Science.gov

Sample records for equity waiting times

  1. Equity in specialist waiting times by socioeconomic groups: evidence from Spain.

    PubMed

    Abásolo, Ignacio; Negrín-Hernández, Miguel A; Pinilla, Jaime

    2014-04-01

    In countries with publicly financed health care systems, waiting time--rather than price--is the rationing mechanism for access to health care services. The normative statement underlying such a rationing device is that patients should wait according to need and irrespective of socioeconomic status or other non-need characteristics. The aim of this paper is to test empirically that waiting times for publicly funded specialist care do not depend on patients' socioeconomic status. Waiting times for specialist care can vary according to the type of medical specialty, type of consultation (review or diagnosis) and the region where patients' reside. In order to take into account such variability, we use Bayesian random parameter models to explain waiting times for specialist care in terms of need and non-need variables. We find that individuals with lower education and income levels wait significantly more time than their counterparts.

  2. Reducing client waiting time.

    PubMed

    1992-01-01

    This first issues of Family Planning (FP) Manager focuses on how to analyze client waiting time and reduce long waits easily and inexpensively. Client flow analysis can be used by managers and staff to identify organizational factors affecting waiting time. Symptoms of long waiting times are overcrowded waiting rooms, clients not returning for services, staff complaints about rushing and waiting, and hurried counseling sessions. Client satisfaction is very important in order to retain FP users. Simple procedures such as routing return visits differently can make a difference in program effectiveness. Assessment of the number of first visits, the number of revisits, and types of methods and services that the clinic provides is a first step. Client flow analysis involves assigning a number to each client on registration, attaching the client flow form to the medical chart, entering the FP method and type of visit, asking staff to note the time at each station, and summarizing data in a master chart. The staff should be involved in plotting data for each client to show waiting versus staff contact time through the use of color coding for each type of staff contact. Bottlenecks become very visible when charted. The amount of time spent at each station can be measured, and gaps in client's contact with staff can be identified. An accurate measure of total waiting time can be obtained. A quick assessment can be made by recording arrival and departure times for each client in one morning or afternoon of a peak day. The procedure is to count the number of clients waiting at 15-minute intervals. The process should be repeated every 3-6 months to observe changes. If waiting times appear long, a more thorough assessment is needed on both a peak and a typical day. An example is given of a completed chart and graph of results with sample data. Managers need to set goals for client flow, streamline client routes, and utilize waiting time wisely by providing educational talks

  3. Feedback control of waiting times

    NASA Astrophysics Data System (ADS)

    Brandes, Tobias; Emary, Clive

    2016-04-01

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

  4. 46 CFR 9.10 - Waiting time.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

  5. 46 CFR 9.10 - Waiting time.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  6. 46 CFR 9.10 - Waiting time.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  7. Advertising emergency department wait times.

    PubMed

    Weiner, Scott G

    2013-03-01

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

  8. Advertising emergency department wait times.

    PubMed

    Weiner, Scott G

    2013-03-01

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

  9. Mathematical Models of Waiting Time.

    ERIC Educational Resources Information Center

    Gordon, Sheldon P.; Gordon, Florence S.

    1990-01-01

    Considered are several mathematical models that can be used to study different waiting situations. Problems involving waiting at a red light, bank, restaurant, and supermarket are discussed. A computer program which may be used with these problems is provided. (CW)

  10. Improving Patient Satisfaction with Waiting Time

    ERIC Educational Resources Information Center

    Eilers, Gayleen M.

    2004-01-01

    Waiting times are a significant component of patient satisfaction. A patient satisfaction survey performed in the author's health center showed that students rated waiting time lowest of the listed categories--A ratings of 58% overall, 63% for scheduled appointments, and 41% for the walk-in clinic. The center used a quality improvement process and…

  11. Electron waiting times for the mesoscopic capacitor

    NASA Astrophysics Data System (ADS)

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

    2016-08-01

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

  12. Waiting time distributions in financial markets

    NASA Astrophysics Data System (ADS)

    Sabatelli, L.; Keating, S.; Dudley, J.; Richmond, P.

    2002-05-01

    We study waiting time distributions for data representing two completely different financial markets that have dramatically different characteristics. The first are data for the Irish market during the 19th century over the period 1850 to 1854. A total of 10 stocks out of a database of 60 are examined. The second database is for Japanese yen currency fluctuations during the latter part of the 20th century (1989-1992). The Irish stock activity was recorded on a daily basis and activity was characterised by waiting times that varied from one day to a few months. The Japanese yen data was recorded every minute over 24 hour periods and the waiting times varied from a minute to a an hour or so. For both data sets, the waiting time distributions exhibit power law tails. The results for Irish daily data can be easily interpreted using the model of a continuous time random walk first proposed by Montroll and applied recently to some financial data by Mainardi, Scalas and colleagues. Yen data show a quite different behaviour. For large waiting times, the Irish data exhibit a cut off; the Yen data exhibit two humps that could arise as result of major trading centres in the World.

  13. Waiting time for radiotherapy in women with cervical cancer

    PubMed Central

    do Nascimento, Maria Isabel; Azevedo e Silva, Gulnar

    2016-01-01

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

  14. Waiting time information services: what are the implications of waiting list behaviour for their design?

    PubMed

    Cromwell, David; Griffiths, David

    2002-01-01

    In some countries, patients requiring elective surgery can access comparative waiting time information for various surgical units. What someone can deduce from this information will depend upon how the statistics are derived, and how waiting lists behave. However, empirical analyses of waiting list behaviour are scarce. This study analysed three years of waiting list data collected at one hospital in Sydney, Australia. The results highlight various issues that raise questions about using particular waiting time statistics to make inferences about patient waiting times. In particular, the results highlight the considerable variation in behaviour that can exist between surgeons in the same specialty, and that can occur over time.

  15. Managing waiting times in diagnostic medical imaging

    PubMed Central

    Nuti, Sabina; Vainieri, Milena

    2012-01-01

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

  16. Waiting for children’s surgery in Canada: the Canadian Paediatric Surgical Wait Times project

    PubMed Central

    Wright, James G.; Menaker, Rena J.

    2011-01-01

    Background In addition to possibly prolonged suffering and anxiety, extended waits for children’s surgery beyond critical developmental periods has potential for lifelong impact. The goal of this study was to determine the duration of waits for surgery for children and youth at Canadian paediatric academic health sciences centres using clinically-derived access targets (i.e., the maximum acceptable waiting periods for completion of specific types of surgery) as used in this Canadian Paediatric Surgical Wait Times project. Methods We prospectively applied standardized wait-time targets for surgery, created by nominal-group consensus expert panels, to pediatric patients at children’s health sciences centres across Canada with decision-to-treat dates of Sept. 1, 2007 or later. From Jan. 1 to Dec. 30, 2009, patients’ actual wait times were compared with their target wait times to determine the percentage of patients receiving surgery after the target waiting period. Results Overall, 27% of pediatric patients from across Canada (17411 of 64012) received their surgery after their standardized target waiting period. Dentistry, ophthalmology, plastic surgery and cancer surgery showed the highest percentages of surgeries completed past target. Interpretation Many children wait too long for surgery in Canada. Specific attention is required, in particular, in dentistry, ophthalmology, plastic surgery and cancer care, to address children’s wait times for surgery. Improved access may be realized with use of national wait-time targets. PMID:21543299

  17. Time while waiting: patients' experiences of scheduled surgery.

    PubMed

    Carr, Tracey; Teucher, Ulrich C; Casson, Alan G

    2014-12-01

    Research on patients' experiences of wait time for scheduled surgery has centered predominantly on the relative tolerability of perceived wait time and impacts on quality of life. We explored patients' experiences of time while waiting for three types of surgery with varied wait times--hip or knee replacement, shoulder surgery, and cardiac surgery. Thirty-two patients were recruited by their surgeons. We asked participants about their perceptions of time while waiting in two separate interviews. Using interpretative phenomenological analysis (IPA), we discovered connections between participant suffering, meaningfulness of time, and agency over the waiting period and the lived duration of time experience. Our findings reveal that chronological duration is not necessarily the most relevant consideration in determining the quality of waiting experience. Those findings helped us create a conceptual framework for lived wait time. We suggest that clinicians and policy makers consider the complexity of wait time experience to enhance preoperative patient care.

  18. Waiting time information services: how well do different statistics forecast a patient's wait?

    PubMed

    Cromwell, David A; Griffiths, David A

    2002-01-01

    This study investigates how accurately the waiting times of patients about to join a waiting list are predicted by the types of statistics disseminated via web-based waiting time information services. Data were collected at a public hospital in Sydney, Australia, on elective surgery activity and waiting list behaviour from July 1995 to June 1998. The data covered 46 surgeons in 10 surgical specialties. The accuracy of the tested statistics varied greatly, being affected more by the characteristics and behaviour of a surgeon's waiting list than by how the statistics were derived. For those surgeons whose waiting times were often over six months, commonly used statistics can be very poor at forecasting patient waiting times.

  19. Willing to wait?: The influence of patient wait time on satisfaction with primary care

    PubMed Central

    Anderson, Roger T; Camacho, Fabian T; Balkrishnan, Rajesh

    2007-01-01

    Background This study examined the relationship between patient waiting time and willingness to return for care and patient satisfaction ratings with primary care physicians. Methods Cross-sectional survey data on a convenience sample of 5,030 patients who rated their physicians on a web-based survey developed to collect detailed information on patient experiences with health care. The survey included self-reported information on wait times, time spent with doctor, and patient satisfaction. Results Longer waiting times were associated with lower patient satisfaction (p < 0.05), however, time spent with the physician was the strongest predictor of patient satisfaction. The decrement in satisfaction associated with long waiting times is substantially reduced with increased time spent with the physician (5 minutes or more). Importantly, the combination of long waiting time to see the doctor and having a short doctor visit is associated with very low overall patient satisfaction. Conclusion The time spent with the physician is a stronger predictor of patient satisfaction than is the time spent in the waiting room. These results suggest that shortening patient waiting times at the expense of time spent with the patient to improve patient satisfaction scores would be counter-productive. PMID:17328807

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

    ERIC Educational Resources Information Center

    Li, Winnie Sim Siew; Arshad, Mohammad Yusof

    2014-01-01

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

  1. Numbers or apologies? Customer reactions to telephone waiting time fillers.

    PubMed

    Munichor, Nira; Rafaeli, Anat

    2007-03-01

    The authors examined the effect of time perception and sense of progress in telephone queues on caller reactions to 3 telephone waiting time fillers: music, apologies, and information about location in the queue. In Study 1, conducted on 123 real calls, call abandonment was lowest, and call evaluations were most positive with information about location in the queue as the time filler. In Study 2, conducted with 83 participants who experienced a simulated telephone wait experience, sense of progress in the queue rather than perceived waiting time mediated the relationship between telephone waiting time filler and caller reactions. The findings provide insight for the management and design of telephone queues, as well as theoretical insight into critical cognitive processes that underlie telephone waiting, opening up an important new research agenda. PMID:17371095

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

    PubMed

    Wheatland

    2000-06-20

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

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

    PubMed

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

    2005-01-01

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

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

    PubMed

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

    2005-01-01

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

  5. Waiting to see the specialist: patient and provider characteristics of wait times from primary to specialty care

    PubMed Central

    2014-01-01

    Background Wait times are an important measure of access to various health care sectors and from a patient’s perspective include several stages in their care. While mechanisms to improve wait times from specialty care have been developed across Canada, little is known about wait times from primary to specialty care. Our objectives were to calculate the wait times from when a referral is made by a family physician (FP) to when a patient sees a specialist physician and examine patient and provider factors related to these wait times. Methods Our study used the Electronic Medical Record Administrative data Linked Database (EMRALD) which is a linkage of FP electronic medical record (EMR) data to the Ontario, Canada administrative data. The EMR referral date was linked to the administrative physician claims date to calculate the wait times. Patient age, sex, socioeconomic status, comorbidity and FP continuity of care and physician age, sex, practice location, practice size and participation in a primary care delivery model were examined with respect to wait times. Results The median waits from medical specialists ranged from 39 to 76 days and for surgical specialists from 33 days to 66 days. With a few exceptions, patient factors were not associated with wait times from primary care to specialty care. Similarly physician factors were not consistently associated with wait times, except for FP practice location and size. Conclusions Actual wait times for a referral from a FP to seeing a specialist physician are longer than those reported by physician surveys. Wait times from primary to specialty care need to be included in the calculation of surgical and diagnostic wait time benchmarks in Canada. PMID:24460619

  6. Patient satisfaction with ambulatory healthcare services: waiting time and filling time.

    PubMed

    Dansky, K H; Miles, J

    1997-01-01

    Customer satisfaction is an important measure of service quality in healthcare organizations. This study investigated the relationship between patient waiting and satisfaction with ambulatory healthcare services, with waiting times divided into segments of the patient-care episode. Two management techniques to alter perceptions of waiting were also examined. Regression models measuring the effect of waiting times on satisfaction found that the total time spent waiting for the clinician was the most significant predictor of patient satisfaction. Informing patients how long their wait would be and being occupied during the wait were also significant predictors of patient satisfaction. These results show that waiting times, even if they cannot be shortened, can be managed more effectively to improve patient satisfaction. PMID:10167452

  7. Patient satisfaction with ambulatory healthcare services: waiting time and filling time.

    PubMed

    Dansky, K H; Miles, J

    1997-01-01

    Customer satisfaction is an important measure of service quality in healthcare organizations. This study investigated the relationship between patient waiting and satisfaction with ambulatory healthcare services, with waiting times divided into segments of the patient-care episode. Two management techniques to alter perceptions of waiting were also examined. Regression models measuring the effect of waiting times on satisfaction found that the total time spent waiting for the clinician was the most significant predictor of patient satisfaction. Informing patients how long their wait would be and being occupied during the wait were also significant predictors of patient satisfaction. These results show that waiting times, even if they cannot be shortened, can be managed more effectively to improve patient satisfaction.

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  9. Resource Selection Using Execution and Queue Wait Time Predictions

    NASA Technical Reports Server (NTRS)

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

    2002-01-01

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

  10. Time to Endoscopy in Patients with Colorectal Cancer: Analysis of Wait-Times

    PubMed Central

    Janssen, Renée M.; Takach, Oliver; Nap-Hill, Estello; Enns, Robert A.

    2016-01-01

    Objective. The Canadian Association of Gastroenterology Wait Time Consensus Group recommends that patients with symptoms associated with colorectal cancer (CRC) should have an endoscopic examination within 2 months. However, in a recent survey of Canadian gastroenterologists, wait-times for endoscopy were considerably longer than the current guidelines recommend. The purpose of this study was to evaluate wait-times for colonoscopy in patients who were subsequently found to have CRC through the Division of Gastroenterology at St. Paul's Hospital (SPH). Methods. This study was a retrospective chart review of outpatients seen for consultation and endoscopy ultimately diagnosed with CRC. Subjects were identified through the SPH pathology database for the inclusion period 2010 through 2013. Data collected included wait-times, subject characteristics, cancer characteristics, and outcomes. Results. 246 subjects met inclusion criteria for this study. The mean wait-time from primary care referral to first office visit was 63 days; the mean wait-time to first endoscopy was 94 days. Patients with symptoms waited a mean of 86 days to first endoscopy, considerably longer than the national recommended guideline of 60 days. There was no apparent effect of length of wait-time on node positivity or presence of distant metastases at the time of diagnosis. Conclusion. Wait-times for outpatient consultation and endoscopic evaluation at the St. Paul's Hospital Division of Gastroenterology exceed current guidelines. PMID:27446872

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

    PubMed

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

    2015-09-01

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

  12. Renewal processes based on generalized Mittag-Leffler waiting times

    NASA Astrophysics Data System (ADS)

    Cahoy, Dexter O.; Polito, Federico

    2013-03-01

    The fractional Poisson process has recently attracted experts from several fields of study. Its natural generalization of the ordinary Poisson process made the model more appealing for real-world applications. In this paper, we generalized the standard and fractional Poisson processes through the waiting time distribution, and showed their relations to an integral operator with a generalized Mittag-Leffler function in the kernel. The waiting times of the proposed renewal processes have the generalized Mittag-Leffler and stretched-squashed Mittag-Leffler distributions. Note that the generalizations naturally provide greater flexibility in modeling real-life renewal processes. Algorithms to simulate sample paths and to estimate the model parameters are derived. Note also that these procedures are necessary to make these models more usable in practice. State probabilities and other qualitative or quantitative features of the models are also discussed.

  13. Creating Time for Equity Together

    ERIC Educational Resources Information Center

    Renée, Michelle

    2015-01-01

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

  14. Maternal Wait Time after Questions for Children with and without Down Syndrome.

    ERIC Educational Resources Information Center

    Vettel, Jennifer K.; Windsor, Jennifer

    1997-01-01

    Maternal wait time after open- and closed-ended questions with eight Down syndrome (DS) and eight language-age (LA) matched peers was investigated. Mothers provided a longer mean wait time for LA children (2.5 seconds) than for DS children (1.8 seconds). These wait times matched well with children's usual response times. No differences for…

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

    ERIC Educational Resources Information Center

    Fowler, Thaddeus W.

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

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

    NASA Astrophysics Data System (ADS)

    Amini, Mohammadreza; Samimi, Abouzar; Mirzavandi, Asra

    2016-04-01

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

  17. Average waiting time in FDDI networks with local priorities

    NASA Technical Reports Server (NTRS)

    Gercek, Gokhan

    1994-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  19. Spacecraft intercept using minimum control energy and wait time

    NASA Astrophysics Data System (ADS)

    Leeghim, H.

    2013-01-01

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

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

    PubMed

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

    2011-09-01

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

  1. Waiting for Teacher: The Frequency and Duration of Times Children Spend Waiting for Teacher Attention in Infant School Classrooms.

    ERIC Educational Resources Information Center

    West, Christine; Wheldall, Kevin

    1989-01-01

    Investigates the amount of time infant school children spend waiting for teacher attention while performing seatwork. Discusses implications of the findings for classroom practice. Suggests that the most advantageous method for securing teacher attention may be found in those classes that use a queue system rather than a hands-up signal. (KO)

  2. Effects of wait-time and intertrial interval durations on learning by children with multiple handicaps.

    PubMed Central

    Valcante, G; Roberson, W; Reid, W R; Wolking, W D

    1989-01-01

    We investigated the influence of teacher wait-time and intertrial interval durations on the performance of 4 multiply handicapped students during instruction in 10 skills. Four experimental conditions were evaluated: long wait-time and long intertrial interval, long wait-time and short intertrial interval, short wait-time and long intertrial interval, and short wait-time and short intertrial interval. Instructors attempted to keep short intervals as close as possible to 1 s and long intervals as close as possible to 10 s for both variables. Results showed that student performance was superior under the long wait-time conditions irrespective of the length of the intertrial interval. PMID:2523372

  3. Waiting time disparities in breast cancer diagnosis and treatment: a population-based study in France.

    PubMed

    Molinié, F; Leux, C; Delafosse, P; Ayrault-Piault, S; Arveux, P; Woronoff, A S; Guizard, A V; Velten, M; Ganry, O; Bara, S; Daubisse-Marliac, L; Tretarre, B

    2013-10-01

    Waiting times are key indicators of a health's system performance, but are not routinely available in France. We studied waiting times for diagnosis and treatment according to patients' characteristics, tumours' characteristics and medical management options in a sample of 1494 breast cancers recorded in population-based registries. The median waiting time from the first imaging detection to the treatment initiation was 34 days. Older age, co-morbidity, smaller size of tumour, detection by organised screening, biopsy, increasing number of specimens removed, multidisciplinary consulting meetings and surgery as initial treatment were related to increased waiting times in multivariate models. Many of these factors were related to good practices guidelines. However, the strong influence of organised screening programme and the disparity of waiting times according to geographical areas were of concern. Better scheduling of diagnostic tests and treatment propositions should improve waiting times in the management of breast cancer in France.

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

    ERIC Educational Resources Information Center

    Boeck, Marjorie A.; Hillenmeyer, Gale P.

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

  5. Models of emergency departments for reducing patient waiting times.

    PubMed

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

    2009-07-02

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

  6. Models of Emergency Departments for Reducing Patient Waiting Times

    PubMed Central

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

    2009-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2000-12-01

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

  8. Comparing Brief and Extended Wait-Time during Small Group Instruction for Children with Challenging Behavior

    ERIC Educational Resources Information Center

    Tincani, Matt; Crozier, Shannon

    2007-01-01

    This preliminary study compared brief (1 s) and extended (4 s) wait-time on response opportunities, academic responses, accuracy, and disruptive behavior of two children with challenging behavior during small group instruction. Brief wait-time increased children's response opportunities, academic responses, and accuracy in comparison to extended…

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

    PubMed Central

    Huan, Mei; Yang, Xiao-bao

    2014-01-01

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

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

    PubMed

    Carlsen, Fredrik; Kaarboe, Oddvar Martin

    2015-11-01

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

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

    PubMed

    Carlsen, Fredrik; Kaarboe, Oddvar Martin

    2015-11-01

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

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

    NASA Astrophysics Data System (ADS)

    Yang, Guan-Ling; Yang, Xinsong

    2016-04-01

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

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

    PubMed

    Mehra, Payal

    2016-08-01

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

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

    ERIC Educational Resources Information Center

    Vitus, Kathrine

    2010-01-01

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

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

    PubMed Central

    2013-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2015-12-01

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

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

    PubMed Central

    Lau, F L; Leung, K P

    1997-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  19. Wait-time, classroom discourse, and the influence of sociocultural factors in science teaching

    NASA Astrophysics Data System (ADS)

    Jegede, Olugbemiro J.; Olajide, Janet O.

    Wait-time, a variable related to questioning in a teaching-learning situation, has been found to have implications for the inquiry mode of science teaching especially in Western classroom environments. Aside from the fact that the literature is very sparse in this area about what obtains in developing countries, nothing appears to be available with regard to how wait-time interacts with the sociocultural factors within non-Western science classrooms. In a non-Western country such as Nigeria where most science programs in schools are inquiry-oriented, do teachers take notice of, and effectively use, wait-time in the teaching-learning process? Are science teachers able to effectively use the mediating role of sociocultural factors in science teaching in a traditional environment which expects children to be seen only and not heard? The main purpose of this study was to investigate the wait-time of Nigerian integrated science teachers in relation to the amount of students' participation in inquiry. This study also investigated the relationship between wait-time and sociocultural attitudinal factors prevalent in traditional societies. The instruments used for data collection were the Hough's Observational Schedule and a modified version of the Socio-Cultural Environment Scale (SCES); a stop-watch was used to measure the wait-time of audio-recorded integrated science lessons of 37 integrated science teachers from selected junior secondary schools in Kaduna State, Nigeria. The results showed that the average wait-time TT and wait-time ST of the integrated science teachers was 3.0 seconds and 0.7 seconds, respectively. The study reported the amount of student participation in the student-teacher classroom discourse to be very low. Wait-time was also shown to have a strong relationship with sociocultural factors of authoritarianism, goal structure, societal expectation, and traditional worldview. The pedagogical and curricular implications of the results have been

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

    PubMed

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

    2005-10-01

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

  1. Discrimination in a universal health system: explaining socioeconomic waiting time gaps.

    PubMed

    Johar, Meliyanni; Jones, Glenn; Keane, Micheal P; Savage, Elizabeth; Stavrunova, Olena

    2013-01-01

    One of the core goals of a universal health care system is to eliminate discrimination on the basis of socioeconomic status. We test for discrimination using patient waiting times for non-emergency treatment in public hospitals. Waiting time should reflect patients' clinical need with priority given to more urgent cases. Using data from Australia, we find evidence of prioritisation of the most socioeconomically advantaged patients at all quantiles of the waiting time distribution. These patients also benefit from variation in supply endowments. These results challenge the universal health system's core principle of equitable treatment. PMID:23202263

  2. Waiting-time solutions of a nonlinear diffusion equation: Experimental study of a creeping flow near a waiting front

    NASA Astrophysics Data System (ADS)

    Marino, B. M.; Thomas, L. P.; Gratton, R.; Diez, J. A.; Betelú, S.; Gratton, J.

    1996-09-01

    We investigate an unsteady plane viscous gravity current of silicone oil on a horizontal glass substrate. Within the lubrication approximation with gravity as the dominant force, this current is described by the nonlinear diffusion equation φt=(φmφx)x (φ is proportional to the liquid thickness h and m=3>0), which is of interest in many other physical processes. The solutions of this equation display a fine example of the competition between diffusive smoothening and nonlinear steepening. This work concerns the so-called waiting-time solutions, whose distinctive character is the presence of an interface or front, separating regions with h≠/0 and h=0, that remains motionless for a finite time interval tw meanwhile a redistribution of h takes place behind the interface. We start the experiments from an initial wedge-shape configuration [h(x)~=α'(x0-x)] with a small angle (α'<=0.12 rad). In this situation, the tip of the wedge, situated at x0 from the rear wall (15 cm<=x0<=75 cm), waits at least several seconds before moving. During this waiting stage, a region characterized by a strong variation of the free surface slope (corner layer) develops and propagates toward the front while it gradually narrows and ∂2h/∂x2 peaks. The stage ends when the corner layer overtakes the front. At this point, the liquid begins to spread over the uncovered substrate. We measure the slope of the free surface in a range ~=10 cm around x0, and, by integration, we determine the fluid thickness h(x) there. We find that the flow tends to a self-similar behavior when the corner layer position tends to x0; however, near the end of the waiting stage, it is perturbed by capillarity. Even if some significant effects are not included in the above equation, the main properties of its solutions are well displayed in the experiments

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

    ERIC Educational Resources Information Center

    Wallace, Stephen R.; And Others

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

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

    PubMed Central

    Liu, Jiming; Tao, Li; Xiao, Bo

    2011-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  6. Family physician access to and wait times for cancer diagnostic investigations

    PubMed Central

    Barisic, Andriana; Kish, Maxine; Gilbert, Julie; Mittmann, Nicole; Moineddin, Rahim; Sisler, Jeffrey; Vedsted, Peter; Grunfeld, Eva

    2016-01-01

    Abstract Objective To examine provincial and regional differences in FPs’ direct access to cancer diagnostic investigations and advice from other specialists regarding investigations and referrals, and to explore FPs’ perceptions about wait times for diagnostic investigations and receipt of results. Design A cross-sectional, online survey. Setting British Columbia, Manitoba, and Ontario. Participants A sample of FPs from participating provinces. Main outcome measures Direct FP access to various diagnostic investigations and advice from other specialists regarding investigations and referrals; FPs’ perceptions about wait times for diagnostic investigations ordered directly; and FPs’ perceptions about wait times for results. Results A total of 1054 surveys were completed by FPs from British Columbia (n = 229), Manitoba (n = 228), and Ontario (n = 597). Distance from a cancer centre was not significantly associated with direct access to or wait times for diagnostic investigations for most of the investigations studied; however, provincial differences were observed. Family physicians in Manitoba and British Columbia were 30% to 45% less likely to report having direct access to endoscopy and some imaging investigations compared with FPs in Ontario. Family physicians in Manitoba and British Columbia were also at increased odds of waiting longer than 12 weeks for endoscopy investigations and longer than 4 weeks for imaging investigations compared with FPs in Ontario. Most FPs reported wait times of less than 2 weeks for imaging results; however, the proportion of FPs who waited longer than 2 weeks for colonoscopy results ranged from 15% in Ontario to 96% in British Columbia. Conclusion Given the disparities observed among provinces, there is an opportunity for provinces to learn from one another to improve direct access to and shorten wait times for diagnostic investigations. This in turn has the potential to shorten the primary care interval for cancer diagnostic

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

    PubMed

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

    2016-08-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

    Hu, Tina; Leung, Fok-Han

    2016-07-01

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

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

    PubMed

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

    2004-01-01

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

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

    PubMed Central

    Mahmoodian, Farzad; Eqtesadi, Razie; Ghareghani, Atefe

    2014-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2016-08-01

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

  13. Why wait? The effect of wait-times on subsequent help-seeking among families looking for children's mental health services.

