Financing Community Colleges: Threats and Opportunities.

ERIC Educational Resources Information Center

Kapraun, E. Daniel; Heard, Don A.

Today many community colleges are faced with a multitude of financial problems that threaten the stability of their educational and operational programs. These problems include decreases in funding, rising costs, outdated funding formulas, and volatile enrollment patterns. The extent to which individual community college leaders understand these…

Helping Students Pay for College--and Achieve Better Outcomes

ERIC Educational Resources Information Center

MDRC, 2013

2013-01-01

America faces a two-pronged problem in higher education: increasing costs and low completion rates. Despite the recent expansion of federal Pell Grants, many students still are left with unmet financial needs and may drop out of college because of financial concerns, pressing work responsibilities, and fears of taking on too much debt. One idea…

Learning to See the (W)holes

ERIC Educational Resources Information Center

Burns, Barbara A.; Jordan, Thomas M.

2006-01-01

Business managers are faced with complex decisions involving a wide range of issues--technical, social, environmental, and financial--and their interaction. Our education system focuses heavily on presenting structured problems and teaching students to apply a set of tools or methods to solve these problems. Yet the most difficult thing to teach…

Apprehensions and problems after laryngectomy: Patients' perspective.

PubMed

Hirani, Ismail; Siddiqui, Atif Hafeez; Muhammad Khyani, Iqbal Abdul

2015-11-01

To evaluate the apprehensions, social, sexual and financial problems in patients with advanced laryngeal cancer after total laryngectomy and the impact of attending laryngeal club on these problems. The analytical study was conducted at the Dow Medical College and Civil Hospital Karachi from January 1996 to December 2011. Patients with total laryngectomy, operated for advanced laryngeal cancer at various centres of Sindh and Balochistan, attending Laryngeal Club of Pakistan, situated at Civil Hospital Karachi, were included. All the patients were evaluated through a questionnaire covering their apprehensions regarding social, sexual and financial impact on their lives after total laryngectomy. Data was analysed using SPSS 16. Of the 125 patients, 120(96%) were males, and 5(4%) were females; all housewives. The overall mean age was 54.8±0.5 years (range: 31-65 years). Further, 92(74%) participants were worried about financial uncertainty, while 84(67%) had regrets over loss of their voice; patients worried about losing family support and facing social rejection were 23(18%) and 15(12%) respectively. Only 7(5%) patients feared losing sexual relationship with their spouse. All these apprehensions were subdued after attending the Laryngeal Club of Pakistan. Severe financial impact was faced by 55(44%) patients due to loss of job, while 05(4%) had moderate impact due to change of job with lower income and 60(48%) patients had no financial problem. A good 102(82%) participants thought the support from their friends and family was upto their expectations; 98(78%) enjoyed satisfactory sex life although with reduced frequency of 1 to 2 intercourses per month; 21(17%) were having the frequency of 3-10 per month; and 3(2%) had more than 10 per month. Only 16(13%) patients were not involved in sexual relations with their spouses due to various reasons. Majority of laryngectomised patients expressed apprehensions and showed some social problems after laryngectomy, especially in the initial phase which improved either with passage of time or after attending Laryngectomy Club. The main problem was financial constraints; majority had good friends and family support and enjoyed satisfactory sexual relationship with their spouse.

Administrative Problem-Solving for Writing Programs and Writing Centers: Scenarios in Effective Program Management.

ERIC Educational Resources Information Center

Myers-Breslin, Linda

Addressing the issues and problems faced by writing program administrators (WPAs) and writing center directors (WCDs), and how they can most effectively resolve the political, pedagogical, and financial questions that arise, this book presents essays from experienced WPAs and WCDs at a wide variety of institutions that offer scenarios and case…

Appropriate Targets for Search Advertising as Part of Online Gatekeeping for Suicide Prevention.

PubMed

Sueki, Hajime; Ito, Jiro

2018-05-01

Gatekeeper training is an effective suicide prevention strategy. However, the appropriate targets of online gatekeeping have not yet been clarified. We examined the association between the outcomes of online gatekeeping using the Internet and the characteristics of consultation service users. An advertisement to encourage the use of e-mail-based psychological consultation services among viewers was placed on web pages that showed the results of searches using suicide-related keywords. All e-mails received between October 2014 and December 2015 were replied to as part of gatekeeping, and the obtained data (responses to an online questionnaire and the content of the received e-mails) were analyzed. A total of 154 consultation service users were analyzed, 35.7% of whom were male. The median age range was 20-29 years. Online gatekeeping was significantly more likely to be successful when such users faced financial/daily life or workplace problems, or revealed their names (including online names). By contrast, the activity was more likely to be unsuccessful when it was impossible to assess the problems faced by consultation service users. It may be possible to increase the success rate of online gatekeeping by targeting individuals facing financial/daily life or workplace problems with marked tendencies for self-disclosure.

Online consensus conferences for clinical guidelines development - a survey among participants from the International Guidelines for the Treatment of Actinic Keratosis.

PubMed

Werner, Ricardo N; Jacobs, Anja; Rosumeck, Stefanie; Nast, Alexander

2014-12-01

Guideline development requires considerable time and financial resources. New technical devices such as software for online conferences may help to reduce time and financial efforts of guidelines development. The present survey may serve as an explorative pilot for a future study to determine the technical feasibility, acceptability and possible weaknesses of online consensus conferences for clinical guidelines development. An anonymous online survey was conducted among participants in the online consensus conference of the International League of Dermatological Societies (ILDS) Guidelines for the Treatment of Actinic Keratosis. The majority of participants reported no technical problems with the participation in the online consensus conference; one participant had substantial technical problems accountable to a regional telephone breakdown. The majority of participants would not have preferred a traditional face-to-face conference, and all participants rated online consensus conferences for international guidelines as absolutely acceptable. Rates of acceptance were particularly high among those participants with prior experience with consensus conferences. Certain aspects, particularly the possibilities of debating, were rated as possibly superior in face-to-face conferences by some participants. The data from the online survey indicate that online consensus conferences may be an appropriate alternative to traditional face-to-face consensus conferences, especially within the frame of international guidelines that would require high travel costs and time. Further research is necessary to confirm the data from this explorative pilot study. © 2014 John Wiley & Sons, Ltd.

Are the Editors faced with e-problems performing their duties and responsibilities satisfactorily?

PubMed

Ali Jawaid, Shaukat; Jawaid, Masood

2013-09-01

Astonishing revolution in information technology, developments in electronic publishing and availability of manuscript management software's has provided lot of facilities to authors, reviewers as well as editors but it has also given birth to lot of e-problems. This communication highlights some of these e-problems besides discussing the manuscript management system practiced by Pakistan Journal of Medical Sciences through modified Open Journal System. It also cautions the editors of small journals faced with financial and human resource constraints to keep themselves abreast of all these developments, go for automation in e publishing gradually as all the stake holders i.e. authors, reviewers and office management staff learns these and become used to it.

Faculty: Thy Administrator's Keeper? Some Evidence

ERIC Educational Resources Information Center

Cunningham, Brendan M.

2009-01-01

Colleges and universities face a principal-agent problem. There are information asymmetries over the actions chosen by administrators. Because non-profit constraints limit the financial stake of trustees there may be insufficient monitoring of administrators and, consequentially, shirking. It is conceivable that faculty will serve as "delegated…

Capital requirements for the US investor-owned electric utility industry, 1985-2005: Final report

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

Kolbe, A.L.; Johnson, S.K.; O'Loughlin, M.P.

1988-06-01

In recent years, financial concerns have increasingly constrained the traditional utility planning focus, on engineering and economic tradeoffs. After a troubled period, however, many utilities have completed major construction programs and face fewer financial constraints in the near term, while other utilities hope to achieve this status shortly. At the same time, many utilities and regulatory commissions are reluctant to begin construction of large new plants, both because of current high reserve margins and because of past unhappy outcomes for ratepayers and investors when load growth proved lower than expected. This study examines the potential long-run financial constraints and risksmore » the electric utility industry faces as a result of the current incentives to delay the start of major new projects as long as possible. The study analyzes industry-wide financial and operating data from 1985 to 2005 under several scenarios. The findings suggest that if the future is no worse than postulated in our scenarios, total construction expenditures and external funding requirements should be manageable at the national level. Also, the study finds that the cost of delaying new construction /en dash/ although possibly significant /en dash/ will depend critically on the relative prices of coal and natural gas which actually occur. Thus this report concludes that the possibility of significant future financial constraints does not appear to be a problem at the national level. There is good reason to believe, however, that there could be a problem under certain adverse conditions for specific regions and for individual utilities. Given the relatively large amount of external funds likely to be needed by some utilities in those situations and the risks investors may perceive in supplying these funds, financial constraints may cause some construction delays. 23 refs., 21 figs., 6 tabs.« less

Survey of projected growth and problems facing air transportation, 1975 - 1985

NASA Technical Reports Server (NTRS)

Williams, L. J.; Wilson, A.

1975-01-01

Results are presented of a survey conducted to determine the current opinion of people working in air transportation demand forecasting on the future of air transportation over the next ten years. In particular, the survey included questions on future demand growth, load factor, fuel prices, introduction date for the next new aircraft, the priorities of problems facing air transportation, and the probability of a substantial change in air transportation regulation. The survey participants included: airlines, manufacturers, universities, government agencies, and other organizations (financial institutions, private research companies, etc.). The results are shown for the average responses within the organization represented as well as the overall averages.

Adopting Extensible Business Reporting Language (XBRL): A Grounded Theory

ERIC Educational Resources Information Center

Cruz, Marivic

2010-01-01

In 2007 and 2008, government challenges consisted of error prone, manually intensive, and inefficient environments for financial reporting. Banking regulators worldwide faced issues with respect to transparency, timeliness, quality, and managing risks associated with accounting opacity. The general problem was the existing reporting standards and…

The Gray Panthers Are Coming: Is Your Institution Ready?

ERIC Educational Resources Information Center

Clewis, John

1981-01-01

Problems facing older faculty and staff members who want to continue working are discussed, along with innovative ways to help them achieve a financially secure retirement. A retirement planning program and seminar plans to help faculty and staff avoid making poor retirement decisions are proposed. (MLW)

Responsibility Center Management: Lessons from 25 Years of Decentralized Management.

ERIC Educational Resources Information Center

Strauss, Jon C.; Curry, John R.

Decentralization of authority is a natural act in universities, but decentralization of responsibility is not. A problem faced by universities is the decoupling of academic authority from financial responsibility. The solution proposed in this book for the coupling is Responsibility Center Management (RCM), also called Revenue Responsibility…

Kansas Rural Schools and Education Service Centers : A 21st Century Solution.

ERIC Educational Resources Information Center

Cook, Rita C.

2003-01-01

Rural Kansas schools facing financial problems and demands for more accountability must cooperate to survive. Smoky Hill Education Service Center, representing 45 school districts, provides on-site staff development and online classes for students and staff, maintains a multimedia library, has a cooperative purchasing program, provides…

EDUCATING THE CULTURALLY DEPRIVED IN THE GREAT CITIES.

ERIC Educational Resources Information Center

KAPLAN, BERNARD A.; AND OTHERS

A SERIES OF ARTICLES FEATURES THE EDUCATION OF THE CULTURALLY DISADVANTAGED IN URBAN AREAS. SUBJECTS RANGE FROM CONSIDERATION OF GENERAL ISSUES INVOLVED (IDENTIFICATION OF THE DISADVANTAGED, DE FACTO SEGREGATION, FINANCIAL ASSISTANCE, INVOLVEMENT OF THE FAMILY), TO SPECIFIC PROBLEMS FACING THE INNER-CITY TEACHER AND A PERSONAL EXPERIENCE OF A…

The New Corporate Stake in Higher Education.

ERIC Educational Resources Information Center

Council for Financial Aid to Education, New York, NY.

The ways that selected companies are managing and structuring their responses to the needs of higher education for financial support and cooperative programs are described. According to General Foods Corporation Chairman James L. Ferguson, the academic world faces the problem of maintaining its standards in light of the decrease of federal…

Data Mining in Finance: Using Counterfactuals To Generate Knowledge from Organizational Information Systems.

ERIC Educational Resources Information Center

Dhar, Vasant

1998-01-01

Shows how counterfactuals and machine learning methods can be used to guide exploration of large databases that addresses some of the fundamental problems that organizations face in learning from data. Discusses data mining, particularly in the financial arena; generating useful knowledge from data; and the evaluation of counterfactuals. (LRW)

Public Funds and Private Colleges.

ERIC Educational Resources Information Center

Pope, Kenneth H.

Financial and survival problems facing private colleges, unless the state governments make major changes in the way public education is financed, are discussed in this speech. The gap between the cost of attending public and private institutions is growing, at least for families with incomes above the median. Many of the best academic colleges and…

Towards Deeper Comprehension in Higher Engineering Education: "Method of Cornerstones"

ERIC Educational Resources Information Center

Korpela, Aki; Tarhasaari, Timo; Kettunen, Lauri; Mikkonen, Risto; Kinnari-Korpela, Hanna

2016-01-01

During the current millennium, universities have faced a new kind of problem: there is not enough higher learning in higher education. Driving forces have mainly been economical, since financial pressure and effort for increasing efficiency have given rise to growing amount of accessed and graduated students. In addition, a pressure for…

World 2/DIAOLS - - A Project Report.

DTIC Science & Technology

1978-05-05

theory of “system dynamics” is finding widespread application, not only in industry, but also in medical research, sociolocy, financial analysis , and...problems facing mankind: poverty, environmental deterioration, loss of faith in...its environment . While it has certain limitations, it is significant in that it is an effort to make explicit a specific world model so that it may be

Retirement Trends and Public Policy: The Carrot and the Stick.

ERIC Educational Resources Information Center

Quinn, Joseph F.; Burkhauser, Richard V.

Recent trends toward earlier retirement have exacerbated the financial problems facing the Social Security system and many other public and private pension plans. The massive commitment of public and private funds to Social Security and pension funds is partly responsible for the trend to early retirement. This, in fact, was one of the early goals…

Advisory Commission for the Study of Public Support for Post-Secondary Education in Maine.

ERIC Educational Resources Information Center

Maine State Advisory Commission for the Study of Public Support for Postsecondary Education, Augusta.

The Advisory Commission for the Study of Public Support for Postsecondary Education in Maine reviewed the financial problems facing Maine's private higher education institutions and the impact of increasing student costs at Maine's public institutions. The text of the state legislation creating the Commission is presented, along with a summary of…

Higher Education Fundraising: A Correlational Examination of Entrepreneurial Self-Efficacy, Fundraising Experience, and Fundraising Training

ERIC Educational Resources Information Center

Abrams, Kenneth P.

2017-01-01

Fundraising is the most challenging issue facing Historically Black Colleges and Universities. The declines in federal and state appropriations have elucidated the need for alternative sources of financial support. The specific problem of interest is that the inherent level of entrepreneurial self-efficacy of the president and development officer…

Financial Awareness Education with Apprentices in the Australian Construction Industry: Program Evaluation

ERIC Educational Resources Information Center

Du Plessis, Karin; Green, Emma

2013-01-01

A financial awareness education program was implemented with construction industry apprentices in Victoria, Australia. The program included face-to-face delivery of education around a range of financial management issues that apprentices face as they begin their apprenticeship. The paper reports on an evaluation of the program, which included…

Gambling harms and gambling help-seeking amongst indigenous Australians.

PubMed

Hing, Nerilee; Breen, Helen; Gordon, Ashley; Russell, Alex

2014-09-01

This paper aimed to analyze the harms arising from gambling and gambling-related help-seeking behaviour within a large sample of Indigenous Australians. A self-selected sample of 1,259 Indigenous Australian adults completed a gambling survey at three Indigenous sports and cultural events, in several communities and online. Based on responses to the problem gambling severity index (PGSI), the proportions of the sample in the moderate risk and problem gambler groups were higher than those for the population of New South Wales. Many in our sample appeared to face higher risks with their gambling and experience severe gambling harms. From PGSI responses, notable harms include financial difficulties and feelings of guilt and regret about gambling. Further harms, including personal, relationship, family, community, legal and housing impacts, were shown to be significantly higher for problem gamblers than for the other PGSI groups. Most problem gamblers relied on family, extended family and friends for financial help or went without due to gambling losses. Nearly half the sample did not think they had a problem with gambling but the results show that the majority (57.7 %) faced some risk with their gambling. Of those who sought gambling help, family, extended family, friends and respected community members were consulted, demonstrating the reciprocal obligations underpinning traditional Aboriginal culture. The strength of this finding is that these people are potentially the greatest source of gambling help, but need knowledge and resources to provide that help effectively. Local Aboriginal services were preferred as the main sources of professional help for gambling-related problems.

Practical solutions when facing cost sharing: the American Cancer Society's Health Insurance Assistance Service.

PubMed

Sharpe, Katherine; Shaw, Beverly; Battaglia Seiler, Mandi

2016-03-01

The American Cancer Society (ACS) has been a leading voice for healthcare reform and an informed advocate for effective health insurance reforms. Since the implementation of the Affordable Care Act (ACA), the ACS has observed a shift in inquiries to its Health Insurance Assistance Service (HIAS) from individuals seeking coverage, to a growing problem of individuals presenting issues from being underinsured. Underinsured patients with cancer face serious financial challenges due to large co-pays and coinsurance costs. HIAS was created to help these patients identify potential options for insurance coverage while tracking patient trends. The types of calls received by HIAS have been captured as part of an internal database that allows for the analysis of trends and emerging issues. By evaluating several case studies that illustrate common issues faced by underinsured individuals, we identified solutions ranging from exploring financial assistance programs, such as co-pay relief and providing appeal information, to searching for more adequate or affordable insurance options. Additionally, the ACS has worked to find strong partnerships with other nonprofit organizations to aid in cost relief. Although the ACA has made plans available to many patients and their families, the maximum for an individual's in-network out-of-pocket costs are still too high for many individuals. New approaches are needed to improve the cost protection of health plans. By documenting access problems faced by patients with cancer, the ACS is better positioned to tell policy makers about the concerns of real patients and work toward policy solutions.

A University Math Help Centre as a Support Framework for Students, the Instructor, the Course, and the Department

ERIC Educational Resources Information Center

Menz, Petra; Jungic, Veselin

2015-01-01

Among many challenges a math department at a post-secondary institution will most likely be faced with the optimization problem of how best to offer out-of-lecture learning support to several thousand first- and second-year university students enrolled in large math service courses within given spatial, scheduling, financial, technological, and…

Institutional Assessment of Research and Studies: Inevitable Feature of a Modern State or One More Bureaucratic Whim in Lithuania?

ERIC Educational Resources Information Center

Dienys, Vincentas; Pukelis, Kestutis; Ziliukas, Pranas

2005-01-01

A number of small countries face similar problems while organising external assessment of higher education institutions: how to select proper experts, how to prepare them and maintain? How to avoid bias or interest conflict between experts who evaluate the institution and the institution being evaluated? How to reduce the financial costs of…

Federal Student Aid and the Goal of Equal Opportunity: The Record and the Future.

ERIC Educational Resources Information Center

Gladieux, Lawrence E.

The history of federal student financial aid legislation, 1965-1985, is traced, and problems faced in the mid-1980s, and possible future directions are considered. The Higher Education Act of 1965 was the first explicit federal commitment to equalizing college opportunities for needy students through grants and programs such as Talent Search. Some…

Availing services for developmental disabilities: parental experiences from a referral center in developing country.

PubMed

Juneja, Monica; Jain, Rahul; Singhal, Swati; Mishra, Devendra

2012-09-01

To identify the problems faced by parents of children with developmental disabilities in availing rehabilitative services and to find their satisfaction level. This study was carried out at a Child Development Clinic (CDC) located in Northern India. Children with developmental disabilities, who were availing services at CDC for at least last 3 mo and had at least 3 follow-up visits, were enrolled. A questionnaire pertaining to the socio-demographic profile, problems faced in availing services and satisfaction level was filled by the parents of the enrolled children. During the study period, 161 parents filled the questionnaire. 77.6% had some problems in getting the services, the major being difficulty in commuting (50%) and financial constraint (21.7%). More than 80% parents use public transport to reach CDC with 19% travelling more than 50 Km. 29.8% had difficulty in bringing their child to the clinic, either due to severe behavioral problems or physical disability. However, majority of the families were well satisfied with the services as 95% of them graded their satisfaction level at 3 or more on the scale of 0-5. Parents of children with developmental disabilities face many problems in getting rehabilitative services. They travel long distances, face hardships in carrying their child, and lose their day's earnings, apart from spending time and money for their child's therapy. However, most of the parents are well satisfied with the services.

The impact of the European financial crisis on clinical research within the European union or "when life gives you lemons, make lemonade".

PubMed

Tsoulfas, G

2012-01-01

The European Union (EU) and the world are faced with unprecedented economic challenges, which if allowed to persist could threaten its continued existence in its current form as a union. Furthermore, these same financial challenges can easily translate into societal hardship. The biomedical and pharmaceutical industries of the U.S. and Europe have been in the midst of severe financial constraints over the last few years, which will worsen in the coming years. A critical factor is a financial crisis that appears to be spreading like wildfire through Europe, with 3 of its oldest members (Greece, Ireland, Portugal) already having enlisted the aid of the International Monetary Fund (IMF) to avoid bankruptcy, and with the possibility of others to follow (Italy, Spain). Adding to this the increasing cost of introducing new medications and devices, and conducting clinical research, as well as the tightening regulatory pressures and the drying pharmaceutical pipelines, cost cutting pressures are mounting on pharmaceutical industries and the biomedical sector, whether in academia or in industry. This paper will attempt to highlight some of the problems that clinical research in Europe may be facing, as well as discuss some of the potential solutions. Although this will by no means be an exhaustive analysis, the goal is to show that times of financial hardship, such as the current one, may also provide the impetus for constructive change.

The impact of the European financial crisis on clinical research within the European union or "when life gives you lemons, make lemonade"

PubMed Central

Tsoulfas, G

2012-01-01

The European Union (EU) and the world are faced with unprecedented economic challenges, which if allowed to persist could threaten its continued existence in its current form as a union. Furthermore, these same financial challenges can easily translate into societal hardship. The biomedical and pharmaceutical industries of the U.S. and Europe have been in the midst of severe financial constraints over the last few years, which will worsen in the coming years. A critical factor is a financial crisis that appears to be spreading like wildfire through Europe, with 3 of its oldest members (Greece, Ireland, Portugal) already having enlisted the aid of the International Monetary Fund (IMF) to avoid bankruptcy, and with the possibility of others to follow (Italy, Spain). Adding to this the increasing cost of introducing new medications and devices, and conducting clinical research, as well as the tightening regulatory pressures and the drying pharmaceutical pipelines, cost cutting pressures are mounting on pharmaceutical industries and the biomedical sector, whether in academia or in industry. This paper will attempt to highlight some of the problems that clinical research in Europe may be facing, as well as discuss some of the potential solutions. Although this will by no means be an exhaustive analysis, the goal is to show that times of financial hardship, such as the current one, may also provide the impetus for constructive change. PMID:23930050

An appraisal of public water supply and coverage in Mzuzu City, northern Malawi

NASA Astrophysics Data System (ADS)

Wanda, Elijah M. M.; Gulula, Lewis C.; Phiri, Gift

Literature on water supply and coverage is mixed about whether Malawi will achieve the MDGs by 2015. Mzuzu City is one of the most rapidly growing urban areas that is faced with public water supply and coverage challenges in Malawi. In view of this, an appraisal was done through documentation review, field visits and face to face interviews in order to evaluate problems of public water supply and coverage. It was observed that inequitable distribution of water points, unreliability of the water supply services and financial losses are some of the problems affecting public water supply in Mzuzu City. The financial losses were attributed to poor financial performance resulting from accrued debts by some individual customers and most government institutions, the board’s reliance on loans for expansion of services which has led into more revenue being spent servicing the loan and accrued interests, and high levels of unaccounted for water. This study found out that only 17% of the study population has piped water in their dwelling homes and yards. It was also observed that 51% of the population accesses the water from community stand pipes supplied by the NRWB. This means that only 68% of the study population in Mzuzu City (mostly those from planned settlements) is covered by NRWB and 32% is not covered and relies on boreholes (13.6%), unprotected wells (16.5%) and rivers (1.9%) as sources of water. The percentage composition of the population not covered by NRWB is of great concern and threat to public health and safety. The study recommends that NRWB should ensure that available funds, which would otherwise have been paid out in form of interest, are used on projects in phases to improve water supply and coverage in Mzuzu City. The study also recommends that the government of Malawi should consider converting the NRWB’s loans into grants in order to alleviate the NRWB’s financial losses. Furthermore, the study recommends that the NRWB should equitably increase its customer base.

ECS Resignations Raise Questions of Fiscal Health: Leader of State Policy Group Says Problems Can Be Fixed

ERIC Educational Resources Information Center

Hoff, David J.

2006-01-01

Kathy Christie, senior vice president at the Education Commission of the States (ECS), resigned on May 1, 2006, saying that the Denver-based group faces a financial crisis, and that she doubts the current ECS president can fix it. By the end of the week, the accounting manager had also resigned, expressing similar concerns, and two policy analysts…

As 1989 Legislatures Convene, Public Colleges in Many States Face Tough Battles for Funds.

ERIC Educational Resources Information Center

Blumenstyk, Goldie

1989-01-01

The summer drought, the oil-market slump, and the desire for political popularity are among the causes for state financial problems. A report by the National Governors' Association and the National Association of State Budget Officers found that in 1987, the amount of money left in general-fund accounts was at its lowest point in 12 years. (MLW)

More with Four: A Look at the Four Day Week in Oregon's Small Schools.

ERIC Educational Resources Information Center

Reinke, Joyce M.

The 4-day school week offers solutions to the financial and instructional problems often faced by small rural schools. Two southern Oregon schools implemented the 4-day school week on a trial basis in 1982-83 and, along with five eastern Oregon districts, continue to use this schedule today. The primary purpose of the change to a 4-day week was…

Financial Conflicts Facing Late-Life Remarried Alzheimer's Disease Caregivers

ERIC Educational Resources Information Center

Sherman, Carey Wexler; Bauer, Jean W.

2008-01-01

This qualitative study explores financial conflicts faced by late-life remarried wives providing care for their husbands with Alzheimer's disease. Interviews with 9 women identified intergenerational secrets and tensions regarding financial and inheritance decisions. Participants' remarried spouse status, underlying family boundary ambiguities,…

Financial sustainability of academic health centers: identifying challenges and strategic responses.

PubMed

Stimpson, Jim P; Li, Tao; Shiyanbola, Oyewale O; Jacobson, Janelle J

2014-06-01

Academic health centers (AHCs) play a vital role in the health care system. The training of health care personnel and delivery of health care services, especially to the most complex and financially challenged patients, has been a responsibility increasingly shouldered by AHCs over the years. Additionally, AHCs play a significant role in researching and developing new treatment protocols, including discovering and validating new health technologies. However, AHCs face unique financial challenges in fulfilling their social mission in the health care system. Reforms being implemented under the Affordable Care Act and shifting economic patterns are threatening the financial sustainability of AHCs.The authors review challenges facing AHCs, including training new health care professionals with fewer funding resources, disproportionate clinical care of complex and costly patients, charity care to uninsured and underinsured, and reduced research funding opportunities. Then, they provide a review of some potential solutions to these challenges, including new reimbursement methods, improvements in operational efficiency, price regulation, subsidization of education, improved decision making and communication, utilization of industrial management tools, and increasing internal and external cooperation. Devising solutions to the evolving problems of AHCs is crucial to improving health care delivery in the United States. Most likely, a combination of market, government, and system reforms will be needed to improve the viability of AHCs and assist them in fulfilling their social and organizational missions.

Barriers to self-care in women of reproductive age with HIV/AIDS in Iran: a qualitative study.

PubMed

Oskouie, Fatemeh; Kashefi, Farzaneh; Rafii, Forough; Gouya, Mohammad Mehdi

2017-01-01

Although increasing attention is paid to HIV/AIDS, patients with HIV still experience several barriers to self-care. These barriers have been previously identified in small quantitative studies on women with HIV, but qualitative studies are required to clarify barriers to self-care. We conducted our study using the grounded theory methodological approach. A total of 28 women with HIV and their family members, were interviewed. The data were analyzed with the Corbin and Strauss method (1998). The key barriers to self-care in women with HIV/AIDS included social stigma, addiction, psychological problems, medication side-effects and financial problems. Women with HIV/AIDS face several barriers to self-care. Therefore, when designing self-care models for these women, social and financial barriers should be identified. Mental health treatment should also be incorporated into such models and patients' access to health care services should be facilitated.

Supporting the spread of health technology in community services.

PubMed

Sitton-Kent, Lucy; Humphreys, Catriona; Miller, Phillip

2018-03-02

Health technology has been proposed as a route to financial savings and improved patient safety for many years within the NHS. Nurses have a key role to play in transforming care through such technology but, despite high-level endorsement, implementation of health technology has been uneven across NHS community services. This article looks at three promising applications of health technology in community nursing: mobile access to digital care records; digital imaging; and remote face-to-face consultations. Current evidence for these technologies gives some indication of what is required before health technologies can benefit patients. Rapidly changing health technologies make it difficult for community services to make fully informed decisions when implementing them. There are challenges in predicting the full financial and efficiency impacts, in making robust estimates of costs and workload implications and in anticipating the effects on patient care and staff experience. Despite these problems, there is mounting evidence of the benefits of technological innovations available to community nurses and their patients.

Female Caregivers and Stroke Severity Determines Caregiver Stress in Stroke Patients.

PubMed

Menon, Bindu; Salini, P; Habeeba, K; Conjeevaram, Jyoti; Munisusmitha, K

2017-01-01

Stroke is among the major causes of short- and long-term disability. This study aimed to understand the caregivers (CGs) stress in stroke survivors. A 22-item questionnaire was administered to 201 CGs of stroke survivors. The variables tested were physical and mental health, social support, financial, and personal problems. CGs were divided into Group A (Barthel index [BI] <75) and B (BI >75) according to patient's BI, according to gender (male and female CG) and relation; spouses (wife, husband), daughters, sons, daughter-in-law, grandchildren, and rest (father, mother, brother, sister, and in-laws). Data were analyzed using SPSS software version-21. Data were analyzed to determine which variables of the patient effects the CG stress. Majority of the CGs (74.62%) were females. 65% of CGs graded their burden as moderate to severe. 81% of CGs had left their work for caregiving. More than half of the CGs felt sleep disturbance and physical strain. Psychological instability and financial burdens were reported in 3/4 th of CGs. Group A CGs faced more sleep, financial, health, and social life disturbance. Patient's bladder and bowel problems, shoulder pain, patients noncooperative attitude for medication administration, and physiotherapy were more upsetting for Group A CGs. Female CGs were subjected to more sleep disturbance, physical and psychological stress, faced more difficulty regarding the patient's bladder, bowel, personal hygiene needs, and physiotherapy. Female CGs felt less motivated in caregiving than male CGs. Wives and daughters-in-law experienced more burden. Time spent and burden perceived was more by female CGs (χ 2 = 15.199, P = 0.002) than males (χ 2 = 11.931, P = 0.018); wives and daughters than other relations (χ 2 = 32.184, P = 0.000), (χ 2 = 35.162, P = 0.019). Our study showed that caregiving burden was predominantly shouldered by females CGs. CGs faced physical, psychological, and socioeconomic burden. The burden was more evident in female CGs and in patients with severe stroke.

Problems of increased transport load as a result of implementation of projects of high-rise constructions

NASA Astrophysics Data System (ADS)

Provotorov, Ivan; Gasilov, Valentin; Anisimova, Nadezhda

2018-03-01

The structure of problems of high-rise construction us suggested, which includes the impact on environment, design solutions, transportation problems, financial costs for construction and operation, and others. Positive and negative aspects of high-rise construction are considered. One of the basic problems of high-rise construction is the problem of increased transport load. Construction of the subway on the basis of the concession mechanism, with the use of unmanned control of rolling stock is proposed as the most expedient solution. An evaluation of the effectiveness of this project is presented, it shows quite high performance indicators for a private investor. Main problems that the project implementation may face in conditions of lack of scientific and methodological support are outlined.

Oxytocin decreases aversion to angry faces in an associative learning task.

PubMed

Evans, Simon; Shergill, Sukhwinder S; Averbeck, Bruno B

2010-12-01

Social and financial considerations are often integrated when real life decisions are made, and recent studies have provided evidence that similar brain networks are engaged when either social or financial information is integrated. Other studies, however, have suggested that the neuropeptide oxytocin can specifically affect social behaviors, which would suggest separable mechanisms at the pharmacological level. Thus, we examined the hypothesis that oxytocin would specifically affect social and not financial information in a decision making task, in which participants learned which of the two faces, one smiling and the other angry or sad, was most often being rewarded. We found that oxytocin specifically decreased aversion to angry faces, without affecting integration of positive or negative financial feedback or choices related to happy vs sad faces.

What is a Hospital? Future Roles and Prospects for Success

PubMed Central

Shalowitz, Joel

2013-01-01

As hospitals consolidate and take on more financial and clinical risk, they face numerous obstacles. While the past can provide answers to solving many of the challenges, some issues are new and require innovative approaches. This article, from a speech delivered to The Business of Medicine: A Course for Physician Leaders symposium presented by Yale-New Haven Hospital and the Medical Directors Leadership Council at Yale University in November 2012, discusses the models for these hospital organizations and the pitfalls they will face in coordinating care. The insights will help these systems overcome potential problems and enhance their chances of success. PMID:24058316

[The impact of autism on the life of parents].

PubMed

Sénéchal, Carole; des Rivières-Pigeon, Catherine

2009-01-01

The aim of this paper is to explore the stress and the psychological distress faced by parents of children living with different types of disability. Its main focus is on parents of children with autism. The first part describes the stress factors faced by parents of children with disabilities and the second, the particularities of the stress faced by parents of children with autism. The third part explores other types of stress factors, such as financial problems, marital discord or beak-up, single parenthood and lack of social support. In the forth part, we examine weather the services are well suited to provide for the needs of families, and, in the fifth part, we describe the major role played by intervention in the life of families of children with autism.

Older and wiser? An affective science perspective on age-related challenges in financial decision making

PubMed Central

Kensinger, Elizabeth A.; Munnell, Alicia H.; Sass, Steven A.; Dickerson, Brad C.; Wright, Christopher I.; Barrett, Lisa Feldman

2011-01-01

Financial planning decisionss are fundamentally affective in nature; they are decisions related to money, longevity and quality of life. Over the next several decades people will be increasingly responsible for managing their own assets and investments, and they will be subject to the affective influences on active, personal decision-making. Many of these crucial decisions are made and revised across the lifespan, including when to buy or sell a home, how to save for childrens’ education, how to manage healthcare costs, when to retire, how much to save for retirement and how to allocate retirement funds. As average life expectancy increases, many retirees will be faced with inadequate savings to live comfortably until the end of their lives. In the current article, we examine the problems of and potential solutions to inadequate financial planning through the lens of affective science, with an emphasis on how brain-based changes in affective processing with age might contribute to the challenge of financial planning. PMID:20587596

Older and wiser? An affective science perspective on age-related challenges in financial decision making.

PubMed

Weierich, Mariann R; Kensinger, Elizabeth A; Munnell, Alicia H; Sass, Steven A; Dickerson, Brad C; Wright, Christopher I; Barrett, Lisa Feldman

2011-04-01

Financial planning decisionss are fundamentally affective in nature; they are decisions related to money, longevity and quality of life. Over the next several decades people will be increasingly responsible for managing their own assets and investments, and they will be subject to the affective influences on active, personal decision-making. Many of these crucial decisions are made and revised across the lifespan, including when to buy or sell a home, how to save for childrens' education, how to manage healthcare costs, when to retire, how much to save for retirement and how to allocate retirement funds. As average life expectancy increases, many retirees will be faced with inadequate savings to live comfortably until the end of their lives. In the current article, we examine the problems of and potential solutions to inadequate financial planning through the lens of affective science, with an emphasis on how brain-based changes in affective processing with age might contribute to the challenge of financial planning.

Partners in public health law: elected officials, health directors, and attorneys.

PubMed

Benjamin, Georges; Lopez, Wilfredo; Monson, Angela Zoe

2002-01-01

The partnership that has developed over the years between elected officials, health directors, and attorneys came about through necessity and practicality. This article examines this partnership and some of the conflicts and problems it contains. The article discusses the problems of overlap of authority between public health departments and elected officials. It also emphasizes that existing laws and regulations often provide sufficiently flexible authority, and that such laws and regulations can be exercised in new ways to address current public health problems. The article concludes with a discussion of the challenges faced by public health officials and legislators in forming a partnership to secure necessary financial support and legal authority for public health activities.

Case Mix Management Systems: An Opportunity to Integrate Medical Records and Financial Management System Data Bases

PubMed Central

Rusnak, James E.

1987-01-01

Due to previous systems selections, many hospitals (health care facilities) are faced with the problem of fragmented data bases containing clinical, demographic and financial information. Projects to select and implement a Case Mix Management System (CMMS) provide an opportunity to reduce the number of separate physical files and to migrate towards systems with an integrated data base. The number of CMMS candidate systems is often restricted due to data base and system interface issues. The hospital must insure the CMMS project provides a means to implement an integrated on-line hospital information data base for use by departments in operating under a DRG-based Prospective Payment System. This paper presents guidelines for use in selecting a Case Mix Mangement System to meet the hospital's financial and operations planning, budgeting, marketing, and other management needs, while considering the data base implications of the implementation.

Evidence is good for your health system: policy reform to remedy catastrophic and impoverishing health spending in Mexico.

PubMed

Knaul, Felicia Marie; Arreola-Ornelas, Héctor; Méndez-Carniado, Oscar; Bryson-Cahn, Chloe; Barofsky, Jeremy; Maguire, Rachel; Miranda, Martha; Sesma, Sergio

2006-11-18

Absence of financial protection in health is a recently diagnosed "disease" of health systems. The most obvious symptom is that families face economic ruin and poverty as a consequence of financing their health care. Mexico was one of the first countries to diagnose the problem, attribute it to lack of financial protection, and propose systemic therapy through health reform. In this article we assess how Mexico turned evidence on catastrophic and impoverishing health spending into a catalyst for institutional renovation through the reform that created Seguro Popular (Popular Health Insurance). We present 15-year trends on the evolution of catastrophic and impoverishing health spending, including evidence on how the situation is improving. The results of the Mexican experience suggest an important role for the organisation and financing of the health system in reducing impoverishment and protecting households during periods of individual and collective financial crisis.

[Evidence is good for your health system: policy reform to remedy catastrophic and impoverishing health spending in Mexico].

PubMed

Knaul, Felicia Marie; Arreola-Ornelas, Héctor; Méndez-Carniado, Oscar; Bryson-Cahn, Chloe; Barofsky, Jeremy; Maguire, Rachel; Miranda, Martha; Sesma, Sergio

2007-01-01

Absence of financial protection in health is a recently diagnosed "disease" of health systems. The most obvious symptom is that families face economic ruin and poverty as a consequence of financing their health care. Mexico was one of the first countries to diagnose the problem, attribute it to lack of financial protection, and propose systemic therapy through health reform. In this article we assess how Mexico turned evidence on catastrophic and impoverishing health spending into a catalyst for institutional renovation through the reform that created Seguro Popular de Salud (Popular Health Insurance). We present 15-year trends on the evolution of catastrophic and impoverishing health spending, including evidence on how the situation is improving. The results of the Mexican experience suggest an important role for the organisation and financing of the health system in reducing impoverishment and protecting households during periods of individual and collective financial crisis.

Bridging the gap between financial distress and available resources for patients with cancer: a qualitative study.

PubMed

Smith, Sophia K; Nicolla, Jonathan; Zafar, S Yousuf

2014-09-01

Cancer treatment-related out-of-pocket costs create substantial financial distress for many patients. However, little work has been done to describe available financial resources and barriers to connecting those resources to patients. This was a single-center, qualitative study that used semistructured interviews and focus groups with social workers and financial care counselors. Interview guides were used to elicit feedback from study participants pertaining to the types of financial problems that their patients were experiencing, the process for addressing these issues, patient assistance resources, and access barriers. Four interviews and two focus group sessions (n = 15) were conducted in which four themes emerged among the social work and financial care counselor samples. Participants cited (1) frustration over the lack of financial resources and increasingly stringent eligibility criteria, (2) barriers to providing assistance such as process inefficiencies, (3) limited resources to identify at- risk patients and refer them for services, and (4) inadequate insurance coverage and availability. To bridge the gap between increasing patient need and limited resources, participants suggested development of interventions designed to aid in patient screening and resource identification. Oncology social workers and financial care counselors reported inadequate financial resources and faced barriers to matching appropriate resources with patients in need. Limited social work resources hindered early screening for financial distress. Interventions that focus on screening for early identification of financial distress and identification of resources are needed. Copyright © 2014 by American Society of Clinical Oncology.

Two management systems in a nursing private practice group.

PubMed

Zahourek, R P

1979-09-01

Entry into private practice can be rewarding for nurses who are willing to risk personal, financial, and professional security. Among the problems faced by the nurse in this new role is the administration of the practice, since few, if any, adequate models exist. This article describes the struggle of nurses in one private nursing practice, Creative Health Services, to meet their needs for individual freedom within an organization that is regulated sufficiently to maintain its viability.

Current Welfare Problems Facing Horses in Great Britain as Identified by Equine Stakeholders.

PubMed

Horseman, Susan V; Buller, Henry; Mullan, Siobhan; Whay, Helen R

2016-01-01

Despite growing concerns about the welfare of horses in Great Britain (GB) there has been little surveillance of the welfare status of the horse population. Consequently we have limited knowledge of the range of welfare problems experienced by horses in GB and the situations in which poor welfare occurs. Thirty-one in-depth interviews were conducted with a cross -section of equine stakeholders, in order to explore their perceptions of the welfare problems faced by horses in GB. Welfare problems relating to health, management and riding and training were identified, including horses being under or over weight, stabling 24 hours a day and the inappropriate use of training aids. The interviewees also discussed broader contexts in which they perceived that welfare was compromised. The most commonly discussed context was where horses are kept in unsuitable environments, for example environments with poor grazing. The racing industry and travellers horses were identified as areas of the industry where horse welfare was particularly vulnerable to compromise. Lack of knowledge and financial constraints were perceived to be the root cause of poor welfare by many interviewees. The findings give insight into the range of welfare problems that may be faced by horses in GB, the contexts in which these may occur and their possible causes. Many of the problems identified by the interviewees have undergone limited scientific investigation pointing to areas where further research is likely to be necessary for welfare improvement. The large number of issues identified suggests that some form of prioritisation may be necessary to target research and resources effectively.

Current Welfare Problems Facing Horses in Great Britain as Identified by Equine Stakeholders

PubMed Central

Horseman, Susan V.; Buller, Henry

2016-01-01

Despite growing concerns about the welfare of horses in Great Britain (GB) there has been little surveillance of the welfare status of the horse population. Consequently we have limited knowledge of the range of welfare problems experienced by horses in GB and the situations in which poor welfare occurs. Thirty-one in-depth interviews were conducted with a cross -section of equine stakeholders, in order to explore their perceptions of the welfare problems faced by horses in GB. Welfare problems relating to health, management and riding and training were identified, including horses being under or over weight, stabling 24 hours a day and the inappropriate use of training aids. The interviewees also discussed broader contexts in which they perceived that welfare was compromised. The most commonly discussed context was where horses are kept in unsuitable environments, for example environments with poor grazing. The racing industry and travellers horses were identified as areas of the industry where horse welfare was particularly vulnerable to compromise. Lack of knowledge and financial constraints were perceived to be the root cause of poor welfare by many interviewees. The findings give insight into the range of welfare problems that may be faced by horses in GB, the contexts in which these may occur and their possible causes. Many of the problems identified by the interviewees have undergone limited scientific investigation pointing to areas where further research is likely to be necessary for welfare improvement. The large number of issues identified suggests that some form of prioritisation may be necessary to target research and resources effectively. PMID:27501387

The problem of IVF cost in developing countries: has natural cycle IVF a place?

PubMed

Shahin, Ahmed Y

2007-07-01

Infertility represents a national health problem in some African countries. Limited financial health resources in developing countries are a major obstacle facing infertility management. IVF is the definitive line of treatment for many couples. Stimulation cycles are associated with risks of ovarian hyperstimulation syndrome and multiple pregnancy. This study evaluates the client acceptability of stimulated versus natural cycle IVF among couples attending one infertility clinic, with respect to cost and pregnancy outcome. Of the patients who were indicated for IVF, 15% (16/107) cancelled, due mostly (12/16, 75%) to financial reasons. The majority of patients who completed their IVF treatment (82/91, 90.1%) felt the price of the medical service offered was high, and 68.1% (62/91) accepted the idea of having cheaper drugs with fewer side effects but with possibly lower chances of pregnancy. Natural cycle IVF has emerged as a potential option that might be suitable for patients worldwide, especially in developing countries.

The Value of Information for Populations in Varying Environments

NASA Astrophysics Data System (ADS)

Rivoire, Olivier; Leibler, Stanislas

2011-04-01

The notion of information pervades informal descriptions of biological systems, but formal treatments face the problem of defining a quantitative measure of information rooted in a concept of fitness, which is itself an elusive notion. Here, we present a model of population dynamics where this problem is amenable to a mathematical analysis. In the limit where any information about future environmental variations is common to the members of the population, our model is equivalent to known models of financial investment. In this case, the population can be interpreted as a portfolio of financial assets and previous analyses have shown that a key quantity of Shannon's communication theory, the mutual information, sets a fundamental limit on the value of information. We show that this bound can be violated when accounting for features that are irrelevant in finance but inherent to biological systems, such as the stochasticity present at the individual level. This leads us to generalize the measures of uncertainty and information usually encountered in information theory.

[Living in hemodialysis without social insurance: The voices of renal sick people and their families].

PubMed

Mercado-Martínez, Francisco J; Correa-Mauricio, Mauricio E

2015-01-01

To examine the perspectives and practices of renal sick people and their families without social insurance regarding problems faced while on dialysis treatment. A qualitative research was developed in Guadalajara, Mexico. Thirty-seven renal sick people on hemodialysis and 50 relatives participated; all affiliated to Seguro Popular. Information was gathered through individual and group interviews. Directed content analysis was carried out. Renal sick people and their families face multiple difficulties while on hemodialysis treatment; nevertheless, economic ones are perceived as a priority due to treatment expenses, lack of financial resources and non-coverage of kidney disease by Seguro Popular. Multiple actions are combined in a circular searching for help process to face the economic burden. Hemodialysis treatment is an unbearable economic burden for renal sick people and their families without social insurance. Universal access to renal therapies should be implemented urgently.

Investment portfolio management from cybernetic point of view

NASA Astrophysics Data System (ADS)

Marchev, Angel, Jr.; Marchev, Angel

2013-12-01

The theory of investment portfolios is a well defined component of financial science. While sound in principle, it faces some setbacks in its real-world implementation. In this paper the authors propose a reformulation of the investment portfolio problem as a cybernetic system where the Investor is the controlling system and the portfolio is the controlled system. Also the portfolio controlling process should be dissected in several ordered phases, so that each phase is represented as a subsystem within the structure of the controlling system Investor.

Superintendent Perspectives of Financial Survival Strategies in Small Schools

ERIC Educational Resources Information Center

Abshier, William Cody

2010-01-01

The purpose of this study was to investigate the perceptions of successful small-school superintendents in regard to maintaining or improving district efficiency and financial status. This investigation sought to reveal superintendent practices that serve to maximize district revenues and improve operating efficiency. Face-to-face interviews were…

Financial Decision Making during Economic Contraction: The Special Case of Community Colleges.

ERIC Educational Resources Information Center

Seater, Barbara

Although faced with declining revenues and increasing enrollments, community colleges have also traditionally provided expensive support services for nontraditional students and maintained costly technological capacities to respond to the training needs of business. Financial decision-makers face unsettling questions as they attempt to achieve…

7 CFR 278.5 - Participation of insured financial institutions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... the appropriate field on the redemption certificate using Magnetic Ink Character Recognition (MICR...-521). (3) Redeemed coupons must be indelibly cancelled on the face of the coupon by the first insured financial institution receiving them. If the cancellation on the coupon face does not show the depositing...

7 CFR 278.5 - Participation of insured financial institutions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... the appropriate field on the redemption certificate using Magnetic Ink Character Recognition (MICR...-521). (3) Redeemed coupons must be indelibly cancelled on the face of the coupon by the first insured financial institution receiving them. If the cancellation on the coupon face does not show the depositing...

7 CFR 278.5 - Participation of insured financial institutions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... the appropriate field on the redemption certificate using Magnetic Ink Character Recognition (MICR...-521). (3) Redeemed coupons must be indelibly cancelled on the face of the coupon by the first insured financial institution receiving them. If the cancellation on the coupon face does not show the depositing...

7 CFR 278.5 - Participation of insured financial institutions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... the appropriate field on the redemption certificate using Magnetic Ink Character Recognition (MICR...-521). (3) Redeemed coupons must be indelibly cancelled on the face of the coupon by the first insured financial institution receiving them. If the cancellation on the coupon face does not show the depositing...

7 CFR 278.5 - Participation of insured financial institutions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... the appropriate field on the redemption certificate using Magnetic Ink Character Recognition (MICR...-521). (3) Redeemed coupons must be indelibly cancelled on the face of the coupon by the first insured financial institution receiving them. If the cancellation on the coupon face does not show the depositing...

Older women and health: an overview.

PubMed

Lewis, M

1985-01-01

Older women's health issues are unique. There are more older women than ever before. They are living increasingly longer than men, yet they report more acute and chronic illness and disability than men. They are disproportionally represented in nursing homes, since many women are alone: twenty-five percent aged 70 or over have no living children and over 60 percent of older women are widowed, divorced, or single. Older women have fewer personal financial resources for health care than men. Health care reimbursement does not meet their needs for financial coverage of chronic outpatient and nursing home care. They face age and sex discrimination on the part of many health care providers and are subject to a growing tendency to be seen as "burdens" and "problems" in the American health care system.

[Retention management by means of applied human resource development: lessons from cardiovascular anaesthesiology].

PubMed

Padosch, Stephan A; Schmidt, Christian E; Spöhr, Fabian A M

2011-05-01

At present, besides well-known financial problems, German hospitals are facing a serious lack of qualified medical staff. Given these facts, it is of great importance, especially in work load burdened disciplines, such as cardiovascular anaesthesiology, to retain highly qualified medical staff. Here, human resource development measures offer valuable tools for efficient retention management. Moreover, most of these are applicable to almost any clinical specialty. Surprisingly, financial aspects play a minor role in such concepts, in contrast to human resource development tools, such as mentoring, interviews, training and motivational activities. Especially, with regard to "Generation Y", an efficient retention management will play a key role to keep these physicians as hospital employees of long duration in the future. © Georg Thieme Verlag Stuttgart · New York.

Understanding the Long-Term Benefits of a Latino Financial Literacy Education Program

ERIC Educational Resources Information Center

Meraz, Antonio Alba; Petersen, Cindy M.; Marczak, Mary S.; Brown, Arthur; Rajasekar, Neeraj

2013-01-01

The long-term impact of a Latino financial literacy program was evaluated with a sample of relatively recent immigrant populations in southern Minnesota. Telephone and face-to-face interviews were conducted with participants 6 months post program completion. Results indicate that improvements in knowledge and skills were retained and that these…

Mission-Based Management in Higher Education: How Do Academic Department Chairpersons Align Decision-Making with Their Organizational Mission?

ERIC Educational Resources Information Center

Hlavac, Craig

2012-01-01

The academic department chairperson continues to face significant challenges in the administration of the contemporary university. Due to retrenchment resultant from the 2008 Global Financial Crisis (GFC), higher education has already faced significant financial cutbacks, and more reductions seem inevitable. Particularly susceptible are…

INTRODUCTION OF UNIVERSAL HEALTH PROGRAM IN GEORGIA: PROBLEMS AND PERSPECTIVES.

