20 CFR 362.3 - Who may file a claim.

Code of Federal Regulations, 2011 CFR

2011-04-01

...' PERSONAL PROPERTY CLAIMS § 362.3 Who may file a claim. A claim may be filed by an employee, by his spouse... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false Who may file a claim. 362.3 Section 362.3... or sister, or both, may file the claim and be entitled to payment in that order of priority. ...

75 FR 45114 - Determination of Insufficient Assets To Satisfy Claims Against Financial Institution in Receivership

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-02

... FDIC as Receiver of Downey Savings and Loan Association, F.A., Attention: Claims Agent, 1601 Bryan... insured depository institution to pay claims. Under the statutory order of priority, administrative...

37 CFR 7.27 - Priority claim of extension of protection for purposes of examination in the Office.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Priority claim of extension of protection for purposes of examination in the Office. 7.27 Section 7.27 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE RULES OF PRACTICE IN FILINGS PURSUANT TO THE PROTOCOL RELATING TO THE...

12 CFR 627.2750 - Priority of claims-banks.

Code of Federal Regulations, 2011 CFR

2011-01-01

... authorized by the receiver, claims for wages and salaries, including vacation pay, earned prior to the... of the receivership to engage or retain for a reasonable period of time. (d) If authorized by the receiver, claims for wages and salaries, including vacation pay, earned prior to the appointment of the...

12 CFR 650.45 - Priority of claims.

Code of Federal Regulations, 2011 CFR

2011-01-01

...) If authorized by the receiver, claims for wages and salaries, including vacation pay, earned prior to... in the best interest of the receivership to engage or retain for a reasonable period of time. (d) If authorized by the receiver, claims for wages and salaries, including vacation pay, earned prior to the...

12 CFR 627.2745 - Priority of claims-associations.

Code of Federal Regulations, 2011 CFR

2011-01-01

...) If authorized by the receiver, claims for wages and salaries, including vacation pay, earned prior to... in the best interest of the receivership to engage or retain for a reasonable period of time. (d) If authorized by the receiver, claims for wages and salaries, including vacation pay, earned prior to the...

12 CFR 627.2752 - Priority of claims-other Farm Credit institutions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... services actually provided by accountants, attorneys, appraisers, examiners, or management companies, or... taxes. (f) All claims of creditors which are secured by specific assets or equities of the institution...

Determinants of escalating costs in low risk workers' compensation claims.

PubMed

Bernacki, Edward J; Yuspeh, Larry; Tao, Xuguang

2007-07-01

To identify and quantify attributes that lead to unanticipated cost escalation in workers' compensation claims. We constructed four claim categories: low initial reserve/low cost, migrated catastrophic (low initial reserve/high cost), high initial reserve/low cost, and catastrophic (high initial reserve/high cost). To assess the attributes associated with the increased cost of migrated catastrophic claims, we analyzed 36,329 Louisiana workers' compensation claims in the four categories over a 5-year period. In the 729 claims initially thought to be low-cost claims (migrated catastrophic), the most significant predictors for cost escalation were attorney involvement and claim duration, followed by low back disorder, married/single/divorced status, male gender, small company size, high premium, reporting delays, and older age. These injuries accounted for 2% of all claims but 32.3% of the costs. Accelerated escalation of costs occurred late in the claim cycle (2 years). Certain attributes, particularly attorney involvement and claim duration, are associated with unanticipated cost escalation in a small number of claims that drastically affect overall losses. The results of this study suggest that these cases may be identified and addressed before rapid escalation occurs.

A cross-sectional analysis of how young adults perceive tobacco brands: implications for FCTC signatories.

PubMed

Gendall, Philip; Hoek, Janet; Edwards, Richard; McCool, Judith

2012-09-17

The Framework Convention on Tobacco Control calls for the elimination of tobacco advertising, promotion and sponsorship. To test whether tobacco packaging functions as advertising by communicating attractive and distinctive brand attributes, we explored how young adult smokers and non-smokers interpreted familiar and unfamiliar tobacco brands. We conducted an on-line survey of 1035 young adult smokers and non-smokers aged 18-30. Participants evaluated eight tobacco brands using ten attributes based on brand personality scales. We used factor analysis and ANOVA to examine patterns in brand-attribute associations. Young adults distinguished between brands on the basis of their packaging alone, associated each brand with specific attributes, and were equally able to interpret familiar and unfamiliar brands. Contrary to our expectations, non-smokers made more favourable brand-attribute associations than smokers, but both groups described Basic, a near generic brand, as 'plain' or 'budget'. There were no significant gender or ethnicity differences. Tobacco packaging uses logos, colours and imagery to create desirable connotations that promote and reinforce smoking. By functioning in the same way as advertising, on-pack branding breaches Article 13 of the FCTC and refutes tobacco companies' claims that pack livery serves only as an indentifying device that simplifies smokers' decision-making. Given this evidence, signatories should see plain packaging policies as a priority consistent with their FCTC obligations to eliminate all tobacco advertising and promotion.

40 CFR 350.3 - Applicability of subpart; priority where provisions conflict; interaction with 40 CFR part 2.

Code of Federal Regulations, 2014 CFR

2014-07-01

... TRADE SECRECY CLAIMS FOR EMERGENCY PLANNING AND COMMUNITY RIGHT-TO-KNOW INFORMATION: AND TRADE SECRET... the disclosure of chemical identity claimed as trade secret, and determinations by EPA of whether this information is entitled to trade secret treatment. Claims for confidentiality of the location of a hazardous...

40 CFR 350.3 - Applicability of subpart; priority where provisions conflict; interaction with 40 CFR part 2.

Code of Federal Regulations, 2012 CFR

2012-07-01

... TRADE SECRECY CLAIMS FOR EMERGENCY PLANNING AND COMMUNITY RIGHT-TO-KNOW INFORMATION: AND TRADE SECRET... the disclosure of chemical identity claimed as trade secret, and determinations by EPA of whether this information is entitled to trade secret treatment. Claims for confidentiality of the location of a hazardous...

40 CFR 350.3 - Applicability of subpart; priority where provisions conflict; interaction with 40 CFR part 2.

Code of Federal Regulations, 2011 CFR

2011-07-01

... TRADE SECRECY CLAIMS FOR EMERGENCY PLANNING AND COMMUNITY RIGHT-TO-KNOW INFORMATION: AND TRADE SECRET... the disclosure of chemical identity claimed as trade secret, and determinations by EPA of whether this information is entitled to trade secret treatment. Claims for confidentiality of the location of a hazardous...

40 CFR 350.3 - Applicability of subpart; priority where provisions conflict; interaction with 40 CFR part 2.

Code of Federal Regulations, 2013 CFR

2013-07-01

... TRADE SECRECY CLAIMS FOR EMERGENCY PLANNING AND COMMUNITY RIGHT-TO-KNOW INFORMATION: AND TRADE SECRET... the disclosure of chemical identity claimed as trade secret, and determinations by EPA of whether this information is entitled to trade secret treatment. Claims for confidentiality of the location of a hazardous...

40 CFR 350.3 - Applicability of subpart; priority where provisions conflict; interaction with 40 CFR part 2.

Code of Federal Regulations, 2010 CFR

2010-07-01

... TRADE SECRECY CLAIMS FOR EMERGENCY PLANNING AND COMMUNITY RIGHT-TO-KNOW INFORMATION: AND TRADE SECRET... the disclosure of chemical identity claimed as trade secret, and determinations by EPA of whether this information is entitled to trade secret treatment. Claims for confidentiality of the location of a hazardous...

Integrating Written Communication Skills: Working towards a Whole of Course Approach

ERIC Educational Resources Information Center

Harris, Anne

2016-01-01

Australian universities, through their graduate attributes, claim that graduates have the ability to communicate, an attribute encompassing, at the least, written and oral literacies. Despite this claim, Australian universities have been criticised over the past decade for their lack of rigour in assessing this attribute; a criticism generally…

12 CFR 360.3 - Priorities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... services actually provided by accountants, attorneys, appraisers, examiners, or management companies, or... taxes, other than Federal income taxes, except to the extent subordinated pursuant to applicable law... taxes; (9) Claims that have been subordinated in whole or in part to general creditor claims, which...

12 CFR 360.3 - Priorities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... taxes, other than Federal income taxes, except to the extent subordinated pursuant to applicable law... Corporation as subrogee or transferee, and all other claims which have accrued and become unconditionally... was operated under the laws of a state that provided a priority for holders of withdrawable accounts...

12 CFR 360.3 - Priorities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... taxes, other than Federal income taxes, except to the extent subordinated pursuant to applicable law... Corporation as subrogee or transferee, and all other claims which have accrued and become unconditionally... was operated under the laws of a state that provided a priority for holders of withdrawable accounts...

12 CFR 360.3 - Priorities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... taxes, other than Federal income taxes, except to the extent subordinated pursuant to applicable law... Corporation as subrogee or transferee, and all other claims which have accrued and become unconditionally... was operated under the laws of a state that provided a priority for holders of withdrawable accounts...

A cross-sectional analysis of how young adults perceive tobacco brands: implications for FCTC signatories

PubMed Central

2012-01-01

Background The Framework Convention on Tobacco Control calls for the elimination of tobacco advertising, promotion and sponsorship. To test whether tobacco packaging functions as advertising by communicating attractive and distinctive brand attributes, we explored how young adult smokers and non-smokers interpreted familiar and unfamiliar tobacco brands. Methods We conducted an on-line survey of 1035 young adult smokers and non-smokers aged 18–30. Participants evaluated eight tobacco brands using ten attributes based on brand personality scales. We used factor analysis and ANOVA to examine patterns in brand-attribute associations. Results Young adults distinguished between brands on the basis of their packaging alone, associated each brand with specific attributes, and were equally able to interpret familiar and unfamiliar brands. Contrary to our expectations, non-smokers made more favourable brand-attribute associations than smokers, but both groups described Basic, a near generic brand, as ‘plain’ or ‘budget’. There were no significant gender or ethnicity differences. Conclusions Tobacco packaging uses logos, colours and imagery to create desirable connotations that promote and reinforce smoking. By functioning in the same way as advertising, on-pack branding breaches Article 13 of the FCTC and refutes tobacco companies’ claims that pack livery serves only as an indentifying device that simplifies smokers’ decision-making. Given this evidence, signatories should see plain packaging policies as a priority consistent with their FCTC obligations to eliminate all tobacco advertising and promotion. PMID:22985407

An importance-performance analysis of hospital information system attributes: A nurses' perspective.

PubMed

Cohen, Jason F; Coleman, Emma; Kangethe, Matheri J

2016-02-01

Health workers have numerous concerns about hospital IS (HIS) usage. Addressing these concerns requires understanding the system attributes most important to their satisfaction and productivity. Following a recent HIS implementation, our objective was to identify priorities for managerial intervention based on user evaluations of the performance of the HIS attributes as well as the relative importance of these attributes to user satisfaction and productivity outcomes. We collected data along a set of attributes representing system quality, data quality, information quality, and service quality from 154 nurse users. Their quantitative responses were analysed using the partial least squares approach followed by an importance-performance analysis. Qualitative responses were analysed using thematic analysis to triangulate and supplement the quantitative findings. Two system quality attributes (responsiveness and ease of learning), one information quality attribute (detail), one service quality attribute (sufficient support), and three data quality attributes (records complete, accurate and never missing) were identified as high priorities for intervention. Our application of importance-performance analysis is unique in HIS evaluation and we have illustrated its utility for identifying those system attributes for which underperformance is not acceptable to users and therefore should be high priorities for intervention. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

29 CFR 4.187 - Recovery of underpayments.

Code of Federal Regulations, 2010 CFR

2010-07-01

...), cert. denied, 350 U.S. 902), and to give contracting agency reprocurement claims priority would be to.... United States, 132 Ct. Cl. 529 (1955), in which the courts gave priority to sureties who had paid unpaid..., PC-330, October 3, 1947; Reynolds Research Corp., Decision of the Administrator, PC-381, October 24...

Application of economic principles in healthcare priority setting.

PubMed

Bate, Angela; Mitton, Craig

2006-06-01

In healthcare, resources are often insufficient to meet all claims on them. In this respect, resources are considered scarce and have to be managed by prioritizing between competing claims. Economics as a discipline explicitly addresses this reality by acknowledging resource scarcity. However, the extent to which economics actually influences such prioritizing decisions in healthcare is unclear. The purpose of this paper is to review the use of economics in priority setting decision making. We outline the key principles of economics as they apply to priority setting and review the methods reported in the literature with respect to these. We find that these methods, even economic methods (e.g., those typically used in conducting economic evaluations such as cost-effectiveness analyses) do not tend to explicitly incorporate economic principles. We argue therefore that these methods, when applied to the context of priority setting, are not sufficient and that what is required is a broader framework that can incorporate the output from economic methods yet also be pragmatically applicable. We then go on to present an alternative approach - namely program budgeting and marginal analysis. Finally, we put forward our case for using program budgeting and marginal analysis in priority setting practice and set out some future research challenges.

Leadership Education Priorities in a Democratic Society

ERIC Educational Resources Information Center

Page, William Tyler

2010-01-01

Is there still an effort to include democratic ideals in public education? Some claim that it is no longer a priority, the result of a lack of common definition or perceived benefits. In today's policy driven climate, school leaders must transition to new and more effective approaches to enhancing learning and teaching. Aspiring principals/leaders…

Personal needs versus national needs: public attitudes regarding health care priorities at the personal and national levels.

PubMed

Kaplan, Giora; Baron-Epel, Orna

2015-01-01

Many stakeholders have little or no confidence in the ability of the public to express their opinions on health policy issues. The claim often arises that lay people prioritize according to their own personal experiences and may lack the broad perspective necessary to understand the needs of the population at large. In order to test this claim empirically, this study compares the public's priorities regarding personal insurance to their priorities regarding allocation of national health resources. Thus, the study should shed light on the extent to which the public's priorities at the national level are a reflection of their priorities at the personal level. A telephone survey was conducted with a representative sample of the Israeli adult population aged 18 and over (n = 1,225). The public's priorities were assessed by asking interviewees to assume that they were the Minister of Health and from this point of view allocate an additional budget among various health areas. Their priorities at the personal level were assessed by asking interviewees to choose preferred items for inclusion in their personal supplementary health insurance. Over half of the respondents (54%) expressed different personal and national priorities. In multivariable logistic analysis, "population group" was the only variable found to be statistically significant; Jews were 1.8 times more likely than Arabs to give a similar response to both questions. Income level was of borderline significance. At least half of the population was able to differentiate between their personal needs and national policy needs. We do not advocate a decision-making process based on polls or referendums. However, we believe that people should be allowed to express their priorities regarding national policy issues, and that decision-makers should consider these as one of the factors used to determine policy decisions.

32 CFR 536.77 - Applicable law for claims under the Military Claims Act.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) The United States will only be liable for the portion of loss or damage attributable to the fault of... preparation and presentation of the claim. (vi) Punitive or exemplary damages are not payable. (vii) Claims... will be considered as an element of damages under paragraph (b)(3)(ii) of this section. Claims for...

32 CFR 536.77 - Applicable law for claims under the Military Claims Act.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) The United States will only be liable for the portion of loss or damage attributable to the fault of... preparation and presentation of the claim. (vi) Punitive or exemplary damages are not payable. (vii) Claims... will be considered as an element of damages under paragraph (b)(3)(ii) of this section. Claims for...

32 CFR 536.77 - Applicable law for claims under the Military Claims Act.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) The United States will only be liable for the portion of loss or damage attributable to the fault of... preparation and presentation of the claim. (vi) Punitive or exemplary damages are not payable. (vii) Claims... will be considered as an element of damages under paragraph (b)(3)(ii) of this section. Claims for...

12 CFR 627.2752 - Priority of claims-other Farm Credit institutions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... wages and salaries, including vacation pay, earned prior to the appointment of the receiver by an... engage or retain for a reasonable period of time. (d) If authorized by the receiver, claims for wages and salaries, including vacation pay, earned prior to the appointment of the receiver, up to a maximum of three...

Synchronization of Leisure Conflicts in the Family Schedule.

ERIC Educational Resources Information Center

Kelly, John R.

The model of the family as a set of contingent careers is brought into focus by Wilbert Moore's suggestions that in schedule synchronization the family takes priority in claiming time, the wife-mother asserts such claims and arranges the schedule, and common leisure activities symbolize the solidarity of the unit. The perception of parents of the…

The contention within health economics: a micro-economic foundation using a macro-economic analysis.

PubMed

Yaxley, I L

1998-03-01

Health economists claim to use market economics combined with the micro-economic concepts of opportunity cost and the margin to advise on priority setting. However, they are advising on setting priorities through a macro-economic analysis using the costs of the supplier, thus prioritising the producer and not the consumer as the dynamic of economic activity. For health economists any contention within priority setting is due to lack of data not their confusion over fundamental concepts.

Perspective: Some Causal and Priority Language about Food Energy Supply as the Sufficient Cause of the Obesity Pandemic is Premature or Incorrect

DTIC Science & Technology

2016-08-09

AFRL-SA-WP-SR-2016-0015 Perspective: Some Causal and Priority Language about Food Energy Supply as the Sufficient Cause of the Obesity ...SUBTITLE Perspective: Some Causal and Priority Language about Food Energy Supply as the Sufficient Cause of the Obesity Pandemic is Premature or...3701, 11 Aug 2014. 14. ABSTRACT Several obesity experts have claimed the growth in food supply after 1965 was the primary cause of the global

Diarrhoeal diseases and the global health agenda: measuring and changing priority.