    PubMed

    Schraeder, Kyleigh E; Reid, Graham J

    2015-04-01

    Placement on a wait-list may increase families' help-seeking efforts, leading them to contact more than one children's mental health (MH) agency/professional. Two issues were examined in the current study: 1) Does time on a wait-list for families impact the time to contact a new agency for children's MH services? 2) What are the effects of predisposing (e.g., child age), need (e.g., child psychopathology), and enabling/system-level factors (e.g., parent treatment history) on the length of time parents wait before they contact a new agency for help with their child's MH problems? A total of 273 families seeking help for their child (64% boys, M = 10.7 years old, SD = 3.3) were asked about their contact with MH agencies/professionals during the previous year. Survival analyses, modeling time from initial wait-list placement to when a new agency was contacted, were conducted separately for families who did (n = 114), and those who did not (n = 159), receive help prior to contacting a new agency. Almost half of wait-listed families contacted a new agency by the end of the study period. Longer wait-time was associated with a greater likelihood of seeking help at a second agency with 25% of families contacting a new agency within the first month of being wait-listed. Parents with previous treatment experience and families living in areas with more agencies contacted a new agency sooner. Subsequent help-seeking behaviour suggests parents' intolerance for lengthy treatment delays may result in disorganized pathways to care. These findings suggest a highly fragmented service delivery system.

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

    PubMed

    Lin, Di; Patrick, Jonathan; Labeau, Fabrice

    2014-03-01

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

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

    PubMed

    Lin, Di; Patrick, Jonathan; Labeau, Fabrice

    2014-03-01

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

  16. Reducing hip and knee replacement wait times: an expanded role for physiotherapists in orthopedic surgical clinics.

    PubMed

    Aiken, Alice B; Atkinson, Marg; Harrison, Mark M; Hope, John

    2007-01-01

    This paper describes a research project that examined an expanded role for physiotherapists to provide pre- and post-operative consultation to patients with hip and knee complaints with the overall goal to save the surgeon's time and improve patient throughput, thereby reducing wait times.

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

    SciTech Connect

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

    2012-07-01

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

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

    SciTech Connect

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

    2014-09-10

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

  19. Wait watchers. Smart organizations are demonstrating that while they can't erase ED wait times, they can leverage technology to keep patients better informed.

    PubMed

    Gamble, Kate Huvane

    2010-04-01

    Increases in ED visits are significantly affecting patient access, quality, cost and care management--a trend that is expected to continue. A number of organizations are dealing with the increased demand for services by implementing technologies to keep patients better informed of wait times. Publishing ED wait times online offers hospitals a way to communicate information to patients quickly without requiring a significant investment from the IT staff. Hospitals are also utilizing visibility boards to keep both patients and staff updated on patient conditions and room status. PMID:20426236

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

    NASA Technical Reports Server (NTRS)

    Kolata, W.

    1982-01-01

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

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

    SciTech Connect

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

    2013-02-01

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

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

    ERIC Educational Resources Information Center

    Gooding, C. Thomas; And Others

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

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

    ERIC Educational Resources Information Center

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

    2016-01-01

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

  4. Patterns for the waiting time in the context of discrete-time stochastic processes

    NASA Astrophysics Data System (ADS)

    Jamali, Tayeb; Jafari, G. R.; Vasheghani Farahani, S.

    2016-09-01

    The aim of this study is to extend the scope and applicability of the level-crossing method to discrete-time stochastic processes and generalize it to enable us to study multiple discrete-time stochastic processes. In previous versions of the level-crossing method, problems with it correspond to the fact that this method had been developed for analyzing a continuous-time process or at most a multiple continuous-time process in an individual manner. However, since all empirical processes are discrete in time, the already-established level-crossing method may not prove adequate for studying empirical processes. Beyond this, due to the fact that most empirical processes are coupled; their individual study could lead to vague results. To achieve the objectives of this study, we first find an analytical expression for the average frequency of crossing a level in a discrete-time process, giving the measure of the time experienced for two consecutive crossings named as the "waiting time." We then introduce the generalized level-crossing method by which the consideration of coupling between the components of a multiple process becomes possible. Finally, we provide an analytic solution when the components of a multiple stochastic process are independent Gaussian white noises. The comparison of the results obtained for coupled and uncoupled processes measures the strength and efficiency of the coupling, justifying our model and analysis. The advantage of the proposed method is its sensitivity to the slightest coupling and shortest correlation length.

  5. Experience of being a low priority patient during waiting time at an emergency department

    PubMed Central

    Dahlen, Ingrid; Westin, Lars; Adolfsson, Annsofie

    2012-01-01

    Background Work in the emergency department is characterized by fast and efficient medical efforts to save lives, but can also involve a long waiting time for patients. Patients are given a priority rating upon their arrival in the clinic based on the seriousness of their problem, and nursing care for lower priority patients is given a lower prioritization. Regardless of their medical prioritization, all patients have a right to expect good nursing care while they are waiting. The purpose of this study was to illustrate the experience of the low prioritized patient during their waiting time in the emergency department. Methods A phenomenological hermeneutic research method was used to analyze an interview transcript. Data collection consisted of narrative interviews. The interviewees were 14 patients who had waited more than three hours for surgical, orthopedic, or other medical care. Results The findings resulted in four different themes, ie, being dependent on care, being exposed, being vulnerable, and being secure. Lower priority patients are not paid as much attention by nursing staff. Patients reported feeling powerless, insulted, and humiliated when their care was delayed without their understanding what was happening to them. Not understanding results in exposure that violates self-esteem. Conclusion The goal of the health care provider must be to minimize and prevent suffering, prevent feelings of vulnerability, and to create conditions for optimal patient well being. PMID:22334799

  6. From blacklist to beacon, a case study in reducing dermatology out-patient waiting times.

    PubMed

    Appleby, A; Lawrence, C

    2001-09-01

    At its worst our dermatology department had a waiting list for routine appointments of 57 weeks. As a result we started to lose contract income and consequently were unable to replace a retiring consultant. The service faced fragmentation and loss of the inpatient ward. Using a series of internally planned and driven initiatives it was possible to retrieve the situation. Our efforts were recognized by a national waiting list Beacon award in 1999. This study describes the methods used to increase new patient throughput, reduce demand and hence reduce waiting time for new patient appointments. Change was achieved only when medical, nursing staff, general practitioners, managers and health authorities were involved in the process. The changes needed to be led by a consultant enthusiast and managed effectively. There remains a constantly increasing demand for the service and reducing the waiting list simply invites a further increase in referral. In a resource-limited health care system the provider must be able to limit demand by using agreed referral exclusion criteria in order to balance supply and demand.

  7. In the queue for total joint replacement: patients' perspectives on waiting times. Ontario Hip and Knee Replacement Project Team.

    PubMed

    Llewellyn-Thomas, H A; Arshinoff, R; Bell, M; Williams, J I; Naylor, C D

    1998-02-01

    We assessed patients on the waiting lists of a purposive sample of orthopaedic surgeons in Ontario, Canada, to determine patients' attitudes towards time waiting for hip or knee replacement. We focused on 148 patients who did not have a definite operative date, obtaining complete information on 124 (84%). Symptom severity was assessed with the Western Ontario/McMaster Osteoarthritis Index and a disease-specific standard gamble was used to elicit patients' overall utility for their arthritic state. Next, in a trade-off task, patients considered a hypothetical choice between a 1-month wait for a surgeon who could provide a 2% risk of post-operative mortality, or a 6-month wait for joint replacement with a 1% risk of post-operative mortality. Waiting times were then shifted systematically until the patient abandoned his/her initial choice, generating a conditional maximal acceptable wait time. Patients were divided in their attitudes, with 57% initially choosing a 6-month wait with a 1% mortality risk. The overall distribution of conditional maximum acceptable wait time scores ranged from 1 to 26 months, with a median of 7 months. Utility values were independently but weakly associated with patients' tolerance of waiting times (adjusted R-square = 0.059, P = 0.004). After splitting the sample along the median into subgroups with a relatively 'low' and 'high' tolerance for waiting, the subgroup with the apparently lower tolerance for waiting reported lower utility scores (z = 2.951; P = 0.004) and shorter times since their surgeon first advised them of the need for surgery (z = 3.014; P = 0.003). These results suggest that, in the establishment and monitoring of a queue management system for quality-of-life-enhancing surgery, patients' own perceptions of their overall symptomatic burden and ability to tolerate delayed relief should be considered along with information derived from clinical judgements and pre-weighted health status instruments.

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

    PubMed

    Nikolova, Silviya; Harrison, Mark; Sutton, Matt

    2016-08-01

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

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

    PubMed

    Nikolova, Silviya; Harrison, Mark; Sutton, Matt

    2016-08-01

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

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

    NASA Astrophysics Data System (ADS)

    Yang, Jin; Pearson, John E.

    2012-06-01

    Binary fluorescence time series obtained from single-molecule imaging experiments can be used to infer protein binding kinetics, in particular, association and dissociation rate constants from waiting time statistics of fluorescence intensity changes. In many cases, rate constants inferred from fluorescence time series exhibit nonintuitive dependence on ligand concentration. Here, we examine several possible mechanistic and technical origins that may induce ligand dependence of rate constants. Using aggregated Markov models, we show under the condition of detailed balance that non-fluorescent bindings and missed events due to transient interactions, instead of conformation fluctuations, may underly the dependence of waiting times and thus apparent rate constants on ligand concentrations. In general, waiting times are rational functions of ligand concentration. The shape of concentration dependence is qualitatively affected by the number of binding sites in the single molecule and is quantitatively tuned by model parameters. We also show that ligand dependence can be caused by non-equilibrium conditions which result in violations of detailed balance and require an energy source. As to a different but significant mechanism, we examine the effect of ambient buffers that can substantially reduce the effective concentration of ligands that interact with the single molecules. To demonstrate the effects by these mechanisms, we applied our results to analyze the concentration dependence in a single-molecule experiment EGFR binding to fluorophore-labeled adaptor protein Grb2 by Morimatsu et al. [Proc. Natl. Acad. Sci. U.S.A. 104, 18013 (2007)], 10.1073/pnas.0701330104.

  11. Dissecting a waiting list.

    PubMed

    Pope, C J; Roberts, J A; Black, N A

    1991-07-01

    This study examines a list of 1,283 patients waiting for general and orthopaedic surgery in an outer London borough. In general surgery varicose vein and hernia surgery accounted for 60% of those waiting more than one year. Of those who had waited more than a year on the orthopaedic list 25% were waiting for knee replacement surgery. The average length of time spent waiting was 10 months, with some people waiting over 5 years. The impact of the numbers waiting a long time on aggregate waiting time was highlighted by weighting the numbers waiting by the months spent waiting. Analysis of urgency codes indicates that although there was a statistically significant relationship between urgency and the length of waiting time there were some anomalies. There was considerable inter-consultant variation in list size, waiting times and the case mix. Analysis of the flows onto the list and work done in one month showed that it would take a considerable time to clear some lists at present rates of activity. Disaggregated information such as this which explores the flows of patients on to and off of the lists is essential for the management of waiting lists and will become increasingly important as waiting lists become a feature of--'contracts'--service agreements, in the reformed NHS.

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

    PubMed

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

    2014-01-01

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

  13. Waiting-time distributions of magnetic discontinuities: Clustering or Poisson process?

    SciTech Connect

    Greco, A.; Matthaeus, W. H.; Servidio, S.; Dmitruk, P.

    2009-10-15

    Using solar wind data from the Advanced Composition Explorer spacecraft, with the support of Hall magnetohydrodynamic simulations, the waiting-time distributions of magnetic discontinuities have been analyzed. A possible phenomenon of clusterization of these discontinuities is studied in detail. We perform a local Poisson's analysis in order to establish if these intermittent events are randomly distributed or not. Possible implications about the nature of solar wind discontinuities are discussed.

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

    SciTech Connect

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

    2005-03-15

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

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

    NASA Astrophysics Data System (ADS)

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

    2016-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Haskell, B.

    2016-09-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2014-10-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2014-09-01

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

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

    PubMed Central

    2009-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2013-12-01

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

  2. Determinants of patient satisfaction with cataract surgery and length of time on the waiting list

    PubMed Central

    Conner-Spady, B L; Sanmugasunderam, S; Courtright, P; McGurran, J J; Noseworthy, T W

    2004-01-01

    Aims: To assess determinants of patient satisfaction with their waiting time (WT) and cataract surgery outcome. Methods: A prospective cohort of consecutive patients waiting for cataract surgery were assessed by their ophthalmologist. Satisfaction, maximum acceptable waiting time (MAWT), urgency, visual function, visual acuity (VA), and health related quality of life (EQ-5D) were assessed using mailed questionnaires before surgery and 8–10 weeks after surgery. Ordinal logistic regression was used to build explanatory models. Results: 166 patients (61.9% female, mean age 73.4 years) had a mean WT of 16 weeks. Patients whose actual WT was shorter than their MAWT had greater odds of being satisfied with their WT than those whose WT was longer (adjusted OR 3.86, 95% CI 1.38 to 10.74). Improvement in visual function (OR 3.19, 95% CI 1.78 to 5.73), and VA (OR 4.27, 95% CI 1.70 to 10.68) significantly predicted satisfaction with surgery. Models were adjusted for age and sex. Conclusion: Patient perspectives on MAWT and satisfaction with WT are important inputs to the process of determining WT standards for levels of patient priority. Patient expectation of WT may mediate satisfaction with actual WT. PMID:15377556

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

    PubMed Central

    2013-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  5. Conceptualising time before surgery: the experience of patients waiting for hip replacement.

    PubMed

    Johnson, Emma C; Horwood, Jeremy; Gooberman-Hill, Rachael

    2014-09-01

    Interpretations of time underlie patients' experiences of illness and the way in which the National Health Service (NHS) is organised. In the NHS, achieving short waiting times for treatment is seen as important, and this is particularly evident in relation to chronic conditions where the time waiting in care from onset of symptoms to successful management can last months and years. One example of a chronic condition with high prevalence is osteoarthritis, estimated to affect 10% of people aged over 55 years in the UK. Osteoarthritis of the hip is particularly common, and treatments include exercise and medication. If these options do not provide enough relief from pain and functional difficulties, then joint replacement may be considered. With over 70,000 such operations conducted every year in England and Wales, processes relating to waiting times impact on many patients. This article explores how 24 patients with osteoarthritis experience time during the lead up to hip replacement surgery. We draw on data collected during longitudinal in-depth interviews with patients a median of 9.5 days before surgery and at two to four weeks post-operatively. Transcripts of audio-recorded interviews were imported into Atlas.ti(®) and inductive thematic analysis undertaken. Increasing pain and deterioration in function altered the experience of time during the journey towards hip replacement. Patients made essential changes to how they filled their days. They experienced lost and wasted time and faced disruption to the temporal order of their lives. A surgical date marked in the calendar became their focus. However, this date was not static, moving because of changing perceptions of duration and real-time alterations by the healthcare system. Findings highlight that patients' experience of time is complex and multi-dimensional and does not reflect the linear, monochronic conceptualisation of time embedded in the healthcare system.

  6. Conceptualising time before surgery: the experience of patients waiting for hip replacement.

    PubMed

    Johnson, Emma C; Horwood, Jeremy; Gooberman-Hill, Rachael

    2014-09-01

    Interpretations of time underlie patients' experiences of illness and the way in which the National Health Service (NHS) is organised. In the NHS, achieving short waiting times for treatment is seen as important, and this is particularly evident in relation to chronic conditions where the time waiting in care from onset of symptoms to successful management can last months and years. One example of a chronic condition with high prevalence is osteoarthritis, estimated to affect 10% of people aged over 55 years in the UK. Osteoarthritis of the hip is particularly common, and treatments include exercise and medication. If these options do not provide enough relief from pain and functional difficulties, then joint replacement may be considered. With over 70,000 such operations conducted every year in England and Wales, processes relating to waiting times impact on many patients. This article explores how 24 patients with osteoarthritis experience time during the lead up to hip replacement surgery. We draw on data collected during longitudinal in-depth interviews with patients a median of 9.5 days before surgery and at two to four weeks post-operatively. Transcripts of audio-recorded interviews were imported into Atlas.ti(®) and inductive thematic analysis undertaken. Increasing pain and deterioration in function altered the experience of time during the journey towards hip replacement. Patients made essential changes to how they filled their days. They experienced lost and wasted time and faced disruption to the temporal order of their lives. A surgical date marked in the calendar became their focus. However, this date was not static, moving because of changing perceptions of duration and real-time alterations by the healthcare system. Findings highlight that patients' experience of time is complex and multi-dimensional and does not reflect the linear, monochronic conceptualisation of time embedded in the healthcare system. PMID:24997442

  7. Conceptualising time before surgery: The experience of patients waiting for hip replacement

    PubMed Central

    Johnson, Emma C.; Horwood, Jeremy; Gooberman-Hill, Rachael

    2014-01-01

    Interpretations of time underlie patients' experiences of illness and the way in which the National Health Service (NHS) is organised. In the NHS, achieving short waiting times for treatment is seen as important, and this is particularly evident in relation to chronic conditions where the time waiting in care from onset of symptoms to successful management can last months and years. One example of a chronic condition with high prevalence is osteoarthritis, estimated to affect 10% of people aged over 55 years in the UK. Osteoarthritis of the hip is particularly common, and treatments include exercise and medication. If these options do not provide enough relief from pain and functional difficulties, then joint replacement may be considered. With over 70,000 such operations conducted every year in England and Wales, processes relating to waiting times impact on many patients. This article explores how 24 patients with osteoarthritis experience time during the lead up to hip replacement surgery. We draw on data collected during longitudinal in-depth interviews with patients a median of 9.5 days before surgery and at two to four weeks post-operatively. Transcripts of audio-recorded interviews were imported into Atlas.ti® and inductive thematic analysis undertaken. Increasing pain and deterioration in function altered the experience of time during the journey towards hip replacement. Patients made essential changes to how they filled their days. They experienced lost and wasted time and faced disruption to the temporal order of their lives. A surgical date marked in the calendar became their focus. However, this date was not static, moving because of changing perceptions of duration and real-time alterations by the healthcare system. Findings highlight that patients' experience of time is complex and multi-dimensional and does not reflect the linear, monochronic conceptualisation of time embedded in the healthcare system. PMID:24997442

  8. A Cross-Sectional Survey of Population-Wide Wait Times for Patients Seeking Medical vs. Cosmetic Dermatologic Care

    PubMed Central

    Yadav, Geeta; Goldberg, Hanna R.; Barense, Morgan D.; Bell, Chaim M.

    2016-01-01

    Background Though previous work has examined some aspects of the dermatology workforce shortage and access to dermatologic care, little research has addressed the effect of rising interest in cosmetic procedures on access to medical dermatologic care. Our objective was to determine the wait times for Urgent and Non-Urgent medical dermatologic care and Cosmetic dermatology services at a population level and to examine whether wait times for medical care are affected by offering cosmetic services. Methods A population-wide survey of dermatology practices using simulated calls asking for the earliest appointment for a Non-Urgent, Urgent and Cosmetic service. Results Response rates were greater than 89% for all types of care. Wait times across all types of care were significantly different from each other (all P < 0.05). Cosmetic care was associated with the shortest wait times (3.0 weeks; Interquartile Range (IQR) = 0.4–3.4), followed by Urgent care (9.0 weeks; IQR = 2.1–12.9), then Non-Urgent Care (12.7 weeks; IQR = 4.4–16.4). Wait times for practices offering only Urgent care were not different from practices offering both Urgent and Cosmetic care (10.3 vs. 7.0 weeks). Interpretation Longer wait times and greater variation for Urgent and Non-Urgent dermatologic care and shorter wait times and less variation for Cosmetic care. Wait times were significantly longer in regions with lower dermatologist density. Provision of Cosmetic services did not increase wait times for Urgent care. These findings suggest an overall dermatology workforce shortage and a need for a more streamlined referral system for dermatologic care. PMID:27632206

  9. Parallel-batch scheduling and transportation coordination with waiting time constraint.

    PubMed

    Gong, Hua; Chen, Daheng; Xu, Ke

    2014-01-01

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

  10. Tumor growth rate of invasive breast cancers during wait times for surgery assessed by ultrasonography.

    PubMed

    Lee, Su Hyun; Kim, Young-Seon; Han, Wonshik; Ryu, Han Suk; Chang, Jung Min; Cho, Nariya; Moon, Woo Kyung

    2016-09-01

    Several studies suggest that delay in the surgical treatment of breast cancer is significantly associated with lower survival. This study evaluated the tumor growth rate (TGR) of invasive breast cancers during wait times for surgery quantitatively using ultrasonography (US) and identified clinicopathologic factors associated with TGR.This retrospective study was approved by our institutional review board and the requirement for written informed consent was waived. Between August 2013 and September 2014, a total of 323 unifocal invasive breast cancers in 323 women with serial US images at the time of diagnosis and surgery were included. Tumor diameters and volumes were measured using 2-orthogonal US images. TGR during wait times for surgery was quantified as specific growth rates (SGR; %/day) and was compared with clinicopathologic variables using univariate and multivariate analyses.Median time from diagnosis to surgery was 31 days (range, 8-78 days). Maximum tumor diameters and volumes at the time of surgery (mean, 15.6 mm and 1.6 cm) were significantly larger than at diagnosis (14.7 mm and 1.3 cm) (P < 0.001). On multivariate analysis, surrogate molecular subtype was a significant independent factor of SGR (P = 0.001); triple negative cancers showed the highest SGR (1.003%/day) followed by HER2-positive (0.859 %/day) and luminal cancers (luminal B, 0.208 %/day; luminal A, 0.175%/day) (P < 0.001). Clinical T stage was more frequently upgraded in nonluminal (triple negative, 18% [12/67]; HER2-positive, 14% [3/22]) than luminal cancers (luminal B, 3% [1/30]; luminal A, 2% [4/204]) (P < 0.001).Invasive breast cancers with aggressive molecular subtypes showed faster TGR and more frequent upgrading of clinical T stage during wait times for surgery. PMID:27631256

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

    NASA Astrophysics Data System (ADS)

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

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

  12. Leveraging Time for School Equity: Indicators to Measure More and Better Learning Time

    ERIC Educational Resources Information Center

    Del Razo, Jaime L.; Saunders, Marisa; Renée, Michelle; López, Ruth M.; Ullucci, Kerri

    2014-01-01

    Using standardized test scores as the main measure of educational achievement is not enough to capture the complexity of a student's or school's needs, challenges, and successes. "Leveraging Time for School Equity: Indicators to Measure More and Better Learning Time" presents a new set of comprehensive, rich, and meaningful…

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

    NASA Technical Reports Server (NTRS)

    Ziegler, C.; Schilling, D. L.

