Leading the Light: A Study of Financial and Organizational Sustainability of Friends Schools

ERIC Educational Resources Information Center

Betof, Ari M.

2011-01-01

As a leader, what can you do when economic turmoil threatens an organization that you have been entrusted to steward? How do you ensure that an organization with deep roots and clear purpose endures during prosperous and challenging times? How can an organization continue to live its mission while operating in an environment that threatens its…

The balanced scorecard: sustainable performance assessment for forensic laboratories.

PubMed

Houck, Max; Speaker, Paul J; Fleming, Arron Scott; Riley, Richard A

2012-12-01

The purpose of this article is to introduce the concept of the balanced scorecard into the laboratory management environment. The balanced scorecard is a performance measurement matrix designed to capture financial and non-financial metrics that provide insight into the critical success factors for an organization, effectively aligning organization strategy to key performance objectives. The scorecard helps organizational leaders by providing balance from two perspectives. First, it ensures an appropriate mix of performance metrics from across the organization to achieve operational excellence; thereby the balanced scorecard ensures that no single or limited group of metrics dominates the assessment process, possibly leading to long-term inferior performance. Second, the balanced scorecard helps leaders offset short term performance pressures by giving recognition and weight to long-term laboratory needs that, if not properly addressed, might jeopardize future laboratory performance. Copyright © 2012 Forensic Science Society. Published by Elsevier Ireland Ltd. All rights reserved.

The German Long-Term Care Insurance Program: Evolution and Recent Developments.

PubMed

Nadash, Pamela; Doty, Pamela; von Schwanenflügel, Matthias

2018-05-08

Since 1995, Germany has operated one of the longest-running public programs providing universal support for the cost of long term services and supports (LTSS). Its self-funding, social insurance approach provides basic supports to nearly all Germans. We discuss its design and development, including recent reforms expanding the program and ensuring its ongoing sustainability. The study reviews legislative and programmatic changes, using program data, as well as legislative documents and program reports. The program is widely accepted among citizens and has achieved many of its original goals: ensuring access to LTSS and reducing reliance on the locally-funded safety-net social assistance program, which can be used to cover nursing home costs. It also strengthened the LTSS provider infrastructure and expanded access to home care. Recent reforms have addressed some of the program's key issues: the benefit's decreasing value, the eligibility and benefit structure that largely excluded cognitive impairment, and the program's longer-term financial sustainability-particularly its ability to sustain newly expanded benefits, which provide stronger protections to caregivers, index-link benefits, and more systematically incorporate cognitive impairment via a new assessment system. It has addressed financing issues by increasing premiums, introducing subsidies for the purchase of private insurance, and creating a "demographic reserve fund." The reforms constitute a significant strengthening of the program, remarkable in an era of retrenchment. Overall, the program provides evidence for the financial viability of a social insurance model, although longer-term challenges may yet arise.

Motivating employees through incentives: productive or a counterproductive strategy.

PubMed

Qayum, Mehran; Sawal, Shefa Haider; Khan, Hassan Mehmood

2014-05-01

The disparity between human resource in health and provision of health services is a growing concern worldwide. Many developing countries are facing this crisis and therefore human resource in health is considered a high priority on their agenda.This imbalance between supplies of human resource is exacerbated by migration of health workers in many countries. Understanding the motivational factor is an important aspect to retain the migrating health workforce. This paper analyses the role of financial and non financial incentives in motivating the health work force. A review of available literature was conducted to understand the role of motivational factor in retaining health workforce. A review of current literature found that an incentive plays a key role in motivating a health worker. Financial incentives are useful in improving the compliance to standard policies and procedures. Comprehensive integrated incentive system approach should be established to develop a sustainable health workforce with required skill. Likewise monetary incentives should be linked to adherence to provincial and national guidelines and procedures. Sustainability could be ensured by commitment of government, political will and involvement of key stakeholders and decision makers.

Building sustainable community partnerships into the structure of new academic public health schools and programs.

PubMed

Gaughan, Monica; Gillman, Laura B; Boumbulian, Paul; Davis, Marsha; Galen, Robert S

2011-01-01

We describe and assess how the College of Public Health at the University of Georgia, established in 2005, has developed formal institutional mechanisms to facilitate community-university partnerships that serve the needs of communities and the university. The College developed these partnerships as part of its founding; therefore, the University of Georgia model may serve as an important model for other new public health programs. One important lesson is the need to develop financial and organizational mechanisms that ensure stability over time. Equally important is attention to how community needs can be addressed by faculty and students in academically appropriate ways. The integration of these 2 lessons ensures that the academic mission is fulfilled at the same time that community needs are addressed. Together, these lessons suggest that multiple formal strategies are warranted in the development of academically appropriate and sustainable university-community partnerships.

Nursing education in Bangladesh: a social business model.

PubMed

Parfitt, Barbara; Nahar, Niru Shamsun

2016-06-01

The aim of this project was to develop a quality nurse education programme in Bangladesh. A sustainable social business financial model was used. The project is a collaboration between Glasgow Caledonian University and the Grameen Health Care Trust. It contributes to the UN development agenda, eradication of poverty, sustainability and the development of global partnerships. There is an acute shortage of nurses in Bangladesh but many young women who wish to become nurses are unable to do so. Women are discriminated against, have few leadership opportunities and poverty affects large proportions of rural society. The collaboration between the University and the Trust provides the necessary input to ensure a quality nursing programme. A business plan was developed, competency-based teaching introduced, infrastructure and financial management processes were set-up and an evaluation framework was put in place. The systems evaluation framework monitors the financial status of the College and the effects of the programme on students. The social business model, providing access to educational loans, has enabled 118 students to graduate into employment. The College is currently on target to be financially sustainable by 2016. This project outlines a business model that tackles poverty, gender equality and contributes to the human resource deficit. Young women are equipped as change agents and leaders. The social business model provides a mechanism for releasing funds for education to those who are impoverished. It provides a viable option for increasing the number of well-educated nurse leaders in developing countries. © 2016 International Council of Nurses.

Determinants of sustainability in solid waste management--the Gianyar Waste Recovery Project in Indonesia.

PubMed

Zurbrügg, Christian; Gfrerer, Margareth; Ashadi, Henki; Brenner, Werner; Küper, David

2012-11-01

According to most experts, integrated and sustainable solid waste management should not only be given top priority, but must go beyond technical aspects to include various key elements of sustainability to ensure success of any solid waste project. Aside from project sustainable impacts, the overall enabling environment is the key feature determining performance and success of an integrated and affordable solid waste system. This paper describes a project-specific approach to assess typical success or failure factors. A questionnaire-based assessment method covers issues of: (i) social mobilisation and acceptance (social element), (ii) stakeholder, legal and institutional arrangements comprising roles, responsibilities and management functions (institutional element); (iii) financial and operational requirements, as well as cost recovery mechanisms (economic element). The Gianyar Waste Recovery Project in Bali, Indonesia was analysed using this integrated assessment method. The results clearly identified chief characteristics, key factors to consider when planning country wide replication but also major barriers and obstacles which must be overcome to ensure project sustainability. The Gianyar project consists of a composting unit processing 60 tons of municipal waste per day from 500,000 inhabitants, including manual waste segregation and subsequent composting of the biodegradable organic fraction. Copyright © 2012 Elsevier Ltd. All rights reserved.

Teacher perspectives on implementing and sustaining a handwashing promotion intervention in Western Kenyan primary schools.

PubMed

Graves, Janessa M; Finsness, Erica D; Quick, Robert; Nyando Integrated Child Health And Education Project Niche Study Team; Harris, Julie R; Daniell, William E

School-based handwashing programs are challenging to establish and sustain, especially in low-resource settings. This qualitative study described teacher perspectives associated with implementing and sustaining a handwashing program in primary schools participating in the Nyando Integrated Child Health and Education (NICHE) project. Structured key informant interviews were conducted with teachers. Prevalent concepts and themes were grouped into themes and topic areas using an iterative, open coding approach. Forty-one teacher respondents reported favorable expectations and benefits of handwashing programs. The importance of available resources (e.g., reliable water) was cited as a primary concern. Other challenges included time and personal or institutional financial commitment necessary to ensure program sustainability. Handwashing programs in low-income, rural schools, where infrastructure is lacking and "student ambassadors" extend the intervention to the surrounding community, hold great promise to improve community health. Teachers must have adequate support and resources to implement and sustain the programs.

Supply chain management with cost-containment & financial-sustainability in a tertiary care hospital.

PubMed

Chandra, Hem; Rinkoo, Arvind Vashishta; Verma, Jitendra Kumar; Verma, Shuchita; Kapoor, Rakesh; Sharma, R K

2013-01-01

Financial crunch in the present recession results in the non-availability of the right materials at the right time in large hospitals. However due to insufficient impetus towards systems development, situation remains dismal even when funds are galore. Cost incurred on materials account for approximately one-third of the total recurring expenditures in hospitals. Systems development for effective and efficient materials management is thus tantamount to cost-containment and sustainability. This scientific paper describes an innovative model, Hospital Revolving Fund (HRF), developed at a tertiary care research institute in Asia. The main idea behind inception of HRF was to ensure availability of all supplies in the hospital so that the quality of healthcare delivery was not affected. The model was conceptualized in the background of non-availability of consumables in the hospital leading to patient as well as staff dissatisfaction. Hospital supplies have been divided into two parts, approximately 3250 unit items and 1750 miscellaneous items. This division is based on cost, relative-utility and case-specific utilization. 0.1 Million USD, separated from non-planned budget, was initially used as seed money in 1998. HRF procures supplies from reputed firms on concessional rates (8-25%) and make them available to patients at much lesser rates vis-à-vis market rates, levying minimal maintenance charges. In 2009-10, total annual purchases of 14 Million USD were made. The balance sheet reflected 1.4 Million USD as fixed deposit investment. The minimal maintenance charges levied on the patients along with the interest income were sufficient to pay for all recurring expenses related to HRF. Even after these expenses, HRF boosted of 0.2 Million USD as cash-in-hand in financial year 2009-10. In-depth analysis of 'balance sheet' and 'Income and Expenditure' statement of the fund for last five financial years affirms that HRF is a self-sustainable and viable supply chain mechanism to ensure availability of the right materials at the right time at a reasonable cost. Thus innovations like HRF will prove robust in rendering quality healthcare at an affordable cost.

Financial sustainability in municipal solid waste management--costs and revenues in Bahir Dar, Ethiopia.

PubMed

Lohri, Christian Riuji; Camenzind, Ephraim Joseph; Zurbrügg, Christian

2014-02-01

Providing good solid waste management (SWM) services while also ensuring financial sustainability of the system continues to be a major challenge in cities of developing countries. Bahir Dar in northwestern Ethiopia outsourced municipal waste services to a private waste company in 2008. While this institutional change has led to substantial improvement in the cleanliness of the city, its financial sustainability remains unclear. Is the private company able to generate sufficient revenues from their activities to offset the costs and generate some profit? This paper presents a cost-revenue analysis, based on data from July 2009 to June 2011. The analysis reveals that overall costs in Bahir Dar's SWM system increased significantly during this period, mainly due to rising costs related to waste transportation. On the other hand, there is only one major revenue stream in place: the waste collection fee from households, commercial enterprises and institutions. As the efficiency of fee collection from households is only around 50%, the total amount of revenues are not sufficient to cover the running costs. This results in a substantial yearly deficit. The results of the research therefore show that a more detailed cost structure and cost-revenue analysis of this waste management service is important with appropriate measures, either by the privates sector itself or with the support of the local authorities, in order to enhance cost efficiency and balance the cost-revenues towards cost recovery. Delays in mitigating the evident financial deficit could else endanger the public-private partnership (PPP) and lead to failure of this setup in the medium to long term, thus also endangering the now existing improved and currently reliable service. We present four options on how financial sustainability of the SWM system in Bahir Dar might be enhanced: (i) improved fee collection efficiency by linking the fees of solid waste collection to water supply; (ii) increasing the value chain by sales of organic waste recycling products; (iii) diversifying revenue streams and financing mechanisms (polluter-pays-, cross-subsidy- and business-principles); and (iv) cost reduction and improved cost-effectiveness. We argue that in a PPP setup such as in Bahir Dar, a strong alliance between the municipality and private enterprise is important so that appropriate solutions for improved financial sustainability of a SWM system can be sought and implemented. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

The challenges to performance and sustaining mutual health organisations/health institutions: an exploratory study in Ghana.

PubMed

Adomah-Afari, Augustine

2015-01-01

The purpose of this paper is to explore challenges to the performance and sustainability of mutual health organisations (MHOs) and health institutions towards enhancing access to quality health care (HC) in Ghana. Data were gathered through interviews and documentary review. Problems with late release of reimbursement funds for discharging with claims by the central government has impacted heavily on the financial and strategic management and decision-making processes of the MHOs and health institutions. The lack of in-depth analysis of the financial viability of the MHOs; and the limited number of schemes selected. Recommends the need to ensure prompt release of reimbursement funds by government to enable the MHOs to reimburse claims to health institutions. There is a perceived tension between the MHOs and HC institutions due to late release of reimbursement funds by the government. Contributes to understanding of how the NHI Act influences the operations of MHOs and health institutions towards increasing access to quality HC and financing.

Optimizing financial effects of HIE: a multi-party linear programming approach.

PubMed

Sridhar, Srikrishna; Brennan, Patricia Flatley; Wright, Stephen J; Robinson, Stephen M

2012-01-01

To describe an analytical framework for quantifying the societal savings and financial consequences of a health information exchange (HIE), and to demonstrate its use in designing pricing policies for sustainable HIEs. We developed a linear programming model to (1) quantify the financial worth of HIE information to each of its participating institutions and (2) evaluate three HIE pricing policies: fixed-rate annual, charge per visit, and charge per look-up. We considered three desired outcomes of HIE-related emergency care (modeled as parameters): preventing unrequired hospitalizations, reducing duplicate tests, and avoiding emergency department (ED) visits. We applied this framework to 4639 ED encounters over a 12-month period in three large EDs in Milwaukee, Wisconsin, using Medicare/Medicaid claims data, public reports of hospital admissions, published payer mix data, and use data from a not-for-profit regional HIE. For this HIE, data accesses produced net financial gains for all providers and payers. Gains, due to HIE, were more significant for providers with more health maintenance organizations patients. Reducing unrequired hospitalizations and avoiding repeat ED visits were responsible for more than 70% of the savings. The results showed that fixed annual subscriptions can sustain this HIE, while ensuring financial gains to all participants. Sensitivity analysis revealed that the results were robust to uncertainties in modeling parameters. Our specific HIE pricing recommendations depend on the unique characteristics of this study population. However, our main contribution is the modeling approach, which is broadly applicable to other populations.

Ideas towards sustainable water security

NASA Astrophysics Data System (ADS)

Dalin, Carole

2016-04-01

With growing global demands and a changing climate, ensuring water security - the access to sufficient, quality water resources for health and livelihoods and an acceptable level of water related risk - is increasingly challenging. While a billion people still lack access to water, over-exploitation of this resource increases in many developed and developing parts of the world. While some solutions to water stress have been known for a long time, financial, cultural and political barriers often prevent their implementations. This talk will highlight three crucial areas that need to be addressed to progress towards sustainable water security. The first point is on scale, the second on the agricultural sector and irrigation, and the third on food trade and policy.

Biobanking sustainability--experiences of the Australian Breast Cancer Tissue Bank (ABCTB).

PubMed

Carpenter, Jane E; Clarke, Christine L

2014-12-01

Sustainability of biorepositories is a key issue globally. This article is a description of the different strategies and mechanisms used by the Australian Breast Cancer Tissue Bank (ABCTB) in developing and operating the resource since its inception in 2005. ABCTB operates according to a hub and spoke model, with a central management hub that is responsible for overall management of the resource including financial, ethical, and legal processes, researcher applications for material, clinical follow-up, information/database activities, and security. A centralized processing laboratory also operates from the hub site where DNA and RNA extractions are performed, digital imaging of stained tumor sections occurs, and specimens are assembled for dispatch for research projects. ABCTB collection sites where donors are identified, consent obtained, and specimens collected and processed for initial storage are located across Australia. Each of the activities of the resource requires financial support and different sources of revenue, some of which are allocated to a specific function of the ABCTB. Different models are in use at different collection centers where local variations may exist and local financial support may sometimes be obtained. There is also significant in-kind support by clinics and diagnostic and research facilities that house the various activities of the resource. However, long-term financial commitment to ensure the survival of the resource is not in place, and forward planning of operations remains challenging under these circumstances.

A bill to amend section 1004 of title 39, United States Code, to include that it is a policy of the Postal Service to ensure reasonable and sustainable workloads and schedules for supervisory and management employees and to clarify provisions relating to consultation and changes or terminations in certain proposals.

THOMAS, 111th Congress

Sen. Akaka, Daniel K. [D-HI

2010-03-19

Senate - 04/06/2010 Committee on Homeland Security and Governmental Affairs referred to Subcommittee on Federal Financial Management, Government Information, Federal Services, and International Security. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

CAEP 2015 Academic Symposium: Current State and Recommendations to Achieve Adequate and Sustainable Funding for Emergency Medicine Academic Units.

PubMed

Lang, Eddy S; Artz, Jennifer D; Wilkie, Ryan D; Stiell, Ian G; Topping, Claude; Belanger, François P; Afilalo, Marc; Renouf, Tia; Crocco, Anthony; Wyatt, Kelly; Christenson, Jim

2016-05-01

To describe the current state of academic emergency medicine (EM) funding in Canada and develop recommendations to grow and establish sustainable funding. A panel of eight leaders from different EM academic units was assembled. Using mixed methods (including a literature review, sharing of professional experiences, a survey of current EM academic heads, and data previously collected from an environmental scan), 10 recommendations were drafted and presented at an academic symposium. Attendee feedback was incorporated, and the second set of draft recommendations was further distributed to the Canadian Association Emergency Physicians (CAEP) Academic Section for additional comments before being finalized. Recommendations were developed around the funding challenges identified and solutions developed by academic EM university-based units across Canada. A strategic plan was seen as integral to achieving strong funding of an EM unit, especially when it aligned with departmental and institutional priorities. A business plan, although occasionally overlooked, was deemed an important component for planning and sustaining the academic mission. A number of recommendations surrounding philanthropy consisted of creating partnerships with existing foundations and engaging multiple stakeholders and communities. Synergy between academic and clinical EM departments was also viewed as an opportunity to ensure integration of common missions. Education and networking for current and future leaders were also viewed as invaluable to ensure that opportunities are optimized through strong leadership development and shared experiences to further the EM academic missions across the country. These recommendations were designed to improve the financial circumstances for many Canadian EM units. There is a considerable wealth of resources that can contribute to financial stability for an academic unit, and an annual networking meeting and continuing education on these issues will facilitate more rapid implementation of these recommendations.

Financial incentives: Possible options for sustainable rangeland management?

PubMed

Louhaichi, Mounir; Yigezu, Yigezu A; Werner, Jutta; Dashtseren, Lojoo; El-Shater, Tamer; Ahmed, Mohamed

2016-09-15

Large-scale mismanagement of natural resources emanating from lack of appropriate policies and regulatory framework is arguably one of the reasons that led to resource degradation and poor livelihoods in many countries in the Middle East and North Africa (MENA) region. Sustainable rangeland management practices (SRMPs) are considered to be a solution to feed shortages and rangeland degradation. However, the scope for SRMP adoption, has been a subject of debate. Using a case study from Syria and the application of the Minimum Data Analysis method (TOA-MD), this paper provides empirical evidence for ensuring wider adoption of SRMP. The paper argues that the introduction of financial incentives in the form of payments for agricultural-environmental services can increase the economic viability and enhance the adoption of SRMPs and is a better alternative to the unsustainable state subsidies for fodder purchases and barley cultivation on rangelands. Model results indicate that further investment in reasearch toward generating low cost technologies and tailored governance strategies including a financial incentive system would lead to better management of rangelands and improve livelihoods in the Syrian Badia. These findings are valuable for policy makers, donors as well as development and extension practitioners in the MENA region as they can better inform future courses of actions. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Balancing the funds in the New Cooperative Medical Scheme in rural China: determinants and influencing factors in two provinces.

PubMed

Zhang, Luying; Cheng, Xiaoming; Liu, Xiaoyun; Zhu, Kun; Tang, Shenglan; Bogg, Lennart; Dobberschuetz, Karin; Tolhurst, Rachel

2010-01-01

In recent years, the central government in China has been leading the re-establishment of its rural health insurance system, but local government institutions have considerable flexibility in the specific design and management of schemes. Maintaining a reasonable balance of funds is critical to ensure that the schemes are sustainable and effective in offering financial protection to members. This paper explores the financial management of the NCMS in China through a case study of the balance of funds and the factors influencing this, in six counties in two Chinese provinces. The main data source is NCMS management data from each county from 2003 to 2005, supplemented by: a household questionnaire survey, qualitative interviews and focus group discussions with all local stakeholders and policy document analysis. The study found that five out of six counties held a large fund surplus, whilst enrolees obtained only partial financial protection. However, in one county greater risk pooling for enrolees was accompanied by relatively high utilisation levels, resulting in a fund deficit. The opportunities to sustainably increase the financial protection offered to NCMS enrolees are limited by the financial pressures on local government, specific political incentives and low technical capacities at the county level and below. Our analysis suggests that in the short term, efforts should be made to improve the management of the current NCMS design, which should be supported through capacity building for NCMS offices. However, further medium-term initiatives may be required including changes to the design of the schemes. Copyright (c) 2009 John Wiley & Sons, Ltd.

Exploring Business Strategy in Health Information Exchange Organizations.

PubMed

Langabeer, James R; Champagne, Tiffany

2016-01-01

Unlike consumer goods industries, healthcare has been slow to implement technolo gies that support exchange of data in patients' health records. This results in avoid able medication errors, avoidable hospital readmissions, unnecessary duplicate testing, and other inefficient or wasteful practices. Community-based regional health information exchange (HIE) organizations have evolved in response to federal aims to encourage interoperability, yet little is known about their strategic approach. We use the lens of institutional and strategic management theories to empirically explore the differences in business strategies deployed in HIEs that are, to date, financially sustainable versus those that are not. We developed a 20-question survey targeted to CEOs to assess HIE business strategies. Our sample consisted of 60 community-based exchanges distributed throughout the United States, and we achieved a 58% response rate. Questions centered on competitive strategy and financial sustainability. We relied on logistic regression methods to explore relationships between variables. Our regression identified characteristics common to sustainable organizations. We defined sustainability as revenues exceeding operational costs. Seventeen of the 35 organizations (49%) defined themselves as currently sustainable. Focus and cost leadership strategies were significantly associated with sustainability. Growth strate gies, which were much more common than other strategies, were not associated with sustainability. We saw little evidence of a differentiation strategy (i.e., the basis of competition whereby the attributes of a product or service are unmatched by rivals). Most CEOs had a relatively optimistic outlook, with 60% stating they were confident of surviving over the next 5 years; however, nearly 9% of the organizations were in some phase of divestiture or exit from the market. HIEs are evolving differently based on local leadership decisions, yet their strategic approach is isomorphic (or similar). Further insight into successful business strategies could help ensure the long-term survival of HIEs.

Determinants of sustainability in solid waste management - The Gianyar Waste Recovery Project in Indonesia

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zurbruegg, Christian, E-mail: zurbrugg@eawag.ch; Gfrerer, Margareth, E-mail: margareth.gfrerer@gmx.net; Ashadi, Henki, E-mail: henki@eng.ui.ac.id

2012-11-15

Highlights: Black-Right-Pointing-Pointer Our assessment tool helps evaluate success factors in solid waste projects. Black-Right-Pointing-Pointer Success of the composting plant in Indonesia is linked to its community integration. Black-Right-Pointing-Pointer Appropriate technology is not a main determining success factor for sustainability. Black-Right-Pointing-Pointer Structured assessment of 'best practices' can enhance replication in other cities. - Abstract: According to most experts, integrated and sustainable solid waste management should not only be given top priority, but must go beyond technical aspects to include various key elements of sustainability to ensure success of any solid waste project. Aside from project sustainable impacts, the overall enabling environmentmore » is the key feature determining performance and success of an integrated and affordable solid waste system. This paper describes a project-specific approach to assess typical success or failure factors. A questionnaire-based assessment method covers issues of: (i) social mobilisation and acceptance (social element), (ii) stakeholder, legal and institutional arrangements comprising roles, responsibilities and management functions (institutional element); (iii) financial and operational requirements, as well as cost recovery mechanisms (economic element). The Gianyar Waste Recovery Project in Bali, Indonesia was analysed using this integrated assessment method. The results clearly identified chief characteristics, key factors to consider when planning country wide replication but also major barriers and obstacles which must be overcome to ensure project sustainability. The Gianyar project consists of a composting unit processing 60 tons of municipal waste per day from 500,000 inhabitants, including manual waste segregation and subsequent composting of the biodegradable organic fraction.« less

Domestic rainwater harvesting to improve water supply in rural South Africa

NASA Astrophysics Data System (ADS)

Mwenge Kahinda, Jean-marc; Taigbenu, Akpofure E.; Boroto, Jean R.

Halving the proportion of people without sustainable access to safe drinking water and basic sanitation, is one of the targets of the 7th Millennium Development Goals (MDGs). In South Africa, with its mix of developed and developing regions, 9.7 million (20%) of the people do not have access to adequate water supply and 16 million (33%) lack proper sanitation services. Domestic Rainwater Harvesting (DRWH), which provides water directly to households enables a number of small-scale productive activities, has the potential to supply water even in rural and peri-urban areas that conventional technologies cannot supply. As part of the effort to achieve the MDGs, the South African government has committed itself to provide financial assistance to poor households for the capital cost of rainwater storage tanks and related works in the rural areas. Despite this financial assistance, the legal status of DRWH remains unclear and DRWH is in fact illegal by strict application of the water legislations. Beyond the cost of installation, maintenance and proper use of the DRWH system to ensure its sustainability, there is risk of waterborne diseases. This paper explores challenges to sustainable implementation of DRWH and proposes some interventions which the South African government could implement to overcome them.

An IMS Station life cycle from a sustainment point of view

NASA Astrophysics Data System (ADS)

Brely, Natalie; Gautier, Jean-Pierre; Foster, Daniel

2014-05-01

The International Monitoring System (IMS) is to consist of 321 monitoring facilities, composed of four different technologies with a variety of designs and equipment types, deployed in a range of environments around the globe. The International Monitoring System is conceived to operate in perpetuity through maintenance, replacement and recapitalization of IMS facilities' infrastructure and equipment when the end of service life is reached [CTBT/PTS/INF.1163]. Life Cycle techniques and modellization are being used by the PTS to plan and forecast life cycle sustainment requirements of IMS facilities. Through historical data analysis, Engineering inputs and Feedback from experienced Station Operators, the PTS currently works towards increasing the level of confidence on these forecasts and sustainment requirements planning. Continued validation, feedback and improvement of source data from scientific community and experienced users is sought and essential in order to ensure limited effect on data availability and optimal costs (human and financial).

Pharmaceutical policies in a crisis? Challenges and solutions identified at the PPRI Conference.

PubMed

Vogler, Sabine; Zimmermann, Nina; Ferrario, Alessandra; Wirtz, Veronika J; de Joncheere, Kees; Pedersen, Hanne Bak; Dedet, Guillaume; Paris, Valérie; Mantel-Teeuwisse, Aukje K; Babar, Zaheer-Ud-Din

2016-01-01

In October 2015, the third international Pharmaceutical Pricing and Reimbursement Information (PPRI) Conference was held in Vienna to foster discussion on challenges in pricing and reimbursement policies for medicines. The research presented highlighted that commonly used pharmaceutical pricing and reimbursement policies are not sufficiently effective to address current challenges. Conference participants called for fundamental reforms to ensure access to medicines, particularly to new and potentially more effective and/or safe medicines, while safeguarding the financial sustainability of health systems and working towards universal health coverage.

The old care paradigm is dead, long live the new sustainable care paradigm: how can GP commissioning consortia meet the demand challenges of 21st century healthcare?

PubMed

Mackenzie, James

2011-07-01

There are many challenges facing the health system in the 21st century - the majority of which are related to managing demand for health services. To meet these challenges emerging GP commissioning consortia will need to take a new approach to commissioning health services - an approach that moves beyond the current acute-centred curative paradigm of care to a new sustainable paradigm of care that focuses on primary care, integrated services and upstream prevention to manage demand. A key part of this shift is the recognition that the health system does not operate in a vacuum and that strategic commissioning decisions must take account of wider determinants of health and well-being, and operate within the finite limits of the planet's natural resources. The sustainable development principle of balancing financial, social and environmental considerations is crucial in managing demand for health services and ensuring that the health system is resilient to risks of resource uncertainty and a changing climate. Building sustainability into the governance and contracting processes of GP commissioning consortia will help deliver efficiency savings, impact on system productivity, manage system risk and help manage demand through the health co-benefits of taking a whole systems approach to commissioning decisions. Commissioning services from providers committed to corporate social responsibility and sustainable business practices allows us to move beyond a health system that cures people reactively to one in which the health of individuals and populations is managed proactively through prevention and education. The opportunity to build sustainability principles into the culture of GP commissioning consortia upfront should be seized now to ensure the new model of commissioning endures and is fit for the future.

The old care paradigm is dead, long live the new sustainable care paradigm: how can GP commissioning consortia meet the demand challenges of 21st century healthcare?

PubMed Central

2011-01-01

There are many challenges facing the health system in the 21st century – the majority of which are related to managing demand for health services. To meet these challenges emerging GP commissioning consortia will need to take a new approach to commissioning health services – an approach that moves beyond the current acute-centred curative paradigm of care to a new sustainable paradigm of care that focuses on primary care, integrated services and upstream prevention to manage demand. A key part of this shift is the recognition that the health system does not operate in a vacuum and that strategic commissioning decisions must take account of wider determinants of health and well-being, and operate within the finite limits of the planet's natural resources. The sustainable development principle of balancing financial, social and environmental considerations is crucial in managing demand for health services and ensuring that the health system is resilient to risks of resource uncertainty and a changing climate. Building sustainability into the governance and contracting processes of GP commissioning consortia will help deliver efficiency savings, impact on system productivity, manage system risk and help manage demand through the health co-benefits of taking a whole systems approach to commissioning decisions. Commissioning services from providers committed to corporate social responsibility and sustainable business practices allows us to move beyond a health system that cures people reactively to one in which the health of individuals and populations is managed proactively through prevention and education. The opportunity to build sustainability principles into the culture of GP commissioning consortia upfront should be seized now to ensure the new model of commissioning endures and is fit for the future. PMID:25949650

New Economic and Financial Indicators of Sustainability

ERIC Educational Resources Information Center

Pittman, James; Wilhelm, Kevin

2007-01-01

Financial accounting methods fall short of fully accounting for the relative sustainability of college and university operations. Management of social, environmental, and economic performance will be aided by changes to and new developments in financial accounting practices to complement other indicators of sustainability.

Views of Canadian patients on or nearing dialysis and their caregivers: a thematic analysis.

PubMed

Barnieh, Lianne; King-Shier, Kathryn; Hemmelgarn, Brenda; Laupacis, Andreas; Manns, Liam; Manns, Braden

2014-01-01

Quality of life of patients receiving dialysis has been rated as poor. To synthesize the views of Canadian patients on or nearing dialysis, and those who care for them. Secondary analysis of a survey, distributed through dialysis centres, social media and the Kidney Foundation of Canada. Pan-Canadian convenience sample. Patients, their caregivers and health-care providers. Text responses to open-ended questions on topics relevant to end-stage renal disease. Statements related to needs, beliefs or feelings were identified, and were analysed by thematic content analysis. A total of 544 relevant statements from 189 respondents were included for the thematic content analysis. Four descriptive themes were identified through the content analysis: gaining knowledge, maintaining quality of life, sustaining psychosocial wellbeing and ensuring appropriate care. Respondents primarily identified a need for more information, better communication, increased psychosocial and financial support for patients and their families and a strong desire to maintain their previous lifestyle. Convenience sample; questions were originally asked with a different intent (to identify patient-important research issues). Patients on or nearing dialysis and their caregivers identified four major themes, gaining knowledge, maintaining quality of life, sustaining psychosocial wellbeing and ensuring appropriate care, several of which could be addressed by the health care system without requiring significant resources. These include the development of patient materials and resources, or sharing of existing resources across Canadian renal programs, along with adopting better communication strategies. Other concerns, such as the need for increased psychosocial and financial support, require consideration by health care funders.

Financial Risk Reduction and Management of Water Reservoirs Using Forecasts: A Case for Pernambuco, Brazil

NASA Astrophysics Data System (ADS)

Kumar, I.; Josset, L.; e Silva, E. C.; Possas, J. M. C.; Asfora, M. C.; Lall, U.

2017-12-01

The financial health and sustainability, ensuring adequate supply, and adapting to climate are fundamental challenges faced by water managers. These challenges are worsened in semi-arid regions with socio-economic pressures, seasonal supply of water, and projected increase in intensity and frequency of droughts. Over time, probabilistic rainfall forecasts are improving and for water managers, it could be key in addressing the above challenges. Using forecasts can also help make informed decisions about future infrastructure. The study proposes a model to minimize cost of water supply (including cost of deficit) given ensemble forecasts. The model can be applied to seasonal to annual ensemble forecasts, to determine the least cost solution. The objective of the model is to evaluate the resiliency and cost associated to supplying water. A case study is conducted in one of the largest reservoirs (Jucazinho) in Pernambuco state, Brazil, and four other reservoirs, which provide water to nineteen municipalities in the Jucazinho system. The state has been in drought since 2011, and the Jucazinho reservoir, has been empty since January 2017. The importance of climate adaptation along with risk management and financial sustainability are important to the state as it is extremely vulnerable to droughts, and has seasonal streamflow. The objectives of the case study are first, to check if streamflow forecasts help reduce future supply costs by comparing k-nearest neighbor ensemble forecasts with a fixed release policy. Second, to determine the value of future infrastructure, a new source of supply from Rio São Francisco, considered to mitigate drought conditions. The study concludes that using forecasts improve the supply and financial sustainability of water, by reducing cost of failure. It also concludes that additional infrastructure can help reduce the risks of failure significantly, but does not guarantee supply during prolonged droughts like the one experienced currently.

Addressing maternal healthcare through demand side financial incentives: experience of Janani Suraksha Yojana program in India.

PubMed

Gopalan, Saji S; Durairaj, Varatharajan

2012-09-15

Demand side financing (DSF) is a widely employed strategy to enhance utilization of healthcare. The impact of DSF on health care seeking in general and that of maternal care in particular is already known. Yet, its effect on financial access to care, out-of-pocket spending (OOPS) and provider motivations is not considerably established. Without such evidence, DSFs may not be recommendable to build up any sustainable healthcare delivery approach. This study explores the above aspects on India's Janani Suraksha Yojana (JSY) program. This study employed design and was conducted in three districts of Orissa, selected through a three-stage stratified sampling. The quantitative method was used to review the Health Management Information System (HMIS). The qualitative methods included focus groups discussions with beneficiaries (n = 19) and community intermediaries (n = 9), and interviews (n = 7) with Ministry of Health officials. HMIS data enabled to review maternal healthcare utilization. Group discussions and interviews explored the perceived impact of JSY on in-facility delivery, OOPS, healthcare costs, quality of care and performance motivation of community health workers. The number of institutional deliveries, ante-and post-natal care visits increased after the introduction of JSY with an annual net growth of 18.1%, 3.6% and 5% respectively. The financial incentive provided partial financial risk-protection as it could cover only 25.5% of the maternal healthcare cost of the beneficiaries in rural areas and 14.3% in urban areas. The incentive induced fresh out-of-pocket spending for some mothers and it could not address maternal care requirements comprehensively. An activity-based community worker model was encouraging to augment maternal healthcare consumption. However, the existing level of financial incentives and systemic support were inadequate to motivate the volunteers optimally on their performance. Demand side financial incentive could enhance financial access to maternal healthcare. However, it did not adequately protect households from financial risks. An effective integration of JSY with similar social protection or financial risk-protection measures may protect mothers substantially from potential out-of-pocket spending. Further, this integrated approach may help upholding more awareness on maternal health rights and entitlements. It can also address maternal health beyond 'maternal healthcare' and ensure sustainability through pooled financial and non-financial resources.

A corporate approach to social monitoring and assessment for development in a fragile environment.

PubMed

May, Peter H; Dabbs, Alan W; Fernández-Dávila, Patricia; Da Vinha, Valéria; Zaidenweber, Nathan

2002-05-01

The prevailing corporate trend regarding development of energy resources in the tropics emphasizes financial gain over long-term societal benefits. Some corporations are beginning to find a competitive advantage linked to proactive relations with host communities and adequate protection of fragile ecosystems. Herein, we describe a case study where an international energy production company worked with stakeholders to achieve social capital and sustainable development. The strategies aimed to strengthen local capacity to improve social welfare and to ensure conservation and wise use of biodiversity. We provide examples, discuss lessons learned and make recommendations for future development projects.

Financial sustainability planning for immunization services in Cambodia.

PubMed

Soeung, Sann Chan; Grundy, John; Maynard, Jim; Brooks, Alan; Boreland, Marian; Sarak, Duong; Jenkinson, Karl; Biggs, Beverley-Ann

2006-07-01

The expanded programme of immunization was established in Cambodia in 1986. In 2002, 67% of eligible children were immunized, despite significant health sector and macro-economic financial constraints. A financial sustainability planning process for immunization was introduced in 2002, in order to mobilize national and international resources in support of the achievement of child health objectives. The aim of this paper is to outline this process, describe its early impact as an advocacy tool and recommend additional strategies for mobilizing additional resources for health. The methods of financial sustainability planning are described, including the advocacy strategies that were applied. Analysis of financial sustainability planning results indicates rising programme costs associated with new vaccine introduction and new technologies. Despite this, the national programme has demonstrated important early successes in using financial sustainability planning to advocate for increased mobilization of national and international sources of funding for immunization. The national immunization programme nevertheless faces formidable system and financial challenges in the coming years associated with rising costs, potentially diminishing sources of international assistance, and the developing role of sub-national authorities in programme management and financing.

Clinical engagement: improving healthcare together.

PubMed

Riches, E; Robson, B

2014-02-01

Clinical engagement can achieve lasting change in the delivery of healthcare. In October 2011, Healthcare Improvement Scotland formulated a clinical engagement strategy to ensure that a progressive and sustainable approach to engaging healthcare professionals is firmly embedded in its health improvement and public assurance activities. The strategy was developed using a 90-day process, combining an evidence base of best practice and feedback from semi-structured interviews and focus groups. The strategy aims to create a culture where clinicians view working with Healthcare Improvement Scotland as a worthwhile venture, which offers a number of positive benefits such as training, career development and research opportunities. The strategy works towards developing a respectful partnership between Healthcare Improvement Scotland, the clinical community and key stakeholders whereby clinicians' contributions are recognised in a non-financial reward system. To do this, the organisation needs a sustainable infrastructure and an efficient, cost-effective approach to clinical engagement. There are a number of obstacles to achieving successful clinical engagement and these must be addressed as key drivers in its implementation. The implementation of the strategy is supported by an action and resource plan, and its impact will be monitored by a measurement plan to ensure the organisation reviews its approaches towards clinical engagement.

Recommendations to Sustain the Academic Mission Ecosystem at U.S. Medical Schools.

PubMed

Kerschner, Joseph E; Hedges, Jerris R; Antman, Karen; Abraham, Edward; Colón Negrón, Edgar; Jameson, J Larry

2018-07-01

Academic medical center (AMC) faculty, administrators, and leaders have the critical tasks of teaching and training the next generation of health care providers and biomedical researchers, as well as generating new knowledge that improves the health of all. In the United States, medical schools and their affiliated hospitals train remarkably high-quality physicians and scientists, and the research conducted at these institutions results in advances in health. To that end, AMCs have become essential engines for driving better health in the United States and the rest of the world; they also have become essential engines driving the economies of their respective communities and regions. The education and research missions, however, require subsidization because tuition and extramural grant funding do not cover the costs of these endeavors. This subsidization largely has come from revenues generated by AMCs' clinical endeavors. The viability of this cross-subsidization, however, is increasingly threatened in the current clinical environment. The authors of this Perspective discuss these issues in depth and provide some concrete recommendations to address these challenges. They hope to stimulate discussion and, ultimately, ensure the financial viability of U.S. AMCs-a national resource of utmost importance. Recommendations to sustain research include creating strategic biomedical research plans, developing a defined and sustained model to support National Institutes of Health funding that keeps pace with inflation, and evolving funding mechanisms. Recommendations to sustain medical education include limiting student debt, creating more cost-effective curricula, and ensuring that clinical training opportunities that meet national standards are available to students.

Open-Access Textbooks and Financial Sustainability: A Case Study on Flat World Knowledge

ERIC Educational Resources Information Center

Hilton, John, III; Wiley, David

2011-01-01

Many college students and their families are concerned about the high costs of textbooks. A company called Flat World Knowledge both gives away and sells open-source textbooks in a way it believes to be financially sustainable. This article reports on the financial sustainability of the Flat World Knowledge open-source textbook model after one…

Incorporating Sustainability Issues into the Financial Accounting Curriculum

ERIC Educational Resources Information Center

Haskin, Daniel L.; Burke, Megan M.

2016-01-01

Changes in the views that society holds of capital allocation suggest that sustainability reporting needs to be incorporated into the financial accounting curriculum. This paper reviews the background and history of corporate social responsibility and sustainability reporting and discusses formation of the Sustainability Accounting Standards Board…

The good, the bad, and the ugly of partnered research: revisiting the sequestration thesis and the role of universities in promoting social justice.

PubMed

Yassi, Annalee; Dharamsi, Shafik; Spiegel, Jerry; Rojas, Alejandro; Dean, Elizabeth; Woollard, Robert

2010-01-01

As universities increasingly rely on external sources of research funding, researchers worldwide are realizing that if their work is financially supported by organizations with distinct political or financial interests, they risk their careers if their results deviate from the interests of their funding partners. This article presents a case that illustrates how ugly this situation can become. Reviewing the literature on the advantages and dangers of partnered research, the historical role of universities, funding trends, and university mission statements, the authors contend that universities must engage in service learning and participatory action research, but must ensure that faculty members engaging in academic activity with partners-whether industry, hospitals, governments, nongovernmental organizations, or communities-have their professional integrity protected. If doubt exists about whether the partner can or will honor these principles or the mission of universities for social good, universities should avoid granting joint or affiliate appointments or accepting funds or favors of any kind. Universities also need formal structures to ensure ethical application of innovation and principled partnership engagement. In becoming servants of government or corporatism, universities have become less vital to society and are failing in their mission to promote social justice and sustainability. Strong measures are needed to restore public trust.

Practice points in utilizing local volunteers in community health projects.

PubMed

Muula, Adamson S; Theu, Joe; Hofman, Jan J

2004-07-01

Community volunteers are recruited for many health intervention projects. There are various motivations for the use of the volunteers and these include: the desire to reduce financial costs of projects/programmes; to encourage community ownership; ensure long-term sustainability of the health intervention; and to empower local communities through training offered the project. Health intervention measures working with community volunteers should not be implemented without due consideration of issues regarding mobilization and engagement, skills and motivation of the volunteers and their effectiveness and efficiency towards the attainment of the project goals. This paper discusses some tips that should be considered when community volunteers are used in resource-limited situations.

The influence of financial incentive programs in promoting sustainable forestry on the nation's family forests

Treesearch

Michael A. Kilgore; John L. Greene; Michael G. Jacobson; Thomas J. Straka; Steven E. Daniels

2007-01-01

Financial incentive programs were evaluated to assess their contribution to promoting sustainable forestry practices on the nation’s family forests. The evaluation consisted of an extensive review of the literature on financial incentive programs, a mail survey of the lead administrator of financial incentive programs in each state forestry agency, and focus groups...

The influence of financial incentive programs in promoting sustainable forestry on the nation's family forests

Treesearch

Michael A. Kilgore; John L. Greene; Michael G. Jacobson; Thomas J. Straka; Steven E. Daniels

2006-01-01

Financial incentive programs were evaluated to assess their contribution to promoting sustainable forestry practices on the nation’s family forests. The evaluation consisted of an extensive review of the literature on financial incentive programs, a mail survey of the lead administrator of financial incentive programs in each state forestry agency, and focus groups...

Determining business models for financial sustainability in regional health information organizations (RHIOs): a review.

PubMed

Maffei, Roxana; Burciago, Daniel; Dunn, Kim

2009-10-01

Regional health information organizations (RHIOs) have the potential to alleviate today's health care problems by granting providers access to a supported body of clinical information for all patients in a given region. While the promise of and enthusiasm for RHIOs is immense, the issue of their financial sustainability remains unclear. It has been said that the business model supporting a regional or national health information network is as essential, if not more essential, than the technology that makes it feasible. Currently, there is a clear lack of concrete business models implemented in RHIOs' projects. This article reports the results of a literature review of the current status of the adaptation and implementation of business models by RHIOs for successful financial sustainability. Based on the review, this article also attempts to evaluate the existing financial situation of RHIOs to determine and recommend the best models of economic sustainability. Significant findings include RHIOs' present financial environment, planning, and self-sustainability methods. Future studies will be needed as RHIOs continue to grow and move toward the implementation phase of their development.

Report: Significant Data Quality Deficiencies Impede EPA’s Ability to Ensure Companies Can Pay for Cleanups

EPA Pesticide Factsheets

Report #16-P-0126, March 31, 2016. Management Alert. Environmental and extensive financial risks exist from the EPA's failure to have accurate and complete data to monitor and ensure compliance with RCRA and CERCLA financial assurance requirements.

Mobile dental operations: capital budgeting and long-term viability.

PubMed

Arevalo, Oscar; Chattopadhyay, Amit; Lester, Harold; Skelton, Judy

2010-01-01

The University of Kentucky College of Dentistry (UKCD) runs a large mobile dental operation. Economic conditions dictate that as the mobile units age it will be harder to find donors willing or able to provide the financial resources for asset replacement. In order to maintain current levels of access for the underserved, consideration of replacement is paramount. A financial analysis for a new mobile unit was conducted to determine self-sustainability, return on investment (ROI), and feasibility of generating a cash reserve for its replacement in 12 years. Information on clinical income, operational and replacement costs, and capital costs was collected. A capital budgeting analysis (CBA) was conducted using the Net Present Value (NPV) methodology in four different scenarios. Depreciation funding was calculated by transferring funds from cash inflows and reinvested to offset depreciation at fixed compound interest. A positive ROI was obtained for two scenarios. He depreciation fund did not generate a cash reserve sufficient to replace the mobile unit. Mobile dental programs can play a vital role in providing access to care to underserved populations and ensuring their mission requires long-term planning. Careful financial viability and CBA based on sound assumptions are excellent decision-making tools.

Utilization of healthcare services and renewal of health insurance membership: evidence of adverse selection in Ghana.

PubMed

Duku, Stephen Kwasi Opoku; Asenso-Boadi, Francis; Nketiah-Amponsah, Edward; Arhinful, Daniel Kojo

2016-12-01

Utilization of healthcare in Ghana's novel National Health Insurance Scheme (NHIS) has been increasing since inception with associated high claims bill which threatens the scheme's financial sustainability. This paper investigates the presence of adverse selection by assessing the effect of healthcare utilization and frequency of use on NHIS renewal. Routine enrolment and utilization data from 2008 to 2013 in two regions in Ghana was analyzed. Pearson Chi-square test was performed to test if the proportion of insured who utilize healthcare in a particular year and renew membership the following year is significantly different from those who utilize healthcare and drop-out. Logistic regressions were estimated to examine the relationship between healthcare utilization and frequency of use in previous year and NHIS renewal in current year. We found evidence suggestive of the presence of adverse selection in the NHIS. Majority of insured who utilized healthcare renewed their membership whiles most of those who did not utilize healthcare dropped out. The likelihood of renewal was significantly higher for those who utilize healthcare than those who did not and also higher for those who make more health facility visits. The NHIS claims bill is high because high risk individuals who self-select into the scheme makes more health facility visits and creates financial sustainability problems. Policy makers should adopt pragmatic ways of enforcing mandatory enrolment so that low risk individuals remain enrolled; and sustainable ways of increasing revenue whiles ensuring that the societal objectives of the scheme are not compromised.

Best Practices for Financial Sustainability of Healthy Food Service Guidelines in Hospital Cafeterias.

PubMed

Jilcott Pitts, Stephanie; Schwartz, Brittany; Graham, John; Warnock, Amy Lowry; Mojica, Angelo; Marziale, Erin; Harris, Diane

2018-05-17

In February and March 2017 we examined barriers and facilitators to financial sustainability of healthy food service guidelines and synthesized best practices for financial sustainability in retail operations. We conducted qualitative, in-depth interviews with 8 hospital food service directors to learn more about barriers and facilitators to financial sustainability of healthy food service guidelines in retail food service operations. Analysts organized themes around headers in the interview guide and also made note of emerging themes not in the original guide. They used the code occurrence and co-occurrence features in Dedoose version 7.0.23 (SocioCultural Research Consultants) independently to analyze patterns across the interviews and to pull illustrative quotes for analysis. Two overarching themes emerged, related to 1) the demand for and sales of healthy foods and beverages, and 2) the production and supply of healthy foods and beverages. Our study provides insights into how hospital food service directors can maximize revenue and remain financially viable while selling healthier options in on-site dining facilities.

