all publicly funded sites across Ontario that deliver outpatient or community OT or PT services (N = 374). Descriptive statistics were used to describe the study sample and to examine wait lists and wait times by setting and client condition. Results: Overall response rate was 57.2% (n = 214). More than 10,000 people were reported to be waiting for OT or PT services across Ontario. Of these, 16% (n = 1,664) were waiting for OT and 84% (n = 8,842) for PT. Of those waiting for OT, 59% had chronic conditions and half were waiting for home care rehabilitation services. Of those waiting for PT, 73% had chronic conditions and 81% were waiting at hospital outpatient departments. Conclusions: Individuals with chronic conditions experience excessive wait times for outpatient and community OT and PT services in Ontario, particularly if they are waiting for services in hospital outpatient departments. PMID:20145747

  2. Waiting times before dental care under general anesthesia in children with special needs in the Children's Hospital of Casablanca

    PubMed Central

    Badre, Bouchra; Serhier, Zineb; El Arabi, Samira

    2014-01-01

    Introduction Oral diseases may have an impact on quality of children's life. The presence of severe disability requires the use of care under general anesthesia (GA). However, because of the limited number of qualified health personnel, waiting time before intervention can be long. Aim: To evaluate the waiting time before dental care under general anesthesia for children with special needs in Morocco. Methods A retrospective cohort study was carried out in pediatric dentistry unit of the University Hospital of Casablanca. Data were collected from records of patients seen for the first time between 2006 and 2011. The waiting time was defined as the time between the date of the first consultation and intervention date. Results 127 children received dental care under general anesthesia, 57.5% were male and the average age was 9.2 (SD = 3.4). Decay was the most frequent reason for consultation (48%), followed by pain (32%). The average waiting time was 7.6 months (SD = 4.2 months). The average number of acts performed per patient was 13.5. Conclusion Waiting times were long, it is necessary to take measures to reduce delays and improve access to oral health care for this special population. PMID:25328594

  3. Size distribution and waiting times for the avalanches of the Cell Network Model of Fracture

    NASA Astrophysics Data System (ADS)

    Villalobos, Gabriel; Kun, Ferenc; Linero, Dorian L.; Muñoz, José D.

    2011-09-01

    The Cell Network Model is a fracture model recently introduced that resembles the microscopical structure and drying process of the parenchymatous tissue of the Bamboo Guadua angustifolia. The model exhibits a power-law distribution of avalanche sizes, with exponent -3.0 when the breaking thresholds are randomly distributed with uniform probability density. Hereby we show that the same exponent also holds when the breaking thresholds obey a broad set of Weibull distributions, and that the humidity decrements between successive avalanches (the equivalent to waiting times for this model) follow in all cases an exponential distribution. Moreover, the fraction of remaining junctures shows an exponential decay in time. In addition, introducing partial breakings and cumulative damages induces a crossover behavior between two power-laws in the histogram of avalanche sizes. This results support the idea that the Cell Network Model may be in the same universality class as the Random Fuse Model.

  4. Waiting time to pregnancy and pregnancy outcome among Danish workers in the textile, clothing, and footwear industries.

    PubMed

    Schaumburg, I; Boldsen, J L

    1992-06-01

    The relationship between time from planned to achieved pregnancy and pregnancy outcome has been studied in a group of 18,658 workers in the textile, clothing and footwear industries. Information on pregnancy outcome and delay in conception in the period 1979-84 was collected by self administered questionnaires in 1985. The response rate was 70.3%. During the study period there had been 5,171 live births and 708 spontaneous abortions. Information on delay in conception was collected in broad categories. The data were analysed by means of a newly developed statistical parametric model in order to collect all possible information from the highly grouped data. Median waiting time before a pregnancy which ended in spontaneous abortion was 1.68 times longer than median waiting time before a pregnancy leading to a live birth. There seems to be a correlation between the length of the waiting time and abortion. PMID:1496329

  5. Emergency Department Waiting Times (EDWaT): A Patient Flow Management and Quality of Care Rating mHealth Application.

    PubMed

    Househ, Mowafa; Yunus, Faisel

    2014-01-01

    Saudi hospital emergency departments (ED) have suffered from long waiting times, which have led to a delay in emergency patient care. The increase in the population of Saudi Arabia is likely to further stretch the healthcare services due to overcrowding leading to decreased healthcare quality, long patient waits, patient dissatisfaction, ambulance diversions, decreased physician productivity, and increased frustration among medical staff. This will ultimately put patients at risk for poor health outcomes. Time is of the essence in emergencies and to get to an ED that has the shortest waiting time can mean life or death for a patient, especially in cases of stroke and myocardial infarction. In this paper, we present our work on the development of a mHealth Application - EDWaT - that will: provide patient flow information to the emergency medical services staff, help in quick routing of patients to the nearest hospital, and provide an opportunity for patients to review and rate the quality of care received at an ED, which will then be forwarded to ED services administrators. The quality ratings will help patients to choose between two EDs with the same waiting time and distance from their location. We anticipate that the use of EDWaT will help improve ED wait times and the quality of care provision in Saudi hospitals EDs. PMID:25000058

  6. Lean-driven improvements slash wait times, drive up patient satisfaction scores.

    PubMed

    2012-07-01

    Administrators at LifePoint Hospitals, based in Brentwood, TN, used lean manufacturing techniques to slash wait times by as much as 30 minutes and achieve double-digit increases in patient satisfaction scores in the EDs at three hospitals. In each case, front-line workers took the lead on identifying opportunities for improvement and redesigning the patient-flow process. As a result of the new efficiencies, patient volume is up by about 25% at all three hospitals. At each hospital, the improvement process began with Kaizen, a lean process that involves bringing personnel together to flow-chart the current system, identify problem areas, and redesign the process. Improvement teams found big opportunities for improvement at the front end of the flow process. Key to the approach was having a plan up front to deal with non-compliance. To sustain improvements, administrators gather and disseminate key metrics on a daily basis. PMID:22838052

  7. Act-and-wait time-delayed feedback control of nonautonomous systems

    NASA Astrophysics Data System (ADS)

    Pyragas, Viktoras; Pyragas, Kestutis

    2016-07-01

    Act-and-wait modification of a time-delayed feedback control (TDFC) algorithm is proposed to stabilize unstable periodic orbits in nonautonomous dynamical systems. Due to periodical switching on and off the control perturbation, an infinite-dimensional function space of the TDFC system is reduced to the finite-dimensional state space. As a result the number of Floquet exponents defining the stability of the controlled orbit remains the same as for the control-free system. The values of these exponents can be effectively manipulated by the variation of control parameters. We demonstrate the advantages of the modification for the chaotic nonautonomous Duffing oscillator with diagonal and nondiagonal control matrices. In both cases very deep minima of the spectral abscissa of Floquet exponents have been attained. The advantage of the modification is particularly remarkable for the nondiagonal coupling; in this case the conventional TDFC fails, whereas the modified version works.

  8. Act-and-wait time-delayed feedback control of nonautonomous systems.

    PubMed

    Pyragas, Viktoras; Pyragas, Kestutis

    2016-07-01

    Act-and-wait modification of a time-delayed feedback control (TDFC) algorithm is proposed to stabilize unstable periodic orbits in nonautonomous dynamical systems. Due to periodical switching on and off the control perturbation, an infinite-dimensional function space of the TDFC system is reduced to the finite-dimensional state space. As a result the number of Floquet exponents defining the stability of the controlled orbit remains the same as for the control-free system. The values of these exponents can be effectively manipulated by the variation of control parameters. We demonstrate the advantages of the modification for the chaotic nonautonomous Duffing oscillator with diagonal and nondiagonal control matrices. In both cases very deep minima of the spectral abscissa of Floquet exponents have been attained. The advantage of the modification is particularly remarkable for the nondiagonal coupling; in this case the conventional TDFC fails, whereas the modified version works. PMID:27575117

  9. Wait Time Management Strategies for Scheduled Care: What Makes Them Succeed?

    PubMed Central

    Pomey, Marie-Pascale; Forest, Pierre-Gerlier; Sanmartin, Claudia; De Coster, Carolyn; Drew, Madeleine

    2010-01-01

    Objectives: To assess experts' perceptions of the contextual and local factors that promote or inhibit the implementation of waiting time management strategies (WTMS) in Canadian healthcare organizations. Methods: We conducted 16 semi-structured interviews and one focus group with individuals involved in WTMS at the federal, provincial or organizational level. Results: The most frequently cited local factor was physicians' participation. Physicians' leadership made the greatest difference in bringing resistant physicians on board. To be effective, however, local leadership had to be supported by senior management. Alignment of financial incentives between the contextual and local levels was also frequently cited, and interviewees stressed the importance of tools used to design, monitor, evaluate and prioritize WTMS. Conclusions: Finding the right balance between supportive resources and tools and an effective management system is a tough challenge. But achieving this balance will help reconcile contradictions between top-down and bottom-up WTMS. PMID:21286269

  10. Arrival time pattern and waiting time distribution of patients in the emergency outpatient department of a tertiary level health care institution of North India

    PubMed Central

    Tiwari, Yogesh; Goel, Sonu; Singh, Amarjeet

    2014-01-01

    Background: Emergency Department (ED) of tertiary health care institute in India is mostly overcrowded, over utilized and inappropriately staffed. The challenges of overcrowded EDs and ill-managed patient flow and admission processes result in excessively long waits for patients. Aim: The objective of the present study was to analyze the patient flow system by assessing the arrival and waiting time distribution of patients in an Emergency out Patient Department (EOPD). Materials and Methods: This short cross-sectional descriptive study was conducted in the EOPD of a Tertiary level health care Institution in North India in the month of May, 2011. The data was obtained from 591 patients, who were present in the EOPD during the month of May, 2011. The waiting time, inter arrival time between two consecutive patients were calculated in addition to the daily census data (discharge rate, admission rate and transfer out rates etc.) of the emergency. Results: Arrival time pattern of patients in the EOPD was highly stochastic with the peak arrival hours to be 9.00-12.00 h in which around 26.3% patients arrived in the EOPD. The primary waiting areas of patients included patients under observation (29.6%); waiting for routine diagnostic tests (16.4%) and waiting for discharge (14.6%). Around 71% patients were waiting due to reasons within emergency complex. Conclusion: The patient flow of the ED could only be addressed by multifaceted, multidisciplinary and hospital wide approach. PMID:25114424

  11. Transient dynamics and waiting time distribution of molecular junctions in the polaronic regime

    NASA Astrophysics Data System (ADS)

    Seoane Souto, R.; Avriller, R.; Monreal, R. C.; Martín-Rodero, A.; Levy Yeyati, A.

    2015-09-01

    We develop a theoretical approach to study the transient dynamics and the time-dependent statistics for the Anderson-Holstein model in the regime of strong electron-phonon coupling. For this purpose we adapt a recently introduced diagrammatic approach to the time domain. The generating function for the time-dependent charge transfer probabilities is evaluated numerically by discretizing the Keldysh contour. The method allows us to analyze the system evolution to the steady state after a sudden connection of the dot to the leads, starting from different initial conditions. Simple analytical results are obtained in the regime of very short times. We study in particular the apparent bistable behavior occurring for strong electron-phonon coupling, small bias voltages, and a detuned dot level. The results obtained are in remarkably good agreement with numerically exact results obtained by quantum Monte Carlo methods. We analyze the waiting time distribution and charge transfer probabilities, showing that only a single electron transfer is responsible for the rich structure found in the short-time regime. A universal scaling (independent of the model parameters) is found for the relative amplitude of the higher order current cumulants in the short-time regime, starting from an initially empty dot. We finally analyze the convergence to the steady state of the differential conductance and of the differential Fano factor at the inelastic threshold, which exhibits a peculiar oscillatory behavior.

  12. Analyzing the waiting time pattern for non-critical patients in the emergency department using six sigma approach

    NASA Astrophysics Data System (ADS)

    Majid, Noriza; Mohd Suradi, Nur Riza; Ahmad Sabri, Safura

    2013-04-01

    This study was conducted to examine the waiting time of non-critical patients in the Emergency Department (ED) of Universiti Kebangsaan Malaysia Medical Centre (UKMMC) using the approach of six sigma (6σ). The define phase is completed by obtaining customers' critical to quality in UKMMC using survey. In measure phase, data on patients to the ED of UKMMC in May 2009 were gathered. Subsequently, analysis phase is performed using cause-and-effect diagram to identify root causes of the problems. Finally, improvements are proposed based on the identified problems. Results show that waiting time is critical to quality for health services in the ED.

  13. Determinants of Patient Waiting Time in the General Outpatient Department of a Tertiary Health Institution in North Western Nigeria

    PubMed Central

    Oche, MO; Adamu, H

    2013-01-01

    Background: The amount of time a patient waits to be seen is one factor which affects utilization of healthcare services. Patients perceive long waiting times as barrier to actually obtaining services and keeping patients waiting unnecessarily can be a cause of stress for both patient and doctor. Aim: This study was aimed at assessing the determinants of patients’ waiting time in the general outpatient department (GOPD) of a tertiary health institution in northern Nigeria. Subjects and Methods: This descriptive cross-sectional study was carried out among new patients attending the GOPD of the Usmanu Danfodiyo University Teaching Hospital, Sokoto, North Western Nigeria. A structured questionnaire was used to elicit information from 100 patients who were recruited into the study using a convenience sampling method. Data collected were entered and analyzed using Statistical Package for Social Sciences version 17; Chi-square test was used to compare differences between proportions with the level of statistical significance set at 5% (P < 0.05). Results: Sixty-one percent (59/96) of the respondents waited for 90-180 min in the clinic, whereas 36.1% (35/96) of the patients spent less than 5 min with the doctor in the consulting room. The commonest reason for the long waiting time in the GOPD was the large number of patients with few healthcare workers. Conclusion: There is an urgent need to increase the number of health workers in the GOPDs which serves as the gate way to the hospital if the aims of the Millennium Development Goals are to be realized. PMID:24380014

  14. Prediction problem for target events based on the inter-event waiting time

    NASA Astrophysics Data System (ADS)

    Shapoval, A.

    2010-11-01

    In this paper we address the problem of forecasting the target events of a time series given the distribution ξ of time gaps between target events. Strong earthquakes and stock market crashes are the two types of such events that we are focusing on. In the series of earthquakes, as McCann et al. show [W.R. Mc Cann, S.P. Nishenko, L.R. Sykes, J. Krause, Seismic gaps and plate tectonics: seismic potential for major boundaries, Pure and Applied Geophysics 117 (1979) 1082-1147], there are well-defined gaps (called seismic gaps) between strong earthquakes. On the other hand, usually there are no regular gaps in the series of stock market crashes [M. Raberto, E. Scalas, F. Mainardi, Waiting-times and returns in high-frequency financial data: an empirical study, Physica A 314 (2002) 749-755]. For the case of seismic gaps, we analytically derive an upper bound of prediction efficiency given the coefficient of variation of the distribution ξ. For the case of stock market crashes, we develop an algorithm that predicts the next crash within a certain time interval after the previous one. We show that this algorithm outperforms random prediction. The efficiency of our algorithm sets up a lower bound of efficiency for effective prediction of stock market crashes.

  15. Are rare, long waiting times between rearrangement events responsible for the slowdown of the dynamics at the glass transition?

    NASA Astrophysics Data System (ADS)

    Ahn, Ji Won; Falahee, Bryn; Del Piccolo, Chiara; Vogel, Michael; Bingemann, Dieter

    2013-03-01

    The dramatic slowdown of the structural relaxation at the glass transition is one of the most puzzling features of glass dynamics. Single molecule orientational correlation times show this strong Vogel-Fulcher-Tammann temperature dependence typical for glasses. Through statistical analysis of single molecule trajectories, we can identify individual glass rearrangement events in the vicinity of a probe molecule in the glass former poly(vinyl acetate) from 8 K below to 6 K above the glass transition temperature. We find that changes in the distribution of waiting times between individual glass rearrangement events are much less dramatic with temperature, the main difference being a small, but decisive number of increasingly long waiting times at lower temperatures. We notice similar individual, local relaxation events in molecular dynamics trajectories for a variety of glassy systems further from the glass transition, leading to waiting time distributions with similar features as those observed in the single molecule experiments. We show that these rare long waiting times are responsible for the dramatic increase in correlation time upon cooling.

  16. Poisson-process generalization for the trading waiting-time distribution in a double-auction mechanism

    NASA Astrophysics Data System (ADS)

    Cincotti, Silvano; Ponta, Linda; Raberto, Marco; Scalas, Enrico

    2005-05-01

    In this paper, empirical analyses and computational experiments are presented on high-frequency data for a double-auction (book) market. Main objective of the paper is to generalize the order waiting time process in order to properly model such empirical evidences. The empirical study is performed on the best bid and best ask data of 7 U.S. financial markets, for 30-stock time series. In particular, statistical properties of trading waiting times have been analyzed and quality of fits is evaluated by suitable statistical tests, i.e., comparing empirical distributions with theoretical models. Starting from the statistical studies on real data, attention has been focused on the reproducibility of such results in an artificial market. The computational experiments have been performed within the Genoa Artificial Stock Market. In the market model, heterogeneous agents trade one risky asset in exchange for cash. Agents have zero intelligence and issue random limit or market orders depending on their budget constraints. The price is cleared by means of a limit order book. The order generation is modelled with a renewal process. Based on empirical trading estimation, the distribution of waiting times between two consecutive orders is modelled by a mixture of exponential processes. Results show that the empirical waiting-time distribution can be considered as a generalization of a Poisson process. Moreover, the renewal process can approximate real data and implementation on the artificial stocks market can reproduce the trading activity in a realistic way.

  17. Using a Time Timer[TM] to Increase Appropriate Waiting Behavior in a Child with Developmental Disabilities

    ERIC Educational Resources Information Center

    Grey, Ian; Healy, Olive; Leader, Geraldine; Hayes, Deirdre

    2009-01-01

    This study aimed to examine the use of a predictive stimulus (Time Timer[TM]) and delayed reinforcement to increase appropriate waiting behavior in a child with developmental disabilities and problem behavior maintained by access to tangible items and activities. The study employed a changing criterion design across settings to gradually increase…

  18. Waiting cycle times and generalized Haldane equality in the steady-state cycle kinetics of single enzymes.

    PubMed

    Ge, Hao

    2008-01-10

    Enzyme kinetics are cyclic. A more realistic reversible three-step mechanism of the Michaelis-Menten kinetics is investigated in detail, and three kinds of waiting cycle times T, T+, T- are defined. It is shown that the mean waiting cycle times T, T+, and T- are the reciprocal of the steady-state cycle flux Jss, the forward steady-state cycle flux Jss+ and the backward steady-state cycle flux Jss, respectively. We also show that the distribution of T+ conditioned on T+waiting cycle time of T+ conditioned on T+waiting cycle times. Furthermore, we extend the same results to the n-step cycle, and finally, experimental and theoretically based evidence are also included. PMID:18069809

  19. COMPARATIVE STUDY ON LIVER TRANSPLANTATION WITH AND WITHOUT HEPATOCELLULAR CARCINOMA WITH CIRRHOSIS: ANALYSIS OF MELD, WAITING TIME AND SURVIVAL

    PubMed Central

    de FREITAS, Alexandre Coutinho Teixeira; SHIGUIHARA, Rafael Shinmi; MONTEIRO, Ruan Teles; PAZETO, Thiago Linck; COELHO, Júlio Cezar Uili

    2016-01-01

    Background : Liver transplantation is the usual treatment for hepatocellular carcinoma. Aim: To analyze the MELD score, waiting time and three month and one year survival for liver transplantation in cirrhotic patients affected by hepatocellular carcinoma or not. Methods : This was a retrospective, observational and analytical study of 93 patients submitted to liver transplantation. Results : There were 28 hepatocellular carcinoma and 65 non-hepatocellular carcinoma patients with no differences related to age and sex distribution. The main causes of cirrhosis on hepatocellular carcinoma were hepatitis C virus (57.1%) and hepatitis B virus (28.5%), more frequent than non-hepatocellular carcinoma patients, which presented 27.7% and 4.6% respectively. The physiological and exception MELD score on hepatocellular carcinoma were 11.9 and 22.3 points. On non-hepatocellular carcinoma, it was 19.4 points, higher than the physiological MELD and lower than the exception MELD on hepatocellular carcinoma. The waiting time for transplantation was 96.2 days for neoplasia, shorter than the waiting time for non-neoplasia patients, which was 165.6 days. Three month and one year survival were 85.7% and 78.6% for neoplasia patients, similar to non-neoplasia, which were 77% and 75.4%. Conclusion: Hepatocellular carcinoma patients presented lower physiological MELD score, higher exception MELD score and shorter waiting time for transplantation when compared to non-hepatocellular carcinoma patients. Three month and one year survival were the same between the groups. PMID:27120734

  20. Gender equity in the Brazilian physics community at the present time

    NASA Astrophysics Data System (ADS)

    Saitovitch, Elisa Maria Baggio; Barbosa, Marcia Cristina; Funchal, Renata Zukanovich; de Pinho, Suani Tavares Rubim; de Santana, Ademir Eugênio

    2015-12-01

    We present an overview of the advances and difficulties in gender equity in the Brazilian physics community at the present time. Recognizing that in some cases the level of gender equity has remained unchanged for a decade, the Commission for Relations and Gender of the Brazilian Physical Society plans not only to continue current activities but also seek new ways to address the issue, which will be discussed at the 2nd Brazilian Conference for Women in Physics, to be organized for 2015.

  1. Pancreatic cancer: Wait times from presentation to treatment and survival in a population-based study.

    PubMed

    Jooste, Valérie; Dejardin, Olivier; Bouvier, Véronique; Arveux, Patrick; Maynadie, Marc; Launoy, Guy; Bouvier, Anne-Marie

    2016-09-01

    Pancreatic survival is one of the worst in oncology. To what extent wait times affect outcomes in unknown No population-based study has previously explored patient and treatment delays among individuals with pancreatic cancer. The aim of this study was to estimate patient and treatment delays in patients with pancreatic cancer and to measure their association with survival in a nonselected population. All patients diagnosed with pancreatic cancer for the first time between 2009 and 2011 and registered in two French digestive cancer registries were included. Patient delay (time from onset of symptoms until the first consultation categorized into <1 or ≥1 month), and treatment delay (time between the first consultation and treatment categorized into less or more than 29 days, the median time) were collected. Overall delay was used to test associations between survival and the timeliness of care by combining patient delay and treatment delay. Patient delay was longer than 1 month in 46% of patients. A patient delay longer than one month was associated with the absence of jaundice (p < 0.001) and the presence of metastasis (p = 0.003). After adjusting for other covariates, such as symptoms and treatment, the presence of metastasis was negatively associated with treatment delay longer than 29 days (p = 0.025). After adjustment for other covariates, especially metastatic dissemination and the result of the resection, overall delay was not significantly associated with prognosis. We found little evidence to suggest that timely care was associated with the survival of patients. PMID:27130333

  2. Access to public healthcare services and waiting times for patients with chronic nonmalignant pain: feedback from a tertiary pain clinic.

    PubMed

    Triva, Petra; Jukić, Marko; Puljak, Livia

    2013-03-01

    Evaluation of healthcare services by patients is an essential component of quality improvement. We studied association between patient satisfaction and accessibility of healthcare services to patients with chronic nonmalignant pain. A hundred patients from the Pain Clinic, Split University Hospital Center, Split, Croatia, completed a 27-item questionnaire about their condition, duration of chronic pain treatment, access to healthcare, waiting times for various healthcare services, and their satisfaction with the pain clinic and health system. Patients were referred to the pain clinic after median of 4.5 years of chronic nonmalignant pain duration. Median waiting time for pain clinic appointment, seeing a specialist and performing diagnostic procedures was 10, 30 and 90 days, respectively. However, some patients waited for an appointment to a specialist and diagnosis for up to one year. Negative association was found between waiting time for pain clinic appointment and healthcare system grade (r = -0.34, P = 0.02). Patient suggestions for improving pain clinic were more staff, better approach to each patient, and better organization. In conclusion, access to public healthcare for patients with chronic nonmalignant pain should be better to improve patient satisfaction and provide better care. PMID:23837276

  3. Wait Time from Suspicion to Surgery for Breast Cancer in Manitoba

    PubMed Central

    Carpenter-Kellett, Tara; Lambert, Pascal; Musto, Grace; Turner, Donna; Cooke, Andrew

    2016-01-01

    Introduction: Breast cancer (BC) is the most common cancer in women. The pathway for its diagnosis and treatment is relatively standardized. Nevertheless, there can be significant delays affecting the journey. The aim of this retrospective study is to describe the BC wait times (WT) from suspicion to first surgery in Manitoba and to examine factors associated with WT variability. Methods: The cohort is composed of patients with stages I-III breast cancer who were diagnosed between September 1, 2009, and August 31, 2010, and referred to a cancer center. Patients’ journeys were tracked and divided into three sequential intervals from suspicion to first diagnostic test, from first diagnostic test to diagnosis and from diagnosis to first surgery. Results: Four hundred and four patients were included of whom 134 presented through the screening program. There was no difference between the study cohort and population data from the provincial Cancer Registry concerning the distribution of age, stage of cancer or residence. The median WT from suspicion to surgery was 78 days. In the screen-detected group (SD), a difference in median WT from suspicion to first diagnostic test was found for distance. This finding was first to test location, where those who travel less had longer WT than those who have longer journeys. Patients who went to centers that offer both imaging and biopsy services, even if the required test is imaging only, had to wait longer than those who went to centers that provide imaging only. SD patients needing more than one diagnostic test had a longer WT from the first test to pathological diagnosis if the first test did not include a biopsy. Patients who were seen by surgeons before final pathological diagnosis had a shorter WT from diagnosis to first surgery than those who had the surgical consult after tissue diagnosis was made. A delay to surgery was observed in the whole cohort if a plastic surgeon is required in addition to the surgical oncologist

  4. Improving Customer Waiting Time at a DMV Center Using Discrete-Event Simulation

    NASA Technical Reports Server (NTRS)

    Arnaout, Georges M.; Bowling, Shannon

    2010-01-01

    Virginia's Department of Motor Vehicles (DMV) serves a customer base of approximately 5.6 million licensed drivers and ID card holders and 7 million registered vehicle owners. DMV has more daily face-to-face contact with Virginia's citizens than any other state agency [1]. The DMV faces a major difficulty in keeping up with the excessively large customers' arrival rate. The consequences are queues building up, stretching out to the entrance doors (and sometimes even outside) and customers complaining. While the DMV state employees are trying to serve at their fastest pace, the remarkably large queues indicate that there is a serious problem that the DMV faces in its services, which must be dealt with rapidly. Simulation is considered as one of the best tools for evaluating and improving complex systems. In this paper, we use it to model one of the DMV centers located in Norfolk, VA. The simulation model is modeled in Arena 10.0 from Rockwell systems. The data used is collected from experts of the DMV Virginia headquarter located in Richmond. The model created was verified and validated. The intent of this study is to identify key problems causing the delays at the DMV centers and suggest possible solutions to minimize the customers' waiting time. In addition, two tentative hypotheses aiming to improve the model's design are tested and validated.

  5. Dedicated Pediatricians in Emergency Department: Shorter Waiting Times and Lower Costs

    PubMed Central

    Melo, Manuel Rocha; Ferreira-Magalhães, Manuel; Flor-Lima, Filipa; Rodrigues, Mariana; Severo, Milton; Almeida-Santos, Luis; Caldas-Afonso, Alberto; Barros, Pedro Pita; Ferreira, António

    2016-01-01

    Background Dedicated pediatricians in emergency departments (EDs) may be beneficial, though no previous studies have assessed the related costs and benefits/harms. We aimed to evaluate the net benefits and costs of dedicated emergency pediatricians in a pediatric ED. Methods Cost-consequences analysis of visits to a pediatric ED of a tertiary hospital. Two pediatric ED Medical Teams (MT) were compared: MT-A (May–September 2012), with general pediatrics physicians only; and MT-B (May–September 2013), with emergency dedicated pediatricians. The main outcomes analyzed were relevant clinical outcomes, patient throughput time and costs. Results We included 8,694 children in MT-A and 9,417 in MT-B. Medication use in the ED increased from 42.3% of the children in MT-A to 49.6% in MT-B; diagnostic tests decreased from 24.2% in MT-A to 14.3% in MT-B. Hospitalization increased from 1.3% in MT-A to 3.0% in MT-B; however, there was no significant difference in diagnosis-related group relative weight of hospitalized children in MT-A and MT-B (MT-A, 0.979; MT-B, 1.075). No differences were observed in ED readmissions or in patients leaving without being seen by a physician. The patient throughput time was significantly shorter in MT-B, with faster times to first medical observation. Within the cost domains analyzed, the total expenditures per children observed in the ED were 16% lower in MT-B: 37.87 euros in MT-A; 31.97 euros in MT-B. Conclusion The presence of dedicated emergency pediatricians in a pediatric ED was associated with significantly lower waiting times in the ED, reduced costs, and similar clinical outcomes. PMID:27564093

  6. Patients' Perspectives on Wait Times and the Referral-Consultation Process While Attending a Tertiary Diabetes and Endocrinology Centre: Is Econsultation an Acceptable Option?

    PubMed

    Keely, Erin; Traczyk, Lara; Liddy, Clare

    2015-08-01

    The goal of this study was to establish patients' perspectives on the acceptability of wait times, the impact of wait times on their health and the possibility of using electronic consultations (eConsultations) to avoid visits to specialists. A 2-stage patient survey (self-administered and with a follow-up telephone call) and a chart audit was conducted on a sequential sample of patients attending their initial consultations in a tertiary diabetes and endocrinology centre. Patients' perspectives on actual and ideal wait times, the impact of waiting for access, the effectiveness of the referral-consultation process and attitudes toward eConsultations as an alternative to traditional referral-consultations were collected. The study involved 101 patients (22% for diabetes, 78% for endocrinologic conditions), whose comments were collated and categorized. Of the 101 patients who completed the survey, 61 also completed telephone interviews. The average wait time was 19 weeks; the median 10 weeks. More than 30% of patients waited longer than 6 months and 6% waited longer than 1 year. Overall, 90% of patients thought that the maximum wait time should be less than 3 months. While waiting, 58% of patients worried about a serious undiagnosed disease, 30% found their symptoms had affected their daily activities and 24% had to miss work or school due to symptoms. Of the patients, 46% considered eConsultation a viable alternative to face-to-face visits. Excessive wait times for specialist care remain barriers and have negative impacts on patients. Wait times significantly exceeded times patients considered acceptable. eConsultations provide acceptable alternatives for many patients, and they reduced the number of patients requiring traditional consultations. PMID:25797111

  7. Diffusion entropy and waiting time statistics of hard-x-ray solar flares

    NASA Astrophysics Data System (ADS)

    Grigolini, Paolo; Leddon, Deborah; Scafetta, Nicola

    2002-04-01

    We show at work a technique of scaling detection based on evaluating the Shannon entropy of the diffusion process obtained by converting the time series under study into trajectories. This method, called diffusion entropy, affords information that cannot be derived from the direct evaluation of waiting times. We apply this method to the analysis of the distribution of time distance τ between two nearest-neighbor solar flares. This traditional part of the analysis is based on the direct evaluation of the distribution function ψ(τ), or of the probability Ψ(τ), that no time distance smaller than a given τ is found. We adopt the paradigm of the inverse power-law behavior, and we focus on the determination of the inverse power index μ, without ruling out different asymptotic properties that might be revealed, at larger scales, with the help of richer statistics. We then use the DE method, with three different walking rules, and we focus on the regime of transition to scaling. This regime of transition and the value of the scaling parameter itself, δ, depends on the walking rule adopted, a property of interest to shed light on the slow process of transition from dynamics to thermodynamics often occurring under anomalous statistical conditions. With the first two rules the transition regime occurs throughout a large time interval, and the information contained in the time series is transmitted, to a great extent, to it, as well as to the scaling regime. By using the third rule, on the contrary, the same information is essentially conveyed to the scaling regime, which, in fact, emerges very quickly after a fast transition process. We show that the DE method not only causes to emerge the long-range correlation with a given μ<3, and so a basin of attraction different from the ordinary Gaussian one, but it also reveals the presence of memory effects induced by the time dependence of the solar flare rate. When this memory is annihilated by shuffling, the scaling

  8. Diffusion entropy and waiting time statistics of hard-x-ray solar flares.

    PubMed

    Grigolini, Paolo; Leddon, Deborah; Scafetta, Nicola

    2002-04-01

    We show at work a technique of scaling detection based on evaluating the Shannon entropy of the diffusion process obtained by converting the time series under study into trajectories. This method, called diffusion entropy, affords information that cannot be derived from the direct evaluation of waiting times. We apply this method to the analysis of the distribution of time distance tau between two nearest-neighbor solar flares. This traditional part of the analysis is based on the direct evaluation of the distribution function psi(tau), or of the probability Psi(tau), that no time distance smaller than a given tau is found. We adopt the paradigm of the inverse power-law behavior, and we focus on the determination of the inverse power index mu, without ruling out different asymptotic properties that might be revealed, at larger scales, with the help of richer statistics. We then use the DE method, with three different walking rules, and we focus on the regime of transition to scaling. This regime of transition and the value of the scaling parameter itself, delta, depends on the walking rule adopted, a property of interest to shed light on the slow process of transition from dynamics to thermodynamics often occurring under anomalous statistical conditions. With the first two rules the transition regime occurs throughout a large time interval, and the information contained in the time series is transmitted, to a great extent, to it, as well as to the scaling regime. By using the third rule, on the contrary, the same information is essentially conveyed to the scaling regime, which, in fact, emerges very quickly after a fast transition process. We show that the DE method not only causes to emerge the long-range correlation with a given mu < 3, and so a basin of attraction different from the ordinary Gaussian one, but it also reveals the presence of memory effects induced by the time dependence of the solar flare rate. When this memory is annihilated by shuffling, the

  9. Waiting Time for Coronal Preparation and the Influence of Different Cements on Tensile Strength of Metal Posts

    PubMed Central

    Oliveira, Ilione Kruschewsky Costa Sousa; Arsati, Ynara Bosco de Oliveira Lima; Basting, Roberta Tarkany; França, Fabiana Mantovani Gomes

    2012-01-01

    This study aimed to assess the effect of post-cementation waiting time for core preparation of cemented cast posts and cores had on retention in the root canal, using two different luting materials. Sixty extracted human canines were sectioned 16 mm from the root apex. After cast nickel-chromium metal posts and cores were fabricated and luted with zinc phosphate (ZP) cement or resin cement (RC), the specimens were divided into 3 groups (n = 10) according to the waiting time for core preparation: no preparation (control), 15 minutes, or 1 week after the core cementation. At the appropriate time, the specimens were subjected to a tensile load test (0.5 mm/min) until failure. Two-way ANOVA (time versus cement) and the Tukey tests (P < 0.05) showed significantly higher (P < 0.05) tensile strength values for the ZP cement groups than for the RC groups. Core preparation and post-cementation waiting time for core recontouring did not influence the retention strength. ZP was the best material for intraradicular metal post cementation. PMID:22291705

  10. Prototype of a Questionnaire and Quiz System for Supporting Increase of Health Awareness During Wait Time in Dispensing Pharmacy

    NASA Astrophysics Data System (ADS)

    Toda, Takeshi; Chen, Poa-Min; Ozaki, Shinya; Ideguchi, Naoko; Miyaki, Tomoko; Nanbu, Keiko; Ikeda, Keiko

    For quit-smoking clinic and its campaign, there was a need for pharmacists to investigate pediatric patient's parent consciousness to tobacco harm utilizing wait time in a pediatric dispensing pharmacy. In this research, we developed the questionnaire and quiz total system using the tablet for user interface, in which people can easily answer the questionnaire/quiz and quickly see the total results on the spot in order to enhance their consciousness to the tobacco harm. The system also provides their tobacco dependence level based on the questionnaire results and some advice for their health and dietary habits due to the tobacco dependence level. From a field trial with one hundred four examinees in the pediatric dispensing pharmacy, the user interface was useful compared to conventional questionnaire form. The system could enhance their consciousness to tobacco harm and make their beneficial use of waiting time in dispensing pharmacy. Some interesting suggestions for improvement and new services were also obtained.