    1977-01-01

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

  14. Application of Queuing Analytic Theory to Decrease Waiting Times in Emergency Department: Does it Make Sense?

    PubMed Central

    Alavi-Moghaddam, Mostafa; Forouzanfar, Reza; Alamdari, Shahram; Shahrami, Ali; Kariman, Hamid; Amini, Afshin; Pourbabaee, Shokooh; Shirvani, Armin

    2012-01-01

    Background Patients who receive care in an emergency department (ED), are usually unattended while waiting in queues. Objectives This study was done to determine, whether the application of queuing theory analysis might shorten the waiting times of patients admitted to emergency wards. Patients and Methods This was an operational study to use queuing theory analysis in the ED. In the first phase, a field study was conducted to delineate the performance of the ED and enter the data obtained into simulator software. In the second phase, "ARENA" software was used for modeling, analysis, creating a simulation and improving the movement of patients in the ED. Validity of the model was confirmed through comparison of the results with the real data using the same instrument. The third phase of the study concerned modeling in order to assess the effect of various operational strategies, on the queue waiting time of patients who were receiving care in the ED. Results In the first phase, it was shown that 47.7% of the 3000 patient records were cases referred for trauma treatment, and the remaining 52.3% were referred for non-trauma services. A total of 56% of the cases were male and 44% female. Maximum input was 4.5 patients per hour and the minimum input was 0.5 per hour. The average length of stay for patients in the trauma section was three hours, while for the non-trauma section it was four hours. In the second phase, modeling was tested with common scenarios. In the third phase, the scenario with the addition of one or more senior emergency resident(s) on each shift resulted in a decreased length of stay from 4 to 3.75 hours. Moreover, the addition of one bed to the Intensive Care Unit (ICU) and/or Critical Care Unit (CCU) in the study hospital, reduced the occupancy rate of the nursing service from 76% to 67%. By adding another clerk to take electrocardiograms (ECG) in the ED, the average time from a request to performing the procedure is reduced from 26 to 18 minutes

  15. The influence of waiting times on cost-effectiveness: a case study of colorectal cancer mass screening.

    PubMed

    Chauvin, Pauline; Josselin, Jean-Michel; Heresbach, Denis

    2014-11-01

    When a cost-effectiveness analysis is implemented, the health-care system is usually assumed to adjust smoothly to the proposed new strategy. However, technological innovations in health care may often induce friction in the organization of care supply, implying the congestion of services and subsequent waiting times. Our objective here is to measure how these short run rigidities can challenge cost-effectiveness recommendations favorable to an innovative mass screening test for colorectal cancer. Using Markov modeling, we compare the standard Guaiac fecal occult blood test (gFOBT) with an innovative screening test for colorectal cancer, namely the immunological fecal occult blood test (iFOBT). Waiting time can occur between a positive screening test and the subsequent confirmation colonoscopy. Five scenarios are considered for iFOBT: no further waiting time compared with gFOBT, twice as much waiting time for a period of 5 or 10 years, and twice as much waiting time for a period of 5 or 10 years combined with a 25% decrease in participation to confirmation colonoscopies. According to our modeling, compared with gFOBT, iFOBT would approximately double colonoscopy demand. Probabilistic sensitivity analysis enables concluding that the waiting time significantly increases the uncertainty surrounding recommendations favorable to iFOBT if it induces a decrease in the adherence rate for confirmation colonoscopy. PMID:23974962

  16. The effect of the endoscopist on the wait-time for colorectal cancer surgery

    PubMed Central

    Karip, Bora; İşcan, Yalın; Ağca, Birol; Fersahoğlu, Mahir; Aydın, Timuçin; Çelik, Kafkas; Bulut, Nuriye Esen; Memişoğlu, Kemal

    2014-01-01

    Objective: The effect of the specialty of physicians who perform endoscopy on preoperative wait-time of colorectal cancer patients was evaluated. Material and Methods: Data from 86 patients who have been operated with a diagnosis of colorectal cancer from January 2011–February 2013 regarding age, sex, tumor location, colonoscopy date, surgery date, the expertise and institution of the endoscopist were retrospectively examined. The time between colonoscopy and surgery was accepted as the pre-operative wait time (PWT). Results: Out of 86 patients, 24 (27.9%) colonoscopies were performed by general surgeons (GS), and 62 (72.1%) by gastroenterologists (GE). When patients who underwent colonoscopy in other centers were extracted, the PWT for our center was 20.4±10.8 days. When grouped according to specialties, the PWT of patients who had their colonoscopy performed by GS was significantly shorter than patients who underwent colonoscopy by GE at the same center (p<0.05). Patient’s age, sex and location of the tumor had no effect on PWT (p>0.05). Conclusion: The preparation time for surgery in colorectal cancer patients is influenced by the specialty of the physician performing the procedure. In order to standardize this period, a common flow diagram after endoscopy should be established for patients with suspected malignancy. PMID:25931897

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

    PubMed Central

    Naidoo, Logandran

    2016-01-01

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

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

    PubMed

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

    2010-08-01

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

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

    PubMed

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

    2013-07-01

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

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

    PubMed

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

    2016-04-01

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

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

    PubMed

    Ugarte, Marta

    2015-01-01

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

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

    PubMed

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

    2016-04-01

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

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

    PubMed Central

    Ugarte, Marta

    2015-01-01

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

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

    PubMed

    Ugarte, Marta

    2015-01-01

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

  5. Evaluation of an Advanced-Practice Physical Therapist in a Specialty Shoulder Clinic: Diagnostic Agreement and Effect on Wait Times

    PubMed Central

    Robarts, Susan; Kennedy, Deborah; McKnight, Cheryl; MacLeod, Anne Marie; Holtby, Richard

    2013-01-01

    ABSTRACT Purpose: To examine the role of an advanced-practice physiotherapist (APP) with respect to (1) agreement with an orthopaedic surgeon on diagnosis and management of patients with shoulder problems; (2) wait times; and (3) satisfaction with care. Methods: This prospective study involved patients with shoulder complaints who were referred to a shoulder specialist in a tertiary care centre. Agreement was examined on seven major diagnostic categories, need for further examination and surgery, and type of surgical procedure. Wait times were compared between the APP- and surgeon-led clinics from referral date to date of initial consultation, date of final diagnostic test, and date of confirmed diagnosis and planned treatment. A modified and validated version of the Visit-Specific Satisfaction Instrument assessed satisfaction in seven domains. Kappa (κ) coefficients and bias- and prevalence-adjusted kappa (PABAK) values were calculated, and strength of agreement was categorized. Wait time and satisfaction data were examined using non-parametric statistics. Results: Agreement on major diagnostic categories varied from 0.68 (good) to 0.96 (excellent). Agreement with respect to indication for surgery was κ=0.75, p<0.001; 95% CI, 0.62–0.88 (good). Wait time for APP assessment was significantly shorter than wait time for surgeon consultation at all time points (p<0.001); the surgeon's wait time was significantly reduced over 3 years. High satisfaction was reported in all components of care received from both health care providers. Conclusions: Using experienced physiotherapists in an extended role reduces wait times without compromising patient clinical management and overall satisfaction. PMID:24381382

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

    PubMed

    Schaumburg, I; Boldsen, J L

    1992-06-01

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

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

    PubMed

    Househ, Mowafa; Yunus, Faisel

    2014-01-01

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

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

    PubMed

    Househ, Mowafa; Yunus, Faisel

    2014-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Pyragas, Viktoras; Pyragas, Kestutis

    2016-07-01

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

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

    PubMed

    Pyragas, Viktoras; Pyragas, Kestutis

    2016-07-01

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

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

    PubMed

    2012-07-01

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

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

    PubMed

    2012-07-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2013-04-01

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

  14. Transitioning from Health Disparities to a Health Equity Research Agenda: The Time Is Now

    PubMed Central

    Williams, Shanita D.

    2014-01-01

    Health disparities are real. The evidence base is large and irrefutable. As such, the time is now to shift the research emphasis away from solely documenting the pervasiveness of the health disparities problem and begin focusing on health equity, the highest level of health possible. The focus on health equity research will require investigators to propose projects that develop and evaluate evidence-based solutions to health differences that are driven largely by social, economic, and environmental factors. This article highlights ongoing research and programmatic efforts underway at the National Institutes of Health that hold promise for advancing population health and improving health equity. PMID:24385668

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

    NASA Astrophysics Data System (ADS)

    Shapoval, A.

    2010-11-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2013-03-01

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

  17. Wait Times for Physical and Occupational Therapy in the Public System for People with Arthritis in Quebec

    PubMed Central

    Bernatsky, Sasha; Raymond, Marie-Hélène; Feldman, Debbie Ehrmann

    2013-01-01

    ABSTRACT Purpose: Although arthritis is the leading cause of pain and disability in Canada, and physical therapy (PT) and occupational therapy (OT) are beneficial both for chronic osteoarthritis (OA) and for inflammatory arthritis such as rheumatoid arthritis (RA), there appear to be problems with access to such services. The aim of this study was to document wait times from referral by physician to consultation with PT or OT in the public health care system for people with arthritis in Quebec, Canada. Method: Appointments were requested by telephone, using hypothetical case scenarios; wait times were defined as the time between initial request and appointment date. Descriptive statistics were used to examine the wait times in relation to diagnosis, service provider and geographic area. Results: For both scenarios (OA and RA) combined, 13% were offered an appointment within 6 months, 13% offered given an appointment within 6–12 months, 24% were told they would need to wait longer than 12 months, and 22% were refused services. The remaining 28% were told they would require an evaluation appointment for functional assessment before being given an appointment for therapy. No difference was found between RA and OA diagnoses. Conclusions: Our study suggests that most people with arthritis living in the province of Quebec are not receiving publicly accessible PT or OT intervention in a timely manner. PMID:24403693

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

    NASA Astrophysics Data System (ADS)

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

    2005-05-01

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

  19. Waiting times to appearance and dominance of advantageous mutants: estimation based on the likelihood.

    PubMed

    Radmacher, M D; Kepler, T B

    2001-03-01

    The germinal center reaction (GCR) of vertebrate immunity provides a remarkable example of evolutionary succession, in which an advantageous phenotype arises as a spontaneous mutation from the parental type and eventually displaces the parental type altogether. In the case of the immune response to the hapten (4-hydroxy-3-nitrophenyl)acetyl (NP), as with several other designed immunogens, the process is dominated by a single key mutation, which greatly simplifies the modeling of and analysis of data. We developed a two-stage model of this process in which the primary stage represents the appearance and establishment of the mutant population as a stochastic process while the second stage represents the growth and dominance of the clone as a deterministic process, conditional on its time of establishment from stage one. We applied this model to the analysis of population samples from several germinal center (GC) reactions and used maximum-likelihood methods to estimate the waiting times to arrival and to dominance of the mutant clone. We determined the sampling properties of the maximum-likelihood estimates using Monte Carlo methods and compared them to their asymptotic distributions. The methods we present here are well-suited for use in the analysis of other systems, such as tumor growth and the experimental evolution of bacteria.

  20. A Physiotherapy Triage Service for Orthopaedic Surgery: An Effective Strategy for Reducing Wait Times

    PubMed Central

    McCormack, Robert G.; Hunt, Michael A.; Brooks-Hill, Alexandra

    2013-01-01

    ABSTRACT Purpose: To investigate the effectiveness of a physiotherapy triage service for orthopaedic surgery referrals from primary-care physicians. Methods: A prospective, observational design was used with patients referred to an orthopaedic surgeon based out of two small urban centres in British Columbia. The level of agreement between the physiotherapist and surgeon was determined using a weighted kappa statistic (κw) with 95% CI. A patient satisfaction questionnaire was administered, and the surgical conversion rate (SCR) was calculated to assess the level of appropriate referrals. Results: The analysis found substantial agreement (κw=0.77; 95% CI, 0.60–0.94) between surgeon and physiotherapist for surgical management decisions. All patients reported being “satisfied” or “very satisfied” with the overall care they received from the physiotherapist. The SCR of patients referred by the physiotherapist to the surgeon was 91%, versus 22% among patients referred by a general practitioner or emergency physician. Conclusion: More than three-fourths of patients referred by primary-care physicians did not need to see a surgeon and were able to be managed by an experienced orthopaedic physiotherapist. This triage model could have considerable impact on orthopaedic wait times in Canada by minimizing unnecessary referrals; the model could also promote timely and conservative management of non-surgical conditions by physiotherapists. PMID:24396164

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

    PubMed

    Ge, Hao

    2008-01-10

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

  2. Comparing Researchers', Teachers', and Students' Perspectives on a Line of Research Attempting to Implement Wait Time in Classrooms.

    ERIC Educational Resources Information Center

    Beyerbach, Barbara A.

    The perspectives of researchers, teachers, and students in a research project attempting to implement wait time in high school classrooms were examined. This study investigates, via participant observation, the inner workings of a highly successful research group. Observation, interviews, and surveys were used to study the workings of the research…

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  4. Advancing health equity to improve health: the time is now.

    PubMed

    Jackson, B; Huston, P

    2016-02-01

    Health inequities, or avoidable inequalities in health between groups of people, are increasingly recognized and tackled to improve public health. Canada's interest in health inequities goes back over 40 years, with the landmark 1974 Lalonde report, and continues with the 2011 Rio Political Declaration on Social Determinants of Health, which affirmed a global political commitment to implementing a social determinants of health approach to reducing health inequities. Research in this area includes documenting and tracking health inequalities, exploring their multidimensional causes, and developing and evaluating ways to address them. Inequalities can be observed in who is vulnerable to infectious and chronic diseases, the impact of health promotion and disease prevention efforts, how disease progresses, and the outcomes of treatment. Many programs, policies and projects with potential impacts on health equity and determinants of health have been implemented across Canada. Recent theoretical and methodological advances in the areas of implementation science and population health intervention research have strengthened our capacity to develop effective interventions. With the launch of a new health equity series this month, the journals Canada Communicable Disease Report and Health Promotion and Chronic Disease Prevention in Canada will continue to reflect and foster analysis of social determinants of health and focus on intervention studies that advance health equity.

  5. Advancing health equity to improve health: the time is now

    PubMed Central

    Jackson, B.; Huston, P.

    2016-01-01

    Abstract Health inequities, or avoidable inequalities in health between groups of people, are increasingly recognized and tackled to improve public health. Canada’s interest in health inequities goes back over 40 years, with the landmark 1974 Lalonde report, and continues with the 2011 Rio Political Declaration on Social Determinants of Health, which affirmed a global political commitment to implementing a social determinants of health approach to reducing health inequities. Research in this area includes documenting and tracking health inequalities, exploring their multidimensional causes, and developing and evaluating ways to address them. Inequalities can be observed in who is vulnerable to infectious and chronic diseases, the impact of health promotion and disease prevention efforts, how disease progresses, and the outcomes of treatment. Many programs, policies and projects with potential impacts on health equity and determinants of health have been implemented across Canada. Recent theoretical and methodological advances in the areas of implementation science and population health intervention research have strengthened our capacity to develop effective interventions. With the launch of a new health equity series this month, the journals Canada Communicable Disease Report and Health Promotion and Chronic Disease Prevention in Canada will continue to reflect and foster analysis of social determinants of health and focus on intervention studies that advance health equity. PMID:26878490

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

    PubMed Central

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

    2016-01-01

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

  7. Portuguese Society of Cardiothoracic and Vascular Surgery/Portuguese Society of Cardiology recommendations for waiting times for cardiac surgery.

    PubMed

    Neves, José; Pereira, Hélder; Sousa Uva, Miguel; Gavina, Cristina; Leite Moreira, Adelino; Loureiro, Maria José

    2015-11-01

    Appointed jointly by the Portuguese Society of Cardiothoracic and Vascular Surgery (SPCCTV) and the Portuguese Society of Cardiology (SPC), the Working Group on Waiting Times for Cardiac Surgery was established with the aim of developing practical recommendations for clinically acceptable waiting times for the three critical phases of the care of adults with heart disease who require surgery or other cardiological intervention: cardiology appointments; the diagnostic process; and invasive treatment. Cardiac surgery has specific characteristics that are not comparable to other surgical specialties. It is important to reduce maximum waiting times and to increase the efficacy of systems for patient monitoring and tracking. The information in this document is mainly based on available clinical information. The methodology used to establish the criteria was based on studies on the natural history of heart disease, clinical studies comparing medical treatment with intervention, retrospective and prospective analyses of patients on waiting lists, and the opinions of experts and working groups. Following the first step, represented by publication of this document, the SPCCTV and SPC, as the bodies best suited to oversee this process, are committed to working together to define operational strategies that will reconcile the clinical evidence with the actual situation and with available resources.

  8. A multi-stage compartmental model for HIV-infected individuals: I--waiting time approach.

    PubMed

    Billard, L; Dayananda, P W A

    2014-03-01

    Traditionally, epidemic processes have focused on establishing systems of differential-difference equations governing the number of individuals at each stage of the epidemic. Except for simple situations such as when transition rates are linear, these equations are notoriously intractable mathematically. In this work, the process is described as a compartmental model. The model also allows for individuals to go directly from any prior compartment directly to a final stage corresponding to death. This allows for the possibility that individuals can die earlier due to some non-disease related cause. Then, the model is based on waiting times in each compartment. Survival probabilities of moving from a given compartment to another compartment are established. While our approach can be used for general epidemic processes, our framework is for the HIV/AIDS process. It is then possible to establish the impact of the HIV/AIDS epidemic process on, e.g., insurance premiums and payouts and health-care costs. The effect of changing model parameter values on these entities is investigated.

  9. System-wide flow initiative slashes patient wait times in the ED, boosts volume by 25%.

    PubMed

    2012-06-01

    Emergency department administrators at Cambridge Health Alliance, a three-hospital health care organization in Cambridge, MA, implemented a system-wide flow initiative that has reduced the average length-of-stay for rapid assessment patients from three hours to just over an hour. Under the approach, patients are immediately placed in a room, and providers and registration staff come to the patients rather than the traditional approach of having patients constantly move from place to place with wait times in between each interval of care. The approach relies on "patient partners," non-clinical personnel who are trained in customer service, to greet and quick-register patients who present to the ED for care. Administrators say 97% of patients who present to the ED are in a room within five minutes, and over 90% of them are seen by a provider within 14 minutes. The leave-without-being-seen (LWBS) rate has been slashed from 4.5% to 0.6%. System-wide ED volume, which was dropping before the new approach was implemented, has gone from 77,000 patients per year to nearly 100,000 patients per year.

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

    NASA Technical Reports Server (NTRS)

    Arnaout, Georges M.; Bowling, Shannon

    2010-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

    Keely, Erin; Traczyk, Lara; Liddy, Clare

    2015-08-01

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

  13. Racial/ethnic disparities in emergency department waiting time for stroke patients in the United States.

    PubMed

    Karve, Sudeep J; Balkrishnan, Rajesh; Mohammad, Yousef M; Levine, Deborah A

    2011-01-01

    Emergency department waiting time (EDWT), the time from arrival at the ED to evaluation by an emergency physician, is a critical component of acute stroke care. We assessed racial/ethnic differences in EDWT in a national sample of patients with ischemic or hemorrhagic stroke. We identified 543 ED visits for ischemic stroke (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] codes 433.x1, 434.xx, and 436.xx) and hemorrhagic stroke (ICD-9-CM codes 430.xx, 431.xx, and 432.xx) in persons age ≥ 18 years representing 2.1 million stroke-related ED visits in the United States using the National Hospital Ambulatory Medical Care Survey for years 1997-2000 and 2003-2005. Using linear regression (outcome, log-transformed EDWT) and logistic regression (outcome, EDWT > 10 minutes, based on National Institute of Neurological Disorders and Stroke guidelines), we adjusted associations between EDWT and race/ethnicity (non-Hispanic whites [designated whites herein], non-Hispanic blacks [blacks], and Hispanics) for age, sex, region, mode of transportation, insurance, hospital characteristics, triage status, hospital admission, stroke type, and survey year. Compared with whites, blacks had a longer EDWT in univariate analysis (67% longer, P = .03) and multivariate analysis (62% longer, P = .03), but Hispanics had a similar EDWT in both univariate analysis (31% longer, P = .65) and multivariate analysis (5% longer, P = .91). Longer EDWT was also seen with nonambulance mode of arrival, urban hospitals, or nonemergency triage. Race was significantly associated with EDWT > 10 minutes (whites, 55% [referent]; blacks, 70% [P = .03]; Hispanics, 62% [P = .53]). These differences persisted after adjustment (blacks: odds ratio [OR] = 2.08, 95% confidence interval [CI] = 1.05-4.09; Hispanics: OR = 1.07, 95% CI = 0.52-2.22). Blacks, but not Hispanics, had significantly longer EDWT than whites. The longer EDWT in black stroke patients may lead to treatment

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

    PubMed

    Grigolini, Paolo; Leddon, Deborah; Scafetta, Nicola

    2002-04-01

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

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

    PubMed

    Grigolini, Paolo; Leddon, Deborah; Scafetta, Nicola

    2002-04-01

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

  16. Resolving the impact of waiting time distributions on the persistence of measles

    PubMed Central

    Conlan, Andrew J. K.; Rohani, Pejman; Lloyd, Alun L.; Keeling, Matthew; Grenfell, Bryan T.

    2010-01-01

    Measles epidemics in human populations exhibit what is perhaps the best empirically characterized, and certainly the most studied, stochastic persistence threshold in population biology. A critical community size (CCS) of around 250 000–500 000 separates populations where measles is predominantly persistent from smaller communities where there are frequent extinctions of measles between major epidemics. The fundamental mechanisms contributing to this pattern of persistence, which are long-lasting immunity to re-infection, recruitment of susceptibles, seasonality in transmission, age dependence of transmission and the spatial coupling between communities, have all been quantified and, to a greater or lesser level of success, captured by theoretical models. Despite these successes there has not been a consensus over whether simple models can successfully predict the value of the CCS, or indeed which mechanisms determine the persistence of measles over a broader range of population sizes. Specifically, the level of the CCS has been thought to be particularly sensitive to the detailed stochastic dynamics generated by the waiting time distribution (WTD) in the infectious and latent periods. We show that the relative patterns of persistence between models with different WTDs are highly sensitive to the criterion of comparison—in particular, the statistical measure of persistence that is employed. To this end, we introduce two new statistical measures of persitence—fade-outs post epidemic and fade-outs post invasion. Contrary to previous reports, we demonstrate that, no matter the choice of persistence measure, appropriately parametrized models of measles demonstrate similar predictions for the level of the CCS. PMID:19793743

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

    NASA Astrophysics Data System (ADS)

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

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

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

    PubMed

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

    2010-06-01

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

  19. Does Extending the Waiting Time of Low-Rectal Cancer Surgery after Neoadjuvant Chemoradiation Increase the Perioperative Complications?

    PubMed Central

    Timudom, Kittinut; Phothong, Natthawut; Akaraviputh, Thawatchai; Chinswangwatanakul, Vitoon; Pongpaibul, Ananya; Petsuksiri, Janjira; Ithimakin, Suthinee

    2016-01-01

    Background. Traditionally, rectal cancer surgery is recommended 6 to 8 weeks after completing neoadjuvant chemoradiation. Extending the waiting time may increase the tumor response rate. However, the perioperative complication rate may increase. The purpose of this study was to determine the association between extending the waiting time of surgery after neoadjuvant chemoradiation and perioperative outcomes. Methods. Sixty patients with locally advanced rectal cancer who underwent neoadjuvant chemoradiation followed by radical resection at Siriraj hospital between June 2012 and January 2015 were retrospectively analyzed. Demographic data and perioperative outcomes were compared between the two groups. Results. The two groups were comparable in term of demographic parameters. The mean time interval from neoadjuvant chemoradiation to surgery was 6.4 weeks in Group A and 11.7 weeks in Group B. The perioperative outcomes were not significantly different between Groups A and B. Pathologic examination showed a significantly higher rate of circumferential margin positivity in Group A than in Group B (30% versus 9.3%, resp.; P = 0.04). Conclusions. Extending the waiting to >8 weeks from neoadjuvant chemoradiation to surgery did not increase perioperative complications, whereas the rate of circumferential margin positivity decreased. PMID:27738430

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

    NASA Astrophysics Data System (ADS)

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

    2006-10-01

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

  1. Two definitions of waiting well.

    PubMed

    Sweeny, Kate; Reynolds, Chandra A; Falkenstein, Angelica; Andrews, Sara E; Dooley, Michael D

    2016-02-01

    Waiting for uncertain news is often distressing, at times even more distressing than facing bad news. The goal of this article was to investigate strategies for "waiting well" during these periods of uncertainty. Specifically, we propose 2 definitions of waiting well. First, people can wait in such a way as to ease their distress during the waiting period. Second, people could wait in such a way as to ease the pain of bad news or enhance the thrill of good news. We conducted a longitudinal study of law graduates (N = 230) awaiting their result on the California bar exam. Participants completed questionnaires prior to the exam, every 2 weeks during the 4-month waiting period, and shortly after learning whether they passed or failed. Cross-lagged models revealed that participants were quite unsuccessful at waiting well by our first definition. That is, their coping strategies were ineffective for reducing distress associated with uncertainty, apparently even backfiring in some cases. However, multiple regression analyses examining relationships between waiting experiences and responses to good and bad news found that many participants were successful at waiting well according to our second definition: Participants who suffered through a waiting period marked by anxiety, rumination, and pessimism responded more productively to bad news and more joyfully to good news, as compared with participants who suffered little during the wait. These findings substantiate the difficulty of enduring a stressful waiting period but suggest that this difficulty may pay off once the news arrives. PMID:26461244

  2. The Effect of ‘On-Line’ POCT on Patient waiting times in an Accident and Emergency Department

    PubMed Central

    Gilkar, Ashfaq; Fink, Richard; Eardley, Philip; Barron, Catriona

    2013-01-01

    This POCT (point of care testing) team was constructed at the start of 2012 to implement the POCT project aiming to define and test the hypothesis that interfacing POCT devices to a clinical electronic order communications system reduces patient waiting times in an NHS Accident and Emergency Department (A&E). The devices selected for evaluation initially comprised the Sysmex XS 1000i haematology analyser and the Abbott i-Stat chemistry analyser. The POCT devices were interfaced to a server (Midlynx) which in turn was connected via the hospital internal network, to the ICE system (Integrated Clinical Environment). Test orders entered on the ICE system produced a bar code label read by the individual POCT devices. Once required tests were assayed, the results were transmitted back to the ICE system, where they could be viewed by users across the hospital site. The quality of POCT analytical performance was assessed by running quality control checks as recommended by the manufacturers and by exchanging samples daily with the clinical laboratory. The I-Stat (a Chemistry analyser manufactured by ‘Abbott plc’) was also tested against material obtained from a national external quality assurance scheme (NEQAS). The time taken to produce POCT tests was calculated as the time elapsed (TE) between requesting tests, and the time at which completed results were returned to the ICE system. Patient waiting times were derived from the patient administration system (Symphony) used in the A&E department. To assess the true effect of POCT on patient waiting times the analysis was confined to cases associated with POCT tests only (n = 217). A control population (n=229) was randomly selected from the clinical laboratory database. The time interval between requesting a test and receiving the results for the POCT tests was 23 minutes and for the laboratory tests, 60 minutes. The patient waiting times (time of discharge - time of arrival) was 167 minutes for the POCT group and 208 for

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    1993-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

    Nanthamongkolkul, Kulisara

    2015-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

    Knapman, Mary; Bonner, Ann

    2010-06-01

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

  9. Managing patients' wait time in specialist out-patient clinic using real-time data from existing queue management and ADT systems.

    PubMed

    Ju, John Chen; Gan, Soon Ann; Tan Siew Wee, Justine; Huang Yuchi, Peter; Mei Mei, Chan; Wong Mei Mei, Sharon; Fong, Kam Weng

    2013-01-01

    In major cancer centers, heavy patients load and multiple registration stations could cause significant wait time, and can be result in patient complains. Real-time patient journey data and visual display are useful tools in hospital patient queue management. This paper demonstrates how we capture patient queue data without deploying any tracing devices; and how to convert data into useful patient journey information to understand where interventions are likely to be most effective. During our system development, remarkable effort has been spent on resolving data discrepancy and balancing between accuracy and system performances. A web-based dashboard to display real-time information and a framework for data analysis were also developed to facilitate our clinics' operation. Result shows our system could eliminate more than 95% of data capturing errors and has improved patient wait time data accuracy since it was deployed.