Report on the Recommended Method to Measure the Carbon Footprint of a USCG Vessel

DTIC Science & Technology

2011-01-01

Sector Standard applies the principles of financial accounting and reporting to ensure the accurate account of an agency’s GHG emissions. These...applies the principles of financial accounting and reporting to ensure the accurate account of an agency’s GHG emissions. These principles include

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lohri, Christian Riuji, E-mail: christian.lohri@eawag.ch; Camenzind, Ephraim Joseph, E-mail: ephraimcamenzind@hotmail.com; Zurbrügg, Christian, E-mail: christian.zurbruegg@eawag.ch

Highlights: • Cost-revenue analysis over 2 years revealed insufficient cost-recovery. • Expenses for motorized secondary collection increased by 82% over two years. • Low fee collection rate and reliance on only one revenue stream are problematic. • Different options for cost reduction and enhanced revenue streams are recommended. • Good public–private alliance is crucial to plan and implement improvement measures. - Abstract: Providing good solid waste management (SWM) services while also ensuring financial sustainability of the system continues to be a major challenge in cities of developing countries. Bahir Dar in northwestern Ethiopia outsourced municipal waste services to a privatemore » waste company in 2008. While this institutional change has led to substantial improvement in the cleanliness of the city, its financial sustainability remains unclear. Is the private company able to generate sufficient revenues from their activities to offset the costs and generate some profit? This paper presents a cost-revenue analysis, based on data from July 2009 to June 2011. The analysis reveals that overall costs in Bahir Dar’s SWM system increased significantly during this period, mainly due to rising costs related to waste transportation. On the other hand, there is only one major revenue stream in place: the waste collection fee from households, commercial enterprises and institutions. As the efficiency of fee collection from households is only around 50%, the total amount of revenues are not sufficient to cover the running costs. This results in a substantial yearly deficit. The results of the research therefore show that a more detailed cost structure and cost-revenue analysis of this waste management service is important with appropriate measures, either by the privates sector itself or with the support of the local authorities, in order to enhance cost efficiency and balance the cost-revenues towards cost recovery. Delays in mitigating the evident financial deficit could else endanger the public-private partnership (PPP) and lead to failure of this setup in the medium to long term, thus also endangering the now existing improved and currently reliable service. We present four options on how financial sustainability of the SWM system in Bahir Dar might be enhanced: (i) improved fee collection efficiency by linking the fees of solid waste collection to water supply; (ii) increasing the value chain by sales of organic waste recycling products; (iii) diversifying revenue streams and financing mechanisms (polluter-pays-, cross-subsidy- and business-principles); and (iv) cost reduction and improved cost-effectiveness. We argue that in a PPP setup such as in Bahir Dar, a strong alliance between the municipality and private enterprise is important so that appropriate solutions for improved financial sustainability of a SWM system can be sought and implemented.« less

Medicare Postacute Care Payment Reforms Have Potential to Improve Efficiency, but May Need Changes to Cut Costs

PubMed Central

Grabowski, David C.; Huckfeldt, Peter J.; Sood, Neeraj; Escarce, José J; Newhouse, Joseph P.

2012-01-01

The Affordable Care Act mandates changes in payment policies for Medicare postacute care services intended to contain spending in the long run and help ensure the program’s financial sustainability. In addition to reducing annual payment increases to providers under the existing prospective payment systems, the act calls for demonstration projects of bundled payment, accountable care organizations, and other strategies to promote care coordination and reduce spending. Experience with the adoption of Medicare prospective payment systems in postacute care settings approximately a decade ago suggests that current reforms could, but need not necessarily, produce such undesirable effects as decreased access for less profitable patients, poorer patient outcomes, and only short-lived curbs on spending. Policy makers will need to be vigilant in monitoring the impact of the Affordable Care Act reforms and be prepared to amend policies as necessary to ensure that the reforms exert persistent controls on spending without compromising the delivery of patient-appropriate postacute services. PMID:22949442

Level and determinants of incentives for village midwives in Indonesia.

PubMed

Ensor, Tim; Quayyum, Zahid; Nadjib, Mardiati; Sucahya, Purwa

2009-01-01

Since the early 1990s Indonesia has attempted to increase the level of skilled attendance at birth by placing rural midwives in every village in an effort to reduce persistently high levels of maternal mortality. Yet evidence suggests that there remains insufficient incentive to ensure an equal distribution across areas while the poor in all areas continue to access skilled attendance much less than those in richer groups. We report on a survey that was conducted as part of a complex evaluation of the rural midwife programme in Banten Province, to better understand the effect of financial incentives on the distribution of midwives and use of services. Midwives obtain almost two-thirds of their income from private clinical practice. Private income is strongly associated with competence and experience. Multivariate analysis suggests that midwives are well able to earn a substantial private income even in remoter areas. Yet the study also found a high level of unwillingness to move posts to a more remote area for a variety of non-financial reasons. The results suggest that the access to skilled attendance of those unable to afford fees may be impaired by the dependence on fee income, a result supported by companion household studies. In addition, ensuring that staff live and work in remoter areas is only likely to be financially sustainable if midwives can be attracted to live in these areas early in their careers. Finally, the overall strategy of basing skilled attendance mainly on village services throughout the country may need to be re-visited, with alternative models offered in areas where it continues to be impractical even with a change in the incentive framework.

76 FR 19263 - National Financial Literacy Month, 2011

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-06

... Financial Literacy Month, 2011 By the President of the United States of America A Proclamation Americans... Financial Literacy Month, we recommit to improving financial literacy and ensuring all Americans have access... hereby proclaim April 2011 as National Financial Literacy Month. I call upon all Americans to observe...

Application of system dynamics for developing financially self-sustaining management policies for water and wastewater systems.

PubMed

Rehan, R; Knight, M A; Haas, C T; Unger, A J A

2011-10-15

Recently enacted regulations in Canada and elsewhere require water utilities to be financially self-sustaining over the long-term. This implies full cost recovery for providing water and wastewater services to users. This study proposes a new approach to help water utilities plan to meet the requirements of the new regulations. A causal loop diagram is developed for a financially self-sustaining water utility which frames water and wastewater network management as a complex system with multiple interconnections and feedback loops. The novel System Dynamics approach is used to develop a demonstration model for water and wastewater network management. This is the first known application of System Dynamics to water and wastewater network management. The network simulated is that of a typical Canadian water utility that has under invested in maintenance. Model results show that with no proactive rehabilitation strategy the utility will need to substantially increase its user fees to achieve financial sustainability. This increase is further exacerbated when price elasticity of water demand is considered. When the utility pursues proactive rehabilitation, financial sustainability is achieved with lower user fees. Having demonstrated the significance of feedback loops for financial management of water and wastewater networks, the paper makes the case for a more complete utility model that considers the complexity of the system by incorporating all feedback loops. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

The significance of African lions for the financial viability of trophy hunting and the maintenance of wild land.

PubMed

Lindsey, Peter Andrew; Balme, Guy Andrew; Booth, Vernon Richard; Midlane, Neil

2012-01-01

Recent studies indicate that trophy hunting is impacting negatively on some lion populations, notably in Tanzania. In 2004 there was a proposal to list lions on CITES Appendix I and in 2011 animal-welfare groups petitioned the United States government to list lions as endangered under their Endangered Species Act. Such listings would likely curtail the trophy hunting of lions by limiting the import of lion trophies. Concurrent efforts are underway to encourage the European Union to ban lion trophy imports. We assessed the significance of lions to the financial viability of trophy hunting across five countries to help determine the financial impact and advisability of the proposed trade restrictions. Lion hunts attract the highest mean prices (US$24,000-US$71,000) of all trophy species. Lions generate 5-17% of gross trophy hunting income on national levels, the proportional significance highest in Mozambique, Tanzania, and Zambia. If lion hunting was effectively precluded, trophy hunting could potentially become financially unviable across at least 59,538 km(2) that could result in a concomitant loss of habitat. However, the loss of lion hunting could have other potentially broader negative impacts including reduction of competitiveness of wildlife-based land uses relative to ecologically unfavourable alternatives. Restrictions on lion hunting may also reduce tolerance for the species among communities where local people benefit from trophy hunting, and may reduce funds available for anti-poaching. If lion off-takes were reduced to recommended maximums (0.5/1000 km(2)), the loss of viability and reduction in profitability would be much lower than if lion hunting was stopped altogether (7,005 km(2)). We recommend that interventions focus on reducing off-takes to sustainable levels, implementing age-based regulations and improving governance of trophy hunting. Such measures could ensure sustainability, while retaining incentives for the conservation of lions and their habitat from hunting.

The Significance of African Lions for the Financial Viability of Trophy Hunting and the Maintenance of Wild Land

PubMed Central

Lindsey, Peter Andrew; Balme, Guy Andrew; Booth, Vernon Richard; Midlane, Neil

2012-01-01

Recent studies indicate that trophy hunting is impacting negatively on some lion populations, notably in Tanzania. In 2004 there was a proposal to list lions on CITES Appendix I and in 2011 animal-welfare groups petitioned the United States government to list lions as endangered under their Endangered Species Act. Such listings would likely curtail the trophy hunting of lions by limiting the import of lion trophies. Concurrent efforts are underway to encourage the European Union to ban lion trophy imports. We assessed the significance of lions to the financial viability of trophy hunting across five countries to help determine the financial impact and advisability of the proposed trade restrictions. Lion hunts attract the highest mean prices (US$24,000–US$71,000) of all trophy species. Lions generate 5–17% of gross trophy hunting income on national levels, the proportional significance highest in Mozambique, Tanzania, and Zambia. If lion hunting was effectively precluded, trophy hunting could potentially become financially unviable across at least 59,538 km2 that could result in a concomitant loss of habitat. However, the loss of lion hunting could have other potentially broader negative impacts including reduction of competitiveness of wildlife-based land uses relative to ecologically unfavourable alternatives. Restrictions on lion hunting may also reduce tolerance for the species among communities where local people benefit from trophy hunting, and may reduce funds available for anti-poaching. If lion off-takes were reduced to recommended maximums (0.5/1000 km2), the loss of viability and reduction in profitability would be much lower than if lion hunting was stopped altogether (7,005 km2). We recommend that interventions focus on reducing off-takes to sustainable levels, implementing age-based regulations and improving governance of trophy hunting. Such measures could ensure sustainability, while retaining incentives for the conservation of lions and their habitat from hunting. PMID:22247772

Assessment of the experiences and coping strategies of people working in the informal sector in their quest to access health care services: the case of Dar es Salaam, Tanzania.

PubMed

Munga, Michael A; Gideon, Gilbert M

2009-02-01

Addressing inequities in health care provision and financing has been at the center stage of Health Sector Reform (HSR) discussions since the early 1980s. The poor, women, and informal health sector workers in most developing countries are rarely covered by formal health insurance mechanisms that are meant to ensure access to essential health services. They are also sidelined in formal banking and credit systems due to their being predominantly low income earners, with little resources to meet eligibility criteria for borrowing and also to be considered creditworthy. In light of this fact, the present paper analyzes both quantitative and qualitative data in an attempt to explore and discuss the experiences and coping strategies of women and men employed in the informal sector economy in their daily attempts to access health care services. The paper employs Malaria as a tracer disease and gender as a unit of analysis. Analysis indicated the significance, as perceived by interviewees, of both informal credit networks and formal insurance and banking systems as important shock-absorbers for vulnerable populations in their struggle to access basic health services in times of need. The paper further highlights and discusses diverse coping strategies that households employ in dealing with illness-related costs and a greater willingness to be integrated into both formal and informal financial mechanisms. The paper finally concludes that the government must take the following steps: 1) enhance existing formal and communitybased initiatives to make them sustainable, 2) devise ways to reduce the lack of flexibility in membership requirements for insurance schemes/financial institutions, and 3) reduce perverse incentives inherent in the health system that may prevent people from seeking membership in available insurance mechanisms. In addition, deliberate steps must be taken by the government to employ 'targeted measures' to ensure that health care access is improved and sustained particularly for vulnerable populations.

Sustaining Financial Support through Workforce Development Grants and Contracts

ERIC Educational Resources Information Center

Brumbach, Mary A.

2005-01-01

Workforce development grants and contracts are important methods for sustaining financial support for community colleges. This chapter details decision factors, college issues, possible pitfalls, and methods for procuring and handling government contracts and grants for workforce training.

Does the ``National Free Health Care'' have financial sustainability in China? A case of Shenmu County, Shaanxi Province, China.

PubMed

Wang, Lijian

2015-01-01

The most populous country in the world, China needs more health care. Shenmu's practices show that National Free Health Care (NFHC) system has played an active role in fulfilling the citizen's needs of health care, and alleviating the difficulties in affording the medical costs and seeing doctors. But NFHC system needs substantial financial supporting. It is worth in-depth discussing and reflecting on whether the NFHC system suits China's national conditions. The paper establishes the population age structure forecasting model and NFHC financial burden model by decomposition methodology and actuarial modelling. And it finds than the financial burden of NFHC system in Shenmu will be increased from 256.64 million Yuan to 656.04 million Yuan in 2013-2020, with the growth rate 12.45%. Meanwhile, the percentage of the financial burden in government's annual revenue is less than 2% in 2013-2020, NFHC system has financial sustainability in Shenmu. According to the successful experience abroad and the calculated results in Shenmu, to extend the NFHC system to the whole of China has financial sustainability and realistic possibility.

What Happens to the Farm? Australian Farmers' Experiences after a Serious Farm Injury.

PubMed

Beattie, Jessica; McLeod, Candis; Murray, Meg; Pedler, Daryl; Brumby, Susan; Gabbe, Belinda

2018-01-01

To investigate the experiences of farmers on returning to farming following a serious farm-related injury. Patients who had sustained major trauma on a farm in Victoria, Australia, were identified using the Victorian State Trauma Registry (VSTR). In depth, semistructured phone interviews were conducted with 31 participants. Interview data were subjected to thematic analysis to identify important recurring themes. Interviews continued until data saturation was achieved. Interviewees included self-employed full-time farmers, part-time farmers with a supplementary income, and agricultural employees. Analysis of participant responses connected to returning to farming after a serious farm-related injury identified five major interconnected themes: (i) effect on farm work, (ii) farming future, (iii) safety advocacy, (iv) changes to farming practices, and (v) financial ramifications. Farmers who have sustained a serious farm-related injury are an important resource; their experiences and perspectives could assist in the development of educational and transitional support services from recovery back to working at a preinjury level, while ensuring farming production is sustainable during this period. Furthermore, farm safety programs can be enhanced by the engagement of farmers, such as participants in this study as advocates for improved farm safety practices.

24 CFR Appendix A to Part 570 - Guidelines and Objectives for Evaluating Project Costs and Financial Requirements

Code of Federal Regulations, 2013 CFR

2013-04-01

... recipient with a framework for financially underwriting and selecting CDBG-assisted economic development... out the economic development project. This is to ensure that time and effort is not wasted on... review the economic development project to ensure that, to the extent practicable, CDBG funds will not be...

24 CFR Appendix A to Part 570 - Guidelines and Objectives for Evaluating Project Costs and Financial Requirements

Code of Federal Regulations, 2014 CFR

2014-04-01

... recipient with a framework for financially underwriting and selecting CDBG-assisted economic development... out the economic development project. This is to ensure that time and effort is not wasted on... review the economic development project to ensure that, to the extent practicable, CDBG funds will not be...

24 CFR Appendix A to Part 570 - Guidelines and Objectives for Evaluating Project Costs and Financial Requirements

Code of Federal Regulations, 2012 CFR

2012-04-01

... recipient with a framework for financially underwriting and selecting CDBG-assisted economic development... out the economic development project. This is to ensure that time and effort is not wasted on... review the economic development project to ensure that, to the extent practicable, CDBG funds will not be...

24 CFR Appendix A to Part 570 - Guidelines and Objectives for Evaluating Project Costs and Financial Requirements

Code of Federal Regulations, 2011 CFR

2011-04-01

... recipient with a framework for financially underwriting and selecting CDBG-assisted economic development... out the economic development project. This is to ensure that time and effort is not wasted on... review the economic development project to ensure that, to the extent practicable, CDBG funds will not be...

USDOT guidance for connected vehicle deployments : institutional and business models and financial sustainability.

DOT National Transportation Integrated Search

2016-07-01

This document provides guidance material in regards to Institutional and Business issues as well as Financial Sustainability for the CV Pilots Deployment Concept Development Phase. This material also provides part of the foundation for the Performanc...

From public to private and back again: sustaining a high service-delivery level during transition of management authority: a Cambodia case study.

PubMed

Jacobs, Bart; Thomé, Jean-Marc; Overtoom, Rob; Sam, Sam Oeun; Indermühle, Lorenz; Price, Neil

2010-05-01

Contracting non-governmental organizations (NGOs) has been shown to increase health service delivery output considerably over relatively short time frames in low-income countries, especially when applying performance-related pay as a stimulus. A key concern is how to manage the transition back to government-operated systems while maintaining health service delivery output levels. In this paper we describe and analyse the transition from NGO-managed to government-managed health services over a 3-year period in a health district in Cambodia with a focus on the level of health service delivery. Data are derived from four sources, including cross-sectional surveys and health management and financial information systems. The transition was achieved by focusing on all the building blocks of the health care system and ensuring an acceptable financial remuneration for the staff members of contracted health facilities. The latter was attained through performance subsidies derived from financial commitment by the central government, and revenue from user fees. Performance management had a crucial role in the gradual handover of responsibilities. Not all responsibilities were handed back to government over the case study period-notably the development of performance indicators and targets and the performance monitoring.

Can innovative health financing policies increase access to MDG-related services? Evidence from Rwanda.

PubMed

Sekabaraga, Claude; Diop, Francois; Soucat, Agnes

2011-11-01

Ensuring financial access to health services is a critical challenge for poor countries if they are to reach the health Millennium Development Goals (MDGs). This article examines the case of Rwanda, a country which has championed innovative health care financing policies. Between 2000 and 2007, Rwanda has improved financial access for the poor, increased utilization of health services and reduced out-of-pocket payments for health care. Poor groups' utilization has increased for all health services, sometimes dramatically. Use of assisted deliveries, for example, increased from 12.1% to 42.7% among the poorest quintile; payments at the point of delivery have also been reduced; and catastrophic expenditures have declined. Part of these achievements is likely linked to innovative health financing policies, particularly the expansion of micro-insurance ('mutuelles') and performance-based financing. The paper concludes that the Rwanda experience provides a useful example of effective implementation of policies that reduce the financial barrier to health services, hereby contributing to the health MDGs. Today's main challenge is to build the sustainability of this system. Finally, the paper proposes a simple set of rigorous metrics to assess the impact of health financing policies and calls for implementing rigorous impact evaluation of health care financing policies in low-income countries.

20 CFR 638.808 - Center financial management and reporting.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Center financial management and reporting... § 638.808 Center financial management and reporting. The Job Corps Director shall establish procedures to ensure that each center operator and each subcontractor maintain a financial management system...

20 CFR 638.808 - Center financial management and reporting.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Center financial management and reporting... § 638.808 Center financial management and reporting. The Job Corps Director shall establish procedures to ensure that each center operator and each subcontractor maintain a financial management system...

Environmental and financial implications of ethanol as a bioethylene feedstock versus as a transportation fuel

NASA Astrophysics Data System (ADS)

McKechnie, Jon; Pourbafrani, Mohammad; Saville, Bradley A.; MacLean, Heather L.

2015-12-01

Bulk chemicals production from biomass may compete with biofuels for low-cost and sustainable biomass sources. Understanding how alternative uses of biomass compare in terms of financial and environmental parameters is therefore necessary to help ensure that efficient uses of resources are encouraged by policy and undertaken by industry. In this paper, we compare the environmental and financial performance of using ethanol as a feedstock for bioethylene production or as a transport fuel in the US life cycle-based models are developed to isolate the relative impacts of these two ethanol uses and generate results that are applicable irrespective of ethanol production pathway. Ethanol use as a feedstock for bioethylene production or as a transport fuel leads to comparable greenhouse gas (GHG) emissions and fossil energy consumption reductions relative to their counterparts produced from fossil sources. By displacing gasoline use in vehicles, use of ethanol as a transport fuel is six times more effective in reducing petroleum energy use on a life cycle basis. In contrast, bioethylene predominately avoids consumption of natural gas. Considering 2013 US ethanol and ethylene market prices, our analysis shows that bioethylene is financially viable only if significant price premiums are realized over conventional ethylene, from 35% to 65% depending on the scale of bioethylene production considered (80 000 t yr-1 to 240 000 t yr-1). Ethanol use as a transportation fuel is therefore the preferred pathway considering financial, GHG emissions, and petroleum energy use metrics, although bioethylene production could have strategic value if demand-side limitations of ethanol transport fuel markets are reached.

Technical Education as a Tool for Ensuring Sustainable Development: A Case of India

ERIC Educational Resources Information Center

Sharma, Gagan Deep; Uppal, Raminder Singh; Mahendru, Mandeep

2016-01-01

This paper notes that education needs to essentially lead to sustainable development serving two-fold purpose--eradicating the problems of unemployment and poverty; and ensuring equitable distribution of wealth while ensuring the right understanding leading to a peaceful, prosperous and developed world. In its current state, technical education…

The performance frontier: innovating for a sustainable strategy.

PubMed

Eccles, Robert G; Serafeim, George

2013-05-01

A mishmash of sustainability tactics does not add up to a sustainable strategy. Too often, companies launch sustainability programs with the hope that they'll be financially rewarded for doing good, even when those programs aren't relevant to their strategy and operations. They fail to understand the trade-offs between financial performance and performance on environmental, social, and governance (ESG) issues. Improving one typically comes at a cost to the other. But it doesn't have to be this way. It's possible to simultaneously boost both financial and ESG performance-if you focus strategically on issues that are the most "material" to shareholder value, and you develop major innovations in products, processes, and business models that prioritize those concerns. Maps being developed by the Sustainability Accounting Standards Board, which rank the materiality of 43 issues for 88 industries, can provide valuable guidance. And broad initiatives undertaken by three companies-Natura, Dow Chemical, and CLP Group-demonstrate the kind of innovations that will push performance into new territory. Communicating the benefits to stakeholders is also critical, which is why integrated reports, which combine financial and ESG reporting, are now gaining in popularity.

The Role of Communication in Ensuring Sustained Behavior Change

EPA Pesticide Factsheets

Webinar series on communications strategies and methods addresses how communications tools can be used throughout the implementation of climate and clean energy programs to achieve behavior change and ensure sustained.

Developing a Sustainable Financial Model in Higher Education for Open Educational Resources

ERIC Educational Resources Information Center

Annand, David

2015-01-01

Financial issues regarding the sustainable production, dissemination, and use of Open Educational Resources (OER) in higher education are reviewed and proposed solutions critiqued. Use of OER produce demonstrable cost savings for students. Yet OER development continues to rely almost completely on government and philanthropic funding. This…

Defense Finance and Accounting Service Work on the Navy Defense Business Operations Fund FY 1995 Financial Statements

DTIC Science & Technology

1996-11-22

consolidation of financial statements , and for an automated process to transfer financial statement data from the Central Data Base to a... consolidation of financial statements . The Deputy Chief Financial Officer also indicated that the DFAS Cleveland Center approved a system change request...ently is developing Standard Operating Procedures to ensure consistency and standardization in the adjustment and consolidation of financial statements .

Who is responsible for business failures?

PubMed

Cleverley, William O

2002-10-01

Two high-profile business failures should be a wake-up call for hospital leaders. Management and boards cannot rely on unaudited financial statements as the principal indicator of financial health. Boards must ensure diligent analysis of key financial measures. Board members need better education about healthcare finance. Hospitals are not immune to financial collapse.

Fostering excellence: roles, responsibilities, and expectations of new family physician clinician investigators.

PubMed

Hogg, William; Kendall, Claire; Muggah, Elizabeth; Mayo-Bruinsma, Liesha; Ziebell, Laura

2014-02-01

A key priority in primary health care research is determining how to ensure the advancement of new family physician clinician investigators (FP-CIs). However, there is little consensus on what expectations should be implemented for new investigators to ensure the successful and timely acquisition of independent salary support. Support new FP-CIs to maximize early career research success. This program description aims to summarize the administrative and financial support provided by the C.T. Lamont Primary Health Care Research Centre in Ottawa, Ont, to early career FP-CIs; delineate career expectations; and describe the results in terms of research productivity on the part of new FP-CIs. Family physician CI's achieved a high level of research productivity during their first 5 years, but most did not secure external salary support. It might be unrealistic to expect new FP-CIs to be self-financing by the end of 5 years. This is a career-development program, and supporting new career FP-CIs requires a long-term investment. This understanding is critical to fostering and strengthening sustainable primary care research programs.

Fostering excellence

PubMed Central

Hogg, William; Kendall, Claire; Muggah, Elizabeth; Mayo-Bruinsma, Liesha; Ziebell, Laura

2014-01-01

Abstract Problem addressed A key priority in primary health care research is determining how to ensure the advancement of new family physician clinician investigators (FP-CIs). However, there is little consensus on what expectations should be implemented for new investigators to ensure the successful and timely acquisition of independent salary support. Objective of program Support new FP-CIs to maximize early career research success. Program description This program description aims to summarize the administrative and financial support provided by the C.T. Lamont Primary Health Care Research Centre in Ottawa, Ont, to early career FP-CIs; delineate career expectations; and describe the results in terms of research productivity on the part of new FP-CIs. Conclusion Family physician CI’s achieved a high level of research productivity during their first 5 years, but most did not secure external salary support. It might be unrealistic to expect new FP-CIs to be self-financing by the end of 5 years. This is a career-development program, and supporting new career FP-CIs requires a long-term investment. This understanding is critical to fostering and strengthening sustainable primary care research programs. PMID:24522688

34 CFR 300.154 - Methods of ensuring services.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 34 Education 2 2012-07-01 2012-07-01 false Methods of ensuring services. 300.154 Section 300.154... CHILDREN WITH DISABILITIES State Eligibility Methods of Ensuring Services § 300.154 Methods of ensuring... following: (1) An identification of, or a method for defining, the financial responsibility of each agency...

7 CFR 4284.620 - Applicant eligibility.

Code of Federal Regulations, 2011 CFR

2011-01-01

.... (b) Applicants must have sufficient financial strength and expertise in activities proposed in the application to ensure accomplishment of the described activities and objectives. (1) Financial strength will be analyzed by the Agency based on financial data provided in the application. The analysis will...

Principles for Promoting the Financial Sustainability of Online Programs

ERIC Educational Resources Information Center

Meyer, Katrina A.; Bruwelheide, Janis; Poulin, Russell

2009-01-01

The project described in this article was an attempt to uncover the principles of financial sustainability for online programs and to align these with a guide to managing online programs. An initial team of experienced online educators developed draft principles, which were then reviewed by an external consultant and revised; the revised…

Developing Knowledge through Practical Experience: The Principles of Financial Sustainability for Online Programs

ERIC Educational Resources Information Center

Meyer, Katrina A.; Bruwelheide, Janis; Poulin, Russell

2007-01-01

Following the theory of situated cognition as proposed by Brown, Collins, and Duguid (1998), this research project tapped into the contextual knowledge of experienced administrators of online programs. Draft principles of financial sustainability for online programs were developed by an initial team of experienced online educators and then…

A Model for Considering the Financial Sustainability of Learning and Teaching Programs: Concepts and Challenges

ERIC Educational Resources Information Center

De Bellis, David

2012-01-01

The expansion of tertiary education, an intensity of focus on accountability and performance, and the emergence of new governance and management structures drives an economic fiscal perspective of the value of learning and teaching. Accurate and meaningful models defining financial sustainability are therefore proposed as an imperative for…

How to ensure sustainable interoperability in heterogeneous distributed systems through architectural approach.

PubMed

Pape-Haugaard, Louise; Frank, Lars

2011-01-01

A major obstacle in ensuring ubiquitous information is the utilization of heterogeneous systems in eHealth. The objective in this paper is to illustrate how an architecture for distributed eHealth databases can be designed without lacking the characteristic features of traditional sustainable databases. The approach is firstly to explain traditional architecture in central and homogeneous distributed database computing, followed by a possible approach to use an architectural framework to obtain sustainability across disparate systems i.e. heterogeneous databases, concluded with a discussion. It is seen that through a method of using relaxed ACID properties on a service-oriented architecture it is possible to achieve data consistency which is essential when ensuring sustainable interoperability.

[Lifestyle interventions at work?].

PubMed

Hulshof, Carel T J

2013-01-01

So far many worksite lifestyle or health promotion programmes have shown only moderate evidence of effectiveness and cost-effectiveness. However, participation in work is in itself an important determinant of health. For this reason ensuring of fitting work and sustained workability should be an aspect of health policy. Workers' health is not only determined by their working environment but also by health practices and lifestyle factors. Under certain preconditions (e.g. on a voluntary basis, confidentiality, integration with health protection) lifestyle interventions during work time can contribute to a healthier working population. As such programmes may result in financial and social benefits for employers, they should be partly responsible for paying the costs. From a societal perspective, governmental commitment to a preventive policy and the involvement of health and income insurance companies are also required.

A crystallographic perspective on sharing data and knowledge

NASA Astrophysics Data System (ADS)

Bruno, Ian J.; Groom, Colin R.

2014-10-01

The crystallographic community is in many ways an exemplar of the benefits and practices of sharing data. Since the inception of the technique, virtually every published crystal structure has been made available to others. This has been achieved through the establishment of several specialist data centres, including the Cambridge Crystallographic Data Centre, which produces the Cambridge Structural Database. Containing curated structures of small organic molecules, some containing a metal, the database has been produced for almost 50 years. This has required the development of complex informatics tools and an environment allowing expert human curation. As importantly, a financial model has evolved which has, to date, ensured the sustainability of the resource. However, the opportunities afforded by technological changes and changing attitudes to sharing data make it an opportune moment to review current practices.

[Telecardiology: Tasks and duties of telemedicine].

PubMed

Borbás, János; Forczek, Erzsébet; Sepp, Róbert; Bari, Ferenc

2017-11-01

Telemedicine is a young science that integrates innovations of information-technology and telecommunications into medical science. A successful telemedicine procedure should guarantee reduced workload of the healthcare system with well secured and cost-effective processes. Our goal was to collect the development phases of telemedicine projects through existing telecardiology solutions. Subsequent to reviewing international publications we analyzed the past and present situation of blood pressure monitoring, remote diagnostics of electrocardiography, implantable cardioverter defibrillator monitoring and pocket ultrasound devices. In case of new solutions (a) several internationally accepted, confidently reproducible "good practices" are needed for creating (b) guidelines and recommendations of international medical associations. They have to ensure (c) cost-effective work, with well-designed sustainability and (d) patient confidentiality. Improving (e) education for professionals and patients is essential. We recommend to telemedicine developers to use our standards in order to introduce their products more effectively into clinical practice. It is encouraging that current possibilities of telecardiology partly or fully meet the aforementioned criteria. Further development of the topic can contribute to financial sustainability of our healthcare and might be able to resolve limitations of human resources. Orv Hetil. 2017; 158(44): 1741-1746.

48 CFR 52.247-6 - Financial Statement.

Code of Federal Regulations, 2010 CFR

2010-10-01

....247-6 Financial Statement. As prescribed in 47.207-1(e), insert the following provision in solicitations for transportation or for transportation-related services to ensure that offerors are prepared to... furnish the Government with a current certified statement of the offeror's financial condition and such...

48 CFR 52.247-6 - Financial Statement.

Code of Federal Regulations, 2011 CFR

2011-10-01

....247-6 Financial Statement. As prescribed in 47.207-1(e), insert the following provision in solicitations for transportation or for transportation-related services to ensure that offerors are prepared to... furnish the Government with a current certified statement of the offeror's financial condition and such...

77 FR 59192 - Agency Information Collection Activities: Submission for OMB Review; Comment Request...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-26

.... Financial Institution Policies and Procedures for Ensuring Employee- Mortgage Loan Originator Compliance... Burden: 244,800 hours. C. Financial Institution Procedures for the Collection and Maintenance of Employee.... F. Financial Institution Procedures for the Collection of Employee Mortgage Loan Originator's...

When nursing takes ownership of financial outcomes: achieving exceptional financial performance through leadership, strategy, and execution.

PubMed

Goetz, Kristopher; Janney, Michelle; Ramsey, Kristin

2011-01-01

With nurses and unlicensed supportive personnel composing the greatest percentage of the workforce at any hospital, it is not surprising nursing leadership plays an increasing role in the attainment of financial goals. The nursing leadership team at one academic medical center reduced costs by more than $10 million over 4 years while outperforming national benchmarks on nurse-sensitive quality indicators. The most critical success factor in attaining exceptional financial performance is a personal and collective accountability to achieving outcomes. Whether it is financial improvement, advancing patient safety, or ensuring a highly engaged workforce, success will not be attained without thoughtful, focused leadership. The accountability model ensures there is a culture built around financial performance where nurses and leaders think and act, on a daily basis, in a manner necessary to understand opportunities, find answers, and overcome obstacles. While structures, processes, and tools may serve as the means to achieve a target, it is leadership's responsibility to set the right goal and motivate others.

Responding to Postsecondary Education Financing Pressures.

ERIC Educational Resources Information Center

Longanecker, David A.

Minnesota has adopted a financial policy that takes into account the increasing pressure to finance postsecondary education. The policy increases the price of college through increased tuition, while at the same time targeting sufficient financial aid to ensure educational opportunity for financially needy students. In practical terms, this…

29 CFR 1960.7 - Financial management.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 9 2012-07-01 2012-07-01 false Financial management. 1960.7 Section 1960.7 Labor... MATTERS Administration § 1960.7 Financial management. (a) The head of each agency shall ensure that the... Official, management officials in charge of each establishment, safety and health officials at all...

29 CFR 1960.7 - Financial management.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 9 2013-07-01 2013-07-01 false Financial management. 1960.7 Section 1960.7 Labor... MATTERS Administration § 1960.7 Financial management. (a) The head of each agency shall ensure that the... Official, management officials in charge of each establishment, safety and health officials at all...

29 CFR 1960.7 - Financial management.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 9 2014-07-01 2014-07-01 false Financial management. 1960.7 Section 1960.7 Labor... MATTERS Administration § 1960.7 Financial management. (a) The head of each agency shall ensure that the... Official, management officials in charge of each establishment, safety and health officials at all...

24 CFR 574.450 - Financial records.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false Financial records. 574.450 Section...) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN... Grantees and Project Sponsors § 574.450 Financial records. The grantee shall agree, and shall ensure that...

29 CFR 1960.7 - Financial management.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 9 2010-07-01 2010-07-01 false Financial management. 1960.7 Section 1960.7 Labor... MATTERS Administration § 1960.7 Financial management. (a) The head of each agency shall ensure that the... Official, management officials in charge of each establishment, safety and health officials at all...

77 FR 37699 - Notice of Proposed Information Collection: Comment Request OSHC Financial Reporting Form

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-22

... Information Collection: Comment Request OSHC Financial Reporting Form AGENCY: Office of Sustainable Housing... Challenge Planning Grant Program, require the financial reporting by grantees. This tracking of grantee... also lists the following information: Title of Proposal: OSHC Financial Reporting Form. OMB Control...

The contribution of community leadership upon the performance of mutual health organisations in Ghana.

PubMed

Adomah-Afari, Augustine

2015-01-01

The purpose of this paper is to investigate the effect of social dynamics on the performance of mutual health organisations (MHOs) exploring the influence of community wealth and community leadership on policy implementation. Four operating district mutual health insurance schemes were selected using geographical locations, among other criteria, as case studies. Data were gathered through interviews and documentary review. The findings were analysed using community field and social capital theories. Traditional leaders like the Chiefs serve as the pivot around which social and human capital of the communities revolve in the developmental process of the country. Lack of exhaustive examination of the financial and institutional viability issues of the MHOs. Future studies could assess the interplay between financial, institutional and social viability models when measuring the financial and overall sustainability of MHOs. Health policy makers need to involve traditional leaders in the formulation and implementation of national policies since their acceptance or rejection of central government policy could have negative consequences. Ghana is a dynamic country and there is the need to utilise existing social networks: inter-family and inter-tribal relationships to ensure the viability of MHOs. There is and can be a successful interplay between public sector funding and community sector revenue mobilisation for financing the health sector in Ghana. This justifies the complementarity between government funding and community's resource mobilisation efforts in the health sector.

Freshman Year Financial Aid Nudges: An Experiment to Increase Financial Aid Renewal and Sophomore Year Persistence

ERIC Educational Resources Information Center

Castleman, Benjamin L.; Page, Lindsay C.

2013-01-01

While considerable effort has been invested to increase FAFSA completion among high school seniors, there has been much less investment to ensure that college freshmen re-apply for financial aid. Text messaging is a promising approach to inform students of important stages in the financial aid re-application process and to connect them to…

Reducing medical claims cost to Ghana's National Health Insurance scheme: a cross-sectional comparative assessment of the paper- and electronic-based claims reviews.

PubMed

Nsiah-Boateng, Eric; Asenso-Boadi, Francis; Dsane-Selby, Lydia; Andoh-Adjei, Francis-Xavier; Otoo, Nathaniel; Akweongo, Patricia; Aikins, Moses

2017-02-06

A robust medical claims review system is crucial for addressing fraud and abuse and ensuring financial viability of health insurance organisations. This paper assesses claims adjustment rate of the paper- and electronic-based claims reviews of the National Health Insurance Scheme (NHIS) in Ghana. The study was a cross-sectional comparative assessment of paper- and electronic-based claims reviews of the NHIS. Medical claims of subscribers for the year, 2014 were requested from the claims directorate and analysed. Proportions of claims adjusted by the paper- and electronic-based claims reviews were determined for each type of healthcare facility. Bivariate analyses were also conducted to test for differences in claims adjustments between healthcare facility types, and between the two claims reviews. The electronic-based review made overall adjustment of 17.0% from GHS10.09 million (USD2.64 m) claims cost whilst the paper-based review adjusted 4.9% from a total of GHS57.50 million (USD15.09 m) claims cost received, and the difference was significant (p < 0.001). However, there were no significant differences in claims cost adjustment rate between healthcare facility types by the electronic-based (p = 0.0656) and by the paper-based reviews (p = 0.6484). The electronic-based review adjusted significantly higher claims cost than the paper-based claims review. Scaling up the electronic-based review to cover claims from all accredited care providers could reduce spurious claims cost to the scheme and ensure long term financial sustainability.

What is Good University Financial Management?

ERIC Educational Resources Information Center

Taylor, Mark P.

2013-01-01

In the current and foreseeable harsh UK higher education environment, aspiring to best-practice financial management will be key to ensuring the prosperity--and indeed the survival--of any university. In this article I argue that good university financial management should provide stability to the institution, allow for investment as well as…

75 FR 20299 - Garnishment of Accounts Containing Federal Benefit Payments

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-19

... proposed rule would establish procedures that financial institutions must follow when a garnishment order... proposed rule would require financial institutions that receive a garnishment order for an account to... to receipt of the order and, if so, would require the financial institution to ensure that the...

Certification of Financial Aid Administrators: Is It Time to Move Forward?

ERIC Educational Resources Information Center

Peterson, Stacey A.

2017-01-01

Financial aid administrators administer various aspects of financial assistance programs; oversee, direct, coordinate, evaluate, and provide training for program activities and the personnel who manage office operations and supervise support staff; and ensure alignment of student and institutional needs while protecting the public interest. They…

In place of fear: aligning health care planning with system objectives to achieve financial sustainability.

PubMed

Birch, Stephen; Murphy, Gail Tomblin; MacKenzie, Adrian; Cumming, Jackie

2015-04-01

The financial sustainability of publicly funded health care systems is a challenge to policymakers in many countries as health care absorbs an ever increasing share of both national wealth and government spending. New technology, aging populations and increasing public expectations of the health care system are often cited as reasons why health care systems need ever increasing funding as well as reasons why universal and comprehensive public systems are unsustainable. However, increases in health care spending are not usually linked to corresponding increases in need for care within populations. Attempts to promote financial sustainability of systems such as limiting the range of services is covered or the groups of population covered may compromise their political sustainability as some groups are left to seek private cover for some or all services. In this paper, an alternative view of financial sustainability is presented which identifies the failure of planning and management of health care to reflect needs for care in populations and to integrate planning and management functions for health care expenditure, health care services and the health care workforce. We present a Health Care Sustainability Framework based on disaggregating the health care expenditure into separate planning components. Unlike other approaches to planning health care expenditure, this framework explicitly incorporates population health needs as a determinant of health care requirements, and provides a diagnostic tool for understanding the sources of expenditure increase. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Emergent themes in the sustainability of primary health care innovation.

PubMed

Sibthorpe, Beverly M; Glasgow, Nicholas J; Wells, Robert W

2005-11-21

A synthesis of the findings of the five studies of sustainability of primary health care innovation across six domains (political, institutional, financial, economic, client and workforce) yielded three main themes. These were: the importance of social relationships, networks and champions; the effect of political, financial and societal forces; and the motivation and capacity of agents within the system. The need for routine assessment of the sustainability of primary health care innovations is discussed. Given the dearth of literature on the sustainability of primary health care innovation, there is potential to develop a program of research directed towards a future synthesis of evidence.

Mapping financial flows for immunisation in Uganda 2009/10 and 2010/11: New insights for methodologies and policy.

PubMed

Guthrie, Teresa; Zikusooka, Charlotte; Kwesiga, Brendan; Abewe, Christabel; Lagony, Stephen; Schutte, Carl; Marinda, Edmore; Humphreys, Kerrin; Motlogelwa, Katlego; Nombewu, Zipozihle Chuma; Brenzel, Logan; Kinghorn, Anthony

2015-05-07

The Global Vaccine Action Plan highlights the need for immunisation programmes to have sustainable access to predictable funding. A good understanding of current and future funding needs, commitments, and gaps is required to enhance planning, improve resource allocation and mobilisation, and to avoid funding bottlenecks, as well as to ensure that co-funding arrangements are appropriate. This study aimed to map the resource envelope and flows for immunisation in Uganda in 2009/10 and 2010/11. To assess costs and financing of immunisation, the study applied a common methodology as part of the multi-country Expanded Program on Immunisation Costing (EPIC) study (Brenzel et al., 2015). The financial mapping developed a customised extension of the System of Health Accounts (SHA) codes to explore immunisation financing in detail. Data were collected from government and external sources. The mapping was able to assess financing more comprehensively than many studies, and the simultaneous costing of routine immunisation collected detailed data about human resources costs. The Ugandan government contributed 56% and 42% of routine immunisation funds in 2009/10 and 2010/11, respectively, higher than previously estimated, and managed up to 90% of funds. Direct delivery of services used 93% of the immunisation financial resources in 2010/11, while the above service delivery costs were small (7%). Vaccines and supplies (41%) and salaries (38%) absorbed most funding. There were differences in the key cost categories between actual resource flows and the estimates from the comprehensive multi-year plan (cMYP). Results highlight that governments and partners need to improve systems to routinely track immunisation financing flows for enhanced accountability, performance, and sustainability. The modified SHA coding allowed financing to be mapped to specific immunisation activities, and could be used for standardised, resource tracking compatible with National Health Accounts (NHA). Recommendations are made for refining routine resource mapping approaches. Copyright © 2014 Elsevier Ltd. All rights reserved.

One vision of academic nursing centers.

PubMed

Esperat, M Christina; Green, Alexia; Acton, Cindy

2004-01-01

Reconciling vision, mission, and financial realities into a successful socially responsive endeavor is a challenge for academic nursing centers. A financially viable faculty practice enterprise is a response to this challenge. Entrepreneurial management and strategy assist in establishing financial sustainability.

32 CFR Appendix B to Part 246 - Business and Financial Operations

Code of Federal Regulations, 2011 CFR

2011-07-01

... ensure timely and economical delivery. 3. As required, to transport Stars and Stripes to officially... States bookstore franchises. The offering of discounts should not endanger the financial viability of the...

32 CFR Appendix B to Part 246 - Business and Financial Operations

Code of Federal Regulations, 2014 CFR

2014-07-01

... ensure timely and economical delivery. 3. As required, to transport Stars and Stripes to officially... States bookstore franchises. The offering of discounts should not endanger the financial viability of the...

32 CFR Appendix B to Part 246 - Business and Financial Operations

Code of Federal Regulations, 2010 CFR

2010-07-01

... ensure timely and economical delivery. 3. As required, to transport Stars and Stripes to officially... States bookstore franchises. The offering of discounts should not endanger the financial viability of the...

32 CFR Appendix B to Part 246 - Business and Financial Operations

Code of Federal Regulations, 2012 CFR

2012-07-01

... ensure timely and economical delivery. 3. As required, to transport Stars and Stripes to officially... States bookstore franchises. The offering of discounts should not endanger the financial viability of the...

32 CFR Appendix B to Part 246 - Business and Financial Operations

Code of Federal Regulations, 2013 CFR

2013-07-01

... ensure timely and economical delivery. 3. As required, to transport Stars and Stripes to officially... States bookstore franchises. The offering of discounts should not endanger the financial viability of the...

Exploring Canadian Physicians' Experiences Providing Medical Assistance in Dying: A Qualitative Study.

PubMed

Khoshnood, Narges; Hopwood, Marie-Clare; Lokuge, Bhadra; Kurahashi, Allison; Tobin, Anastasia; Isenberg, Sarina; Husain, Amna

2018-05-15

MAiD allows a practitioner to administer or prescribe medication for the purpose of ending a patient's life. In 2016, Canada was the latest country, following several European countries and American states, to legalize physician-assisted death. Although some studies report on physician attitudes towards MAiD or describe patient characteristics, there are few that explore the professional challenges faced by physicians who provide MAiD. To explore the professional challenges faced by Canadian physicians who provide MAiD. Sixteen physicians from across Canada who provide MAiD completed in-depth, semi-structured telephone interviews. An inductive thematic analysis approach guided data collection and the iterative, interpretive analysis of interview transcripts. Three members of the research team systematically co-coded interview transcripts and the emerging themes were developed with the broader research team. NVivo was used to manage the coded data. Participants described three challenges associated with providing MAiD: 1) their relationships with other MAiD providers were enhanced and relationships with objecting colleagues were sometimes strained, 2) they received inadequate financial compensation for time, and, 3) they experienced increased workload, resulting in sacrifices to personal time. Although these providers did not intend to stop providing MAiD at the time of the interview, they indicated their concerns about whether they would be able to sustain this service over time. Physicians described relationship, financial, and workload challenges to providing MAiD. We provide several recommendations to address these challenges and help ensure the sustainability of MAiD in countries that provide this service. Copyright © 2018. Published by Elsevier Inc.

Working toward financial sustainability of integrated behavioral health services in a public health care system.

PubMed

Monson, Samantha Pelican; Sheldon, J Christopher; Ivey, Laurie C; Kinman, Carissa R; Beacham, Abbie O

2012-06-01

The need, benefit, and desirability of behavioral health integration in primary care is generally accepted and has acquired widespread positive regard. However, in many health care settings the economics, business aspects, and financial sustainability of practice in integrated care settings remains an unsolved puzzle. Organizational administrators may be reluctant to expand behavioral health services without evidence that such programs offer clear financial benefits and financial sustainability. The tendency among mental health professionals is to consider positive clinical outcomes (e.g., reduced depression) as being globally valued indicators of program success. Although such outcomes may be highly valued by primary care providers and patients, administrative decision makers may require demonstration of more tangible financial outcomes. These differing views require program developers and evaluators to consider multiple outcome domains including clinical/psychological symptom reduction, potential cost benefit, and cost offset. The authors describe a process by which a pilot demonstration project is being implemented to demonstrate programmatic outcomes with a focus on the following: 1) clinician efficiency, 2) improved health outcomes, and 3) direct revenue generation associated with the inclusion of integrated primary care in a public health care system. The authors subsequently offer specific future directions and commentary regarding financial evaluation in each of these domains.

Internal Controls and Compliance with Laws and Regulations for the Defense Business Operations Fund Consolidated Financial Statements for FY 1996

DTIC Science & Technology

1997-06-26

business areas such as Supply Management, Depot Maintenance, and Transportation. The Defense Business Operations Fund Consolidated Financial Statements for... Consolidated Financial Statements were presented fairly in accordance with Office of Management and Budget Bulletin No. 94-01, "Form and Content of...Agency Financial Statements," November 16, 1993. In addition, we determined whether controls were adequate to ensure that the consolidated financial statements were

What does sustainability mean in the HIV and AIDS response?

PubMed

Oberth, Gemma; Whiteside, Alan

2016-01-01

Immense progress has been made in the fight against HIV and AIDS. Achieving and exceeding the AIDS targets for the Millennium Development Goals (MDGs) was accomplished, in large part, due to an unprecedented financial investment from the international community. Following an $800 million dip in donor disbursements in 2010, the discourse has since shifted to the need for greater sustainability of funding. But what does sustainability mean? Current efforts focus heavily on fiscal imperatives such as increasing domestic funding. This is important - needs are increasing at a faster rate than donor funding, especially with increased treatment coverage. The problem is that measures of financial sustainability tell very little about the actual sustainability of specific programmes, disease trajectories or enabling environments. Recognising that current definitions of sustainability lack clarity and depth, we offer a new six-tenet conceptualisation of what sustainability means in the HIV and AIDS response: (1) financial, (2) epidemiological, (3) political, (4) structural, (5) programmatic, and (6) human rights. Based on these, we examine examples of donor transitions for their approach to sustainability, including PEPFAR in South Africa, the Global Fund in Eastern Europe, and the Bill and Melinda Gates Foundation in India (Avahan). We conclude that sustainability must be understood within a broader framework beyond funding stability. We also recommend that certain interventions, such as programming for key populations, may have to continue to receive external support even if affected countries can afford to pay.

More for less: best patient outcomes in a time of financial restraint.