PubMed

Bump, Jesse B; Reich, Michael R; Johnson, Anne M

2013-12-01

We investigate priority setting and the global health agenda by analysing the control of diarrhoeal diseases (CDD). CDD was one of the 'twin engines' of the 1980s' child survival movement, but now has a low priority on the global health agenda, even though diarrhoeal diseases still claim around 1.5 million children annually. In this article, we develop a framework and four indicators of priority to measure CDD's overall prominence on the global health agenda over the last three decades: trends in treatment coverage, changes in perceived priority, changes in financial support and institutional involvement and bibliographic trends. We find that CDD's priority is now one-sixth to one-third of its level in 1985. We then use political analysis to suggest strategies for reframing CDD as an issue and promoting its priority on the global health agenda.

The information-anchoring model of first offers: When moving first helps versus hurts negotiators.

PubMed

Loschelder, David D; Trötschel, Roman; Swaab, Roderick I; Friese, Malte; Galinsky, Adam D

2016-07-01

Does making the first offer increase or impair a negotiator's outcomes? Past research has found evidence supporting both claims. To reconcile these contradictory findings, we developed and tested an integrative model-the Information-Anchoring Model of First Offers. The model predicts when and why making the first offer helps versus hurts. We suggest that first offers have 2 effects. First, they serve as anchors that pull final settlements toward the initial first-offer value; this anchor function often produces a first-mover advantage. Second, first offers can convey information on the senders' priorities, which makes the sender vulnerable to exploitation and increases the risk of a first-mover disadvantage. To test this model, 3 experiments manipulated the information that senders communicated in their first offer. When senders did not reveal their priorities, the first-mover advantage was replicated. However, when first offers revealed senders' priorities explicitly, implicitly, or both, a first-mover disadvantage emerged. Negotiators' social value orientation moderated this effect: A first-mover disadvantage occurred when senders faced proself recipients who exploited priority information, but not with prosocial recipients. Moderated mediation analyses supported the model assumptions: Proself recipients used their integrative insight to feign priorities in their low-priority issues and thereby claimed more individual value than senders. The final discussion reviews theoretical and applied implications of the Information-Anchoring Model of First Offers. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Body mass index as a predictor of firefighter injury and workers' compensation claims.

PubMed

Kuehl, Kerry S; Kisbu-Sakarya, Yasemin; Elliot, Diane L; Moe, Esther L; Defrancesco, Carol A; Mackinnon, David P; Lockhart, Ginger; Goldberg, Linn; Kuehl, Hannah E

2012-05-01

To determine the relationship between lifestyle variables including body mass index and filing a workers' compensation claim due to firefighter injury. A cross-sectional evaluation of firefighter injury related to workers" compensation claims occurring 5 years after the original Promoting Healthy Lifestyles: Alternative Models' Effects study intervention. A logistic regression analysis for variables predicting filing a workers' compensation claim due to an injury was performed with a total of 433 participants. The odds of filing a compensation claim were almost 3 times higher for firefighters with a body mass index of more than 30 kg/m than firefighters with a normal body mass index (odds ratio, 2.89; P < 0.05). This study addresses a high-priority area of reducing firefighter injuries and workers' compensation claims. Maintaining a healthy body weight is important to reduce injury and workers' compensation claims among firefighters.

Priority setting in health care: on the relation between reasonable choices on the micro-level and the macro-level.

PubMed

Baerøe, Kristine

2008-01-01

There has been much discussion about how to obtain legitimacy at macro-level priority setting in health care by use of fair procedures, but how should we consider priority setting by individual clinicians or health workers at the micro-level? Despite the fact that just health care totally hinges upon their decisions, surprisingly little attention seems being paid to the legitimacy of these decisions. This paper addresses the following question: what are the conditions that have to be met in order to ensure that individual claims on health care are well aligned with an overall concept of just health care? Drawing upon a distinction between individual and aggregated needs, I argue that even though we assume the legitimacy of macro-level guidelines, this legitimacy is not directly transferable to decisions at micro-level simply by adherence to the guidelines' recommendation. Further, I argue that individual claims are subject to the formal principle of equality and the demands of vertical and horizontal equity in a way that gives context- and patient-related equity concerns precedence over equity concerns captured at the macro-level. I conclude that if we aim to achieve just health care, we need to develop a complementary framework for legitimising individual judgment of patients' claims on health care resources. Moreover, I suggest the basic structure of such a framework.

Causal uncertainty, claimed and behavioural self-handicapping.

PubMed

Thompson, Ted; Hepburn, Jonathan

2003-06-01

Causal uncertainty beliefs involve doubts about the causes of events, and arise as a consequence of non-contingent evaluative feedback: feedback that leaves the individual uncertain about the causes of his or her achievement outcomes. Individuals high in causal uncertainty are frequently unable to confidently attribute their achievement outcomes, experience anxiety in achievement situations and as a consequence are likely to engage in self-handicapping behaviour. Accordingly, we sought to establish links between trait causal uncertainty, claimed and behavioural self-handicapping. Participants were N=72 undergraduate students divided equally between high and low causally uncertain groups. We used a 2 (causal uncertainty status: high, low) x 3 (performance feedback condition: success, non-contingent success, non-contingent failure) between-subjects factorial design to examine the effects of causal uncertainty on achievement behaviour. Following performance feedback, participants completed 20 single-solution anagrams and 12 remote associate tasks serving as performance measures, and 16 unicursal tasks to assess practice effort. Participants also completed measures of claimed handicaps, state anxiety and attributions. Relative to low causally uncertain participants, high causally uncertain participants claimed more handicaps prior to performance on the anagrams and remote associates, reported higher anxiety, attributed their failure to internal, stable factors, and reduced practice effort on the unicursal tasks, evident in fewer unicursal tasks solved. These findings confirm links between trait causal uncertainty and claimed and behavioural self-handicapping, highlighting the need for educators to facilitate means by which students can achieve surety in the manner in which they attribute the causes of their achievement outcomes.

Consumer attitudes and understanding of low-sodium claims on food: an analysis of healthy and hypertensive individuals.

PubMed

Wong, Christina L; Arcand, JoAnne; Mendoza, Julio; Henson, Spencer J; Qi, Ying; Lou, Wendy; L'Abbé, Mary R

2013-06-01

Sodium-related claims on food labels should facilitate lower-sodium food choices; however, consumer attitudes and understanding of such claims are unknown. We evaluated consumer attitudes and understanding of different types of sodium claims and the effect of having hypertension on responses to such claims. Canadian consumers (n = 506), with and without hypertension, completed an online survey that contained a randomized mock-package experiment, which tested 4 packages that differed only by the claims they carried as follows: 3 sodium claims (disease risk reduction, function, and nutrient-content claims) and a tastes-great claim (control). Participants answered the same questions on attitudes and understanding of claims after seeing each package. Food packages with any sodium claim resulted in more positive attitudes toward the claim and the product healthfulness than did packages with the taste control claim, although all mock packages were identical nutritionally. Having hypertension increased ratings related to product healthfulness and purchase intentions, but there was no difference in reported understanding between hypertensives and normotensives. In general, participants attributed additional health benefits to low-sodium products beyond the well-established relation of sodium and hypertension. Sodium claims have the potential to facilitate lower-sodium food choices. However, we caution that consumers do not seem to differentiate between different types of claims, but the nutritional profiles of foods that carry different sodium claims can potentially differ greatly in the current labeling environment. Additional educational efforts are needed to ensure that consumers do not attribute inappropriate health benefits to foods with low-sodium claims. This trial was registered at clinicaltrials.gov as NCT01764724.

12 CFR 709.5 - Payout priorities in involuntary liquidation.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) Administrative costs and expenses of liquidation; (2) Claims for wages and salaries, including vacation... case involving liquidation of a low-income designated credit union, any outstanding secondary capital...

47 CFR 73.5007 - Designated entity provisions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... lower the cost of its winning bid on any broadcast construction permit. Any winning bidder claiming new... underlying its new entrant bidding credit eligibility claim, or that of any attributable interest-holder in... of the new entrant bidding credit claimed in the applicant's FCC Form 175 application, if the change...

47 CFR 73.5007 - Designated entity provisions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... lower the cost of its winning bid on any broadcast construction permit. Any winning bidder claiming new... underlying its new entrant bidding credit eligibility claim, or that of any attributable interest-holder in... of the new entrant bidding credit claimed in the applicant's FCC Form 175 application, if the change...

47 CFR 73.5007 - Designated entity provisions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... lower the cost of its winning bid on any broadcast construction permit. Any winning bidder claiming new... underlying its new entrant bidding credit eligibility claim, or that of any attributable interest-holder in... of the new entrant bidding credit claimed in the applicant's FCC Form 175 application, if the change...

47 CFR 73.5007 - Designated entity provisions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... lower the cost of its winning bid on any broadcast construction permit. Any winning bidder claiming new... underlying its new entrant bidding credit eligibility claim, or that of any attributable interest-holder in... of the new entrant bidding credit claimed in the applicant's FCC Form 175 application, if the change...

47 CFR 73.5007 - Designated entity provisions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... lower the cost of its winning bid on any broadcast construction permit. Any winning bidder claiming new... underlying its new entrant bidding credit eligibility claim, or that of any attributable interest-holder in... of the new entrant bidding credit claimed in the applicant's FCC Form 175 application, if the change...

APPETITE CONTROL: METHODOLOGICAL ASPECTS OF THE EVALUATION OF FOODS

PubMed Central

Blundell, John; de Graaf, Cees; Hulshof, Toine; Jebb, Susan; Livingstone, Barbara; Lluch, Anne; Mela, David; Salah, Samir; Schuring, Ewoud; van der Knaap, Henk; Westerterp, Margriet

2013-01-01

This report describes a set of scientific procedures used to assess the impact of foods and food ingredients on the expression of appetite (psychological and behavioural). An overarching priority has been to enable potential evaluators of health claims about foods to identify justified claims, and to exclude claims that are not supported by scientific evidence for the effect cited. This priority follows precisely from the principles set down in the PASSCLAIM report. (4) The report allows the evaluation of the strength of health claims, about the effects of foods on appetite, which can be sustained on the basis of the commonly used scientific designs and experimental procedures. The report includes different designs for assessing effects on satiation as opposed to satiety,detailed coverage of the extent to which a change in hunger can stand-alone as a measure of appetite control, and an extensive discussion of the statistical procedures appropriate for handling data in this field of research. Since research in this area is continually evolving, new improved methodologies may emerge over time and will need to be incorporated into the framework. One main objective of the report has been to produce guidance on good practice in carrying out appetite research, and not to set down a series of commandments that must be followed. PMID:20122136

The effect of extrinsic attributes on liking of cottage cheese.

PubMed

Hubbard, E M; Jervis, S M; Drake, M A

2016-01-01

Preference mapping studies with cottage cheese have demonstrated that cottage cheese liking is influenced by flavor, texture, curd size, and dressing content. However, extrinsic factors such as package, label claims, and brand name may also influence liking and have not been studied. The objective of this study was to evaluate the role of package attributes and brand on the liking of cottage cheese. A conjoint survey with Kano analysis (n=460) was conducted to explore the effect of extrinsic attributes (brand, label claim, milkfat content, and price) on liking. Following the survey, 150 consumers evaluated intrinsic attributes of 7 cottage cheeses with and without brand information in a 2-d crossover design. Results were evaluated by 2-way ANOVA and multivariate analyses. Milkfat content and price had the highest influence on liking by conjoint analysis. Cottage cheese with 2% milkfat and a low price was preferred. Specific label claims such as "excellent source of calcium (>10%)" were more attractive to consumers than "low sodium" or "extra creamy." Branding influenced overall liking and purchase intent for cottage cheeses to differing degrees. For national brands, acceptance scores were enhanced in the presence of the brand. An all-natural claim was more appealing than organic by conjoint analysis and this result was also confirmed with consumer acceptance testing. Findings from this study can help manufacturers, as well as food marketers, better target their products and brands with attributes that drive consumer choice. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Health-related claims on food labels in Australia: understanding environmental health officers' roles and implications for policy.

PubMed

Condon-Paoloni, Deanne; Yeatman, Heather R; Grigonis-Deane, Elizabeth

2015-01-01

Health and related claims on food labels can support consumer education initiatives that encourage purchase of healthier foods. A new food Standard on Nutrition, Health and Related Claims became law in January 2013. Implementation will need careful monitoring and enforcement to ensure that claims are truthful and have meaning. The current study explored factors that may impact on environmental health officers' food labelling policy enforcement practices. The study used a mixed-methods approach, using two previously validated quantitative questionnaire instruments that provided measures of the level of control that the officers exercised over their work, as well as qualitative, semi-structured, in-depth interviews. Local government; Australia. Thirty-seven officers in three Australian states participated in semi-structured in-depth interviews, as well as completing the quantitative questionnaires. Senior and junior officers, including field officers, participated in the study. The officers reported a high level of autonomy and control of their work, but also a heavy workload, dominated by concerns for public health and food safety, with limited time for monitoring food labels. Compliance of labels with proposed health claims regulations was not considered a priority. Lipsky's theory of street-level bureaucracy was used to enhance understanding of officers' work practices. Competing priorities affect environmental health officers' monitoring and enforcement of regulations. Understanding officers' work practices and their perceptions of enforcement is important to increase effectiveness of policy implementation and hence its capacity to augment education initiatives to optimize health benefits.

Nutrition marketing on processed food packages in Canada: 2010 Food Label Information Program.

PubMed

Schermel, Alyssa; Emrich, Teri E; Arcand, JoAnne; Wong, Christina L; L'Abbé, Mary R

2013-06-01

The current study describes the frequency of use of different forms of nutrition marketing in Canada and the nutrients and conditions that are the focus of nutrition marketing messages. Prepackaged foods with a Nutrition Facts table (N = 10,487) were collected between March 2010 and April 2011 from outlets of the 3 largest grocery chains in Canada and 1 major western Canadian grocery retailer. The nutrition marketing information collected included nutrient content claims, disease risk reduction claims, and front-of-pack nutrition rating systems (FOPS). We found that nutrition marketing was present on 48.1% of Canadian food packages, with nutrient content claims being the most common information (45.5%), followed by FOPS on 18.9% of packages. Disease risk reduction claims were made least frequently (1.7%). The marketing messages used most often related to total fat and trans fat (15.6% and 15.5% of nutrient content claims, respectively). Limiting total and trans fats is a current public health priority, as recommended by Health Canada and the World Health Organization. However, other nutrients that are also recommended to be limited, including saturated fats, sodium, and added sugars, were not nearly as prominent on food labels. Thus, greater emphasis should be placed by the food industry on these other important nutrients. Repeated data collection in the coming years will allow us to track longitudinal changes in nutrition marketing messages over time as food marketing, public health, and consumer priorities evolve.

Are the correct herbal claims by Hildegard von Bingen only lucky strikes? A new statistical approach.

PubMed

Uehleke, Bernhard; Hopfenmueller, Werner; Stange, Rainer; Saller, Reinhard

2012-01-01

Ancient and medieval herbal books are often believed to describe the same claims still in use today. Medieval herbal books, however, provide long lists of claims for each herb, most of which are not approved today, while the herb's modern use is often missing. So the hypothesis arises that a medieval author could have randomly hit on 'correct' claims among his many 'wrong' ones. We developed a statistical procedure based on a simple probability model. We applied our procedure to the herbal books of Hildegard von Bingen (1098- 1179) as an example for its usefulness. Claim attributions for a certain herb were classified as 'correct' if approximately the same as indicated in actual monographs. The number of 'correct' claim attributions was significantly higher than it could have been by pure chance, even though the vast majority of Hildegard von Bingen's claims were not 'correct'. The hypothesis that Hildegard would have achieved her 'correct' claims purely by chance can be clearly rejected. The finding that medical claims provided by a medieval author are significantly related to modern herbal use supports the importance of traditional medicinal systems as an empirical source. However, since many traditional claims are not in accordance with modern applications, they should be used carefully and analyzed in a systematic, statistics-based manner. Our statistical approach can be used for further systematic comparison of herbal claims of traditional sources as well as in the fields of ethnobotany and ethnopharmacology. Copyright © 2012 S. Karger AG, Basel.

13 CFR 127.203 - What are the rules governing the requirement that economically disadvantaged women must own EDWOSBs?

Code of Federal Regulations, 2010 CFR

2010-01-01

... may be considered. The personal financial condition of the woman claiming economic disadvantage... within two years. Assets that a woman claiming economic disadvantage transferred within two years of the date of the concern's certification will be attributed to the woman claiming economic disadvantage if...

43 CFR 2521.8 - Contests.

Code of Federal Regulations, 2014 CFR

2014-10-01

... OF THE INTERIOR LAND RESOURCE MANAGEMENT (2000) DESERT-LAND ENTRIES Procedures § 2521.8 Contests. (a... involved against a party to any desert-land entry because of priority of claim or for any sufficient cause...

43 CFR 2521.8 - Contests.

Code of Federal Regulations, 2011 CFR

2011-10-01

... OF THE INTERIOR LAND RESOURCE MANAGEMENT (2000) DESERT-LAND ENTRIES Procedures § 2521.8 Contests. (a... involved against a party to any desert-land entry because of priority of claim or for any sufficient cause...