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

    PubMed

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

    2014-12-01

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

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

    PubMed

    Nascimento, Maria Isabel do; Silva, Gulnar Azevedo E

    2015-11-01

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

  12. A "package solution" fast track program can reduce the diagnostic waiting time in head and neck cancer.

    PubMed

    Sorensen, Jesper Roed; Johansen, Jørgen; Gano, Lars; Sørensen, Jens Ahm; Larsen, Stine Rosenkilde; Andersen, Peter Bøgeskov; Thomassen, Anders; Godballe, Christian

    2014-05-01

    In 2007, a fast track program for patients with suspicion of head and neck cancer (HNC) was introduced in Denmark to reduce unnecessary waiting time. The program was based on so called "package solutions" including pre-booked slots for outpatient evaluation, imaging, and diagnostic surgical procedures. The purpose of this study is to present a model for fast track handling of patients suspicious of cancer in the head and neck region and to evaluate the effect of implementation on the diagnostic work up time. Patients with suspicion of HNC referred to the same university department of ENT Head and Neck Surgery during three comparable time intervals 2006-2007, 2007-2008, and 2011-2012 (groups 1-3) were investigated. We recorded the time from patient referral, to first consultation and final diagnosis. The first interval was before initiation of the "package solution", the second just after the introduction, and the third interval represents the current situation. The median time from referral to first consultation was reduced from eight calendar days in group 1 to only one day in groups 2 and 3 (p < 0.001). The combined median time from referral to the final cancer diagnosis decreased from 24 calendar days in group 1 to 7 and 10 days in groups 2 and 3, respectively (p < 0.005). The hit rate of finding malignancy was 41% in group 1, 49% in group 2, and 43% in group 3 with no difference among the groups (p = 0.13). The frequency of newly diagnosed HNC was 19% in group 1, 21% in group 2, and 17% in group 3 (p = 0.52). A "package solution" including pre-booked slots for diagnostic procedures is feasible and can significantly reduce the waiting time for patients with suspicion of HNC. PMID:23775302

  13. The first attempt to create a national strategy for reducing waiting times in Poland: will it succeed?

    PubMed

    Kowalska, Iwona; Sagan, Anna; Mokrzycka, Anna; Zabdyr-Jamróz, Michał

    2015-03-01

    The waiting lists package, proposed in March 2014, is the first attempt to create a national strategy to reduce waiting times for specialist care in Poland. The policy proposes a number of measures directed at primary, specialist ambulatory and hospital care with the goal of shifting patients to the lowest possible level of care. Initially, it has been welcomed by the patients and there has been, so far, no strong opposition against the reform from other stakeholders. However, this may be because there is some disbelief that the policy would actually be implemented (due to limited funding available for its implementation) and because some of the proposed changes are vague and have yet to be clarified. One stakeholder group that may obstruct the implementation of the reform, if they are not satisfied with the final shape of the proposed measures, is the primary care doctors. They are directly affected by the reform and enjoy a relatively strong bargaining position compared to other groups of medical professionals. Thus, the future of the reform remains uncertain.

  14. Improvement in obstructive sleep apnea diagnosis and management wait times: A retrospective analysis of home management pathway for obstructive sleep apnea.

    PubMed

    Stewart, Samuel Alan; Skomro, Robert; Reid, John; Penz, Erika; Fenton, Mark; Gjevre, John; Cotton, David

    2015-01-01

    Obstructive sleep apnea is a common condition within the Canadian population. The current gold standard for diagnosis and management of patients is in-laboratory (in-lab) polysomnography; however, the limited availability of testing options for patients has led to long wait times and increased disease burden within the population. The Sleep Research Laboratory in Saskatoon (Saskatchewan) implemented a home management program to run in parallel with the in-lab system several years ago in an effort to increase their capacity and reduce wait times. The present study was a retrospective analysis of all patients referred to the program between 2009 and 2012. The home management system has improved wait times by diagnosing and managing up to one-half of the referred patient population, reducing the wait for in-lab treatment from a median of 152 days in 2009 to 92 days in 2012 (P<0.0001). Moving forward, home management can provide a viable alternative to in-lab testing for patients who meet strict entry criteria, reducing the in-lab workload and, ultimately, reducing wait times.

  15. A School Finance Dilemma for Texas: Achieving Equity in a Time of Fiscal Constraint.

    ERIC Educational Resources Information Center

    Picus, Lawrence O.; Hertert, Linda

    A study employing a traditional equity framework was used to calculate the equity of Texas' school-finance structure. Horizontal and vertical equity as well as fiscal neutrality are used as principles in the study. Data on school-district enrollments, tax assessments, and state revenues from the Resource Planning Office of the Texas Education…

  16. Effect of α-stable sorptive waiting times on microbial transport in microflow cells

    NASA Astrophysics Data System (ADS)

    Bonilla, F. Alejandro; Cushman, John H.

    2002-09-01

    The interaction of bacteria in the fluid phase with pore walls of a porous material involves a wide range of effective reaction times which obey a diversity of substrate-bacteria adhesion conditions, and adhesive mechanisms. For a transported species, this heterogeneity in sorption conditions occurs both in time and space. Modern experimental methods allow one to measure adhesive reaction times of individual bacteria. This detailed information may be incorporated into nonequilibrium transport-sorption models that capture the heterogeneity in reaction times caused by varying chemical conditions. We have carried out particle (Brownian dynamic) simulations of adhesive, self-motile bacteria convected between two infinite plates as a model for a microflow cell. The adhesive heterogeneity is included by introducing adhesive reaction time (understood as time spent at a solid boundary once the particle collides against it) as a random variable that can be infinite (irreversible sorption) or vary over a wide range of values. This is made possible by treating this reaction time random variable as having an α-stable probability distribution whose properties (e.g., infinite moments and long tails) are distinctive from the standard exponential distribution commonly used to model reversible sorption. In addition, the α-stable distribution is renormalizable and hence upscalable to complex porous media. Simulations are performed in a pressure-driven microflow cell. Bacteria motility (driven by an effective Brownian force) acts as a dispersive component in the convective field. Upon collision with the pore wall, bacteria attachment or detachment occurs. The time bacteria spend at the wall varies over a wide range of time scales. This model has the advantage of being parsimonious, that is, involving very few parameters to model complex irreversible or reversible adhesion in heterogeneous environments. It is shown that, as in Taylor dispersion, the ratio of the channel half width b

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

    PubMed

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

    2016-01-01

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

  18. A probabilistic model for estimating the waiting time until the simultaneous collapse of two contingencies

    SciTech Connect

    Barnett, C.S.

    1991-06-01

    The Double Contingency Principle (DCP) is widely applied to criticality safety practice in the United States. Most practitioners base their application of the principle on qualitative, intuitive assessments. The recent trend toward probabilistic safety assessments provides a motive to search for a quantitative, probabilistic foundation for the DCP. A Markov model is tractable and leads to relatively simple results. The model yields estimates of mean time to simultaneous collapse of two contingencies as a function of estimates of mean failure times and mean recovery times of two independent contingencies. The model is a tool that can be used to supplement the qualitative methods now used to assess effectiveness of the DCP. 3 refs., 1 fig.

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

    ERIC Educational Resources Information Center

    Neville, Brian

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

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

    SciTech Connect

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

    2010-01-10

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

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

    ERIC Educational Resources Information Center

    Ingram, Jenni; Elliott, Victoria

    2016-01-01

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

  2. [Factors associated with waiting time and access to kidney transplants in Belo Horizonte, Minas Gerais State, Brazil'].

    PubMed

    Machado, Elaine Leandro; Gomes, Isabel Cristina; Acurcio, Francisco de Assis; César, Cibele Comini; Almeida, Maria Cristina de Mattos; Cherchiglia, Mariangela Leal

    2012-12-01

    The objective of this study was to analyze factors associated with access to kidney transplants from living and cadaver donors in Belo Horizonte, Minas Gerais State, Brazil. The authors conducted a non-concurrent cohort study of patients on the waiting list for kidney transplants from 2000 to 2004 and followed until transplantation, death, exclusion, or continued presence on the line at the end of the study on December 31, 2005. The Cox model was used for competing risks. Of the 835 patients, 22.7% were transplanted. Lower risk of transplantation from living donors and cadavers was observed in patients with more time on dialysis and blood type O. Lower risk of transplantation from living donors was observed in residents in a high health risk area and in recipients with diabetes. The greatest disparity in access was observed in transplants from living donors, since there were no significant socio-demographic differences in transplants from cadaver donors. One can infer that the organ allocation system contributed to mitigating socio-demographic inequalities, and that clinical issues were more relevant in access to transplants from cadaver donors.

  3. "Kairos" and the Time of Gender Equity Policy in Australian Schooling

    ERIC Educational Resources Information Center

    Gannon, Susanne

    2016-01-01

    Almost 20 years ago the Australian government released "Gender Equity: A Framework for Australian Schools" (1997). It was adopted by all states but almost immediately disappeared from sight after a conservative change of government. This was followed by the dismantling of gender equity units in each state, and a turn to boys' education…

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

    PubMed

    Hosking, Jonathan; Gibson, Colin

    2016-07-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2014-05-01

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

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

    PubMed

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

    2016-10-01

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

  7. Waiting Online: A Review and Research Agenda.

    ERIC Educational Resources Information Center

    Ryan, Gerard; Valverde, Mireia

    2003-01-01

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

  8. G-quadruplex and G-rich sequence stimulate Pif1p-catalyzed downstream duplex DNA unwinding through reducing waiting time at ss/dsDNA junction

    PubMed Central

    Zhang, Bo; Wu, Wen-Qiang; Liu, Na-Nv; Duan, Xiao-Lei; Li, Ming; Dou, Shuo-Xing; Hou, Xi-Miao; Xi, Xu-Guang

    2016-01-01

    Alternative DNA structures that deviate from B-form double-stranded DNA such as G-quadruplex (G4) DNA can be formed by G-rich sequences that are widely distributed throughout the human genome. We have previously shown that Pif1p not only unfolds G4, but also unwinds the downstream duplex DNA in a G4-stimulated manner. In the present study, we further characterized the G4-stimulated duplex DNA unwinding phenomenon by means of single-molecule fluorescence resonance energy transfer. It was found that Pif1p did not unwind the partial duplex DNA immediately after unfolding the upstream G4 structure, but rather, it would dwell at the ss/dsDNA junction with a ‘waiting time’. Further studies revealed that the waiting time was in fact related to a protein dimerization process that was sensitive to ssDNA sequence and would become rapid if the sequence is G-rich. Furthermore, we identified that the G-rich sequence, as the G4 structure, equally stimulates duplex DNA unwinding. The present work sheds new light on the molecular mechanism by which G4-unwinding helicase Pif1p resolves physiological G4/duplex DNA structures in cells. PMID:27471032

  9. Contraceptive Equity

    PubMed Central

    Temkin, Elizabeth

    2007-01-01

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

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

    ERIC Educational Resources Information Center

    Philadelphia Citizens for Children and Youth, PA.

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

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

    PubMed

    Du, Shichuan; Martinez, Aleix M

    2013-03-18

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

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

    PubMed Central

    Du, Shichuan; Martinez, Aleix M.

    2013-01-01

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

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

    SciTech Connect

    Volkán-Kacsó, Sándor

    2014-06-14

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

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

    NASA Astrophysics Data System (ADS)

    Volkán-Kacsó, Sándor

    2014-06-01

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

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

    PubMed

    Volkán-Kacsó, Sándor

    2014-06-14

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

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

    SciTech Connect

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

    2006-03-30

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

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

    NASA Astrophysics Data System (ADS)

    Kennedy, A.

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

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

    PubMed Central

    Chowdhury, Rezwan; Boyce, Andrew; Halperin, Ross

    2015-01-01

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

  19. The ticking time bomb: escalating antibiotic resistance in Neisseria gonorrhoeae is a public health disaster in waiting.

    PubMed

    Whiley, David M; Goire, Namraj; Lahra, Monica M; Donovan, Basil; Limnios, Athena E; Nissen, Michael D; Sloots, Theo P

    2012-09-01

    From a once easily treatable infection, gonorrhoea has evolved into a challenging disease, which in future may become untreatable in certain circumstances. International spread of extensively drug-resistant gonococci would have severe public health implications. It seems clear that under the current treatment pressure from extended-spectrum cephalosporins, and owing to Neisseria gonorrhoeae's remarkable evolutionary adaptability, further rise of ceftriaxone-resistant strains around the world is inevitable. Simply increasing the doses of extended-spectrum cephalosporins will likely prove ineffective in the long run, and has been a lesson learnt for all single-agent therapies used for gonorrhoea to date. We recommend that dual therapy, especially those consisting of extended-spectrum cephalosporins and azithromycin, be adopted more widely and complemented by strengthening of antimicrobial resistance surveillance. Unless there is urgent action at international and local levels to combat the problem of N. gonorrhoeae antimicrobial resistance, we are in for gloomy times ahead in terms of gonorrhoea disease and control.

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

    PubMed

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

    2016-06-01

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

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

    PubMed

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

    2016-06-01

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

  2. Colour Consideration for Waiting areas in hospitals

    NASA Astrophysics Data System (ADS)

    Zraati, Parisa

    2012-08-01

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

  3. Length of stay, wait time to surgery and 30-day mortality for patients with hip fractures after the opening of a dedicated orthopedic weekend trauma room

    PubMed Central

    Taylor, Michel; Hopman, Wilma; Yach, Jeff

    2016-01-01

    Background In September 2011, Kingston General Hospital (KGH) opened a dedicated orthopedic weekend trauma room. Previously, 1 weekend operating room (OR) was used by all surgical services. We assessed the impact this dedicated weekend trauma room had on hospital length of stay (LOS), time to surgery and 30-day mortality for patients with hip fractures. Methods Patients admitted between Oct. 1, 2009, and Sept. 30, 2012, were identified through our trauma registry, representing the 2 years before and 1 year after the opening of the orthopedic weekend trauma room. We documented type of fracture, mode of fixation, age, sex, American Society of Anesthesiologists (ASA) score, time to OR, LOS, discharge disposition and 30-day mortality. We excluded patients with multiple fractures, open fractures and those requiring trauma team activation. Results Our study included 609 patients (405 pre- and 204 post–trauma room opening). Mean LOS decreased from 11.6 to 9.4 days (p = 0.005) and there was a decreasing trend in mean time to OR from 31.5 to 28.5 hours (p = 0.16). There was no difference in 30-day mortality (p = 0.24). The LOS decreased by an average of 2 days following opening of the weekend trauma room (p = 0.031) and by an average of 2.2 additional days if the patient was admitted on the weekend versus during the week (p = 0.024). Conclusion The weekend trauma OR at KGH significantly decreased the LOS and appears to have decreased wait times to surgery. Further analysis is needed to assess the cost-effectiveness of the current strategy, the long-term outcome of this patient population and the impact the additional orthopedic weekend trauma room has had on other surgical services (i.e., general surgery) and their patients. PMID:27668332

  4. Challenging "Waiting for Superman"

    ERIC Educational Resources Information Center

    Bruhn, Molle

    2014-01-01

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

  5. Waiting in the surgery.

    PubMed

    Fry, F

    1994-07-01

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

  6. Waiting in the surgery.

    PubMed

    Fry, F

    1994-07-01

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

  7. Organ Type and Waiting Time

    MedlinePlus

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

  8. Waiting for care. Queuing and resource allocation.

    PubMed

    Bloom, B S; Fendrick, A M

    1987-02-01

    Queues arise in medical care and serve as allocators in the absence of an effective market and when resources become perceptibly constrained. This is essentially the case in all countries where money is not the means for gaining access to medical services. A study estimated that the total wait in England was 96 days for nonemergency care leading to hospitalization, including primary and specialty ambulatory care, for that one quarter of patients who had been placed on a waiting list. Of the remaining hospitalized population one half were admitted immediately and another one fourth were either booked or transferred from other hospitals. The widely accepted notion that a large majority of hospitalized patients wait a long time for care in Britain is mistaken. The emphasis on primary ambulatory care means that essentially no one has to wait for general practitioner care. The wait for elective ambulatory specialty care averaged approximately 8 weeks for all patients. Although mortality is rarely an issue for those who wait, an argument can be made that convenience and quality of life are importantly affected.

  9. Waiting for coronary angiography: is there a clinically ordered queue?

    PubMed

    Hemingway, H; Crook, A M; Feder, G; Dawson, J R; Timmis, A

    2000-03-18

    Among over 3000 patients undergoing coronary angiography in the absence of a formal queue-management system, we found that a-priori urgency scores were strongly associated with waiting times, prevalence of coronary-artery disease, rate of revascularisation, and mortality. These data challenge the widely held assumption that such waiting lists are not clinically ordered; however, the wide variation in waiting times within urgency categories suggests the need for further improvements in clinical queueing.

  10. Optimal quality, waits and charges in health insurance.

    PubMed

    Gravelle, Hugh; Siciliani, Luigi

    2008-05-01

    We examine the role of quality and waiting time in health insurance when there is ex post moral hazard. Quality and waiting time provide additional instruments to control demand and potentially can improve the trade-off between optimal risk bearing and optimal consumption of health care. We show that optimal quality is lower than it would be in the absence of ex post moral hazard. But it is never optimal to have a positive waiting time if the marginal cost of waiting is higher for patients with greater benefits from health care.

  11. Waiting for Water

    ERIC Educational Resources Information Center

    Lamson-Nussbaum, Jorie

    2013-01-01

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

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

    ERIC Educational Resources Information Center

    Lopez, Janet; Rivera, Peter

    2015-01-01

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

  13. Pricing foreign equity option with stochastic volatility

    NASA Astrophysics Data System (ADS)

    Sun, Qi; Xu, Weidong

    2015-11-01

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

  14. Correlation based networks of equity returns sampled at different time horizons

    NASA Astrophysics Data System (ADS)

    Tumminello, M.; di Matteo, T.; Aste, T.; Mantegna, R. N.

    2007-01-01

    We investigate the planar maximally filtered graphs of the portfolio of the 300 most capitalized stocks traded at the New York Stock Exchange during the time period 2001 2003. Topological properties such as the average length of shortest paths, the betweenness and the degree are computed on different planar maximally filtered graphs generated by sampling the returns at different time horizons ranging from 5 min up to one trading day. This analysis confirms that the selected stocks compose a hierarchical system progressively structuring as the sampling time horizon increases. Finally, a cluster formation, associated to economic sectors, is quantitatively investigated.

  15. Impact of UCSF criteria according to pre- and post-OLT tumor features: analysis of 479 patients listed for HCC with a short waiting time.

    PubMed

    Decaens, Thomas; Roudot-Thoraval, Françoise; Hadni-Bresson, Solange; Meyer, Carole; Gugenheim, Jean; Durand, Francois; Bernard, Pierre-Henri; Boillot, Olivier; Sulpice, Laurent; Calmus, Yvon; Hardwigsen, Jean; Ducerf, Christian; Pageaux, Georges-Philippe; Dharancy, Sebastien; Chazouilleres, Olivier; Cherqui, Daniel; Duvoux, Christophe

    2006-12-01

    Orthotopic liver transplantation (OLT) indication for hepatocellular carcinoma (HCC) is currently based on the Milan criteria. The University of California, San Francisco (UCSF) recently proposed an expansion of the selection criteria according to tumors characteristics on the explanted liver. This study: 1) assessed the validity of these criteria in an independent large series and 2) tested for the usefulness of these criteria when applied to pre-OLT tumor evaluation. Between 1985 and 1998, 479 patients were listed for liver transplantation (LT) for HCC and 467 were transplanted. According to pre-OLT (imaging at date of listing) or post-OLT (explanted liver) tumor characteristics, patients were retrospectively classified according to both the Milan and UCSF criteria. The 5-yr survival statistics were assessed by the Kaplan-Meier method and compared by the log-rank test. Pre-OLT UCSF criteria were analyzed according to an intention-to-treat principle. Based on the pre-OLT evaluation, 279 patients were Milan+, 44 patients were UCSF+ but Milan- (subgroup of patients that might benefit from the expansion), and 145 patients were UCSF- and Milan-. With a short median waiting time of 4 months, 5-yr survival was 60.1 +/- 3.0%, 45.6 +/- 7.8%, and 34.7 +/- 4.0%, respectively (P < 0.001). The 5-yr survival was arithmetically lower in UCSF+ Milan- patients compared to Milan+ but this difference was not significant (P = 0.10). Based on pathological features of the explanted liver, 5-yr survival was 70.4 +/- 3.4%, 63.6 +/- 7.8%, and 34.1 +/- 3.1%, in Milan+ patients (n = 184), UCSF+ Milan- patients (n = 39), and UCSF- Milan- patients (n = 238), respectively (P < 0.001). However, the 5-yr survival did not differ between Milan+ and UCSF+ Milan- patients (P = 0.33). In conclusion, these results show that when applied to pre-OLT evaluation, the UCSF criteria are associated with a 5-yr survival below 50%. Their applicability is therefore limited, despite similar survival rates

  16. Waiting for rare entropic fluctuations

    NASA Astrophysics Data System (ADS)

    Saito, Keiji; Dhar, Abhishek

    2016-06-01

    Nonequilibrium fluctuations of various stochastic variables, such as work and entropy production, have been widely discussed recently in the context of large deviations, cumulants and fluctuation relations. Typically one looks at the probability distributions for entropic fluctuations of various sizes to occur in a fixed time interval. An important and natural question is to ask for the time one has to wait to see fluctuations of a desired size. We address this question by studying the first-passage time distribution (FPTD). We derive the general basic equation to get the FPTD for entropic variables. Based on this, the FPTD on entropy production in a driven colloidal particle in the ring geometry is illustrated. A general asymptotic form of the FPTD and integral fluctuation relation symmetry in terms of the first passages are found.

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

    PubMed Central

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

    2015-01-01

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

  18. Protocol to Exploit Waiting Resources for UASNs.

    PubMed

    Hung, Li-Ling; Luo, Yung-Jeng

    2016-01-01

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

  19. Protocol to Exploit Waiting Resources for UASNs.

    PubMed

    Hung, Li-Ling; Luo, Yung-Jeng

    2016-01-01

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

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

    ERIC Educational Resources Information Center

    Melnick, R. Shep

    2016-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2014-09-01

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

  2. Patients’ perceptions of waiting for bariatric surgery: a qualitative study

    PubMed Central

    2013-01-01

    Background In Canada waiting lists for bariatric surgery are common, with wait times on average > 5 years. The meaning of waiting for bariatric surgery from the patients’ perspective must be understood if health care providers are to act as facilitators in promoting satisfaction with care and quality care outcomes. The aims of this study were to explore patients’ perceptions of waiting for bariatric surgery, the meaning and experience of waiting, the psychosocial and behavioral impact of waiting for treatment and identify health care provider and health system supportive measures that could potentially improve the waiting experience. Methods Twenty-one women and six men engaged in in-depth interviews that were digitally recorded, transcribed verbatim and analysed using a grounded theory approach to data collection and analysis between June 2011 and April 2012. The data were subjected to re-analysis to identify perceived health care provider and health system barriers to accessing bariatric surgery. Results Thematic analysis identified inequity as a barrier to accessing bariatric surgery. Three areas of perceived inequity were identified from participants’ accounts: socioeconomic inequity, regional inequity, and inequity related to waitlist prioritization. Although excited about their acceptance as candidates for surgery, the waiting period was described as stressful, anxiety provoking, and frustrating. Anger was expressed towards the health care system for the long waiting times. Participants identified the importance of health care provider and health system supports during the waiting period. Recommendations on how to improve the waiting experience included periodic updates from the surgeon’s office about their position on the wait list; a counselor who specializes in helping people going through this surgery, dietitian support and further information on what to expect after surgery, among others. Conclusion Patients’ perceptions of accessing and

  3. How Long Do Adolescents Wait for Psychiatry Appointments?

    PubMed

    Steinman, Kenneth J; Shoben, Abigail B; Dembe, Allard E; Kelleher, Kelly J

    2015-10-01

    Appointment wait times are a neglected dimension of children's access to psychiatry. We systematically examined how long an adolescent waits for a new patient appointment with a psychiatrist for routine medication management. From state directories, we identified 578 providers of adolescent psychiatric care in Ohio. Researchers posing as parents telephoned randomly selected offices, seeking care for a hypothetical 14-year-old patient under different scenarios. Overall, we measured 498 wait times at 140 unique offices. The median wait time was 50 days (interquartile range = 29-81 days). In adjusted models, adolescents with Medicaid waited longer than those with private insurance, especially during the spring (geometric mean = 50.9 vs. 41.9 days; p = 0.02). Wait times also varied markedly by region, with geometric means ranging from 22.4 to 75.1 days (p < 0.01). This study demonstrates that adolescents often experience lengthy wait times for routine care. This methodology represents a useful approach to real-time monitoring of psychiatric services. PMID:26108305

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

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2015-10-06

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

  6. 26 CFR 301.9100-5T - Time and manner of making certain elections under the Tax Equity and Fiscal Responsibility Act of...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... under the Tax Equity and Fiscal Responsibility Act of 1982. 301.9100-5T Section 301.9100-5T Internal... manner of making certain elections under the Tax Equity and Fiscal Responsibility Act of 1982. (a... elections provided under the Tax Equity and Fiscal Responsibility Act of 1982. Section of act Section...

  7. 26 CFR 301.9100-5T - Time and manner of making certain elections under the Tax Equity and Fiscal Responsibility Act of...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... under the Tax Equity and Fiscal Responsibility Act of 1982. 301.9100-5T Section 301.9100-5T Internal... manner of making certain elections under the Tax Equity and Fiscal Responsibility Act of 1982. (a... elections provided under the Tax Equity and Fiscal Responsibility Act of 1982. Section of act Section...

  8. Waiting for hip arthroplasty: economic costs and health outcomes.

    PubMed

    Fielden, Jann M; Cumming, J M; Horne, J G; Devane, P A; Slack, A; Gallagher, L M

    2005-12-01

    This prospective cohort study of 153 patients aimed to determine the economic and health costs of waiting for total hip arthroplasty (THA). Health-related quality of life, using self-completed WOMAC and EQ-5D questionnaires, was assessed monthly from enrolment preoperatively to 6 months postsurgery. Monthly cost diaries were used to record costs. The mean waiting time was 5.1 months and mean total cost of waiting for surgery was NZ 4305 dollars(US 2876 dollars) per person (pp) (NZ 1 dollar = US 0.668 dollar). Waiting more than 6 months was associated with a higher total mean cost (NZ 4278 dollars/US 2858 dollars pp) than waiting less than 6 months (NZ 2828 dollars/US 1889 dollars pp; P < .01). Improvements from preoperative to postoperative WOMAC and EQ-5D scores were identified (P < or = .01). Waiting longer led to poorer physical function preoperatively (P < or = .01). Those with poor initial health status showed greater improvement in WOMAC (P = .0001) and EQ-5D (P = .003) measures by 6 months after surgery. Longer waits for total hip arthroplasty incur greater economic costs and deterioration in physical function while waiting. PMID:16376253

  9. Equity in community care.

    PubMed Central

    Challis, L.; Henwood, M.

    1994-01-01

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

  10. Strategy as active waiting.

    PubMed

    Sull, Donald N

    2005-09-01

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

  11. Monitor to investigate trust for making patients wait too long.

    PubMed

    2014-10-01

    HEALTH REGULATOR Monitor has launched an investigation into Yorkshire Teaching Hospital NHS Foundation Trust after finding that some patients had been waiting too long to be assessed for emergency care. The regulator believes that repeated failures to ensure patients were seen soon enough may indicate wider problems at the trust, which has failed to meet the quarterly national emergency department waiting time target five times in nearly two years.