PubMed

Merry, Alan F; Hamblin, Richard

2012-12-01

In many countries, expenditure on health care has increased dramatically over recent years. There have been parallel improvements in many indicators of population health, but too many patients continue to be harmed by health care or receive care that is supply-sensitive, ineffective, or poorly aligned with their needs and values. In addition to human costs, this translates into substantial waste of resource. The world has recently faced economic challenges unseen since the great depression of the 1930s. The financial situation of a country can, like a business, be expressed in three sets of accounts: statements of financial position, financial performance, and cash flow. A key test of solvency is the ability to pay debts as they become due (whether from current account or further borrowing). In general, this is a function of public debt, which for many countries has become very high. However, private debt and net financial position are also relevant to a country's financial prospects. Ultimately, borrowing is not sustainable indefinitely and given limited prospects for growth in income in the coming years, most countries will likely need to reduce or at least constrain expenditure on health care. This implies obtaining better value from the resources that are available, and we suggest that the key to this lies in improving the quality of care and, in particular, reducing variation in health care. In the United States, new legislation promoting accountable care organizations may help to do this. Cardiac surgery can be particularly effective in extending patients' lives and in improving the quality of their lives. Our ability to continue to provide cardiac surgery in the face of constrained economic times will depend on engaging more actively in ensuring that what we do is the right thing: that our operations are effective and that they truly meet the needs and values of our patients. It will also depend on doing these operations right the first time.

More for Less: Best Patient Outcomes in a Time of Financial Restraint

PubMed Central

Merry, Alan F.; Hamblin, Richard

2012-01-01

Abstract: In many countries, expenditure on health care has increased dramatically over recent years. There have been parallel improvements in many indicators of population health, but too many patients continue to be harmed by health care or receive care that is supply-sensitive, ineffective, or poorly aligned with their needs and values. In addition to human costs, this translates into substantial waste of resource. The world has recently faced economic challenges unseen since the great depression of the 1930s. The financial situation of a country can, like a business, be expressed in three sets of accounts: statements of financial position, financial performance, and cash flow. A key test of solvency is the ability to pay debts as they become due (whether from current account or further borrowing). In general, this is a function of public debt, which for many countries has become very high. However, private debt and net financial position are also relevant to a country’s financial prospects. Ultimately, borrowing is not sustainable indefinitely and given limited prospects for growth in income in the coming years, most countries will likely need to reduce or at least constrain expenditure on health care. This implies obtaining better value from the resources that are available, and we suggest that the key to this lies in improving the quality of care and, in particular, reducing variation in health care. In the United States, new legislation promoting accountable care organizations may help to do this. Cardiac surgery can be particularly effective in extending patients’ lives and in improving the quality of their lives. Our ability to continue to provide cardiac surgery in the face of constrained economic times will depend on engaging more actively in ensuring that what we do is the right thing: that our operations are effective and that they truly meet the needs and values of our patients. It will also depend on doing these operations right the first time. PMID:23441557

76 FR 81933 - Agency Information Collection Activities Regarding Savings and Loan Holding Companies...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-29

... accounting principles (SAP) financial statements. The proposal also stated that there could be a few SLHCs... Generally Accepted Accounting Principles (``GAAP'') financial statements that are consolidated at the top... approved by the Board will provide data to analyze the overall financial condition of most SLHCs to ensure...

Internal Controls and Compliance With Laws and Regulations for the DOD Consolidated Financial Statements for FY 1996

DTIC Science & Technology

1997-06-30

The primary audit objective was to determine whether the DoD Consolidated Financial Statements for FY 1996 were presented fairly in accordance with...In addition, we determined whether controls were adequate to ensure that the DoD consolidated financial statements were free of material error. We

3 CFR 8493 - Proclamation 8493 of April 2, 2010. National Financial Literacy Month, 2010

Code of Federal Regulations, 2011 CFR

2011-01-01

... complex. This has left too many Americans behind, unable to build a secure financial future for themselves... never happens again will require new rules to protect consumers and better information to empower them. The new Consumer Financial Protection Agency I have proposed will ensure ordinary Americans get clear...

INTERNATIONAL COOPERATION ON RADIOLOGICAL THREAT REDUCTION PROGRAMS IN RUSSIA

DOE Office of Scientific and Technical Information (OSTI.GOV)

Landers, Christopher C.; Tatyrek, Aaron P.

Since its inception in 2004, the United States Department of Energy’s Global Threat Reduction Initiative (GTRI) has provided the Russian Federation with significant financial and technical assistance to secure its highly vulnerable and dangerous radiological material. The three program areas of this assistance are the removal of radioisotope thermoelectric generators (RTG), the physical protection of vulnerable in-use radiological material of concern, and the recovery of disused or abandoned radiological material of concern. Despite the many successes of the GTRI program in Russia, however, there is still a need for increased international cooperation in these efforts. Furthermore, concerns exist over howmore » the Russian government will ensure that the security of its radiological materials provided through GTRI will be sustained. This paper addresses these issues and highlights the successes of GTRI efforts and ongoing activities.« less

Financial Sustainability and Efficiency in Full Economic Costing of Research in UK Higher Education Institutions

ERIC Educational Resources Information Center

Universities UK, 2010

2010-01-01

A Task Group was created to consider the financial sustainability of research undertaken in universities and other institutions of higher education in the United Kingdom. The UK has a very successful Higher Education sector across all key areas of activity, but it is vital that the sector reinvests for the future and is transparent in the use of…

Idaho National Laboratory Site Pollution Prevention Plan

DOE Office of Scientific and Technical Information (OSTI.GOV)

E. D. Sellers

2007-03-01

It is the policy of the Department of Energy (DOE) that pollution prevention and sustainable environmental stewardship will be integrated into DOE operations as a good business practice to reduce environmental hazards, protect environmental resources, avoid pollution control costs, and improve operational efficiency and mission sustainability. In furtherance of this policy, DOE established five strategic, performance-based Pollution Prevention (P2) and Sustainable Environmental Stewardship goals and included them as an attachment to DOE O 450.1, Environmental Protection Program. These goals and accompanying strategies are to be implemented by DOE sites through the integration of Pollution Prevention into each site's Environmental Managementmore » System (EMS). This document presents a P2 and Sustainability Program and corresponding plan pursuant to DOE Order 450.1 and DOE O 435.1, Radioactive Waste Management. This plan is also required by the state of Idaho, pursuant to the Resource Conservation and Recovery Act (RCRA) partial permit. The objective of this document is to describe the Idaho National Laboratory (INL) Site P2 and Sustainability Program. The purpose of the program is to decrease the environmental footprint of the INL Site while providing enhanced support of its mission. The success of the program is dependent on financial and management support. The signatures on the previous page indicate INL, ICP, and AMWTP Contractor management support and dedication to the program. P2 requirements have been integrated into working procedures to ensure an effective EMS as part of an Integrated Safety Management System (ISMS). This plan focuses on programmatic functions which include environmentally preferable procurement, sustainable design, P2 and Sustainability awareness, waste generation and reduction, source reduction and recycling, energy management, and pollution prevention opportunity assessments. The INL Site P2 and Sustainability Program is administratively managed by the INL Site P2 Coordinator. Development and maintenance of this overall INL Site plan is ultimately the responsibility of DOE-ID. This plan is applicable to all INL Site contractors except those at the Naval Reactors Facility.« less

What CFOs should know--and do--about corporate responsibility.

PubMed

Peregrine, Michael W; Schwartz, James R

2002-12-01

Not-for-profit healthcare organizations are not immune to the scrutiny arising from corporate accounting scandals and legislation. Financial managers will play a critical role in satisfying corporate-responsibility concerns. Financial managers need to understand the public-policy concerns fueling the corporate-responsibility movement and the effects. Financial managers should take steps related to certifying financial statements, establishing audit committees, and ensuring independence of audits, among other actions.

Traps and transformations influencing the financial viability of tourism on private-land conservation areas.

PubMed

Clements, Hayley S; Cumming, Graeme S

2018-04-01

The ability of private conservation organizations to remain financially viable is a key factor influencing their effectiveness. One-third of financially motivated private-land conservation areas (PLCAs) surveyed in South Africa are unprofitable, raising questions about landowners' abilities to effectively adapt their business models to the socioeconomic environment. In any complex system, options for later adaptation can be constrained by starting conditions (path dependence). We tested 3 hypothesized drivers of path dependence in PLCA ecotourism and hunting business models: (H1) the initial size of a PLCA limits the number of mammalian game and thereby predators that can be sustained; (H2) initial investments in infrastructure limit the ability to introduce predators; and (H3) rainfall limits game and predator abundance. We further assessed how managing for financial stability (optimized game stocking) or ecological sustainability (allowing game to fluctuate with environmental conditions) influenced the ability to overcome path dependence. A mechanistic PLCA model based on simple ecological and financial rules was run for different initial conditions and management strategies, simulating landowner options for adapting their business model annually. Despite attempts by simulated landowners to increase profits, adopted business models after 13 years were differentiated by initial land and infrastructural assets, supporting H1 and H2. A conservation organization's initial assets can cause it to become locked into a financially vulnerable business model. In our 50-year simulation, path dependence was overcome by fewer of the landowners who facilitated natural ecological variability than those who maintained constant hunting rates and predator numbers, but the latter experienced unsustainably high game densities in low rainfall years. Management for natural variability supported long-term ecological sustainability but not shorter term socioeconomic sustainability for PLCAs. Our findings highlight trade-offs between ecological and economic sustainability and suggest a role for governmental support of the private conservation industry. © 2017 Society for Conservation Biology.

Strategies for promoting equity: experience with community financing in three African countries.

PubMed

Gilson, L; Kalyalya, D; Kuchler, F; Lake, S; Oranga, H; Ouendo, M

2001-10-01

Although the need for a pro-poor health reform agenda in low and middle income countries is increasingly clear, implementing such policy change is always difficult. This paper seeks to contribute to thinking about how to take forward such an agenda by reflection on the community financing activities of the UNICEF/WHO Bamako Initiative. It presents findings from a three-country study, undertaken in Benin, Kenya and Zambia in 1994/95, which was initiated in order to better understand the nature of the equity impact of community financing activities as well as the factors underlying this impact. The sustained relative affordability gains achieved in Benin emphasise the importance of ensuring that financing change is used as a policy lever for strengthening health service management in support of quality of care improvements. All countries, however, failed in protecting the most poor from the burden of payment, benefiting this group preferentially and ensuring that their views were heard in decision-making. Tackling these problems requires, amongst other things, an appropriate balance between central and local-level decision-making as well as the creation of local decision-making structures which have representation from civil society groups that can voice the needs of the most poor. Leadership, strategy and tactics are also always important in securing any kind of equity gain-such as establishing equity goals to drive implementation. In the experiences examined, the dominance of the goal of financial sustainability contributed to their equity failures. Further research is required to understand what equity goals communities themselves would prefer to guide financing policy.

The Transformation of Traditional Universities into Entrepreneurial Universities to Ensure Sustainable Higher Education

ERIC Educational Resources Information Center

Bikse, Veronika; Lusena-Ezera, Inese; Rivza, Baiba; Volkova, Tatjana

2016-01-01

This paper aims to investigate the experience and to identify the drivers of transforming traditional universities into Entrepreneurial Universities for ensuring sustainable higher education in Latvia. Due to the wide scope, Entrepreneurial University characteristics, the present research study is limited and focuses on the university providing…

Democratic transitions, health institutions, and financial protection in the emerging economies: insights from Asia.

PubMed

Gómez, Eduardo J

2017-07-01

In recent years, several emerging economies have introduced national health insurance programs ensuring access to health care while offering financial protection from out-of-pocket and catastrophic expenses. Nevertheless, in several nations these expenses continue to increase. While recent research has emphasized the lack of funding, poor policy design and corruption as the main culprits, little is known about the politics of establishing federal regulatory agencies ensuring that state governments adhere to national insurance reimbursement and coverage procedures. This article fills in this lacuna by providing an alternative perspective, one that accounts for differences between nations in the creation of regulatory institutions, with an emphasis instead on governing elite strategies to campaign on access to health care during transitions to democracy, civil societal mobilization, constitutional constraints and the national electoral incentives to overcome ineffective decentralization processes. The cases of Indonesia and China are introduced as examples of how and why their differences in this political process accounted for Indonesia's success and China's failure to ensure financial protection.

Assessment and Evaluation of Primary Prevention in Spinal Cord Injury

PubMed Central

2013-01-01

Although the incidence of spinal cord injury (SCI) is low, the consequences of this disabling condition are extremely significant for the individual, family, and the community. Sequelae occur in the physical, psychosocial, sexual, and financial arenas, making global prevention of SCI crucial. Understanding how to assess and evaluate primary prevention programs is an important competency for SCI professionals. Assessing a program’s success requires measuring processes, outcomes, and impact. Effective evaluation can lead future efforts for program design while ensuring accountability for the program itself. The intended impact of primary prevention programs for SCI is to decrease the number of individuals who sustain traumatic injury; many programs have process and outcome goals as well. An understanding of the basic types of evaluation, evaluation design, and the overall process of program evaluation is essential for ensuring that these programs are efficacious. All health care professionals have the opportunity to put prevention at the forefront of their practice. With the current paucity of available data, it is important that clinicians share their program design, their successes, and their failures so that all can benefit and future injury can be prevented. PMID:23678281

Residents' perceptions about surrogate decision makers' financial conflicts of interest in ventilator withdrawal.

PubMed

Wastila, Lisa J; Farber, Neil J

2014-05-01

There have been no studies to date that examine physicians' decisions to withdraw life-sustaining treatment for patients based on their surrogates' financial gain. The authors' objective was to ascertain physician attitudes about withdrawing life-sustaining treatment when financial considerations are involved. A survey was developed and pretested containing eight scenarios in which a terminally ill patient's spouse had a decision to make regarding withdrawal of the ventilator, which was deemed medically futile. Nested variables included agreement or disagreement between the spouse and patient, decision to withdraw or continue the ventilator, and financial gain or no financial gain for the spouse. The authors surveyed all internal medicine residents at the University of California, San Diego in the autumn of 2011 and winter of 2012. The responses on each of the three variables for which respondents were likely to withdraw the ventilator were analyzed via student's t-tests. Residents were more likely to withdraw the ventilator when requested to do so than when it was requested to be continued. They were also more likely to withdraw the ventilator when there was agreement in the decision between the spouse and the patient. Residents were more likely to withdraw the ventilator when the spouse would not benefit financially. Internal medicine residents make some decisions about whether to withdraw life-sustaining treatment based on financial considerations. There needs to be ongoing communication with residents about end-of-life decisions where conflicts may exist between the surrogate decision makers and patients or physicians.

Internal Controls and Compliance With Laws and Regulations for the DOD Consolidated Financial Statements for FY 1997

DTIC Science & Technology

1998-06-22

The primary audit objective was to determine whether the DoD Consolidated Financial Statements for FY 1997 were presented fairly in accordance with...determined whether controls were adequate to ensure that the DoD consolidated financial statements were free of material error. We also assessed DoD

Financial Aid and Enrollment: Questions for Boards to Consider

ERIC Educational Resources Information Center

Baum, Sandy

2015-01-01

This white paper encourages board members to take a step back and think about long-term strategies for ensuring that financial aid policies are consistent with institutional mission at the same time that they serve fiscal and enrollment goals. While board members can determine financial aid and enrollment policies only at the broadest level, it is…

Rising labor costs, earnings management, and financial performance of health care providers around the world.

PubMed

Dong, Gang Nathan

2015-01-01

Amid increasing interest in how government regulation and market competition affect the cost and financial sustainability in health care sector, it remains unclear whether health care providers behave similarly to their counterparts in other industries. The goal of this chapter is to study the degree to which health care providers manipulate accruals in periods of financial difficulties caused, in part, by the rising costs of labor. We collected the financial information of health care provider in 43 countries from 1984 to 2013 and conducted a pooled cross-sectional study with country and year fixed-effects. The empirical evidence shows that health care providers with higher wage costs are more likely to smooth their earnings in order to maintain financial sustainability. The finding of this study not only informs regulators that earnings management is pervasive in health care organizations around the world, but also contributes to the studies of financial booktax reporting alignment, given the existing empirical evidence linking earnings management to corporate tax avoidance in this very sector.

Investing in Cultural Participation and Financial Sustainability: Cross-Cohort Analysis of the Arts Regional Initiative, 2009-2014. Insight: Lessons Learned from Our Grantmaking Programs

ERIC Educational Resources Information Center

James Irvine Foundation, 2016

2016-01-01

Between 2009 and 2014, The James Irvine Foundation invested $13.4 million through the Arts Regional Initiative to build the capacity of a group of nonprofit arts organizations in California locales outside of major arts centers. The aim was two-fold: to increase cultural participation and improve financial sustainability. The following lessons,…

Development of a system dynamics model for financially sustainable management of municipal watermain networks.

PubMed

Rehan, R; Knight, M A; Unger, A J A; Haas, C T

2013-12-15

This paper develops causal loop diagrams and a system dynamics model for financially sustainable management of urban water distribution networks. The developed causal loop diagrams are a novel contribution in that it illustrates the unique characteristics and feedback loops for financially self-sustaining water distribution networks. The system dynamics model is a mathematical realization of the developed interactions among system variables over time and is comprised of three sectors namely watermains network, consumer, and finance. This is the first known development of a water distribution network system dynamics model. The watermains network sector accounts for the unique characteristics of watermain pipes such as service life, deterioration progression, pipe breaks, and water leakage. The finance sector allows for cash reserving by the utility in addition to the pay-as-you-go and borrowing strategies. The consumer sector includes controls to model water fee growth as a function of service performance and a household's financial burden due to water fees. A series of policy levers are provided that allow the impact of various financing strategies to be evaluated in terms of financial sustainability and household affordability. The model also allows for examination of the impact of different management strategies on the water fee in terms of consistency and stability over time. The paper concludes with a discussion on how the developed system dynamics water model can be used by water utilities to achieve a variety of utility short and long-term objectives and to establish realistic and defensible water utility policies. It also discusses how the model can be used by regulatory bodies, government agencies, the financial industry, and researchers. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Personal financial incentives for changing habitual health-related behaviors: A systematic review and meta-analysis.

PubMed

Mantzari, Eleni; Vogt, Florian; Shemilt, Ian; Wei, Yinghui; Higgins, Julian P T; Marteau, Theresa M

2015-06-01

Uncertainty remains about whether personal financial incentives could achieve sustained changes in health-related behaviors that would reduce the fast-growing global non-communicable disease burden. This review aims to estimate whether: i. financial incentives achieve sustained changes in smoking, eating, alcohol consumption and physical activity; ii. effectiveness is modified by (a) the target behavior, (b) incentive value and attainment certainty, (c) recipients' deprivation level. Multiple sources were searched for trials offering adults financial incentives and assessing outcomes relating to pre-specified behaviors at a minimum of six months from baseline. Analyses included random-effects meta-analyses and meta-regressions grouped by timed endpoints. Of 24,265 unique identified articles, 34 were included in the analysis. Financial incentives increased behavior-change, with effects sustained until 18months from baseline (OR: 1.53, 95% CI 1.05-2.23) and three months post-incentive removal (OR: 2.11, 95% CI 1.21-3.67). High deprivation increased incentive effects (OR: 2.17; 95% CI 1.22-3.85), but only at >6-12months from baseline. Other assessed variables did not independently modify effects at any time-point. Personal financial incentives can change habitual health-related behaviors and help reduce health inequalities. However, their role in reducing disease burden is potentially limited given current evidence that effects dissipate beyond three months post-incentive removal. Copyright © 2015. Published by Elsevier Inc.

Teaching Professionalism: Passing the Torch.

ERIC Educational Resources Information Center

Hensel, William A.; Dickey, Nancy W.

1998-01-01

Medical faculty must ensure that students understand the appropriate balance between financial and professional considerations. Faculty should place financial considerations in proper perspective and should teach the basic components of professionalism, how current cost-containment efforts may threaten medicine's professional status, appropriate…

Principles for consistent value assessment and sustainable funding of orphan drugs in Europe.

PubMed

Gutierrez, Laura; Patris, Julien; Hutchings, Adam; Cowell, Warren

2015-05-03

The European Orphan Medicinal Products (OMP) Regulation has successfully encouraged research to develop treatments for rare diseases resulting in the authorisation of new OMPs in Europe. While decisions on OMP designation and marketing authorisation are made at the European Union level, reimbursement decisions are made at the national level. OMP value and affordability are high priority issues for policymakers and decisions regarding their pricing and funding are highly complex. There is currently no European consensus on how OMP value should be assessed and inequalities of access to OMPs have previously been observed. Against this background, policy makers in many countries are considering reforms to improve access to OMPs. This paper proposes ten principles to be considered when undertaking such reforms, from the perspective of an OMP manufacturer. We recommend the continued prioritisation of rare diseases by policymakers, an increased alignment between payer and regulatory frameworks, pricing centred on OMP value, and mechanisms to ensure long-term financial sustainability allowing a continuous and virtuous development of OMPs. Our recommendations support the development of more consistent frameworks and encourage collaboration between all stakeholders, including research-based industry, payers, clinicians, and patients.

New dialogue for the way forward in maternal health: addressing market inefficiencies.

PubMed

McCarthy, Katharine; Ramarao, Saumya; Taboada, Hannah

2015-06-01

Despite notable progress in Millennium Development Goal (MDG) five, to reduce maternal deaths three-quarters by 2015, deaths due to treatable conditions during pregnancy and childbirth continue to concentrate in the developing world. Expanding access to three effective and low-cost maternal health drugs can reduce preventable maternal deaths, if available to all women. However, current failures in markets for maternal health drugs limit access to lifesaving medicines among those most in need. In effort to stimulate renewed action planning in the post-MDG era, we present three case examples from other global health initiatives to illustrate how market shaping strategies can scale-up access to essential maternal health drugs. Such strategies include: sharing intelligence among suppliers and users to better approximate and address unmet need for maternal health drugs, introducing innovative financial strategies to catalyze otherwise unattractive markets for drug manufacturers, and employing market segmentation to create a viable and sustainable market. By building on lessons learned from other market shaping interventions and capitalizing on opportunities for renewed action planning and partnership, the maternal health field can utilize market dynamics to better ensure sustainable and equitable distribution of essential maternal health drugs to all women, including the most marginalized.

Ecological restoration of farmland: progress and prospects.

PubMed

Wade, Mark R; Gurr, Geoff M; Wratten, Steve D

2008-02-27

Sustainable agricultural practices in conjunction with ecological restoration methods can reduce the detrimental effects of agriculture. The Society for Ecological Restoration International has produced generic guidelines for conceiving, organizing, conducting and assessing ecological restoration projects. Additionally, there are now good conceptual frameworks, guidelines and practical methods for developing ecological restoration programmes that are based on sound ecological principles and supported by empirical evidence and modelling approaches. Restoration methods must also be technically achievable and socially acceptable and spread over a range of locations. It is important to reconcile differences between methods that favour conservation and those that favour economic returns, to ensure that conservation efforts are beneficial for both landowners and biodiversity. One option for this type of mutual benefit is the use of agri-environmental schemes to provide financial incentives to landholders in exchange for providing conservation services and other benefits. However, further work is required to define and measure the effectiveness of agri-environmental schemes. The broader potential for ecological restoration to improve the sustainability of agricultural production while conserving biodiversity in farmscapes and reducing external costs is high, but there is still much to learn, particularly for the most efficient use of agri-environmental schemes to change land use practice.

Malta: Health system review.

PubMed

Azzopardi Muscat, Natasha; Calleja, Neville; Calleja, Antoinette; Cylus, Jonathan

2014-01-01

This analysis of the Maltese health system reviews the developments in its organization and governance, health financing, health-care provision, health reforms and health system performance. The health system in Malta consists of a public sector, which is free at the point of service and provides a comprehensive basket of health services for all its citizens, and a private sector, which accounts for a third of total health expenditure and provides the majority of primary care. Maltese citizens enjoy one of the highest life expectancies in Europe. Nevertheless, non-communicable diseases pose a major concern with obesity being increasingly prevalent among both adults and children. The health system faces important challenges including a steadily ageing population, which impacts the sustainability of public finances. Other supply constraints stem from financial and infrastructural limitations. Nonetheless, there exists a strong political commitment to ensure the provision of a healthcare system that is accessible, of high quality, safe and also sustainable. This calls for strategic investments to underpin a revision of existing processes whilst shifting the focus of care away from hospital into the community. World Health Organization 2014 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and Policies).

[Financing Regional Dementia Networks in Germany: Determinants of Sustainable Healthcare Networks].

PubMed

Michalowsky, B; Wübbeler, M; Thyrian, J R; Holle, B; Gräske, J; Schäfer-Walkmann, S; Fleßa, S; Hoffmann, W

2017-12-01

Analysis of practice-based financing concepts in German dementia networks (DN); Provision of sustainable financing structures and their determinants in DN. Qualitative expert interviews with leaders of 13 DN were conducted. A semi-structured interview guide was used to analyse four main topics: Finance-related organization, cost, sources of funding and financial sustainability. DN were primarily financed by membership fees, earnings of services provided, public funds and payments by municipalities or health care providers. 63% of the DN reported a financial sustainability. Funds to support the interpersonal expanding, a mix of internal and external financing sources and investments of the municipality were determinants of a sustainable financing. Overall, DN in rural areas seemed to be disadvantaged due to a lack of potential linkable service providers. DN in urban regions are more likely able to gather sustainable funding resources. A minimum funding of 50.000 €/year for human resources coordinating the DN, seems to be a threshold for a sustainable DN. © Georg Thieme Verlag KG Stuttgart · New York.

Essential and non-essential paediatric surgery: implications for the future delivery of state health care in the UK.

PubMed

Farrelly, Paul J; Losty, Paul D

2015-09-01

Delivery of health care in the UK faces enormous challenges with the Department of Health driving significant financial cost savings to ensure viability of public health services. We have analysed and modelled the concept of 'essential' and 'non-essential' paediatric surgery linked to the delivery of children's surgery in the NHS in England. Operation codes for surgical operations in newborns, children and adolescents were identified and Healthcare Resource Group tariffs-£Stg matched. Operations were designated as 'essential' or 'non-essential' based on the criteria-(1) life saving-neonatal surgery, emergency general surgery of childhood, cancer surgery; (2) debility if uncorrected; (3) aesthetics and (4) culture/attitude. Hospital Episode Statistics (HES) data were accessed and sampled for the total number of paediatric surgical operations-(age range 0-14 years) performed in NHS hospitals from 2009 to 2010. Annual costs (£) of both 'essential' and 'non-essential' operations were then calculated. The commonest 'essential' operations performed in children and adolescents in the year 2009-2010 was appendicectomy at a cost of over £51 million pounds. Costs of performing a selection of 'non-essential' paediatric surgery operations were >£14 million pounds/year. The NHs funds for example almost 11,000 paediatric circumcisions annually at a cost of >£8 million pounds-50% are performed for non-therapeutic reasons. Surgeons must engage and work actively with health care systems to ensure diminishing financial resources prioritise 'essential' operations for children. Commissioners must embrace evidence-based surgery. 'Essential' and 'non-essential' surgery has wide implications for the sustainability of the NHS and concepts herein developed can be applied to nations worldwide.

Preferred Pricing Technique Used in Tourism Small and Medium Enterprises in Badung, Bali, Indonesia

NASA Astrophysics Data System (ADS)

Armoni, N. L. E.; Nadra, N. M.; Suarta, I. K.; Widia, I. W.

2018-01-01

This research aims to examine various pricing techniques used in 3 types of tourism small and medium enterprises (SMEs) as well as to identify dominant techniques applied in support to sustainable business and tourism. The method used is qualitative method by means of interviewing pricing decision makers in tourism SMEs in Badung regency, in Bali. The results showed that there are 5 techniques used by Tourism SMEs, in Badung regency; among those, 2 pricing methods are dominantly used, these include: the accommodation and transportation businesses are more dominant in using competitor-based pricing techniques, whilst for restaurant business generally using cost-plus pricing techniques. Except for the motor/car rental, which has methodically assessed the financial sustainability of the business by devising ‘breakeven point’ pricing technique, the others still use a traditional way of common sense and gut feeling in assuring the sustainability of the business and the return of the investment. ‘Competitor-based pricing’ becomes the most preferred technic of tourism SMEs, however entrepreneurs should also apply long-term oriented pricing that ensure the profitability and sustainability of the business, as well as deliver value for customers. ‘Value-based pricing’ is practiced by one business respondent - an accommodation provider. This could be used as a reference by other tourism SMEs, as this shows customer orientation and uses quality as an advantage to compete and survive. To be able to operate in this domain tourism SMEs need to offer quality products, have customer service orientation and use them as a ‘competitive advantage’. The research results could become a reference for tourism SMEs in setting prices for sustainable enterprises. Academically, it will enrich the knowledge about tourism that related to product-costing particularly in tourism SMEs.

Financial Accounting for Local and State School Systems: 2009 Edition. NCES 2009-325

ERIC Educational Resources Information Center

Allison, Gregory S.; Honegger, Steven D.; Johnson, Frank

2009-01-01

This handbook has been designed as the national standard for state and local education agencies to use in tracking and reporting financial data for school districts to use in preparing their comprehensive annual financial reports (CAFRs). The purpose of the handbook is to ensure that education fiscal data can be reported in a comprehensive manner.…

Internal Controls and Compliance With Laws and Regulations for Expense Account Line Items on the FY 1996 Defense Business Operations Fund Consolidated Financial Statements.

DTIC Science & Technology

1998-03-04

issues discussed in this report. The primary audit objective was to determine whether the expenses on the FY 1996 DBOF consolidated financial statements were...34 November 16, 1993. In addition, we determined whether controls were adequate to ensure that the consolidated financial statements were free of material

A New Partnership: Reshaping the Federal and State Commitment to Need-Based Aid. Executive Summary

ERIC Educational Resources Information Center

Doyle, William R.

2013-01-01

This brief provides five recommendations for reforming the college financial aid system. Five principles for reform are presented: (1) The purpose of federal financial aid is to ensure that individuals who can benefit from college and would not otherwise attend are able to enroll. (2) Efforts to reform financial aid must limit the unsustainable…

National Summit on Economic & Financial Literacy (Washington, DC, March 3, 2005). Executive Summary

ERIC Educational Resources Information Center

National Council on Economic Education (NJ3), 2005

2005-01-01

On March 3, 2005, a gathering of policy-shapers, thought-leaders and decision-makers met for The National Summit on Economic and Financial Literacy to promote the benefits of economic and financial literacy to individuals, families, businesses and communities. The ultimate goal of the Summit was to ensure that everyone has the real-life skills…

Establishing sustainable performance-based incentive schemes: views of rural health workers from qualitative research in three sub-Saharan African countries.

PubMed

Yé, M; Aninanya, G A; Sié, A; Kakoko, D C V; Chatio, S; Kagoné, M; Prytherch, H; Loukanova, S; Williams, J E; Sauerborn, R

2014-01-01

Performance-based incentives (PBIs) are currently receiving attention as a strategy for improving the quality of care that health providers deliver. Experiences from several African countries have shown that PBIs can trigger improvements, particularly in the area of maternal and neonatal health. The involvement of health workers in deciding how their performance should be measured is recommended. Only limited information is available about how such schemes can be made sustainable. This study explored the types of PBIs that rural health workers suggested, their ideas regarding the management and sustainability of such schemes, and their views on which indicators best lend themselves to the monitoring of performance. In this article the authors reported the findings from a cross-country survey conducted in Burkina Faso, Ghana and Tanzania. The study was exploratory with qualitative methodology. In-depth interviews were conducted with 29 maternal and neonatal healthcare providers, four district health managers and two policy makers (total 35 respondents) from one district in each of the three countries. The respondents were purposively selected from six peripheral health facilities. Care was taken to include providers who had a management role. By also including respondents from district and policy level a comparison of perspectives from different levels of the health system was facilitated. The data that was collected was coded and analysed with support of NVivo v8 software. The most frequently suggested PBIs amongst the respondents in Burkina Faso were training with per-diems, bonuses and recognition of work done. The respondents in Tanzania favoured training with per-diems, as well as payment of overtime, and timely promotion. The respondents in Ghana also called for training, including paid study leave, payment of overtime and recognition schemes for health workers or facilities. Respondents in the three countries supported the mobilisation of local resources to make incentive schemes more sustainable. There was a general view that it was easier to integrate the cost of non-financial incentives in local budgets. There were concerns about the fairness of such schemes from the provider level in all three countries. District managers were worried about the workload that would be required to manage the schemes. The providers themselves were less clear about which indicators best lent themselves to the purpose of performance monitoring. District managers and policy makers most commonly suggested indicators that were in line with national maternal and neonatal healthcare indicators. The study showed that health workers have considerable interest in performance-based incentive schemes and are concerned about their sustainability. There is a need to further explore the use of non-financial incentives in PBI schemes, as such incentives were considered to stand a greater chance of being integrated into local budgets. Ensuring participation of healthcare providers in the design of such schemes is likely to achieve buy-in and endorsement from the health workers involved. However, input from managers and policy makers is essential to keep expectations realistic and to ensure the indicators selected fit the purpose and are part of routine reporting systems.

12 CFR 1815.100 - Policy.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Banking COMMUNITY DEVELOPMENT FINANCIAL INSTITUTIONS FUND, DEPARTMENT OF THE TREASURY ENVIRONMENTAL QUALITY § 1815.100 Policy. The Community Development Financial Institution Fund's policy is to ensure that environmental factors and concerns are given appropriate consideration in decisions and actions by the Fund and...

Assessing the Financial Viability of Academic Programmes

ERIC Educational Resources Information Center

Swift, Lynette

2012-01-01

This paper reviews and examines approaches to determining the financial viability of academic programmes as a critical component of assessing a programme's overall sustainability. Key to assessing the financial viability of a programme is understanding the teaching activities required to deliver the programme and the cost of those activities. A…

The Promise of Tailoring Incentives for Healthy Behaviors.

PubMed

Kullgren, Jeffrey T; Williams, Geoffrey C; Resnicow, Kenneth; An, Lawrence C; Rothberg, Amy; Volpp, Kevin G; Heisler, Michele

2016-01-01

To describe how tailoring financial incentives for healthy behaviors to employees' goals, values, and aspirations might improve the efficacy of incentives. We integrate insights from self-determination theory (SDT) with principles from behavioral economics in the design of financial incentives by linking how incentives could help meet an employee's life goals, values, or aspirations. Tailored financial incentives could be more effective than standard incentives in promoting autonomous motivation necessary to initiate healthy behaviors and sustain them after incentives are removed. Previous efforts to improve the design of financial incentives have tested different incentive designs that vary the size, schedule, timing, and target of incentives. Our strategy for tailoring incentives builds on strong evidence that difficult behavior changes are more successful when integrated with important life goals and values. We outline necessary research to examine the effectiveness of this approach among at-risk employees. Instead of offering simple financial rewards for engaging in healthy behaviors, existing programs could leverage incentives to promote employees' autonomous motivation for sustained health improvements. Effective application of these concepts could lead to programs more effective at improving health, potentially at lower cost. Our approach for the first time integrates key insights from SDT, behavioral economics, and tailoring to turn an extrinsic reward for behavior change into an internalized, self-sustaining motivator for long-term engagement in risk-reducing behaviors.

Sustainability in the University Student's Mind: Are University Endorsements, Financial Support, and Programs Making a Difference?

ERIC Educational Resources Information Center

Perrault, Evan K.; Clark, Scott K.

2017-01-01

Despite the increasing awareness that sustainability is an issue needing ongoing attention, and despite millions of dollars spent yearly at universities to promote sustainable behaviors, previous research has found college students have primarily a unidimensional understanding of what sustainability encompasses. The current research sought to…

Economic gains stimulate negative evaluations of corporate sustainability initiatives

NASA Astrophysics Data System (ADS)

Makov, Tamar; Newman, George E.

2016-09-01

In recent years, many organizations have sought to align their financial goals with environmental ones by identifying strategies that maximize profits while minimizing environmental impacts. Examples of this `win-win' approach can be found across a wide range of industries, from encouraging the reuse of hotel towels, to the construction of energy efficient buildings, to the large-scale initiatives of multi-national corporations. Although win-win strategies are generally thought to reflect positively on the organizations that employ them, here we find that people tend to respond negatively to the notion of profiting from environmental initiatives. In fact, observers may evaluate environmental win-wins less favourably than profit-seeking strategies that have no environmental benefits. The present studies suggest that how those initiatives are communicated to the general public may be of central importance. Therefore, organizations would benefit from carefully crafting the discourse around their win-win initiatives to ensure that they avoid this type of backlash.

Continuity of operations planning in college athletic programs: The case for incorporating Federal Emergency Management Guidelines.

PubMed

Hall, Stacey A; Allen, Brandon L; Phillips, Dennis

2016-01-01

College athletic departments have a responsibility to provide a safe environment for student-athletes; however, most colleges do not have a crisis management plan that includes procedures for displaced student-athletes or alternate facilities to perform athletic events. Continuity of operations planning ensures athletic programs are equipped to maintain essential functions during, or shortly after, a disruption of operations due to possible hazards. Previous studies have identified a lack of emergency preparedness and continuity planning in college athletic departments. The purpose of this article is to illustrate in detail one approach to disaster planning for college athletic departments, namely the Federal Emergency Management Agency (FEMA) continuity of operations framework. By adhering to FEMA guidelines and promoting a best practices model, athletic programs can effectively plan to address potential hazards, as well as protect the organization's brand, image, and financial sustainability after a crisis event.

[Primary health care: challenges for implementation in Latin America].

PubMed

Giraldo Osorio, Alexandra; Vélez Álvarez, Consuelo

2013-01-01

A development process, marked by the re-appearance of the primary health care as the core of health systems, has emerged in Latin America. Governments have made a commitment to renew this strategy as the basis of their health systems. However, these health systems are mainly faced with re-introducing equity values, and there are common challenges such as providing the health systems with trained human resources in sufficient numbers, overcoming the fragmentation/segmentation of the systems, ensuring financial sustainability, improving governance, quality of care and information systems, expanding coverage, preparing to face the consequences of an aging population, the changing epidemiological profile, and increase in the response capacity of the public health system. This article is intended to provide a comprehensive view of the progress and challenges of the inclusion of primary care health systems in Latin American countries. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Factors influencing sustainability of communally-managed water facilities in rural areas of Zimbabwe

NASA Astrophysics Data System (ADS)

Kativhu, T.; Mazvimavi, D.; Tevera, D.; Nhapi, I.

2017-08-01

Sustainability of point water facilities is a major development challenge in many rural settings of developing countries not sparing those in the Sub-Saharan Africa region. This study was done in Zimbabwe to investigate the factors influencing sustainability of rural water supply systems. A total of 399 water points were studied in Nyanga, Chivi and Gwanda districts. Data was collected using a questionnaire, observation checklist and key informant interview guide. Multi-Criteria analysis was used to assess the sustainability of water points and inferential statistical analysis such as Chi square tests and Analysis of Variance (ANOVA) were used to determine if there were significant differences on selected variables across districts and types of lifting devices used in the study area. The thematic approach was used to analyze qualitative data. Results show that most water points were not functional and only 17% across the districts were found to be sustainable. A fusion of social, technical, financial, environmental and institutional factors was found to be influencing sustainability. On technical factors the ANOVA results show that the type of lifting device fitted at a water point significantly influences sustainability (F = 37.4, p < 0.01). Availability of spare parts at community level was found to be determining the downtime period of different lifting devices in the studied wards. Absence of user committees was found to be central in influencing sustainability as water points that did not have user committees were not sustainable and most of them were not functional during the time of the survey. Active participation by communities at the planning stage of water projects was also found to be critical for sustainability although field results showed passive participation by communities at this critical project stage. Financial factors of adequacy of financial contributions and establishment of operation and maintenance funds were also found to be of great importance in sustaining water supply systems. It is recommended that all factors should be considered when assessing sustainability since they are interrelated.

76 FR 7091 - Notice of Intent To Require Reporting Forms for Savings and Loan Holding Companies

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-08

... title: Financial Statements for Bank Holding Companies. Agency form number: FR Y-9C, FR Y-9LP, FR Y-9SP... financial statements for the consolidated BHC and the parent holding company only. The FR Y-9 family of... condition to ensure safe and sound operations. The FR Y-9C consists of standardized financial statements...

Independent assessment is key to financial well-being.

PubMed

Karling, J; Pyper, T

1999-02-01

Both traditional group practices and IPAs have felt the impact of changes brought about by managed care. Group practices need to ensure that their financial reporting and cost-accounting methods capture information that is key to decision making. An independent assessment of financial procedures helps identify any outstanding issues and maintain financial well-being. This assessment should be conducted at least quarterly so that potential problems can be resolved, income opportunities explored, and cost-saving measures adopted in a timely manner.

Comparative Analysis of Sustainable Approaches and Systems for Scientific Data Stewardship

NASA Astrophysics Data System (ADS)

Downs, R. R.; Chen, R. S.

2012-12-01

Sustainable data systems are critical components of the cyberinfrastructure needed to provide long-term stewardship of scientific data, including Earth science data, throughout their entire life cycle. A variety of approaches may help ensure the sustainability of such systems, but these approaches must be able to survive the demands of competing priorities and decreasing budgets. Analyzing and comparing alternative approaches can identify viable aspects of each approach and inform decisions for developing, managing, and supporting the cyberinfrastructure needed to facilitate discovery, access, and analysis of data by future communities of users. A typology of sustainability approaches is proposed, and example use cases are offered for comparing the approaches over time. These examples demonstrate the potential strengths and weaknesses of each approach under various conditions and with regard to different objectives, e.g., open vs. limited access. By applying the results of these analyses to their particular circumstances, systems stakeholders can assess their options for a sustainable systems approach along with other metrics and identify alternative strategies to ensure the sustainability of the scientific data and information for which they are responsible. In addition, comparing sustainability approaches should inform the design of new systems and the improvement of existing systems to meet the needs for long-term stewardship of scientific data, and support education and workforce development efforts needed to ensure that the appropriate scientific and technical skills are available to operate and further develop sustainable cyberinfrastructure.

HRD Challenges Faced in the Post-Global Financial Crisis Period--Insights from the UK

ERIC Educational Resources Information Center

Keeble-Ramsay, Diane Rose; Armitage, Andrew

2015-01-01

Purpose: The paper aims to report initial empirical research that examines UK employees' perceptions of the changing nature of work since the Global Financial Crisis (GFC) to consider how the financial context may have constrained HRD practice and more sustainable approaches. Design/methodology/approach: Focus group research was facilitated…

12 CFR 1815.100 - Policy.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 12 Banks and Banking 10 2014-01-01 2014-01-01 false Policy. 1815.100 Section 1815.100 Banks and Banking COMMUNITY DEVELOPMENT FINANCIAL INSTITUTIONS FUND, DEPARTMENT OF THE TREASURY ENVIRONMENTAL QUALITY § 1815.100 Policy. The Community Development Financial Institution Fund's policy is to ensure that...

40 CFR 35.6270 - Standards for financial management systems.

Code of Federal Regulations, 2010 CFR

2010-07-01

... § 35.6270 Standards for financial management systems. (a) Accounting system standards—(1) General. The... Agreement. (6) Accounting system control procedures. Except as provided for in paragraph (a)(3) of this section, accounting system control procedures must ensure that accounting information is: (i) Accurate...

14 CFR 1240.113 - Financial accounting.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 5 2013-01-01 2013-01-01 false Financial accounting. 1240.113 Section 1240.113 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION INVENTIONS AND CONTRIBUTIONS... appropriate database and accounting system(s) to ensure that award payments are recorded and disbursed in an...

20 CFR 633.309 - Recordkeeping requirements.

Code of Federal Regulations, 2011 CFR

2011-04-01

... requirements. (a) Each grantee shall ensure maintenance of systems whose financial management and participant...) The grantee shall ensure that systems: (1) Maintain data elements used in required Federal reports in... controls to avoid conflict-of-interest situations and prevent irregular transactions or activities; (9...

Estimating Congestion Benefits of Transportation Projects with FIXiT 2.0: Updating and Improving the Sketch Planning Tool

DOT National Transportation Integrated Search

2017-11-01

Transportation agencies face continual pressure to ensure the proper allocation of transportation investments and financial resources. Choosing the right set of congestion mitigation and mobility strategies is critical to ensuring the wise applicatio...

Development of Impact Assessment Methodologies for Environmental Sustainability

EPA Science Inventory

Sustainability has been discussed for many years, with no consensus on how to ensure that environmental sustainability is reached or even that progress is made in the right direction. The Brundtland Commission statement that sustainability “meets the needs of the present without...

Healthcare sustainability and the challenges of innovation to biopharmaceuticals in Canada.

PubMed

Rosenberg-Yunger, Zahava R S; Daar, Abdallah S; Singer, Peter A; Martin, Douglas K

2008-09-01

Governments around the world have focused on issues of sustainability, innovations and priority setting within their health systems. Tension exists between governments' desire to increase biotechnology innovation and the need to address health system sustainability. This commentary will: (1) review government initiatives in biotechnology in health innovation; (2) discuss how innovation, specifically biopharmaceuticals, challenges health system sustainability; and (3) explore how the tension between innovation and sustainability can be addressed using fairness and legitimacy. It is evident that a uni-jurisdictional approach may not be optimal in promoting innovation while ensuring a sustainable health system. Harmonization of biotechnology policies across the federal, provincial, and territorial governments will ensure consistent policies across all branches in order to circumvent the possibility of one governmental branch refusing to reimburse the very innovations other branches are promoting.

Food production & availability--essential prerequisites for sustainable food security.

PubMed

Swaminathan, M S; Bhavani, R V

2013-09-01

Food and nutrition security are intimately interconnected, since only a food based approach can help in overcoming malnutrition in an economically and socially sustainable manner. Food production provides the base for food security as it is a key determinant of food availability. This paper deals with different aspects of ensuring high productivity and production without associated ecological harm for ensuring adequate food availability. By mainstreaming ecological considerations in technology development and dissemination, we can enter an era of evergreen revolution and sustainable food and nutrition security. Public policy support is crucial for enabling this.

Asset sustainability index : quick guide : proposed metrics for the long-term financial sustainability of highway networks.

DOT National Transportation Integrated Search

2013-04-01

"This report provides a Quick Guide to the concept of asset sustainability metrics. Such metrics address the long-term performance of highway assets based upon expected expenditure levels. : It examines how such metrics are used in Australia, Britain...

[The economic-financial sustainability of the Family Health Strategy in large municipalities].

PubMed

Portela, Gustavo Zoio; Ribeiro, José Mendes

2011-03-01

The universalization of basic care and commitment budget of the Ministry of Health with the Family Health Strategy (ESF) through new systematic financing incentives have been highlighted in the Brazilian health policy scenario. One of the great problems observed is the expansion of the strategy for large urban centres. This paper studies the economic-financial sustainability of ESF in Brazilian municipalities of more than 100 thousand inhabitants according to some selected indicators, considering the geographical region to which they belong, their population size and participation in Project for the Expansion and Consolidation Family Health (Proesf). Municipalities belonging to the Southeast region, more developed of the country, have on average better economic-financial performance, but lower average values of coverage of ESF. Municipalities from the North and Northeast, with the lowest average for economic-financial sustainability indicators, were the ones that made more effort to developments in the period. Thus, we observed the dynamics between bigger fiscal capacity and budgetary commitment with the Health Sector for biggest municipalities and in more economically developed regions, and greater vulnerability and dependence of federative transferences for municipalities with less people, in less developed areas.

77 FR 15286 - Confidential Treatment of Privileged Information

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-15

... that Federal consumer financial law is enforced consistently.\\22\\ These goals would be undermined if a... enforced consistently, without regard to the status of a person as a depository institution, in order to... applicable, enforce Federal consumer financial law consistently for the purpose of ensuring that all...

78 FR 52197 - Office of the Assistant Secretary for Financial Resources, Statement of Organization, Functions...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-22

... accordance with policy for the consistent development and implementation of accounting systems; (3) Monitors the accounting center, OPDIV, and Department's financial system change management to ensure accounting... systems, including the three major core accounting systems (the Healthcare Integrated General Ledger...

Creating a market strategy for 'brand loyalty'.

PubMed

Hutter, G M

1991-10-01

A healthcare organization's financial well-being stems from sound strategic planning, which increasingly requires the merger of marketing intelligence and financial management expertise. As a participant in strategic planning, a hospital's chief financial officer (CFO) ensures that plans achieve organizational goals for growth and return on investment. CFOs can apply their analytical and measurement skills to help determine areas of strength and potential growth, then match those services to market segments.

DOD Financial Management: Actions Under Way Need to Be Successfully Completed to Address Long-standing Funds Control Weaknesses

DTIC Science & Technology

2014-04-01

FISCAM Federal Information System Controls Audit Manual FMFIA Federal Managers’ Financial Integrity Act FMR Financial Management Regulation GAAP ...rules are incorporated into generally accepted accounting principles ( GAAP ) for the federal government. For additional information on the two methods of...to hold executive branch officials accountable for proper use of budgetary resources, and to ensure proper stewardship and transparency of the use

33 CFR 332.7 - Management.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., the activity causing the authorized impacts. (b) Sustainability. Compensatory mitigation projects... sustainability. Where active long-term management and maintenance are necessary to ensure long-term sustainability (e.g., prescribed burning, invasive species control, maintenance of water control structures...

33 CFR 332.7 - Management.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., the activity causing the authorized impacts. (b) Sustainability. Compensatory mitigation projects... sustainability. Where active long-term management and maintenance are necessary to ensure long-term sustainability (e.g., prescribed burning, invasive species control, maintenance of water control structures...