  11. Understanding waiting lists as the matching of surgical capacity to demand: are we wasting enough surgical time?

    PubMed

    Pandit, J J; Pandit, M; Reynard, J M

    2010-06-01

    If surgical 'capacity' always matched or exceeded 'demand' then there should be no waiting lists for surgery. However, understanding what is meant by 'demand', 'capacity' and 'matched' requires some mathematical concepts that we outline in this paper. 'Time' is the relevant measure: 'demand' for a surgical team is best understood as the total min required for the surgery booked from outpatient clinics every week; and 'capacity' is the weekly operating time available. We explain how the variation in demand (not just the mean demand) influences the analysis of optimum capacity. However, any capacity chosen in this way is associated with only a likelihood (that is, a probability rather than certainty) of absorbing the prevailing demand. A capacity that suitably absorbs the demand most of the time (for example, > 80% of weeks) will inevitably also involve considerable waste (that is, many weeks in which there is spare, unused capacity). Conversely, a level of capacity chosen to minimise wasted time will inevitably cause an increase in size of the waiting list. Thus the question of how to balance demand and capacity is intimately related to the question of how to balance utilisation and waste. These mathematical considerations enable us to consider objectively how to manage the waiting list. They also enable us critically to analyse the extent to which philosophies adopted by the National Health Service (such as 'Lean' or 'Six Sigma') will be successful in matching surgical capacity to demand. PMID:20565395

  12. Triggering and synchronization of stick slip: Waiting times and frequency-energy distribution

    NASA Astrophysics Data System (ADS)

    Chelidze, T.; Lursmanashvili, O.; Matcharashvili, T.; Devidze, M.

    2006-10-01

    if the direct component of voltage is larger than the periodic one. Synchronization affects not only waiting times, but also frequency-energy distribution: i. the energy of bursts emitted in synchronized mode have much less scatter than in the absence of the periodic forcing, ii. the sudden decrease of synchronizing forcing is followed by acoustic burst of much larger energy than during forcing. The elementary theory of EM triggering and synchronization is given: the effects are explained by the action of EM ponderomotive (electrostriction) forces, which modify Coulomb stress similar to the well known pore pressure model. The formalism of transition from 1:2 to 1:1 synchronization is considered.

  13. Pigeons' wait-time responses to transitions in interfood-interval duration: Another look at cyclic schedule performance

    PubMed Central

    Higa, Jennifer J.; Thaw, Jean M.; Staddon, John E. R.

    1993-01-01

    Recent developments reveal that animals can rapidly learn about intervals of time. We studied the nature of this fast-acting process in two experiments. In Experiment 1 pigeons were exposed to a modified fixed-time schedule, in which the time between food rewards (interfood interval) changed at an unpredictable point in each session, either decreasing from 15 to 5 s (step-down) or increasing from 15 to 45 s (step-up). The birds were able to track under both conditions by producing postreinforcement wait times proportional to the preceding interfood-interval duration. However, the time course of responding differed: Tracking was apparently more gradual in the step-up condition. Experiment 2 studied the effect of having both kinds of transitions within the same session by exposing pigeons to a repeating (cyclic) sequence of the interfood-interval values used in Experiment 1. Pigeons detected changes in the input sequence of interfood intervals, but only for a few sessions—discrimination worsened with further training. The dynamic effects we observed do not support a linear waiting process of time discrimination, but instead point to a timing mechanism based on the frequency and recency of prior interfood intervals and not the preceding interfood interval alone. PMID:16812693

  14. Interactive effects of musical and visual cues on time perception: an application to waiting lines in banks.

    PubMed

    Chebat, J C; Gelinas-Chebat, C; Filiatrault, P

    1993-12-01

    This study explores the interactive effects of musical and visual cues on time perception in a specific situation, that of waiting in a bank. Videotapes are employed to stimulate the situation; a 2 x 3 factorial design (N = 427) is used: 2 (high vs low) amounts of visual information and 2 (fast vs slow) levels of musical tempo in addition to a no-music condition. Two mediating variables are tested in the relation between the independent variables (musical and visual ones) and the dependent variable (perceived waiting time), mood and attention. Results of multivariate analysis of variance and a system of simultaneous equations show that musical cues and visual cues have no symmetrical effects: the musical tempo has a global (moderating) effect on the whole structure of the relations between dependent, independent, and mediating variables but has no direct influence on time perception. The visual cues affect time perception, the significance of which depends on musical tempo. Also, the "Resource Allocation Model of Time Estimation" predicts the attention-time relation better than Ornstein's "storage-size theory." Mood state serves as a substitute for time information with slow music, but its effects are cancelled with fast music. PMID:8284188

  15. No More Waits and Delays: Streamlining Workflow to Decrease Patient Time of Stay for Image-guided Musculoskeletal Procedures.

    PubMed

    Cheung, Yvonne Y; Goodman, Eric M; Osunkoya, Tomiwa O

    2016-01-01

    Long wait times limit our ability to provide the right care at the right time and are commonly products of inefficient workflow. In 2013, the demand for musculoskeletal (MSK) procedures increased beyond our department's ability to provide efficient and timely service. We initiated a quality improvement (QI) project to increase efficiency and decrease patient time of stay. Our project team included three MSK radiologists, one senior resident, one technologist, one administrative assistant/scheduler, and the lead technologist. We adopted and followed the Lean Six Sigma DMAIC (define, measure, analyze, improve, and control) approach. The team used tools such as voice of the customer (VOC), along with affinity and SIPOC (supplier, input, process, output, customer) diagrams, to understand the current process, identify our customers, and develop a project charter in the define stage. During the measure stage, the team collected data, created a detailed process map, and identified wastes with the value stream mapping technique. Within the analyze phase, a fishbone diagram helped the team to identify critical root causes for long wait times. Scatter plots revealed relationships among time variables. Team brainstorming sessions generated improvement ideas, and selected ideas were piloted via plan, do, study, act (PDSA) cycles. The control phase continued to enable the team to monitor progress using box plots and scheduled reviews. Our project successfully decreased patient time of stay. The highly structured and logical Lean Six Sigma approach was easy to follow and provided a clear course of action with positive results. (©)RSNA, 2016. PMID:27163595

  16. Longer waiting times for early stage cervical cancer patients undergoing radical hysterectomy are associated with diminished long-term overall survival

    PubMed Central

    Nanthamongkolkul, Kulisara

    2015-01-01

    Objective The aim of this study was to evaluate the impact of surgical waiting time on clinical outcome in early stage cervical cancer. Methods The cohort consisted of 441 patients diagnosed with stages IA2-IB1cervical cancer who underwent radical hysterectomy and pelvic node dissection. The patients were divided into two groups based on surgical waiting time. The associations between waiting time and other potential prognostic factors with clinical outcome were evaluated. Results The median surgical waiting time was 43 days. Deep stromal invasion (hazard ratio [HR], 2.5; 95% confidence interval [CI], 1.4 to 4.6; p=0.003) and lymph node metastasis (HR, 2.9; 95% CI, 1.3 to 6.7; p=0.026) were identified as independent prognostic factors for recurrence-free survival while no prognostic significance of surgical waiting time was found (p=0.677). On multivariate analysis of overall survival (OS), only deep stromal invasion (HR, 2.6; 95% CI, 1.3 to 5.0; p=0.009) and lymph node metastasis (HR, 3.6; 95% CI, 1.5 to 8.6; p=0.009) were identified as independent prognostic factors for OS. Although OS showed no significant difference between short (≤8 weeks) and long (>8 weeks) waiting times, multivariate analysis of OS with time-varying effects revealed that a waiting time longer than 8 weeks was associated with poorer long-term survival (after 5 years; HR, 3.4; 95% CI, 1.3 to 9.2; p=0.021). Conclusion A longer surgical waiting time was associated with diminished long-term OS of early stage cervical cancer patients. PMID:26404122

  17. Wait times to rheumatology care for patients with rheumatic diseases: a data linkage study of primary care electronic medical records and administrative data

    PubMed Central

    Widdifield, Jessica; Bernatsky, Sasha; Thorne, J. Carter; Bombardier, Claire; Jaakkimainen, R. Liisa; Wing, Laura; Paterson, J. Michael; Ivers, Noah; Butt, Debra; Lyddiatt, Anne; Hofstetter, Catherine; Ahluwalia, Vandana; Tu, Karen

    2016-01-01

    Background: The Wait Time Alliance recently established wait time benchmarks for rheumatology consultations in Canada. Our aim was to quantify wait times to primary and rheumatology care for patients with rheumatic diseases. Methods: We identified patients from primary care practices in the Electronic Medical Record Administrative data Linked Database who had referrals to Ontario rheumatologists over the period 2000-2013. To assess the full care pathway, we identified dates of symptom onset, presentation in primary care and referral from electronic medical records. Dates of rheumatologist consultations were obtained by linking with physician service claims. We determined the duration of each phase of the care pathway (symptom onset to primary care encounter, primary care encounter to referral, and referral to rheumatologist consultation) and compared them with established benchmarks. Results: Among 2430 referrals from 168 family physicians, 2015 patients (82.9%) were seen by 146 rheumatologists within 1 year of referral. Of the 2430 referrals, 2417 (99.5%) occurred between 2005 and 2013. The main reasons for referral were osteoarthritis (32.4%) and systemic inflammatory rheumatic diseases (30.6%). Wait times varied by diagnosis and geographic region. Overall, the median wait time from referral to rheumatologist consultation was 74 (interquartile range 27-101) days; it was 66 (interquartile range 18-84) days for systemic inflammatory rheumatic diseases. Wait time benchmarks were not achieved, even for the most urgent types of referral. For systemic inflammatory rheumatic diseases, most of the delays occurred before referral. Interpretation: Rheumatology wait times exceeded established benchmarks. Targeted efforts are needed to promote more timely access to both primary and rheumatology care. Routine linkage of electronic medical records with administrative data may help fill important gaps in knowledge about waits to primary and specialty care. PMID:27398365

  18. Overcrowding in medium-volume emergency departments: effects of aged patients in emergency departments on wait times for non-emergent triage-level patients.

    PubMed

    Knapman, Mary; Bonner, Ann

    2010-06-01

    This study aims to examine patient wait times from triaging to physician assessment in the emergency department (ED) for non-emergent patients, and to see whether patient flow and process (triage) are impacted by aged patients. A retrospective study method was used to analyse 185 patients in three age groups. Key data recorded were triage level, wait time to physician assessment and ED census. Multiple linear regression analysis was used to determine the strength of association with increased wait time. A longer average wait time for all patients occurred when there was an increase in the number of patients aged > or = 65 years in the ED. Further analysis showed 12.1% of the variation extending ED wait time associated with the triage process was explained by the number of patients aged > or = 65 years. In addition, extended wait time, overcrowding and numbers of those who left without being seen were strongly associated (P < 0.05) with the number of aged patients in the ED. The effects of aged patients on ED structure and process have significant implications for nursing. Nursing process and practice sets clear responsibilities for nursing to ensure patient safety. However, the impact of factors associated with aged patients in ED, nursing's role and ED process can negatively impact performance expectations and requires further investigation. PMID:20618543

  19. [The significance of early evaluation of outpatient integrated care in psychiatry taking patients' waiting time as an example].

    PubMed

    Hausen, Anita; Glaeske, Gerd

    2014-03-01

    Quality indicators are widely used instruments of quality assurance measures to illustrate/document/take on record output variables. We here want to review and discuss the significance of quality indicators in outpatient integrated psychiatric care. Taking patient waiting time as an example, we want to discuss the challenges and difficulties to make clear statements about achievements in outpatient psychiatric care, and what parameters determine (or temper) these results and statements. As a conclusion, we strongly suggest early evaluation in the implementation of new ways and structures of patient care to prevent adverse outcomes by deficient or erroneous use of quality indicators. PMID:24089314

  20. The effectiveness of service delivery initiatives at improving patients' waiting times in clinical radiology departments: a systematic review.

    PubMed

    Olisemeke, B; Chen, Y F; Hemming, K; Girling, A

    2014-12-01

    We reviewed the literature for the impact of service delivery initiatives (SDIs) on patients' waiting times within radiology departments. We searched MEDLINE, EMBASE, CINAHL, INSPEC and The Cochrane Library for relevant articles published between 1995 and February, 2013. The Cochrane EPOC risk of bias tool was used to assess the risk of bias on studies that met specified design criteria. Fifty-seven studies met the inclusion criteria. The types of SDI implemented included extended scope practice (ESP, three studies), quality management (12 studies), productivity-enhancing technologies (PETs, 29 studies), multiple interventions (11 studies), outsourcing and pay-for-performance (one study each). The uncontrolled pre- and post-intervention and the post-intervention designs were used in 54 (95%) of the studies. The reporting quality was poor: many of the studies did not test and/or report the statistical significance of their results. The studies were highly heterogeneous, therefore meta-analysis was inappropriate. The following type of SDIs showed promising results: extended scope practice; quality management methodologies including Six Sigma, Lean methodology, and continuous quality improvement; productivity-enhancing technologies including speech recognition reporting, teleradiology and computerised physician order entry systems. We have suggested improved study design and the mapping of the definitions of patient waiting times in radiology to generic timelines as a starting point for moving towards a situation where it becomes less restrictive to compare and/or pool the results of future studies in a meta-analysis. PMID:24888629

  1. [Effect of waiting time for radiotherapy on five-year overall survival in women with cervical cancer, 1995-2010].

    PubMed

    Nascimento, Maria Isabel do; Silva, Gulnar Azevedo E

    2015-11-01

    Overall 5-year survival and factors associated with death were evaluated in a cohort of 342 women with cervical cancer referred to radiotherapy in the Baixada Fluminense, in Greater Metropolitan Rio de Janeiro State, Brazil. Overall 5-year survival was 25.3%, reaching 60.8% in women with stage IIA or less. The model adjusted by extended Cox proportional regression showed an increase in mortality risk for patients with stages IIB-IIIB (HR = 1.89; 95%CI: 1.214; 2.957) and IVA-IVB (HR = 5.78; 95%CI: 2.973; 11.265). Cytology in asymptomatic women (HR = 0.58; 95%CI: 0.362; 0.961) and referral for first consultation in an oncology service in the Baixada Fluminense (HR = 0.60; 95%CI: 0.418; 0.875) were the main protective factors identified by the study. Waiting time (> 60 versus ≤ 60 days) was not statistically significant, but a delay of 4 days worsened the outcome. The 60-day limit for initiating radiotherapy should be respected, because delay greater than 64 days showed a significant association between all waiting time cut-off points and 5-year mortality risk. PMID:26840822

  2. On the gap between an empirical distribution and an exponential distribution of waiting times for price changes in a financial market

    NASA Astrophysics Data System (ADS)

    Sazuka, Naoya

    2007-03-01

    We analyze waiting times for price changes in a foreign currency exchange rate. Recent empirical studies of high-frequency financial data support that trades in financial markets do not follow a Poisson process and the waiting times between trades are not exponentially distributed. Here we show that our data is well approximated by a Weibull distribution rather than an exponential distribution in the non-asymptotic regime. Moreover, we quantitatively evaluate how much an empirical data is far from an exponential distribution using a Weibull fit. Finally, we discuss a transition between a Weibull-law and a power-law in the long time asymptotic regime.

  3. While We Wait for Life, Life Passes: The Time Metaphors Questionnaire-Short Form.

    PubMed

    Sobol-Kwapinska, Malgorzata; Przepiorka, Aneta; Nosal, Czeslaw

    2016-01-01

    The aim of the present study was to develop a short version of the Time Metaphors Questionnaire (TMQ; Sobol-Kwapinska & Nosal, 2009 ). The original TMQ consists of 95 items and was designed to measure time conceiving. Because completing the TMQ is very time-consuming, this research develops a short form of this questionnaire-Time Metaphors Questionnaire-Short Form (TMQ-SF). A sample of 990 Polish adults completed the TMQ. One-half of the sample was used to construct the TMQ-SF by selecting items based on the exploratory factor analysis. The other half of the sample was used to cross-validate the factorial structure of the TMQ-SF by means of confirmatory factor analysis. The TMQ-SF presented high internal consistency and a clear three-factor structure. The convergent and discriminant validity were assessed based on comparison with the Big Five factors of personality, satisfaction with life, positive and negative affect, time perspective, and mindfulness. PMID:27410054

  4. Team effort identifies opportunities to reduce wait times, improve safety for patients.

    PubMed

    2013-07-01

    The ED at Avera Marshall Regional Medical Center in Marshall, MN, has been able to implement a number of improvements in its throughput process by holding monthly "quick hits" meetings aimed at identifying opportunities for improvement and potential solutions. Among the improvements that grew out of this process is a 12-minute dent in the ED's average decision-to-admit times. Administrators say a collaborative culture has been key to keeping the meetings positive and productive. The "quick hits" meetings typically included nurses, an ED physician, two representatives from the hospital's quality department, and representatives from lab or X-ray as needed. The ED director scheduled the meetings during the morning hours when the ED is typically not busy, and the physician has time to attend. Decision-to-admit times were reduced by giving charge nurses an earlier notification when patients presenting to the ED were likely to be admitted. PMID:23828969

  5. Waiting for Paternity: An Observational Study of the Timing of Fatherhood.

    ERIC Educational Resources Information Center

    Neville, Brian

    The aim of this study was to examines the effects of life-span contextual variation on father-child relationships. Sixty families in which both parents were either younger than 26 or older than 29 when they began childbearing, and whose oldest or only child was between the ages of 3 and 5 at the time of the study participated. Questionnaires were…

  6. A Critical Analysis of the Role of Wait Time in Classroom Interactions and the Effects on Student and Teacher Interactional Behaviours

    ERIC Educational Resources Information Center

    Ingram, Jenni; Elliott, Victoria

    2016-01-01

    Extending the pauses between teachers' and students' turns (wait time) has been recommended as a way of improving classroom learning. Drawing on the Conversation Analysis literature on classroom interactions alongside extracts of classroom interactions, the relationship between these pauses and the interactional behaviour of teachers and students…

  7. The Effect of the Transition to Home Monitoring for the Diagnosis of OSAS on Test Availability, Waiting Time, Patients' Satisfaction, and Outcome in a Large Health Provider System

    PubMed Central

    Etzioni, Tamar; Fliss, Dan; Pillar, Giora; Shapira, Chen

    2014-01-01

    During 2009, the Haifa district of Clalit Health Services (CHS) has switched from in-lab polysomnography (PSG) to home studies for the diagnosis of obstructive sleep apnea (OSA). We assessed the effects of this change on accessibility, waiting time, satisfaction, costs, and CPAP purchase by the patients. Data regarding sleep studies, CPAP purchase, and waiting times were collected retrospectively from the computerized database of CHS. Patients' satisfaction was assessed utilizing a telephone questionnaire introduced to a randomized small sample of 70 patients. Comparisons were made between 2007 and 2008 (in-lab PSGs) and 2010 and 2011 (when most studies were ambulatory). Of about 650000 insured individuals in the Haifa district of CHS, 1471 sleep studies were performed during 2007-2008 compared to 2794 tests during 2010-2011. The average waiting time was 9.9 weeks in 2007-2008 compared to 1.1 weeks in 2010-2011 (P < 0.05). 597 CPAPs were purchased in 2007-2008 compared to 831 in 2010-2011. The overall patients' satisfaction was similar, but discomfort tended to be higher in the in-laboratory group (4.1 vs 2.7 in a scale of 0–10; P = 0.11). Switching to ambulatory diagnosis improved the test accessibility and reduced the waiting times. Patients' satisfaction remained similarly high. The total direct cost of OSA management was reduced. PMID:24876974

  8. ON THE BRIGHTNESS AND WAITING-TIME DISTRIBUTIONS OF A TYPE III RADIO STORM OBSERVED BY STEREO/WAVES

    SciTech Connect

    Eastwood, J. P.; Hudson, H. S.; Krucker, S.; Bale, S. D.; Wheatland, M. S.; Maksimovic, M.; Bougeret, J.-L.; Goetz, K.

    2010-01-10

    Type III solar radio storms, observed at frequencies below {approx}16 MHz by space-borne radio experiments, correspond to the quasi-continuous, bursty emission of electron beams onto open field lines above active regions. The mechanisms by which a storm can persist in some cases for more than a solar rotation whilst exhibiting considerable radio activity are poorly understood. To address this issue, the statistical properties of a type III storm observed by the STEREO/WAVES radio experiment are presented, examining both the brightness distribution and (for the first time) the waiting-time distribution (WTD). Single power-law behavior is observed in the number distribution as a function of brightness; the power-law index is {approx}2.1 and is largely independent of frequency. The WTD is found to be consistent with a piecewise-constant Poisson process. This indicates that during the storm individual type III bursts occur independently and suggests that the storm dynamics are consistent with avalanche-type behavior in the underlying active region.

  9. Power law signature of media exposure in human response waiting time distributions

    NASA Astrophysics Data System (ADS)

    Crane, Riley; Schweitzer, Frank; Sornette, Didier

    2010-05-01

    We study the humanitarian response to the destruction brought by the tsunami generated by the Sumatra earthquake of December 26, 2004, as measured by donations, and find that it decays in time as a power law ˜1/tα with α=2.5±0.1 . This behavior is suggested to be the rare outcome of a priority queuing process in which individuals execute tasks at a rate slightly faster than the rate at which new tasks arise. We believe this to be an empirical evidence documenting the recently predicted [G. Grinstein and R. Linsker, Phys. Rev. E 77, 012101 (2008)] regime, and provide additional independent evidence that suggests that this “highly attentive regime” arises as a result of the intense focus placed on this donation “task” by the media.

  10. Ambulatory health service users' experience of waiting time and expenditure and factors associated with the perception of low quality of care in Mexico

    PubMed Central

    2010-01-01

    Background A principal reason for low use of public health care services is the perception of inferior quality of care. Studying health service user (HSU) experiences with their care and their perception of health service quality is critical to understanding health service utilization. The aim of this study was to define reference points for some aspects of health care quality and to analyze which HSU experiences resulted in perceptions of overall low quality of care. Methods Data from the National Health Survey 2006 were used to compare the experiences of HSUs with their ambulatory care at Ministry of Health and affiliated institutions (MOH), social security institutions (SSI) and private institutions (PrivI). Reference points of quality of care related to waiting time and expenditure were defined for each of the three types of institutions by analyzing HSU experiences rated as 'acceptable'. A multivariable logistic regression model was used to identify the principal factors associated with the general perception of low quality of care. Results A total of 11,959 HSUs were included in the analysis, of whom 37.6% (n = 4,500) HSUs received care at MOH facilities; 31.2% (n = 3,730) used SSI and 31.2% (n = 3,729) PrivI. An estimated travel and waiting time of 10 minutes respectively was rated as acceptable by HSUs from all institutions. The differences between the waiting time rated as acceptable and the actual waiting time were the largest for SSI (30 min) in comparison to MoH (20 min) and PrivI (5 min) users. The principal factors associated with an overall perception of low quality of care are type of institution (OR 4.36; 95% CI 2.95-6.44), waiting time (OR 3.20; 95% CI 2.35-4.35), improvement of health after consultation (OR 2.93; CI 2.29-3.76) and consultation length of less than 20 minutes (2.03; 95% CI 1.60-2.57). Conclusions The reference points derived by the HSUs' own ratings are useful in identifying where quality improvements are required. Prioritizing the

  11. Impact of the single point of access referral system to reduce waiting times and improve clinical outcomes in an assistive technology service.

    PubMed

    Hosking, Jonathan; Gibson, Colin

    2016-07-01

    The introduction of a single point referral system that prioritises clients depending on case complexity and overcomes the need for re-admittance to a waiting list via a review system has been shown to significantly reduce maximum waiting times for a Posture and Mobility (Special Seating) Service from 102.0 ± 24.33 weeks to 19.2 ± 8.57 weeks (p = 0.015). Using this service model linear regression revealed a statistically significant improvement in the performance outcome of prescribed seating solutions with shorter Episode of Care completion times (p = 0.023). In addition, the number of Episodes of Care completed per annum was significantly related to the Episode of Care completion time (p = 0.019). In conclusion, it is recommended that it may be advantageous to apply this service model to other assistive technology services in order to reduce waiting times and to improve clinical outcomes. PMID:27098983

  12. Generic waiting lists for routine spinal surgery.

    PubMed

    Leach, P; Rutherford, S A; King, A T; Leggate, J R S

    2004-03-01

    National Health Service Hospitals are under pressure to reduce waiting lists within the constraints of a limited infrastructure. We implemented two systems to reduce waiting times for elective non-complex spinal surgery. The first of these was the introduction of managed generic waiting lists for both initial outpatient appointments and subsequent surgery. Thereafter, the MRI booking system was integrated with outpatient review appointments. Times from referral to first outpatient appointment and from scan to outpatient review and time on waiting list for surgery were analysed before and after implementation of these changes. Despite constant unit capacity there was a global decrease in waiting times. Before introduction of the generic waiting list, 37% of listed patients waited for more than 9 months; this figure fell to zero. Time from scan to outpatient review was 185 days before integration, 30 days after. Changes of this sort demand a quorum of consultants who will accept each others' recommendations. The generic waiting list will have impact only when there are large disparities in waiting times for different consultants. Targets are met at the expense of continuity of care. PMID:14996957

  13. Traffic-related air pollution in the community of San Ysidro, CA, in relation to northbound vehicle wait times at the US-Mexico border Port of Entry

    NASA Astrophysics Data System (ADS)

    Quintana, Penelope J. E.; Dumbauld, Jill J.; Garnica, Lynelle; Chowdhury, M. Zohir; Velascosoltero, José; Mota-Raigoza, Arturo; Flores, David; Rodríguez, Edgar; Panagon, Nicolas; Gamble, Jamison; Irby, Travis; Tran, Cuong; Elder, John; Galaviz, Vanessa E.; Hoffman, Lisa; Zavala, Miguel; Molina, Luisa T.

    2014-05-01

    The San Diego/Tijuana US-Mexico border crossing at the San Ysidro Port of Entry (POE) is the world's busiest international land border crossing (GSA, 2013). San Ysidro, California, is the US community immediately adjacent to the border crossing. More than 90% of San Ysidro residents are Hispanic, and the average household income is less than 60% of the San Diego regional average. This study investigated the San Ysidro POE as a source of traffic-related air pollutants in San Ysidro, especially in relation to wind direction and northbound vehicle wait times. The pollutants ultrafine particulate matter (UFP), black carbon (BC), and particulate matter <2.5 μm in diameter (PM2.5) were periodically sampled through the course of 2010 at four rooftop locations: one commercial establishment near the POE, two elementary schools in San Ysidro, and a coastal estuary reference site. Weather data from two nearby sites and northbound border wait times were also collected. Results indicate consistently higher daytime BC and UFP concentrations at the measurement sites near the POE. Pollution concentrations were higher during low wind speeds or when wind was blowing from the POE towards San Ysidro. In February, March and November measurements, black carbon pollution appeared to be significantly positively associated with the POE northbound wait times when the wind direction was blowing from the POE towards San Ysidro or during low wind speeds, but not when the wind direction was from the west/northwest towards the POE. This pilot study is the first to investigate the potential effect of the POE, especially the long northbound traffic delays, on the nearby community of San Ysidro. Disparities in traffic exposures are an environmental justice issue and this should be taken into account during planning and operation of POEs.

  14. Whittling Down the Wait Time: Exploring Models to Minimize the Delay from Initial Concern to Diagnosis and Treatment of Autism Spectrum Disorder.

    PubMed

    Gordon-Lipkin, Eliza; Foster, Jessica; Peacock, Georgina

    2016-10-01

    The process from initial concerns to diagnosis of autism spectrum disorder (ASD) can be a long and complicated process. The traditional model for evaluation and diagnosis of ASD often consists of long wait-lists and evaluations that result in a 2-year difference between the earliest signs of ASD and mean age of diagnosis. Multiple factors contribute to this diagnostic bottleneck, including time-consuming evaluations, cost of care, lack of providers, and lack of comfort of primary care providers to diagnose autism. This article explores innovative clinical models that have been implemented to address this as well as future directions and opportunities. PMID:27565363

  15. Waiting Online: A Review and Research Agenda.

    ERIC Educational Resources Information Center

    Ryan, Gerard; Valverde, Mireia

    2003-01-01

    Reviews 21 papers based on 13 separate empirical studies on waiting on the Internet, drawn from the areas of marketing, system response time, and quality of service studies. The article proposes an agenda for future research, including extending the range of research methodologies, broadening the definition of waiting on the Internet, and…

  16. ESTIMATES OF THE NUMBE R OF STRANDED PERSONS AND THE RESCUE WAITING TIME IN CASE OF LARGE-SCALE FLOODS WITH EFFECTIVENESS ANALYSIS OF THE MITIGATORY OPERATIONS

    NASA Astrophysics Data System (ADS)

    Ikeuchi, Koji; Ochi, Shigeo; Yasuda, Goro; Okamura, Jiro; Aono, Masashi

    In order to enhance the emergency preparedness for large-scale floods of the Ara River, we conducted flooded water surface calculation for many possible levee failure points an d categorized the flood patterns. We also conducted hearing survey from the National Police Agency, the Fire and Disaster Management Agency and the Defense Ministry about the number and the capacity of the rescue boats available as well as the estimated cycle time of the rescue operations. Employing these data, we constructed rescue simulation model and estimated the number of the stranded persons and the rescue waiting time. The damage mitigation effectiveness analysis of rescue operations, drainage pumps operations, and evacuation rate improving measures was conducted. The results of the analysis showed the proper operations of rescue and drainage pumps as well as achieving higher evacua tion rate can substantially decrease the number of the stranded persons 3 days, which is an important reference time for stranded persons' health, after the flooding.

  17. Contraceptive Equity

    PubMed Central

    Temkin, Elizabeth

    2007-01-01

    The Equity in Prescription Insurance and Contraceptive Coverage Act, introduced in Congress in 1997 and still unpassed, seeks to redress health insurers’ failure to pay for birth control as they pay for other prescription drugs, most paradoxically Viagra. In 1936 the International Workers Order (IWO), a fraternal society, became the first insurer to include contraception in its benefits package. A forerunner in the movement for prepaid medical care, the IWO offered its members primary care and contraceptive services for annual flat fees. Founded at a time when the legal status of contraception was in flux, the IWO’s Birth Control Center was the only such clinic to operate on an insurance system. Recent state laws and judicial actions have revived the IWO’s groundbreaking view of contraception as a basic preventive service deserving of insurance coverage. PMID:17761562

  18. Implementing wait-time reductions under Ontario government benchmarks (Pay-for-Results): a Cluster Randomized Trial of the Effect of a Physician-Nurse Supplementary Triage Assistance team (MDRNSTAT) on emergency department patient wait times

    PubMed Central

    2013-01-01

    Background Internationally, emergency departments are struggling with crowding and its associated morbidity, mortality, and decreased patient and health-care worker satisfaction. The objective was to evaluate the addition of a MDRNSTAT (Physician (MD)-Nurse (RN) Supplementary Team At Triage) on emergency department patient flow and quality of care. Methods Pragmatic cluster randomized trial. From 131 weekday shifts (8:00–14:30) during a 26-week period, we randomized 65 days (3173 visits) to the intervention cluster with a MDRNSTAT presence, and 66 days (3163 visits) to the nurse-only triage control cluster. The primary outcome was emergency department length-of-stay (EDLOS) for patients managed and discharged only by the emergency department. Secondary outcomes included EDLOS for patients initially seen by the emergency department, and subsequently consulted and admitted, patients reaching government-mandated thresholds, time to initial physician assessment, left-without being seen rate, time to investigation, and measurement of harm. Results The intervention’s median EDLOS for discharged, non-consulted, high acuity patients was 4:05 [95th% CI: 3:58 to 4:15] versus 4:29 [95th% CI: 4:19–4:38] during comparator shifts. The intervention’s median EDLOS for discharged, non-consulted, low acuity patients was 1:55 [95th% CI: 1:48 to 2:05] versus 2:08 [95th% CI: 2:02–2:14]. The intervention’s median physician initial assessment time was 0:55 [95th% CI: 0:53 to 0:58] versus 1:21 [95th% CI: 1:18 to 1:25]. The intervention’s left-without-being-seen rate was 1.5% versus 2.2% for the control (p = 0.06). The MDRNSTAT subgroup analysis resulted in significant decreases in median EDLOS for discharged, non-consulted high (4:01 [95th% CI: 3:43–4:16]) and low acuity patients (1:10 95th% CI: 0:58–1:19]), as well as physician initial assessment time (0:25 [95th% CI: 0:23–0:26]). No patients returned to the emergency department after being discharged by the

  19. Waiting in Line: Low Income Families and the Search for Housing. Watching Out for Children in Changing Times.

    ERIC Educational Resources Information Center

    Philadelphia Citizens for Children and Youth, PA.

    The existing housing crisis for Philadelphia's low income families has been exacerbated by a decrease in the real income of these families over the past 10 years, a shortage of affordable housing during the same period, and the deterioration of much of the existing housing stock. "Watching Out for Children in Changing Times," a joint effort…

  20. The Relationship between Wait Time after Triage and Show Rate for Intake in a Nonurgent Student Population

    ERIC Educational Resources Information Center

    DiMino, John; Blau, Gary

    2012-01-01

    Ideally, students requesting services should be seen quickly at their university counseling center to increase the likelihood of a successful treatment outcome. However, in these times of ever-increasing demand for university counseling services and the challenges of securing resources to keep up with that demand, the reality of prompt…

  1. Wait, are you sad or angry? Large exposure time differences required for the categorization of facial expressions of emotion

    PubMed Central

    Du, Shichuan; Martinez, Aleix M.

    2013-01-01

    Abstract Facial expressions of emotion are essential components of human behavior, yet little is known about the hierarchical organization of their cognitive analysis. We study the minimum exposure time needed to successfully classify the six classical facial expressions of emotion (joy, surprise, sadness, anger, disgust, fear) plus neutral as seen at different image resolutions (240 × 160 to 15 × 10 pixels). Our results suggest a consistent hierarchical analysis of these facial expressions regardless of the resolution of the stimuli. Happiness and surprise can be recognized after very short exposure times (10–20 ms), even at low resolutions. Fear and anger are recognized the slowest (100–250 ms), even in high-resolution images, suggesting a later computation. Sadness and disgust are recognized in between (70–200 ms). The minimum exposure time required for successful classification of each facial expression correlates with the ability of a human subject to identify it correctly at low resolutions. These results suggest a fast, early computation of expressions represented mostly by low spatial frequencies or global configural cues and a later, slower process for those categories requiring a more fine-grained analysis of the image. We also demonstrate that those expressions that are mostly visible in higher-resolution images are not recognized as accurately. We summarize implications for current computational models. PMID:23509409

  2. Two-state theory of binned photon statistics for a large class of waiting time distributions and its application to quantum dot blinking

    SciTech Connect

    Volkán-Kacsó, Sándor

    2014-06-14

    A theoretical method is proposed for the calculation of the photon counting probability distribution during a bin time. Two-state fluorescence and steady excitation are assumed. A key feature is a kinetic scheme that allows for an extensive class of stochastic waiting time distribution functions, including power laws, expanded as a sum of weighted decaying exponentials. The solution is analytic in certain conditions, and an exact and simple expression is found for the integral contribution of “bright” and “dark” states. As an application for power law kinetics, theoretical results are compared with experimental intensity histograms from a number of blinking CdSe/ZnS quantum dots. The histograms are consistent with distributions of intensity states around a “bright” and a “dark” maximum. A gap of states is also revealed in the more-or-less flat inter-peak region. The slope and to some extent the flatness of the inter-peak feature are found to be sensitive to the power-law exponents. Possible models consistent with these findings are discussed, such as the combination of multiple charging and fluctuating non-radiative channels or the multiple recombination center model. A fitting of the latter to experiment provides constraints on the interaction parameter between the recombination centers. Further extensions and applications of the photon counting theory are also discussed.