  12. Waiting Narratives of Lung Transplant Candidates

    PubMed Central

    Yelle, Maria T.; Stevens, Patricia E.; Lanuza, Dorothy M.

    2013-01-01

    Before 2005, time accrued on the lung transplant waiting list counted towards who was next in line for a donor lung. Then in 2005 the lung allocation scoring system was implemented, which meant the higher the illness severity scores, the higher the priority on the transplant list. Little is known of the lung transplant candidates who were listed before 2005 and were caught in the transition when the lung allocation scoring system was implemented. A narrative analysis was conducted to explore the illness narratives of seven lung transplant candidates between 2006 and 2007. Arthur Kleinman's concept of illness narratives was used as a conceptual framework for this study to give voice to the illness narratives of lung transplant candidates. Results of this study illustrate that lung transplant candidates expressed a need to tell their personal story of waiting and to be heard. Recommendation from this study calls for healthcare providers to create the time to enable illness narratives of the suffering of waiting to be told. Narrative skills of listening to stories of emotional suffering would enhance how healthcare providers could attend to patients' stories and hear what is most meaningful in their lives. PMID:23476760

  13. Science Education and Equity.

    ERIC Educational Resources Information Center

    Bates, Percy; And Others

    1994-01-01

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

  14. Equity Assessment Study. Summary.

    ERIC Educational Resources Information Center

    Fadale, LaVerna M.; Zhao, Peisheng

    This assessment study is a culminating activity of an eight-year initiative to facilitate gender equity and more equitable campus environments - Mentoring Institutional Equity in New York State Two-Year Colleges. Eighteen two-year colleges participated in the application and implementation of an educational equity model designed to enhance gender…

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

    PubMed

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

    2015-01-01

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

  16. Weight-ing: the experience of waiting on weight loss.

    PubMed

    Glenn, Nicole M

    2013-03-01

    Perhaps we want to be perfect, strive for health, beauty, and the admiring gaze of others. Maybe we desire the body of our youth, the "healthy" body, the body that has just the right fit. Regardless of the motivation, we might find ourselves striving, wanting, and waiting on weight loss. What is it to wait on weight loss? I explore the meaning of this experience-as-lived using van Manen's guide to phenomenological reflection and writing. Weight has become an increasing focus of contemporary culture, demonstrated, for example, by a growing weight-loss industry and global obesity "epidemic." Weight has become synonymous with health status, and weight loss with "healthier." I examine the weight wait through experiences of the common and uncommon, considering relations to time, body, space, and the other with the aim of evoking a felt, embodied, emotive understanding of the meaning of waiting on weight loss. I also discuss the implications of the findings.

  17. Access & Equity Newsletter. Volume 6

    ERIC Educational Resources Information Center

    South Carolina Commission on Higher Education, 2004

    2004-01-01

    Included in this edition of the "In-the-Know" Access & Equity Newsletter are: (1) State Losing Black Instructors (Gina Smith); (2) Time to Join Together to Seek "Economic Rights" (Darla Moore); and (3) "Advancing Diversity in Higher Education--Diversity Digest" (Mark Giles, Ed.), which is a reprint of an article originally published in…

  18. Review of "Waiting for Superman"

    ERIC Educational Resources Information Center

    Dutro, Elizabeth

    2011-01-01

    "Waiting for Superman" offers what appear to be straightforward, commonsense solutions to inequities in schooling. The film argues that heroic action can be taken to fix what it portrays as the disaster of public schooling. The film disregards poverty as a factor in school performance and connection--and therefore never addresses anti-poverty…

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-06-01

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

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

    PubMed

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

    2016-06-01

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

  2. Waiting for Unruh

    NASA Astrophysics Data System (ADS)

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

    2016-08-01

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

  3. Waiting for Unruh

    NASA Astrophysics Data System (ADS)

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

    2016-08-01

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

  4. Melding Excellence and Equity.

    ERIC Educational Resources Information Center

    Bennett, David A.

    1983-01-01

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

  5. Gender Equity. IDRA Forum.

    ERIC Educational Resources Information Center

    IDRA Newsletter, 1994

    1994-01-01

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

  6. Men, Women, and Equity

    ERIC Educational Resources Information Center

    Rapoport, Rhona; Rapoport, Robert N.

    1975-01-01

    The concept of equity is proposed as having advantages over that of equality. By equity, we mean a fair allocation both of opportunity and of constraints. It is put forward as a concept which goes beyond that of equality; it acknowledges differences between men and women and the need to think in terms of variations of patterns. Paper presented at…

  7. New Directions For Foundations In Health Equity.

    PubMed

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

    2016-08-01

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

  8. Protocol to Exploit Waiting Resources for UASNs †

    PubMed Central

    Hung, Li-Ling; Luo, Yung-Jeng

    2016-01-01

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

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

    PubMed

    Goddard, J A; Tavakoli, M

    1998-09-01

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

  10. Racial equity or racial equality.

    PubMed

    Daymont, T N

    1980-11-01

    This study examines the relationship between racial equity in labor market processes and racial equality in future labor market rewards. In particular, a regression standardization procedure is used to project the degree of racial inequality in earnings that would exist among men at various future points in time based on three different sets of assumptions about attainment processes in labor market and educational institutions. The most important results suggest that even if racial discrimination were eliminated immediately in labor market and educational institutions, it would take almost 50 years for the black-white earnings ratio to reach .95. This incompatibility between equity and equality needs to be considered more explicitly both by those who advocate a color-blind labor market and those who advocate preferential treatment for blacks.

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

    MedlinePlus

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

  12. Info card for surgery waiting room improves satisfaction.

    PubMed

    2015-11-01

    A hospital is reporting improved patient satisfaction from providing an information card in the surgery department. The card includes expected wait times. The card is provided by the patient transport team. Telephone numbers are included for more information. Staff update family members hourly during surgery.

  13. Strategic Attention Deployment for Delay of Gratification in Working and Waiting Situations.

    ERIC Educational Resources Information Center

    Peake, Philip K.; Hebl, Michelle; Mischel, Walter

    2002-01-01

    Two studies examined whether effects of attention to rewards during a delay of gratification task in waiting situations affects preschoolers' ability to delay gratification in working situations. Findings show that when work provides distraction, attention on rewards reduces delay time whether working or waiting; when work is not engaging,…

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

    ERIC Educational Resources Information Center

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

    2003-01-01

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

  15. Research: Why Wait till High School?

    ERIC Educational Resources Information Center

    Landreau, Janice

    2011-01-01

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

  16. The Religious Meaning in "Waiting for Godot"

    ERIC Educational Resources Information Center

    Wang, Jing

    2011-01-01

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

  17. Myth 14: Waiting for Santa Claus

    ERIC Educational Resources Information Center

    Adams, Cheryll M.

    2009-01-01

    Just as in 1982, when the myth of waiting for Santa Claus was first addressed in "Gifted Child Quarterly," many districts all over the country are still waiting for Santa Claus to arrive with a sleigh full of presents. Unfortunately, Santa and his presents in the form of mandates to identify and serve, funding, teachers licensed in gifted…

  18. The Equity of Public Education Funding in Georgia, 1988-1996.

    ERIC Educational Resources Information Center

    Rubenstein, Ross; Doering, Dwight; Gess, Larry

    2000-01-01

    Employs school funding formulas enacted under Georgia's Quality Basic Education Act to explore changes in interdistrict equity over time. Regarding overall distribution of per-pupil resources across districts (horizontal equity) and for special- needs students (vertical equity), dispersion measures approach Odden and Picus' suggested equity…

  19. Carbapenemases: a problem in waiting?

    PubMed

    Livermore, D M; Woodford, N

    2000-10-01

    Carbapenems are stable to most prevalent beta-lactamases, and chromosomal carbapenemases are restricted to Stenotrophomonas maltophilia, to a few Bacteroides fragilis, and to rare pathogens. Nevertheless, an acquired metallo-beta-lactamase called IMP-1 is beginning to emerge in Pseudomonas aeruginosa and Enterobacteriaceae isolates in Japan, and has also been found in isolates from Singapore. Furthermore, IMP-producing Acinetobacter spp. have been identified in Italy and Hong Kong. Recently a second group of acquired metallo-carbapenemases, the VIM types, has been recorded from P. aeruginosa isolates in five Eurasian countries. Weak carbapenemases belonging to molecular class D are emerging in A. baumannii world-wide, with two sub-groups apparent. A few acquired carbapenemases belonging to molecular class A also have been reported. Finally it has also been shown that enzymes with feeble carbapenemase activity (e.g. AmpC types and some SHV enzymes) may confer resistance in exceptionally impermeable strains; counterwise, even potent carbapenemases, such as IMP-1, may only give a small reduction in susceptibility in Enterobacteriaceae that lack permeability lesions. Is the emergence of carbapenemase a problem waiting to happen?

  20. Waiting list management practices for home-care occupational therapy in the province of Quebec, Canada.

    PubMed

    Raymond, Marie-Hélène; Demers, Louise; Feldman, Debbie E

    2016-03-01

    Referral prioritisation is commonly used in home-based occupational therapy to minimise the negative impacts of waiting, but this practice is not standardised. This may lead to inequities in access to care, especially for clients considered as low priority, who tend to bear the brunt of lengthy waiting lists. This cross-sectional study aimed to describe waiting list management practices targeting low-priority clients in home-based occupational therapy in the province of Quebec, Canada, and to investigate the association between these practices and the length of the waiting list. A structured telephone interview was conducted in 2012-2013 with the person who manages the occupational therapy waiting list in 55 home care programmes across Quebec. Questions pertained to strategies aimed at servicing low-priority clients, the date of the oldest referral and the number of clients waiting. Results were analysed using descriptive statistics and non-parametric tests. The median wait time for the oldest referral was 18 months (range: 2-108 months). A variety of strategies were used to service low-priority clients. Programmes that used no strategies to service low-priority clients (n = 16) had longer wait times (P < 0.0001) and a greater number of people on the waiting list (P = 0.006) compared with programmes that applied a maximum wait time target (n = 12). In conclusion, diverse strategies exist to allocate services to low-priority clients in home-based occupational therapy programmes. However, in programmes where none of these strategies are used, low-priority clients may be denied access to services indefinitely.

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

    ERIC Educational Resources Information Center

    Department of Education, Washington, DC.

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

  2. Equity and extramarital sexuality.

    PubMed

    Walster, E; Traupmann, J; Walster, G W

    1978-03-01

    Equity theory has recently been found to be a useful framework for understanding the effects of imbalances in intimate "contractual" relationships such as marriage. Equitable couples seem to be happier, more satisfied with their relationship, and more confident that it will last than are their more mismatched, i.e., inequitable, counterparts. Furthermore, inequitable couples predictably act to "set things right" in their marriage. They either restore actual equity to the relationship or psychologically set their relationship in balance. If neither works, they may "leave the field." Extramarital sex may be viewed as an equity restoration mechanism in that (1) it may be used by the deprived partner to achieve actual equity, (2) it may indicate a partner's readiness to leave the relationship because he feels he can "do better," or (3) it may represent a desire to achieve equity in an alternative relationship(s) when inequity pervades the primary one. The hypothesis that the inequitable/underbenefited group should be more likely than the equitable group or the inequitable/overbenefited group to have engaged in extramarital sex was tested using data from a large-scale Psychology Today questionnaire. The results indicated that men and women in inequitable/underbenefited relationships had more extramarital affairs and began their extramarital activities earlier than did men and women in equitable and inequitable/overbenefited relationships. Alternative explanations of this finding, sex-role demands and length of the relationship, are explored and discarded as untenable.

  3. Individual Differences in Equity Models

    ERIC Educational Resources Information Center

    Hofmans, Joeri

    2012-01-01

    In the present paper, we (1) study whether people differ in the equity models they use, and (2) test whether individual differences in equity models relate to individual differences in equity sensitivity. To achieve this goal, an Information Integration experiment was performed in which participants were given information on the performance of two…

  4. Equity, by what measure?

    PubMed

    Houston, Shane

    2006-12-01

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

  5. Waiting for child developmental and rehabilitation services: an overview of issues and needs.

    PubMed

    Miller, Anton R; Armstrong, Robert W; Mâsse, Louise C; Klassen, Anne F; Shen, Jane; O'Donnell, Maureen E

    2008-11-01

    Concern about the length of time that children, young people, and families may have to wait to access assessment, diagnostic, interventional, therapeutic, and supportive child developmental and rehabilitation (CDR) services is widespread, but adequate data collection and research on this issue remain limited. We review key concepts and issues relevant to waiting for CDR services from the published literature, a national workshop devoted to this topic, and international experience. We conclude that gaps in data, evidence, and consensus challenge our ability to address the issue of waiting for CDR services in a systematic way. A program of research coupled with actions based on consensus-building is required. Research priorities include acquiring evidence of the appropriateness and effectiveness of different models of intervention and rehabilitation services, and documenting the experience and expectations of waiting families. Consensus-building processes are critical to identify, categorize, and prioritize 'sentinel' components of CDR service pathways: (1) to reduce the inherent complexity of the field; (2) to create benchmarks for waiting for these respective services; and (3) to develop definitions for wait-time subcomponents in CDR services. Collection of accurate and replicable data on wait times for CDR services can be used to document baseline realities, to monitor and improve system performance, and to conduct comparative and analytic research in the field of CDR services.

  6. Waiting pedestrians in the social force model

    NASA Astrophysics Data System (ADS)

    Johansson, Fredrik; Peterson, Anders; Tapani, Andreas

    2015-02-01

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

  7. Improving Patients Experience in Peadiatric Emergency Waiting Room.

    PubMed

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

    2016-01-01

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

  8. Teacher Communities for Equity

    ERIC Educational Resources Information Center

    Cochran-Smith, Marilyn

    2015-01-01

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

  9. Student Equity Policy.

    ERIC Educational Resources Information Center

    Guichard, Gus

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

  10. Equity Literacy for All

    ERIC Educational Resources Information Center

    Gorski, Paul C.; Swalwell, Katy

    2015-01-01

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

  11. Sex Equity Coordinator's Handbook.

    ERIC Educational Resources Information Center

    Rubenstein, Dorothy; Sillman, Donna

    This guidebook was designed to assist sex equity coordinators in the Los Angeles Community College District in promoting the recruitment, retention, and placement of students in vocational programs that are non-traditional for their sex. The guidebook's first ten chapters present: (1) outlines of relevant legislation and legal guidelines for…

  12. Equity. IDRA Focus.

    ERIC Educational Resources Information Center

    IDRA Newsletter, 1998

    1998-01-01

    This theme issue focuses on equity in children's literature, public funding for private schools, women in educational fields, female dropouts, and the relationship between school violence and family and community violence. "Violence in Our Schools" (Bradley Scott) explores reasons for school violence (media violence, isolation from family, racial…

  13. Global Equity Gauge Alliance.

    PubMed

    Ntuli, Antoinette

    2007-01-01

    The lack of attention to equity in health, health care and determinants of health is a burden to the attainment of good health in many countries. With this underlying problem as a basis, a series of meetings took place between 1999 and 2000, culminating in the creation the Global Equity Gauge Alliance (GEGA). G EGA is an international network of groups in developing countries, mainly Asia, Africa and Latin America, which develop projects designed to confront and mitigate inequities in health, know as Equity Gauges. Equity Gauges aim to contribute towards the sustained decline in inequities in both the broad sociopolitical determinants of health, as well as inequities in the health system. Their approach is based on three broad spheres of action, known as "pillars": 1) measurement and monitoring, 2) advocacy, and 3) community empowerment. Through a series of examples from local or national level gauges, this paper showcases their work promoting the interaction between research and evidence-based policy formulation and implementation, and the interaction between the community and policy makers. PMID:17665716

  14. Gender Equity. IDRA Focus.

    ERIC Educational Resources Information Center

    IDRA Newsletter, 1996

    1996-01-01

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

  15. Computer Equity @ School.

    ERIC Educational Resources Information Center

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

    1999-01-01

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

  16. Redressing School Finance Equity.

    ERIC Educational Resources Information Center

    Crampton, Faith E.

    1997-01-01

    Outlines trends in school finance litigation. Examines definitions of fiscal equity, reviews 20 years of litigation, and analyzes recent legal activity. Recent litigation has challenged some states' school finance systems. Court decisions have split evenly regarding permissible disparities in per-pupil operating expenditures, a measure of…

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

    PubMed

    Betancourt, Joseph R

    2014-01-01

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

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

    PubMed

    Betancourt, Joseph R

    2014-01-01

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

  19. Promoting equity in health.

    PubMed

    Yach, D; Skov Jensen, M; Norris, A; Evans, T

    1998-06-01

    There is evidence that widening income gaps are a global phenomenon; that in many advanced industrialised countries unemployment rates are rising; that globalisation of the world economy has led to several countries becoming marginalised with a concomitant increase in poverty; and that the absolute number of poor has steadily increased over the last decade. All of these phenomena emphasise the need to focus on equity as a global concern. PMID:9672961

  20. Promoting equity in health.

    PubMed

    Yach, D; Skov Jensen, M; Norris, A; Evans, T

    1998-06-01

    There is evidence that widening income gaps are a global phenomenon; that in many advanced industrialised countries unemployment rates are rising; that globalisation of the world economy has led to several countries becoming marginalised with a concomitant increase in poverty; and that the absolute number of poor has steadily increased over the last decade. All of these phenomena emphasise the need to focus on equity as a global concern.

  1. Developing Agency for Equity-Minded Change

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  2. Clinical and lay preferences for the explicit prioritisation of elective waiting lists: survey evidence from Wales.

    PubMed

    Edwards, Rhiannon Tudor; Boland, Angela; Wilkinson, Clare; Cohen, David; Williams, John

    2003-03-01

    Waiting lists are a persistent feature of public health care systems. The United Kingdom National Health Service (NHS) is considering priority scoring systems as a means of ensuring that patients are treated according to clinical need rather than maximum waiting time targets. Our objective was to elicit the preferences of those involved in the finance, delivery and receipt of elective health care regarding the clinical and social factors that should and should not determine waiting time. We conducted a postal survey of 750 general practitioners, 500 consultants, 29 health authority commissioners and 1000 members of the general public across Wales. We found both professional and lay support for a more explicit system of rationing access to elective health care by waiting list. The majority of each of the survey groups believe that level of pain, rate of deterioration of disease, level of distress and level of disability should play the most influential role in determining waiting times. They agree that age, ability to pay, cost of treatment, evidence of cost-effectiveness, existence of dependants, and self-inflicted ill health should have little or no influence on patient priority. In conclusion, were the NHS to widen its use of waiting list priority scoring systems, our study suggests that there may be some degree of consensus as to the criteria to be used.

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

    PubMed

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

    2014-05-01

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

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

    PubMed Central

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

    2014-01-01

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

  5. Operationalizing Equity: The Complexities of Equity in Practice

    ERIC Educational Resources Information Center

    Andreasson, Ingela; Ohlsson, Lisbeth; Assarson, Inger

    2015-01-01

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

  6. Parental Strategies for Assisting Children to Wait

    ERIC Educational Resources Information Center

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

    2006-01-01

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

  7. 46 CFR 535.604 - Waiting period.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 9 2010-10-01 2010-10-01 false Waiting period. 535.604 Section 535.604 Shipping FEDERAL MARITIME COMMISSION REGULATIONS AFFECTING OCEAN SHIPPING IN FOREIGN COMMERCE OCEAN COMMON CARRIER AND MARINE TERMINAL OPERATOR AGREEMENTS SUBJECT TO THE SHIPPING ACT OF 1984 Action on Agreements §...

  8. Psychiatric Patients Face Longer Waits in ER

    MedlinePlus

    ... MedlinePlus Site Map FAQs Contact Us Health Topics Drugs & Supplements Videos & Tools Español You Are Here: Home → Latest Health News → Article URL of this page: https://medlineplus.gov/news/fullstory_160934.html Psychiatric Patients Face Longer Waits in ER And they're ...

  9. A Tribute to Waiting Room Moms Everywhere

    ERIC Educational Resources Information Center

    Ansfield, Mara

    2008-01-01

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

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

    PubMed

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

    2016-03-01

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

  11. If private equity sized up your business.

    PubMed

    Pozen, Robert C

    2007-11-01

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

  12. Technology and Equity. ERIC Digest.

    ERIC Educational Resources Information Center

    Neuman, Delia

    This examination of the relationship that exists between technology and students warns that, although technology is routinely touted as a potentially powerful agent of educational reform, technology and equity are not inevitable partners. A review of the literature on computer equity reveals that many students--not only minority, disadvantaged,…

  13. Leadership, Equity, and School Effectiveness.

    ERIC Educational Resources Information Center

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

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

  14. Screening Educational Equity: A Filmography.

    ERIC Educational Resources Information Center

    Shaffer, Susan Morris, Comp.

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

  15. Sex Equity: Is It Feasible?

    ERIC Educational Resources Information Center

    Shocklee, Georgia

    This guide presents a model and plan to expedite implementation of sex equity in vocational education through the elimination of sex stereotyping and sex bias. Aimed at vocational education administrators, the guide is organized into the four steps of the plan. Step 1 provides a rationale for the decision to implement a model sex equity program,…

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

    NASA Astrophysics Data System (ADS)

    Wang, Jianfeng

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

  2. 24 CFR 982.205 - Waiting list: Different programs.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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

  3. Intergenerational equity and conservation

    NASA Technical Reports Server (NTRS)

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

    1980-01-01

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

  4. 24 CFR 4001.118 - Equity sharing.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 5 2011-04-01 2011-04-01 false Equity sharing. 4001.118 Section... Requirements and Underwriting Procedures § 4001.118 Equity sharing. (a) Initial Equity. For purposes of section 257(k)(1) of the Act, the initial equity created as a direct result of the origination of a...

  5. 24 CFR 4001.118 - Equity sharing.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 5 2010-04-01 2010-04-01 false Equity sharing. 4001.118 Section... Requirements and Underwriting Procedures § 4001.118 Equity sharing. (a) Initial Equity. For purposes of section 257(k)(1) of the Act, the initial equity created as a direct result of the origination of a...

  6. Rethinking Equity--There Are Alternatives.

    ERIC Educational Resources Information Center

    Picus, Lawrence O.

    1998-01-01

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

  7. 75 FR 48661 - Equity and Excellence Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-11

    ... Equity and Excellence Commission AGENCY: U.S. Department of Education, Office for Civil Rights. ACTION: Notice of Establishment of the Equity and Excellence Commission. SUMMARY: The U.S. Secretary of Education (Secretary) announces the establishment of the Equity and Excellence Commission (Equity Commission...

  8. 75 FR 48662 - Equity and Excellence Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-11

    ... Equity and Excellence Commission AGENCY: Office for Civil Rights, U.S. Department of Education. ACTION: Request for Nominations to Serve on the Equity and Excellence Commission. SUMMARY: The Secretary of... Equity and Excellence Commission. SUPPLEMENTARY INFORMATION: The Equity and Excellence Commission...

  9. Health equity and social justice.

    PubMed

    Peter, F

    2001-01-01

    There is consistent and strong empirical evidence for social inequalities in health, as a vast and growing literature shows. In recent years, these findings have helped to move health equity high on international research and policy agendas. This paper examines how the empirical identification of social inequalities in health relates to a normative judgment about health inequities and puts forward an approach which embeds the pursuit of health equity within the general pursuit of social justice. It defends an indirect approach to health equity, which views social inequalities in health as unjust in so far as they are the result of an unjust basic structure of society in Rawls' sense.

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

    PubMed

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

    2011-11-01

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

  11. Equity in health care utilization in Chile.

    PubMed

    Núñez, Alicia; Chi, Chunhuei

    2013-01-01

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

  12. Equity in health care utilization in Chile.

    PubMed

    Núñez, Alicia; Chi, Chunhuei

    2013-08-12

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

  13. Equity in health care utilization in Chile

    PubMed Central

    2013-01-01

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

  14. Special program to reduce cardiology consultation waiting lists: report on an innovatory experience.

    PubMed

    Proença, Gonçalo; Ferreira, Daniel; Freitas, António; Madeira, Francisco; Soares, Ana Oliveira; Ferreira, Rafael

    2003-11-01

    The problem of waiting lists has been widely debated in the Portuguese society. In this paper, the authors report the first results of a prioritization approach, started in March 2000. In this program cardiologists and general practitioners work in close proximity, coordinating efforts in order to improve the establishment of clinical priorities, and consequently optimize hospital referral. Working as cardiology consultants, the authors were able to reduce the number of first consultation requests by 77.9% (December 2002). For the first time it was possible to match the number of requests with the available consultation times, halting the growth of the waiting list.

  15. Strategic attention deployment for delay of gratification in working and waiting situations.

    PubMed

    Peake, Philip K; Mischel, Walter; Hebl, Michelle

    2002-03-01

    Two studies examined whether the detrimental effects of attention to rewards on delay of gratification in waiting situations holds-or reverses-in working situations. In Study 1, preschoolers waited or worked for desired delayed rewards. Delay times increased when children worked in the presence of rewards but, as predicted, this increase was due to the distraction provided by the work itself. not because attention to rewards motivated children to sustain work. Analysis of spontaneous attention deployment showed that attending to rewards reduces delay time regardless of the working or waiting nature of the task. Fixing attention on rewards was a particularly detrimental strategy regardless of the type of task. Study 2 showed that when the work is not engaging, however, attention to rewards can motivate instrumental work and facilitate delay of gratification as long as attention deployment does not become fixed on the rewards.

  16. Learning to wait: A laboratory investigation

    USGS Publications Warehouse

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

    2009-01-01

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

  17. Addition of long-distance heart procurement promotes changes in heart transplant waiting list status

    PubMed Central

    Atik, Fernando Antibas; Couto, Carolina Fatima; Tirado, Freddy Ponce; Moraes, Camila Scatolin; Chaves, Renato Bueno; Vieira, Nubia W.; Reis, João Gabbardo

    2014-01-01

    Objective Evaluate the addition of long-distance heart procurement on a heart transplant program and the status of heart transplant recipients waiting list. Methods Between September 2006 and October 2012, 72 patients were listed as heart transplant recipients. Heart transplant was performed in 41 (57%), death on the waiting list occurred in 26 (36%) and heart recovery occurred in 5 (7%). Initially, all transplants were performed with local donors. Long-distance, interstate heart procurement initiated in February 2011. Thirty (73%) transplants were performed with local donors and 11 (27%) with long-distance donors (mean distance=792 km±397). Results Patients submitted to interstate heart procurement had greater ischemic times (212 min ± 32 versus 90 min±18; P<0.0001). Primary graft dysfunction (distance 9.1% versus local 26.7%; P=0.23) and 1 month and 12 months actuarial survival (distance 90.1% and 90.1% versus local 90% and 86.2%; P=0.65 log rank) were similar among groups. There were marked incremental transplant center volume (64.4% versus 40.7%, P=0.05) with a tendency on less waiting list times (median 1.5 month versus 2.4 months, P=0.18). There was a tendency on reduced waiting list mortality (28.9% versus 48.2%, P=0.09). Conclusion Incorporation of long-distance heart procurement, despite being associated with longer ischemic times, does not increase morbidity and mortality rates after heart transplant. It enhances viable donor pool, and it may reduce waiting list recipient mortality as well as waiting time. PMID:25372907

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  19. Continuity of care for patients on a waiting list for institutional long-term care.