43 CFR 2521.8 - Contests.

Code of Federal Regulations, 2013 CFR

2013-10-01

... OF THE INTERIOR LAND RESOURCE MANAGEMENT (2000) DESERT-LAND ENTRIES Procedures § 2521.8 Contests. (a... involved against a party to any desert-land entry because of priority of claim or for any sufficient cause...

43 CFR 2521.8 - Contests.

Code of Federal Regulations, 2012 CFR

2012-10-01

... OF THE INTERIOR LAND RESOURCE MANAGEMENT (2000) DESERT-LAND ENTRIES Procedures § 2521.8 Contests. (a... involved against a party to any desert-land entry because of priority of claim or for any sufficient cause...

The badness of death and priorities in health.

PubMed

Solberg, Carl Tollef; Gamlund, Espen

2016-04-14

The state of the world is one with scarce medical resources where longevity is not equally distributed. Given such facts, setting priorities in health entails making difficult yet unavoidable decisions about which lives to save. The business of saving lives works on the assumption that longevity is valuable and that an early death is worse than a late death. There is a vast literature on health priorities and badness of death, separately. Surprisingly, there has been little cross-fertilisation between the academic fields of priority setting and badness of death. Our aim is to connect philosophical discussions on the badness of death to contemporary debates in health priorities. Two questions regarding death are especially relevant to health priorities. The first question is why death is bad. Death is clearly bad for others, such as family, friends and society. Many philosophers also argue that death can be bad for those who die. This distinction is important for health priorities, because it concerns our fundamental reasons for saving lives. The second question is, 'When is the worst time to die?' A premature death is commonly considered worse than a late death. Thus, the number of good life years lost seems to matter to the badness of death. Concerning young individuals, some think the death of infants is worse than the death of adolescents, while others have contrary intuitions. Our claim is that to prioritise between age groups, we must consider the question of when it is worst to die. Deprivationism provides a more plausible approach to health priorities than Epicureanism. If Deprivationism is accepted, we will have a firmer basis for claiming that individuals, in addition to having a health loss caused by morbidity, will have a loss of good life years due to mortality. Additionally, Deprivationism highlights the importance of age and values for health priorities. Regarding age, both variants of Deprivationism imply that stillbirths are included in the Global Burden of Disease. Finally, we suggest that the Time-Relative Interest Account may serve as an alternative to the discounting and age weighting previously applied in the Global Burden of Disease.

A Chance for Attributable Agency.

PubMed

Briegel, Hans J; Müller, Thomas

Can we sensibly attribute some of the happenings in our world to the agency of some of the things around us? We do this all the time, but there are conceptual challenges purporting to show that attributable agency, and specifically one of its most important subspecies, human free agency, is incoherent. We address these challenges in a novel way: rather than merely rebutting specific arguments, we discuss a concrete model that we claim positively illustrates attributable agency in an indeterministic setting. The model, recently introduced by one of the authors in the context of artificial intelligence, shows that an agent with a sufficiently complex memory organization can employ indeterministic happenings in a meaningful way. We claim that these considerations successfully counter arguments against the coherence of libertarian (indeterminism-based) free will.

Annual audits of IDS risk contract settlements improve payment accuracy.

PubMed

Pearce, J W

1999-12-01

Integrated delivery systems (IDSs) should conduct annual audits of payers' settlements under risk contracts to verify that the payer attributed the appropriate amounts of revenue and charged the appropriate claims expenses to the IDS. In particular, IDSs should verify that payers calculated revenues and expenses based on consistent member counts and that the determined commercial revenue was based on the actual premiums paid. IDSs also should determine whether payers have used appropriate demographic factors and countywide rates as a basis for determining Medicare revenue, charged the IDS for claims only for valid members, paid capitated providers the correct capitation amounts, and used appropriate historical data to estimate the amounts of incurred-but-not-reported claims attributed to the IDS.

An Assessment of Champus Expenditures for Cardiovascular Health Care Services in the Fort Leonard Wood Catchment Area

DTIC Science & Technology

1992-12-01

segmented, target marketing can occur and priorities can be established ( Kotler & Clarke, 1987). Any successful re-capturing of CHAMPUS workload or...introduction, one of the new challenges confronting MTF commanders is the need to engage in target marketing . Kotler and Clarke (1987) pointed out...cardiovascu’ar claims paid during CY 1991 (n=57) and all CHAMPUS tc’dae:et cardi :vascular claims -aid rim;- Se-,t.... E... 19,9 L** onal, an" market area

Power in global health agenda-setting: the role of private funding Comment on "Knowledge, moral claims and the exercise of power in global health".

PubMed

Levine, Ruth E

2015-03-04

The editorial by Jeremy Shiffman, "Knowledge, moral claims and the exercise of power in global health", highlights the influence on global health priority-setting of individuals and organizations that do not have a formal political mandate. This sheds light on the way key functions in global health depend on private funding, particularly from the Bill & Melinda Gates Foundation. © 2015 by Kerman University of Medical Sciences.

Disciplinary Epistemologies, Generic Attributes and Undergraduate Academic Writing in Nursing and Midwifery

ERIC Educational Resources Information Center

Gimenez, Julio

2012-01-01

Generic attributes such as "holding a critical stance", "using evidence to support claims", and "projecting an impersonal voice" are central to disciplinary academic writing in higher education. These attributes, also referred to as "skills", have for a long time been conceptualised as transferable in that…

Classification accuracy of claims-based methods for identifying providers failing to meet performance targets.

PubMed

Hubbard, Rebecca A; Benjamin-Johnson, Rhondee; Onega, Tracy; Smith-Bindman, Rebecca; Zhu, Weiwei; Fenton, Joshua J

2015-01-15

Quality assessment is critical for healthcare reform, but data sources are lacking for measurement of many important healthcare outcomes. With over 49 million people covered by Medicare as of 2010, Medicare claims data offer a potentially valuable source that could be used in targeted health care quality improvement efforts. However, little is known about the operating characteristics of provider profiling methods using claims-based outcome measures that may estimate provider performance with error. Motivated by the example of screening mammography performance, we compared approaches to identifying providers failing to meet guideline targets using Medicare claims data. We used data from the Breast Cancer Surveillance Consortium and linked Medicare claims to compare claims-based and clinical estimates of cancer detection rate. We then demonstrated the performance of claim-based estimates across a broad range of operating characteristics using simulation studies. We found that identification of poor performing providers was extremely sensitive to algorithm specificity, with no approach identifying more than 65% of poor performing providers when claims-based measures had specificity of 0.995 or less. We conclude that claims have the potential to contribute important information on healthcare outcomes to quality improvement efforts. However, to achieve this potential, development of highly accurate claims-based outcome measures should remain a priority. Copyright © 2014 John Wiley & Sons, Ltd.

TREATMENT AFTER ACUTE CORONARY SYNDROME: ANALYSIS OF PATIENT'S PRIORITIES WITH ANALYTIC HIERARCHY PROCESS.

PubMed

Mühlbacher, Axel C; Bethge, Susanne; Kaczynski, Anika

2016-01-01

Cardiovascular disease is one of the most common causes of death worldwide, with many individuals having experienced acute coronary syndrome (ACS). How patients with a history of ACS value aspects of their medical treatment have been evaluated rarely. The aim of this study was to determine patient priorities for long-term drug therapy after experiencing ACS. To identify patient-relevant treatment characteristics, a systematic literature review and qualitative patient interviews were conducted. A questionnaire was developed to elicit patient's priorities for different characteristics of ACS treatment using Analytic Hierarchy Process (AHP). To evaluate the patient-relevant outcomes, the eigenvector method was applied. Six-hundred twenty-three patients participated in the computer-assisted personal interviews and were included in the final analysis. Patients showed a clear priority for the attribute "reduction of mortality risk" (weight: 0.402). The second most preferred attribute was the "prevention of a new myocardial infarction" (weight: 0.272), followed by "side effect: dyspnea" (weight: 0.165) and "side effect: bleeding" (weight: 0.117). The "frequency of intake" was the least important attribute (weight: 0.044). In conclusion, this study shows that patients strongly value a reduction of the mortality risk in post-ACS treatment. Formal consideration of patient preferences and priorities can help to inform a patient-centered approach, clinical practice, development of future effective therapies, and health policy for decision makers that best represents the needs and goals of the patient.

Language Display: Authenticating Claims to Social Identity.

ERIC Educational Resources Information Center

Eastman, Carol M.; Stein, Roberta F.

1993-01-01

Discusses "language display," a language use strategy whereby members of one group lay claims to attributes associated with another, conveying messages of social, professional, ethnic identity. Examples from academia, politics, business, and advertising reveal language display functions as artifact of crossing linguistic boundaries…

A Seven-Year Longitudinal Claim Analysis to Assess the Factors Contributing to the Increased Severity of Work-Related Injuries.

PubMed

Kalia, Nimisha; Lavin, Robert A; Yuspeh, Larry; Bernacki, Edward J; Tao, Xuguang Grant

2016-09-01

In recent decades, the frequency of Medical Only (MO) and Lost Time (LT) workers' compensation claims has decreased, while average severity (medical and indemnity costs) has increased. The aim of this study was to compare claim frequency, mix, and severity (cost) over two periods using a claim cohort follow-up method. Sixty-two thousand five hundred thirty-three claims during two periods (1999 to 2002 and 2003 to 2006) were followed seven years postinjury. Descriptive analysis and significant testing methods were used to compare claim frequency and costs. The number of claims per $1 M of premium decreased 50.4% for MO claims and 35.6% for LT claims, consequently increasing the LT claim proportion. The average cost of LT claims did not increase. The severity increase is attributable to the proportional change in LT and MO claims. While the number of LT claims decreased, the inflation-adjusted average cost of LT claims did not increase.

Best practices: Product category rule creation and use

EPA Science Inventory

Benefits of life cycle-based claims For most products, the majority of impact occurs upstream or downstream of product use . Single-stage claims for products (e.g., recycled content; energy efficient) don’t capture the relevance of that attribute in life-cycle environmental per...

Vision, knowledge, and assertion.

PubMed

Turri, John

2016-04-01

I report two experiments studying the relationship among explicit judgments about what people see, know, and should assert. When an object of interest was surrounded by visibly similar items, it diminished people's willingness to judge that an agent sees, knows, and should tell others that it is present. This supports the claim, made by many philosophers, that inhabiting a misleading environment intuitively decreases our willingness to attribute perception and knowledge. However, contrary to stronger claims made by some philosophers, inhabiting a misleading environment does not lead to the opposite pattern whereby people deny perception and knowledge. Causal modeling suggests a specific psychological model of how explicit judgments about perception, knowledge, and assertability are made: knowledge attributions cause perception attributions, which in turn cause assertability attributions. These findings advance understanding of how these three important judgments are made, provide new evidence that knowledge is the norm of assertion, and highlight some important subtleties in folk epistemology. Copyright © 2016 Elsevier Inc. All rights reserved.

Scientific Uncertainties in Climate Change Detection and Attribution Studies

NASA Astrophysics Data System (ADS)

Santer, B. D.

2017-12-01

It has been claimed that the treatment and discussion of key uncertainties in climate science is "confined to hushed sidebar conversations at scientific conferences". This claim is demonstrably incorrect. Climate change detection and attribution studies routinely consider key uncertainties in observational climate data, as well as uncertainties in model-based estimates of natural variability and the "fingerprints" in response to different external forcings. The goal is to determine whether such uncertainties preclude robust identification of a human-caused climate change fingerprint. It is also routine to investigate the impact of applying different fingerprint identification strategies, and to assess how detection and attribution results are impacted by differences in the ability of current models to capture important aspects of present-day climate. The exploration of the uncertainties mentioned above will be illustrated using examples from detection and attribution studies with atmospheric temperature and moisture.

77 FR 28258 - Copayments for Medications in 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-14

..., 2012, the copayment amount for veterans in the VA health care system in enrollment priority categories... practice and procedure; Alcohol abuse; Alcoholism; Claims; Day care; Dental health; Drug abuse; Foreign relations; Government contracts; Grant programs--health; Grant programs--veterans; Health care; Health...

Lessons to be learned: a retrospective analysis of physiotherapy injury claims.

PubMed

Johnson, Gillian M; Skinner, Margot A; Stephen, Rachel E

2012-08-01

Retrospective, descriptive analysis. To describe the prevalence and nature of insurance claims for injuries attributed to physiotherapy care. In New Zealand, a national insurance scheme, the Accident Compensation Corporation, provides comprehensive, no-fault personal injury coverage. The patterns of injury sustained during physiotherapy care have not previously been described. De-identified data for all injuries registered with the Accident Compensation Corporation from 2005 to 2010 and attributed to physiotherapy were accessed. Prevalence patterns (percentages) of new-claim data were determined for physiotherapy intervention category, injury site, nature of injury, age, and sex. A subcategory, exercise-related injuries, was analyzed according to injury site and whether the injury was related (primary) or unrelated (secondary) to the intended therapeutic goal. There were 279 claims related to physiotherapy care filed with the Accident Compensation Corporation during the studied reporting period. Injury was attributed predominantly to exercise (n = 88, 31.5% of cases) and manual therapy (n = 74, 26.5% of cases). The prevalence of events categorized as exercise related was greatest in those who were 55 to 59 years of age (n = 14, 16.3%) and greater in females (n = 47, 54.7%). Of the exercise-related injuries, 39.8% were in the lower-limb region and 35.2% were categorized as sprains/strains. Injuries attributed to exercise exceeded those linked to other therapies provided by physiotherapists, yet exercise therapy rarely features as a cause of adverse events reported to the physiotherapy profession. The proportion of exercise-related injury events underlines the need for ensuring safe and careful consideration of exercise prescription. Harm, level 4.

Empowerment: the right medicine for improving employee commitment and morale in the NHS?

PubMed

Cunningham, I; Hyman, J

1996-01-01

States that in recent years, empowerment of National Health Service (NHS) Trust employees has been given substantial political and managerial support. Examines the extent to which the commitment and morale of staff in two NHS Trust hospitals has altered following the introduction of a raft of techniques under the empowerment label. The researchers interviewed substantial numbers of staff with managerial responsibilities, personnel specialists and conducted written surveys seeking employee opinion. Reports the findings, which confirm that, under empowerment, the work of both managers and staff has become more intensive, but managers claim that their commitment has risen, while for non-managerial employees, severe problems of commitment to the Trust, declining morale and high stress were exposed. Identifies reasons for these difficulties which were: the salience of budgetary and operational priorities; lack of training; resistance to the implementation of empowerment; and recognition that little real authority was being devolved to employees. Concludes that the limited effects attributable to empowerment could be explained by its association with harder-edged manpower policies introduced to meet financial and competitive pressures. Under favourable contextual conditions, empowerment may exert more positive effects.

Assessment of perceived injury risks and priorities among truck drivers and trucking companies in Washington State.

PubMed

Spielholz, Peregrin; Cullen, Jennifer; Smith, Caroline; Howard, Ninica; Silverstein, Barbara; Bonauto, David

2008-01-01

The trucking industry experiences one of the highest work-related injury rates. Little work has been conducted previously in the United States to assess the hazards, needs, and injury prevention priorities in trucking. Two separate industry-wide surveys of 359 trucking companies and 397 commercial truck drivers were conducted in Washington State. Trucking companies and drivers both ranked musculoskeletal and slip, trip, fall injuries as the top two priorities. Controlling heavy lifting, using appropriate equipment, and addressing slippery surfaces were frequently listed as solutions. There appears to be a gap in safety climate perception between workers and employers. However, driver and company priorities agreed with industry workers' compensation claims. There is room for safety program management improvement in the industry. The study findings detail opportunities for prioritizing and reducing injuries. This information can be used to focus and design interventions for the prevention of work-related injuries while improving industry competitiveness.

Priority of discovery in the life sciences

PubMed Central

Vale, Ronald D; Hyman, Anthony A

2016-01-01

The job of a scientist is to make a discovery and then communicate this new knowledge to others. For a scientist to be successful, he or she needs to be able to claim credit or priority for discoveries throughout their career. However, despite being fundamental to the reward system of science, the principles for establishing the "priority of discovery" are rarely discussed. Here we break down priority into two steps: disclosure, in which the discovery is released to the world-wide community; and validation, in which other scientists assess the accuracy, quality and importance of the work. Currently, in biology, disclosure and an initial validation are combined in a journal publication. Here, we discuss the advantages of separating these steps into disclosure via a preprint, and validation via a combination of peer review at a journal and additional evaluation by the wider scientific community. PMID:27310529

Work-related asthma in health care in Ontario.

PubMed

Liss, Gary M; Buyantseva, Larisa; Luce, Carol E; Ribeiro, Marcos; Manno, Michael; Tarlo, Susan M

2011-04-01

The health of workers in health care has been neglected in the past. There are few reports regarding occupational asthma (OA) in this group, and work-exacerbated asthma (WEA) has rarely been considered. We examined the frequency of claims for OA and WEA allowed by the compensation board in Ontario, Canada for which industry was coded as "health care" between 1998 and 2002, to determine the frequency of OA and WEA, causative agents, and occupations. During this period, five claims were allowed for sensitizer OA, two for natural rubber latex (NRL), and three for glutaraldehyde/photographic chemicals. The two NRL cases occurred in nurses who had worked for >10 years prior to "date of accident." There were 115 allowed claims for WEA; health care was the most frequent industry for WEA. Compared to the rest of the province, claims in health care made up a significantly greater proportion of WEA claims (17.8%) than OA (5.1%) (odds ratio, 4.1, 95% CI 1.6-11.6; P = 0.002). The rate of WEA claims was 2.1 times greater than that in the rest of the workforce (P < 0.0001). WEA claims occurred in many jobs (e.g., clerk), other than "classic" health care jobs such as nurses, and were attributed to a variety of agents such as construction dust, secondhand smoke, and paint fumes. WEA occurs frequently in this industrial sector. Those affected and attributed agents include many not typically expected in health care. The incidence of OA claims in this sector in general was low; the continued low number of OA claims due to NRL is consistent with the successful interventions for prevention. Copyright © 2011 Wiley-Liss, Inc.