  3. Wait Times Experienced by Lung Cancer Patients in the BC Southern Interior to Obtain Oncologic Care: Exploration of the Intervals from First Abnormal Imaging to Oncologic Treatment

    PubMed Central

    Chowdhury, Rezwan; Boyce, Andrew; Halperin, Ross

    2015-01-01

    Background: Lung cancer is associated with rapid disease progression, which can significantly progress over a duration of four to eight weeks. This study examines the time interval lung cancer patients from the interior of British Columbia (BC) experience while undergoing diagnostic evaluation, biopsy, staging, and preparation for treatment. Methods: A chart review of lung cancer patients (n=231) referred to the BC Cancer Agency Centre for the Southern Interior between January 1, 2010 and December 31, 2011 was performed. Time zero was defined as the date of the first abnormal chest imaging. Time intervals, expressed as median averages, to specialist consult, biopsy, oncologic referral, initial oncology consultation, and commencement of oncologic treatment were obtained. Results: The median time interval from first abnormal chest imaging to a specialist consultation was 18 days (interquartile range, IQR, 7-36). An additional nine days elapsed prior to biopsy in the form of bronchoscopy, CT-guided biopsy, or sputum cytology (median; IQR, 3-21); if lobectomy was required, 18 days elapsed (median; IQR, 9-28). Eight days were required for pathologic diagnosis and subsequent referral to the cancer centre (median; IQR, 3-16.5). Once referral was received, 10 days elapsed prior to consultation with either a medical or radiation oncologist (median, IQR 5-18). Finally, eight days was required for initiation of radiation and/or chemotherapy (median; IQR, 1-15). The median wait time from detection of lung cancer on imaging to oncologic treatment in the form of radiation and/or chemotherapy was 65.5 days (IQR, 41.5-104.3).  Interpretation: Patients in the BC Southern Interior experience considerable delays in accessing lung cancer care. During this time, the disease has the potential to significantly progress and it is possible that a subset of patients may lose their opportunity for curative intent treatment. PMID:26543688

  4. The Wait Calculation: The Broader Consequences of the Minimum Time from Now to Interstellar Destinations and its Significance to the Space Economy

    NASA Astrophysics Data System (ADS)

    Kennedy, A.

    This paper summarises the wait calculation [1] of interstellar voyagers which finds the minimum time to destination given exponential growth in the rate of travel available to a civilisation. The minimum time obliges stellar system colonisers to consider departure times a significant risk factor in their voyages since a departure then to a destination will beat a departure made at any other time before or after. Generalised conclusions will be drawn about the significant impact that departures to interstellar destinations before, at, or after the minimum time will have on the economic potential of missions and on the inevitability of competition between them. There will be no international law operating in interstellar space and an ability to escape predatory actions en route, or at the destination, can only be done by precise calculations of departure times. Social and economic forces affecting the factors in the growth equation are discussed with reference to the probability of accelerating growth reaching the technological Singularity and strengthening the growth incentive trap. Islamic banking practices are discussed as a credible alternative to compounding interest bearing paper for funding the space economy in the long term and for supporting stakeholder investment in such long term mission development. The paper considers the essential free productivity of the Earth's biosphere and the capital accumulations made possible by land productivity are essential components to a viable long term space economy and that research into re-creating the costless productivity of the biosphere at a destination will determine both the mission's ultimate success and provide means of returns for stakeholders during the long build up. Conclusions of these arguments suggest that the Icarus project should ignore a robotic interstellar mission concept and develop a manned colonising mission from now.

  5. Waiting times for the appearance of cytotoxic T-lymphocyte escape mutants in chronic HIV-1 infection

    SciTech Connect

    Liu Yi . E-mail: yiliu197@u.washington.edu; Mullins, James I.; Mittler, John E.

    2006-03-30

    The failure of HIV-1 to escape at some cytotoxic T-lymphocyte (CTL) epitopes has generally been explained in terms of viral fitness costs or ineffective or attenuated CTL responses. Relatively little attention has been paid to the evolutionary time required for escape mutants to be detected. This time is significantly affected by selection, mutation rates, the presence of other advantageous mutations, and the effective population size of HIV-1 in vivo (typically estimated to be {approx}10{sup 3} in chronically infected patients, though one study has estimated it to be {approx}10{sup 5}). Here, we use a forward simulator with experimentally estimated HIV-1 parameters to show that these delays can be substantial. For an effective population size of 10{sup 3}, even highly advantageous mutants (s = 0.5) may not be detected for a couple of years in chronically infected patients, while moderately advantageous escape mutants (s = 0.1) may not be detected for up to 10 years. Even with an effective population size of 10{sup 5}, a moderately advantageous escape mutant (s = 0.1) may not be detected in the population within 2 years if it has to compete with other selectively advantageous mutants. Stochastic evolutionary forces, therefore, in addition to viral fitness costs and ineffective or attenuated CTL responses, must be taken into account when assessing the selection of CTL escape mutations.

  6. OP30DIAGNOSTIC DELAY AND SURVIVAL IN HIGH GRADE GLIOMAS - EVIDENCE OF THE “WAITING TIME PARADOX”

    PubMed Central

    Aggarwal, Ajay; Herz, Naomi; Arkush, Leo; Short, Susan; Rees, Jeremy

    2014-01-01

    INTRODUCTION: We present a retrospective single centre study to determine whether delays in diagnosis in high grade glioma (HGG) impact on overall survival (OS). METHOD: Consecutive patients diagnosed with HGG at The National Hospital for Neurology and Neurosurgery, a single neuroscience centre in 2011 were reviewed. Route of referral and time from initial presentation to diagnosis were analysed and correlated with OS. RESULTS: 118 patients were studied, 92 had with glioblastoma (GBM). Diagnosis of GBM in patients presenting to emergency services was quicker than through outpatients (8 days vs 26 days, p < 0.0001), but these patients had significantly worse OS (181 days vs 386 days p = 0.0075 ). CONCLUSION: Earlier diagnosis is paradoxically associated with a worse OS in GBM. An “aggressive” phenotype with rapid symptomatic deterioration and hence emergency presentation is a poor prognostic factor not influenced by more rapid treatment or earlier diagnosis.

  7. Colour Consideration for Waiting areas in hospitals

    NASA Astrophysics Data System (ADS)

    Zraati, Parisa

    2012-08-01

    Colour is one the most important factors in the nature that can have some affects on human behaviour. Many years ago, it was proven that using colour in public place can have some affect on the users. Depend of the darkness and lightness; it can be vary from positive to negative. The research will mainly focus on the colour and psychological influences and physical factors. The statement of problem in this research is what is impact of colour usually applied to waiting area? The overall aim of the study is to explore the visual environment of hospitals and to manage the colour psychological effect of the hospital users in the waiting area by creating a comfortable, pleasant and cozy environment for users while spend their time in waiting areas. The analysisconcentrate on satisfaction and their interesting regarding applied colour in two private hospital waiting area in Malaysia.

  8. Evaluation of patients' attitudes to their care during oral and maxillofacial surgical outpatient consultations: the importance of waiting times and quality of interaction between patient and doctor.

    PubMed

    Dimovska, E O F; Sharma, S; Trebble, T M

    2016-06-01

    Knowing what patients think about their care is fundamental to the provision of an effective, quality service, and it can help to direct change and reduce costs. Much of the work in oral and maxillofacial departments concerns the treatment of outpatients, but as little is known about what they think about their care, we aimed to find out which aspects were associated with satisfaction. Consecutive patients (n=244) who attended the oral and maxillofacial outpatient department at Southampton University Hospital NHS Foundation Trust over a 7-day period were given a questionnaire to complete before and after their consultation. It included questions with Likert scale responses on environmental, procedural, and interactive aspects of the visit, and a 16-point scale to rank their priorities. A total of 187 patients (77%) completed the questionnaires. No association was found between expected (p=0.93) or actual (p=0.41) waiting times, and 90% of patients were satisfied with their visit. Seeing the doctor, having confidence in the treatment plan, being listened to, and the ability of the doctor to recognise their personal needs, were ranked as important. Environmental and procedural aspects were considered the least important. These findings may be of value in the development of services to improve patient-centred care. PMID:26994564

  9. Are disparities of waiting times for breast cancer care related to socio-economic factors? A regional population-based study (France).

    PubMed

    Ayrault-Piault, Stéphanie; Grosclaude, Pascale; Daubisse-Marliac, Laetitia; Pascal, Jean; Leux, Christophe; Fournier, Evelyne; Tagri, Anne-Delphine; Métais, Magali; Lombrail, Pierre; Woronoff, Anne-Sophie; Molinié, Florence

    2016-11-01

    The increasing number of breast cancer cases may induce longer waiting times (WT), which can be a source of anxiety for patients and may play a role in survival. The aim of this study was to examine the factors, in particular socio-economic factors, related to treatment delays. Using French Cancer Registry databases and self-administered questionnaires, we included 1,152 women with invasive non-metastatic breast cancer diagnosed in 2007. Poisson regression analysis was used to identify WTs' influencing factors. For 973 women who had a malignant tissue sampling, the median of overall WT between the first imaging procedure and the first treatment was 44 days (9 days for pathological diagnostic WT and 31 days for treatment WT). The medical factors mostly explained inequalities in WTs. Socio-economic and behavioral factors had a limited impact on WTs except for social support which appeared to be a key point. Better identifying the factors associated with increase in WTs will make it possible to develop further interventional or prospective studies to confirm their causal role in delay and at last reduce disparities in breast cancer management. PMID:27405647

  10. Waiting in the surgery.

    PubMed

    Fry, F

    1994-07-01

    The concise Oxford English Dictionary defines 'dilemma' as an argument forcing one to choose one of two alternatives, both of which are unfavourable. This is a situation that frequently confronts the general practitioner. This paper will present one practitioner's view on the subject of patients waiting to see the doctor. PMID:8060274

  11. Challenging "Waiting for Superman"

    ERIC Educational Resources Information Center

    Bruhn, Molle

    2014-01-01

    A group of New York City public school teachers, angry about the depiction of public schools in 'Waiting for Superman," decide to make their own film about the realities of the current education reform movement. They persevered even though they had no budget when they started and lacked a background in filmmaking. "The Inconvenient…

  12. Organ Type and Waiting Time

    MedlinePlus

    ... Liver Disease/Pediatric End-Stage Liver Disease). The system offers liver to candidates with the highest MELD/PELD scores first. Geographic factors are also taken into consideration. Please see ...

  13. History of Pay Equity Studies.

    ERIC Educational Resources Information Center

    Barbezat, Debra A.

    2002-01-01

    Traces the evolution of salary-equity studies over time, and how the findings have changed with regard to pay differences by gender and race/ethnicity. Reviews the literature on salary equity for both faculty and nonfaculty academic employees. (EV)

  14. Waiting for Water

    ERIC Educational Resources Information Center

    Lamson-Nussbaum, Jorie

    2013-01-01

    The author waits in the hot and oppressive air while dust devils are born and die over the newly plowed field. It is a dry spring and she prays for rain. The lupine beans withered to dry threads last week and the corn that sprouted in a green haze over the north field is turning to brown paper. However, driving north, the author discovers the Rum…

  15. Increasing Time and Enriching Learning for Greater Equity in Schools: Perspective from Two Community Funders

    ERIC Educational Resources Information Center

    Lopez, Janet; Rivera, Peter

    2015-01-01

    Foundations across the country engage in grantmaking to eliminate the opportunity and achievement gaps in K-12 public schools. Many of the strategies and investments that funders have supported in recent years focus not only on "more time" but also on "better use of time" in schools. This better use of time centers on outcomes…

  16. Pricing foreign equity option with stochastic volatility

    NASA Astrophysics Data System (ADS)

    Sun, Qi; Xu, Weidong

    2015-11-01

    In this paper we propose a general foreign equity option pricing framework that unifies the vast foreign equity option pricing literature and incorporates the stochastic volatility into foreign equity option pricing. Under our framework, the time-changed Lévy processes are used to model the underlying assets price of foreign equity option and the closed form pricing formula is obtained through the use of characteristic function methodology. Numerical tests indicate that stochastic volatility has a dramatic effect on the foreign equity option prices.

  17. Mapping individual differences in the experience of a waiting period.

    PubMed

    Sweeny, Kate; Andrews, Sara E

    2014-06-01

    Waiting for uncertain news, such as the outcome of a job interview or medical test, is a ubiquitous and difficult but little studied experience. We conducted a longitudinal examination, guided by the predictions of the uncertainty navigation model (Sweeny & Cavanaugh, 2012), to examine broad trends and individual differences in experiences during a consequential waiting period. Fifty students preparing for the California bar exam completed questionnaires at 6 time points: shortly before and after the exam, at 2 intermediate time points during the 4-month waiting period, and immediately before and after learning whether they passed. We identified key individual differences in the overall experience of a waiting period, such that dispositional optimists reported lower levels of anxiety and rumination on average, and defensive pessimists and people uncomfortable with uncertainty reported higher levels. Longitudinal growth curve modeling analyses suggested that waiting is most difficult at the start and end of a waiting period, although people maintained hope and optimism throughout the wait. These temporal trends were generally robust, although some individual differences emerged. These findings provide the first evidence regarding when and for whom waiting periods are most difficult and thus can serve as the basis for future investigations of waiting experiences. PMID:24841102

  18. Protocol to Exploit Waiting Resources for UASNs.

    PubMed

    Hung, Li-Ling; Luo, Yung-Jeng

    2016-01-01

    The transmission speed of acoustic waves in water is much slower than that of radio waves in terrestrial wireless sensor networks. Thus, the propagation delay in underwater acoustic sensor networks (UASN) is much greater. Longer propagation delay leads to complicated communication and collision problems. To solve collision problems, some studies have proposed waiting mechanisms; however, long waiting mechanisms result in low bandwidth utilization. To improve throughput, this study proposes a slotted medium access control protocol to enhance bandwidth utilization in UASNs. The proposed mechanism increases communication by exploiting temporal and spatial resources that are typically idle in order to protect communication against interference. By reducing wait time, network performance and energy consumption can be improved. A performance evaluation demonstrates that when the data packets are large or sensor deployment is dense, the energy consumption of proposed protocol is less than that of existing protocols as well as the throughput is higher than that of existing protocols. PMID:27005624

  19. Out-of-School-Time Academic Programs to Improve School Achievement: A Community Guide Health Equity Systematic Review

    PubMed Central

    Knopf, John A.; Hahn, Robert A.; Proia, Krista K.; Truman, Benedict I.; Johnson, Robert L.; Muntaner, Carles; Fielding, Jonathan E.; Jones, Camara Phyllis; Fullilove, Mindy T.; Hunt, Pete C.; Qu, Shuli; Chattopadhyay, Sajal K.; Milstein, Bobby

    2015-01-01

    Context Low-income and minority status in the United States are associated with poor educational outcomes, which, in turn, reduce the long-term health benefits of education. Objective This systematic review assessed the extent to which out-of-school-time academic (OSTA) programs for at-risk students, most of whom are from low-income and racial/ethnic minority families, can improve academic achievement. Because most OSTA programs serve low-income and ethnic/racial minority students, programs may improve health equity. Design Methods of the Guide to Community Preventive Services were used. An existing systematic review assessing the effects of OSTA programs on academic outcomes (Lauer et al 2006; search period 1985–2003) was supplemented with a Community Guide update (search period 2003–2011). Main Outcome Measure Standardized mean difference. Results Thirty-two studies from the existing review and 25 studies from the update were combined and stratified by program focus (ie, reading-focused, math-focused, general academic programs, and programs with minimal academic focus). Focused programs were more effective than general or minimal academic programs. Reading-focused programs were effective only for students in grades K-3. There was insufficient evidence to determine effectiveness on behavioral outcomes and longer-term academic outcomes. Conclusions OSTA programs, particularly focused programs, are effective in increasing academic achievement for at-risk students. Ongoing school and social environments that support learning and development may be essential to ensure the longer-term benefits of OSTA programs. PMID:26062096

  20. Civil Wrongs: Federal Equity Initiative Promotes Paperwork, Not Equality

    ERIC Educational Resources Information Center

    Melnick, R. Shep

    2016-01-01

    In October 2014, U.S. secretary of education Arne Duncan announced the Obama administration's new "education equity initiative," explaining that the president could not "continue to wait" for Congress to act "on behalf of vulnerable children." The centerpiece of this initiative was a 37-page "Dear Colleague"…

  1. A wavelet-based evaluation of time-varying long memory of equity markets: A paradigm in crisis

    NASA Astrophysics Data System (ADS)

    Tan, Pei P.; Chin, Cheong W.; Galagedera, Don U. A.

    2014-09-01

    This study, using wavelet-based method investigates the dynamics of long memory in the returns and volatility of equity markets. In the sample of five developed and five emerging markets we find that the daily return series from January 1988 to June 2013 may be considered as a mix of weak long memory and mean-reverting processes. In the case of volatility in the returns, there is evidence of long memory, which is stronger in emerging markets than in developed markets. We find that although the long memory parameter may vary during crisis periods (1997 Asian financial crisis, 2001 US recession and 2008 subprime crisis) the direction of change may not be consistent across all equity markets. The degree of return predictability is likely to diminish during crisis periods. Robustness of the results is checked with de-trended fluctuation analysis approach.

  2. [Longer waiting time and higher mortality in older people with traumatic brain injuries. Mapping of emergency prehospital management and hospital management in Västerbotten].

    PubMed

    Holzmann, Martin; Bylund, Per O; Degerfält, Lisa; Carlsson, Axel C; Wändell, Per; Ruge, Toralph

    2015-01-01

    The main purpose was to study the prehospital and early intrahospital treatment of patients with traumatic brain injury (TBI) in the county of Västerbotten 2011-2012. In total, 162 patients were included. The main finding was that a large proportion of TBI patients were older men who fell in the same or from a different level. Older patients had higher mortality and had to wait longer for diagnostic imaging compared to younger patients. Furthermore, most patients were initially relatively unaffected by the injury and around 1/5 of the patients were transported to hospital by private transport. Finally, we observed that most patients were admitted to hospital and computer tomography scan of the head was performed within 4 hours. PMID:26440946

  3. [A study on organ transplantation waiting lines in Brazil's Unified National Health System].

    PubMed

    Marinho, Alexandre

    2006-10-01

    This study analyzes the waiting lines for solid organ transplants in Brazil's Unified National Health System. By using a queuing theory model, we estimate the waiting times for different organs under alternative scenarios. The model reveals the elasticity of various waiting times with respect to arrival and service rates for organ transplantation within the system. Average waiting time for a solid organ transplant is very long and highly elastic in Brazil. The article discusses some important possibilities for reducing such waiting times. PMID:16951895

  4. Are our cornea waiting lists dynamic enough?

    PubMed

    Palamar, Melis; Egrilmez, Sait; Yagci, Ayse

    2016-04-01

    The purpose of this study was to evaluate the dynamic reality of the corneal transplant (CT) waiting list and if the CT candidates are really eager to operation. We evaluated the response of consecutive 96 CT candidates to call for operation. The age, functional visual acuity, CT indication, waiting period, and the excuse of refusal for candidates that postponed the operation were also evaluated. The patients were classified into two groups according to the availability (Group 1, available; Group 2, unavailable). To find an available candidate for transplantation of 48 consecutive corneal tissues, 96 patients had to be called. The mean age of the patients was 57.49 ± 18.75. The mean age of Group 1 and Group 2 was 54.28 ± 18.12 (13-80) and 60.44 ± 19.01 (9-88) years, respectively (p = 0.108). It was found that the call refusal was higher in patients elder than age 70 (p = 0.04). The mean time between being added to the list and the call was 22.96 ± 7.80 (9-39) months for Group 1, 27.02 ± 8.25 (9-53) months for Group 2 (p = 0.015). The estimation point for waiting period was 22 months (p = 0.044). The most common reasons of excuse were inconvenience of timing, giving up operation, and secondary health problems, whereas anticoagulant use was the most common reason for postponement. As the waiting period gets longer and CT candidates get older, they tend to give up operation. The secondary health problems and use of systemic anticoagulants are important problems that might cause postponing the CT surgery and ruin the dynamicity of the waiting lists. PMID:26208680

  5. Strategy as active waiting.

    PubMed

    Sull, Donald N

    2005-09-01

    Successful executives who cut their teeth in stable industries or in developed countries often stumble when they face more volatile markets. They falter, in part, because they assume they can gaze deep into the future and develop a long-term strategy that will confer a sustainable competitive advantage. But visibility into the future of volatile markets is sharply limited because so many different variables are in play. Factors such as technological innovation, customers' evolving needs, government policy, and changes in the capital markets interact with one another to create unexpected outcomes. Over the past six years, Donald Sull, an associate professor at London Business School, has led a research project examining some of the world's most volatile markets, from national markets like China and Brazil to industries like enterprise software, telecommunications, and airlines. One of the most striking findings from this research is the importance of taking action during comparative lulls in the storm. Huge business opportunities are relatively rare; they come along only once or twice in a decade. And, for the most part, companies can't manufacture those opportunities; changes in the external environment converge to make them happen. What managers can do is prepare for these golden opportunities by managing smart during the comparative calm of business as usual. During these periods of active waiting, leaders must probe the future and remain alert to anomalies that signal potential threats or opportunities; exercise restraint to preserve their war chests; and maintain discipline to keep the troops battle ready. When a golden opportunity or"sudden death"threat emerges, managers must have the courage to declare the main effort and concentrate resources to seize the moment. PMID:16171216

  6. Equity in community care.

    PubMed

    Challis, L; Henwood, M

    1994-06-01

    The implementation of the NHS and Community Care Act 1990 made local authority social services departments responsible for the organisation and funding of support and care in the community. This development took effect at the same time as a blurring of the boundaries between health and social care. One consequence is that the relevance of equity (a guiding principle of the 1946 National Health Service Act, but relatively lacking from the 1948 National Assistance Act, the foundation of many social services) has come to be more keenly appreciated within personal social services. Equity questions arise in community care over the distribution of public resources between different client groups, income groups, generations, and localities. Moreover, no mechanisms exist to monitor the trends that emerge from different ways that people get access to care. Yet there is a risk that substantial divisive consequences may occur, particularly between generations. PMID:8019286

  7. What's in a wait? Contrasting management science and economic perspectives on waiting for emergency care.

    PubMed

    Morton, Alec; Bevan, Gwyn

    2008-02-01

    The current paper reviews and contrasts a management science view of waiting for healthcare, which centres on queues as devices for buffering demand, with an economic view, which stresses the role of the incentive structure, in the context of English Accident and Emergency Departments. We demonstrate that the management science view provides insight into waiting time performance within a single facility but is limited in its ability to shed light on variations in performance across facilities. We argue, with reference to supporting data, that such variations may be explainable by a proper understanding of the incentive structure in A&E Departments. PMID:17825940

  8. The impact of rural hospital closures on equity of commuting time for haemodialysis patients: simulation analysis using the capacity-distance model

    PubMed Central

    2012-01-01

    Background Frequent and long-term commuting is a requirement for dialysis patients. Accessibility thus affects their quality of lives. In this paper, a new model for accessibility measurement is proposed in which both geographic distance and facility capacity are taken into account. Simulation of closure of rural facilities and that of capacity transfer between urban and rural facilities are conducted to evaluate the impacts of these phenomena on equity of accessibility among dialysis patients. Methods Post code information as of August 2011 of all the 7,374 patients certified by municipalities of Hiroshima prefecture as having first or third grade renal disability were collected. Information on post code and the maximum number of outpatients (capacity) of all the 98 dialysis facilities were also collected. Using geographic information systems, patient commuting times were calculated in two models: one that takes into account road distance (distance model), and the other that takes into account both the road distance and facility capacity (capacity-distance model). Simulations of closures of rural and urban facilities were then conducted. Results The median commuting time among rural patients was more than twice as long as that among urban patients (15 versus 7 minutes, p < 0.001). In the capacity-distance model 36.1% of patients commuted to the facilities which were different from the facilities in the distance model, creating a substantial gap of commuting time between the two models. In the simulation, when five rural public facilitiess were closed, Gini coefficient of commuting times among the patients increased by 16%, indicating a substantial worsening of equity, and the number of patients with commuting times longer than 90 minutes increased by 72 times. In contrast, closure of four urban public facilities with similar capacities did not affect these values. Conclusions Closures of dialysis facilities in rural areas have a substantially larger impact on

  9. Transplant Versus Resection for the Management of Hepatocellular Carcinoma Meeting Milan Criteria in the MELD Exception Era at a Single Institution in a UNOS Region with Short Wait Times

    PubMed Central

    SQUIRES, MALCOLM H.; HANISH, STEVEN I.; FISHER, SARAH B.; GARRETT, CRISTEN; KOOBY, DAVID A.; SARMIENTO, JUAN M.; CARDONA, KENNETH; ADAMS, ANDREW B.; RUSSELL, MARIA C.; MAGLIOCCA, JOSEPH F.; KNECHTLE, STUART J.; STALEY, CHARLES A.; MAITHEL, SHISHIR K.

    2015-01-01

    Background Management of hepatocellular carcinoma (HCC) in the Model for End-Stage Liver Disease (MELD) exception era remains regionally variable. Outcomes were compared for patients undergoing transplant versus resection at a single institution in a UNOS region with short wait times for organ availability. Methods All patients who underwent resection of HCC from January 2000 to August 2012 and patients who underwent transplant post-January 2006, during the Milan Criteria (MC)-based MELD exception policy for HCC, were identified. Primary outcomes were overall survival (OS) and recurrence-free survival (RFS). Results Two hundred fifty-seven patients were analyzed, of whom 131 underwent transplant and 126 underwent resection. All transplant patients met MC; 45 (36%) resection patients met MC. Median follow-up time was 30 months. Median wait time to transplant was 55 days; no patients dropped off the waitlist while awaiting an organ. Among patients meeting MC, transplant demonstrated significantly greater 5-year OS (65.7% vs. 43.8%; P = 0.005) and RFS (85.3% vs. 22.7%; P < 0.001) versus resection. For patients with hepatitis C, transplant (n = 87) demonstrated significantly improved 5-year outcomes compared to patients meeting MC who underwent resection (n = 21; OS: 63.5% vs. 23.3%; P = 0.001; RFS: 83.5% vs. 23.7%; P < 0.001). Conclusion In a region with short waitlist times for organ availability, liver transplant is associated with improved survival compared to resection for HCC within MC and should be considered for all patients meeting MC, particularly those with hepatitis C. PMID:24347475

  10. The Impact of Patient-to-Patient Interaction in Health Facility Waiting Rooms on Their Perception of Health Professionals.

    PubMed

    Willis, William Kent; Ozturk, Ahmet Ozzie; Chandra, Ashish

    2015-01-01

    Patients have to wait in waiting rooms prior to seeing the physician. But there are few studies that demonstrate what they are actually doing in the waiting room. This exploratory study was designed to investigate the types of discussions that patients in the waiting room typically engage in with other patients and how the conversations affected their opinion on general reputation of the clinic, injections/blocks as treatment procedures, waiting time, time spent with the caregiver, overall patient satisfaction, and the pain medication usage policy. The study demonstrates that patient interaction in the waiting room has a positive effect on patient opinion of the pain clinic and the caregivers. PMID:25839351

  11. Science Education and Equity.

    ERIC Educational Resources Information Center

    Bates, Percy; And Others

    1994-01-01

    This double issue of "Equity Coalition" deals with issues related to the need for inclusive science training and encouraging the interest of women and minorities groups in science. The following articles are included: (1) "Say Yes to Science" (Percy Bates); (2) "Science and Equity: Why This Issue Is Important" (Eleanor Linn); (3) "Race Equity and…

  12. Schools Achieving Gender Equity.

    ERIC Educational Resources Information Center

    Revis, Emma

    This guide is designed to assist teachers presenting the Schools Achieving Gender Equity (SAGE) curriculum for vocational education students, which was developed to align gender equity concepts with the Kentucky Education Reform Act (KERA). Included in the guide are lesson plans for classes on the following topics: legal issues of gender equity,…

  13. Waiting Impulsivity: The Influence of Acute Methylphenidate and Feedback

    PubMed Central

    Chang-Webb, Yee Chien; Morris, Laurel S.; Cooper, Ella; Sethi, Arjun; Baek, Kwangyeol; Grant, Jon; Robbins, Trevor W.; Harrison, Neil A

    2016-01-01

    Background: The ability to wait and to weigh evidence is critical to behavioral regulation. These behaviors are known as waiting and reflection impulsivity. In Study 1, we examined the effects of methylphenidate, a dopamine and norepinephrine reuptake inhibitor, on waiting and reflection impulsivity in healthy young individuals. In study 2, we assessed the role of learning from feedback in disorders of addiction. Methods: We used the recently developed 4-Choice Serial Reaction Time task and the Beads task. Twenty-eight healthy volunteers were tested twice in a randomized, double-blind, placebo-controlled cross-over trial with 20mg methylphenidate. In the second study, we analyzed premature responses as a function of prior feedback in disorders of addiction. Results: Study 1: Methylphenidate was associated with greater waiting impulsivity to a cue predicting reward along with faster responding to target onset without a generalized effect on reaction time or attention. Methylphenidate influenced reflection impulsivity based on baseline impulsivity. Study 2: More premature responses occurred after premature responses in stimulant-dependent subjects. Conclusions: We show that methylphenidate has dissociable effects on waiting and reflection impulsivity. Chronic stimulant exposure impairs learning from prior premature responses, suggesting a failure to learn that premature responding is suboptimal. These findings provide a greater mechanistic understanding of waiting impulsivity. PMID:26136351

  14. Waiting to descend.

    PubMed

    Berger, Stephanie

    2010-01-01

    A second-time mother uses a combination of comfort measures and hypnosis for childbirth to achieve a medication-free birth. In the hospital, her use of hypnosis and the posterior position of her cervix made it appear that she was not dilated. After she was fully dilated, pushing took several hours. Throughout the birth, the mother remained calm and did not experience pain, thanks to her practice with prenatal yoga and the Hypnobabies method of childbirth. PMID:21358827

  15. [Waiting lists management model based on timeliness and justice].

    PubMed

    Julio, Cristian; Wolff, Patricio; Vegoña Yarza, María

    2016-06-01

    Waiting lists for elective surgery are considered a major health policy concern in most countries of the world. The most common reason to explain this phenomenon is that demand exceeds supply. Traditionally, the management of waiting lists has been focused on timeliness of medical attention. The objective of this paper is to present a waiting lists management model that includes the concepts of timeliness and justice simultaneously. We designed a prioritization method based solely on medical criteria. We developed a computer software to register patients, to prioritize and monitor the waiting lists. The system was implemented in 2013 and is currently used in all surgical specialties at a public hospital. The results show that timeliness does not suffice to manage the waiting lists for elective surgery, and therefore it should be complemented with an indicator of justice. Under this management model, hospitals should attempt to balance justice with timeliness of care and prioritize initiatives that improve both indicators at the same time. In addition, we propose using this model to manage the waiting lists of other hospital processes. PMID:27598499

  16. Waiting for Unruh

    NASA Astrophysics Data System (ADS)

    Fewster, Christopher J.; Juárez-Aubry, Benito A.; Louko, Jorma

    2016-08-01

    How long does a uniformly accelerated observer need to interact with a quantum field in order to record thermality in the Unruh temperature? We address this question for a pointlike Unruh–DeWitt detector, coupled linearly to a real Klein–Gordon field of mass m≥slant 0 and treated within first order perturbation theory, in the limit of large detector energy gap {E}{gap}. We first show that when the interaction duration {{Δ }}T is fixed, thermality in the sense of detailed balance cannot hold as {E}{gap}\\to ∞ , and this property generalises from the Unruh effect to any Kubo–Martin–Schwinger state satisfying certain technical conditions. We then specialise to a massless field in four spacetime dimensions and show that detailed balance does hold when {{Δ }}T grows as a power-law in {E}{gap} as {E}{gap}\\to ∞ , provided the switch-on and switch-off intervals are stretched proportionally to {{Δ }}T and the switching function has sufficiently strong Fourier decay. By contrast, if {{Δ }}T grows by stretching a plateau in which the interaction remains at constant strength but keeping the duration of the switch-on and switch-off intervals fixed, detailed balance at {E}{gap}\\to ∞ requires {{Δ }}T to grow faster than any polynomial in {E}{gap}, under mild technical conditions. The results also hold for a static detector in a Minkowski heat bath. The results limit the utility of the large {E}{gap} regime as a probe of thermality in time-dependent versions of the Hawking and Unruh effects, such as an observer falling into a radiating black hole. They may also have implications on the design of prospective experimental tests of the Unruh effect.

  17. [Equity and health].

    PubMed

    Laguna-García, J; Fernández de Castro, J; Cordera, A

    1992-01-01

    This paper discusses the right to health in Mexico. The authors present some ideas regarding equity and data which shows the existence of a deep inequity in the field of health in the country. The efforts of the social security agencies and of the Ministry of Health aimed at diminishing inequity in health are also described. The authors conclude that it is time to avoid retorical positions and attitudes of administrative solidarity and start to implement actions to improve the health conditions of those living in extreme poverty. These actions should include providing comprehensive health services to all the population, reinforcing specific preventive programs, improving certain basic health indicators and prompting intersectoral collaboration. PMID:1411783

  18. Waiting management at the emergency department – a grounded theory study

    PubMed Central

    2013-01-01

    Background An emergency department (ED) should offer timely care for acutely ill or injured persons that require the attention of specialized nurses and physicians. This study was aimed at exploring what is actually going on at an ED. Methods Qualitative data was collected 2009 to 2011 at one Swedish ED (ED1) with 53.000 yearly visits serving a population of 251.000. Constant comparative analysis according to classic grounded theory was applied to both focus group interviews with ED1 staff, participant observation data, and literature data. Quantitative data from ED1 and two other Swedish EDs were later analyzed and compared with the qualitative data. Results The main driver of the ED staff in this study was to reduce non-acceptable waiting. Signs of non-acceptable waiting are physical densification, contact seeking, and the emergence of critical situations. The staff reacts with frustration, shame, and eventually resignation when they cannot reduce non-acceptable waiting. Waiting management resolves the problems and is done either by reducing actual waiting time by increasing throughput of patient flow through structure pushing and shuffling around patients, or by changing the experience of waiting by calming patients and feinting maneuvers to cover up. Conclusion To manage non-acceptable waiting is a driving force behind much of the staff behavior at an ED. Waiting management is done either by increasing throughput of patient flow or by changing the waiting experience. PMID:23496853

  19. Supply and demand: estimating the real need for care while meeting the 48 hour waiting time target in a genitourinary medicine clinic by a closed appointment system

    PubMed Central

    Clarke, J; Christodoulides, H; Taylor, Y

    2006-01-01

    Aim To attempt to assess demand for access to sexual health services in a community where a “closed” appointment system operates in the local genitourinary medicine (GUM) clinic. Setting A large GUM clinic serving a provincial city in England. Appointments for new episodes are available only 1 or 2 days ahead. Service user complaints about repeated difficulty in getting through to book a visit prompted a review of all methods of access. Methods A prospective review of all calls received in the departmental telephone booking service was performed. Temporary extra staff manned a cascade sequence of telephone lines and recorded all calls and caller characteristics such as age and declaration of symptoms. All attempts to book an appointment in person, by written referral, or by telephone in a period of 5 working days were also logged. This total demand was compared with the actual capacity and maximum theoretical capacity of the clinic during the same time period. Results 626 appointments would be required in the working week to accommodate all patients within 48 hours of requesting to be seen. 84% of all calls requested a new appointment, and 77% all new appointment requests were by phone. There were 181 new appointments available; 72% of those requesting an appointment could not be seen. The clinic was working at 103% capacity. To accommodate demand at this quiet time of the academic year, the GUM service would need to increase capacity by 3–4‐fold. Conclusions Closed appointment systems in GUM services may produce an apparent “improvement” in waiting times to 48 hours, but many callers are not able to book an appointment at all. Demand for GUM services outstrips capacity to an extent that internal efficiency savings cannot hope to address. PMID:16461602

  20. Gender Equity. IDRA Forum.

    ERIC Educational Resources Information Center

    IDRA Newsletter, 1994

    1994-01-01

    This newsletter contains six articles on issues of gender equity for Chicanas and other women. "Recognizing Chicana Contributions: Cultural History & Gender Equity on the Line" (Mikki Symonds) discusses the invisibility of Mexican Americans in general and of Chicanas in particular in U.S. history books, school curricula, and pop culture, and…

  1. Melding Excellence and Equity.

    ERIC Educational Resources Information Center

    Bennett, David A.