    PubMed

    Caris-Verhallen, W M; Kerkstra, A

    2001-01-01

    The aim of this study was to examine patients' satisfaction with continuity of care while on a waiting list for residential care or nursing home care. Two hundred and seventy-eight patients participated in the study, all living in the community setting of two cities in the Netherlands. These patients were positively assessed and on a waiting list for admission in a nursing home or a residential home. The respondents were interviewed by telephone, using a structured questionnaire. From the results, it appeared that people waiting for residential care are in general over 80 years of age and dependent on help for their daily activities. They used several types of home care facility, such as home help services, home nursing and meals on wheels. Patient satisfaction was moderately high as regards the supply of substitute care and the length of time it took to receive a home care package. There was dissatisfaction, however, with the coordination of care and the amount of information on procedures regarding the waiting list. Patients on the waiting list also reported a lack of guidance in case of problems and would not know where to turn to if their situation became more severe. The establishment of a service desk to provide information or real help in these circumstances is recommended.

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

    PubMed

    Rung, Jillian M; Young, Michael E

    2015-01-01

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

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

    PubMed

    Rung, Jillian M; Young, Michael E

    2015-01-01

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

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

    PubMed

    Goodman, Karyn A

    2016-07-01

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

  3. Variety of Behavior of Equity Returns in Financial Markets

    NASA Astrophysics Data System (ADS)

    Bonanno, Giovanni; Lillo, Fabrizio; Mantegna, Rosario N.

    2001-03-01

    The price dynamics of a set of equities traded in an efficient market is pretty complex. It consists of almost not redundant time series which have (i) long-range correlated volatility and (ii) cross-correlation between each pair of equities. We perform a study of the statistical properties of an ensemble of equities returns which is fruitful to elucidate the nature and role of time and ensemble correlation. Specifically, we investigate a statistical ensemble of daily returns of n equities traded in United States financial markets. For each trading day of our database, we study the ensemble return distribution. We find that a typical ensemble return distribution exists in most of the trading days [1] with the exception of crash and rally days and of the days following to these extreme events [2]. We analyze each ensemble return distribution by extracting its first two central moments. We call the second moment of the ensemble return distribution the variety of the market. We choose this term because high variety implies a variated behavior of the equities returns in the considered day. We observe that the mean return and the variety are fluctuating in time and are stochastic processes themselves. The variety is a long-range correlated stochastic process. Customary time-averaged statistical properties of time series of stock returns are also considered. In general, time-averaged and portfolio-averaged returns have different statistical properties [1]. We infer from these differences information about the relative strength of correlation between equities and between different trading days. We also compare our empirical results with those predicted by the single-index model and we conclude that this simple model is unable to explain the statistical properties of the second moment of the ensemble return distribution. Correlation between pairs of equities are continuously present in the dynamics of a stock portfolio. Hence, it is relevant to investigate pair correlation

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

    PubMed

    Armitage, James O; Longo, Dan L

    2016-06-01

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

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

    PubMed Central

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

    2016-01-01

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

  6. Bridging Literacy and Equity: The Essential Guide to Social Equity Teaching. Language & Literacy

    ERIC Educational Resources Information Center

    Lazar, Althier M.; Edwards, Patricia A.; McMillon, Gwendolyn Thompson

    2012-01-01

    "Bridging Literacy and Equity" synthesizes the essential research and practice of social equity literacy teaching in one succinct, user-friendly volume. Extraordinary K-12 teachers show us what social equity literacy teaching looks like and how it advances children's achievement. Chapters identify six key dimensions of social equity teaching that…

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

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

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

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

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

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

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

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

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

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

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

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

  11. 7 CFR 1980.391 - Equity sharing.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... assistance granted on the account. (b) Miscellaneous provisions—(1) Changes in terms. Shared equity will not... section. (c) Affordable housing proposals. Shared equity under an affordable housing innovation (such...

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

    ERIC Educational Resources Information Center

    Gerstl-Pepin, Cynthia

    2015-01-01

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

  13. Interstellar Sweat Equity

    NASA Astrophysics Data System (ADS)

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

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

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

    ERIC Educational Resources Information Center

    Mireau, Ruth; Inch, Roxanne

    2009-01-01

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

  15. 7 CFR 930.60 - Equity holders.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Equity holders. 930.60 Section 930.60 Agriculture... Regulations § 930.60 Equity holders. (a) Inventory reserve ownership. The inventory reserve shall be the sole responsibility of the handlers who place products into the inventory reserve. A handler's equity in the...

  16. 7 CFR 1980.391 - Equity sharing.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 14 2011-01-01 2011-01-01 false Equity sharing. 1980.391 Section 1980.391 Agriculture... REGULATIONS (CONTINUED) GENERAL Rural Housing Loans § 1980.391 Equity sharing. The policy of RHS is to collect... described in paragraph (a) of this section occur, if any equity exists in the security. (a) Determining...

  17. Understanding Equity Strategies of Training Providers

    ERIC Educational Resources Information Center

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

    2004-01-01

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

  18. Framework for Evaluation of Equity Initiatives

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  19. Exemplary & Promising Gender Equity Programs, 2000.

    ERIC Educational Resources Information Center

    Department of Education, Washington, DC.

    This report identifies promising and exemplary programs that promote gender equity in and through education during the 1996-99 Gender Equity Expert Panel review cycle. These programs need to meet four criteria: evidence of success/effectiveness in promoting gender equity, quality of program, educational significance, and usefulness to others or…

  20. 77 FR 31605 - Equity and Excellence Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-29

    ... Equity and Excellence Commission AGENCY: Office for Civil Rights, U.S. Department of Education. ACTION...- ] coming meeting of the Equity and Excellence Commission (Commission). The notice also describes the..., Equity and Excellence Commission, U.S. Department of Education, 400 Maryland Avenue SW., Washington,...

  1. 76 FR 41233 - Equity and Excellence Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-13

    ... Equity and Excellence Commission AGENCY: U.S. Department of Education, Office for Civil Rights. ACTION... meeting of the Equity and Excellence Commission (Commission). The notice also describes the functions of... INFORMATION CONTACT: Stephen Chen, Designated Federal Official, Equity and Excellence Commission,...

  2. 76 FR 55059 - Equity and Excellence Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-06

    ... Equity and Excellence Commission AGENCY: Office for Civil Rights, U.S. Department of Education. ACTION...-coming meeting of the Equity and Excellence Commission (Commission). The notice also describes the... Auditorium. FOR FURTHER INFORMATION CONTACT: Jim Eichner, Designated Federal Official, Equity and...

  3. 77 FR 484 - Equity and Excellence Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-05

    ... Equity and Excellence Commission AGENCY: Office for Civil Rights, U.S. Department of Education. ACTION...-coming meeting of the Equity and Excellence Commission (Commission). The notice also describes the..., Equity and Excellence Commission, U.S. Department of Education, 400 Maryland Avenue SW, Washington,...

  4. 76 FR 6774 - Equity and Excellence Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-08

    ... Equity and Excellence Commission AGENCY: Office for Civil Rights, Department of Education. ACTION: Notice... meeting of the Equity and Excellence Commission (Commission). The notice also describes the functions of... Chen, Designated Federal Official, Equity and Excellence Commission, U.S. Department of Education,...

  5. 76 FR 27034 - Equity and Excellence Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-10

    ... Equity and Excellence Commission AGENCY: Office for Civil Rights, U.S. Department of Education. ACTION... upcoming meeting of the Equity and Excellence Commission (Commission). The notice also describes the... Auditorium. FOR FURTHER INFORMATION CONTACT: Stephen Chen, Designated Federal Official, Equity and...

  6. New pathways to bypass the 15O waiting point

    SciTech Connect

    Stefan, I.; de Oliveira Santos, F.; Pellegriti, M. G.; Angelique, M.; Dalouzy, J. C.; de Grancey, F.; Fadil, M.; Grevy, S.; Lenhardt, M.; Lewitowicz, M.; Navin, A.; Perrot, L.; Saint Laurent, M. G.; Ray, I.; Sorlin, O.; Stodel, C.; Thomas, J. C.; Dumitru, G.; Buta, A.; Borcea, R.

    2007-02-26

    Two reactions 15O(p,{beta}+)16O and 15O(p,{gamma})({beta}+)16O are proposed as new pathways to bypass the 15O waiting point in astrophysical context. The later reaction is found to have a surprisingly high cross section, approximately 1010 times higher than the first reaction. These cross sections were calculated after precise measurements of energies and widths of the proton-unbound 16F low lying states, obtained using the H(15O,p)15O reaction. The large (p,{gamma})({beta}+) cross section can be understood to arise from the more efficient feeding of the low energy wing of the ground state resonance by the gamma decay. The implications of the new reactions are discussed.

  7. A delay discounting task produces a greater likelihood of waiting than a deferred gratification task.

    PubMed

    Young, Michael E; McCoy, Anthony W

    2015-01-01

    A first-person-shooter video game was adapted for the study of choice between smaller sooner and larger later outcomes to compare the behavioral patterns produced by deferred gratification (DG) and delay discounting (DD) tasks. Participants played a game in which they could either fire their weapon sooner and do a small amount of damage or wait a few seconds to fire their weapon and do a larger amount of damage. For the DD task, a failure to fire within one second committed the player to waiting for the larger later outcome thus removing the opportunity to defect during the delay that is present in the DG task. The incentive structure changed multiple times during game play so that at times the optimal decision was to choose the smaller sooner outcome whereas at other times the optimal decision was to wait for the larger later outcome. Players assigned to the DD task showed a greater tendency to wait and lower sensitivity to the changing incentives.

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

    ERIC Educational Resources Information Center

    Fishman, Christine A.

    2010-01-01

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

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

    ERIC Educational Resources Information Center

    Mohrman, Mary Beth; Stuerke, Pamela S.

    2014-01-01

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

  10. 8 CFR 207.5 - Waiting lists and priority handling.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  11. 8 CFR 207.5 - Waiting lists and priority handling.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

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

  12. 28 CFR 345.33 - Waiting list hiring exceptions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

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

  13. 28 CFR 345.33 - Waiting list hiring exceptions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

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

  14. 28 CFR 345.33 - Waiting list hiring exceptions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

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

  15. 28 CFR 345.33 - Waiting list hiring exceptions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

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

  16. Strategic operating indicators point to equity growth.

    PubMed

    Cleverley, W O

    1988-07-01

    As healthcare managers become more business-like in their behavior, they are becoming increasingly concerned with the equity growth rate of their organizations. Strong equity growth means a financially healthy organization. Equity growth can be expressed as a product of five financial ratios--the most important ratio being the operating margin. Improvements in operating margins will lead to improvements in equity growth. Thirty indicators, called strategic operating indicators, have been developed to monitor operating margins. These indicators, when compared with values from other peer groups, can help point to strategies for improvement of operating margins, and hence equity growth.

  17. Advocacy for Health Equity: A Synthesis Review

    PubMed Central

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

    2015-01-01

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

  18. Zoning, equity, and public health.

    PubMed Central

    Maantay, J

    2001-01-01

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

  19. Cuesta College Student Equity Plan.

    ERIC Educational Resources Information Center

    Gonzales, Frank S.; Hayner, Claudia

    Presenting the Student Equity Plan developed at Cuesta College, in California, this document provides background to the development of the plan, reviews plan components, and discusses implementation and evaluation. Introductory materials indicate that the plan was intended to create a campus environment that assures that enrollment, retention, and…

  20. Designing Exhibits for Gender Equity

    ERIC Educational Resources Information Center

    Dancu, Toni Nicole

    2010-01-01

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

  1. Using Data to Promote Equity

    ERIC Educational Resources Information Center

    Shum, Brenda

    2016-01-01

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

  2. Lessons on Leading for Equity

    ERIC Educational Resources Information Center

    Larson, Rob; Barton, Rhonda

    2013-01-01

    Leading for equity is hard, yet inspiring, work. It requires thoughtful and bold conversations about race and poverty; close examination of policies and practices; and astute attention paid to a variety of data and evidence of student achievement, progress, and success. Above all, it requires a willingness to look deeply at one's beliefs and…

  3. Mathematics Equity. A Resource Book.

    ERIC Educational Resources Information Center

    Tyree, Eddy; And Others

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

  4. Digital Equity and Intercultural Education

    ERIC Educational Resources Information Center

    Resta, Paul; Laferrière, Thérèse

    2015-01-01

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

  5. Privilege, Equity, and the Advanced Placement Program: Tug of War

    ERIC Educational Resources Information Center

    Schneider, Jack

    2009-01-01

    The Advanced Placement Program is growing at a striking rate in US high schools and at the same time being abandoned by high-status schools. This paper explores the history of the Advanced Placement Program, from its roots in the 1950s as a programme for challenging high-achieving students at high-status schools, through its equity-motivated…

  6. The Equity of the Distribution of Student Financial Aid.

    ERIC Educational Resources Information Center

    Hyde, William

    The equity of student financial aid as it is distributed among full-time, dependent freshmen students of different parental incomes and at various types of institutions is examined. The first part of this paper clarifies concepts and definitions surrounding student financial aid. Calculation of the ability to pay, the financial standard of…

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

    PubMed

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

    2015-10-01

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

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

    PubMed

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

    2015-10-01

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

  9. Ethics in radiology: wait lists queue jumping.

    PubMed

    Cunningham, Natalie; Reid, Lynette; MacSwain, Sarah; Clarke, James R

    2013-08-01

    Education in ethics is a requirement for all Royal College residency training programs as laid out in the General Standards of Accreditation for residency programs in Canada. The ethical challenges that face radiologists in clinical practice are often different from those that face other physicians, because the nature of the physician-patient interaction is unlike that of many other specialties. Ethics education for radiologists and radiology residents will benefit from the development of teaching materials and resources that focus on the issues that are specific to the specialty. This article is intended to serve as an educational resource for radiology training programs to facilitate teaching ethics to residents and also as a continuing medical education resource for practicing radiologists. In an environment of limited health care resources, radiologists are frequently asked to expedite imaging studies for patients and, in some respects, act as gatekeepers for specialty care. The issues of wait lists, queue jumping, and balancing the needs of individuals and society are explored from the perspective of a radiologist.

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

    ERIC Educational Resources Information Center

    Ozmusul, Mustafa

    2013-01-01

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

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

    PubMed Central

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

    2013-01-01

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

  12. Abuse pattern of toluene exposure alters mouse behavior in a waiting-for-reward operant task.

    PubMed

    Bowen, Scott E; McDonald, Phillip

    2009-01-01

    Inhaling solvents for recreational purposes continues to be a world-wide public health concern. Toluene, a volatile solvent in many abused products, adversely affects the central nervous system. However, the long-term neurobehavioral effects of exposure to high-concentration, binge patterns typical of toluene abuse remain understudied. We studied the behavioral effects of repeated toluene exposure on cognitive function following binge toluene exposure on behavioral impulse control in Swiss Webster mice using a "wait-for-reward" operant task. Mice were trained on a fixed-ratio (FR) schedule using sweetened milk as a reward. Upon achieving FR15, a wait component was added which delivered free rewards in the absence of responses at increasing time intervals (2s, 4s, 6s, etc...). Mice continued to receive free rewards until they pressed a lever that reinstated the FR component (FR Reset). Once proficient in the FR-Wait task, mice were exposed to either 1000 ppm, 3600 ppm or 6000 ppm toluene, or 0ppm (air controls) for 30 min per day for 40 days. To avoid acute effects of toluene exposure, behavior was assessed approximately 22-23 h later. Repeated toluene exposure decreased response rates, the number of FR resets, and increased mean wait time, resulting in a higher response-to-reinforcer ratio than exhibited by controls. Mice receiving the higher exposure level (6000 ppm) showed a dramatic decrease in the number of rewards received, which was reversed when toluene exposure ceased. Mice receiving the lower exposure level (1000 ppm) showed little change in the number of rewards. These results indicate that repeated binge exposures to high concentrations of toluene can significantly interfere with performance as measured by a waiting-for-reward task, suggesting a significant impact on cognitive and/or psychomotor function.

  13. Take-Wait-Stop: a patient-centered strategy for writing PRN medication instructions.

    PubMed

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

    2013-01-01

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

  14. Geometric Brownian Motion with Tempered Stable Waiting Times

    NASA Astrophysics Data System (ADS)

    Gajda, Janusz; Wyłomańska, Agnieszka

    2012-08-01

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

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

    MedlinePlus

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

  16. Theseus Waits on Lakebed for First Flight

    NASA Technical Reports Server (NTRS)

    1996-01-01

    The Theseus prototype research aircraft waits on the lakebed before its first test flight from NASA's Dryden Flight Research Center, Edwards, California, on May 24, 1996. The Theseus aircraft, built and operated by Aurora Flight Sciences Corporation, Manassas, Virginia, was a unique aircraft flown at NASA's Dryden Flight Research Center, Edwards, California, under a cooperative agreement between NASA and Aurora. Dryden hosted the Theseus program, providing hangar space and range safety for flight testing. Aurora Flight Sciences was responsible for the actual flight testing, vehicle flight safety, and operation of the aircraft. The Theseus remotely piloted aircraft flew its maiden flight on May 24, 1996, at Dryden. During its sixth flight on November 12, 1996, Theseus experienced an in-flight structural failure that resulted in the loss of the aircraft. As of the beginning of the year 2000, Aurora had not rebuilt the aircraft. Theseus was built for NASA under an innovative, $4.9 million fixed-price contract by Aurora Flight Sciences Corporation and its partners, West Virginia University, Morgantown, West Virginia, and Fairmont State College, Fairmont, West Virginia. The twin-engine, unpiloted vehicle had a 140-foot wingspan, and was constructed largely of composite materials. Powered by two 80-horsepower, turbocharged piston engines that drove twin 9-foot-diameter propellers, Theseus was designed to fly autonomously at high altitudes, with takeoff and landing under the active control of a ground-based pilot in a ground control station 'cockpit.' With the potential ability to carry 700 pounds of science instruments to altitudes above 60,000 feet for durations of greater than 24 hours, Theseus was intended to support research in areas such as stratospheric ozone depletion and the atmospheric effects of future high-speed civil transport aircraft engines. Instruments carried aboard Theseus also would be able to validate satellite-based global environmental change

  17. Theseus Waits on Lakebed for First Flight

    NASA Technical Reports Server (NTRS)

    1996-01-01

    The Theseus prototype remotely-piloted aircraft (RPA) waits on the lakebed before its first test flight from NASA's Dryden Flight Research Center, Edwards, California, on May 24, 1996. The Theseus aircraft, built and operated by Aurora Flight Sciences Corporation, Manassas, Virginia, was a unique aircraft flown at NASA's Dryden Flight Research Center, Edwards, California, under a cooperative agreement between NASA and Aurora. Dryden hosted the Theseus program, providing hangar space and range safety for flight testing. Aurora Flight Sciences was responsible for the actual flight testing, vehicle flight safety, and operation of the aircraft. The Theseus remotely piloted aircraft flew its maiden flight on May 24, 1996, at Dryden. During its sixth flight on November 12, 1996, Theseus experienced an in-flight structural failure that resulted in the loss of the aircraft. As of the beginning of the year 2000, Aurora had not rebuilt the aircraft. Theseus was built for NASA under an innovative, $4.9 million fixed-price contract by Aurora Flight Sciences Corporation and its partners, West Virginia University, Morgantown, West Virginia, and Fairmont State College, Fairmont, West Virginia. The twin-engine, unpiloted vehicle had a 140-foot wingspan, and was constructed largely of composite materials. Powered by two 80-horsepower, turbocharged piston engines that drove twin 9-foot-diameter propellers, Theseus was designed to fly autonomously at high altitudes, with takeoff and landing under the active control of a ground-based pilot in a ground control station 'cockpit.' With the potential ability to carry 700 pounds of science instruments to altitudes above 60,000 feet for durations of greater than 24 hours, Theseus was intended to support research in areas such as stratospheric ozone depletion and the atmospheric effects of future high-speed civil transport aircraft engines. Instruments carried aboard Theseus also would be able to validate satellite-based global environmental

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

    PubMed Central

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

    2011-01-01

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

  19. 13. VIEW TO SOUTHEAST OF WAITING AREA SHOWING STAIRS TO ...

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

    13. VIEW TO SOUTHEAST OF WAITING AREA SHOWING STAIRS TO FIRST FLOOR (LEFT) AND HALL TO MANAGERS OFFICES (RIGHT). - Rosie the Riveter National Historical Park, Ford Assembly Plant, 1400 Harbour Way South, Richmond, Contra Costa County, CA

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

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

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

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

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

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

  2. Ultrasound waiting lists: rational queue or extended capacity?

    PubMed

    Brasted, Christopher

    2008-06-01

    The features and issues regarding clinical waiting lists in general and general ultrasound waiting lists in particular are reviewed, and operational aspects of providing a general ultrasound service are also discussed. A case study is presented describing a service improvement intervention in a UK NHS hospital's ultrasound department, from which arises requirements for a predictive planning model for an ultrasound waiting list. In the course of this, it becomes apparent that a booking system is a more appropriate way of describing the waiting list than a conventional queue. Distinctive features are identified from the literature and the case study as the basis for a predictive model, and a discrete event simulation model is presented which incorporates the distinctive features.

  3. 1. Historic American Buildings Survey, Carl Waite, Photographer June 10, ...

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

    1. Historic American Buildings Survey, Carl Waite, Photographer June 10, 1936 SOUTH ELEVATION (COPY MADE FROM OLD PHOTO). - St. Christopher's-By-The-River, Old Mill Road, Gates Mills, Cuyahoga County, OH

  4. 3. Historic American Buildings Survey, Carl Waite, Photographer June 10, ...

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

    3. Historic American Buildings Survey, Carl Waite, Photographer June 10, 1936 DETAIL OF MAIN ENTRANCE (SOUTH ELEVATION). - St. Christopher's-By-The-River, Old Mill Road, Gates Mills, Cuyahoga County, OH

  5. 1. Historic American Buildings Survey, Carl Waite, Photographer June 10, ...

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

    1. Historic American Buildings Survey, Carl Waite, Photographer June 10, 1936 MAIN ENTRANCE DETAIL (NORTH ELEVATION. - Chagrin Valley Hunt Club (Doorway), Mayfield & River Roads, Gates Mills, Cuyahoga County, OH

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

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

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

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

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

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

  8. 41. Detail, northeast facade, original door from platform to waiting ...

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

    41. Detail, northeast facade, original door from platform to waiting room, now non-functional, view to southwest, 90mm lens; compare with CA-2278-13. - Southern Pacific Depot, 559 El Camino Real, San Carlos, San Mateo County, CA

  9. 40. STEEL, INGOTS, ON INGOT BUGGIES, WAIT TO BE STRIPPED. ...

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

    40. STEEL, INGOTS, ON INGOT BUGGIES, WAIT TO BE STRIPPED. STRIPPER CRANE CAN BE SEEN AT THE END OF THE RAILROAD TRACKS, AT CENTER. - Corrigan, McKinney Steel Company, 3100 East Forty-fifth Street, Cleveland, Cuyahoga County, OH

  10. 27. View from waiting area level looking up ramp to ...

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

    27. View from waiting area level looking up ramp to F train platform and down ramp to street level. Looking north. - Stillwell Avenue Station, Intersection of Stillwell & Surf Avenues, Brooklyn, Kings County, NY

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

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

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

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

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

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

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

  14. Equity effects of economic instruments for greenhouse gas abatement

    SciTech Connect

    Harrison, D. Jr.

    1994-12-31

    This paper discusses the equity effects of using economic instruments--such as a carbon tax or carbon emissions trading program--to regulate greenhouse gas emissions. Determining these equity effects is more complicated than assessing overall costs and benefits, although some of the same issues arise. Among the key issues are the following: (1) benchmark for evaluating impacts of economic instruments (status quo or regulatory program that achieves the same emission reductions); (2) use of any government revenues collected, which are transfers overall but affect gains and losses; (3) time period (long-term or transitional impacts); and (4) groupings (income groups, sectors or regions). Empirical studies suggest that a national tax is regressive in the US but may be less so in other countries. The equity impacts of an international carbon tax or emissions trading program differ greatly depending upon the specific elements. The paper considers options to compensate or mitigate adverse effects to income groups, sectors, or regions of the world. Although impossible to avoid all losses to every group, it would be possible to avoid major equity effects if carbon taxes or carbon trading programs were used to control global warming.

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

    NASA Astrophysics Data System (ADS)

    Campbell, Patricia B.; Storo, Jennifer

    1996-12-01

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

  16. Influence of Actual and Perceived Wait for Counseling Services on Client Outcome Variables.

    ERIC Educational Resources Information Center

    Obetz, Susan Ancona; Farber, Ruth S.; Rosenstein, Ilene C.

    1997-01-01

    Examines whether 73 students' perceptions of waiting length between intake and first counseling session was related to their satisfaction and responses during the waiting period. Results show that students' perceptions of how long they waited were significantly associated with their responses during the wait and several measures of their…

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

    PubMed

    Murray, Mark; Berwick, Donald M

    2003-02-26

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

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

    PubMed

    Murray, Mark; Berwick, Donald M

    2003-02-26

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

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

    ERIC Educational Resources Information Center

    Novogrodsky, Myra; Wells, Margaret

    1989-01-01

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

  20. 7 CFR 1735.18 - Additional equity.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 11 2011-01-01 2011-01-01 false Additional equity. 1735.18 Section 1735.18 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF... Basic Policies § 1735.18 Additional equity. If determined by the Administrator to be necessary for...

  1. 7 CFR 1735.18 - Additional equity.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 11 2010-01-01 2010-01-01 false Additional equity. 1735.18 Section 1735.18 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF... Basic Policies § 1735.18 Additional equity. If determined by the Administrator to be necessary for...

  2. 28 CFR 548.15 - Equity.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Equity. 548.15 Section 548.15 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT RELIGIOUS PROGRAMS Religious Beliefs and Practices of Committed Offenders § 548.15 Equity. No one may disparage the religious...