The quest for a framework for sustainable and institutionalised priority-setting for health research in a low-resource setting: the case of Zambia.

PubMed

Kapiriri, Lydia; Chanda-Kapata, Pascalina

2018-02-17

Priority-setting for health research in low-income countries remains a major challenge. While there have been efforts to systematise and improve the processes, most of the initiatives have ended up being a one-off exercise and are yet to be institutionalised. This could, in part, be attributed to the limited capacity for the priority-setting institutions to identify and fund their own research priorities, since most of the priority-setting initiatives are driven by experts. This paper reports findings from a pilot project whose aim was to develop a systematic process to identify components of a locally desirable and feasible health research priority-setting approach and to contribute to capacity strengthening for the Zambia National Health Research Authority. Synthesis of the current literature on the approaches to health research prioritisations. The results of the synthesis were presented and discussed with a sample of Zambian researchers and decision-makers who are involved in health research priority-setting. The ultimate aim was for them to explore the different approaches available for guiding health research priority-setting and to identify an approach that would be relevant and feasible to implement and sustain within the Zambian context. Based on the evidence that was presented, the participants were unable to identify one approach that met the criteria. They identified attributes from the different approaches that they thought would be most appropriate and proposed a process that they deemed feasible within the Zambian context. While it is easier to implement prioritisation based on one approach that the initiator might be interested in, researchers interested in capacity-building for health research priority-setting organisations should expose the low-income country participants to all approaches. Researchers ought to be aware that sometimes one shoe may not fit all, as in the case of Zambia, instead of choosing one approach, the stakeholders may select desirable attributes from the different approaches and piece together an approach that would be feasible and acceptable within their context. An approach that builds on the decision-makers' understanding of their contexts and their input to its development would foster local ownership and has a greater potential for sustainability.

Letters to the New Mexico congressional delegation regarding the long-term monitoring activities and claims for reimbursement

EPA Pesticide Factsheets

Feb. 23, 2016: added letters to the state of Utah, the Ten Tribes Partnership, the Southern Ute Indian Tribe and the Ute Mountain Tribe about adding the Bonita Peak Mining District to the Superfund National Priorities List (NPL).

Gender Differences in Work Adjustment of Prison Employees.

ERIC Educational Resources Information Center

Fry, Lincoln J.; Glaser, Daniel

1987-01-01

Examined 1,300 employees at three California prisons. Fieldwork supported claim that male staff are negatively oriented toward female employees and that women staff and women's prisons receive low priority from male-dominated state agencies. Survey of employees revealed little gender differences in work adjustment. (Author/NB)

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 survey of time management and particular tasks undertaken by consultant microbiologists in the UK.

PubMed

Riordan, Terry; Cartwright, Keith; Cunningham, Richard; Logan, Margaret; Wright, Paul

2007-05-01

Medical microbiology practice encompasses a diverse range of activities. Consultant medical microbiologists (CMMs) attribute widely differing priorities to, and spend differing proportions of time on various components of the job. To obtain a professional consensus on what are high-priority and low-priority activities, and to identify the time spent on low-priority activities. National survey. Many respondents felt that time spent on report authorisation and telephoning of results was excessive, whereas time spent on ward-based work was inadequate. Timesaving could also be achieved through better prioritisation of infection-control activities. CMMs should apportion their time at work focusing on high-priority activities identified through professional consensus.

Variation in the anthropomorphization of supernatural beings and its implications for cognitive theories of religion.

PubMed

Shtulman, Andrew

2008-09-01

The cognitive study of religion has been highly influenced by P. Boyer's (2001, 2003) claim that supernatural beings are conceptualized as persons with counterintuitive properties. The present study tests the generality of this claim by exploring how different supernatural beings are conceptualized by the same individual and how different individuals conceptualize the same supernatural beings. In Experiment 1, college undergraduates decided whether three types of human properties (psychological, biological, physical) could or could not be attributed to two types of supernatural beings (religious, fictional). On average, participants attributed more human properties to fictional beings, like fairies and vampires, than to religious beings, like God and Satan, and they attributed more psychological properties than nonpsychological properties to both. In Experiment 2, 5-year-old children and their parents made both open-ended and closed-ended property attributions. Although both groups of participants attributed a majority of human properties to the fictional beings, children attributed a majority of human properties to the religious beings as well. Taken together, these findings suggest that anthropomorphic theories of supernatural-being concepts, though fully predictive of children's concepts, are only partially predictive of adults' concepts. (c) 2008 APA, all rights reserved.

The impact of front-of-pack marketing attributes versus nutrition and health information on parents' food choices.

PubMed

Georgina Russell, Catherine; Burke, Paul F; Waller, David S; Wei, Edward

2017-09-01

Front-of-pack attributes have the potential to affect parents' food choices on behalf of their children and form one avenue through which strategies to address the obesogenic environment can be developed. Previous work has focused on the isolated effects of nutrition and health information (e.g. labeling systems, health claims), and how parents trade off this information against co-occurring marketing features (e.g. product imagery, cartoons) is unclear. A Discrete Choice Experiment was utilized to understand how front-of-pack nutrition, health and marketing attributes, as well as pricing, influenced parents' choices of cereal for their child. Packages varied with respect to the two elements of the Australian Health Star Rating system (stars and nutrient facts panel), along with written claims, product visuals, additional visuals, and price. A total of 520 parents (53% male) with a child aged between five and eleven years were recruited via an online panel company and completed the survey. Product visuals, followed by star ratings, were found to be the most significant attributes in driving choice, while written claims and other visuals were the least significant. Use of the Health Star Rating (HSR) system and other features were related to the child's fussiness level and parents' concerns about their child's weight with parents of fussy children, in particular, being less influenced by the HSR star information and price. The findings suggest that front-of-pack health labeling systems can affect choice when parents trade this information off against marketing attributes, yet some marketing attributes can be more influential, and not all parents utilize this information in the same way. Copyright © 2017. Published by Elsevier Ltd.

Investigation of Priority Needs in Terms of Museum Service Accessibility for Visually Impaired Visitors

ERIC Educational Resources Information Center

Handa, Kozue; Dairoku, Hitoshi; Toriyama, Yoshiko

2010-01-01

This study investigates the priority needs of museum service accessibility for visually impaired visitors. For this purpose, conjoint analysis was utilized. Four conjoint attributes of museum services were selected: A--facilities for wayfinding; B--exhibitions and collections including objects for touching, hearing, smelling, etc.; C--information…

38 CFR 3.300 - Claims based on the effects of tobacco products.

Code of Federal Regulations, 2010 CFR

2010-07-01

... heart disease or other cardiovascular disease under § 3.310(b). (c) For claims for secondary service... on the basis that it resulted from injury or disease attributable to the veteran's use of tobacco... disease or injury that is otherwise shown to have been incurred or aggravated during service. For purposes...

38 CFR 3.300 - Claims based on the effects of tobacco products.

Code of Federal Regulations, 2012 CFR

2012-07-01

... heart disease or other cardiovascular disease under § 3.310(b). (c) For claims for secondary service... on the basis that it resulted from injury or disease attributable to the veteran's use of tobacco... disease or injury that is otherwise shown to have been incurred or aggravated during service. For purposes...

38 CFR 3.300 - Claims based on the effects of tobacco products.

Code of Federal Regulations, 2013 CFR

2013-07-01

... heart disease or other cardiovascular disease under § 3.310(b). (c) For claims for secondary service... on the basis that it resulted from injury or disease attributable to the veteran's use of tobacco... disease or injury that is otherwise shown to have been incurred or aggravated during service. For purposes...

38 CFR 3.300 - Claims based on the effects of tobacco products.

Code of Federal Regulations, 2011 CFR

2011-07-01

... heart disease or other cardiovascular disease under § 3.310(b). (c) For claims for secondary service... on the basis that it resulted from injury or disease attributable to the veteran's use of tobacco... disease or injury that is otherwise shown to have been incurred or aggravated during service. For purposes...

38 CFR 3.300 - Claims based on the effects of tobacco products.

Code of Federal Regulations, 2014 CFR

2014-07-01

... heart disease or other cardiovascular disease under § 3.310(b). (c) For claims for secondary service... on the basis that it resulted from injury or disease attributable to the veteran's use of tobacco... disease or injury that is otherwise shown to have been incurred or aggravated during service. For purposes...

12 CFR 360.3 - Priorities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... vacation and sick leave pay and contributions to employee benefit plans, earned prior to the appointment of... interests of the receivership to engage or retain for a reasonable period of time; (4) If authorized by the receiver, claims for wages and salaries, including vacation and sick leave pay and contributions to...

Clinical Utility and "DSM-V"

ERIC Educational Resources Information Center

Mullins-Sweatt, Stephanie N.; Widiger, Thomas A.

2009-01-01

The construction of the American Psychiatric Association's diagnostic manual has been guided primarily by concerns of construct validity rather than of clinical utility, despite claims by its authors that the highest priority has in fact been clinical utility. The purpose of this article was to further articulate the concept and importance of…

38 CFR 3.1602 - Special conditions governing payments.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., funeral, plot, interment and transportation expenses, the burial and plot or interment allowance will be... transportation services or furnished the burial plot will have priority over claims of persons whose personal... burial allowance or plot or interment allowance will be made where it would escheat. [26 FR 1621, Feb. 24...

Redirecting Educational Priorities.

ERIC Educational Resources Information Center

Lourie, Sylvain

Few nations can claim that education is not a source of conflict. Although education alone cannot overcome all social evils, two problems can be attacked through a redirection of educational policies. The problems of illiteracy and of providing a basic education to all are the objectives of the United Nations Educational, Scientific, and Cultural…

Priority setting in healthcare: towards guidelines for the program budgeting and marginal analysis framework.

PubMed

Peacock, Stuart J; Mitton, Craig; Ruta, Danny; Donaldson, Cam; Bate, Angela; Hedden, Lindsay

2010-10-01

Economists' approaches to priority setting focus on the principles of opportunity cost, marginal analysis and choice under scarcity. These approaches are based on the premise that it is possible to design a rational priority setting system that will produce legitimate changes in resource allocation. However, beyond issuing guidance at the national level, economic approaches to priority setting have had only a moderate impact in practice. In particular, local health service organizations - such as health authorities, health maintenance organizations, hospitals and healthcare trusts - have had difficulty implementing evidence from economic appraisals. Yet, in the context of making decisions between competing claims on scarce health service resources, economic tools and thinking have much to offer. The purpose of this article is to describe and discuss ten evidence-based guidelines for the successful design and implementation of a program budgeting and marginal analysis (PBMA) priority setting exercise. PBMA is a framework that explicitly recognizes the need to balance pragmatic and ethical considerations with economic rationality when making resource allocation decisions. While the ten guidelines are drawn from the PBMA framework, they may be generalized across a range of economic approaches to priority setting.

Evaluating the influential priority of the factors on insurance loss of public transit

PubMed Central

Su, Yongmin; Chen, Xinqiang

2018-01-01

Understanding correlation between influential factors and insurance losses is beneficial for insurers to accurately price and modify the bonus-malus system. Although there have been a certain number of achievements in insurance losses and claims modeling, limited efforts focus on exploring the relative role of accidents characteristics in insurance losses. The primary objective of this study is to evaluate the influential priority of transit accidents attributes, such as the time, location and type of accidents. Based on the dataset from Washington State Transit Insurance Pool (WSTIP) in USA, we implement several key algorithms to achieve the objectives. First, K-means algorithm contributes to cluster the insurance loss data into 6 intervals; second, Grey Relational Analysis (GCA) model is applied to calculate grey relational grades of the influential factors in each interval; in addition, we implement Naive Bayes model to compute the posterior probability of factors values falling in each interval. The results show that the time, location and type of accidents significantly influence the insurance loss in the first five intervals, but their grey relational grades show no significantly difference. In the last interval which represents the highest insurance loss, the grey relational grade of the time is significant higher than that of the location and type of accidents. For each value of the time and location, the insurance loss most likely falls in the first and second intervals which refers to the lower loss. However, for accidents between buses and non-motorized road users, the probability of insurance loss falling in the interval 6 tends to be highest. PMID:29298337

Evaluating the influential priority of the factors on insurance loss of public transit.

PubMed

Zhang, Wenhui; Su, Yongmin; Ke, Ruimin; Chen, Xinqiang

2018-01-01

Understanding correlation between influential factors and insurance losses is beneficial for insurers to accurately price and modify the bonus-malus system. Although there have been a certain number of achievements in insurance losses and claims modeling, limited efforts focus on exploring the relative role of accidents characteristics in insurance losses. The primary objective of this study is to evaluate the influential priority of transit accidents attributes, such as the time, location and type of accidents. Based on the dataset from Washington State Transit Insurance Pool (WSTIP) in USA, we implement several key algorithms to achieve the objectives. First, K-means algorithm contributes to cluster the insurance loss data into 6 intervals; second, Grey Relational Analysis (GCA) model is applied to calculate grey relational grades of the influential factors in each interval; in addition, we implement Naive Bayes model to compute the posterior probability of factors values falling in each interval. The results show that the time, location and type of accidents significantly influence the insurance loss in the first five intervals, but their grey relational grades show no significantly difference. In the last interval which represents the highest insurance loss, the grey relational grade of the time is significant higher than that of the location and type of accidents. For each value of the time and location, the insurance loss most likely falls in the first and second intervals which refers to the lower loss. However, for accidents between buses and non-motorized road users, the probability of insurance loss falling in the interval 6 tends to be highest.

Do falls and falls-injuries in hospital indicate negligent care -- and how big is the risk? A retrospective analysis of the NHS Litigation Authority Database of clinical negligence claims, resulting from falls in hospitals in England 1995 to 2006.

PubMed

Oliver, D; Killick, S; Even, T; Willmott, M

2008-12-01

Accidental falls are very common in older hospital patients -- accounting for 32% of reported adult patient safety incidents in UK National Health Service (NHS) hospitals and occurring with similar frequency in settings internationally. In countries where the population is ageing, and care is provided in inpatient settings, falls prevention is therefore a significant and growing risk-management issue. Falls may lead to a variety of harms and costs, are cited in formal complaints and can lead to claims of clinical negligence. The NHS Litigation Authority (NHSLA) negligence claims database provides a novel opportunity to systematically analyse such (falls-related) claims made against NHS organisations in England and to learn lessons for risk-management systems and claims recording. To describe the circumstances and injuries most frequently cited in falls-related claims; to investigate any association between the financial impact (total cost), and the circumstances of or injuries resulting from falls in "closed" claims; to draw lessons for falls risk management and for future data capture on falls incidents and resulting claims analysis; to identify priorities for future research. A keyword search was run on the NHSLA claims database for April 1995 to February 2006, to identify all claims apparently relating to falls. Claims were excluded from further analysis if, on scrutiny, they had not resulted from falls, or if they were still "open" (ie, unresolved). From the narrative descriptions of closed claims (ie, those for which the financial outcome was known), we developed categories of "principal" and "secondary" injury/harm and "principal" and "contributory" circumstance of falls. For each category, it was determined whether cases had resulted in payment and what total payments (damages and costs) were awarded. The proportions of contribution-specific injuries or circumstances to the number of cases and to the overall costs incurred were compared in order to identify circumstances that tend to be more costly. Means were compared and tested through analysis of variance (ANOVA). The association between categorical variables was tested using the chi-square test. Of 668 claims identified by word search, 646 met inclusion criteria. The results presented are for the 479 of these that were "closed" at the time of the census. Of these, 290 (60.5%) had resulted in payment of costs or damages, with the overall total payment being 6,200,737 pound (mean payment 12,945 pound). All claims were settled out of court, so no legal rulings on establishing liability or causation of injury are available. "Falls whilst walking;" "from beds or trolleys" ("with and without bedrails applied") or "transferring/from a chair" were the most frequent source of these claims (n = 308, 64.2%). Clear secondary contributory circumstances were identified in 190 (39.7%) of closed claims. The most common circumstances cited were "perioperative/procedural incidents" (60, 12.5%) and "requests for bedrails being ignored" (54, 11.3%). For primary injuries, "hip/femoral/pelvic fracture" accounted for 203 (42.4%) of closed claims with total payments of 3,228,781 pound (52.1% of all payments), with a mean payment 15,905 pound per closed case. A "secondary" contributory circumstance could be attributed in 133 (27.8%) of cases. Of these, "delay in diagnosis of injury," "recurrent falls during admission" and "fatalities relating to falls" were the commonest circumstances (n = 59, 12.2%). Although falls are the highest volume patient safety incident reported in hospital trusts in England, they result in a relatively small number of negligence claims and receive a relatively low total payment (0.019% in both cases). The mean payment in closed claims is also relatively small. This may reflect the high average age of the people who fall and difficulty in establishing causation, especially where individuals are already frail when they fall. The patterns of claims and the narrative descriptions provide wider lessons for improving risk-management strategies. However, the inherent limitations and biases in the data routinely recorded for legal purposes suggest that for more informative research or actuarial claims analysis, more comprehensive and systematic data to be recorded for each incident claim are needed.