PubMed

Verulava, T; Jorbenadze, R; Barkalaia, T

2017-01-01

Since 2013, Georgia enacted Universal Healthcare (UHC) program. Inclusion of uninsured population in the UHC program will have a positive impact on their financial accessibility to the health services. The study aims to analyze the referral rate of the beneficiaries to the health service providers before introduction and after application of the UHC program, particularly, how much it increased the recently uninsured population referral to primary health care units, and also to study the level of satisfaction with the UHC program. Research was conducted by qualitative and quantitative methods. The target groups' (program beneficiaries, physicians, personnel of the Social Service Agency) opinions were identified by means of face-to-face interviews. Enactment of the UHC programs significantly raised the population refferal to the family physicians, and the specialists. Insignificantly, but also increased the frequency of laboratory and diagnostic services. Despite the serious positive changes caused by UHC program implementation there still remain the problems in the primary healthcare system. Also, it is desirable to raise the financial availability of those medical services, which may cause catastrophic costs. In this respect, such medical services must be involved in the universal healthcare program and been expanded their scale. For the purpose of effective usage of the limited funds allocated for health care services provision, the private health insurance companies should be involved in UHC programs. This, together with the reduction of health care costs will increase a competition in the medical market, and enhance the quality of health service.

[Frequency and consequences of financial problems in patients undergoing outpatient psychosomatic treatment].

PubMed

Wagner, Stefanie; Münster, Eva; Beutel, Manfred E

2010-01-01

About seven million people in Germany are affected by overindebtedness and insolvency. Being severely in debt is a very stressful situation that can result in social marginalisation, reducted overall activity, and physical and mental illness. The present study investigated the frequency of financial problems and their effects on physical and mental disorders at a university psychosomatic clinic. The study included a total of 659 patients. Their mental status was assessed with the Symptom Checklist (SCL-90-R), their physical status with the Gießener Beschwerdebogen (GBB). 37 percent of the subjects reported experiencing financial problems. We found that subjects with financial problems reported more physical and mental disorders than those without financial problems. Furthermore, therapists more often recommended that patients with financial problems receive inpatient therapy than patients without financial problems. The study suggests that financial problems should be included in any anamnesis, therapeutic recommendation, and actual therapy of patients in psychosomatic treatment.

Fathers' views on their financial situations, father-child activities, and preventing child injuries.

PubMed

Olsen, Lise L; Oliffe, John L; Brussoni, Mariana; Creighton, Genevieve

2015-01-01

Unintentional injuries are a leading public health problem for children, particularly among those living at lower socioeconomic levels. Parents play an important preventive role, and the aim of this study was to examine fathers' views on the role of their family financial situation in preventing children's injuries. In-depth interviews were conducted with 15 fathers of children 2 to 7 years living in western Canada. Questions solicited fathers' views about their financial situation and their child injury prevention efforts. Data analysis was underpinned by masculinity theory and guided by constant comparative grounded theory methods. Findings included that fathers living with fewer financial limitations emphasized use of safety equipment and aligned themselves with provider and protector masculine ideals. Fathers with moderate financial constraint described more child-centered safety efforts and efforts to manage finances. Those facing greatest constraint demonstrated aspects of marginalized masculinities, whereby they acknowledged their economic provider limitations while strongly aligning with the protector role. These findings hold relevance for development of interventions aimed at reducing child injury risk inequities. Taking into account how masculinities may shape their beliefs and practices can inform design of father-centered interventions for men living at different points on the socioeconomic spectrum. © The Author(s) 2013.

Challenges around Access to and Cost of Life-Saving Medications after Allogeneic Hematopoietic Cell Transplantation for Medicare Patients.

PubMed

Farnia, Stephanie; Ganetsky, Alex; Silver, Alicia; Hwee, Theresa; Preussler, Jaime; Griffin, Joan; Khera, Nandita

2017-08-01

Hematopoietic cell transplantation (HCT) is an expensive, medically complicated, and potentially life-threatening therapy for multiple hematologic and nonhematologic disorders with a prolonged trajectory of recovery. Similar to financial issues in other cancer treatments, adverse financial consequences of HCT are emerging as an important issue and may be associated with poor quality of life and increased distress in HCT survivors. Prescription medicine coverage for HCT for Medicare and some Medicaid beneficiaries, especially in the long-term, remains suboptimal because of inadequate payer formularies or prohibitive copays. With an increasing number of older patients undergoing HCT and improvement in the overall survival after HCT, the problem of financial burden faced by Medicare beneficiaries with fixed incomes is going to worsen. In this article, we describe the typical financial burden borne by HCT recipients based on estimated copayment amounts attached to the categories of key medications as elucidated through 2 case studies. We also suggest some possible solutions for consideration to help these patients and families get through the HCT by minimizing the financial burden from essential medications needed during the post-HCT period. Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

The challenges facing wearable sensor systems.

PubMed

McAdams, Eric; Gehin, Claudine; Massot, Bertrand; McLaughlin, James

2012-01-01

It has been pointed out that, in spite of significant national and international funding programmes, there is a dearth of successfully commercialised wearable monitoring systems. Although problems such as financial reimbursement, device interoperability and the present lack of the required connected healthcare infrastructure are major hurdles to the provision of remote clinical monitoring of home-based patients, the "Mount Everest" of monitoring applications, why are wearable systems not already commercialised and used in less demanding applications? The numerous wearable systems which appear on the Web and even in the literature are, for the most part, basic prototypes unsuited to the demands of real-life applications. SMEs which do seek to commercialise clinically promising systems are unfortunately faced with many challenges and few as yet have survived long enough to successfully commercialise their innovations.

Raising the Cash: A Study of the Role of Leadership in a Capital Campaign

ERIC Educational Resources Information Center

Diaz, Sandra L.

2013-01-01

Institutions of higher education are facing a number of challenges as they compete in the new global economy. Many of these institutions face increasing internal and external challenges, all of which involve additional expenses at a time when resources are diminishing. With growing financial uncertainties caused by fluctuating financial markets…

Causative factors of cost overrun in highway projects of Sindh province of Pakistan

NASA Astrophysics Data System (ADS)

Sohu, S.; Halid, A.; Nagapan, S.; Fattah, A.; Latif, I.; Ullah, K.

2017-11-01

Cost overrun is an increase of cost of project from approved budget which was signed by parties at the time of tender. Cost overrun in construction of highway projects is a common problem worldwide and construction industry of Pakistan is also facing this crucial problem of cost overrun in highway projects of Pakistan. The main objective of this research is to identify the causative factors of cost overrun in highway projects of Sindh province of Pakistan. A well designed questionnaire was developed based on 64 common factors of cost overrun from literature review. Developed questionnaire was distributed among selected 30 experts from owner/client, designer/consultant and contractor who have experience more than 20 years’ experience in highway projects. The collected data was statistical analyzed. After analysis results showed that delay process in payment by client, inadequate planning, client interference, poor contract management, delay of decision making, change of scope of project and financial problems faced by client were most causative factors of cost overrun in highway projects. This research will provide alertness to stakeholders of highway projects of Sindh province to avoid cost overrun in projects.

How do insured perceive their financial security in the event of illness?--a panel data analysis for Germany.

PubMed

Lange, Ansgar; Prenzler, Anne; Zuchandke, Andy

2012-01-01

There is a lack of research regarding the subjective perception of financial security in the event of illness of insured persons. Therefore, the aim of our study was to analyze the subjective perception of financial security in the event of illness in the German setting over time and to identify major determinants of that perception. We applied a probit-adapted ordinary least squares estimation procedure including fixed effects to a balanced data set from the German Socio-Economic Panel. After correcting our data set, we included approximately 23,500 observations in our analyses. We show that higher income and the existence of private health insurance have a positive and significant impact on the perception of financial security. Furthermore, private supplementary health insurance has a positive and significant effect on this perception; however, this is solely true for policies that cover special features during hospital stays. Experience with the health care system is also positively related to the individual's perception. Finally, our regression results illustrate that the overall perception is declining over time. The results indicate that political decision makers are facing challenges regarding the declining subjective perception in the German health care system. Because of the positive correlation between experience and subjective perception, it can be assumed that the health care system and especially statutory health insurance are better than their presentation in the media. Hence, there is a problem of communication and information, and political decision makers face challenges in presenting the system objectively and handling the media in a proper way. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Living on the edge: health care expenses strain family budgets.

PubMed

Cummingham, Peter J; Miller, Carolyn; Cassil, Alwyn

2008-12-01

Affordability of medical care is a central focus of health care reform efforts. As health care costs continue to increase and the economy declines sharply, there is very little cushion in family budgets for health care costs, even for families with insurance coverage. Financial pressures on families from medical bills increase sharply when out-of-pocket spending for health care services exceeds 2.5 percent of family income, according to a new national study by the Center for Studying Health System Change (HSC). Low-income families and people in poor health experience financial pressures at even lower levels of spending, largely because they have already accumulated large medical debts they are unable to pay off. Many Californians also incur substantial burdens from health care expenses, although the rate of medical bill problems is somewhat lower in California compared with the overall United States. Extended interviews with a select number of families facing problems with medical bills provide additional detail on how families are forced to make difficult trade-offs with other family necessities, put off paying other bills, cut down on other expenses and delay getting needed medical care

Assisting Australians with mental health problems and financial difficulties: a Delphi study to develop guidelines for financial counsellors, financial institution staff, mental health professionals and carers.

PubMed

Bond, Kathy S; Chalmers, Kathryn J; Jorm, Anthony F; Kitchener, Betty A; Reavley, Nicola J

2015-06-03

There is a strong association between mental health problems and financial difficulties. Therefore, people who work with those who have financial difficulties (financial counsellors and financial institution staff) need to have knowledge and helping skills relevant to mental health problems. Conversely, people who support those with mental health problems (mental health professionals and carers) may need to have knowledge and helping skills relevant to financial difficulties. The Delphi expert consensus method was used to develop guidelines for people who work with or support those with mental health problems and financial difficulties. A systematic review of websites, books and journal articles was conducted to develop a questionnaire containing items about the knowledge, skills and actions relevant to working with or supporting someone with mental health problems and financial difficulties. These items were rated over three rounds by five Australian expert panels comprising of financial counsellors (n = 33), financial institution staff (n = 54), mental health professionals (n = 31), consumers (n = 20) and carers (n = 24). A total of 897 items were rated, with 462 items endorsed by at least 80 % of members of each of the expert panels. These endorsed statements were used to develop a set of guidelines for financial counsellors, financial institution staff, mental health professionals and carers about how to assist someone with mental health problems and financial difficulties. A diverse group of expert panel members were able to reach substantial consensus on the knowledge, skills and actions needed to work with and support people with mental health problems and financial difficulties. These guidelines can be used to inform policy and practice in the financial and mental health sectors.

Parental Financial Support and the Financial and Family Problems of College Freshmen

ERIC Educational Resources Information Center

Bunnett, Nancy Hubbell

1975-01-01

Freshmen completed the Mooney Problem Check List and reported how much financial support their parents provided. The relationship between parents' support and finances, living conditions, and employment problems was highly significant, with women reporting more financial problems than men. (Author)

Reforming the primary care physician payment system: eliminating E & M codes and creating the financial incentives for an "advanced medical home".

PubMed

Goldfield, Norbert; Averill, Richard; Vertrees, James; Fuller, Richard; Mesches, David; Moore, Gordon; Wasson, John H; Kelly, William

2008-01-01

The problem faced by primary care physicians is that they can only maintain or increase their (inflation adjusted) incomes by increasing the volume of visits and associated services. The fundamental flaw in a fee-for-service system is that only paying for individual services creates incentives for more services. This article offers a very different approach to paying primary care physicians that will result in both significantly higher incomes for these underpaid professionals together with incentives for creating a medical home.

The Japanese national health screening and intervention program aimed at preventing worsening of the metabolic syndrome.

PubMed

Kohro, Takahide; Furui, Yuji; Mitsutake, Naohiro; Fujii, Ryo; Morita, Hiroyuki; Oku, Shinya; Ohe, Kazuhiko; Nagai, Ryozo

2008-03-01

Similar to the healthcare systems in other industrialized countries, the Japanese healthcare system is facing the problem of increasing medical expenditure. In Japan, this situation may be primarily attributed to advanced technological developments, an aging population, and increasing patient demand. Japan also faces the problem of a declining youth population due to a low birth rate. Taken together, these problems present the healthcare system with a very difficult financial situation. Several reforms have been undertaken to contain medical expenditure, such as increasing employee copayment for health insurance from 10% to 20% in 1997 and from 20% to 30% in 2003 in order to curb unnecessary visits to medical institutions. Since the aging of the Japanese population is inevitable, a suitable method to contain medical expenditure may be to screen individuals who are likely to develop lifestyle-related diseases and conduct early intervention programs for them to prevent the development of diseases such as myocardial infarction or stroke that are costly to treat. If this goal is attained, it may contribute to the containment of medical expenditure as well as to improving the quality of life of the elderly. Therefore, the Japanese Ministry of Health, Labor and Welfare has decided to introduce a nationwide health screening and intervention program specifically targeting the metabolic syndrome commencing April 2008. Here, we discuss (1) the background of the Japanese healthcare system and the problems facing it, (2) the underlying objective and details of the new screening program, and (3) the expected impact of the program.

Financial Literacy of High School Students: Evidence from Germany

ERIC Educational Resources Information Center

Erner, Carsten; Goedde-Menke, Michael; Oberste, Michael

2016-01-01

After graduating high school, underage individuals soon face ever more complex and important financial decisions. Pivotal to the development of improved financial literacy programs is a comprehensive examination of financial literacy levels and potentially related factors. The authors conducted a survey among German high school students and found…

Financial management in leading health care systems.

PubMed

Smith, D G; Wheeler, J R; Rivenson, H L; Reiter, K L

2000-01-01

To understand better the financial management practices and strategies of modern health care organizations, we conducted interviews with chief financial officers (CFOs) of several leading health care systems. In this introduction, we present an overview of the project and summary responses on corporate financial structures and strategic challenges facing CFOs.

Dealing with the financial burden of cancer: perspectives of older breast cancer survivors.

PubMed

Pisu, Maria; Martin, Michelle Y; Shewchuk, Richard; Meneses, Karen

2014-11-01

Financial burden among cancer survivors is often overlooked in survivorship care planning. Cancer survivors with limited incomes may be particularly affected. Yet, little data are available to address financial issues among them. Eliciting the survivors' perspectives on how to deal with this financial burden is a first crucial step to identifying the means to provide this supportive care. In this pilot study, three nominal group technique (NGT) sessions were conducted with a convenience sample of 23 older breast cancer survivors (age 52 to 83) recruited from a county safety net hospital and a Comprehensive Cancer Center. One single NGT question was posed in these sessions, namely "What could help women deal with the financial burden that cancer brings to them and their families?" Survivors responded in an iterative fashion and then ranked the most relevant responses. The most relevant responses addressed the (1) need for affordable insurance; (2) need to have prompt information on treatment costs patients will face, insurance coverage, and agencies or programs that provide needed products and services; and (3) need to access social workers, navigators, support groups, or others knowledgeable about available resources. Survivors also suggested that physicians become aware of cancer costs and financial issues faced by patients and consider costs in their treatment plans. Older survivors face financial challenges for which there are few available resources. They suggested several avenues to address cancer-related financial issues that may be considered in developing supportive interventions.

Dealing with the financial burden of cancer: perspectives of older breast cancer survivors

PubMed Central

Pisu, Maria; Martin, Michelle Y.; Shewchuk, Richard; Meneses, Karen

2014-01-01

Purpose Financial burden among cancer survivors is often overlooked in survivorship care planning. Cancer survivors with limited incomes may be particularly affected. Yet, little data are available to address financial issues among them. Eliciting the survivors’ perspectives on how to deal with this financial burden is a first crucial step to identifying the means to provide this supportive care. Methods In this pilot study, three Nominal Group Technique (NGT) sessions were conducted with a convenience sample of 23 older breast cancer survivors (age 52 to 83) recruited from a county safety net hospital and a Comprehensive Cancer Center. One single NGT question was posed in these sessions, namely “What could help women deal with the financial burden that cancer brings to them and their families?” Survivors responded in an iterative fashion and then ranked the most relevant responses. Results The most relevant responses addressed the: (1) need for affordable insurance; (2) need to have prompt information on treatment costs patients will face, insurance coverage, and agencies or programs that provide needed products and services; and (3) need to access social workers, navigators, support groups, or others knowledgeable about available resources. Survivors also suggested that physicians become aware of cancer costs and financial issues faced by patients, and consider costs in their treatment plans. Conclusions Older survivors face financial challenges for which there are few available resources. They suggested several avenues to address cancer-related financial issues that may be considered in developing supportive interventions. PMID:24912858

Teaching and Technology Transfer as Alternative Revenue Streams: A Primer on the Potential Legal Implications for UK Universities

ERIC Educational Resources Information Center

Van Hoorebeek, Mark; Marson, James

2005-01-01

Purpose: The purpose of this paper is to assess the financial and intellectual issues facing the university sector as many institutions in the UK pursue alternative revenue streams. As a consequence to the increasing financial pressures, university departments are increasingly exposed to new forms of potential litigation and also face the risk to…

78 FR 4175 - Eco Global Corporation, Execute Sports, Inc., FacePrint Global Solutions, Inc., FinancialContent...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-18

... SECURITIES AND EXCHANGE COMMISSION [File No. 500-1] Eco Global Corporation, Execute Sports, Inc., FacePrint Global Solutions, Inc., FinancialContent, Inc., and Firstgold Corp.; Order of Suspension of Trading January 16, 2013. It appears to the Securities and Exchange Commission that there is a lack of current and accurate information concerning...

A Model for settlement of health insurance organizations’ debt to health service delivery institutions

PubMed Central

Abolhallaj, Masood; Hosseini, Seyed Mohammadreza; Jafari, Mehdi; Alaei, Fatemeh

2017-01-01

Background: Sukuk is a type of financial instrument backed by balance sheet and physical assets. This applied and descriptive study aimed at providing solutions to the problems faced by insurance companies in the health sector. Methods: In this study, we achieved operational models by reviewing the release nature and mechanism of any of the securities and combining them. Results: According to the model presented in this study, 2 problems could be solved: settling the past debts and avoiding future debts. This model was deigned based on asset backed securities. Conclusion: Utilizing financing instruments (such as Sukuk), creating investment funds, and finding a solution to this problem, this study was conducted in 2 aspects: (1) models that are settling old debts of the organization, and (2) models that prevent debts in the future.

A case for the expansion of day surgery.

PubMed

Ogg, T; Heath, P; Brownlie, G

1989-12-01

The efficiency of the National Health Service (NHS) is currently under scrutiny and the problems faced by the surgical services include a shortage of financial resources, fewer beds, poor nursing recruitment and rising waiting lists. During 1984-1988 a purpose built, separate 12-bedded day surgery unit at Addenbrooke's Hospital, Cambridge operated upon 13,000 patients, with a readmission rate of less than 1%. Senior medical staff are involved and the overall surgical waiting list has been reduced by 40.9%. Nurse recruitment has been excellent, and the community medical and nursing services have not been overburdened. The results detailed in this paper suggest that day surgery deserves special consideration as one acceptable solution to some of the current NHS problems.

Impact of the recent recession on self-harm: Longitudinal ecological and patient-level investigation from the Multicentre Study of Self-harm in England.

PubMed

Hawton, Keith; Bergen, Helen; Geulayov, Galit; Waters, Keith; Ness, Jennifer; Cooper, Jayne; Kapur, Navneet

2016-02-01

Economic recessions are associated with increases in suicide rates but there is little information for non-fatal self-harm. To investigate the impact of the recent recession on rates of self-harm in England and problems faced by patients who self-harm. Analysis of data from the Multicentre Study of Self-harm in England for 2001-2010 and local employment statistics for Oxford, Manchester and Derby, including interrupted time series analyses to estimate the effect of the recession on rates of self-harm. Rates of self-harm increased in both genders in Derby and in males in Manchester in 2008-2010, but not in either gender in Oxford, results which largely followed changes in general population unemployment. More patients who self-harm were unemployed in 2008-10 compared to before the recession. The proportion in receipt of sickness or disability allowances decreased. More patients of both genders had employment and financial problems in 2008-2010 and more females also had housing problems, changes which were also largely found in employed patients. We have assumed that the recession began in 2008 and information on problems was only available for patients having a psychosocial assessment. Increased rates of self-harm were found in areas where there were greater rises in rates of unemployment. Work, financial and housing problems increased in people who self-harmed. Changes in welfare benefits may have contributed. None. Copyright © 2015 Elsevier B.V. All rights reserved.

Finding Medical Care for Colorectal Cancer Symptoms: Experiences among Those Facing Financial Barriers

ERIC Educational Resources Information Center

Thomson, Maria D.; Siminoff, Laura A.

2015-01-01

Financial barriers can substantially delay medical care seeking. Using patient narratives provided by 252 colorectal cancer patients, we explored the experience of financial barriers to care seeking. Of the 252 patients interviewed, 84 identified financial barriers as a significant hurdle to obtaining health care for their colorectal cancer…

Fiscal Year 2011 U.S. Government Financial Statements: The Federal Government Faces Continuing Financial Management and Long-Term Fiscal Challenges

DTIC Science & Technology

2012-03-01

GAO annually audits the consolidated financial statements of the U.S. government. The Congress and the President need reliable, useful, and timely...based consolidated financial statements . Unless these weaknesses are adequately addressed, they will, among other things, continue to (1) hamper the

Reentry challenges facing women with mental health problems.

PubMed

Visher, Christy A; Bakken, Nicholas W

2014-01-01

Women entering the correctional system represent a population at high risk for mental health and the body of research on the mental health needs of women offenders is growing. These mental health problems pose challenges for women at every stage of the criminal justice process, from arrest to incarceration to community reentry and reintegration. In this article, we examined mental health status among a sample of 142 women leaving confinement and the role that mental health problems played in shaping their reentry outcomes using data collected between 2002 and 2005 in Houston, Texas. In the year after leaving prison, women with mental health problems reported poorer health, more hospitalizations, more suicidal thoughts, greater difficulties securing housing and employment, more involvement in criminal behavior, and less financial support from family than women with no indication of mental health problems. However, mental health status did not increase the likelihood of substance use relapse or reincarceration. The article concludes with a discussion of recommendations for improved policy and practice.

The transition from resident to private practice--important financial decisions.

PubMed

Wherry, Jeffrey E; Thomalla, Kenneth

2008-02-01

A newly graduated resident faces many new challenges in the first year of practice. Foremost among these is how to handle the newfound wealth that typically accompanies the transition from residency to a successful practice. The ramifications of these decisions are not insignificant. This article explains the important financial considerations a new practitioner must face in the transition from resident to private practice.

Sociocultural aspects of arsenicosis in Bangladesh: community perspective.

PubMed

Ahmad, Sheikh A; Sayed, Muhammad H S; Khan, Manzurul H; Karim, Muhammad N; Haque, Muhammad A; Bhuiyan, Mohammad S A; Rahman, Muhammad S; Faruquee, Mahmud H

2007-10-01

This was a cross-sectional study under taken to explore the socioeconomic perspective of the arsenicosis problem, carried out in arsenic contaminated Upazillas where at least 100 arsenicosis patients had been identified. Two of the Upazillas with significant arsenic mitigation intervention and three of the Upazillas with limited interventions were selected for the study. Seven hundred fifty respondents were included in the study from 25 villages of the 5 Upazillas. Arsenicosis became a serious problem for the affected communities. Majority (71.31%) of respondents obtained their drinking water from tubewells, almost one third (29%) of the respondents still knowingly using arsenic contaminated water. Primary reason identified for this practice was distance of safe water source. Majority (58.6%) of the respondents said to face economic and 17.9% said to face social problem of varied range. Patients of lower income group were particularly more likely to face economic problems (P< .001) as well as social problem (P< .01). About half (50.7%) of the arsenicosis patients faced difficulty whilst receiving treatment, particularly female patients were more likely to face problem than male (P< .05). Several concerns also were surfaced regarding the heath care service provider particularly to the women patients, some of which are: long waiting time for receiving treatment (15%), discrimination in service delivery (10.7%) and inadequate separate facility for female patients (14.3%). Moreover the issues of financial burden raised by the respondents seem to have emerged as significant in terms of health care access. Access to Health service was particularly difficult for poor patients, as they often had to face problems associated with accessing service like, non availability of medicines in the hospitals (50.7%), traveling long distance (26.7%), purchasing medicine in most cases (32.4%) etc. Their dissatisfaction was compounded by negligent behavior of health care staff and nature of treatment provided. Furthermore length of time needed for reversal of symptoms led to loosing faith on efficacy of treatment, which cascades to negligence of patient's part in seeking health care. Women are less likely to get treatment for arsenicosis than men (P< .01). As there appear to be specific difficulties for women particularly for poor women in accessing health care, social and cultural values make it difficult for them to attend to their own health needs and to travel to service providers. Study findings suggest that a significant proportion (79.9%) of arsenicosis patient was found to access alternative health care. This includes; Homeopath, village doctors, Kabiraj and local pharmacists. Respondents in high intervention Upazillas were significantly more likely to get treatment (P< .05), to face fewer problems and to be satisfied with the facility (P< .001). Provision of safe water options, periodic screening of water source for arsenic, availability of trained doctor, regular availability of medicine, doorstep treatment, follow up on severe patients were the suggestions came from community for improvement.

Internal marketing and the antecedents of nurse satisfaction and loyalty.

PubMed

Peltier, James W; Pointer, Lucille; Schibrowsky, John A

2008-01-01

Employee satisfaction and retention are critical issues that influence the success of any organization. Yet, one of the most critical problems facing the worldwide health care industry is the shortage of qualified nurses. Recent calls have been made within the traditional nursing literature for research that utilizes marketing and business models to better understand nurse satisfaction and retention. The purpose of this study is to develop scales that can be used to empirically test a model of the proposed antecedents of nurse job satisfaction and loyalty which have been used widely in the internal marketing and the relationship-marketing literature. Specifically, the study will investigate the degree to which structural bonding, social bonding, financial bonding activities, and quality of care impact how well nurses are satisfied with their job and their commitment to the organization. The results show that quality of care most impacted nurse satisfaction and loyalty, followed by structural, social, and financial bonds.

Exploring the Classroom Practices That May Enable a Compassionate Approach to Financial Literacy Education

ERIC Educational Resources Information Center

Blue, Levon Ellen; O'Brien, Mia; Makar, Katie

2018-01-01

From an early age, children are faced with financial dilemmas and are expected to make effective financial decisions about money. In this paper, we explore the classroom practices that may enable a compassionate approach to financial literacy education. We observed an inquiry-based mathematics lesson in a Year 4 primary school classroom. The…

Financial Literacy. Snapshots. Volume 6, Issue 6, Article 1

ERIC Educational Resources Information Center

Thomson, Sue

2015-01-01

Young people face financial issues at an earlier age than their parents. Decisions about higher education, the need to be able to manage online payment facilities or even mobile phone plans require a level of financial literacy. PISA 2012 offered an opportunity to collect information about the financial literacy of Australian 15-year-old students,…

Development of a conceptual framework for understanding financial barriers to care among patients with cardiovascular-related chronic disease: a protocol for a qualitative (grounded theory) study.

PubMed

Campbell, David J T; Manns, Braden J; Hemmelgarn, Brenda R; Sanmartin, Claudia; King-Shier, Kathryn M

2016-01-01

Patients with cardiovascular-related chronic diseases may face financial barriers to accessing health care, even in Canada, where universal health care insurance is in place. No current theory or framework is adequate for understanding the impact of financial barriers to care on these patients or how they experience financial barriers. The overall objective of this study is to develop a framework for understanding the role of financial barriers to care in the lives of patients with cardiovascular-related chronic diseases and the impact of such barriers on their health. We will perform an inductive qualitative grounded theory study to develop a framework to understand the effect of financial barriers to care on patients with cardiovascular-related chronic diseases. We will use semistructured interviews (face-to-face and telephone) with a purposive sample of adult patients from Alberta with at least 1 of hypertension, diabetes, heart disease or stroke. We will analyze interview transcripts in triplicate using grounded theory coding techniques, including open, focused and axial coding, following the principle of constant comparison. Interviews and analysis will be done iteratively to theoretical saturation. Member checking will be used to enhance rigour. A comprehensive framework for understanding financial barriers to accessing health care is instrumental for both researchers and clinicians who care for patients with chronic diseases. Such a framework would enable a better understanding of patient behaviour and nonadherence to recommended medical therapies and lifestyle modifications.

Problems and Opportunities in School Financial Management: A Consultant's Perspective.

ERIC Educational Resources Information Center

Chabotar, Kent John

1987-01-01

Summarizes major problems in school financial management and suggests practical improvements to aid external reporting of financial data and internal management. Sections of the article describe these categories of problems: (1) budget presentation; (2) management control; (3) cost accounting; and (4) financial reporting. (PS)

The incidence of high medical expenses by health status in seven developed countries.

PubMed

Baird, Katherine Elizabeth

2016-01-01

Health care policy seeks to ensure that citizens are protected from the financial risk associated with needing health care. Yet rising health care costs in many countries are leading to a greater reliance on out-of-pocket (OOP) measures. This paper uses 2010 household survey data from seven countries to measure and compare the burden OOP expenses place on individuals. It compares countries based on the extent to which citizens with health problems devote a large share of their income to OOP expenses. The paper finds that in all countries but France, and to a lesser extent Slovenia, citizens with health problems face considerably higher medical costs than do those without. As many as one-quarter of less healthy citizens in the US, Poland, Russia and Israel devote a large share of their income to OOP expenses. The paper also finds a strong cross-national correlation between the degree to which citizens face high OOP expenses, and the disparities in OOP expenses between those with and without health problems. The levels of high OOP spending uncovered, and their inequitable impact on those with health problems in the seven countries, underscore the potential for OOP measures to undermine core objectives of health care systems, including those of equitable financing, equal access, and improved health among the population. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Identifying Self-Efficacy and Financial Behaviors as Predictors of Undergraduate College Students' Financial Literacy at a Land Grant University in North Carolina

ERIC Educational Resources Information Center

Hucul, Donna T.

2015-01-01

Financial literacy has become a serious concern in the wake of the Great Recession of 2008. This study explored the financial literacy of undergraduate college students, who as a group constitute a distinct cohort of learners, emerging adults. The college student population represents a financially at-risk group facing mounting student loan debt.…

Too easily lead? Health effects of gasoline additives.

PubMed Central

Menkes, D B; Fawcett, J P

1997-01-01

Octane-enhancing constituents of gasoline pose a number of health hazards. This paper considers the relative risks of metallic (lead, manganese), aromatic (e.g., benzene), and oxygenated additives in both industrialized and developing countries. Technological advances, particularly in industrialized countries, have allowed the progressive removal of lead from gasoline and the increased control of exhaust emissions. The developing world, by contrast, has relatively lax environmental standards and faces serious public health problems from vehicle exhaust and the rapid increase in automobile use. Financial obstacles to the modernization of refineries and vehicle fleets compound this problem and the developing world continues to import large quantities of lead additives and other hazardous materials. Progress in decreasing environmental health problems depends both on the adoption of international public health standards as well as efforts to decrease dependence on the private automobile for urban transport. Images Figure 1. Figure 2. PMID:9171982

Financial conflicts of interest in science.

PubMed

Sax, Joanna K

2012-01-01

This Article proposes a new direction for addressing financial conflicts of interest, which plague biomedical research and threaten scientific integrity. This Article descriptively states the controversy surrounding financial conflicts of interest by explaining how these conflicts arise and the damage that can be created as a result. By describing the scientific process, the Article explains that changes to the academic environment may allow the public-private interaction to proceed, without creating the problems associated with financial conflicts of interest. Financial conflicts of interest are created when the profit-seeking motive of a private funding source unduly influences an academic scientist's primary responsibilities. The problem with financial conflicts of interest has grown since the passage of the Bayh-Dole Act in 1980. The cornerstone of current policies to address financial conflicts of interest is disclosure, which is inadequate and unsatisfying. The analysis herein changes the trajectory of current approaches in this area by proposing that an analysis of the underlying environment and behavior leading to conflicts of interest must be considered. This Article proposes the use of behavioral economics to craft a policy that effectively addresses conflicts of interest. To this end, this Article applies research from the field of psychology to understand both the environment of academic scientists as well as to begin to understand how academic scientists make decisions. Drawing on psychology literature, this article proposes that academic scientists may experience cognitive dissonance when faced with a situation in which a conflict of interest may arise. This helps to understand why an academic scientist may make a decision that creates a conflict of interest. In addition, this Article utilizes the results of an empirical study conducted by myself and a colleague. In this study, we asked faculty at five medical schools to respond to an anonymous survey containing hypothetical situations in which a conflict may arise. The combination of the psychology literature and our empirical study can provide support to the creation of new policies. Policy proposals include implementation of default rules, education, and changes to academic requirements. Furthermore, this Article considers ways to incentivize medical centers to implement effective policies as well as changes to intellectual property law.

Smokers with financial stress are more likely to want to quit but less likely to try or succeed: findings from the International Tobacco Control (ITC) Four Country Survey.

PubMed

Siahpush, Mohammad; Yong, Hua-Hie; Borland, Ron; Reid, Jessica L; Hammond, David

2009-08-01

To examine the association of financial stress with interest in quitting smoking, making a quit attempt and quit success. The analysis used data from 4984 smokers who participated in waves 4 and 5 (2005-07) of the International Tobacco Control (ITC) Four Country Survey, a prospective study of a cohort of smokers in the United States, Canada, the United Kingdom and Australia. The outcomes were interest in quitting at wave 4, making a quit attempt and quit success at wave 5. The main predictor was financial stress at wave 4: '. . . because of a shortage of money, were you unable to pay any important bills on time, such as electricity, telephone or rent bills?'. Additional socio-demographic and smoking-related covariates were also examined. Smokers with financial stress were more likely than others to have an interest in quitting at baseline [odds ratio (OR): 1.63; 95% confidence interval (CI): 1.22-2.19], but were less likely to have made a quit attempt at follow-up (OR: 0.74; 95% CI: 0.57-0.96). Among those who made a quit attempt, financial stress was associated with a lower probability of abstinence at follow-up (OR: 0.53; 95% CI: 0.33-0.87). Cessation treatment efforts should consider assessing routinely the financial stress of their clients and providing additional counseling and resources for smokers who experience financial stress. Social policies that provide a safety net for people who might otherwise face severe financial problems, such as not being able to pay for rent or food, may have a favorable impact on cessation rates.

Education in Neurology Resident Documentation Using Payroll Simulation.

PubMed

Liang, John W; Shanker, Vicki L

2017-04-01

Approaches for teaching neurology documentation include didactic lectures, workshops, and face-to-face meetings. Few studies have assessed their effectiveness. To improve the quality of neurology resident documentation through payroll simulation. A documentation checklist was created based on Medicaid and Medicare evaluation and management (E/M) guidelines. In the preintervention phase, neurology follow-up clinic charts were reviewed over a 16-week period by evaluators blinded to the notes' authors. Current E/M level, ideal E/M level, and financial loss were calculated by the evaluators. Ideal E/M level was defined as the highest billable level based on the documented problems, alongside a supporting history and examination. We implemented an educational intervention that consisted of a 1-hour didactic lecture, followed by e-mail feedback "paystubs" every 2 weeks detailing the number of patients seen, income generated, income loss, and areas for improvement. Follow-up charts were assessed in a similar fashion over a 16-week postintervention period. Ten of 11 residents (91%) participated. Of 214 charts that were reviewed preintervention, 114 (53%) had insufficient documentation to support the ideal E/M level, leading to a financial loss of 24% ($5,800). Inadequate documentation was seen in all 3 components: history (47%), examination (27%), and medical decision making (37%). Underdocumentation did not differ across residency years. Postintervention, underdocumentation was reduced to 14% of 273 visits ( P < .001), with a reduction in the financial loss to 6% ($1,880). Improved documentation and increased potential reimbursement was attained following a didactic lecture and a 16-week period in which individual, specific feedback to neurology residents was provided.

Investigation on factors that contribute to the abandonment of building in construction industry in Malaysia

NASA Astrophysics Data System (ADS)

Farhayu Ariffin, Nur; Jaafar, Mohd Faizal Md; Idris Ali, Mohamad; Irwan Ramli, Noram; Muthusamy, Khairunisa; Shukor Lim, Nor Hasanah Abdul

2018-03-01

In Malaysia, the construction sector is one of the important sectors that contribute to economic growth and employments. However, a major concern facing the construction industry is the growing rate of delays in project delivery. In the worse cases, the projects were abandoned due to some reasons when the contract period ended. Abandoned building defines as construction work that has been continuously stalled for 6 months or more, during the project completion period or beyond the scheduled date of completion. When the projects become abandoned, it gives an adverse effect on many parties such as the developer, contractor, consultant and also client. According to previous researchers, the abandonment of building causes a serious problem and need some mitigation plan to avoid this problem from occurring. This study will investigate the fundamental factors that contribute to the abandonment of building and projects in Malaysia based on the current data of the abandoned building in most states in Malaysia. The data was collected from the respondents who is in the construction industry and had experience working with abandoned housing project. Form the respondents perspective, it shows that the main factor contribute to the building abandonment is due to the financial problem facing by the developer company.

Head games. The psychology of medical group financial management and the role of physician leaders.

PubMed

Zismer, Daniel K

2003-01-01

Good practice leaders must understand the psychology of presenting and managing the financial performance of the medical group. Leaders--especially physicians--must strive to understand this psychology to shepherd the group through the various financial challenges it will face.

Individual versus systemic risk and the Regulator's Dilemma.

PubMed

Beale, Nicholas; Rand, David G; Battey, Heather; Croxson, Karen; May, Robert M; Nowak, Martin A

2011-08-02

The global financial crisis of 2007-2009 exposed critical weaknesses in the financial system. Many proposals for financial reform address the need for systemic regulation--that is, regulation focused on the soundness of the whole financial system and not just that of individual institutions. In this paper, we study one particular problem faced by a systemic regulator: the tension between the distribution of assets that individual banks would like to hold and the distribution across banks that best supports system stability if greater weight is given to avoiding multiple bank failures. By diversifying its risks, a bank lowers its own probability of failure. However, if many banks diversify their risks in similar ways, then the probability of multiple failures can increase. As more banks fail simultaneously, the economic disruption tends to increase disproportionately. We show that, in model systems, the expected systemic cost of multiple failures can be largely explained by two global parameters of risk exposure and diversity, which can be assessed in terms of the risk exposures of individual actors. This observation hints at the possibility of regulatory intervention to promote systemic stability by incentivizing a more diverse diversification among banks. Such intervention offers the prospect of an additional lever in the armory of regulators, potentially allowing some combination of improved system stability and reduced need for additional capital.

Investigating parents/caregivers financial burden of care for children with non-communicable diseases in Ghana.

PubMed

Abuosi, Aaron A; Adzei, Francis A; Anarfi, John; Badasu, Delali M; Atobrah, Deborah; Yawson, Alfred

2015-11-16

The introduction of the Ghana national health insurance scheme (NHIS) has led to progressive and significant increase in utilization of health services. However, the financial burden of caring for children with non-communicable diseases (NCDs) under the dispensation of the NHIS, especially during hospitalization, is less researched. This paper therefore sought to assess the financial burden parents/caregivers face in caring for children hospitalized with NCDs in Ghana, in the era of the Ghana NHIS. We conducted a cross-sectional survey of 225 parents or caregivers of children with NCDS hospitalized in three hospitals. Convenience sampling was used to select those whose children were discharged from hospital after hospitalization. Descriptive statistics such as frequencies and chi-square and logistic regression were used in data analysis. The main outcome variable was financial burden of care, proxied by cost of hospitalization. The independent variable included socio-economic and other indicators such as age, sex, income levels and financial difficulties faced by parents/caregivers. The study found that over 30 % of parents/caregivers spend more than Gh¢50 (25$) as cost of treatment of children hospitalized with NCDs; and over 40 % of parents/caregivers also face financial difficulties in providing health care to their wards. It was also found that even though many children hospitalized with NCDs have been covered by the NHIS, and that the NHIS indeed, provides significant financial relief to parents in the care of children with NCDs, children who are insured still pay out-of-pocket for health care, in spite of their insurance status. It was also found that there is less support from relatives and friends in the care of children hospitalized with NCDs, thus exacerbating parents/caregivers financial burden of caring for the children. Even though health insurance has proven to be of significant relief to the financial burden of caring for children with NCDs, parents/caregivers still face significant financial burden in the care of their wards. Stakeholders in health care delivery should therefore ensure that all children with NCDs including those excluded from the NHIS should be covered by NHIS. A special effort focusing on identifying children with NCDs within the lower income groups, especially from rural areas, in order to exempt them from any form of payment for their health care is recommended.

Utilizing the Composite Financial Index as Strategic Financial Analysis for Measuring Financial Health and Student Success Rates among Iowa Community Colleges

ERIC Educational Resources Information Center

Humburg, Dawn Ann

2012-01-01

The phrase "survival of the fittest" is coming to fruition in higher education today. Less than strategic financial moves have no place in post-secondary education. Facing the realities of our current economy is dictating major changes in how colleges are "doing business." These changes present enormous challenges to community…

Budget Cuts: Financial Aid Offices Face Budget Cuts and Increasing Workload. Quick Scan Survey Results

ERIC Educational Resources Information Center

National Association of Student Financial Aid Administrators (NJ1), 2010

2010-01-01

The majority of college financial aid offices have seen cuts to their operating budgets this year compared to the 2007-08 academic year when the recession began, according to the National Association of Student Financial Aid Administrator's latest QuickScan Survey. Sixty-two percent of financial aid offices reported operating budget cuts this year…

A Quantitative Study on Student Emergency Financial Assistance: The Impact on Community College Student Success, Persistence, and Completion Rates

ERIC Educational Resources Information Center

Benz, Abigail

2016-01-01

Financial instability is a common fiscal burden for many community college students and can serve as primary barrier to educational success (Quaye & Harper, 2015). Although traditional financial aid is structured to assist students in financing college expenses, many low-income students often face financial emergencies beyond the scope of…

Level of self-esteem and contingencies of self-worth: unique effects on academic, social, and financial problems in college students.

PubMed

Crocker, Jennifer; Luhtanen, Riia K

2003-06-01

The unique effects of level of self-esteem and contingencies of self-worth assessed prior to college on academic, social, and financial problems experienced during the freshman year were examined in a longitudinal study of 642 college students. Low self-esteem predicted social problems, even controlling for demographic and personality variables (neuroticism, agreeableness, and social desirability), but did not predict academic or financial problems with other variables controlled. Academic competence contingency predicted academic and financial problems and appearance contingency predicted financial problems, even after controlling for relevant personality variables. We conclude that contingencies of self-worth uniquely contribute to academic and financial difficulties experienced by college freshmen beyond level of self-esteem and other personality variables. Low self-esteem, on the other hand, appears to uniquely contribute to later social difficulties.

IMPROVED CORROSION RESISTANCE OF ALUMINA REFRACTORIES

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

John P. Hurley; Patty L. Kleven

2001-09-30

The initial objective of this project was to do a literature search to define the problems of refractory selection in the metals and glass industries. The problems fall into three categories: Economic--What do the major problems cost the industries financially? Operational--How do the major problems affect production efficiency and impact the environment? and Scientific--What are the chemical and physical mechanisms that cause the problems to occur? This report presents a summary of these problems. It was used to determine the areas in which the EERC can provide the most assistance through bench-scale and laboratory testing. The final objective of thismore » project was to design and build a bench-scale high-temperature controlled atmosphere dynamic corrosion application furnace (CADCAF). The furnace will be used to evaluate refractory test samples in the presence of flowing corrodents for extended periods, to temperatures of 1600 C under controlled atmospheres. Corrodents will include molten slag, steel, and glass. This test should prove useful for the glass and steel industries when faced with the decision of choosing the best refractory for flowing corrodent conditions.« less

Teaching OOP with Financial Literacy

ERIC Educational Resources Information Center

Zhu, Hongwei

2011-01-01

Students lose interest in learning programming when the materials are not related to their lives. A challenge facing most students is that they lack the financial literacy necessary to manage their debts. An approach is developed to integrate financial literacy into an object-oriented programming (OOP) course. The approach is effective in…

A Knowledge Management Model for Firms in the Financial Services Industry

ERIC Educational Resources Information Center

Held, Carsten; Duncan, Glen; Yanamandram, Venkat

2013-01-01

The financial services industry faces many demanding challenges. Firms within this industry are predominantly knowledge-based, as are most of the industry's products, processes and services. The application of knowledge management represents a clear opportunity for financial services firms to confront challenges. However, no industry specific…

Financial Performance of Academic Health Center Hospitals, 1994-2000.

ERIC Educational Resources Information Center

Dobson, Allen; Koenig, Lane; Sen, Namrata; Ho, Silver; Gilani, Jawaria

This study examined how competitive market dynamics between 1994 and 2000 have affected the financial stability of Academic Health Center (AHC) hospitals and their ability to support their academic and social missions. It looked at the financial challenges facing AHC hospitals through a survey involving 1,138 teaching hospitals. Findings…

Competitive Strategies and Financial Performance of Small Colleges

ERIC Educational Resources Information Center

Barron, Thomas A., Jr.

2017-01-01

Many institutions of higher education are facing significant financial challenges, resulting in diminished economic viability and, in the worst cases, the threat of closure (Moody's Investor Services, 2015). The study was designed to explore the effectiveness of competitive strategies for small colleges in terms of financial performance. Five…

Challenges for medical educators: results of a survey among members of the German Association for Medical Education.

PubMed

Huwendiek, Sören; Hahn, Eckhart G; Tönshoff, Burkhard; Nikendei, Christoph

2013-01-01

Despite the increasing interest in medical education in the German-speaking countries, there is currently no information available on the challenges which medical educators face. To address this problem, we carried out a web-based survey among the members of the Association for Medical Education (Gesellschaft für medizinische Ausbildung, GMA). A comprehensive survey was carried out on the need for further qualifications, expertise and the general conditions of medical educators in Germany. As part of this study, the educators were asked to list the three main challenges which they faced and which required urgent improvement. The results were analysed by means of qualitative content analysis. The questionnaire was completed by 147 of the 373 members on the GMA mailing list (response rate: 39%). The educators named a total of 346 challenges and emphasised the following areas: limited academic recognition for engagement in teaching (53.5% of educators), insufficient institutional (31.5%) and financial support (28.4%), a curriculum in need of reform (22.8%), insufficient time for teaching assignments (18,9%), inadequate teacher competence in teaching methods (18.1%), restricted faculty development programmes (18.1%), limited networking within the institution (11.0%), lack of teaching staff (10.2%), varying preconditions of students (8.7%), insufficient recognition and promotion of medical educational research (5.5%), extensive assessment requirements (4.7%), and the lack of role models within medical education (3.2%). The medical educators found the biggest challenges which they faced to be limited academic recognition and insufficient institutional and financial support. Consequently, improvements should be implemented to address these issues.

Financially At-Risk College Students: An Exploratory Investigation of Student Loan Debt and Prioritization of Debt Repayment

ERIC Educational Resources Information Center

Pinto, Mary Beth; Mansfield, Phylis M.

2006-01-01

College students today face heavy student loan debt that is intensified by the amount of credit card debt they carry. This study provides a profile of financially at-risk students based on their credit card usage behavior. When compared to the non-financially at-risk students, those in the financially at-risk group were found to have higher…

Are Survivors Who Report Cancer-Related Financial Problems More Likely to Forgo or Delay Medical Care?

PubMed Central

Kent, Erin E.; Forsythe, Laura P.; Yabroff, K. Robin; Weaver, Kathryn E.; de Moor, Janet S.; Rodriguez, Juan L.; Rowland, Julia H.

2015-01-01

BACKGROUND Financial problems caused by cancer and its treatment can substantially affect survivors and their families and create barriers to seeking health care. METHODS The authors identified cancer survivors diagnosed as adults (n = 1556) from the nationally representative 2010 National Health Interview Survey. Using multivariable logistic regression analyses, the authors report sociodemographic, clinical, and treatment-related factors associated with perceived cancer-related financial problems and the association between financial problems and forgoing or delaying health care because of cost. Adjusted percentages using the predictive marginals method are presented. RESULTS Cancer-related financial problems were reported by 31.8% (95% confidence interval, 29.3%–34.5%) of survivors. Factors found to be significantly associated with cancer-related financial problems in survivors included younger age at diagnosis, minority race/ethnicity, history of chemotherapy or radiation treatment, recurrence or multiple cancers, and shorter time from diagnosis. After adjustment for covariates, respondents who reported financial problems were more likely to report delaying (18.3% vs 7.4%) or forgoing overall medical care (13.8% vs 5.0%), prescription medications (14.2% vs 7.6%), dental care (19.8% vs 8.3%), eyeglasses (13.9% vs 5.8%), and mental health care (3.9% vs 1.6%) than their counterparts without financial problems (all P<.05). CONCLUSIONS Cancer-related financial problems are not only disproportionately represented in survivors who are younger, members of a minority group, and have a higher treatment burden, but may also contribute to survivors forgoing or delaying medical care after cancer. PMID:23907958

Are survivors who report cancer-related financial problems more likely to forgo or delay medical care?

PubMed

Kent, Erin E; Forsythe, Laura P; Yabroff, K Robin; Weaver, Kathryn E; de Moor, Janet S; Rodriguez, Juan L; Rowland, Julia H

2013-10-15

Financial problems caused by cancer and its treatment can substantially affect survivors and their families and create barriers to seeking health care. The authors identified cancer survivors diagnosed as adults (n=1556) from the nationally representative 2010 National Health Interview Survey. Using multivariable logistic regression analyses, the authors report sociodemographic, clinical, and treatment-related factors associated with perceived cancer-related financial problems and the association between financial problems and forgoing or delaying health care because of cost. Adjusted percentages using the predictive marginals method are presented. Cancer-related financial problems were reported by 31.8% (95% confidence interval, 29.3%-34.5%) of survivors. Factors found to be significantly associated with cancer-related financial problems in survivors included younger age at diagnosis, minority race/ethnicity, history of chemotherapy or radiation treatment, recurrence or multiple cancers, and shorter time from diagnosis. After adjustment for covariates, respondents who reported financial problems were more likely to report delaying (18.3% vs 7.4%) or forgoing overall medical care (13.8% vs 5.0%), prescription medications (14.2% vs 7.6%), dental care (19.8% vs 8.3%), eyeglasses (13.9% vs 5.8%), and mental health care (3.9% vs 1.6%) than their counterparts without financial problems (all P<.05). Cancer-related financial problems are not only disproportionately represented in survivors who are younger, members of a minority group, and have a higher treatment burden, but may also contribute to survivors forgoing or delaying medical care after cancer. Copyright © 2013 American Cancer Society.

Climate Leadership in the Financial Sector Webinar

EPA Pesticide Factsheets

Financial sector winners from the 2015 Climate Leadership Awards discuss best practices and challenges faced by their corporations based on their experience of attempting to reduce greenhouse gas emissions and address climate risk.

A Qualitative Study of Psychosocial Problems among Parents of Children with Cerebral Palsy Attending Two Tertiary Care Hospitals in Western India

PubMed Central

Panchal, Dhara Antani

2014-01-01

Objective. To explore the psychosocial problems faced by the parents of children with cerebral palsy (CP) in rural and urban settings. Design. Qualitative research design using focus group discussions (FGDs) was used for the study. Setting. Two FGDs comprising one at a rural tertiary level care hospital and the other at an urban tertiary level care hospital were conducted. Participants. A total of thirteen parents participated in the two FGDs. Main Outcome Measured. Psychosocial problems experienced by the parents of children suffering from CP were measured. Results. The problems experienced by the mothers were associated with common themes such as disturbed social relationships, health problems, financial problems, moments of happiness, worries about future of the child, need for more support services, and lack of adequate number of trained physiotherapists. All the parents had children with problems since birth and most had approached various health care providers for a cure for their child. Conclusions. A wide range of psychosocial problems are experienced by the parents of children with CP. Studies like this can provide valuable information for designing a family centered care programme for children with CP. PMID:24967331

The Impact of Respite Programming on Caregiver Resilience in Dementia Care: A Qualitative Examination of Family Caregiver Perspectives

PubMed Central

Roberts, Emily; Struckmeyer, Kristopher M.

2018-01-01

Family members with a relative with dementia often experience what has been called the “unexpected career of caregiver” and face multifaceted, complex, and stressful life situations that can have important consequences. This exploratory study was designed to address this major public health challenge through the lens of caregiver resilience and caregiver respite programming. While many caregivers report that they derive significant emotional and spiritual rewards from their caregiving role, many also experience physical and emotional problems directly related to the stress and demands of daily care. One way to alleviate these demands is the growing respite care field, providing services in a variety of settings for caregiver. Through qualitative analysis from face-to-face interviews with 33 family caregivers of individuals with dementia, several themes emerged describing the path to caregiver resilience which include family dynamics, isolation, financial struggles, seeking respite, and acceptance. While much research focuses on a caregiving burden perspective, the innovation of the present study is applying the resilience framework to outcomes from respite programming. PMID:29424252

Financial Education in TRIO Programs. Institutional Policy Brief

ERIC Educational Resources Information Center

Yang, Hannah; Kezar, Adrianna

2009-01-01

To address some of the financial challenges facing low-income students, federal policymakers enacted a provision in the 2008 Higher Education Opportunity Act (HEOA) that makes financial literacy a required service of all TRIO programs (or, in the case of McNair, simply makes permissible). Effective August 2008, these programs started offering…

Financial Condition and Tuition in Private Nonprofit Baccalaureate Higher Education

ERIC Educational Resources Information Center

Peruso, Dominick F., Jr.