  3. Elementary Mathematics Teachers' Knowledge of Equity Pedagogy

    ERIC Educational Resources Information Center

    Jackson, Christa

    2013-01-01

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

  4. 28 CFR 548.15 - Equity.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  5. Orwell and the Politics of Equity.

    ERIC Educational Resources Information Center

    Townsend, Richard G.

    1983-01-01

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

  6. 7 CFR 930.60 - Equity holders.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Equity holders. 930.60 Section 930.60 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulations § 930.60 Equity holders. (a) Inventory reserve ownership. The inventory reserve shall be the...

  7. Learning Equity in a University Classroom

    ERIC Educational Resources Information Center

    van der Westhuizen, G. J.

    2012-01-01

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

  8. Teacher Education and Gender Equity. ERIC Digest.

    ERIC Educational Resources Information Center

    Sanders, Jo

    To ensure that future generations of girls as well as boys fulfill their potential without restriction, it is important that gender equity be taught in teacher education programs as a matter of course. Gender equity is defined as the set of behaviors and knowledge that permits educators to recognize inequality in educational opportunities, to…

  9. Examining Equity in Texas Public School Funding

    ERIC Educational Resources Information Center

    Bingham, Wayne; Jones, Timothy B.; Jackson, Sherion H.

    2007-01-01

    This research examined the level of equity of the public school funding system in Texas that in September of 2004 was held to be unconstitutional by a state district judge. The study also introduces a mechanism, referred to as the Revenue-to-Population Index or RTP Index, which compares funding equity within the unconstitutional system among 1031…

  10. Educational Equity: Challenges for Educator Effectiveness

    ERIC Educational Resources Information Center

    Best, Jane; Winslow, Emily

    2015-01-01

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

  11. Multicriteria approaches for a private equity fund

    NASA Astrophysics Data System (ADS)

    Tammer, Christiane; Tannert, Johannes

    2012-09-01

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

  12. Implementation and Innovation: The Route to Equity

    ERIC Educational Resources Information Center

    Campbell, Carol; Milton, Penny

    2011-01-01

    "If we are really serious about equity in education, what will it take to achieve improvements?" This question became the focus of a project between the Canadian Education Association and the Stanford Center for Opportunity Policy in Education to foster dialogue about equity and educational improvement. Although the two countries have different…

  13. Leisure Today: Equity Issues in Leisure Services.

    ERIC Educational Resources Information Center

    Dustin, Daniel L., Ed.; And Others

    1990-01-01

    Seven articles on equity issues in leisure services focus on conservation for the future, resource allocation inequities in wildland recreation, leisure services for people of color and people with disabilities, serving all children in community recreation, women and leisure services, and equity in public sector resource allocations. (JD)

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

    ERIC Educational Resources Information Center

    Standing, Hilary; Baume, Elaine

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

  15. Gender Equity for Males. WEEA Digest.

    ERIC Educational Resources Information Center

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

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

  16. Toward a Pluralistic Perspective on Equity.

    ERIC Educational Resources Information Center

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

    1992-01-01

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

  17. Inclusive Education: Examining Equity on Five Continents

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  18. Handbook for Achieving Sex Equity through Education.

    ERIC Educational Resources Information Center

    Klein, Susan S., Ed.

    This handbook of collected papers is intended to aid in the achievement of sex equity in education, and in society through education. It is divided into six parts, each with a separate editor (or editors) and contains the following chapters: (1) Examining the Achievement of Sex Equity in and through Education (S. S. Klein, and others); (2)…

  19. Implementing Sex Equity in Vocational Education.

    ERIC Educational Resources Information Center

    Shocklee, Georgia

    This publication contains five teaching units for implementing sex equity into vocational education. The units, prepared for preservice or inservice teacher education courses, can be adapted to various teacher situations. Units cover sex equity legislation and definitions; facts and figures about women in the workforce; methods of recruiting male…

  20. Poverty, equity, human rights and health.

    PubMed Central

    Braveman, Paula; Gruskin, Sofia

    2003-01-01

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

  1. 76 FR 62394 - Equity and Excellence Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-07

    ... Equity and Excellence Commission AGENCY: Office for Civil Rights, U.S. Department of Education. ACTION...-coming meeting of the Equity and Excellence Commission (Commission). The notice also describes the... Excellence Commission, ] U.S. Department of Education, 400 Maryland Avenue, SW., Washington, DC 20202....

  2. 77 FR 29621 - Equity and Excellence Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-18

    ... Equity and Excellence Commission AGENCY: U.S. Department of Education, Office for Civil Rights. ACTION...-coming meeting of the Equity and Excellence Commission (Commission). The notice also describes the... and Excellence Commission, U.S. Department of Education, 400 Maryland Avenue SW., Washington, DC...

  3. 77 FR 18798 - Equity and Excellence Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-28

    ... Equity and Excellence Commission AGENCY: U.S. Department of Education. ACTION: Notice; Advisory Committee... of the Equity and Excellence Commission scheduled for March 29, 2012 and announced in the Federal... Excellence Commission, U.S. Department of Education, 400 Maryland Avenue SW., Washington, DC 20202....

  4. 77 FR 2711 - Equity and Excellence Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-19

    ... Register (FR Doc. 2011-33800 Filed 1-4-12; 8:45 a.m.) a notice of open meeting on January 23, 2012 for the Equity and Excellence Commission. This notice amends the January 5, 2012 notice by providing notice of a... Equity and Excellence Commission AGENCY: Office for Civil Rights, Education. ACTION: Notice of...

  5. 77 FR 49441 - Equity and Excellence Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-16

    ... Equity and Excellence Commission AGENCY: Office for Civil Rights, U.S. Department of Education. ACTION...-coming meeting of the Equity and Excellence Commission (Commission). The notice also describes the... Excellence Commission, U.S. Department of Education, 400 Maryland Avenue SW., Washington, DC 20202....

  6. Social equity and environmental risk

    SciTech Connect

    Zimmerman, R. )

    1993-12-01

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

  7. Equity - some theory and its policy implications

    PubMed Central

    Culyer, A.

    2001-01-01

    This essay seeks to characterise the essential features of an equitable health care system in terms of the classical Aristotelian concepts of horizontal and vertical equity, the common (but ill-defined) language of "need" and the economic notion of cost-effectiveness as a prelude to identifying some of the more important issues of value that policy-makers will have to decide for themselves; the characteristics of health (and what determines it) that can cause policy to be ineffective (or have undesired consequences); the information base that is required to support a policy directed at securing greater equity, and the kinds of research (theoretical and empirical) that are needed to underpin such a policy. Key Words: Health care systems • equity • horizontal equity • vertical equity • cost-effectiveness PMID:11479360

  8. Vertical equity: weighting outcomes? or establishing procedures?

    PubMed

    Mooney, G; Jan, S

    1997-01-01

    Considerations of equity in the health policy literature have in the main focussed on horizontal equity (the equal treatment of equals) and as a consequence have tended to overlook vertical equity (the unequal, but equitable, treatment of unequals). There is evidence from earlier, if preliminary, work carried out by the authors and a colleague that health care decision makers may well want to embrace concerns for vertical equity in the allocation of health service resources. This paper examines some possibilities for incorporating vertical equity into health care policy through distributive and/or procedural justice. While no firm solutions are offered, it is suggested that the idea of fitting John Broome's notion of 'claims' within a communitarian framework holds promise.

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

    PubMed

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

    2014-01-01

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

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

    SciTech Connect

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

    2008-12-31

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2014-01-01

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

  13. EMG reactivity and oral habits among facial pain patients in a scheduled-waiting competitive task.

    PubMed

    Nicholson, R A; Lakatos, C A; Gramling, S E

    1999-12-01

    For individuals with temporomandibular disorder (TMD) it has been theorized that stressful events trigger oral habits (e.g., teeth grinding), thereby increasing masticatory muscle tension and subsequent pain. Recent research involving adjunctive behaviors found an increase in masseter surface EMG (sEMG) and oral habits when students with TMD symptomatology were placed on a fixed-time reinforcement schedule. The current study used a treatment-seeking community sample with TMD symptomatology in a competitive task designed to be a more naturalistic Fixed Time task. The experiment consisted of Adaptation, Free-Play, Scheduled-Play, and Recovery phases. During the Scheduled-Play phase participants played, and waited to play, an electronic poker game. Results indicated that masseter muscle tension in the Scheduled-Play phase was significantly higher (p < .001) than in any other phase. Moreover, during the Scheduled-Play phase masseter sEMG was higher (p < .001) when participants waited to play. Self-reported oral habits and overall affect were significantly higher (p's < .05) in the Free-Play and Scheduled-Play phases relative to Adaptation and Recovery. The observation that masseter sEMG was elevated during the Scheduled-Play phase relative to all other phases, and within the Scheduled-Play phase sEMG was highest while waiting, suggests that adjunctive oral habits may lead to TMD symptomatology.

  14. The Consultant Orthodontists Group survey of hospital waiting lists and treated cases.

    PubMed

    Willmot, D R; Dibiase, D; Birnie, D J; Heesterman, R A

    1995-02-01

    A questionnaire sent to all U.K. hospital orthodontic consultants resulted in an 88 per cent response rate. The average waiting time for initial consultation was 31.6 weeks for routine cases and 3.6 weeks for urgent cases. The average waiting time for out patient treatment was 68.7 weeks for routine cases and 7.5 weeks for urgent cases. Nearly 33 per cent of hospitals used the Dental Health Component of the Index of Orthodontic Treatment need (IOTN) as a guide to placing patients on waiting lists. 'Urgency' and 'Complexity' were used more frequently than indices. Sixty-nine per cent of hospitals exclude some categories of malocclusion from treatment in their departments. A prospective survey reported on 2480 completed treatments over a six week period and there was an average discontinuation rate of 9.2 per cent of all cases finished during the period. Comparison of the completed and discontinued groups revealed few significant treatment-related factors. There was some evidence that the more senior and experienced the operator, the less the rate of discontinuation. A greater rate of discontinuation was seen in removable appliance cases when compared with fixed appliance cases.

  15. Trading with the waiting-list: the justice of living donor list exchange.

    PubMed

    den Hartogh, Govert

    2010-05-01

    In a Living Donor List Exchange program, the donor makes his kidney available for allocation to patients on the postmortal waiting-list and receives in exchange a postmortal kidney, usually an O-kidney, to be given to the recipient he favours. The program can be a solution for a candidate donor who is unable to donate directly or to participate in a paired kidney exchange because of blood group incompatibility or a positive cross-match. Each donation within an LDLE program makes an additional organ available for transplantation. But because most of the pairs making use of the program will be A/O incompatible, it will also tend to increase the waiting time for patients with blood group O, who already have the longest waiting time. It has therefore been objected that the program is materially unjust, because it further disadvantages the least advantaged. This objection appeals to John Rawls' difference principle. However, the context for which Rawls proposed that difference principle, is significantly different from the present one. Applying the principle here amounts to a lop-sided trade-off between considerations of need and considerations of overall utility. Considerations of formal justice, however, may lead to a stronger objection to LDLE programs. Such a program means that one O-patient on the waiting list is exempted from the application of the general criteria used in constructing the list because he has a special bargaining advantage. This objection is spelled out and weighed against the obvious attraction of LDLE in a situation of (extreme) organ scarcity.

  16. Gender equity & human development.

    PubMed

    Vepa, Swarna S

    2007-10-01

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

  17. Waiting lists and elective surgery: ordering the queue.

    PubMed

    Curtis, Andrea J; Russell, Colin O H; Stoelwinder, Johannes U; McNeil, John J

    2010-02-15

    In the Australian public health system, access to elective surgery is rationed through the use of waiting lists in which patients are assigned to broad urgency categories. Surgeons are principally responsible for referring patients to waiting lists, deciding on the appropriate urgency category, and selecting patients from the waiting list to receive surgery. There are few agreed-upon criteria to help surgeons make these decisions, leading to striking differences between institutions in proportions of patients allocated to urgency categories. In other countries with publicly funded health systems, programs have been developed that aim to make prioritisation more consistent and access to surgery more equitable. As demand for health care increases, similar programs should be established in Australia using relevant clinical and psychosocial factors. Prioritisation methodology adapted for elective surgery may have a role in prioritising high-demand procedures in other areas of health care.

  18. "Waiting in Araf" research without consent: a Turkish mother's experience.

    PubMed

    Ulusoy, M F

    1998-01-01

    In this article, a nurse author from Turkey relates the anxiety and struggle that she experienced with the birth of her first baby when, for unknown reasons, the baby experienced acute rectal bleeding after birth. Unsatisfactory doctor-patient relations, abolishment of patient rights, suspicion of research without permission, and clinical iatrogenesis are discussed. The mother describes the 10 days she spent with her child in the hospital as "waiting in Araf." According to Middle Eastern culture, "Araf" is defined in the Koran as a place between Eden and Hell where people who have sinned are required to wait. Though anticipating acceptance into Eden, they wait with fear as they watch Hell on one side, and with hope while watching the happiness of Eden on the other side. The author's story depicts such an experience.

  19. 12 CFR 627.2730 - Preservation of equity.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Preservation of equity. 627.2730 Section 627..., AND VOLUNTARY LIQUIDATIONS Receivers and Receiverships § 627.2730 Preservation of equity. (a) Except..., participation certificates, equity reserves, or other allocated equities of an institution in receivership...

  20. 12 CFR 627.2797 - Preservation of equity.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 6 2011-01-01 2011-01-01 false Preservation of equity. 627.2797 Section 627..., AND VOLUNTARY LIQUIDATIONS Voluntary Liquidation § 627.2797 Preservation of equity. (a) Immediately... institution, the capital stock, participation certificates, equity reserves, and allocated equities of...

  1. 12 CFR 627.2730 - Preservation of equity.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 6 2011-01-01 2011-01-01 false Preservation of equity. 627.2730 Section 627..., AND VOLUNTARY LIQUIDATIONS Receivers and Receiverships § 627.2730 Preservation of equity. (a) Except..., participation certificates, equity reserves, or other allocated equities of an institution in receivership...

  2. 12 CFR 627.2797 - Preservation of equity.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Preservation of equity. 627.2797 Section 627..., AND VOLUNTARY LIQUIDATIONS Voluntary Liquidation § 627.2797 Preservation of equity. (a) Immediately... institution, the capital stock, participation certificates, equity reserves, and allocated equities of...

  3. 17 CFR 190.07 - Calculation of allowed net equity.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... equity. 190.07 Section 190.07 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION BANKRUPTCY § 190.07 Calculation of allowed net equity. Allowed net equity shall be computed as follows: (a) Allowed claim. The allowed net equity claim of a customer shall be equal to the aggregate of the...

  4. 12 CFR 615.5270 - Retirement of other equities.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 6 2011-01-01 2011-01-01 false Retirement of other equities. 615.5270 Section..., LOAN POLICIES AND OPERATIONS, AND FUNDING OPERATIONS Retirement of Equities and Payment of Dividends § 615.5270 Retirement of other equities. (a) Equities other than eligible borrower stock shall...

  5. Triage in opioid replacement therapy: what's the wait?

    PubMed

    Harlow, Warren; Happell, Brenda Mary; Browne, Graeme; Choudhury, Jahar; Pinchin, David

    2013-01-01

    In Australia, a wait for Opioid Replacement Therapy (ORT) has been reported although the magnitude is unknown. This study examined data recorded by one urban publicly funded ORT clinic (from 2009 to 2011) to identify if people (n = 803) were waiting for ORT assessment appointments and to explore how triage influences access to ORT. Data analysis incorporated descriptive methods and the use of Kaplan-Meier estimator of the cumulative incidence function. The implications and limitations of this study are included with further research suggestions.

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

    PubMed

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

    2013-11-21

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

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

    PubMed

    Spiers, Johanna; Smith, Jonathan A

    2016-10-01

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

  8. Private equity investment in health care services.

    PubMed

    Robbins, Catherine J; Rudsenske, Todd; Vaughan, James S

    2008-01-01

    Sophisticated private equity investors in health services provide venture capital for early-stage companies, growth capital for mid-stage companies, and equity capital for buyouts of mid-stage and mature companies. They pursue opportunities in provider sectors that are large and have a stable reimbursement environment, such as acute care services; sectors with room to execute consolidation strategies, such as labs; alternative-site sectors, such as "storefront" medicine; and clinical services, such as behavioral health, that are subject to profitably increasing quality and lowering costs. The innovations created through private equity investments could challenge established health services organizations.

  9. Equity trees and graphs via information theory

    NASA Astrophysics Data System (ADS)

    Harré, M.; Bossomaier, T.

    2010-01-01

    We investigate the similarities and differences between two measures of the relationship between equities traded in financial markets. Our measures are the correlation coefficients and the mutual information. In the context of financial markets correlation coefficients are well established whereas mutual information has not previously been as well studied despite its theoretically appealing properties. We show that asset trees which are derived from either the correlation coefficients or the mutual information have a mixture of both similarities and differences at the individual equity level and at the macroscopic level. We then extend our consideration from trees to graphs using the "genus 0" condition recently introduced in order to study the networks of equities.

  10. Equity in health and economic globalisation.

    PubMed

    Schuftan, C

    1999-11-01

    This article proposes that equity in health is inseparable from social equity in its broadest sense. An equitable system allows the lowest income sectors to have access to an acceptable level of basic goods and services. Equity in health thus entails decreasing the differences in access to, and use of all health services. Globalization, on the other hand, means the process by which economic power is expanding and increasingly concentrated in the hands of corporations that are progressively entering national economies worldwide through the international free-market ideology. Explored in this article were some ways in which globalization leads to inequities.

  11. Where does the waiting list begin? A short review of the dynamics and organization of modern waiting lists.

    PubMed

    Rotstein, Dalia L; Alter, David A

    2006-06-01

    Waiting for medical care is the by-product of system rationing, where demand exceeds supply. In this short report we expand on the conventional concept of the queue, by focusing on the regulation of demand and by incorporating a funnel and spout analogy. Real-world examples are used to illustrate the infancy of funnel or demand-side reform initiatives targeting the queue, and the suggestion is made that policy needs to address the concept of 'waiting' much earlier in the treatment cycle.

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

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

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

  13. Getting into the System: The Physician's Staff and Waiting Room

    PubMed Central

    1976-01-01

    This article represents a panel discussion with the staff of the Family Practice Unit at the Plains Health Centre, Regina, Sask. It outlines those things found helpful in presenting a positive image to the patient by a physician and his staff - telephone contacts, waiting rooms, patient flow, and common complaints. PMID:21308056

  14. 16 CFR 803.11 - Termination of waiting period.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Termination of waiting period. 803.11 Section 803.11 Commercial Practices FEDERAL TRADE COMMISSION RULES, REGULATIONS, STATEMENTS AND INTERPRETATIONS UNDER THE HART-SCOTT-RODINO ANTITRUST IMPROVEMENTS ACT OF 1976 TRANSMITTAL RULES §...

  15. 16 CFR 803.11 - Termination of waiting period.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Termination of waiting period. 803.11 Section 803.11 Commercial Practices FEDERAL TRADE COMMISSION RULES, REGULATIONS, STATEMENTS AND INTERPRETATIONS UNDER THE HART-SCOTT-RODINO ANTITRUST IMPROVEMENTS ACT OF 1976 TRANSMITTAL RULES §...

  16. For Admissions Deans, Waiting-List Roulette Gets Trickier

    ERIC Educational Resources Information Center

    Hoover, Eric

    2008-01-01

    This article reports that with a weak economy and a record number of applications at many campuses, admissions deans have deliberately undershot their targets and lengthened their waiting lists. For months a four-digit number has hovered over Douglas L. Christiansen. It's there when he falls asleep and there when he wakes up. The number is 1,550,…

  17. The Waite Campus: Industry, Research and Educational Collaboration.

    ERIC Educational Resources Information Center

    PEB Exchange, 1997

    1997-01-01

    The Waite Campus at the University of Adelaide, South Australia, houses industrial, research, and educational organizations. One advantage of this co-location is sharing the cost of facilities and equipment. The facilities described include Plant Research Center, Wine Science Laboratory, refectory, library, conference facilities, teleteaching,…

  18. 24 CFR 982.205 - Waiting list: Different programs.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... program, project-based voucher program or moderate rehabilitation program: (i) If the PHA's waiting list... public housing program, project-based voucher program or moderate rehabilitation program, the PHA must... list for its public housing program, project-based voucher program or moderate rehabilitation......

  19. 28 CFR 345.33 - Waiting list hiring exceptions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... top ten percent of the waiting lists unless the inmate was transferred for disciplinary reasons, was... reason other than formal education, vocational training, drug abuse or similar formal programs). For... affected may be transferred to remaining FPI factories ahead of the top portion of the inmates on...

  20. 27. Interior of former waiting room, now used as restaurant; ...

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

    27. Interior of former waiting room, now used as restaurant; only remaining original fixtures are windows and Romanesque-arched fireplace, the latter uncovered during removal of railroad-placed drywall by restaurant owner; view to south, 65mm lens. - Southern Pacific Depot, 559 El Camino Real, San Carlos, San Mateo County, CA

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

    ERIC Educational Resources Information Center

    Miner, Barbara

    2011-01-01

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

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

    PubMed

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

    2015-07-01

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

  3. Innovatus Interregnum: Waiting for a Paradigm Shift

    ERIC Educational Resources Information Center

    English, Fenwick W.; Ehrich, Lisa Catherine

    2015-01-01

    Purpose: The purpose of this paper is to establish the case that innovation in the theory and practice of educational administration/leadership is very unlikely to occur within the existing "doxa" of our times. By innovation is meant a novel conceptual or practical change in the field of practice. By "doxa" is meant the…

  4. Equity Theory Ratios as Causal Schemas.

    PubMed

    Arvanitis, Alexios; Hantzi, Alexandra

    2016-01-01

    Equity theory approaches justice evaluations based on ratios of exchange inputs to exchange outcomes. Situations are evaluated as just if ratios are equal and unjust if unequal. We suggest that equity ratios serve a more fundamental cognitive function than the evaluation of justice. More particularly, we propose that they serve as causal schemas for exchange outcomes, that is, they assist in determining whether certain outcomes are caused by inputs of other people in the context of an exchange process. Equality or inequality of ratios in this sense points to an exchange process. Indeed, Study 1 shows that different exchange situations, such as disproportional or balanced proportional situations, create perceptions of give-and-take on the basis of equity ratios. Study 2 shows that perceptions of justice are based more on communicatively accepted rules of interaction than equity-based evaluations, thereby offering a distinction between an attribution and an evaluation cognitive process for exchange outcomes. PMID:27594846

  5. Vocational Education: Access, Equity, and Consequence.

    ERIC Educational Resources Information Center

    Campbell, Paul B.

    1986-01-01

    Describes five patterns of student participation in vocational courses: (1) concentrators, (2) limited concentrators, (3) concentrators/explorers, (4) explorers, and (5) incidental/personals. Highlights some equity issues. (Author/CH)

  6. Equity Theory Ratios as Causal Schemas.

    PubMed

    Arvanitis, Alexios; Hantzi, Alexandra

    2016-01-01

    Equity theory approaches justice evaluations based on ratios of exchange inputs to exchange outcomes. Situations are evaluated as just if ratios are equal and unjust if unequal. We suggest that equity ratios serve a more fundamental cognitive function than the evaluation of justice. More particularly, we propose that they serve as causal schemas for exchange outcomes, that is, they assist in determining whether certain outcomes are caused by inputs of other people in the context of an exchange process. Equality or inequality of ratios in this sense points to an exchange process. Indeed, Study 1 shows that different exchange situations, such as disproportional or balanced proportional situations, create perceptions of give-and-take on the basis of equity ratios. Study 2 shows that perceptions of justice are based more on communicatively accepted rules of interaction than equity-based evaluations, thereby offering a distinction between an attribution and an evaluation cognitive process for exchange outcomes.

  7. Equity Theory Ratios as Causal Schemas

    PubMed Central

    Arvanitis, Alexios; Hantzi, Alexandra

    2016-01-01

    Equity theory approaches justice evaluations based on ratios of exchange inputs to exchange outcomes. Situations are evaluated as just if ratios are equal and unjust if unequal. We suggest that equity ratios serve a more fundamental cognitive function than the evaluation of justice. More particularly, we propose that they serve as causal schemas for exchange outcomes, that is, they assist in determining whether certain outcomes are caused by inputs of other people in the context of an exchange process. Equality or inequality of ratios in this sense points to an exchange process. Indeed, Study 1 shows that different exchange situations, such as disproportional or balanced proportional situations, create perceptions of give-and-take on the basis of equity ratios. Study 2 shows that perceptions of justice are based more on communicatively accepted rules of interaction than equity-based evaluations, thereby offering a distinction between an attribution and an evaluation cognitive process for exchange outcomes.

  8. Equity Theory Ratios as Causal Schemas

    PubMed Central

    Arvanitis, Alexios; Hantzi, Alexandra

    2016-01-01

    Equity theory approaches justice evaluations based on ratios of exchange inputs to exchange outcomes. Situations are evaluated as just if ratios are equal and unjust if unequal. We suggest that equity ratios serve a more fundamental cognitive function than the evaluation of justice. More particularly, we propose that they serve as causal schemas for exchange outcomes, that is, they assist in determining whether certain outcomes are caused by inputs of other people in the context of an exchange process. Equality or inequality of ratios in this sense points to an exchange process. Indeed, Study 1 shows that different exchange situations, such as disproportional or balanced proportional situations, create perceptions of give-and-take on the basis of equity ratios. Study 2 shows that perceptions of justice are based more on communicatively accepted rules of interaction than equity-based evaluations, thereby offering a distinction between an attribution and an evaluation cognitive process for exchange outcomes. PMID:27594846

  9. Reproductive strategies of northern geese: Why wait?

    USGS Publications Warehouse

    Ely, C.R.; Bollinger, K.S.; Densmore, R.V.; Rothe, T.C.; Petrula, M.J.; Takekawa, J.Y.; Orthmeyer, D.L.

    2007-01-01

    Migration and reproductive strategies in waterbirds are tightly linked, with timing of arrival and onset of nesting having important consequences for reproductive success. Whether migratory waterbirds are capital or income breeders is predicated by their spring migration schedule, how long they are on breeding areas before nesting, and how adapted they are to exploiting early spring foods at northern breeding areas. However, for most species, we know little about individual migration schedules, arrival times, and duration of residence on breeding areas before nesting. To document these relationships in a northern nesting goose, we radiotracked winter-marked Tule Greater White-fronted Geese (Anser albifrons elgasi; hereafter “Tule Geese”; n = 116) from the time of their arrival in Alaska through nesting. Tule Geese arrived on coastal feeding areas in mid-April and moved to nesting locations a week later. They initiated nests 15 days (range: 6–24 days) after arrival, a period roughly equivalent to the duration of rapid follicle growth. Tule Geese that arrived the earliest were more likely to nest than geese that arrived later; early arrivals also spent more time on the breeding grounds and nested earlier than geese that arrived later. The length of the prenesting period was comparable to that of other populations of this species, but longer than for goose species that initiate rapid follicle growth before arrival on the breeding grounds. We suggest that Tule Geese nesting in more temperate climates are more likely to delay breeding to exploit local food resources than Arctic-nesting species that may be constrained by short growing seasons.