    1983-01-01

    This document examines the issues of educational excellence and equity. The Milwaukee Public School System, Wisconsin, is cited as an example of a desegregation program that both exceeded court requirements of equity and also made a substantial contribution to the goals of excellence in education. The school effectiveness movement, like…

  2. New Directions For Foundations In Health Equity.

    PubMed

    Doykos, Patricia; Gray-Akpa, Kristina; Mitchell, Faith

    2016-08-01

    Rising income inequality and pessimism about the current and future status of race relations in the United States make this both a challenging time for the pursuit of health equity and also an important opportunity for action. We glean lessons from past and ongoing philanthropic investments in health equity and recommend approaches that can guide future work by foundations. Improving health equity is a complex process that must take into account a variety of factors that affect health, of which access to high-quality health care is just one element. Accordingly, improving health equity will require the combined forces of philanthropy, the public sector, and sectors that have not traditionally been identified with health. PMID:27503980

  3. Referral rates and waiting lists: some empirical evidence.

    PubMed

    Goddard, J A; Tavakoli, M

    1998-09-01

    This paper provides some empirical evidence on topics discussed at greater length in a recent paper in Health Economics (Goddard, J.A., Malek, M. and Tavakoli, M. Health Economics 1995; 4: 41-55), which modelled the relationship between referral rates and waiting lists for hospital treatment for non-urgent conditions within a queuing theory framework. Here, we estimate a version of the demand function used in this model, with panel data for Scottish Health Board Areas during the period 1990-1992. Separate models are estimated for each of six broadly defined 'waiting list' specialisms, for which we have data on referral rates and waiting times. The six specialisms are General Surgery, Ear Nose and Throat Surgery, Gynaecology, Ophthalmology, Orthopaedics and Urology. PMID:9809711

  4. Protocol to Exploit Waiting Resources for UASNs †

    PubMed Central

    Hung, Li-Ling; Luo, Yung-Jeng

    2016-01-01

    The transmission speed of acoustic waves in water is much slower than that of radio waves in terrestrial wireless sensor networks. Thus, the propagation delay in underwater acoustic sensor networks (UASN) is much greater. Longer propagation delay leads to complicated communication and collision problems. To solve collision problems, some studies have proposed waiting mechanisms; however, long waiting mechanisms result in low bandwidth utilization. To improve throughput, this study proposes a slotted medium access control protocol to enhance bandwidth utilization in UASNs. The proposed mechanism increases communication by exploiting temporal and spatial resources that are typically idle in order to protect communication against interference. By reducing wait time, network performance and energy consumption can be improved. A performance evaluation demonstrates that when the data packets are large or sensor deployment is dense, the energy consumption of proposed protocol is less than that of existing protocols as well as the throughput is higher than that of existing protocols. PMID:27005624

  5. Wait too long to talk about kidney disease and you could be waiting for a kidney.

    MedlinePlus

    ... Home Current Issue Past Issues Public Service Announcement Kidney Disease Past Issues / Summer 2006 Table of Contents ... Javascript on. Wait too long to talk about kidney disease and you could be waiting for a ...

  6. Wait too long to talk about kidney disease and you could be waiting for a kidney.

    MedlinePlus

    ... Home Current Issue Past Issues Public Service Announcement Kidney Disease Past Issues / Summer 2006 Table of Contents For ... Javascript on. Wait too long to talk about kidney disease and you could be waiting for a kidney. ...

  7. The nocebo effect for women in waiting.

    PubMed

    Dietsch, Elaine; Davies, Carmel

    2007-07-01

    This paper, drawn from a larger phenomenological study, critiques the effects of "waiting" for women when they have an abnormal Pap test result. The hurt and injury incurred by women who perceive they have no choice but to become patient waiters in a health system that seemingly values the time of the health care provider over the health care recipient is discussed. These iatrogenic, unintended, harmful consequences are referred to as the nocebo effect. The participants provide the principal voices and their stories are dialogued to a lesser degree with the literature and the discourse of critical theorists who question power relationships in health professional practice. The purpose of this paper is served when the women's stories strip away some of the taken-for-granted, invisible aspects of the health professional's power. PMID:18074766

  8. Spatial and socio-demographic predictors of time-to-immunization in a rural area in Kenya: Is equity attainable?

    PubMed Central

    Moïsi, Jennifer C.; Kabuka, Jonathan; Mitingi, Dorah; Levine, Orin S.; Scott, J. Anthony G.

    2010-01-01

    We conducted a vaccine coverage survey in Kilifi District, Kenya in order to identify predictors of childhood immunization. We calculated travel time to vaccine clinics and examined its relationship to immunization coverage and timeliness among the 2169 enrolled children (median age: 12.5 months). 86% had vaccine cards available, >95% had received three doses of DTP-HepB-Hib and polio vaccines and 88% of measles. Travel time did not affect vaccination coverage or timeliness. The Kenyan EPI reaches nearly all children in Kilifi and delays in vaccination are few, suggesting that vaccines will have maximal impact on child morbidity and mortality. PMID:20600489

  9. Efficiency and Equity in the Time Pattern of Teacher Pension Benefits: An Analysis of Four State Systems. Working Paper 6

    ERIC Educational Resources Information Center

    Costrell, Robert M.; Podgursky, Michael

    2007-01-01

    Defined Benefit pension plans often generate odd time patterns of benefits. One typical pattern exhibits low accrual in early years, accelerating in mid-late years, followed by dramatic decline, or even negative returns in years that are relatively young for retirement. We consider four states for specific analysis: Arkansas, Missouri, California…

  10. Research: Why Wait till High School?

    ERIC Educational Resources Information Center

    Landreau, Janice

    2011-01-01

    Schools often wait until students are in high school before they require them to do research reports, but even 1st graders can benefit from learning to conduct research and write reports. Such projects are motivational for the students and give them a head start over students who wait till high school to learn these skills.

  11. The Religious Meaning in "Waiting for Godot"

    ERIC Educational Resources Information Center

    Wang, Jing

    2011-01-01

    "Waiting for Godot" is one of the classic works of theater of the absurd. The play seems absurd but with a deep religious meaning. This text tries to explore the theme in four parts of God and man, breaking the agreement, repentance and imprecation and waiting for salvation.

  12. Is waiting bad for subjective health?

    PubMed

    Howell, Jennifer L; Sweeny, Kate

    2016-08-01

    The present study examined the possibility that waiting is bad for one's subjective health. Specifically, we examined longitudinal trends in the self-reported health, self-reported sleep disruption, distress, and emotion regulation strategies of law school graduates waiting for their bar exam results. Multilevel analyses suggest that waiting was particularly detrimental to participants' self-reported health and sleep disruption at the beginning and end of the waiting period. Moreover, distress and most emotion regulation efforts were associated with poorer subjective health on average, and personal increases in distress and emotion regulation were largely associated with personal increases in poor self-reported health and sleep disruption. Our results suggest that waiting periods can take a toll on subjective health and that individual and temporal variations in distress and emotion regulation efforts are associated with these health trajectories. PMID:26969093

  13. After-School for All? Exploring Access and Equity in After-School Programs. Out-of-School Time Policy Commentary #4

    ERIC Educational Resources Information Center

    Pittman, Karen; Wilson-Ahlstrom, Alicia; Yohalem, Nicole

    2003-01-01

    While significant progress has occurred over the past several years regarding the expansion of the quantity and quality of after-school opportunities, the ambitious idea of "after-school for all" remains a distant goal. In this commentary, we push beyond some of the numbers to take a close look at questions related to access and equity, in order…

  14. Measurement of equity sensitivity: a comparison of the Equity Sensitivity Instrument and Equity Preference Questionnaire.

    PubMed

    Shore, Ted H; Strauss, Judy

    2008-02-01

    The psychometric properties of the Equity Sensitivity Instrument (Huseman, Hatfield, & Miles, 1985, 1987) and Equity Preference Questionnaire (Sauley & Bedeian, 2000) are compared. 173 undergraduate business majors completed several work attitude and personality measures. Results suggest that the Equity Preference Questionnaire may be a better measure of the equity sensitivity construct than the Equity Sensitivity Instrument which is typically used in research. Reliabilities for the scores on the Equity Sensitivity Instrument and Equity Preference Questionnaire were equivalent (coefficient alphas of .85 and .86, respectively); however, evidence for convergent and content validity was greater for the Equity Preference Questionnaire. Understanding individual differences in perceptions of equity and how best to measure these differences can affect workplace outcomes (e.g., turnover, employee engagement. PMID:18481667

  15. Gender Equity Expert Panel: Exemplary & Promising Gender Equity Programs, 2000.

    ERIC Educational Resources Information Center

    Department of Education, Washington, DC.

    The U.S. Department of Education developed the Gender Equity Expert Panel to identify promising and exemplary programs that promote gender equity in and through education. This panel of experts reviewed self-nominated programs to determine whether they met four criteria: evidence of success/effectiveness in promoting gender equity; quality of the…

  16. Waiting pedestrians in the social force model

    NASA Astrophysics Data System (ADS)

    Johansson, Fredrik; Peterson, Anders; Tapani, Andreas

    2015-02-01

    Microscopic simulation of pedestrian traffic is an important and increasingly popular method to evaluate the performance of existing or proposed infrastructure. The social force model is a common model in simulations, describing the dynamics of pedestrian crowds given the goals of the simulated pedestrians encoded as their preferred velocities. The main focus of the literature has so far been how to choose the preferred velocities to produce realistic dynamic route choices for pedestrians moving through congested infrastructure. However, limited attention has been given the problem of choosing the preferred velocity to produce other behaviors, such as waiting, commonly occurring at, e.g., public transport interchange stations. We hypothesize that: (1) the inclusion of waiting pedestrians in a simulated scenario will significantly affect the level of service for passing pedestrians, and (2) the details of the waiting model affect the predicted level of service, that is, it is important to choose an appropriate model of waiting. We show that the treatment of waiting pedestrians have a significant impact on simulations of pedestrian traffic. We do this by introducing a series of extensions to the social force model to produce waiting behavior, and provide predictions of the model extensions that highlight their differences. We also present a sensitivity analysis and provide sufficient criteria for stability.

  17. Restructuring Schooling: The Equity Infrastructure.

    ERIC Educational Resources Information Center

    Murphy, Joseph

    1993-01-01

    Argues that the school restructuring movement offers considerable promise for enhancing educational equity. Reviews equity definitions, outlines restructuring principles, and describes three powerful ethics (competitive/utilitarian, social justice, and caring) underlying current attempts to highlight equity values in education. Presents a strategy…

  18. Improving Patients Experience in Peadiatric Emergency Waiting Room.

    PubMed

    Ehrler, Frederic; Siebert, Johan; Wipfli, Rolf; Duret, Cyrille; Gervaix, Alain; Lovis, Christian

    2016-01-01

    When visiting the emergency department, the perception of the time spent in the waiting room before the beginning of the care, may influence patients' experience. Based on models of service evaluation, highlighting the importance of informing people about their waiting process and their place in the queue, we have developed an innovative information screen aiming at improving perception of time by patients. Following an iterative process, a group of experts including computer scientists, ergonomists and caregivers designed a solution adapted to the pediatric context. The solution includes a screen displaying five lanes representing triage levels. Patients are represented by individual avatars, drawn sequentially in the appropriate line. The interface has been designed using gamification principle, aiming at increasing acceptance, lowering learning curve and improving satisfaction. Questionnaire based evaluation results revealed high satisfaction from the 278 respondents even if the informative content was not always completely clear. PMID:27332258

  19. Equity, by what measure?

    PubMed

    Houston, Shane

    2006-12-01

    Equity has in many instances been framed around the notion of fairness. But the metric used to determine what is fair leaves some people at a disadvantage because the things that they value are not always taken properly into account. If I value mangoes and you value oranges is a measure of fairness based on how many oranges I seek appropriate? If I am expected to give up my love of mangoes in order to get ahead is that fair? The debate about judging equity - about measuring fairness - needs to find the conceptual and methodological space to allow the voices and claims of the other to be heard. PMID:17176236

  20. James R. Wait (1924-1998)

    NASA Astrophysics Data System (ADS)

    Hill, David A.

    James (Jim) R.Wait, a pioneer in electromagnetic theory and applications to geophysical exploration, died of cancer in Tucson, Arizona, on October 1, 1998. At 74, he was still very active and innovative in electromagnetics as Regents Professor Emeritus, University of Arizona, and as a consultant in electrical geophysics. He is survived by his wife, Gertrude; his son, George; his daughter, Laura; and three grandchildren, James, Carolyn, and Connor.Jim was born in Ottawa, Ontario, Canada, on January 23, 1924. He obtained B.A.Sc.and M.A.Sc. degrees in 1948 and 1949, respectively and his Ph.D. degree in 1951, in electrical engineering, all from the University of Toronto. He obtained his “T” in skiing and remained an avid skier all his life. Jim stayed in great shape and always found time to work out despite his busy schedule. I still remember the business trip where Jim and I ran laps around the parking lot of a Holiday Inn for his daily workout.

  1. Gender Equity. IDRA Focus.

    ERIC Educational Resources Information Center

    IDRA Newsletter, 1996

    1996-01-01

    This newsletter includes five articles on gender equity and related issues in education, with particular reference to the education of Hispanic girls. "IDRA's MIJA Program Expands" (Aurora Yanez-Perez) describes a program for sixth-grade Hispanic girls that promotes awareness of science- and math-related careers, provides training in science and…

  2. Equity and Art.

    ERIC Educational Resources Information Center

    Veale, Ann

    In an effort to ensure that the arts receive equity with other areas of study, this paper presents an argument for the value of arts education in children's development. The argument is based on the work of four experts: (1) Nelson Goodman, who held that symbols are indispensable to communication, and that children's capacity for acquiring…

  3. Computer Equity @ School.

    ERIC Educational Resources Information Center

    Equity Coalition for Race, Gender, and National Origin, 1999

    1999-01-01

    This edition of "Equity Coalition" is designed to be a resource to assist those who have responsibility for technology in the schools. The authors of these articles discuss a variety of issues related to computer uses in education and equal access to educational technology. The issue contains the following articles: (1) "Technology--A New Kind of…

  4. Student Equity Policy.

    ERIC Educational Resources Information Center

    Guichard, Gus

    Following a decrease in minority student enrollment within the California Community Colleges (CCC), the Board of Governors (BOG) convened a special statewide symposium to examine issues of minority student enrollment, retention, and transfer, and established a standing Board Committee on Equity and Diversity. Over the past 2 years, a system policy…

  5. Teacher Communities for Equity

    ERIC Educational Resources Information Center

    Cochran-Smith, Marilyn

    2015-01-01

    Teachers working together in learning communities is a popular aspect of school reform projects in countries around the world. However, teacher communities vary greatly from one another. This article describes two communities whose purpose is to help teachers work for equity by focusing on questions that emerge from practice and from genuine…

  6. Equity Literacy for All

    ERIC Educational Resources Information Center

    Gorski, Paul C.; Swalwell, Katy

    2015-01-01

    If the authors have learned anything working with schools across the United States, they've learned this: When it comes to educational equity, the trouble is not a lack of multicultural programs or diversity initiatives in schools. Nor is it a lack of educators who appreciate and even champion diversity. The trouble lies in how so many diversity…

  7. [Waiting lists guarantee in health care. Some theoretical reflections].

    PubMed

    Piene, H; Hauge, H K; Nyen, P A

    1997-01-30

    In 1990 a "waiting list guarantee" was introduced in the Norwegian health care system to secure treatment within six months for patients belonging to priority group II. (Priority group II are patients in need of treatment to avoid health hazards or serious long-term effects.) This guarantee has been difficult to honour and has caused considerable political unrest in the recent years. In an attempt to reform the guarantee, an analysis of our hospitals' capacity problems has been carried out, based on the general theory of queues. One result was that in order to fulfill the guarantee it is necessary to drastically reduce the queues and increase the capacity to deliver health services. This article presents the reasoning behind the analysis, in order to demonstrate the necessary foundation for a health policy that aims to reduce the time Norwegian patients have to wait for treatment in hospital. PMID:9064860

  8. In pursuit of high-value healthcare: the case for improving quality and achieving equity in a time of healthcare transformation.

    PubMed

    Betancourt, Joseph R

    2014-01-01

    The passage of the Patient Protection and Affordable Care Act and current efforts in payment reform signal the beginning of a significant transformation for the US healthcare system. As we embark on this transformation, disparities have emerged as the hallmark of low-value healthcare--care that does not meet quality standards, is inefficient, and is usually of high cost. A new set of structures is being developed to facilitate increased access to care that is cost-effective and high in quality--otherwise known as high-value healthcare. Addressing disparities and achieving equity are the perfect target areas for recouping value, and doing so will pave the way for high-value healthcare. As healthcare leaders make difficult choices, they should consider the realities of healthcare equity. First, racial and ethnic disparities in healthcare persist and are a clear sign of poor-quality, low-value healthcare. Second, the root causes of these disparities are complex, but a well-developed set of evidence-based approaches is available to help leaders address healthcare inequity. Third, evidence suggests that being inattentive to the root causes of disparities adversely affects efficiency and an organization's bottom line. Finally, if healthcare organizations are progressive, thoughtful, and prepared for success in such an environment, a new healthcare system that offers accessible, high-value, equitable, culturally competent, and high-quality care to all is well within reach. PMID:25291891

  9. Waiting in line: should selected patients ever be moved up?

    PubMed

    Jonasson, O

    1989-06-01

    Assuring equitable access of patients to needed organ transplants is a responsibility that must be shared by transplantation teams, the patients, their families, referring physicians, and society as a whole. Barriers of major proportion still exist that strongly bias the initial selection of patients for placement on waiting lists and adversely affect the rates of transplantation among the older age groups, nonwhites, and the poor. The very issue of making up the waiting list is fundamental to the development of fair and equitable distribution of the national resource of organs for transplantation. Actual organ allocation must involve medical judgment and must strive to achieve the maximal benefit to patients. Despite dangers of paternalism and bias masquerading as medical criteria, to overlook outcome predictions in selecting the recipient of a scarce resource is to be irresponsible toward the donor and society as well as to the patients on the list. Insofar as benefit and need can both be served, as in the case of liver transplantation for fulminant liver failure or kidney transplantation in a well-matched recipient, these considerations should far outweigh the poor criterion of length of time on the waiting list. In many instances, it will be the most appropriate choice to give the organ to a patient waiting on the list at home rather than to a desperately ill patient who will doubtlessly die without the operation but whose risks of failure are significantly higher. As difficult as these decisions are, especially in life and death situations, a system of organ allocation based on medical judgment, with appropriate safeguards and thorough monitoring, eventually will prove to be the fairest method. PMID:2662482

  10. Scaling laws of ambush predator 'waiting' behaviour are tuned to a common ecology.

    PubMed

    Wearmouth, Victoria J; McHugh, Matthew J; Humphries, Nicolas E; Naegelen, Aurore; Ahmed, Mohammed Z; Southall, Emily J; Reynolds, Andrew M; Sims, David W

    2014-05-01

    The decisions animals make about how long to wait between activities can determine the success of diverse behaviours such as foraging, group formation or risk avoidance. Remarkably, for diverse animal species, including humans, spontaneous patterns of waiting times show random 'burstiness' that appears scale-invariant across a broad set of scales. However, a general theory linking this phenomenon across the animal kingdom currently lacks an ecological basis. Here, we demonstrate from tracking the activities of 15 sympatric predator species (cephalopods, sharks, skates and teleosts) under natural and controlled conditions that bursty waiting times are an intrinsic spontaneous behaviour well approximated by heavy-tailed (power-law) models over data ranges up to four orders of magnitude. Scaling exponents quantifying ratios of frequent short to rare very long waits are species-specific, being determined by traits such as foraging mode (active versus ambush predation), body size and prey preference. A stochastic-deterministic decision model reproduced the empirical waiting time scaling and species-specific exponents, indicating that apparently complex scaling can emerge from simple decisions. Results indicate temporal power-law scaling is a behavioural 'rule of thumb' that is tuned to species' ecological traits, implying a common pattern may have naturally evolved that optimizes move-wait decisions in less predictable natural environments. PMID:24619440

  11. Examining Waiting Placement in Hospital: Utilization and the Lived Experience

    PubMed Central

    Wilson, Donna M.; Vihos, Jill; Hewitt, Jessica A.; Barnes, Nancy; Peterson, Karen; Magnus, Ralph

    2014-01-01

    This mixed-methods study addressed the problem that although waiting placement is considered a major hospital utilization issue, minimal evidence exists to highlight the extent of it and the personal impact of waiting placement. An analysis of two years of complete hospital data for the Canadian province of Alberta was undertaken to examine waiting placement rates and describe waiting placement patients. Qualitative interviews and observations of elderly patients waiting in hospital for nursing home placement were also undertaken to gain an understanding of the lived experience of waiting for placement in hospital. Only 1.8% of all inpatients were waiting placement with an ALC (Alternative Level of Care) designation, 80% of ALC waits were less than 41 days (mean=29.85, median=14), and 2.2% of total hospital bed days in these two years were used by ALC patients. Three qualitative themes emerged: (a) coming to a realization of this significant move, (b) waiting is boring and distressing, and (c) hospitals are not designed for waiting placement. The findings of this study should raise awareness that although relatively few people wait placement in hospital, there are some major possible negative effects of waiting for placement in hospital for those who wait; with remedies to address waiting placement care deficits needed. PMID:24576361

  12. Developing Agency for Equity-Minded Change

    ERIC Educational Resources Information Center

    Felix, Eric R.; Bensimon, Estela Mara; Hanson, Debbie; Gray, James; Klingsmith, Libby

    2015-01-01

    This chapter highlights the use of the Equity Scorecard with the Community College of Aurora. The Equity Scorecard is a theory-based strategy that assists community colleges in embedding equity into their institutional norms, practices, and policies.

  13. Outcomes following watchful waiting for stage II-IV follicular lymphoma patients in the modern era.

    PubMed

    Nastoupil, Loretta J; Sinha, Rajni; Byrtek, Michelle; Ziemiecki, Ryan; Zhou, Xiaolei; Taylor, Michael; Friedberg, Jonathan W; Link, Brian K; Cerhan, James R; Dawson, Keith; Flowers, Christopher R

    2016-03-01

    To examine the effectiveness of an initial management strategy of watchful waiting for follicular lymphoma (FL) in clinical practice, we compared outcomes for patients diagnosed 2004-2007 in the United States initially managed with watchful waiting with outcomes following initial rituximab monotherapy and chemoimmunotherapy. In total, 1754 stage II-IV patients in the National LymphoCare Study underwent watchful waiting (n = 386), rituximab monotherapy (n = 296) or rituximab plus chemotherapy (n = 1072) as initial management strategy. Female patients and those who received treatment in the Northeast or in an academic setting more commonly underwent watchful waiting versus initial chemoimmunotherapy; whereas patients with grade 3 histology, anaemia, elevated lactate dehydrogenase, extranodal involvement, B symptoms or performance status ≥1 more commonly received chemoimmunotherapy. Although time to new treatment and progression-free survival following first- and second-line therapy were improved with chemoimmunotherapy, and time to chemotherapy was improved with rituximab monotherapy, there were no differences in overall survival between watchful waiting and chemoimmunotherapy or rituximab monotherapy. With 8-year overall survival estimates of 74%, initial management with watchful waiting in the context of sequential therapy remains a viable option for FL patients in the modern era. This trial was registered at www.clinicaltrials.gov (NCT00097565). PMID:26729445

  14. Parental Strategies for Assisting Children to Wait

    ERIC Educational Resources Information Center

    Cuskelly, Monica; Jobling, Anne; Gilmore, Linda; Glenn, Sheila

    2006-01-01

    This study examined parents' behaviours as they waited with their child. Children were presented with an attractively wrapped gift and then asked not to touch it until the experimenter returned from finishing some work in another room. Three parent groups and their children participated in the study--parents of children with Down syndrome, parents…

  15. A Tribute to Waiting Room Moms Everywhere

    ERIC Educational Resources Information Center

    Ansfield, Mara

    2008-01-01

    Waiting rooms are oases for mothers of children with special needs. They congregate in these small holding areas, sitting on musty couches, while their children receive the latest therapeutic interventions. Sometimes they sit quietly, sneaking glances at each other while pretending to read year-old "People" magazines. Sometimes they crawl under a…

  16. 12 CFR 238.76 - Waiting period.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 4 2012-01-01 2012-01-01 false Waiting period. 238.76 Section 238.76 Banks and Banking FEDERAL RESERVE SYSTEM (CONTINUED) BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM (CONTINUED) SAVINGS AND LOAN HOLDING COMPANIES (REGULATION LL) Notice of Change of Director or Senior...

  17. 12 CFR 238.76 - Waiting period.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 4 2013-01-01 2013-01-01 false Waiting period. 238.76 Section 238.76 Banks and Banking FEDERAL RESERVE SYSTEM (CONTINUED) BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM (CONTINUED) SAVINGS AND LOAN HOLDING COMPANIES (REGULATION LL) Notice of Change of Director or Senior...

  18. 12 CFR 238.76 - Waiting period.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 4 2014-01-01 2014-01-01 false Waiting period. 238.76 Section 238.76 Banks and Banking FEDERAL RESERVE SYSTEM (CONTINUED) BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM (CONTINUED) SAVINGS AND LOAN HOLDING COMPANIES (REGULATION LL) Notice of Change of Director or Senior...

  19. Operationalizing Equity: The Complexities of Equity in Practice

    ERIC Educational Resources Information Center

    Andreasson, Ingela; Ohlsson, Lisbeth; Assarson, Inger

    2015-01-01

    The aim of this article is to offer some reflections on the relationship between meanings of equity at the national level and those working with these questions in local schools. We argue that meanings of equity at the national level are in strong contrast to the range complexity identified in local schools. The article draws from case study…

  20. Vocational Equity Resources from the Vocational Equity Resource Center.

    ERIC Educational Resources Information Center

    Wisconsin Univ., Madison. Vocational Studies Center.

    This catalog identifies and describes 767 written and audiovisual resources on equity available on loan from the Vocational Equity Resource and Technical Assistance Center in Madison, Wisconsin. The publication lists materials under 44 headings: affirmative action, aging, apprenticeship, assessment instruments, bias-free communications,…

  1. Interior view; Street Car Waiting House North Philadelphia Station, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Interior view; Street Car Waiting House - North Philadelphia Station, Street Car Waiting House, 2900 North Broad Street, on northwest corner of Broad Street & Glenwood Avenue, Philadelphia, Philadelphia County, PA

  2. North view; Street Car Waiting House, south (front) elevation ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    North view; Street Car Waiting House, south (front) elevation - North Philadelphia Station, Street Car Waiting House, 2900 North Broad Street, on northwest corner of Broad Street & Glenwood Avenue, Philadelphia, Philadelphia County, PA

  3. Detail; Street Car Waiting House window, north wall North ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Detail; Street Car Waiting House window, north wall - North Philadelphia Station, Street Car Waiting House, 2900 North Broad Street, on northwest corner of Broad Street & Glenwood Avenue, Philadelphia, Philadelphia County, PA

  4. West view; Street Car Waiting House, east elevation North ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    West view; Street Car Waiting House, east elevation - North Philadelphia Station, Street Car Waiting House, 2900 North Broad Street, on northwest corner of Broad Street & Glenwood Avenue, Philadelphia, Philadelphia County, PA

  5. Detail; Street Car Waiting House, support for exterior light fixture ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Detail; Street Car Waiting House, support for exterior light fixture - North Philadelphia Station, Street Car Waiting House, 2900 North Broad Street, on northwest corner of Broad Street & Glenwood Avenue, Philadelphia, Philadelphia County, PA

  6. If private equity sized up your business.

    PubMed

    Pozen, Robert C

    2007-11-01

    As the dust settles on the recent frenzy of private equity deals (including transactions topping $20 billion), what lessons can companies glean? Directors and executives of public companies may now be slightly less fearful of imminent takeover, yet the pressure remains: They face shareholders who wonder why they aren't getting private-equity-level returns. Rather than dismiss the value private equity has created as manipulated or aberrant, public company leaders should recognize the disciplined management that often underlies it. Pozen, a longtime leader in the financial services industry, finds that in the aftermath of buyouts, companies undergo five major thrusts of reform. These translate into five key questions that directors should pose to senior management: Have we left too much cash on our balance sheet instead of raising our cash dividends or buying back shares? Do we have the optimal capital structure, with the lowest weighted after-tax cost of total capital, including debt and equity? Do we have an operating plan that will significantly increase shareholder value, with specific metrics to monitor performance? Are the compensation rewards for our top executives tied closely enough to increases in shareholder value, with real penalties for nonperformance? Finally, does our board have enough industry experts who have made the time commitments and been given the financial incentives necessary to maximize shareholder value? The era of private equity is far from over - the top funds have become very large and are likely to play an influential role in future market cycles. Boards that ask these questions, and act on them, won't just beat the takeover artists to the punch. They will build stronger businesses. PMID:18159788

  7. Methodology for Analysis, Modeling and Simulation of Airport Gate-waiting Delays

    NASA Astrophysics Data System (ADS)

    Wang, Jianfeng

    This dissertation presents methodologies to estimate gate-waiting delays from historical data, to identify gate-waiting-delay functional causes in major U.S. airports, and to evaluate the impact of gate operation disruptions and mitigation strategies on gate-waiting delay. Airport gates are a resource of congestion in the air transportation system. When an arriving flight cannot pull into its gate, the delay it experiences is called gate-waiting delay. Some possible reasons for gate-waiting delay are: the gate is occupied, gate staff or equipment is unavailable, the weather prevents the use of the gate (e.g. lightning), or the airline has a preferred gate assignment. Gate-waiting delays potentially stay with the aircraft throughout the day (unless they are absorbed), adding costs to passengers and the airlines. As the volume of flights increases, ensuring that airport gates do not become a choke point of the system is critical. The first part of the dissertation presents a methodology for estimating gate-waiting delays based on historical, publicly available sources. Analysis of gate-waiting delays at major U.S. airports in the summer of 2007 identifies the following. (i) Gate-waiting delay is not a significant problem on majority of days; however, the worst delay days (e.g. 4% of the days at LGA) are extreme outliers. (ii) The Atlanta International Airport (ATL), the John F. Kennedy International Airport (JFK), the Dallas/Fort Worth International Airport (DFW) and the Philadelphia International Airport (PHL) experience the highest gate-waiting delays among major U.S. airports. (iii) There is a significant gate-waiting-delay difference between airlines due to a disproportional gate allocation. (iv) Gate-waiting delay is sensitive to time of a day and schedule peaks. According to basic principles of queueing theory, gate-waiting delay can be attributed to over-scheduling, higher-than-scheduled arrival rate, longer-than-scheduled gate-occupancy time, and reduced gate

  8. 24 CFR 982.205 - Waiting list: Different programs.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Waiting list: Different programs...-Based Program § 982.205 Waiting list: Different programs. (a) Merger and cross-listing—(1) Merged... its waiting list for the other program. (b) Other housing assistance: Effect of application...

  9. 24 CFR 982.205 - Waiting list: Different programs.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Waiting list: Different programs...-Based Program § 982.205 Waiting list: Different programs. (a) Merger and cross-listing—(1) Merged... its waiting list for the other program. (b) Other housing assistance: Effect of application...

  10. Screening Educational Equity: A Filmography.

    ERIC Educational Resources Information Center

    Shaffer, Susan Morris, Comp.

    The more than 300 films and videos listed in this annotated filmography for use by educators and their students are presented in 14 categories: (1) Biases in Early Childhood Education; (2) Career and Vocational Opportunities; (3) Curriculum Equity; (4) Discrimination in Employment; (5) Equity in Sports; (6) A Legal Context; (7) Male Sex Role…

  11. Leadership, Equity, and School Effectiveness.

    ERIC Educational Resources Information Center

    Baptiste, H. Prentice, Jr., Ed.; And Others

    This collection of essays focuses on the intersection between equity and excellence in educational leadership and urges a reconceptualization that gives appropriate consideration to women and ethnic and racial minorities. The book begins with an introductory chapter, entitled "Equity and Excellence in Educational Leadership: A Necessary Nexus," by…

  12. Rethinking Equity--There Are Alternatives.

    ERIC Educational Resources Information Center

    Picus, Lawrence O.

    1998-01-01

    Defines "equity" in terms of three concepts (horizontal equity, vertical equity, and fiscal neutrality), summarizes school finance litigation history, and presents alternative distribution formats to improve student achievement. Enhancing equity and efficiency requires reallocation of existing resources, incentives for improved performance, a more…

  13. Intergenerational equity and conservation

    NASA Technical Reports Server (NTRS)

    Otoole, R. P.; Walton, A. L.

    1980-01-01

    The issue of integenerational equity in the use of natural resources is discussed in the context of coal mining conversion. An attempt to determine if there is a clear-cut benefit to future generations in setting minimum coal extraction efficiency standards in mining is made. It is demonstrated that preserving fossil fuels beyond the economically efficient level is not necessarily beneficial to future generations even in terms of their own preferences. Setting fossil fuel conservation targets for intermediate products (i.e. energy) may increase the quantities of fossil fuels available to future generations and hence lower the costs, but there may be serious disadvantages to future generations as well. The use of relatively inexpensive fossil fuels in this generation may result in more infrastructure development and more knowledge production available to future generations. The value of fossil fuels versus these other endowments in the future depends on many factors which cannot possibly be evaluated at present. Since there is no idea of whether future generations are being helped or harmed, it is recommended that integenerational equity not be used as a factor in setting coal mine extraction efficiency standards, or in establishing requirements.

  14. The active management of surgical waiting lists: a urological surgery case study.

    PubMed

    Briggs, Russell J; Smith, Katrina M; Dejager, Ebony M; Callahan, John T; Abernethy, Jennifer A; Dunn, Eddie J; Hunter-Smith, David J

    2011-11-01

    Elective surgery waiting list management is a major public healthcare issue. This case study describes an integrated multifaceted approach to waiting list management at Peninsula Health, a public health service in Victoria, Australia. At the commencement of this study it was recognised that several issues associated with the urological surgical service constituted potential clinical risk. These included: recall mechanisms for multiple surveillance procedures; significant resource deficits; and long surgery waiting times. Responding to these issues a multifaceted approach to wait list management was implemented including: audit; direct lines of communication between clinical and administrative staff; urgent caseload management; utilisation of the Elective Surgery Access Scheme; financial and resource analysis justifying the appointment of a full-time urologist, and the establishment of a urology service from a satellite campus; implementation of a recall database; development of an outpatient service; and commencement of a day surgery initiative. This approach yielded results that included a 67% reduction in the number of 'ready for care' patients and a 78% reduction in the number of patients classified as 'overdue for surgery'. Average wait time for semi-urgent and non-urgent patients reduced from 248 days to 180 days in the 10-month period. PMID:22126940

  15. Waiting for a Specialist Consultation for a New Condition in Ontario: Impacts on Patients' Lives

    PubMed Central

    Harrington, Daniel W.; Wilson, Kathi; Rosenberg, Mark W.

    2014-01-01

    As leading barriers to specialist care, wait times are at the forefront of the Canadian healthcare policy agenda. However, knowledge is limited about how wait times affect patients' lives. We utilized the 2010 Canadian Community Health Survey to examine the experience of patients requiring a consultation with a medical specialist for a new condition. Multivariate logistic regression predicted the likelihood that a respondent self-reported his or her life was affected. Subsequent cross-tabulations determined the ways in which life was affected. Females, middle-aged respondents, new immigrants and those with low income and poor health status were more likely to report their life was affected. Worry, stress and anxiety were the most frequently reported impacts, followed by pain, stress on family/friends, deterioration of health and loss of work. Our research demonstrates a need to address the impacts of wait times on health and well-being, with a focus on particular subpopulation groups. PMID:24973486

  16. Learning to wait: A laboratory investigation

    USGS Publications Warehouse

    Oprea, R.; Friedman, D.; Anderson, S.T.

    2009-01-01

    Human subjects decide when to sink a fixed cost C to seize an irreversible investment opportunity whose value V is governed by Brownian motion. The optimal policy is to invest when V first crosses a threshold V* = (1 + w*) C, where the wait option premium w* depends on drift, volatility, and expiration hazard parameters. Subjects in the Low w* treatment on average invest at values quite close to optimum. Subjects in the two Medium and the High w* treatments invested at values below optimum, but with the predicted ordering, and values approached the optimum by the last block of 20 periods. ?? 2009 The Review of Economic Studies Limited.

  17. Equity Gains in Bangladesh Primary Education

    NASA Astrophysics Data System (ADS)

    Chowdhury, A. Mushtaque R.; Nath, Samir R.; Choudhury, Rasheda K.