2012-01-01

The rate of tuition inflation at U.S. colleges and universities is alarming and threatens both access and choice. Private nonprofit baccalaureate colleges often possess the highest tuition rates but routinely face financial challenges. This study was designed to better understand the relationship between tuition and financial condition for the…

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

ERIC Educational Resources Information Center

Keeble-Ramsay, Diane Rose; Armitage, Andrew

2015-01-01

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

Students with Disabilities: Financial Aid Policy Issues

ERIC Educational Resources Information Center

Wolanin, Thomas R.

2005-01-01

This article describes some of the special financial aid needs of students with disabilities and the policy implications of those needs. It focuses on the financial burdens of having a disability, the time demands faced by those with disabilities, the multiple and complex sources from which students with disabilities derive support, and the…

Construction Management Program Builds Financial Development from the Ground up

ERIC Educational Resources Information Center

Nobe, Michael D.; Shuler, Scott; Grosse, Larry

2007-01-01

Recent economic and legislative changes have hit higher education hard and threaten the financial viability of many educational programs nationwide. With state support dwindling to less than 10 percent in some cases, institutions across the nation face a financial crisis. Many strategies have been explored and implemented, from campaigns to…

Health insurance in Croatia: dynamics and politics of balancing revenues and expenditures.

PubMed

Voncina, Luka; Kehler, Jenni; Evetovits, Tamas; Bagat, Mario

2010-04-01

Since 2002, the Croatian social health insurance system has undergone substantial reforms, initiated for the most part with the aim of addressing the perpetual financial deficits of the state health insurance fund. While the reforms focussed heavily on increasing the inflow of private funds into the health care system, underlying inefficiencies contributing significantly to poor financial performance have been largely ignored. Furthermore, contrary to demographic trends and developments in social health insurance schemes in other countries, funding health care became even more dependent on its main collection mechanism-payroll tax-and consequently on the employment ratio and wage level. Little effort has been made to diversify the revenue base or to increase the efficiency of revenue collection. Like other countries, Croatia is facing difficulties in adjusting its 'Bismarck' system to its changing demographic and socioeconomic context. Instead of targetting a comprehensive effort at improving revenue collection and limitating unnecessary expenditure and system inefficiencies, simplified approaches to balance the budget have been implemented at a high price to users and with limited effect. As a result, the Croatian health insurance system now offers a lower level of financial protection, while still facing the problem of spending more than can be collected through the current mix of revenue collection mechanisms. The authors suggest that, in order to meet the sustainability requirement of the health financing system, measures affecting both revenue and expenditure should be considered and implemented. On the revenue collection side, the Croatian government must make further efforts to improve collection from the informally employed to broaden the base of contributing members; equally important is the diversification of revenue sources by increasing transfers from general taxation revenues. On the expenditure side, exploring inefficiencies of the delivery system can be delayed no longer, and the introduction of effective cost-control mechanisms and financial discipline would seem to be unavoidable.

Impacts on employment, finances, and lifestyle for working age people facing an expected premature death: A systematic review.

PubMed

Kochovska, Slavica; Luckett, Tim; Agar, Meera; Phillips, Jane L

2018-06-01

ABSTRACTObjective:The working ages (25-65 years) are a period when most people have significant work, financial, and family responsibilities. A small proportion of working age people will face an expected premature death from cancer or other life-limiting illness. Understanding the impact an expected premature death has on this population is important for informing support. The current study set out to summarize research describing the effects that facing an expected premature death has on employment, financial, and lifestyle of working age people and their families. A systematic review using narrative synthesis approach. Four electronic databases were searched in July 2016 for peer-reviewed, English language studies focusing on the financial, employment, and lifestyle concerns of working age adults living with an advanced life-limiting illness and/or their carers and/or children. Fifteen quantitative and 12 qualitative studies were included. Two-thirds (n = 18) were focused on cancer. All studies identified adverse effects on workforce participation, finances, and lifestyle. Many patients were forced to work less or give up work/retire early because of symptoms and reduced functioning. In addition to treatment costs, patients and families were also faced with child care, travel, and home/car modification costs. Being younger was associated with greater employment and financial burden, whereas having children was associated with lower functional well-being. Changes in family roles were identified as challenging regardless of diagnosis, whereas maintaining normalcy and creating stability was seen as a priority by parents with advanced cancer. This review is limited by the smaller number of studies focussing on the needs of working age people with nonmalignant disease. Working age people facing an expected premature death and their families have significant unmet financial, employment, and lifestyle needs. Comparing and contrasting their severity, timing, and priority for people with nonmalignant conditions is required to better understand their unique needs.

"Members of the same club": challenges and decisions faced by US IRBs in identifying and managing conflicts of interest.

PubMed

Klitzman, Robert

2011-01-01

Conflicts of interest (COIs) in research have received increasing attention, but many questions arise about how Institutional Review Boards (IRBs) view and approach these. I conducted in-depth interviews of 2 hours each with 46 US IRB chairs, administrators, and members, exploring COI and other issues related to research integrity. I contacted leaders of 60 IRBs (every fourth one among the top 240 institutions by NIH funding), and interviewed IRB leaders from 34 of these institutions (response rate = 55%). Data were analyzed using standard qualitative methods, informed by Grounded Theory. IRBs confront financial and non-financial COIs of PIs, institutions, and IRBs themselves. IRB members may seek to help, or compete with, principal investigators (PIs). Non-financial COI also often appear to be "indirect financial" conflicts based on gain (or loss) not to oneself, but to one's colleagues or larger institution. IRBs faced challenges identifying and managing these COI, and often felt that they could be more effective. IRBs' management of their own potential COI vary, and conflicted members may observe, participate, and/or vote in discussions. Individual IRB members frequently judge for themselves whether to recuse themselves. Challenges arise in addressing these issues, since institutions and PIs need funding, financial information is considered confidential, and COI can be unconscious. This study, the first to explore qualitatively how IRBs confront COIs and probe how IRBs confront non-financial COIs, suggests that IRBs face several types of financial and non-financial COIs, involving themselves, PIs, and institutions, and respond varyingly. These data have critical implications for practice and policy. Disclosure of indirect and non-financial COIs to subjects may not be feasible, partly since IRBs, not PIs, are conflicted. Needs exist to consider guidelines and clarifications concerning when and how, in protocol reviews, IRB members should recuse themselves from participating, observing, and/or voting.

Is your financial house in order?

PubMed

Kubik, M J

1998-01-01

In today's rapidly changing world individuals are being faced by many new issues that are challenging their ability to survive financially. It is therefore important that we recognize the need to manage our financial lives. To do that requires a commitment of time to identify assets held and determine how best to protect them, set future financial goals, and then determine how assets can be used to reach those goals.

Household financial contribution to the health System in Shiraz, Iran in 2012.

PubMed

Kavosi, Zahra; Keshtkaran, Ali; Hayati, Ramin; Ravangard, Ramin; Khammarnia, Mohammad

2014-10-01

One common challenge to social systems is achieving equity in financial contributions and preventing financial loss. Because of the large and unpredictable nature of some costs, achieving this goal in the health system presents important and unique problems. The present study investigated the Household Financial Contributions (HFCs) to the health system. The study investigated 800 households in Shiraz. The study sample size was selected using stratified sampling and cluster sampling in the urban and rural regions, respectively. The data was collected using the household section of the World Health Survey (WHS) questionnaire. Catastrophic health expenditures were calculated based on the ability of the household to pay and the reasons for the catastrophic health expenditures by a household were specified using logistic regression. The results showed that the fairness financial contribution index was 0.6 and that 14.2% of households were faced with catastrophic health expenditures. Logistic regression analysis revealed that household economic status, the basic and supplementary insurance status of the head of the household, existence of individuals in the household who require chronic medical care, use of dental and hospital care, rural location of residences, frequency of use of outpatient services, and Out-of-Pocket (OOP) payment for physician visits were effective factors for determining the likelihood of experiencing catastrophic health expenditure. It appears that the current method of health financing in Iran does not adequately protect households against catastrophic health expenditure. Consequently, it is essential to reform healthcare financing.

“We Routinely Borrow to Survive”: Exploring the Financial Capability of Income-Poor People in India.

PubMed

Banerjee, Mahasweta M

2016-10-01

A lack of financial capability—financial opportunities and abilities—and poverty are highly interlinked. Over 65 percent of people in India are excluded from any financial services. This article explores income-poor Indians’ experiences with financial capability through a qualitative study. Purposive sampling was used to collect data from 658 individuals, through focus groups (n = 566) and face-to-face interviews (n = 92). Findings show that 97 percent of respondents had the opportunity to earn an income, and 55 percent earned through financial inclusion programs, but 87 percent of respondents earned less than U.S. $2 a day. Although almost all saved and needed to borrow, 46 percent were eligible for formal savings and only 23 percent for formal loans. Financial abilities or knowledge and skills related to income, savings, and loans were higher among the few who had a stable income or had medium and high income in relation to those who had unstable and low income. Respondents experienced many challenges with their financial capabilities, including borrowing to save, fearing formal loans, and lacking clarity about loan and interest rate; banks miscalculating interest rates; and political parties influencing access to loans. Implications for social policy and social work practice are discussed.

Migration of Lebanese nurses: a questionnaire survey and secondary data analysis.

PubMed

El-Jardali, Fadi; Dumit, Nuhad; Jamal, Diana; Mouro, Gladys

2008-10-01

Nursing is becoming a mobile profession. Nurse migration is multifactorial and not limited to financial incentives. Non-economic factors that might lead to migration include poor recruitment and retention strategies, poor job satisfaction and working conditions, socio-political and economic stability, and the poor social image of the nursing profession. Lebanon is facing a problem of excessive nurse migration to countries of the Gulf, North America and Europe. No study has been conducted to understand the determinants and magnitude of the problem. The objective of this study is to provide an evidence base for understanding the incidence of nurse migration out of Lebanon, its magnitude and reasons. A cross-sectional research design comprising both quantitative and qualitative methods was employed to achieve the stated objectives. This includes a survey of nursing schools in Lebanon, survey of nurse recruitment agencies, secondary data analysis and survey of migrant nurses. An estimated one in five nurses that receive a bachelors of science in nursing migrates out of Lebanon within 1 or 2 years of graduation. The majority of nurses migrate to countries of the Gulf. The main reasons for migration included: shift work, high patient/nurse ratios, lack of autonomy in decision-making, lack of a supportive environment, and poor commitment to excellent nursing care. Further, nurses reported that combinations of financial and non-financial incentives can encourage them to return to practice in Lebanon. The most recurring incentives (pull factors) to encourage nurses to return to practice in Lebanon included educational support, managerial support, better working conditions, utilization of best nursing practices and autonomy. Nurse migration and retention have become major health workforce issues confronting many health systems in the East Mediterranean Region. Our study demonstrated that nurse migration is a product of poor management and lack of effective retention strategies and sufficient knowledge about the context, needs and challenges facing nurses. Nurse migration in Lebanon underscores the importance of developing a monitoring system that would identify implications and help implement innovative retention strategies. Nurse migration out of Lebanon is likely to persist and even increase if underlying factors are not properly resolved.

Efficient Financial Management in Rural Schools: Common Problems and Solutions from the Field. ERIC Digest.

ERIC Educational Resources Information Center

Inman-Freitas, Deborah

Based on a recent nationwide survey of rural administrators, this digest reports on the financial problems of rural school districts and some possible strategies for improvement. Rural administrators reported the following financial management problems: (1) cash flow problems due to late receipt of state aid or taxes; (2) expenditures that are…

Reflections on US health care information technology policy from a global perspective.

PubMed

Huerta, Timothy R; Ford, Eric W

2012-01-01

Health information technology (HIT) has been lauded as a foundation upon which the development of an integral solution to cost and quality problems facing many nations is predicated. Countries throughout the world have taken differing approaches in their efforts to advance that foundation through policy, financial, and cultural systems that come to support or hinder adoption. As we explore potential opportunities to learn from the experience of others, we pause to consider the environmental, regulatory, financial, and social dynamics that define the US context. This chapter outlines the framework for a comparative approach through four dimensions--environmental, regulation, financial, and social--through which comparative HIT studies should be explored. With such markedly different contexts in which their HIT is embedded, it is important to not simply look at other countries as a yardstick upon which we compare our failures and successes. Rather, we must look critically at these examples understanding that the dynamics at play in each context have created opportunities and obligations that have come to define each country's implementation. The need for a common framework through which scholars can explore comparative HIT systems, while remaining grounded in the US context is an important aspect of effective knowledge translation in adoption.

The importance of providing counselling and financial support to patients receiving treatment for multi-drug resistant TB: mixed method qualitative and pilot intervention studies.

PubMed

Baral, Sushil C; Aryal, Yeshoda; Bhattrai, Rekha; King, Rebecca; Newell, James N

2014-01-17

People with multi-drug resistant tuberculosis (MDR-TB) in low-income countries face many problems during treatment, and cure rates are low. The purpose of the study was (a) to identify and document the problems experienced by people receiving care for MDR-TB, and how they cope when support is not provided, to inform development of strategies; (b) to estimate the effectiveness of two resultant strategies, counselling alone, and joint counselling and financial support, of increasing DOTS-plus treatment success under routine programme conditions. A mixed-method study comprising a formative qualitative study, pilot intervention study and explanatory qualitative study to better understand barriers to completion of treatment for MDR-TB. Participants were all people starting MDR-TB treatment in seven DOTS-plus centres in the Kathmandu Valley, Nepal during January to December 2008. The primary outcome measure was cure, as internationally defined. MDR-TB treatment caused extreme social, financial and employment hardship. Most patients had to move house and leave their job, and reported major stigmatisation. They were concerned about the long-term effects of their disease, and feared infecting others. In the resultant pilot intervention study, the two strategies appeared to improve treatment outcomes: cure rates for those receiving counselling, combined support and no support were 85%, 76% and 67% respectively. Compared with no support, the (adjusted) risk ratios of cure for those receiving counselling and receiving combined support were 1.2 (95% CI 1.0 to 1.6) and 1.2 (95% CI 0.9 to 1.6) respectively. The explanatory study demonstrated that patients valued both forms of support. MDR-TB patients are extremely vulnerable to stigma and extreme financial hardship. Provision of counselling and financial support may not only reduce their vulnerability, but also increase cure rates. National Tuberculosis Programmes should consider incorporating financial support and counselling into MDR-TB care: costs are low, and benefits high, especially since costs to society of incomplete treatment and potential for incurable TB are extremely high.

Exploring the impact of financial barriers on secondary prevention of heart disease.

PubMed

Dhaliwal, Kirnvir K; King-Shier, Kathryn; Manns, Braden J; Hemmelgarn, Brenda R; Stone, James A; Campbell, David J T

2017-02-14

Patients with coronary artery disease experience various barriers which impact their ability to optimally manage their condition. Financial barriers may result in cost related non-adherence to medical therapies and recommendations, impacting patient health outcomes. Patient experiences regarding financial barriers remain poorly understood. Therefore, we used qualitative methods to explore the experience of financial barriers to care among patients with heart disease. We conducted a qualitative descriptive study of participants in Alberta, Canada with heart disease (n = 13) who perceived financial barriers to care. We collected data using semi-structured face-to-face or telephone interviews inquiring about patients experience of financial barriers and the strategies used to cope with such barriers. Multiple analysts performed inductive thematic analysis and findings were bolstered by member checking. The aspects of care to which participants perceived financial barriers included access to: medications, cardiac rehabilitation and exercise, psychological support, transportation and parking. Some participants demonstrated the ability to successfully self-advocate in order to effectively navigate within the healthcare and social service systems. Financial barriers impacted patients' ability to self-manage their cardiovascular disease. Financial barriers contributed to non-adherence to essential medical therapies and health recommendations, which may lead to adverse patient outcomes. Given that it is such a key skill, enhancing patients' self-advocacy and navigation skills may assist in improving patient health outcomes.

Manifesto for a healthy and health-creating society.

PubMed

Crisp, Nigel; Stuckler, David; Horton, Richard; Adebowale, Victor; Bailey, Sue; Baker, Maureen; Bell, John; Bird, John; Black, Carol; Campbell, Jane; Davies, Janet; Henry, Heather; Lechler, Robert; Mawson, Andrew; Maxwell, Patrick H; McKee, Martin; Warwick, Cathy

2016-12-10

Brexit and the troubled state of the NHS call for re-thinking the UK's approach to health. The EU referendum vote reveals deep social divisions as well as presenting the country with important decisions and negotiations about the future. At the same time, health problems are growing; the NHS faces severe financial constraints and appears to lurch from crisis to crisis, with leaving the European Union likely to exacerbate many problems including staffing issues across the whole sector. However, new scientific developments and digital technology offer societies everywhere massive and unprecedented opportunities for improving health. It is vital for the country that the NHS is able to adopt these discoveries and see them translated into improved patient care and population health, but also that the UK benefits from its capabilities and strengths in these areas. Copyright © 2016 Elsevier Ltd. All rights reserved.

75 FR 36506 - Final Rule Regarding Amendment of the Temporary Liquidity Guarantee Program To Extend the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-28

... percent or more of their assets. II. Interim Rule While the immediate financial crisis that led to the... facing community banks have intensified as the lingering consequences of the 2008 financial crisis and... financial crisis and recession are expected to persist for some time, especially as the magnitude of...

Education in Neurology Resident Documentation Using Payroll Simulation

PubMed Central

Liang, John W.

2017-01-01

Background Approaches for teaching neurology documentation include didactic lectures, workshops, and face-to-face meetings. Few studies have assessed their effectiveness. Objective To improve the quality of neurology resident documentation through payroll simulation. Methods A documentation checklist was created based on Medicaid and Medicare evaluation and management (E/M) guidelines. In the preintervention phase, neurology follow-up clinic charts were reviewed over a 16-week period by evaluators blinded to the notes' authors. Current E/M level, ideal E/M level, and financial loss were calculated by the evaluators. Ideal E/M level was defined as the highest billable level based on the documented problems, alongside a supporting history and examination. We implemented an educational intervention that consisted of a 1-hour didactic lecture, followed by e-mail feedback “paystubs” every 2 weeks detailing the number of patients seen, income generated, income loss, and areas for improvement. Follow-up charts were assessed in a similar fashion over a 16-week postintervention period. Results Ten of 11 residents (91%) participated. Of 214 charts that were reviewed preintervention, 114 (53%) had insufficient documentation to support the ideal E/M level, leading to a financial loss of 24% ($5,800). Inadequate documentation was seen in all 3 components: history (47%), examination (27%), and medical decision making (37%). Underdocumentation did not differ across residency years. Postintervention, underdocumentation was reduced to 14% of 273 visits (P < .001), with a reduction in the financial loss to 6% ($1,880). Conclusions Improved documentation and increased potential reimbursement was attained following a didactic lecture and a 16-week period in which individual, specific feedback to neurology residents was provided. PMID:28439359

Implications of economic transition and demographics for financing pensions in the former socialist economies.

PubMed

Jenkins, G P

1993-01-01

"This paper is concerned primarily with the financing of pensions, or the old-age income maintenance portion of the social security system. While the discussion here will be limited to Hungary and Poland, most of the post-socialist countries of East and Central Europe and of the former Soviet Union face similar problems." The author suggests "a set of alternative pension financing strategies....A novel approach is to replace the payroll tax with part of a value-added tax, which may be a good short run solution to current financial crises of the pension systems in these countries." excerpt

Effects of Large Financial Incentives for Long-Term Smoking Cessation: A Randomized Trial.

PubMed

Etter, Jean-François; Schmid, Felicia

2016-08-23

It is not known whether large financial incentives enhance long-term smoking cessation rates outside clinical or workplace settings. The goal of this study was to test whether large financial incentives improved long-term smoking cessation rates in low-income smokers, in a general population setting, without face-to-face or telephone counseling. This was a 2-arm, parallel group, individually randomized controlled trial, with follow-up after 3, 6, and 18 months. Participants were 805 low-income smokers enrolled between 2011 and 2013 from the general population in Geneva, Switzerland. We randomly assigned participants to receive either booklets plus access to a smoking cessation website (control group, n = 404), or the same intervention plus financial incentives (intervention group, n = 401). Incremental financial rewards, to a maximum of U.S. $1,650, were offered for biochemically verified abstinence at 1, 2, and 3 weeks, and 1, 3, and 6 months. No in-person counseling, telephone counseling, or medications were provided. The primary outcome was continuous abstinence between 6 months (end of incentives) and 18 months (12 months after the incentives ended), verified by expired carbon monoxide and salivary cotinine. We also assessed biochemically verified 7-day abstinence at 3, 6, and 18 months. Rates of continuous abstinence between months 6 and 18 were 9.5% in the incentive group and 3.7% in the control group (p = 0.001). Rates of 7-day abstinence were higher in the incentive group than in the control group at 3 (54.9% vs. 11.9%; p < 0.001), 6 (44.6% vs. 11.1%; p < 0.001), and 18 months (18.2% vs. 11.4%; p = 0.006). In low-income smokers who did not receive face-to-face or telephone smoking cessation counseling, large financial incentives increased long-term rates of smoking cessation. (Financial incentives for smoking cessation in low-income smokers; ISRCTN04019434). Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Health sector reform in the Occupied Palestinian Territories (OPT): targeting the forest or the trees?

PubMed Central

GIACAMAN, RITA; ABDUL-RAHIM, HANAN F; WICK, LAURA

2006-01-01

Since the signing of the Oslo Peace Accords and the establishment of the Palestinian Authority in 1994, reform activities have targeted various spheres, including the health sector. Several international aid and UN organizations have been involved, as well as local and international non-governmental organizations, with considerable financial and technical investments. Although important achievements have been made, it is not evident that the quality of care has improved or that the most pressing health needs have been addressed, even before the second Palestinian Uprising that began in September 2000. The crisis of the Israeli re-invasion of Palestinian-controlled towns and villages since April 2002 and the attendant collapse of state structures and services have raised the problems to critical levels. This paper attempts to analyze some of the obstacles that have faced reform efforts. In our assessment, those include: ongoing conflict, frail Palestinian quasi-state structures and institutions, multiple and at times inappropriate donor policies and practices in the health sector, and a policy vacuum characterized by the absence of internal Palestinian debate on the type and direction of reform the country needs to take. In the face of all these considerations, it is important that reform efforts be flexible and consider realistically the political and economic contexts of the health system, rather than focus on mere narrow technical, managerial and financial solutions imported from the outside. PMID:12582108

Financial Stress, Parental Depressive Symptoms, Parenting Practices, and Children's Externalizing Problem Behaviors: Underlying Processes

ERIC Educational Resources Information Center

Lee, Chih-Yuan Steven; Lee, Jaerim; August, Gerald J.

2011-01-01

This study examined the relationships among financial stress encountered by families, parents' social support, parental depressive symptoms, parenting practices, and children's externalizing problem behaviors to advance our understanding of the processes by which family financial stress is associated with children's problem behaviors. We also…

Individual versus systemic risk and the Regulator's Dilemma

PubMed Central

Beale, Nicholas; Rand, David G.; Battey, Heather; Croxson, Karen; May, Robert M.; Nowak, Martin A.

2011-01-01

The global financial crisis of 2007–2009 exposed critical weaknesses in the financial system. Many proposals for financial reform address the need for systemic regulation—that is, regulation focused on the soundness of the whole financial system and not just that of individual institutions. In this paper, we study one particular problem faced by a systemic regulator: the tension between the distribution of assets that individual banks would like to hold and the distribution across banks that best supports system stability if greater weight is given to avoiding multiple bank failures. By diversifying its risks, a bank lowers its own probability of failure. However, if many banks diversify their risks in similar ways, then the probability of multiple failures can increase. As more banks fail simultaneously, the economic disruption tends to increase disproportionately. We show that, in model systems, the expected systemic cost of multiple failures can be largely explained by two global parameters of risk exposure and diversity, which can be assessed in terms of the risk exposures of individual actors. This observation hints at the possibility of regulatory intervention to promote systemic stability by incentivizing a more diverse diversification among banks. Such intervention offers the prospect of an additional lever in the armory of regulators, potentially allowing some combination of improved system stability and reduced need for additional capital. PMID:21768387

An exploratory study of illegal gamblers in Hong Kong.

PubMed

Tessler, Andrew; El Beyrouty, Kareen; Crapnell, Natasha

2017-01-01

This study investigates the nature and behaviour of illegal gamblers in Hong Kong. A face-to-face street survey of 512 gamblers was conducted in Hong Kong between September and December 2015 with supplementary convenience sampling allowing for analysis of a total sample of 103 illegal gamblers. 56% of illegal gamblers recorded results consistent with this study's definition of 'excessive gambling' [i.e. moderate risk and problem gamblers under the Problem Gambling Severity Index (PGSI)]. 81% of surveyed illegal gamblers were male, 77% were aged between 30 and 49 and 67% were in blue collar occupations. Illegal gamblers bet more frequently on both legal and illegal games than their legal counterparts and spent more when they did bet. While this research did not indicate the direction of causality between illegal and excessive gambling, international work (de Bruin et al. in verslingerd aan meer dan een spel: Een onderzoek naar de aard en omvang van kansspelproblematiek in Nederland, WODC/CVO, Utrecht, http://www.lexandgaming.eu/nl/wp-content/uploads/2015/01/Verslingerd-aan-meer-dan-een-spel.pdf, 2005; Binde in What are the most harmful forms of gambling? Analysing problem gambling prevalence surveys, http://www.utbildning.gu.se/digitalAssets/1327/1327132_cefos-wp12.pdf, 2011) suggests that excessive gamblers are drawn to illegal gambling. Reform could allow excessive gambling by illegal gamblers to be better addressed and initial work suggests some financial benefits to Hong Kong.

New media, old media: The technologies of international development

NASA Astrophysics Data System (ADS)

Ingle, Henry T.

1986-09-01

The research, theory and practice of educational technology over the past 75 years provide convincing evidence that this process offers a comprehensive and integrated approach to solving educational and social problems. The use of media and technology in development has shifted from an emphasis on mass media to personal media. A variety of electronic delivery systems are being used and are usually coordinated by centralized governmental agencies. There are no patterns of use since the problems vary and the medium used is responsive to the problem. Computers are used most frequently and satellite telecommunication networks follow. The effective use of these and other technologies requires a long-term commitment to financial support and training of personnel. The extension model of face-to-face contact still prevails in developing nations whether in agriculture, education or rural development. Low-cost technologies are being used in local projects while major regional and national companies use radio, film and related video technologies. The use of all available and cost-effective media and technologies make possible appropriate communications for specific goals with specific audiences. There appears to be no conflict among proponents of various media formats. Development in education and other sectors has much to gain from old and new communication technologies and has hardly been tapped. Several new educational technology developments are discussed as potential contributors to formal and nonformal education.

24 CFR 886.101 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-04-01

... potentially serious financial problems which, on the basis of financial and/or management analysis, appear to... potentially serious financial difficulties. A first priority should be given to projects with presently serious financial problems, which are likely to result in a claim on the insurance fund in the near future...

24 CFR 886.101 - Applicability.

Code of Federal Regulations, 2011 CFR

2011-04-01

... potentially serious financial problems which, on the basis of financial and/or management analysis, appear to... potentially serious financial difficulties. A first priority should be given to projects with presently serious financial problems, which are likely to result in a claim on the insurance fund in the near future...

A face only an investor could love: CEOs' facial structure predicts their firms' financial performance.

PubMed

Wong, Elaine M; Ormiston, Margaret E; Haselhuhn, Michael P

2011-12-01

Researchers have theorized that innate personal traits are related to leadership success. Although links between psychological characteristics and leadership success have been well established, research has yet to identify any objective physical traits of leaders that predict organizational performance. In the research reported here, we identified leaders' facial structure as a specific physical trait that correlates with organizational performance. Specifically, we found that firms whose male CEOs have wider faces (relative to facial height) achieve superior financial performance. Decision-making dynamics within a firm's leadership team moderate this effect, such that the relationship between a given CEO's facial measurements and his firm's financial performance is stronger in firms with cognitively simple leadership teams.

Entrepreneurship and state/mental health center relationships.

PubMed

McLaughlin, C P; Zelman, W N

1987-01-01

An effective Community Mental Health Center (CMHC) program in entrepreneurship--the provision of services in the marketplace at a profit to subsidize other programs--requires the support and encouragement of the state-level mental health authority. This paper discusses potential financial, programmatic, political, and managerial risks and rewards to CMHCs and to state authorities from such efforts. As each party faces certain risks as well as rewards from such efforts, it is important that they participate in a process of mutual risk reduction involving: Documenting and legitimizing the entrepreneurship program; Separating funding for seed monies and working capital for ventures, Restructuring the Centers' finances and/or corporate structure to reduce the problems of funds diversion and comingling, Negotiating in advance how the proceeds of the ventures will be used to benefit programs, and Providing technical assistance to enhance the probabilities of success in such ventures. For these steps to work the state authorities must be willing to give up some financial and programmatic control to motivate entrepreneurship on the part of CMHCs.

Unmarried women’s ways of facing single motherhood in Sri Lanka – a qualitative interview study

PubMed Central

2013-01-01

Background In Sri Lanka, motherhood within marriage is highly valued. Sex out of wedlock is socially unacceptable and can create serious public health problems such as illegal abortions, suicide and infanticide, and single motherhood as a result of premarital sex is considered shameful. The way unmarried women facing single motherhood reflect on and make use of their agency in their social environments characterised by limited social and financial support has consequences for the health and well-being of both themselves and their children. The aim of this study was to explore and describe how unmarried women facing single motherhood in Sri Lanka handle their situation. Methods This qualitative study comprised semi-structured interviews with 28 unmarried pregnant women or single mothers. The data were analysed by qualitative content analysis and the results related to the conceptual framework of social navigation. Results The women facing single motherhood expressed awareness of having trespassed norms of sexuality through self-blame, victimhood and obedience, and by considering or attempting suicide. They demonstrated willingness to take responsibility for becoming pregnant before marriage by giving the child up for adoption, bringing up the child themselves, claiming a father for their child, refraining from marriage in the future, permanently leave their home environment, and taking up employment. Throughout the interviews, the women expressed fear of shame, and striving for familial and societal acceptance and financial survival. Conclusions A social environment highly condemning of unmarried motherhood hindered these women from making strategic choices on how to handle their situation. However, to achieve acceptance and survival, the women tactically navigated norms of femininity, strong family dependence, a limited work market, and different sources of support. Limited access to resources restricted the women’s sexual and reproductive health and rights, including their ability to make acceptable and healthy choices for themselves and their children. PMID:23388103

Impact of Drug Shortages on Health System Pharmacies in the Southeastern United States

PubMed Central

Mehta, Brenna; Bookstaver, P. Brandon; Sims, LaVetra D.; Stevenson, Bill

2015-01-01

Background: Drug shortages have become all too common and affect all aspects of the health care delivery system. The increased number of drug shortages has had a negative impact on patient care as well as costly financial implications. Objectives: This article identifies the current problems and negative outcomes drug shortages have caused and provides a framework for how to best prepare for and combat future shortages. It highlights specific problems faced by health care system pharmacies in the Southeastern United States and the managerial responses to address these shortage situations. Methods: A 34-question, multiple-choice survey was distributed to pharmacy directors in North Carolina, South Carolina, Georgia, and Florida. Results: Of 549 surveys distributed, 219 (40%) responses were received. Respondents reported that drug shortages cause 1% to 5% error rates in hospitals and that 60% of the time drug shortages create unsafe conditions for patients and staff. Many of the respondents reported a 300% to 500% markup on medications on the shortage list. Seventy-six percent of institutions have autosubstitutions for drug shortages that have been preapproved by Pharmacy & Therapeutics Committees. Conclusions: The causes of drug shortages are multifaceted, and the safety and financial implications can be costly. In the short term, health care institutions can utilize pharmacists to assist in circumventing the drug shortage problem. The combined efforts of all health care professionals, the US government, manufacturers, and the lay public are necessary to bring awareness and plausible solutions to the drug shortage problems in the long term. PMID:26448658

Socially disadvantaged parents of children treated with allogeneic haematopoietic stem cell transplantation (HSCT): report from a supportive intervention study, Denmark.

PubMed

Larsen, Hanne Bækgaard; Heilmann, Carsten; Johansen, Christoffer; Adamsen, Lis

2013-06-01

This study was undertaken to test a daily Family Navigator Nurse (FNN) conducted intervention program, to support parents during the distressful experience of their child's Allogeneic Haematopoietic Stem Cell Transplantation (HSCT). A qualitative analysis of the supportive intervention program for parents whose child is under HSCT treatment while hospitalized. Parents to 25 children were included in the intervention group. Twenty-five parents were included in a participant observational study and 21 of these completed a semi-structured interview 100 days following HSCT. Three main problems faced by all parents included 1) the emotional strain of the child's HSCT; 2) re-organizing of the family's daily life to include hospitalization with the child; and 3) the financial strain of manoeuvring within the Danish welfare system. The FNN performed daily intervention rounds to ease each of these problems during the study period. Having the following pre-existing risk factors, negatively influenced the parents' ability to address these problems: 1) being a single parents; 2) low-level income; 3) low-level education; 4) low-level network support: 5) being a student or unemployed; 6) physical/psychiatric illness; and 7) ethnicity. Six families with 4 or more risk factors had complex emotional, social and financial problems that required extensive intervention by the FNN and that impacted their ability to provide care for the child. The parents' pre-existing risk factors were further complicated by their children's HSCT. A recommendation for clinical practice is to identify families with multiple interrelated problems and allocate resources to support these families. Copyright © 2012 Elsevier Ltd. All rights reserved.

Addressing the Economic Security Issues Facing Same-Sex Couples.

ERIC Educational Resources Information Center

Dolan, Elizabeth M.; Stum, Marlene S.; Rupured, Michael

1999-01-01

Provides educators and researchers with an awareness of the financial security issues faced by same-sex couples and offers suggestions for incorporating the discussion of these ideas into existing curricula and research. (Author/JOW)

“Members of the Same Club”: Challenges and Decisions Faced by US IRBs in Identifying and Managing Conflicts of Interest

PubMed Central

Klitzman, Robert

2011-01-01

Conflicts of interest (COIs) in research have received increasing attention, but many questions arise about how Institutional Review Boards (IRBs) view and approach these. Methods I conducted in-depth interviews of 2 hours each with 46 US IRB chairs, administrators, and members, exploring COI and other issues related to research integrity. I contacted leaders of 60 IRBs (every fourth one among the top 240 institutions by NIH funding), and interviewed IRB leaders from 34 of these institutions (response rate = 55%). Data were analyzed using standard qualitative methods, informed by Grounded Theory. Results IRBs confront financial and non-financial COIs of PIs, institutions, and IRBs themselves. IRB members may seek to help, or compete with, principal investigators (PIs). Non-financial COI also often appear to be “indirect financial” conflicts based on gain (or loss) not to oneself, but to one's colleagues or larger institution. IRBs faced challenges identifying and managing these COI, and often felt that they could be more effective. IRBs' management of their own potential COI vary, and conflicted members may observe, participate, and/or vote in discussions. Individual IRB members frequently judge for themselves whether to recuse themselves. Challenges arise in addressing these issues, since institutions and PIs need funding, financial information is considered confidential, and COI can be unconscious. Conclusions This study, the first to explore qualitatively how IRBs confront COIs and probe how IRBs confront non-financial COIs, suggests that IRBs face several types of financial and non-financial COIs, involving themselves, PIs, and institutions, and respond varyingly. These data have critical implications for practice and policy. Disclosure of indirect and non-financial COIs to subjects may not be feasible, partly since IRBs, not PIs, are conflicted. Needs exist to consider guidelines and clarifications concerning when and how, in protocol reviews, IRB members should recuse themselves from participating, observing, and/or voting. PMID:21829516

A Financial Condition Indicator System for School Districts: A Case Study of New York

ERIC Educational Resources Information Center

Ammar, Salwa; Duncombe, William; Jump, Bernard; Wright, Ronald

2005-01-01

State governments are in the midst of one of the most severe fiscal crises of the last half century. The magnitude of the fiscal challenges facing state and local governments highlights the importance of sound fiscal planning and access to key financial indicators. The objective of this article is to develop a financial condition indicator system…

The effects of multi-disciplinary psycho-social care on socio-economic problems in cancer patients: a cluster-randomized trial.

PubMed

Singer, Susanne; Roick, Julia; Meixensberger, Jürgen; Schiefke, Franziska; Briest, Susanne; Dietz, Andreas; Papsdorf, Kirsten; Mössner, Joachim; Berg, Thomas; Stolzenburg, Jens-Uwe; Niederwieser, Dietger; Keller, Annette; Kersting, Anette; Danker, Helge

2018-06-01

We examined whether multi-disciplinary stepped psycho-social care decreases financial problems and improves return-to-work in cancer patients. In a university hospital, wards were randomly allocated to either stepped or standard care. Stepped care comprised screening for financial problems, consultation between doctor and patient, and the provision of social service. Outcomes were financial problems at the time of discharge and return-to-work in patients < 65 years old half a year after baseline. The analysis employed mixed-effect multivariate regression modeling. Thirteen wards were randomized and 1012 patients participated (n = 570 in stepped care and n = 442 in standard care). Those who reported financial problems at baseline were less likely to have financial problems at discharge when they had received stepped care (odds ratio (OR) 0.2, 95% confidence interval (CI) 0.1, 0.7; p = 0.01). There was no evidence for an effect of stepped care on financial problems in patients without such problems at baseline (OR 1.1, CI 0.5, 2.6; p = 0.82). There were 399 patients < 65 years old who were not retired at baseline. In this group, there was no evidence for an effect of stepped care on being employed half a year after baseline (OR 0.7, CI 0.3, 2.0; p = 0.52). NCT01859429 CONCLUSIONS: Financial problems can be avoided more effectively with multi-disciplinary stepped psycho-social care than with standard care in patients who have such problems.

Capital management helps hospitals face hard times.

PubMed

Harris, J; Pitts, K

1989-03-01

Financial officers of healthcare organizations in severe financial distress must map out an effective capital management strategy to help their institutions avoid disaster. An executive's plan of action should include streamlining and restructuring the organization, studying long- and short-term assets to improve cash flow, and investigating ways to refinance debt. Healthcare organizations must develop warning signals for impending financial difficulties and contingency plans that address operating and capital responses to such a crisis. Learning to guide an organization through financial difficulties may be an executive's most important financial skill in the decade to come.

An empirical research on evaluating banks' credit assessment of corporate customers.

PubMed

Tsai, Sang-Bing; Li, Guodong; Wu, Chia-Huei; Zheng, Yuxiang; Wang, Jiangtao

2016-01-01

Under the rapid change of the global financial environment, the risk control of the credit granting is viewed as the foremost task to each bank. With the impact one by one from financial crisis and European debt crisis, the steady bank business is also facing the severe challenge. Banks approve the credits for their customers and then make money from the interest. Credit granting is not only the primary job but also the main source of income. The quality of credit granting concerns not just the reclaims of creditor's rights; it also affects the successful running of banks. To enhance the reliability and usefulness of bank credit risk assessment, we first will delve in the facets and indexes in the bank credit risk assessment. Then, we will examine the different dimensions of cause-effect relationships and correlations in the assessment process. Finally, the study focuses on how to raise the functions and benefits of the bank credit risk assessment. In those five credit risk evaluation dimensions, A "optional capability" and D "competitiveness" are of high relation and high prominence among those dimensions, influencing other items obviously. By actively focusing on these two dimensions and improving their credit risk assessment ability will solve the foremost problems and also solve other facets of credit risk assessment problems at the same time.

How much is new information worth? Evaluating the financial benefit of resolving management uncertainty

USGS Publications Warehouse

Maxwell, Sean L.; Rhodes, Jonathan R.; Runge, Michael C.; Possingham, Hugh P.; Ng, Chooi Fei; McDonald Madden, Eve

2015-01-01

Conservation decision-makers face a trade-off between spending limited funds on direct management action, or gaining new information in an attempt to improve management performance in the future. Value-of-information analysis can help to resolve this trade-off by evaluating how much management performance could improve if new information was gained. Value-of-information analysis has been used extensively in other disciplines, but there are only a few examples where it has informed conservation planning, none of which have used it to evaluate the financial value of gaining new information. We address this gap by applying value-of-information analysis to the management of a declining koala Phascolarctos cinereuspopulation. Decision-makers responsible for managing this population face uncertainty about survival and fecundity rates, and how habitat cover affects mortality threats. The value of gaining new information about these uncertainties was calculated using a deterministic matrix model of the koala population to find the expected population growth rate if koala mortality threats were optimally managed under alternative model hypotheses, which represented the uncertainties faced by koala managers. Gaining new information about survival and fecundity rates and the effect of habitat cover on mortality threats will do little to improve koala management. Across a range of management budgets, no more than 1·7% of the budget should be spent on resolving these uncertainties. The value of information was low because optimal management decisions were not sensitive to the uncertainties we considered. Decisions were instead driven by a substantial difference in the cost efficiency of management actions. The value of information was up to forty times higher when the cost efficiencies of different koala management actions were similar. Synthesis and applications. This study evaluates the ecological and financial benefits of gaining new information to inform a conservation problem. We also theoretically demonstrate that the value of reducing uncertainty is highest when it is not clear which management action is the most cost efficient. This study will help expand the use of value-of-information analyses in conservation by providing a cost efficiency metric by which to evaluate research or monitoring.

Inequalities in financial risk protection in Bangladesh: an assessment of universal health coverage.

PubMed

Islam, Md Rashedul; Rahman, Md Shafiur; Islam, Zobida; Nurs, Cherri Zhang B; Sultana, Papia; Rahman, Md Mizanur

2017-04-04

Financial risk protection and equity are major components of universal health coverage (UHC), which is defined as ensuring access to health services for all citizens without any undue financial burden. We investigated progress towards UHC financial risk indicators and assessed variability of inequalities in financial risk protection indicators by wealth quintile. We further examined the determinants of different financial hardship indicators related to healthcare costs. A cross-sectional, three-stage probability survey was conducted in Bangladesh, which collected information from 1600 households from August to November 2011. Catastrophic health payments, impoverishment, and distress financing (borrowing or selling assets) were treated as financial hardship indicators in UHC. Poisson regression models were used to identify the determinants of catastrophic payment, impoverishment and distress financing separately. Slope, relative and concentration indices of inequalities were used to assess wealth-based inequalities in financial hardship indicators. The study found that around 9% of households incurred catastrophic payments, 7% faced distress financing, and 6% experienced impoverishing health payments in Bangladesh. Slope index of inequality indicated that the incidence of catastrophic health payment and distress financing among the richest households were 12 and 9 percentage points lower than the poorest households respectively. Multivariable Poisson regression models revealed that all UHC financial hardship indicators were significantly higher among household that had members who received inpatient care or were in the poorest quintile. The presence of a member with chronic illness in a household increased the risk of impoverishment by nearly double. This study identified a greater inequality in UHC financial hardship indicators. Rich households in Bangladesh were facing disproportionately less financial hardship than the poor ones. Households can be protected from financial hardship associated with healthcare costs by implementing risk pooling mechanism, increasing GDP spending on health, and properly monitoring subsidized programs in public health facilities.

78 FR 52285 - Clearing Exemption for Certain Swaps Entered Into by Cooperatives

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-22

... for their members. In this role, the cooperatives, in effect, face the financial markets as... not need a cooperative to face the market. The ICBA also commented that all of the component entities...

Challenges for health care development in Croatia.

PubMed

Ostojić, Rajko; Bilas, Vlatka; Franc, Sanja

2012-09-01

The main aim of the research done in this paper was to establish key challenges and perspectives for health care development in the Republic of Croatia in the next two decades. Empirical research was conducted in the form of semi-structured interviews involving 49 subjects, representatives of health care professionals from both, public and private sectors, health insurance companies, pharmaceutical companies, drug wholesalers, and non-governmental organisations (patient associations). The results have shown that key challenges and problems of Croatian health care can be divided into three groups: functioning of health care systems, health care personnel, and external factors. Research has shown that key challenges related to the functioning of health care are inefficiency, financial unviability, inadequate infrastructure, and the lack of system transparency. Poor governance is another limiting factor. With regard to health care personnel, they face the problems of low salaries, which then lead to migration challenges and a potential shortage of health care personnel. The following external factors are deemed to be among the most significant challenges: ageing population, bad living habits, and an increase in the number of chronic diseases. However, problems caused by the global financial crisis and consequential macroeconomic situation must not be neglected. Guidelines for responding to challenges identified in this research are the backbone for developing a strategy for health care development in the Republic of Croatia. Long-term vision, strategy, policies, and a regulatory framework are all necessary preconditions for an efficient health care system and more quality health services.

"It's at a time in your life when you are most vulnerable": a qualitative exploration of the financial impact of a cancer diagnosis and implications for financial protection in health.

PubMed

Timmons, Aileen; Gooberman-Hill, Rachael; Sharp, Linda

2013-01-01

Although cancer patients may incur a wide range of cancer-related out-of-pocket costs and experience reduced income, the consequences of this financial burden are poorly understood. We investigated: financial adjustments needed to cope with the cancer-related financial burden; financial distress (defined as a reaction to the state of personal finances); and factors that increase risk of financial difficulties. Two sets of semi-structured face-to-face interviews were conducted with 20 patients with breast, lung and prostate cancer and 21 hospital-based oncology social workers (OSWs) in Ireland, which has a mixed public-private healthcare system. Participants were asked about: strategies to cope with the cancer-related financial burden; the impact of the financial burden on the family budget, other aspects of daily life, and wellbeing. OSWs were also asked about patient groups they thought were more likely to experience financial difficulties. The two interview sets were analysed separately using a thematic approach. Financial adjustments included: using savings; borrowing money; relying on family and friends for direct and indirect financial help; and cutting back on household spending. Financial distress was common. Financial difficulties were more likely for patients who were older or younger, working at diagnosis, lacked social support, had dependent children, had low income or had few savings. These issues often interacted with one another. As has been seen in predominantly publically and predominantly privately-funded healthcare settings, a complex mixed public-private healthcare system does not always provide adequate financial protection post-cancer. Our findings highlight the need for a broader set of metrics to measure the financial impact of cancer (and to assess financial protection in health more generally); these should include: out-of-pocket direct medical and non-medical costs; changes in income; financial adjustments (including financial coping strategies and household consumption patterns); and financial distress. In the interim, cancer patients require financial information and advice intermittently post diagnosis.

Finding resiliency in the face of financial barriers: Development of a conceptual framework for people with cardiovascular-related chronic disease.

PubMed

Campbell, David J T; Manns, Braden J; Leblanc, Pamela; Hemmelgarn, Brenda R; Sanmartin, Claudia; King-Shier, Kathryn

2016-12-01

Patients with chronic diseases often face financial barriers to optimize their health. These financial barriers may be related to direct healthcare costs such as medications or self-monitoring supplies, or indirect costs such as transportation to medical appointments. No known framework exists to understand how financial barriers impact patients' lives or their health outcomes.We undertook a grounded theory study to develop such a framework. We used semistructured interviews with a purposive sample of participants with cardiovascular-related chronic disease (hypertension, diabetes, heart disease, or stroke) from Alberta, Canada. Interview transcripts were analyzed in triplicate, and interviews continued until saturation was reached.We interviewed 34 participants. We found that the confluence of 2 events contributed to the perception of having a financial barrier-onset of chronic disease and lack of income or health benefits. The impact of having a perceived financial barrier varied considerably. Protective, predisposing, or modifying of factors determined how impactful a financial barrier would be. An individual's particular set of factors is then shaped by their worldview. This combination of factors and lens determines one's degree of resiliency, which ultimately impacts how well they cope with their disease.The role of financial barriers is complex. How well an individual copes with their financial barriers is intimately tied to resiliency, which is related to the composite of a personal circumstances and their worldview. Our framework for understanding the experience of financial barriers can be used by both researchers and clinicians to better understand patient behavior.

Impact of financial burden of cancer on survivors' quality of life.

PubMed

Fenn, Kathleen M; Evans, Suzanne B; McCorkle, Ruth; DiGiovanna, Michael P; Pusztai, Lajos; Sanft, Tara; Hofstatter, Erin W; Killelea, Brigid K; Knobf, M Tish; Lannin, Donald R; Abu-Khalaf, Maysa; Horowitz, Nina R; Chagpar, Anees B

2014-09-01

Little is known about the relationship between the financial burden of cancer and the physical and emotional health of cancer survivors. We examined the association between financial problems caused by cancer and reported quality of life in a population-based sample of patients with cancer. Data from the 2010 National Health Interview Survey (NHIS) were analyzed. A multivariable regression model was used to examine the relationship between the degree to which cancer caused financial problems and the patients' reported quality of life. Of 2,108 patients who answered the survey question, "To what degree has cancer caused financial problems for you and your family?," 8.6% reported "a lot," whereas 69.6% reported "not at all." Patients who reported "a lot" of financial problems as a result of cancer care costs were more likely to rate their physical health (18.6% v 4.3%, P < .001), mental health (8.3% v 1.8%, P < .001), and satisfaction with social activities and relationships (11.8% v 3.6%, P < .001) as poor compared to those with no financial hardship. On multivariable analysis controlling for all of the significant covariates on bivariate analysis, the degree to which cancer caused financial problems was the strongest independent predictor of quality of life. Patients who reported that cancer caused "a lot" of financial problems were four times less likely to rate their quality of life as "excellent," "very good," or "good" (odds ratio = 0.24; 95% CI, 0.14 to 0.40; P < .001). Increased financial burden asa result of cancer care costs is the strongest independent predictor of poor quality of life among cancer survivors. Copyright © 2014 by American Society of Clinical Oncology.

Financial Issues Experienced by Students in Private Higher Education Institutions

ERIC Educational Resources Information Center

Alkandari, Nabila Y.

2014-01-01

The study was conducted in order to understand the way in which the financial status of students in Kuwait is affected as a result of enrolling in private higher education institutions. The aim is to analyze whether they face financial issues upon the time of payment and how these issues can be resolved. The analysis was done on a sample of 1280…

Early & Often: Designing a Comprehensive System of Financial Aid Information. Abridged Report of the Advisory Committee on Student Financial Assistance

ERIC Educational Resources Information Center

Advisory Committee on Student Financial Assistance, 2008

2008-01-01

Students and parents need ample time and accurate information to prepare for the financial burden of a college education--those who lack this knowledge base face a significant access barrier to higher education. The early intervention community is calling for a method of delivering age-appropriate information in a timely manner as one means of…

7 CFR Appendix I to Subpart E of... - Instructions for Loan Guarantees for Drought and Disaster Relief

Code of Federal Regulations, 2010 CFR

2010-01-01

... financial obligations in a timely fashion. In addition, D&D loan proceeds may be used for hotels, motels... guaranteed portion of each note is indicated below. This instrument is attached to note ___ in the face amount of $_____ and is number ___ of ___ . Lender's Identifying Number Face Amount Percent of Total Face...

7 CFR Appendix I to Subpart E of... - Instructions for Loan Guarantees for Drought and Disaster Relief

Code of Federal Regulations, 2011 CFR

2011-01-01

... financial obligations in a timely fashion. In addition, D&D loan proceeds may be used for hotels, motels... guaranteed portion of each note is indicated below. This instrument is attached to note ___ in the face amount of $_____ and is number ___ of ___ . Lender's Identifying Number Face Amount Percent of Total Face...

The Experiences of Blacks Who Obtained Doctorates from Predominantly White Institutions

ERIC Educational Resources Information Center

Nickelberry, Tressie A.