  10. Should I stay or should I go? Waiting lists and cross-border care in the Netherlands.

    PubMed

    Brouwer, Werner; van Exel, Job; Hermans, Bert; Stoop, Arjen

    2003-03-01

    The recent ruling of the European Court of Justice in the case Smits-Peerbooms explicitly mentions undue delay as a legitimisation for cross-border care within the EU. In the Netherlands, waiting times are well above the norm set by several health care parties as well as maximally acceptable waiting times elicited in patients. This might indicate that Dutch patients are often entitled to care in other Member States, in the sense that insurers cannot withhold reimbursement of cross-border care in the present situation. However, experiments clearly demonstrate that few Dutch patients are willing to travel abroad. Patients seem to prefer longer waiting in the Netherlands over shorter waiting by going abroad, even those living in border regions. In addition, mobility of patients within the Netherlands is very modest. Given this inertia in patient mobility, in the short run, cross-border care will probably remain an insignificant phenomenon in terms of quantities of patients travelling abroad and therefore the impact of the Smits-Peerbooms rulings is limited. PMID:12595128

  11. Equity and length of lifespan are not the same.

    PubMed

    Seligman, Benjamin; Greenberg, Gabi; Tuljapurkar, Shripad

    2016-07-26

    Efforts to understand the dramatic declines in mortality over the past century have focused on life expectancy. However, understanding changes in disparity in age of death is important to understanding mechanisms of mortality improvement and devising policy to promote health equity. We derive a novel decomposition of variance in age of death, a measure of inequality, and apply it to cause-specific contributions to the change in variance among the G7 countries (Canada, France, Germany, Italy, Japan, the United Kingdom, and the United States) from 1950 to 2010. We find that the causes of death that contributed most to declines in the variance are different from those that contributed most to increase in life expectancy; in particular, they affect mortality at younger ages. We also find that, for two leading causes of death [cancers and cardiovascular disease (CVD)], there are no consistent relationships between changes in life expectancy and variance either within countries over time or between countries. These results show that promoting health at younger ages is critical for health equity and that policies to control cancer and CVD may have differing implications for equity.

  12. Health equity in humanitarian emergencies: a role for evidence aid.

    PubMed

    Pottie, Kevin

    2015-02-01

    Humanitarian emergencies require a range of planned and coordinated actions: security, healthcare, and, as this article highlights, health equity responses. Health equity is an evidence-based science that aims to address unfair and unjust health inequality outcomes. New approaches are using health equity to guide the development of community programs, equity methods are being used to identify disadvantaged groups that may face health inequities in a humanitarian emergency, and equity is being used to prevent unintended harms and consequences in interventions. Limitations to health equity approaches include acquiring sufficient data to make equity interpretations, integrating disadvantage populations in to the equity approach, and ensuring buy-in from decision-makers. This article uses examples from World Health Organization, Refugee Health Guidelines and Health Impact Assessment to demonstrate the emerging role for health equity in humanitarian emergencies. It is based on a presentation at the Evidence Aid Symposium, on 20 September 2014, at Hyderabad, India.

  13. Waiting for the W - and the Higgs

    NASA Astrophysics Data System (ADS)

    Tannenbaum, M. J.

    2016-10-01

    The search for the left-handed W ± bosons, the proposed quanta of the weak interaction, and the Higgs boson, which spontaneously breaks the symmetry of unification of electromagnetic and weak interactions, has driven elementary-particle physics research from the time that I entered college to the present and has led to many unexpected and exciting discoveries which revolutionized our view of subnuclear physics over that period. In this article I describe how these searches and discoveries have intertwined with my own career.

  14. SouthWest view, Street Car Waiting House, north and east elevations ...

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

    South-West view, Street Car Waiting House, north and east elevations - North Philadelphia Station, Street Car Waiting House, 2900 North Broad Street, on northwest corner of Broad Street & Glenwood Avenue, Philadelphia, Philadelphia County, PA

  15. NorthEast view; Street Car Waiting House, south (front) and west ...

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

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

  16. Test Equity for Individuals Who Are Deaf or Hard of Hearing. PEPNet Test Equity Summit

    ERIC Educational Resources Information Center

    PEPNet-West, 2010

    2010-01-01

    This paper presents the highlights of the 2008 Test Equity Summit held in Bloomfield, Colorado last August 6-8, 2008. The 2008 Test Equity Summit convened by the Postsecondary Education Programs Network (PEPNet) identified and examined problems, challenges, and issues that academic and psychoeducational tests pose for individuals who are deaf or…

  17. Students as Policy Actors: The TDSB Equity Foundation Statement and Commitments to Equity Policy

    ERIC Educational Resources Information Center

    Ferfolja, Tania

    2013-01-01

    Discrimination on the basis of homophobia/transphobia in many schools is an internationally recognised problem. The Toronto District School Board's (TDSB) Equity Foundation Statement and Commitments to Equity Policy (EFS) provides an explicit mandate to schools in its jurisdiction to address such discrimination and educate about sexual and…

  18. Keynes, population, and equity prices.

    PubMed

    Tarascio, V J

    1985-01-01

    Keynes in 1937 examined the phenomenon of the Great Depression from a longrun perspective in contradiction to the "General Theory," where the focus was on the shortrun. "Some Economic Consequences of a Declining Population," Keynes' article, reveals the context in which the "General Theory" was written. In the "General Theory," the focus is on short-term fluctuations, i.e., business cycles, but Keynes fails to provide any theoretical explanation as to why the depression of the 1930s was so severe and intractable. In the 1937 article, the depression is seen as the result of the combined effects of a decline in longrun growth due to population growth decline and a shortrun cyclical decline, together producing severe economic consequences. What is important for the purposes of this discussion is the implication, within the context of the 1937 article, that not only was the stock market crash of 1929 related to population change (with its accompanying collapse in expectations) but that, in general, changes in the rate of growth of population are accompanied by stock price movements in the same direction. The remainder of the discussion is devoted to a simple empirical test of this relationship. The data used are population size (POP), defined as the total residential population in the US from 1870-1979, and the Standard and Poor 500 Stock index (SP) for the corresponding 109-year period. In addition, a 3rd series was constructed, a price deflated Standard and Poor index (RSP) with a base period of 1870, to account for possible inflationary distortion of the index. The empirical results do not invalidate the hypothesis that population growth rates affect equity markets. In fact, there seems to be strong evidence that they are related in a manner suggestive of Keynes' intutition, namely, that the stock market crash of 1929 was due to factors more fundamental than those often perceived from a shortrun perspective. According to Keynes (1937), population is the most

  19. Keynes, population, and equity prices.

    PubMed

    Tarascio, V J

    1985-01-01

    Keynes in 1937 examined the phenomenon of the Great Depression from a longrun perspective in contradiction to the "General Theory," where the focus was on the shortrun. "Some Economic Consequences of a Declining Population," Keynes' article, reveals the context in which the "General Theory" was written. In the "General Theory," the focus is on short-term fluctuations, i.e., business cycles, but Keynes fails to provide any theoretical explanation as to why the depression of the 1930s was so severe and intractable. In the 1937 article, the depression is seen as the result of the combined effects of a decline in longrun growth due to population growth decline and a shortrun cyclical decline, together producing severe economic consequences. What is important for the purposes of this discussion is the implication, within the context of the 1937 article, that not only was the stock market crash of 1929 related to population change (with its accompanying collapse in expectations) but that, in general, changes in the rate of growth of population are accompanied by stock price movements in the same direction. The remainder of the discussion is devoted to a simple empirical test of this relationship. The data used are population size (POP), defined as the total residential population in the US from 1870-1979, and the Standard and Poor 500 Stock index (SP) for the corresponding 109-year period. In addition, a 3rd series was constructed, a price deflated Standard and Poor index (RSP) with a base period of 1870, to account for possible inflationary distortion of the index. The empirical results do not invalidate the hypothesis that population growth rates affect equity markets. In fact, there seems to be strong evidence that they are related in a manner suggestive of Keynes' intutition, namely, that the stock market crash of 1929 was due to factors more fundamental than those often perceived from a shortrun perspective. According to Keynes (1937), population is the most

  20. The costs of delay: waiting versus postponing in intertemporal choice.

    PubMed

    Paglieri, Fabio

    2013-05-01

    Intertemporal choices are typically regarded as indicative of delay discounting. In this view, the degree of behavioral propensity to wait for a reward is attributed to an underlying process of reward devaluation as a function of delay. However, this widespread interpretation overlooks the role that the costs of delay might have in determining intertemporal choices. In this paper I review evidence of a marked discrepancy in intertemporal behavior across different tasks, and argue that the differential costs of delay can account for this anomaly better than alternative explanations. In particular, I characterize two types of delay, waiting versus postponing, examine how they impact behavioral choices across delay discounting tasks, what methodological challenges they present for new experimental paradigms, and what theoretical implications they have for our understanding of intertemporal choice.

  1. The costs of delay: waiting versus postponing in intertemporal choice.

    PubMed

    Paglieri, Fabio

    2013-05-01

    Intertemporal choices are typically regarded as indicative of delay discounting. In this view, the degree of behavioral propensity to wait for a reward is attributed to an underlying process of reward devaluation as a function of delay. However, this widespread interpretation overlooks the role that the costs of delay might have in determining intertemporal choices. In this paper I review evidence of a marked discrepancy in intertemporal behavior across different tasks, and argue that the differential costs of delay can account for this anomaly better than alternative explanations. In particular, I characterize two types of delay, waiting versus postponing, examine how they impact behavioral choices across delay discounting tasks, what methodological challenges they present for new experimental paradigms, and what theoretical implications they have for our understanding of intertemporal choice. PMID:23413105

  2. Equity of health care in Australia.

    PubMed

    Lairson, D R; Hindson, P; Hauquitz, A

    1995-08-01

    This paper examines the equity characteristics of health care financing and delivery in Australia and compares its performance with recent findings on systems in Europe and the United States. Vertical equity of finance is evaluated with income and payment concentration indices derived from published survey data on taxes and expenditure by income decile. Horizontal equity of health care delivery is assessed with standardized expenditure concentration coefficients for three measures of health status and four types of health services, derived from household survey data on health care utilization, health status, income and demographics. Health cover is available to the entire population. Results show the financing system is slightly progressive despite the fact that 30% of payment comes from private sources, which are regressive. The equity index compares favorably to many European countries and is much better than the U.S. which has a regressive financing system. The Australian system fares less well in terms of equity of health care delivery. Several features favor privately insured higher income persons in use of health care and this is reflected, for some health status measures and types of service, in inequity favoring the better off. This contrasts with inequity favoring the less well off in many European countries and the U.S. This analysis provides a benchmark for monitoring the equity of the Australian system and provides information on the equity of a mixed private and public financing system that covers the entire population. This is relevant to the U.S. which is moving in this direction by extending private cover to the uninsured and to European countries that are increasing private sector involvement in health care financing. PMID:7481941

  3. 75 FR 16529 - Legg Mason Partners Equity Trust, et al.; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-01

    ... COMMISSION Legg Mason Partners Equity Trust, et al.; Notice of Application March 26, 2010. AGENCY: Securities... group of investment companies. APPLICANTS: Legg Mason Partners Equity Trust (``LMP Equity Trust''), Legg Mason Partners Variable Equity Trust (``LMP Variable Equity Trust,'' and together with LMP Equity...

  4. Ninety-day waiting period limitation. Final rules.

    PubMed

    2014-06-25

    These final regulations clarify the maximum allowed length of any reasonable and bona fide employment-based orientation period, consistent with the 90-day waiting period limitation set forth in section 2708 of the Public Health Service Act, as added by the Patient Protection and Affordable Care Act (Affordable Care Act), as amended, and incorporated into the Employee Retirement Income Security Act of 1974 and the Internal Revenue Code.

  5. 29. Attic interior showing roof truss system over waiting room; ...

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

    29. Attic interior showing roof truss system over waiting room; note knob-and-tube wiring system; brick section at far left is rear of tower, which of brick masonry construction above the first story level, joined to the exterior walls of stone masonry; view to southeast along axis of building, 90mm lens and electronic flash illumination. - Southern Pacific Depot, 559 El Camino Real, San Carlos, San Mateo County, CA

  6. Design and Feasibility Testing of the truth FinishIt Tobacco Countermarketing Brand Equity Scale.

    PubMed

    Evans, W Douglas; Rath, Jessica; Pitzer, Lindsay; Hair, Elizabeth C; Snider, Jeremy; Cantrell, Jennifer; Vallone, Donna

    2016-07-01

    The original truth campaign was a branded, national smoking prevention mass media effort focused on at-risk youth ages 12-17. Today the truth brand focuses on the goal of finishing tobacco (truth FinishIt). There have been significant changes in the tobacco control landscape, leading FinishIt to focus on 15- to 21-year-olds. The present article reports on formative research and media monitoring data collected to pilot test a new truth FinishIt brand equity scale. The goals of this study were to (a) content analyze truth FinishIt mass media ads, (b) assess truth's social media and followers' perceptions of truth's digital brand identity, and (c) develop and feasibility test a new version of the truth FinishIt brand equity scale using data from an existing Truth Initiative media monitoring study. Through factor analysis, we identified a brand equity scale, as in previous research, consisting of 4 main constructs: brand loyalty, leadership/satisfaction, personality, and awareness. Targeted truth attitudes and beliefs about social perceptions, acceptability, and industry-related beliefs were regressed on the higher order factor and each of the 4 individual brand equity factors. Ordinary least squares regression models generally showed associations in the expected directions (positive for anti-tobacco and negative for pro-tobacco) between targeted attitudes/beliefs and truth FinishIt brand equity. This study succeeded in developing and validating a new truth FinishIt brand equity scale. The scale may be a valuable metric for future campaign evaluation. Future studies should examine the effects of truth FinishIt brand equity on tobacco use behavioral outcomes over time. PMID:27315354

  7. Design and Feasibility Testing of the truth FinishIt Tobacco Countermarketing Brand Equity Scale.

    PubMed

    Evans, W Douglas; Rath, Jessica; Pitzer, Lindsay; Hair, Elizabeth C; Snider, Jeremy; Cantrell, Jennifer; Vallone, Donna

    2016-07-01

    The original truth campaign was a branded, national smoking prevention mass media effort focused on at-risk youth ages 12-17. Today the truth brand focuses on the goal of finishing tobacco (truth FinishIt). There have been significant changes in the tobacco control landscape, leading FinishIt to focus on 15- to 21-year-olds. The present article reports on formative research and media monitoring data collected to pilot test a new truth FinishIt brand equity scale. The goals of this study were to (a) content analyze truth FinishIt mass media ads, (b) assess truth's social media and followers' perceptions of truth's digital brand identity, and (c) develop and feasibility test a new version of the truth FinishIt brand equity scale using data from an existing Truth Initiative media monitoring study. Through factor analysis, we identified a brand equity scale, as in previous research, consisting of 4 main constructs: brand loyalty, leadership/satisfaction, personality, and awareness. Targeted truth attitudes and beliefs about social perceptions, acceptability, and industry-related beliefs were regressed on the higher order factor and each of the 4 individual brand equity factors. Ordinary least squares regression models generally showed associations in the expected directions (positive for anti-tobacco and negative for pro-tobacco) between targeted attitudes/beliefs and truth FinishIt brand equity. This study succeeded in developing and validating a new truth FinishIt brand equity scale. The scale may be a valuable metric for future campaign evaluation. Future studies should examine the effects of truth FinishIt brand equity on tobacco use behavioral outcomes over time.

  8. Uncertainty intervention for watchful waiting in prostate cancer.

    PubMed

    Bailey, Donald E; Mishel, Merle H; Belyea, Michael; Stewart, Janet L; Mohler, James

    2004-01-01

    Watchful waiting is a reasonable alternative to treatment for some older men with localized prostate cancer, but it inevitably brings uncertainty. This study tested the effectiveness of the watchful waiting intervention (WWI) in helping men cognitively reframe and manage the uncertainty of watchful waiting. Based on Mishel's Reconceptualized Uncertainty in Illness Theory (Image. 1990; 256-262), the WWI was tested with a convenience sample of 41 men. Experimental subjects received 5 weekly intervention calls from a nurse. Control subjects received usual care. Outcomes were new view of life, mood state, quality of life, and cognitive reframing. Repeated measures of analysis of variance were used to test the effectiveness of the WWI. The sample was 86% Caucasian and 14% African American, with an average age of 75.4 years. Intervention subjects were significantly more likely than controls to view their lives in a new light (P = .02) and experience a decrease in confusion (P = .04) following the intervention. Additionally, intervention subjects reported greater improvement in their quality of life than did controls (P = .01) and believed their quality of life in the future would be better than did controls (P = .01). This study's findings document the benefits of the WWI for patients living with uncertainty.

  9. Did Equity of Reproductive and Maternal Health Service Coverage Increase during the MDG Era? An Analysis of Trends and Determinants across 74 Low- and Middle-Income Countries

    PubMed Central

    Sharma, Suneeta

    2015-01-01

    Introduction Despite widespread gains toward the 5th Millennium Development Goal (MDG), pro-rich inequalities in reproductive health (RH) and maternal health (MH) are pervasive throughout the world. As countries enter the post-MDG era and strive toward UHC, it will be important to monitor the extent to which countries are achieving equity of RH and MH service coverage. This study explores how equity of service coverage differs across countries, and explores what policy factors are associated with a country’s progress, or lack thereof, toward more equitable RH and MH service coverage. Methods We used RH and MH service coverage data from Demographic and Health Surveys (DHS) for 74 countries to examine trends in equity between countries and over time from 1990 to 2014. We examined trends in both relative and absolute equity, and measured relative equity using a concentration index of coverage data grouped by wealth quintile. Through multivariate analysis we examined the relative importance of policy factors, such as political commitment to health, governance, and the level of prepayment, in determining countries’ progress toward greater equity in RH and MH service coverage. Results Relative equity for the coverage of RH and MH services has continually increased across all countries over the past quarter century; however, inequities in coverage persist, in some countries more than others. Multivariate analysis shows that higher education and greater political commitment (measured as the share of government spending allocated to health) were significantly associated with higher equity of service coverage. Neither country income, i.e., GDP per capita, nor better governance were significantly associated with equity. Conclusion Equity in RH and MH service coverage has improved but varies considerably across countries and over time. Even among the subset of countries that are close to achieving the MDGs, progress made on equity varies considerably across countries

  10. 22 CFR 17.4 - Equity and good conscience.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... DISABILITY FUND UNDER THE FOREIGN SERVICE RETIREMENT AND DISABILITY SYSTEM (FSRDS) AND THE FOREIGN SERVICE PENSION SYSTEM (FSPS) § 17.4 Equity and good conscience. (a) Defined. Recovery is against equity and...

  11. Health care and equity in India.

    PubMed

    Balarajan, Y; Selvaraj, S; Subramanian, S V

    2011-02-01

    In India, despite improvements in access to health care, inequalities are related to socioeconomic status, geography, and gender, and are compounded by high out-of-pocket expenditures, with more than three-quarters of the increasing financial burden of health care being met by households. Health-care expenditures exacerbate poverty, with about 39 million additional people falling into poverty every year as a result of such expenditures. We identify key challenges for the achievement of equity in service provision, and equity in financing and financial risk protection in India. These challenges include an imbalance in resource allocation, inadequate physical access to high-quality health services and human resources for health, high out-of-pocket health expenditures, inflation in health spending, and behavioural factors that affect the demand for appropriate health care. Use of equity metrics in monitoring, assessment, and strategic planning; investment in development of a rigorous knowledge base of health-systems research; development of a refined equity-focused process of deliberative decision making in health reform; and redefinition of the specific responsibilities and accountabilities of key actors are needed to try to achieve equity in health care in India. The implementation of these principles with strengthened public health and primary-care services will help to ensure a more equitable health care for India's population.

  12. Managing Time.

    ERIC Educational Resources Information Center

    Murphy, Linda; Della Corte, Suzanne

    1991-01-01

    This newsletter issue discusses time management techniques for parents of special needs children. Techniques include changing one's attitudes about perfection, prioritizing tasks, having a back-up plan, learning to say "no," asking for help, keeping things simple, hiring others, using waiting time wisely, and doing two things at once. Household…

  13. Exzellenz und Equity: Neue Bildungstheoretische Perspektiven FÜR ein Altes SPANNUNGSVERHÄLTNIS

    NASA Astrophysics Data System (ADS)

    Stamm, Margrit; Viehhauser, Martin

    2009-07-01

    EXCELLENCE AND EQUITY: APPLYING NEW PERSPECTIVES IN THE THEORY OF EDUCATION TO A TRADITIONALLY TENSE RELATIONSHIP - The majority of international assessments of school performance, as well as the international standards-based education reform focus on optimising the skills of children who perform poorly in school. This article, however, places the focus on the top␣performers ("excellence") and links this with the theory of equal opportunities ("equity"). The article follows two main lines of argument. The argument relating to the theory of education deems the achievement of equal opportunities and equity likely only if and when all children start from an equal position and are then allowed to develop unequally and appropriately, according to their individual talents. The second argument highlights the tense relationship between excellence and equity with regard to school children's varying home backgrounds, and asks how intellectual potential can best be discovered and encouraged. At the same time, the article demonstrates that the concept of accelerated learning, in differentiating between individuals within homogenous groups of learners, opens up a number of interesting perspectives and can ultimately redress the tense relationship between excellence and equity.

  14. Decentralization and equity of resource allocation: evidence from Colombia and Chile.

    PubMed Central

    Bossert, Thomas J.; Larrañaga, Osvaldo; Giedion, Ursula; Arbelaez, José Jesus; Bowser, Diana M.

    2003-01-01

    OBJECTIVE: To investigate the relation between decentralization and equity of resource allocation in Colombia and Chile. METHODS: The "decision space" approach and analysis of expenditures and utilization rates were used to provide a comparative analysis of decentralization of the health systems of Colombia and Chile. FINDINGS: Evidence from Colombia and Chile suggests that decentralization, under certain conditions and with some specific policy mechanisms, can improve equity of resource allocation. In these countries, equitable levels of per capita financial allocations at the municipal level were achieved through different forms of decentralization--the use of allocation formulae, adequate local funding choices and horizontal equity funds. Findings on equity of utilization of services were less consistent, but they did show that increased levels of funding were associated with increased utilization. This suggests that improved equity of funding over time might reduce inequities of service utilization. CONCLUSION: Decentralization can contribute to, or at least maintain, equitable allocation of health resources among municipalities of different incomes. PMID:12751417

  15. Waiting for better, not for more: corvids respond to quality in two delay maintenance tasks

    PubMed Central

    Hillemann, Friederike; Bugnyar, Thomas; Kotrschal, Kurt; Wascher, Claudia A. F.

    2015-01-01

    Self-control, that is, overcoming impulsivity towards immediate gratification in favour of a greater but delayed reward, is seen as a valuable skill when making future-oriented decisions. Experimental studies in nonhuman primates revealed that individuals of some species are willing to tolerate delays of up to several minutes in order to gain food of a higher quantity or quality. Recently, birds (carrion crows, Corvus corone, common ravens, Corvus corax, Goffin cockatoos, Cacatua goffiniana) performed comparably to primates in an exchange task, contradicting previous notions that birds may lack any impulse control. However, performance differed strikingly with the currency of exchange: individuals of all three species performed better when asked to wait for a higher food quality, rather than quantity. Here, we built on this work and tested whether the apparent difference in levels of self-control expressed in quality versus quantity tasks reflects cognitive constraints or is merely due to methodological limitations. In addition to the exchange paradigm, we applied another established delay maintenance methodology: the accumulation task. In this latter task, food items accumulated to a maximum of four pieces, whereas in the exchange task, an initial item could be exchanged for a reward item after a certain time delay elapsed. In both tasks, birds (seven crows, five ravens) were asked to wait in order to optimize either the quality or the quantity of food. We found that corvids were willing to delay gratification when it led to a food reward of higher quality, but not when waiting was rewarded with a higher quantity, independent of the experimental paradigm. This study is the first to test crows and ravens with two different paradigms, the accumulation and the exchange of food, within the same experiment, allowing for fair comparisons between methods and species. PMID:25892738

  16. Sex Equity Ideabook for the District of Columbia Public Schools.

    ERIC Educational Resources Information Center

    Grady, Walteen; And Others

    This publication contains lesson plans and classroom activities to assist K-12 teachers develop sex equity themes. It supplements the "Sex Equity Resource Directory" (SO 013 579) which is a guide to sex equity resources available through the District of Columbia Public Schools. The "Ideabook" has several major sections each containing materials…

  17. Conceptions of Equity: How Influential Actors View a Contested Concept

    ERIC Educational Resources Information Center

    Bulkley, Katrina E.

    2013-01-01

    Discussions of educational equity have played an important role in educational policy in the United States over the past 50 years, and advocates with a broad range of perspectives on reform have sought to claim the equity mantle. In this article, I examine aspects of equity, including the distribution of "inputs" to public education, the…

  18. The Sublime Objects of Education Policy: Quality, Equity and Ideology

    ERIC Educational Resources Information Center

    Clarke, Matthew

    2014-01-01

    Quality and equity are touchstones of education policy in the twenty-first century in a range of global contexts. On the surface, this seems fitting: after all, who could object to more quality and greater equity in education? Yet what do we mean by quality and equity, and how are they related? This paper draws on Lacanian psychoanalytic theory to…

  19. 5 CFR 845.303 - Equity and good conscience.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Equity and good conscience. 845.303 Section 845.303 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE... Overpayments § 845.303 Equity and good conscience. Recovery is against equity and good conscience when— (a)...

  20. Pursuing Equity in and through Teacher Education Program Admissions

    ERIC Educational Resources Information Center

    Childs, Ruth A.; Broad, Kathryn; Gallagher-Mackay, Kelly; Sher, Yael; Escayg, Kerry-Ann; McGrath, Christopher

    2011-01-01

    This case study investigated equity in teacher education admissions. Through document analysis and structured interviews with ten past or current members of the admissions committee in a large initial teacher education program in Ontario, we developed an understanding of equity in teacher education admissions as encompassing two foci: equity in…