33 CFR 332.7 - Management.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., the activity causing the authorized impacts. (b) Sustainability. Compensatory mitigation projects... sustainability. Where active long-term management and maintenance are necessary to ensure long-term sustainability (e.g., prescribed burning, invasive species control, maintenance of water control structures...

40 CFR 230.97 - Management.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., the activity causing the authorized impacts. (b) Sustainability. Compensatory mitigation projects... sustainability. Where active long-term management and maintenance are necessary to ensure long-term sustainability (e.g., prescribed burning, invasive species control, maintenance of water control structures...

33 CFR 332.7 - Management.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., the activity causing the authorized impacts. (b) Sustainability. Compensatory mitigation projects... sustainability. Where active long-term management and maintenance are necessary to ensure long-term sustainability (e.g., prescribed burning, invasive species control, maintenance of water control structures...

40 CFR 230.97 - Management.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., the activity causing the authorized impacts. (b) Sustainability. Compensatory mitigation projects... sustainability. Where active long-term management and maintenance are necessary to ensure long-term sustainability (e.g., prescribed burning, invasive species control, maintenance of water control structures...

40 CFR 230.97 - Management.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., the activity causing the authorized impacts. (b) Sustainability. Compensatory mitigation projects... sustainability. Where active long-term management and maintenance are necessary to ensure long-term sustainability (e.g., prescribed burning, invasive species control, maintenance of water control structures...

40 CFR 230.97 - Management.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., the activity causing the authorized impacts. (b) Sustainability. Compensatory mitigation projects... sustainability. Where active long-term management and maintenance are necessary to ensure long-term sustainability (e.g., prescribed burning, invasive species control, maintenance of water control structures...

The Student Affairs Committee. Effective Committees. Board Basics.

ERIC Educational Resources Information Center

Goodale, Thomas G.

1997-01-01

Responsibilities of the college or university governing board's student affairs committee include representing students' interests in all policy decisions, ensuring provision of adequate financial resources to support a comprehensive student affairs program, ensuring that board policies keep pace with students' diverse and changing needs, and…

The Promise of Tailoring Incentives for Healthy Behaviors

PubMed Central

Kullgren, Jeffrey T.; Williams, Geoffrey C.; Resnicow, Kenneth; An, Lawrence C.; Rothberg, Amy; Volpp, Kevin G.; Heisler, Michele

2017-01-01

Purpose To describe how tailoring financial incentives for healthy behaviors to employees’ goals, values, and aspirations might improve the efficacy of incentives. Design/methodology/approach We integrate insights from self-determination theory (SDT) with principles from behavioral economics in the design of financial incentives by linking how incentives could help meet an employee’s life goals, values, or aspirations. Findings Tailored financial incentives could be more effective than standard incentives in promoting autonomous motivation necessary to initiate healthy behaviors and sustain them after incentives are removed. Research implications Previous efforts to improve the design of financial incentives have tested different incentive designs that vary the size, schedule, timing, and target of incentives. Our strategy for tailoring incentives builds on strong evidence that difficult behavior changes are more successful when integrated with important life goals and values. We outline necessary research to examine the effectiveness of this approach among at-risk employees. Practical implications Instead of offering simple financial rewards for engaging in healthy behaviors, existing programs could leverage incentives to promote employees’ autonomous motivation for sustained health improvements. Social implications Effective application of these concepts could lead to programs more effective at improving health, potentially at lower cost. Originality/value Our approach for the first time integrates key insights from SDT, behavioral economics, and tailoring to turn an extrinsic reward for behavior change into an internalized, self-sustaining motivator for long-term engagement in risk-reducing behaviors. PMID:29242715

Factors affecting sustainability of rural water schemes in Swaziland

NASA Astrophysics Data System (ADS)

Peter, Graciana; Nkambule, Sizwe E.

The Millennium Development Goal (MDG) target to reduce the proportion of people without sustainable access to safe drinking water by the year 2015 has been met as of 2010, but huge disparities exist. Some regions, particularly Sub-Saharan Africa are lagging behind it is also in this region where up to 30% of the rural schemes are not functional at any given time. There is need for more studies on factors affecting sustainability and necessary measures which when implemented will improve the sustainability of rural water schemes. The main objective of this study was to assess the main factors affecting the sustainability of rural water schemes in Swaziland using a Multi-Criteria Analysis Approach. The main factors considered were: financial, social, technical, environmental and institutional. The study was done in Lubombo region. Fifteen functional water schemes in 11 communities were studied. Data was collected using questionnaires, checklist and focused group discussion guide. A total of 174 heads of households were interviewed. Statistical Package for Social Sciences (SPSS) was used to analyse the data and to calculate sustainability scores for water schemes. SPSS was also used to classify sustainability scores according to sustainability categories: sustainable, partially sustainable and non-sustainable. The averages of the ratings for the different sub-factors studied and the results on the sustainability scores for the sustainable, partially sustainable and non-sustainable schemes were then computed and compared to establish the main factors influencing sustainability of the water schemes. The results indicated technical and social factors as most critical while financial and institutional, although important, played a lesser role. Factors which contributed to the sustainability of water schemes were: functionality; design flow; water fetching time; ability to meet additional demand; use by population; equity; participation in decision making on operation and maintenance; existence of fund for operation and maintenance; willingness to contribute money; existence of a user’s committee; participation in the initial planning and design of the water scheme; and coordination between the local leaders and user’s committee. The main factors which made the schemes unsustainable were: long fetching time; non-involvement in decision making; lack of willingness to contribute funds; absence of users committee; and lack of cooperation between local leaders and the users committee. Water service providers should address the technical, social, financial and institutional factors identified affecting sustainability in their planning and implementation of rural water schemes.

The Roles, Duties, and Ethical Responsibilities of the Chief Financial Officer. Perspectives…Presenting Thought Leaders' Points of View

ERIC Educational Resources Information Center

Ladd, Lawrence R.

2011-01-01

Released in conjunction with the "Sustaining an Ethical Culture on Campus" webcast, this essay in the "Perspectives" series examines the complexities of the role of the chief financial officer. This white paper focuses on how the financial leader of an institution must balance technical knowledge along with stellar…

Sustainability as an Ethical Principle: Ensuring Its Systematic Place in Professional Nursing Practice

PubMed Central

Riedel, Annette

2015-01-01

Alongside the central focus on the persons requiring nursing care in professional nursing practice, the perspective of the sustainability of interventions and the use of materials (for example, nursing aids and hygiene articles) is gaining prominence in nursing decision-making processes. This contribution makes the principle of sustainability concrete and delineates its importance in the context of professional nursing practice and decision-making. It further suggests the development of an ethical policy in order to systematically ensure that sustainability has a place in ethical reflection and decision-making, and describes the elements involved. Finally, a synthesis is made between the importance of the principle of sustainability, suggested ethical policies (system of ethical reflection) as they affect nursing practice and professional reflection, decision-making, and practice. PMID:27417590

Sustainability as an Ethical Principle: Ensuring Its Systematic Place in Professional Nursing Practice.

PubMed

Riedel, Annette

2015-12-30

Alongside the central focus on the persons requiring nursing care in professional nursing practice, the perspective of the sustainability of interventions and the use of materials (for example, nursing aids and hygiene articles) is gaining prominence in nursing decision-making processes. This contribution makes the principle of sustainability concrete and delineates its importance in the context of professional nursing practice and decision-making. It further suggests the development of an ethical policy in order to systematically ensure that sustainability has a place in ethical reflection and decision-making, and describes the elements involved. Finally, a synthesis is made between the importance of the principle of sustainability, suggested ethical policies (system of ethical reflection) as they affect nursing practice and professional reflection, decision-making, and practice.

33 CFR 165.510 - Delaware Bay and River, Salem River, Christina River and Schuylkill River-Regulated Navigation Area.

Code of Federal Regulations, 2010 CFR

2010-07-01

... within the regulated navigation area and: (i) Sustained winds are greater than 25 knots but less than 40 knots, ensure the main engines are ready to provide full power in five minutes or less; and (ii) Sustained winds are 40 knots or over, ensure that the main engines are on line to immediately provide...

Incentives in Rheumatology: the Potential Contribution of Physician Responses to Financial Incentives, Public Reporting, and Treatment Guidelines to Health Care Sustainability.

PubMed

Harrison, Mark; Milbers, Katherine; Mihic, Tamara; Anis, Aslam H

2016-07-01

Concerns about the sustainability of current health care expenditure are focusing attention on the cost, quality and value of health care provision. Financial incentives, for example pay-for-performance (P4P), seek to reward quality and value in health care provision. There has long been an expectation that P4P schemes are coming to rheumatology. We review the available evidence about the use of incentives in this setting and provide two emerging examples of P4P schemes which may shape the future of service provision in rheumatology. Currently, there is limited and equivocal evidence in rheumatology about the impact of incentive schemes. However, reporting variation in the quality and provision of rheumatology services has highlighted examples of inefficiencies in the delivery of care. If financial incentives can improve the delivery of timely and appropriate care for rheumatology patients, then they may have an important role to play in the sustainability of health care provision.

Potential approaches to the management of third-party impacts from groundwater transfers

NASA Astrophysics Data System (ADS)

Skurray, James H.; Pannell, David J.

2012-08-01

Groundwater extraction can have varied and diffuse effects. Negative external effects may include costs imposed on other groundwater users and on surrounding ecosystems. Environmental damages are commonly not reflected in market transactions. Groundwater transfers have the potential to cause spatial redistribution, concentration, and qualitative transformation of the impacts from pumping. An economically and environmentally sound groundwater transfer scheme would ensure that marginal costs from trades do not exceed marginal benefits, accounting for all third-party impacts, including those of a non-monetary nature as well as delayed effects. This paper proposes a menu of possible management strategies that would help preclude unacceptable impacts by restricting transfers with certain attributes, ideally ensuring that permitted transfers are at least welfare-neutral. Management tools would require that transfers limit or reduce environmental impacts, and provide for the compensation of financial impacts. Three management tools are described. While these tools can limit impacts from a given level of extraction, they cannot substitute for sustainable overall withdrawal limits. Careful implementation of transfer limits and exchange rates, and the strategic use of management area boundaries, may enable a transfer system to restrict negative externalities mainly to monetary costs. Provision for compensation of these costs could be built into the system.

Post-installation activities in the Comprehensive Nuclear Test Ban Treaty (CTBT) International Monitoring System (IMS) infrasound network

NASA Astrophysics Data System (ADS)

Vivas Veloso, J. A.; Christie, D. R.; Hoffmann, T. L.; Campus, P.; Bell, M.; Langlois, A.; Martysevich, P.; Demirovik, E.; Carvalho, J.; Kramer, A.; Wu, Sean F.

2002-11-01

The provisional operation and maintenance of IMS infrasound stations after installation and subsequent certification has the objective to prepare the infrasound network for entry into force of the Comprehensive Nuclear-Test-Ban Treaty (CTBT). The goal is to maintain and fine tune the technical capabilities of the network, to repair faulty equipment, and to ensure that stations continue to meet the minimum specifications through evaluation of data quality and station recalibration. Due to the globally dispersed nature of the network, this program constitutes a significant undertaking that requires careful consideration of possible logistic approaches and their financial implications. Currently, 11 of the 60 IMS infrasound stations are transmitting data in the post-installation Testing & Evaluation mode. Another 5 stations are under provisional operation and are maintained in post-certification mode. It is expected that 20% of the infrasound network will be certified by the end of 2002. This presentation will focus on the different phases of post-installation activities of the IMS infrasound program and the logistical challenges to be tackled to ensure a cost-efficient management of the network. Specific topics will include Testing & Evaluation and Certification of Infrasound Stations, as well as Configuration Management and Network Sustainment.

The New Education CFO: From Scorekeeper to Strategic Leader

ERIC Educational Resources Information Center

Hovey, Don; Boser, Ulrich

2014-01-01

Traditionally, district and corporate leaders regarded chief financial officers, or CFOs, as chief accountants. They were the individuals tasked with ensuring financial compliance, settling the books, creating reports, and cutting costs. The CFO was inherently risk averse and internally focused; he or she was there to backstop the ambitious plans…

Governance and Funding of Higher Education in Germany.

ERIC Educational Resources Information Center

Hufner, Klaus

2003-01-01

Describes the complex functioning of decision making in relation to legal, administrative, planning, and financial matters in Germany, examining the current increase of privatization of higher education and the ensuring legal and financial problem, and discussing the introduction of new funding schemes based on performance indicators which augur…

Statistics and the Canada Millennium Scholarship Foundation.

ERIC Educational Resources Information Center

Kirby, Dale

2002-01-01

Critiques the Canada Millennium Scholarship Foundation's claim that recent research indicates that "Canada must move beyond its focus on student financial assistance" as a means of ensuring access to postsecondary education since "three out of four Canadian youth cite non-financial reasons to explain why those chose not to pursue…

32 CFR 34.41 - Monitoring and reporting program and financial performance.

Code of Federal Regulations, 2014 CFR

2014-07-01

... organizations, or may include equivalent technical and financial reporting requirements that ensure reasonable oversight of the expenditure of appropriated funds. As a minimum, equivalent requirements must include: (a... portions of the reports shall provide summarized details on the status of resources (federal funds and non...

Making Loans Work: How Community Colleges Support Responsible Borrowing

ERIC Educational Resources Information Center

Burdman, Pamela

2012-01-01

To ensure that students have access to the full range of financial aid they may need to succeed, colleges must be able to confidently and responsibly offer federal student loans. The Institute for College Access & Success (TICAS) and the California Community Colleges Student Financial Aid Administrators' Association (CCCSFAAA) support…

14 CFR § 1240.113 - Financial accounting.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 5 2014-01-01 2014-01-01 false Financial accounting. § 1240.113 Section § 1240.113 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION INVENTIONS AND... provide for appropriate database and accounting system(s) to ensure that award payments are recorded and...

Political commitment for vulnerable populations during donor transition.

PubMed

Rodríguez, Daniela C; Whiteside, Alan; Bennett, Sara

2017-02-01

The responsibilities for the programmatic, technical and financial support of health programmes are increasingly being passed from external donors to governments. Programmes for family planning, human immunodeficiency virus, immunization, malaria and tuberculosis have already faced such donor transition, which is a difficult and often political process. Wherever programmes and services aimed at vulnerable populations are primarily supported by donors, the post-transition future is uncertain. Overreliance on donor support is often a reflection of limited domestic political commitment. Limited commitment, which is frequently expressed as the persecution of vulnerable groups, poses a risk to individuals as well as to the effectiveness and sustainability of health programmes. We argue that, for reasons linked to human rights, the social contract and the cost-effectiveness of health promotion, prevention and treatment programmes, it is critical that governments sustain health services for vulnerable populations during and after donor transition. Although civil society organizations could help by engaging with government stakeholders, pushing to change social norms and supporting mechanisms that demand accountability, they may be constrained by economic, political and social factors. Vulnerable populations need to be actively involved in the planning and implementation of donor transition - to ensure that their voice and needs are taken into account and to establish a platform that improves visibility and accountability. As transitions spread across all aspects of global health, transparent conversations about the building and sustainment of political commitment for health services for vulnerable populations become a critical human rights issue.

12 CFR 1750.10 - General.

Code of Federal Regulations, 2010 CFR

2010-01-01

... establishes the methodology for computing the risk-based capital level for each Enterprise. The board of directors of each Enterprise is responsible for ensuring that the Enterprise maintains total capital at a level that is sufficient to ensure the continued financial viability of the Enterprise and is equal to...

Banking for health: the role of financial sector actors in investing in global health

PubMed Central

Kickbusch, Ilona; Franz, Christian; Wells, Nadya

2018-01-01

The world faces multiple health financing challenges as the global health burden evolves. Countries have set an ambitious health policy agenda for the next 15 years with prioritisation of universal health coverage under the Sustainable Development Goals. The scale of investment needed for equitable access to health services means global health is one of the key economic opportunities for decades to come. New financing partnerships with the private sector are vital. The aim of this study is to unlock additional financing sources, acknowledging the imperative to link financial returns to the providers of capital, and create profitable, sustainable financing structures. This paper outlines the global health investment opportunity exploring intersections of financial and health sector interests, and the role investment in health can play in economic development. Considering increasing demand for impact investments, the paper explores responsible financing initiatives and expansion of the global movement for sustainable capital markets. Adding an explicit health component (H) to the Environmental, Social and Governance (ESG) investment criteria, creating the ESG+H initiative, could serve as catalyst for the inclusion of health criteria into mainstream financial actors’ business practices and investment objectives. The conclusion finds that health considerations directly impact profitability of the firm and therefore should be incorporated into financial analysis. Positive assessment of health impact, at a broad societal or environmental level, as well as for a firm’s employees can become a value enhancing competitive advantage. An ESG+H framework could incorporate this into mainstream financial decision-making and into scalable investment products. PMID:29736278

Banking for health: the role of financial sector actors in investing in global health.

PubMed

Krech, Rüdiger; Kickbusch, Ilona; Franz, Christian; Wells, Nadya

2018-01-01

The world faces multiple health financing challenges as the global health burden evolves. Countries have set an ambitious health policy agenda for the next 15 years with prioritisation of universal health coverage under the Sustainable Development Goals. The scale of investment needed for equitable access to health services means global health is one of the key economic opportunities for decades to come. New financing partnerships with the private sector are vital. The aim of this study is to unlock additional financing sources, acknowledging the imperative to link financial returns to the providers of capital, and create profitable, sustainable financing structures. This paper outlines the global health investment opportunity exploring intersections of financial and health sector interests, and the role investment in health can play in economic development. Considering increasing demand for impact investments, the paper explores responsible financing initiatives and expansion of the global movement for sustainable capital markets. Adding an explicit health component (H) to the Environmental, Social and Governance (ESG) investment criteria, creating the ESG+H initiative, could serve as catalyst for the inclusion of health criteria into mainstream financial actors' business practices and investment objectives. The conclusion finds that health considerations directly impact profitability of the firm and therefore should be incorporated into financial analysis. Positive assessment of health impact, at a broad societal or environmental level, as well as for a firm's employees can become a value enhancing competitive advantage. An ESG+H framework could incorporate this into mainstream financial decision-making and into scalable investment products.

"Must-know" legal issues for healthcare CFOS.

PubMed

Peregrine, Michael W; Schwartz, James R

2002-03-01

Healthcare financial managers are finding that regulatory agencies' customary focus on Medicare and tax-exemption concerns is shifting to other issues directly related to financial management. Regulatory agencies, such as the Securities and Exchange Commission, are scrutinizing not-for-profit and charitable trust law matters. Because of this renewed attention to existing regulations, healthcare financial managers need to increase their diligence in ensuring their organizations' compliance with those laws governing areas for which they traditionally have been accountable, including auditor relationships, restricted gifts, consulting arrangements, investment management, and financial reporting.

Technical, Managerial and Financial (TMF) Capacity Resources for Small Drinking Water Systems

EPA Pesticide Factsheets

Resources are available to help public water systems build the technical, managerial and financial (TMF) capacity. TMF capacity is necessary to achieve and maintain long-term sustainability and compliance with national safe drinking water regulations.

The cost of free health care for all Kenyans: assessing the financial sustainability of contributory and non-contributory financing mechanisms.

PubMed

Okungu, Vincent; Chuma, Jane; McIntyre, Di

2017-02-27

The need to provide quality and equitable health services and protect populations from impoverishing health care costs has pushed universal health coverage (UHC) to the top of global health policy agenda. In many developing countries where the majority of the population works in the informal sector, there are critical debates over the best financing mechanisms to progress towards UHC. In Kenya, government health policy has prioritized contributory financing strategy (social health insurance) as the main financing mechanism for UHC. However, there are currently no studies that have assessed the cost of either social health insurance (SHI) as the contributory approach or an alternative financing mechanism involving non-contributory (general tax funding) approaches to UHC in Kenya. The aim of this study was to critically assess the financial requirements of both contributory and non-contributory mechanisms to financing UHC in Kenya in the context of large informal sector populations. SimIns Basic® model, Version 2.1, 2008 (WHO/GTZ), was used to assess the feasibility of UHC in Kenya and provide estimates of financial resource needs for UHC over a 17-year period (2013-2030). Data sources included review of national and international literature on inflation, demography, macro-economy, health insurance, health services unit costs and utilization rates. The data were triangulated across geographic regions for accuracy and integrity of the simulation. SimIns models for 10 years only so data from the final year of the model was used to project for another 7 years. The 17-year period was necessary because the Government of Kenya aims to achieve UHC by 2030. The results show that SHI is financially sustainable (Sustainability in this study is used to mean that expenditure does not outstrip revenue.) (revenues and expenditure match) within the first five years of implementation, but it becomes less sustainable with time. Modelling for a non-contributory scenario, on the other hand, showed greater sustainability both in the short- and long-term. The financial resource requirements for universal access to health care through general government revenue are compared with a contributory health insurance scheme approach. Although both funding options would require considerable government subsidies, given the magnitude of the informal sector in Kenya and their limited financial capacity, a tax-funded system would be less costly and more sustainable in the long-term than an insurance scheme approach. However, more innovative financing for health care as well as giving the health sector higher priority in government expenditure will be required to make the non-contributory financing mechanism more sustainable.

Designing sustainable acute hospitals.

PubMed

Cory, Alistair

2008-01-01

The need to provide sustainable hospitals lies in the fact that we have an obligation to act responsibly towards good stewardship of our environment and the world's precious resources, ensuring a healthy future for coming generations. As such, a sustainable hospital must sit squarely in a sustainable society, and the global and local context should be considered when designing a sustainable health facility.

College Students' View of Biotechnology Products and Practices in Sustainable Agriculture Systems

ERIC Educational Resources Information Center

Anderson, William A.

2008-01-01

Sustainable agriculture implies the use of products and practices that sustain production, protect the environment, ensure economic viability, and maintain rural community viability. Disagreement exists as to whether or not the products and practices of modern biotechnological support agricultural sustainability. The purpose of this study was to…

Sustainable water management practices and remote sensing.

EPA Science Inventory

The United States Environmental Protection Agency’s charge to protect human health and the environment requires a long-term commitment to creating sustainable solutions to environmental problems. The most direct way to ensure that management practices are achieving sustainability...

Food production & availability - Essential prerequisites for sustainable food security

PubMed Central

Swaminathan, M.S.; Bhavani, R.V.

2013-01-01

Food and nutrition security are intimately interconnected, since only a food based approach can help in overcoming malnutrition in an economically and socially sustainable manner. Food production provides the base for food security as it is a key determinant of food availability. This paper deals with different aspects of ensuring high productivity and production without associated ecological harm for ensuring adequate food availability. By mainstreaming ecological considerations in technology development and dissemination, we can enter an era of evergreen revolution and sustainable food and nutrition security. Public policy support is crucial for enabling this. PMID:24135188

Ensuring Equal Access to High-Quality Education. Revised

ERIC Educational Resources Information Center

Office for Civil Rights, US Department of Education, 2011

2011-01-01

The Office for Civil Rights (OCR) in the U.S. Department of Education (Department) is a law enforcement agency charged with enforcing federal civil rights laws to ensure that educational institutions receiving federal financial assistance do not engage in discriminatory conduct. OCR enforces the federal civil rights laws that prohibit…

The trophy hunting of African lions: scale, current management practices and factors undermining sustainability.

PubMed

Lindsey, Peter Andrew; Balme, Guy Andrew; Funston, Paul; Henschel, Philipp; Hunter, Luke; Madzikanda, Hilary; Midlane, Neil; Nyirenda, Vincent

2013-01-01

The trophy hunting of lions Panthera leo is contentious due to uncertainty concerning conservation impacts and because of highly polarised opinions about the practice. African lions are hunted across at least ~558,000 km(2), which comprises 27-32% of the lion range in countries where trophy hunting of the species is permitted. Consequently, trophy hunting has potential to impart significant positive or negative impacts on lions. Several studies have demonstrated that excessive trophy harvests have driven lion population declines. There have been several attempts by protectionist non-governmental organisations to reduce or preclude trophy hunting via restrictions on the import and export of lion trophies. We document the management of lion hunting in Africa and highlight challenges which need addressing to achieve sustainability. Problems include: unscientific bases for quota setting; excessive quotas and off-takes in some countries; fixed quotas which encourage over-harvest; and lack of restrictions on the age of lions that can be hunted. Key interventions needed to make lion hunting more sustainable, include implementation of: enforced age restrictions; improved trophy monitoring; adaptive management of quotas and a minimum length of lion hunts of at least 21 days. Some range states have made important steps towards implementing such improved management and off-takes have fallen steeply in recent years. For example age restrictions have been introduced in Tanzania and in Niassa in Mozambique, and are being considered for Benin and Zimbabwe, several states have reduced quotas, and Zimbabwe is implementing trophy monitoring. However, further reforms are needed to ensure sustainability and reduce conservation problems associated with the practice while allowing retention of associated financial incentives for conservation.

The Trophy Hunting of African Lions: Scale, Current Management Practices and Factors Undermining Sustainability

PubMed Central

Lindsey, Peter Andrew; Balme, Guy Andrew; Funston, Paul; Henschel, Philipp; Hunter, Luke; Madzikanda, Hilary; Midlane, Neil; Nyirenda, Vincent

2013-01-01

The trophy hunting of lions Panthera leo is contentious due to uncertainty concerning conservation impacts and because of highly polarised opinions about the practice. African lions are hunted across at least ∼558,000 km2, which comprises 27–32% of the lion range in countries where trophy hunting of the species is permitted. Consequently, trophy hunting has potential to impart significant positive or negative impacts on lions. Several studies have demonstrated that excessive trophy harvests have driven lion population declines. There have been several attempts by protectionist non-governmental organisations to reduce or preclude trophy hunting via restrictions on the import and export of lion trophies. We document the management of lion hunting in Africa and highlight challenges which need addressing to achieve sustainability. Problems include: unscientific bases for quota setting; excessive quotas and off-takes in some countries; fixed quotas which encourage over-harvest; and lack of restrictions on the age of lions that can be hunted. Key interventions needed to make lion hunting more sustainable, include implementation of: enforced age restrictions; improved trophy monitoring; adaptive management of quotas and a minimum length of lion hunts of at least 21 days. Some range states have made important steps towards implementing such improved management and off-takes have fallen steeply in recent years. For example age restrictions have been introduced in Tanzania and in Niassa in Mozambique, and are being considered for Benin and Zimbabwe, several states have reduced quotas, and Zimbabwe is implementing trophy monitoring. However, further reforms are needed to ensure sustainability and reduce conservation problems associated with the practice while allowing retention of associated financial incentives for conservation. PMID:24058491

Value Chains of Public and Private Health-care Services in a Small EU Island State: A SWOT Analysis.

PubMed

Buttigieg, Sandra C; Schuetz, Marcus; Bezzina, Frank

2016-01-01

The global financial and macroeconomic crisis of 2008/2009 and the ensuing recessions obliged policy makers to maximize use of resources and cut down on waste. Specifically, in health care, governments started to explore ways of establishing collaborations between the public and private health-care sectors. This is essential so as to ensure the best use of available resources, while securing quality of delivery of care as well as health systems sustainability and resilience. This qualitative study explores complementary and mutual attributes in the value creation process to patients by the public and private health-care systems in Malta, a small European Union island state. A workshop was conducted with 28 professionals from both sectors to generate two separate value chains, and this was followed by an analysis of strengths, weaknesses, opportunities, and threats (SWOT). The latter revealed several strengths and opportunities, which can better equip health-policy makers in the quest to maximize provision of health-care services. Moreover, the analysis also highlighted areas of weaknesses in both sectors as well as current threats of the external environment that, unless addressed, may threaten the state's health-care system sustainability and resilience to macroeconomic shocks. The study goes on to provide feasible recommendations aimed at maximizing provision of health-care services in Malta.

State Financial Aid: Policies to Enhance Articulation and Transfer

ERIC Educational Resources Information Center

Long, Bridget Terry

2005-01-01

Financing and financial aid issues in higher education continue to plague state policymakers and higher education leaders. Every year, they struggle with questions of how to meet growing needs through state allocations, how best to ensure shared and equitable responsibility for paying for higher education, and how best to use subsidies such as…

Annual Financial Reporting Requirements for Texas Public Community Colleges, Fiscal Year 1996.

ERIC Educational Resources Information Center

Texas State Higher Education Coordinating Board, Austin. Div. of Research, Planning and Finance.

This manual provides a comprehensive set of definitions, rules, formats, and illustrations for use by public community and junior colleges in Texas to ensure consistent and uniform financial reporting. Chapter 1 provides an introduction to the manual, highlighting changes in requirements for Fiscal Year (FY) 1996. Chapter 2 presents general…

Beyond meaningful use: getting meaningful value from IT.

PubMed

Fortin, Jason; Zywiak, Walt

2010-02-01

The HITECH provisions of ARRA include financial incentives for providers to demonstrate meaningful use of certified EHR technology. However, to maximize the value of IT under new payment models, provider organizations will need to go beyond meaningful use criteria in three key areas: Delivering high-quality care. Ensuring coordinated care. Integrating financial systems.

How Biobanks Are Assessing and Measuring Their Financial Sustainability.

PubMed

Brown, Tony; Kelly, Devon D; Vercauteren, Suzanne M; Wilson, William H; Werner, Alexander

2017-02-01

As guest editors of this sustainability issue of Biopreservation and Biobanking focused on business planning, utilization, and marketing, we invited a number of experts from different sectors of the biobanking arena to provide their views on business planning issues. Each expert was asked to provide a brief background statement on their biobanks, to build a context to understand their answers to the sustainability questions. We hope that these insights and experiences can provide valuable considerations and ideas for other biobanks who wish to develop or refine their own business plans, measure their utilization rates, and work toward financial sustainability. In addition, after the expert input was gathered, the guest editors invited an additional expert to provide summary comments and observations on cost and operational optimization strategies. The broad experiences from all of the experts included and scope of the biobanks they represent should provide a level of relevant representation for all interested parties.

How to Educate Children for Sustainable Learning and for a Sustainable World

ERIC Educational Resources Information Center

Samuelsson, Ingrid Pramling; Park, Eunhye

2017-01-01

This article discusses how early learning might be made sustainable for children. It considers the application of Goal 4 of the Sustainable Development Goals to early childhood education to ensure that inclusive and equitable quality education that promotes lifelong learning opportunities is available to all children. Early childhood practitioners…

Navy Enterprise Resource Planning System Does Not Comply With the Standard Financial Information Structure and U.S. Government Standard General Ledger

DTIC Science & Technology

2012-02-13

Operations DCMO Deputy Chief Management Officer DDRS Defense Departmental Reporting System DFAS Defense Finance and Accounting Service ERP Enterprise...for your review and comment. The Navy approved deployment of the Navy Enterprise Resource Planning ( ERP ) System without ensuring it complied with the...Comments from the Deputy Assistant Secretary of the Navy (Financial Management and Comptroller, Office of Financial Operations) and the Navy ERP Program

Intercity passenger rail : Amtrak's progress in improving its financial condition has been mixed

DOT National Transportation Integrated Search

1999-07-01

Since its creation in 1971, Amtrak has accumulated massive financial losses, with recent losses averaging more than $800 million per year. To help Amtrak sustain operations and make needed capital investments, the federal government has provided Amtr...

Civil society: the catalyst for ensuring health in the age of sustainable development.

PubMed

Smith, Julia; Buse, Kent; Gordon, Case

2016-07-16

Sustainable Development Goal Three is rightly ambitious, but achieving it will require doing global health differently. Among other things, progressive civil society organisations will need to be recognised and supported as vital partners in achieving the necessary transformations. We argue, using illustrative examples, that a robust civil society can fulfill eight essential global health functions. These include producing compelling moral arguments for action, building coalitions beyond the health sector, introducing novel policy alternatives, enhancing the legitimacy of global health initiatives and institutions, strengthening systems for health, enhancing accountability systems, mitigating the commercial determinants of health and ensuring rights-based approaches. Given that civil society activism has catalyzed tremendous progress in global health, there is a need to invest in and support it as a global public good to ensure that the 2030 Agenda for Sustainable Development can be realised.

Why Ecologists Should Care about Financial Markets.

PubMed

Galaz, Victor; Gars, Johan; Moberg, Fredrik; Nykvist, Björn; Repinski, Cecilia

2015-10-01

Financial actors such as international banks and investors play an important role in the global economy. This role is shifting due to financial innovations, increased sustainability ambitions from large financial actors, and changes in international commodity markets. These changes are creating new global connections that potentially make financial markets, actors, and instruments important aspects of global environmental change. Despite this, the way financial markets and actors affect ecosystem change in different parts of the world has seldom been elaborated in the literature. We summarize these financial trends, explore how they connect to ecosystems and ecological change in both direct and indirect ways, and elaborate on crucial research gaps. Copyright © 2015 Elsevier Ltd. All rights reserved.

Strategic business planning linking strategy with financial reality.

PubMed

Bachrodt, Andrew K; Smyth, J Patrick

2004-11-01

To succeed in today's complex and often adverse business environment, a healthcare organization's strategic direction must be calculated, focused, and financially sustainable. Strategic business planning is an essential tool to help organizations focus strategic choices within the financial realities of their environment. An effective strategic business planning cycle includes conducting an assessment, identifying business objectives, developing strategy, conducting an impact analysis, and developing an implementation plan.

Predictors of the highest long-term care expenditures in Japan.

PubMed

Olivares-Tirado, Pedro; Tamiya, Nanako; Kashiwagi, Masayo; Kashiwagi, Kimikazu

2011-05-17

In Japan, as the number of elderly covered by the Long-term Care Insurance (LTCI) system has increased, demand for long-term care services has increased substantially and consequently growing expenditures are threatening the sustainability of the system. Understanding the predictive factors associated with long-term care expenditures among the elderly would be useful in developing future strategies to ensure the sustainability of the system. We report a set of predictors of the highest long-term care expenditures in a cohort of elderly persons who received consecutive long-term care services during a year in a Japanese city. Data were obtained from databases of the LTC insurer of City A in Japan. Binary logistic regression was used to examine the predictors of the highest long-term care expenditures. We used a simplified model that focused on the effects of disability status and type of services used, while controlling for several relevant factors. Goodness of fit, a multicollinearity test, and logistic regression diagnostics were carried out for the final model. The study cohort consisted of 862 current users of LTCI system in city A. After controlling for gender and income, age, increased utilization rate of benefits, decline in functional status, higher care needs level and institutional care were found to be associated with the highest LTCI expenditures. An increased utilization rate of benefits (OR = 24.2) was a strong main effect predictors of the high LTC expenditures. However, a significant interaction between institutional care and high care need level was found, providing evidence of the combined effect of the two covariates. Beyond to confirm that disability status of elderly persons is the main factor driving the demand of LTC services and consequently the expenditures, we showed that changes in utilization rate of benefits -a specific insurance factor- and the use of institutional care conditional on the high care level, were strongest predictors of the highest LTC expenditures. These findings could become crucial for tracking policies aimed at ensuring financial sustainability of LTCI from a public insurer perspective in Japan.

Predictors of the highest long-term care expenditures in Japan

PubMed Central

2011-01-01

Background In Japan, as the number of elderly covered by the Long-term Care Insurance (LTCI) system has increased, demand for long-term care services has increased substantially and consequently growing expenditures are threatening the sustainability of the system. Understanding the predictive factors associated with long-term care expenditures among the elderly would be useful in developing future strategies to ensure the sustainability of the system. We report a set of predictors of the highest long-term care expenditures in a cohort of elderly persons who received consecutive long-term care services during a year in a Japanese city. Methods Data were obtained from databases of the LTC insurer of City A in Japan. Binary logistic regression was used to examine the predictors of the highest long-term care expenditures. We used a simplified model that focused on the effects of disability status and type of services used, while controlling for several relevant factors. Goodness of fit, a multicollinearity test, and logistic regression diagnostics were carried out for the final model. Results The study cohort consisted of 862 current users of LTCI system in city A. After controlling for gender and income, age, increased utilization rate of benefits, decline in functional status, higher care needs level and institutional care were found to be associated with the highest LTCI expenditures. An increased utilization rate of benefits (OR = 24.2) was a strong main effect predictors of the high LTC expenditures. However, a significant interaction between institutional care and high care need level was found, providing evidence of the combined effect of the two covariates. Conclusions Beyond to confirm that disability status of elderly persons is the main factor driving the demand of LTC services and consequently the expenditures, we showed that changes in utilization rate of benefits -a specific insurance factor- and the use of institutional care conditional on the high care level, were strongest predictors of the highest LTC expenditures. These findings could become crucial for tracking policies aimed at ensuring financial sustainability of LTCI from a public insurer perspective in Japan. PMID:21575260

Augmenting the impact of technology adoption with financial incentive to improve radiology report signature times.

PubMed

Andriole, Katherine P; Prevedello, Luciano M; Dufault, Allen; Pezeshk, Parham; Bransfield, Robert; Hanson, Richard; Doubilet, Peter M; Seltzer, Steven E; Khorasani, Ramin

2010-03-01

Radiology report signature time (ST) can be a substantial component of total report turnaround time. Poor turnaround time resulting from lengthy ST can adversely affect patient care. The combination of technology adoption with financial incentive was evaluated to determine if ST improvement can be augmented and sustained. This prospective study was performed at a 751-bed, urban, tertiary care adult teaching hospital. Test-site imaging volume approximated 48,000 examinations per month. The radiology department has 100 trainees and 124 attending radiologists serving multiple institutions. Over a study period of 4 years and 4 months, three interventions focused on radiologist signature performance were implemented: 1) a notification paging application that alerted radiologists when reports were ready for signature, 2) a picture archiving and communications systems (PACS)-integrated speech recognition report generation system, and 3) a departmental financial incentive to reward radiologists semiannually for ST performance. Signature time was compared before and after the interventions. Wilcoxon and linear regression statistical analyses were used to assess the significance of trends. Technology adoption (paging plus speech recognition) reduced median ST from >5 to <1 hour (P < .001) and 80th-percentile ST from >24 to 15 to 18 hours (P < .001). Subsequent addition of a financial incentive further improved 80th-percentile ST to 4 to 8 hours (P < .001). The gains in median and 80th-percentile ST were sustained over the final 31 months of the study period. Technology interventions coupled with financial incentive can result in synergistic and sustainable improvement in radiologist report-signing behavior. The addition of a financial incentive leads to better performance than that achievable through technology alone.

Stratum Electricity Markets: Toward Multi-temporal Distributed Risk Management for Sustainable Electricity Provision

NASA Astrophysics Data System (ADS)

Wu, Zhiyong (Richard)

Motivated by the overall challenge of ensuring long-term sustainable electricity service, we view this challenge as a long-term decision making problem under uncertainties. We start by recognizing that, independent of the industry organization, the uncertainties are enormous and often exogenous to the energy service providers. They are multi-dimensional and are result of fundamental drivers, ranging from the supply side, through the demand side, to the regulatory and policy sides. The basic contribution of this thesis comes from the recognition that long-term investments for ensuring reliable and stable electricity service critically depend on how these uncertainties are perceived, valued and managed by the different stakeholders within the complex industry organization such as the electric power industry. We explain several reasons why price signals obtained from current short-term electricity markets alone are not sufficient enough for long-term sustainable provision. Some enhancements are presented in the thesis to improve the short-term electricity market price signals to reflect the true cost of operation. New market mechanisms and instruments are needed to facilitate the stakeholders to better deal with long-term risks. The problems of ensuring long-term stable reliable service in the sense of the traditional resource adequacy requirements are revisited in both the restructuring industry and regulated industry. We introduce a so-called Stratum Electricity Market (SEM) design as the basic market mechanism for solving the problem of long-term reliable electricity service through a series of interactive multi-lateral market exchange platforms for risks communication, management and evaluations over various time horizons and by the different groups of stakeholders. In other words, our proposed SEM is a basic IT-enabled framework for the decision making processes by various parties over different time. Because of the uniqueness of electricity as a commodity, the values for the same amount of energy during different time and at different location can vary dramatically. Moreover, for the same hour, the values for the same amount of power at base load level or at peak load level are different due to the different generation technologies and other non-convex constraints like unit commitment. The multiple market products at zonal/nodal levels with different time horizon and time of use categories are designed to reflect more realistic demand and supply conditions at various temporal and spatial granularities. Detailed market rules, rights and regulations (3Rs) concerning the sub-markets interactions, product hierarchy and financial settlements are also examined.

Critical factors for sustainable food procurement in zoological collections.

PubMed

Hanson, Jonathan H

2015-01-01

Food procurement can play an important role in sustainable food supply chain management by zoos, linking organizational operations to the biodiversity conservation and sustainability mission of zoological collections. This study therefore examines the critical factors that shape sustainable food procurement in zoo and aquariums. Using a web-based survey data was collected from 41 members of the British and Irish Association of Zoos and Aquariums (BIAZA). This included information on the sustainable food procurement practices of these institutions for both their human and animal food supply chains, as well as profile information and data on the factors contributing to and inhibiting sustainable procurement practices. Zoological collections operated by charities, and those with a certified sustainability standard, were found to have significantly higher levels of sustainable food procurement. Zoos and aquariums whose human food operations were not contracted to an external party were also found to have significantly higher levels of sustainable food procurement in their human food supply chain. The most important drivers of sustainable food procurement were cost savings, adequate financial support and improved product quality. The highest ranking barriers were higher costs, other issues taking priority and a lack of alternative suppliers. The results suggest that a number of critical factors shape sustainable food procurement in zoological collections in the British Isles. Financial factors, such as cost savings, were important considerations. The significance of mission-related factors, such as charity status, indicated that core values held by zoos and aquariums can also influence their food procurement practices. © 2015 Wiley Periodicals, Inc.

Evaluation of Sustainable Development in Rural Territories in Latgale Region (Latvia) by Using the Conception of Smart Specialization

ERIC Educational Resources Information Center

Šipilova, Viktorija; Ostrovska, Inta; Jermolajeva, Elita; Aleksejeva, Ludmila; Olehnovics, Dmitrijs

2017-01-01

One of the approaches to achieve sustainable development is based on smart specialization. Rural areas are of particular importance in ensuring sustainable development, the smart development of which largely determines the balanced sustainable development of a state as a whole. The present study reflects the quantitative and the qualitative…

About the Role of Universities and Their Contribution to Sustainable Development

ERIC Educational Resources Information Center

Filho, Walter Leal

2011-01-01

The debate on sustainable development is not new and the search for new approaches, methods and means to further the case of sustainability in a higher education context is needed today more than ever. This paper reviews the status of sustainable development at universities and presents issues which need to be considered in ensuring sustainable…

Success factors for implementing and sustaining a mature electronic medical record in a low-resource setting: a case study of iSanté in Haiti.

PubMed

deRiel, E; Puttkammer, N; Hyppolite, N; Diallo, J; Wagner, S; Honoré, J G; Balan, J G; Celestin, N; Vallès, J S; Duval, N; Thimothé, G; Boncy, J; Coq, N R L; Barnhart, S

2018-03-01

Electronic health information systems, including electronic medical records (EMRs), have the potential to improve access to information and quality of care, among other things. Success factors and challenges for novel EMR implementations in low-resource settings have increasingly been studied, although less is known about maturing systems and sustainability. One systematic review identified seven categories of implementation success factors: ethical, financial, functionality, organizational, political, technical and training. This case study applies this framework to iSanté, Haiti's national EMR in use in more than 100 sites and housing records for more than 750 000 patients. The author group, consisting of representatives of different agencies within the Haitian Ministry of Health (MSPP), funding partner the Centers for Disease Control and Prevention (CDC) Haiti, and implementing partner the International Training and Education Center for Health (I-TECH), identify successes and lessons learned according to the seven identified categories, and propose an additional cross-cutting category, sustainability. Factors important for long-term implementation success of complex information systems are balancing investments in hardware and software infrastructure upkeep, user capacity and data quality control; designing and building a system within the context of the greater eHealth ecosystem with a plan for interoperability and data exchange; establishing system governance and strong leadership to support local system ownership and planning for system financing to ensure sustainability. Lessons learned from 10 years of implementation of the iSanté EMR system are relevant to sustainability of a full range of increasingly interrelated information systems (e.g. for laboratory, supply chain, pharmacy and human resources) in the health sector in low-resource settings. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Sustainability of recurrent expenditure on public social welfare programmes: expenditure analysis of the free maternal care programme of the Ghana National Health Insurance Scheme.

PubMed

Ankrah Odame, Emmanuel; Akweongo, Patricia; Yankah, Ben; Asenso-Boadi, Francis; Agyepong, Irene

2014-05-01

Sustainability of public social welfare programmes has long been of concern in development circles. An important aspect of sustainability is the ability to sustain the recurrent financial costs of programmes. A free maternal care programme (FMCP) was launched under the Ghana National Health Insurance Scheme (NHIS) in 2008 with a start-up grant from the British Government. This article examines claims expenditure under the programme and the implications for the financial sustainability of the programme, and the lessons for donor and public financing of social welfare programmes. Records of reimbursement claims for services and medicines by women benefitting from the policy in participating facilities in one sub-metropolis in Ghana were analysed to gain an understanding of the expenditure on this programme at facility level. National level financial inflow and outflow (expenditure) data of the NHIS, related to implementation of this policy for 2008 and 2009, were reviewed to put the facility-based data in the national perspective. A total of US$936 450.94 was spent in 2009 by the scheme on FMCP in the sub-metropolis. The NHIS expenditure on the programme for the entire country in 2009 was US$49.25 million, exceeding the British grant of US$10.00 million given for that year. Subsequently, the programme has been entirely financed by the National Health Insurance Fund. The rapidly increasing, recurrent demands on this fund from the maternal delivery exemption programme-without a commensurate growth on the amounts generated annually-is an increasing threat to the sustainability of the fund. Provision of donor start-up funding for programmes with high recurrent expenditures, under the expectation that government will take over and sustain the programme, must be accompanied by clear long-term analysis and planning as to how government will sustain the programme.

Examination of Success Factors in Obtaining and Sustaining Clean Audit Opinions Within DoD Components

DTIC Science & Technology

2006-12-01

inventories …Further, unreliable cost and budget information related to nearly a reported $1 trillion of liabilities and about $347 billion of net costs...produce the financial reports required by the auditing entity. From counting inventory to preparing the financial statements themselves...financial sections within the agency count inventories , research acquisition histories or enter data; and did the agency spend money on contractors and

Evidence of Product Differentiation in the Microfinance Industry

DTIC Science & Technology

2011-05-09

financial services, which include deposits and more importantly credit. Access to credit allows the poor to overcome initial capital barriers when...of microfinance provides financial access to the poorest regions of the world and is seen by many as a means of creating self-sustaining markets. The...that as more for- profit MFI enter the microfinance industry, non-profit MFIs will be crowded out, reducing borrowers‟ access to financial services

Maternity waiting homes and institutional birth in Nicaragua: policy options and strategic implications.

PubMed

García Prado, Ariadna; Cortez, Rafael

2012-01-01

With the aim of promoting institutional births and reducing the high maternal and child mortality rates in rural and poor zones, the government of Nicaragua is supporting the creation of maternity waiting homes. This study analyzes that strategy and examines the factors associated with the use of maternity waiting homes and institutional birth. To that end, we apply a quantitative approach, by means of an econometric analysis of the data extracted from surveys conducted in 2006 on a sample of women and parteras or traditional birth attendants, as well as a qualitative approach based on interviews with key informants. Results indicate that although the operation of the maternity waiting homes is usually satisfactory, there is still room for improvement along the following lines: (i) disseminating information about the homes to both women and men, as the latter frequently decide the course of women's healthcare, and to parteras, who can play an important role in referring women; (ii) strengthening the postpartum care; (iii) ensuring financial sustainability by obtaining regular financial support from the government to complement contributions from the community; and (iv) strengthening the local management and involvement of the regional government. These measures might be useful for health policy makers in Nicaragua and in other developing countries that are considering this strategy. Copyright © 2011 John Wiley & Sons, Ltd.

Sustainability and the health care manager: Part II.

PubMed

Ramirez, Bernardo; Oetjen, Reid M; Malvey, Donna

2011-01-01

Are there additional costs associated with achieving goals of sustainable health care? Will going green enhance or impede financial performance? These are questions that all health care managers should confront, yet there is little evidence to show that health care sustainability is affordable or profitable. This article considers what is presently known and suggests that health care managers use an assessment framework to determine whether they are ready to achieve health care sustainability.

Using a Mixed Model to Explore Evaluation Criteria for Bank Supervision: A Banking Supervision Law Perspective

PubMed Central

Tsai, Sang-Bing; Chen, Kuan-Yu; Zhao, Hongrui; Wei, Yu-Min; Wang, Cheng-Kuang; Zheng, Yuxiang; Chang, Li-Chung; Wang, Jiangtao

2016-01-01

Financial supervision means that monetary authorities have the power to supervise and manage financial institutions according to laws. Monetary authorities have this power because of the requirements of improving financial services, protecting the rights of depositors, adapting to industrial development, ensuring financial fair trade, and maintaining stable financial order. To establish evaluation criteria for bank supervision in China, this study integrated fuzzy theory and the decision making trial and evaluation laboratory (DEMATEL) and proposes a fuzzy-DEMATEL model. First, fuzzy theory was applied to examine bank supervision criteria and analyze fuzzy semantics. Second, the fuzzy-DEMATEL model was used to calculate the degree to which financial supervision criteria mutually influenced one another and their causal relationship. Finally, an evaluation criteria model for evaluating bank and financial supervision was established. PMID:27992449

Using a Mixed Model to Explore Evaluation Criteria for Bank Supervision: A Banking Supervision Law Perspective.