2012-01-01

Being in a doctoral program requires a substantial amount of one's time, energy, and commitment. Doctoral students face many challenges while pursuing their degrees. For example, some may be on financial aid, work full-time, and/or have a family. While doctoral students face many hurdles, Black doctoral students face additional barriers. The…

About ATMPs, SOPs and GMP: The Hurdles to Produce Novel Skin Grafts for Clinical Use

PubMed Central

Hartmann-Fritsch, Fabienne; Marino, Daniela; Reichmann, Ernst

2016-01-01

Background The treatment of severe full-thickness skin defects represents a significant and common clinical problem worldwide. A bio-engineered autologous skin substitute would significantly reduce the problems observed with today's gold standard. Methods Within 15 years of research, the Tissue Biology Research Unit of the University Children's Hospital Zurich has developed autologous tissue-engineered skin grafts based on collagen type I hydrogels. Those products are considered as advanced therapy medicinal products (ATMPs) and are routinely produced for clinical trials in a clean room facility following the guidelines for good manufacturing practice (GMP). This article focuses on hurdles observed for the translation of ATMPs from research into the GMP environment and clinical application. Results and Conclusion Personalized medicine in the field of rare diseases has great potential. However, ATMPs are mainly developed and promoted by academia, hospitals, and small companies, which face many obstacles such as high financial burdens. PMID:27781022

Socioeconomic Status and Financial Coping Strategies: The Mediating Role of Perceived Control

ERIC Educational Resources Information Center

Caplan, Leslie J.; Schooler, Carmi

2007-01-01

We examine the relations among socioeconomic status, control beliefs, and two coping styles (problem-focused vs. emotion-focused) in the context of financial stress. Findings indicate that low socioeconomic status (SES) is linked to greater use of emotion-focused financial coping and lesser use of problem-focused financial coping. The effects of…

[Inequality in access to health care services. Policy recommendations aimed at achieving equity].

PubMed

Urbanos-Garrido, Rosa

2016-11-01

This article reveals the presence of inequalities in access to health care that may be considered unfair and avoidable. These inequalities are related to coverage of clinical needs, to the financial problems faced by families in completing medical treatments, or to disparities in waiting times and the use of services for equal need. A substantial proportion of inequalities appears to have increased as a result of the measures adopted to face the economic crisis. The recommendations aimed at improving equity affect different pillars of the taxpayer-funded health system, including, among others, the definition of the right to public health care coverage, the formulas of cost-sharing, the distribution of powers between primary and specialty care, the reforms of clinical management, and the production and dissemination of information to facilitate the decision-making processes of health authorities, professionals and citizens. Moreover, it is recommended to focus on particularly vulnerable population groups. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Financing Academic Departments of Psychiatry

ERIC Educational Resources Information Center

Liptzin, Benjamin; Meyer, Roger E.

2011-01-01

Objective: The authors describe the many financial challenges facing academic departments of psychiatry and the resulting opportunities that may arise. Method: The authors review the history of financial challenges, the current economic situation, and what may lie ahead for academic departments of psychiatry. Results: The current environment has…

The Missing Curriculum Link: Personal Financial Planning

ERIC Educational Resources Information Center

Neidermeyer, Adolph A.; Neidermeyer, Presha E.

2010-01-01

With increasing personal and business financial challenges facing today's professionals, we, as business school faculty, have a responsibility to offer the educational background that should enable rising professionals to successfully manage finances. Unfortunately, the results of a recent analysis of curriculum offerings in Personal Financial…

Comparison of web-based and face-to-face interviews for application to an anesthesiology training program: a pilot study

PubMed Central

Malkin, Mathew R.; Lenart, John; Stier, Gary R.; Gatling, Jason W.; Applegate II, Richard L.

2016-01-01

Objectives This study compared admission rates to a United States anesthesiology residency program for applicants completing face-to-face versus web-based interviews during the admissions process. We also explored factors driving applicants to select each interview type. Methods The 211 applicants invited to interview for admission to our anesthesiology residency program during the 2014-2015 application cycle were participants in this pilot observational study. Of these, 141 applicants selected face-to-face interviews, 53 applicants selected web-based interviews, and 17 applicants declined to interview. Data regarding applicants' reasons for selecting a particular interview type were gathered using an anonymous online survey after interview completion. Residency program admission rates and survey answers were compared between applicants completing face-to-face versus web-based interviews. Results One hundred twenty-seven (75.1%) applicants completed face-to-face and 42 (24.9%) completed web-based interviews. The admission rate to our residency program was not significantly different between applicants completing face-to-face versus web-based interviews. One hundred eleven applicants completed post-interview surveys. The most common reasons for selecting web-based interviews were conflict of interview dates between programs, travel concerns, or financial limitations. Applicants selected face-to-face interviews due to a desire to interact with current residents, or geographic proximity to the residency program. Conclusions These results suggest that completion of web-based interviews is a viable alternative to completion of face-to-face interviews, and that choice of interview type does not affect the rate of applicant admission to the residency program. Web-based interviews may be of particular interest to applicants applying to a large number of programs, or with financial limitations. PMID:27039029

Patient views on financial relationships between surgeons and surgical device manufacturers.

PubMed

Camp, Mark W; Gross, Allan E; McKneally, Martin F

2015-10-01

Over the past decade, revelations of inappropriate financial relationships between surgeons and surgical device manufacturers have challenged the presumption that surgeons can collaborate with surgical device manufacturers without damaging public trust in the surgical profession. We explored postoperative Canadian patients' knowledge and opinions about financial relationships between surgeons and surgical device manufacturers. This complex issue was explored using qualitative methods. We conducted semistructured face-to-face interviews with postoperative patients in follow-up arthroplasty clinics at an academic hospital in Toronto, Canada. Interviews were audiotaped, transcribed and analyzed. Patient-derived concepts and themes were uncovered. We interviewed 33 patients. Five major themes emerged: 1) many patients are unaware of the existence of financial relationships between surgeons and surgical device manufacturers; 2) patients approve of financial relationships that support innovation and research but are opposed to relationships that involve financial incentives that benefit only the surgeon and the manufacturer; 3) patients do not support disclosure of financial relationships during the consent process as it may shift focus away from the more important risks; 4) patients support oversight at the professional level but reject the idea of government involvement in oversight; and 5) patients entrust their surgeons to make appropriate patient-centred choices. This qualitative study deepens our understanding of financial relationships between surgeons and industry. Patients support relationships with industry that provide potential benefit to current or future patients. They trust our ability to self-regulate. Disclosure combined with appropriate oversight will strengthen public trust in professional collaboration with industry.

Financial Neutrality for Living Organ Donors: Reasoning, Rationale, Definitions, and Implementation Strategies.

PubMed

Hays, R; Rodrigue, J R; Cohen, D; Danovitch, G; Matas, A; Schold, J; LaPointe Rudow, D

2016-07-01

In the United States, live organ donation can be a costly and burdensome undertaking for donors. While most donation-related medical expenses are covered, many donors still face lost wages, travel expenses, incidentals, and potential for future insurability problems. Despite widespread consensus that live donors (LD) should not be responsible for the costs associated with donation, little has changed to alleviate financial burdens for LDs in the last decade. To achieve this goal, the transplant community must actively pursue strategies and policies to eliminate unreimbursed out-of-pocket costs to LDs. Costs should be more appropriately distributed across all stakeholders; this will also make live donation possible for people who, in the current system, cannot afford to proceed. We propose the goal of LD "financial neutrality," offer an operational definition to include the coverage/reimbursement of all medical, travel, and lodging costs, along with lost wages, related to the act of donating an organ, and guidance for consideration of medical care coverage, and wage and other expense reimbursement. The intent of this report is to provide a foundation to inform discussion within the transplant community and to advance initiatives for policy and resource allocation. © Copyright 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.

Fiscal Year 2010 U.S. Government Financial Statements: Federal Government Continues To Face Financial Management And Long-Term Fiscal Challenges

DTIC Science & Technology

2011-03-09

effective oversight of federal government programs and policies. Over the years, certain material weaknesses in internal control over...ineffective process for preparing the consolidated financial statements. In addition to the material weaknesses underlying these major impediments, GAO...noted material weaknesses involving billions of dollars in improper payments, information security, and tax collection activities. With regard to the

Market value: an underused financial planning tool.

PubMed

Harris, J P; Schimmel, V E

1987-04-01

Two issues facing CFOs are capital formation and the long-range financial impact of strategic planning decisions. For not-for-profit organizations, debt capacity is the main determining factor of capital formation while investment analysis is the key to the financial evaluation of strategic planning options. And, the market, or sale, value of the organization can serve as an effective tool to manage current debt capacity and future investment decisions.

Registrars' Group Faces a Financial Free Fall.

ERIC Educational Resources Information Center

Gose, Ben

1998-01-01

The organizational transformation process begun several years ago by the American Association of Collegiate Registrars and Admissions Officers has resulted in the association's once-solid financial base collapsing, bringing internal tensions about the transformation to the surface. Debate centers on the organization's ability to be a policy leader…

Hospital financial condition and the quality of patient care.

PubMed

Bazzoli, Gloria J; Chen, Hsueh-Fen; Zhao, Mei; Lindrooth, Richard C

2008-08-01

Concerns about deficiencies in the quality of care delivered in US hospitals grew during a time period when an increasing number of hospitals were experiencing financial problems. Our study examines a six-year longitudinal database of general acute care hospitals in 11 states to assess the relationship between hospital financial condition and quality of care. We evaluate two measures of financial performance: operating margin and a broader profitability measure that encompasses both operating and non-operating sources of income. Our model specification allows for gradual adjustments in quality-enhancing activities and recognizes that current realizations of patient quality may affect future financial performance. Empirical results suggest that there is a relationship between financial performance and quality of care, but not as strong as suggested in earlier research. Overall, our results suggest that deep financial problems that go beyond the patient care side of business may be important to prompting quality problems. Copyright (c) 2007 John Wiley & Sons, Ltd.

77 FR 74896 - Self-Regulatory Organizations; Financial Industry Regulatory Authority, Inc.; Notice of Filing of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-18

... as ``remaining principal balance'' or ``RPB'') to (2) the original face value of the ABS. Such... to report the original face value of the security; in (B)(ii), for a transaction in an amortizing ABS, other than a TBA transaction, a member would be required to report the original face value of the...

Women's reasons for participation in a clinical trial for menstrual pain: a qualitative study

PubMed Central

Blödt, Susanne; Witt, Claudia M; Holmberg, Christine

2016-01-01

Objectives The aim of the study was to explore women's motivations for participating in a clinical trial and to evaluate how financial compensation impacts women's explanations for participation. Design, setting and participants Semistructured interviews were conducted face to face or by telephone with 25 of 220 women who participated in a pragmatic randomised trial for app-administered self-care acupressure for dysmenorrhoea (AKUD). Of these 25 women, 10 had entered AKUD knowing they would receive a financial compensation of €30. A purposive sampling strategy was used. Results Women had a long history of seeking help and were unsatisfied with the options available, namely painkillers and oral contraceptives. While interviewees were open to painkillers, they were uneasy about taking them on a monthly basis. The AKUD trial offered the possibility to find an alternative solution. A second reason for participation was the desire to add a new treatment to routine medical care, for which the interviewees considered randomised trials a prerequisite. The financial incentive was a subsidiary motivation in the interviewees' narratives. Conclusions Our results contribute to the ongoing discussion of the impact of financial compensation on research participants' assessment of risk. The interviewed women considered all research participants able to make their own choices regarding trial participation, even in the face of financial compensation or payment of study participants. Furthermore, the importance of clinical trials providing new treatments that could change medical practice might be an overlooked reason for trial participation and could be used in future recruitment strategies. PMID:27965251

Reforms in the Greek pharmaceutical market during the financial crisis.

PubMed

Vandoros, Sotiris; Stargardt, Tom

2013-01-01

Following the financial crisis of 2008, Greece has been facing severe fiscal problems associated with high public debt and deficit. Given their significant contribution to public sector expenditure, part of the effort to reduce public expenditure has involved a focus on pharmaceutical markets. Our aim is to provide an overview of recent policy changes in the Greek pharmaceutical market as a response to the crisis. We also discuss other potential measures that can be implemented. The recommendations are relevant to European countries facing debt crises, but also to any other country, as improving efficiency makes funds available to be used on other interventions. In 2010 and 2011, following the debt crisis and the agreement with the IMF, EU and ECB, the Greek government introduced several policy measures aimed at cost-containment. These changes included (a) price cuts, (b) the re-introduction of a positive list, (c) changes in the profit margins of pharmacies and wholesalers, and (d) tenders for hospital drugs. As a result, public drug expenditure decreased from €5.09 billion in 2009 to €4.25 billion in 2010 and €4.10 billion in 2011. As the need to cut expenditure becomes more urgent, seeking efficiency is possibly the only option for countries that do not wish to compromise quality of healthcare and public health. However, efficiency and cost containment are not only about introducing new policies, but also about the enforcement of existing laws and fighting corruption. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Disease management programs: barriers and benefits.

PubMed

Magnezi, Racheli; Kaufman, Galit; Ziv, Arnona; Kalter-Leibovici, Ofra; Reuveni, Haim

2013-04-01

The healthcare system in Israel faces difficulties similar to those of most industrialized countries, including limited resources, a growing chronically ill population, and demand for high quality care. Disease management programs (DMPs) for patients with a chronic illness aim to alleviate some of these problems, primarily by improving patient self-management skills and quality of care. This study surveyed the opinions of senior healthcare administrators regarding barriers, benefits, and support for implementing DMPs. Cross-sectional survey. A 21-item questionnaire was self-completed by 87 of 105 (83%) healthcare administrators included in the study. Participants were 65.5% male and 47% physicians, 25.3% nurses, 17.3% administrators, and 10.3% other healthcare professionals. The main perceived benefit of DMPs among all respondents was improving quality of care. Other benefits noted were better contact with patients (81.6%) and better compliance with treatment (75.9%). Efficient long-term utilization of system resources was perceived as a benefit by only 58.6%. The main perceived barriers to implementing DMPs were lack of budgetary resources (69%) and increased time required versus financial compensation received (63.2%). The benefits of DMPs were patient oriented; barriers were perceived as financial and limiting professional autonomy. Information regarding long-term benefits (better patient outcomes) that ultimately provide better value for the system versus short-term barriers (increased costs and expenditures of time without compensation) might encourage the implementation of DMPs in countries faced with a growing population of patients with at least 1 chronic illness.

Malaria eradication: the economic, financial and institutional challenge.

PubMed

Mills, Anne; Lubell, Yoel; Hanson, Kara

2008-12-11

Malaria eradication raises many economic, financial and institutional challenges. This paper reviews these challenges, drawing on evidence from previous efforts to eradicate malaria, with a special focus on resource-poor settings; summarizes more recent evidence on the challenges, drawing on the literature on the difficulties of scaling-up malaria control and strengthening health systems more broadly; and explores the implications of these bodies of evidence for the current call for elimination and intensified control. Economic analyses dating from the eradication era, and more recent analyses, suggest that, in general, the benefits of malaria control outweigh the costs, though few studies have looked at the relative returns to eradication versus long-term control. Estimates of financial costs are scanty and difficult to compare. In the 1960s, the consolidation phase appeared to cost less than $1 per capita and, in 1988, was estimated to be $2.31 per capita (both in 2006 prices). More recent estimates for high coverage of control measures suggest a per capita cost of several dollars. Institutional challenges faced by malaria eradication included limits to the rule of law (a major problem where malaria was concentrated in border areas with movement of people associated with illegal activities), the existence and performance of local implementing structures, and political sustainability at national and global levels. Recent analyses of the constraints to scaling-up malaria control, together with the historical evidence, are used to discuss the economic, financial and institutional challenges that face the renewed call for eradication and intensified control. The paper concludes by identifying a research agenda covering: issues of the allocative efficiency of malaria eradication, especially using macro-economic modelling to estimate the benefits and costs of malaria eradication and intensified control, and studies of the links between malaria control and economic development, the costs and consequences of the various tools and mixes of tools employed in control and eradication, issues concerning the extension of coverage of interventions and service delivery approaches, especially those that can reach the poorest, research on the processes of formulating and implementing malaria control and eradication policies, at both international and national levels, research on financing issues, at global and national levels.

Malaria eradication: the economic, financial and institutional challenge

PubMed Central

Mills, Anne; Lubell, Yoel; Hanson, Kara

2008-01-01

Malaria eradication raises many economic, financial and institutional challenges. This paper reviews these challenges, drawing on evidence from previous efforts to eradicate malaria, with a special focus on resource-poor settings; summarizes more recent evidence on the challenges, drawing on the literature on the difficulties of scaling-up malaria control and strengthening health systems more broadly; and explores the implications of these bodies of evidence for the current call for elimination and intensified control. Economic analyses dating from the eradication era, and more recent analyses, suggest that, in general, the benefits of malaria control outweigh the costs, though few studies have looked at the relative returns to eradication versus long-term control. Estimates of financial costs are scanty and difficult to compare. In the 1960s, the consolidation phase appeared to cost less than $1 per capita and, in 1988, was estimated to be $2.31 per capita (both in 2006 prices). More recent estimates for high coverage of control measures suggest a per capita cost of several dollars. Institutional challenges faced by malaria eradication included limits to the rule of law (a major problem where malaria was concentrated in border areas with movement of people associated with illegal activities), the existence and performance of local implementing structures, and political sustainability at national and global levels. Recent analyses of the constraints to scaling-up malaria control, together with the historical evidence, are used to discuss the economic, financial and institutional challenges that face the renewed call for eradication and intensified control. The paper concludes by identifying a research agenda covering: ∘ issues of the allocative efficiency of malaria eradication, especially using macro-economic modelling to estimate the benefits and costs of malaria eradication and intensified control, and studies of the links between malaria control and economic development ∘ the costs and consequences of the various tools and mixes of tools employed in control and eradication ∘ issues concerning the extension of coverage of interventions and service delivery approaches, especially those that can reach the poorest ∘ research on the processes of formulating and implementing malaria control and eradication policies, at both international and national levels ∘ research on financing issues, at global and national levels. PMID:19091035

Index-Based Insurance Contracts to FOSTER Cooperation Between Agents Exposed to Uncorrelated Drought and Flooding Risks

NASA Astrophysics Data System (ADS)

Denaro, S.; Giuliani, M.; Castelletti, A.; Characklis, G. W.

2017-12-01

Worldwide, conflict over shared water resources is exacerbated by population growth, economic development and climate change. In multi-purpose water systems, stakeholders can face higher financial risks as a consequence of increased hydrological uncertainty and recurrent extreme events. In this context, a financial hedging tool able to bundle together the uncorrelated risks faced by different stakeholders may be an efficient solution to both foster cooperation and manage the financial losses associated with extreme events. In this work we explore the potential of risk diversification strategies involving index-based insurance joint contract solutions, to manage financial risk in a multi-purpose water system prone to both drought and flood risk. Risk diversification can allow for reduced insurance premiums in situations in which the bundled risks are entirely, or mostly, uncorrelated. Jointly covering flood and drought related risks from competing users in the same geographic area represents a novel application. The approach is demonstrated using a case study on Lake Maggiore, a regulated lake whose management is highly controversial due to numerous and competing human activities. In particular we focus on the ongoing conflict among the lakeshore population, affected by flood risk, and the downstream farmers' districts, facing drought related losses. Results are promising and indicate that bundling uncorrelated risks from competing users is beneficial to both promoting insurance premium affordability and facilitating collaboration schemes at the catchment scale.

Integrating financial and strategic planning.

PubMed

Pivnicny, V C

1989-09-01

As hospitals face mounting profitability and liquidity concerns, the need to integrate strategic and financial planning also will continue to grow. This article describes a process for integrating these planning functions and the ideal organizational framework to facilitate the process. Obstacles to the integration of these planning processes also are discussed.

Performance-Based Scholarships: Replication at Six Sites Using Randomized Controlled Trials

ERIC Educational Resources Information Center

Mayer, Alexander

2014-01-01

Performance-based scholarships were developed to help tackle some of the financial obstacles facing students in the postsecondary education system. In general, these scholarships aim to help reduce the financial burdens of low-income college students, and are structured to help incentivize good academic progress. Performance-based scholarships…

Enrollment Pathways to Financial Sustainability: Choosing the Road Less Traveled

ERIC Educational Resources Information Center

Supplee, Janice L.

2014-01-01

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

Improving Financial Education and Awareness on Insurance and Private Pensions

ERIC Educational Resources Information Center

OECD Publishing (NJ3), 2008

2008-01-01

With public pensions under pressure and private pensions exposed to risk, individuals face an increasing variety of financial risks, particularly those linked to their retirement. This book analyzes the level of risk awareness of consumers and highlights good practices governments might initiate to enhance consumers' awareness and education on…

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

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC.

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

A Double-Edged Sword: Assessing the Impact of Tuition Discounting.

ERIC Educational Resources Information Center

Hubbell, Loren W. Loomis; Rush, Sean C.

1991-01-01

A discussion of the interrelationships between college tuition pricing, family resources, externally funded financial aid, and institutionally funded financial aid suggests that, as the range of tuition levels broadens, institutions must focus more closely on net tuition income in their forecasting or face erosion of revenues. (MSE)

A Tale of Transformation

ERIC Educational Resources Information Center

Gohn, David; Moore, John

2007-01-01

Underperforming institutions frequently face financial and enrollment challenges, and/or lack a sense of direction and momentum. There is no single or easy approach to turning things around and putting the institution on track to positive development. In 1983, Drury University in Springfield, Missouri, faced declining enrollments, a growing…

Integrating Physical Actions and Financial Instruments to Manage Environmental Financial Risk

NASA Astrophysics Data System (ADS)

Foster, B.

2016-12-01

Exposure to extreme weather events can be reduced through physical actions (e.g., dams/reservoirs) or mitigated financially (e.g., insurance). Often physical actions involve investments in expensive infrastructure that reduce exposure, but whose benefits are only occasionally realized. Financial risk management does not reduce the impacts of an event, but rather redistributes them temporally, albeit at a cost. Nonetheless, these costs are typically much smaller, at least in the short run, than those incurred for physical actions. Financial strategies are also more flexible than physical ones in the face of an uncertain future. Financial contracts specifically designed to manage extreme environmental risks are becoming more common and can either replace or complement infrastructural investments as part of a risk management portfolio. In order to make optimal decisions as to the relative levels of physical and financial risk mitigation to employ, it is necessary to understand the relative merits of each strategy. This research develops a method for analyzing tradeoffs between physical and financial risk management strategies. We identify the unique cost and benefit properties of each strategy and integrate them into a single model that details the tradeoffs involved in various portfolios of physical and financial strategies. These methods are then applied to evaluate decisions to pursue emergency dredging during drought on the Mississippi River, which is used to mitigate the increased costs and/or reduced revenues barge operators face when water levels are low. Currently the U.S. Army Corps of Engineers funds most emergency dredging operations during major droughts and they are considering more intensive strategies for future droughts. Barge carriers and shippers though could manage at least some portion of their financial risks through a series of existing and experimental financial contracts. This work involves the formulation of these experimental contracts and the development of methods to evaluate integrated portfolios of physical and financial risk management strategies.

Patient views on financial relationships between surgeons and surgical device manufacturers

PubMed Central

Camp, Mark W.; Gross, Allan E.; McKneally, Martin F.

2015-01-01

Background Over the past decade, revelations of inappropriate financial relationships between surgeons and surgical device manufacturers have challenged the presumption that surgeons can collaborate with surgical device manufacturers without damaging public trust in the surgical profession. We explored postoperative Canadian patients’ knowledge and opinions about financial relationships between surgeons and surgical device manufacturers. Methods This complex issue was explored using qualitative methods. We conducted semistructured face-to-face interviews with postoperative patients in follow-up arthroplasty clinics at an academic hospital in Toronto, Canada. Interviews were audiotaped, transcribed and analyzed. Patient-derived concepts and themes were uncovered. Results We interviewed 33 patients. Five major themes emerged: 1) many patients are unaware of the existence of financial relationships between surgeons and surgical device manufacturers; 2) patients approve of financial relationships that support innovation and research but are opposed to relationships that involve financial incentives that benefit only the surgeon and the manufacturer; 3) patients do not support disclosure of financial relationships during the consent process as it may shift focus away from the more important risks; 4) patients support oversight at the professional level but reject the idea of government involvement in oversight; and 5) patients entrust their surgeons to make appropriate patient-centred choices. Conclusion This qualitative study deepens our understanding of financial relationships between surgeons and industry. Patients support relationships with industry that provide potential benefit to current or future patients. They trust our ability to self-regulate. Disclosure combined with appropriate oversight will strengthen public trust in professional collaboration with industry. PMID:26384147

OLDER ADULTS’ COPING WITH NEGATIVE LIFE EVENTS: COMMON PROCESSES OF MANAGING HEALTH, INTERPERSONAL, AND FINANCIAL/WORK STRESSORS*

PubMed Central

MOOS, RUDOLF H.; BRENNAN, PENNY L.; SCHUTTE, KATHLEEN K.; MOOS, BERNICE S.

2007-01-01

This study examined how older adults cope with negative life events in health, interpersonal, and financial/work domains and whether common stress and coping processes hold across these three domains. On three occasions, older adults identified the most severe negative event they faced in the last year and described how they appraised and coped with that event, their ambient chronic stressors, and event and functioning outcomes. The stress and coping process was largely consistent across the three life domains. Individuals who appraised events as challenging and relied more on approach coping were more likely to report some benefit from those events. Individuals who experienced more chronic stressors and favored avoidance coping were more likely to be depressed and to have late-life drinking problems. Chronic stressors, as well as approach and avoidance coping, were predictably associated with overall outcomes in all three event domains. These findings provide a basis for preventive interventions that may help older adults’ address the most prevalent stressors of aging more effectively. PMID:16454482

Self-reported financial burden of cancer care and its effect on physical and mental health-related quality of life among US cancer survivors.

PubMed

Kale, Hrishikesh P; Carroll, Norman V

2016-04-15

Cancer-related financial burden has been linked to cancer survivors (CS) forgoing/delaying medical care, skipping follow-up visits, and discontinuing medications. To the authors' knowledge, little is known regarding the effect of financial burden on the health-related quality of life of CS. The authors analyzed 2011 Medical Expenditure Panel Survey data. Financial burden was present if one of the following problems was reported: borrowed money/declared bankruptcy, worried about paying large medical bills, unable to cover the cost of medical care visits, or other financial sacrifices. The following outcomes were evaluated: Physical Component Score (PCS) and Mental Component Score (MCS) of the 12-Item Short-Form Health Survey (SF-12), depressed mood, psychological distress, and worry related to cancer recurrence. The authors also assessed the effect of the number of financial problems on these outcomes. Of the 19.6 million CS analyzed, 28.7% reported financial burden. Among them, the average PCS (42.3 vs 44.9) and MCS (48.1 vs 52.1) were lower for those with financial burden versus those without. In adjusted analyses, CS with financial burden had significantly lower PCS (β = -2.45), and MCS (β = -3.05), had increased odds of depressed mood (odds ratio, 1.95), and were more likely to worry about cancer recurrence (odds ratio, 3.54). Survivors reporting ≥ 3 financial problems reported statistically significant and clinically meaningful differences (≥3 points) in the mean PCS and MCS compared with survivors without financial problems. Cancer-related financial burden was associated with lower health-related quality of life, increased risk of depressed mood, and a higher frequency of worrying about cancer recurrence among CS. © 2015 American Cancer Society.

"A Different World"

ERIC Educational Resources Information Center

Stuart, Reginald

2012-01-01

HBCUs are facing a myriad of challenges amid efforts to stay financially viable and competitive with majority counterparts. They are facing more pressure to reinvent themselves to stay alive and relevant as more and more Black students choose to attend majority institutions and private, for-profit colleges. Higher education administrators are…

Higher Education: Special Interest or National Asset?

ERIC Educational Resources Information Center

Skorton, David J.

2008-01-01

The deepening financial crisis that is now affecting markets and people around the globe gives new context to what the nation is facing. Americans cannot think of business as usual in any sector of public or private life, including higher education. President-elect Barack Obama will have very little financial latitude and enormous immediate…

Financial Stress in Academe.

ERIC Educational Resources Information Center

Morgan Guaranty Survey, 1971

1971-01-01

The financial crisis that higher education is facing is largely an outgrowth of the unprecedented expansion that has occurred within the system during most of the past decade and a half. Budgets have increased more than sixfold since 1955 and enrollment has nearly tripled. This expansion, which was fostered in part by a marked increase in federal…

Effects of emotional preferences on value-based decision making are mediated by mentalizing not reward networks

PubMed Central

Evans, Simon; Fleming, Stephen M.; Dolan, Raymond J.; Averbeck, Bruno B.

2012-01-01

Real-world decision-making often involves social considerations. Consequently, the social value of stimuli can induce preferences in choice behavior. However, it is unknown how financial and social values are integrated in the brain. Here, we investigated how smiling and angry face stimuli interacted with financial reward feedback in a stochastically-rewarded decision-making task. Subjects reliably preferred the smiling faces despite equivalent reward feedback, demonstrating a socially driven bias. We fit a Bayesian reinforcement learning model to factor the effects of financial rewards and emotion preferences in individual subjects, and regressed model predictions on the trial-by-trial fMRI signal. Activity in the sub-callosal cingulate and the ventral striatum, both involved in reward learning, correlated with financial reward feedback, whereas the differential contribution of social value activated dorsal temporo-parietal junction and dorsal anterior cingulate cortex, previously proposed as components of a mentalizing network. We conclude that the impact of social stimuli on value-based decision processes is mediated by effects in brain regions partially separable from classical reward circuitry. PMID:20946058

Financial Autonomy and Challenges to Being a Regionally Responsive Higher Education Institution

ERIC Educational Resources Information Center

Kohtamaki, Vuokko; Lyytinen, Anu

2004-01-01

This paper discusses some current problems and challenges of the Finnish AMKs (polytechnic institutions), and whether financial autonomy could contribute to finding solutions for some of these problems. It provides an overview of the current status of financial autonomy of polytechnics in 6 European countries, and finally attempts to find links…

Women's reasons for participation in a clinical trial for menstrual pain: a qualitative study.

PubMed

Blödt, Susanne; Witt, Claudia M; Holmberg, Christine

2016-12-13

The aim of the study was to explore women's motivations for participating in a clinical trial and to evaluate how financial compensation impacts women's explanations for participation. Semistructured interviews were conducted face to face or by telephone with 25 of 220 women who participated in a pragmatic randomised trial for app-administered self-care acupressure for dysmenorrhoea (AKUD). Of these 25 women, 10 had entered AKUD knowing they would receive a financial compensation of €30. A purposive sampling strategy was used. Women had a long history of seeking help and were unsatisfied with the options available, namely painkillers and oral contraceptives. While interviewees were open to painkillers, they were uneasy about taking them on a monthly basis. The AKUD trial offered the possibility to find an alternative solution. A second reason for participation was the desire to add a new treatment to routine medical care, for which the interviewees considered randomised trials a prerequisite. The financial incentive was a subsidiary motivation in the interviewees' narratives. Our results contribute to the ongoing discussion of the impact of financial compensation on research participants' assessment of risk. The interviewed women considered all research participants able to make their own choices regarding trial participation, even in the face of financial compensation or payment of study participants. Furthermore, the importance of clinical trials providing new treatments that could change medical practice might be an overlooked reason for trial participation and could be used in future recruitment strategies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Strategy and Finance in Higher Education. Surviving the '90s.

ERIC Educational Resources Information Center

Massy, William F., Ed.; Meyerson, Joel W., Ed.

This book provides a new look at educational management in the face of mounting financial pressures. The demands for accountability that today's university administrators must face require them to apply the sophistication of modern business and institutional management while preserving the expensive and often difficult-to-measure contributions of…

Coping with Quality Assurance Challenges Faced by Secondary Schools' Headteachers in Gucha District, Kenya

ERIC Educational Resources Information Center

Mobegi, Florence Osiri; Ondigi, Benjamin A.

2011-01-01

Since independence, the Kenyan government has demonstrated its commitment to the provision of quality secondary school education through allocation of financial resources, provision of trained teachers and establishment of quality assurance department. However, despite the substantial allocation of resources, secondary schools still face major…

The Thief With a Thousand Faces and the Victim With None: Identifying Determinants for Online Identity Theft Victimization With Routine Activity Theory.

PubMed

Reyns, Bradford W; Henson, Billy

2016-08-01

Available evidence suggests that identity theft is a growing problem that has significant consequences for victims, not the least of which is billions of dollars in financial losses. However, very little is known about the correlates or causes of identity theft victimization. Utilizing a nationally representative sample of individuals from the Canadian General Social Survey, the current study attempts to address this deficiency by examining the link between victims' online routine activities and their online identity theft victimization. It was found that certain routine activities directly influence the likelihood of experiencing identity theft. Potential research and policy implications also are discussed. © The Author(s) 2015.

Financial Management and Young Australian Workers

ERIC Educational Resources Information Center

Dowling, Nicki; Hoiles, Lauren; Corney, Tim; Clark, David

2008-01-01

In two studies of young Australian workers, participants generally displayed positive attitudes towards financial management practices; however, a substantial proportion failed to display positive financial management practices, experienced financial problems and dissatisfaction, and reported low rates of seeking financial assistance, particularly…

Extreme Economics: Teaching Children and Teenagers about Money. Second Edition

ERIC Educational Resources Information Center

Babbage, Keen J.

2009-01-01

What Financial future awaits the current generation of children and teenagers in the United States? Our children and teenagers did not cause the financial problems that confront the nation and impacts their families, but they will pay part of the price for these financial problems. What should children and teenagers know about personal finance?…

Economic abuse between intimate partners in Australia: prevalence, health status, disability and financial stress.

PubMed

Kutin, Jozica; Russell, Roslyn; Reid, Mike

2017-06-01

Economic abuse is a form of domestic violence that has a significant impact on the health and financial wellbeing of victims, but is understudied. This study determined the lifetime prevalence of economic abuse in Australia by age and gender, and the associated risk factors. The 2012 ABS Personal Safety Survey was used, involving a cross-sectional population survey of 17,050 randomly selected adults using face-to-face interviews. The survey-weighted prevalence of economic abuse was calculated and analysed by age and gender. Logistic regression was used to adjust odds ratios for possible confounding between variables. The lifetime prevalence of economic abuse in the whole sample was 11.5%. Women in all age groups were more likely to experience economic abuse (15.7%) compared to men (7.1%). Disability, health and financial stress status were significant markers of economic abuse. For women, financial stress and disability were important markers of economic abuse. However, prevalence rates were influenced by the measures used and victims' awareness of the abuse, which presents a challenge for screening and monitoring. Implications for public health: Social, health and financial services need to be aware of and screen for the warning signs of this largely hidden form of domestic violence. © 2017 The Authors.

Coordinated clinical and financial analysis as a powerful tool to influence vendor pricing.

PubMed

Logan, Catherine A; Wu, Roger Y; Mulley, Debra; Smith, Paul C; Schwaitzberg, Steven D

2010-01-01

As costs continue to outpace reimbursements, hospital administrators and clinicians face increasing pressure to justify new capital purchases. Massachusetts Health Care Reform has added further economic challenges for Disproportionate Share Hospitals (DSH), as resources formerly available to treat the uninsured have been redirected. In this challenging climate, many hospitals still lack a standardized process for technology planning and/or vendor negotiation. : The purpose of this study was to determine whether a simple, coordinated clinical and financial analysis of a technology, Endoscopic Carpal Tunnel Release (ECTR), is sufficient to impact vendor pricing at Cambridge Health Alliance (CHA), a disproportionate share hospital (DSH) in Cambridge, Massachusetts. This case study addressed the topic of technology adoption, a complex decision-making process every hospital administration faces. Taking note of other hospitals approaches to instill a strategic management culture, CHA combined a literature review on clinical outcomes and financial analysis on profitability. Clinical effectiveness was evaluated through a literature review. The financial analysis was based on a retrospective inquiry of fixed and variable costs, reimbursement rates, actual payer mix, and profitability of adopting ECTR over open carpal tunnel release at CHA. This clinical and financial analysis was then shared with the vendor. A literature review revealed that although there are short-term benefits to ECTR, there is little to no difference in long-term outcomes to justify a calculated incremental loss of $91.49 in revenue per case. Sharing this analysis with the vendor resulted in a 30% price reduction. A revised cost analysis demonstrated a $53.51 incremental gain in revenue per case. CHA has since elected to offer ECTR to its patients. Smaller hospital systems often have modest leverage in vendor negotiations. Our results suggest that the development of adoption criteria and an evidence-based managerial approach can create dialogue with vendors and directly impact pricing. Coordinated clinical and financial analysis is a powerful tool, enabling administrators, clinicians, and medical device suppliers to work constructively to provide patients access to innovative technology, even in the face of a challenging payer mix. Ongoing assessment of clinical outcomes and financial data must be performed to reflect the most up-to-date scientific and economic climate.

Exploring the classroom practices that may enable a compassionate approach to financial literacy education

NASA Astrophysics Data System (ADS)

Blue, Levon Ellen; O'Brien, Mia; Makar, Katie

2017-08-01

From an early age, children are faced with financial dilemmas and are expected to make effective financial decisions about money. In this paper, we explore the classroom practices that may enable a compassionate approach to financial literacy education. We observed an inquiry-based mathematics lesson in a Year 4 primary school classroom. The financial maths task asked students to decide on the best fundraising option for the school. We used the theory of practice architectures to analyse the interactions in the classroom in order to understand what may have enabled and constrained classroom practices. We found that classroom practices such as engaging with peers through positive and collaborative learning opportunities, making ethical, social and mathematical connections of the task, and considering the impact of financial decisions on others may enable a compassionate approach to financial literacy education.

Exploring the classroom practices that may enable a compassionate approach to financial literacy education

NASA Astrophysics Data System (ADS)

Blue, Levon Ellen; O'Brien, Mia; Makar, Katie

2018-06-01

From an early age, children are faced with financial dilemmas and are expected to make effective financial decisions about money. In this paper, we explore the classroom practices that may enable a compassionate approach to financial literacy education. We observed an inquiry-based mathematics lesson in a Year 4 primary school classroom. The financial maths task asked students to decide on the best fundraising option for the school. We used the theory of practice architectures to analyse the interactions in the classroom in order to understand what may have enabled and constrained classroom practices. We found that classroom practices such as engaging with peers through positive and collaborative learning opportunities, making ethical, social and mathematical connections of the task, and considering the impact of financial decisions on others may enable a compassionate approach to financial literacy education.

Facing Off with Unfair Others: Introducing Proxemic Imaging as an Implicit Measure of Approach and Avoidance during Social Interaction

PubMed Central

McCall, Cade; Singer, Tania

2015-01-01

Nonverbal behavior expresses many of the dynamics underlying face-to-face social interactions, implicitly revealing one’s attitudes, emotions, and social motives. Although research has often described nonverbal behavior as approach versus avoidant (i.e., through the study of proxemics), psychological responses to many social contexts are a mix of these two. Fairness violations are an ideal example, eliciting strong avoidance-related responses such as negative attitudes, as well as strong approach-related responses such as anger and retaliation. As such, nonverbal behavior toward unfair others is difficult to predict in discrete approach versus avoidance terms. Here we address this problem using proxemic imaging, a new method which creates frequency images of dyadic space by combining motion capture data of interpersonal distance and gaze to provide an objective but nuanced analysis of social interactions. Participants first played an economic game with fair and unfair players and then encountered them in an unrelated task in a virtual environment. Afterwards, they could monetarily punish the other players. Proxemic images of the interactions demonstrate that, overall, participants kept the fair player closer. However, participants who actively punished the unfair players were more likely to stand directly in front of those players and even to turn their backs on them. Together these patterns illustrate that fairness violations influence nonverbal behavior in ways that further predict differences in more overt behavior (i.e., financial punishment). Moreover, they demonstrate that proxemic imaging can detect subtle combinations of approach and avoidance behavior during face-to-face social interactions. PMID:25675444

Student Credit Card Debt in the 21st Century: Options for Financial Aid Administrators.

ERIC Educational Resources Information Center

Oleson, Mark

2001-01-01

Provides multiple workable solutions financial aid offices can offer students throughout their college experience to deal with debt: preventive solutions for avoiding problems with credit card debt, holistic solutions for other related problems, and remedial solutions for existing problems. (EV)

Joint venture versus outreach: a financial analysis of case studies.

PubMed

Forsman, R W

2001-01-01

Medical centers across the country are facing cost challenges, and national commercial laboratories are experiencing financial declines that necessitate their capturing market share in any way possible. Many laboratories are turning to joint ventures or partnerships for financial relief. However, it often is in the best interest of the patient and the medical center to integrate laboratory services across the continuum of care. This article analyzes two hypothetical joint ventures involving a laboratory management agreement and full laboratory outsourcing.

Impact of sanctions on procurement of medicine and medical devices in Iran; a technical response.

PubMed

Hosseini, Seyed Alireza

2013-12-01

Following recent sanctions on foreign trade, financial and banking services, Iran has faced major difficulties for importing medicines (both finished products and pharmaceutical raw materials) and medical devices. Problems with money transfer have made it extremely lengthy in time to import medicine and medical devices and these have negatively affected access to and affordability of medicines. Quality of pharmaceuticals and treatment of patients have also been affected due to changing the sources of imported medicines and raw materials for locally produced pharmaceuticals. Several interventions have been employed during the past few months in Iran to overcome the effects imposed by recent sanctions and drug shortages have been managed to some extent with attempts made by Iran Food and Drug Organization (IRI FDO). As recommended by the experts, a specific Society for Worldwide Interbank Financial Telecommunication line should be allocated for transferring money for medicines and medical devices and certain financial institutions are assigned for this purpose. It is also suggested that defining a white list of Iranian pharmaceuticals and medical device companies together with their foreign counterparts would facilitate this process. It appears that, in a public health prospective, ordinary people and patients are hurt and paying the cost for current sanctions. It remains the responsibility of the public health and international communities to separate public health from politics and to ease the pain of public from sanctions.

Risk Factors: Colleges Look to Manage Threats Ranging from Fraud to Data Breaches

ERIC Educational Resources Information Center

Wills, Lisa M.

2011-01-01

When an individual hears the term risk, he/she usually thinks of the financial institutions whose mismanagement of risk was instrumental in causing the 2008 financial crash. But all organizations, including colleges and universities, face various types and levels of risk, which threaten to harm the institutions and their ability to fulfill their…

Teaching Business Ethics after the Financial Meltdown: Is It Time for Ethics with a Sermon?

ERIC Educational Resources Information Center

Cavaliere, Frank J.; Mulvaney, Toni P.; Swerdlow, Marleen R.

2010-01-01

Our country is faced with a financial crisis of mammoth proportions: a crisis rooted in ethics, or rather, the lack of ethics. Critics are increasingly complaining that business schools focus too much teaching effort on maximizing shareholder value, with only a limited understanding of ethical and social aspects of business leadership. Business…

Restructuring Medical Schools to Better Manage Their Three Missions in the Face of Financial Scarcity.

ERIC Educational Resources Information Center

Allcorn, Seth; Winship, Daniel H.

1996-01-01

A discussion of changes in medical school organization to meet new financial challenges looks at the traditional medical school management model and proposes an alternative, the service line management matrix model. In this model, each institutional mission (teaching, research, patient care) must be managed for its cost-effectiveness. Roles of…

Catholic Colleges Face Unusual Financial Pressures

ERIC Educational Resources Information Center

Supiano, Beckie

2008-01-01

When the main building of Our Lady of the Lake University was damaged in a fire this spring, its president, Tessa Martinez Pollack, worried the blaze would exacerbate its money woes. She told "The New York Times" that it's a known fact and that they are like a lot of other Catholic universities that are struggling to stay afloat financially. Not…

Development and Preliminary Psychometric Evaluation of the Domestic Violence-Related Financial Issues Scale (DV-FI)

ERIC Educational Resources Information Center

Weaver, Terri L.; Sanders, Cynthia K.; Campbell, Carole L.; Schnabel, Meg

2009-01-01

Intimate partner violence (IPV) occurs at disproportionate rates within impoverished groups of women and can include economic abuse as a form of psychological maltreatment. The current study developed a comprehensive assessment of the unique financial issues facing female victims of IPV using a sheltered sample (N = 113). An exploratory factor…

Language, Academic, Socio-Cultural and Financial Adjustments of Mainland Chinese Students Studying in Hong Kong

ERIC Educational Resources Information Center

Cheung, Alan C. K.

2013-01-01

Purpose: The purpose of this paper is to examine language, academic, social-cultural and financial adjustments facing mainland Chinese students in Hong Kong. Design/methodology/approach: The current study employed both quantitative and qualitative methods and included over 300 mainland Chinese students from seven major universities in Hong Kong.…

The Financial and Non-Financial Aspects of Developing a Data-Driven Decision-Making Mindset in an Undergraduate Business Curriculum

ERIC Educational Resources Information Center

Bohler, Jeffrey; Krishnamoorthy, Anand; Larson, Benjamin

2017-01-01

Making data-driven decisions is becoming more important for organizations faced with confusing and often contradictory information available to them from their operating environment. This article examines one college of business' journey of developing a data-driven decision-making mindset within its undergraduate curriculum. Lessons learned may be…

College Financial Aid Rules and the Allocation of Savings

ERIC Educational Resources Information Center

Reyes, Jessica Wolpaw

2008-01-01

The college financial aid system imposes an implicit asset tax that is prevalent and substantial. Facing this tax, rational families should reduce their total assets and shelter assets in protected categories. I find that the tax induces a 7-12% reduction in total assets, a result in line with the literature. Furthermore, I find evidence that…

Specific problems in visual cognition of dyslexic readers: Face discrimination deficits predict dyslexia over and above discrimination of scrambled faces and novel objects.

PubMed

Sigurdardottir, Heida Maria; Fridriksdottir, Liv Elisabet; Gudjonsdottir, Sigridur; Kristjánsson, Árni

2018-06-01

Evidence of interdependencies of face and word processing mechanisms suggest possible links between reading problems and abnormal face processing. In two experiments we assessed such high-level visual deficits in people with a history of reading problems. Experiment 1 showed that people who were worse at face matching had greater reading problems. In experiment 2, matched dyslexic and typical readers were tested, and difficulties with face matching were consistently found to predict dyslexia over and above both novel-object matching as well as matching noise patterns that shared low-level visual properties with faces. Furthermore, ADHD measures could not account for face matching problems. We speculate that reading difficulties in dyslexia are partially caused by specific deficits in high-level visual processing, in particular for visual object categories such as faces and words with which people have extensive experience. Copyright © 2018 Elsevier B.V. All rights reserved.

Perspectives of transplant physicians and surgeons on reimbursement, compensation, and incentives for living kidney donors.

PubMed

Tong, Allison; Chapman, Jeremy R; Wong, Germaine; Craig, Jonathan C

2014-10-01

The shortage of donors for organ transplantation has stimulated debate on financial incentives for living kidney donors. This study aims to describe the range of attitudes and opinions of transplant physicians on financial reimbursement, compensation, and incentives in living kidney donation. Qualitative study. 110 transplant nephrologists and surgeons from 12 countries across 43 transplantation units in Europe, Australasia, and North America. Face-to-face semistructured interviews were conducted. Transcripts were thematically analyzed. We identified 7 major themes. Prioritizing the removal of disincentives for living kidney donors was largely deemed acceptable. By contrast, provision of financial incentives raised concerns about undermining benevolence, compromising human dignity and value, and traversing market forces. Some contended that financial incentives potentially were legitimate if regulated, arguing that this would maximize utility in transplantation, but most also acknowledged the difficulty and that operational feasibility of a regulated system of financial incentivization may be limited. Participants were English speaking and from Western high-income countries; therefore, the transferability of our findings may be limited. Transplantation specialists believed that minimizing disincentives would support equity and justice in living kidney donation. Direct financial incentivization for living kidney donors, even in the context of a regulated market, was regarded by most as unjustified because of the potential moral consequences and uncertain feasibility. Removing financial disincentives and safeguarding the intrinsic volunteerism, value, and meaning of donation were viewed to uphold integrity in living kidney donation. Copyright © 2014 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Social Determinants and Access to Induced Abortion in Burkina Faso: From Two Case Studies

PubMed Central

Ouédraogo, Ramatou

2014-01-01

Unsafe abortion constitutes a major public health problem in Burkina Faso and concerns mainly young women. The legal restriction and social stigma make abortions most often clandestine and risky for women who decide to terminate a pregnancy. However, the exposure to the risk of unsafe induced abortion is not the same for all the women who faced unwanted pregnancy and decide to have an abortion. Drawn from a qualitative study on the issue of abortion in Ouagadougou, Burkina Faso's capital, the contrasting cases of two young women who had abortion allow us to show how the women's personal resources (such as the school level, financial resources, the compliance to social norms, the social network, etc.) may determine the degree of vulnerability of women, the delay to have an abortion, the type of care they are likely to benefit from, and the cost they have to face. This study concludes that the poorest always pay more (cost and consequences), take longer to have an abortion, and have more exposure to the risk of unsafe abortion. PMID:24790605

Clinical-outcome-based demand management in health services.

PubMed

Brogan, C; Lawrence, D; Mayhew, L

2008-01-01

THE PROBLEM OF MANAGING DEMAND: Most healthcare systems have 'third-party payers' who face the problem of keeping within budgets despite pressures to increase resources due to the ageing population, new technologies and patient demands to lower thresholds for care. This paper uses the UK National Health Service as a case study to suggest techniques for system-based demand management, which aims to control demand and costs whilst maintaining the cost-effectiveness of the system. The technique for managing demand in primary, elective and urgent care consists of managing treatment thresholds for appropriate care, using a whole-systems approach and costing the care elements in the system. It is important to analyse activity in relation to capacity and demand. Examples of using these techniques in practice are given. The practical effects of using such techniques need evaluation. If these techniques are not used, managing demand and limiting healthcare expenditure will be at the expense of clinical outcomes and unmet need, which will perpetuate financial crises.

[Introductory concepts of health economics and the social impact of alcohol abuse].

PubMed

Moraes, Edilaine; Campos, Geraldo M; Figlie, Neliana B; Laranjeira, Ronaldo R; Ferraz, Marcos B

2006-12-01

Brazilian society bears high economic costs in view of the problems resulting from the alcohol consumption. There is a lack of economic studies into alcohol misuse or dependence in Brazil due to the limited financial resources, despite the huge health problems the country has been facing. This paper aims to introduce basic concepts of Heath Economics to health care practitioners, such as: Complete and Incomplete Economic Evaluation, Disease Costs, Cost Comparison, Types of Evaluation (cost-minimisation, cost-effectiveness, cost-utility, and cost-benefice), Point of View Analysis (from patient, health institution, Ministry of Health, or society), Types of Costs (direct, indirect and intangible), and other ones. In addition, research data on the impact of the alcohol consumption on the Brazilian society is described. We do not intend to exhaust the subjects addressed in this paper, but emphasise the need for more national researches that link the economic evaluation to the alcohol addiction issue in order to seek maximum efficiency by maximising the health care and minimising the scarce health system resources.

Complex adaptive strategy to produce capacity-driven financial improvement.

PubMed

Capuano, Terry; MacKenzie, Richard; Pintar, Kristi; Halkins, Deborah; Nester, Brian

2009-01-01

Managing capacity in hospitals and emergency departments (EDs) is a global problem. This article demonstrates an efficiency model applied to an acute care hospital facing a budget shortfall as a result of capacity constraints that negatively affected admissions and increased ED diversions. Operating on the hypothesis that reducing inpatient length of stay would allow patients access through all service points and would return the admissions growth rate to budget, a turnaround team was quickly assembled and charged by the chief executive officer to fix the primary cause of financial underperformance--the creeping length of stay--within 60 days. This case study is generalizable to all organizations, regardless of size. Deploying an efficiency model based on the complex adaptive systems approach of "swarmware," the hospital's rapid turnaround efforts produced the results necessary to achieve two established goals: (1) length of stay was decreased to 0.1 days below budget in the 60-day time frame, and (2) all admissions and potential admissions were accepted (saying "yes" to patients) through key points of access in the hospital. Transfer Center denials were reduced to 0 in 19 days, and monthly ED diversions decreased from 110 hours to 20 hours in 60 days. By using a swarmware approach, the hospital created additional bed capacity, allowing for community demand to be accommodated, budgeted admissions target to be exceeded, and market share to be stabilized. This article describes this project's processes and outcomes and the lessons learned and applied, which will assist healthcare leaders who are facing capacity issues in their own organization.

Is clinician refusal to treat an emerging problem in injury compensation systems?