Genetic and Environmental Parent-Child Transmission of Value Orientations: An Extended Twin Family Study

ERIC Educational Resources Information Center

Kandler, Christian; Gottschling, Juliana; Spinath, Frank M.

2016-01-01

Despite cross-cultural universality of core human values, individuals differ substantially in value priorities, whereas family members show similar priorities to some degree. The latter has often been attributed to intrafamilial socialization. The analysis of self-ratings on eight core values from 399 twin pairs (ages 7-11) and their biological…

A survey of time management and particular tasks undertaken by consultant microbiologists in the UK

PubMed Central

Riordan, Terry; Cartwright, Keith; Cunningham, Richard; Logan, Margaret; Wright, Paul

2007-01-01

Background Medical microbiology practice encompasses a diverse range of activities. Consultant medical microbiologists (CMMs) attribute widely differing priorities to, and spend differing proportions of time on various components of the job. Aim To obtain a professional consensus on what are high‐priority and low‐priority activities, and to identify the time spent on low‐priority activities. Method National survey. Results Many respondents felt that time spent on report authorisation and telephoning of results was excessive, whereas time spent on ward‐based work was inadequate. Timesaving could also be achieved through better prioritisation of infection‐control activities. Conclusion CMMs should apportion their time at work focusing on high‐priority activities identified through professional consensus. PMID:16714398

Multi-Attribute Consensus Building Tool

ERIC Educational Resources Information Center

Shyyan, Vitaliy; Christensen, Laurene; Thurlow, Martha; Lazarus, Sheryl

2013-01-01

The Multi-Attribute Consensus Building (MACB) method is a quantitative approach for determining a group's opinion about the importance of each item (strategy, decision, recommendation, policy, priority, etc.) on a list (Vanderwood, & Erickson, 1994). This process enables a small or large group of participants to generate and discuss a set…

Is dentistry a profession? Part 1. Professionalism defined.

PubMed

Welie, Jos V M

2004-09-01

Individual dentists and organized dentistry alike invariably claim to be (members of) a profession. This label is cherished because it suggests special social, moral and political status. However, almost every self-respecting occupation nowadays claims to be a profession. Hence, the question arises as to what exactly is meant when dentists claim to be professionals and, more important, whether they can justifiably lay claim to this label. Rather than reviewing the manifold and divergent discussions in the literature about professionalism, the author proposes--in this first of 3 consecutive articles--a definition of the term "profession" that is based on the literal origins of the word. Next, it is argued that a profession arises out of a social contract between the public and a service occupation that professes to give priority to the existential needs of the people served. In the second article, the author deduces several professional responsibilities. The third and final article examines whether and to what extent dentistry fulfills these responsibilities and outlines some future challenges.

Off Our Lawns and out of Our Basements: How We (Mis)Understand the Millennial Generation

ERIC Educational Resources Information Center

Mechler, Heather

2013-01-01

In this article, the author explores the existing research on the characteristics of Millennials within historical, social, and economic contexts. While many researchers have made claims about Millennials, they fail to consider how parenting styles, economic factors, historical events, and shifts in educational priorities may have created the…

Social Cohesion as the Goal: Can Social Cohesion Be Directly Pursued?

ERIC Educational Resources Information Center

Koonce, Kelly A.

2011-01-01

This article establishes an understanding of social cohesion in general and discusses organizations and activities that are known to promote social cohesion before introducing organizations that claim to work toward social cohesion as one of their main priorities. The Council of Europe's Directorate General of Social Cohesion represents a…

Liberal Democracy and Objective Journalism: Partners or Adversaries?

ERIC Educational Resources Information Center

Reeb, Richard H., Jr.

Contemporary journalism, although claiming to be politically objective and neutral, has become a powerful critic of the conduct of the government, often seeming to be a force for the reordering of national priorities along leftist lines. This "adversary journalism" of the past 15 years has strayed a long way from the neutral journalism…

An Analysis of the Air Force Enlisted Performance Feedback System

DTIC Science & Technology

1992-09-01

1990:740). Seligman and others found that most individuals preferred to use the attributional characteristics for a given event to determine the...relied on their personal theories to determine the attributions ( Seligman and others, 1979:242). Mikulincer’s research supports these claims which...Analysis. Cary NC: Dellen Publishing Company, 1987. 30. Seligman , M. E. P., and others. "Depressive Attributional Style," Journal of Abnormal Psychology, 88

Importance-performance analysis of dental satisfaction among three ethnic groups in malaysia.

PubMed

Dewi, Fellani Danasra; Gundavarapu, Kalyan C; Cugati, Navaneetha

2013-01-01

To find the differences in patient satisfaction related to dental services among three ethnic groups - Chinese, Indian and Malay - at AIMST University Dental Centre and analyse them with an importance-performance grid, identifying the weak and strong points, in order to provide better service. This questionnaire-based study consisted of convenience samples of 174 patients of Chinese, Indian and Malay ethnicity. Importance-performance analysis for 20 attributes were compared using Likert's scale. The data obtained were statistically analysed using the Kruskal-Wallis test. Chinese and Indians both emphasised low performance on the interpersonal relationship attribute in terms of the receptionist's courtesy, whereas the Malay participants were concerned with convenience attributes. All the ethnic groups favoured maintaining existing major attributes towards technical competency, interpersonal relationship and facility factors. This study demonstrated priority differences between the ethnic groups' perception of the quality of dental services, where ethnic Chinese showed the highest gap (measure of dissatisfaction) between importance and performance compared to ethnic Malays, followed by ethnic Indians. The patients from the three major ethnic groups of Malaysia were generally well satisfied. Perhaps more priority should be placed on improving the interpersonal relationship attribute, especially with the receptionists.

10 CFR 770.9 - What conditions apply to DOE indemnification of claims against a person or entity based on the...

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false What conditions apply to DOE indemnification of claims... pollutant or contaminant attributable to DOE? 770.9 Section 770.9 Energy DEPARTMENT OF ENERGY TRANSFER OF REAL PROPERTY AT DEFENSE NUCLEAR FACILITIES FOR ECONOMIC DEVELOPMENT § 770.9 What conditions apply to...

10 CFR 770.9 - What conditions apply to DOE indemnification of claims against a person or entity based on the...

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false What conditions apply to DOE indemnification of claims... pollutant or contaminant attributable to DOE? 770.9 Section 770.9 Energy DEPARTMENT OF ENERGY TRANSFER OF REAL PROPERTY AT DEFENSE NUCLEAR FACILITIES FOR ECONOMIC DEVELOPMENT § 770.9 What conditions apply to...

Work-attributed illness arising from excess heat exposure in Ontario, 2004-2010.

PubMed

Fortune, Melanie K; Mustard, Cameron A; Etches, Jacob J C; Chambers, Andrea G

2013-09-12

To describe the incidence of occupational heat illness in Ontario. Heat illness events were identified in two population-based data sources: work-related emergency department (ED) records and lost time claims for the period 2004-2010 in Ontario, Canada. Incidence rates were calculated using denominator estimates from national labour market surveys and estimates were adjusted for workers' compensation insurance coverage. Proportional morbidity ratios were estimated for industry, occupation and tenure of employment. There were 785 heat illness events identified in the ED encounter records (incidence rate 1.6 per 1,000,000 full-time equivalent (FTE) months) and 612 heat illness events identified in the lost time claim records (incidence rate 1.7 per 1,000,000 FTE months) in the seven-year observation period with peak incidence observed in the summer months. The risk of heat illness was elevated for men, young workers, manual workers and those with shorter employment tenure. A higher proportion of lost time claims attributed to heat illness were observed in the government services, agriculture and construction sectors relative to all lost time claims. Occupational heat illnesses are experienced in Ontario's population and are observed in ED records and lost time claims. The variation of heat illness incidence observed with worker and industry characteristics, and over time, can inform prevention efforts by occupational health services in Ontario.

Priority Determination of Underwater Tourism Site Development in Gorontalo Province using Analytical Hierarchy Process (AHP)

NASA Astrophysics Data System (ADS)

Rohandi, M.; Tuloli, M. Y.; Jassin, R. T.

2018-02-01

This research aims to determine the development of priority of underwater tourism in Gorontalo province using the Analytical Hierarchy Process (AHP) method which is one of DSS methods applying Multi-Attribute Decision Making (MADM). This method used 5 criteria and 28 alternatives to determine the best priority of underwater tourism site development in Gorontalo province. Based on the AHP calculation it appeared that the best priority development of underwater tourism site is Pulau Cinta whose total AHP score is 0.489 or 48.9%. This DSS produced a reliable result, faster solution, time-saving, and low cost for the decision makers to obtain the best underwater tourism site to be developed.

Time Sharing Between Robotics and Process Control: Validating a Model of Attention Switching.

PubMed

Wickens, Christopher Dow; Gutzwiller, Robert S; Vieane, Alex; Clegg, Benjamin A; Sebok, Angelia; Janes, Jess

2016-03-01

The aim of this study was to validate the strategic task overload management (STOM) model that predicts task switching when concurrence is impossible. The STOM model predicts that in overload, tasks will be switched to, to the extent that they are attractive on task attributes of high priority, interest, and salience and low difficulty. But more-difficult tasks are less likely to be switched away from once they are being performed. In Experiment 1, participants performed four tasks of the Multi-Attribute Task Battery and provided task-switching data to inform the role of difficulty and priority. In Experiment 2, participants concurrently performed an environmental control task and a robotic arm simulation. Workload was varied by automation of arm movement and both the phases of environmental control and existence of decision support for fault management. Attention to the two tasks was measured using a head tracker. Experiment 1 revealed the lack of influence of task priority and confirmed the differing roles of task difficulty. In Experiment 2, the percentage attention allocation across the eight conditions was predicted by the STOM model when participants rated the four attributes. Model predictions were compared against empirical data and accounted for over 95% of variance in task allocation. More-difficult tasks were performed longer than easier tasks. Task priority does not influence allocation. The multiattribute decision model provided a good fit to the data. The STOM model is useful for predicting cognitive tunneling given that human-in-the-loop simulation is time-consuming and expensive. © 2016, Human Factors and Ergonomics Society.

[Patients' Priorities in the Treatment of Neuroendocrine Tumours: An Analytical Hierarchy Process].

PubMed

Mühlbacher, A C; Juhnke, C; Kaczynski, A

2016-10-01

Background: Neuroendocrine tumours (NET) are relatively rare, usually slow-growing malignant tumours. So far there are no data on the patient preferences/priorities regarding the therapy for NET. This empirical study aimed at the elicitation of patient priorities in the drug treatment of NET. Method: Qualitative patient interviews (N=9) were conducted. To elicit the patient's perspective regarding various treatment aspects of NET a self-administered questionnaire using the Analytical Hierarchy Process (AHP) was developed. The data collection was carried out using paper questionnaires supported by an item response system in a group discussion. To evaluate the patient-relevant outcomes, the eigenvector method was applied. Results: N=24 patients, experts and relatives participated in the AHP survey. In the AHP all respondents had clear priorities for all considered attributes. The attribute "overall survival" was the most significant feature of a drug therapy for all respondents. As in the qualitative interviews, "efficacy attributes" dominated the side effects in the AHP as well. The evaluation of all participants thus showed the attributes "overall survival" (Wglobal:0.418), "progression-free survival" (Wglobal:0.172) and "response to treatment" (Wglobal:0.161) to be most relevant. "Occurrence of abdominal pain" (Wglobal:0.051) was ranked sixth, with "tiredness/fatigue" and "risk of a hypoglycaemia" (Wglobal:0.034) in a shared seventh place. Conclusion: The results thus provide evidence about how much influence a treatment capacity has on therapeutic decisions. Using the AHP major aspects of drug therapy from the perspective of those affected were captured, and positive and negative therapeutic properties could be related against each other. Based on the assessment of the patient's perspective further investigation must elicit patient preferences for NET drug therapy. In the context of a discrete choice experiment or another choice-based method of preference measurement, the results obtained here can be validated and the therapeutic features weighted according to their preferability. © Georg Thieme Verlag KG Stuttgart · New York.

What do hospital decision-makers in Ontario, Canada, have to say about the fairness of priority setting in their institutions?

PubMed Central

Reeleder, David; Martin, Douglas K; Keresztes, Christian; Singer, Peter A

2005-01-01

Background Priority setting, also known as rationing or resource allocation, occurs at all levels of every health care system. Daniels and Sabin have proposed a framework for priority setting in health care institutions called 'accountability for reasonableness', which links priority setting to theories of democratic deliberation. Fairness is a key goal of priority setting. According to 'accountability for reasonableness', health care institutions engaged in priority setting have a claim to fairness if they satisfy four conditions of relevance, publicity, appeals/revision, and enforcement. This is the first study which has surveyed the views of hospital decision makers throughout an entire health system about the fairness of priority setting in their institutions. The purpose of this study is to elicit hospital decision-makers' self-report of the fairness of priority setting in their hospitals using an explicit conceptual framework, 'accountability for reasonableness'. Methods 160 Ontario hospital Chief Executive Officers, or their designates, were asked to complete a survey questionnaire concerning priority setting in their publicly funded institutions. Eight-six Ontario hospitals completed this survey, for a response rate of 54%. Six close-ended rating scale questions (e.g. Overall, how fair is priority setting at your hospital?), and 3 open-ended questions (e.g. What do you see as the goal(s) of priority setting in your hospital?) were used. Results Overall, 60.7% of respondents indicated their hospitals' priority setting was fair. With respect to the 'accountability for reasonableness' conditions, respondents indicated their hospitals performed best for the relevance (75.0%) condition, followed by appeals/revision (56.6%), publicity (56.0%), and enforcement (39.5%). Conclusions For the first time hospital Chief Executive Officers within an entire health system were surveyed about the fairness of priority setting practices in their institutions using the conceptual framework 'accountability for reasonableness'. Although many hospital CEOs felt that their priority setting was fair, ample room for improvement was noted, especially for the enforcement condition. PMID:15663792

Contemporary Thinking about Causation in Evaluation: A Dialogue with Tom Cook and Michael Scriven

ERIC Educational Resources Information Center

Cook, Thomas D.; Scriven, Michael; Coryn, Chris L. S.; Evergreen, Stephanie D. H.

2010-01-01

Legitimate knowledge claims about causation have been a central concern among evaluators and applied researchers for several decades and often have been the subject of heated debates. In recent years these debates have resurfaced with a renewed intensity, due in part to the priority currently being given to randomized experiments by many funders…

Rethinking Networks in Education: Case Studies of Organisational Development Networks in Neoliberal Contexts

ERIC Educational Resources Information Center

Townsend, Andrew

2013-01-01

In 2002 the National College for School Leadership in England launched what they claimed to be the biggest school networking initiative of its kind. The networks which were members of this programme involved schools working together to achieve shared priorities and can be viewed as examples of organisational development networks. These networks,…

78 FR 77540 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-23

... settlement, adjust, retain priority for, or otherwise correctly process an order, Quote/Order, message, or... Directors of NASDAQ OMX an analysis of the total value of eligible claims. FINRA has provided the required analysis. The provision further requires that Nasdaq will file with the Commission a rule proposal setting...

78 FR 7759 - Patent Cooperation Treaty

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-04

...) Concerning a Submission Under 35 U.S.C. 371 (PTO-1390) PCT/Model of Power of Attorney 15 minutes 4,829 1,207 PCT/Model of General Power of Attorney 15 minutes 483 121 Indications Relating to a Deposited...,508 Acceptance of an unintentionally delayed claim for priority (37 2 hours 294 588 CFR 1.78(a)(3...

Images and Identity: Children Constructing a Sense of Belonging to Europe

ERIC Educational Resources Information Center

Healy, Mary; Richardson, Mary

2017-01-01

The European Framework for Key Competences (2006) promotes a shared European identity as a priority for assuring a cohesive future for the European Union (EU), yet the development of a discrete European identity remains acutely contentious, with critics claiming it is too shallow to support the bonds of solidarity needed to engender and support a…

Factoring economic costs into conservation planning may not improve agreement over priorities for protection.

PubMed

Armsworth, Paul R; Jackson, Heather B; Cho, Seong-Hoon; Clark, Melissa; Fargione, Joseph E; Iacona, Gwenllian D; Kim, Taeyoung; Larson, Eric R; Minney, Thomas; Sutton, Nathan A

2017-12-21

Conservation organizations must redouble efforts to protect habitat given continuing biodiversity declines. Prioritization of future areas for protection is hampered by disagreements over what the ecological targets of conservation should be. Here we test the claim that such disagreements will become less important as conservation moves away from prioritizing areas for protection based only on ecological considerations and accounts for varying costs of protection using return-on-investment (ROI) methods. We combine a simulation approach with a case study of forests in the eastern United States, paying particular attention to how covariation between ecological benefits and economic costs influences agreement levels. For many conservation goals, agreement over spatial priorities improves with ROI methods. However, we also show that a reliance on ROI-based prioritization can sometimes exacerbate disagreements over priorities. As such, accounting for costs in conservation planning does not enable society to sidestep careful consideration of the ecological goals of conservation.