PubMed

Tsai, Sang-Bing; Chen, Kuan-Yu; Zhao, Hongrui; Wei, Yu-Min; Wang, Cheng-Kuang; Zheng, Yuxiang; Chang, Li-Chung; Wang, Jiangtao

2016-01-01

Financial supervision means that monetary authorities have the power to supervise and manage financial institutions according to laws. Monetary authorities have this power because of the requirements of improving financial services, protecting the rights of depositors, adapting to industrial development, ensuring financial fair trade, and maintaining stable financial order. To establish evaluation criteria for bank supervision in China, this study integrated fuzzy theory and the decision making trial and evaluation laboratory (DEMATEL) and proposes a fuzzy-DEMATEL model. First, fuzzy theory was applied to examine bank supervision criteria and analyze fuzzy semantics. Second, the fuzzy-DEMATEL model was used to calculate the degree to which financial supervision criteria mutually influenced one another and their causal relationship. Finally, an evaluation criteria model for evaluating bank and financial supervision was established.

Professionalism for Medicine: Opportunities and Obligations*

PubMed Central

Cruess, Sylvia R; Cruess, Richard L; Johnston, Sharon

2004-01-01

Physicians' dual roles-as healer and professional-are linked by codes of ethics governing behaviour and are empowered by science.Being part of a profession entails a societal contract. The profession is granted a monopoly over the use of a body of knowledge and the privilege of self-regulation and, in return, guarantees society professional competence, integrity and the provision of altruistic service.Societal attitudes to professionalism have changed from supportive to increasingly critical-with physicians being criticised for pursuing their own financial interests, and failing to self-regulate in a way that guarantees competence.Professional values are also threatened by many other factors. The most important are the changes in healthcare delivery in the developed world, with control shifting from the profession to the State and/or the corporate sector.For the ideal of professionalism to survive, physicians must understand it and its role in the social contract. They must meet the obligations necessary to sustain professionalism and ensure that healthcare systems support, rather than subvert, behaviour that is compatible with professionalism's values. PMID:15296199

Modern Management Principles Come to the Dental School.

PubMed

Wataha, John C; Mouradian, Wendy E; Slayton, Rebecca L; Sorensen, John A; Berg, Joel H

2016-04-01

The University of Washington School of Dentistry may be the first dental school in the nation to apply lean process management principles as a primary tool to re-engineer its operations and curriculum to produce the dentist of the future. The efficiencies realized through re-engineering will better enable the school to remain competitive and viable as a national leader of dental education. Several task forces conducted rigorous value stream analyses in a highly collaborative environment led by the dean of the school. The four areas undergoing evaluation and re-engineering were organizational infrastructure, organizational processes, curriculum, and clinic operations. The new educational model was derived by thoroughly analyzing the current state of dental education in order to design and achieve the closest possible ideal state. As well, the school's goal was to create a lean, sustainable operational model. This model aims to ensure continued excellence in restorative dental instruction and to serve as a blueprint for other public dental schools seeking financial stability in this era of shrinking state support and rising costs.

Professionalism for medicine: opportunities and obligations.

PubMed

Cruess, Sylvia R; Johnston, Sharon; Cruess, Richard L

2002-08-19

Physicians' dual roles - as healer and professional - are linked by codes of ethics governing behaviour and are empowered by science. Being part of a profession entails a societal contract. The profession is granted a monopoly over the use of a body of knowledge and the privilege of self-regulation and, in return, guarantees society professional competence, integrity and the provision of altruistic service. Societal attitudes to professionalism have changed from supportive to increasingly critical - with physicians being criticised for pursuing their own financial interests, and failing to self-regulate in a way that guarantees competence. Professional values are also threatened by many other factors. The most important are the changes in healthcare delivery in the developed world, with control shifting from the profession to the State and/or the corporate sector. For the ideal of professionalism to survive, physicians must understand it and its role in the social contract. They must meet the obligations necessary to sustain professionalism and ensure that healthcare systems support, rather than subvert, behaviour that is compatible with professionalism's values.

Professionalism for medicine: opportunities and obligations.

PubMed

Cruess, Sylvia R; Johnston, Sharon; Cruess, Richard L

2004-01-01

Physicians' dual roles--as healer and professional--are linked by codes of ethics governing behaviour and are empowered by science. Being part of a profession entails a societal contract. The profession is granted a monopoly over the use of a body of knowledge and the privilege of self-regulation and, in return, guarantees society professional competence, integrity and the provision of altruistic service. Societal attitudes to professionalism have changed from supportive to increasingly critical--with physicians being criticised for pursuing their own financial interests, and failing to self-regulate in a way that guarantees competence. Professional values are also threatened by many other factors. The most important are the changes in healthcare delivery in the developed world, with control shifting from the profession to the State and/or the corporate sector. For the ideal of professionalism to survive, physicians must understand it and its role in the social contract. They must meet the obligations necessary to sustain professionalism and ensure that healthcare systems support, rather than subvert, behaviour that is compatible with professionalism's values.

From State-controlled to Polycentric Governance in Forest Landscape Restoration: The Case of the Ecological Forest Purchase Program in Yong'an Municipality of China.

PubMed

Long, Hexing; Liu, Jinlong; Tu, Chengyue; Fu, Yimin

2018-07-01

Forest landscape restoration is emerging as an effective approach to restore degraded forests for the provision of ecosystem services and to minimize trade-offs between conservation and rural livelihoods. Policy and institutional innovations in China illustrate the governance transformation of forest landscape restoration from state-controlled to polycentric governance. Based on a case study of the Ecological Forest Purchase Program in Yong'an municipality, China's Fujian Province, this paper explores how such forest governance transformation has evolved and how it has shaped the outcomes of forest landscape restoration in terms of multi-dimensionality and actor configurations. Our analysis indicates that accommodating the participation of multiple actors and market-based instruments facilitate a smoother transition from state-centered to polycentric governance in forest landscape restoration. Governance transitions for forest landscape restoration must overcome a number of challenges including ensurance of a formal participation forum, fair participation, and a sustainable legislative and financial system to enhance long-term effectiveness.

Introduction of Sequential Inactivated Polio Vaccine–Oral Polio Vaccine Schedule for Routine Infant Immunization in Brazil’s National Immunization Program

PubMed Central

Domingues, Carla Magda Allan S.; de Fátima Pereira, Sirlene; Marreiros, Ana Carolina Cunha; Menezes, Nair; Flannery, Brendan

2015-01-01

In August 2012, the Brazilian Ministry of Health introduced inactivated polio vaccine (IPV) as part of sequential polio vaccination schedule for all infants beginning their primary vaccination series. The revised childhood immunization schedule included 2 doses of IPV at 2 and 4 months of age followed by 2 doses of oral polio vaccine (OPV) at 6 and 15 months of age. One annual national polio immunization day was maintained to provide OPV to all children aged 6 to 59 months. The decision to introduce IPV was based on preventing rare cases of vaccine-associated paralytic polio, financially sustaining IPV introduction, ensuring equitable access to IPV, and preparing for future OPV cessation following global eradication. Introducing IPV during a national multivaccination campaign led to rapid uptake, despite challenges with local vaccine supply due to high wastage rates. Continuous monitoring is required to achieve high coverage with the sequential polio vaccine schedule. PMID:25316829

Influence and effectiveness of financial incentive programs in promoting sustainable forestry in the south

Treesearch

Michael G. Jacobson; John L. Greene; Thomas J. Straka; Steven E. Daniels; Michael A. Kilgore

2009-01-01

State forestry officials responsible for forestry incentive programs in each of the 13 southern states were surveyed concerning their opinions on financial incentiveprograms available to nonindustrial private forest owners. The forestry officials were asked to name and describe the public and...

Performance-based financing with GAVI health system strengthening funding in rural Cambodia: a brief assessment of the impact.

PubMed

Matsuoka, Sadatoshi; Obara, Hiromi; Nagai, Mari; Murakami, Hitoshi; Chan Lon, Rasmey

2014-07-01

Though Cambodia made impressive gains in immunization coverage between the years 2000 and 2005, it recognized several health system challenges to greater coverage of immunization and sustainability. The Global Alliance for Vaccines and Immunization (GAVI) opened a Health System Strengthening (HSS) funding window in 2006. To address the health system challenges, Cambodia has been receiving the GAVI HSS fund since October 2007. The major component of the support is performance-based financing (PBF) for maternal, neonatal and child health (MNCH) services. To examine the impact of the PBF scheme on MNCH services and administrative management in rural Cambodia. Quantitative and qualitative studies were conducted in Kroch Chhmar Operational District (OD), Cambodia. Quantitative analyses were conducted on the trends of the numbers of MNCH services. A brief analysis was conducted using qualitative data. After the commencement of the PBF support, the volume of MNCH services was significantly boosted. In addition, strengthened financial and operational management was observed in the study area. However, the quality of the MNCH services was not ensured. Technical assistance, rather than the PBF scheme, was perceived by stakeholders to play a vital role in increasing the quality of the services. To improve the quality of the health services provided, it is better to include indicators on the quality of care in the PBF scheme. Mutual co-operation between PBF models and technical assistance may ensure better service quality while boosting the quantity. A robust but feasible data validation mechanism should be in place, as a PBF could incentivize inaccurate reporting. The capacity for financial management should be strengthened in PBF recipient ODs. To address the broader aspects of MNCH, a balanced input of resources and strengthening of all six building blocks of a health system are necessary. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

Describing an Environment for a Self-Sustaining Technology Transfer Service in a Small Research Budget University: A Case Study

ERIC Educational Resources Information Center

Nieb, Sharon Lynn

2014-01-01

This single-site qualitative study sought to identify the characteristics that contribute to the self sustainability of technology transfer services at universities with small research budgets through a case study analysis of a small research budget university that has been operating a financially self-sustainable technology transfer service for…

Making the End as Good as the Beginning: Financial Planning and Retirement for Women Plastic Surgeons.

PubMed

Johnson, Debra J; Shenaq, Deana; Thakor, Manisha

2016-10-01

Financial planning is critically important to ensure financial security both during a plastic surgical career and in retirement. Unfortunately, plastic surgery training includes very little in the way of financial planning. The information that is available in the literature is mostly geared toward men. Women, with longer lifespans and more family care responsibilities, have unique needs when it comes to financial planning. Adequate attention must also be paid to life after retirement. A plastic surgical career can be all-encompassing, and thus women need to carefully plan volunteer activities, new hobbies, and even a second career to make their retirement years fulfilling and enjoyable. Key points regarding financial planning during the various phases of a woman plastic surgeon's career are discussed. Options for retirement are presented.

77 FR 44654 - Rental Assistance Demonstration (RAD) Application Form

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-30

... sustainability of properties and enable owners to leverage private financing to address immediate and long-term.... FOR FURTHER INFORMATION CONTACT: Colette Pollard., Reports Management Officer, QDAM, Department of... the physical and financial sustainability of properties and enable owners to leverage private...

Promoting universal financial protection: evidence from seven low- and middle-income countries on factors facilitating or hindering progress

PubMed Central

2013-01-01

Although universal health coverage (UHC) is a global health policy priority, there remains limited evidence on UHC reforms in low- and middle-income countries (LMICs). This paper provides an overview of key insights from case studies in this thematic series, undertaken in seven LMICs (Costa Rica, Georgia, India, Malawi, Nigeria, Tanzania, and Thailand) at very different stages in the transition to UHC. These studies highlight the importance of increasing pre-payment funding through tax funding and sometimes mandatory insurance contributions when trying to improve financial protection by reducing out-of-pocket payments. Increased tax funding is particularly important if efforts are being made to extend financial protection to those outside formal-sector employment, raising questions about the value of pursuing contributory insurance schemes for this group. The prioritisation of insurance scheme coverage for civil servants in the first instance in some LMICs also raises questions about the most appropriate use of limited government funds. The diverse reforms in these countries provide some insights into experiences with policies targeted at the poor compared with universalist reform approaches. Countries that have made the greatest progress to UHC, such as Costa Rica and Thailand, made an explicit commitment to ensuring financial protection and access to needed care for the entire population as soon as possible, while this was not necessarily the case in countries adopting targeted reforms. There also tends to be less fragmentation in funding pools in countries adopting a universalist rather than targeting approach. Apart from limiting cross-subsidies, fragmentation of pools has contributed to differential benefit packages, leading to inequities in access to needed care and financial protection across population groups; once such differentials are entrenched, they are difficult to overcome. Capacity constraints, particularly in purchasing organisations, are a pervasive problem in LMICs. The case studies also highlighted the critical role of high-level political leadership in pursuing UHC policies and citizen support in sustaining these policies. This series demonstrates the value of promoting greater sharing of experiences on UHC reforms across LMICs. It also identifies key areas of future research on health care financing in LMICs that would support progress towards UHC. PMID:24228762

Promoting universal financial protection: evidence from seven low- and middle-income countries on factors facilitating or hindering progress.

PubMed

McIntyre, Di; Ranson, Michael K; Aulakh, Bhupinder K; Honda, Ayako

2013-09-24

Although universal health coverage (UHC) is a global health policy priority, there remains limited evidence on UHC reforms in low- and middle-income countries (LMICs). This paper provides an overview of key insights from case studies in this thematic series, undertaken in seven LMICs (Costa Rica, Georgia, India, Malawi, Nigeria, Tanzania, and Thailand) at very different stages in the transition to UHC.These studies highlight the importance of increasing pre-payment funding through tax funding and sometimes mandatory insurance contributions when trying to improve financial protection by reducing out-of-pocket payments. Increased tax funding is particularly important if efforts are being made to extend financial protection to those outside formal-sector employment, raising questions about the value of pursuing contributory insurance schemes for this group. The prioritisation of insurance scheme coverage for civil servants in the first instance in some LMICs also raises questions about the most appropriate use of limited government funds.The diverse reforms in these countries provide some insights into experiences with policies targeted at the poor compared with universalist reform approaches. Countries that have made the greatest progress to UHC, such as Costa Rica and Thailand, made an explicit commitment to ensuring financial protection and access to needed care for the entire population as soon as possible, while this was not necessarily the case in countries adopting targeted reforms. There also tends to be less fragmentation in funding pools in countries adopting a universalist rather than targeting approach. Apart from limiting cross-subsidies, fragmentation of pools has contributed to differential benefit packages, leading to inequities in access to needed care and financial protection across population groups; once such differentials are entrenched, they are difficult to overcome. Capacity constraints, particularly in purchasing organisations, are a pervasive problem in LMICs. The case studies also highlighted the critical role of high-level political leadership in pursuing UHC policies and citizen support in sustaining these policies.This series demonstrates the value of promoting greater sharing of experiences on UHC reforms across LMICs. It also identifies key areas of future research on health care financing in LMICs that would support progress towards UHC.

Sustainable gold mining management waste policy in Romania

NASA Astrophysics Data System (ADS)

Tudor, Elena; Filipciuc, Constantina

2016-04-01

Sustainable mining practices and consistent implementation of the mining for the closure planning approach, within an improved legislative framework, create conditions for the development of creative, profitable, environmentally-sound and socially-responsible management and reuse of mine lands. According to the World Commission on Environment and Development definition, sustainable development is the type of development that meets the needs of the present without compromising the ability of future generations to meet their own needs. Romania has the largest gold reserves in Europe (760 million tons of gold-silver ores, of which 40 million tons in 68 gold deposits in the Apuseni Mountains. New mining projects draw particular attention regarding the environmental risks they cause. Rehabilitation is an ongoing consideration throughout the mine's lifecycle, both from a technical and a financial standpoint. The costs of land rehabilitation are classified as the mine's operating costs. According to Directive 2004/35/EC on environmental liability, the prevention and remedying of environmental damage should be implemented by applying the "polluter pays" principle, in line with the principle of sustainable development. Directive on the management of waste from extractive industries and amending Directive obliges operators to provide (and periodically adjust in size) a financial guarantee for waste facility maintenance and post-closure site restoration, including land rehabilitation. According to the Romanian Mining Law, the license holder has the following obligations related to land use and protection: to provide environmental agreements as one of the prerequisites for a building permit; to regularly update the mine closure plan; to set up and maintain the financial guarantee for environmental rehabilitation; and to execute and finalize the environmental rehabilitation of affected land in the mining site, according to the mine closure plan, including the post-closure monitoring program implementation and financing. Apart from the Mining Law, the Government Decision, which transposes EU Directive on the management of waste from extractive industries, as well as Government Emergency Ordinance, which implements the requirements of EU Directive 2004/35/CE on environmental liability, requests financial guarantees for waste facilities maintenance and for environment restoration in the case of pollution, respectively. In practice, there are problems in the calculation of the financial guarantee and the development of financial security instruments and markets as required by Directive, due to the lack of expertise in financial, economic and liability matters. Mining companies are usually not required to set up a special guarantee for the waste facilities, but only to set up and maintain the financial guarantee regulated under the Mining Law. Romania - because of the structure of its mining sector - has serious environmental legacies, a lack of funds for their restoration and the need to strengthen the administrative capacity in this area, as well as the important tasks on harmonization and/or implementation of the EU mining waste legislation. This work is presented within the framework of SUSMIN project. Key words : sustainable development, waste management, policy

Renewable energy-based electricity for rural social and economic development in Ghana

DOE Office of Scientific and Technical Information (OSTI.GOV)

Weingart, J.

1997-12-01

This paper describes a project whose goals include the establishment of a pilot renewable energy-based rural energy services enterprise to serve communities in the Mamprusi East District, focused on: economically productive activities; community services; household non-thermal energy. The program also seeks to establish the technical, economic, financial, institutional, and socio-cultural requirements for sustainability, to demonstrate bankability and financial sustainability, as a pre-investment prelude to commercial growth of such projects, and to establish technical, financial, and service performance standards for private sector rural energy service companies. This project is being implemented now because the government is undergoing structural reform, including privatizationmore » of the power sector, there is active foreign capital available for international development, and the government and people are committed to and able to pay for renewable energy services.« less

Drug-resistant tuberculosis control in China: progress and challenges.

PubMed

Long, Qian; Qu, Yan; Lucas, Henry

2016-01-29

China has the second highest caseload of multidrug-resistant tuberculosis (MDR-TB) in the world. In 2009, the Chinese government agreed to draw up a plan for MDR-TB prevention and control in the context of a comprehensive health system reform launched in the same year. China is facing high prevalence rates of drug-resistant TB and MDR-TB. MDR-TB disproportionally affects the poor rural population and the highest rates are in less developed regions largely due to interrupted and/or inappropriate TB treatment. Most households with an affected member suffer a heavy financial burden because of a combination of treatment and other related costs. The influential Global Fund programme for MDR-TB control in China provides technical and financial support for MDR-TB diagnosis and treatment. However, this programme has a fixed timeline and cannot provide a long term solution. In 2009, the Bill and Melinda Gates Foundation, in cooperation with the National Health and Family Planning Commission of China, started to develop innovative approaches to TB/MDR-TB management and case-based payment mechanisms for treatment, alongside increased health insurance benefits for patients, in order to contain medical costs and reduce financial barriers to treatment. Although these efforts appear to be in the right direction, they may not be sufficient unless (a) domestic sources are mobilized to raise funding for TB/MDR-TB prevention and control and (b) appropriate incentives are given to both health facilities and their care providers. Along with the on-going Chinese health system reform, sustained government financing and social health protection schemes will be critical to ensure universal access to appropriate TB treatment in order to reduce risk of developing MDR-TB and systematic MDR-TB treatment and management.

The Cost of Family Medicine Residency Training: Impacts of Federal and State Funding.

PubMed

Pauwels, Judith; Weidner, Amanda

2018-02-01

Numerous organizations are calling for the expansion of graduate medical education (GME) positions nationally. Developing new residency programs and expanding existing programs can only happen if financial resources are available to pay for the expenses of training beyond what can be generated in direct clinical income by the residents and faculty in the program. The goal of this study was to evaluate trended data regarding the finances of family medicine residency programs to identify what financial resources are needed to sustain graduate medical education programs. A group of family medicine residency programs have shared their financial data since 2002 through a biennial survey of program revenues, expenses, and staffing. Data sets over 12 years were collected and analyzed, and results compared to analyze trends. Overall expenses increased 70.4% during this period. Centers for Medicare and Medicaid Services (CMS) GME revenue per resident increased by 15.7% for those programs receiving these monies. Overall, total revenue per resident, including clinical revenues, state funding, and any other revenue stream, increased 44.5% from 2006 to 2016. The median cost per resident among these programs, excluding federal GME funds, is currently $179,353; this amount has increased over the 12 years by 93.7%. For this study group of family medicine programs, data suggests a cost per resident per year, excluding federal and state GME funding streams, of about $180,000. This excess expense compared to revenue must be met by other agencies, whether from CMS, the Health Resources and Services Administration (HRSA), state expenditures or other sources, through stable long-term commitments to these funding mechanisms to ensure program viability for these essential family medicine programs in the future.

Biocultural approaches to well-being and sustainability indicators across scales

Treesearch

Eleanor J. Sterling; Christopher Filardi; Anne Toomey; Amanda Sigouin; Erin Betley; Nadav Gazit; Jennifer Newell; Simon Albert; Diana Alvira; Nadia Bergamini; Mary Blair; David Boseto; Kate Burrows; Nora Bynum; Sophie Caillon; Jennifer E. Caselle; Joachim Claudet; Georgina Cullman; Rachel Dacks; Pablo B. Eyzaguirre; Steven Gray; James Herrera; Peter Kenilorea; Kealohanuiopuna Kinney; Natalie Kurashima; Suzanne Macey; Cynthia Malone; Senoveva Mauli; Joe McCarter; Heather McMillen; Pua’ala Pascua; Patrick Pikacha; Ana L. Porzecanski; Pascale de Robert; Matthieu Salpeteur; Myknee Sirikolo; Mark H. Stege; Kristina Stege; Tamara Ticktin; Ron Vave; Alaka Wali; Paige West; Kawika B. Winter; Stacy D. Jupiter

2017-01-01

Monitoring and evaluation are central to ensuring that innovative, multi-scale, and interdisciplinary approaches to sustainability are effective. The development of relevant indicators for local sustainable management outcomes, and the ability to link these to broader national and international policy targets, are key challenges for resource managers, policymakers, and...

Enrollment Pathways to Financial Sustainability: Choosing the Road Less Traveled

ERIC Educational Resources Information Center

Supplee, Janice L.

2014-01-01

Rising costs, burgeoning debt, and falling credit ratings are among the financial challenges faced by small, tuition-dependent private colleges, including many members of the Council for Christian Colleges & Universities (CCCU). In their efforts to generate more revenue, most of these institutions have focused on enrollment strategies as the…

Major Management Challenges and Program Risks. Performance and Accountability Series.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC.

In its 2001 performance and accountability report on the Department of Education, the General Accounting Office (GAO) identified challenges with student financial-aid programs, financial management, and other areas facing education. The information presented in this report is intended to help sustain congressional attention and a departmental…

13 CFR 120.825 - Financial ability to operate.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Development Company Loan Program (504) Requirements for Cdc Certification and Operation § 120.825 Financial ability to operate. A CDC must be able to sustain its operations continuously, with reliable sources of... funds generated from 503 and 504 loan activity by a CDC remaining after payment of staff and overhead...

13 CFR 120.825 - Financial ability to operate.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Development Company Loan Program (504) Requirements for Cdc Certification and Operation § 120.825 Financial ability to operate. A CDC must be able to sustain its operations continuously, with reliable sources of... funds generated from 503 and 504 loan activity by a CDC remaining after payment of staff and overhead...

13 CFR 120.825 - Financial ability to operate.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Development Company Loan Program (504) Requirements for Cdc Certification and Operation § 120.825 Financial ability to operate. A CDC must be able to sustain its operations continuously, with reliable sources of... funds generated from 503 and 504 loan activity by a CDC remaining after payment of staff and overhead...

13 CFR 120.825 - Financial ability to operate.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Development Company Loan Program (504) Requirements for Cdc Certification and Operation § 120.825 Financial ability to operate. A CDC must be able to sustain its operations continuously, with reliable sources of... funds generated from 503 and 504 loan activity by a CDC remaining after payment of staff and overhead...

13 CFR 120.825 - Financial ability to operate.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Development Company Loan Program (504) Requirements for Cdc Certification and Operation § 120.825 Financial ability to operate. A CDC must be able to sustain its operations continuously, with reliable sources of... funds generated from 503 and 504 loan activity by a CDC remaining after payment of staff and overhead...

Archiving of Comprehensive Annual Financial Reports (CAFRs) on State Government Web Sites

ERIC Educational Resources Information Center

Thornton, Joel B.

2012-01-01

Rising cost and declining revenues have hampered the financial affairs of state governments, forcing many to curtail services, reduce employee benefits, and trim the workforce, calling into question the fiscal sustainability of many state governments. As a result, stakeholders are demanding greater accountability and increased transparency into…

Mineral supply for sustainable development requires resource governance.

PubMed

Ali, Saleem H; Giurco, Damien; Arndt, Nicholas; Nickless, Edmund; Brown, Graham; Demetriades, Alecos; Durrheim, Ray; Enriquez, Maria Amélia; Kinnaird, Judith; Littleboy, Anna; Meinert, Lawrence D; Oberhänsli, Roland; Salem, Janet; Schodde, Richard; Schneider, Gabi; Vidal, Olivier; Yakovleva, Natalia

2017-03-15

Successful delivery of the United Nations sustainable development goals and implementation of the Paris Agreement requires technologies that utilize a wide range of minerals in vast quantities. Metal recycling and technological change will contribute to sustaining supply, but mining must continue and grow for the foreseeable future to ensure that such minerals remain available to industry. New links are needed between existing institutional frameworks to oversee responsible sourcing of minerals, trajectories for mineral exploration, environmental practices, and consumer awareness of the effects of consumption. Here we present, through analysis of a comprehensive set of data and demand forecasts, an interdisciplinary perspective on how best to ensure ecologically viable continuity of global mineral supply over the coming decades.

Mineral supply for sustainable development requires resource governance

USGS Publications Warehouse

Ali, Saleem H.; Giurco, Damien; Arndt, Nicholas; Nickless, Edmund; Brown, Graham; Demetriades, Alecos; Durrheim, Ray; Enriquez, Maria Amélia; Kinnaird, Judith; Littleboy, Anna; Meinert, Lawrence D.; Oberhänsli, Roland; Salem, Janet; Schodde, Richard; Schneider, Gabi; Vidal, Olivier; Yakovleva, Natalia

2017-01-01

Successful delivery of the United Nations sustainable development goals and implementation of the Paris Agreement requires technologies that utilize a wide range of minerals in vast quantities. Metal recycling and technological change will contribute to sustaining supply, but mining must continue and grow for the foreseeable future to ensure that such minerals remain available to industry. New links are needed between existing institutional frameworks to oversee responsible sourcing of minerals, trajectories for mineral exploration, environmental practices, and consumer awareness of the effects of consumption. Here we present, through analysis of a comprehensive set of data and demand forecasts, an interdisciplinary perspective on how best to ensure ecologically viable continuity of global mineral supply over the coming decades.

Mineral supply for sustainable development requires resource governance

NASA Astrophysics Data System (ADS)

Ali, Saleem H.; Giurco, Damien; Arndt, Nicholas; Nickless, Edmund; Brown, Graham; Demetriades, Alecos; Durrheim, Ray; Enriquez, Maria Amélia; Kinnaird, Judith; Littleboy, Anna; Meinert, Lawrence D.; Oberhänsli, Roland; Salem, Janet; Schodde, Richard; Schneider, Gabi; Vidal, Olivier; Yakovleva, Natalia

2017-03-01

Successful delivery of the United Nations sustainable development goals and implementation of the Paris Agreement requires technologies that utilize a wide range of minerals in vast quantities. Metal recycling and technological change will contribute to sustaining supply, but mining must continue and grow for the foreseeable future to ensure that such minerals remain available to industry. New links are needed between existing institutional frameworks to oversee responsible sourcing of minerals, trajectories for mineral exploration, environmental practices, and consumer awareness of the effects of consumption. Here we present, through analysis of a comprehensive set of data and demand forecasts, an interdisciplinary perspective on how best to ensure ecologically viable continuity of global mineral supply over the coming decades.

Financial Hardship, Unmet Medical Need, and Health Self-Efficacy among African American Men

ERIC Educational Resources Information Center

Tucker-Seeley, Reginald D.; Mitchell, Jamie A.; Shires, Deirdre A.; Modlin, Charles S., Jr.

2015-01-01

Background: Health self-efficacy (the confidence to take care of one's health) is a key component in ensuring that individuals are active partners in their health and health care. The purpose of this study was to determine the association between financial hardship and health self-efficacy among African American men and to determine if unmet…

Aid and Innovation: How Federal Financial Aid Policy Impacts Student Success and How States Can Respond. Policy Bulletin

ERIC Educational Resources Information Center

Reichert, Katrina

2012-01-01

From Washington to Connecticut, Arkansas to Indiana, state policymakers and community college leaders are focused on building completion pathways to ensure that more students succeed in postsecondary education and make smooth transitions to careers. Financial aid is both an effective and a necessary policy lever to promote this goal. Not only do…

Acting Administrator Welcomes New CFO

NASA Image and Video Library

2018-04-03

Acting NASA Administrator Robert Lightfoot, left, and newly appointed NASA Chief Financial Officer Jeff DeWit, meet on DeWit's first day in office, Tuesday, April 3, 2018 at NASA Headquarters in Washington. As NASA CFO, DeWit ensures the financial health of the agency, which includes effectively employing agency resources toward the achievement of NASA's strategic plan. Photo Credit: (NASA/Bill Ingalls)

Financial disclosure and toxic products: encouraging wall street to anticipate product risk and exercise precaution.

PubMed

Lewis, Sanford; Byrne, Margaret

2009-01-01

Amidst discussion by policymakers about how regulators' failure to ensure disclosure of risks contributed to the current financial crisis, we assess how emerging product toxicity risks are addressed in companies' financial reports. Will corporations blindside investors with "the next asbestos?" Existing disclosures are found lacking in the specificity needed to forewarn of liabilities and reputational damage from the use of potentially harmful materials-from nanotechnologies, to asthmagens, to perfluorinated compounds. Improved standards could protect investors while also enhancing corporate incentives to use safer materials. Reforms by the Securities and Exchange Commission and the Financial Accounting Standards Board are recommended.

Ensuring accountability through health professional regulatory bodies: the case of conflict of interest.

PubMed

Zelisko, Debra; Baumann, Andrea; Gamble, Brenda; Laporte, Audrey; Deber, Raisa B

2014-09-01

How do self-regulated health professions' regulatory bodies address financial conflict of interest (coi) and ensure accountability to the public? using document analysis, we examined how four ontario regulatory colleges (physicians, nurses, physiotherapists, audiologists/speech-language pathologists) defined coi and the education, guidance and enforcement they provided for coi-related issues. These colleges are upholding the mandates to define, identify and address financial coi by providing regulations or standards and guidelines to their membership; they differed in the amount of educational materials provided to their registrants and in the possible coi scenarios they presented. Although there were few disciplinary hearings pertaining to financial coi, findings for the hearings that did occur were documented and posted on the college public registers (the listing of all registered college members along with all relevant practice information), informing the public of any limitations or restrictions placed on a member as a result of the hearing. Copyright © 2014 Longwoods Publishing.

The board's role in organizational finance.

PubMed

Curran, Connie R

2010-01-01

Health care reform will result in significant changes in reimbursement with much greater emphasis put on primary care, home care, and other types of non-acute care. The changes in reimbursement will necessitate significant changes in organizational structure and operations. It is essential board members keep current in their knowledge of health care finance so they can execute their responsibilities for the financial health of the organization. The board must ensure that the budget is aligned with the organization's financial objectives and monitor the financial performance. It is essential the chief nursing officer (CNO) contributes to the board's understanding of the financial health of the organization. The board of trustees will more effectively execute their financial responsibilities with the input of nurse trustees and the CNO.

Role of wood production in ecosystem management : proceedings of the Sustainable Forestry Working Group at the IUFRO All Division 5 conference, Pullman, Washington, July 1997

Treesearch

R. J. Barbour; K. E. Skog

1997-01-01

The presentations at this symposium discussed concepts of ecosystem management and sustainability as viewed by various levels of government and private land managers. The theme was to integrate ecology, silviculture, forest operations, wood products, and economics to find ways to develop healthy sustainable ecosystems under financially sound management practices....

Is CO2 emission a side effect of financial development? An empirical analysis for China.

PubMed

Hao, Yu; Zhang, Zong-Yong; Liao, Hua; Wei, Yi-Ming; Wang, Shuo

2016-10-01

Based on panel data for 29 Chinese provinces from 1995 to 2012, this paper explores the relationship between financial development and environmental quality in China. A comprehensive framework is utilized to estimate both the direct and indirect effects of financial development on CO 2 emissions in China using a carefully designed two-stage regression model. The first-difference and orthogonal-deviation Generalized Method of Moments (GMM) methods are used to control for potential endogeneity and introduce dynamics. To ensure the robustness of the estimations, two indicators measuring financial development-financial depth and financial efficiency-are used. The empirical results indicate that the direct effects of financial depth and financial efficiency on environmental quality are positive and negative, respectively. The indirect effects of both indicators are U shaped and dominate the shape of the total effects. These findings suggest that the influences of the financial development on environment depend on the level of economic development. At the early stage of economic growth, financial development is environmentally friendly. When the economy is highly developed, a higher level of financial development is harmful to the environmental quality.

7 CFR 550.46 - Competition.

Code of Federal Regulations, 2010 CFR

2010-01-01

... performance, financial and technical resources or accessibility to other necessary resources. In certain... eliminate competition or otherwise restrain trade. In order to ensure objective contractor performance and...

49 CFR 1.38 - Delegations to the Assistant Secretary for Administration.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Improvement Act of 2002. (c) Sustainability. Responsible for ensuring that the Department meets its sustainability goals pursuant to the Energy Independence and Security Act (EISA) of 2007 (Pub. L. 110-140); the...

49 CFR 1.38 - Delegations to the Assistant Secretary for Administration.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Improvement Act of 2002. (c) Sustainability. Responsible for ensuring that the Department meets its sustainability goals pursuant to the Energy Independence and Security Act (EISA) of 2007 (Pub. L. 110-140); the...

49 CFR 1.38 - Delegations to the Assistant Secretary for Administration.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Improvement Act of 2002. (c) Sustainability. Responsible for ensuring that the Department meets its sustainability goals pursuant to the Energy Independence and Security Act (EISA) of 2007 (Pub. L. 110-140); the...

Withholding and withdrawal of life-sustaining treatments in low-middle-income versus high-income Asian countries and regions.

PubMed

Phua, Jason; Joynt, Gavin M; Nishimura, Masaji; Deng, Yiyun; Myatra, Sheila Nainan; Chan, Yiong Huak; Binh, Nguyen Gia; Tan, Cheng Cheng; Faruq, Mohammad Omar; Arabi, Yaseen M; Wahjuprajitno, Bambang; Liu, Shih-Feng; Hashemian, Seyed Mohammad Reza; Kashif, Waqar; Staworn, Dusit; Palo, Jose Emmanuel; Koh, Younsuck

2016-07-01

To compare the attitudes of physicians towards withholding and withdrawing life-sustaining treatments in intensive care units (ICUs) in low-middle-income Asian countries and regions with those in high-income ones, and to explore differences in the role of families and surrogates, legal risks, and financial considerations between these countries and regions. Questionnaire study conducted in May-December 2012 on 847 physicians from 255 ICUs in 10 low-middle-income countries and regions according to the World Bank's classification, and 618 physicians from 211 ICUs in six high-income countries and regions. After we accounted for personal, ICU, and hospital characteristics on multivariable analyses using generalised linear mixed models, physicians from low-middle-income countries and regions were less likely to limit cardiopulmonary resuscitation, mechanical ventilation, vasopressors and inotropes, tracheostomy and haemodialysis than those from high-income countries and regions. They were more likely to involve families in end-of-life care discussions and to perceive legal risks with limitation of life-sustaining treatments and do-not-resuscitate orders. Nonetheless, they were also more likely to accede to families' requests to withdraw life-sustaining treatments in a patient with an otherwise reasonable chance of survival on financial grounds in a case scenario (adjusted odds ratio 5.05, 95 % confidence interval 2.69-9.51, P < 0.001). Significant differences in ICU physicians' self-reported practice of limiting life-sustaining treatments, the role of families and surrogates, perception of legal risks and financial considerations exist between low-middle-income and high-income Asian countries and regions.

Sustaining Arts Programs in Public Education

ERIC Educational Resources Information Center

Dunstan, David

2016-01-01

The purpose of this qualitative research case study was to investigate leadership and funding decisions that determine key factors responsible for sustaining arts programs in public schools. While the educational climate, financial constraints, and standardized testing continue to impact arts programs in public education, Eastland High School, the…

The Decade of Education for Sustainable Development: A Perspective from Australia

ERIC Educational Resources Information Center

Lang, Josephine R.

2005-01-01

Amidst Australia's background of ecological devastation there is hope as people and their communities search for ways to re-think and revision their future, moving ever so slowly towards sustainability. For the author, sustainability is the intersection where humanity consciously engages with the ecological systems in ways to ensure all life is…

Sustaining Teen Pregnancy Prevention Programs in Schools: Needs and Barriers Identified by School Leaders

ERIC Educational Resources Information Center

Craft, Lesley R.; Brandt, Heather M.; Prince, Mary

2016-01-01

Background: To reduce teen pregnancy rates, prevention programs must be consistently available to large numbers of youth. However, prevention efforts have been historically conducted with little emphasis on ensuring program sustainability. This study examined the needs and barriers to sustaining teen pregnancy prevention (TPP) programming in…

Early Childhood Education and Sustainability: A Living Curriculum

ERIC Educational Resources Information Center

MacDonald, Margaret

2015-01-01

As climate change, overpopulation, and inequalities begin to take their toll on our planet and on global human development, sustainability has become increasingly important for a prosperous future. How can we ensure quality of life for future generations? How can we make choices and cultivate environments in which sustainable practices are the…

Utilizing Commercial Real Estate Owner and Investor Data to Analyze the Financial Performance of Energy Efficient, High-Performance Office Buildings

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cloutier, Deborah; Hosseini, Farshid; White, Andrew

Evidence has shown that owning and operating energy-efficient, high-performance, “green” properties results in multiple benefits including lower utility bills, higher rents, improved occupancy, and greater net operating income. However, it is difficult to isolate and control moderating factors to identify the specific drivers behind improved financial performance and value to investors that results from sustainability in real estate. DOE is interested in facilitating deeper investigation of the correlation between energy efficiency and financial performance, reducing data acquisition and matching challenges, and developing a stronger understanding of how sustainable design and energy efficiency impact value. DOE commissioned this pilot study tomore » test the logistical and empirical procedures required to establish a Commercial Real Estate Data Aggregation & Trends Analysis lab, determine the potential benefits available through the lab, and contribute to the existing body of evidence in this field.« less

Value Chains of Public and Private Health-care Services in a Small EU Island State: A SWOT Analysis

PubMed Central

Buttigieg, Sandra C.; Schuetz, Marcus; Bezzina, Frank

2016-01-01

The global financial and macroeconomic crisis of 2008/2009 and the ensuing recessions obliged policy makers to maximize use of resources and cut down on waste. Specifically, in health care, governments started to explore ways of establishing collaborations between the public and private health-care sectors. This is essential so as to ensure the best use of available resources, while securing quality of delivery of care as well as health systems sustainability and resilience. This qualitative study explores complementary and mutual attributes in the value creation process to patients by the public and private health-care systems in Malta, a small European Union island state. A workshop was conducted with 28 professionals from both sectors to generate two separate value chains, and this was followed by an analysis of strengths, weaknesses, opportunities, and threats (SWOT). The latter revealed several strengths and opportunities, which can better equip health-policy makers in the quest to maximize provision of health-care services. Moreover, the analysis also highlighted areas of weaknesses in both sectors as well as current threats of the external environment that, unless addressed, may threaten the state’s health-care system sustainability and resilience to macroeconomic shocks. The study goes on to provide feasible recommendations aimed at maximizing provision of health-care services in Malta. PMID:27683658

Overcoming challenges to sustainable immunization financing: early experiences from GAVI graduating countries

PubMed Central

Hecht, Robert; Kaddar, Miloud; Schmitt, Sarah; Ryckman, Theresa; Cornejo, Santiago

2015-01-01

Over the 5-year period ending in 2018, 16 countries with a combined birth cohort of over 6 million infants requiring life-saving immunizations are scheduled to transition (graduate) from outside financial and technical support for a number of their essential vaccines. This support has been provided over the past decade by the GAVI Alliance. Will these 16 countries be able to continue to sustain these vaccination efforts? To address this issue, GAVI and its partners are supporting transition planning, entailing country assessments of readiness to graduate and intensive dialogue with national officials to ensure a smooth transition process. This approach was piloted in Bhutan, Republic of Congo, Georgia, Moldova and Mongolia in 2012. The pilot showed that graduating countries are highly heterogeneous in their capacity to assume responsibility for their immunization programmes. Although all possess certain strengths, each country displayed weaknesses in some of the following areas: budgeting for vaccine purchase, national procurement practices, performance of national regulatory agencies, and technical capacity for vaccine planning and advocacy. The 2012 pilot experience further demonstrated the value of transition planning processes and tools. As a result, GAVI has decided to continue with transition planning in 2013 and beyond. As the graduation process advances, GAVI and graduating countries should continue to contribute to global collective thinking about how developing countries can successfully end their dependence on donor aid and achieve self-sufficiency. PMID:24510369

From Millennium Development Goals to post-2015 sustainable development: sexual and reproductive health and rights in an evolving aid environment.

PubMed

Hill, Peter S; Huntington, Dale; Dodd, Rebecca; Buttsworth, Michael

2013-11-01

Using research from country case studies, this paper offers insights into the range of institutional and structural changes in development assistance between 2005 and 2011, and their impact on the inclusion of a sexual and reproductive health and rights agenda in national planning environments. At a global level during this period, donors supported more integrative modalities of aid - sector wide approaches, poverty reduction strategy papers, direct budgetary support - with greater use of economic frameworks in decision-making. The Millennium Development Goals brought heightened attention to maternal mortality, but at the expense of a broader sexual and reproductive health and rights agenda. Advocacy at the national planning level was not well linked to programme implementation; health officials were disadvantaged in economic arguments, and lacked financial and budgetary controls to ensure a connection between advocacy and action. With increasing competency in higher level planning processes, health officials are now refocusing the post-2015 development goals. If sexual and reproductive health and rights is to claim engagement across all its multiple elements, advocates need to link them to the key themes of sustainable development: inequalities in gender, education, growth and population, but also to urbanisation, migration, women in employment and climate change. Copyright © 2013 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Sustainability and scalability of the hospital elder life program at a community hospital.

PubMed

Rubin, Fred H; Neal, Kelly; Fenlon, Kerry; Hassan, Shuja; Inouye, Sharon K

2011-02-01

The Hospital Elder Life Program (HELP), an effective intervention to prevent delirium in older hospitalized adults, has been successfully replicated in a community teaching hospital as a quality improvement project. This article reports on successfully sustaining the program over 7 years and expanding its scale from one to six inpatient units at the same hospital. The program currently serves more than 7,000 older patients annually and is accepted as the standard of care throughout the hospital. Innovations that enhanced scalability and widespread implementation included ensuring dedicated staffing for the program, local adaptations to streamline protocols, continuous recruitment of volunteers, and more-efficient data collection. Outcomes include a lower rate of incident delirium; shorter length of stay (LOS); greater satisfaction of patients, families, and nursing staff; and significantly lower costs for the hospital. The financial return of the program, estimated at more than $7.3 million per year during 2008, comprises cost savings from delirium prevention and revenue generated from freeing up hospital beds (shorter LOS of HELP patients with and without delirium). Delirium poses a major challenge for hospital quality of care, patient safety, Medicare no-pay conditions, and costs of hospital care for older persons. Faced with rising numbers of elderly patients, hospitals can use HELP to improve the quality and cost-effectiveness of care. © 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.

E-Business Reporting: Towards a Global Standard for Financial Reporting Systems Using XBRL

ERIC Educational Resources Information Center

Long, Margaret J.

2013-01-01

Reporting systems can provide transparency into financial markets necessary for a sustainable, prosperous global economy. The most widely used global platform for exchanging electronic information about companies to regulatory bodies is XBRL. Standards for this platform are in the process of becoming legally harmonized, but not all countries are…

Lessons learned from a colocation model using psychiatrists in urban primary care settings.

PubMed

Weiss, Meredith; Schwartz, Bruce J

2013-07-01

Comorbid psychiatric illness has been identified as a major driver of health care costs. The colocation of psychiatrists in primary care practices has been proposed as a model to improve mental health and medical care as well as a model to reduce health care costs. Financial models were developed to determine the sustainability of colocation. We found that the population studied had substantial psychiatric and medical burdens, and multiple practice logistical issues were identified. The providers found the experience highly rewarding and colocation was financially sustainable under certain conditions. The colocation model was effective in identifying and treating psychiatric comorbidities.

Creating a Better Future through Teamwork: Using Advisers to Develop a Plan for the Future of Your Child with Special Needs

ERIC Educational Resources Information Center

Finn, Brian

2006-01-01

For most families, financial planning involves paying the monthly bills while putting money aside for the children's college funds and the parents' retirement. However, for parents of children with special needs, planning often takes on a very different meaning. Ensuring that children will have the resources to meet their financial, educational,…

Financial Crisis Now Striking Home for School Districts: Project Delays, Worries About Cash Flow Result of Tight Credit Markets

ERIC Educational Resources Information Center

Davis, Michelle R.

2008-01-01

This article reports that the crisis besetting U.S. and world financial markets is hitting school districts hard, as they struggle to float the bonds needed for capital projects, borrow money to ensure cash flow, and get access to investment funds locked up in troubled institutions. Some schools districts depend heavily on borrowed money to pay…

The Irony of Open Access: An Examination of a New York State Financial Aid Policy and Its Effect on Students

ERIC Educational Resources Information Center

Baksh-Jarrett, Gail

2011-01-01

Open access institutions have achieved the goal of providing higher education to all who seek it. To compete in a global economy, these higher educational institutions must do more than open the door; they must ensure that admitted students succeed. This study examined effects of New York State's financial aid policy that requires…

Sustainable Development in Surgery: The Health, Poverty, and Equity Impacts of Charitable Surgery in Uganda

PubMed Central

Shrime, Mark G.; Sekidde, Serufusa; Linden, Allison; Cohen, Jessica L.; Weinstein, Milton C.; Salomon, Joshua A.

2016-01-01

Background The recently adopted Sustainable Development Goals call for the end of poverty and the equitable provision of healthcare. These goals are often at odds, however: health seeking can lead to catastrophic spending, an outcome for which cancer patients and the poor in resource-limited settings are at particularly high risk. How various health policies affect the additional aims of financial wellbeing and equity is poorly understood. This paper evaluates the health, financial, and equity impacts of governmental and charitable policies for surgical oncology in a resource-limited setting. Methods Three charitable platforms for surgical oncology delivery in Uganda were compared to six governmental policies aimed at improving healthcare access. An extended cost-effectiveness analysis using an agent-based simulation model examined the numbers of lives saved, catastrophic expenditure averted, impoverishment averted, costs, and the distribution of benefits across the wealth spectrum. Findings Of the nine policies and platforms evaluated, two were able to provide simultaneous health and financial benefits efficiently and equitably: mobile surgical units and governmental policies that simultaneously address surgical scaleup, the cost of surgery, and the cost of transportation. Policies that only remove user fees are dominated, as is the commonly employed short-term “surgical mission trip”. These results are robust to scenario and sensitivity analyses. Interpretation The most common platforms for increasing access to surgical care appear unable to provide health and financial risk protection equitably. On the other hand, mobile surgical units, to date an underutilized delivery platform, are able to deliver surgical oncology in a manner that meets sustainable development goals by improving health, financial solvency, and equity. These platforms compare favorably with policies that holistically address surgical delivery and should be considered as countries strengthen health systems. PMID:28036357

Sustainable Development in Surgery: The Health, Poverty, and Equity Impacts of Charitable Surgery in Uganda.

PubMed

Shrime, Mark G; Sekidde, Serufusa; Linden, Allison; Cohen, Jessica L; Weinstein, Milton C; Salomon, Joshua A

2016-01-01

The recently adopted Sustainable Development Goals call for the end of poverty and the equitable provision of healthcare. These goals are often at odds, however: health seeking can lead to catastrophic spending, an outcome for which cancer patients and the poor in resource-limited settings are at particularly high risk. How various health policies affect the additional aims of financial wellbeing and equity is poorly understood. This paper evaluates the health, financial, and equity impacts of governmental and charitable policies for surgical oncology in a resource-limited setting. Three charitable platforms for surgical oncology delivery in Uganda were compared to six governmental policies aimed at improving healthcare access. An extended cost-effectiveness analysis using an agent-based simulation model examined the numbers of lives saved, catastrophic expenditure averted, impoverishment averted, costs, and the distribution of benefits across the wealth spectrum. Of the nine policies and platforms evaluated, two were able to provide simultaneous health and financial benefits efficiently and equitably: mobile surgical units and governmental policies that simultaneously address surgical scaleup, the cost of surgery, and the cost of transportation. Policies that only remove user fees are dominated, as is the commonly employed short-term "surgical mission trip". These results are robust to scenario and sensitivity analyses. The most common platforms for increasing access to surgical care appear unable to provide health and financial risk protection equitably. On the other hand, mobile surgical units, to date an underutilized delivery platform, are able to deliver surgical oncology in a manner that meets sustainable development goals by improving health, financial solvency, and equity. These platforms compare favorably with policies that holistically address surgical delivery and should be considered as countries strengthen health systems.