PubMed Central

Brijnath, Bianca; Mazza, Danielle; Kosny, Agnieszka; Bunzli, Samantha; Singh, Nabita; Ruseckaite, Rasa; Collie, Alex

2016-01-01

Objective The reasons that doctors may refuse or be reluctant to treat have not been widely explored in the medical literature. To understand the ethical implications of reluctance to treat there is a need to recognise the constraints of doctors working in complex systems and to consider how these constraints may influence reluctance. The aim of this paper is to illustrate these constraints using the case of compensable injury in the Australian context. Design Between September and December 2012, a qualitative investigation involving face-to-face semistructured interviews examined the knowledge, attitudes and practices of general practitioners (GPs) facilitating return to work in people with compensable injuries. Setting Compensable injury management in general practice in Melbourne, Australia. Participants 25 GPs who were treating, or had treated a patient with compensable injury. Results The practice of clinicians refusing treatment was described by all participants. While most GPs reported refusal to treat among their colleagues in primary and specialist care, many participants also described their own reluctance to treat people with compensable injuries. Reasons offered included time and financial burdens, in addition to the clinical complexities involved in compensable injury management. Conclusions In the case of compensable injury management, reluctance and refusal to treat is likely to have a domino effect by increasing the time and financial burden of clinically complex patients on the remaining clinicians. This may present a significant challenge to an effective, sustainable compensation system. Urgent research is needed to understand the extent and implications of reluctance and refusal to treat and to identify strategies to engage clinicians in treating people with compensable injuries. PMID:26792215

A Collaborative Approach to College and University Student Health and Wellness

ERIC Educational Resources Information Center

Fullerton, Darren S.

2011-01-01

As colleges and universities around the country face extreme financial pressures, they also face mounting public expectations to improve and increase the quality and number of services they provide to their students. Some of these expectations include the presumption that the institutions will offer quality health care, fitness, and wellness…

A Comparison of Robbers' Use of Physical Coercion in Commercial and Street Robberies

ERIC Educational Resources Information Center

McCluskey, John D.

2013-01-01

The face-to-face confrontation involved in the crime of robbery renders vast amounts of financial, physical, and psychological injury in the United States. This study developed hypotheses from existing literature regarding salient situational factors associated with the prevalence of overt physical coercion during commercial and street robberies.…

Feedlot Nutritionist Boot Camp: An Intensive Short-Course for Commercial Agriculture Graduate Students

ERIC Educational Resources Information Center

Reinhardt, Chris; Hubbert, Mike

2014-01-01

In the digital age, face-to-face meetings combining didactic and experiential learning are valuable. Beef cattle nutrition graduate students (n = 33) from 11 universities attended a 5-day feedlot nutrition and management short-course. Topics included nutrition, veterinary medicine, feedmill maintenance, and management of the financial and human…

76 FR 28031 - Clarification of Statement of Policy

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-13

... a conviction, and the definition of de minimis offenses. DATES: The change to the policy statement..., which a party might face, based on the covered crime of which they are convicted, but where the offense... aggregate face value of $1,000 or less, and no insured financial institution or insured credit union was a...

The New York State Mentoring Program.

ERIC Educational Resources Information Center

Cuomo, Matilda R.

This conference address discusses New York State programs for children and families, focusing on a mentoring program. New York State has 44 rural counties, which comprise 80% of the state's total area. Rural schools face limited financial resources and access to services. Rural school children are more likely to face failure than urban or suburban…

Introducing Online Training in an Early Childhood Professional Development System: Lessons Learned in One State

ERIC Educational Resources Information Center

Stone-MacDonald, Angi; Douglass, Anne

2015-01-01

Online educational opportunities provide improved access to high quality professional development for the early education and care workforce. Online and technology mediated learning can create sustainable education and development opportunities for states when face-to-face training is financially prohibitive. This study examined one state's…

The Perceptions of Twelfth-Grade Students on Financial Literacy

ERIC Educational Resources Information Center

Harrelson, Joseph Christopher

2010-01-01

The problem of financial illiteracy at the high school level is becoming a growing pandemic in America. The current financial curriculum may not be preparing high school students against reported financial pitfalls. At the study site, high school students graduate without financial skills that may impact their future financial status. The purpose…

Assessing College Student Needs for Comprehensive Financial Counseling

ERIC Educational Resources Information Center

Choi, Shinae; Gudmunson, Clinton G.; Griesdorn, Timothy S.; Hong, Gong-Soog

2016-01-01

To meet college student needs for financial counseling, it is important to assess why they seek counseling and the extent to which differing financial situations are tied to financial stress. This study examined these issues with a sample of 554 college students who participated in financial counseling and found financial problems in various…

Small Wastewater Systems Research

EPA Pesticide Factsheets

Small communities face barriers to building and maintaining effective wastewater treatment services, challenges include financial/economic limitations, lack of managerial training and geographic isolation/remoteness.

Financial Management. Working for Clean Water: An Information Program for Advisory Groups. Instructor Guide.

ERIC Educational Resources Information Center

Auker, Dennis; And Others

The implementation of water quality programs in the face of rising costs raises many questions for states and local communities, including: How much can taxpayers afford to pay? Who will pay? How can they pay? Described is an hour-long learning session on financial management that is designed to help citizen advisory groups play an integral role…

Farming-Dependent Counties and the Financial Well-Being of Farm Operator Households. Agriculture Information Bulletin Number 544.

ERIC Educational Resources Information Center

Ahearn, Mary; And Others

The financial well-being of farmers varies with the local economy's dependence on farming. Farming-dependent counties (where farming contributes at least 20 percent of the county's total earnings in 1980-84), offer limited nonfarm employment opportunities. These operators earn high farm incomes but face large debts. Declining land values have…

Older Adults' Coping with Negative Life Events: Common Processes of Managing Health, Interpersonal, and Financial/Work Stressors

ERIC Educational Resources Information Center

Moos, Rudolf H.; Brennan, Penny L.; Schutte, Kathleen K.; Moos, Bernice S.

2006-01-01

This study examined how older adults cope with negative life events in health, interpersonal, and financial/work domains and whether common stress and coping processes hold across these three domains. On three occasions, older adults identified the most severe negative event they faced in the last year and described how they appraised and coped…

Principals' and Students' Perceptions on Parental Contribution to Financial Management in Secondary Schools in Kenya

ERIC Educational Resources Information Center

Koross, Peter Kiplangat; Ngware, Moses Waithanji; Sang, Anthony Kiplangat

2009-01-01

Purpose: The management of secondary schools in Kenya has faced a number of challenges over the past few years. These challenges have been manifested in the many ways including lack of financial transparency, which culminate in unaffordable secondary schools fees. The aim of this paper is to present the findings of an investigation into the…

78 FR 56575 - Changes to the Home Equity Conversion Mortgage Program Requirements: Financial Assessments...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-12

... impairments may access this number via TTY by calling the Federal Relay Service at 800-877-8339. Copies of all... number via TTY by calling the toll-free Federal Relay Service during business hours at 1-800-877-8337... Congress'' that was published by the Consumer Financial Protection Bureau.\\1\\ The specific issues facing...

Allocating capital systemwide. Who gets how much and why.

PubMed

Albertina, R M; Bakewell, T F

1989-05-01

The maturing of multi-institutional healthcare systems has created a need for systemwide approaches to managing investment in capital expenditures. Historically, hospitals have allocated capital using traditional capital budgeting techniques, including discounted cash flow, net present value, and internal rate of return methodologies. Now systems can use a multifactored model to allocate capital among member hospitals. This approach uses historical and projected financial and statistical information to quantify the risks member hospitals face. At the system level, capital allocation decisions should start with the strategic and financial planning processes. Catholic systems face an additional caveat: The system's mission statement drives the planning processes. Conceptually, the capital allocation plan is an attempt to value each hospital as a going, or viable, concern. From this perspective, value is understood as a function of expected return, the certainty of the return, and the return offered by similar investments in other hospital markets. Despite the many determinants of business and financial risk, much of the variance in asset market value can be explained through five assessment criteria: market demographics, position within the market, historical and projected financial performance, historical utilization, and third-party reimbursement mix.

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

PubMed

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

2015-08-01

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

[The report of the Commission on Macroeconomics and Health: its relevance to the countries of Latin America and the Caribbean].

PubMed

2002-09-01

The Commission on Macroeconomics and Health (CMH) was established by the Director-General of the World Health Organization (WHO) to evaluate the role of health in economic development. On 20 December 2001 the CMH submitted its report to the WHO Director-General. Entitled Macroeconomics and Health: Investing in Health for Economic Development, the CMH report affirms that in order to reduce poverty; and achieve economic development, it is essential to improve the health of the poor; to accomplish this, it is necessary to expand the access that the poor have to essential health services. The Commission believes that more financial resources are needed, that the health expenditures of less-developed and low-income countries are insufficient for the challenges that these countries face, and that high-income countries must increase their financial assistance in order to help solve the main health problems of less-developed and low-income countries. This piece summarizes a report that was prepared by the Program on Public Policy and Health of the Division of Health and Human Development of the Pan American Health Organization (PAHO). The PAHO document analyzes the importance of the CMH report for the countries of Latin America and the Caribbean, focusing on some of the central arguments put forth in the CMH report as they relate to achieving better health conditions in the Americas. These arguments have been organized around three major themes in the CMH report: a) the relationships between health and economic growth, b) the principal health problems that affect the poor in low-income and low-middle-income#10; countries, and c) the gap between the funding needed to address the principal problems that affect these countries and the actual spending levels. #10;

ARSH 1: Reproductive and sexual health problems of adolescents and young adults: a cross sectional community survey on knowledge, attitude and practice.

PubMed

Nair, M K C; Leena, M L; Thankachi, Yamini; George, Babu; Russell, Paul Swamidhas Sudhakar

2013-11-01

To understand the problems faced and the difference in knowledge, attitude and practice of young people across the age group of 10-24 y on reproductive and sexual health issues and to get their suggestions regarding adolescent care services. This cross sectional community survey involving three districts in Kerala was conducted among adolescents and young adults of 10-24 y using a population proportion to sample size technique. The main problems faced by the young people between 10 and 24 y of age were financial, substance abuse in family, poor academic performance, difference of opinion, disease in self/family, mental problems, lack of talent, strict parents, difficulty in mingling, love failure, broken family, loneliness and problems at school/office in the descending order. As the age advances higher percentage of both boys (43.4%) and girls (61.7%) discuss reproductive sexual health issues among themselves. There was a statistically significant difference in personal hygiene practices like changing napkins/cloths more than once a day (94.3%), cleaning genital organs with soap every day (71.7%), washing after urination (69.2%), washing from front to back after defecation (62.2%) and washing hands with soap after defecation (73.2%) between 10-14, 15-19, and 20-24 y age group with higher percentages in the older groups. In order to make the service more useful, more of the older group participants suggested giving information on adolescent services to parents, adolescents and society as a whole by creating better societal acceptance and keeping confidentiality in service delivery. This study has shown an overall inadequacy in reproductive health knowledge in all age groups, but increasing knowledge gain and better attitude and practices on reproductive and sexual health as the age increases. The suggestions made by the group regarding need for adolescent reproductive sexual health (ARSH) and counseling services with privacy and confidentiality ensured, is useful for planning ARSH services under National Rural Health Mission.

Financial and employment problems in families of children with special health care needs: implications for research and practice.

PubMed

Looman, Wendy S; O'Conner-Von, Susan K; Ferski, Gabriela J; Hildenbrand, Debra A

2009-01-01

The purpose of this study was to identify factors related to financial burden among families of children with special needs and to identify specific provider-level activities associated with decreased risk for such burden. Data for secondary analysis are from the National Survey of Children with Special Health Care Needs (CSHCN). Logistic regression analysis of state-level data was conducted to identify significant predictors of financial and employment problems among families of children with SHCN in Minnesota. Children with more severe conditions and whose family members provided health care at home were more likely to have parents report financial and employment problems due to the child's condition. On the other hand, families whose health care providers communicated well with other service providers and who helped them feel like partners in their child's care were significantly less likely to report financial and employment problems. Pediatric nurses and nurse practitioners can use these findings as they work with families for optimal family outcomes. Advocacy and policy implications at state and federal levels also are discussed.

Catastrophe Finance: An Emerging Discipline

NASA Astrophysics Data System (ADS)

Elsner, James B.; Burch, R. King; Jagger, Thomas H.

2009-08-01

While the recent disasters in the world's financial markets demonstrate that finance theory remains far from perfected, science also faces steep challenges in the quest to predict and manage the effects of natural disasters. Worldwide, as many as half a million people have died in disasters such as earthquakes, tsunamis, and tropical cyclones since the turn of the 21st century [Wirtz, 2008]. Further, natural disasters can lead to extreme financial losses, and independent financial collapses can be exacerbated by natural disasters. In financial cost, 2008 was the second most expensive year on record for such catastrophes and for financial market declines. These extreme events in the natural and financial realms push the issue of risk management to the fore, expose the deficiencies of existing knowledge and practice, and suggest that progress requires further research and training at the graduate level.

The financial crisis in Italy: implications for the healthcare sector.

PubMed

de Belvis, Antonio Giulio; Ferrè, Francesca; Specchia, Maria Lucia; Valerio, Luca; Fattore, Giovanni; Ricciardi, Walter

2012-06-01

The global economic and financial crisis is having and impact on the Italian healthcare system which is undergoing a devolution process from the central government to regions and where about one third of the regional governments (mainly in the central and southern part of the country) are facing large financial deficits. The paper briefly describes the current macro scenario and the main responses taken to face the crisis and highlights the downside risks of introducing "linear" cuts in the allocation of resources. While justified by the risk of a national debt default, present fiscal policies might increase inequalities in access to care, deteriorate overall health indicators and population wellbeing, and sharpen existing difference in the quality of care between regions. Preliminary evidence shows that the crisis is affecting the quality of nutrition and the incidence of psychiatric disorders. During this difficult financial situation Italy is also facing the risk of a major reduction in investments for preventive medicine, Evidence Based Medicine infrastructures, health information systems and physical capital renewal. This cost-cutting strategy may have negative long term consequences Also, important achievement in terms of limiting waiting lists, improving continuity of care and patients' centeredness, and promoting integration between social and health care may be negatively affected by unprecedented resources' cuts. It is essential that in such a period of public funding constraints health authorities monitor incidence of diseases and access to care of the most vulnerable groups and specifically target interventions to those who may be disproportionally hit by the crisis. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Overcoming a perfect storm: an academic cardiology section's story of survival.

PubMed

Calvin, James E

2007-03-01

Increasingly, academic institutions are grappling with financial pressures that threaten the academic mission. The author presents an actual case history in which a section of cardiology in an academic health center was confronted with huge projected deficits that had to be eliminated within the fiscal year. The section used eight principles to shift from deficit to profitability (i.e., having revenue exceed costs). These principles included confronting the brutal facts, managing costs and revenue cycles, setting expectations for faculty, and quality improvement. The section accomplished deficit reduction through reducing faculty salaries (nearly $2 million) and nonfaculty salaries ($1.3 million) and reducing operational costs while maintaining revenues by increasing individual faculty productivity and reducing accounts receivable. In the face of these reductions, clinical revenues were maintained, but research revenue and productivity fell (but research is being fostered now that clinical services are profitable again). These principles can be used to stabilize the financial position of clinical practices in academic settings that are facing financial challenges.

Campus Commons? What Faculty, Financial Officers and Others Think About Controlling College Costs

ERIC Educational Resources Information Center

Immerwahr, John; Johnson, Jean; Gasbarra, Paul

2009-01-01

There is emerging consensus that the United States faces major higher education challenges, including: (1) America's fall from first to tenth place internationally in the percentage of the population with higher education degrees at a time when the country faces increased global economic competition in a knowledge-intensive economy; (2) Education…

Utilizing Online Education in Florida to Meet Mandated Class Size Limitations

ERIC Educational Resources Information Center

Mattox, Kari Ann

2012-01-01

With the passage of a state constitutional amendment in 2002, Florida school districts faced the challenge of meeting class size mandates in core subjects, such as mathematics, English, and science by the 2010-2011 school year, or face financial penalties. Underpinning the amendment's goals was the argument that smaller classes are more effective…

Single Student Parents Face Financial Difficulties, Debt, without Adequate Aid. Fact Sheet #C394

ERIC Educational Resources Information Center

Miller, Kevin

2012-01-01

Parents with dependent children were nearly one quarter of students enrolled for credit at American postsecondary institutions in 2008. These students face significant challenges to remaining enrolled and graduating, including limited access to affordable child care, difficulty balancing the demands of school with the demands of work and family,…

Public Higher-Education Systems Face Painful Choices as Three Northeastern States Confront Massive Deficits.

ERIC Educational Resources Information Center

Blumenstyk, Goldie

1989-01-01

Massachusetts, Connecticut, and New York face giant deficits in their state budgets. The financial impact of the 1986 federal tax reform law was underestimated by colleges and income estimates were overly optimistic for 1988 and 1989. Unpopular, new taxes are seen as the way to solve the budget crunch. (MLW)

Credible Leadership: Exploring Differences in Perception of the Credibility of the Senior Student Affairs Officer among CIC College Presidents and Their Senior Leadership Teams

ERIC Educational Resources Information Center

Powers, Wendy A.

2014-01-01

Modern higher education institutions face tremendous challenges, including dwindling financial resources, waning public support, demands for greater accountability, and daunting student needs and expectations. Campus presidents simply cannot face these challenges as isolated or solitary leaders. High functioning, inclusive, collaborative, and…

Communities respond to predatory lending.

PubMed

Caplan, Mary Ager

2014-04-01

Low-income communities in the United States have faced a history of financial marginalization and exploitation, most evident today in the proliferation of predatory financial services, such as payday lending and check-cashing services. Ameliorating the negative effects of predatory lending has become increasingly important on the agenda of community development efforts and the field of social work. Through the use of case studies, this article describes three specific strategies that communities use to increase financial inclusion and buffer against the deleterious effects of predatory lending: inclusion, community-based alternatives, and community advocacy.

Value measurement in health care: a new perspective.

PubMed

Michelman, J E; Rausch, P E; Barton, T L

1999-08-01

Vital to the success of any healthcare organization is the ability to obtain useful information and feedback about its performance. In particular, healthcare organizations need to begin to understand how non-value-adding work activities detract from their bottom lines. Additionally, financial managers and information systems need to provide data and reports throughout the continuum of care. Overall, healthcare organizations must align the management information and control systems with the planning and decision-making processes. The horizontal information system is a tool to manage three common problems facing today's healthcare managers: (1) the use of existing information to focus on control rather than improve business, (2) failure to focus on satisfying the customer, and (3) failure to combine their efforts with those of the employees by developing trust and a common focus.

The need for econometric research in laboratory animal operations.

PubMed

Baker, David G; Kearney, Michael T

2015-06-01

The scarcity of research funding can affect animal facilities in various ways. These effects can be evaluated by examining the allocation of financial resources in animal facilities, which can be facilitated by the use of mathematical and statistical methods to analyze economic problems, a discipline known as econometrics. The authors applied econometrics to study whether increasing per diem charges had a negative effect on the number of days of animal care purchased by animal users. They surveyed animal numbers and per diem charges at 20 research institutions and found that demand for large animals decreased as per diem charges increased. The authors discuss some of the challenges involved in their study and encourage research institutions to carry out more robust econometric studies of this and other economic questions facing laboratory animal research.

A systematic review of financial debt in adolescents and young adults: prevalence, correlates and associations with crime.

PubMed

Hoeve, Machteld; Stams, Geert Jan J M; van der Zouwen, Marion; Vergeer, Margaretha; Jurrius, Kitty; Asscher, Jessica J

2014-01-01

Financial debt in young people has increased in recent years. Because debt may have severe consequences, and it may enhance criminal behavior, insight into the prevalence and determinants of debt and its association with crime is important. We conducted a systematic review and meta-analysis of 36 manuscripts to examine the prevalence of financial debt (k = 23), correlates and risk factors of debt (k = 16), and associations between debt and criminal behavior in adolescents and young adults (k = 8). Findings revealed that the prevalence of debt is substantial among young people; on average, 49% reported to have at least some debt, 22% had financial problems. Older participants and ethnic minorities were found to have higher levels of debt than younger and indigenous counterparts. Females had more financial problems and higher student loans. Low self-esteem, a pro-debt attitude (of young people and their parents), lack of perceived control towards financial management, poor social functioning, financial stress and external locus of control were found to have the strongest associations with debt. Studies reported strong associations between debt and crime. Particularly, strong associations were found between serious and persistent crime in young people and later (young adult) debt or financial problems.

A Systematic Review of Financial Debt in Adolescents and Young Adults: Prevalence, Correlates and Associations with Crime

PubMed Central

Hoeve, Machteld; Stams, Geert Jan J. M.; van der Zouwen, Marion; Vergeer, Margaretha; Jurrius, Kitty; Asscher, Jessica J.

2014-01-01

Financial debt in young people has increased in recent years. Because debt may have severe consequences, and it may enhance criminal behavior, insight into the prevalence and determinants of debt and its association with crime is important. We conducted a systematic review and meta-analysis of 36 manuscripts to examine the prevalence of financial debt (k = 23), correlates and risk factors of debt (k = 16), and associations between debt and criminal behavior in adolescents and young adults (k = 8). Findings revealed that the prevalence of debt is substantial among young people; on average, 49% reported to have at least some debt, 22% had financial problems. Older participants and ethnic minorities were found to have higher levels of debt than younger and indigenous counterparts. Females had more financial problems and higher student loans. Low self-esteem, a pro-debt attitude (of young people and their parents), lack of perceived control towards financial management, poor social functioning, financial stress and external locus of control were found to have the strongest associations with debt. Studies reported strong associations between debt and crime. Particularly, strong associations were found between serious and persistent crime in young people and later (young adult) debt or financial problems. PMID:25136797

Insurance coverage and financial burden for families of children with special health care needs.

PubMed

Chen, Alex Y; Newacheck, Paul W

2006-01-01

To examine the role of insurance coverage in protecting families of children with special health care needs (CSHCN) from the financial burden associated with care. Data from the 2001 National Survey of Children with Special Health Care Needs were analyzed. We built 2 multivariate regression models by using "work loss/cut back" and "experiencing financial problems" as the dependent variables, and insurance status as the primary independent variable of interest while adjusting for income, race/ethnicity, functional limitation/severity, and other sociodemographic predictors. Approximately 29.9% of CSHCN live in families where their condition led parents to report cutting back on work or stopping work completely. Families of 20.9% of CSHCN reported experiencing financial difficulties due to the child's condition. Insurance coverage significantly reduced the likelihood of financial problems for families at every income level. The proportion of families experiencing financial problems was reduced from 35.7% to 23.0% for the poor and 44.9% to 24.5% for low-income families with continuous insurance coverage (P < .01 for both comparisons). Similarly, the proportion of parents having to cut back or stop work was reduced from 42.8% to 35.9% for the poor (P < .05) and 43.5% to 33.9% for low-income families (P < .01). Continuous health insurance coverage provides protection from financial burden and hardship for families of CSHCN in all income groups. This evidence is supportive of policies designed to promote universal coverage for CSHCN. However, many poor and low-income families continue to experience work loss and financial problems despite insurance coverage. Hence, health insurance should not be viewed as a solution in itself, but instead as one element of a comprehensive strategy to provide financial safety for families with CSHCN.

Health-Related Financial Catastrophe, Inequality and Chronic Illness in Bangladesh

PubMed Central

Rahman, Md. Mizanur; Gilmour, Stuart; Saito, Eiko; Sultana, Papia; Shibuya, Kenji

2013-01-01

Background Bangladesh has a high proportion of households incurring catastrophic health expenditure, and very limited risk sharing mechanisms. Identifying determinants of out-of-pocket (OOP) payments and catastrophic health expenditure may reveal opportunities to reduce costs and protect households from financial risk. Objective This study investigates the determinants of high healthcare expenditure and healthcare- related financial catastrophe. Methods A cross-sectional household survey was conducted in Rajshahi city, Bangladesh, in 2011. Catastrophic health expenditure was estimated separately based on capacity to pay and proportion of non-food expenditure. Determinants of OOP payments and financial catastrophe were estimated using double hurdle and Poisson regression models respectively. Results On average households spent 11% of their total budgets on health, half the residents spent 7% of the monthly per capita consumption expenditure for one illness, and nearly 9% of households faced financial catastrophe. The poorest households spent less on health but had a four times higher risk of catastrophe than the richest households. The risk of financial catastrophe and the level of OOP payments were higher for users of inpatient, outpatient public and private facilities respectively compared to using self-medication or traditional healers. Other determinants of OOP payments and catastrophic expenses were economic status, presence of chronic illness in the household, and illness among children and adults. Conclusion Households that received inpatient or outpatient private care experienced the highest burden of health expenditure. The poorest members of the community also face large, often catastrophic expenses. Chronic illness management is crucial to reducing the total burden of disease in a household and its associated increased risk of level of OOP payments and catastrophic expenses. Households can only be protected from these situations by reducing the health system's dependency on OOP payments and providing more financial risk protection. PMID:23451102

Acceptability of Financial Incentives for Health Behaviours: A Discrete Choice Experiment.

PubMed

Giles, Emma L; Becker, Frauke; Ternent, Laura; Sniehotta, Falko F; McColl, Elaine; Adams, Jean

2016-01-01

Healthy behaviours are important determinants of health and disease, but many people find it difficult to perform these behaviours. Systematic reviews support the use of personal financial incentives to encourage healthy behaviours. There is concern that financial incentives may be unacceptable to the public, those delivering services and policymakers, but this has been poorly studied. Without widespread acceptability, financial incentives are unlikely to be widely implemented. We sought to answer two questions: what are the relative preferences of UK adults for attributes of financial incentives for healthy behaviours? Do preferences vary according to the respondents' socio-demographic characteristics? We conducted an online discrete choice experiment. Participants were adult members of a market research panel living in the UK selected using quota sampling. Preferences were examined for financial incentives for: smoking cessation, regular physical activity, attendance for vaccination, and attendance for screening. Attributes of interest (and their levels) were: type of incentive (none, cash, shopping vouchers or lottery tickets); value of incentive (a continuous variable); schedule of incentive (same value each week, or value increases as behaviour change is sustained); other information provided (none, written information, face-to-face discussion, or both); and recipients (all eligible individuals, people living in low-income households, or pregnant women). Cash or shopping voucher incentives were preferred as much as, or more than, no incentive in all cases. Lower value incentives and those offered to all eligible individuals were preferred. Preferences for additional information provided alongside incentives varied between behaviours. Younger participants and men were more likely to prefer incentives. There were no clear differences in preference according to educational attainment. Cash or shopping voucher-type financial incentives for healthy behaviours are not necessarily less acceptable than no incentives to UK adults.

Technology Confidence, Competence and Problem Solving Strategies: Differences within Online and Face-to-Face Formats

ERIC Educational Resources Information Center

Peterson, Sharon L.; Palmer, Louann Bierlein

2011-01-01

This study identified the problem solving strategies used by students within a university course designed to teach pre-service teachers educational technology, and whether those strategies were influenced by the format of the course (i.e., face-to-face computer lab vs. online). It also examined to what extent the type of problem solving strategies…

Disease-specific out-of-pocket and catastrophic health expenditure on hospitalization in India: Do Indian households face distress health financing?

PubMed

Kastor, Anshul; Mohanty, Sanjay K

2018-01-01

Rising non-communicable diseases (NCDs) coupled with increasing injuries have resulted in a significant increase in health spending in India. While out-of-pocket expenditure remains the major source of health care financing in India (two-thirds of the total health spending), the financial burden varies enormously across diseases and by the economic well-being of the households. Though prior studies have examined the variation in disease pattern, little is known about the financial risk to the families by type of diseases in India. In this context, the present study examines disease-specific out-of-pocket expenditure (OOPE), catastrophic health expenditure (CHE) and distress health financing. Unit data from the 71st round of the National Sample Survey Organization (2014) was used for this study. OOPE is defined as health spending on hospitalization net of reimbursement, and CHE is defined as household health spending exceeding 10% of household consumption expenditure. Distress health financing is defined as a situation when a household has to borrow money or sell their property/assets or when it gets contributions from friends/relatives to meet its health care expenses. OOPE was estimated for 16 selected diseases and across three broad categories- communicable diseases, NCDs and injuries. Multivariate logistic regression was used to understand the determinants of distress financing and CHE. Mean OOPE on hospitalization was INR 19,210 and was the highest for cancer (INR 57,232) followed by heart diseases (INR 40,947). About 28% of the households incurred CHE and faced distress financing. Among all the diseases, cancer caused the highest CHE (79%) and distress financing (43%). More than one-third of the inpatients reported distressed financing for heart diseases, neurological disorders, genito urinary problems, musculoskeletal diseases, gastro-intestinal problems and injuries. The likelihood of incurring distress financing was 3.2 times higher for those hospitalized for cancer (OR 3.23; 95% CI: 2.62-3.99) and 2.6 times for tuberculosis patients (OR 2.61; 95% CI: 2.06-3.31). A large proportion of households who had reported distress financing also incurred CHE. Free treatment for cancer and heart diseases is recommended for the vulnerable sections of the society. Risk-pooling and social security mechanisms based on contributions from both households as well as the central and state governments can reduce the financial burden of diseases and avert households from distress health financing.

Opportunities in the international health services arena.

PubMed

McLean, R A

1997-08-01

Fundamental changes in domestic healthcare delivery in the '90s have prompted many U.S. healthcare organizations to consider entering international markets. Opportunities available to U.S. organizations include investing in foreign organizations, controlling foreign facilities, and obtaining referrals from extraterritorial or cooperating foreign providers. Before entering into these arrangements, however, organizations must consider the benefits, risks, and constraints they may face, specifically with regard to reimbursement and cash flow, currency risk, regulation, and political risk. To succeed in international service delivery ventures, organizations also may need to make adjustments in the training of healthcare financial managers who will face the international marketplace. Being sensitive to the culture of the countries with which they will be dealing is just as important as knowing the currency and financial regulations.

Holistic Management of Schizophrenia Symptoms Using Pharmacological and Non-pharmacological Treatment.

PubMed

Ganguly, Pronab; Soliman, Abdrabo; Moustafa, Ahmed A

2018-01-01

Individuals with schizophrenia lead a poor quality of life, due to poor medical attention, homelessness, unemployment, financial constraints, lack of education, and poor social skills. Thus, a review of factors associated with the holistic management of schizophrenia is of paramount importance. The objective of this review is to improve the quality of life of individuals with schizophrenia, by addressing the factors related to the needs of the patients and present them in a unified manner. Although medications play a role, other factors that lead to a successful holistic management of schizophrenia include addressing the following: financial management, independent community living, independent living skill, relationship, friendship, entertainment, regular exercise for weight gained due to medication administration, co-morbid health issues, and day-care programmes for independent living. This review discusses the relationship between different symptoms and problems individuals with schizophrenia face (e.g., homelessness and unemployment), and how these can be managed using pharmacological and non-pharmacological methods. Thus, the target of this review is the carers of individuals with schizophrenia, public health managers, counselors, case workers, psychiatrists, and clinical psychologists aiming to enhance the quality of life of individuals with schizophrenia.

Measuring water affordability in developed economies. The added value of a needs-based approach.

PubMed

Vanhille, Josefine; Goedemé, Tim; Penne, Tess; Van Thielen, Leen; Storms, Bérénice

2018-07-01

In developed countries, water affordability problems remain up on the agenda as the increasing financial costs of water services can impede the realisation of an equal access to water. More than ever, public authorities that define water tariffs face the challenge of reconciling environmental and cost recovery objectives with equity and financial accessibility for all. Indicators of water affordability can be helpful in this regard. Conventional affordability indicators often rely on the actual amount that households spend on water use. In contrast, we propose a needs-based indicator that measures the risk of being unable to afford the amount of water necessary to fulfill essential needs, i.e. needs that should be fulfilled for adequate participation in society. In this paper we set forth the methodological choices inherent to constructing a needs-based affordability indicator. Using a micro-dataset on households in Flanders (Belgium), we compare its results with the outcomes of a more common actual expenses-indicator. The paper illustrates how the constructed needs-based indicator can complement existing affordability indicators, and its capacity to reveal important risk groups. Copyright © 2018 Elsevier Ltd. All rights reserved.

Minding Your Business: How to Avoid the Seven Deadly Financial Pitfalls.

ERIC Educational Resources Information Center

Stephens, Keith

1990-01-01

Describes financial management problems typically encountered by child care center directors and owners. Offers suggestions for planning and management techniques to overcome problems of cash flow, budgeting, rising costs, underpricing, declining revenues, fee collection, and liquidity. (NH)

Portable parallel portfolio optimization in the Aurora Financial Management System

NASA Astrophysics Data System (ADS)

Laure, Erwin; Moritsch, Hans

2001-07-01

Financial planning problems are formulated as large scale, stochastic, multiperiod, tree structured optimization problems. An efficient technique for solving this kind of problems is the nested Benders decomposition method. In this paper we present a parallel, portable, asynchronous implementation of this technique. To achieve our portability goals we elected the programming language Java for our implementation and used a high level Java based framework, called OpusJava, for expressing the parallelism potential as well as synchronization constraints. Our implementation is embedded within a modular decision support tool for portfolio and asset liability management, the Aurora Financial Management System.

[The potential financial impact of oral health problems in the families of preschool children].

PubMed

Ribeiro, Gustavo Leite; Gomes, Monalisa Cesarino; de Lima, Kenio Costa; Martins, Carolina Castro; Paiva, Saul Martins; Granville-Garcia, Ana Flávia

2016-04-01

The aim of the study was to evaluate the perception of parents/caregivers regarding the financial impact of oral health problems on the families of preschool children. A preschool-based, cross-sectional study was conducted with 834 preschool children in Campina Grande, Brazil. Parents/caregivers answered the Early Childhood Oral Health Impact Scale. "Financial impact" was the dependent variable. Questionnaires addressing socio-demographic variables, history of toothache and health perceptions were administered. Clinical exams were performed by three dentists previously calibrated (Kappa: 0.85-0.90). Descriptive statistics were performed, followed by logistic regression for complex samples (α = 5%). The frequency of financial impact due to oral health problems in preschool children was 7.7%. The following variables were significantly associated with financial impact: parental perception of child's oral health as poor, the interaction between history of toothache and absence of dental caries and the interaction between history of toothache and presence of dental caries. It is concluded that often parents/caregivers reported experiencing a financial impact due to seeking treatment late, mainly by the presence of toothache and complications of the clinical condition.

Mental Health Problems in Parents of Children with Congenital Heart Disease.

PubMed

Kolaitis, Gerasimos A; Meentken, Maya G; Utens, Elisabeth M W J

2017-01-01

This review will provide a concise description of mental health problems in parents of children with a (non-syndromic) congenital heart disease (CHD) during different stressful periods. Predictors of these problems and also implications for clinical practice will be mentioned. Having a child with CHD can be very stressful for parents, who have to face overwhelming emotions and also extra physical, financial, and other practical challenges. Parental distress has been reported in 30-80% of parents and appears not to be related to severity of CHD. Parental mental health, parenting, the parent-child relationship, and parental quality of life can all be affected. Parents, and especially mothers, are at risk of psychological distress, anxiety, depression, somatization, hopelessness, and posttraumatic stress symptoms, which in turn may influence mother's responsiveness. In the long term, the majority of parents adapt successfully to living with a child with CHD, but approximately 40% report a need for psychosocial care. These families may be helped by early psychosocial interventions to alleviate stress and reduce children's emotional and behavioral problems. A holistic approach to early psychosocial interventions should aim at improving coping and enhance parenting. During routine medical checkups, medical professionals should ask about parental stress, family functioning, and psychosocial functioning of the child and, when needed, adequate psychosocial care should be provided.

Supporting Students beyond Financial Aid: Low-Income Students Need Support That Goes Beyond Tuition Assistance

ERIC Educational Resources Information Center

Pierce, Dennis

2016-01-01

Low-income students face a number of obstacles that go beyond the cost of tuition and fees. For instance, their schooling often requires expenses that aren't covered by financial aid, such as books and commuting costs. What's more, education is often competing for their time with other responsibilities, such as the need to work or take care of…

Worldwide Threat Assessment of the US Intelligence Community

DTIC Science & Technology

2014-01-29

data-deletion and system- damaging attacks.  In early 2013, the US financial sector faced wide-scale network denial-of-service attacks that...South Sudan Nigeria Central African Republic Democratic Republic of the Congo Lord’s Resistance Army 19 19 19 19 19 20 20 21 21 East Asia...operations, financial activities, and personnel recruitment. Cyber criminal organizations are as ubiquitous as they are problematic on digital

Restructuring: The Changing Face of Motor Gasoline Marketing

EIA Publications

2001-01-01

This report reviews the U.S. motor gasoline marketing industry during the period 1990 to 1999, focusing on changes that occurred during the period. The report incorporates financial and operating data from the Energy Information Administration's Financial Reporting System (FRS), motor gasoline outlet counts collected by the National Petroleum News from the states, and U.S. Census Bureau salary and employment data published in County Business Patterns.

JPRS Report, Science & Technology Europe

DTIC Science & Technology

1992-08-24

different European countries are incompatible. Moreover, the European market is very weak and this has resulted in a limited choice and high prices ...Research, the Treasury, and the Ministry for Economic Planning, and, within the limits therein established, to apply to the financial market, for the...funds from the financial market in accordance with the conditions and the limits established for the ASI. German Airbus Faces Difficulties

Challenges and Strategies for Hospice Caregivers: A Qualitative Analysis.

PubMed

Oliver, Debra Parker; Demiris, George; Washington, Karla T; Clark, Carlyn; Thomas-Jones, Deborah

2017-08-01

Family caregivers of hospice patients are responsible for the day-to-day care of their loved ones during the final months of life. They are faced with numerous challenges. The purpose of this study was to understand the challenges and coping strategies used by hospice caregivers as they care for their family members. This study is a secondary analysis of data from an attention control group in a large randomized controlled trial testing a cognitive behavioral intervention with hospice caregivers. Audiotaped interviews were coded with initial themes and combined into final categories of caregiving challenges and strategies for managing the hospice caregiving experience. Caregivers shared narratives discussing challenges that included their frustrations with patient care issues, emotional challenges, frustrations with various health care systems, financial problems, and personal health concerns. They also discussed coping strategies involving patient care, self-care, and emotional support. The coping techniques were both problem and emotion based. There is a need for interventions that focus on strengthening both problem-based and emotional-based coping skills to improve the caregiving experience. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Personality and psychopathology of university students.

PubMed

Tosevski, Dusica L; Milovancevic, Milica P; Gajic, Saveta D

2010-01-01

University students represent the national capital and investment for the future, with an implicit mission both for their families and for society as a whole. However, they face multiple stressors such as academic overload, constant pressure to succeed, competition with peers and in some countries financial burden and concerns about the future. As all this may lead to psychopathology, the health of university students has been the subject of increasing focus in recent years. Multiple protective and risk factors are involved in the psychological well being and distress of university students. Specific risk factors for the development of psychopathology are high test anxiety, lower self-efficacy, as well as certain personality traits. Moreover, some students arrive at college with already existing mental health problems. The most frequent mental disorders among students are substance abuse, depression, self-harm and suicide, eating and anxiety disorders. Acquiring and improving knowledge about the student population is a crucial factor in the development of mental health promotion programs in order to meet their needs and to help them cope with various problems. Better understanding and care of the personality profile of university students can be helpful in academic and career choice and prevention of future mental health problems.

Construction of a single atom trap for quantum information protocols

NASA Astrophysics Data System (ADS)

Shea, Margaret E.; Baker, Paul M.; Gauthier, Daniel J.; Duke Physics Department Team

2016-05-01

The field of quantum information science addresses outstanding problems such as achieving fundamentally secure communication and solving computationally hard problems. Great progress has been made in the field, particularly using photons coupled to ions and super conducting qubits. Neutral atoms are also interesting for these applications and though the technology for control of neutrals lags behind that of trapped ions, they offer some key advantages: primarily coupling to optical frequencies closer to the telecom band than trapped ions or superconducting qubits. Here we report progress on constructing a single atom trap for 87 Rb. This system is a promising platform for studying the technical problems facing neutral atom quantum computing. For example, most protocols destroy the trap when reading out the neutral atom's state; we will investigate an alternative non-destructive state detection scheme. We detail the experimental systems involved and the challenges addressed in trapping a single atom. All of our hardware components are off the shelf and relatively inexpensive. Unlike many other systems, we place a high numerical aperture lens inside our vacuum system to increase photon collection efficiency. We gratefully acknowledge the financial support of the ARO through Grant # W911NF1520047.

Australian baby boomers face retirement during the global financial crisis.

PubMed

Kendig, Hal; Wells, Yvonne; O'Loughlin, Kate; Heese, Karla

2013-01-01

This paper examines the impact in Australia of the global financial crisis on the baby boom cohort approaching later life. Data from national focus groups of people aged 50 to 64 years (N = 73), conducted in late 2008, found widespread but variable concern and uncertainty concerning work and retirement plans and experiences. A national survey (N = 1,009) of those aged 50 to 64 years in mid-2009 reported lower levels of financial satisfaction compared with other life domains; many planned to postpone retirement. Findings are interpreted in the context of policies and markets that differed significantly from those in the United States, notwithstanding the global nature of the financial crisis.

Environmental performance and financial report integrity: challenges for the mining sector in Indonesia

NASA Astrophysics Data System (ADS)

Mayangsari, S.

2018-01-01

This study investigates the influence of environmental performance on the financial report integrity. The statistics used were primary data from interviews with senior members of the mining sector regarding environmental issues, as well as secondary data using Financial Report 2016. The samples were listed mining companies with semester data. Questionnaires were used to measure their perceptions of the challenges concerning climate change faced by the mining sector. The results of this research show that regulatory interventions will be critical to environmental issues. This study employed KLD as a proxy for environmental performance, correlated with other variables regarding the integrity of disclosure. The outcome indicates that environmental issues will increase the integrity of financial reports.

Catastrophic expenditure to pay for surgery worldwide: a modelling study.

PubMed

Shrime, Mark G; Dare, Anna J; Alkire, Blake C; O'Neill, Kathleen; Meara, John G

2015-04-27

Approximately 150 million individuals worldwide face catastrophic expenditure each year from medical costs alone, and the non-medical costs of accessing care increase that number. The proportion of this expenditure related to surgery is unknown. Because the World Bank has proposed elimination of medical impoverishment by 2030, the effect of surgical conditions on financial catastrophe should be quantified so that any financial risk protection mechanisms can appropriately incorporate surgery. To estimate the global incidence of catastrophic expenditure due to surgery, we built a stochastic model. The income distribution of each country, the probability of requiring surgery, and the medical and non-medical costs faced for surgery were incorporated. Sensitivity analyses were run to test the robustness of the model. 3·7 billion people (posterior credible interval 3·2-4·2 billion) risk catastrophic expenditure if they need surgery. Each year, 81·3 million people (80·8-81·7 million) worldwide are driven to financial catastrophe-32·8 million (32·4-33·1 million) from the costs of surgery alone and 48·5 million (47·7-49·3) from associated non-medical costs. The burden of catastrophic expenditure is highest in countries of low and middle income; within any country, it falls on the poor. Estimates were sensitive to the definition of catastrophic expenditure and the costs of care. The inequitable burden distribution was robust to model assumptions. Half the global population is at risk of financial catastrophe from surgery. Each year, surgical conditions cause 81 million individuals to face catastrophic expenditure, of which less than half is attributable to medical costs. These findings highlight the need for financial risk protection for surgery in health-system design. MGS received partial funding from NIH/NCI R25CA92203. Copyright © 2015 Shrime et al. Open Access article distributed under the terms of CC BY-NC-ND. Published by Elsevier Ltd.. All rights reserved.

Provider-patient interaction in rural Cameroon--how it relates to the patient's understanding of diagnosis and prescribed drugs, the patient's concept of illness, and access to therapy.

PubMed

Labhardt, Niklaus Daniel; Schiess, Kaspar; Manga, Engelbert; Langewitz, Wolf

2009-08-01

This cross-sectional survey examines the relation between provider-patient interaction and several patient-outcomes in a rural health district in Cameroon. We used structured patient interviews and the Roter Interaction Analysis System (RIAS) for analysis of audio-recorded consultations. Data from 130 primary care consultations with 13 health-care providers were analysed. 51% of patients correctly named their diagnoses after the consultation; in 47% of prescribed drugs patients explained correctly the purpose. Patients' ability to recall diagnoses was related to the extent of clarity a provider used in mentioning it during consultation (recall rates: 87.5% if mentioned explicitly, 56.7% if mentioned indirectly and 19.2% if not mentioned at all; p<0.001). Two thirds of patients were able to describe their concept of illness before the consultation, but only 47% of them mentioned it during consultations. On average patients who mentioned their disease concept were faced with more remarks of disapproval from providers (1.73 vs 0.63 per consultation; p<0.01). Although 41% of patients admitted problems with financial resources to buy prescribed drugs, discussion about financial issues was very rare during consultations. Providers issued financial questions in 32%, patients in 21% of consultations. This study shows that provider-patient interaction in primary health care in a rural Cameroon district deserves more attention. It might improve the patients' knowledge about their health condition and support them in beneficial health behaviour. Our findings should encourage providers to give more medical explanation, to discuss patients' health beliefs in a non-judgmental manner, and to consider financial issues more carefully.

Financial Resource Allocation in Higher Education

ERIC Educational Resources Information Center

Ušpuriene, Ana; Sakalauskas, Leonidas; Dumskis, Valerijonas

2017-01-01

The paper considers a problem of financial resource allocation in a higher education institution. The basic financial management instruments and the multi-stage cost minimization model created are described involving financial instruments to constraints. Both societal and institutional factors that determine the costs of educating students are…

Relationship between financial competence and cognitive function in patients with schizophrenia.

PubMed

Niekawa, Nobuyuki; Sakuraba, Yukie; Uto, Hanae; Kumazawa, Yoshiko; Matsuda, Osamu

2007-10-01

The present study examined financial competence in patients with schizophrenia and the relationship between their financial competence and cognitive function. The subjects consisted of 25 patients with schizophrenia (10 inpatients and 15 outpatients) and 22 normal controls who were community-dwelling people with no psychiatric disorders or cognitive deficit. To assess the subjects' cognitive function and financial competence, they completed the Japanese version of the Neurobehavioral Cognitive Status Examination (COGNISTAT), which has 10 subtests, and the Financial Competency Assessment Tool (FCAT), which has six subordinate domains of financial competence. Patients with schizophrenia performed significantly worse than the controls in all scores on the FCAT. The financial scores that were significantly different between the patients and the normal controls were significantly positively correlated with the scores on several COGNISTAT subtests (e.g. comprehension). These results suggest that patients with schizophrenia have problems with financial competence and that these problems may be accounted for by deficits in several cognitive functions.

Structuring an MBA Consulting Course: Aligning Pedagogical Strategies to Meet the Needs of a Business School's Critical Stakeholders

ERIC Educational Resources Information Center

Roche, Olivier P.; Downie, Yvonne; Diriker, Memo

2013-01-01

At a time when business schools of second-tieruniversities face budget constraints, the MBA consulting program has become avehicle to build a school's reputation and to engage the business community inorder to raise financial resources. Business schools also face competition fromon-line programs, and consulting assignments help to define a…

Employment Alone is Not Enought for America's Low-Income Children and Families. Living at the Edge Research Brief.

ERIC Educational Resources Information Center

Cauthen, Nancy K.; Lu, Hsien-Hen

Families with incomes between the official poverty level and the minimum economic security level face many of the same material hardships and financial pressures that officially poor families face, partly because as their income grows, they lose eligibility for public benefits. This report focuses on the role that public policies play in…

A study on operation efficiency evaluation based on firm's financial index and benchmark selection: take China Unicom as an example

NASA Astrophysics Data System (ADS)

Wu, Zu-guang; Tian, Zhan-jun; Liu, Hui; Huang, Rui; Zhu, Guo-hua

2009-07-01

Being the only listed telecom operators of A share market, China Unicom has always been attracted many institutional investors under the concept of 3G recent years,which itself is a great technical progress expectation.Do the institutional investors or the concept of technical progress have signficant effect on the improving of firm's operating efficiency?Though reviewing the documentary about operating efficiency we find that schoolars study this problem useing the regress analyzing based on traditional production function and data envelopment analysis(DEA) and financial index anayzing and marginal function and capital labor ratio coefficient etc. All the methods mainly based on macrodata. This paper we use the micro-data of company to evaluate the operating efficiency.Using factor analyzing based on financial index and comparing the factor score of three years from 2005 to 2007, we find that China Unicom's operating efficiency is under the averge level of benchmark corporates and has't improved under the concept of 3G from 2005 to 2007.In other words,institutional investor or the conception of technical progress expectation have faint effect on the changes of China Unicom's operating efficiency. Selecting benchmark corporates as post to evaluate the operating efficiency is a characteristic of this method ,which is basicallly sipmly and direct.This method is suit for the operation efficiency evaluation of agriculture listed companies because agriculture listed also face technical progress and marketing concept such as tax-free etc.

The South African Experience of Conservation and Social Forestry Outreach Nurseries

NASA Astrophysics Data System (ADS)

Botha, Jenny; Witkowski, Ed T. F.; Cock, Jacklyn

2006-11-01

Outreach nurseries are favored conservation and social forestry tools globally, but, as with many integrated conservation and development programs (ICDPs), they do not always produce anticipated results. A synopsis of the experience of South African practitioners is provided in this study of 65 outreach nurseries. South African outreach nurseries frequently include financial objectives, creating additional challenges in simultaneously attaining conservation and socioeconomic goals. Progress was hindered by biophysical problems (e.g., lack of water, poor soils, etc.) as well as the harsh socioeconomic conditions facing most communities in which nurseries had been established. Attaining financial viability was challenging. Business management skills were often restricted, and few viability studies included adequate market research. Costs to community participants were usually high, and benefits were limited. Conservation objectives were frequently lost in the struggle to attain financial viability. The management of social processes also proved challenging. Although small scale and relatively straightforward compared with many ICDPs, nurseries usually require substantial institutional support, including a range of technical, business, and development services. Project time frames need to be reconsidered, as practitioners estimate that it takes 5-10 years for nurseries to start meeting objectives, and donors and implementing agencies often operate on 2-3-year project cycles. Detailed viability studies are essential, incorporating a social probe and an assessment of potential impacts of projects on community participants. Progress needs to be continuously evaluated to enable institutions and community participants to adapt to changing conditions as well as ensure that the spectrum of objectives are being achieved.

The South African experience of conservation and social forestry outreach nurseries.

PubMed

Botha, Jenny; Witkowski, Ed T F; Cock, Jacklyn

2006-11-01

Outreach nurseries are favored conservation and social forestry tools globally, but, as with many integrated conservation and development programs (ICDPs), they do not always produce anticipated results. A synopsis of the experience of South African practitioners is provided in this study of 65 outreach nurseries. South African outreach nurseries frequently include financial objectives, creating additional challenges in simultaneously attaining conservation and socioeconomic goals. Progress was hindered by biophysical problems (e.g., lack of water, poor soils, etc.) as well as the harsh socioeconomic conditions facing most communities in which nurseries had been established. Attaining financial viability was challenging. Business management skills were often restricted, and few viability studies included adequate market research. Costs to community participants were usually high, and benefits were limited. Conservation objectives were frequently lost in the struggle to attain financial viability. The management of social processes also proved challenging. Although small scale and relatively straightforward compared with many ICDPs, nurseries usually require substantial institutional support, including a range of technical, business, and development services. Project time frames need to be reconsidered, as practitioners estimate that it takes 5-10 years for nurseries to start meeting objectives, and donors and implementing agencies often operate on 2-3-year project cycles. Detailed viability studies are essential, incorporating a social probe and an assessment of potential impacts of projects on community participants. Progress needs to be continuously evaluated to enable institutions and community participants to adapt to changing conditions as well as ensure that the spectrum of objectives are being achieved.

Beyond income poverty: Measuring disadvantage in terms of material hardship and health

PubMed Central

Neckerman, Kathryn M.; Garfinkel, Irwin; Teitler, Julien O.; Waldfogel, Jane; Wimer, Christopher

2016-01-01

The New York City (NYC) Longitudinal Study of Wellbeing, or “Poverty Tracker,” is a survey of about 2,300 New York City residents. Its purpose is to provide a multidimensional and dynamic understanding of economic disadvantage in NYC. Measures of disadvantage were collected at baseline and a 12-month follow-up, and include three types of disadvantage: (1) income poverty, using a measure based on the new Supplemental Poverty Measure; (2) material hardship, including indicators of food insecurity, housing hardship, unmet medical needs, utility cutoffs, and financial insecurity; and (3) adult health problems, which can drain family time and resources. This paper presents initial results for NYC families with children under 18. At baseline, 56% of families with children had one or more type of disadvantage, including 28% with income poverty, 39% with material hardship, and 17% with an adult health problem. Even among nonpoor families, 33% experienced material hardship and 14% reported an adult health problem. Two-thirds of all families faced disadvantage at either baseline or follow-up, with 46% experiencing some kind of disadvantage at both time points. Respondents with a college education were much less likely to face disadvantage. Even after adjusting for educational attainment and family characteristics, the families of black and Hispanic respondents had elevated rates of disadvantage. Considering income poverty alone greatly understates the extent of disadvantage among families with children in New York City. These results suggest that in addition to addressing income poverty, policymakers should give priority to efforts to reduce material hardship and help families cope with chronic physical or mental illness. The need for these resources extends far above the poverty line. PMID:27044702

Beyond Income Poverty: Measuring Disadvantage in Terms of Material Hardship and Health.