Care work versus career work: sibling conflict over getting priorities right.

PubMed

Lashewicz, Bonnie

2011-01-01

As the average age of the Canadian population continues to increase, and providing care at home to frail older adults becomes ever more prevalent, support for family and friend caregivers remains a key social policy issue. Economic support is an important consideration given the impact of caregiving on labour force participation. Yet the caregiving/paid work relationship is not always straightforward. While caregiving often restricts employment, limited attachment to employment may also influence the decision to provide care. Isabel's story, collected as part of a study of sibling views of fairness in sharing parent care as well as parent assets, provides a case study in how siblings give different priority to care work versus career work and what support needs arise including those related to sibling conflict over differing priorities. Isabel claims she sacrificed her career to care for her ailing mother while her siblings argue that through caregiving, Isabel was sheltered from the paid workforce.

Are We Exacerbating Students' Learning Disabilities? An Investigation of Preservice Teachers' Attributions of the Educational Outcomes of Students with Learning Disabilities

ERIC Educational Resources Information Center

Woodcock, Stuart; Vialle, Wilma

2011-01-01

While claims of the importance of attribution theory and teachers' expectations of students for student performance are repeatedly made, there is little comprehensive research identifying the perceptions preservice teachers have of students with learning disabilities (LD). Accordingly, 444 Australian preservice primary school teachers were…

A Cross-National Comparison of Attributional Patterns toward Students with and without Learning Disabilities

ERIC Educational Resources Information Center

Woodcock, Stuart; Jiang, Han

2018-01-01

Claims of the importance of having positive perceptions and expectations of students with learning disabilities (LD) have been repeatedly made over recent years. This article aims to raise awareness of the importance of attributional beliefs in relation to the educational outcomes of students with LD in Australia and China. Australian and Chinese…

Attribute Development Using Continuous Stakeholder Engagement to Prioritize Treatment Decisions: A Framework for Patient-Centered Research.

PubMed

dosReis, Susan; Castillo, Wendy Camelo; Ross, Melissa; Fitz-Randolph, Marcy; Vaughn-Lee, Angela; Butler, Beverly

To develop a methodological approach for selecting, validating, and prioritizing attributes for health care decision making. Participants (n = 48) were recruited from community support groups if they had a child aged 26 years or younger diagnosed with a coexisting mental health condition and cognitive impairment. Six in-depth interviews eliciting care management experiences were transcribed and coded into themes following the principles of grounded theory and the constant comparative method. Six focus groups involving 42 participants assessed the relevance, priority, and meaning and inter-relationship among the themes. The positive predictive value and sensitivity assessed agreement on thematic meaning. A final list was selected from the top priorities with good agreement as candidate attributes. Attribute levels reflecting the range of experiences in care management decisions emerged from the verbatim passages within each coded theme. Participants were the child's mother (73%), white (77%), married (69%), and on average 48 years old. The children were on average 14 years old; 44% had an intellectual disability, 25% had autism, and more than half had anxiety or attention-deficit/hyperactivity disorder. All 14 attributes identified from the in-depth interviews were deemed relevant. The positive predictive value exceeded 90%, and the sensitivity ranged from 64% to 89%. The final set of attributes formed the framework for care management decisions consisting of six attributes (medication, behavior, services, social, treatment effects, and school) each with three levels. A systematic approach grounded in qualitative methods produced a framework of relevant, important, and actionable attributes representing competing alternatives in clinical decisions. Copyright © 2016. Published by Elsevier Inc.

Influence of package and health-related claims on perception and sensory acceptability of snack bars.

PubMed

Pinto, Vinícius Rodrigues Arruda; Freitas, Tamara Beatriz de Oliveira; Dantas, Maria Inês de Souza; Della Lucia, Suzana Maria; Melo, Laura Fernandes; Minim, Valéria Paula Rodrigues; Bressan, Josefina

2017-11-01

Concerns for health can lead to healthier food choices, especially if the consumer is well informed. This study aimed to evaluate the importance of package and health-related claims on Brazilian consumers' acceptance of snack bars. In order to evaluate package attributes, in focus groups discussions, 19 consumers chose the most important factors that influence their purchase decisions. Next, 102 consumers evaluated six commercial brands of snack bars in a three-session acceptance test: the first with no information about the product, the second containing the product package and the third with information on health-related claims associated with consumption of the bar. In general, package attributes, price and flavor were the most important factors that influence the purchase of snack bars. Health claims positively influenced consumer acceptance, but information concerning the absence of gluten and lactose did not significantly alter sensory acceptance. The presence of omega-3s, sugars, preservatives, flavorings and colorings have the potential to improve acceptability, because they were able to raise the acceptance of the seed bar, removing it from the rejection region. Protein and nut bars are not well known to the general public and the lower mean acceptance of the seed and protein bars demonstrated the need for sensorial improvement. Copyright © 2017 Elsevier Ltd. All rights reserved.

Dissociations among judgments do not reflect cognitive priority: an associative explanation of memory for frequency information in contingency learning.

PubMed

Vadillo, Miguel A; Luque, David

2013-03-01

Previous research on causal learning has usually made strong claims about the relative complexity and temporal priority of some processes over others based on evidence about dissociations between several types of judgments. In particular, it has been argued that the dissociation between causal judgments and trial-type frequency information is incompatible with the general cognitive architecture proposed by associative models. In contrast with this view, we conduct an associative analysis of this process showing that this need not be the case. We conclude that any attempt to gain a better insight on the cognitive architecture involved in contingency learning cannot rely solely on data about these dissociations.

Impact of Arts Education on Children's Learning and Wider Outcomes

ERIC Educational Resources Information Center

See, Beng Huat; Kokotsaki, Dimitra

2016-01-01

Almost every educational system in the world regards numeracy and literacy as more important than the arts. In the UK arts interest groups and politicians have, for years, asked for arts education to be accorded the same priority arguing that arts contribute to learning and development of useful skills. It is not clear if these claims were based…

On-Iine Management System for the Periodicals in JAERl

NASA Astrophysics Data System (ADS)

Itabashi, Keizo; Mineo, Yukinobu

The article describes the outlines of the on-line serials control system utilizing a mini-computer. The system is dealt with subscription, check-in, claiming, inquiry of serials information and binding of journals. In this system journal acquisition with serial arrival prediction in an on-line mode is carried on a priority principle to record the actual receipt of incoming issues.

Educating for a High Skills Society? The Landscape of Federal Employment, Training and Lifelong Learning Policy in Canada

ERIC Educational Resources Information Center

Gibb, Tara; Walker, Judith

2011-01-01

Government reports and documents claim that building a knowledge economy and innovative society are key goals in Canada. In this paper, we draw on critical policy analysis to examine 10 Canadian federal government training and employment policies in relation to the government's espoused priorities of innovation and developing a high skills society…

Consumer Perception of Retail Pork Bacon Attributes Using Adaptive Choice-based Conjoint Analysis and Maximum Differential Scaling.

PubMed

McLean, K G; Hanson, D J; Jervis, S M; Drake, M A

2017-11-01

Bacon is one of the most recognizable consumer pork products and is differentiated by appearance, flavor, thickness, and several possible product claims. The objective of this study was to explore the attributes of retail bacon that influence consumers to purchase and consume bacon. An Adaptive Choice-Based Conjoint (ACBC) survey was designed for attributes of raw American-style bacon. An ACBC survey (N = 1410 consumers) and Kano questioning were applied to determine the key attributes that influenced consumer purchase. Attributes included package size, brand, thickness, label claims, flavor, price, and images of the bacon package displaying fat:lean ratio. Maximum Difference Scaling (MaxDiff) was used to rank appeal of 20 different bacon images with variable fat:lean ration and slice shape. The most important attribute for bacon purchase was price followed by fat:lean appearance and then flavor. Three consumer clusters were identified with distinct preferences. For 2 clusters, price was not the primary attribute. Understanding preferences of distinct consumer clusters will enable manufacturers to target consumers and make more appealing bacon. Adaptive Choice-Based Conjoint (ACBC) is a research technique that allows consumers to react to assembled products and identify product attributes that they prefer. Kano questions allow researchers to look at the individual aspects of a product and understand consumer sentiment and expectations towards those product qualities while Maximum Difference scaling allows consumers to directly rank single attributes of a product relative to one another. A combination of these 3 approaches can provide key understandings on consumer perception of retail bacon allowing companies to optimize and maximize their development and advertising resources. © 2017 Institute of Food Technologists®.

Three Myths from the Language Acquisition Literature

PubMed Central

Schoneberger, Ted

2010-01-01

Three popular assertions have hindered the promotion of an empiricist approach to language acquisition: (a) that Brown and Hanlon (1970) claimed to offer data that parents do not reinforce their children's grammaticality; (b) that Brown and Hanlon also claimed to offer data that parents do not provide negative evidence (i.e., corrective feedback) for ungrammaticality; and (c) that Gold (1967) claimed to offer a formal proof showing that, without negative evidence, a child cannot acquire a language solely from environmental input. In this paper I offer introductory comments on the nature–nurture distinction (including interactionism, and the nativists' claim to have found a gene for language). Next I debunk the three aforementioned assertions by arguing that the authors (Brown & Hanlon; Gold) never made the claims attributed to them; review evidence on the role of reinforcement and corrective feedback in language acquisition; and offer some concluding comments. PMID:22477466

Burden of Disease Study and Priority Setting in Korea: an Ethical Perspective

PubMed Central

2016-01-01

When thinking about priority setting in access to healthcare resources, decision-making requires that cost-effectiveness is balanced against medical ethics. The burden of disease has emerged as an important approach to the assessment of health needs for political decision-making. However, the disability adjusted life years approach hides conceptual and methodological issues regarding the claims and value of disabled people. In this article, we discuss ethical issues that are raised as a consequence of the introduction of evidence-based health policy, such as economic evidence, in establishing resource allocation priorities. In terms of ethical values in health priority setting in Korea, there is no reliable rationale for the judgment used in decision-making as well as for setting separate and distinct priorities for different government bodies. An important question, therefore, is which ethical values guiding the practice of decision-making should be reconciled with the economic evidence found in Korean healthcare. The health technology assessment core model from the European network for Health Technology Assessment (EUnetHTA) project is a good example of incorporating ethical values into decision-making. We suggest that a fair distribution of scarce healthcare resources in South Korea can be achieved by considering the ethical aspects of healthcare. PMID:27775247

"Visions" for Children's Health and Wellbeing: Exploring the Complex and Arbitrary Processes of Putting Theory into Practice

ERIC Educational Resources Information Center

Wellard, Ian; Secker, Michelle

2017-01-01

It could be claimed that the priority of any Government should be to look after the interests of the public it serves. Much of this role includes attempting to actively develop and implement policies and programmes that best contribute to or enhance general standards of living. Addressing health and wellbeing, it follows, is a reasonable vision…

Consumer perceptions of graded, graphic and text label presentations for qualified health claims.

PubMed

Kapsak, Wendy Reinhardt; Schmidt, David; Childs, Nancy M; Meunier, John; White, Christy

2008-03-01

On December 18, 2002, the Food and Drug Administration (FDA) announced the Consumer Health Information for Better Nutrition Initiative. The initiative's goal is to make available more and better information about conventional foods and dietary supplements to help Americans improve their health and reduce risk of disease by making sound dietary decisions. It included a rating system to assess the "weight of the publicly available evidence." It assigns one of four ranked levels to the claim thus resulting in qualified health claims. Two phases of research were conducted by the International Food Information Council (IFIC) Foundation. Qualitative research to assess consumer understanding, vocabulary, and familiarity with claims helped with the design and orientation of the second quantitative research phase. The quantitative phase employed a Web-based survey. The claim formats included: report card graphic, report card text, embedded claim text, point-counterpoint, structure/function claim, and nutrient content claim. Respondents were asked to rate the product for perceived strength of scientific evidence provided to support the claim, and questions about the product's perceived healthfulness, quality, safety, and purchase intent. Consumers found it difficult to discriminate across four levels and showed inclination to project the scientific validity grade onto other product attributes. Consumers showed preference for simpler messages.

Workers' compensation claims for musculoskeletal disorders and injuries of the upper extremity and knee among union carpenters in Washington State, 1989-2008.

PubMed

Lipscomb, Hester J; Schoenfisch, Ashley L; Cameron, Wilfrid; Kucera, Kristen L; Adams, Darrin; Silverstein, Barbara A

2015-04-01

Numerous aspects of construction place workers at risk of musculoskeletal disorders and injuries (MSDIs). Work organization and the nature of MSDIs create surveillance challenges. By linking union records with workers' compensation claims, we examined 20-year patterns of MSDIs involving the upper extremity (UE) and the knee among a large carpenter cohort. MSDIs were common and accounted for a disproportionate share of paid lost work time (PLT) claims; UE MSDIs were three times more common than those of the knee. Rates declined markedly over time and were most pronounced for MSDIs of the knee with PLT. Patterns of risk varied by extremity, as well as by age, gender, union tenure, and predominant work. Carpenters in drywall installation accounted for the greatest public health burden. A combination of factors likely account for the patterns observed over time and across worker characteristics. Drywall installers are an intervention priority. © 2015 Wiley Periodicals, Inc.

Learning from malpractice claims about negligent, adverse events in primary care in the United States

PubMed Central

Phillips, R; Bartholomew, L; Dovey, S; Fryer, G; Miyoshi, T; Green, L

2004-01-01

Background: The epidemiology, risks, and outcomes of errors in primary care are poorly understood. Malpractice claims brought for negligent adverse events offer a useful insight into errors in primary care. Methods: Physician Insurers Association of America malpractice claims data (1985–2000) were analyzed for proportions of negligent claims by primary care specialty, setting, severity, health condition, and attributed cause. We also calculated risks of a claim for condition-specific negligent events relative to the prevalence of those conditions in primary care. Results: Of 49 345 primary care claims, 26 126 (53%) were peer reviewed and 5921 (23%) were assessed as negligent; 68% of claims were for negligent events in outpatient settings. No single condition accounted for more than 5% of all negligent claims, but the underlying causes were more clustered with "diagnosis error" making up one third of claims. The ratios of condition-specific negligent event claims relative to the frequency of those conditions in primary care revealed a significantly disproportionate risk for a number of conditions (for example, appendicitis was 25 times more likely to generate a claim for negligence than breast cancer). Conclusions: Claims data identify conditions and processes where primary health care in the United States is prone to go awry. The burden of severe outcomes and death from malpractice claims made against primary care physicians was greater in primary care outpatient settings than in hospitals. Although these data enhance information about error related negligent events in primary care, particularly when combined with other primary care data, there are many operating limitations. PMID:15069219

Good physicians from the perspective of their patients

PubMed Central

Schattner, Ami; Rudin, Dan; Jellin, Navah

2004-01-01

Background It is not currently known what is the patient's viewpoint of a "good" physician. We set out to define patient's priorities regarding different physician's attributes in 3 domains important in medical care. Methods Patients hospitalized or attending clinics at a large teaching hospital selected the 4 attributes that they considered most important out of 21 listed arbitrarily in a questionnaire. The questionnaire included 7 items each in the domains of patient autonomy, professional expertise and humanism. Results Participating patients (n = 445, mean age 57.5 ± 16 years) selected professional expertise (50%), physician's patience and attentiveness (38% and 30%, respectively), and informing the patient, representing the patient's interests, being truthful and respecting patient's preferences (25–36% each) as the most essential attributes. Patient's selections were not significantly influenced by different demographic or clinical background. Selections of attributes in the domain of patient's autonomy were significantly more frequent and this was the preferred domain for 31% and as important as another domain for 16% – significantly more than the domain of professional expertise (P = 0.008), and much more than the domain of humanism and support (P < 0.0005). Conclusions Patients studied want their physicians to be highly professional and expert clinicians and show humaneness and support, but their first priority is for the physician to respect their autonomy. PMID:15361255

Analysis of NHSLA claims in orthopedic surgery.

PubMed

Khan, Irfan H; Jamil, Wiqqas; Lynn, Sam Mathew; Khan, Osman H; Markland, Kate; Giddins, Grey

2012-05-01

National Health Service (NHS) statistics in the United Kingdom demonstrate an increase in clinical negligence claims over the past 30 years. Reasons for this include elements of a cultural shift in attitudes toward the medical profession and the growth of the legal services industry. This issue affects medical and surgical health providers worldwide.The authors analyzed 2117 NHS Litigation Authority (NHSLA) orthopedic surgery claims between 1995 and 2001 with respect to these clinical areas: emergency department, outpatient care, surgery (elective or trauma operations), and inpatient care. The authors focused on the costs of settling and defending claims, costs attributable to clinical areas, common causes of claims, and claims relating to elective or trauma surgery. Numbers of claims and legal costs increased most notably in surgery (elective and trauma) and in the emergency department. However, claims are being defended more robustly. The annual cost for a successful defense has remained relatively stable, showing a slight decline. The common causes of claims are postoperative complication; wrong, delayed, or failure of diagnosis; inadequate consent; and wrong-site surgery. Certain surgical specialties (eg, spine and lower-limb surgery) have the most claims made during elective surgery, whereas upper-limb surgery has the most claims made during trauma surgery.The authors recommend that individual trusts liaise with orthopedic surgeons to devise strategies to address areas highlighted in our study. Despite differences in health care systems worldwide, the underlying issues are common. With improved understanding, physicians can deliver the service they promise their patients. Copyright 2012, SLACK Incorporated.