Energy-water-food nexus under financial constraint environment: good, the bad, and the ugly sustainability reforms in sub-Saharan African countries.

PubMed

Zaman, Khalid; Shamsuddin, Sadaf; Ahmad, Mehboob

2017-05-01

Environmental sustainability agenda are generally compromised by energy, water, and food production resources, while in the recent waves of global financial crisis, it mediates to increase the intensity of air pollutants, which largely affected the less developing countries due to their ease of environmental regulation policies and lack of optimal utilization of economic resources. Sub-Saharan African (SSA) countries are no exception that majorly hit by the recent global financial crisis, which affected the country's natural environment through the channel of unsustainable energy-water-food production. The study employed panel random effect model that addresses the country-specific time-invariant shocks to examine the non-linear relationship between water-energy-food resources and air pollutants in a panel of 19 selected SSA countries, for a period of 2000-2014. The results confirmed the carbon-fossil-methane environmental Kuznets curve (EKC) that turned into inverted U-shaped relationships in a panel of selected SSA countries. Food resources largely affected greenhouse gas (GHG), methane (CH 4 ), and nitrous oxide (N 2 O) emissions while water resource decreases carbon dioxide (CO 2 ), fossil fuel, and CH 4 emissions in a region. Energy efficiency improves air quality indicators while industry value added increases CO 2 emissions, fossil fuel energy, and GHG emissions. Global financial crisis increases the risk of climate change across countries. The study concludes that although SSA countries strive hard to take some "good" initiatives to reduce environmental degradation in a form of improved water and energy sources, however, due to lack of optimal utilization of food resources and global financial constraints, it leads to "the bad" and "the ugly" sustainability reforms in a region.

Chemical Safety for Sustainability Research Action Plan 2012-2016

EPA Pesticide Factsheets

EPA’s Chemical Safety for Sustainability (CSS) research program presents the purpose, design and themes of the Agency’s CSS research efforts to ensure safety in the design, manufacture and use of existing and future chemicals

Economic Woes May Hurt Colleges' Green Efforts

ERIC Educational Resources Information Center

Carlson, Scott

2008-01-01

Recent events on Wall Street raise a complicated question: Will the financial crisis help or hurt colleges' sustainability efforts? Both are possible. In this article, the author discusses how the Wall Street meltdown may hurt colleges' green initiatives. However, advocates of sustainability see an opportunity to change the conversation. A…

Implementing and Sustaining School-Located Influenza Vaccination Programs: Perspectives from Five Diverse School Districts

ERIC Educational Resources Information Center

Wilson, Dulmini; Sanchez, Kathleen M.; Blackwell, Susan H.; Weinstein, Eva; El Amin, A. Nelson

2013-01-01

Local health departments have typically led school-located influenza vaccination (SLIV) programs, assuming resource-intensive roles in design, coordination, and vaccination. This level of involvement is often not financially sustainable over time. Five diverse school districts in Los Angeles County designed, implemented, refined, and…

Tracking Environmental Sustainability Performance of Public Universities in Kenya

ERIC Educational Resources Information Center

Mungai, David N.

2017-01-01

Environmental Sustainability Performance Contract (PC) targets were introduced in the 2012/13 financial year as part of the broader public sector reforms and a strategy for performance improvement in the public service that includes Kenyan public universities. However, no evaluation has been conducted to assess performance improvement and impact.…

Using FTE and RVU performance measures to assess financial viability of academic nurse-managed centers.

PubMed

Vonderheid, Susan; Pohl, Joanne; Schafer, Patricia; Forrest, Kathy; Poole, Michele; Barkauskas, Violet; Mackey, Thomas A

2004-01-01

Financial performance measures are essential to improve the fiscal management of academic nurse-managed centers (ANMCs). Measures are compared among six ANMCs in a consortium and against an external, self-sustainable, profitable ANMC and national data for family practice physicians. Performance measures help identify a center's strengths and weaknesses facilitating the development of strategies aimed at a variety of targets (business practices related to revenue and costs) to improve financial viability. Using a variety of financial performance measures to inform decision making will aid ANMCs in keeping their doors open for business.

Standardization by ISO to Ensure the Sustainability of Space Activities

NASA Astrophysics Data System (ADS)

Kato, A.; Lazare, B.; Oltrogge, D.; Stokes, H.

2013-08-01

The ISO / Technical Committee 20 / Sub-committee 14 develops debris-related standards and technical reports to mitigate debris and help ensure mission and space sustainability. While UN Guidelines and the IADC Guidelines encourage national governments and agencies to promote debris mitigation design and operation, the ISO standards will help the global space industry promote and sustain its space-related business. In this paper the scope and status of each ISO standard is discussed within an overall framework. A comparison with international guidelines is also provided to demonstrate the level of consistency. Finally, as a case study, the ISO standards are applied to a CubeSat mission, thus demonstrating their usability on a relatively recent and popular class of satellite.

Putting solid household waste to sustainable use: a case study in the city of Rio de Janeiro, Brazil.

PubMed

Carvalho, Márcia da Silva; Rosa, Luiz Pinguelli; Bufoni, André Luiz; Oliveira, Luciano Basto

2012-12-01

The management of solid residues has, in recent decades, been a source of concern for public administrators the world over. Experiments in the sustainable use of such residues are highly relevant in social and environmental terms, stimulating widespread interest and debate, with considerable research going into sustainability projects. In many areas, however, adequate public funding for sustainable-use projects is hard to come by. One of the major reasons for this is that public authorities, particularly in times of financial constraints, are reluctant to invest in undertakings in which the economic returns are difficult to quantify. Official scrutiny of the expenditures of public authorities is also normally heavily influenced by cost-benefit analyses. The specific objective of this article is to show that putting solid domestic residue (household solid waste) to sustainable use is capable of generating economic returns, as well as environmental benefits for society as a whole. These economic returns can be set out in financial statements, which may, in turn, be used to justify expenditures by public authorities on sustainable-use projects and as a basis for further investment in such incentives. We drew on the findings of existing research into sustainable use, undertaken by the Municipal Urban Cleaning Company in the city of Rio de Janeiro, Brazil, to establish a conceptual framework for setting out the economic results of the collection of household solid waste.

Sustainability considerations for integrated biorefineries.

PubMed

Azapagic, Adisa

2014-01-01

Integrated biorefineries have the potential to contribute towards sustainable production of transportation fuels, energy, and chemicals. However, because there are currently no commercial biorefining plants in operation, it is not clear how sustainable they really are. This paper sets out to examine key issues associated with biorefining that should be considered carefully along the whole supply chain to ensure sustainable development of the sector. Copyright © 2013 Elsevier Ltd. All rights reserved.

Design and Implementation of Green Construction Scheme for a High-rise Residential Building Project

NASA Astrophysics Data System (ADS)

Zhou, Yong; Huang, You Zhen

2018-06-01

This paper mainly studies the green construction scheme of a high-rise residential building project. From "four sections one environmental protection", saving material, water saving, energy saving, economical use of land and environmental protection conduct analysis and research. Adopting scientific, advanced, reasonable and economical construction technology measures, implementing green construction method. Promoting energy-saving technologies in buildings, ensuring the sustainable use of resources, Maximum savings of resources and energy, increase energy efficiency, to reduce pollution, reducing the adverse environmental impact of construction activities, ensure construction safety, build sustainable buildings.

Making the Case for Using Financial Indicators in Local Public Health Agencies

PubMed Central

Suarez, Virginia; Denison, Dwight

2011-01-01

The strength of the public health infrastructure determines the ability of local public health agencies to respond to emergencies and provide essential services. Organizational and systems capacity measures and assessments are important components of the public health infrastructure. Hospitals and governments have a long tradition of using financial indicators to assess fiscal and operational activities. We reviewed the literature on how hospitals use financial indicators to monitor financial risk, promote organizational sustainability, and improve organizational capacity. Given that financial indicators have not generally been employed by public health practitioners, we discuss how these measures can be applied to local public health agencies to improve their organizational capacity. PMID:21233438

Seaweeds: an opportunity for wealth and sustainable livelihood for coastal communities.

PubMed

Rebours, Céline; Marinho-Soriano, Eliane; Zertuche-González, José A; Hayashi, Leila; Vásquez, Julio A; Kradolfer, Paul; Soriano, Gonzalo; Ugarte, Raul; Abreu, Maria Helena; Bay-Larsen, Ingrid; Hovelsrud, Grete; Rødven, Rolf; Robledo, Daniel

2014-01-01

The European, Canadian, and Latin American seaweed industries rely on the sustainable harvesting of natural resources. As several countries wish to increase their activity, the harvest should be managed according to integrated and participatory governance regimes to ensure production within a long-term perspective. Development of regulations and directives enabling the sustainable exploitation of natural resources must therefore be brought to the national and international political agenda in order to ensure environmental, social, and economic values in the coastal areas around the world. In Europe, Portugal requires an appraisal of seaweed management plans while Norway and Canada have developed and implemented coastal management plans including well-established and sustainable exploitation of their natural seaweed resources. Whereas, in Latin America, different scenarios of seaweed exploitation can be observed; each country is however in need of long-term and ecosystem-based management plans to ensure that exploitation is sustainable. These plans are required particularly in Peru and Brazil, while Chile has succeeded in establishing a sustainable seaweed-harvesting plan for most of the economically important seaweeds. Furthermore, in both Europe and Latin America, seaweed aquaculture is at its infancy and development will have to overcome numerous challenges at different levels (i.e., technology, biology, policy). Thus, there is a need for regulations and establishment of "best practices" for seaweed harvesting, management, and cultivation. Trained human resources will also be required to provide information and education to the communities involved, to enable seaweed utilization to become a profitable business and provide better income opportunities to coastal communities.

Constructing Education for Sustainable Development: The Secondary School Geography Curriculum and Initial Teacher Training

ERIC Educational Resources Information Center

Firth, Roger; Winter, Christine

2007-01-01

If education is a solution in working toward a sustainable future then initial teacher training (ITT) provides a strategic opportunity for ensuring that all teachers are able to teach for sustainability when they begin their teaching careers. This paper reports on a study of how four Postgraduate Certificate of Education (PGCE) student teachers…

Re-Examining the Importance of Indigenous Perspectives in the Western Environmental Education for Sustainability: "From Tribal to Mainstream Education"

ERIC Educational Resources Information Center

Chandra, Doreen Vikashni

2014-01-01

This paper highlights the importance of integrating indigenous perspectives on environmental sustainability into mainstream education as a way of bridging the gap in the understanding of indigenous knowledge systems into Western science explanations of sustainable development (SD) in education, at the same time ensuring traditional ecological…

Soil and Water Indicators of the Sustainable Rangelands Roundtable

Treesearch

M.G. Sherm Karl; D.A. Pyke; P.T. Tueller; G.E. Schuman; R.W. Shafer; S.J. Borchard; D.T. Booth; W.G. Ypsilantis; R.H. Jr. Barrett

2006-01-01

The Sustainable Rangelands Roundtable (SRR) has explicitly included conservation and maintenance of soil and water resources as a criterion, a category of conditions or processes that can be assessed nationally to determine if the current level of rangeland management will ensure sustainability. Within the soil/water criterion, 10 indicators, 5 soil-based and 5 water-...

Chemical Safety for Sustainability: Research Action Plan

EPA Pesticide Factsheets

The Strategic Research Action Plan for EPA’s Chemical Safety for Sustainability research program presents the purpose, design and themes of the Agency’s research efforts to ensure safety in the design, manufacture and use of existing and future chemicals.

20 CFR 667.275 - What are a recipient's obligations to ensure nondiscrimination and equal opportunity, and what...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What are a recipient's obligations to ensure... administered and enforced by the DOL Civil Rights Center. (3) As described in § 667.260(a), financial... religious worship are described at 29 CFR 37.6(f)(2). See section 188(a)(3) of the Workforce Investment Act...

Theorizing Strategic Human Resource Development: Linking Financial Performance and Sustainable Competitive Advantage

ERIC Educational Resources Information Center

Hu, Po

2007-01-01

This paper is to explore potential new underlying theory of strategic human resource development based on critiques of current theoretical foundations of HRD. It offers a new definition and model of Strategic HRD based on resource-based view of firm and human resource, with linkage to financial performance and competitiveness. Proposed new model…

Reinventing Financial Aid: Charting a New Course to College Affordability

ERIC Educational Resources Information Center

Kelly, Andrew P., Ed.; Goldrick-Rab, Sara, Ed.

2014-01-01

In this provocative volume, two experts with very different points of view address the growing concern that student loan programs are not a sustainable solution to the problem of mounting college costs. They argue that the time has come to reform the financial aid system so that it is more effective in promoting college affordability, access, and…

7 CFR 1717.161 - Application process.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Consolidations of Electric Borrowers § 1717.161 Application process. (a) Borrowers are responsible for ensuring... proposed merger is likely to: (1) Contribute to greater operating efficiency and financial soundness; (2...

Clinical care & finance: can this marriage be saved?

PubMed

Craig, Teresa R

2003-11-01

Financial staff and clinical staff do not necessarily see eye-to-eye. However, mutual understanding of one another's areas of expertise is essential to the success of a hospice. Financial and clinical staff can work together to streamline employee reporting, such as on time sheets and during annual reviews, to ensure that important data is being collected and staff don't waste time reporting on and analyzing extraneous data.

The dynamic model of enterprise revenue management

NASA Astrophysics Data System (ADS)

Mitsel, A. A.; Kataev, M. Yu; Kozlov, S. V.; Korepanov, K. V.

2017-01-01

The article presents the dynamic model of enterprise revenue management. This model is based on the quadratic criterion and linear control law. The model is founded on multiple regression that links revenues with the financial performance of the enterprise. As a result, optimal management is obtained so as to provide the given enterprise revenue, namely, the values of financial indicators that ensure the planned profit of the organization are acquired.

On emissions trading, toxic debt and the Australian power market

DOE Office of Scientific and Technical Information (OSTI.GOV)

Simshauser, Paul

2009-03-15

Implementation of emissions trading will have profound effects on the financial stability of coal generators. While the impact on equity capital is well understood, the potential fallout in the market for project finance is not. During the current global financial crisis, the form and quantum of transitional assistance to coal generators will be crucial to ensure ongoing participation of domestic and foreign project banks in the power markets. (author)

Costs to Community Mental Health Agencies to Sustain an Evidence-Based Practice.

PubMed

Roundfield, Katrina D; Lang, Jason M

2017-09-01

Dissemination of evidence-based practices (EBPs) has become a priority in children's mental health services. Although implementation approaches and initiatives are proliferating, little is known about sustainment of EBPs, but evidence suggests that most EBPs are not sustained for more than a few years. Cost is the most frequently cited barrier to sustainment, yet very little is known about these costs. This study provides a method for quantifying incremental costs of an EBP compared with usual care and preliminary data on the costs in staff time, lost revenue, and other expenses of sustaining an EBP (trauma-focused cognitive-behavioral therapy [TF-CBT]) in community mental health settings. Fourteen community mental health agencies (CMHAs) completed a measure developed for this study to collect administrative data on implementation costs to sustain TF-CBT. Survey items captured activities that were related specifically to TF-CBT and that would not otherwise be conducted for usual care, such as TF-CBT training. Staff time in hours was converted to monetary estimates. Costs varied widely across agencies. Preliminary results indicated that agencies spent on average $65,192 per year (2014 U.S.$) on incremental costs for TF-CBT sustainment (excluding costs of external trainers and other support); the average incremental cost per client was $1,896. The costs to sustain the EBP suggest that maintaining an EBP is a financial burden for CMHAs and that these costs can be a potential barrier to broader EBP uptake. Implications for public policy include providing reimbursement rates and financial incentives to offset potential implementation costs and promote sustainment of EBPs.

Effect of the Medicare Prescription Drug Improvement and Modernization Act on the bottom line.

PubMed

Jarrett, Anne T

2006-11-01

An historical perspective on the impact of the Medicare Prescription Drug Improvement and Modernization Act (MMA) on pharmaceutical reimbursement, and the financial bottom line at health systems and various strategies to use in the inpatient and outpatient setting to improve the bottom line are described. Implementation of MMA has affected the entire healthcare continuum by reducing pharmaceutical reimbursement rates and health system revenues and increasing prescription drug copayments, emergency department visits, and hospital admissions. Physician-owned clinics are less profitable than in the past because of MMA, which may prompt clinic closures and shift the patient care burden to clinics at public hospitals. Negotiating carve-outs for costly drugs and evaluating the feasibility of obtaining outlier payments can improve the bottom line in the hospital inpatient setting. Ensuring that billing codes are accurate and verifying that reimbursement was received can help minimize the impact of MMA on the financial bottom line in the outpatient setting. Negotiating favorable purchasing contracts and ensuring that drugs are used appropriately by following evidence-based guidelines can improve the financial bottom line in both the inpatient and outpatient settings. Strategies to decrease drug acquisition costs and increase reimbursement rates can help minimize the adverse impact of MMA on the financial bottom line at health systems.

Financial burden for tuberculosis patients in low- and middle-income countries: a systematic review

PubMed Central

Tanimura, Tadayuki; Jaramillo, Ernesto; Weil, Diana; Raviglione, Mario; Lönnroth, Knut

2014-01-01

In order to inform the development of appropriate strategies to improve financial risk protection, we conducted a systematic literature review of the financial burden of tuberculosis (TB) faced by patients and affected families. The mean total costs ranged from $55 to $8198, with an unweighted average of $847. On average, 20% (range 0–62%) of the total cost was due to direct medical costs, 20% (0–84%) to direct non-medical costs, and 60% (16–94%) to income loss. Half of the total cost was incurred before TB treatment. On average, the total cost was equivalent to 58% (range 5–306%) of reported annual individual and 39% (4–148%) of reported household income. Cost as percentage of income was particularly high among poor people and those with multidrug-resistant TB. Commonly reported coping mechanisms included taking a loan and selling household items. The total cost of TB for patients can be catastrophic. Income loss often constitutes the largest financial risk for patients. Apart from ensuring that healthcare services are fairly financed and delivered in a way that minimises direct and indirect costs, there is a need to ensure that TB patients and affected families receive appropriate income replacement and other social protection interventions. PMID:24525439

Financial burden for tuberculosis patients in low- and middle-income countries: a systematic review.

PubMed

Tanimura, Tadayuki; Jaramillo, Ernesto; Weil, Diana; Raviglione, Mario; Lönnroth, Knut

2014-06-01

In order to inform the development of appropriate strategies to improve financial risk protection, we conducted a systematic literature review of the financial burden of tuberculosis (TB) faced by patients and affected families. The mean total costs ranged from $55 to $8198, with an unweighted average of $847. On average, 20% (range 0-62%) of the total cost was due to direct medical costs, 20% (0-84%) to direct non-medical costs, and 60% (16-94%) to income loss. Half of the total cost was incurred before TB treatment. On average, the total cost was equivalent to 58% (range 5-306%) of reported annual individual and 39% (4-148%) of reported household income. Cost as percentage of income was particularly high among poor people and those with multidrug-resistant TB. Commonly reported coping mechanisms included taking a loan and selling household items. The total cost of TB for patients can be catastrophic. Income loss often constitutes the largest financial risk for patients. Apart from ensuring that healthcare services are fairly financed and delivered in a way that minimises direct and indirect costs, there is a need to ensure that TB patients and affected families receive appropriate income replacement and other social protection interventions. ©ERS 2014.

Overview of methods in economic analyses of behavioral interventions to promote oral health

PubMed Central

O’Connell, Joan M.; Griffin, Susan

2016-01-01

Background Broad adoption of interventions that prove effective in randomized clinical trials or comparative effectiveness research may depend to a great extent on their costs and cost-effectiveness (CE). Many studies of behavioral health interventions for oral health promotion and disease prevention lack robust economic assessments of costs and CE. Objective To describe methodologies employed to assess intervention costs, potential savings, net costs, CE, and the financial sustainability of behavioral health interventions to promote oral health. Methods We provide an overview of terminology and strategies for conducting economic evaluations of behavioral interventions to improve oral health based on the recommendations of the Panel of Cost-Effectiveness in Health and Medicine. To illustrate these approaches, we summarize methodologies and findings from a limited number of published studies. The strategies include methods for assessing intervention costs, potential savings, net costs, CE, and financial sustainability from various perspectives (e.g., health-care provider, health system, health payer, employer, society). Statistical methods for estimating short-term and long-term economic outcomes and for examining the sensitivity of economic outcomes to cost parameters are described. Discussion Through the use of established protocols for evaluating costs and savings, it is possible to assess and compare intervention costs, net costs, CE, and financial sustainability. The addition of economic outcomes to outcomes reflecting effectiveness, appropriateness, acceptability, and organizational sustainability strengthens evaluations of oral health interventions and increases the potential that those found to be successful in research settings will be disseminated more broadly. PMID:21656966

Overview of methods in economic analyses of behavioral interventions to promote oral health.

PubMed

O'Connell, Joan M; Griffin, Susan

2011-01-01

Broad adoption of interventions that prove effective in randomized clinical trials or comparative effectiveness research may depend to a great extent on their costs and cost-effectiveness (CE). Many studies of behavioral health interventions for oral health promotion and disease prevention lack robust economic assessments of costs and CE. To describe methodologies employed to assess intervention costs, potential savings, net costs, CE, and the financial sustainability of behavioral health interventions to promote oral health. We provide an overview of terminology and strategies for conducting economic evaluations of behavioral interventions to improve oral health based on the recommendations of the Panel of Cost-Effectiveness in Health and Medicine. To illustrate these approaches, we summarize methodologies and findings from a limited number of published studies. The strategies include methods for assessing intervention costs, potential savings, net costs, CE, and financial sustainability from various perspectives (e.g., health-care provider, health system, health payer, employer, society). Statistical methods for estimating short-term and long-term economic outcomes and for examining the sensitivity of economic outcomes to cost parameters are described. Through the use of established protocols for evaluating costs and savings, it is possible to assess and compare intervention costs, net costs, CE, and financial sustainability. The addition of economic outcomes to outcomes reflecting effectiveness, appropriateness, acceptability, and organizational sustainability strengthens evaluations of oral health interventions and increases the potential that those found to be successful in research settings will be disseminated more broadly.

Economic values and corporate financial statements.

PubMed

Magness, Vanessa

2003-07-01

Corporate financial statements do not include environmental values. This deficiency has contributed to the criticism that company managers do not include environmental impacts in the internal decision-making process. The accounting profession has not developed effective environmental reporting guidelines. This situation contributes to a second problem: the apparent inability of corporate reports to provide useful information to external parties. It has been suggested that by using nonmarket valuation methodologies, financial statements can be used to measure progress toward sustainable development. Nonmarket valuations are not generally accepted by the accounting profession. They are too subjective to support effective decisions, and too costly to obtain. Furthermore, demand for this sort of information appears small. Some of these issues may be resolved over time. The most serious challenge, however, concerns how enhanced financial reports would be used. Financial statements are supposed to help investors assess the amount, timing, and uncertainty of future cash flows. A substantial portion of environmental value is based on nonuse benefits, much of which will never be realized in company cash flows. In other words, the role of financial statements would have to change. Furthermore, since there is no general agreement as to the meaning of "sustainable development," efforts to operationalize the term have been fraught with difficulty. Moreover, monetization of environmental values could jeopardize their preservation, leaving some to question the overall objective of this form of reporting. For these reasons, while it is to be hoped that better reporting of environmental impacts will be forthcoming, the greatest advances will likely be outside the financial statements themselves.

Physicians' early perspectives on Oregon's Coordinated Care Organizations.

PubMed

Stock, Ronald; Hall, Jennifer; Chang, Anna Marie; Cohen, Deborah

2016-06-01

Through development of Coordinated Care Organizations (CCOs), Oregon's version of the Accountable Care Organization (ACO) for Medicaid beneficiaries, Oregon is redesigning the healthcare system delivering care to some of its most vulnerable citizens. While clinicians are central to healthcare transformation, little is known about the impact on their role. The aim of this study was to understand the current and perceived effect CCO-related changes have on Oregon physicians' professional and personal lives. This qualitative observational study involved semi-structured interviews, conducted between March and October, 2013, of twenty-two purposively selected physicians who varied in years of practice, gender, employment status, specialty, and geographic location from three different CCOs. A grounded theory approach was used to analyze data. Physicians expressed uncertainty and ambiguity about the CCO model, reporting minor financial changes in the first year, but anticipating future reimbursement changes; new team-based care roles and responsibilities, accountability for quality incentive measures; and effects of CCO implementation on their personal lives. To meet CCO model changes and requirements, physicians requested collegial networking, team-based care training, and data system and information technology support for undergoing health system transformation. Although perhaps not immediate, healthcare reform can have a real and perceived impact on physicians' professional and personal lives. Attention to the impact of healthcare reform on physicians' personal and professional lives is important to ensure strategies are implemented to maintain a viable workforce, professional satisfaction, financial sustainability, and quality of care. Copyright © 2015 Elsevier Inc. All rights reserved.

How shall we examine and learn about public-private partnerships (PPPs) in the health sector? Realist evaluation of PPPs in Hong Kong.

PubMed

Wong, Eliza L Y; Yeoh, Eng-Kiong; Chau, Patsy Y K; Yam, Carrie H K; Cheung, Annie W L; Fung, Hong

2015-12-01

The World Health Organization advocates the goal of universal coverage of health systems to ensure that everyone can avail the services they need and are protected from the associated financial risks. Governments are increasingly engaging and interacting with the private sector in initiatives collectively referred to as public-private partnerships (PPPs) to enhance the capacity of health systems to meet this objective. Understanding the values that motivate partners and demonstrating commitment for building relationships were found to be key lessons in building effective PPPs; however there, remain many research gaps. This study focusses on the practice of PPPs at the inter-organisational (meso) level and interpersonal (micro) level in Hong Kong Special Administrative Region (HKSAR). The influence of the structural components of different PPPs on stakeholder interpretation and actions, as well as the eventual outcomes of the PPPs, is examined, in terms of a realist evaluation, which applies a context-mechanism-outcome configuration as the research methodology. Seven key factors initiating commitment in a partnership, critical for sustainable PPPs, were identified as follows: (1) building of trust; (2) clearly defined objectives and roles; (3) time commitment; (4) transparency and candid information, particularly in relation to risk and benefit; (5) contract flexibility; (6) technical assistance or financial incentive behind procedural arrangements; and (7) the awareness and acceptability of structural changes related to responsibility and decisions (power and authority). Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Conducting financial due diligence of medical practices.

PubMed

Louiselle, P

1995-12-01

Many healthcare organizations are acquiring medical practices in an effort to build more integrated systems of healthcare products and services. This acquisition activity must be approached cautiously to ensure that medical practices being acquired do not have deficiencies that would jeopardize integration efforts. Conducting a thorough due diligence analysis of medical practices before finalizing the transaction can limit the acquiring organizations' legal and financial exposure and is a necessary component to the acquisition process. The author discusses the components of a successful financial due diligence analysis and addresses some of the risk factors in a practice acquisition.

Designing Sustainable Supply Chains for Biofuels

EPA Science Inventory

Driven by the Energy and Independence Act of 2007 mandate to increase production of alternative fuels and to ensure that this increase causes minimal environmental impact, a project to design sustainable biofuel supply chains has been developed. This effort uses life cycle asses...

Sustainable System Management with Fisher Information based Objectives

EPA Science Inventory

Sustainable ecosystem management that integrates ecological, economic and social perspectives is a complex task where simultaneous persistence of human and natural components of the system must be ensured. Given the complexity of this task, systems theory approaches based on soun...

Education for Sustainable Development: Enhancing Climate Change Adaptation Expertise in Developing Countries

ERIC Educational Resources Information Center

Fahey, Shireen; Verstraten, Luke; Berry, Ashton J.

2016-01-01

This article presents the results of an innovative education capacity assessment and delivery project to promote sustainable development in large ocean states in the Western Indian Ocean (WIO) region. Science education can help prepare the present and coming generations for stability in an uncertain future. Limited financial, geographical and…

Sustaining Higher Education Reforms: Knowledge and Policy Implications Learned from Thailand

ERIC Educational Resources Information Center

Phusavat, Kongkiti; Ketsarapong, Suphattra; Ooi, Keng-Boon; Shyu, Stacy H.P.

2012-01-01

Purpose: The paper aims to share experiences in Thailand's higher educational reforms in which academic excellence cannot be sustained without proper financial and fiscal consideration. The overall goal is to disclose the experiences and future issues facing public universities. Design/methodology/approach: The paper is based on actual involvement…

The Independent School Financial Model--Is It Sustainable?

ERIC Educational Resources Information Center

Lourie, David

2016-01-01

Almost seven years removed, the Great Recession still looms large in the minds of independent school trustees and administrators. While not producing many positives in the lives of our schools and the nation's economy, it did instigate important and long overdue questions and discussions about the long-term sustainability of the so-called…

Community forestry enterprises in Mexico: sustainability and competitiveness

Treesearch

Frederick W. Cubbage; Robert R. Davis; Diana Rodriguez Paredes; Ramon Mollenhauer; Yoanna Kraus Elsin; Gregory E. Frey; Ignacio A. Gonzalez Hernandez; Humberto Albarran Hurtado; Anita Mercedes Salazar Cruz; Diana Nacibe Chemor Salas

2015-01-01

Community-based forest management such as Community Forests Enterprises (CFEs), has potential to generate positive socio-environmental and economic outcomes. We performed a detailed survey of financial and production parameters for 30 of the approximately 992 CFEs in Mexico in order to estimate costs, income, profits and sustainability, but only two of these had...

Implementing Sustainable Data Collection for a Cardiac Outcomes Registry in an Australian Public Hospital.

PubMed

Cox, Nicholas; Brennan, Angela; Dinh, Diem; Brien, Rita; Cowie, Kath; Stub, Dion; Reid, Christopher M; Lefkovits, Jeffrey

2018-04-01

Clinical outcome registries are an increasingly vital component of ensuring quality and safety of patient care. However, Australian hospitals rarely have additional resources or the capacity to fund the additional staff time to complete the task of data collection and entry. At the same time, registry funding models do not support staff for the collection of data at the site but are directed towards the central registry tasks of data reporting, managing and quality monitoring. The sustainability of a registry is contingent on building efficiencies into data management and collection. We describe the methods used in a large Victorian public hospital to develop a sustainable data collection system for the Victorian Cardiac Outcomes Registry (VCOR), using existing staff and resources common to many public hospitals. We describe the features of the registry and the hospital specific strategies that allowed us to do this as part of our routine business of providing good quality cardiac care. All clinical staff involved in patient care were given some data collection task with the entry of these data embedded into the staff's daily workflow. A senior cardiology registrar was empowered to allocate data entry tasks to colleagues when data were found to be incomplete. The task of 30-day follow-up proved the most onerous part of data collection. Cath-lab nursing staff were allocated this role. With hospital accreditation and funding models moving towards performance based quality indicators, collection of accurate and reliable information is crucial. Our experience demonstrates the successful implementation of clinical outcome registry data collection in a financially constrained public hospital environment utilising existing resources. Copyright © 2017. Published by Elsevier B.V.

Set-up of a decision support system to support sustainable development of the Laguna de Bay, Philippines.

PubMed

Nauta, Tjitte A; Bongco, Alicia E; Santos-Borja, Adelina C

2003-01-01

Over recent decades, population expansion, deforestation, land conversion, urbanisation, intense fisheries and industrialisation have produced massive changes in the Laguna de Bay catchment, Philippines. The resulting problems include rapid siltation of the lake, eutrophication, inputs of toxics, flooding problems and loss of biodiversity. Rational and systematic resolution of conflicting water use and water allocation interests is now urgently needed in order to ensure sustainable use of the water resources. With respect to the competing and conflicting pressures on the water resources, the Laguna Lake Development Authority (LLDA) needs to achieve comprehensive management and development of the area. In view of these problems and needs, the Government of the Netherlands was funding a two-year project entitled 'Sustainable Development of the Laguna de Bay Environment'.A comprehensive tool has been developed to support decision-making at catchment level. This consists of an ArcView GIS-database linked to a state-of-the-art modelling suite, including hydrological and waste load models for the catchment area and a three-dimensional hydrodynamic and water quality model (Delft3D) linked to a habitat evaluation module for the lake. In addition, MS Office based tools to support a stakeholder analysis and financial and economic assessments have been developed. The project also focused on technical studies relating to dredging, drinking water supply and infrastructure works. These aimed to produce technically and economically feasible solutions to water quantity and quality problems. The paper also presents the findings of a study on the development of polder islands in the Laguna de Bay, addressing the water quantity and quality problems and focusing on the application of the decision support system.

Mainstreaming nutrition into maternal and child health programmes: scaling up of exclusive breastfeeding.

PubMed

Bhandari, Nita; Kabir, A K M Iqbal; Salam, Mohammed Abdus

2008-04-01

Interventions to promote exclusive breastfeeding have been estimated to have the potential to prevent 13% of all under-5 deaths in developing countries and are the single most important preventive intervention against child mortality. According to World Health Organization and United Nations Children Funds (UNICEF), only 39% infants are exclusively breastfed for less than 4 months. This review examines programme efforts to scale up exclusive breastfeeding in different countries and draws lesson for successful scale-up. Opportunities and challenges in scaling up of exclusive breastfeeding into Maternal and Child Health programmes are identified. The key processes required for exclusive breastfeeding scale-up are: (1) an evidence-based policy and science-driven technical guidelines; and (2) an implementation strategy and plan for achieving high exclusive breastfeeding rates in all strata of society, on a sustainable basis. Factors related to success include political will, strong advocacy, enabling policies, well-defined short- and long-term programme strategy, sustained financial support, clear definition of roles of multiple stakeholders and emphasis on delivery at the community level. Effective use of antenatal, birth and post-natal contacts at homes and through community mobilization efforts is emphasized. Formative research to ensure appropriate intervention design and delivery is critical particularly in areas with high HIV prevalence. Strong communication strategy and support, quality trainers and training contributed significantly to programme success. Monitoring and evaluation with feedback systems that allow for periodic programme corrections and continued innovation are central to very high coverage. Legal framework must make it possible for mothers to exclusively breastfeed for at least 4 months. Sustained programme efforts are critical to achieve high coverage and this requires strong national- and state-level leadership.

Quality use of medicine in a developing economy: Measures to overcome challenges in the Malaysian healthcare system.

PubMed

Mohd-Tahir, Nurul-Ain; Paraidathathu, Thomas; Li, Shu-Chuen

2015-01-01

Malaysia inherits a highly subsidized tax-based public healthcare system complemented by a fee-for-service private sector. Population health in Malaysia has considerably improved since independence using a relatively small amount of gross domestic product (~4%). Brain drain of highly specialized personnel, growth in healthcare spending, demographic and disease pattern changes and increase in patients' demands and expectations towards better medical care are exerting pressure on the sustainability of the system to continuously provide efficient and effective services at relatively low cost. Malaysia has adopted and implemented some of the quality use of medicine concepts such as National Essential Medicine List, health technology assessment and promotion of generic medicines in their health policy, but so far the results may not be optimal. Activities to further promote these strategies are needed for successful implementation to achieve more positive and sustained beneficial outcomes. Better strategic planning, management and collaboration between various stakeholders, considering the needs and barriers of the strategies, are important to ensure effective implementation of the strategies. More emphasis should be placed upon more equitable and rational distribution of healthcare resources to cater for rapid urbanization. Additionally, a sustainable health financing structure that is more progressive and does not encourage moral hazard should be established. In conclusion, Malaysia has achieved good outcomes in population health with relatively low financial inputs since independence. However, changes in the overall environment have created issues which would threaten the long-term viability of the healthcare system if not tackled properly. The numbers of internationally trialled strategies could be used to deal with these challenges. In addition, coordinated implementation of these strategies and effective engagement and communication between various stakeholders are necessary to further strengthen the Malaysian healthcare system effectively.

Quality use of medicine in a developing economy: Measures to overcome challenges in the Malaysian healthcare system

PubMed Central

Mohd-Tahir, Nurul-Ain; Paraidathathu, Thomas

2015-01-01

Malaysia inherits a highly subsidized tax-based public healthcare system complemented by a fee-for-service private sector. Population health in Malaysia has considerably improved since independence using a relatively small amount of gross domestic product (~4%). Brain drain of highly specialized personnel, growth in healthcare spending, demographic and disease pattern changes and increase in patients’ demands and expectations towards better medical care are exerting pressure on the sustainability of the system to continuously provide efficient and effective services at relatively low cost. Malaysia has adopted and implemented some of the quality use of medicine concepts such as National Essential Medicine List, health technology assessment and promotion of generic medicines in their health policy, but so far the results may not be optimal. Activities to further promote these strategies are needed for successful implementation to achieve more positive and sustained beneficial outcomes. Better strategic planning, management and collaboration between various stakeholders, considering the needs and barriers of the strategies, are important to ensure effective implementation of the strategies. More emphasis should be placed upon more equitable and rational distribution of healthcare resources to cater for rapid urbanization. Additionally, a sustainable health financing structure that is more progressive and does not encourage moral hazard should be established. In conclusion, Malaysia has achieved good outcomes in population health with relatively low financial inputs since independence. However, changes in the overall environment have created issues which would threaten the long-term viability of the healthcare system if not tackled properly. The numbers of internationally trialled strategies could be used to deal with these challenges. In addition, coordinated implementation of these strategies and effective engagement and communication between various stakeholders are necessary to further strengthen the Malaysian healthcare system effectively. PMID:26770795

24 CFR 248.201 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... cash or assets for subsequent withdrawal, and excluding repayment of advances made for reasonable and... long-range planning by the board of directors to ensure the physical, financial and social viability of...

Towards sustainable traumatic brain injury care systems: healthcare leadership imperatives in Canada.

PubMed

Caro, Denis

2011-01-01

Traumatic brain injuries pose strategic population health challenges in the face of burgeoning clinical demands that continue to tax capital, financial, and social resource capacities. The sustainability of traumatic brain injury care systems depends on paradigmatic shifts in healthcare leadership thinking. In quest for high-performance care and sustained quality of life for traumatic brain injury patients, this article presents a unique paradigm of seven care performance layers and seven health leadership imperatives that together form the paradigm for the systemic sustainability of TBI care systems of the future.

Livestock vaccination in India: an analysis of theory and practice among multiple stakeholders.

PubMed

Rathod, P; Chander, M; Bangar, Y

2016-12-01

An effective and efficient disease prevention and control strategy is of paramount importance to improve the quality and quantity of livestock production in the Indian context. Although livestock vaccination is considered an emerging innovation of socioeconomic importance in the Indian dairy industry, the rate of adoption and diffusion of vaccination technology is very low at field level. In this context, the authors examined the efforts of the Government of India to protect livestock health and control disease, considered the lessons learnt from rinderpest eradication, looked at field practices and the reality on the ground, and studied the perceptions of multiple stakeholders with regards to the relevance, profitability and sustainability of vaccination. In this study, the authors consider policy implications for the Indian dairy industry using the responses of 360 dairy farmers, 80 research scientists and 40 extension workers in India. The study revealed that scientists and extension experts rated vaccination highly in terms of its relevance, profitability and sustainability, while the perception of farmers was less favourable. The study also observed that, even after implementation of various disease control programmes with heavy financial expenditure, there was a wide gap between farmers and scientists and between farmers and extension workers with regards to their perceptions of the relevance, profitability and sustainability of vaccination, while the gap was very narrow between scientists and extension workers. It can be concluded, therefore, that there is a need to generate innovations for disease control that are perceived as relevant, profitable and sustainable so as to encourage higher levels of diffusion and adoption at field level. This study recommends that farmers partner with researchers and extension workers to ensure effective generation and transfer of new dairying technologies, leading to higher production and productivity in the Indian dairy sector. © OIE (World Organisation for Animal Health), 2016.

Fostering Inclusive, Sustainable Economic Growth and "Green" Skills Development in Learning Cities through Partnerships

ERIC Educational Resources Information Center

Pavlova, Margarita

2018-01-01

One of the requirements of building a learning city is working to ensure its sustainable development. In 2014, UNESCO developed a framework of the key features of learning cities, at the centre of which there are six pillars or "building blocks" which support sustainable development. This article focuses on the third of these pillars,…

Sustainability in the Architectural Design Studio: A Case Study of Designing On-Campus Academic Staff Housing in Konya and Izmir, Turkey

ERIC Educational Resources Information Center

Bala, Havva Alkan

2010-01-01

It is important to engender a "sustainable" architectural consciousness in the students who will be the next generation architects. In architectural education, design decisions taken during the early phases of the design process play an important role in ensuring concern for the sustainability issue. But, in general, all discussions…

Towards a sustainable framework for computer based health information systems (CHIS) for least developed countries (LDCs).

PubMed

Gordon, Abekah Nkrumah; Hinson, Robert Ebo

2007-01-01

The purpose of this paper is to argue for a theoretical framework by which development of computer based health information systems (CHIS) can be made sustainable. Health Management and promotion thrive on well-articulated CHIS. There are high levels of risk associated with the development of CHIS in the context of least developed countries (LDC), thereby making them unsustainable. This paper is based largely on literature survey on health promotion and information systems. The main factors accounting for the sustainability problem in less developed countries include poor infrastructure, inappropriate donor policies and strategies, poor infrastructure and inadequate human resource capacity. To counter these challenges and to ensure that CHIS deployment in LDCs is sustainable, it is proposed that the activities involved in the implementation of these systems be incorporated into organizational routines. This will ensure and secure the needed resources as well as the relevant support from all stakeholders of the system; on a continuous basis. This paper sets out to look at the issue of CHIS sustainability in LDCs, theoretically explains the factors that account for the sustainability problem and develops a conceptual model based on theoretical literature and existing empirical findings.

To the problem of ensuring stability of activities of construction companies engaged in high-rise building construction

NASA Astrophysics Data System (ADS)

Ivanov, Nikolay; Safe Aldeen, Ahmed

2018-03-01

Recently, more and more attention in scientific literature has been drawn to improving the sustainability of organization. The growth in the volume of high-rise construction in Russia makes the task of assessing and ensuring the sustainability of organizations and enterprises leading this type of construction very relevant. The article considers the approach to assessing the sustainability of the organization's activities in the context of functioning of quality management system (QMS). It puts forward the hypothesis that assessment of sustainability of an organization that has a real and efficient functioning quality management system can be based on the results of assessing the effectiveness of the QMS. The article describes in sufficient detail the sequence of actions to form a list of criteria for assessing the effectiveness of the QMS and sustainability of the organization, and to evaluate both characteristics on the basis of these criteria. For a clear interpretation of the results obtained, the authors use so-called petal diagrams. It suggests an original approach to their creation and analysis. Based on the results of the study, the authors conclude that in order to assess the sustainability of enterprises and organizations analysis of the dynamics of changes in the basic sustainability factors is mandatory.

MAINTENANCE MANAGEMENT ACCOUNTING SYSTEM OF WASTE WATER DISPOSAL SYSTEMS

NASA Astrophysics Data System (ADS)

Hori, Michihiro; Tsuruta, Takashi; Kaito, Kiyoyuki; Kobayashi, Kiyoshi

Sewage works facilities consist of various assets groups. And there are many kinds of financial resources. In order to optimize the maintenance plan, and to secure the stability and sustainability of sewage works management, it is necessary to carry out financial simulation based on the life-cycle cost analysis. Furthermore, it is important to develop management accounting system that is interlinked with the financial accounting system, because many sewage administration bodies have their financial accounting systems as public enterprises. In this paper, a management accounting system, which is designed to provide basic information for asset management of sewage works facilities, is presented. Also the applicability of the management accounting system presented in this paper is examined through financial simulations.

Alternative financial institutions? Sustainability, development, social reproduction, and gender analysis.

PubMed

Kidder, T

1999-08-01

This paper proposes a conceptual framework for alternative financial institutions in Nicaragua. The article includes a discussion on innovative services and policies, which differentiate CARUNA (National Savings and Credit Cooperative ¿Caja Rural¿), and other financial institutions from conventional banks. It further examines theories that have altered the way development practitioners think about the economy, poverty reduction, and the positions of men and women in the society. These theories are the feminist economic theory and alternative development theories. Specific ways to incorporate the concepts of alternative and feminist economic theories in the design of financial institutions include open credit, savings, and remittance mechanisms, and coordinating councils. The gender analysis approach was used to evaluate the design of financial institutions.

Caracteristics of beef cattle operations in the west

USDA-ARS?s Scientific Manuscript database

In 2011, the Beef Checkoff’s U.S. Beef Industry Sustainability Assessment was launched to benchmark environmental, social and economic aspects of beef industry sustainability. The assessment includes data gathered from seven cattle-producing regions across the country to ensure that opportunities un...

Beyond Greening: Strategies for a Sustainable World.

ERIC Educational Resources Information Center

Hart, Stuart L.

1997-01-01

Many companies have accepted their responsibility to do no harm to the environment. In industrialized nations, more companies are realizing that they can reduce pollution and increase profits at the same time. Corporations should lead the way to ensuring a sustainable world. (JOW)

Financial reporting practices: a comprehensive evaluation.

PubMed

Godwin, Norman H; Mueller, Jennifer M

2005-01-01

A distinguishing characteristic of high performance organizations is a strong internal control structure-controls that ensure patient care, compliance with regulations, internal efficiencies, and financial reporting. It is controls on financial reporting that are receiving a great deal of attention under a new law, the Sarbanes-Oxley Act of 2002. Public companies are now required by law to document controls over financial reporting, in order to fully address exposures and the effectiveness of current controls. Though many healthcare organizations are not directly affected by the law, regulatory agencies could follow suit and require similar compliance. In fact, several states have introduced bills that require nonprofit organizations to adhere to portions of the act. This article provides a guide for organizations desiring to stay ahead of the curve.

Japan's long-term care policy for older people: the emergence of innovative "mobilisation" initiatives following the 2005 reforms.

PubMed

Hayashi, Mayumi

2015-04-01

Japan leads the global race for solutions to the increasing long-term care demand from an ageing population. Initial responses in 2000 saw the launch of the public Long-Term Care Insurance (LTCI) system which witnessed an unexpectedly substantial uptake - with doubts raised about financial viability and sustainability. The post-2005 LTCI reform led to the adoption of innovations - including the "mobilisation" of active, older volunteers to support their frailer peers. This strategy, within the wider government's "2025 Vision" to provide total care for the entire older population, sought to secure financial viability and sustainability. Drawing on qualitative in-depth interviews with 21 provider organisations this study will examine three "mobilisation" schemes and identify those factors contributing to overall strengths while acknowledging complexities, diversities and challenges the schemes encountered. Initial literature written by mobilisation proponents may have been overly optimistic: this study seeks to balance such views through providing an understanding and analysis of these mobilisation schemes' realities. The findings will provide insights and suggest more caution to policy-makers intending to promote such schemes - in both Japan and in countries considering doing so. Furthermore, more evaluation is required to obtain evidence to support financial feasibility and sustainability. Copyright © 2015 Elsevier Inc. All rights reserved.

Two decades of reforms. Appraisal of the financial reforms in the Russian public healthcare sector.

PubMed

Gordeev, Vladimir S; Pavlova, Milena; Groot, Wim

2011-10-01

This paper reviews the empirical evidence on the outcomes of the financial reforms in the Russian public healthcare sector. A systematic literature review identified 37 relevant publications that presented empirical evidence on changes in quality, equity, efficiency and sustainability in public healthcare provision due to the Russian public healthcare financial reforms. Evidence suggests that there are substantial inter-regional inequalities across income groups both in terms of financing and access to public healthcare services. There are large efficiency differences between regions, along with inter-regional variations in payment and reimbursement mechanisms. Informal and quasi-formal payments deteriorate access to public healthcare services and undermine the overall financing sustainability. The public healthcare sector is still underfinanced, although the implementation of health insurance gave some premises for future increases of efficiency. Overall, the available empirical data are not sufficient for an evidence-based evaluation of the reforms. More studies on the quality, equity, efficiency and sustainability impact of the reforms are needed. Future reforms should focus on the implementation of cost-efficiency and cost-control mechanisms; provide incentives for better allocation and distribution of resources; tackle problems in equity in access and financing; implement a system of quality controls; and stimulate healthy competition between insurance companies. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Are community-based forest enterprises in the tropics financially viable? Case studies from the Brazilian Amazon

Treesearch

Shoana Humphries; Thomas P. Holmes; Karen Kainer; Carlos Gabriel Goncalves Koury; Edson Cruz; Rosana de Miranda Rocha

2012-01-01

Community-based forest management is an integral component of sustainable forest management and conservation in the Brazilian Amazon, where it has been heavily subsidized for the last ten years. Yet knowledge of the financial viability and impact of community-based forest enterprises (CFEs) is lacking. This study evaluates the profitability of three CFEs in the...

The Global Financial Crisis: Analysis and Policy Implications

DTIC Science & Technology

2009-11-25

stimulus through government spending not sustainable. August 27. The Federal Deposit Insurance Corporation revealed that the number of U.S. banks at...compensation and governance decisions. Among legislative initiatives, S. 1074 would provide for greater influence by shareholders in selecting corporate ...insurance companies, and other financial institutions, as well as government capital injections and loans to private corporations have become parts of

Financial incentive programs' influence in promoting sustainable forestry in the northern region

Treesearch

Michael G. Jacobson; Thomas J. Straka; John L. Greene; Michael A. Kilgore; Steven E. Daniels

2009-01-01

Selected forestry officials in each of the 20 northern states were surveyed concerning their opinions on the public and private financial incentive programs available to nonindustrial private forest owners in their state. The officials were asked to name and describe the programs and to assess forest owners' awareness of each one, its appeal among the owners aware...