PubMed

Neckerman, Kathryn M; Garfinkel, Irwin; Teitler, Julien O; Waldfogel, Jane; Wimer, Christopher

2016-04-01

The New York City (NYC) Longitudinal Study of Wellbeing, or "Poverty Tracker," is a survey of approximately 2300 NYC residents. Its purpose is to provide a multidimensional and dynamic understanding of economic disadvantage in NYC. Measures of disadvantage were collected at baseline and a 12-month follow-up, and include 3 types of disadvantage: 1) income poverty, using a measure on the basis of the new Supplemental Poverty Measure; 2) material hardship, including indicators of food insecurity, housing hardship, unmet medical needs, utility cutoffs, and financial insecurity; and 3) adult health problems, which can drain family time and resources. In this article initial results for NYC families with children younger than the age of 18 years are presented. At baseline, 56% of families with children had 1 or more type of disadvantage, including 28% with income poverty, 39% with material hardship, and 17% with an adult health problem. Even among nonpoor families, 33% experienced material hardship and 14% reported an adult health problem. Two-thirds of all families faced disadvantage at either baseline or follow-up, with 46% experiencing some kind of disadvantage at both time points. Respondents with a college education were much less likely to face disadvantage. Even after adjusting for educational attainment and family characteristics, the families of black and Hispanic respondents had increased rates of disadvantage. Considering income poverty alone the extent of disadvantage among families with children in NYC is greatly understated. These results suggest that in addition to addressing income poverty, policymakers should give priority to efforts to reduce material hardship and help families cope with chronic physical or mental illness. The need for these resources extends far above the poverty line. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Financial Education Can Change Behavior.

ERIC Educational Resources Information Center

Varcoe, Karen P.; Wright, Joan

1991-01-01

Interviews with 190 participants in Money Sense--a financial management education program based on the "master volunteer" approach--showed that the program taught them food shopping and money management skills and helped save money on food costs. Most experienced fewer financial problems and perceived their financial status as improved.…

Is clinician refusal to treat an emerging problem in injury compensation systems?

PubMed

Brijnath, Bianca; Mazza, Danielle; Kosny, Agnieszka; Bunzli, Samantha; Singh, Nabita; Ruseckaite, Rasa; Collie, Alex

2016-01-20

The reasons that doctors may refuse or be reluctant to treat have not been widely explored in the medical literature. To understand the ethical implications of reluctance to treat there is a need to recognise the constraints of doctors working in complex systems and to consider how these constraints may influence reluctance. The aim of this paper is to illustrate these constraints using the case of compensable injury in the Australian context. Between September and December 2012, a qualitative investigation involving face-to-face semistructured interviews examined the knowledge, attitudes and practices of general practitioners (GPs) facilitating return to work in people with compensable injuries. Compensable injury management in general practice in Melbourne, Australia. 25 GPs who were treating, or had treated a patient with compensable injury. The practice of clinicians refusing treatment was described by all participants. While most GPs reported refusal to treat among their colleagues in primary and specialist care, many participants also described their own reluctance to treat people with compensable injuries. Reasons offered included time and financial burdens, in addition to the clinical complexities involved in compensable injury management. In the case of compensable injury management, reluctance and refusal to treat is likely to have a domino effect by increasing the time and financial burden of clinically complex patients on the remaining clinicians. This may present a significant challenge to an effective, sustainable compensation system. Urgent research is needed to understand the extent and implications of reluctance and refusal to treat and to identify strategies to engage clinicians in treating people with compensable injuries. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Balanced scorecard application in the health care industry: a case study.

PubMed

Kocakülâh, Mehmet C; Austill, A David

2007-01-01

Balanced scorecards became a popular strategic performance measurement and management tool in the 1990s by Robert Kaplan and David Norton. Mainline companies accepted balanced scorecards quickly, but health care organizations were slow to adopt them for use. A number of problems face the health care industry, including cost structure, payor limitations and constraints, and performance and quality issues that require changes in how health care organizations, both profit and nonprofit, manage operations. This article discusses balanced scorecards generally from theoretical and technical views, and why they should be used by health care organizations. The authors argue that balanced scorecards are particularly applicable to hospitals, clinics, and other health care companies. Finally, the authors perform a case study of the development, implementation, and use of balance scorecards by a regional Midwestern health care system. The positive and negative aspects of the subject's balanced scorecard are discussed. Leaders in today's health care industry are under great pressure to meet their financial goals. The industry is faced with financial pressures from consumers, insurers, and governments. Inflation in the industry is much higher than it is within the overall economy. Employers can no longer bear the burden of rising group health insurance costs for its employees. Too many large companies have used bankruptcy law as a shield to reduce or shift some of their legal obligations to provide health insurance coverage to present or retired employees. Stakeholders of health care providers are demanding greater control over costs. As the segment of un- or underinsured within the United States becomes larger as a percentage of the population, voters are seriously beginning to demand some form of national health insurance, which will drastically change the health care industry.

Parental perspectives on the financial impact of caring for a child with CKD.

PubMed

Medway, Meredith; Tong, Allison; Craig, Jonathan C; Kim, Siah; Mackie, Fiona; McTaggart, Steven; Walker, Amanda; Wong, Germaine

2015-03-01

The economic consequences of chronic kidney disease (CKD) are severe for adult patients and their households, but the out-of-pocket expenses and economic burden of CKD and how this affects the caregivers of children with kidney disease are unclear. This study aims to describe parental perspectives on the financial impact of caring for a child with CKD. Face-to-face semistructured interviews. Parents of children with CKD from 3 pediatric nephrology centers in Australia. Transcripts were analyzed thematically. 27 parents of 26 children participated. We identified 5 themes: loss of freedom and control (prioritizing care, limiting occupational opportunities, and appreciating socioeconomic advantage), burden of sole responsibility (inability to rely on others, lack of respite, increased separation of family roles, and self-reliance), adapting for survival (vigilant budgeting, redefining normality and expectations, rechanneling resources to basic needs, and negotiating work flexibility), instability of circumstances (depleted capacity to work, unpredictability of child's health, burden of travel-related costs, imposition of debt, and domestic upheaval), and struggle in seeking support ("falling through the cracks" and unmet information needs). Few participants were fathers (n=5), and results may not be transferable to non-English-speaking caregivers because these participants were excluded. Parents focused their resources and attention on meeting the complex needs of their child. Inability to sustain employment due to focus on their child's care and both medical and nonmedical expenses were major contributors to the financial impact, with financial stress compounded by difficulties accessing government support. As a result, parents experienced profound financial and social instability and physical and psychological fatigue and exercised extreme financial vigilance. Increased access to respite and domestic support and financial and psychosocial interventions are suggested to minimize the financial impact of caring for a child with CKD, which in turn may lead to better care, quality of life, and health outcomes for children with CKD and their families. Copyright © 2015 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Sustainable water future with global implications: everyone's responsibility.

PubMed

Kuylenstierna, J L; Bjorklund, G; Najlis, P

1997-01-01

The current use and management of freshwater is not sustainable in many countries and regions of the world. If current trends are maintained, about two-thirds of the world's population will face moderate to severe water stress by 2025 compared to one-third at present. This water stress will hamper economic and social development unless action is taken to deal with the emerging problems. The Comprehensive Assessment of the Freshwater Resources of the World, prepared by the UN and the Stockholm Environment Institute, calls for immediate action to prevent further deterioration of freshwater resources. Although most problems related to water quantity and quality require national and regional solutions, only a global commitment can achieve the necessary agreement on principles, as well as financial means to attain sustainability. Due to the central and integrated role played by water in human activities, any measures taken need to incorporate a wide range of social, ecological and economic factors and needs. The Assessment thus addresses the many issues related to freshwater use, such as integrated land and water management at the watershed level, global food security, water supply and sanitation, ecosystem requirements, pollution, strengthening of major groups, and national water resource assessment capabilities and monitoring networks. Governments are urged to work towards a consensus regarding global principles and guidelines for integrated water management, and towards their implementation in local and regional water management situations. The alternative development options available to countries facing water stress, or the risk thereof, needs to be considered in all aspects of development planning.

Latin America and the International Lending Organizations: The Ties that Bind.

DTIC Science & Technology

1980-07-23

necessary end Identify by block number) Argentina , Authoritarian Regimes, Brazil, Bureaucratic-Authoritar- 4 J ianism, Debt-Public and Private, Direct...domestic poli- cies to satisfy the requirements and gain the approval of the international financial community. Third, during times of financial crisis ...bility of debt service obligations constrain the options available to a government facing a debt crisis created by an absolute drop in export earnings or

Financial Strain, Major Family Life Events, and Parental Academic Involvement During Adolescence.

PubMed

Camacho-Thompson, Daisy E; Gillen-O'Neel, Cari; Gonzales, Nancy A; Fuligni, Andrew J

2016-06-01

Parental academic involvement-whether through school participation and communication, or supervision and assistance at home-often has been cited as a way to enhance academic achievement. Yet, little is known about how the financial and life pressures faced by families can compromise parents' ability to become involved in their adolescents' education. In the current study, these dynamics were examined among Mexican-origin families, who often may face challenging financial and familial circumstances, and whose students may have more difficulty in secondary school. Parents of Mexican-origin ninth and tenth grade students from two high schools in Los Angeles (N = 428; 50 % female) completed quantitative interviews. The results revealed that financial strain predicted less involvement at school, and major family life events predicted less involvement at home, even after controlling for potentially confounding factors. Moreover, both of the associations between parental stress and parental academic involvement were mediated by lower levels of relationship quality between parents and adolescents, but not by conflict within the parent-adolescent dyad or parental depressive and somatic symptoms. The findings suggest that stress may limit parents' ability to become involved their adolescents' education, and highlight the importance of understanding family dynamics when examining parental academic involvement among Mexican-origin families.

Exploring low-income families' financial barriers to food allergy management and treatment.

PubMed

Minaker, Leia M; Elliott, Susan J; Clarke, Ann

2014-01-01

Objectives. Low-income families may face financial barriers to management and treatment of chronic illnesses. No studies have explored how low-income individuals and families with anaphylactic food allergies cope with financial barriers to anaphylaxis management and/or treatment. This study explores qualitatively assessed direct, indirect, and intangible costs of anaphylaxis management and treatment faced by low-income families. Methods. In-depth, semistructured interviews with 23 participants were conducted to gain insight into income-related barriers to managing and treating anaphylactic food allergies. Results. Perceived direct costs included the cost of allergen-free foods and allergy medication and costs incurred as a result of misinformation about social support programs. Perceived indirect costs included those associated with lack of continuity of health care. Perceived intangible costs included the stress related to the difficulty of obtaining allergen-free foods at the food bank and feeling unsafe at discount grocery stores. These perceived costs represented barriers that were perceived as especially salient for the working poor, immigrants, youth living in poverty, and food bank users. Discussion. Low-income families report significant financial barriers to food allergy management and anaphylaxis preparedness. Clinicians, advocacy groups, and EAI manufacturers all have a role to play in ensuring equitable access to medication for low-income individuals with allergies.

Financial Strain, Major Family Life Events, and Parental Academic Involvement during Adolescence

PubMed Central

Camacho-Thompson, Daisy E.; Gillen-O’Neel, Cari; Gonzales, Nancy A.; Fuligni, Andrew J.

2017-01-01

Parental academic involvement—whether through school participation and communication, or supervision and assistance at home—often has been cited as a way to enhance academic achievement. Yet, little is known about how the financial and life pressures faced by families can compromise parents’ ability to become involved in their adolescents’ education. In the current study, these dynamics were examined among Mexican-origin families, who often may face challenging financial and familial circumstances, and whose students may have more difficulty in secondary school. Parents of Mexican-origin ninth and tenth grade students from two high schools in Los Angeles (N = 428; 49% female) completed quantitative interviews. The results revealed that financial strain predicted less involvement at school, and major family life events predicted less involvement at home, even after controlling for potentially confounding factors. Moreover, both of the associations between parental stress and parental academic involvement were mediated by lower levels of relationship quality between parents and adolescents, but not by conflict within the parent-adolescent dyad or parental depressive and somatic symptoms. The findings suggest that stress may limit parents’ ability to become involved their adolescents’ education, and highlight the importance of understanding family dynamics when examining parental academic involvement among Mexican-origin families. PMID:26951508

Expressing the sense of Congress that financial institutions should work proactively with their customers affected by the shutdown of the Federal Government who may be facing short-term financial hardship and long-term damage to their creditworthiness through no fault of their own.

THOMAS, 113th Congress

Rep. Waters, Maxine [D-CA-43

2013-10-11

House - 10/11/2013 Referred to the Committee on Financial Services, and in addition to the Committee on Oversight and Government Reform, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the... (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Financial Conditions: An In-Depth Look at Fiscal Troubles on Campus.

ERIC Educational Resources Information Center

Scoby, Jerry L.

1993-01-01

A survey of 300 college and university business officers investigated the extent of the institutions' financial difficulties. Results reveal administrators' perceptions of the reasons for and solutions to financial problems, factors in institutional stability or strength, plans to maintain or strengthen the institution's financial condition,…

Some problems and prospects for marine transportation of oil in the 1970s

NASA Technical Reports Server (NTRS)

Zannetos, Z. S.

1973-01-01

The problems associated with, and the financial resources required for ocean transportation of petroleum in the 1970s are discussed in terms of the energy crisis. Spot rate fluctuations for tankers are examined along with the financial requirements for ocean transportation.

Did the strong get stronger and the weak get weaker? Examining changes in hospital financial condition.

PubMed

Bazzoli, Gloria J; Lindrooth, Richard C; Clement, Jan P; Zhao, Mei; Chukmaitov, Askar

2006-01-01

In the late 1990s and early 2000s, many industry observers expressed the view that there was a growing dichotomy in the hospital industry in which financially weak hospitals were getting weaker and financially strong hospitals were getting stronger. Although existing analysis of cross-sectional financial data concur with this view, our analysis of 1993 to 2000 longitudinal data provides only partial support. We find that about one half of general acute care hospitals classified as financially strong in 1993-95 continued to be strong in 1998-00. More persistence was found for hospitals in weak financial position in 1993-95 with about 60 to 70 percent of them continuing to be weak in 1998-00. Persistently weak hospitals did experience deteriorating financial condition whereas persistently strong hospitals appeared at best to hold their ground financially. Although many Medicare payment policies appear well-targeted to hospitals that would otherwise have financial problems (for example, isolated rural institutions and teaching hospitals), policymakers may need to consider the development of temporary loan or grant programs to assist hospitals that experience transitory financial problems during difficult times.

Counting to 20: Online Implementation of a Face-to-Face, Elementary Mathematics Methods Problem-Solving Activity

ERIC Educational Resources Information Center

Schwartz, Catherine Stein

2012-01-01

This study describes implementation of the same problem-solving activity in both online and face-to-face environments. The activity, done in the first class period or first module of a K-2 mathematics methods course, was initially used in a face-to-face class and then adapted later for use in an online class. While the task was originally designed…

An elective course in personal finance for health care professionals.

PubMed

Chui, Michelle A

2009-02-19

To create, implement, and assess an elective course on the principles and applications of personal finance. A 1.5 unit (15 hours total) elective course was designed using active-learning pedagogy, lecture, and group discussion. Homework assignments were designed to provide practical tools and materials that students could individualize and apply to their personal financial goals. Student satisfaction, using a standard course evaluation form, revealed consistent high ratings. Student enrollment increased from 19 students in its initial year to 90 students in its fourth year. Student knowledge, assessed using the Jump$tart Financial Literacy Survey, indicated significant knowledge acquisition. Many pharmacy students are ill equipped to effectively handle the complex financial decisions they face after graduation. This course provides students with practical tools to identify appropriate ways to achieve their financial goals and critically evaluate financial advice and advisors.

Hospice Care

MedlinePlus

... help connect you to these agencies. Other Family Counseling and Support Services Seniors and family caregivers facing ... organizations offer resources that address everything from family counseling to financial planning: Family Caregiver Alliance supports and ...

Financial stress, parent functioning and adolescent problem behavior: an actor-partner interdependence approach to family stress processes in low-, middle-, and high-income families.

PubMed

Ponnet, Koen

2014-10-01

The family stress model proposes that financial stress experienced by parents is associated with problem behavior in adolescents. The present study applied an actor-partner interdependence approach to the family stress model and focused on low-, middle-, and high-income families to broaden our understanding of the pathways by which the financial stress of mothers and fathers are related to adolescent outcomes. The study uses dyadic data (N = 798 heterosexual couples) from the Relationship between Mothers, Fathers and Children study in which two-parent families with an adolescent between 11 and 17 years of age participated. Path-analytic results indicated that in each of the families the association between parents' financial stress and problem behavior in adolescents is mediated through parents' depressive symptoms, interparental conflict, and positive parenting. Family stress processes also appear to operate in different ways for low-, middle-, and high-income families. In addition to a higher absolute level of financial stress in low-income families, financial stress experienced by mothers and fathers in these families had significant direct and indirect effects on problem behavior in adolescents, while in middle- and high-income families only significant indirect effects were found. The financial stress of a low-income mother also had a more detrimental impact on her level of depressive feelings than it had on mothers in middle-income families. Furthermore, the study revealed gender differences in the pathways of mothers and fathers. Implications for research, clinical practice, and policy are also discussed.

Psychosocial outcomes following spinal cord injury in Iran.

PubMed

Khazaeipour, Zahra; Norouzi-Javidan, Abbas; Kaveh, Mahboobeh; Khanzadeh Mehrabani, Fatemeh; Kazazi, Elham; Emami-Razavi, Seyed-Hasan

2014-05-01

Objective/background In patients with spinal cord injury (SCI), SCI causes psychosocial complications that vary based on culture, conditions, and the amenities of each community. Health planners and social services should have full knowledge of these issues in order to plan schedules that address them. In this study, we aimed to understand the psychosocial problems of persons with SCI in Iran and to explore the requirements for minimizing these difficulties. Design This was a descriptive cross-sectional study. Setting Brain and Spinal Cord Injury Research (BASIR) Center, Tehran University of Medical Sciences, Tehran, Iran. Participants One hundred nineteen persons with SCI referred to BASIR clinic to receive outpatient rehabilitation. Methods In this study, trained interviewers administered a questionnaire to the participants. The questionnaire consisted of socio-demographic variables and psychosocial questions about finances, employment, housing, education, and social communication problems. Results Psychosocial problems for persons with SCI are mainly associated with financial hardship due to unemployment and the high cost of living, followed by difficulties with transportation, house modification, education, marriage, social communication, sports, and entertainment. Psychological problems include sadness, depression, irritability/anger, suicidal thoughts, and a lack of self-confidence. The levels of the aforementioned problems differ with respect to sex. Conclusion Persons suffering from SCI can face some serious psychosocial problems that may vary according to sex. For example, transportation difficulties can lead to problems such as unsociability. After recognizing these problems, the next step would be providing services to facilitate a productive lifestyle, enhancing social communication and psychological health, and ultimately creating a higher quality of life.

Catastrophic health expenditure among households with members with special diseases: A case study in Kurdistan

PubMed Central

Moradi, Ghobad; Safari, Hossein; Piroozi, Bakhtiar; Qanbari, Laila; Farshadi, Salahadin; Qasri, Homan; Farhadifar, Fariba

2017-01-01

Background: One of the main goals of health systems is to protect people against financial risks associated with diseases that can be catastrophic for patients. In 2014, Health Sector Evolution Plan (HSEP) was implemented in Iran; one of the objectives of HSEP was to reduce out-of-pocket payments and provide more financial protection for people. Therefore, the present study aimed at exploring the likelihood of facing catastrophic health expenditures (CHE) among households with members suffering from dialysis, kidney transplant, or multiple sclerosis (MS) after the implementation of HSEP. Methods: A total number of 385 households were selected using stratified random sampling and were asked to complete the World Health Survey questionnaire through telephone conversations. As outlined by the World Health Organization (WHO), when household out-of-pocket expense for health services is ≥40% of its capacity to pay, then that household is considered to be facing CHE. Furthermore, determinants of CHE were identified using logistic regression. Results: The percentage of facing catastrophic health care expenditures for households with a MS, dialysis, and kidney transplant patient was 20.6%, 18.7%, and 13.8%, respectively. Results of logistic regression analysis revealed that patient’s economic status, level of education, supplementary insurance status, type of disease, multiple members with special diseases in the household, rural residence, use of inpatient, dental, and rehabilitation services were effective factors for determining the likelihood of facing CHE. Conclusion: Despite the implementation of HSEP, the percentage of CHE is still high for households that have members who suffer from special diseases. However, basic health insurance packages should be amended and more cost-sharing exemptions should be granted to provide more financial protection for the vulnerable households. PMID:29445672

Catastrophic health expenditure among households with members with special diseases: A case study in Kurdistan.

PubMed

Moradi, Ghobad; Safari, Hossein; Piroozi, Bakhtiar; Qanbari, Laila; Farshadi, Salahadin; Qasri, Homan; Farhadifar, Fariba

2017-01-01

Background: One of the main goals of health systems is to protect people against financial risks associated with diseases that can be catastrophic for patients. In 2014, Health Sector Evolution Plan (HSEP) was implemented in Iran; one of the objectives of HSEP was to reduce out-of-pocket payments and provide more financial protection for people. Therefore, the present study aimed at exploring the likelihood of facing catastrophic health expenditures (CHE) among households with members suffering from dialysis, kidney transplant, or multiple sclerosis (MS) after the implementation of HSEP. Methods: A total number of 385 households were selected using stratified random sampling and were asked to complete the World Health Survey questionnaire through telephone conversations. As outlined by the World Health Organization (WHO), when household out-of-pocket expense for health services is ≥40% of its capacity to pay, then that household is considered to be facing CHE. Furthermore, determinants of CHE were identified using logistic regression. Results: The percentage of facing catastrophic health care expenditures for households with a MS, dialysis, and kidney transplant patient was 20.6%, 18.7%, and 13.8%, respectively. Results of logistic regression analysis revealed that patient's economic status, level of education, supplementary insurance status, type of disease, multiple members with special diseases in the household, rural residence, use of inpatient, dental, and rehabilitation services were effective factors for determining the likelihood of facing CHE. Conclusion: Despite the implementation of HSEP, the percentage of CHE is still high for households that have members who suffer from special diseases. However, basic health insurance packages should be amended and more cost-sharing exemptions should be granted to provide more financial protection for the vulnerable households.

Food stress in Adelaide: the relationship between low income and the affordability of healthy food.

PubMed

Ward, Paul R; Verity, Fiona; Carter, Patricia; Tsourtos, George; Coveney, John; Wong, Kwan Chui

2013-01-01

Healthy food is becoming increasingly expensive, and families on low incomes face a difficult financial struggle to afford healthy food. When food costs are considered, families on low incomes often face circumstances of poverty. Housing, utilities, health care, and transport are somewhat fixed in cost; however food is more flexible in cost and therefore is often compromised with less healthy, cheaper food, presenting an opportunity for families on low incomes to cut costs. Using a "Healthy Food Basket" methodology, this study costed a week's supply of healthy food for a range of family types. It found that low-income families would have to spend approximately 30% of household income on eating healthily, whereas high-income households needed to spend about 10%. The differential is explained by the cost of the food basket relative to household income (i.e., affordability). It is argued that families that spend more than 30% of household income on food could be experiencing "food stress." Moreover the high cost of healthy foods leaves low-income households vulnerable to diet-related health problems because they often have to rely on cheaper foods which are high in fat, sugar, and salt.

Food Stress in Adelaide: The Relationship between Low Income and the Affordability of Healthy Food

PubMed Central

Ward, Paul R.; Verity, Fiona; Carter, Patricia; Tsourtos, George; Coveney, John; Wong, Kwan Chui

2013-01-01

Healthy food is becoming increasingly expensive, and families on low incomes face a difficult financial struggle to afford healthy food. When food costs are considered, families on low incomes often face circumstances of poverty. Housing, utilities, health care, and transport are somewhat fixed in cost; however food is more flexible in cost and therefore is often compromised with less healthy, cheaper food, presenting an opportunity for families on low incomes to cut costs. Using a “Healthy Food Basket” methodology, this study costed a week's supply of healthy food for a range of family types. It found that low-income families would have to spend approximately 30% of household income on eating healthily, whereas high-income households needed to spend about 10%. The differential is explained by the cost of the food basket relative to household income (i.e., affordability). It is argued that families that spend more than 30% of household income on food could be experiencing “food stress.” Moreover the high cost of healthy foods leaves low-income households vulnerable to diet-related health problems because they often have to rely on cheaper foods which are high in fat, sugar, and salt. PMID:23431321

35 Years of Experience From the American Association for Women Radiologists: Increasing the Visibility of Women in Radiology.

PubMed

Spalluto, Lucy B; Arleo, Elizabeth K; Macura, Katarzyna J; Rumack, Carol M

2017-03-01

Women radiologists remain in minority, unchanged for the past several decades. In 1981, the American Association for Women Radiologists (AAWR) was founded to address the problems that women radiologists were experiencing in being subordinate to male radiologists in the workplace and at the national level in organizations with respect to political power and financial compensation, as well as additional issues unique to women in radiology. The AAWR defined goals to meet the needs of women in radiology: improve the visibility of women radiologists, advance the professional and academic standing of women in radiology, and identify and address issues faced by women in radiology. AAWR efforts have included providing opportunities for career development and award recognition, hosting educational programs at national meetings, and publishing numerous manuscripts on issues faced by women in radiology. The AAWR recognizes that although there has been significant progress in the standing of women in radiology over the past 35 years, there is much room for improvement. The AAWR will continue to advocate for the needs of women in radiology. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Theory Oriented Research: Problems and Challenges.

ERIC Educational Resources Information Center

Greer, John T.

This paper discusses problems the author encountered in attempting to conduct a study of teacher motivation as influenced by a combination of participative decision-making and financial rewards. Over a 3-year period, teacher motivation was to be viewed as influenced by two independent variables--participative decision-making and financial rewards;…

28 CFR Appendix B to Subpart I of... - Age Distinctions in Federal Statutes or Regulations Affecting Financial Assistance Administered...

Code of Federal Regulations, 2011 CFR

2011-07-01

.... The Department administers financial assistance under the Juvenile Justice and Delinquency Prevention... justice systems and for purposes related to the prevention of juvenile delinquency. The Department's... the provision of grants addressing problems related to juvenile delinquency and problems related to...

28 CFR Appendix B to Subpart I of... - Age Distinctions in Federal Statutes or Regulations Affecting Financial Assistance Administered...

Code of Federal Regulations, 2012 CFR

2012-07-01

.... The Department administers financial assistance under the Juvenile Justice and Delinquency Prevention... justice systems and for purposes related to the prevention of juvenile delinquency. The Department's... the provision of grants addressing problems related to juvenile delinquency and problems related to...

28 CFR Appendix B to Subpart I of... - Age Distinctions in Federal Statutes or Regulations Affecting Financial Assistance Administered...

Code of Federal Regulations, 2013 CFR

2013-07-01

.... The Department administers financial assistance under the Juvenile Justice and Delinquency Prevention... justice systems and for purposes related to the prevention of juvenile delinquency. The Department's... the provision of grants addressing problems related to juvenile delinquency and problems related to...

28 CFR Appendix B to Subpart I of... - Age Distinctions in Federal Statutes or Regulations Affecting Financial Assistance Administered...

Code of Federal Regulations, 2010 CFR

2010-07-01

.... The Department administers financial assistance under the Juvenile Justice and Delinquency Prevention... justice systems and for purposes related to the prevention of juvenile delinquency. The Department's... the provision of grants addressing problems related to juvenile delinquency and problems related to...

Underbanked: Cooperative Banking as a Potential Solution to the Marijuana-Banking Problem.

PubMed

Tighe, Patrick A

2016-01-01

Numerous states have recently legalized recreational marijuana, which has created a burgeoning marijuana industry needing and demanding access to a variety of banking and financial services. Due, however, to the interplay between the federal criminalization of marijuana and federal anti-money laundering laws, U.S. financial institutions cannot handle legally the proceeds from marijuana activity. As a result, most financial institutions are unwilling to flout federal anti-money laundering laws, and so too few marijuana-related businesses can access banking services. This Note argues that the most viable policy option for resolving this "underbanking" problem is a financial cooperative approach such as a cannabis-only financial cooperative. Even in light of federal anti-money laundering laws, this Note contends that the Federal Reserve is legally authorized to grant some cannabis-only financial cooperatives access to its payment system services under the Monetary Control Act of 1980.

[Reliability and validity of the Chinese version on Comprehensive Scores for Financial Toxicity based on the patient-reported outcome measures].

PubMed

Yu, H H; Bi, X; Liu, Y Y

2017-08-10

Objective: To evaluate the reliability and validity of the Chinese version on comprehensive scores for financial toxicity (COST), based on the patient-reported outcome measures. Methods: A total of 118 cancer patients were face-to-face interviewed by well-trained investigators. Cronbach's α and Pearson correlation coefficient were used to evaluate reliability. Content validity index (CVI) and exploratory factor analysis (EFA) were used to evaluate the content validity and construct validity, respectively. Results: The Cronbach's α coefficient appeared as 0.889 for the whole questionnaire, with the results of test-retest were between 0.77 and 0.98. Scale-content validity index (S-CVI) appeared as 0.82, with item-content validity index (I-CVI) between 0.83 and 1.00. Two components were extracted from the Exploratory factor analysis, with cumulative rate as 68.04% and loading>0.60 on every item. Conclusion: The Chinese version of COST scale showed high reliability and good validity, thus can be applied to assess the financial situation in cancer patients.

Fluid flow enhances the effectiveness of toxin export by aquatic microorganisms: a first-passage perspective

NASA Astrophysics Data System (ADS)

Licata, Nicholas; Clark, Aaron

2014-03-01

Aquatic microorganisms face a variety of challenges in the course of development. One central challenge is efficiently regulating the export of toxic molecules inside the developing embryo. The strategies employed should be robust with respect to the variable ocean environment and limit the chances that exported toxins are reabsorbed. In this talk we consider the first-passage problem for the uptake of exported toxins by a spherical embryo. A perturbative solution of the advection-diffusion equation reveals that a concentration boundary layer forms in the vicinity of the embryo, and that fluid flow enhances the effectiveness of toxin export. We highlight connections between the model results and recent experiments on the development of sea urchin embryos. We acknowledge financial support from the University of Michigan-Dearobrn CASL Faculty Summer Research Grant.

Providing web-based mental health services to at-risk women

PubMed Central

2011-01-01

Background We examined the feasibility of providing web-based mental health services, including synchronous internet video conferencing of an evidence-based support/education group, to at-risk women, specifically poor lone mothers. The objectives of this study were to: (i) adapt a face-to-face support/education group intervention to a web-based format for lone mothers, and (ii) evaluate lone mothers' response to web-based services, including an online video conferencing group intervention program. Methods Participating mothers were recruited through advertisements. To adapt the face-to-face intervention to a web-based format, we evaluated participant motivation through focus group/key informant interviews (n = 7), adapted the intervention training manual for a web-based environment and provided a computer training manual. To evaluate response to web-based services, we provided the intervention to two groups of lone mothers (n = 15). Pre-post quantitative evaluation of mood, self-esteem, social support and parenting was done. Post intervention follow up interviews explored responses to the group and to using technology to access a health service. Participants received $20 per occasion of data collection. Interviews were taped, transcribed and content analysis was used to code and interpret the data. Adherence to the intervention protocol was evaluated. Results Mothers participating in this project experienced multiple difficulties, including financial and mood problems. We adapted the intervention training manual for use in a web-based group environment and ensured adherence to the intervention protocol based on viewing videoconferencing group sessions and discussion with the leaders. Participant responses to the group intervention included decreased isolation, and increased knowledge and confidence in themselves and their parenting; the responses closely matched those of mothers who obtained same service in face-to-face groups. Pre-and post-group quantitative evaluations did not show significant improvements on measures, although the study was not powered to detect these. Conclusions We demonstrated that an evidence-based group intervention program for lone mothers developed and evaluated in face-to-face context transferred well to an online video conferencing format both in terms of group process and outcomes. PMID:21854563

Providing web-based mental health services to at-risk women.

PubMed

Lipman, Ellen L; Kenny, Meghan; Marziali, Elsa

2011-08-19

We examined the feasibility of providing web-based mental health services, including synchronous internet video conferencing of an evidence-based support/education group, to at-risk women, specifically poor lone mothers. The objectives of this study were to: (i) adapt a face-to-face support/education group intervention to a web-based format for lone mothers, and (ii) evaluate lone mothers' response to web-based services, including an online video conferencing group intervention program. Participating mothers were recruited through advertisements. To adapt the face-to-face intervention to a web-based format, we evaluated participant motivation through focus group/key informant interviews (n = 7), adapted the intervention training manual for a web-based environment and provided a computer training manual. To evaluate response to web-based services, we provided the intervention to two groups of lone mothers (n = 15). Pre-post quantitative evaluation of mood, self-esteem, social support and parenting was done. Post intervention follow up interviews explored responses to the group and to using technology to access a health service. Participants received $20 per occasion of data collection. Interviews were taped, transcribed and content analysis was used to code and interpret the data. Adherence to the intervention protocol was evaluated. Mothers participating in this project experienced multiple difficulties, including financial and mood problems. We adapted the intervention training manual for use in a web-based group environment and ensured adherence to the intervention protocol based on viewing videoconferencing group sessions and discussion with the leaders. Participant responses to the group intervention included decreased isolation, and increased knowledge and confidence in themselves and their parenting; the responses closely matched those of mothers who obtained same service in face-to-face groups. Pre-and post-group quantitative evaluations did not show significant improvements on measures, although the study was not powered to detect these. We demonstrated that an evidence-based group intervention program for lone mothers developed and evaluated in face-to-face context transferred well to an online video conferencing format both in terms of group process and outcomes.

Parenting stress and child behaviour problems among parents with intellectual disabilities: the buffering role of resources.

PubMed

Meppelder, M; Hodes, M; Kef, S; Schuengel, C

2015-07-01

Parents with intellectual disabilities (ID) are at risk for high levels of parenting stress. The present study evaluated resources, including parental adaptive functioning, financial resources and access to a support network, as moderators of the association between child behaviour problems and parenting stress. A total of 134 parents with ID and their children (ages 1-7 years) were recruited from 10 Dutch care organisations. Questionnaires were administered to the parents to obtain information on parenting stress in the parent and child domain, financial resources and their support network. Teachers and care workers reported on child behaviour problems and parental adaptive functioning, respectively. Parents experienced more stress with regard to their children than towards their own functioning and situation. Parenting stress was less in parents who were not experiencing financial hardship. Child behaviour problems were associated with high child-related parenting stress, not parent-related parenting stress. Large support networks decreased the association between child behaviour problems and child-related parenting stress. Financial resources did not significantly moderate the association. Parenting stress among parents with ID is focused on problems with the child, especially when little social support is available. © 2014 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Patients with mental problems - the most defenseless travellers.

PubMed

Felkai, Peter; Kurimay, Tamas

2017-09-01

Severe mental illness occurring abroad is a difficult situation for patients, their families, and for the local medical community. Patients with mental problem are doublely stigmatized due to their mental illness and because they are foreigners in an unfamiliar country. The appropriate treatment is often delayed, while patients are often dealt with in a manner that violates their human rights. Moreover, repatriation - which is vital in this case - is often delayed due to the lack of international protocols for the transportation and treatment of mentally ill travelers. Authors analyzed several factors related to acute mental health problems during travel: the etiology of symptoms, the appropriate treatment possibilities abroad, and medical evacuation and repatriation of the psychotic patient. The article presents a brief review of travel-related mental disorders, the epidemiology of mental health issues faced by travelers, and the significance of pre-travel advice for these patients. The first problem is to recognize (and redress) the particular challenges faced by a psychotic patient in a strange country. The second challenge is to prepare the patients, often in a poor psychiatric state, for medical evacuation by commercial aircraft. Another important question is the best way to take the patient through customs and security control. All of these, as yet unresolved, issues can make the mental patient virtually defenseless. Although timely repatriation of a mentally ill patient is vital and urgent, most travel insurance policies exclude treatment and repatriation costs incurred due to acute mental illness. The high cost of treatment and repatriation must be paid by the patient or their family, which could lead to severe financial strain or insolvency. Changing the approaches taken by the local mental health care community, police, airport security, and insurance companies remain a challenge for psychiatrists. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

Measuring Financial Capability and Its Determinants Using Survey Data

ERIC Educational Resources Information Center

Taylor, Mark

2011-01-01

Financial capability, or people's ability to manage and take control of their finances, is receiving increasing interest among policy makers as more people find themselves in difficult financial situations during the current economic downturn. We tackle the problem of how to measure financial capability--with a specific focus on making ends meet…

A Small District's Quest for Survival.

ERIC Educational Resources Information Center

Salinas, Claudio

In Texas, a financially troubled school district must submit a plan of action to the Texas Education Agency (TEA) for improving its financial situation without harming the quality of education delivered. If things get worse, TEA assigns a financial monitor to advise the district on overcoming its financial problems and to determine if further…

Growing concerns and controversies to Taiwan's National Health Insurance-what are the lessons from mainland China, South Korea and Singapore?

PubMed

Lee, Yen-Han; Ang, Ting Fang Alvin; Chiang, Timothy C; Kaplan, Warren A

2018-01-01

It has been over 20 years since Taiwan's implementation of its National Health Insurance (NHI) program. Under this program, the health insurance coverage rate has reached approximately 99% of the population. Despite guaranteeing the residents of Taiwan equal access regardless of socioeconomic status and background, critical problems and controversies persist, and they continue to challenge the NHI. We analyze the primary issues facing the NHI program with emphasis on financial and consumer behavioral aspects. Furthermore, we apply models from mainland China, South Korea and Singapore to discuss what Taiwan could learn from the systems employed by these countries to modify the NHI. Targeting the needs of the NHI, we have three policy recommendations: separating the NHI scheme into different target populations, strengthening the NHI referral system and regulating the access of overseas citizens to health services while in Taiwan. After two decades in existence, problems persist and there is a continuing need to improve Taiwan's NHI. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

John Snow’s legacy: epidemiology without borders

PubMed Central

Fine, Paul; Victora, Cesar G; Rothman, Kenneth J; Moore, Patrick S; Chang, Yuan; Curtis, Val; Heymann, David L; Slutkin, Gary; May, Robert M; Patel, Vikram; Roberts, Ian; Wortley, Richard; Torgerson, Carole; Deaton, Angus

2013-01-01

This Review provides abstracts from a meeting held at the London School of Hygiene and Tropical Medicine, on April 11–12, 2013, to celebrate the legacy of John Snow. They describe conventional and unconventional applications of epidemiological methods to problems ranging from diarrhoeal disease, mental health, cancer, and accident care, to education, poverty, financial networks, crime, and violence. Common themes appear throughout, including recognition of the importance of Snow’s example, the philosophical and practical implications of assessment of causality, and an emphasis on the evaluation of preventive, ameliorative, and curative interventions, in a wide variety of medical and societal examples. Almost all self-described epidemiologists nowadays work within the health arena, and this is the focus of most of the societies, journals, and courses that carry the name epidemiology. The range of applications evident in these contributions might encourage some of these institutions to consider broadening their remits. In so doing, they may contribute more directly to, and learn from, non-health-related areas that use the language and methods of epidemiology to address many important problems now facing the world. PMID:23582396

Empirical Studies Development Of Creative Industry Its Contribution To Make-Up Of Product Orientation Exporting In Denpasar-Bali

NASA Astrophysics Data System (ADS)

Suryathi, W.; Gede, I. G. K.

2018-01-01

The puIDRose of this study are : 1) to study the model of development of creative industries which export-oriented in Denpasar 2) to examine the main problems and constraints faced by creative industries 3) to know the increasing of product export in Denpasar.The number of samples are 15 creatives industries such as sub-sector of handicraft, fashion and culinary. Sampling technique used cluster and puIDRosive sampling. Data collection by interview, observation, literature study and questioner. Data analysis using qualitative and quantitative description. The results of this study explain: The model development of creative industry in Denpasar City basically consist of three phases that is : development input, development process and development output. The problems and business constraints in creative industries about skill and salary of human resources, capital of financial, promotion of marketing, raw material of resources, technology and modern administration of production. From the product export showed that woods were hight one of crafting sub sector, textiles were hight one of fashion sub sector, tuna fish were hight one of culinary sub sector.

The Affordable Care Act and Expanded Insurance Eligibility Among Nonelderly Adult Cancer Survivors.

PubMed

Davidoff, Amy J; Hill, Steven C; Bernard, Didem; Yabroff, K Robin

2015-09-01

Cancer survivors may face barriers to accessing health insurance and experience financial hardship because of medical expenditures. We examined potential improvements in access to insurance for cancer survivors through adult Medicaid expansions and premium tax credits in the new insurance marketplaces under the Affordable Care Act (ACA). Eligibility for Medicaid and premium tax credits was simulated for cancer survivors age 18 to 64 years in the 2008 to 2010 Medical Expenditure Panel Survey using a detailed deterministic model. Financial hardship was determined as: 1) delays or unmet need for medical, prescription, or dental care because of cost or insurance issues and/or 2) family out-of-pocket medical spending that was 20% or more of gross income. Descriptive analyses were stratified by whether the state of residence chose to expand Medicaid by January 2015. All statistical tests were two-sided. Overall, 14.7% of 9.44 million cancer survivors were uninsured, with 18% reporting financial hardship. Under the ACA, 19% overall, 30% of the uninsured, and 39% of those reporting financial hardship would be Medicaid eligible. An additional 10% would be eligible for premium tax credits, with the remainder able to participate in the Marketplace without tax credits. However, 21% of uninsured cancer survivors in states not expanding Medicaid would be ineligible for assistance with coverage. Under the ACA, many of the uninsured and a larger proportion of survivors facing financial hardship will be eligible for Medicaid or premium tax credits in the Marketplaces. ACA implementation will dramatically enhance insurance availability and is likely to reduce financial hardship for vulnerable cancer survivors. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Financial barriers to HIV treatment in Yaoundé, Cameroon: first results of a national cross-sectional survey

PubMed Central

Marcellin, Fabienne; Ongolo-Zogo, Pierre; Abega, Séverin-Cécile; Nantchouang, Robert; Spire, Bruno; Moatti, Jean-Paul

2009-01-01

Abstract Objective To assess the extent to which user fees for antiretroviral therapy (ART) represent a financial barrier to access to ART among HIV-positive patients in Yaoundé, Cameroon. Methods Sociodemographic, economic and clinical data were collected from a random sample of 707 HIV-positive patients followed up in six public hospitals of the capital city (Yaoundé) and its surroundings through face-to-face interviews carried out by trained interviewers independently from medical staff and medical questionnaires filled out by prescribing physicians. Logistic regression models were used to identify factors associated with self-reported financial difficulties in purchasing ART during the previous 3 months. Findings Of the 532 patients treated with ART at the time of the survey, 20% reported financial difficulty in purchasing their antiretroviral drugs during the previous 3 months. After adjustment for socioeconomic and clinical factors, reports of financial difficulties were significantly associated with lower adherence to ART (odds ratio, OR: 0.24; 95% confidence interval, CI: 0.15–0.40; P < 0.0001) and with lower CD4+ lymphocyte (CD4) counts after 6 months of treatment (OR: 2.14; 95% CI: 1.15–3.96 for CD4 counts < 200 cells/µl; P = 0.04). Conclusion Removing a financial barrier to treatment with ART by eliminating user fees at the point of care delivery, as recommended by WHO, could lead to increased adherence to ART and to improved clinical results. New health financing mechanisms based on the public resources of national governments and international donors are needed to attain universal access to drugs and treatment for HIV infection. PMID:19551236

The Affordable Care Act and Expanded Insurance Eligibility Among Nonelderly Adult Cancer Survivors

PubMed Central

Hill, Steven C.; Bernard, Didem; Yabroff, K. Robin

2015-01-01

Background: Cancer survivors may face barriers to accessing health insurance and experience financial hardship because of medical expenditures. We examined potential improvements in access to insurance for cancer survivors through adult Medicaid expansions and premium tax credits in the new insurance marketplaces under the Affordable Care Act (ACA). Methods: Eligibility for Medicaid and premium tax credits was simulated for cancer survivors age 18 to 64 years in the 2008 to 2010 Medical Expenditure Panel Survey using a detailed deterministic model. Financial hardship was determined as: 1) delays or unmet need for medical, prescription, or dental care because of cost or insurance issues and/or 2) family out-of-pocket medical spending that was 20% or more of gross income. Descriptive analyses were stratified by whether the state of residence chose to expand Medicaid by January 2015. All statistical tests were two-sided. Results: Overall, 14.7% of 9.44 million cancer survivors were uninsured, with 18% reporting financial hardship. Under the ACA, 19% overall, 30% of the uninsured, and 39% of those reporting financial hardship would be Medicaid eligible. An additional 10% would be eligible for premium tax credits, with the remainder able to participate in the Marketplace without tax credits. However, 21% of uninsured cancer survivors in states not expanding Medicaid would be ineligible for assistance with coverage. Conclusions: Under the ACA, many of the uninsured and a larger proportion of survivors facing financial hardship will be eligible for Medicaid or premium tax credits in the Marketplaces. ACA implementation will dramatically enhance insurance availability and is likely to reduce financial hardship for vulnerable cancer survivors. PMID:26134034

Space Applications and Global Information Infrastructure: a Global Approach against Epidemics

NASA Astrophysics Data System (ADS)

Bastos, C. R.

2002-01-01

Brazilian space expenditures correspond to a low-middle rank among the space-faring nations. In this regard, international partnerships have opened doors for the country to take part in a wider range of projects than it would be possible if carried out on its own. Within the above framework, this paper will address a concept in which countries join efforts in pursuit of common objectives and needs in the field of health, countries whose similarities tend to make them face the same types of health problems. Exactly for this reason, such countries can get together and share the costs, risks and ultimately the benefits of their joint efforts. Infectious diseases are mankind's leading causes of death. And their agents travel around the world by the action of their vectors: insects, birds, winds, infected individuals, and others. The ways how Global Information Infrastructure and Space applications can be very helpful in the detection, identification, tracking and fighting migratory diseases will then be discussed. A concept for an international cooperative initiative is presented, addressing its composition, its implementation, the international coordination requirements, the financial and funding issues related to its implementation and sustainability, and the roles to be played by such an organization. The funding issue deserves a closer attention, since many good ideas are killed by financial problems in their early implementation stages. Finally, a conclusion drives the audience's attention towards the potential advantages of space-based assets in covering large portions of the Earth, and consequently being suitable for global initiatives for the benefit of mankind.

America's Elderly at Risk. A Report Presented by the Chairman of the Select Committee on Aging. House of Representatives, Ninety-Ninth Congress, First Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Select Committee on Aging.

This report examines the health risks and related financial risks faced by America's elderly. Documentation of the elderly's increased financial risk is presented which is based on data from a case study of the elderly in Massachusetts and on an analysis of the elderly's out-of-pocket health care costs using data from the Health Care Financing…

Critical Problems Facing Technology Education: Perceptions of Indiana Teachers

ERIC Educational Resources Information Center

Lazaros, Edward J.; Rogers, George E.

2006-01-01

In 1993 Wicklein conducted a study to determine the present and the future critical issues and problems facing the technology education (TE) profession. The Wicklein study questioned 25 panelists from 15 states and the District of Columbia to ascertain the issues and problems facing TE. However, in the Wicklein study, only seven of the panelists…

Telephone triage by GPs in out-of-hours primary care in Denmark: a prospective observational study of efficiency and relevance

PubMed Central

Huibers, Linda; Moth, Grete; Carlsen, Anders H; Christensen, Morten B; Vedsted, Peter

2016-01-01

Background In the UK, telephone triage in out-of-hours primary care is mostly managed by nurses, whereas GPs perform triage in Denmark. Aim To describe telephone contacts triaged to face-to-face contacts, GP-assessed relevance, and factors associated with triage to face-to-face contact. Design and setting A prospective observational study in Danish out-of-hours primary care, conducted from June 2010 to May 2011. Method Information on patients was collected from the electronic patient administration system and GPs completed electronic questionnaires about the contacts. The GPs conducting the face-to-face contacts assessed relevance of the triage to face-to-face contacts. The authors performed binomial regression analyses, calculating relative risk (RR) and 95% confidence intervals. Results In total, 59.2% of calls ended with a telephone consultation. Factors associated with triage to a face-to-face contact were: patient age >40 years (40–64: RR = 1.13; >64: RR = 1.34), persisting problem for 12–24 hours (RR = 1.15), severe problem (RR = 2.60), potentially severe problem (RR = 5.81), and non-severe problem (RR = 2.23). Face-to-face contacts were assessed as irrelevant for 12.7% of clinic consultations and 11.7% of home visits. A statistically significantly higher risk of irrelevant face-to-face contact was found for a persisting problem of >24 hours (RR = 1.25), contact on weekday nights (RR = 1.25), and contact <2 hours before the patient’s own GP’s opening time (RR = 1.80). Conclusion Around 12% of all face-to-face consultations in the study are assessed as irrelevant by GP colleagues, suggesting that GP triage is efficient. Knowledge of the factors influencing triage can provide better education for GPs, but future studies are needed to investigate other quality aspects of GP telephone triage. PMID:27432608

The effect of housing on the mental health of older people: the impact of lifetime housing history in Whitehall II

PubMed Central

2011-01-01

Background This study describes differences in trajectories of self-reported mental health in an ageing cohort, according to their housing, while controlling for confounders. Methods The General Health Questionnaire was measured on six occasions as part of Whitehall II cohort study of office-based British civil servants (1985-2009); 10,308 men and women aged 35-55 at baseline. Results Home-ownership was the predominant tenure at baseline and increased over the life-course, but the social gradient remained. In the bivariate analysis, by phase nine, renters had higher (poorer mental health) GHQ scores (55.48) than owner occupiers (51.98). Those who reported difficulty paying bills or problems with housing had higher GHQ scores at baseline (financial difficulties 57.70 vs 54.34; house problems 58.06 vs 53.99) and this relative difference increased by phase nine (financial difficulties 59.64 vs 51.67; house problems 56.68 vs 51.22). In multivariate models, the relative differences in GHQ scores by tenure increased with age, but were no longer significant after adjusting for confounders. Whereas GHQ scores for those with housing problems and financial difficulties were still significantly higher as participants grew older. Conclusion The social gradient in the effect of home ownership on mental health, which is evident at baseline, diminishes as people get older, whereas housing quality and financial problems become relatively more important in explaining older people's health. Inequalities in housing quality and ability to deal with household financial problems will become increasingly important mental health issues as the population ages. PMID:21884619

Legal capacity of the elderly in Greece.

PubMed

Giannouli, Vaitsa; Tsolaki, Magda

2014-01-01

Legal capacity of the elderly people in Greece is of great legal, medical and social importance, but has received little attention till now from medical literature. This paper aims to study whether elderly people with dementia are able to participate in legal contracts like sales, purchases, loans, leases, donations and testaments. We tried to introduce a new test for the above legal-financial contracts and show some preliminary findings. The test consists of six examined relevant domains concerning basic monetary skills, cash transactions, bank statement management, financial conceptual knowledge, knowledge of potential heirs (beneficiaries) and assets/estate and finally the decision making process for different dilemmas on sales, purchases, loans, leases, donations and testaments. We studied 203 people. Eighty three people were healthy, 64 with Alzheimer's disease (AD) (10 with severe AD, 22 with moderate, and 32 with mild AD), 10 with Parkinson's disease (PD), and 46 with amnestic Mild Cognitive Impairment (aMCI). Individuals were included in the study only if they were aged 60 and over and only if they had a partner or a guardian who could give information on the individual's daily living. The exclusion criteria were predefined as follows: history of any other mental health disease and/or any other serious somatic health disease except for their official diagnosis of dementia. Results showed statistically significant differences with all three groups of patients characterized as incapable for legal-financial actions. Patients with severe AD (P<0.001), patients with moderate AD (P<0.001), patients with mild AD (P<0.001), patients with PD (P<0.001) and aMCI patients (P<0.001) differed significantly from healthy controls. Further research should include more extensive sampling of elderly patients with varying demographic characteristics in Greece, to confirm and expand our initial findings. In conclusion, our new test which is based on Marson's theoretical model of financial capacity seems to be highly correlated with the so far use of MMSE/HMSE scores, but it gives more specific information that is of interest in the field of civil forensics for characterizing someone as legally (in) capable for large and/or small scale financial acts. Our preliminary results show for the first time in Greece that: a) four groups of elderly people (suffering from Alzheimer's disease at different stages, Parkinson's disease and amnestic Mild Cognitive Impairment and healthy elders) show a significantly different profile on all examined domains of this new test according to their diagnosis, b) people with MCI from Greece do face problems in the domains outlined above (mainly financial decision making problems), and that c) subsequent changes in the Greek law should be made.