    2003-11-01

    Although equity is a desirable objective of any form of development intervention, including education, not many studies dwell upon this important area. Information on related trends is even more rare. This essay uses field-level data from Bangladesh to examine equity levels and trends in primary education, including enrolment and quality of learning, focusing on equity for different gender, urban or rural, economic and ethnic groups. The study shows that while some disparity between girls and boys has been eliminated, girls are still far behind boys in terms of learning achievement. Children belonging to poorer families and ethnic minority groups lag behind the respective dominant groups in terms of both enrolment and learning achievement. At the same time, there have been some improvements for hitherto excluded groups such as rural girls and children of the poor. These changes are attributed mainly to 'positive discriminatory' steps taken by the government and non-governmental organizations in favour of such groups. If this trend continues, Bangladesh can look forward to establishing itself as a more equitable society than it is now.

  18. Equity in health care utilization in Chile.

    PubMed

    Núñez, Alicia; Chi, Chunhuei

    2013-01-01

    One of the most extensive Chilean health care reforms occurred in July 2005, when the Regime of Explicit Health Guarantees (AUGE) became effective. This reform guarantees coverage for a specific set of health conditions. Thus, the purpose of this study is to provide timely evidence for policy makers to understand the current distribution and equity of health care utilization in Chile.The authors analyzed secondary data from the National Socioeconomic Survey (CASEN) for the years 1992-2009 and the 2006 Satisfaction and Out-of-Pocket Payment Survey to assess equity in health care utilization using two different approaches. First, we used a two-part model to estimate factors associated with the utilization of health care. Second, we decomposed income-related inequalities in medical care use into contributions of need and non-need factors and estimated a horizontal inequity index.Findings of this empirical study include evidence of inequities in the Chilean health care system that are beneficial to the better-off. We also identified some key factors, including education and health care payment, which affect the utilization of health care services. Results of this study could help researchers and policy makers identify targets for improving equity in health care utilization and strengthening availability of health care services accordingly. PMID:23937894

  19. Equity in health care utilization in Chile

    PubMed Central

    2013-01-01

    One of the most extensive Chilean health care reforms occurred in July 2005, when the Regime of Explicit Health Guarantees (AUGE) became effective. This reform guarantees coverage for a specific set of health conditions. Thus, the purpose of this study is to provide timely evidence for policy makers to understand the current distribution and equity of health care utilization in Chile. The authors analyzed secondary data from the National Socioeconomic Survey (CASEN) for the years 1992–2009 and the 2006 Satisfaction and Out-of-Pocket Payment Survey to assess equity in health care utilization using two different approaches. First, we used a two-part model to estimate factors associated with the utilization of health care. Second, we decomposed income-related inequalities in medical care use into contributions of need and non-need factors and estimated a horizontal inequity index. Findings of this empirical study include evidence of inequities in the Chilean health care system that are beneficial to the better-off. We also identified some key factors, including education and health care payment, which affect the utilization of health care services. Results of this study could help researchers and policy makers identify targets for improving equity in health care utilization and strengthening availability of health care services accordingly. PMID:23937894

  20. Rural residency and the risk of mortality while waiting for liver transplantation.

    PubMed

    Renfrew, Paul Douglas; Molinari, Michele

    2012-01-01

    Our liver transplant program services a region that has a prominent rural demographic. The influence of rural residency on liver transplant wait-list mortality has not been previously studied. We hypothesized that residence in a rural setting, by imposing challenges to medical care access, might be associated with inferior survival while waiting for liver transplantation. To test this hypothesis, multivariable time-to-event analysis was performed using Cox proportional hazards and competing risks regression on data from a consecutive five-yr cohort of 159 primary liver transplant candidates, to derive covariate adjusted effect measures for the association between residence in a rural area and wait-list mortality. For the primary analysis, a standardized, census-based, definition was used to assign rural residency status. The Kaplan-Meier estimated 90-d and one-yr wait-list mortality for the cohort was 7.6% (95% CI: 4.2-13.8) and 15.6% (95% CI: 9.4-25.2). The covariate adjusted hazard ratio for the relationship between Rural and Small Town residency status and wait-list mortality was 0.497 (95% CI: 0.171-1.438, p = 0.197) for the Cox regression model and 0.628 (95% CI: 0.224-1.757, p = 0.376) for the competing risk regression model. As defined in this study, candidate residence in a rural setting was not found to be associated with inferior survival while awaiting liver transplantation. PMID:22211831

  1. Learning to wait for more likely or just more: greater tolerance to delays of reward with increasingly longer delays.

    PubMed

    Rung, Jillian M; Young, Michael E

    2015-01-01

    Little research has focused on training greater tolerance to delays of rewards in the context of delayed gratification. In delayed gratification, waiting for a delayed outcome necessitates the ability to resist defection for a continuously available smaller, immediate outcome. The present research explored the use of a fading procedure for producing greater waiting in a video-game based, delayed gratification task. Participants were assigned to conditions in which either the reward magnitude, or the probability of receiving a reward, was a function of time waited and the delay to the maximum reward was gradually increased throughout this training. Waiting increased for all participants but less for those waiting for a greater reward magnitude than a greater reward probability. All participants showed a tendency to wait in a final testing phase, but training with probabilistic outcomes produced a significantly greater likelihood of waiting during testing. The behavioral requirements of delay discounting versus delay gratification are discussed, as well as the benefits of training greater self-control in a variety of contexts. PMID:25641081

  2. Definitive Chemoradiotherapy ("Watch-and-Wait" Approach).

    PubMed

    Goodman, Karyn A

    2016-07-01

    Preoperative chemoradiotherapy (CRT) followed by total mesorectal excision has been the standard of care for locally advanced patients with rectal cancer. Some patients achieve a pathologic complete response (pCR) to CRT and the oncologic outcomes are particularly favorable in this group. The role of surgery in patients with a pCR is now being questioned as radical rectal resection is associated with significant morbidity and long-term effects on quality of life. In an attempt to better tailor therapy, there is an interest in a "watch-and-wait" approach in patients who have a clinical complete response (cCR) after CRT with the goal of omitting surgery and allowing for organ preservation. However, a cCR does not always indicate a pCR, and improved clinical and imaging modalities are needed to better predict which patients have achieved a pCR and therefore can safely undergo a "watch-and-wait" approach. This article reviews the current data on nonoperative management and on-going controversies associated with this approach. PMID:27238472

  3. Small Wins: An Initiative to Promote Gender Equity in Higher Education

    ERIC Educational Resources Information Center

    Johnson, Katherine A.; Warr, Deborah J.; Hegarty, Kelsey; Guillemin, Marilys

    2015-01-01

    Gender inequity in leadership and management roles within the higher education sector remains a widespread problem. Researchers have suggested that a multi-pronged method is the preferred approach to reach and maintain gender equity over time. A large university faculty undertook an audit to gauge the level of gender equity on the senior…

  4. Is watch and wait still acceptable for patients with low-grade follicular lymphoma?

    PubMed

    Armitage, James O; Longo, Dan L

    2016-06-01

    Follicular lymphoma (FL) represents more than 20% of all non-Hodgkin lymphomas worldwide and approximately 30% of the non-Hodgkin lymphomas diagnosed in the United States. Although occasionally localized at the time of diagnosis, most patients have disseminated disease. However, patients are frequently asymptomatic, and this, in combination with a long median survival, led to the initial studies of observing asymptomatic patients without initial therapy, ie, "watch and wait." Since the initial report of watch and wait as a treatment strategy for patients with low-grade FL, our understanding of the biology of the disease has advanced; multiple active new agents have been introduced into practice, and the survival of patients with low-grade FL has improved. Given these changes, is watch and wait still an acceptable treatment recommendation for a newly diagnosed patient with low-grade FL? PMID:26994147

  5. Does the wait for lumbar degenerative spinal stenosis surgery have a detrimental effect on patient outcomes? A prospective observational study

    PubMed Central

    Bailey, Christopher S.; Gurr, Kevin R.; Bailey, Stewart I.; Taylor, David; Rosas-Arellano, M. Patricia; Tallon, Corinne; Bureau, Yves; Urquhart, Jennifer C.

    2016-01-01

    Background: Waits for elective spine surgery are common in Canada. We examined whether a prolonged wait for surgery for lumbar degenerative spinal stenosis was detrimental to outcome. Methods: In this prospective observational study, we enrolled 166 consecutive patients referred to our centre for treatment of lumbar degenerative spinal stenosis between 2006 and 2010. Outcome measures were assessed at referral, preoperatively and until 24 months postoperatively. Primary outcome measures were the physical and mental component summary scores of the 36-Item Short-Form Health Survey and the Oswestry Disability Index. Secondary outcome measures included the symptom severity scale of the Zurich Claudication Questionnaire, a numeric rating scale for back and leg pain, and patient satisfaction with treatment. Wait time was defined as the time from referral to surgery. Results: The follow-up rate at 2 years was 85%. The median wait time was 349 days. All health-related quality of life measures deteriorated during the waiting period, but there was no significant correlation between wait time and magnitude of the change in outcome measure. At 6 months postoperatively, the Pearson correlation was significantly positive between wait time and change in disability (r = 0.223), Zurich Claudication Questionnaire score (r = 0.2) and leg pain score (r = 0.221). At 12 months, the correlation remained significant for change in disability (r = 0.205) and was significant for change in mental well-being (r = -0.224). At 12 months, patients with a shorter wait (≤ 12 months) showed greater improvement in mental well-being (mean difference in change [and 95% confidence interval (CI)] 5.7 [1.4-9.9]) and decrease in disability (-9.3 [95% CI -15.1 to -3.6]) and leg pain (-1.6 [95% CI -3.0 to -0.3]). There were no statistically significant differences in outcome or patient satisfaction with treatment between those with shorter and longer waits at 24 months. Interpretation: Patients awaiting

  6. Australian deceased donor kidney allocation protocols: Transplant waiting and graft quality for children and adolescents.

    PubMed

    Le Page, Amelia K; Johnstone, Lilian M; Kennedy, Sean E

    2015-09-01

    DD kidney allocation protocols may influence timing of transplantation and graft quality for pediatric recipients. This study aimed to evaluate the effects of these protocols, including pediatric priority, on waiting time on dialysis, transplant type, donor age, and HLA matching according to state of transplant in Australia. De-identified information on patients <15 yr of age who commenced RRT in NSW, Qld, and Victoria from 2002 to 2011 was retrieved from the ANZDATA. Transplant type, donor age, and HLA mismatching were compared between states, with competing risk regression used to examine the time to transplant. There were significant differences in waiting time to DD transplantation between the three states. Children in NSW and Qld waited a median of 14 and 11 months vs. 21 months in Victoria. The ratio of LD to DD transplants was lower in NSW and Qld. Differences correlated with DD pediatric priority in NSW and Qld. DDs in NSW were older than in the other states. HLA matching did not differ. DD kidney allocation protocols with pediatric priority in Australian states were associated with shorter waiting times and increased DD proportion. PMID:26103210

  7. 16. Historic American Buildings Survey, Carl F. Waite, Photographer April, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    16. Historic American Buildings Survey, Carl F. Waite, Photographer April, 1934 INTERIOR, GENERAL VIEW LOOKING WEST, SECOND FLOOR - Kirtland Temple (Mormon), 9020 Chillicoth Road, Kirtland, Lake County, OH

  8. 3. Historic American Buildings Survey, Carl Waite, Photographer June 29, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    3. Historic American Buildings Survey, Carl Waite, Photographer June 29, 1936 INTERIOR OF OFFICE (NORTH ELEVATION). - Joshua R. Giddings Law Office, Chestnut & Walnut Streets, Jefferson, Ashtabula County, OH

  9. 4. Historic American Buildings Survey, Carl Waite, Photographer June 29, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    4. Historic American Buildings Survey, Carl Waite, Photographer June 29, 1936 INTERIOR DETAIL (NORTH ELEVATION). - Joshua R. Giddings Law Office, Chestnut & Walnut Streets, Jefferson, Ashtabula County, OH

  10. 2. Historic American Buildings Survey, Carl Waite, Photographer June 29, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    2. Historic American Buildings Survey, Carl Waite, Photographer June 29, 1936 MAIN DOORWAY (WEST ELEVATION). - Joshua R. Giddings Law Office, Chestnut & Walnut Streets, Jefferson, Ashtabula County, OH

  11. Brief Solution-Focused Counseling: A Practical Effective Strategy for Dealing with Wait Lists in Community-Based Mental Health Services

    ERIC Educational Resources Information Center

    Mireau, Ruth; Inch, Roxanne

    2009-01-01

    Community-based mental health services are increasingly challenged by waiting lists for individual counseling. A strengths-based, brief solution-focused counseling (BSFC) model was used to increase the number of clients served while maintaining high-quality services. Clients who participated in BSFC experienced both shorter wait times than did…

  12. Popular Media Portrayals of Inequity and School Reform in "The Wire" and "Waiting for 'Superman'"

    ERIC Educational Resources Information Center

    Gerstl-Pepin, Cynthia

    2015-01-01

    Two popular media forms are examined--the documentary film "Waiting for 'Superman'" and the HBO television series, "The Wire"--that present distinct, and at times conflicting, depictions of how to address educational inequity. Qualitative media content analysis was used to analyze the two media documents and to situate them…

  13. The equity lens in the health care performance evaluation system.

    PubMed

    Barsanti, Sara; Nuti, Sabina

    2014-01-01

    The main objective of this paper is to describe how indicators of the equity of access to health care according to socioeconomic conditions may be included in a performance evaluation system (PES) in the regional context level and in the planning and strategic control system of healthcare organisations. In particular, the paper investigates how the PES adopted, in the experience of the Tuscany region in Italy, indicators of vertical equity over time. Studies that testify inequality of access to health services often remain just a research output and are not used as targets and measurements in planning and control systems. After a brief introduction to the concept of horizontal and vertical equity in health care systems and equity measures in PES, the paper describes the 'equity process' by which selected health indicators declined by socioeconomic conditions were shared and used in the evaluation of health care institutions and in the CEOs' rewarding system, and subsequently analyses the initial results. Results on the maternal and child path and the chronicity care path not only show improvements in addressing health care inequalities, but also verify whether the health system responds appropriately to different population groups. PMID:23722829

  14. How to cope with a temporarily aborted transplant program: solutions for a prolonged waiting period

    PubMed Central

    Vanden Eynden, Frédéric; Antoine, Martine; El Oumeiri, Bachar; Chirade, Marie-Luce; Vachiéry, Jean-Luc

    2015-01-01

    Background Due to budgetary restrictions our university heart transplant program came to a standstill to be gradually restarted early 2011. Consequently waiting-times for transplantation increased dramatically beyond the usual 10-15 months. We reviewed the clinical results of this peculiar transplant program over the past 4 years. Methods Since March 2011 until February 2015, 65 patients (age 48±23 years) were listed for heart transplantation. Eight patients (11%) of whom three in high emergency were transplanted without any form of mechanical assistance. Fifty-one patients required a left ventricular assist device (LVAD) Heartware (Heartware Inc., Miami Lakes, FL, USA) as a bridge-to-transplant due to terminal heart failure. Merely 5 listed patients remain without assistance. Results One patient without assistance and 11 LVAD patients (22%) died on the waiting-list. Meanwhile 10 LVAD patients were transplanted after a 2-year waiting time (770±717 days). Four transplanted patients died of early graft failure none after LVAD explantation. Survival at 1 and 3 years was respectively 78 (72%) and 83 (78%) for transplanted and assisted patients (log-rank P=0.056). Cox multivariable regression analysis identified crash-to-burn patients (P=0.002) and waiting-times over 2 years (P=0.044) as risk factors for early death, while age above 60 (P=0.008) and ischemic aetiology (P=0.029) and pulmonary hypertension (P=0.092) were risk factors for survival. Conclusions In times of donor shortage mechanical assistance proves very effective as bridge-to-transplant in patients for whom candidacy follows the standard inclusion procedures. In our settings, a steep increase in LVAD implantation served to salvage patients for whom transplantation became jeopardized due to an ever increasing waiting-time. Circulatory LVAD support could be considered as primary therapy in the future. PMID:26697466

  15. 8 CFR 207.5 - Waiting lists and priority handling.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... REFUGEES § 207.5 Waiting lists and priority handling. Waiting lists are maintained for each designated refugee group of special humanitarian concern. Each applicant whose application is accepted for filing by... of case control. Refugees or groups of refugees may be selected from these lists in a manner...

  16. 8 CFR 207.5 - Waiting lists and priority handling.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... REFUGEES § 207.5 Waiting lists and priority handling. Waiting lists are maintained for each designated refugee group of special humanitarian concern. Each applicant whose application is accepted for filing by... filing is the priority date for purposes of case control. Refugees or groups of refugees may be...

  17. 28 CFR 345.33 - Waiting list hiring exceptions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Waiting list hiring exceptions. 345.33 Section 345.33 Judicial Administration FEDERAL PRISON INDUSTRIES, INC., DEPARTMENT OF JUSTICE FEDERAL PRISON INDUSTRIES (FPI) INMATE WORK PROGRAMS Recruitment and Hiring Practices § 345.33 Waiting...

  18. 28 CFR 345.33 - Waiting list hiring exceptions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Waiting list hiring exceptions. 345.33 Section 345.33 Judicial Administration FEDERAL PRISON INDUSTRIES, INC., DEPARTMENT OF JUSTICE FEDERAL PRISON INDUSTRIES (FPI) INMATE WORK PROGRAMS Recruitment and Hiring Practices § 345.33 Waiting...

  19. 28 CFR 345.33 - Waiting list hiring exceptions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Waiting list hiring exceptions. 345.33 Section 345.33 Judicial Administration FEDERAL PRISON INDUSTRIES, INC., DEPARTMENT OF JUSTICE FEDERAL PRISON INDUSTRIES (FPI) INMATE WORK PROGRAMS Recruitment and Hiring Practices § 345.33 Waiting...

  20. 28 CFR 345.33 - Waiting list hiring exceptions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Waiting list hiring exceptions. 345.33 Section 345.33 Judicial Administration FEDERAL PRISON INDUSTRIES, INC., DEPARTMENT OF JUSTICE FEDERAL PRISON INDUSTRIES (FPI) INMATE WORK PROGRAMS Recruitment and Hiring Practices § 345.33 Waiting...

  1. 8 CFR 207.5 - Waiting lists and priority handling.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... REFUGEES § 207.5 Waiting lists and priority handling. Waiting lists are maintained for each designated refugee group of special humanitarian concern. Each applicant whose application is accepted for filing by... filing is the priority date for purposes of case control. Refugees or groups of refugees may be...

  2. 8 CFR 207.5 - Waiting lists and priority handling.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... REFUGEES § 207.5 Waiting lists and priority handling. Waiting lists are maintained for each designated refugee group of special humanitarian concern. Each applicant whose application is accepted for filing by... of case control. Refugees or groups of refugees may be selected from these lists in a manner...

  3. 8 CFR 207.5 - Waiting lists and priority handling.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... REFUGEES § 207.5 Waiting lists and priority handling. Waiting lists are maintained for each designated refugee group of special humanitarian concern. Each applicant whose application is accepted for filing by... of case control. Refugees or groups of refugees may be selected from these lists in a manner...

  4. 75 FR 48661 - Equity and Excellence Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-11

    ...The U.S. Secretary of Education (Secretary) announces the establishment of the Equity and Excellence Commission (Equity Commission or Commission). The Federal Advisory Committee Act (FACA) (Pub. L. 92-463, as amended; 5 U.S.C.A., Appendix 2) shall govern the Equity Commission. Purpose: The Secretary is establishing the Commission in order to collect information, analyze issues, and obtain......

  5. An Examination of Charter School Equity.

    ERIC Educational Resources Information Center

    Wamba, Nathalis Guy; Ascher, Carol

    2003-01-01

    Investigates the implications of charter school choice for equity, discussing three standards of equity (racial balance, resources, and outcome). Reviews the equity provisions of state charter legislation, research on who chooses charter schools for their children and why, and analyses of the demographic characteristics of charter school students.…

  6. Understanding Equity Strategies of Training Providers

    ERIC Educational Resources Information Center

    McIntyre, John; Volkoff, Veronica; Egg, Mez; Solomon, Nicky

    2004-01-01

    Limited research has been undertaken to identify and examine systemic issues associated with the provision of vocational education and training (VET) to equity groups. This report focuses on the institutional relationships and policies that determine equity provision, and proposes three principles for framing equity practices. The principles are:…

  7. Investing Equity Funding in Early Literacy

    ERIC Educational Resources Information Center

    Batten, Pat

    2004-01-01

    The United States has long been concerned with providing equal, quality education for all its citizens. With state-granted equity funding to needy districts comes the responsibility of wise use of equity monies. This study is an example of how three New Jersey districts invested their equity funding in a highly effective early literacy…

  8. Framework for Evaluation of Equity Initiatives

    ERIC Educational Resources Information Center

    Bexley, Emmaline; Harris, Kerri-Lee; James, Richard

    2010-01-01

    The Framework for Evaluation of Equity Initiatives has been prepared to support the Go8 Equity Strategy. Its purpose is to assist Group of Eight (Go8) universities to evaluate the effectiveness of their equity initiatives and interventions in the context of federal policies and the distinctive missions and responsibilities of the individual Go8…

  9. Waiting for Merlot: anticipatory consumption of experiential and material purchases.

    PubMed

    Kumar, Amit; Killingsworth, Matthew A; Gilovich, Thomas

    2014-10-01

    Experiential purchases (money spent on doing) tend to provide more enduring happiness than material purchases (money spent on having). Although most research comparing these two types of purchases has focused on their downstream hedonic consequences, the present research investigated hedonic differences that occur before consumption. We argue that waiting for experiences tends to be more positive than waiting for possessions. Four studies demonstrate that people derive more happiness from the anticipation of experiential purchases and that waiting for an experience tends to be more pleasurable and exciting than waiting to receive a material good. We found these effects in studies using questionnaires involving a variety of actual planned purchases, in a large-scale experience-sampling study, and in an archival analysis of news stories about people waiting in line to make a purchase. Consumers derive value from anticipation, and that value tends to be greater for experiential than for material purchases. PMID:25147143

  10. Interstellar Sweat Equity

    NASA Astrophysics Data System (ADS)

    Cohen, M. H.; Becker, R. E.; O'Donnell, D. J.; Brody, A. R.

    So, you have just launched aboard the Starship, headed to an exoplanet light years from Earth. You will spend the rest of your natural life on this journey in the expectation and hope that your grandchildren will arrive safely, land, and build a new settlement. You will need to govern the community onboard the Starship. This system of governance must meet unique requirements for participation, representation, and decision-making. On a spaceship that can fly and operate by itself, what will the crewmembers do for their generations in transit? Certainly, they will train and train again to practice the skills they will need upon arrival at a new world. However, this vicarious practice neither suffices to prepare the future pioneers for their destiny at a new star nor will it provide them with the satisfaction in their own work. To hone the crewmembers' inventive and technical skills, to challenge and prepare them for pioneering, the crew would build and expand the interstellar ship in transit. This transstellar ``sweat equity'' gives a stake in the enterprise to all the people, providing meaningful and useful activity to the new generations of crewmembers. They build all the new segments of the vessel from raw materials - including atmosphere - stored on board. Construction of new pressure shell modules would be one option, but they also reconstruct or fill-in existing pressurized volumes. The crew makes new life support system components and develops new agricultural modules in anticipation of their future needs. Upon arrival at the new star or planet, the crew shall apply these robustly developed skills and self-sufficient spirit to their new home.

  11. Making Way for Equity: Elementary Principals' Interpretations of Equity

    ERIC Educational Resources Information Center

    Fishman, Christine A.

    2010-01-01

    Treating education as a socially transformative and morally conscious enterprise calls for educators to expose and improve social conditions related to oppression. These beliefs herald a different kind of practice for teachers and administrators in public schools, a practice that deals directly with dilemmas of equity and pluralism. Limited…

  12. Shareowners' Equity at Campbell Soup: How Can Equity Be Negative?

    ERIC Educational Resources Information Center

    Mohrman, Mary Beth; Stuerke, Pamela S.

    2014-01-01

    This paper presents an instructional case based on the 2001 annual report of the Campbell Soup Company (CPB). During that year, CPB's shareowners' equity went from a surplus of USD137 million to a deficit of USD247 million. The analysis will allow students to determine that the change resulted from borrowing to purchase treasury stock. Students…

  13. Efficiency and Equity in the Time Pattern of Teacher Pension Benefits: An Analysis of Four State Systems. Working Paper 2007-01

    ERIC Educational Resources Information Center

    Costrell, Robert M.; Podgursky, Michael J.

    2007-01-01

    Defined Benefit pension plans often generate odd time patterns of benefits. One typical pattern exhibits low accrual in early years, accelerating in mid-late years, followed by dramatic decline, or even negative returns in years that are relatively young for retirement. We consider four states for specific analysis: Arkansas, Missouri, California…

  14. Randomized control trial: Online parent program and waiting period for unmarried parents in Title IV-D court.

    PubMed

    Rudd, Brittany N; Holtzworth-Munroe, Amy; Reyome, Jason G; Applegate, Amy G; D'Onofrio, Brian M

    2015-10-01

    Despite a lack of research on parent education programs for unmarried parents, many judicial officers mandate participation. We recruited an understudied sample likely at high risk for negative outcomes-182 court cases involving unmarried parents on government assistance in which paternity was contested and then established via genetic testing ordered by the court. This 2 × 2 randomized controlled trial evaluated the impact on initial litigation outcomes of two factors: (a) participation in an online parent education program or not and (b) having a waiting period between the establishment of paternity and the court hearing concerning child-related issues or not. Using an intent-to-treat framework, we found that among cases not assigned to the program, there was no difference in the rate of full agreement on child-related issues (e.g., child support, custody, parenting time) when comparing cases assigned to a waiting period and cases not assigned to a waiting period. In contrast, for cases assigned to the program, cases also assigned a waiting period were less likely to reach a full agreement than cases that had their hearing on the same day. In addition, cases in the "program and waiting period" condition were less likely to return to court for their hearing than cases in the "no program and waiting period" condition. In exploratory analyses of the subsample of cases in which both parents were present at the court hearing, the pattern of results remained the same, although the findings were no longer statistically significant. PMID:26075738

  15. Advocacy for Health Equity: A Synthesis Review

    PubMed Central

    Farrer, Linden; Marinetti, Claudia; Cavaco, Yoline Kuipers; Costongs, Caroline

    2015-01-01

    Context Health inequalities are systematic differences in health among social groups that are caused by unequal exposure to—and distributions of—the social determinants of health (SDH). They are persistent between and within countries despite action to reduce them. Advocacy is a means of promoting policies that improve health equity, but the literature on how to do so effectively is dispersed. The aim of this review is to synthesize the evidence in the academic and gray literature and to provide a body of knowledge for advocates to draw on to inform their efforts. Methods This article is a systematic review of the academic literature and a fixed-length systematic search of the gray literature. After applying our inclusion criteria, we analyzed our findings according to our predefined dimensions of advocacy for health equity. Last, we synthesized our findings and made a critical appraisal of the literature. Findings The policy world is complex, and scientific evidence is unlikely to be conclusive in making decisions. Timely qualitative, interdisciplinary, and mixed-methods research may be valuable in advocacy efforts. The potential impact of evidence can be increased by “packaging” it as part of knowledge transfer and translation. Increased contact between researchers and policymakers could improve the uptake of research in policy processes. Researchers can play a role in advocacy efforts, although health professionals and disadvantaged people, who have direct contact with or experience of hardship, can be particularly persuasive in advocacy efforts. Different types of advocacy messages can accompany evidence, but messages should be tailored to advocacy target. Several barriers hamper advocacy efforts. The most frequently cited in the academic literature are the current political and economic zeitgeist and related public opinion, which tend to blame disadvantaged people for their ill health, even though biomedical approaches to health and political short

  16. Equity in Education: Next Steps

    ERIC Educational Resources Information Center

    Canuel, Ron

    2011-01-01

    In October of 2010, Canadian Education Association (CEA), in conjunction with colleagues from SCOPE (Stanford Centre for Opportunity Policy in Education), hosted an event entitled "Achieving Equity through Innovation: A Canada-United States Colloquium." This two-day event provided an important platform for the exchange of ideas, insights, and…

  17. Using Data to Promote Equity

    ERIC Educational Resources Information Center

    Shum, Brenda

    2016-01-01

    Data plays a starring role in promoting educational equity, and data-driven decision making begins with good state policies. With the recent passage of the Every Student Succeeds Act (ESSA) and a proposed federal rule to address racial disproportionality in special education, states will shoulder increased responsibility for eliminating…

  18. Digital Equity and Intercultural Education

    ERIC Educational Resources Information Center

    Resta, Paul; Laferrière, Thérèse

    2015-01-01

    Digital equity and intercultural education continue to be areas of concern in the emerging knowledge-based society. The digital divide is present across the globe as the result of a complex of factors such as the inequality in: access to hardware and connectivity; autonomy of use; digital and literacy skills; availability of technical and social…

  19. Education between Quality and Equity.

    ERIC Educational Resources Information Center

    Reuter, Lutz-Rainer; And Others

    Papers read by three German educationalists at a workshop on "Education between Quality and Equity" are included in this document. The first, by Han Leo Reimann, is entitled "Simulated Reality: The Instructional Objectives within the Framework of Pedagogical Paper Plays." This paper describes a gaming method of simulating realistic planning and…

  20. Mathematics Equity. A Resource Book.

    ERIC Educational Resources Information Center

    Tyree, Eddy; And Others

    Provided in this document is a brief summary of current research on equity in mathematics, readings on the topic, and lists of selected programs and resource materials. Readings presented include: "Teaching Mathematics in a Multicultural Setting: Some Considerations when Teachers and Students are of Differing Cultural Backgrounds" (Willis N.…

  1. Zoning, equity, and public health.

    PubMed

    Maantay, J

    2001-07-01

    Zoning, the most prevalent land use planning tool in the United States, has substantial implications for equity and public health. Zoning determines where various categories of land use may go, thereby influencing the location of resulting environmental and health impacts. Industrially zoned areas permit noxious land uses and typically carry higher environmental burdens than other areas. Using New York City as a case study, the author shows that industrial zones have large residential populations within them or nearby. Noxious uses tend to be concentrated in poor and minority industrial neighborhoods because more affluent industrial areas and those with lower minority populations are rezoned for other uses, and industrial zones in poorer neighborhoods are expanded. Zoning policies, therefore, can have adverse impacts on public health and equity. The location of noxious uses and the pollution they generate have ramifications for global public health and equity; these uses have been concentrated in the world's poorer places as well as in poorer places within more affluent countries. Planners, policymakers, and public health professionals must collaborate on a worldwide basis to address these equity, health, and land use planning problems. PMID:11441726

  2. Zoning, equity, and public health.

    PubMed Central

    Maantay, J

    2001-01-01

    Zoning, the most prevalent land use planning tool in the United States, has substantial implications for equity and public health. Zoning determines where various categories of land use may go, thereby influencing the location of resulting environmental and health impacts. Industrially zoned areas permit noxious land uses and typically carry higher environmental burdens than other areas. Using New York City as a case study, the author shows that industrial zones have large residential populations within them or nearby. Noxious uses tend to be concentrated in poor and minority industrial neighborhoods because more affluent industrial areas and those with lower minority populations are rezoned for other uses, and industrial zones in poorer neighborhoods are expanded. Zoning policies, therefore, can have adverse impacts on public health and equity. The location of noxious uses and the pollution they generate have ramifications for global public health and equity; these uses have been concentrated in the world's poorer places as well as in poorer places within more affluent countries. Planners, policymakers, and public health professionals must collaborate on a worldwide basis to address these equity, health, and land use planning problems. PMID:11441726

  3. Designing Exhibits for Gender Equity

    ERIC Educational Resources Information Center

    Dancu, Toni Nicole

    2010-01-01

    Gender equity has been a national and global aim for over half a century (Ceci & Williams, 2007; National Center for Education Statistics, 2003; National Science Board, 2008). While gains have been made, one area where inequity remains is spatial reasoning ability, where a large gender gap in favor of males has persisted over the years…

  4. Employment Equity for Aboriginal Teachers

    ERIC Educational Resources Information Center

    British Columbia Teachers' Federation, 2012

    2012-01-01

    This paper is a letter of understanding between British Columbia Teachers' Federation (BCTF) and British Columbia Public School Employers' Association (BCPSEA) in response to Employment Equity for Aboriginal Teachers. The parties recognize that Aboriginal teachers are under-represented in the public education system. The parties are committed to…

  5. Holding Schools Accountable for Equity.

    ERIC Educational Resources Information Center

    Olsen, Laurie

    2001-01-01

    Good reforms can have harmful results if equity effects are ignored. As California implements its accountability system, certain questions must be addressed concerning the system's data use, measurement features (consistency, meaningfulness, achievement growth, achievement gaps among groups), instructional improvement focus, incentives for…

  6. National Equity and School Autonomy.

    ERIC Educational Resources Information Center

    Porter, Andrew C.

    1994-01-01

    Supports William Clune's focus on outputs, rather than inputs and procedures. However, national and state standard setting and systemic reform would foster more school improvement and educational equity than the single-school approach. Focus on outcomes allows considerable local curricular discretion. Schools should be held accountable for student…

  7. Take-Wait-Stop: A Patient-Centered Strategy for Writing PRN Medication Instructions

    PubMed Central

    McCarthy, Danielle M.; Davis, Terry C.; King, Jennifer P.; Mullen, Rebecca J.; Bailey, Stacy C.; Serper, Marina; Jacobson, Kara L.; Parker, Ruth M.; Wolf, Michael S.

    2013-01-01

    Recent studies have linked patient misunderstanding of label instructions for as needed (PRN) medications to dosing errors. This study conducted a preliminary field test of patient-centered PRN label instructions. Patients participated in a hypothetical dosing experiment and were randomized to a patient-centered label (referred to as “Take-Wait-Stop”) or standard label. Participants were asked to demonstrate dosing the medicine over 24 hours. Three types of independent dosing errors were measured: (a) taking more than two pills at one time, (b) exceeding the maximum daily dose, and (c) waiting fewer than 4 hours between doses. Generalized linear models were used to assess the association between label type, health literacy, and sociodemographic characteristics. Participants' mean age was 39.8 years, 62.1% were female, 43.7% were White, and 72.4% had adequate literacy. Of participants, 31.8% who were shown the standard label demonstrated taking in excess of 6 pills in 24 hours compared with only 14.0% of participants who were shown the Take-Wait-Stop label (p = .05). Overall, only 1 person demonstrated he would take more than 2 pills in a single dose. Of the standard label group, 20.5% demonstrated dosing intervals of fewer than 4 hours compared with 23.3% of the Take-Wait-Stop label group (p = .75). In a multivariate model, participants who were exposed to the standard label were 2.5 times more likely to exceed the recommended maximum daily dose (95% CI [1.05, 7.70], p = .03). The Take-Wait-Stop label was beneficial in preventing participants from exceeding the maximum dose in 24 hours, although it did not significantly reduce other dosing errors. PMID:24093344

  8. Equity Index in the School Systems of Selected OECD Countries

    ERIC Educational Resources Information Center

    Ozmusul, Mustafa

    2013-01-01

    The purpose of this study is to analysis the equity in the school systems of selected OECD countries. For this purpose, the international data for selected OECD countries was analyzed in terms of four dimensions of equity as learning equity, school resource equity, participating in education, and digital equity. When analyzing data, the equity…

  9. Wait Time for Treatment in Hospital Emergency Departments: 2009

    MedlinePlus

    ... Vital Statistics Rapid Release Quarterly Provisional Estimates Dashboard Technical Notes Other Publications Advance Data From Vital and ... Vital Statistics of the United States: 1890-1938 Technical Appendices Miscellaneous Publications National Conference on Health Statistics ...

  10. Geometric Brownian Motion with Tempered Stable Waiting Times

    NASA Astrophysics Data System (ADS)

    Gajda, Janusz; Wyłomańska, Agnieszka

    2012-08-01

    One of the earliest system that was used to asset prices description is Black-Scholes model. It is based on geometric Brownian motion and was used as a tool for pricing various financial instruments. However, when it comes to data description, geometric Brownian motion is not capable to capture many properties of present financial markets. One can name here for instance periods of constant values. Therefore we propose an alternative approach based on subordinated tempered stable geometric Brownian motion which is a combination of the popular geometric Brownian motion and inverse tempered stable subordinator. In this paper we introduce the mentioned process and present its main properties. We propose also the estimation procedure and calibrate the analyzed system to real data.