Systems and methods for maintaining multiple objects within a camera field-of-view

DOEpatents

Gans, Nicholas R.; Dixon, Warren

2016-03-15

In one embodiment, a system and method for maintaining objects within a camera field of view include identifying constraints to be enforced, each constraint relating to an attribute of the viewed objects, identifying a priority rank for the constraints such that more important constraints have a higher priority that less important constraints, and determining the set of solutions that satisfy the constraints relative to the order of their priority rank such that solutions that satisfy lower ranking constraints are only considered viable if they also satisfy any higher ranking constraints, each solution providing an indication as to how to control the camera to maintain the objects within the camera field of view.

Balzac's Louis Lambert : schizophrenia before Kraepelin and Bleuler.

PubMed

Dieguez, Sebastian

2013-01-01

Honoré de Balzac (1799-1850) is well known for his penetrating observations and descriptions of the burgeoning social life and emerging modernity of 19th century France. This chapter focuses on the novel Louis Lambert, first published in 1832. It is argued that its main character provides the first complete and convincing description of schizophrenia - 69 years before Kraepelin fully developed the concept of dementia praecox and 76 years before Bleuler coined the word 'schizophrenia'. We consider the history of the concept of schizophrenia and the intriguing possibility that it is a recent disease. Indeed, if schizophrenia had always existed, it would seem odd that Balzac's novel should be the very first convincing and complete literary account of the disease. This claim is examined by a thorough description of Louis Lambert's symptoms as they appear in the text, and compared to other claims of priority (namely, Shakespeare's King Lear and Gogol's Diary of a Madman). The chapter also provides some background on Balzac's relationship with mysticism, mental illness, and the world of psychiatry. We conclude with remarks regarding influences of Louis Lambert, the case for the priority of the novel as the princeps case of schizophrenia, and its relevance to the recency hypothesis of schizophrenia. Copyright © 2013 S. Karger AG, Basel.

Digital mine claim density map for Federal lands in Montana, 1996

USGS Publications Warehouse

Campbell, Harry W.; Hyndman, Paul C.

1998-01-01

This report describes a digital map and data files generated by the U.S. Geological Survey (USGS) to provide digital spatial mining claim information for Federal lands in Montana as of March, 1997. Statewide, 159,704 claims had been recorded with the Bureau of Land Management since 1975. Of those claims, 21,055 (13%) are still actively held while 138,649 (87%) are closed and are no longer held. Montana contains 147,704 sections (usually 1 section equals 1 square mile) in the Public Land Survey System, with 8,569 sections (6%) containing claim data. Of the sections with claim data, 2,192 (26%) contain actively held claims. Only 1.5% of Montana’s sections contains actively held mining claims. The four types of mining claim are lode, placer, mill, and tunnel. A mill claim may be as much as 5 acres or 1/128th (0.78125%) of a square mile. A lode claim, about 20 acres, would cover 1/32nd (3.125%) of a square mile. Mining claim data is earth science information deemed to be relevant to the assessment of historic, current, and future ecological, economic, and social systems. The digital map and data files that are available in this report are suitable for geographic information system (GIS)-based regional assessments at a scale of 1:100,000 or smaller. Campbell (1996) summarized the methodology and GIS techniques that were used to produce the mining claim density map of the Pacific Northwest. Campbell and Hyndman (1997) displayed mining claim information for the Pacific Northwest that used data acquired in 1994. Appendix A of this report lists the attribute data for the digital data files. Appendix B contains the GIS metadata.

Communitarian claims and community capabilities: furthering priority setting?

PubMed

Mooney, Gavin

2005-01-01

Priority setting in health care is generally not done well. This paper draws on ideas from Amartya Sen and Martha Nussbaum and adds some communitarian underpinnings to provide a way of improving on current uses of program budgeting and marginal analysis (PBMA) in priority setting. The paper suggests that shifting to a communitarian base for priority setting alters the distribution of property rights over health service decision making and increases the probability that recommendations from PBMA exercises will be implemented. The approach is built on a paradigm which departs from three tenets of welfarism as it is normally conceived: (i) individuals qua individuals seek to maximise their individual utility/well-being; (ii) individuals want to do this; and (iii) it is the values of individuals qua individuals that count. Some of the problems of PBMA, as it has been applied to date, are highlighted. It is argued that these are due largely to a lack of 'credible commitment'. Bringing in the community and communitarian values to PBMA priority setting exercises can help to overcome some of the barriers to getting PBMA recommendations implemented. The approach has the merit of reflecting Sen's concept of capabilities (but extending that to a community level). It avoids the often consequentialist base of a conventional welfarist framework, and it allows community values as opposed to individual values to come to the fore. How to elicit communitarian values is explored.

How Strong Is Your Coffee? The Influence of Visual Metaphors and Textual Claims on Consumers’ Flavor Perception and Product Evaluation

PubMed Central

Fenko, Anna; de Vries, Roxan; van Rompay, Thomas

2018-01-01

This study investigates the relative impact of textual claims and visual metaphors displayed on the product’s package on consumers’ flavor experience and product evaluation. For consumers, strength is one of the most important sensory attributes of coffee. The 2 × 3 between-subjects experiment (N = 123) compared the effects of visual metaphor of strength (an image of a lion located either on top or on the bottom of the package of coffee beans) and the direct textual claim (“extra strong”) on consumers’ responses to coffee, including product expectation, flavor evaluation, strength perception and purchase intention. The results demonstrate that both the textual claim and the visual metaphor can be efficient in communicating the product attribute of strength. The presence of the image positively influenced consumers’ product expectations before tasting. The textual claim increased the perception of strength of coffee and the purchase intention of the product. The location of the image also played an important role in flavor perception and purchase intention. The image located on the bottom of the package increased the perceived strength of coffee and purchase intention of the product compared to the image on top of the package. This result could be interpreted from the perspective of the grounded cognition theory, which suggests that a picture in the lower part of the package would automatically activate the “strong is heavy” metaphor. As heavy objects are usually associated with a position on the ground, this would explain why perceiving a visually heavy package would lead to the experience of a strong coffee. Further research is needed to better understand the relationships between a metaphorical image and its spatial position in food packaging design. PMID:29459840

Fraction of stroke mortality attributable to alcohol consumption in Russia.

PubMed

Y E, Razvodovsky

2014-01-01

Stroke is an international health problem with high associated human and economic costs. The mortality rate from stroke in Russia is one of the highest in the world. Risk factors identification is therefore a high priority from the public health perspective. Epidemiological evidence suggests that binge drinking is an important determinant of high stroke mortality rate in Russia. The aim of the present study was to estimate the premature stroke mortality attributable to alcohol abuse in Russia on the basis of aggregate-level data of stroke mortality and alcohol consumption. Age-standardized sex-specific male and female stroke mortality data for the period 1980-2005 and data on overall alcohol consumption were analyzed by means ARIMA time series analysis. The results of the analysis suggest that 26.8% of all male stroke deaths and 18.4% female stroke deaths in Russia could be attributed to alcohol. The estimated alcohol-attributable fraction for men ranged from 16.2% (75+ age group) to 57,5% (30-44 age group) and for women from 21.7% (60-74 age group) and 43.5% (30- 44 age group). The outcomes of this study provide support for the hypothesis that alcohol is an important contributor to the high stroke mortality rate in Russian Federation. Therefore prevention of alcohol-attributable harm should be a major public health priority in Russia. Given the distribution of alcohol-related stroke deaths, interventions should be focused on the young and middle-aged men and women.

Measuring, Enabling and Comparing Modularity, Regularity and Hierarchy in Evolutionary Design

NASA Technical Reports Server (NTRS)

Hornby, Gregory S.

2005-01-01

For computer-automated design systems to scale to complex designs they must be able to produce designs that exhibit the characteristics of modularity, regularity and hierarchy - characteristics that are found both in man-made and natural designs. Here we claim that these characteristics are enabled by implementing the attributes of combination, control-flow and abstraction in the representation. To support this claim we use an evolutionary algorithm to evolve solutions to different sizes of a table design problem using five different representations, each with different combinations of modularity, regularity and hierarchy enabled and show that the best performance happens when all three of these attributes are enabled. We also define metrics for modularity, regularity and hierarchy in design encodings and demonstrate that high fitness values are achieved with high values of modularity, regularity and hierarchy and that there is a positive correlation between increases in fitness and increases in modularity. regularity and hierarchy.

Does a global budget superimposed on fee-for-service payments mitigate hospitals' medical claims in Taiwan?

PubMed

Hsu, Pi-Fem

2014-12-01

Taiwan's global budgeting for hospital health care, in comparison to other countries, assigns a regional budget cap for hospitals' medical benefits claimed on the basis of fee-for-service (FFS) payments. This study uses a stays-hospitals-years database comprising acute myocardial infarction inpatients to examine whether the reimbursement policy mitigates the medical benefits claimed to a third-payer party during 2000-2008. The estimated results of a nested random-effects model showed that hospitals attempted to increase their medical benefit claims under the influence of initial implementation of global budgeting. The magnitudes of hospitals' responses to global budgeting were significantly attributed to hospital ownership, accreditation status, and market competitiveness of a region. The results imply that the regional budget cap superimposed on FFS payments provides only blunt incentive to the hospitals to cooperate to contain medical resource utilization, unless a monitoring mechanism attached with the payment system.

Malpractice risk prevention for primary care physicians.

PubMed

Blackston, Joseph W; Bouldin, Marshall J; Brown, C Andrew; Duddleston, David N; Hicks, G Swink; Holman, Honey E

2002-10-01

The recent medical malpractice "crisis" has seen skyrocketing liability premiums and increasing fear of liability. Primary care physicians, especially family medicine and internal medicine physicians, have historically experienced low rates of malpractice claims, both in number and amount of payment. This can be attributed to several factors: the esteem held by internal medicine and family medicine physicians in their communities, relatively low numbers of invasive procedures, reluctance of patients to include "their" primary care physician in any potential litigation, and, probably most importantly, the atmosphere of mutual trust and communication between the internist or family physician and the patient. Recent years have seen this trend erased, as insurance industry data suggest primary care physicians presently face significant potential exposure for medical malpractice claims. It is imperative that primary care physicians take steps to insure they are adequately covered in case of a malpractice claim and that they practice aggressive but appropriate risk management to lessen the likelihood of a claim.

Comparison of the nutritional content of products, with and without nutrient claims, targeted at children in Brazil.

PubMed

Rodrigues, Vanessa Mello; Rayner, Mike; Fernandes, Ana Carolina; de Oliveira, Renata Carvalho; Proença, Rossana Pacheco da Costa; Fiates, Giovanna Medeiros Rataichesck

2016-06-01

Many children's food products highlight positive attributes on their front-of-package labels in the form of nutrient claims. This cross-sectional study investigated all retailed packaged foods (n 5620) in a major Brazilian supermarket, in order to identify the availability of products targeted at children, and to compare the nutritional content of products with and without nutrient claims on labels. Data on energy, carbohydrate, protein, fibre, Na and total and SFA content, along with the presence and type of nutrient claims, were obtained in-store from labels of all products. Products targeted at children were identified, divided into eight food groups and compared for their nutritional content per 100 g/ml and the presence of nutrient claims using the Mann-Whitney U test (P<0·05). Of the 535 food products targeted at children (9·5 % of all products), 270 (50·5 %) displayed nutrient claims on their labels. Children's products with nutrient claims had either a similar or worse nutritional content than their counterparts without nutrient claims. The major differences among groups were found in Group 8 (e.g. sauces and ready meals), in which children's products bearing nutrient claims had higher energy, carbohydrate, Na and total and SFA content per 100 g/ml than products without nutrient claims (P<0·05). This suggests that, to prevent misleading parents who are seeking healthier products for their children, the regulation on the use of nutrient claims should be revised, so that only products with appropriate nutrient profiles are allowed to display them.

The Future of the High North: Cooperation or Cold War

DTIC Science & Technology

2017-04-06

fledged international organization,” and the 2010 delimitation agreement with Norway.42 However, demonstrating the Arctic´s role in Russian “nation...honored this position, through submitting claims to the U.N. in 11 2001,95 the first nation to do so, and through the 2010 delimitation agreement ...priority but a security issue, Russia is “reconsider[ing] its policy of involving Western countries in Arctic projects.”201 The agreement between

The Multi-Attribute Group Decision-Making Method Based on Interval Grey Trapezoid Fuzzy Linguistic Variables.

PubMed

Yin, Kedong; Wang, Pengyu; Li, Xuemei

2017-12-13

With respect to multi-attribute group decision-making (MAGDM) problems, where attribute values take the form of interval grey trapezoid fuzzy linguistic variables (IGTFLVs) and the weights (including expert and attribute weight) are unknown, improved grey relational MAGDM methods are proposed. First, the concept of IGTFLV, the operational rules, the distance between IGTFLVs, and the projection formula between the two IGTFLV vectors are defined. Second, the expert weights are determined by using the maximum proximity method based on the projection values between the IGTFLV vectors. The attribute weights are determined by the maximum deviation method and the priorities of alternatives are determined by improved grey relational analysis. Finally, an example is given to prove the effectiveness of the proposed method and the flexibility of IGTFLV.

Use of Falling Weight Deflectometer Data for Assessing Pavement Structural Evaluation Values

DOT National Transportation Integrated Search

1999-09-01

Structural evaluation can be very useful at the network level for project prioritization purposes. In the project priority ranking procedure of the Kansas Department of Transportation (KDOT), a pavement rating attribute, Pavement Structural Evaluatio...

Attributing the responsibility for ambulating patients: a qualitative study.

PubMed

Doherty-King, Barbara; Bowers, Barbara J

2013-09-01

Functional decline has been identified as a leading negative outcome of hospitalization for older person. Functional decline is defined as a loss in ability to perform activities of daily living including a loss of independent ambulation. In the hospital literature, a patient's loss in ability to independently ambulate during the hospital stay varies between 15 and 59%. Lack of ambulation and deconditioning effects of bed rest are one of the most predictable causes of loss of independent ambulation in hospitalized older persons. Nurses have been identified as the professional most capable of promoting walking independence in the hospital setting. However, nurses do not routinely walk patients. The purpose of this study was to explore the relationship between nurses' attributions of responsibility for ambulating hospitalized patients and their decisions about whether to ambulate. A descriptive, secondary analysis of data gathered for a parent study was conducted. Grounded dimensional analysis was used to analyze the data. Participants consisted of 25 registered nurses employed on medical or surgical units from two urban hospitals in the United States. Nurses fell into two groups: those who claimed ambulation of patients within their responsibility of practice and those who attributed the responsibility to another discipline. Nurses who claimed responsibility for ambulation focused on patient independence and psychosocial well-being. This resulted in actions related to collaborating with physical therapy, determining the appropriateness of activity orders, diminishing the risk and adjusting to resource availability. Nurses who attributed the responsibility deferred decisions about initiating ambulation to either physical therapy or medicine. This resulted in actions related to waiting, which involved, waiting for physical therapy clearance, physician orders, risks to decrease, and resources to improve before ambulating. Nurses who claimed responsibility for ambulating patients within their domain of practice described actions that promoted patient independent function and were more likely to get patient s up to ambulate. Copyright © 2013 Elsevier Ltd. All rights reserved.

Practice Benchmarking in the Age of Targeted Auditing

PubMed Central

Langdale, Ryan P.; Holland, Ben F.

2012-01-01

The frequency and sophistication of health care reimbursement auditing has progressed rapidly in recent years, leaving many oncologists wondering whether their private practices would survive a full-scale Office of the Inspector General (OIG) investigation. The Medicare Part B claims database provides a rich source of information for physicians seeking to understand how their billing practices measure up to their peers, both locally and nationally. This database was dissected by a team of cancer specialists to uncover important benchmarks related to targeted auditing. All critical Medicare charges, payments, denials, and service ratios in this article were derived from the full 2010 Medicare Part B claims database. Relevant claims were limited by using Medicare provider specialty codes 83 (hematology/oncology) and 90 (medical oncology), with an emphasis on claims filed from the physician office place of service (11). All charges, denials, and payments were summarized at the Current Procedural Terminology code level to drive practice benchmarking standards. A careful analysis of this data set, combined with the published audit priorities of the OIG, produced germane benchmarks from which medical oncologists can monitor, measure and improve on common areas of billing fraud, waste or abuse in their practices. Part II of this series and analysis will focus on information pertinent to radiation oncologists. PMID:23598847

Practice benchmarking in the age of targeted auditing.

PubMed

Langdale, Ryan P; Holland, Ben F

2012-11-01

The frequency and sophistication of health care reimbursement auditing has progressed rapidly in recent years, leaving many oncologists wondering whether their private practices would survive a full-scale Office of the Inspector General (OIG) investigation. The Medicare Part B claims database provides a rich source of information for physicians seeking to understand how their billing practices measure up to their peers, both locally and nationally. This database was dissected by a team of cancer specialists to uncover important benchmarks related to targeted auditing. All critical Medicare charges, payments, denials, and service ratios in this article were derived from the full 2010 Medicare Part B claims database. Relevant claims were limited by using Medicare provider specialty codes 83 (hematology/oncology) and 90 (medical oncology), with an emphasis on claims filed from the physician office place of service (11). All charges, denials, and payments were summarized at the Current Procedural Terminology code level to drive practice benchmarking standards. A careful analysis of this data set, combined with the published audit priorities of the OIG, produced germane benchmarks from which medical oncologists can monitor, measure and improve on common areas of billing fraud, waste or abuse in their practices. Part II of this series and analysis will focus on information pertinent to radiation oncologists.