Multiplicative Effects of Social and Psychological Risk Factors on College Students' Suicidal Behaviors.

PubMed

Assari, Shervin

2018-05-17

Less is known about the multiplicative effects of social and psychological risk and protective factors of suicidality on college campuses. The current study aimed to investigate the multiplicative effects of social (identifying oneself as gay/lesbian, financial difficulty, violence victimization, and religiosity) and psychological (anxiety, depression, problem alcohol use, drug use) and risk/protective factors on suicidal behaviors among college students in the United States. Using a cross-sectional design, the Healthy Mind Study (HMS; 2016⁻2017), is a national online survey of college students in the United States. Social (identifying oneself as gay/lesbian, violence victimization, financial difficulty, and religiosity) and psychological (anxiety, depression, problem alcohol use, and drug use) risk/protective factors were assessed among 27,961 individuals. Three aspects of suicidality, including ideation, plan, and attempt, were also assessed. Logistic regression models were used for data analysis. Financial difficulty, violence victimization, identifying oneself as gay/lesbian, anxiety, depression, and drug use increased, while religiosity reduced the odds of suicidal behaviors. Multiplicative effects were found between the following social and psychological risk factors: (1) financial difficulty and anxiety; (2) financial difficulty and depression; (3) depression and drug use; (4) problem alcohol use and drug use; and (5) depression and problem alcohol use. There is a considerable overlap in the social and psychological processes, such as financial stress, mood disorders, and substance use problems, on risk of suicide in college students. As social and psychological risk factors do not operate independently, comprehensive suicidal risk evaluations that simultaneously address multiple social and psychological risk factors may be superior to programs that only address a single risk factor.

7 CFR 764.457 - Vendor requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) Maintain and use a financial management information system to make financial decisions; (3) Understand and... budget; and (6) Use production records and other production information to identify problems, evaluate... general goal setting, risk management, and planning. (2) Financial management courses, covering all...

Financial considerations in living organ donation.

PubMed

Jacobs, Cheryl; Thomas, Charlie

2003-06-01

The shortage of cadaveric organs and increased success of living donor transplantation support the use of living organ donors. Clinical social workers have the opportunity to explore a variety of donor-specific issues when performing psychosocial evaluations of living donors, including motivation, psychological stability, and personal and family consequences of donation, as well as the direct and indirect financial consequences faced by living donors. Although most donor-related medical costs are covered, other associated expenses are not reimbursable and may put donors at risk for financial hardship. Out-of-pocket expenses also serve as a disincentive to donate for some volunteers. During the evaluation process, healthcare professionals should openly discuss how surgery, recovery, and any potential complications might impact prospective donors' financial situation. Donors can then decide whether they are able to realistically handle the costs of donation. We present the financial dilemmas experienced by many living donors and highlight efforts that have been made to deal with them.

Dental Care Presents The Highest Level Of Financial Barriers, Compared To Other Types Of Health Care Services.

PubMed

Vujicic, Marko; Buchmueller, Thomas; Klein, Rachel

2016-12-01

The Affordable Care Act is improving access to and the affordability of a wide range of health care services. While dental care for children is part of the law's essential health benefits and state Medicaid programs must cover it, coverage of dental care for adults is not guaranteed. As a result, even with the recent health insurance expansion, many Americans face financial barriers to receiving dental care that lead to unmet oral health needs. Using data from the 2014 National Health Interview Survey, we analyzed financial barriers to a wide range of health care services. We found that irrespective of age, income level, and type of insurance, more people reported financial barriers to receiving dental care, compared to any other type of health care. We discuss policy options to address financial barriers to dental care, particularly for adults. Project HOPE—The People-to-People Health Foundation, Inc.

Association between financial strain, social network and five-year recovery from first episode psychosis.

PubMed

Mattsson, Maria; Topor, Alain; Cullberg, Johan; Forsell, Yvonne

2008-12-01

Despite much effort to positively affect long-term outcome in psychosis and schizophrenia many patients are still facing a poor outcome with persistent psychotic symptoms and decline in social functioning. The aim of this study was to examine the relationship between financial strain and social network and five-year outcome of first episode psychosis (FEP). FEP patients were divided into recovered (n = 52) and non-recovered (n = 19). Each person was matched according to age and gender with four persons (n = 284) from a longitudinal population-based study. All persons had answered an extensive questionnaire including social network, quantitative and qualitative, financial strain and mental health. Linear regression analysis showed that both financial strain and social network were associated, and had a unique contribution, to outcome. The results indicate that FEP patients might benefit from interventions that reduce financial strain thus facilitating daily life and cultural and social activities.

An Elective Course in Personal Finance for Health Care Professionals

PubMed Central

2009-01-01

Objectives To create, implement, and assess an elective course on the principles and applications of personal finance. Design A 1.5 unit (15 hours total) elective course was designed using active-learning pedagogy, lecture, and group discussion. Homework assignments were designed to provide practical tools and materials that students could individualize and apply to their personal financial goals. Assessment Student satisfaction, using a standard course evaluation form, revealed consistent high ratings. Student enrollment increased from 19 students in its initial year to 90 students in its fourth year. Student knowledge, assessed using the Jump$tart Financial Literacy Survey, indicated significant knowledge acquisition. Conclusion Many pharmacy students are ill equipped to effectively handle the complex financial decisions they face after graduation. This course provides students with practical tools to identify appropriate ways to achieve their financial goals and critically evaluate financial advice and advisors. PMID:19513143

To Grow or Not to Grow? A Post-Great Recession Synopsis of the Political, Financial, and Social Contract Challenges Facing the University of California. Research & Occasional Paper Series: CSHE.15.13

ERIC Educational Resources Information Center

Douglass, John Aubrey

2013-01-01

After more than two decades of state disinvestment, the University of California faces significant challenges and misunderstandings regarding its operating costs, its wide array of activities, and its mission. Reduced funding from the state for public higher education, including UC, has essentially severed the historic link between state…

Financial Transfers to Husbands' and Wives' Elderly Mothers in Mexico: Do Couples Exhibit Preferential Treatment by Lineage?

PubMed

Noël-Miller, Claire; Tfaily, Rania

2009-11-01

The aim of this study was to contrast the likelihood that a husband's elderly mother receives financial assistance from a couple with that of a wife's mother. Prior U.S.-based research has documented a strong bias toward transfers to wives' parents. The authors aimed to extend this literature to Mexico, where financial help from adult children is a critical source of support for a rapidly aging population lacking institutional assistance. The authors' approach to modeling competition between mothers accounted for the nature of their need. The results demonstrate that among mothers of similar financial need, a husband's mother is twice as likely to receive financial assistance as a wife's mother. In contrast, when faced with personal care needs, a wife's mother is disproportionately favored. These results reflect gender differences in Mexican adult children's responsibility for family members' financial and physical well-being. The findings uncover new complexity in the patterns by which couples transfer money to parents of different lineage.

"Financial Bubbles" and Monetary Policy

ERIC Educational Resources Information Center

Tikhonov, Yuriy A.; Pudovkina, Olga E.; Permjakova, Juliana V.

2016-01-01

The relevance of this research is caused by the need of strengthening a role of monetary regulators to prevent financial bubbles in the financial markets. The aim of the article is the analysis of a problem of crisis phenomena in the markets of financial assets owing to an inadequate growth of their cost, owing to subjective reasons. The leading…

The convergence between self-reports and observer ratings of financial skills and direct assessment of financial capabilities in patients with schizophrenia: more detail is not always better.

PubMed

Harvey, Philip D; Stone, Laura; Lowenstein, David; Czaja, Sara J; Heaton, Robert K; Twamley, Elizabeth W; Patterson, Thomas L

2013-06-01

Despite multiple lines of evidence suggesting that people with schizophrenia tend to overestimate their ability to perform everyday tasks such as money management, self-report methods are still widely used to assess functioning. In today's technology driven financial world patients are faced with increasingly complex financial management tasks. To meet these challenges adequate financial skills are required. Thus, accurate assessments of these abilities are critical to decisions regarding a patient's need for support such as a financial trustee. As part of the larger VALERO study, 195 patients with schizophrenia were asked to self-report their everyday financial skills (five common financial tasks) with the Independent Living Skills Survey (ILSS). They were also assessed with performance-based measures of neuro-cognition and functional capacity with a focus on financial skills. In addition, a friend, relative, or clinician informant was interviewed with the ILSS and a best estimate rating of functioning was generated. Scores on the performance-based measures of financial skills and neuropsychological tests were uncorrelated with self-reported financial activities. Interviewer and all informant judgments of financial abilities were also minimally correlated with performance on functional skill tests. Discrete financial skills appear to be challenging for clinicians to rate with accuracy without the use of direct assessments. Direct assessment of financial skills seems prudent when making determinations about the need for guardianship or other financial supervision. Copyright © 2013 Elsevier B.V. All rights reserved.

The Convergence between Self-reports and Observer Ratings of Financial Skills and Direct Assessment of Financial Capabilities in Patients with Schizophrenia: More Detail is Not Always Better

PubMed Central

Harvey, Philip D.; Stone, Laura; Lowenstein, David; Czaja, Sara J.; Heaton, Robert K.; Patterson, Thomas L

2013-01-01

Despite multiple lines of evidence suggesting that people with schizophrenia tend to overestimate their ability to perform everyday tasks such as money management, self-report methods are still widely used to assess functioning. In today’s technology driven financial world patients are faced with increasingly complex financial management tasks. To meet these challenges adequate financial skills are required. Thus, accurate assessments of these abilities are critical to decisions regarding a patient’s need for support such as a financial trustee. As part of the larger VALERO study, 195 patients with schizophrenia were asked to self-report their everyday financial skills (five common financial tasks) with the Independent Living Skills Survey (ILSS). They were also assessed with performance-based measures of neuro-cognition and functional capacity with a focus on financial skills. In addition, a friend, relative, or clinician informant was interviewed with the ILSS and a best estimate rating of functioning was generated. Scores on the performance-based measures of financial skills and neuropsychological tests were uncorrelated with self-reported financial activities. Interviewer and all informant judgments of financial abilities were also minimally correlated with performance on functional skills tests. Discrete financial skills appear to be challenging for clinicians to rate with accuracy without the use of direct assessments. Direct assessment of financial skills seems prudent when making determinations about the need for guardianship or other financial supervision. PMID:23537475

The Social Problem-Solving Questionnaire: Evaluation of Psychometric Properties among Turkish Primary School Students

ERIC Educational Resources Information Center

Dereli Iman, Esra

2013-01-01

Problem Statement: Children, like adults, face numerous problems and conflicts in their everyday lives, including issues with peers, siblings, older children, parents, teachers, and other adults. The methods children use to solve such problems are more important than actually facing the problems. The lack of effective social problem-solving skills…

A Survey on Sentiment Classification in Face Recognition

NASA Astrophysics Data System (ADS)

Qian, Jingyu

2018-01-01

Face recognition has been an important topic for both industry and academia for a long time. K-means clustering, autoencoder, and convolutional neural network, each representing a design idea for face recognition method, are three popular algorithms to deal with face recognition problems. It is worthwhile to summarize and compare these three different algorithms. This paper will focus on one specific face recognition problem-sentiment classification from images. Three different algorithms for sentiment classification problems will be summarized, including k-means clustering, autoencoder, and convolutional neural network. An experiment with the application of these algorithms on a specific dataset of human faces will be conducted to illustrate how these algorithms are applied and their accuracy. Finally, the three algorithms are compared based on the accuracy result.

Analyzing the Financial State of Colleges and Universities.

ERIC Educational Resources Information Center

Frances, Carol; Stenner, A. Jackson

1979-01-01

Ten pitfalls for financial analysts are described: information lags, misinterpreting trend data, data shortcomings, sample institutions' problems, misuse of panel ratings, using same indicators for private and public institutions, underdevelopment of conceptual framework, arbitrary financial health scales, shaky use of discriminant analysis, and…

Financial sustainability planning for immunization services in Cambodia.

PubMed

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

2006-07-01

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

Development of a financial literacy course for patients with newly diagnosed cancer.

PubMed

Shankaran, Veena; Linden, Hannah; Steelquist, Jordan; Watabayashi, Kate; Kreizenbeck, Karma; Leahy, Tony; Overstreet, Karen

2017-03-01

Although patients with cancer often face serious financial hardships, few studies have reported on strategies to mitigate this burden. Improving literacy about the financial aspects of cancer care may decrease the negative financial impact of cancer diagnosis and treatment. We obtained input from patient stakeholders on the perceived value and optimal design of a financial literacy program in the advanced cancer setting. Prospective cohort survey.  A series of semi-structured interviews were conducted, during which patients with either colorectal or breast cancer were asked to describe the impact of cancer on their finances and employment, to state their preferences about discussing costs with their providers, and to give input on development of a financial literacy course. Twenty-one patients (76% Caucasian) completed interviews, the majority of whom had Medicare or commercial insurance (71%). Lost income from early retirement or disability was the most financially burdensome experience for 67% of patients. The majority of patients (76%) reported that a financial literacy course would be helpful in navigating the cost of cancer care. Most preferred the course be administered at diagnosis in a live group format. Feedback from patients with cancer supported the development of a group financial literacy course that addresses barriers to discussing cost concerns, employment changes during cancer, and available resources for financial assistance.

The Medicare Cost Report and the limits of hospital accountability: improving financial accounting data.

PubMed

Kane, N M; Magnus, S A

2001-02-01

Health policy makers, legislators, providers, payers, and a broad range of other players in the health care market routinely seek information on hospital financial performance. Yet the data at their disposal are limited, especially since hospitals' audited financial statements--the "gold standard" in hospital financial reporting--are not publicly available in many states. As a result, the Medicare Cost Report (MCR), filed annually by most U.S. hospitals in order to receive payment for treating Medicare patients, has become the primary public source of hospital financial information. However, financial accounting elements in the MCR are unreliable, poorly defined, and lacking in critical detail. Comparative analyses of MCRs and matched, audited financial statements reveal long-standing problems with the MCR's data, including major differences in reported profits; variations in the reporting of both revenues and expenses; an absence of relevant details, such as charity care, bad debt, operating versus nonoperating income, and affiliate transactions; an inconsistent classification of changes in net assets; and a failure to provide cash flow statements. Because of these problems, MCR financial data give only a limited and often inaccurate picture of the financial position of hospitals. Audited financial statements provide a more complete perspective, enabling analysts to address important questions left unanswered by the MCR data. Regulatory action is needed to create a national database of financial information based upon audited statements.

Payeeship, financial leverage, and the client-provider relationship.

PubMed

Angell, Beth; Martinez, Noriko I; Mahoney, Colleen A; Corrigan, Patrick W

2007-03-01

Although representative payeeship provided within clinical settings is believed to have therapeutic benefits, its potential negative impact on the therapeutic alliance or client-provider relationship is of concern. This study examined the effects of payeeship and perceived financial leverage on positive and negative dimensions of the client-provider relationship. The sample consisted of 205 adults ages 18 to 65 with axis I disorders who were receiving mental health services from a large urban community mental health clinic. Information about money management characteristics and ratings of the client-provider relationship were collected via face-to-face interview. Fifty-three percent of the sample had a payee or money manager, and 79% of this group had a clinician payee. Respondents with co-occurring psychotic and substance use disorders, lower functioning, and lower insight about their illness were more likely to have a clinician payee. Forty percent of those with a clinician payee reported perceived financial leverage. Having a clinician payee was also associated with perceived financial leverage and with higher levels of conflict in the case management relationship. When examined in combination, financial leverage was found to mediate the effects of payeeship on conflict in the case management relationship (mean+/-SE=2.37+/-1.33, 95% confidence interval=16-5.52, p<.05). That is, payeeship appeared to increase conflict in the therapeutic alliance when used as a source of treatment leverage. Although payeeship provides important support and may enhance functional outcomes for the patient, decisions about using the mechanism for promoting treatment adherence should take into account the potential disruption to the client-provider relationship.

Making the business case for telemedicine: an interactive spreadsheet.

PubMed

McCue, Michael J; Palsbo, Susan E

2006-04-01

The objective of this study was to demonstrate the business case for telemedicine in nonrural areas. We developed an interactive spreadsheet to conduct multiple financial analyses under different capital investment, revenue, and expense scenarios. We applied the spreadsheet to the specific case of poststroke rehabilitation in urban settings. The setting involved outpatient clinics associated with a freestanding rehabilitation hospital in Oklahoma. Our baseline scenario used historical financial data from face-to-face encounters as the baseline for payer and volume mix. We assumed a cost of capital of 10% to finance the project. The outcome measures were financial breakeven points and internal rate of return. A total of 340 telemedicine visits will generate a positive net cash flow each year. The project is expected to recoup the initial investment by the fourth year, produce a positive present value dollar return of more than $2,000, and earn rate of return of 20%, which exceeds the hospital's cost of capital. The business case is demonstrated for this scenario. Urban telemedicine programs can be financially self-sustaining without accounting for reductions in travel time by providers or patients. Urban telemedicine programs can be a sound business investment and not depend on grants or subsidies for start-up funding. There are several key decision points that affect breakeven points and return on investment. The best business strategy is to approach the decision as whether or not to build a new clinic.

Synthetic Biology and the Translational Imperative.

PubMed

Heidari Feidt, Raheleh; Ienca, Marcello; Elger, Bernice Simone; Folcher, Marc

2017-12-18

Advances at the interface between the biological sciences and engineering are giving rise to emerging research fields such as synthetic biology. Harnessing the potential of synthetic biology requires timely and adequate translation into clinical practice. However, the translational research enterprise is currently facing fundamental obstacles that slow down the transition of scientific discoveries from the laboratory to the patient bedside. These obstacles including scarce financial resources and deficiency of organizational and logistic settings are widely discussed as primary impediments to translational research. In addition, a number of socio-ethical considerations inherent in translational research need to be addressed. As the translational capacity of synthetic biology is tightly linked to its social acceptance and ethical approval, ethical limitations may-together with financial and organizational problems-be co-determinants of suboptimal translation. Therefore, an early assessment of such limitations will contribute to proactively favor successful translation and prevent the promising potential of synthetic biology from remaining under-expressed. Through the discussion of two case-specific inventions in synthetic biology and their associated ethical implications, we illustrate the socio-ethical challenges ahead in the process of implementing synthetic biology into clinical practice. Since reducing the translational lag is essential for delivering the benefits of basic biomedical research to society at large and promoting global health, we advocate a moral obligation to accelerating translational research: the "translational imperative."

The utility and feasibility of business training for neurosurgeons.

PubMed

Giller, Cole A

2008-04-01

Socioeconomic changes have imposed many administrative demands on neurosurgeons, including managing facilities such as the intensive care unit without absolute authority and maintaining referrals, marketing in an increasingly competitive environment, effecting change within stubborn hospital systems, negotiating fair contracts with insurance companies, using financial statements to make financial decisions, managing small groups under new rules of human resources, navigating a Byzantine system of reimbursement, and assessing entrepreneurial opportunities. A set of new tools and skills has been developed by the business community in response to similar problems that may be of use to neurosurgeons. These advances are reviewed in a neurosurgical context, and routes to business training for the neurosurgeon are discussed. Recent advances in business are discussed with a focus on their relevance to neurosurgical practice. Current neurosurgical interest in business training and training opportunities for neurosurgeons are presented. Interest in business training within the neurosurgery community is keen, and advances in the field of business may be helpful in addressing the new tasks faced by neurosurgeons. New tools from advances in business are available which have been invaluable to corporations and may be helpful to neurosurgeons wanting to improve efficiency and maintain competitive advantage. Business training is available to neurosurgeons through a variety of routes.

How financial hardship is associated with the onset of mental health problems over time.

PubMed

Kiely, Kim M; Leach, Liana S; Olesen, Sarah C; Butterworth, Peter

2015-06-01

Poor mental health has been consistently linked with the experience of financial hardship and poverty. However, the temporal association between these factors must be clarified before hardship alleviation can be considered as an effective mental health promotion and prevention strategy. We examined whether the longitudinal associations between financial hardship and mental health problems are best explained by an individual's current or prior experience of hardship, or their underlying vulnerability. We analysed nine waves (years: 2001-2010) of nationally representative panel data from the Household, Income, and Labour Dynamics in Australia survey (n = 11,134). Two components of financial hardship (deprivation and cash-flow problems) and income poverty were coded into time-varying and time-invariant variables reflecting the contemporaneous experience of hardship (i.e., current), the prior experience of hardship (lagged/12 months), and any experience of hardship during the study period (vulnerability). Multilevel, mixed-effect logistic regression models tested the associations between these measures and mental health. Respondents who reported deprivation and cash-flow problems had greater risk of mental health problems than those who did not. Individuals vulnerable to hardship had greater risk of mental health problems, even at the times they did not report hardship. However, their risk of mental health problems was greater on occasions when they did experience hardship. The results are consistent with the argument that economic and social programmes that address and prevent hardship may promote community mental health.

Tread lightly through these accounting minefields.

PubMed

Sherman, H D; Young, S D

2001-01-01

In the current economic climate, there is tremendous pressure--and personal incentive for managers--to report sales growth and meet investors' revenue expectations. As a result, more companies have been issuing misleading financial reports, according to the SEC, especially involving game playing around earnings. But it's shareholders who suffer from aggressive accounting strategies; they don't get a true sense of the financial health of the company, and when problems come to light, the shares they're holding can plummet in value. How can investors and their representatives on corporate boards spot trouble before it blows up in their faces? According to the authors, they should keep their eyes peeled for common abuses in six areas: revenue measurement and recognition, provisions and reserves for uncertain future costs, asset valuation, derivatives, related party transactions, and information used for bench-marking performance. If a disaster strikes, it will most likely be in one of these accounting minefields. This article examines the hazards of each minefield in turn, using examples like Metallgesellschaft, Xerox, MicroStrategy, and Lernout & Hauspie. It also provides a set of questions to ask in order to determine where a company's accounting practices might be overly aggressive. For those whose greatest interest is in fairly valuing the business--not presenting it in the best possible light--these questions are the first line of defense against creative accounting. Accounting game players are adroit, but it's both foolish and dangerous, contend the authors, to declare oneself ignorant and hence powerless against their machinations. They argue that members of corporate boards need to be financially literate.

Causal Inference and Omitted Variable Bias in Financial Aid Research: Assessing Solutions

ERIC Educational Resources Information Center

Riegg, Stephanie K.

2008-01-01

This article highlights the problem of omitted variable bias in research on the causal effect of financial aid on college-going. I first describe the problem of self-selection and the resulting bias from omitted variables. I then assess and explore the strengths and weaknesses of random assignment, multivariate regression, proxy variables, fixed…

Livelihood analysis of floating net cages fish farmers at Sendang Village Sub-district of Gajah Mungkur Reservoir of Wonogiri Regency

NASA Astrophysics Data System (ADS)

Nissa, Z. N. A.; Suadi; Sukardi

2018-03-01

Floating net cages farming (KJA) is one of the main livelihood resources in Sendang Village, Gajah Mungkur Reservoir. The purposes of this study were to determine the livelihood asset of fish farmers, the problems of livelihood asset management and the utilization strategy to support aquaculture businesses also farmers livelihood. The study showed that the natural capital, provides easiest way to farmer in fish cultivation. The fish farmers also have good technical capabilities in fish cultivation and the product has high demand and value which is essential for farmers livelihood. The main problems faced by small-scale farmers and all large-scale farmers were transition period, and the rise of cost price which sometime cause the failure in the business. The strategies to deal the problems include technological adjustment, managing the pattern of stocking of tilapia seeds and income source diversification. There were differences in dealing the rise of cost. The small-scale farmers borrow from the bank, while medium-scale farmers use their savings. Another difference of livelihood strategy was the management of financial capital. However, various strategies were still required to increase the livelihood of fish farmers and could address the vulnerabilities in the cultivation of KJA as a common pool resources.

The Financial Assessment of Colleges and Universities and Its Implication for State Policy. [Working] Papers in Education Finance, No. 4.

ERIC Educational Resources Information Center

Minter, W. John

Important issues and technical problems related to assessing the financial health of colleges and universities are described, along with implications of financial health assessment for state policy-making. It is proposed that a distinction be made between the assessments of financial health and program success. Other issues that should be…

28 CFR 58.12 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... “audited financial statements” means financial reports audited by independent certified public accountants... Certified Public Accountants; (10) The term “certificate” means the certificate identified in 11 U.S.C. 521... all methods by which the client can develop a plan to respond to the financial problems without...

28 CFR 58.12 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... “audited financial statements” means financial reports audited by independent certified public accountants... Certified Public Accountants; (10) The term “certificate” means the certificate identified in 11 U.S.C. 521... all methods by which the client can develop a plan to respond to the financial problems without...

78 FR 14422 - Notice of Open Public Hearing

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-05

....-listed Chinese companies accounting and financial management problems have created concern about the... to disclose details of business strategies, financial records and operations. With SEC and U.S... enterprises. With U.S. firms eager to meet growing demand for their financial services, witnesses will testify...

Prolonged Financial Distress After the Deepwater Horizon Oil Spill Predicts Behavioral Health.

PubMed

Buckingham-Howes, Stacy; Holmes, Katherine; Glenn Morris, J; Grattan, Lynn M

2018-03-13

The economic impact of disasters is well known; however, the link between financial loss and behavioral health problems is unknown. Participants included 198 adults of ages 21 to 82, living within 10 miles of the Gulf Coast during the Deepwater Horizon Oil Spill and were involved in the fishing, harvesting, seafood processing, or service/tourism industries. The functional impact of financial resource loss at 2.5 years post spill was measured using the 26-item Financial Life Events Checklist (FLEC). Individuals responded to financial distress by reducing social events and utility bills and changing food-shopping habits. The FLEC significantly predicted higher drug use (Drug Abuse Screening Test), alcohol use (Alcohol Use Disorders Identification Test), mood problems (Profile of Mood States), and depressive symptoms (Beck Depression Inventory II) (p values ≤ 0.05) 4.5 years after the spill. This preliminary study supports the notion that the functional impact of financial loss has a long-term impact on behavioral health after an oil spill.

Early retirement and the financial assets of individuals with back problems.

PubMed

Schofield, Deborah J; Shrestha, Rupendra N; Percival, Richard; Callander, Emily J; Kelly, Simon J; Passey, Megan E

2011-05-01

This paper quantifies the relationship between early retirement due to back problems and wealth, and contributes to a more complete picture of the full costs associated with back problems. The output data set of the microsimulation model Health&WealthMOD was analysed. Health&WealthMOD was specifically designed to measure the economic impacts of ill health on Australian workers aged 45-64 years. People aged 45-64 years who are out of the labour force due to back problems have significantly less chance of having any accumulated wealth. While almost all individuals who are in full-time employment with no chronic health condition have some wealth accumulated, a significantly smaller proportion (89%) of those who have retired early due to back problems do. Of those who have retired early due to back problems who do have some wealth, on average the total value of this wealth is 87% less (95% CI: -90 to -84%) than the total value of wealth accumulated by those who have remained in full-time employment with no health condition controlling for age, sex and education. The financial burden placed on those retiring early due to back problems is likely to cause financial stress in the future, as not only have retired individuals lost an income stream from paid employment, but they also have little or no wealth to draw upon. Preventing early retirement due to back problems will increase the time individuals will have to amass savings to finance their retirement and to protect against financial shocks.

A Meta-Analytic and Qualitative Review of Online versus Face-to-Face Problem-Based Learning

ERIC Educational Resources Information Center

Jurewitsch, Brian

2012-01-01

Problem-based learning (PBL) is an instructional strategy that is poised for widespread application in the current, growing, on-line digital learning environment. While enjoying a track record as a defensible strategy in face-to-face learning settings, the research evidence is not clear regarding PBL in on-line environments. A review of the…

Promoting Pluralism.

ERIC Educational Resources Information Center

Zijp, W.

1998-01-01

Rural agricultural development is facing challenges of poverty, hunger, and environmental quality, necessitating sustainable, profitable, and productive practices. Extension education is challenged to increase diversity, relevance, and financial support. Examples of World Bank innovations illustrate some pathways for agricultural extension. (SK)

Consumers with an intellectual disability and carers: perceptions of interactions with banks.

PubMed

Hayes, Susan C; Martin, Fiona B

2007-03-01

As more people with an intellectual disability reside independently in the community, there is both the need and the opportunity for them to use financial services, including banks and credit unions, and products such as cash machine cards, credit cards and loans. There is a dearth of information about interactions between consumers with intellectual disabilities and their carers, and financial service providers. This study investigated the perceptions of 94 consumers with an intellectual disability and 53 carers regarding interactions with financial service providers. Consumers and carers mentioned a number of problems with banks, and reported a low rate of successful resolution of these difficulties. Carers mentioned more problems than consumers, and more frequently reported intangible problems such as discrimination. The 'digital divide' was evident, with few consumers having access to Internet or telephone banking. People with intellectual disabilities need education programmes about electronic banking, their rights as consumers and their access to problem resolution strategies.

Tobacco use and perceived financial strain among junior enlisted in the U.S. Military in 2002.

PubMed

Pyle, Sara A; Haddock, C Keith; Poston, Walker S Carlos; Bray, Robert M; Williams, Jason

2007-12-01

The detrimental health effects of tobacco use have long been documented and accepted. Recent research has begun to explore the financial strain that tobacco places on those who use it (e.g. Mokdad, A.H., Marks, J.S., Stroup, D.F., Gerberding, J.L., 2004. Actual causes of death in the United States, 2000. J. Am. Med. Assoc. 291, 1239-1245). The issue of this financial burden is particularly salient for young enlisted in the military who often struggle with financial issues and who continue to use tobacco at relatively high rates. Using the 2002 Department of Defense Survey of Health Related Behaviors among Military Personnel, the current study examines the percentage of income young military members spend on tobacco given varying levels of consumption. In addition, a representative sample of junior enlisted (E1-E4) from all four military branches were surveyed about their tobacco use and their experiences of financial strain and experienced stress from financial problems. Adjusted logistic models demonstrated that smokers reported substantially higher amounts of both financial strain and stress from financial problems then those who did not smoke. This study suggests there is a relationship between financial stress and tobacco use among junior military members.

Perception of Cervical Cancer Patients on their Financial Challenges in Western Kenya.

PubMed

Owenga, Jane A; Nyambedha, Erick Otieno

2018-04-10

The number of cervical cancer cases is reported to increase among women of reproductive age in the recent past with patients facing challenges with care and management of the illness. However, little is known about the financial challenges these patients undergo in contexts such as western Kenya. This study assessed financial challenges and sources of financial assistance for cervical cancer patients in western Kenya. A cross-sectional study involving 334 cervical cancer patients was conducted in Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) in Kisumu from September 2014 to February 2015. Structured questionnaire, in-depth interview guide and key informant interview guide were used to collect data. Quantitative data was analyzed using Statistical Package for Social Scientists (SPSS) Version 20 at a statistical significance of P ≤ 0.05, descriptive statistics and crosstabulations were performed. For qualitative data, the responses were transcribed verbatim and the content was then analyzed by searching for emerging themes on the financial challenges faced by cervical cancer patients. Qualitative data was presented in textual form with verbatim reports for illustrations. The key financial challenges from the study were costs of medication 291 (87%), cost of travel 281 (84%) and cost of diagnostic tests 250 (75%). Other costs incurred by the patients were cost of cloths and wigs 91 (27%), and cost of home and child care 80 (24%). Most 304 (91%) of the cervical cancer patients admitted and referred to JOOTRH did not have insurance cover and only 30 (9%) had National Hospital Insurance Fund cover which catered for only bed component of inpatient costs. Results showed that no patient received any assistance from well-wishers. Only a few received assistance from charity organizations 43 (13%), friends 91 (27%) and colleagues 31 (9%). Some patients received some assistance from relatives 32 (10%) and church 32 (10%). Cervical cancer patients experience several financial challenges yet only few of them had insurance cover which catered for only bed component of inpatient costs. There is a need for the Kenyan health care system to develop mechanisms for provision of financial support for cervical cancer patients.

Considering abortion: a 12-month audit of records of women contacting a Pregnancy Advisory Service.

PubMed

Rowe, Heather J; Kirkman, Maggie; Hardiman, E Annarella; Mallett, Shelley; Rosenthal, Doreen A

2009-01-19

To characterise the demographic and psychosocial circumstances of women contacting Victoria's largest public pregnancy advisory service (PAS). Audit of PAS electronic records for the 12 months from 1 October 2006 to 30 September 2007. De-identified data were extracted from a comprehensive electronic database used for recording consultations. Summary statistics and measures of association. During the 12 months, 5462 women contacted PAS; records were created for 3827 women, and data were available in more than 80% of records for 77% (13/17) of items. Over half of the women receiving pregnancy support from PAS (60%) were 18-29 years old; 12% lived outside the metropolitan area; 51% held a health care card, and smaller percentages faced housing, financial, or drug and alcohol problems; 16% reported violence, but 71% described partners as involved and supportive. Most (79%) made contact within 2 weeks of discovering pregnancy, and 72% were referred by a general practitioner. Later gestation at contact was associated with younger age (P < 0.001), having a health care card (P < 0.001), and living outside the metropolitan area (P < 0.001). The most common reasons for seeking abortion were the desire to delay pregnancy (23%) and family completion (18%); 42% already had at least one child. Twenty-three women reported that the pregnancy was the result of rape. Ten per cent had mental health problems, and smaller numbers faced access barriers and had special needs. This PAS responds to demand from women with diverse social and personal circumstances. Findings provide evidence for policy, prevention and service development.

Medicare changes create accounting, reporting, and auditing problems. Task Force on Federal Health Care Legislation, American Institute of Certified Public Accountants.

PubMed

1984-11-01

Hospital auditors and financial officers must adjust and react to the changing financial healthcare environment brought about by PPS. A close review of accounting systems, reporting methods, auditing procedures, and internal control systems should be made to determine that assets are safe-guarded and financial information is presented in conformity with GAAP. This article identified new problems and suggested solutions. Old tasks may no longer be necessary. For example, retroactive adjustments are not as important as they used to be. Estimates for capital and outpatient costs may continue to be required, but elaborate cost-finding techniques may no longer be necessary to estimate retroactive adjustments for reimbursable items. We recommend that prior to beginning an audit of a hospital's financial statements, each hospital's financial officers and its auditors discuss the possible accounting, reporting, and auditing implications as a result of PPS.

Topics in Finance Part III--Leverage

ERIC Educational Resources Information Center

Laux, Judy

2010-01-01

This article investigates operating and financial leverage from the perspective of the financial manager, accenting the relationships to stockholder wealth maximization (SWM), risk and return, and potential agency problems. It also covers some of the pertinent literature related specifically to the implications of operating and financial risk and…

Research on the Undergraduate Financial Engineering Education in China

ERIC Educational Resources Information Center

Ma, Haiyong; Zhang, Weiwei

2011-01-01

The rapid development of modern economy has put forward higher requirements for financial engineering education. This paper analyzes the status and problems in undergraduate financial engineering education in china, such as indistinct training objective, rigid curriculum structure, and superficial teaching methods, etc. and puts forward…

Flaws in Fellowships: Institutional Support Essential to Boosting Number of African American Doctoral Students.

ERIC Educational Resources Information Center

Manzo, Kathleen Kennedy

1994-01-01

An analysis of student financial aid for African American doctoral students combines discussion of problems in student recruitment and persistence, particularly for financial reasons, with data on patterns of minority group graduate student enrollment, financial aid, debt, and degree awards. (MSE)

No Vacancy: Inn Provides Revenue Source for Financially Troubled Institute.

ERIC Educational Resources Information Center

Bridges, Jerry G.; Brant, Joseph F.

1994-01-01

The Peabody Institute of Baltimore (Maryland), the Johns Hopkins University's music school, addressed its financial problems by converting four campus buildings into an inn used to house Elderhostel participants. Annual program revenues cover all costs and yield a financial reserve for the school. (MSE)

See More, Do More, Teach More: Surgical Resident Autonomy and the Transition to Independent Practice.

PubMed

Hashimoto, Daniel A; Bynum, William E; Lillemoe, Keith D; Sachdeva, Ajit K

2016-06-01

The graduate medical education system is tasked with training competent and autonomous health care providers while also improving patient safety, delivering more efficient care, and cutting costs. Concerns about resident autonomy and preparation for independent and safe practice appear to be growing, and the field of surgery faces unique challenges in preparing graduates for independent practice. Multiple factors are contributing to an erosion of resident autonomy and decreased operative experience, including differing views of autonomy, financial forces, duty hours regulations, and diverse community health care needs. Identifying these barriers and developing solutions to overcome them are vital first steps in reversing the trend of diminishing autonomy in surgical residency training. This Commentary highlights the problem of decreasing autonomy, outlines specific threats to resident autonomy, and discusses potential solutions to mitigate their impact on the successful transition to independent practice.

The Greening Role of Tour Operators

NASA Astrophysics Data System (ADS)

Lozano, Javier; Arbulú, Italo; Rey-Maquieira, Javier

2016-01-01

This paper shows that the tour operators (TOs) can play a coordinating role in the adoption of environmental management upstream the tourism supply chain. This is done using a dynamic model to analyze the environmental management adoption by hotels in a tourism destination induced by a TO. The TO can create incentives to greening hotels' management through the sharing of an environmental price premium. We show that the extent of green management adoption depends on interest rate, the willingness to pay for environmental quality, and hotels' organizational inertia. We also show how the financial yields from green management are shared between TOs and hotels. Finally, we consider a destination manager that subsidizes hotels' green management. If the destination manager does not take the greening role of TOs into account, she could mistake the true trade-off that she faces between the destination's economic and environmental outcomes for the win-win setting that characterizes the general problem.

The Greening Role of Tour Operators.

PubMed

Lozano, Javier; Arbulú, Italo; Rey-Maquieira, Javier

2016-01-01

This paper shows that the tour operators (TOs) can play a coordinating role in the adoption of environmental management upstream the tourism supply chain. This is done using a dynamic model to analyze the environmental management adoption by hotels in a tourism destination induced by a TO. The TO can create incentives to greening hotels' management through the sharing of an environmental price premium. We show that the extent of green management adoption depends on interest rate, the willingness to pay for environmental quality, and hotels' organizational inertia. We also show how the financial yields from green management are shared between TOs and hotels. Finally, we consider a destination manager that subsidizes hotels' green management. If the destination manager does not take the greening role of TOs into account, she could mistake the true trade-off that she faces between the destination's economic and environmental outcomes for the win-win setting that characterizes the general problem.

Global women's health in 2010: facing the challenges.

PubMed

Lester, Felicia; Benfield, Nerys; Fathalla, Mohamed M F

2010-11-01

Women's health is closely linked to a nation's level of development, with the leading causes of death in women in resource-poor nations attributable to preventable causes. Unlike many health problems in rich nations, the cure relies not only on the discovery of new medications or technology but also getting basic services to the people who need them most and addressing underlying injustice. In order to do this, political will and financial resources must be dedicated to developing and evaluating a scaleable approach to strengthen health systems, support community-based programs, and promote widespread campaigns to address gender inequality, including promoting girls' education. The Millennium Development Goals (MDGs) have highlighted the importance of addressing maternal health and promoting gender equality for the overall development strategy of a nation. We must capitalize on the momentum created by this and other international campaigns and continue to advocate for comprehensive strategies to improve global women's health.

China's quest for management of academic medicine.

PubMed

Butler, W T; Ruma, S J

1990-08-01

The China Medical Board organized a management conference for the presidents of China's national medical universities. A three-person consulting team arranged by the Association of American Medical Colleges led the conference. Designed as a preliminary examination of the management problems faced by the national medical universities, the conference covered content similar to that of the AAMC Executive Development Seminars, including governance, financial management, faculty practice plans, technology transfer, information management, and organizational diagnosis. China's national medical universities are strategically managed by the Ministry of Public Health in Beijing, and for several years the ministry has increasingly decentralized the management and operational planning and control of these universities. The universities do not have enough properly trained personnel to absorb the additional management responsibilities, and the university presidents feel that they and their senior staffs need extensive training in adapting western-style management principles and practice to the Chinese setting.

Asbestos in schools. Hearing before the Subcommittee on Transportation, Tourism, and Hazardous Materials on the Committee on Energy and Commerce, House of Representatives, One Hundredth Congress, First Session on H. J. Res. 153, February 19, 1987

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

Not Available

1987-01-01

A hearing on H.J. Res. 153, under which the Environmental Protection Agency (EPA) would issue grants and loans to help school administrators finish the job of eliminating asbestos hazards from school buildings, included testimony from educators, school boards, citizen groups, and representatives of EPA. At issue was the administration's position that there is need for federal assistance for the clean-up, and that previous federal expenditures have been adequate. Witnesses explored the financial problems local schoold face in removing the asbestos and their need for further help. The hearing record includes the test of H.J. Res. 153, the testimony of themore » nine principal witnesses, and additional material submitted for the record.« less

Amygdala hypoactivity to fearful faces in boys with conduct problems and callous-unemotional traits.

PubMed

Jones, Alice P; Laurens, Kristin R; Herba, Catherine M; Barker, Gareth J; Viding, Essi

2009-01-01

Although early-onset conduct problems predict both psychiatric and health problems in adult life, little research has been done to index neural correlates of conduct problems. Emerging research suggests that a subgroup of children with conduct problems and elevated levels of callous-unemotional traits may be genetically vulnerable to manifesting disturbances in neural reactivity to emotional stimuli indexing distress. Using functional MRI, the authors evaluated differences in neural response to emotional stimuli between boys with conduct problems and elevated levels of callous-unemotional traits and comparison boys. Seventeen boys with conduct problems and elevated levels of callous-unemotional traits and 13 comparison boys of equivalent age (mean=11 years) and IQ (mean=100) viewed blocked presentations of fearful and neutral faces. For each face, participants distinguished the sex of the face via manual response. Relative to the comparison group, boys with conduct problems and elevated levels of callous-unemotional traits manifested lesser right amygdala activity to fearful faces. This finding is in line with data from studies of adults with antisocial behavior and callous-unemotional traits (i.e., psychopaths), as well as from a recent study of adolescents with callous-unemotional traits, and suggests that the neural substrates of emotional impairment associated with callous-unemotional antisocial behavior are already present in childhood.

Return on investment. What is ROI and how to use it.

PubMed

Cotter, Steve

2014-08-01

Formulated and interpreted correctly, ROI tools and techniques can be very useful for EMS managers when evaluating various competing projects and initiatives within the organization. More so, decision makers and elected bodies responsible for approving the financial support of these initiatives are demanding that they be presented with a more complete picture of the return for any dollars allocated under ever-tightening financial considerations that all organizations face today. ROI can be a powerful tool in supporting your organization when competing for limited dollars.

Financial Stress and Behavioral Health in Military Servicemembers: Risk, Resilience, Mechanisms and Targets for Intervention Stress, Resilience, and Well Being

DTIC Science & Technology

2016-02-29

can contribute to altered health, mental health, and individual and family functioning including risk for suicide . Understand ing the sources and...r.isk and resilience, economics, mode ls of stress behavior, and suicide who understand the challenges faced by military servicemembers and their...particularly important and is a high risk time for a number of mental illnesses as well as suicidality . • The perception of financial stress is itself a

Year 2000 Computing Crisis: Significant Risks Remain to Department of Education's Student Financial Aid Systems. Testimony before the Subcommittee on Oversight and Investigations, Committee on Education and the Workforce, House of Representatives.

ERIC Educational Resources Information Center

Willemssen, Joel C.

This testimony discusses the risks faced by the U.S. Department of Education due to the year 2000 (Y2K) computing crisis, focusing on student financial aid systems, the actions the Department has taken in recent months to address these risks, and the key issues the Department must deal with if its computer systems are to be ready for the century…

Paying Less for College: 1993. The Complete Guide to $28 Billion in Financial Aid. Tenth Edition.

ERIC Educational Resources Information Center

Peterson's Guides, Inc., Princeton, NJ.

This book on financial aid for college education is designed to be a guide to sources and an aid to the process of obtaining financial assistance. An introductory essay titled "The Twenty Most-Asked Questions About Financial Aid" gives a basic orientation on the issues and expert advice on how to tackle the problems of filling out forms,…

Financial Management: Education's Financial Management Problems Persist. Testimony before the Task Force on Education, Committee on the Budget, House of Representatives.

ERIC Educational Resources Information Center

Jarmon, Gloria L.; Engel, Gary T.

This document discusses the Department of Education's (DOE) fiscal year 1999 financial audit results; the relationship between the audit findings and the potential for waste, fraud, and abuse; and the results of the General Accounting Office's (GAO) review of the DOE's grantback account. The DOE's financial activity is important to the federal…

Training the Force: Developing Financially Fit Service Members for Today’s Military

DTIC Science & Technology

2003-01-01

significantly impacted readiness and soldier well-being. To offset this trend, Army leaders should act in concert with Consumer Affairs Financial...should act in concert with Consumer Affairs Financial Assistance Program (CAFAP) personnel to combat debt proliferation and associated problems...Building AGR Active Guard Reserve AIT Advanced Individual Training APR Annual Percentage Rate CAFAP Consumer Affairs Financial Advocacy Program CFS

The most common problem facing by the maintenance department: A case Study between Universiti Tun Hussein Onn Malaysia (UTHM) and Universiti Teknologi Malaysia (UTM)

NASA Astrophysics Data System (ADS)

Norazam Yasin, Mohd; Mohamad Zin, Rosli; Halid Abdullah, Abd; Shafiq Mahmad, Muhammad; Fikri Hasmori, Muhammad

2017-11-01

From time to time, the maintenance works become more challenging due to construction of new building and also aging of the existing buildings. University buildings without any exception require proper maintenance services to support their function requirements and this can be considered as major responsibilities to be fulfilled by the maintenance department in the universities. Maintenance department specifically will face various kinds of problems in their operation works and thus this might influence the maintenance work operations itself. This study purposely to identify the common problem facing by the maintenance department and also to examine the current status of the maintenance department. In addition, this study would also propose any suitable approach that could be implemented to overcome the problem facing by the maintenance department. To achieve the objectives of this study, a combination of deep literature study and carrying out a survey is necessary. Literature study aimed to obtain deeper information about this study, meanwhile a survey aimed at identifying the common problem facing by the maintenance department and also to provide the information of the maintenance department’s organization. Several methods will be used in analyzing the data obtained through the survey, including Microsoft Office Excel and also using mean index formula. This study has identified three categories of problem in the maintenance department, which are management problems, human resource problem, and technical problems. Following the findings, several solutions being proposed which can be implemented as the solution to the problem facing. These suggestions have the potential to improve the maintenance department work efficiency, thus could help to increase the department productivity.

Application of Problem Based Learning ((PBL) in a Course on Financial Accounting Principles

ERIC Educational Resources Information Center

Manaf, Nor Aziah Abdul; Ishak, Zuaini; Hussin, Wan Nordin Wan

2011-01-01

Purpose: This paper aims to share experiences in teaching a Financial Accounting Principles course using a hybrid problem based learning (PBL) method. The three specific objectives of this paper are to document how the PBL project for this course was developed and managed in class, to compare the academic performance of PBL students with non-PBL…

Launching New Institutions: Solving the Chicken-or-Egg Problem in American Higher Education

ERIC Educational Resources Information Center

Manning, Sylvia

2014-01-01

Currently, a US college or university must be accredited to be eligible to receive federal financial aid. To get accredited, an institution must have already been serving students, but most students are dependent on federal financial aid. As a result, in order to launch a new college or university, there is an insurmountable problem: having…

Financial Problems in the Stafford Student Loan Program. Testimony before the Committee on Banking, Housing and Urban Affairs, United States Senate.

ERIC Educational Resources Information Center

Frazier, Franklin

This statement of the Director of Education and Employment Issues of the General Accounting Office's Human Resources Division discusses how the Stafford Student Loan program works, the growth in loans guaranteed and defaulted, and the concerns surrounding the financial problems being experienced by the Higher Education Assistance Foundation…

31 CFR 370.21 - Are there any requirements related to a prenotification entry?

Code of Federal Regulations, 2010 CFR

2010-07-01

... specified time period, we may interpret the nonresponsiveness as the financial institution's agreement to.... In our discretion, we may initiate a prenotification entry to a financial institution prior to... there might be problems with sending a subsequent debit entry. (b) Requirements placed upon financial...

What School Financial Reports Reveal and Hide.

ERIC Educational Resources Information Center

Walters, Donald L.

The problem of full disclosure of the financial operation and position of a school system is discussed in this paper. Techniques described for analyzing revenue and expenditure patterns include percentage changes and index numbers for horizontal analysis and proportions for vertical analysis. Also discussed are how financial reports are affected…

Colleges Turn to Private Companies To Build and Run Student Housing.

ERIC Educational Resources Information Center

van der Werf, Martin

1999-01-01

Increasingly, colleges and universities are privatizing housing, attracted to the limited financial outlay and involvement in management. Critics fear that institutions' financial positions will be compromised if the private developers have problems, and that institutions will lose control of financial aspects and quality of residence-hall life,…

Managing Costs and Medical Information

Cancer.gov

People with cancer may face major financial challenges and need help dealing with the high costs of care. Cancer treatment can be very expensive, even when you have insurance. Learn ways to manage medical information, paperwork, bills, and other records.

Is policy well-targeted to remedy financial strain among caregivers of severely injured U.S. service members?

PubMed

Van Houtven, Courtney Harold; Friedemann-Sánchez, Greta; Clothier, Barbara; Levison, Deborah; Taylor, Brent C; Jensen, Agnes C; Phelan, Sean M; Griffin, Joan M

U.S. military service members have sustained severe injuries since the start of the wars in Iraq and Afghanistan. This paper aims to determine the factors associated with financial strain of their caregivers and establish whether recent federal legislation targets caregivers experiencing financial strain. In our national survey, 62.3% of caregivers depleted assets and/or accumulated debt, and 41% of working caregivers left the labor force. If a severely injured veteran needed intensive help, the primary caregiver faced odds 4.63 times higher of leaving the labor force, and used $27,576 more in assets and/or accumulated debt compared to caregivers of veterans needing little or no assistance.

An Architectural Model of Visual Motion Understanding

DTIC Science & Technology

1989-08-01

of the Center for Visual Sciences of the University of Rochester. Their courage in the face of the overwhelming com- plexity of the human visual...analysis should perform better than either approach by itself. Notice that the problems of the two approaches are non-overlapping. Continuous methods face no...success. This is not terribly surprising, as the problem is inherently very difficult. Consider the problems faced by a unit that is trying to compute the

A review of promoting access to medicines in China - problems and recommendations.

PubMed

Sun, Jing; Hu, Cecile Jia; Stuntz, Mark; Hogerzeil, Hans; Liu, Yuanli

2018-02-20

Despite recent reforms, distorting funding mechanisms and over-prescribing still maintain severe financial barriers to medicines access in China. Complicated and interrelated problems in the pharmaceutical sector require a common framework to be resolved as fragmented solutions do not work. We present a preliminary assessment of the impact of the national healthcare reforms on access to medicines, and propose policy recommendations for promoting universal access to medicines in China. Drawing on multiple sources of information, including a review of published literatures and official national data, field investigations in six provinces and interviews with key opinion leaders, this paper presents a preliminary assessment of the impact of the national healthcare reforms on access to medicines, and proposes policy recommendations for promoting universal access to medicines in China. Public expenditure on medicines has been strictly controlled since the national healthcare reforms of 2009. Yet total pharmaceutical expenditure (TPE) and total health expenditure growth rates continuously outpaced the growth of gross domestic product (GDP). With 2.4% of GDP, TPE now exceeds that of most high income countries. The distorted provider and consumer incentives in the Chinese health system have not fundamentally changed. Price-setting and reimbursement mechanisms do not promote cost-effective use of medicines. Inappropriate price controls and perverse financial incentives are the un-resolved root causes of preference of originator brands for some major diseases and shortages of low-cost and low-consumption medicines. In addition, access to expensive life-saving medicines is yet systematically addressed. The complicated and interdependent problems interact in a way that leads to significant system problems in China, which create dual challenges that both the developing country and the developed countries are facing. To further promote access to medicines, China should speed up the re-assessment of the quality and efficacy of domestically produced generic medicines; coordinate various reforms of price determination, insurance payments, and procurement policies; address medicine shortages through comprehensive policies and legislation; establish specific mechanisms to achieve sustainable equitable access to expensive essential medicines with health technology assessment as a tool to ensure that policy and priority setting are created in a coherent and evidence-based way.