  11. Developmental changes in anger expression and attention focus: Learning to wait

    PubMed Central

    Cole, Pamela M.; Tan, Patricia Z.; Hall, Sarah E.; Zhang, Yiyun; Crnic, Keith A.; Blair, Clancy B.; Li, Runze

    2011-01-01

    Being able to wait is an essential part of self-regulation. The present study examined the developmental course of changes in the latency to and duration of target waiting behaviors by following 65 boys and 55 girls from rural and semi-rural economically strained homes from ages 18 to 48 months. Age-related changes in latency to and duration of children’s anger expressions and attention focus (e.g., self-initiated distraction) during an eight minute wait for a gift were found. On average, at 18 and 24 months of age, children were quick to react angrily and slower to shift attention away from the desired object than they were at later ages. Over time, children were quicker to distract themselves. By 36 months, distractions occurred before children expressed anger, and anger expressions were briefer. At 48 months, children typically made a quick bid to mother about demands of waiting before distracting themselves; on average, they did not appear angry until the latter half of the wait. Unexpectedly, children bid to their mothers as much at age 48 months as they had at 18 months; however bids became less angry as children got older. Developmental changes in distraction and bidding predicted age-related changes in the latency to anger. Findings are discussed in terms of the neurocognitive control of attention around age 30 months, the limitations of children’s self-regulatory efforts at age 48 months, and the importance of fostering children’s ability to forestall, as well as modulate, anger. PMID:21639619

  12. 4. EASTBOUND VIEW. NORTH TRACK WAITING STATION ON LEFT. STATION ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    4. EASTBOUND VIEW. NORTH TRACK WAITING STATION ON LEFT. STATION ON RIGHT. NOTE TUNNEL IN BACKGROUND. - Baltimore & Ohio Railroad, Harpers Ferry Station, Potomac Street, Harpers Ferry, Jefferson County, WV

  13. 17. UPPER STATION, FIRST FLOOR, WAITING ROOM, LOOKING WEST, NORTHWEST. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    17. UPPER STATION, FIRST FLOOR, WAITING ROOM, LOOKING WEST, NORTHWEST. - Monongahela Incline Plane, Connecting North side of Grandview Avenue at Wyoming Street with West Carson Street near Smithfield Street, Pittsburgh, Allegheny County, PA

  14. 7. LOWER STATION, FIRST FLOOR, WAITING ROOM, LOOKING EAST. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    7. LOWER STATION, FIRST FLOOR, WAITING ROOM, LOOKING EAST. - Monongahela Incline Plane, Connecting North side of Grandview Avenue at Wyoming Street with West Carson Street near Smithfield Street, Pittsburgh, Allegheny County, PA

  15. 17. View of masonry gatehouse, safety gates and pedestrian waiting ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    17. View of masonry gatehouse, safety gates and pedestrian waiting shelter with ripped copper roofing and missing columns. (Nov. 30, 1988) - University Heights Bridge, Spanning Harlem River at 207th Street & West Harlem Road, New York County, NY

  16. 36. VIEW OF PASSENGER WAITING ROOM, FERRY HOUSE, NORTH CENTRAL ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    36. VIEW OF PASSENGER WAITING ROOM, FERRY HOUSE, NORTH CENTRAL BUILDING, SECOND LEVEL, LOOKING EAST - Central Railroad of New Jersey, Jersey City Ferry Terminal, Johnson Avenue at Hudson River, Jersey City, Hudson County, NJ

  17. 1. Historic American Buildings Survey, Carl Waite, Photographer September 29, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. Historic American Buildings Survey, Carl Waite, Photographer September 29, 1936 SOUTH ELEVATION (TAKEN FROM OLD PHOTOGRAPH). - H. M. Gillette Residence, Route 18, Blue Goose Corners, Wellington, Lorain County, OH

  18. Topological structures in the equities market network

    PubMed Central

    Leibon, Gregory; Pauls, Scott; Rockmore, Daniel; Savell, Robert

    2008-01-01

    We present a new method for articulating scale-dependent topological descriptions of the network structure inherent in many complex systems. The technique is based on “partition decoupled null models,” a new class of null models that incorporate the interaction of clustered partitions into a random model and generalize the Gaussian ensemble. As an application, we analyze a correlation matrix derived from 4 years of close prices of equities in the New York Stock Exchange (NYSE) and National Association of Securities Dealers Automated Quotation (NASDAQ). In this example, we expose (i) a natural structure composed of 2 interacting partitions of the market that both agrees with and generalizes standard notions of scale (e.g., sector and industry) and (ii) structure in the first partition that is a topological manifestation of a well-known pattern of capital flow called “sector rotation.” Our approach gives rise to a natural form of multiresolution analysis of the underlying time series that naturally decomposes the basic data in terms of the effects of the different scales at which it clusters. We support our conclusions and show the robustness of the technique with a successful analysis on a simulated network with an embedded topological structure. The equities market is a prototypical complex system, and we expect that our approach will be of use in understanding a broad class of complex systems in which correlation structures are resident.

  19. 13. 'WAITING AT THE DRAWBRIDGE.' THE COAL SCHOONER LUCY MAY ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    13. 'WAITING AT THE DRAWBRIDGE.' THE COAL SCHOONER LUCY MAY WAITING AT THE DRAW, JUNE 19, 1896. Photocopy of photograph (original glass plate negative #T89 in the collection of the Annisquam Historical Society, Annisquam, Massachusetts). Photographer: Martha Harvey (1862-1949). (The handwritten legend along the top edge of the photograph is scratched in the emulsion of the original glass plate negative. Consequently it reads in reverse when printed.) - Annisquam Bridge, Spanning Lobster Cove between Washington & River Streets, Gloucester, Essex County, MA

  20. Fault-tolerant wait-free shared objects

    NASA Technical Reports Server (NTRS)

    Jayanti, Prasad; Chandra, Tushar D.; Toueg, Sam

    1992-01-01

    A concurrent system consists of processes communicating via shared objects, such as shared variables, queues, etc. The concept of wait-freedom was introduced to cope with process failures: each process that accesses a wait-free object is guaranteed to get a response even if all the other processes crash. However, if a wait-free object 'crashes,' all the processes that access that object are prevented from making progress. In this paper, we introduce the concept of fault-tolerant wait-free objects, and study the problem of implementing them. We give a universal method to construct fault-tolerant wait-free objects, for all types of 'responsive' failures (including one in which faulty objects may 'lie'). In sharp contrast, we prove that many common and interesting types (such as queues, sets, and test&set) have no fault-tolerant wait-free implementations even under the most benign of the 'non-responsive' types of failure. We also introduce several concepts and techniques that are central to the design of fault-tolerant concurrent systems: the concepts of self-implementation and graceful degradation, and techniques to automatically increase the fault-tolerance of implementations. We prove matching lower bounds on the resource complexity of most of our algorithms.

  1. Voices of Equity: Beginning Teachers Are Crucial Partners and Emerging Leaders of Equity Education

    ERIC Educational Resources Information Center

    West-Burns, Nicole; Murray, Karen; Watt, Jennifer

    2013-01-01

    This article describes an equity education program established in 2009 by Ontario's (Canada) Ministry of Education to improve outcomes for students at risk and create the conditions needed for student success. Beginning teachers were crucial partners and emerging leaders of equity education. Some of the equity concerns these teachers faced…

  2. Faces on the Waiting List: Waiting for Child Care Assistance in Ramsey County. A Survey of Ramsey County Families on the Waiting List for Basic Sliding Fee Child Care Assistance.

    ERIC Educational Resources Information Center

    Schlick, Deborah

    Concerns about the growing waiting list for the child care assistance program in Ramsey County, Minnesota precipitated a telephone survey study of the experiences and attitudes of families on the waiting list. Participating in the study were 270 families randomly selected as a representative sample of individuals on the waiting list for March…

  3. Reducing the distance: equity issues in distance learning in public education

    NASA Astrophysics Data System (ADS)

    Campbell, Patricia B.; Storo, Jennifer

    1996-12-01

    Distance learning and educational equity both began with an emphasis on access, on providing underserved students with an increased access to education. Today definitions of equity have gone beyond simple access to include equal or equivalent treatment and outcomes while definitions of underserved students have expanded to include girls, children of color, children with limited English proficiency and children with disabilities. At the same time the definition of distance learning has expanded to include new technologies, new audiences and new roles. Based on these new definitions and roles, the article raises a number of equity challenges for distance learning educators centering around who is taught, what is taught and how the teaching is done. To answer these challenges, a series of recommendations are suggested that educators can implement to make distance learning a leader in increasing educational equity for all students. The time to act is now.

  4. Advanced access: reducing waiting and delays in primary care.

    PubMed

    Murray, Mark; Berwick, Donald M

    2003-02-26

    Delay of care is a persistent and undesirable feature of current health care systems. Although delay seems to be inevitable and linked to resource limitations, it often is neither. Rather, it is usually the result of unplanned, irrational scheduling and resource allocation. Application of queuing theory and principles of industrial engineering, adapted appropriately to clinical settings, can reduce delay substantially, even in small practices, without requiring additional resources. One model, sometimes referred to as advanced access, has increasingly been shown to reduce waiting times in primary care. The core principle of advanced access is that patients calling to schedule a physician visit are offered an appointment the same day. Advanced access is not sustainable if patient demand for appointments is permanently greater than physician capacity to offer appointments. Six elements of advanced access are important in its application balancing supply and demand, reducing backlog, reducing the variety of appointment types, developing contingency plans for unusual circumstances, working to adjust demand profiles, and increasing the availability of bottleneck resources. Although these principles are powerful, they are counter to deeply held beliefs and established practices in health care organizations. Adopting these principles requires strong leadership investment and support. PMID:12597760

  5. Outcome Probability versus Magnitude: When Waiting Benefits One at the Cost of the Other

    PubMed Central

    Young, Michael E.; Webb, Tara L.; Rung, Jillian M.; McCoy, Anthony W.

    2014-01-01

    Using a continuous impulsivity and risk platform (CIRP) that was constructed using a video game engine, choice was assessed under conditions in which waiting produced a continuously increasing probability of an outcome with a continuously decreasing magnitude (Experiment 1) or a continuously increasing magnitude of an outcome with a continuously decreasing probability (Experiment 2). Performance in both experiments reflected a greater desire for a higher probability even though the corresponding wait times produced substantive decreases in overall performance. These tendencies are considered to principally reflect hyperbolic discounting of probability, power discounting of magnitude, and the mathematical consequences of different response rates. Behavior in the CIRP is compared and contrasted with that in the Balloon Analogue Risk Task (BART). PMID:24892657

  6. Mass Measurements beyond the Major r-Process Waiting Point {sup 80}Zn

    SciTech Connect

    Baruah, S.; Herlert, A.; Schweikhard, L.; Audi, G.; Guenaut, C.; Lunney, D.; Blaum, K.; George, S.; Dworschak, M.; Herfurth, F.; Yazidjian, C.; Hager, U.; Kellerbauer, A.; Kluge, H.-J.; Schatz, H.

    2008-12-31

    High-precision mass measurements on neutron-rich zinc isotopes {sup 71m,72-81}Zn have been performed with the Penning trap mass spectrometer ISOLTRAP. For the first time, the mass of {sup 81}Zn has been experimentally determined. This makes {sup 80}Zn the first of the few major waiting points along the path of the astrophysical rapid neutron-capture process where neutron-separation energy and neutron-capture Q-value are determined experimentally. The astrophysical conditions required for this waiting point and its associated abundance signatures to occur in r-process models can now be mapped precisely. The measurements also confirm the robustness of the N=50 shell closure for Z=30.

  7. Age and fertility: can women wait until their early thirties to try for a first birth?

    PubMed

    McDonald, John W; Rosina, Alessandro; Rizzi, Ester; Colombo, Bernardo

    2011-11-01

    Postponing the start of childbearing raises the question of fertility postponed versus fertility foregone. One of the limitations of previous studies of 'How late can you wait?' is that any observed decline in the probability of conception with age could be due to a decline in fecundability with age or due to a decline in coital frequency with age or due to both factors. Using data from a multinational longitudinal study conducted to determine the daily probability of conception among healthy subjects, a discrete-time event history model with long-term survivors (sterile population) is used to study the relationship between age and fecundability for childless women, while controlling for the pattern of intercourse within a menstrual cycle. The findings suggest that women can wait until their early thirties to try for a first birth, providing that they are not already sterile, as the magnitude of the decline in fecundability is very modest and of little practical importance. PMID:21944061

  8. Outcome probability versus magnitude: when waiting benefits one at the cost of the other.

    PubMed

    Young, Michael E; Webb, Tara L; Rung, Jillian M; McCoy, Anthony W

    2014-01-01

    Using a continuous impulsivity and risk platform (CIRP) that was constructed using a video game engine, choice was assessed under conditions in which waiting produced a continuously increasing probability of an outcome with a continuously decreasing magnitude (Experiment 1) or a continuously increasing magnitude of an outcome with a continuously decreasing probability (Experiment 2). Performance in both experiments reflected a greater desire for a higher probability even though the corresponding wait times produced substantive decreases in overall performance. These tendencies are considered to principally reflect hyperbolic discounting of probability, power discounting of magnitude, and the mathematical consequences of different response rates. Behavior in the CIRP is compared and contrasted with that in the Balloon Analogue Risk Task (BART). PMID:24892657

  9. "Chicks and Hunks:" Teenagers and Sex Equity.

    ERIC Educational Resources Information Center

    Novogrodsky, Myra; Wells, Margaret

    1989-01-01

    Looks at issues of gender equity that are important to teenagers, showing how students' thoughts and feelings can be used as reference points in the social studies classroom. Suggests class discussions on work equity, gender communication, and intervention strategies. Reminds teachers that they must act as positive role models. (LS)

  10. 76 FR 41233 - Equity and Excellence Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-13

    ... Equity and Excellence Commission AGENCY: U.S. Department of Education, Office for Civil Rights. ACTION... meeting of the Equity and Excellence Commission (Commission). The notice also describes the functions of... Center Plaza, 550 12th Street, SW., Washington, DC 20202 in the auditorium (room 10026). FOR...

  11. 77 FR 29621 - Equity and Excellence Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-18

    ..., in Room 1W105/108. FOR FURTHER INFORMATION CONTACT: Guy Johnson, Designated Federal Official, Equity... equitycommission@ed.gov or via U.S. mail to Guy Johnson, Designated Federal Official, Equity and Excellence... contact Guy Johnson at (202) 453-6567 or by email at equitycommission@ed.gov . Individuals who will...

  12. Poverty, equity, human rights and health.

    PubMed Central

    Braveman, Paula; Gruskin, Sofia

    2003-01-01

    Those concerned with poverty and health have sometimes viewed equity and human rights as abstract concepts with little practical application, and links between health, equity and human rights have not been examined systematically. Examination of the concepts of poverty, equity, and human rights in relation to health and to each other demonstrates that they are closely linked conceptually and operationally and that each provides valuable, unique guidance for health institutions' work. Equity and human rights perspectives can contribute concretely to health institutions' efforts to tackle poverty and health, and focusing on poverty is essential to operationalizing those commitments. Both equity and human rights principles dictate the necessity to strive for equal opportunity for health for groups of people who have suffered marginalization or discrimination. Health institutions can deal with poverty and health within a framework encompassing equity and human rights concerns in five general ways: (1) institutionalizing the systematic and routine application of equity and human rights perspectives to all health sector actions; (2) strengthening and extending the public health functions, other than health care, that create the conditions necessary for health; (3) implementing equitable health care financing, which should help reduce poverty while increasing access for the poor; (4) ensuring that health services respond effectively to the major causes of preventable ill-health among the poor and disadvantaged; and (5) monitoring, advocating and taking action to address the potential health equity and human rights implications of policies in all sectors affecting health, not only the health sector. PMID:12973647

  13. Educational Equity: Challenges for Educator Effectiveness

    ERIC Educational Resources Information Center

    Best, Jane; Winslow, Emily

    2015-01-01

    With increasingly diverse student populations, educational equity is a bigger challenge than ever for public schools across the United States. While federal government, states, and school districts work to identify and address the root causes of equity gaps, efforts are often hampered by a limited body of research-based strategies and approaches…

  14. 76 FR 27034 - Equity and Excellence Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-10

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF EDUCATION Equity and Excellence Commission AGENCY: Office for Civil Rights, U.S. Department of Education. ACTION... upcoming meeting of the Equity and Excellence Commission (Commission). The notice also describes...

  15. 77 FR 67637 - Equity and Excellence Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-13

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF EDUCATION Equity and Excellence Commission AGENCY: U.S. Department of Education, Office for Civil Rights. ACTION... Federal Official, Equity and Excellence Commission, U.S. Department of Education, 400 Maryland Avenue...

  16. Learning Equity in a University Classroom

    ERIC Educational Resources Information Center

    van der Westhuizen, G. J.

    2012-01-01

    Since 1994, education policy documents in South Africa have prioritised the goal of equity in education, understood as increased access to programmes, more equitable staff and student profiles, and curricula that are more responsive to the needs of all students. The challenge of effecting the goal of equity at levels of teaching and learning in…

  17. 77 FR 484 - Equity and Excellence Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-05

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF EDUCATION Equity and Excellence Commission AGENCY: Office for Civil Rights, U.S. Department of Education. ACTION..., Equity and Excellence Commission, U.S. Department of Education, 400 Maryland Avenue SW, Washington,...

  18. 76 FR 62394 - Equity and Excellence Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-07

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF EDUCATION Equity and Excellence Commission AGENCY: Office for Civil Rights, U.S. Department of Education. ACTION...-coming meeting of the Equity and Excellence Commission (Commission). The notice also describes...

  19. Elementary Mathematics Teachers' Knowledge of Equity Pedagogy

    ERIC Educational Resources Information Center

    Jackson, Christa

    2013-01-01

    Currently, mathematics instruction in U.S. classrooms is far from achieving equity for African American students. This qualitative study reports the results of eight successful elementary mathematics teachers' knowledge of equity pedagogy, specifically their knowledge of culturally relevant pedagogy, cultural competence, and critical…

  20. Working Together toward Equity for All Students.

    ERIC Educational Resources Information Center

    Bates, Percy; And Others

    1989-01-01

    This inaugural edition of "Equity Coalition" introduces a new publication from the Programs for Educational Opportunity at the University of Michigan, one of 10 regional centers funded by the Federal Government to provide technical assistance to school districts on issues concerning race, gender, and national origin equity. This issue explores the…

  1. Spotlight on Sex Equity: A Filmography.

    ERIC Educational Resources Information Center

    Shaffer, Susan Morris, Comp.

    This catalog contains a list of films, slide-tape presentations, and filmstrips presented at a 2-day film festival sponsored by the Mid-Atlantic Center for Sex Equity and other resources. The guide represents new media resources in addition to classics that meet the requirements of Title IX provisions on sex equity. The filmography is divided into…

  2. Inclusive Education: Examining Equity on Five Continents

    ERIC Educational Resources Information Center

    Artiles, Alfredo J., Ed.; Kozleski, Elizabeth B., Ed.; Waitoller, Federico R., Ed.

    2011-01-01

    Despite the impressive growth of inclusive education around the world, questions and considerations about equity have been neglected. This edited volume makes a major contribution to the field of inclusive education by analyzing equity concerns that have emerged from the implementation of inclusive education models in nine nations on five…

  3. Equity, Equal Opportunities, Gender and Organization Performance.

    ERIC Educational Resources Information Center

    Standing, Hilary; Baume, Elaine

    The issues of equity, equal opportunities, gender, and organization performance in the health care sector worldwide was examined. Information was gathered from the available literature and from individuals in 17 countries. The analysis highlighted the facts that employment equity debates and policies refer largely to high-income countries and…

  4. Multicriteria approaches for a private equity fund

    NASA Astrophysics Data System (ADS)

    Tammer, Christiane; Tannert, Johannes

    2012-09-01

    We develop a new model for a Private Equity Fund based on stochastic differential equations. In order to find efficient strategies for the fund manager we formulate a multicriteria optimization problem for a Private Equity Fund. Using the e-constraint method we solve this multicriteria optimization problem. Furthermore, a genetic algorithm is applied in order to get an approximation of the efficient frontier.

  5. Toward a Pluralistic Perspective on Equity.

    ERIC Educational Resources Information Center

    Pollard, Diane S.; Avery, Maria-Paz Beltran

    1992-01-01

    This digest deals with the challenges of living in a pluralistic society. Comprised of three articles, the first (by Diane S. Pollard) is a discussion of the problems resulting from the fragmented effort of the equity movement, as many different groups working for equity in gender, race, class, and other concerns, have sought independence from…

  6. Gender Equity in Vocational Education. WEEA Digest.

    ERIC Educational Resources Information Center

    McAuliffe, Anne, Ed.

    This digest contains three articles on gender equity in vocational education, especially in relation to the provisions of the Vocational Education Act of 1976 and the Carl Perkins Act of 1984. "Gender Equity in Vocational Education" (Debra J. Robbin) describes interviews with students at a New England vocational school, in which they reported a…

  7. Understanding Gender Equity in the Workplace.

    ERIC Educational Resources Information Center

    Nunnelley State Technical Coll., Childersburg, AL.

    This document discusses issues of gender equity in the workplace which are pertinent to the high school counselor. The first chapter provides guidelines for helping students to understand gender equity issues. These guidelines include asking the students if they would have the same career goals if they were of the other sex and challenging the…

  8. Orwell and the Politics of Equity.

    ERIC Educational Resources Information Center

    Townsend, Richard G.

    1983-01-01

    Reviews three general themes--each related to contemporary situations affecting educational equity--in the works of George Orwell. These include (1) that it is difficult for the weak to preserve their "inner core"; (2) that revolutions for equality can fail; and (3) that all people, including those who work for educational equity, are attracted to…

  9. 28 CFR 548.15 - Equity.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Equity. 548.15 Section 548.15 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT RELIGIOUS PROGRAMS Religious Beliefs and Practices of Committed Offenders § 548.15 Equity. No one may disparage the religious...

  10. Gender Equity for Males. WEEA Digest.

    ERIC Educational Resources Information Center

    Flood, Craig, Ed.; Bates, Percy, Ed.; Potter, Julia, Ed.

    Traditionally, the term "gender equity" is associated with equalizing the playing field for girls. However, gender equity by definition applies to both genders. This digest states that, in the best possible scenario, gender equitable education provides equal opportunities and enables each student to reach his or her potential, reducing the gender…

  11. [Notes on equity in health outcomes].

    PubMed

    Fresneda-Bautista, Oscar

    2008-12-01

    The article locates analysing health outcomes within a set of elements covering evaluating equity in health and suggests some orientations for such analysis. The model of analysis for examining equity in health which has been adopted by the Equity in Quality of Life and Health> has been taken as a point of reference. The text approaches the following questions: What is the role played by evaluating health outcomes within the context of equity in health? How can inequities in health outcomes be evaluated? What should be evaluated regarding health outcomes? The final part deals with how the topic of equity in health does not become exhausted in examining unjust inequalities between individuals or groups. PMID:19377730

  12. Social equity and environmental risk

    SciTech Connect

    Zimmerman, R. )

    1993-12-01

    Social equity has become an important concern of the environmental movement over the past decade. The equity issue is analyzed here for practically all of the inactive hazardous waste disposal sites on the National Priorities List (NPL) regulated under the Comprehensive Response Compensation and Liability Act and its 1986 Superfund Amendments and Reauthorization Act (CERCLA/SARA). Two dimensions of equity are emphasized, namely, site location relative to the location of minority population and the distribution of cleanup plans or Records of Decision (ROD) across communities with NPL sites that have different socioeconomic characteristics. With respect to site location, the percentage of Blacks and Hispanics aggregated at the Census Place or MCD level in communities with NPL sites was greater than is typical nationwide (largely attributable to the concentration of minority populations in a few large urban areas with NPL sites). The percentage of the population below the poverty line in communities with NPL sites largely matched that of the nation as a whole. With respect to site cleanup, communities with relatively higher percentages of racial minority population have fewer cleanup plans than other communities with NPL site. Whether a ROD exists is influenced by when the site was designated for the NPL: sites designated earlier are more likely to have RODs and less likely to have high proportions of racial minority populations than sites designated later. This implies that initially the designation process may have resulted in NPL sites being located disproportionately in minority areas, but this pattern seems to be reversing itself in more recently designated sites. Racial and ethnic disproportionalities with respect to inactive hazardous waste site location seem to be concentrated in a relatively few areas. 35 refs., 12 tabs.

  13. Waiting for a kidney from a deceased donor: an interpretative phenomenological analysis.

    PubMed

    Spiers, Johanna; Smith, Jonathan A

    2016-10-01

    Demand for kidneys from deceased donors far outstrips supply. Despite this, there appears to be little research that focuses solely on the experience of waiting for a kidney from a deceased donor. This study uses the qualitative methodology interpretative phenomenological analysis to explore the lives of 10 people on the transplant list, with the aims of illuminating the potential psychological challenges those on the list may face during this time, and providing information to help clinicians more fully support such people in the future. Two themes connected to the experience of waiting - adjustment to the uncertainty of waiting and thinking about receiving a kidney from a living donor - are presented here. Participants describe a sense of confusion and uncertainty around life on the list, and discuss their strategies for dealing with this. Novel complexities around the ambiguous challenge of receiving an organ from a deceased donor are revealed. It is recommended that health care teams provide a forum for this patient group to work through these feelings of confusion and ambiguity. PMID:26584590

  14. Treatment of indolent lymphomas: watchful waiting v aggressive combined modality treatment

    SciTech Connect

    Young, R.C.; Longo, D.L.; Glatstein, E.; Ihde, D.C.; Jaffe, E.S.; DeVita, V.T. Jr.

    1988-04-01

    Patients with advanced indolent lymphoma often have long survival (median, 4 to 8 years) in spite of frequent relapses. The inability of combination chemotherapy or radiation therapy (RT) to render patients disease free has led to radically divergent treatment approaches. Initial treatment may vary from aggressive combined modality therapy to no initial treatment. We sought to evaluate these two divergent approaches in a randomized trial of advanced indolent lymphomas (nodular, poorly differentiated lymphocytic; nodular mixed; diffuse, well-differentiated lymphocytic; diffuse, intermediately differentiated lymphocytic; and diffuse, poorly differentiated lymphocytic). A total of 104 patients were entered: 44 were randomly assigned to watch and wait in which only carefully defined, limited RT was administered if necessary; 45 were randomly assigned to aggressive combined modality treatment with prednisone, methotrexate, doxorubicin, cyclophosphamide, plus etoposide plus mechlorethamine, vincristine, procarbazine, prednisone (ProMACE-MOPP), followed by total nodal irradiation (TNI); and 15, with symptoms requiring initial therapy, received the identical combined treatment but were not randomly assigned. Of 41 evaluable patients on watch and wait, 23 (56%) have still not required systemic therapy, although 16 (39%) have received limited RT. Median time to crossover was 34 months. Of 18 patients crossed over, seven of the 16 who completed therapy (43%) achieved CR; two (11%) have relapsed. Histologic progression was seen in six (15%) of 41 patients on watch and wait without intervening chemotherapy. Of 45 patients randomly assigned to chemotherapy, 37 (82%) have completed induction therapy, and 29 of the 37 (78%) achieved CR.

  15. Bridging and downstaging treatments for hepatocellular carcinoma in patients on the waiting list for liver transplantation.

    PubMed

    Pompili, Maurizio; Francica, Giampiero; Ponziani, Francesca Romana; Iezzi, Roberto; Avolio, Alfonso Wolfango

    2013-11-21

    Several therapeutic procedures have been proposed as bridging treatments for patients with hepatocellular carcinoma (HCC) awaiting liver transplantation (LT). The most used treatments include transarterial chemoembolization and radiofrequency ablation. Surgical resection has also been successfully used as a bridging procedure, and LT should be considered a rescue treatment in patients with previous HCC resection who experience tumor recurrence or post-treatment severe decompensation of liver function. The aims of bridging treatments include decreasing the waiting list dropout rate before transplantation, reducing HCC recurrence after transplantation, and improving post-transplant overall survival. To date, no data from prospective randomized studies are available; however, for HCC patients listed for LT within the Milan criteria, prolonging the waiting time over 6-12 mo is a risk factor for tumor spread. Bridging treatments are useful in containing tumor progression and decreasing dropout. Furthermore, the response to pre-LT treatments may represent a surrogate marker of tumor biological aggressiveness and could therefore be evaluated to prioritize HCC candidates for LT. Lastly, although a definitive conclusion can not be reached, the experiences reported to date suggest a positive impact of these treatments on both tumor recurrence and post-transplant patient survival. Advanced HCC may be downstaged to achieve and maintain the current conventional criteria for inclusion in the waiting list for LT. Recent studies have demonstrated that successfully downstaged patients can achieve a 5-year survival rate comparable to that of patients meeting the conventional criteria without requiring downstaging. PMID:24282343

  16. Tutorial in medical decision modeling incorporating waiting lines and queues using discrete event simulation.

    PubMed

    Jahn, Beate; Theurl, Engelbert; Siebert, Uwe; Pfeiffer, Karl-Peter

    2010-01-01

    In most decision-analytic models in health care, it is assumed that there is treatment without delay and availability of all required resources. Therefore, waiting times caused by limited resources and their impact on treatment effects and costs often remain unconsidered. Queuing theory enables mathematical analysis and the derivation of several performance measures of queuing systems. Nevertheless, an analytical approach with closed formulas is not always possible. Therefore, simulation techniques are used to evaluate systems that include queuing or waiting, for example, discrete event simulation. To include queuing in decision-analytic models requires a basic knowledge of queuing theory and of the underlying interrelationships. This tutorial introduces queuing theory. Analysts and decision-makers get an understanding of queue characteristics, modeling features, and its strength. Conceptual issues are covered, but the emphasis is on practical issues like modeling the arrival of patients. The treatment of coronary artery disease with percutaneous coronary intervention including stent placement serves as an illustrative queuing example. Discrete event simulation is applied to explicitly model resource capacities, to incorporate waiting lines and queues in the decision-analytic modeling example. PMID:20345550

  17. Gender equity & human development.

    PubMed

    Vepa, Swarna S

    2007-10-01

    The welfare of both women and men constitutes the human welfare. At the turn of the century amidst the glory of unprecedented growth in national income, India is experiencing the spread of rural distress. It is mainly due to the collapse of agricultural economy. Structural adjustments and competition from large-scale enterprises result in loss of rural livelihoods. Poor delivery of public services and safety nets, deepen the distress. The adverse impact is more on women than on men. This review examines the adverse impact of the events in terms of endowments, livelihood opportunities and nutritional outcomes on women in detail with the help of chosen indicators at two time-periods roughly representing mid nineties and early 2000. The gender equality index computed and the major indicators of welfare show that the gender gap is increasing in many aspects. All the aspects of livelihoods, such as literacy, unemployment and wages now have larger gender gaps than before. Survival indicators such as juvenile sex ratio, infant mortality, child labour have deteriorated for women, compared to men, though there has been a narrowing of gender gaps in life expectancy and literacy. The overall gender gap has widened due to larger gaps in some indicators, which are not compensated by the smaller narrowing in other indicators both in the rural and urban context. PMID:18032808

  18. 'Suspended in a paradox'-patient attitudes to wait-listing for kidney transplantation: systematic review and thematic synthesis of qualitative studies.

    PubMed

    Tong, Allison; Hanson, Camilla S; Chapman, Jeremy R; Halleck, Fabian; Budde, Klemens; Josephson, Michelle A; Craig, Jonathan C

    2015-07-01

    Patients on waiting lists for kidney transplantation have higher mortality rates and have specific anxieties about their eligibility, process, and outcomes of wait-listing. We aimed to describe patient experiences and attitudes to wait-listing for kidney transplantation. Electronic databases were searched to September 2014. Thematic synthesis was used to analyze the findings. From 22 studies (n = 795 patients), we identified six themes: accepting the only option (chance to regain normality, avoiding guilt, impulsive decision-making); maintaining hope (determined optimism, appreciating a fortuitous gift, enduring for optimal outcomes, trust in clinical judgment); burden of testing (strenuous commitment, losing the battle, medical mistrust); permeating vulnerability (eligibility enigma, being threatened, angst of timing uncertainty, desperate urgency, living in limbo, spiraling doubt and disappointment, residual ambivalence); deprived of opportunity (unfairly dismissed, unexpected disqualification, self-resignation and acceptance, jealousy, suspicious of inequity); and moral guilt (awaiting someone's death, questioning deservingness). The waiting list offered hope of restored normality. However, the demands of workup, uncertainty about eligibility, and waiting times that exceeded expectations impelled patients to disillusionment, despair, and suspicion of inequity. Managing patient expectations and ensuring transparency of wait-listing and allocation decisions may allay patient disappointment and skepticism, to improve patient satisfaction and treatment outcomes. PMID:25847569

  19. 28 CFR 345.33 - Waiting list hiring exceptions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Section 345.33 Judicial Administration FEDERAL PRISON INDUSTRIES, INC., DEPARTMENT OF JUSTICE FEDERAL PRISON INDUSTRIES (FPI) INMATE WORK PROGRAMS Recruitment and Hiring Practices § 345.33 Waiting list... reason other than formal education, vocational training, drug abuse or similar formal programs)....

  20. 30. VIEW OF STEEL STAIRCASE FROM MAIN 1889 WAITING ROOM ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    30. VIEW OF STEEL STAIRCASE FROM MAIN 1889 WAITING ROOM IN HEAD HOUSE, LOOKING EAST TO PASSENGER CONCOURSE AT SECOND LEVEL OF FERRY PORTION - Central Railroad of New Jersey, Jersey City Ferry Terminal, Johnson Avenue at Hudson River, Jersey City, Hudson County, NJ

  1. The Ultimate $uperpower: Supersized Dollars Drive "Waiting for "Superman"" Agenda

    ERIC Educational Resources Information Center

    Miner, Barbara

    2011-01-01

    For nearly 40 years, according to this author, "follow the money" has been an axiom in both journalism and politics--although, as Shakespeare might complain, one "more honour'd in the breach than the observance." It is useful to resurrect the axiom in analyzing the multimedia buzz and policy debates swirling around the movie "Waiting for…

  2. Frailty Predicts Wait-List Mortality in Liver Transplant Candidates

    PubMed Central

    Lai, Jennifer C.; Feng, Sandy; Terrault, Norah A.; Lizaola, Blanca; Hayssen, Hilary; Covinsky, Kenneth

    2014-01-01

    We aimed to determine whether frailty, a validated geriatric construct of increased vulnerability to physiologic stressors, predicts mortality in liver transplant (LT) candidates. Consecutive adult outpatients listed for LT with laboratory MELD≥12 at a single center (97% recruitment rate) underwent 4 frailty assessments: Fried Frailty, Short Physical Performance Battery (SPPB), Activities of Daily Living (ADL), and Instrumental ADL (IADL) scales. Competing risks models associated frailty with wait-list mortality (death/delisting for being too sick for LT). 294 listed LT patients with MELD≥12, median age 60y, and MELD 15 were followed for 12 months. By Fried Frailty score≥3, 17% were frail; 11/51 (22%) of the frail versus 25/243 (10%) of the not frail died/were delisted (p=0.03). Each 1-unit increase in the Fried Frailty score was associated with a 45% (95%CI, 4-202%) increased risk of wait-list mortality adjusted for MELD. Similarly, the adjusted risk of wait-list mortality associated with each 1-unit decrease (i.e., increasing frailty) in the SPPB (HR 1.19, 95%CI 1.07-1.32). Frailty is prevalent in LT candidates. It strongly predicts wait-list mortality, even after adjustment for liver disease severity demonstrating the applicability and importance of the frailty construct in this population. PMID:24935609

  3. 4. PACK TRAIN WAITING TO BE UNLOADED AT FOOT OF ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    4. PACK TRAIN WAITING TO BE UNLOADED AT FOOT OF YAKI TRAIL. APPROXIMATELY TWO-AND-ONE-HALF TONS OF STEEL ON ANIMALS SHOWN. NOTE COIL OF 1-1/2' WIND CABLE IN FOREGROUND. - Kaibab Trail Suspension Bridge, Spanning Colorado River, Grand Canyon, Coconino County, AZ

  4. RMS end effector waiting for command and SPAS-01 nearby

    NASA Technical Reports Server (NTRS)

    1983-01-01

    The end effector of the remote manipulator system (RMS) appears to be waiting for its next command at the top of this frame and the Shuttle pallet satellite (SPAS-01), in its free flying mode, appears nearby. The three letters legible on the SPAS stand for Messerschmitt-Boelkow-Blohm Gmbit, a West German firm.