Schooling the Crisis? Education in the Aftermath of the Global Financial Crisis

ERIC Educational Resources Information Center

Morgan, John

2014-01-01

Five years on from the onset of the global financial crisis, there has been little sustained discussion of its implications for schooling. This is surprising when we consider that for the past three decades education has been shaped by assumptions about the need to prepare students for life in global capitalist economies. The consensus seems to be…

Parental views on withdrawing life-sustaining therapies in critically ill children.

PubMed

Michelson, Kelly Nicole; Koogler, Tracy; Sullivan, Christine; Ortega, María del Pilar; Hall, Emily; Frader, Joel

2009-11-01

To broaden existing knowledge of pediatric end-of-life decision making by exploring factors described by parents of patients in the pediatric intensive care unit (PICU) as important/influential if they were to consider withdrawing life-sustaining therapies. Quantitative and qualitative analysis of semi-structured one-on-one interviews. The PICUs at 2 tertiary care hospitals. English- or Spanish-speaking parents who were older than 17 years and whose child was admitted to the PICU for more than 24 hours to up to 1 week. Semi-structured one-on-one interviews. Forty of 70 parents (57%) interviewed said they could imagine a situation in which they would consider withdrawing life-sustaining therapies. When asked if specific factors might influence their decision making, 64% of parents said they would consider withdrawing life-sustaining therapies if their child were suffering; 51% would make such a decision based on quality-of-life considerations; 43% acknowledged the influence of physician-estimated prognosis in their decision; and 7% said financial burden would affect their consideration. Qualitative analysis of their subsequent comments identified 9 factors influential to parents when considering withdrawing life-sustaining therapies: quality of life, suffering, ineffective treatments, faith, time, financial considerations, general rejection of withdrawing life-sustaining therapies, mistrust/doubt toward physicians, and reliance on self/intuition. Parents describe a broad range of views regarding possible consideration of withdrawing life-sustaining therapies for their children and what factors might influence such a decision.

Parental Views on Withdrawing Life-Sustaining Therapies in Critically Ill Children

PubMed Central

Michelson, Kelly Nicole; Koogler, Tracy; Sullivan, Christine; del Pilar Ortega, María; Hall, Emily; Frader, Joel

2009-01-01

Objective To broaden existing knowledge of pediatric end-of-life decision making by exploring factors described by parents of patients in the pediatric intensive care unit (PICU) as important/influential if they were to consider withdrawing life-sustaining therapies. Design Quantitative and qualitative analysis of semi-structured one-on-one interviews. Setting The PICUs at 2 tertiary care hospitals. Participants English- or Spanish-speaking parents who were older than 17 years and whose child was admitted to the PICU for more than 24 hours to up to 1 week. Intervention Semi-structured one-on-one interviews. Results Forty of 70 parents (57%) interviewed said they could imagine a situation in which they would consider withdrawing life-sustaining therapies. When asked if specific factors might influence their decision making, 64% of parents said they would consider withdrawing life-sustaining therapies if their child were suffering; 51% would make such a decision based on quality-of-life considerations; 43% acknowledged the influence of physician-estimated prognosis in their decision; and 7% said financial burden would affect their consideration. Qualitative analysis of their subsequent comments identified 9 factors influential to parents when considering withdrawing life-sustaining therapies: quality of life, suffering, ineffective treatments, faith, time, financial considerations, general rejection of withdrawing life-sustaining therapies, mistrust/doubt toward physicians, and reliance on self/intuition. Conclusion Parents describe a broad range of views regarding possible consideration of withdrawing life-sustaining therapies for their children and what factors might influence such a decision. PMID:19884588

Service to the Nation, Strength for the Future. Fiscal Year 2013 United States Army Annual Financial Report

DTIC Science & Technology

2013-01-01

implementing several internal monthly controls testing initiatives, and other similar accomplishments geared to achieving a full audit-ready financial report...existence and completeness of assets, internal controls, and other critical functions required to meet audit readiness goals. The Army is on-track...ensure the integrity of their reporting systems, programs, and operations. This section focuses on the Army’s system of internal controls to

The Bottom Line: Ensuring That Students and Parents Understand the Net Price of College. A Report to the U.S. Congress and Secretary of Education

ERIC Educational Resources Information Center

Advisory Committee on Student Financial Assistance, 2011

2011-01-01

In making decisions about college, it is essential that students and parents focus on net price, which is the dollar amount that must be paid after subtracting financial assistance from cost of attendance. A net price calculator is one of two financial aid tools designed to provide students and parents with accurate and timely information about…

Accountability and Internal Control--Do We Really Need It?

ERIC Educational Resources Information Center

Clarke, Allan B.

1987-01-01

Briefly looks at some of the basic principles of accountability and internal control as a review of present accounting system procedures to aid administrators to ensure reliable financial records. (MLF)

Corporate Social Responsibility: A Real Options Approach to the Challenge of Financial Sustainability

PubMed Central

2015-01-01

Background In contemporary complex societies, social values like ethics, corporate social responsibility, and being respectful with the environment, among others, are becoming social requirements. Corporations are expected to fulfill them and, according to empirical evidence, an overwhelming majority aspires to good social valuation. At the same time, the maximization of market share value in the long run continues to be the central corporate goal. Making environmental and social expenses compatible with value creation is a central challenge for corporations since it implies the financial sustainability of Corporate Social Responsibility (CSR). Methods and Results The value creation capacity of CSR projects, mainly through innovation, is widely acknowledged in economic literature and corporate practice. This fact arouses the need of having a quantitative framework capable of summarizing the value creation capacity of the variables involved in CSR projects. With this aim we build up a sensitivity analysis of real option ratios that studies and quantifies the value creation capacity of CSR projects connected with innovation. Ratio analysis has the advantage of being scale independent. Hence, it furnishes a homogeneous framework to express the interaction of value creation variables and, thus, supports strategic thinking quantitatively. Often, CSR expenses can be regarded as preliminary projects that create the opportunity to undertake a full future project. For them, we obtain the minimum expectations scenario that makes financially sustainable a preliminary project that can be interpreted as a call option. We propose a classification of CSR projects from the decision analysis perspective following a two-fold approach: Their relationship with value creation and their links with existing corporate activities. This classification of CSR projects aims at contributing to choose the best capital budgeting method to study the financial sustainability of the project and identifying those CSR projects that fulfill the required features to be studied from the real options perspective. PMID:25938410

Corporate social responsibility: a real options approach to the challenge of financial sustainability.

PubMed

Bosch-Badia, Maria-Teresa; Montllor-Serrats, Joan; Tarrazon-Rodon, Maria-Antonia

2015-01-01

In contemporary complex societies, social values like ethics, corporate social responsibility, and being respectful with the environment, among others, are becoming social requirements. Corporations are expected to fulfill them and, according to empirical evidence, an overwhelming majority aspires to good social valuation. At the same time, the maximization of market share value in the long run continues to be the central corporate goal. Making environmental and social expenses compatible with value creation is a central challenge for corporations since it implies the financial sustainability of Corporate Social Responsibility (CSR). The value creation capacity of CSR projects, mainly through innovation, is widely acknowledged in economic literature and corporate practice. This fact arouses the need of having a quantitative framework capable of summarizing the value creation capacity of the variables involved in CSR projects. With this aim we build up a sensitivity analysis of real option ratios that studies and quantifies the value creation capacity of CSR projects connected with innovation. Ratio analysis has the advantage of being scale independent. Hence, it furnishes a homogeneous framework to express the interaction of value creation variables and, thus, supports strategic thinking quantitatively. Often, CSR expenses can be regarded as preliminary projects that create the opportunity to undertake a full future project. For them, we obtain the minimum expectations scenario that makes financially sustainable a preliminary project that can be interpreted as a call option. We propose a classification of CSR projects from the decision analysis perspective following a two-fold approach: Their relationship with value creation and their links with existing corporate activities. This classification of CSR projects aims at contributing to choose the best capital budgeting method to study the financial sustainability of the project and identifying those CSR projects that fulfill the required features to be studied from the real options perspective.

Saving mothers and newborns in communities: strengthening community midwives to provide high quality essential newborn and maternal care in Baluchistan, Pakistan in a financially sustainable manner.

PubMed

Mumtaz, Zubia; Cutherell, Andrea; Bhatti, Afshan

2014-04-06

To address it's persistently high maternal mortality rate of 276/100,000 live births, the government of Pakistan created a new cadre of community based midwives (CMW). One expectation is that CMWs will improve access to maternal health services for underserved women. Recent research shows the CMWs have largely failed to establish midwifery practices, because CMW's lack of skills, both clinical and entrepreneurial and funds necessary to develop their practice infrastructure and logistics. Communities also lack trust in their competence to conduct safe births. To address these issues, the Saving Mothers and Newborn (SMNC) intervention will implement three key elements to support the CMWs to establish their private practices: (1) upgrade CMW clinical skills (2) provide business-skills training and small loans (3) generate demand for CMW services using cellular phone SMS technology and existing women's support groups. This 3-year project aims to investigate whether CMWs enrolled in this initiative are providing the essential maternal and newborn health care to women and children living in districts of Quetta, and Gwadar in a financially self-sustaining manner. Specifically the research will use quasi-experimental impact assessment to document whether the SMNC initiative is having an impact on CMW services uptake, financial analysis to assess if the initiative enabled CMWs to develop financially self-sustainable practices and observation methods to assess the quality of care the CMWs are providing. A key element of the SMNC initiative - the provision of business skills training and loans to establish private practices - is an innovative initiative in Pakistan and little is known about its effectiveness. This research will provide emperic evidence of the effectiveness of the intervention as well as contribute to the body of evidence around potential solutions to improve sustainable coverage of high impact Maternal, Neonatal and Child Health interventions in vulnerable populations living in remote rural areas.

Ensuring Environmentally Sustainable Production of Dedicated Biomass Feedstocks

Treesearch

V.R. Tolbert; D.A. Mays; A. Houston; D.D. Tyler; C.H. Perry; K.E. Brooks; F.C. Thornton; B.R. Bock; J.D. Joslin; Carl C. Trettin; J. Isebrands

2000-01-01

Ensuring acceptance of dedicated biomass feedstocks by landowners, agricultural communities, environmental and public interest groups, requires that the environmental benefits, concerns, and risks associated with their production be quantified. Establishment and management measures to benefit soil and water quality are being identified by ongoing research. Field...

Defining Value-Based Care in Cardiac and Vascular Anesthesiology: The Past, Present, and Future of Perioperative Cardiovascular Care.

PubMed

Kolarczyk, Lavinia M; Arora, Harendra; Manning, Michael W; Zvara, David A; Isaak, Robert S

2018-02-01

Health care reimbursement models are transitioning from volume-based to value-based models. Value-based models focus on patient outcomes both during the hospital admission and postdischarge. These models place emphasis on cost, quality of care, and coordination of multidisciplinary services. Perioperative physicians are challenged to evaluate traditional practices to ensure coordinated, cost-effective, and evidence-based care. With the Centers for Medicare and Medicaid Services planned introduction of bundled payments for coronary artery bypass graft surgery, cardiovascular anesthesiologists are financially responsible for postdischarge outcomes. In order to meet these patient outcomes, multidisciplinary care pathways must be designed, implemented, and sustained, a process that is challenging at best. This review (1) provides a historical perspective of health care reimbursement; (2) defines value as it pertains to quality, service, and cost; (3) reviews the history of value-based care for cardiac surgery; (4) describes the drive toward optimization for vascular surgery patients; and (5) discusses how programs like Enhanced Recovery After Surgery assist with the delivery of value-based care. Copyright © 2018 Elsevier Inc. All rights reserved.

[Are investment activity and backlog in investments risks for university medicine in Germany?].

PubMed

Amann, I; Heyder, R; Strehl, R

2009-08-01

University medicine in Germany requires significantly higher funding and investment because its tasks not only include health care but also research and teaching. However, over recent decades less and less funding compared to the development of the turnover has been available. This trend is due to decreasing public funding. The diminishing funding has caused a major backlog of investment at German university hospitals. The first part of the article summarizes the investments policies at university hospitals and other hospitals. The second part describes the investment needs in university medicine and exposes risk factors for research, education and health care due to the process of investment planning and realization. Goal-oriented solutions are shown to facilitate investments. The third part discusses several risks caused by insufficient investments in university medicine. There are special risks for research, teaching, and the capacity for innovation in university medicine besides economical and medical risks. Some policies and financial strategies to overcome the backlog in investments are presented. After a summary, the article concludes with some practical examples of further measures to ensure sustainable funding.

Interventional Radiation Oncology (IRO): Transition of a magnetic resonance simulator to a brachytherapy suite.

PubMed

Anderson, Roberta; Armour, Elwood; Beeckler, Courtney; Briner, Valerie; Choflet, Amanda; Cox, Andrea; Fader, Amanda N; Hannah, Marie N; Hobbs, Robert; Huang, Ellen; Kiely, Marilyn; Lee, Junghoon; Morcos, Marc; McMillan, Paige E; Miller, Dave; Ng, Sook Kien; Prasad, Rashmi; Souranis, Annette; Thomsen, Robert; DeWeese, Theodore L; Viswanathan, Akila N

As a core component of a new gynecologic cancer radiation program, we envisioned, structured, and implemented a novel Interventional Radiation Oncology (IRO) unit and magnetic resonance (MR)-brachytherapy environment in an existing MR simulator. We describe the external and internal processes required over a 6-8 month time frame to develop a clinical and research program for gynecologic brachytherapy and to successfully convert an MR simulator into an IRO unit. Support of the institution and department resulted in conversion of an MR simulator to a procedural suite. Development of the MR gynecologic brachytherapy program required novel equipment, staffing, infrastructural development, and cooperative team development with anesthetists, nurses, therapists, physicists, and physicians to ensure a safe and functional environment. Creation of a separate IRO unit permitted a novel billing structure. The creation of an MR-brachytherapy environment in an MR simulator is feasible. Developing infrastructure includes several collaborative elements. Unique to the field of radiation oncology, formalizing the space as an Interventional Radiation Oncology unit permits a sustainable financial structure. Copyright © 2018 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

[The pharmaceutical industry and the sustainability of healthcare systems in developed countries and in Latin America].

PubMed

Iñesta, Antonio; Oteo, Luis Angel

2011-06-01

The global economic crisis and its impact on public finances in most developed countries are giving rise to cost-containment policies in healthcare systems. Prevailing legislation on medication requires the safety, quality, and efficacy of these products. A few countries include efficiency criteria, primarily for new medication that they wish to include in public financing. The appropriate use of generic and "biosimilar medication" is very important for maintaining the financial equilibrium of the Health Services. The problem in Latin America is that not all multisource products are bioequivalent and not all countries have the resources to conduct bioequivalence studies in vivo. The European Medicines Agency in 2005 adopted guidelines on "biosimilar medicines" and thirteen of them were subsequently approved for general release. Benchmarking of this model by other countries would be important. The influence of the pharmaceutical industry on political and administrative areas is enormous and control is necessary. The pharmaceutical companies claim that they act with corporate social responsibility, therefore, they must ensure this responsibility toward society.

Health care service provision in Europe and regional diversity: a stochastic metafrontier approach.

PubMed

Schley, Katharina

2018-05-31

■■■: In the last decades, demographic change coupled with new and expensive medical innovations have put most health care systems in developed countries under financial pressure. Therefore, ensuring efficient service provision is essential for a sustainable health care system. This paper investigates the performance of regional health care services in six West European countries between 2005 and 2014. We apply a stochastic metafrontier model to capture the different conditions in the health care systems in the countries within the European Union. By means of this approach, it is possible to detect performance differences in the European health care systems subject to different conditions and technologies relative to the potential technology available. The results indicate that regional deprivation plays a key role for the efficiency of health care provision. Furthermore, a pooled model which assumes a similar technology for all countries cannot sufficiently account for differences between countries. Surprisingly, the Scandinavian regions lag behind other regions with respect to the metafrontier. C23, D61, I12, I18, R10.

Additional funding mechanisms for Public Hospitals in Greece: the case of Chania Mental Health Hospital

PubMed Central

2010-01-01

Objectives To investigate whether the long term lease of public hospital owned land could be an additional financing mechanism for Greek public (mental) health hospitals. Methods We performed a financial analysis of the official 2008 data of a case - study hospital (Mental Health Hospital of Chania). We used a capital budgeting approach to investigate whether value is created for the public hospital by engaging its assets in a project for the development of a private renal dialysis Unit. Results The development of the private unit in hospital owned land is a good investment decision, as it generates high project Net Present Value and Internal Rate of Return. When the project commences generating operating cash flows, nearly €400.000 will be paid annually to the Mental Health Hospital of Chania as rent, thereby gradually decreasing the annual deficit of the hospital. Conclusions Revenue generated from the long term lease of public hospital land is crucial to gradually eliminate hospital deficit. The Ministry of Health should encourage similar forms of Public Private Partnerships in order to ensure the sustainability of public (mental) hospitals. PMID:21067580

Strategic planning in Brazilian protected areas: Uses and adjustments.

PubMed

Barreto, Cristiane Gomes; Drummond, José Augusto L

2017-09-15

Management plans for protected areas commonly use strategic planning tools in their drafting. It is proposed that the adequate use of the instruments of planning and management of protected areas can improve their strategic competitiveness, providing greater financial and administrative independence, enabling them to be economically sustainable organizations. This study evaluated the application of concepts and strategy formulation, strategy principles and competitiveness, organizational diagnosis, strategic maps, scenarios, and other strategic planning instruments used for conservation management in Brazil. 25 management plans of 25 different protected areas were selected and studied, with special attention to the indicators used in each plan. Results indicate that there is a high suitability for the application of SP tools to the universe of protected areas, although management plans did not take full advantage of these tools. We also found that the broader use of these tools did not guarantee greater managerial effectiveness. We suggest that other governance variables beyond planning strategies must be improved, to ensure a better performance of protected areas. Copyright © 2017 Elsevier Ltd. All rights reserved.

Ecology, Democracy, and Green Schools: An Integrated Framework

ERIC Educational Resources Information Center

Kensler, Lisa A. W.

2012-01-01

Sustainability is the integration of ecological, social, and economic approaches to ensuring healthy local and global communities for present and future generations. Although environmental science and social studies teachers have assumed primary responsibility for sustainability related programs and initiatives, whole school approaches to teaching…

Existing and Potential Incentives for Practicing Sustainable Forestry on Non-industrial Private Forest Lands

Treesearch

John L. Greene; Michael A. Kilgore; Michael G. Jacobson; Steven E. Daniels; Thomas J. Straka

2007-01-01

This study examined the compatibility between sustainable forestry practices and the framework of public and private financial incentive programs directed toward nonindustrial private forest (NIPF) owners. The incentives include tax, cost-share, and other types of programs. The study consisted of four components: a literature review, a mail survey of selected...

Financial and ecological indicators of reduced impact logging performance in the eastern Amazon

Treesearch

Thomas P. Holmes; Geoffrey M. Blate; Johan C. Zweede; Rodrigo Pereira; Paulo Barreto; Frederick Boltz; Roberto Bauch

2002-01-01

Reduced impact logging (RIL) systems are currently being promoted in Brazil and other tropical countries in response to domestic and international concern over the ecological and economic sustainability of harvesting natural tropical forests. RIL systems are necessary, but not sufficient, for sustainable forest management because they reduce damage to the forest...

Standard terms and conditions applicable to foreign grant recipients

EPA Pesticide Factsheets

The recipient agrees to maintain appropriate systems, policies, and procedures for ensuring the proper stewardship and financial management of EPA grant funds in accordance with the terms and conditions of this award.

29 CFR 20.37 - Responsibilities of the Chief Financial Officer.

Code of Federal Regulations, 2012 CFR

2012-07-01

... and officials in carrying out this subpart, including the issuance of guidelines and instructions... steps as may be appropriate to carry out the purposes and ensure the effective implementation of this...

29 CFR 20.37 - Responsibilities of the Chief Financial Officer.

Code of Federal Regulations, 2011 CFR

2011-07-01

... and officials in carrying out this subpart, including the issuance of guidelines and instructions... steps as may be appropriate to carry out the purposes and ensure the effective implementation of this...

29 CFR 20.37 - Responsibilities of the Chief Financial Officer.

Code of Federal Regulations, 2013 CFR

2013-07-01

... and officials in carrying out this subpart, including the issuance of guidelines and instructions... steps as may be appropriate to carry out the purposes and ensure the effective implementation of this...

About OBF

Cancer.gov

The Office of Budget and Finance (OBF) advises the NCI Office of the Director and senior NCI staff on the effective management of financial and other resources to ensure that NCI operates in an efficient and fiscally responsible manner.

34 CFR 303.525 - Delivery of services in a timely manner.

Code of Federal Regulations, 2011 CFR

2011-07-01

... development of procedures to ensure that services are provided to eligible children and their families in a... INFANTS AND TODDLERS WITH DISABILITIES State Administration Policies and Procedures Related to Financial...

34 CFR 303.525 - Delivery of services in a timely manner.

Code of Federal Regulations, 2010 CFR

2010-07-01

... development of procedures to ensure that services are provided to eligible children and their families in a... INFANTS AND TODDLERS WITH DISABILITIES State Administration Policies and Procedures Related to Financial...

75 FR 38564 - National Endowment for the Arts; Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-02

... ensure that requested data is provided in the desired format; reporting burden (time and financial resources) is minimized; collection instruments are clearly understood; and the impact of collection...

The European Plate Observing System (EPOS) Services for Solid Earth Science

NASA Astrophysics Data System (ADS)

Cocco, Massimo; Atakan, Kuvvet; Pedersen, Helle; Consortium, Epos

2016-04-01

The European Plate Observing System (EPOS) aims to create a pan-European infrastructure for solid Earth science to support a safe and sustainable society. The main vision of the European Plate Observing System (EPOS) is to address the three basic challenges in Earth Sciences: (i) unravelling the Earth's deformational processes which are part of the Earth system evolution in time, (ii) understanding the geo-hazards and their implications to society, and (iii) contributing to the safe and sustainable use of geo-resources. The mission of EPOS is to monitor and understand the dynamic and complex Earth system by relying on new e-science opportunities and integrating diverse and advanced Research Infrastructures in Europe for solid Earth Science. EPOS will enable innovative multidisciplinary research for a better understanding of the Earth's physical and chemical processes that control earthquakes, volcanic eruptions, ground instability and tsunami as well as the processes driving tectonics and Earth's surface dynamics. EPOS will improve our ability to better manage the use of the subsurface of the Earth. Through integration of data, models and facilities EPOS will allow the Earth Science community to make a step change in developing new concepts and tools for key answers to scientific and socio-economic questions concerning geo-hazards and geo-resources as well as Earth sciences applications to the environment and to human welfare. EPOS has now started its Implementation Phase (EPOS-IP). One of the main challenges during the implementation phase is the integration of multidisciplinary data into a single e-infrastructure. Multidisciplinary data are organized and governed by the Thematic Core Services (TCS) and are driven by various scientific communities encompassing a wide spectrum of Earth science disciplines. These include Data, Data-products, Services and Software (DDSS), from seismology, near fault observatories, geodetic observations, volcano observations, satellite observations, geomagnetic observations, as well as data from various anthropogenic hazard episodes, geological information and modelling. In addition, transnational access to multi-scale laboratories and geo-energy test-beds for low-carbon energy will be provided. TCS DDSS will be integrated into Integrated Core Services (ICS), a platform that will ensure their interoperability and access to these services by the scientific community as well as other users within the society. This requires dedicated tasks for interactions with the various TCS-WPs, as well as the various distributed ICS (ICS-Ds), such as High Performance Computing (HPC) facilities, large scale data storage facilities, complex processing and visualization tools etc. Computational Earth Science (CES) services are identified as a transversal activity and is planned to be harmonized and provided within the ICS. The EPOS Thematic Services will rely in part on strong and sustainable participation by national organisations and international consortia. While this distributed architecture will contribute to ensure pan European involvement in EPOS, it also raises specific challenges: ensuring similar granularity of services, compatibility of technical solutions, homogeneous legal agreements and sustainable financial engagement from the partner institutions and organisations. EPOS is engaging actions to address all of these issues during 2016-2017, after which the services will enter a final validation phase by the EPOS Board of Governmental Representatives.

Department of Defense Financial Management Regulation. Volume 8. Civilian Pay Policy Procedures

DTIC Science & Technology

1999-08-01

servicing HRO perform a review of employee records to ensure that previously reported retirement plans are correct. Ensure that frozen CSRS accounts... meal periods) occur during the hours specified. See 53 Comp. Gen. 814 (1974) (reference (p)). Shift differential also is payable when an employee is: 1...Temporary Quarters Subsistence Allowance. The TQSA is an allowance granted to an employee for the reasonable cost of temporary quarters, meals and laundry

Corrigendum to: Picosecond Laser Surface Cleaning of AM1 Superalloy. Proceeding of 9th International Conference on Photonic Technologies - LANE 2016 Physics Procedia (2016), vol. 83

NASA Astrophysics Data System (ADS)

Moskal, D.; Martan, J.; Kučera, M.; Houdková, Š.; Kromer, R.

Acknowledgements The result was developed within the CENTEM project, reg. no. CZ.1.05/2.1.00/03.0088, co-funded by the ERDF as part of the Ministry of Education, Youth and Sports of the Czech Republic OP RDI program and in the follow-up sustainability stage, supported through CENTEM PLUS (LO1402) by financial means from the Ministry of Education, Youth and Sports under the "National Sustainability Programme I" and project SGS-2016-005. The authors gratefully acknowledge the ANR (French agency) for financial assistance in the ARCOLE (12-BS09-0009) project and Safran Aircraft-Engines, Genevilliers France for the studied samples.

Crop and livestock enterprise integration: Livestock impacts on forage, stover, and grain production

USDA-ARS?s Scientific Manuscript database

Enterprise diversity is the key to ensure productive and sustainable agriculture for the future. Integration of crops and livestock enterprises is one way to improve agricultural sustainability, and take advantage of beneficial enterprise synergistic effects. Our objectives were to develop cropping ...

Using Bayesian Population Viability Analysis to Define Relevant Conservation Objectives.

PubMed

Green, Adam W; Bailey, Larissa L

2015-01-01

Adaptive management provides a useful framework for managing natural resources in the face of uncertainty. An important component of adaptive management is identifying clear, measurable conservation objectives that reflect the desired outcomes of stakeholders. A common objective is to have a sustainable population, or metapopulation, but it can be difficult to quantify a threshold above which such a population is likely to persist. We performed a Bayesian metapopulation viability analysis (BMPVA) using a dynamic occupancy model to quantify the characteristics of two wood frog (Lithobates sylvatica) metapopulations resulting in sustainable populations, and we demonstrate how the results could be used to define meaningful objectives that serve as the basis of adaptive management. We explored scenarios involving metapopulations with different numbers of patches (pools) using estimates of breeding occurrence and successful metamorphosis from two study areas to estimate the probability of quasi-extinction and calculate the proportion of vernal pools producing metamorphs. Our results suggest that ≥50 pools are required to ensure long-term persistence with approximately 16% of pools producing metamorphs in stable metapopulations. We demonstrate one way to incorporate the BMPVA results into a utility function that balances the trade-offs between ecological and financial objectives, which can be used in an adaptive management framework to make optimal, transparent decisions. Our approach provides a framework for using a standard method (i.e., PVA) and available information to inform a formal decision process to determine optimal and timely management policies.

Sustainability issues in rural water supply in Asia.

PubMed

1998-03-01

This article identifies some sustainability issues in management of water supplies in rural Asia. The International Drinking Water Supply and Sanitation Decade was 1981-90. At present, less than 50% of the rural population in several Asian countries have access to safe water, and even less have access to adequate sanitation. Access does not ensure quality of services or supplies. Data on coverage is inadequate and does not take into account water quality, hours of service, reliability of supplies, distance to the source, and community use patterns. It is difficult to improve access to the poor. There is no single uniform strategy that works for all parts of a country. Countries need to promote community management that has strategic vision and appropriate priorities. Local management is constrained by centralized authority, the orientation of sector agencies, and staff with weak managerial, financial, technical, and communications skills. Many countries lack resources to maintain water delivery infrastructures and to prevent deterioration of services. There is a need to develop low cost appropriate technologies, management requirements, health education, community participation, mobilization of women, and synergistic, nonsequential development. Demand for water and sanitation is driven by survival and privacy issues. Rural water supply programs should view water as an economic and social good. Water management is effective when decisions are made locally. Local governments need to be strengthened in order to be able to perform demand management, select institutional options, and to take care of the unserviced.

Effectiveness of financial incentive programs in promoting sustainable forestry in the west

Treesearch

John L. Greene; Steven E. Daniels; Michael A. Kilgore; Thomas J. Straka; Michael G. Jacobson

2011-01-01

Selected forestry officials in each of the 13 western states were surveyed in 2005 concerning their opinions on the public and private financial incentive programs available to nonindustrial private forest owners in their state. The officials were asked to name and describe the programs and to assess forest owners’ awareness of each one, its appeal among owners aware...

Depreciating and stating the value of hospital buildings what you need to know.

PubMed

Holmes, John R; Felsenthal, David

2009-10-01

Healthcare financial executives of not-for-profit hospitals may be overdepreciating and understating the value of the hospital building on their financial statements. Changing the remaining lives of assets and their depreciation will help enhance the bottom line for many organizations. Ensuring that they are correctly stating the investment value of their assets is one way CFOs can have a positive impact on their organization's bottom line in a tough economy.

Emulating Excellence: Financial Management Lessons for the Navy from the Experiences of the Corporation for National and Community Service

DTIC Science & Technology

2007-12-01

Treasury instruments of the United States and these earning grow the fund’s balance.66 The Corporation was appropriated separate funds to pay for...in fiscal 2003 data quality was an important issue. The Corporation is highly decentralized and relies on data flow to ensure accuracy of financial...information. Information necessarily flows from the Corporation to its grantees and from grantees to the Corporation. Information on new volunteers

Providing Coverage for the Unique Lifelong Health Care Needs of Living Kidney Donors Within the Framework of Financial Neutrality.

PubMed

Gill, J S; Delmonico, F; Klarenbach, S; Capron, A M

2017-05-01

Organ donation should neither enrich donors nor impose financial burdens on them. We described the scope of health care required for all living kidney donors, reflecting contemporary understanding of long-term donor health outcomes; proposed an approach to identify donor health conditions that should be covered within the framework of financial neutrality; and proposed strategies to pay for this care. Despite the Affordable Care Act in the United States, donors continue to have inadequate coverage for important health conditions that are donation related or that may compromise postdonation kidney function. Amendment of Medicare regulations is needed to clarify that surveillance and treatment of conditions that may compromise postdonation kidney function following donor nephrectomy will be covered without expense to the donor. In other countries lacking health insurance for all residents, sufficient data exist to allow the creation of a compensation fund or donor insurance policies to ensure appropriate care. Providing coverage for donation-related sequelae as well as care to preserve postdonation kidney function ensures protection against the financial burdens of health care encountered by donors throughout their lives. Providing coverage for this care should thus be cost-effective, even without considering the health care cost savings that occur for living donor transplant recipients. © 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.

Financial Responsibility for Reentry Vehicle Operations

DOT National Transportation Integrated Search

1995-05-01

The Department of Transportation's Office of Commercial Space Transportation is : in the process of assessing the safety of a reentry vehicle and its operation : and is developing an associated regulatory framework for ensuring public safety : while ...

The Role of Cash Flow in Financial Early Warning of Agricultural Enterprises Based on Logistic Model

NASA Astrophysics Data System (ADS)

Sun, Fengru

2018-01-01

This paper chooses the agricultural listed companies as the research object, compares the financial situation of the enterprise and the theory of financial early warning, combines the financial status of the agricultural listed companies, selects the relevant cash flow indicators, discusses the application of the Logistic financial early warning model in the agricultural listed companies, Agricultural enterprises get better development. Research on financial early warning of agricultural listed companies will help the agricultural listed companies to predict the financial crisis. Financial early warning model is simple to establish, operational and strong, the use of financial early warning model, to help enterprises in the financial crisis before taking rapid and effective measures, which can avoid losses. Help enterprises to discover signs of deterioration of the financial situation in time to maintain the sustainable development of agricultural enterprises. In addition, through the financial early warning model, investors can correctly identify the financial situation of agricultural enterprises, and can evaluate the financial situation of agricultural enterprises and to help investors to invest in scientific and rational, beneficial to investors to analyze the safety of investment. But also help the relevant regulatory agencies to effectively monitor the market and promote the healthy and stable development of the market.

Fair equality of opportunity critically reexamined: the family and the sustainability of health care systems.

PubMed

Engelhardt, H Tristram

2012-12-01

A complex interaction of ideological, financial, social, and moral factors makes the financial sustainability of health care systems a challenge across the world. One difficulty is that some of the moral commitments of some health care systems collide with reality. In particular, commitments to equality in access to health care and to fair equality of opportunity undergird an unachievable promise, namely, to provide all with the best of basic health care. In addition, commitments to fair equality of opportunity are in tension with the existence of families, because families are aimed at advantaging their own members in preference to others. Because the social-democratic state is committed to fair equality of opportunity, it offers a web of publicly funded entitlements that make it easier for persons to exit the family and to have children outside of marriage. In the United States, in 2008, 41% of children were born outside of wedlock, whereas, in 1940, the percentage was only 3.8%, and in 1960, 5%, with the further consequence that the social and financial capital generated through families, which aids in supporting health care in families, is diminished. In order to explore the challenge of creating a sustainable health care system that also supports the traditional family, the claims made for fair equality of opportunity in health care are critically reconsidered. This is done by engaging the expository device of John Rawls's original position, but with a thin theory of the good that is substantively different from that of Rawls, one that supports a health care system built around significant copayments, financial counseling, and compulsory savings, with a special focus on enhancing the financial and social capital of the family. This radical recasting of Rawls, which draws inspiration from Singapore, is undertaken as a heuristic to aid in articulating an approach to health care allocation that can lead past the difficulties of social-democratic policy.

Multilateral development banks and socially responsible investments--the case of tobacco.

PubMed

Lal, Pranay

2012-12-01

Globally, tobacco kills more people than HIV-related conditions or AIDS, tuberculosis and malaria combined. In 1991, The World Bank, the world's largest lender, pledged that it would no longer support tobacco-related projects. It was expected that other financial investors would follow, but most did not respond to this call. As a result, several financial institutions continue to invest in tobacco and fuel an epidemic to an unprecedented scale. Using tobacco as a case in point, this review highlights the continuing investments among financial institutions which do not conform to 'socially responsible investments' and calls for monitoring and reporting such unethical practices. The paper also underscores the need to harmonise the numerous criteria, principles and voluntary codes that govern socially responsible investing and ensure that financial institutions comply with them.

Turning a DoD GOLD Leaf: BRAC 133 at Mark Center

DTIC Science & Technology

2010-06-01

building of the same size–a savings of 4.5 million gallons annually. • Water saving strategies include: – Low flow faucets , shower heads, and plumbing...environmentally sustainable construction and site development the team ensured the highest levels of water savings, energy efficiency, indoor...Sustainability Symposium & Exhibition “Going For GOLD” Sustainability goals: It is anticipated that the building will use 45% less water than a traditional

Satellite water quality monitoring in coastal and estuarine waters: a look at SeaWiFS, MODIS, MERIS, and HICO

EPA Science Inventory

The United States Environmental Protection Agency’s charge to protect human health and the environment requires a long-term commitment to creating sustainable solutions to environmental problems. The most direct way to ensure that management practices are achieving sustainability...

Advances in forest hydrology: challenges and opportunities

Treesearch

D.M. Amatya; K.R. Douglas-Mankin; T.M. Williams; R.W. Skaggs; J.E. Nettles

2011-01-01

Forests are an integral component of the landscape, and maintaining their functional integrity is fundamental for the sustainability of ecosystems and societies alike. Tools, innovations, and practices, analogous to those developed to improve agricultural production and quantify environmental impacts, are needed to ensure the sustainability of these forested landscapes...

Parsimonious Use of Indicators for Evaluating Sustainability Systems with Multivariate Statistical Analyses

EPA Science Inventory

Indicators are commonly used for evaluating relative sustainability for competing products and processes. When a set of indicators is chosen for a particular system of study, it is important to ensure that they are variable independently of each other. Often the number of indicat...

Making process improvement 'stick'.

PubMed

Studer, Quint

2014-06-01

To sustain gains from a process improvement initiative, healthcare organizations should: Explain to staff why a process improvement initiative is needed. Encourage leaders within the organization to champion the process improvement, and tie their evaluations to its outcomes. Ensure that both leaders and employees have the skills to help sustain the sought-after process improvements.

Preferences on policy options for ensuring the financial sustainability of health care services in the future: results of a stakeholder survey.

PubMed

Tordrup, David; Angelis, Aris; Kanavos, Panos

2013-12-01

Universal access to health care in most western European countries has been a given for many decades; however, macroeconomic developments and increased pressure on health care budgets could mean the status quo cannot be maintained. As populations age, a declining proportion of economically active citizens are being required to support a larger burden of health and social care, while increasing availability of novel technologies for extending and improving life continues to push health care costs upwards. With health expenditure continuing to rise as a proportion of national income, concerns are raised about the current and future financial sustainability of Organisation for Economic Co-Operation and Development (OECD) health care systems. Against this backdrop, a discussion about options to fund health care in the future, including whether to raise additional health care finance (and the ways to do so), reallocate resources and/or ration services becomes very pertinent. This study elicits preferences among a group of key stakeholders (payers, providers, government, academia and health-related industry) on the issue of health care financial sustainability and the future funding of health care services, with a view to understanding the different degrees of acceptability between policy interventions and future funding options as well as their feasibility. We invited 842 individuals from academia, other research organisations (eg. think tanks), national health services, providers, health insurance organisations, government representatives and health-related industry and related advisory stakeholders to participate in an online survey collecting preferences on a variety of revenue-generating mechanisms and cost/demand reducing policies. Respondents represented the 28 EU member states as well as Norway, Iceland, Switzerland, Australia, Russian Federation, Canada and New Zealand. We received 494 responses to our survey from all stakeholder groups. Across all groups, the highest preference was for policies to modify lifestyle and implement more extensive screening within risk groups for high burden illnesses. There was a broad consensus not to reallocate resources from social security/education. Between stakeholders, there were differences of opinion between industry/advisory and a range of other groups, with industry being generally more in favour of market-based interventions and an increased role for the private sector in health care financing/delivery. Conversely, stakeholders from academia, government, national health services and insurance were relatively more in favour of more restrictive purchasing of new and expensive technologies, and (to varying extent) of higher income/corporate taxes. Taxes on cigarettes/alcohol were by far considered the most politically feasible option. According to this study, policy options that are broadly acceptable across stakeholder groups with different inherent interests exist but are limited to lifestyle modification, screening interventions and excise taxes on harmful products. Representatives from the private sector tend to view solutions rooted in the private sector as both effective and politically feasible options, while stakeholders from academia and the public sector seem to place more emphasis on solutions that do not disproportionately impact certain population groups.

Chemical leasing in the context of sustainable chemistry.

PubMed

Moser, Frank; Karavezyris, Vassilios; Blum, Christopher

2015-05-01

Chemical leasing is a new and innovative approach of selling chemicals. It aims at reducing the risks emanating from hazardous substances and ensuring long-term economic success within a global system of producing and using chemicals. This paper explores how, through chemical leasing, the consumption of chemicals, energy, resources and the generation of related wastes can be reduced. It also analyses the substitution of hazardous chemicals as a tool to protect environmental, health and safety and hence ensure compliance with sustainability criteria. For this, we are proposing an evaluation methodology that seeks to provide an answer to the following research questions: (1) Does the application of chemical leasing promote sustainability in comparison to an existing chemicals production and management system? 2. If various chemical leasing project types are envisaged, which is the most promising in terms of sustainability? The proposed methodology includes a number of basic goals and sub-goals to assess the sustainability for eight different chemical leasing case studies that have been implemented both at the local and the national levels. The assessment is limited to the relative assessment of specific case studies and allows the comparisons of different projects in terms of their relative contribution to sustainable chemistry. The findings of our assessment demonstrate that chemical leasing can be regarded as promoting sustainable chemistry in five case studies with certainty. However, on the grounds of our assessment, we cannot conclude with certainty that chemical leasing has equivalent contribution to sustainable chemistry in respect of three further case studies.

75 FR 24599 - Order Finding That the ICE Dominion-South Financial Basis Contract Traded on the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-05

... Pipe Line (Nokesville station) and Texas Eastern Transmission (Lebanon, Oakford, Chambersburg, Perulack... increased oversight engendered by the issue of a SPDC Order increases transparency and helps to ensure fair...

In Pain and Agonizing Over the Bills: Financial Assistance Resource Directory

MedlinePlus

... organizations and with its own resources to ensure economic, social, and political security for all Americans with ... National Disability Institute, strives to increase social and economic independence amongst individuals with a disability. For more ...

33 CFR 135.3 - Applicability.

Code of Federal Regulations, 2011 CFR

2011-07-01

... POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OFFSHORE OIL POLLUTION COMPENSATION FUND General § 135.3...) Sustains an economic loss as a consequence of oil pollution arising from Outer Continental Shelf activities...

Review of Namibian legislation and policies pertinent to environmental flows

NASA Astrophysics Data System (ADS)

Bethune, Shirley; Amakali, Maria; Roberts, Kevin

The rationale for evaluating Namibian environmental flows is essentially that of ensuring ‘the maintenance of ecosystems, essential ecological processes and biological diversity’ and the sustainable utilisation of natural resources as promoted in clause 95 of the Namibian Constitution. Recent policy and legislative reforms have created a unique opportunity for Namibia to incorporate environmental sensitivity clauses such as those to ensure adequate environmental flows for river systems. The Second National Development Plan and the National Water Policy White Paper form the basis for the new Water Resources Management Act, promulgated in December 2004. The National Water Policy includes a basic principle headed “Ecosystem values and sustainability” that stresses that the management of water resources needs to harmonise human and environmental requirements, recognising the role of water in supporting the ecosystem. One of the strategies given to ensure environmental and economic sustainability reads: “Ensure that in-stream flows are adequate both in terms of quality and quantity to sustain the ecosystem”. Although the water policy clearly states that: “The legislation will provide for determining an environmental water reserve for freshwater sources before they can be used to supply other demands than domestic and subsistence livestock watering”, there is now no direct mention of environmental flows in the new Water Act. This paper explores to what extent the need for the determination of environmental water needs has been incorporated into Namibian policies, legislation and development plans. It makes recommendations, pertinent to the Namibian situation, of what needs to be done to ensure that environmental water requirements are taken into account in future planning, operation and management of Namibia’s precious water resources.

Influence and effectiveness of financial incentive programs in programs in promoting sustainable forestry in the South

Treesearch

John L. Greene; Thomas J. Straka; Steven E. Daniels; Michael G. Jacobson; Michael A. Kilgore

2009-01-01

Selected state agency foresters in each of the 13 southern states were surveyed about the financial incentive programs available to nonindustrial private forest owners. The foresters were asked to name and describe the public and private programs available in their state, to assess forest owners’ awareness of each program, its appeal among the owners aware of it, its...

The financial performance of labor and delivery units.

PubMed

von Gruenigen, Vivian E; Powell, Diane M; Sorboro, Susan; McCarroll, Michelle L; Kim, Unhee

2013-07-01

Hospitals and health care systems are already seeing the effect of health care reform with declining dollars. Hospital services, which had narrow financial margins in the past, will have further challenges. This article will review definitions, challenges, and potential financial solutions for labor and delivery units. Improving quality, efficiency, and cost requires substantial physician cooperation in the changing paradigm from physician-centric care to the transparent safety of teams. The financial contribution margin should increase the net revenue, but significant volumes are also needed. The challenge of this model for obstetrics is the slowing birth rate with the ultimate limitation for growth. Therefore, cost containment is imperative for sustainability. Standardization of hospital policies and procedures can improve quality and cost-savings with new incentive models. Examples include decreasing expensive pharmaceuticals, minimizing elective inductions of labor, and encouraging breast-feeding. As providers of health care to women, we all must engage in the triple aim of (1) improving the experience of care, (2) improving the health of populations, and (3) reducing per capita costs of health care. Although accountable care organizations presently are focused on Medicare populations for cost containment, all health care providers and institutions must be vigilant on both quality cost-effective care for sustainability, especially in obstetrics. Copyright © 2013 Mosby, Inc. All rights reserved.

Crisis management can leave residual effects.

PubMed

Margolis, G L; DeMuro, P R

1991-10-01

A healthcare organization that once suffered from poor financial performance may fail to correct recovery methods that can cause lingering legal and accounting problems. A crisis management style is prone to creating problems with an organization's debt structure, Medicare and Medicaid payment, tax issues, labor relations, licensing and accreditation, compliance with fraud and abuse rules, and accounting for charity care. After stabilizing a worrisome financial situation, a healthcare organization should conduct an internal audit to ensure that its legal and accounting practices remain above board.

The failure of AHERF: 5 important lessons.

PubMed

Goldstein, Lisa

2008-08-01

Important lessons from AHERF's downfall: Strong governance and oversight of management are needed to ensure accountability; Disciplined growth strategies need to be supported by rigorous financial planning and feasibility analysis; Physician integration is critical to grow market share, but needs to be methodical and measured; Robust information systems are necessary to manage costs, maximize revenue, and provide differentiation in quality and clinical outcomes; Disclosure of the financial performance of all of a health system's operations creates greater transparency and builds credibility.

Financial Aid for All Students Act of 1991. Hearing on S. 1845 To Ensure that All Americans Have the Opportunity for a Higher Education of the Committee on Labor and Human Resources, United States Senate, One Hundred Second Congress, First Session, on S. 1845.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on Labor and Human Resources.

This hearing document presents testimony comprising prepared statements and letters that address the direct loan concept (as authored by Senators Simon and Durenberger) in student financial aid, and the idea of tying repayment to income (income-contingent loan) as a means of simplifying the nation's guaranteed student loan process. Testimony…

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hall, F.K.

Ever since man became conscious of the finite dimensions of Planet Earth, he has worried about his ability to survive in an ever-more crowded environment. This paper reports that the fundamental question underlying this concern is sustainability: Can we indefinitely supply, maintain, and prolong that which we have This question is, of course, multifaceted. Man's early concerns quickly polarized the scientists and economists of this world into two philosophical camps---the Malthusians and the Cornucopians. Over time, economists learned that Malthus seriously underestimated the capacity of technology to enhance productivity, although Malthusian sympathizers (both scientists and economists) continually raised the spectermore » of imminent doom. Much of what lies ahead will provide a series of daunting challenges for us all, and the engine that drives sustainability has to be technology. The central issue is to ensure that the right kind of technology is available, and that it is used widely to ensure sustainability.« less

Strengthening immunization in a West African country: Mali.

PubMed

Milstien, J B; Tapia, M; Sow, S O; Keita, L; Kotloff, K

2007-11-01

OBJECTIVES AND CONTEXT: This paper describes the preliminary outcomes of a collaborative capacity-building initiative performed in Mali to strengthen the immunization program. We conducted baseline assessments, training and post-training assessments in four programmatic areas: vaccine management, immunization safety, surveillance, and vaccine coverage, using adapted World Health Organization (WHO) tools. Impact assessment was done by evaluation of trainee performance, programmatic impact and sustainability. Qualitative and quantitative improvement of trainee performance was seen after the training interventions: some knowledge improvement, greater compliance with vaccine management practices and improved vaccine coverage. Deficiencies in information transfer to the periphery were identified. The program involves shared responsibility for planning, implementation and financing with national stakeholders while emphasizing the training of leaders and managers to ensure sustainability. Although short-term gains were measured, our initial assessments indicate that sustained impact will require improvements in staffing, financing and guidelines to ensure delivery of information and skills to the periphery.

Global initiatives in maternal and newborn health

PubMed Central

Tunçalp, Özge

2017-01-01

In 2015, 17 sustainable development goals were established for 2030. These global goals aim to ensure healthy lives and promote wellbeing for all. In support of the sustainable development goals, the World Health Organization proposed a new global strategy for women’s, children’s, and adolescents’ health in 2016 with three overarching objectives: to survive, to thrive, and to transform. We are now globally seeking not only to end preventable deaths but also to ensure health and wellbeing, and expand enabling environments. This strategy builds on several prior initiatives in maternal and newborn health, such as the Every Woman, Every Child initiative, and the strategy to end preventable maternal mortality and implementation of an action plan to end preventable newborn death. This confluence of initiatives, strategies, and novel financing mechanisms under the umbrella of the sustainable development goals and the global strategy pave the way for a global agenda in which securing women’s health is critical. PMID:28491127

South-Africa (Goodstart III) trial: community-based maternal and newborn care economic analysis.