Health care delivery systems in review.

PubMed

Dunmire, S N

1988-01-01

Plagued with insolvency, physician discontent, and employer demands, the health maintenance organization (HMO) industry is seeking solutions to their crippling ailments. As buyers are more difficult to find for troubled plans, some executives are forced to resign or face bankruptcy. Still other executives have been able to turn around their financial and physician staffing challenges. The preferred provider organization (PPO) industry remains in the background of the HMO turmoil, facing the issues of quality assurance and cost containment.

[Medico-social aspects of AIDS].

PubMed

Rabitti, G; Stati, A; Del Bove Orlandi, G; Gallese, A

1992-01-01

The AIDS crisis has brought us face to face with complex medical and social challenges unparalleled in this century. The magnitude of this tragic epidemic is measured not only in the cost in human lives, but also the enormous financial burdens of health care and lost productivity which each and every one of us, as well as future generations, will ultimately bear. This article presents an opportunity to explore a variety of health, social, economic, juridical and working issues of AIDS.

Issues faced by community health centers.

PubMed

Grover, Jane

2009-05-01

Federally qualified health centers face numerous issues with regard to marketplace competition, staffing, and reimbursement streams that assure financial viability. Positioning the dental department of a health center to a high community profile strengthens the health center in professional educational development leading to a pipeline of workforce members, effective dental directors, and innovative fund-raising. A new dental team member developed by the American Dental Association can be utilized in health centers to make all traditional auxiliaries more productive.

Patients' barriers to receipt of cancer care, and factors associated with needing more assistance from a patient navigator.

PubMed

Hendren, Samantha; Chin, Nancy; Fisher, Susan; Winters, Paul; Griggs, Jennifer; Mohile, Supriya; Fiscella, Kevin

2011-08-01

Racial minorities have poorer cancer survival in the United States compared to whites. The purpose of this study was to better understand patients' barriers to cancer care and to determine which patients have a greater need for assistance from a patient navigator. Community health workers assisted newly-diagnosed breast and colorectal cancer patients during a randomized trial of patient navigation and collected information about patients' barriers. Barriers to care were characterized and compared between non-Hispanic white and minority patients. A multivariate model was constructed of factors associated with increased log navigation time, a measure of patients' need for assistance. Patients' (n = 103) most commonly identified barriers to care included a lack of social support, insurance/financial concerns, and problems communicating with health care providers. Barriers differed between nonminority and minority patients, and minority patients faced a greater number of barriers (p = .0001). In univariate analysis, log navigation time was associated with race/ethnicity, education, income, employment, insurance type, health literacy, marital status, language, and comorbidity. A multivariate model (R2 = 0.43) for log navigation time was created using stepwise selection, and included the following factors: minority race/ethnicity (p = .032), non-full-time employment (p = .0004), unmarried status (p = .085), university center (p = .0005), and months in study (p <.0001). Newly diagnosed cancer patients' most common barriers to care include lack of social support, insurance/financial concerns, and problems with health care communications. In this sample of patients, a greater need for assistance was independently associated with minority race/ethnicity and unemployment. These data may help in the design and targeting of interventions to reduce cancer health disparities.

[Mediating effects on depression regarding the relationship between negative life events and suicide ideation among college students].

PubMed

Wu, Jiao; Wu, Yun-tao; Feng, Shu-xiu; Meng, Heng; Chen, Hui

2012-11-01

To understand the relationship between negative life events and suicide ideation, and how it was influenced by the mediating effect of depression. 1145 college students from one university were selected using cluster sampling. Both Symptom Check List (SCL-90) and Questionnaire were administered to measure depression and suicide ideation in the past week and on the prevalence of negative life events and related information. Recent negative life events would include physical illness, academic problem, financial problem and interpersonal conflict etc. Multiple logistic regressions were used to identify the mediating effect of depression. Physical illness (OR = 2.5, P = 0.028), interpersonal conflict (OR = 7.2, P = 0.002) and financial problem (OR = 1.6, P = 0.026) were significantly associated with suicide ideation, but academically-related problems did not seem to be significantly associated with suicide ideation (OR = 1.8, P = 0.090). After adjusted for depression, both physical illness and interpersonal conflicts were not but financial problem remained significantly associated with suicide ideation (OR = 1.7, P = 0.014). Our data showed that depression fully mediated the relationship between physical illness, interpersonal conflict and suicide ideation, but did not mediate the relationship between financial problem and suicide ideation. Depression played different mediating roles between different negative life events and suicide ideation. The findings from this study might be able to provide some clues for the prevention interventions on college students.

Some Problems in Educational Administration

ERIC Educational Resources Information Center

Lyons, Raymond F.

1977-01-01

Educational administration problems in developing countries are discussed. Possible solutions to problems of decision-making, decision implementation, communications, task definition, and financial control are suggested. (Author/DB)

Semisupervised kernel marginal Fisher analysis for face recognition.

PubMed

Wang, Ziqiang; Sun, Xia; Sun, Lijun; Huang, Yuchun

2013-01-01

Dimensionality reduction is a key problem in face recognition due to the high-dimensionality of face image. To effectively cope with this problem, a novel dimensionality reduction algorithm called semisupervised kernel marginal Fisher analysis (SKMFA) for face recognition is proposed in this paper. SKMFA can make use of both labelled and unlabeled samples to learn the projection matrix for nonlinear dimensionality reduction. Meanwhile, it can successfully avoid the singularity problem by not calculating the matrix inverse. In addition, in order to make the nonlinear structure captured by the data-dependent kernel consistent with the intrinsic manifold structure, a manifold adaptive nonparameter kernel is incorporated into the learning process of SKMFA. Experimental results on three face image databases demonstrate the effectiveness of our proposed algorithm.

Problems Facing Rural Schools.

ERIC Educational Resources Information Center

Stewart, C. E.; And Others

Problems facing rural Scottish schools range from short term consideration of daily operation to long term consideration of organizational alternatives. Addressed specifically, such problems include consideration of: (1) liaison between a secondary school and its feeder primary schools; (2) preservice teacher training for work in small, isolated…

Expected value information improves financial risk taking across the adult life span.

PubMed

Samanez-Larkin, Gregory R; Wagner, Anthony D; Knutson, Brian

2011-04-01

When making decisions, individuals must often compensate for cognitive limitations, particularly in the face of advanced age. Recent findings suggest that age-related variability in striatal activity may increase financial risk-taking mistakes in older adults. In two studies, we sought to further characterize neural contributions to optimal financial risk taking and to determine whether decision aids could improve financial risk taking. In Study 1, neuroimaging analyses revealed that individuals whose mesolimbic activation correlated with the expected value estimates of a rational actor made more optimal financial decisions. In Study 2, presentation of expected value information improved decision making in both younger and older adults, but the addition of a distracting secondary task had little impact on decision quality. Remarkably, provision of expected value information improved the performance of older adults to match that of younger adults at baseline. These findings are consistent with the notion that mesolimbic circuits play a critical role in optimal choice, and imply that providing simplified information about expected value may improve financial risk taking across the adult life span.

The multidimensional nature of the financial and economic burden of a cancer diagnosis on patients and their families: qualitative findings from a country with a mixed public-private healthcare system.

PubMed

Timmons, Aileen; Gooberman-Hill, Rachael; Sharp, Linda

2013-01-01

Although awareness is increasing that cancer can have an adverse financial and economic impact for patients, the overall burden remains poorly understood. To elucidate these issues, we used qualitative methods to explore the financial impact of a cancer diagnosis in Ireland, which has a mixed public-private healthcare system and where sick leave and sick pay are at employers' discretion. Face-to-face semi-structured interviews were conducted with hospital-based oncology social workers (OSWs; 21 OSWs from 11 hospitals) and patients (20 from eight hospitals; 11 breast, 5 prostate and 4 lung cancer). Participants were asked about the (1) extra expenses incurred, (2) cancer's impact on work and income, and (3) accessing financial assistance/social welfare benefits. The two interview sets were analysed separately using thematic analysis. Broad themes that emerged included the wide range of additional cancer-related medical and non-medical expenses incurred by all patients, including those with medical cards (which entitle the bearer to receive health services free of charge) and those with private health insurance; the major impact of cancer and its treatment on work and patient/household income (all patients who were working at diagnosis experienced a drop in income); and difficulties in accessing medical cards and benefits. This study reveals the complex, multidimensional nature of the financial and economic burden cancer imposes on patients and the whole family unit. Changes in income post-cancer exacerbate the effects of cancer-related out-of-pocket expenses. These findings have implications for healthcare professionals, service providers and policy makers.

Multi-Dimensional, Non-Pyrolyzing Ablation Test Problems

NASA Technical Reports Server (NTRS)

Risch, Tim; Kostyk, Chris

2016-01-01

Non-pyrolyzingcarbonaceous materials represent a class of candidate material for hypersonic vehicle components providing both structural and thermal protection system capabilities. Two problems relevant to this technology are presented. The first considers the one-dimensional ablation of a carbon material subject to convective heating. The second considers two-dimensional conduction in a rectangular block subject to radiative heating. Surface thermochemistry for both problems includes finite-rate surface kinetics at low temperatures, diffusion limited ablation at intermediate temperatures, and vaporization at high temperatures. The first problem requires the solution of both the steady-state thermal profile with respect to the ablating surface and the transient thermal history for a one-dimensional ablating planar slab with temperature-dependent material properties. The slab front face is convectively heated and also reradiates to a room temperature environment. The back face is adiabatic. The steady-state temperature profile and steady-state mass loss rate should be predicted. Time-dependent front and back face temperature, surface recession and recession rate along with the final temperature profile should be predicted for the time-dependent solution. The second problem requires the solution for the transient temperature history for an ablating, two-dimensional rectangular solid with anisotropic, temperature-dependent thermal properties. The front face is radiatively heated, convectively cooled, and also reradiates to a room temperature environment. The back face and sidewalls are adiabatic. The solution should include the following 9 items: final surface recession profile, time-dependent temperature history of both the front face and back face at both the centerline and sidewall, as well as the time-dependent surface recession and recession rate on the front face at both the centerline and sidewall. The results of the problems from all submitters will be collected, summarized, and presented at a later conference.

Telemedicine in rural areas: general practitioners’ representations and experiences

PubMed

Durupt, Maxime; Bouchy, Olivier; Christophe, Sonia; Kivits, Joëlle; Boivin, Jean-Marc

2016-10-19

Introduction: Telemedicine is a rapidly growing new mode of healthcare practice. It is particularly used and needed in remote areas in Lorraine (North East of France) that currently face a shortage of general practitioners and specialists. The objective of this study was to analyse general practitioner’s representations of telemedicine and teleconsultation. The study also identified the advantages and disadvantages of this new mode of medical practice. Methods: A qualitative research was led: 5 focus groups were conducted with 32 doctors in areas faced with the problems of health professional shortages between June 2014 and July 2015. Results: This study reveals a general ignorance of telemedicine. Doctors want to play a central role in this new form of medical practice which must remain optional. Their reluctance essentially concerns financial and legal aspects that constitute obstacles to the development of telemedicine. Finally, this new mode of medical practice must comply with a legal framework regarding medical responsibility and personal data protection. Discussion.More than 100 medical procedures are delivered by telemedicine in Lorraine each month. This new technology is a solution to provide healthcare services in medically underserved areas. However, general practitioners want to preserve the “doctor-patient” relationship and do not wish to change their practice.

If they get sick, they are in trouble: health care restructuring, user charges, and equity in Vietnam.

PubMed

Sepehri, Ardeshir; Chernomas, Robert; Akram-Lodhi, A Haroon

2003-01-01

The transition from a centrally planned economy in the 1980s and the implementation of a series of neoliberal health policy reform measures in 1989 affected the delivery and financing of Vietnam's health care services. More specifically, legalization of private medical practice, liberalization of the pharmaceutical industry, and introduction of user charges at public health facilities have effectively transformed Vietnam's near universal, publicly funded and provided health services into a highly unregulated private-public mix system, with serious consequences for Vietnam's health system. Using Vietnam's most recent household survey data and published facility-based data, this article examines some of the problems faced by Vietnam's health sector, with particular reference to efficiency, access, and equity. The data reveal four important findings: self-treatment is the dominant mode of treatment for both the poor and nonpoor; there is little or no regulation to protect patients from financial abuse by private medical providers, pharmacies, and drug vendors; in the face of a dwindling share of the state health budget in public hospital revenues and low salaries, hospitals increasingly rely on user charges and insurance premiums to finance services, including generous staff bonuses; and health care costs, especially hospital costs, are substantial for many low- and middle-income households.

Catastrophic Health Expenditures for Households with Disabled Members: Evidence from the Korean Health Panel

PubMed Central

2016-01-01

Persons with disabilities use more health care services due to ill health and face higher health care expenses and burden. This study explored the incidence of catastrophic health expenditures of households with persons with disabilities compared to that of those without such persons. We used the Korean Health Panel (KHP) dataset for the years 2010 and 2011. The final sample was 5,610 households; 800 (14.3%) of these were households with a person with a disability and 4,810 (85.7%) were households without such a person. Households with a person with a disability faced higher catastrophic health expenditures, spending about 1.2 to 1.4 times more of their annual living expenditures for out-of-pocket medical expenses, compared to households without persons with disabilities. Households having low economic status and members with chronic disease were more likely to face catastrophic health expenditures, while those receiving public assistance were less likely. Exemption or reduction of out-of-pocket payments in the National Health Insurance and additional financial support are needed so that the people with disabilities can use medical services without suffering financial crisis. PMID:26955233

Catastrophic Health Expenditures for Households with Disabled Members: Evidence from the Korean Health Panel.

PubMed

Lee, Jeong-Eun; Shin, Hyung-Ik; Do, Young Kyung; Yang, Eun Joo

2016-03-01

Persons with disabilities use more health care services due to ill health and face higher health care expenses and burden. This study explored the incidence of catastrophic health expenditures of households with persons with disabilities compared to that of those without such persons. We used the Korean Health Panel (KHP) dataset for the years 2010 and 2011. The final sample was 5,610 households; 800 (14.3%) of these were households with a person with a disability and 4,810 (85.7%) were households without such a person. Households with a person with a disability faced higher catastrophic health expenditures, spending about 1.2 to 1.4 times more of their annual living expenditures for out-of-pocket medical expenses, compared to households without persons with disabilities. Households having low economic status and members with chronic disease were more likely to face catastrophic health expenditures, while those receiving public assistance were less likely. Exemption or reduction of out-of-pocket payments in the National Health Insurance and additional financial support are needed so that the people with disabilities can use medical services without suffering financial crisis.

Predicting Firm Success From the Facial Appearance of Chief Executive Officers of Non-Profit Organizations.

PubMed

Re, Daniel E; Rule, Nicholas O

2016-10-01

Recent research has demonstrated that judgments of Chief Executive Officers' (CEOs') faces predict their firms' financial performance, finding that characteristics associated with higher power (e.g., dominance) predict greater profits. Most of these studies have focused on CEOs of profit-based businesses, where the main criterion for success is financial gain. Here, we examined whether facial appearance might predict measures of success in a sample of CEOs of non-profit organizations (NPOs). Indeed, contrary to findings for the CEOs of profit-based businesses, judgments of leadership and power from the faces of CEOs of NPOs negatively correlated with multiple measures of charitable success (Study 1). Moreover, CEOs of NPOs looked less powerful than the CEOs of profit-based businesses (Study 2) and leadership ratings positively associated with warmth-based traits and NPO success when participants knew the faces belonged to CEOs of NPOs (Study 3). CEOs who look less dominant may therefore achieve greater success in leading NPOs, opposite the relationship found for the CEOs of profit-based companies. Thus, the relationship between facial appearance and leadership success varies by organizational context. © The Author(s) 2016.

Challenges faced by parents of children with learning disabilities in Opuwo, Namibia.

PubMed

Taderera, Clever; Hall, Herna

2017-01-01

Parenting children with learning disabilities requires a high level of knowledge and access to resources, information and services. In developing countries, however, these resources and services are not always available. Parents in Namibia, a developing country, therefore face challenges addressing children's learning and other developmental disabilities, including challenges related to preventative and supportive interventions. This research focuses on challenges faced by parents as they parent children with learning disabilities in Opuwo, Namibia. In-depth interviews were conducted with eight parents regarding the challenges they face in parenting their children with learning disabilities. Thematic analysis enabled the researchers to identify, analyse and report on themes that emerged from the qualitative interview data. Analysis of the interviews indicated that some participants had only a vague understanding of learning disabilities, as they did not have access to essential knowledge about this phenomenon. They also lacked an awareness of the availability of programmes, services and policies meant to benefit their children with learning disabilities. Participants voiced that they, their children with learning disabilities and community members have stereotypes and prejudices regarding learning disabilities. In this study, most of the children with learning disabilities were raised by single, unemployed parents who seemed to have access to less support from external sources than married couples parenting children with learning disabilities. These single parents are usually not married and because of lack of financial support from the other parent, the majority of them indicated that they struggle to meet the financial and material needs of their children. The researchers concluded that the participants in this study experience a range of challenges in parenting their children with learning disabilities. The main challenges emanate from financial instability, as well as lack of knowledge regarding services and programmes for children with learning disabilities. This lack of knowledge on the part of participants could indicate poor policy education by policy implementers at grass-roots level.

Challenges faced by parents of children with learning disabilities in Opuwo, Namibia

PubMed Central

Taderera, Clever

2017-01-01

Background Parenting children with learning disabilities requires a high level of knowledge and access to resources, information and services. In developing countries, however, these resources and services are not always available. Parents in Namibia, a developing country, therefore face challenges addressing children’s learning and other developmental disabilities, including challenges related to preventative and supportive interventions. Objective This research focuses on challenges faced by parents as they parent children with learning disabilities in Opuwo, Namibia. Method In-depth interviews were conducted with eight parents regarding the challenges they face in parenting their children with learning disabilities. Thematic analysis enabled the researchers to identify, analyse and report on themes that emerged from the qualitative interview data. Results Analysis of the interviews indicated that some participants had only a vague understanding of learning disabilities, as they did not have access to essential knowledge about this phenomenon. They also lacked an awareness of the availability of programmes, services and policies meant to benefit their children with learning disabilities. Participants voiced that they, their children with learning disabilities and community members have stereotypes and prejudices regarding learning disabilities. In this study, most of the children with learning disabilities were raised by single, unemployed parents who seemed to have access to less support from external sources than married couples parenting children with learning disabilities. These single parents are usually not married and because of lack of financial support from the other parent, the majority of them indicated that they struggle to meet the financial and material needs of their children. Conclusion The researchers concluded that the participants in this study experience a range of challenges in parenting their children with learning disabilities. The main challenges emanate from financial instability, as well as lack of knowledge regarding services and programmes for children with learning disabilities. This lack of knowledge on the part of participants could indicate poor policy education by policy implementers at grass-roots level. PMID:28951851

Detecting driver fatigue through the use of advanced face monitoring techniques

DOT National Transportation Integrated Search

2001-09-01

Driver fatigue is an important factor in many vehicular accidents.Reducing the number of fatigue-related accidents would save : society a significant amount financially,in addition to reducing personal suffering.The researchers developed a driver fat...

Retailing and Shopping on the Internet.

ERIC Educational Resources Information Center

Rowley, Jennifer

1996-01-01

Internet advertising and commercial activity are increasing. This article examines challenges facing the retail industry on the Internet: location; comparison shopping; security, especially financial transactions; customer base and profile; nature of the shopping experience; and legal and marketplace controls. (PEN)

Challenges and opportunities for minority owned trucking firms under affirmative actions : a case study.

DOT National Transportation Integrated Search

2012-01-01

Despite the steady growth and the introduction of "set-aside" programs/Affirmative Actions, minority owned firms often faced stiff business challenges. These challenges include a lack of business networking opportunities, limited financial resources,...

Goals and everyday problem solving: examining the link between age-related goals and problem-solving strategy use.

PubMed

Hoppmann, Christiane A; Coats, Abby Heckman; Blanchard-Fields, Fredda

2008-07-01

Qualitative interviews on family and financial problems from 332 adolescents, young, middle-aged, and older adults, demonstrated that developmentally relevant goals predicted problem-solving strategy use over and above problem domain. Four focal goals concerned autonomy, generativity, maintaining good relationships with others, and changing another person. We examined both self- and other-focused problem-solving strategies. Autonomy goals were associated with self-focused instrumental problem solving and generative goals were related to other-focused instrumental problem solving in family and financial problems. Goals of changing another person were related to other-focused instrumental problem solving in the family domain only. The match between goals and strategies, an indicator of problem-solving adaptiveness, showed that young individuals displayed the greatest match between autonomy goals and self-focused problem solving, whereas older adults showed a greater match between generative goals and other-focused problem solving. Findings speak to the importance of considering goals in investigations of age-related differences in everyday problem solving.

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

PubMed

Merry, Alan F; Hamblin, Richard

2012-12-01

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

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

PubMed Central

Merry, Alan F.; Hamblin, Richard

2012-01-01

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

Influence of socio-economic status on access to different components of SCI management across Indian population.

PubMed

Chhabra, H S; Bhalla, A M

2015-11-01

To assess the influence of financial constraints on access to different components of spinal cord injury (SCI) management in various socio-economic strata of the Indian population. Indian Spinal Injuries Centre (ISIC). One hundred fifty SCI individuals who came for follow-up at ISIC between March 2009 and March 2013 with at least 1 year of community exposure after discharge were included in the study. Socio-economic classification was carried out according to the Kuppuswamy scale, a standard scale for the Indian population. A self-designed questionnaire was administered. No sample was available from the lower group. There was a statistically significant difference (P<0.05) for the levels of difficulty perceived by different socio-economic groups in accessing different components of SCI management. Aided upper lower group was dependent on welfare schemes for in-hospital treatment but could not access other components of management once discharged. Unaided upper lower group either faced severe difficulty or could not access management. Majority of lower middle group faced severe difficulty. Upper middle group was equally divided into facing severe, moderate or no difficulty. Most patients in the upper group faced no difficulty, whereas some faced moderate and a small number of severe difficulty. Financial constraints affected all components of SCI management in all except the upper group. The results of the survey suggest that a very large percentage of the Indian population would find it difficult to access comprehensive SCI management and advocate extension of essential medical coverage to unaided upper lower, lower middle and upper middle groups.

Financial and Managerial Accounting for Elementary and Secondary School Systems. Third Edition.

ERIC Educational Resources Information Center

Tidwell, Sam B.

This book describes recent improvements in governmental accounting, auditing, and financial reporting for school business officials. Applications of financial accounting and reporting principles in typical transactions of school systems are illustrated by questions, cases, and problems at the end of each chapter. The first of the two sections,…

The Financial Knowledge of College Freshmen

ERIC Educational Resources Information Center

Avard, Stephen; Manton, Edgar; English, Donald; Walker, Janet

2005-01-01

The problem of the study was to determine college freshmen's financial knowledge. The entire freshman English 101, College Reading and Writing class at Texas A&M University--Commerce was surveyed. There were a total of 407 students enrolled in these classes. There were 20 multiple choice questions dealing with basic knowledge of financial issues,…

Ten financial management principles for survival.

PubMed

Cleverley, W O

1988-03-01

Financial insolvency is the primary cause of hospital failure. Managers may analyze a hospital's financial statements to anticipate and prevent fiscal problems. Ten measures of fiscal status may be used to evaluate the following: operating profitability nonoperating income equity growth liquidity debt capacity age of facilities revenue generation replacement funds receivables survivability Based on data from the Financial Analysis Service, Catholic hospitals are doing better than other U.S. hospitals in some areas of financial preparedness. In most areas, however, all hospitals suffer by comparison with manufacturers. The 10 principles of solvent and successful operations can help hospitals improve financial resiliency.

Oncology navigators' perceptions of cancer-related financial burden and financial assistance resources.

PubMed

Spencer, Jennifer C; Samuel, Cleo A; Rosenstein, Donald L; Reeder-Hayes, Katherine E; Manning, Michelle L; Sellers, Jean B; Wheeler, Stephanie B

2018-04-01

As the cost of cancer treatment continues to rise, many patients are faced with significant emotional and financial burden. Oncology navigators guide patients through many aspects of care and therefore may be especially aware of patients' financial distress. Our objective was to explore navigators' perception of their patients' financial burden and their role in addressing financial needs. We conducted a real-time online survey of attendees at an oncology navigators' association conference. Participants included lay navigators, oncology nurse navigators, community health workers, and social workers. Questions assessed perceived burden in their patient population and their role in helping navigate patients through financial resources. Answers to open-ended questions are reported using identified themes. Seventy-eight respondents participated in the survey, reporting that on average 75% of their patients experienced some degree of financial toxicity related to their cancer. Only 45% of navigators felt the majority of these patients were able to get some financial assistance, most often through assistance with medical costs (73%), subsidized insurance (36%), or non-medical expenses (31%). Commonly identified barriers for patients obtaining assistance included lack of resources (50%), lack of knowledge about resources (46%), and complex/duplicative paperwork (20%). Oncology navigators reported a high burden of financial toxicity among their patients but insufficient knowledge or resources to address this need. This study underscores the importance of improved training and coordination for addressing financial burden, and the need to address community and system-level barriers.

Impact of trained oncology financial navigators on patient out-of-pocket spending.

PubMed

Yezefski, Todd; Steelquist, Jordan; Watabayashi, Kate; Sherman, Dan; Shankaran, Veena

2018-03-01

Patients with cancer often face financial hardships, including loss of productivity, high out-of-pocket (OOP) costs, depletion of savings, and bankruptcy. By providing financial guidance and assistance through specially trained navigators, hospitals and cancer care clinics may be able mitigate the financial burdens to patients and also minimize financial losses for the treating institutions. Financial navigators at 4 hospitals were trained through The NaVectis Group, an organization that provides training to healthcare staff to increase patient access to care and assist with OOP expenses. Data regarding financial assistance and hospital revenue were collected after instituting these programs. Amount and type of assistance (free medication, new insurance enrollment, premium/co-pay assistance) were determined annually for all qualifying patients at the participating hospitals. Of 11,186 new patients with cancer seen across the 4 participating hospitals between 2012 and 2016, 3572 (32%) qualified for financial assistance. They obtained $39 million in total financial assistance, averaging $3.5 million per year in the 11 years under observation. Patients saved an average of $33,265 annually on medication, $12,256 through enrollment in insurance plans, $35,294 with premium assistance, and $3076 with co-pay assistance. The 4 hospitals were able to avoid write-offs and save on charity care by an average of $2.1 million per year. Providing financial navigation training to staff at hospitals and cancer centers can significantly benefit patients through decreased OOP expenditures and also mitigate financial losses for healthcare institutions.

Can we match ultraviolet face images against their visible counterparts?

NASA Astrophysics Data System (ADS)

Narang, Neeru; Bourlai, Thirimachos; Hornak, Lawrence A.

2015-05-01

In law enforcement and security applications, the acquisition of face images is critical in producing key trace evidence for the successful identification of potential threats. However, face recognition (FR) for face images captured using different camera sensors, and under variable illumination conditions, and expressions is very challenging. In this paper, we investigate the advantages and limitations of the heterogeneous problem of matching ultra violet (from 100 nm to 400 nm in wavelength) or UV, face images against their visible (VIS) counterparts, when all face images are captured under controlled conditions. The contributions of our work are three-fold; (i) We used a camera sensor designed with the capability to acquire UV images at short-ranges, and generated a dual-band (VIS and UV) database that is composed of multiple, full frontal, face images of 50 subjects. Two sessions were collected that span over the period of 2 months. (ii) For each dataset, we determined which set of face image pre-processing algorithms are more suitable for face matching, and, finally, (iii) we determined which FR algorithm better matches cross-band face images, resulting in high rank-1 identification rates. Experimental results show that our cross spectral matching (the heterogeneous problem, where gallery and probe sets consist of face images acquired in different spectral bands) algorithms achieve sufficient identification performance. However, we also conclude that the problem under study, is very challenging, and it requires further investigation to address real-world law enforcement or military applications. To the best of our knowledge, this is first time in the open literature the problem of cross-spectral matching of UV against VIS band face images is being investigated.

Memory for angry faces, impulsivity, and problematic behavior in adolescence.

PubMed

d'Acremont, Mathieu; Van der Linden, Martial

2007-04-01

Research has shown that cognitive processes like the attribution of hostile intention or angry emotion to others contribute to the development and maintenance of conduct problems. However, the role of memory has been understudied in comparison with attribution biases. The aim of this study was thus to test if a memory bias for angry faces was related to conduct problems in youth. Adolescents from a junior secondary school were presented with angry and happy faces and were later asked to recognize the same faces with a neutral expression. They also completed an impulsivity questionnaire. A teacher assessed their behavior. The results showed that a better recognition of angry faces than happy faces predicted conduct problems and hyperactivity/inattention as reported by the teacher. The memory bias effect was more pronounced for impulsive adolescents. It is suggested that a memory bias for angry faces favors disruptive behavior but that a good ability to control impulses may moderate the negative impact of this bias.

[Quality of life of primary care patients in Rio de Janeiro and São Paulo, Brasil: associations with stressful life events and mental health].

PubMed

Portugal, Flávia Batista; Campos, Mônica Rodrigues; Gonçalves, Daniel Almeida; Mari, Jair de Jesus; Fortes, Sandra Lúcia Correia Lima

2016-02-01

Quality of life (QoL) is a subjective construct, which can be negatively associated with factors such as mental disorders and stressful life events (SLEs). This article seeks to identify the association between socioeconomic and demographic variables, common mental disorders, symptoms suggestive of depression and anxiety, SLEs with QoL in patients attended in Primary Care (PC). It is a transversal study, conducted with 1,466 patients attended in PC centers in the cities of São Paulo and Rio de Janeiro in 2009 and 2010. Bivariate analysis was performed using the T-test and four multiple linear regressions for each QoL domain. The scores for the physical, psychological, social relations and environment domains were, respectively, 64.7; 64.2; 68.5 and 49.1. By means of multivariate analysis, associations of the physical domain were found with health problems and discrimination; of the psychological domain with discrimination; of social relations with financial/structural problems; of external causes and health problems; and of the environment with financial/structural problems, external causes and discrimination. Mental health variables, health problems and financial/structural problems were the factors negatively associated with QoL.

Association of financial hardship with poor sleep health outcomes among men who have sex with men.

PubMed

Duncan, Dustin T; Hyun Park, Su; Al-Ajlouni, Yazan A; Hale, Lauren; Jean-Louis, Girardin; Goedel, William C; Chaix, Basile; Elbel, Brian

2017-12-01

Previous studies have identified an association between socioeconomic status and sleep health. While some research has studied this association among sexual minority groups, including men who have sex with men (MSM), they exclusively focused on US-based populations. The interplay between the two in shaping sleep health has not been previously examined on populations residing outside the US. This study considers both determinants, by investigating whether financial hardship is associated with sleep health among a sample of MSM in Paris, France. Broadcast advertisements were placed on a popular geosocial-networking smartphone application for MSM to direct users in Paris to a web-based survey measuring financial hardship and five dimensions of sleep health as well as socio-demographic characteristics. Modified Poisson models with robust error variance were computed to estimate risk ratios (RRs) and 95% confidence intervals (CI) for the associations between financial hardship and the following self-reported outcomes: 1) poor sleep quality, 2) short sleep duration; and 3) sleep problems. In total, 580 respondents completed the survey. In this sample, both financial hardship and poor sleep health were common - 45.5% reported that it was extremely, very, or somewhat difficult for them to meet their monthly payments on bills (referred to as "high financial hardship") and 30.1% rated their sleep as fairly bad or very bad (referred to as "poor sleep quality"). Multivariate models revealed that, compared to participants who reported low financial hardship, those who reported high financial hardship were more likely to report poor sleep quality (aRR: 1.35, 95% CI: 1.04, 1.77), to report problems falling asleep (aRR: 1.23, 95% CI: 1.02, 1.49), and to report problems staying awake in the daytime (aRR: 3.12, 95% CI: 1.83, 5.31). Future research should investigate whether this relationship is causal and determine whether interventions to reduce financial hardships could promote sleep health among MSM.

Water and health in Europe. A joint report from the European Environment Agency and the WHO Regional Office for Europe.

PubMed

2002-01-01

Shortage of water may be most urgent health problem currently facing some European countries. Climate change is predicted to influence water availability, especially in coastal areas. The extend of provision of piped drinking-water supplies to households varies across Europe and between urban and rural populations. The utilization of water for irrigation and for industry exerts pressure on water resources. Changes in populaton distribution and density are key factors influencing the quality of water resources. Outbreaks of waterborne diseases continue to occur across Europe, and minor supply problems are encountered in all countries. Inadequate sewerage systems are a significant threat to public health. Numerous chemicals are found throughout the aquatic environment. Eutrophication is a major threat to European surface waters. Considerate evidence has accrued linking the quality of bathing water with minor illnesses. Additional efforts are required to sustain the European Region's water resources and to provide safe water. Partnerships and cooperation are needed between the environment and health sectors at al levels of government to disseminate technology, to improve management and to provide financial and institutional support to ensure access to safe water and sanitation for all.

Job and life satisfaction of nonstandard workers in South Korea.

PubMed

Lee, Bokim

2013-08-01

Since the South Korean financial crisis of the late 1990s, the number of nonstandard workers in South Korea has increased rapidly. With such a drastic change, it has been difficult to establish national welfare systems (e.g., accident insurance or support for families with dependent children) for nonstandard workers and identify critical aspects of their health. To evaluate job and life satisfaction among nonstandard workers, this study used a representative sample of South Koreans. Using data from the 2008 Korean Labor and Income Panel Study, the sample size totaled 4,340 observations, of which 1,344 (31.0%) involved nonstandard workers. Significant differences in job and life satisfaction between nonstandard workers and standard workers were found. The results also indicate discrimination in the welfare and fringe benefit systems in South Korea. Occupational health nurses must address the physical and psychological health issues, personal problems, and everyday life concerns of nonstandard workers. Given that the employment status of nonstandard workers in companies is generally unstable, it is difficult for these workers to report poor working conditions to employers or other authorities. Accordingly, occupational health nurses should advocate for nonstandard workers by notifying employers of the many problems they face. Copyright 2013, SLACK Incorporated.

Expanding access through public coverage: permitting families to use tax credits to buy into Medicaid or SCHIP.

PubMed

Weil, A R

2001-01-01

A new tax credit to help low-income families and individuals purchase health insurance can address the problem of affordability, but will not overcome other barriers these populations face in obtaining coverage. This paper proposes that families have the option of using a new tax credit to buy into a state-administered system such as Medicaid or the State Children's Health Insurance Program. This option has three advantages. First, it allows families to remain with a single health program and health plan as their income fluctuates. Second, it provides an alternative to the complex and confusing individual insurance market. This alternative is community rated, does not use underwriting, and allows health plan behavior to be monitored closely by the state. Third, it allows the state to act as a financial buffer-helping overcome the barrier to participation that cash-flow problems and year-end reconciliation concerns are likely to create among a low-income population. Many people would want to use their tax credit in the private market, but the buy-in option increases the likelihood that the tax credit approach would succeed.

Problems of Mathematical Finance by Stochastic Control Methods

NASA Astrophysics Data System (ADS)

Stettner, Łukasz

The purpose of this paper is to present main ideas of mathematics of finance using the stochastic control methods. There is an interplay between stochastic control and mathematics of finance. On the one hand stochastic control is a powerful tool to study financial problems. On the other hand financial applications have stimulated development in several research subareas of stochastic control in the last two decades. We start with pricing of financial derivatives and modeling of asset prices, studying the conditions for the absence of arbitrage. Then we consider pricing of defaultable contingent claims. Investments in bonds lead us to the term structure modeling problems. Special attention is devoted to historical static portfolio analysis called Markowitz theory. We also briefly sketch dynamic portfolio problems using viscosity solutions to Hamilton-Jacobi-Bellman equation, martingale-convex analysis method or stochastic maximum principle together with backward stochastic differential equation. Finally, long time portfolio analysis for both risk neutral and risk sensitive functionals is introduced.

Applications of polynomial optimization in financial risk investment

NASA Astrophysics Data System (ADS)

Zeng, Meilan; Fu, Hongwei

2017-09-01

Recently, polynomial optimization has many important applications in optimization, financial economics and eigenvalues of tensor, etc. This paper studies the applications of polynomial optimization in financial risk investment. We consider the standard mean-variance risk measurement model and the mean-variance risk measurement model with transaction costs. We use Lasserre's hierarchy of semidefinite programming (SDP) relaxations to solve the specific cases. The results show that polynomial optimization is effective for some financial optimization problems.

A Study and Model of Operating Level Financial Management Philosophy Under RMS.

DTIC Science & Technology

The lack of financial management education has prevented base level managers from using PRIME data as intended. This study examines the Air Force...operating level financial management philosophy before and after PRIME and the environment of PRIME adoption. A model in the form of two case problems...with solutions is created to portray the financial management concepts under PRIME to help educate base level Air Force logistic managers. The model

Financial risks from ill health in Myanmar: evidence and policy implications.

PubMed

Htet, Soe; Fan, Victoria; Alam, Khurshid; Mahal, Ajay

2015-05-01

The government of Myanmar, with support from international donors, plans to address household financial risks from ill health and expand coverage. But evidence to design policy is limited. WHS (World Health Survey) data for 6045 households were used to investigate the association of out-of-pocket (OOP) health spending, catastrophic expenditures, and household borrowing and asset sales associated with illness with key socioeconomic and demographic correlates in Myanmar. Households with elderly and young children and chronically ill individuals, poor households, and ethnic minorities face higher financial stress from illness. Rural households use less care, suggesting their lower OOP health spending may be at the cost of health. Poorer groups rely more on public sector health services than richer groups. Better targeting, increased budgetary allocations, and more effective use of resources via designing cost-effective benefits packages appear key to sustainably addressing financial risks from ill health in Myanmar. © 2014 APJPH.

Financial Risks From Ill Health in Myanmar: Evidence and Policy Implications

PubMed Central

Htet, Soe; Fan, Victoria; Alam, Khurshid; Mahal, Ajay

2017-01-01

The government of Myanmar, with support from international donors, plans to address household financial risks from ill health and expand coverage. But evidence to design policy is limited. WHS (World Health Survey) data for 6045 households were used to investigate the association of out-of-pocket (OOP) health spending, catastrophic expenditures, and household borrowing and asset sales associated with illness with key socioeconomic and demographic correlates in Myanmar. Households with elderly and young children and chronically ill individuals, poor households, and ethnic minorities face higher financial stress from illness. Rural households use less care, suggesting their lower OOP health spending may be at the cost of health. Poorer groups rely more on public sector health services than richer groups. Better targeting, increased budgetary allocations, and more effective use of resources via designing cost-effective benefits packages appear key to sustainably addressing financial risks from ill health in Myanmar. PMID:25424245

Transportation Infrastructure: Central Artery/Tunnel Project Faces Continued Financial Uncertainties

DOT National Transportation Integrated Search

1996-05-01

At a cost of over $1 billion a mile, the Central Artery/Tunnel project - an Interstate Highway System project in Boston, Massachusetts - is one of the largest, most complex, and most expensive highway construction projects ever undertaken. In respons...

Examination of Regional Transit Service Under Contracting : A Case Study in the Greater New Orleans Region

DOT National Transportation Integrated Search

2011-04-01

Many local governments and transit agencies in the United States face financial difficulties in providing adequate public transit service in individual systems, and in providing sufficient regional coordination to accommodate transit trips involving ...

Preparing for HEA Reauthorization: Recommendations for Practitioners

ERIC Educational Resources Information Center

Inge, Brittany; Fowler, Pamela; Gross, Jacob P.

2015-01-01

The upcoming reauthorization of the Higher Education Act of 1965 provides opportunities and presents challenges for financial aid administrators. This article outlines steps that aid administrators can take and challenges they may face in preparing for and responding to new legislation.

Adult informal caregivers reporting financial burden in Hawaii, Kansas, and Washington: Results from the 2007 Behavioral Risk Factor Surveillance System.

PubMed

Kusano, Claudia T; Bouldin, Erin D; Anderson, Lynda A; McGuire, Lisa C; Salvail, Florentina R; Simmons, Katrina Wynkoop; Andresen, Elena M

2011-10-01

Given the unpaid nature of the work, informal caregiving can create a financial burden for caregivers. Little has been done to identify specific predictors of experiencing financial burden. This study investigated demographic and health factors comparing caregivers who reported having or not having financial burden. Data are derived from adult caregivers (N = 3,317) as part of the 2007 Behavioral Risk Factor Surveillance System in Hawaii, Kansas, and Washington. The adjusted odds ratios for reporting a financial burden were estimated for demographic and other risk factors. Caregivers who reported a financial burden were younger, had lower incomes, were more likely to be current smokers, have had a stroke, and rate their health as fair or poor compared to caregivers who did not report a financial burden. Caregivers who were younger (ages 18-34), resided with care recipients, spent 20-39 hours per week providing care, and reported having a disability were at a statistically significantly higher odds of reporting a financial burden. Given the current economic difficulties faced by many Americans, further insights into the perceived financial burdens experienced by informal caregivers as well as linkages to policy and programs designed to support caregivers are critical for public health professionals to address the expanding needs in states and communities. Published by Elsevier Inc.

Guidance strategies for a participatory ergonomic intervention to increase the use of ergonomic measures of workers in construction companies: a study design of a randomised trial.

PubMed

Visser, Steven; van der Molen, Henk F; Sluiter, Judith K; Frings-Dresen, Monique H W

2014-04-17

More than seven out of 10 Dutch construction workers describe their work as physically demanding. Ergonomic measures can be used to reduce these physically demanding work tasks. To increase the use of ergonomic measures, employers and workers have to get used to other working methods and to maintaining them. To facilitate this behavioural change, participatory ergonomics (PE) interventions could be useful. For this study a protocol of a PE intervention is adapted in such a way that the intervention can be performed by an ergonomics consultant through face-to-face contacts or email contacts. The objective of this study is to evaluate the effectiveness of the face-to-face guidance strategy and the e-guidance strategy on the primary outcome measure: use of ergonomic measures by individual construction workers, and on the secondary outcome measures: the work ability, physical functioning and limitations due to physical problems of individual workers. The present study is a randomised intervention trial of six months in 12 companies to establish the effects of a PE intervention guided by four face-to-face contacts (N = 6) or guided by 13 email contacts (N = 6) on the primary and secondary outcome measures at baseline and after six months. Construction companies are randomly assigned to one of the guidance strategies with the help of a computer generated randomisation table. In addition, a process evaluation for both strategies will be performed to determine reach, dose delivered, dose received, precision, competence, satisfaction and behavioural change to find possible barriers and facilitators for both strategies. A cost-benefit analysis will be performed to establish the financial consequences of both strategies. The present study is in accordance with the CONSORT statement. The outcome of this study will help to 1) evaluate the effect of both guidance strategies, and 2) find barriers to and facilitators of both guidance strategies. When these strategies are effective, implementation within occupational health services can take place to guide construction companies (and others) with the implementation of ergonomic measures. [corrected] Trailnumber: ISRCTN73075751, Date of registration: 30 July 2013.

Corruption of pharmaceutical markets: addressing the misalignment of financial incentives and public health.

PubMed

Gagnon, Marc-André

2013-01-01

This paper explains how the current architecture of the pharmaceutical markets has created a misalignment of financial incentives and public health that is a central cause of harmful practices. It explores three possible solutions to address that misalignment: taxes, increased financial penalties, and drug pricing based on value. Each proposal could help to partly realign financial incentives and public health. However, because of the limits of each proposal, there is no easy solution to fixing the problem of financial incentives. © 2013 American Society of Law, Medicine & Ethics, Inc.

Examining Information Problem-Solving, Knowledge, and Application Gains within Two Instructional Methods: Problem-Based and Computer-Mediated Participatory Simulation

ERIC Educational Resources Information Center

Newell, Terrance S.

2008-01-01

This study compared the effectiveness of two instructional methods--problem-based instruction within a face-to-face context and computer-mediated participatory simulation--in increasing students' content knowledge and application gains in the area of information problem-solving. The instructional methods were implemented over a four-week period. A…

Welfare, Tax Burden and Fiscal Balance in Artificial Societies

NASA Astrophysics Data System (ADS)

Kikuchi, Toshiko

Japan's social security system is facing a crisis by short-sighted policies to balance of the accounts in a financial crisis. However, such a balance of accounts does not necessarily bring remedy of financial difficulties. If it is possible to reduce the social security payments because the weak become independent, it is considered that short-sighted reforms cause a further financial crisis. This study explores how welfare and tax burden influence fiscal balance using multi-agent simulations. The results of simulation show that fiscal balance is improved by high-welfare than a cut in fiscal expenditures, and that welfare reducing is impossible unless the three relations of social configuration (market, obligatory, and communal relations) function in balance with each other.

Comparing the financial condition of Texas hospitals using a novel definition for the safety net.

PubMed

Stauffer, Brett D; Amarasingham, Ruben; Pickens, Sue; Anderson, Ron J

2008-08-01

Lack of health insurance is more prevalent in the state of Texas than in the rest of the country. To get necessary medical care, uninsured Texans must rely on safety net hospitals. Economic turmoil and fluctuating public support routinely threaten the financial stability of these hospitals. Safety net hospitals must be identified to craft public policy solutions that ensure their viability. In this paper, we propose a new method to identify these hospitals by incorporating criteria established previously by economists with additional measures of community value. Our data indicate that safety net hospitals continue to face financial challenges. Texas will need to move forward along several policy fronts to preserve this vital system of care.

The financial impacts of the nursing shortage.

PubMed

Rivers, Patrick A; Tsai, Kai-Li; Munchus, George

2005-01-01

This article examines the multiple factors leading to the nursing shortage and the financial impact of the nursing shortage on hospitals and health care providers, the government, society and educational institutions. Nursing shortages have occurred in this country throughout history, however, the current shortage is especially grappling due to the financial condition of the health care system, Health Insurance Portability and Accountability Act, the Balanced Budget Act, the compounding conditions that have led up to the shortage and the forecasted health care needs. Many solutions have been proposed to improve the nursing shortage. This article provides recommendations to problem solving methods and discusses some current policy alternatives, including recently enacted "nurse-patient ratio" regulation, demonstrated by California state policy and the "Magnet Certification" program developed by American Nursing Credential Center (ANCC). This article further examines the financial impacts on nursing shortage problem.

Making college worth it: a review of the returns to higher education.

PubMed

Oreopoulos, Philip; Petronijevic, Uros

2013-01-01

Despite a general rise in the return to college, likely due to technological change, the cost-benefit calculus facing prospective students can make the decision to invest in and attend college dauntingly complex. Philip Oreopoulos and Uros Petronijevic review research on the varying costs and benefits of higher education and explore in full the complexity of the decision to invest in and attend college. Optimal college attainment decisions are different for all prospective students, who diverge in terms of what they are likely to get out of higher education and what specific options might be best for them. Earnings of college graduates depend in important measure on the program of study and eventual occupation they choose. Students uninterested in or unable to complete a four-year college degree appear to benefit from completing a two-year degree. Prospective students may also face both financial constraints, which prohibit them from taking advantage of more education, and information problems and behavioral idiosyncrasies, such as reluctance to take on debt, which keep them from making optimal decisions about attending college. In their discussion of how student debt figures in the college investment, the authors note that some students borrow too little and, as a result, underinvest in their education. Carefully calculating the return on the college investment can help determine the "appropriate" amount of debt. Students are more likely to benefit from postsecondary education the more informed they are about the expenses associated with college and the potential options for financial aid, which can be extremely complex. To make the best college investment, Oreopoulos and Petronijevic stress, prospective students must give careful consideration to selecting the institution itself, the major to follow, and the eventual occupation to pursue. For any particular program at a particular school, anticipated future labor market earnings, the likelihood of completion, the costs, and the value of any student debt must all be factored into the assessment.

Hierarchical Spatio-Temporal Probabilistic Graphical Model with Multiple Feature Fusion for Binary Facial Attribute Classification in Real-World Face Videos.

PubMed

Demirkus, Meltem; Precup, Doina; Clark, James J; Arbel, Tal

2016-06-01

Recent literature shows that facial attributes, i.e., contextual facial information, can be beneficial for improving the performance of real-world applications, such as face verification, face recognition, and image search. Examples of face attributes include gender, skin color, facial hair, etc. How to robustly obtain these facial attributes (traits) is still an open problem, especially in the presence of the challenges of real-world environments: non-uniform illumination conditions, arbitrary occlusions, motion blur and background clutter. What makes this problem even more difficult is the enormous variability presented by the same subject, due to arbitrary face scales, head poses, and facial expressions. In this paper, we focus on the problem of facial trait classification in real-world face videos. We have developed a fully automatic hierarchical and probabilistic framework that models the collective set of frame class distributions and feature spatial information over a video sequence. The experiments are conducted on a large real-world face video database that we have collected, labelled and made publicly available. The proposed method is flexible enough to be applied to any facial classification problem. Experiments on a large, real-world video database McGillFaces [1] of 18,000 video frames reveal that the proposed framework outperforms alternative approaches, by up to 16.96 and 10.13%, for the facial attributes of gender and facial hair, respectively.

Ordered LOGIT Model approach for the determination of financial distress.

PubMed

Kinay, B

2010-01-01

Nowadays, as a result of the global competition encountered, numerous companies come up against financial distresses. To predict and take proactive approaches for those problems is quite important. Thus, the prediction of crisis and financial distress is essential in terms of revealing the financial condition of companies. In this study, financial ratios relating to 156 industrial firms that are quoted in the Istanbul Stock Exchange are used and probabilities of financial distress are predicted by means of an ordered logit regression model. By means of Altman's Z Score, the dependent variable is composed by scaling the level of risk. Thus, a model that can compose an early warning system and predict financial distress is proposed.

The Intersection of Financial Exploitation and Financial Capacity

PubMed Central

Lichtenberg, P.A.

2016-01-01

Research in the past decade has documented that financial exploitation of older adults has become a major problem and Psychology is only recently increasing its presence in efforts to reduce exploitation. During the same time period, Psychology has been a leader in setting best practices for the assessment of diminished capacity in older adults culminating in the 2008 ABA/APA joint publication on a handbook for psychologists. Assessment of financial decision making capacity is often the cornerstone assessment needed in cases of financial exploitation. This paper will examine the intersection of financial exploitation and decision making capacity; introduce a new conceptual model and new tools for both the investigation and prevention of financial exploitation. PMID:27159438

Patient-Centered Medical Home and Family Burden in Attention-Deficit Hyperactivity Disorder.

PubMed

Ronis, Sarah D; Baldwin, Constance D; Blumkin, Aaron; Kuhlthau, Karen; Szilagyi, Peter G

2015-01-01

Attention-deficit hyperactivity disorder (ADHD) can impair child health and functioning, but its effects on the family's economic burden are not well understood. The authors assessed this burden in US families of children with ADHD, and the degree to which access to a patient-centered medical home (PCMH) might reduce this burden. We conducted cross-sectional analyses of 2005-2006 and 2009-2010 National Surveys of Children with Special Health Care Needs, focusing on families of children with ADHD. They defined family economic burden as (1) family financial problems (annual expenses for the child's health care or illness-related financial problems for the family) and/or (2) family employment problems (job loss, work time loss, or failure to change jobs to avoid insurance loss). Relative risk models assessed associations between PCMH and family economic burden, adjusted for child age, sex, ethnicity, ADHD severity, poverty status, caregiver education, and insurance. In 2009, 26% of families reported financial problems because of the child's ADHD, 2.1% reported out-of-pocket expenses >5% of income, and 36% reported employment problems. Only 38% reported care that met all 5 criteria for a PCMH (similar to rates in 2005-2006). In multivariable analysis, care in a PCMH was associated with 48% lower relative risk (RR) of financial problems (RR = 0.52, p < .001) and 36% lower relative risk of employment problems (RR = 0.64, p < .001). Among PCMH components, family-centered care and care coordination were more strongly associated with lower burden. The economic burdens of families with ADHD are significant but may be alleviated by family-centered care and care coordination in a medical home.