  5. Changing the Rules of the 'ROE': A Reform in Waiting

    SciTech Connect

    Rokach, Joshua Z.

    2006-05-15

    Congress and FERC recognize the need to attract more investment in transmission. FERC promised to increase cash flow for companies investing in transmission and introduced incremental changes in rates of return. But the agency can do better. FERC should enact comprehensive reform of its return-on-equity calculus to conform policy to market reality. (author)

  6. Private equity investment in health care services.

    PubMed

    Robbins, Catherine J; Rudsenske, Todd; Vaughan, James S

    2008-01-01

    Sophisticated private equity investors in health services provide venture capital for early-stage companies, growth capital for mid-stage companies, and equity capital for buyouts of mid-stage and mature companies. They pursue opportunities in provider sectors that are large and have a stable reimbursement environment, such as acute care services; sectors with room to execute consolidation strategies, such as labs; alternative-site sectors, such as "storefront" medicine; and clinical services, such as behavioral health, that are subject to profitably increasing quality and lowering costs. The innovations created through private equity investments could challenge established health services organizations. PMID:18780929

  7. Equity trees and graphs via information theory

    NASA Astrophysics Data System (ADS)

    Harré, M.; Bossomaier, T.

    2010-01-01

    We investigate the similarities and differences between two measures of the relationship between equities traded in financial markets. Our measures are the correlation coefficients and the mutual information. In the context of financial markets correlation coefficients are well established whereas mutual information has not previously been as well studied despite its theoretically appealing properties. We show that asset trees which are derived from either the correlation coefficients or the mutual information have a mixture of both similarities and differences at the individual equity level and at the macroscopic level. We then extend our consideration from trees to graphs using the "genus 0" condition recently introduced in order to study the networks of equities.

  8. Innovatus Interregnum: Waiting for a Paradigm Shift

    ERIC Educational Resources Information Center

    English, Fenwick W.; Ehrich, Lisa Catherine

    2015-01-01

    Purpose: The purpose of this paper is to establish the case that innovation in the theory and practice of educational administration/leadership is very unlikely to occur within the existing "doxa" of our times. By innovation is meant a novel conceptual or practical change in the field of practice. By "doxa" is meant the…

  9. Advancing Efforts to Achieve Health Equity: Equity Metrics for Health Impact Assessment Practice

    PubMed Central

    Heller, Jonathan; Givens, Marjory L.; Yuen, Tina K.; Gould, Solange; Benkhalti Jandu, Maria; Bourcier, Emily; Choi, Tim

    2014-01-01

    Equity is a core value of Health Impact Assessment (HIA). Many compelling moral, economic, and health arguments exist for prioritizing and incorporating equity considerations in HIA practice. Decision-makers, stakeholders, and HIA practitioners see the value of HIAs in uncovering the impacts of policy and planning decisions on various population subgroups, developing and prioritizing specific actions that promote or protect health equity, and using the process to empower marginalized communities. There have been several HIA frameworks developed to guide the inclusion of equity considerations. However, the field lacks clear indicators for measuring whether an HIA advanced equity. This article describes the development of a set of equity metrics that aim to guide and evaluate progress toward equity in HIA practice. These metrics also intend to further push the field to deepen its practice and commitment to equity in each phase of an HIA. Over the course of a year, the Society of Practitioners of Health Impact Assessment (SOPHIA) Equity Working Group took part in a consensus process to develop these process and outcome metrics. The metrics were piloted, reviewed, and refined based on feedback from reviewers. The Equity Metrics are comprised of 23 measures of equity organized into four outcomes: (1) the HIA process and products focused on equity; (2) the HIA process built the capacity and ability of communities facing health inequities to engage in future HIAs and in decision-making more generally; (3) the HIA resulted in a shift in power benefiting communities facing inequities; and (4) the HIA contributed to changes that reduced health inequities and inequities in the social and environmental determinants of health. The metrics are comprised of a measurement scale, examples of high scoring activities, potential data sources, and example interview questions to gather data and guide evaluators on scoring each metric. PMID:25347193

  10. Should I stay or should I go? Waiting lists and cross-border care in the Netherlands.

    PubMed

    Brouwer, Werner; van Exel, Job; Hermans, Bert; Stoop, Arjen

    2003-03-01

    The recent ruling of the European Court of Justice in the case Smits-Peerbooms explicitly mentions undue delay as a legitimisation for cross-border care within the EU. In the Netherlands, waiting times are well above the norm set by several health care parties as well as maximally acceptable waiting times elicited in patients. This might indicate that Dutch patients are often entitled to care in other Member States, in the sense that insurers cannot withhold reimbursement of cross-border care in the present situation. However, experiments clearly demonstrate that few Dutch patients are willing to travel abroad. Patients seem to prefer longer waiting in the Netherlands over shorter waiting by going abroad, even those living in border regions. In addition, mobility of patients within the Netherlands is very modest. Given this inertia in patient mobility, in the short run, cross-border care will probably remain an insignificant phenomenon in terms of quantities of patients travelling abroad and therefore the impact of the Smits-Peerbooms rulings is limited. PMID:12595128

  11. SouthWest view, Street Car Waiting House, north and east elevations ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    South-West view, Street Car Waiting House, north and east elevations - North Philadelphia Station, Street Car Waiting House, 2900 North Broad Street, on northwest corner of Broad Street & Glenwood Avenue, Philadelphia, Philadelphia County, PA

  12. NorthEast view; Street Car Waiting House, south (front) and west ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    North-East view; Street Car Waiting House, south (front) and west elevations - North Philadelphia Station, Street Car Waiting House, 2900 North Broad Street, on northwest corner of Broad Street & Glenwood Avenue, Philadelphia, Philadelphia County, PA

  13. 76 FR 6774 - Equity and Excellence Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-08

    ... finance systems to achieve equity in the distribution of educational resources and further ] student performance, especially for the students at the lower end of the achievement gap. The Commission will...

  14. 76 FR 55059 - Equity and Excellence Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-06

    ... finance systems to achieve equity in the distribution of educational resources and further student performance, especially for the students at the lower end of the achievement gap. The Commission will...

  15. 77 FR 49441 - Equity and Excellence Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-16

    ... finance systems to achieve equity in the distribution of educational resources and further student performance, especially for the students at the lower end of the achievement gap. The Commission will...

  16. Equity Theory Ratios as Causal Schemas

    PubMed Central

    Arvanitis, Alexios; Hantzi, Alexandra

    2016-01-01

    Equity theory approaches justice evaluations based on ratios of exchange inputs to exchange outcomes. Situations are evaluated as just if ratios are equal and unjust if unequal. We suggest that equity ratios serve a more fundamental cognitive function than the evaluation of justice. More particularly, we propose that they serve as causal schemas for exchange outcomes, that is, they assist in determining whether certain outcomes are caused by inputs of other people in the context of an exchange process. Equality or inequality of ratios in this sense points to an exchange process. Indeed, Study 1 shows that different exchange situations, such as disproportional or balanced proportional situations, create perceptions of give-and-take on the basis of equity ratios. Study 2 shows that perceptions of justice are based more on communicatively accepted rules of interaction than equity-based evaluations, thereby offering a distinction between an attribution and an evaluation cognitive process for exchange outcomes. PMID:27594846

  17. The Alliance for Equity in Higher Education

    ERIC Educational Resources Information Center

    Merisotis, Jamie P.; Goulian, Katherine A.

    2004-01-01

    This chapter describes the organization, operations, and goals of the Alliance for Equity in Higher Education, a national coalition of associations and institutions founded to serve the emerging majority of racially diverse college students.

  18. Iranian nursing students' perspectives of educational equity.

    PubMed

    Ghiyasvandian, Shahrzad; Nikbakht-Nasrabadi, Alireza; Mohammadpour, Ali; Abbasi, Mahmoud; Javadi, Mostafa

    2014-01-01

    Around the world there is a growing consensus that students' rights must be protected, regardless of race, creed, color, sex, religion, and socioeconomic status. One of these rights is the educational equity. However, little is known about these phenomena in nursing education. The aim of this study was to explore the educational equity from the perspective of nursing students. A qualitative study was conducted. Thus, we purposefully recruited for in-depth interviews 13 nursing students (8 female and 5 male). All interviews were transcribed verbatim and analyzed by thematic analysis approach to identify categories and themes. Four main themes emerged from the data: Fair Educational Opportunity, fair evaluation, attempts to combat discrimination, and employing qualified teachers.  It is argued that educational equity should be developed in higher education. Principles of equity and students' rights may form the most basic rationale for all formal and informal efforts to extend the right of equal access to education. PMID:25530059

  19. Equity Theory Ratios as Causal Schemas.

    PubMed

    Arvanitis, Alexios; Hantzi, Alexandra

    2016-01-01

    Equity theory approaches justice evaluations based on ratios of exchange inputs to exchange outcomes. Situations are evaluated as just if ratios are equal and unjust if unequal. We suggest that equity ratios serve a more fundamental cognitive function than the evaluation of justice. More particularly, we propose that they serve as causal schemas for exchange outcomes, that is, they assist in determining whether certain outcomes are caused by inputs of other people in the context of an exchange process. Equality or inequality of ratios in this sense points to an exchange process. Indeed, Study 1 shows that different exchange situations, such as disproportional or balanced proportional situations, create perceptions of give-and-take on the basis of equity ratios. Study 2 shows that perceptions of justice are based more on communicatively accepted rules of interaction than equity-based evaluations, thereby offering a distinction between an attribution and an evaluation cognitive process for exchange outcomes. PMID:27594846

  20. The Crisis in Excellence and Equity.

    ERIC Educational Resources Information Center

    Marshall, Catherine

    1984-01-01

    Highlights the insufficient explanations and fundamental fallacies in policy and programs for sex equity in educational administration. Examines the lack of incentives for promotion of women to positions of leadership. (SK)

  1. 7 CFR 1980.391 - Equity sharing.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... market value based on the Lender's and RHS approval official's knowledge of the property and the area. (B... the shared equity calculation. In the event a junior lienholder forecloses, the RHS approval...

  2. Equity: A Future Issue in American Education.

    ERIC Educational Resources Information Center

    Snowden, Petra E.

    1981-01-01

    Reveals how equity, as the resort to specific strategies or plans of action based on general principles of fairness and justice whenever existing law is inadequate, will determine the future character of educational policy. (Author)

  3. 75 FR 48662 - Equity and Excellence Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-11

    ... Secretary for Civil Rights. Nomination Process: Any interested person or organization may nominate one or...: Send to: WhiteHouseLiaison@ed.gov (specify in the e-mail subject line, ``Equity Commission...

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

    PubMed Central

    2011-01-01

    Background Long waiting times for registration to see a doctor is problematic in China, especially in tertiary hospitals. To address this issue, a web-based appointment system was developed for the Xijing hospital. The aim of this study was to investigate the efficacy of the web-based appointment system in the registration service for outpatients. Methods Data from the web-based appointment system in Xijing hospital from January to December 2010 were collected using a stratified random sampling method, from which participants were randomly selected for a telephone interview asking for detailed information on using the system. Patients who registered through registration windows were randomly selected as a comparison group, and completed a questionnaire on-site. Results A total of 5641 patients using the online booking service were available for data analysis. Of them, 500 were randomly selected, and 369 (73.8%) completed a telephone interview. Of the 500 patients using the usual queuing method who were randomly selected for inclusion in the study, responses were obtained from 463, a response rate of 92.6%. Between the two registration methods, there were significant differences in age, degree of satisfaction, and total waiting time (P < 0.001). However, gender, urban residence, and valid waiting time showed no significant differences (P > 0.05). Being ignorant of online registration, not trusting the internet, and a lack of ability to use a computer were three main reasons given for not using the web-based appointment system. The overall proportion of non-attendance was 14.4% for those using the web-based appointment system, and the non-attendance rate was significantly different among different hospital departments, day of the week, and time of the day (P < 0.001). Conclusion Compared to the usual queuing method, the web-based appointment system could significantly increase patient's satisfaction with registration and reduce total waiting time effectively. However

  5. 76 FR 64348 - Granting of Request for Early Termination of the Waiting Period Under the Premerger Notification...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-18

    ... Machines Corporation. 20111426 G Platinum Equity Capital Partners II, L.P.; Carlyle Strategic Partners, L.P.; Platinum Equity Capital Partners II, L.P. 20111436 G Littlejohn Fund IV, L.P.; CHS Private Equity V...

  6. Mandatory weight loss during the wait for bariatric surgery.

    PubMed

    Glenn, Nicole M; Raine, Kim D; Spence, John C

    2015-01-01

    Mandatory presurgical, behavior-induced weight loss, although not standard, is a relatively common practice among bariatric surgical clinics. We explore the patient's experience of this practice using phenomenology. We gathered experiential accounts from 7 individuals waiting to have the procedure at a large publically funded clinic in western Canada. In writing this article, we focused on four phenomenological themes: "just nod your head and carry on"-silencing through the ideal; waiting and weighing-promoting weight consciousness to the weight conscious; paying for surgical approval through weight loss; and presurgical weight loss and questioning the need for weight loss surgery altogether. We contrast the experiential findings with the clinical literature to question the impact and possible (unintended or unexpected) effects the practice might have, particularly on patients' lives. We situate this article within a larger discussion about the possible contribution of experiential knowledge to clinical guidelines, practices, and pedagogies. PMID:25185162

  7. Waiting for a miracle... miracles, miraclism, and discrimination.

    PubMed

    Savulescu, Julian; Clarke, Steve

    2007-12-01

    We argue that the use of publicly funded medical facilities for patients who are waiting for a miracle amounts to discrimination against atheists, agnostics and advocates, of faiths that do not accept miracle claims. The only exception is when this use can be justified by considerations that demonstrate that waiting makes it more likely that a miracle will occur and will aid the patient's recovery. Such justification can be grounded on considerations of faith or of reason. We consider both possibilities and suggest conditions of acceptability for both. In arguing this way, we steer a middle path between discrimination against atheists, agnostics, and advocates of faiths that do not accept miracle claims--miraclism--and a failure to respect religious belief. PMID:18090974

  8. 29. Attic interior showing roof truss system over waiting room; ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    29. Attic interior showing roof truss system over waiting room; note knob-and-tube wiring system; brick section at far left is rear of tower, which of brick masonry construction above the first story level, joined to the exterior walls of stone masonry; view to southeast along axis of building, 90mm lens and electronic flash illumination. - Southern Pacific Depot, 559 El Camino Real, San Carlos, San Mateo County, CA

  9. DIME Students Waiting for Their Turn to Drop Experiment

    NASA Technical Reports Server (NTRS)

    2002-01-01

    Students pause while waiting their turn at the 2.2-second Drop Tower during the second Dropping in a Microgravity Environment (DIME) competition held April 23-25, 2002, at NASA's Glenn Research Center. Competitors included two teams from Sycamore High School, Cincinnati, OH, and one each from Bay High School, Bay Village, OH, and COSI Academy, Columbus, OH. DIME is part of NASA's education and outreach activities. Details are on line at http://microgravity.grc.nasa.gov/DIME_2002.html.

  10. HYPOXIA AMONG PATIENTS ON THE LIVER-TRANSPLANT WAITING LIST

    PubMed Central

    NACIF, Lucas Souto; ANDRAUS, Wellington; SARTORI, Kathryn; BENITES, Carlos Marlon; SANTOS, Vinicius Rocha; ROCHA-FILHO, Joel Avancini; D'ALBUQUERQUE, Luiz Carneiro

    2014-01-01

    Background Hepatopulmonary syndrome is formed by a triad of liver disease, intrapulmonary vascular dilatation and changes in blood gases. This condition is present in 4-32% of patients with cirrhosis. Aim To analyze the blood gas changes data of patients in liver-transplant waiting list. Method Clinical data of 279 patients in liver transplantation waiting list in May 2013 were studied. Overall patient was analyzed by the demographic aspects, laboratorial and image findings on exams that determine lung disease (hypoxemia) in these cirrhotic patients. The mean values and standard deviations were used to examine normally distributed variables. Results There was a high prevalence of male patients (68%); the mean age was 51(±5,89) years, and the predominant reason for listing was hepatitis C cirrhosis. The MELD score mean was 16±5,89, without prioritization or special situation. The most common blood type was O in 129 cases (46%) and the mean of body max index was 25,94±4,58. Regarding arterial blood gas tests was observed 214 patients with PaO2 <90 mmHg, 80 with PaO2 <80 mmHg and 39 with PaO2 <50 mmHg. In relation to O2 saturation, 50 patients had <90%, 33 <80% and 10 <50%. Conclusion Was observed a high rate of hypoxemia in patients on waiting list liver transplant. Due to the high severity and morbidity, is suggested better monitoring and therapeutic support to hypoxemic patients on liver transplant waiting list. PMID:24676301

  11. RMS end effector waiting for command and SPAS-01 nearby

    NASA Technical Reports Server (NTRS)

    1983-01-01

    The end effector of the remote manipulator system (RMS) appears to be waiting for its next command at the top of this frame and the Shuttle pallet satellite (SPAS-01), in its free flying mode, appears nearby. The three letters legible on the SPAS stand for Messerschmitt-Boelkow-Blohm Gmbit, a West German firm. The earth's horizon is visible at the bottom of the frame.

  12. Test Equity for Individuals Who Are Deaf or Hard of Hearing. PEPNet Test Equity Summit

    ERIC Educational Resources Information Center

    PEPNet-West, 2010

    2010-01-01

    This paper presents the highlights of the 2008 Test Equity Summit held in Bloomfield, Colorado last August 6-8, 2008. The 2008 Test Equity Summit convened by the Postsecondary Education Programs Network (PEPNet) identified and examined problems, challenges, and issues that academic and psychoeducational tests pose for individuals who are deaf or…

  13. Curriculum and Research for Equity. A Training Manual for Promoting Sex Equity in the Classroom.

    ERIC Educational Resources Information Center

    Lockheed, Marlaine E.; And Others

    The Curriculum And Research for Equity (C-A-R-E) program materials are inservice teacher training modules (workshops, curricula, references, and research data) designed to promote educational equity in elementary school classrooms. The training manual is intended to help elementary education professionals identify, assess, and rectify the problem…

  14. Promoting Educational Equity through School Libraries. Module 5: Educational Equity in the Library.

    ERIC Educational Resources Information Center

    Nilsen, Alleen Pace; Tyler, Karen Beyard

    Suggestions offered in the fifth module of a continuing education program for inservice school media specialists are designed to aid in identifying sexism and sex-role stereotyping in instructional materials, and help trainees foster educational equity in their own institutions. The first part is concerned with the promotion of such equity through…

  15. Students as Policy Actors: The TDSB Equity Foundation Statement and Commitments to Equity Policy

    ERIC Educational Resources Information Center

    Ferfolja, Tania

    2013-01-01

    Discrimination on the basis of homophobia/transphobia in many schools is an internationally recognised problem. The Toronto District School Board's (TDSB) Equity Foundation Statement and Commitments to Equity Policy (EFS) provides an explicit mandate to schools in its jurisdiction to address such discrimination and educate about sexual and…

  16. Educational Equity: The Integration of Equity into Preservice Teacher Education Programs.

    ERIC Educational Resources Information Center

    Dawson, Martha E.; And Others

    This volume of papers, written by professors of education, an administrator, and a clinical psychologist, illustrate how the concept of equity can be woven into the professional components of teacher education. In "A Matter of Linkage: Multicultural Education and Educational Equity," Martha E. Dawson maintains that multicultural education is an…

  17. Did Equity of Reproductive and Maternal Health Service Coverage Increase during the MDG Era? An Analysis of Trends and Determinants across 74 Low- and Middle-Income Countries

    PubMed Central

    Sharma, Suneeta

    2015-01-01

    Introduction Despite widespread gains toward the 5th Millennium Development Goal (MDG), pro-rich inequalities in reproductive health (RH) and maternal health (MH) are pervasive throughout the world. As countries enter the post-MDG era and strive toward UHC, it will be important to monitor the extent to which countries are achieving equity of RH and MH service coverage. This study explores how equity of service coverage differs across countries, and explores what policy factors are associated with a country’s progress, or lack thereof, toward more equitable RH and MH service coverage. Methods We used RH and MH service coverage data from Demographic and Health Surveys (DHS) for 74 countries to examine trends in equity between countries and over time from 1990 to 2014. We examined trends in both relative and absolute equity, and measured relative equity using a concentration index of coverage data grouped by wealth quintile. Through multivariate analysis we examined the relative importance of policy factors, such as political commitment to health, governance, and the level of prepayment, in determining countries’ progress toward greater equity in RH and MH service coverage. Results Relative equity for the coverage of RH and MH services has continually increased across all countries over the past quarter century; however, inequities in coverage persist, in some countries more than others. Multivariate analysis shows that higher education and greater political commitment (measured as the share of government spending allocated to health) were significantly associated with higher equity of service coverage. Neither country income, i.e., GDP per capita, nor better governance were significantly associated with equity. Conclusion Equity in RH and MH service coverage has improved but varies considerably across countries and over time. Even among the subset of countries that are close to achieving the MDGs, progress made on equity varies considerably across countries

  18. Design and Feasibility Testing of the truth FinishIt Tobacco Countermarketing Brand Equity Scale.

    PubMed

    Evans, W Douglas; Rath, Jessica; Pitzer, Lindsay; Hair, Elizabeth C; Snider, Jeremy; Cantrell, Jennifer; Vallone, Donna

    2016-07-01

    The original truth campaign was a branded, national smoking prevention mass media effort focused on at-risk youth ages 12-17. Today the truth brand focuses on the goal of finishing tobacco (truth FinishIt). There have been significant changes in the tobacco control landscape, leading FinishIt to focus on 15- to 21-year-olds. The present article reports on formative research and media monitoring data collected to pilot test a new truth FinishIt brand equity scale. The goals of this study were to (a) content analyze truth FinishIt mass media ads, (b) assess truth's social media and followers' perceptions of truth's digital brand identity, and (c) develop and feasibility test a new version of the truth FinishIt brand equity scale using data from an existing Truth Initiative media monitoring study. Through factor analysis, we identified a brand equity scale, as in previous research, consisting of 4 main constructs: brand loyalty, leadership/satisfaction, personality, and awareness. Targeted truth attitudes and beliefs about social perceptions, acceptability, and industry-related beliefs were regressed on the higher order factor and each of the 4 individual brand equity factors. Ordinary least squares regression models generally showed associations in the expected directions (positive for anti-tobacco and negative for pro-tobacco) between targeted attitudes/beliefs and truth FinishIt brand equity. This study succeeded in developing and validating a new truth FinishIt brand equity scale. The scale may be a valuable metric for future campaign evaluation. Future studies should examine the effects of truth FinishIt brand equity on tobacco use behavioral outcomes over time. PMID:27315354

  19. Developmental Origins, Epigenetics, and Equity: Moving Upstream.

    PubMed

    Wallack, Lawrence; Thornburg, Kent

    2016-05-01

    The Developmental Origins of Health and Disease and the related science of epigenetics redefines the meaning of what constitutes upstream approaches to significant social and public health problems. An increasingly frequent concept being expressed is "When it comes to your health, your zip code may be more important than your genetic code". Epigenetics explains how the environment-our zip code-literally gets under our skin, creates biological changes that increase our vulnerability for disease, and even children's prospects for social success, over their life course and into future generations. This science requires us to rethink where disease comes from and the best way to promote health. It identifies the most fundamental social equity issue in our society: that initial social and biological disadvantage, established even prior to birth, and linked to the social experience of prior generations, is made worse by adverse environments throughout the life course. But at the same time, it provides hope because it tells us that a concerted focus on using public policy to improve our social, physical, and economic environments can ultimately change our biology and the trajectory of health and social success into future generations. PMID:27029539

  20. Managing Time.

    ERIC Educational Resources Information Center

    Murphy, Linda; Della Corte, Suzanne

    1991-01-01

    This newsletter issue discusses time management techniques for parents of special needs children. Techniques include changing one's attitudes about perfection, prioritizing tasks, having a back-up plan, learning to say "no," asking for help, keeping things simple, hiring others, using waiting time wisely, and doing two things at once. Household…

  1. Sex Equity Research: Keeping the Campus Out of the Courtroom. AIR 1984 Annual Forum Paper.

    ERIC Educational Resources Information Center

    Brown, Marilyn K.; And Others

    Sex equity research efforts undertaken by the Office of Institutional Studies at the University of Maryland at College Park are discussed. A plan was developed for examining salary differences at three distinct times: time of appointment, upon promotion and/or award of tenure, and at annual salary reviews. Salaries of male and female faculty…

  2. Waiting for better, not for more: corvids respond to quality in two delay maintenance tasks

    PubMed Central

    Hillemann, Friederike; Bugnyar, Thomas; Kotrschal, Kurt; Wascher, Claudia A. F.

    2015-01-01

    Self-control, that is, overcoming impulsivity towards immediate gratification in favour of a greater but delayed reward, is seen as a valuable skill when making future-oriented decisions. Experimental studies in nonhuman primates revealed that individuals of some species are willing to tolerate delays of up to several minutes in order to gain food of a higher quantity or quality. Recently, birds (carrion crows, Corvus corone, common ravens, Corvus corax, Goffin cockatoos, Cacatua goffiniana) performed comparably to primates in an exchange task, contradicting previous notions that birds may lack any impulse control. However, performance differed strikingly with the currency of exchange: individuals of all three species performed better when asked to wait for a higher food quality, rather than quantity. Here, we built on this work and tested whether the apparent difference in levels of self-control expressed in quality versus quantity tasks reflects cognitive constraints or is merely due to methodological limitations. In addition to the exchange paradigm, we applied another established delay maintenance methodology: the accumulation task. In this latter task, food items accumulated to a maximum of four pieces, whereas in the exchange task, an initial item could be exchanged for a reward item after a certain time delay elapsed. In both tasks, birds (seven crows, five ravens) were asked to wait in order to optimize either the quality or the quantity of food. We found that corvids were willing to delay gratification when it led to a food reward of higher quality, but not when waiting was rewarded with a higher quantity, independent of the experimental paradigm. This study is the first to test crows and ravens with two different paradigms, the accumulation and the exchange of food, within the same experiment, allowing for fair comparisons between methods and species. PMID:25892738

  3. Pay Equity Act, 17 May 1988.

    PubMed

    1988-01-01

    This document contains major provisions of the 1988 Pay Equity Act of Prince Edward Island, Canada. (Nova Scotia enacted similar legislation in 1988.) This act defines "female-dominated class" or "male-dominated class" as a class with 60% or more female or male incumbents, respectively. The objective of this act is to achieve pay equity among public sector employers and employees by identifying systemic gender discrimination through a comparison of the relative wages and value of the work performed by female- and male-dominated classes. The value of work is to be determined by considering the skill, effort, and responsibility required by the work as well as the conditions under which it is performed. A difference in wages between a female- and male-dominated class performing work of equal or comparable value can be justified by a formal performance appraisal system or formal seniority system that does not discriminate on the basis of gender or by a skills shortage which requires a temporary inflation in wages to attract workers for a certain position. No wages shall be reduced to implement pay equity. Implementation of pay equity will include the work of bargaining agents to achieve agreement on salient points. Pay equity may be implemented in four stages over a period of 24 months. PMID:12289286

  4. Decentralization and equity of resource allocation: evidence from Colombia and Chile.

    PubMed Central

    Bossert, Thomas J.; Larrañaga, Osvaldo; Giedion, Ursula; Arbelaez, José Jesus; Bowser, Diana M.

    2003-01-01

    OBJECTIVE: To investigate the relation between decentralization and equity of resource allocation in Colombia and Chile. METHODS: The "decision space" approach and analysis of expenditures and utilization rates were used to provide a comparative analysis of decentralization of the health systems of Colombia and Chile. FINDINGS: Evidence from Colombia and Chile suggests that decentralization, under certain conditions and with some specific policy mechanisms, can improve equity of resource allocation. In these countries, equitable levels of per capita financial allocations at the municipal level were achieved through different forms of decentralization--the use of allocation formulae, adequate local funding choices and horizontal equity funds. Findings on equity of utilization of services were less consistent, but they did show that increased levels of funding were associated with increased utilization. This suggests that improved equity of funding over time might reduce inequities of service utilization. CONCLUSION: Decentralization can contribute to, or at least maintain, equitable allocation of health resources among municipalities of different incomes. PMID:12751417

  5. 17 CFR 190.07 - Calculation of allowed net equity.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... equity. 190.07 Section 190.07 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION BANKRUPTCY § 190.07 Calculation of allowed net equity. Allowed net equity shall be computed as follows: (a... the most active market. (iii) Special rule for valuing dealer options. A dealer option which is...

  6. 17 CFR 190.07 - Calculation of allowed net equity.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... equity. 190.07 Section 190.07 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION (CONTINUED) BANKRUPTCY § 190.07 Calculation of allowed net equity. Allowed net equity shall be computed as...) of this section, the trustee should use the most active market. (iii) Special rule for valuing...

  7. 26 CFR 1.809-10 - Computation of equity base.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 8 2011-04-01 2011-04-01 false Computation of equity base. 1.809-10 Section 1... (CONTINUED) INCOME TAXES (CONTINUED) Gain and Loss from Operations § 1.809-10 Computation of equity base. (a) In general. For purposes of section 809, the equity base of a life insurance company includes...

  8. 46 CFR 67.31 - Stock or equity interest requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 2 2010-10-01 2010-10-01 false Stock or equity interest requirements. 67.31 Section 67... VESSELS DOCUMENTATION OF VESSELS Citizenship Requirements for Vessel Documentation § 67.31 Stock or equity interest requirements. (a) The stock or equity interest requirements for citizenship under this...

  9. 46 CFR 67.31 - Stock or equity interest requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 2 2011-10-01 2011-10-01 false Stock or equity interest requirements. 67.31 Section 67... VESSELS DOCUMENTATION OF VESSELS Citizenship Requirements for Vessel Documentation § 67.31 Stock or equity interest requirements. (a) The stock or equity interest requirements for citizenship under this...

  10. 31 CFR 29.523 - Equity and good conscience.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance: Treasury 1 2014-07-01 2014-07-01 false Equity and good conscience. 29.523... Standards for Waiver of Overpayments § 29.523 Equity and good conscience. Recovery is against equity and good conscience when there is substantial evidence that— (a) It would cause financial hardship to...

  11. 5 CFR 831.1403 - Equity and good conscience.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Equity and good conscience. 831.1403... REGULATIONS (CONTINUED) RETIREMENT Standards for Waiver of Overpayments § 831.1403 Equity and good conscience. (a) Defined. Recovery is against equity and good conscience when— (1) It would cause...

  12. 5 CFR 845.303 - Equity and good conscience.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Equity and good conscience. 845.303 Section 845.303 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE... Overpayments § 845.303 Equity and good conscience. Recovery is against equity and good conscience when— (a)...

  13. 22 CFR 17.4 - Equity and good conscience.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Equity and good conscience. 17.4 Section 17.4 Foreign Relations DEPARTMENT OF STATE PERSONNEL OVERPAYMENTS FROM THE FOREIGN SERVICE RETIREMENT AND... PENSION SYSTEM (FSPS) § 17.4 Equity and good conscience. (a) Defined. Recovery is against equity and...

  14. 5 CFR 845.303 - Equity and good conscience.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Equity and good conscience. 845.303 Section 845.303 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE... Overpayments § 845.303 Equity and good conscience. Recovery is against equity and good conscience when— (a)...

  15. 5 CFR 845.303 - Equity and good conscience.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Equity and good conscience. 845.303 Section 845.303 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE... Overpayments § 845.303 Equity and good conscience. Recovery is against equity and good conscience when— (a)...

  16. 22 CFR 17.4 - Equity and good conscience.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Equity and good conscience. 17.4 Section 17.4 Foreign Relations DEPARTMENT OF STATE PERSONNEL OVERPAYMENTS FROM THE FOREIGN SERVICE RETIREMENT AND... PENSION SYSTEM (FSPS) § 17.4 Equity and good conscience. (a) Defined. Recovery is against equity and...

  17. 22 CFR 17.4 - Equity and good conscience.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Equity and good conscience. 17.4 Section 17.4 Foreign Relations DEPARTMENT OF STATE PERSONNEL OVERPAYMENTS FROM THE FOREIGN SERVICE RETIREMENT AND... PENSION SYSTEM (FSPS) § 17.4 Equity and good conscience. (a) Defined. Recovery is against equity and...

  18. 22 CFR 17.4 - Equity and good conscience.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Equity and good conscience. 17.4 Section 17.4 Foreign Relations DEPARTMENT OF STATE PERSONNEL OVERPAYMENTS FROM THE FOREIGN SERVICE RETIREMENT AND... PENSION SYSTEM (FSPS) § 17.4 Equity and good conscience. (a) Defined. Recovery is against equity and...

  19. 22 CFR 17.4 - Equity and good conscience.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Equity and good conscience. 17.4 Section 17.4 Foreign Relations DEPARTMENT OF STATE PERSONNEL OVERPAYMENTS FROM THE FOREIGN SERVICE RETIREMENT AND... PENSION SYSTEM (FSPS) § 17.4 Equity and good conscience. (a) Defined. Recovery is against equity and...

  20. 31 CFR 29.523 - Equity and good conscience.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance: Treasury 1 2013-07-01 2013-07-01 false Equity and good conscience. 29.523... Standards for Waiver of Overpayments § 29.523 Equity and good conscience. Recovery is against equity and good conscience when there is substantial evidence that— (a) It would cause financial hardship to...

  1. 31 CFR 29.523 - Equity and good conscience.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance: Treasury 1 2012-07-01 2012-07-01 false Equity and good conscience. 29.523... Standards for Waiver of Overpayments § 29.523 Equity and good conscience. Recovery is against equity and good conscience when there is substantial evidence that— (a) It would cause financial hardship to...

  2. 5 CFR 845.303 - Equity and good conscience.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Equity and good conscience. 845.303 Section 845.303 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE... Overpayments § 845.303 Equity and good conscience. Recovery is against equity and good conscience when— (a)...

  3. 5 CFR 831.1403 - Equity and good conscience.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Equity and good conscience. 831.1403... REGULATIONS (CONTINUED) RETIREMENT Standards for Waiver of Overpayments § 831.1403 Equity and good conscience. (a) Defined. Recovery is against equity and good conscience when— (1) It would cause...

  4. 5 CFR 831.1403 - Equity and good conscience.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Equity and good conscience. 831.1403... REGULATIONS (CONTINUED) RETIREMENT Standards for Waiver of Overpayments § 831.1403 Equity and good conscience. (a) Defined. Recovery is against equity and good conscience when— (1) It would cause...

  5. 31 CFR 29.523 - Equity and good conscience.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Equity and good conscience. 29.523... Standards for Waiver of Overpayments § 29.523 Equity and good conscience. Recovery is against equity and good conscience when there is substantial evidence that— (a) It would cause financial hardship to...

  6. 5 CFR 831.1403 - Equity and good conscience.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Equity and good conscience. 831.1403... REGULATIONS (CONTINUED) RETIREMENT Standards for Waiver of Overpayments § 831.1403 Equity and good conscience. (a) Defined. Recovery is against equity and good conscience when— (1) It would cause...

  7. 5 CFR 845.303 - Equity and good conscience.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Equity and good conscience. 845.303 Section 845.303 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE... Overpayments § 845.303 Equity and good conscience. Recovery is against equity and good conscience when— (a)...

  8. 5 CFR 831.1403 - Equity and good conscience.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Equity and good conscience. 831.1403... REGULATIONS (CONTINUED) RETIREMENT Standards for Waiver of Overpayments § 831.1403 Equity and good conscience. (a) Defined. Recovery is against equity and good conscience when— (1) It would cause...

  9. 31 CFR 29.523 - Equity and good conscience.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance: Treasury 1 2011-07-01 2011-07-01 false Equity and good conscience. 29.523... Standards for Waiver of Overpayments § 29.523 Equity and good conscience. Recovery is against equity and good conscience when there is substantial evidence that— (a) It would cause financial hardship to...

  10. Conceptions of Equity: How Influential Actors View a Contested Concept

    ERIC Educational Resources Information Center

    Bulkley, Katrina E.