PubMed

Daviaud, Emmanuelle; Nkonki, Lungiswa; Ijumba, Petrida; Doherty, Tanya; Lawn, Joy E; Owen, Helen; Jackson, Debra; Tomlinson, Mark

2017-10-01

In light of South Africa's generalized HIV/AIDS epidemic coupled with high infant mortality, we undertook a cluster Randomized Control Trial (2008-10) assessing the effect of Community Health Worker (CHW) antenatal and postnatal home visits on, amongst other indicators, levels of HIV-free survival, and exclusive and appropriate infant feeding at 12 weeks. Cost and time implications were calculated, by assessing the 15 participating CHWs, using financial records, mHealth and interviews. Sustainability and scalability were assessed, enabling identification of health system issues. The majority (96%) of women in the community received an average of 4.1 visits (target seven). The paid, single purpose CHWs spent 13 h/week on the programme. The financial cost per mother amounted to $94 ($23 per home visit). Modelling target coverage (95% mothers, seven visits) and increased efficiency showed that if CHWs spent 25 h/week on the programme, the number of CHWs required would decrease from 15 to 12. The intervention almost doubled exclusive breastfeeding (EBF) at 12 weeks and showed a 6% relative increase in EBF with each additional CHW visit. Home visit programmes improve access and prevention but are not an inexpensive alternative: the observed cost per home visit is twice that of a clinic visit and in target/efficiency scenario decreases to 70% of the cost of a clinic visit. Ensuring sustainability requires optimizing the design of programmes and deployment of human resources, whilst maintaining impact. However, low remuneration of CHWs leads to shorter working hours, low motivation and sub-optimal coverage even in a situation with well-resourced supervision. The community-based care programme in South-Africa is based on multi-purpose CHWs, its cost and impact should be compared with results from this study. Quality of support for multi-purpose CHWs may be the biggest challenge to address to achieving higher efficiency of community-based services. ISRCTN41046462. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Towards achieving Abuja targets: identifying and addressing barriers to access and use of insecticides treated nets among the poorest populations in Kenya.

PubMed

Chuma, Jane; Okungu, Vincent; Ntwiga, Janet; Molyneux, Catherine

2010-03-16

Ensuring that the poor and vulnerable population benefit from malaria control interventions remains a challenge for malaria endemic countries. Until recently, ownership and use of insecticides treated nets (ITNs) in most countries was low and inequitable, although coverage has increased in countries where free ITN distribution is integrated into mass vaccination campaigns. In Kenya, free ITNs were distributed to children aged below five years in 2006 through two mass campaigns. High and equitable coverage were reported after the campaigns in some districts, although national level coverage remained low, suggesting that understanding barriers to access remains important. This study was conducted to explore barriers to ownership and use of ITNs among the poorest populations before and after the mass campaigns, to identify strategies for improving coverage, and to make recommendations on how increased coverage levels can be sustained. The study was conducted in the poorest areas of four malaria endemic districts in Kenya. Multiple data collection methods were applied including: cross-sectional surveys (n = 708 households), 24 focus group discussions and semi-structured interviews with 70 ITN suppliers. Affordability was reported as a major barrier to access but non-financial barriers were also shown to be important determinants. On the demand side key barriers to access included: mismatch between the types of ITNs supplied through interventions and community preferences; perceptions and beliefs on illness causes; physical location of suppliers and; distrust in free delivery and in the distribution agencies. Key barriers on the supply side included: distance from manufacturers; limited acceptability of ITNs provided through interventions; crowding out of the commercial sector and the price. Infrastructure, information and communication played a central role in promoting or hindering access. Significant resources have been directed towards addressing affordability barriers through providing free ITNs to vulnerable groups, but the success of these interventions depends largely on the degree to which other barriers to access are addressed. Only if additional efforts are directed towards addressing non-financial barriers to access, will high coverage levels be achieved and sustained.

Managing the Risks of Climate Change and Terrorism

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rosa, Eugene; Dietz, Tom; Moss, Richard H.

2012-04-07

Society has difficult decisions to make about how best to allocate its resources to ensure future sustainability. Risk assessment can be a valuable tool: it has long been used to support decisions to address environmental problems. But in a time when the risks to sustainability range from climate change to terrorism, applying risk assessment to sustainability will require careful rethinking. For new threats, we will need a new approach to risk assessment.

Using the Program Sustainability Assessment Tool to Assess and Plan for Sustainability

PubMed Central

Mainor, Avia; Moreland-Russell, Sarah; Maier, Ryan C.; Brossart, Laura; Luke, Douglas A.

2014-01-01

Implementing and growing a public health program that benefits society takes considerable time and effort. To ensure that positive outcomes are maintained over time, program managers and stakeholders should plan and implement activities to build sustainability capacity within their programs. We describe a 3-part sustainability planning process that programs can follow to build their sustainability capacity. First, program staff and stakeholders take the Program Sustainability Assessment Tool to measure their program’s sustainability across 8 domains. Next, managers and stakeholders use results from the assessment to inform and prioritize sustainability action planning. Lastly, staff members implement the plan and keep track of progress toward their sustainability goals. Through this process, staff can more holistically address the internal and external challenges and pressures associated with sustaining a program. We include a case example of a chronic disease program that completed the Program Sustainability Assessment Tool and engaged in program sustainability planning. PMID:24456644

Organizational characteristics of HIV/syphilis testing services for men who have sex with men in South China: a social entrepreneurship analysis and implications for creating sustainable service models.

PubMed

Tucker, Joseph D; Muessig, Kathryn E; Cui, Rosa; Bien, Cedric H; Lo, Elaine J; Lee, Ramon; Wang, Kaidi; Han, Larry; Liu, Feng-Ying; Yang, Li-Gang; Yang, Bin; Larson, Heidi; Peeling, Rosanna W

2014-11-25

UNAIDS has called for greater HIV/syphilis testing worldwide just as local HIV/syphilis testing programs are cut or altered. New models are needed to make HIV/syphilis testing services sustainable while retaining their essential public health function. Social entrepreneurship, using business principles to promote a social cause, provides a framework to pilot programs that sustainably expand testing. Drawing on fieldwork in two South Chinese cities, we examined organizational and financial characteristics of current HIV/syphilis testing systems for men who have sex with men (MSM) in addition to new pilot programs focused on revenue-generation for sustainability. We undertook a qualitative study to explore organizational and financial characteristics of HIV/syphilis testing for MSM. Data were collected from men who have sex with men and policy stakeholders in Guangzhou and Hong Kong. Framework analysis was used to identify themes and then code the data. Our qualitative research study included MSM and policy stakeholders (n = 84). HIV/syphilis testing services were implemented at a wide range of organizations which we grouped broadly as independent community-based organizations (CBOs), independent clinics, and hybrid CBO-clinic sites. From an organizational perspective, hybrid CBO-clinic sites offered the inclusive environment of an MSM CBO linked to the technical capacity and trained staff of a clinic. From a financial perspective, stakeholders expressed concern about the sustainability and effectiveness of sexual health services reliant on external funding. We identified four hybrid CBO-clinic organizations that launched pilot testing programs in order to generate revenue while expanding HIV testing. Many MSM CBOs are searching for new organizational models to account for decreased external support. Hybrid CBO-clinic organizations create a strong foundation to increase HIV/syphilis testing using social entrepreneurship models in China.

78 FR 69413 - Meeting of the Environmental Financial Advisory Board; Public Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-19

... topics: tribal environmental programs; transit- oriented development in sustainable communities, energy efficiency/ green house gas emissions reduction; drinking water pricing and infrastructure investment; and...

77 FR 27832 - Shipping Coordinating Committee; Notice of Committee Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-11

... Scheme --Integration of women in the maritime sector --Global maritime training institutions --Impact... financial sustainability of the Organization --Voluntary IMO Member State Audit Scheme --Consideration of...

Controlling Neglected Tropical Diseases (NTDs) in Haiti: Implementation Strategies and Evidence of Their Success

PubMed Central

Lemoine, Jean Frantz; Desormeaux, Anne Marie; Monestime, Franck; Fayette, Carl Renad; Desir, Luccene; Direny, Abdel Nasser; Carciunoiu, Sarah; Miller, Lior; Knipes, Alaine; Lammie, Patrick; Smith, Penelope; Stockton, Melissa; Trofimovich, Lily; Bhandari, Kalpana; Reithinger, Richard; Crowley, Kathryn; Ottesen, Eric; Baker, Margaret

2016-01-01

Lymphatic filariasis (LF) and soil-transmitted helminths (STH) have been targeted since 2000 in Haiti, with a strong mass drug administration (MDA) program led by the Ministry of Public Health and Population and its collaborating international partners. By 2012, Haiti’s neglected tropical disease (NTD) program had reached full national scale, and with such consistently good epidemiological coverage that it is now able to stop treatment for LF throughout almost all of the country. Essential to this success have been in the detail of how MDAs were implemented. These key programmatic elements included ensuring strong community awareness through an evidence-based, multi-channel communication and education campaign facilitated by voluntary drug distributors; strengthening community trust of the drug distributors by ensuring that respected community members were recruited and received appropriate training, supervision, identification, and motivation; enforcing a “directly observed treatment” strategy; providing easy access to treatment though numerous distribution posts and a strong drug supply chain; and ensuring quality data collection that was used to guide and inform MDA strategies. The evidence that these strategies were effective lies in both the high treatment coverage obtained– 100% geographical coverage reached in 2012, with almost all districts consistently achieving well above the epidemiological coverage targets of 65% for LF and 75% for STH—and the significant reduction in burden of infection– 45 communes having reached the target threshold for stopping treatment for LF. By taking advantage of sustained international financial and technical support, especially during the past eight years, Haiti’s very successful MDA campaign resulted in steady progress toward LF elimination and development of a strong foundation for ongoing STH control. These efforts, as described, have not only helped establish the global portfolio of “best practices” for NTD control but also are poised to help solve two of the most important future NTD challenges—how to maintain control of STH infections after the community-based LF “treatment platform” ceases and how to ensure appropriate morbidity management for patients currently suffering from lymphatic filarial disease. PMID:27706162

Controlling Neglected Tropical Diseases (NTDs) in Haiti: Implementation Strategies and Evidence of Their Success.

PubMed

Lemoine, Jean Frantz; Desormeaux, Anne Marie; Monestime, Franck; Fayette, Carl Renad; Desir, Luccene; Direny, Abdel Nasser; Carciunoiu, Sarah; Miller, Lior; Knipes, Alaine; Lammie, Patrick; Smith, Penelope; Stockton, Melissa; Trofimovich, Lily; Bhandari, Kalpana; Reithinger, Richard; Crowley, Kathryn; Ottesen, Eric; Baker, Margaret

2016-10-01

Lymphatic filariasis (LF) and soil-transmitted helminths (STH) have been targeted since 2000 in Haiti, with a strong mass drug administration (MDA) program led by the Ministry of Public Health and Population and its collaborating international partners. By 2012, Haiti's neglected tropical disease (NTD) program had reached full national scale, and with such consistently good epidemiological coverage that it is now able to stop treatment for LF throughout almost all of the country. Essential to this success have been in the detail of how MDAs were implemented. These key programmatic elements included ensuring strong community awareness through an evidence-based, multi-channel communication and education campaign facilitated by voluntary drug distributors; strengthening community trust of the drug distributors by ensuring that respected community members were recruited and received appropriate training, supervision, identification, and motivation; enforcing a "directly observed treatment" strategy; providing easy access to treatment though numerous distribution posts and a strong drug supply chain; and ensuring quality data collection that was used to guide and inform MDA strategies. The evidence that these strategies were effective lies in both the high treatment coverage obtained- 100% geographical coverage reached in 2012, with almost all districts consistently achieving well above the epidemiological coverage targets of 65% for LF and 75% for STH-and the significant reduction in burden of infection- 45 communes having reached the target threshold for stopping treatment for LF. By taking advantage of sustained international financial and technical support, especially during the past eight years, Haiti's very successful MDA campaign resulted in steady progress toward LF elimination and development of a strong foundation for ongoing STH control. These efforts, as described, have not only helped establish the global portfolio of "best practices" for NTD control but also are poised to help solve two of the most important future NTD challenges-how to maintain control of STH infections after the community-based LF "treatment platform" ceases and how to ensure appropriate morbidity management for patients currently suffering from lymphatic filarial disease.

How to choose the right financial planner.

PubMed

Maurer, Timothy J

2010-01-01

An "economic Pearl Harbor." That is how the world's most famous investor, Warren Buffett, described what we have gone through and what we're still going through.' Even the most optimistic appraisals of our economic conditions suggest that we are likely to feel the effects of the Great Recession through the decade we recently entered. Healthcare reform, in whatever form, may also create change in your medical practice ranging from immaterial to revolutionary. To whom should you turn to ensure that your personal economy survives and thrives, especially in these times? A financial planner, possibly, but what is a financial planner, how do you choose one, and what sort of service should you expect?

Equitable Access to Healthcare Services and Income Replacement for Cancer: Is Critical Illness Insurance a Help or a Hindrance?

PubMed Central

Longo, Christopher J.

2010-01-01

Canada's publicly funded healthcare system ensures that medically necessary hospital and physician services are available without financial barriers, but not all community-based care is covered. Consequently, many patients experience financial shocks (FS) related to community-based healthcare services not funded by government, and perhaps also from lost income, a situation that may be difficult for patients to avoid. Critical illness insurance (CII) offers a patient-funded alternative to those who qualify and desire protection against FS, leaving those without CII exposed. The author discusses the benefits and limitations of CII to mitigate financially derived healthcare access inequities, using cancer as an example. PMID:21532761

Principles and practices board. Issue Analysis 98-1. Compliance with laws and regulations for healthcare organizations. Healthcare Financial Management Association.

PubMed

1998-09-01

This is the third Issue Analysis of HFMA's Principles and Practices (P&P) Board. The P&P Board writes an Issue Analysis in response to the need for practical information on emerging issues in healthcare financial management. An Issue Analysis is factual but not authoritative. It is not sent out for public comment and provides the healthcare industry short-term assistance on emerging issues. The purpose of P&P Board Issue Analysis 98-1, Compliance with Laws and Regulations for Healthcare Organizations, is to help healthcare financial managers understand their responsibility to implement and maintain an effective internal control system to ensure compliance with laws and regulations.

Ensuring Sustainability of Tomorrow through Green Chemistry Integrated with Sustainable Development Concepts (SDCS)

ERIC Educational Resources Information Center

Karpudewan, Mageswary; Ismail, Zurida; Roth, Wolff-Michael

2012-01-01

The purpose of this article is to describe a best practice: an approach to teaching chemistry that our quantitative research has shown to produce large differences between experimental and control groups in terms of achievement, pro-environmental attitudes, values, and motivation. Our interest in teaching chemistry by focusing on sustainable…

RESTORATION PLUS: A COLLABORATIVE RESEARCH PROGRAM TO DEVELOP AND EVALUATE ECOSYSTEM RESTORATION AND MANAGEMENT OPTIONS TO ACHIEVE ECOLOGICALLY AND ECONOMICALLY SUSTAINABLE SOLUTIONS

EPA Science Inventory

EPA is evaluating ecosystem restoration and management techniques to ensure they create sustainable solutions for degraded watersheds. ORD NRMRL initiated the Restoration Plus (RePlus) program in 2002 to a) evaluate ecosystem restoration and management options, b) assess the non-...

Regenerating Rural Social Space? Teacher Education for Rural-Regional Sustainability

ERIC Educational Resources Information Center

Reid, Jo-Anne; Green, Bill; Cooper, Maxine; Hastings, Wendy; Lock, Graeme; White, Simone

2010-01-01

The complex interconnection among issues affecting rural-regional sustainability requires an equally complex program of research to ensure the attraction and retention of high-quality teachers for rural children. The educational effects of the construction of the rural within a deficit discourse are highlighted. A concept of rural social space is…

INCORPORATING RESILIENCE INTO LAW AND POLICY: A case for preserving a natural resource legacy and promoting a sustainable future

EPA Science Inventory

The concept of sustainability has been widely embraced by society and in environmental law and policy as a measure to ensure a heritage of economic viability, social equity, and environmental stewardship. In a large number of statutes, Congress and many state legislatures have be...

Variables Associated with Enhanced Sustainability of School-Wide Positive Behavioral Interventions and Supports

ERIC Educational Resources Information Center

McIntosh, Kent; Kim, Jerin; Mercer, Sterett H.; Strickland-Cohen, M. Kathleen; Horner, Robert H.

2015-01-01

Practice sustainability is important to ensure that students have continued access to evidence-based practices. In this study, respondents from a national sample of 860 schools at varying stages of implementing school-wide positive behavioral interventions and supports (SWPBIS) were administered a research-validated measure of factors predicting…

Towards an Integrated Model for Developing Sustainable Assessment Skills

ERIC Educational Resources Information Center

Fastre, Greet M. J.; van der Klink, Marcel R.; Sluijsmans, Dominique; van Merrienboer, Jeroen J. G.

2013-01-01

One of the goals of current education is to ensure that graduates can act as independent lifelong learners. Graduates need to be able to assess their own learning and interpret assessment results. The central question in this article is how to acquire sustainable assessment skills, enabling students to assess their performance and learning…

Open Education and the Sustainable Development Goals: Making Change Happen

ERIC Educational Resources Information Center

Lane, Andy

2017-01-01

Education for All has been a concept at the heart of international development since 1990 and has found its latest instantiation within the Sustainable Development Goals (SDGs) as SDG 4, "Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all". Open education, in the form of resources and…

Education for Sustainability: Becoming Naturally Smart

ERIC Educational Resources Information Center

Clarke, Paul

2011-01-01

In this book, Paul Clarke argues that in order to live sustainably we need to learn how to live and flourish in our environment in a manner that uses finite resources with ecologically informed discretion. Education is perfectly placed to create the conditions for innovative and imaginative solutions and to provide the formulas that ensure that…

Sustaining Parenting Education in WI

ERIC Educational Resources Information Center

Riley, Dave; Eisenmann, Kathleen; Gruenewald, Mary

2004-01-01

How can educators ensure that a good parenting program continues to be offered in the community year after year? A project in Wisconsin illustrates one way to create this sustained commitment and funding. This project has worked well, has been fairly easy and inexpensive, and has even led to new opportunities for parenting education. The project…

Emergency department information system implementation and process redesign result in rapid and sustained financial enhancement at a large academic center.

PubMed

Shapiro, Jason S; Baumlin, Kevin M; Chawla, Neal; Genes, Nicholas; Godbold, James; Ye, Fen; Richardson, Lynne D

2010-05-01

The objectives were to measure the financial impact of implementing a fully integrated emergency department information system (EDIS) and determine the length of time to "break even" on the initial investment. A before-and-after study design was performed using a framework of analysis consisting of four 15-month phases: 1) preimplementation, 2) peri-implementation, 3) postimplementation, and 4) sustained effects. Registration and financial data were reviewed. Costs and rates of professional and facility charges and receipts were calculated for the phases in question and compared against monthly averages for covariates such as volume, collections rates, acuity, age, admission rate, and insurance status with an autoregressive time series analysis using a segmented model. The break-even point was calculated by measuring cumulative monthly receipts for the last three study phases in excess of the average monthly receipts from the preimplementation phase, corrected for change in volume, and then plotting this against cumulative overall cost. Time to break even on the initial EDIS investment was less than 8 months. Total revenue enhancement at the end of the 5-year study period was $16,138,953 with an increase of 69.40% in charges and 70.06% in receipts. This corresponds to an increase in receipts per patient from $50 to $90 for professional services and $131 to $183 for facilities charges. Other than volume, there were no significant changes in trends for covariates between the preimplementation and sustained-effects periods. A comprehensive EDIS implementation with process redesign resulted in sustained increases in professional and facility revenues and a rapid initial break-even point. .

Do your nurses speak finance?

PubMed

Studer, Quint

2010-06-01

To ensure that financial and clinical leaders have the same perspective on the direction their organization is taking, hospitals should: Build a platform of common understanding. Connect to the"why". Be transparent. Give clinical leaders the tools they need. Create true collaboration.

Elevating the role of finance at Mary Lanning Healthcare.

PubMed

Hoffman, Amanda; Spence, Jay

2013-11-01

To effectively partner with hospital operations leaders, healthcare finance leaders should: Streamline and align financial planning and budgeting functions across the organization; Ensure capital planning is regarded as a strategic process; Optimize performance monitoring across management levels.

40 CFR 31.37 - Subgrants.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE UNIFORM ADMINISTRATIVE REQUIREMENTS FOR GRANTS AND COOPERATIVE AGREEMENTS TO STATE AND LOCAL GOVERNMENTS Post-Award...) of financial assistance to local and Indian tribal governments. States shall: (1) Ensure that every...

The Good Buy.

ERIC Educational Resources Information Center

Newsom, John

2002-01-01

Describes school purchasing process, examples of illegal or wasteful purchasing activities, a concise ethical guide to school purchasing excerpted from the Texas Agency's Financial Accountability System Resource Guide, and suggestions from experts on how schools can ensure legal and ethical purchasing practices. (PKP)

12 CFR 1815.114 - Fund decisionmaking procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Section 1815.114 Banks and Banking COMMUNITY DEVELOPMENT FINANCIAL INSTITUTIONS FUND, DEPARTMENT OF THE... the decisionmaking process, shall accompany the relevant proposal or action through the Fund's decisionmaking process to ensure adequate consideration of environmental factors; (b) The Decisionmaker shall...

48 CFR 2032.402 - General.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Chief Financial Officer, Division of Accounting and Finance, to ensure completeness of contractor... REQUIREMENTS CONTRACT FINANCING Advance Payments for Non-Commercial Items 2032.402 General. (a) The contracting... contract terms concerning advance payments. (b) Before authorizing any advance payment agreements, except...

A heterogeneous artificial stock market model can benefit people against another financial crisis

PubMed Central

2018-01-01

This paper presents results of an artificial stock market and tries to make it more consistent with the statistical features of real stock data. Based on the SFI-ASM, a novel model is proposed to make agents more close to the real world. Agents are divided into four kinds in terms of different learning speeds, strategy-sizes, utility functions, and level of intelligence; and a crucial parameter has been found to ensure system stability. So, some parameters are appended to make the model which contains zero-intelligent and less-intelligent agents run steadily. Moreover, considering real stock markets change violently due to the financial crisis; the real stock markets are divided into two segments, before the financial crisis and after it. The optimal modified model before the financial crisis fails to replicate the statistical features of the real market after the financial crisis. Then, the optimal model after the financial crisis is shown. The experiments indicate that the optimal model after the financial crisis is able to replicate several of real market phenomena, including the first-order autocorrelation, kurtosis, standard deviation of yield series and first-order autocorrelation of yield square. We point out that there is a structural change in stock markets after the financial crisis, which can benefit people forecast the financial crisis. PMID:29912893

A heterogeneous artificial stock market model can benefit people against another financial crisis.

PubMed

Yang, Haijun; Chen, Shuheng

2018-01-01

This paper presents results of an artificial stock market and tries to make it more consistent with the statistical features of real stock data. Based on the SFI-ASM, a novel model is proposed to make agents more close to the real world. Agents are divided into four kinds in terms of different learning speeds, strategy-sizes, utility functions, and level of intelligence; and a crucial parameter has been found to ensure system stability. So, some parameters are appended to make the model which contains zero-intelligent and less-intelligent agents run steadily. Moreover, considering real stock markets change violently due to the financial crisis; the real stock markets are divided into two segments, before the financial crisis and after it. The optimal modified model before the financial crisis fails to replicate the statistical features of the real market after the financial crisis. Then, the optimal model after the financial crisis is shown. The experiments indicate that the optimal model after the financial crisis is able to replicate several of real market phenomena, including the first-order autocorrelation, kurtosis, standard deviation of yield series and first-order autocorrelation of yield square. We point out that there is a structural change in stock markets after the financial crisis, which can benefit people forecast the financial crisis.

Challenges and strategies for sustaining youth-friendly health services - a qualitative study from the perspective of professionals at youth clinics in northern Sweden.

PubMed

Thomée, Suzanne; Malm, Desiré; Christianson, Monica; Hurtig, Anna-Karin; Wiklund, Maria; Waenerlund, Anna-Karin; Goicolea, Isabel

2016-12-21

Youth-friendly health-care services - those that are accessible, acceptable, equitable, appropriate and effective for different youth subpopulations - are beneficial for youth health, but not easy to implement and sustain. Sweden is among the few countries where youth-friendly health-care services have been integrated within the public health system and sustained for a long time. This study explores the challenges and strategies in providing sustainable youth-friendly health-care services, from the perspective of professionals working in youth clinics in northern Sweden. Eleven semi-structured interviews with various health-care professionals working in youth clinics in northern Sweden were conducted. The interviews were transcribed verbatim, and analysed using thematic analysis in relation to the World Health Organization domains of youth friendliness. Four themes emerged from the analysis of the data: 1) 'Meeting youths on their own terms - the key to ensuring a holistic and youth-centred care' was related to the acceptability and appropriateness of the services; 2) 'Organizational challenges and strategies in keeping professionals' expertise on youth updated' referred to the domain of effectiveness; 3) 'Youth clinics are accessible for those who know and can reach them' was related to the domains of accessibility and equity, and 4) 'The challenge of combining strong directions and flexibility in diverse local realities' focused on the struggle to sustain the youth clinics organization and their goals within the broader health system. Professionals working in youth clinics are perceived as motivated, interested and knowledgeable about youth, and the clinics ensure confidentiality and a youth-centred and holistic approach. Challenges remain, especially in terms of ensuring equitable access to different youth subpopulations, improving monitoring routines and ensuring training and competence for all professionals, independently of the location and characteristics of the clinic. Youth clinics are perceived as an indisputable part of the Swedish health system, but organizational challenges are also pointed out in terms of weak clear directives and leadership, heavy workload, local/regional diversity and unequitable distribution of resources.

Environmental Engineering in the Slovak Republic

NASA Astrophysics Data System (ADS)

Stevulova, N.; Balintova, M.; Zelenakova, M.; Estokova, A.; Vilcekova, S.

2017-10-01

The fundamental role of environmental engineering is to protect human population and environment from impacts of human activities and to ensure environmental quality. It relates to achieving the environmental sustainability goals through advanced technologies for pollutants removing from air, water and soil in order to minimize risk in ecosystem and ensuring favourable conditions for life of humans and organisms. Nowadays, a critical analysis of the environment quality and innovative approaches to problem solving in order to achieve sustainability in environmental engineering, are necessary. This article presents an overview of the quality of the environment and progress in environmental engineering in Slovakia and gives information regarding the environmental engineering education at Faculty of Civil Engineering at Technical University in Kosice.

Aligning Utility Incentives with Investment in Energy Efficiency

EPA Pesticide Factsheets

Describes the financial effects on a utility of its spending on energy efficiency programs, how those effects could constitute barriers to more aggressive and sustained utility investment in energy efficiency.

Multidrug-resistant tuberculosis: The problem and some priorities in controlling it.

PubMed

Hoffner, Sven

2016-12-01

Multidrug-resistant tuberculosis (MDR-TB), and even more severe forms of drug resistance, cause significant problems and costs for national TB control programs and constitutes an increasing public health concern globally. In parts of the former Soviet Union, the prevalence of MDR-TB is as high as 50% and one third of all newly detected TB patients are infected with MDR strains. Such strains transmit and certain MDR-TB clones constitute an important part of the problem, especially in high MDR-TB burden areas. There are several actions that should be given priority to control this situation. A first important step is timely detection of all patients infected with resistant strains, which makes possible prompt change of standard TB chemotherapy to more effective combinations of drugs. This is important both from the public health and clinical perspectives, since it renders the individual patient noninfectious and subsequently cured. Early detection of MDR-TB also allows infection control to be focused where it is most needed. Strengthened infection control measures are crucial for limiting the ongoing spread of resistant TB in hospitals and elsewhere. In addition, a sustainable drug supply must be ensured to guarantee that all patients are initiated on effective treatment and can avoid interruptions due to drug shortages. An extra focus should be put on vulnerable cases, such as immunosuppressed individuals, prisoners, drug addicts, and migrants, in whom TB is generally more frequent and difficult to control than in the normal population. Finally, political support is needed to ensure necessary infrastructures, human and financial resources to effectively control drug resistant TB. Copyright © 2016.

Managing Enrollments for Institutional Vitality.

ERIC Educational Resources Information Center

Hossler, Don

1985-01-01

The concept of enrollment management is gaining acceptance as a means of ensuring institutional vitality. Those responsible for enrollment management must have direct responsibility for: student marketing and recruitment, pricing and financial aid, academic and career advising, academic assistance programs, institutional research, orientation,…

77 FR 73454 - Revision of Information Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-10

... ensure that requested data can be provided in the desired format, reporting burden (time and financial... with standard national performance measure requirements; revise the Grant Application Narrative... express the desired outcomes; Facilitate stronger alignment between narrative sections and the performance...

30 CFR 778.8 - Information collection.

Code of Federal Regulations, 2010 CFR

2010-07-01

... COAL MINING AND RECLAMATION OPERATIONS PERMITS AND COAL EXPLORATION SYSTEMS UNDER REGULATORY PROGRAMS PERMIT APPLICATIONS-MINIMUM REQUIREMENTS FOR LEGAL, FINANCIAL, COMPLIANCE, AND RELATED INFORMATION § 778...-0117. The information collected will be used by the regulatory authority to ensure that all legal...

12 CFR 1750.1 - General.

Code of Federal Regulations, 2010 CFR

2010-01-01

... a level that is sufficient to ensure the continued financial viability of the Enterprise and that equals or exceeds the minimum capital requirement contained in this subpart A. ... AND SOUNDNESS CAPITAL Minimum Capital § 1750.1 General. The regulation contained in this subpart A...

The "Som la Pera" intervention: sustainability capacity evaluation of a peer-led social-marketing intervention to encourage healthy lifestyles among adolescents.

PubMed

Llauradó, Elisabet; Aceves-Martins, Magaly; Tarro, Lucia; Papell-Garcia, Ignasi; Puiggròs, Francesc; Prades-Tena, Jordi; Kettner, Helle; Arola, Lluis; Giralt, Montse; Solà, Rosa

2018-02-10

Sustainability capacity, always considered a challenge, is the ability to maintain effective long-term intervention in a community. The aim of the study was to improve the sustainability capacity of effective "Som la Pera," a school-based, peer-led, social-marketing intervention that encourages healthy diet and physical activity, in low socioeconomic adolescents from Spain. The sustainability capacity was analyzed by a "programme sustainability assessment tool (PSAT)" comprising eight domains: political support, funding stability, partnerships, organizational capacity, programme evaluation, programme adaptation, communications, and strategic planning. Each domain was evaluated from 1 (no or to a small extent) to 7 points (to a great extent). The final score for sustainability capacity was the mean of the eight domain scores. The PSAT was assessed by nine professionals (researchers, staff members, and stakeholders) at two periods during intervention implementation: end of the first year (January 2015) and end of the second year (September 2015). At the end of the first year, strategic planning (4.43 ± 1.98) and funding stability (4.38 ± 1) were considered deficient domains, and at the end of the second year, these domains had improved by 1.67 points (p =.043) and 0.59 points (p = .159), respectively. The funding stability increase was not significant because only one of the five specific items, "policies implemented to ensure sustained funding," improved by 1.08 points (p = .036). The sustainability capacity final score was 5.93 ± 1.13. The sustainability capacity assessment during the intervention allows its improvement before the programme expires, ensuring the long-term implementation of the "Som la Pera" intervention programme to encourage healthy lifestyles in adolescents. © Society of Behavioral Medicine 2018. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

7 CFR 1709.110 - Use of grant funds.

Code of Federal Regulations, 2010 CFR

2010-01-01

... help establish the financial and technical sustainability of the project, provided that such costs do not exceed more than 10 percent of total project costs; (2) Design and engineering costs, including...

An older worker's decision to "push or protect self" following a work-related injury.

PubMed

Stikeleather, Jill

2004-01-01

This study highlights the return-to-work experience of older workers on worker's compensation as there is a dearth of research in this area. Qualitative research methods delineated the experience of four older workers who had sustained work-related musculoskeletal injuries. "Push or Protect Self" emerged as the core category with three themes, including the level of employer support and degree of flexibility in work; continued health problems; and financial distress. These themes influenced each worker's decision to either "push self" to meet their pre-injury work demands, or "protect self" and accept a job post-injury that was less physically demanding, but was at a lower pay level. The four workers sustained financial difficulties subsequent to being off work, and reported continued health problems related to their injuries after being discharged from the worker's compensation system. Degree of employer support in providing flexibility in work demands varied, where low support and inflexibility in job tasks contributed to difficulty in returning to work or in sustaining the work demands of the job.

Sustainable Development and Protection of the Environment: Two Management Strategies Not Always Compatible

NASA Astrophysics Data System (ADS)

Athanassakis, Artemios M.

2010-01-01

The definition of Sustainable Development has received intense criticism and contestations with the result, that International Union for the Conservation of Natural Resources (I.U.C.N.), and the World Wide Fund for Nature (W.W.F.) clarified that sustainable development means the improvement of life quality, inside the limits of clarified capacity of ecosystems. According to its critics, is considered as a general concept, indefinite and contradictory. Those disputes put the accent on the close relation between the Sustainable Development and the values of the today's global market. This relationship transforms the Sustainable Development to an one dimensional economical growth with the "ecological ornaments" of sustainability and protection of environment. Therefore this paper looks for, whether the sustainable development consists one more device, focuses on the world financial system, or establishes one optimistic developmental perspective, which might harmonize the economical activities with the natural function of our planetic ecosystems.

Cost Analysis of Establishing a Relationship Between a Surgical Program in the US and Vietnam

PubMed Central

Chu, Quyen D.; Nguyen, Thu; Nguyen, Phuong; Ho, Hung S.

2012-01-01

“Twinning” refers to a constructive partnership between hospitals in developed and developing nations. Such an effort may contribute immensely to capacity building for the developing nation, but one of the reasons given for the lack of sustainability is cost. We share a detailed operating cost analysis of our recent experience with an institution in Vietnam. We were awarded a 1-year $54,000 grant from the Vietnam Education Foundation (VEF) to conduct a live tele-video conferencing course on the “Fundamentals of Clinical Surgery” with Thai Binh Medical University (TBMU). In-country lectures as well as an assessment of the needs at TBMU were performed. Total financial assistance and expenditures were tabulated to assess up-front infrastructure investment and annual cost required to sustain the program. The total amount of direct money ($66,686) and in-kind services ($70,276) was $136,962. The initial infrastructure cost was $41,085, which represented 62% of the direct money received. The annual cost to sustain the program was approximately $11,948. We concluded that the annual cost to maintain a “twinning” program was relatively low, and the efforts to sustain a “twinning” program were financially feasible and worthwhile endeavors. “Twinning” should be a critical part of the surgical humanitarian volunteerism effort. PMID:23102082

Cost analysis of establishing a relationship between a surgical program in the US and Vietnam.

PubMed

Chu, Quyen D; Nguyen, Thu; Nguyen, Phuong; Ho, Hung S

2012-01-01

"Twinning" refers to a constructive partnership between hospitals in developed and developing nations. Such an effort may contribute immensely to capacity building for the developing nation, but one of the reasons given for the lack of sustainability is cost. We share a detailed operating cost analysis of our recent experience with an institution in Vietnam. We were awarded a 1-year $54,000 grant from the Vietnam Education Foundation (VEF) to conduct a live tele-video conferencing course on the "Fundamentals of Clinical Surgery" with Thai Binh Medical University (TBMU). In-country lectures as well as an assessment of the needs at TBMU were performed. Total financial assistance and expenditures were tabulated to assess up-front infrastructure investment and annual cost required to sustain the program. The total amount of direct money ($66,686) and in-kind services ($70,276) was $136,962. The initial infrastructure cost was $41,085, which represented 62% of the direct money received. The annual cost to sustain the program was approximately $11,948. We concluded that the annual cost to maintain a "twinning" program was relatively low, and the efforts to sustain a "twinning" program were financially feasible and worthwhile endeavors. "Twinning" should be a critical part of the surgical humanitarian volunteerism effort.

Biobanking 3.0: evidence based and customer focused biobanking.

PubMed

Simeon-Dubach, Daniel; Watson, Peter

2014-03-01

Biobanking is a new and very dynamic field. To achieve long term financial sustainability of biobank infrastructures we propose that a new focus is needed on activities, products and services provided by the biobank that relate to the external stakeholder: biobanking 3.0. Earlier stages of biobanking are biobanking 1.0 (primary focus on the number of biospecimens and data) and biobanking 2.0 (primary focus on the quality of biospecimens and data). Both stages 1.0 and 2.0 are predominantly product oriented areas and have required a mostly internal focus on operational development within the biobank itself. In this paper we will introduce our concept of biobanking 3.0 which capitalizes on the earlier stages but dictates a shift in focus to enhancing the value and impact for the three major sets of external stakeholders (people/patients, funders, and research customers) and creating a path to balanced and planned investment in biobank infrastructure and the sustainability of biobanking. Biobanking 3.0 will improve real understanding as well as perceptions of value across different stakeholders. Patients and donors will appreciate seeing how their biospecimens and data are effectively used for research. Funders will value the ability to plan efficient targeting of funding and to monitor the impact of their support. Researchers will capitalize on the ability to translate their ideas into effective knowledge. Ultimately adoption of biobanking 3.0 will impact on the sustainability in the three main dimensions relevant to biobanking: social sustainability (acceptability), operational sustainability (efficiency), and financial sustainability (accomplishment). Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

Sustainability of High Intensity Forest Management with Respect to Water QuaIity and Site Nutrient Reserves

Treesearch

Virginia R. Tolbert; Carl C. Trettin; Dale W. Johnson; John W. Parsons; Allan E. Houston; David A. Mays

2001-01-01

Ensuring sustainability of intensively managed woody crops requires determining soil and water quality effects using a combination of field data and modeling projections. Plot- and catchrnent-scale research, models, and meta-analyses are addressing nutrient availability, site quality, and measures to increase short-rotation woody crop (SRWC) productivity and site...

Using soil quality indicators for monitoring sustainable forest management

Treesearch

James A. Burger; Garland Gray; D. Andrew Scott

2010-01-01

Most private and public forest land owners and managers are compelled to manage their forests sustainably, which means management that is economically viable,environmentally sound, and socially acceptable. To meet this mandate, the USDA Forest Service protects the productivity of our nation’s forest soils by monitoring and evaluating management activities to ensure...

PISA for Development and the Sustainable Development Goals. PISA for Development Brief 17

ERIC Educational Resources Information Center

OECD Publishing, 2017

2017-01-01

The PISA for Development brief series is a set of concise monthly education policy-oriented notes published by the OECD which are designed to describe a specific PISA for Development topic. In this brief, PISA's role in monitoring the fourth United Nations Sustainable Development Goal--to "ensure inclusive and equitable quality education and…

Characteristics of sustainable forest management

Treesearch

Stephen R. Shifley; Francisco X. Aguilar; Nianfu Song; Susan I. Stewart; David J. Nowak; Dale D. Gormanson; W. Keith Moser; Sherri Wormstead; Eric J. Greenfield

2012-01-01

Forests can provide numerous benefits to society today, tomorrow, and far into the future. Many in society seek sustainable forest management to ensure that future generations enjoy those benefits. The foundation of professional forest management is “the use of the natural resources for the greatest good of the greatest number for the longest time” (Gifford Pinchot...

The Sustainable Forestry Initiative of the American Forest & Paper Association

Treesearch

Chris Barneycastle

2001-01-01

The Sustainable Forestry Initiative (SFI)is a comprehensive program of forestry and conservation practices designed to ensure that future generations of Americans will have the same abundant forests that we enjoy today. The SFI was developed by the American Forest & Paper Association (AF&PA),the national trade group that represents forest and paper companies....

Expressions of Liberal Justice? Examining the Aims of the UN's Sustainable Development Goals for Education

ERIC Educational Resources Information Center

VanderDussen Toukan, Elena

2017-01-01

This paper analyzes the United Nations' Sustainable Development Goals (SDGs) for education, which sets benchmarks for member states to "ensure inclusive and equitable quality education and promote lifelong opportunities for all" by the year 2030. I examine ways in which the underlying philosophical rationale for the targets invokes a…

For Function or Transformation? A Critical Discourse Analysis of Education under the Sustainable Development Goals

ERIC Educational Resources Information Center

Brissett, Nigel; Mitter, Radhika

2017-01-01

We conduct a critical discourse analysis of the extent to which Sustainable Development Goal 4, "to ensure inclusive and equitable quality education for all and promote lifelong learning," promotes a utilitarian and/or transformative approach to education. Our findings show that despite transformative language used throughout the Agenda,…

Sinking Ships, Emerging Leadership: A True Story of Sustainability (or the Lack Thereof)

ERIC Educational Resources Information Center

Mulford, Bill; Moreno, Juan Manuel

2006-01-01

Sustainable educational leadership--leadership which leaves a legacy that lasts beyond the leader's professional lifetime--is very much in fashion nowadays. A recent edition of this journal was devoted entirely to the topic (Hargreaves 2005a). However, it is important to ensure that, together with leadership itself, the impact of leadership is…

RESTORATION PLUS: A COLLABORATIVE ENVIRONMENTAL PROTECTION AGENCY RESEARCH PROGRAM TO DEVELOP AND EVALUATE ECOSYSTEM RESTORATION AND MANAGEMENT OPTIONS TO ACHIEVE ECOLOGICALLY AND ECONOMICALLY SUSTAINABLE SOLUTIONS

EPA Science Inventory

The U.S. Environmental Protection Agency (U.S. EPA) is evaluating ecosystem restoration and management techniques to ensure they create sustainable solutions for degraded watersheds. The ORD/NRMRL initiated the Restoration Plus (RePlus) program in 2002, which emphasizes collabora...

7 CFR 1775.11 - Priority.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE... program. (a) Projects proposing to give priority for available services to rural communities having a... demonstrate sustainability of project without Federal financial support. ...

7 CFR 1775.11 - Priority.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE... program. (a) Projects proposing to give priority for available services to rural communities having a... demonstrate sustainability of project without Federal financial support. ...

7 CFR 1775.11 - Priority.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE... program. (a) Projects proposing to give priority for available services to rural communities having a... demonstrate sustainability of project without Federal financial support. ...

7 CFR 1775.11 - Priority.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE... program. (a) Projects proposing to give priority for available services to rural communities having a... demonstrate sustainability of project without Federal financial support. ...

Radiology journals in transition: a summary of the 2013 Intersociety Committee Summer Conference.

PubMed

Dodd, Gerald D

2015-01-01

The digital and online revolution is having a profound impact on radiology journals, forcing a migration from print to online publication and altering traditional revenue streams needed to sustain the journals. The 2013 Intersociety Committee Summer Conference attendees reviewed the history of the development of radiology journals, explored the forces driving the transition from print to electronic publication, and examined the impact of the alteration of the traditional revenue streams, such as subscription and advertisement dollars, on the financial sustainability of journals. The attendees also discussed the international movement toward open access to journal content and its impact on a journal's financial viability. Lastly, the committee explored the perceived value of radiology journals based on readership type: academic, private practice, or industry. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Collaborating With Businesses to Support and Sustain Research.

PubMed

Moch, Susan Diemert; Jansen, Debra A; Jadack, Rosemary A; Page, Phil; Topp, Robert

2015-10-01

Financial assistance is necessary for sustaining research at universities. Business collaborations are a potential means for obtaining these funds. To secure funding, understanding the process for obtaining these business funds is important for nursing faculty members. Although faculty rarely request funding from businesses, they are often in a position to solicit financial support due to existing relationships with clinical agency administrators, staff, and community leaders. The economic support received from businesses provides outcomes in nursing research, research education, academic-service partnerships, and client health care. This article describes the steps and processes involved in successfully obtaining research funding from businesses. In addition, case examples for securing and maintaining funding from health care agencies (evidence-based practice services) and from a health manufacturing company (product evaluation) are used to demonstrate the process. © The Author(s) 2015.

Health Care Infrastructure for Financially Sustainable Clinical Genomics.

PubMed

Lennerz, Jochen K; McLaughlin, Heather M; Baron, Jason M; Rasmussen, David; Sumbada Shin, Meini; Berners-Lee, Nancy; Miller Batten, Julie; Swoboda, Kathryn J; Gala, Manish K; Winter, Harland S; Schmahmann, Jeremy D; Sweetser, David A; Boswell, Marianne; Pacula, Maciej; Stenzinger, Albrecht; Le, Long P; Hynes, William; Rehm, Heidi L; Klibanski, Anne; Black-Schaffer, Stephen W; Golden, Jeffrey A; Louis, David N; Weiss, Scott T; Iafrate, A John

2016-09-01

Next-generation sequencing has evolved technically and economically into the method of choice for interrogating the genome in cancer and inherited disorders. The introduction of procedural code sets for whole-exome and genome sequencing is a milestone toward financially sustainable clinical implementation; however, achieving reimbursement is currently a major challenge. As part of a prospective quality-improvement initiative to implement the new code sets, we adopted Agile, a development methodology originally devised in software development. We implemented eight functionally distinct modules (request review, cost estimation, preauthorization, accessioning, prebilling, testing, reporting, and reimbursement consultation) and obtained feedback via an anonymous survey. We managed 50 clinical requests (January to June 2015). The fraction of pursued-to-requested cases (n = 15/50; utilization management fraction, 0.3) aimed for a high rate of preauthorizations. In 13 of 15 patients the insurance plan required preauthorization, which we obtained in 70% and ultimately achieved reimbursement in 50%. Interoperability enabled assessment of 12 different combinations of modules that underline the importance of an adaptive workflow and policy tailoring to achieve higher yields of reimbursement. The survey confirmed a positive attitude toward self-organizing teams. We acknowledge the individuals and their interactions and termed the infrastructure: human pipeline. Nontechnical barriers currently are limiting the scope and availability of clinical genomic sequencing. The presented human pipeline is one approach toward long-term financial sustainability of clinical genomics. Copyright © 2016 American Society for Investigative Pathology and the Association for Molecular Pathology. Published by Elsevier Inc. All rights reserved.

The Ponseti Method of Treatment for Clubfoot in Brazil: Barriers to Bracing Compliance

PubMed Central

Nogueira, Monica Paschoal; Fox, Mark; Miller, Kathleen; Morcuende, Jose

2013-01-01

Background Clubfoot is the most common extremity birth defect. It causes the feet of affected individuals to point inward and downward, preventing them from walking normally. Neglected clubfoot causes disabilities that result in a lack of social integration, creating a psychological and financial burden for the family and community. Clubfoot has been effectively treated through the Ponseti method, a treatment utilizing serial casts to correct the deformity followed by use of an abduction brace for approximately 2-4 years. sustained use of the brace is necessary to prevent relapse and ensure a successful outcome. Brace compliance in the setting of limited resources in the developing world can be challenging. The purpose of this study was to identify the barriers to bracing compliance in southeastern Brazil. In addition to socioeconomic and cultural barriers, this study also looked at improper prescribing practices by physicians as a potential cause of noncompliance. The study sought to identify the role of physician education in the use of the Ponseti method and physicians’ knowledge of the bracing process. Purpose of the study Identify the barriers to bracing adherence that could negatively impact the treatment of children with clubfoot. Methods Forty-five orthopedists from several centers in southeastern Brazil were interviewed. Physicians were asked about their training in the Ponseti method, their protocol when prescribing the brace, their evaluation of its importance, and a series of open-ended questions designed to identify the positive and negative qualities of local braces. They were also asked what they perceived to be the biggest challenges to sustained brace use. Results sixteen of the physicians interviewed were orthopedic residents, and 29 had completed their residencies. Of these two groups, only 25% and 65%, respectively, appropriately prescribe the abduction brace for patients, with the majority recommending use of the brace for an inadequate period of time. The high costs and delays in acquisition of the brace and a lack of orthopedic stores able to adequately construct the orthotic, also present considerable barriers to sustained brace use. Conclusions Many of the causes of noncompliance with bracing protocol stem from systemic inequities and challenges, rather than a lack of collaboration from the families themselves. Furthermore, insufficient prescription of the brace by physicians may represent a major barrier to bracing compliance in southeastern Brazil. This research indicates a need to evaluate physician training and continuing medical education in order to ensure that physicians are adequately utilizing the brace. PMID:24027477

The Ponseti method of treatment for clubfoot in Brazil: barriers to bracing compliance.

PubMed

Nogueira, Monica Paschoal; Fox, Mark; Miller, Kathleen; Morcuende, Jose

2013-01-01

Clubfoot is the most common extremity birth defect. It causes the feet of affected individuals to point inward and downward, preventing them from walking normally. Neglected clubfoot causes disabilities that result in a lack of social integration, creating a psychological and financial burden for the family and community. Clubfoot has been effectively treated through the Ponseti method, a treatment utilizing serial casts to correct the deformity followed by use of an abduction brace for approximately 2-4 years. sustained use of the brace is necessary to prevent relapse and ensure a successful outcome. Brace compliance in the setting of limited resources in the developing world can be challenging. The purpose of this study was to identify the barriers to bracing compliance in southeastern Brazil. In addition to socioeconomic and cultural barriers, this study also looked at improper prescribing practices by physicians as a potential cause of noncompliance. The study sought to identify the role of physician education in the use of the Ponseti method and physicians' knowledge of the bracing process. Identify the barriers to bracing adherence that could negatively impact the treatment of children with clubfoot. Forty-five orthopedists from several centers in southeastern Brazil were interviewed. Physicians were asked about their training in the Ponseti method, their protocol when prescribing the brace, their evaluation of its importance, and a series of open-ended questions designed to identify the positive and negative qualities of local braces. They were also asked what they perceived to be the biggest challenges to sustained brace use. sixteen of the physicians interviewed were orthopedic residents, and 29 had completed their residencies. Of these two groups, only 25% and 65%, respectively, appropriately prescribe the abduction brace for patients, with the majority recommending use of the brace for an inadequate period of time. The high costs and delays in acquisition of the brace and a lack of orthopedic stores able to adequately construct the orthotic, also present considerable barriers to sustained brace use. Many of the causes of noncompliance with bracing protocol stem from systemic inequities and challenges, rather than a lack of collaboration from the families themselves. Furthermore, insufficient prescription of the brace by physicians may represent a major barrier to bracing compliance in southeastern Brazil. This research indicates a need to evaluate physician training and continuing medical education in order to ensure that physicians are adequately utilizing the brace.