    2013-01-01

    Discussions of educational equity have played an important role in educational policy in the United States over the past 50 years, and advocates with a broad range of perspectives on reform have sought to claim the equity mantle. In this article, I examine aspects of equity, including the distribution of "inputs" to public education, the…

  11. Investigating Ten Years of Equity Policy in Australian Higher Education

    ERIC Educational Resources Information Center

    Coates, Hamish; Krause, Kerri-Lee

    2005-01-01

    This paper reports issues arising from a longitudinal study of 1991 to 2002 Australian higher education equity data. The national equity framework uses an empirical performance indicator system to monitor access, participation, success and retention of six designated equity groups. The paper examines three possible approaches for defining new…

  12. What Is Equity in Education? Reflections from the Capability Approach

    ERIC Educational Resources Information Center

    Unterhalter, Elaine

    2009-01-01

    While there is a substantial conceptual literature on equality in education, there has been little clarificatory discussion on the term equity, despite its frequent use in policy and planning documents. The article draws out some different ways in which equity can be understood in education. It distinguishes three forms of equity, looking at the…

  13. Pursuing Equity in and through Teacher Education Program Admissions

    ERIC Educational Resources Information Center

    Childs, Ruth A.; Broad, Kathryn; Gallagher-Mackay, Kelly; Sher, Yael; Escayg, Kerry-Ann; McGrath, Christopher

    2011-01-01

    This case study investigated equity in teacher education admissions. Through document analysis and structured interviews with ten past or current members of the admissions committee in a large initial teacher education program in Ontario, we developed an understanding of equity in teacher education admissions as encompassing two foci: equity in…

  14. The Sublime Objects of Education Policy: Quality, Equity and Ideology

    ERIC Educational Resources Information Center

    Clarke, Matthew

    2014-01-01

    Quality and equity are touchstones of education policy in the twenty-first century in a range of global contexts. On the surface, this seems fitting: after all, who could object to more quality and greater equity in education? Yet what do we mean by quality and equity, and how are they related? This paper draws on Lacanian psychoanalytic theory to…

  15. 33 CFR 385.19 - Environmental and economic equity.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Environmental and economic equity... Implementation Processes § 385.19 Environmental and economic equity. (a) Project Management Plans and Program Management Plans shall include information concerning any environmental and economic equity activities to...

  16. 33 CFR 385.19 - Environmental and economic equity.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Environmental and economic equity... Implementation Processes § 385.19 Environmental and economic equity. (a) Project Management Plans and Program Management Plans shall include information concerning any environmental and economic equity activities to...

  17. 33 CFR 385.19 - Environmental and economic equity.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Environmental and economic equity... Implementation Processes § 385.19 Environmental and economic equity. (a) Project Management Plans and Program Management Plans shall include information concerning any environmental and economic equity activities to...

  18. 33 CFR 385.19 - Environmental and economic equity.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Environmental and economic equity... Implementation Processes § 385.19 Environmental and economic equity. (a) Project Management Plans and Program Management Plans shall include information concerning any environmental and economic equity activities to...

  19. 33 CFR 385.19 - Environmental and economic equity.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Environmental and economic equity... Implementation Processes § 385.19 Environmental and economic equity. (a) Project Management Plans and Program Management Plans shall include information concerning any environmental and economic equity activities to...

  20. Sex Equity Ideabook for the District of Columbia Public Schools.

    ERIC Educational Resources Information Center

    Grady, Walteen; And Others

    This publication contains lesson plans and classroom activities to assist K-12 teachers develop sex equity themes. It supplements the "Sex Equity Resource Directory" (SO 013 579) which is a guide to sex equity resources available through the District of Columbia Public Schools. The "Ideabook" has several major sections each containing materials…

  1. Taxpayer Equity in the Financing of Public Schools.

    ERIC Educational Resources Information Center

    Aronson, J. Richard; Hilley, John L.

    To test whether equity in educational expenditure can include equity for taxpayers, the authors analyze two suggested methods for achieving educational equity. The two methods are district power equalizing (DPE), which grants state aid in inverse proportion to school district wealth, and the wealth neutral system (WNS), which takes account of…

  2. As Endowment Managers Turn to Private Equity, Questions Arise

    ERIC Educational Resources Information Center

    Fuller, Andrea; Blumenstyk, Goldie

    2012-01-01

    Endowment growth in 2011 came in no small part because universities have increasingly invested in private equity--the same private equity that has become a hot-button issue on the 2012 campaign trail, with some candidates and commentators calling into question its social value. Private equity is "of increasing significance" for endowments. It made…

  3. Reviving Pay Equity: New Strategies for Attacking the Wage Gap.

    ERIC Educational Resources Information Center

    Kahn, Peggy; Figart, Deborah M.

    1998-01-01

    Pay equity remains a problem linked to the problem of low pay. Pay equity must be understood as one solution to the problem of securing a living wage for women and men in the restructuring economy as well as a means for challenging gender equity. (JOW)

  4. 17 CFR 49.5 - Equity interest transfers.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... agreement(s) that could result in an equity interest transfer of ten percent or more in the swap data.... (1) Upon a transfer of an equity interest of ten percent or more in a registered swap data repository... of this chapter, following the date on which the equity interest of ten percent or more was...

  5. Gender Equity and Mass Communication's Female Student Majority.

    ERIC Educational Resources Information Center

    Golombisky, Kim

    2002-01-01

    Provides an overview of the history and politics of gender equity to make problematic the phrase "gender equity," to introduce the gender equity in education literature, and to outline some issues relevant to mass communication. Suggests that equal access represents a sex-blind approach dependent on a male standard. (SG)

  6. Cultural Differences in Equity Theory Predictions of Relational Maintenance Strategies

    ERIC Educational Resources Information Center

    Yum, Young-ok; Canary, Daniel J.

    2009-01-01

    This study examined whether the theoretic role of equity in predicting relational maintenance strategies is modified by participant country and culture. Research on equity theory in relationships has been conducted primarily in the United States and Western Europe. We argue that equity theory predictions regarding relational communication probably…

  7. Aspects of Student Equity and Higher Education in South Africa

    ERIC Educational Resources Information Center

    Beckmann, J.

    2008-01-01

    Badat (2004, 4) refers to the triple challenge facing higher education: to promote equity and growth within a democratic framework and to consolidate a fledgling democracy. In higher education there is inherent tension between growth (access to education) and equity. The article argues that the vagueness in which the term "equity" is generally…

  8. 12 CFR 1026.40 - Requirements for home equity plans.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 8 2013-01-01 2013-01-01 false Requirements for home equity plans. 1026.40...) Special Rules for Certain Home Mortgage Transactions § 1026.40 Requirements for home equity plans. The... to consumers for home equity plans must provide the brochure required under paragraph (e) of...

  9. Medical pluralism: global perspectives on equity issues.

    PubMed

    Marian, Florica

    2007-12-01

    Over the last decades, awareness has increased about the phenomenon of medical pluralism and the importance to integrate biomedicine and other forms of health care. The broad variety of healing cultures existing alongside biomedicine is called complementary or alternative medicine (CAM) in industrialized countries and traditional medicine (TM) in developing countries. Considerable debate has arisen about ethical problems related to the growing use of CAM in industrialized countries. This article focuses on equity issues and aims to consider them from a global perspective of medical pluralism. Several dimensions of equity are explored and their interrelatedness discussed: access to care, research (paradigm and founding) and recognition. This so-called 'equity circle' is then related to Iris Marion Young's justice theory and particularly to the concepts of cultural imperialism, powerlessness and marginalisation. PMID:18219205

  10. Negotiating equity for management of DOE wastes

    SciTech Connect

    Carnes, S.A.

    1994-09-01

    One important factor frustrating optimal management of Department of Energy (DOE)-complex wastes is the inability to use licensed and permitted facilities systematically. Achieving the goal of optimal use of DOE`s waste management facilities is politically problematic for two reasons. First, no locale wants to bear a disproportionate burden from DOE wastes. Second, the burden imposed by additional wastes transported from one site to another is difficult to characterize. To develop a viable framework for equitably distributing these burdens while achieving efficient use of all DOE waste management facilities, several implementation and equity issues must be addressed and resolved. This paper discusses stakeholder and equity issues and proposes a framework for joint research and action that could facilitate equity negotiations among stakeholder and move toward a more optimal use of DOE`s waste management capabilities.

  11. Equity and adequacy in school funding.

    PubMed

    Augenblick, J G; Myers, J L; Anderson, A B

    1997-01-01

    Since 1971, most states have been subject to lawsuits seeking to reform their education funding systems. These cases are litigated on the basis of state (not federal) constitutional language and generally seek either greater equity in funding among school districts or a guaranteed level of adequate funding for education. State supreme courts have found the finance systems unconstitutional in 16 states, and many states are still actively involved in litigation. Even where litigation has not occurred or has not succeeded, the prospect of litigation has prompted revisions of state funding policies. Despite the predominant role equity and adequacy play in litigation, there are no universally accepted definitions for either of these words in education funding. Most commonly, equity is measured in terms of the variation in per-pupil revenues among school districts in a single state. By this measure, some states have greater funding equity than others, and in most states wealthy districts have significantly higher per-pupil expenditures than do poor districts. Equity is likely to be greater when the residents of poor districts pay higher taxes. (In some states, residents in poorer areas pay twice as much of their income in local taxes as do residents of wealthier communities.) Equity is also greater in those states where the state's share of the education budget is higher and where the state consistently targets its contributions to lower-income districts. Much of current litigation and legislative activity in education funding seeks to assure "adequacy," that is, a sufficient level of funding to deliver an adequate education to every student in the state. Most states have not explicitly addressed the questions of how much education is "adequate" or how educational standards can be converted to a finance formula. Several approaches to calculating the cost of an adequate education are described. PMID:10892466

  12. An exploration of the basis for patient complaints about the oldness of magazines in practice waiting rooms: cohort study

    PubMed Central

    Alrutz, Stowe; Moyes, Simon

    2014-01-01

    Objective To explore the basis for patient complaints about the oldness of most magazines in practice waiting rooms. Design Cohort study. Setting Waiting room of a general practice in Auckland, New Zealand. Participants 87 magazines stacked into three mixed piles and placed in the waiting room: this included non-gossipy magazines (Time magazine, the Economist, Australian Women’s Weekly, National Geographic, BBC History) and gossipy ones (not identified for fear of litigation). Gossipy was defined as having five or more photographs of celebrities on the front cover and most gossipy as having up to 10 such images. Interventions The magazines were marked with a unique number on the back cover, placed in three piles in the waiting room, and monitored twice weekly. Main outcome measures Disappearance of magazines less than 2 months old versus magazines 3-12 months old, the overall rate of loss of magazines, and the rate of loss of gossipy versus non-gossipy magazines. Results 47 of the 82 magazines with a visible date on the front cover were aged less than 2 months. 28 of these 47 (60%) magazines and 10 of the 35 (29%) older magazines disappeared (P=0.002). After 31 days, 41 of the 87 (47%, 95% confidence interval 37% to 58%) magazines had disappeared. None of the 19 non-gossipy magazines (the Economist and Time magazine) had disappeared compared with 26 of the 27 (96%) gossipy magazines (P<0.001). All 15 of the most gossipy magazines and all 19 of the non-gossipy magazines had disappeared by 31 days. The study was terminated at this point. Conclusions General practice waiting rooms contain mainly old magazines. This phenomenon relates to the disappearance of the magazines rather than to the supply of old ones. Gossipy magazines were more likely to disappear than non-gossipy ones. On the grounds of cost we advise practices to supply old copies of non-gossipy magazines. A waiting room science curriculum is urgently needed. PMID:25500116

  13. The Delta IV launch table waits for transfer to CCAFS

    NASA Technical Reports Server (NTRS)

    2000-01-01

    In the turn basin near the Vehicle Assembly Building (left) a launch table is docked, waiting for transfer to Launch Complex 37B, Cape Canaveral Air Force Station. The table was fabricated by Jered Industries in Georgia in support of the Delta Evolved Expendable Launch Vehicle (EELV) program, known as Delta IV. It was floated on a barge down the Intercoastal Waterway, through the Barge Canal to the turn basin. The table is approximately 70 feet long, 40 feet wide and 50 feet high, and weighs about 600,000 pounds. Accompanying the launch table on the barge are flame deflectors, which are also to be erected on pad 37B.

  14. The Application of Waiting Lines System in Improving Customer Service Management: The Examination of Malaysia Fast Food Restaurants Industry

    NASA Astrophysics Data System (ADS)

    Ismail, Zurina; Shokor, Shahrul Suhaimi AB

    2016-03-01

    Rapid life time change of the Malaysian lifestyle had served the overwhelming growth in the service operation industry. On that occasion, this paper will provide the idea to improve the waiting line system (WLS) practices in Malaysia fast food chains. The study will compare the results in between the single server single phase (SSSP) and the single server multi-phase (SSMP) which providing Markovian Queuing (MQ) to be used for analysis. The new system will improve the current WLS, plus intensifying the organization performance. This new WLS were designed and tested in a real case scenario and in order to develop and implemented the new styles, it need to be focusing on the average number of customers (ANC), average number of customer spending time waiting in line (ACS), and the average time customers spend in waiting and being served (ABS). We introduced new WLS design and there will be prompt discussion upon theories of benefits and potential issues that will benefit other researchers.

  15. Traffic pollutant exposures experienced by pedestrians waiting to enter the U.S. at a major U.S.-Mexico border crossing

    NASA Astrophysics Data System (ADS)

    Galaviz, V. E.; Yost, M. G.; Simpson, C. D.; Camp, J. E.; Paulsen, M. H.; Elder, J. P.; Hoffman, L.; Flores, D.; Quintana, P. J. E.

    2014-05-01

    Pedestrians waiting to cross into the US from Mexico at Ports of Entry experience long wait times near idling vehicles. The near-road environment is associated with elevated pollutant levels and adverse health outcomes. This is the first exposure assessment conducted to quantify northbound pedestrian commuter exposure to traffic-related air pollutants at the U.S.-Mexico border San Ysidro Port of Entry (SYPOE). Seventy-three persons who regularly crossed the SYPOE in the pedestrian line and 18 persons who did not cross were recruited to wear personal air monitors for 24-h to measure traffic pollutants particulate matter less than 2.5 μm (PM2.5), 1-nitropyrene (1-NP) - a marker for diesel exhaust - and carbon monoxide (CO). Fixed site concentrations were collected at SYPOE and occurred during the time subjects were crossing northbound to approximate their exposure to 1-NP, ultrafine particles (UFP), PM2.5, CO, and black carbon (BC) while standing in line during their border wait. Subjects who crossed the border in pedestrian lanes had a 6-fold increase in exposure to 1-NP, a 3-fold increase in exposure to CO, and a 2-fold increase in exposure to gravimetric PM2.5, vs. non-border commuters. Univariate regression analysis for UFP (median 40,000 # cm-3) found that border wait time for vehicles explained 21% of variability and relative humidity 13%, but when modeled together neither predictor remained significant. Concentrations at the SYPOE of UFP, PM2.5, CO, and BC are similar to those in other near-roadway studies that show associations with acute and chronic adverse health effects. Although results are limited by small sample numbers, these findings warrant concern for adverse health effects experienced by pedestrian commuters waiting in a long northbound queue at SYPOE and demonstrates a potential health benefit of reduced wait times at the border.

  16. Probability-Based Determination Methods for Service Waiting in Service-Oriented Computing Environments

    NASA Astrophysics Data System (ADS)

    Zeng, Sen; Huang, Shuangxi; Liu, Yang

    Cooperative business processes (CBP)-based service-oriented enterprise networks (SOEN) are emerging with the significant advances of enterprise integration and service-oriented architecture. The performance prediction and optimization for CBP-based SOEN is very complex. To meet these challenges, one of the key points is to try to reduce an abstract service’s waiting number of its physical services. This paper introduces a probability-based determination method (PBDM) of an abstract service’ waiting number, M l , and time span, τ i , for its physical services. The determination of M i and τ i is according to the physical services’ arriving rule and their overall performance’s distribution functions. In PBDM, the arriving probability of the physical services with the best overall performance value is a pre-defined reliability. PBDM has made use of the information of the physical services’ arriving rule and performance distribution functions thoroughly, which will improve the computational efficiency for the scheme design and performance optimization of the collaborative business processes in service-oriented computing environments.

  17. Surveillance of Patients in the Waiting Area of the Department of Emergency Medicine

    PubMed Central

    Hubner, Pia; Schober, Andreas; Sterz, Fritz; Stratil, Peter; Wallmueller, Christian; Testori, Christoph; Grassmann, Daniel; Lebl, Nitaya; Ohrenberger, Iris; Herkner, Harald; Weiser, Chirstoph

    2015-01-01

    Abstract Many patients visiting an emergency department are in reduced general condition of health and at risk of suffering further deterioration during their stay. We wanted to test the feasibility of a new monitoring system in a waiting area of an emergency department. In an observational cross-sectional single-center study, patients with acute cardiac or pulmonary symptoms or in potentially life-threatening conditions were enrolled. Monitoring devices providing vital signs via short range radio (SRR) at certain time points and compliance evaluation forms were used. Out of 230 patients, 4 wanted to terminate their participation prematurely. No data was lost due to technical difficulties. Over a median monitoring period of 178 (118–258) min per patient, 684 h of vital sign data were collected and used to assist managing those patients. Linear regression analysis between clinical symptom category groups of patients showed significant differences in the respiratory rate and noninvasive blood pressure courses. Feedback from patients and users via questionnaires showed overall very good acceptance and patients felt that they were given better care. To assist medical staff of an emergency department waiting area to rapidly response to potentially life-threatening situations of its patients, a new monitoring system proved to be feasible and safe. PMID:26705221

  18. "Wait a while, my love" -- an Indonesian popular song with a family planning message.

    PubMed

    Pekerti, R; Musa, R

    1989-10-01

    "Wait a While, My Love," recorded by pop singer Irianti Emingpraja, was the first Indonesian rock sock to contain a family planning message. The album including the song has sold over 100,000 copies. The song has also been packaged as a 60-second video that can be used as an opening theme for radio and television programs. The song, aimed at encouraging Indonesian youth to postpone marriage, has the following lyrics: "Flying free like a seagull/I'll cover many places 'round the world/Give me time for study and reflection, to grow as a mature wise woman/Oh, wait a while, my love/Don't buy me a ring, reflection of your inner love/I'll climb my way up to the top of the world/And reaching our rainbow of hope." The song was produced with support from the United Nations Fund for Population Activities and the Indonesian National Family Planning Coordinating Board. Key factors to be examined in producing a popular song with a family planning message include the specific message desired, the target audience, type of music, the singer, the producer, marketing, a multimedia campaign strategy, and distribution outlets. PMID:12315970

  19. Safety evaluation of signalized intersections with left-turn waiting area in China.

    PubMed

    Jiang, Xinguo; Zhang, Guopeng; Bai, Wei; Fan, Wenbo

    2016-10-01

    In recent years the metropolitans in China have seen the surging installations of the left-turn waiting area (LWA) at the signalized intersections. The design allows the left-turning vehicles to enter the intersection at the onset of the through green phase (of the same approach) and wait for the exclusive left-turn signal at the LWA. The LWA layout can effectively reduce the probability of stranded and queue overflow of the left-turn vehicles, but no study is conducted yet to assess the safety performance of the signalized intersections with LWA. The paper adopts the traffic conflict technique (represented by post-encroachment time), compares the discrepancy of conflict types between intersections with LWA and without, and develops the severity models to identify the contributing factors for the left-turn conflicts. Results demonstrate that the left-turn volume, driving outside the LWA, running red light, the presence of secondary conflicts, and the rear-end conflicts significantly increase the severities of traffic conflicts at the LWA. The findings serve to provide recommendations to revise the current design standard of the LWA (GB5768-2009) and consequently improve the safety operations of signalized intersections with LWA in China. PMID:26410241

  20. Surveillance of Patients in the Waiting Area of the Department of Emergency Medicine.

    PubMed

    Hubner, Pia; Schober, Andreas; Sterz, Fritz; Stratil, Peter; Wallmueller, Christian; Testori, Christoph; Grassmann, Daniel; Lebl, Nitaya; Ohrenberger, Iris; Herkner, Harald; Weiser, Chirstoph

    2015-12-01

    Many patients visiting an emergency department are in reduced general condition of health and at risk of suffering further deterioration during their stay. We wanted to test the feasibility of a new monitoring system in a waiting area of an emergency department.In an observational cross-sectional single-center study, patients with acute cardiac or pulmonary symptoms or in potentially life-threatening conditions were enrolled. Monitoring devices providing vital signs via short range radio (SRR) at certain time points and compliance evaluation forms were used.Out of 230 patients, 4 wanted to terminate their participation prematurely. No data was lost due to technical difficulties. Over a median monitoring period of 178 (118-258) min per patient, 684 h of vital sign data were collected and used to assist managing those patients. Linear regression analysis between clinical symptom category groups of patients showed significant differences in the respiratory rate and noninvasive blood pressure courses. Feedback from patients and users via questionnaires showed overall very good acceptance and patients felt that they were given better care.To assist medical staff of an emergency department waiting area to rapidly response to potentially life-threatening situations of its patients, a new monitoring system proved to be feasible and safe. PMID:26705221

  1. Waiting in pigeons: the effects of daily intercalation on temporal discrimination.

    PubMed Central

    Wynne, C D; Staddon, J E

    1992-01-01

    Pigeons trained on cyclic-interval schedules adjust their postfood pause from interval to interval within each experimental session. But on regular fixed-interval schedules, many sessions at a given parameter value are usually necessary before the typical fixed-interval "scallop" appears. In the first case, temporal control appears to act from one interfood interval to the next; in the second, it appears to act over hundreds of interfood intervals. The present experiments look at the intermediate case: daily variation in schedule parameters. In Experiments 1 and 2 we show that pauses proportional to interfood interval develop on short-valued response-initiated-delay schedules when parameters are changed daily, that additional experience under this regimen leads to little further improvement, and that pauses usually change as soon as the schedule parameter is changed. Experiment 3 demonstrates identical waiting behavior on fixed-interval and response-initiated-delay schedules when the food delays are short (less than 20 s) and conditions are changed daily. In Experiment 4 we show that daily intercalation prevents temporal control when interfood intervals are longer (25 to 60 s). The results of Experiment 5 suggest that downshifts in interfood interval produce more rapid waiting-time adjustments than upshifts. These and other results suggest that the effects of short interfood intervals seem to be more persistent than those of long intervals. PMID:1645101

  2. Watch and wait approach to rectal cancer: A review.

    PubMed

    Pozo, Marcos E; Fang, Sandy H

    2015-11-27

    In 2014, there were an estimated 136800 new cases of colorectal cancer, making it the most common gastrointestinal malignancy. It is the second leading cause of cancer death in both men and women in the United States and over one-third of newly diagnosed patients have stage III (node-positive) disease. For stage II and III colorectal cancer patients, the mainstay of curative therapy is neoadjuvant therapy, followed by radical surgical resection of the rectum. However, the consequences of a proctectomy, either by low anterior resection or abdominoperineal resection, can lead to very extensive comorbidities, such as the need for a permanent colostomy, fecal incontinence, sexual and urinary dysfunction, and even mortality. Recently, trends of complete regression of the rectal cancer after neoadjuvant chemoradiation therapy have been confirmed by clinical and radiographic evaluation-this is known as complete clinical response (cCR). The "watch and wait" approach was first proposed by Dr. Angelita Habr-Gama in Brazil in 2009. Those patients with cCR are followed with close surveillance physical examinations, endoscopy, and imaging. Here, we review management of rectal cancer, the development of the "watch and wait" approach and its outcomes. PMID:26649153

  3. Nine centuries waiting: The experiences of Iranians surrogacy commissioning mothers

    PubMed Central

    Zandi, Mitra; Vanaki, Zohreh; Shiva, Marziyeh; Mohammadi, Eesa

    2014-01-01

    Background: There are a few studies about commissioning mothers’ understanding from the surrogacy during 9 months of waiting for delivery in Iran and other countries. This study was conducted with an aim to explore and explain the nature of concerns (experiences) of commissioning mothers. Materials and Methods: A qualitative design with a conventional content analysis approach was used to gather and analyze the experiences of commissioning mothers. They were selected from Royan Research Centre and other infertility centers in Iran. After purposive sampling for the selection of the participants, unstructured interviews were held for data collection. Twenty-four unstructured interviews were conducted with 12 commissioning mothers, 2 surrogate mothers, and 2 infertility center social workers who directly and continuously dealt with these mothers. Results: Two main themes emerged from the data analysis: 1. cultural dilemma (consisting of three subthemes: Social taboo, concerns about disclosure to others and the child, concerns about altering maternal and child's identity, and 2. uncertain waiting (consisting of three subthemes: Concerns about health of fetus and surrogate, concerns about an unfamiliar surrogate, and concerns about lack of preparation for maternal role). Conclusions: The study reveals the importance of maternal emotional care in this group and introduces a new arena for nurses’ activity. These findings help the mothers by nurses’ activities in health care clinics and anywhere they deliver nursing care. PMID:24949058

  4. Healthcare Use for Pain in Women Waiting for Gynaecological Surgery

    PubMed Central

    Walker, Sarah; Hopman, Wilma M.; Carley, Meg E.; Mann, Elizabeth G.; VanDenKerkhof, Elizabeth G.

    2016-01-01

    Background. Pain while waiting for surgery may increase healthcare utilization (HCU) preoperatively. Objective. Examine the association between preoperative pain and HCU in the year prior to gynecological surgery. Methods. 590 women waiting for surgery in a Canadian tertiary care centre were asked to report on HCU in the year before surgery. Pain was assessed using the Brief Pain Inventory. Results. 33% reported moderate to severe pain intensity and interference in the week before surgery. Sixty-one percent (n = 360) reported a total of 2026 healthcare visits, with 21% (n = 126) reporting six or more visits in the year before surgery. After controlling for covariates, women with moderate to severe (>3/10) pain intensity/interference reported higher odds of overall HCU (≥3 pain-related visits to family doctor or specialist in the past year or ≥1 to emergency/walk-in clinic) compared to women with no or mild pain. Lower body mass index (BMI < 30 versus ≥30) and anxiety and/or depression were associated with emergency department or walk-in visits but not visits to family doctors or specialists. Conclusions. There is a high burden of pain in women awaiting gynecological surgery. Decisions about resource allocation should consider the impact of pain on individuals and the healthcare system. PMID:27445595

  5. Automated Primary Care Screening in Pediatric Waiting Rooms

    PubMed Central

    Carroll, Aaron E.; Downs, Stephen M.

    2012-01-01

    BACKGROUND AND OBJECTIVE: Implementing US Preventive Services Task Force and American Academy of Pediatrics preventive service guidelines within the short duration of a visit is difficult because identifying which of a large number of guidelines apply to a particular patient is impractical. Clinical decision support system integrated with electronic medical records offer a good strategy for implementing screening in waiting rooms. Our objective was to determine rates of positive risk screens during typical well-care visits among children and adolescents in a primary care setting. METHODS: Child Health Improvement through Computer Automation (CHICA) is a pediatric clinical decision support system developed by our research group. CHICA encodes clinical guidelines as medical logic modules to generate scanable paper forms: the patient screening form to collect structured data from patient families in the waiting room and the physician worksheet to provide physician assessments at each visit. By using visit as a unit of analysis from CHICA’s database, we have determined positive risk screen rates in our population. RESULTS: From a cohort of 16 963 patients, 408 601 questions were asked in 31 843 visits. Of the questions asked, 362 363 (89%) had a response. Of those, 39 176 (11%) identified positive risk screens in both the younger children and the adolescent age groups. CONCLUSIONS: By automating the process of screening and alerting the physician to those who screened positive, we have significantly decreased the burden of identifying relevant guidelines and screening of patient families in our clinics. PMID:22508925

  6. Determinants of exposure to fine particulate matter (PM 2.5) for waiting passengers at bus stops

    NASA Astrophysics Data System (ADS)

    Hess, Daniel Baldwin; Ray, Paul David; Stinson, Anne E.; Park, JiYoung

    2010-12-01

    This research evaluates commuter exposure to particulate matter during pre-journey commute segments for passengers waiting at bus stops by investigating 840 min of simultaneous exposure levels, both inside and outside seven bus shelters in Buffalo, New York. A multivariate regression model is used to estimate the relation between exposure to particulate matter (PM 2.5 measured in μg m -3) and three vectors of determinants: time and location, physical setting and placement, and environmental factors. Four determinants have a statistically significant effect on particulate matter: time of day, passengers' waiting location, land use near the bus shelter, and the presence of cigarette smoking at the bus shelter. Model results suggest that exposure to PM 2.5 inside a bus shelter is 2.63 μg m -3 (or 18 percent) higher than exposure outside a bus shelter, perhaps due in part to the presence of cigarette smoking. Morning exposure levels are 6.51 μg m -3 (or 52 percent) higher than afternoon levels. Placement of bus stops can affect exposure to particulate matter for those waiting inside and outside of shelters: air samples at bus shelters located in building canyons have higher particulate matter than bus shelters located near open space.

  7. The Status of Equity for Hispanics in Public Higher Education in Florida and Texas

    ERIC Educational Resources Information Center

    Perna, Laura W.; Li, Chunyan; Walsh, Erin; Raible, Stephanie

    2010-01-01

    This article uses descriptive analyses of data from the Integrated Postsecondary Education Data System to examine the status of equity for Hispanic students in public higher education institutions in Florida and Texas. The analyses show substantial inequities for Hispanics in enrollment, full-time faculty, and executive, administrative, and…

  8. Using an Equity/Performance Matrix to Address Salary Compression/Inversion and Performance Pay Issues

    ERIC Educational Resources Information Center

    Richardson, Peter; Thomas, Steven

    2013-01-01

    Pay compression and inversion are significant problems for many organizations and are often severe in schools of business in particular. At the same time, there is more insistence on showing accountability and paying employees based on performance. The authors explain and show a detailed example of how to use a Compensation Equity/ Performance…

  9. Stagewise Regression--A Different Approach to Salary Equity Studies. AIR 1986 Annual Forum Paper.

    ERIC Educational Resources Information Center

    Ehrich, Elizabeth A.; Michels, Gabriele A.

    The use of stagewise regression was investigated in a university study of salary equity for full-time staff-exempt personnel. The commonly used method of regression substitution was modified in three ways: (1) shifting the emphasis away from estimating inequity and toward describing the impact of men's and women's population differences on…

  10. Nonprofit equity: a behavioral model and its policy implications.

    PubMed

    Tuckman, H P; Chang, C F

    1992-01-01

    This article assumes that nonprofit decisionmakers have an incentive to earn and accumulate surpluses, and it suggests six reasons for this being the case. Based on the assumption that both the program outputs and the equity of a nonprofit yield satisfaction to its decisionmakers, a behavioral model is developed. This is used to derive a demand function for equity, which is then applied to a national sample of 6168 charitable nonprofits drawn by the Internal Revenue Service for the 1985 taxable year. The results substantiate the hypothesis that nonprofit decisionmakers consciously plan to increase their organization's equity. Currently, evidence of continued equity buildup is not sufficient to call into question a nonprofit's exempt status, because federal tax laws assume that surplus accumulations will ultimately be used in support of program mission. However, equity accumulation can become excessive. We present several criteria to define excessive equity accumulation and discuss why large equity accumulations may not be in the best interest of society. PMID:10116416

  11. The effect of watchful waiting compared to immediate test ordering instructions on general practitioners' blood test ordering behaviour for patients with unexplained complaints; a randomized clinical trial (ISRCTN55755886)

    PubMed Central

    2012-01-01

    Background Immediate blood testing for patients presenting with unexplained complaints in family practice is superfluous from a diagnostic point of view. However, many general pracitioners (GPs) order tests immediately. Watchful waiting reduces the number of patients to be tested and the number of false-positive results. The objectives of this study are: to determine the feasibility of watchful waiting compared to immediate test ordering; to determine if a special quality improvement strategy can improve this feasibility; and to determine if watchful waiting leads to testing at a later time. Methods The study is a cluster-randomized clinical trial with three groups, on blood test ordering strategies in patients with unexplained complaints. GPs in group one were instructed to order tests immediately and GPs in group two to apply a watchful waiting approach. GPs in group three received the same instruction as group two, but they were supported by a systematically designed quality improvement strategy. A total of 498 patients with unexplained complaints from 63 practices of Dutch GPs participated. We measured: the percentage of patients for whom tests were ordered and number of tests ordered at the first consultation; performance on the strategy's performance objectives (i.e., ordering fewer tests and specific communication skills); the number of tests ordered after four weeks; and GP and patient characteristics. Results Immediate test ordering proved feasible in 92% of the patients; watchful waiting in 86% and 84%, respectively, for groups two and three. The two watchful waiting groups did not differ significantly in the achievement of any of the performance objectives. Of the patients who returned after four weeks, none from group one and six from the two watchful waiting groups had tests ordered for them. Conclusions Watchful waiting is a feasible approach. It does not lead to testing immediately afterwards. Furthermore, watchful waiting was not improved by the

  12. 77 FR 31605 - Equity and Excellence Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-29

    ...This notice sets forth the schedule and proposed agenda of an up- coming meeting of the Equity and Excellence Commission (Commission). The notice also describes the functions of the Commission. Notice of this meeting is required by section 10(a)(2) of the Federal Advisory Committee Act (FACA) and is intended to notify the public of their opportunity to...

  13. National VET Equity Advisory Taskforce. Final Report

    ERIC Educational Resources Information Center

    Australian Government Department of Education, Employment and Workplace Relations, 2009

    2009-01-01

    The purview of the National VET (Vocational Education and Training) Equity Advisory Taskforce (NVEAT) encompasses a range of clients and issues across the full spectrum of the VET sector. NVEAT has undertaken a number of activities to gain a better understanding of the range of issues affecting all learners and particular disadvantaged groups of…

  14. Private Schooling and Equity: Dilemmas of Choice.

    ERIC Educational Resources Information Center

    Cookson, Peter W., Jr.

    1991-01-01

    Identifies some of the salient characteristics of American private schools. Examines possible effects that the status composition of the student body might have in influencing the educational opportunity structure. Raises questions about the educational and social equity of supporting private schools financially through school choice mechanisms…

  15. Sex Equity for Rural American Women.

    ERIC Educational Resources Information Center

    Holder, Birdie H.

    1982-01-01

    Cites evidence showing traditional values are highly resistant to change regarding females in nontraditional skill/trade areas. Suggests a model for sex equity in vocational education in rural education systems, incorporating all components of rural education systems to interact in development of programs free from sex-role stereotyping. (NEC)

  16. With Equity and Excellence for All.

    ERIC Educational Resources Information Center

    Fipp, Mary; Barry, Carol; Hargrave, Chris; Countryman, Cassandra

    1996-01-01

    Presents a case study, as seen through the eyes of the principal and sixth-grade team, of one middle school's attempt to move away from a tracking system which discriminated against students on the basis of test scores, and therefore, against students of color. Explores movement toward student equity through heterogeneous grouping and the…

  17. 77 FR 18798 - Equity and Excellence Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-28

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF EDUCATION Equity and Excellence Commission AGENCY: U.S. Department of Education. ACTION: Notice; Advisory Committee Meeting Cancellation. SUMMARY: The Department of Education gives notice of the cancellation of the...

  18. Diversity/Equity. [SITE 2002 Section].

    ERIC Educational Resources Information Center

    Justice, Madeline, Ed.

    This document contains the following papers on diversity/equity from the SITE (Society for Information Technology & Teacher Education) 2002 conference: (1) "Modeling and Developing Technology Integration with Pre-Service Indigenous Teachers" (Shadow W. J. Armfield and Marilyn Durocher); (2) "Integrating Diversity in Children's Literature into the…

  19. Achieving Equity: New Ideas for Teacher Education

    ERIC Educational Resources Information Center

    Davis, Brent; Sumara, Dennis

    2011-01-01

    The route to greater equity in education is tied to a clearer understanding of learning theory, including current research findings that are "game changers" for educators. These "game changers" include rapidly evolving definitions of "learning" and "learners"; an understanding that intelligence and ability are more learned than bestowed; a…

  20. A Decade of "Sex Equity" in Massachusetts.

    ERIC Educational Resources Information Center

    Lipman, Elinor

    1981-01-01

    Looks at how effective state and federal sex equity mandates (Chapter 622 and Title IX) have been in reducing bias and sex segregation in Massachusetts schools, particularly in the areas of physical education, athletics, home economics, and industrial arts. (Condensed from "The Massachusetts Teacher," April 1981, p6-12.) (Editor/SJL)