Patients' Priorities Regarding Female-to-Male Gender Affirmation Surgery of the Genitalia-A Pilot Study of 47 Patients in Sweden.

PubMed

Jacobsson, Josephine; Andréasson, My; Kölby, Lars; Elander, Anna; Selvaggi, Gennaro

2017-06-01

No surgical technique is reported to be the best option for gender-affirmation surgery (GAS) of the genitalia in transmen. Although patients' preferences are central when choosing a surgical technique, no studies have evaluated this factor. To investigate transmen's priorities and preferences regarding GAS of the genitalia. From November 2015 to March 2016, 54 transmen with the diagnosis of gender dysphoria who were referred to Sahlgrenska University Hospital for discussion of therapeutic steps (surgery and hormonal treatments) were asked to complete a questionnaire on different attributes achievable with GAS, such as sexual and urinary function and appearance. Forty-seven patients (87%) completed the questionnaire. Age ranged from 18 to 52 years (mean = 26 years, SD = 7.4 years). At the time of interview, no patient had undergone GAS of the genitalia. Answers to completed questionnaires. Seventy-six percent of patients identified themselves as male, and 24% wrote other terms such as "mostly male," "inter-gender" and "non-binary." Gender identity had a significant impact on patients' preferences for two questions: the importance of vaginal removal and the importance of having a penis that would be passable in places such as male dressing rooms. These items were more important to patients identifying themselves as male. The most important attributes requested were preserved orgasm ability and tactile sensation. The least important attribute was removal of the vagina, followed by having a penis of human material, minimal scarring, and size. The ability to urinate while standing was considered a high priority by some and a low priority by others. All answers ranged from "unimportant" to "imperative." This series of patients demonstrates a considerable heterogeneity among transmen in their gender identity and preferences regarding GAS of the genitalia, which supports the need for several techniques. Patients must be accurately informed on the different techniques and their specific benefits and limitations to make an informed choice. Jacobsson J, Andréasson M, Kölby L, et al. Patients' Priorities Regarding Female-to-Male Gender Affirmation Surgery of the Genitalia-A Pilot Study of 47 Patients in Sweden. J Sex Med 2017;14:857-864. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Quality of medicines commonly used in the treatment of soil transmitted helminths and giardia in ethiopia: a nationwide survey.

PubMed

Suleman, Sultan; Zeleke, Gemechu; Deti, Habtewold; Mekonnen, Zeleke; Duchateau, Luc; Levecke, Bruno; Vercruysse, Jozef; D'Hondt, Matthias; Wynendaele, Evelien; De Spiegeleer, Bart

2014-12-01

The presence of poor quality medicines in the market is a global threat on public health, especially in developing countries. Therefore, we assessed the quality of two commonly used anthelminthic drugs [mebendazole (MEB) and albendazole (ALB)] and one antiprotozoal drug [tinidazole (TNZ)] in Ethiopia. A multilevel stratified random sampling, with as strata the different levels of supply chain system in Ethiopia, geographic areas and government/privately owned medicines outlets, was used to collect the drug samples using mystery shoppers. The three drugs (106 samples) were collected from 38 drug outlets (government/privately owned) in 7 major cities in Ethiopia between January and March 2012. All samples underwent visual and physical inspection for labeling and packaging before physico-chemical quality testing and evaluated based on individual monographs in Pharmacopoeias for identification, assay/content, dosage uniformity, dissolution, disintegration and friability. In addition, quality risk was analyzed using failure mode effect analysis (FMEA) and a risk priority number (RPN) was assigned to each quality attribute. A clinically rationalized desirability function was applied in quantification of the overall quality of each medicine. Overall, 45.3% (48/106) of the tested samples were substandard, i.e. not meeting the pharmacopoeial quality specifications claimed by their manufacturers. Assay was the quality attribute most often out-of-specification, with 29.2% (31/106) failure of the total samples. The highest failure was observed for MEB (19/42, 45.2%), followed by TNZ (10/39, 25.6%) and ALB (2/25, 8.0%). The risk analysis showed that assay (RPN = 512) is the most critical quality attribute, followed by dissolution (RPN = 336). Based on Derringer's desirability function, samples were classified into excellent (14/106,13%), good (24/106, 23%), acceptable (38/106, 36%%), low (29/106, 27%) and bad (1/106,1%) quality. This study evidenced that there is a relatively high prevalence of poor quality MEB, ALB and TNZ in Ethiopia: up to 45% if pharmacopoeial acceptance criteria are used in the traditional, dichotomous approach, and 28% if the new risk-based desirability approach was applied. The study identified assay as the most critical quality attributes. The country of origin was the most significant factor determining poor quality status of the investigated medicines in Ethiopia.

Quality of Medicines Commonly Used in the Treatment of Soil Transmitted Helminths and Giardia in Ethiopia: A Nationwide Survey

PubMed Central

Suleman, Sultan; Zeleke, Gemechu; Deti, Habtewold; Mekonnen, Zeleke; Duchateau, Luc; Levecke, Bruno; Vercruysse, Jozef; D'Hondt, Matthias; Wynendaele, Evelien; De Spiegeleer, Bart

2014-01-01

Background The presence of poor quality medicines in the market is a global threat on public health, especially in developing countries. Therefore, we assessed the quality of two commonly used anthelminthic drugs [mebendazole (MEB) and albendazole (ALB)] and one antiprotozoal drug [tinidazole (TNZ)] in Ethiopia. Methods/Principal Findings A multilevel stratified random sampling, with as strata the different levels of supply chain system in Ethiopia, geographic areas and government/privately owned medicines outlets, was used to collect the drug samples using mystery shoppers. The three drugs (106 samples) were collected from 38 drug outlets (government/privately owned) in 7 major cities in Ethiopia between January and March 2012. All samples underwent visual and physical inspection for labeling and packaging before physico-chemical quality testing and evaluated based on individual monographs in Pharmacopoeias for identification, assay/content, dosage uniformity, dissolution, disintegration and friability. In addition, quality risk was analyzed using failure mode effect analysis (FMEA) and a risk priority number (RPN) was assigned to each quality attribute. A clinically rationalized desirability function was applied in quantification of the overall quality of each medicine. Overall, 45.3% (48/106) of the tested samples were substandard, i.e. not meeting the pharmacopoeial quality specifications claimed by their manufacturers. Assay was the quality attribute most often out-of-specification, with 29.2% (31/106) failure of the total samples. The highest failure was observed for MEB (19/42, 45.2%), followed by TNZ (10/39, 25.6%) and ALB (2/25, 8.0%). The risk analysis showed that assay (RPN = 512) is the most critical quality attribute, followed by dissolution (RPN = 336). Based on Derringer's desirability function, samples were classified into excellent (14/106,13%), good (24/106, 23%), acceptable (38/106, 36%%), low (29/106, 27%) and bad (1/106,1%) quality. Conclusions/Significance This study evidenced that there is a relatively high prevalence of poor quality MEB, ALB and TNZ in Ethiopia: up to 45% if pharmacopoeial acceptance criteria are used in the traditional, dichotomous approach, and 28% if the new risk-based desirability approach was applied. The study identified assay as the most critical quality attributes. The country of origin was the most significant factor determining poor quality status of the investigated medicines in Ethiopia. PMID:25473966

Bisphosphonate-related osteonecrosis of the jaws: legal liability from the perspective of the prescribing physician.

PubMed

Lo Russo, Lucio; Lo Muzio, Lorenzo; Buccelli, Claudio; Di Lorenzo, Pierpaolo

2013-09-01

Recently, it has been reported that patients administered with bisphosphonates (BP), in particular cancer patients receiving intravenous amino-bisphosphonates, as well as patients taking oral BP for prevention/treatment of diseases of altered bone turnover, may be affected by a significant adverse reaction-BP-related osteonecrosis of the jaws (BRONJ). This condition may cause high morbidity and detriment of quality of life. Its treatment is complex and often unsatisfactory, and prevention strategies may have limited effectiveness, if any; thus, BRONJ may become a source of litigation in the near future. Although most cases seem to be triggered by invasive dental procedures and oral health care providers are more exposed to malpractice claims and legal actions pursuant to BRONJ, the attribution of liability requires caution. In fact, types of possible negligence claims against oral health care providers have already been highlighted. However, according to the medico-legal methodology, since BRONJ is an adverse reaction to BP administration, the attribution of liability, if any, requires a comprehensive consideration of the chain of events and figures acting before, and potentially related to BRONJ. The physician prescribing BP at the start of this chain has specific duties which we are going to address, and breaching these duties may set the stage for potential liability claims.

Labor Needs to Adjust Compensation Benefits It Pays Injured Federal Employees to Levels Appropriate to Their Disabilities.

DTIC Science & Technology

1984-03-26

with little j likelihood of criticism from the claimant. Taken together, p. these factors tend to give examiners little motivation to estab- lish wage...claims examiners are expected to place a high priority on these tasks. Similar motivation does not exist for wage earning capacity determinations. Low 4...8217- pS4 -% ..:4.: .,.,, O :,% ’’- ,’ , , ;" , ’:",,’,i k. ’, ’, , ’ .vv

U.S.-Vietnam Relations in 2011: Current Issues and Implications for U.S. Policy

DTIC Science & Technology

2012-05-18

higher priority to cleaning up sites contaminated by Agent Orange/dioxin used by U.S. troops during the Vietnam War. Over the past several years, the two...a policy of neutrality on the claims by the parties, which also include Brunei, Indonesia, Malaysia , the Philippines, and Taiwan. Throughout 2009...territorial disputes. Roughly one and a half times the size of the Mediterranean Sea, it is ringed by China, Vietnam, Malaysia , Indonesia, Brunei

JPRS Report, Near East & South Asia

DTIC Science & Technology

1991-04-26

Arabs as through everyone’s cooperation and generosity, far from if they were in a new age of ignorance [i.e., pre-Islamic any quashing, invasion, or...Iraqi initiative encour- America claims authorized it to carry out its security role aged Iran and the Soviet Union to present initiatives, the in...America assigned refuge in another time in the past. He may choose to live higher priority to the Gulf crisis-which involved petro- in the age of Ibn

Identifying Key Attributes for Protein Beverages.

PubMed

Oltman, A E; Lopetcharat, K; Bastian, E; Drake, M A

2015-06-01

This study identified key attributes of protein beverages and evaluated effects of priming on liking of protein beverages. An adaptive choice-based conjoint study was conducted along with Kano analysis to gain insight on protein beverage consumers (n = 432). Attributes evaluated included label claim, protein type, amount of protein, carbohydrates, sweeteners, and metabolic benefits. Utility scores for levels and importance scores for attributes were determined. Subsequently, two pairs of clear acidic whey protein beverages were manufactured that differed by age of protein source or the amount of whey protein per serving. Beverages were evaluated by 151 consumers on two occasions with or without priming statements. One priming statement declared "great flavor," the other priming statement declared 20 g protein per serving. A two way analysis of variance was applied to discern the role of each priming statement. The most important attribute for protein beverages was sweetener type, followed by amount of protein, followed by type of protein followed by label claim. Beverages with whey protein, naturally sweetened, reduced sugar and ≥15 g protein per serving were most desired. Three consumer clusters were identified, differentiated by their preferences for protein type, sweetener and amount of protein. Priming statements positively impacted concept liking (P < 0.05) but had no effect on overall liking (P > 0.05). Consistent with trained panel profiles of increased cardboard flavor with higher protein content, consumers liked beverages with 10 g protein more than beverages with 20 g protein (6.8 compared with 5.7, P < 0.05). Protein beverages must have desirable flavor for wide consumer appeal. © 2015 Institute of Food Technologists®

Asymmetrical knowledge claims in general practice consultations with frequently attending patients: limitations and opportunities for patient participation.

PubMed

Ariss, Steven M

2009-09-01

Asymmetry of knowledge does not simply relate to knowing or not knowing. Participants in consultations also display normative entitlements to knowledge which are related to their identities in the interaction. Claims of entitlement to knowledge are oriented to by the other participant as either straightforwardly acceptable or problematic. Thus research has shown that asymmetry in doctor-patient interactions is collaboratively achieved. Whilst the asymmetry of medical consultations has long been recognised, understanding asymmetry in the context of patient participation is becoming an increasingly important priority. This paper is not concerned with potential benefits or the feasibility of increasing patient participation in general practice (GP) consultations. Rather it seeks to describe specific limitations and opportunities for the participation of patients regarding the discussion of their problems, treatments and management of illness. Using Conversation Analysis this paper investigates GP consultations with frequently attending patients in the UK. It describes how the moral dimensions of epistemic authority constrain the different conversational resources available to GPs and patients. Findings suggest that in maintaining asymmetrical claims to knowledge debate is foregone in favour of efficient progression through the phases of the interaction. Thus interactions militate against the discussion of areas where alignment of perspectives might be lacking and participants do not pursue actions which might lead towards claiming a greater understanding of each others' point of view. However, there are aspects of consultations with frequently attending patients which display reduced asymmetry with regard to participants' claims to epistemic authority.

An assessment of implementation and evaluation phases of strategic plans in Iranian hospitals.

PubMed

Sadeghifar, Jamil; Tofighi, Shahram; Roshani, Mohamad; Toulideh, Zahra; Mohsenpour, Seyedramezan; Jafari, Mehdi

2017-01-01

To assess the implementation and evaluation phases of strategic plans in selected hospitals. We conducted a cross-sectional study of implementation and evaluation of strategic plan in 24 hospitals in 2015, using a questionnaire which consisted of two separate sections for strategic implementation and strategic evaluation. Data were analyzed with SPSS version 18. Nearly one-third of hospitals claimed that they allocate their budget based on priorities and strategic goals. However, it turned out that although goals had been set, no formal announcements had been made. Most of the hospitals stated that they used measures when evaluating the plan. For hospital staff, clarifying the hospital's priorities was the most important advantage of a strategic plan. There is no clear definition for strategic management in Iranian hospitals, which results in chaotic implementation and control of strategic planning.

Small-molecule inhibitors of hepatitis C virus (HCV) non-structural protein 5A (NS5A): a patent review (2010-2015).

PubMed

Ivanenkov, Yan A; Aladinskiy, Vladimir A; Bushkov, Nikolay A; Ayginin, Andrey A; Majouga, Alexander G; Ivachtchenko, Alexandre V

2017-04-01

Non-structural 5A (NS5A) protein has achieved a considerable attention as an attractive target for the treatment of hepatitis C (HCV). A number of novel NS5A inhibitors have been reported to date. Several drugs having favorable ADME properties and mild side effects were launched into the pharmaceutical market. For instance, daclatasvir was launched in 2014, elbasvir is currently undergoing registration, ledipasvir was launched in 2014 as a fixed-dose combination with sofosbuvir (NS5B inhibitor). Areas covered: Thomson integrity database and SciFinder database were used as a valuable source to collect the patents on small-molecule NS5A inhibitors. All the structures were ranked by the date of priority. Patent holder and antiviral activity for each scaffold claimed were summarized and presented in a convenient manner. A particular focus was placed on the best-in-class bis-pyrrolidine-containing NS5A inhibitors. Expert opinion: Several first generation NS5A inhibitors have recently progressed into advanced clinical trials and showed superior efficacy in reducing viral load in infected subjects. Therapy schemes of using these agents in combination with other established antiviral drugs with complementary mechanisms of action can address the emergence of resistance and poor therapeutic outcome frequently attributed to antiviral drugs.

Economic cost and epidemiological characteristics of patients with fibromyalgia claims.

PubMed

Robinson, Rebecca L; Birnbaum, Howard G; Morley, Melissa A; Sisitsky, Tamar; Greenberg, Paul E; Claxton, Ami J

2003-06-01

Fibromyalgia (FM) is characterized by widespread pain that can lead to significant patient disability, complex management decisions for physicians, and economic burden on society. We investigated the total costs of FM in an employer population. Administrative claims data of a Fortune 100 manufacturer were used to quantify direct (i.e., medical and pharmaceutical claims) and indirect (i.e., disability claims and imputed absenteeism) costs associated with FM. A total of 4699 patients with at least one FM claim between 1996 and 1998 were contrasted with a 10% random sample of the overall beneficiary population. Employee-only subsets of both samples also were drawn. Medical utilization, receipt of prescription drugs, and annual total costs were proportionately similar yet significantly greater among FM claimants than the overall sample (all p < 0.0001). Total annual costs for FM claimants were $5945 versus $2486 for the typical beneficiary (p < 0.0001). Six percent of these costs were attributable to FM-specific claims. The prevalence of disability was twice as high among FM employees than overall employees (p < 0.0001). For every dollar spent on FM-specific claims, the employer spent another $57 to $143 on additional direct and indirect costs. Hidden costs of disability and comorbidities greatly increase the true burden of FM. Regardless of the clinical understanding of FM, when a claim for FM is present, considerable costs are involved. Findings suggest that within the management of FM there may be large cost-offset opportunities for reductions in patient, physician, and employer burdens.

Consumer understanding, interpretation and perceived levels of personal responsibility in relation to satiety-related claims.

PubMed

Bilman, Els M; Kleef, Ellen van; Mela, David J; Hulshof, Toine; van Trijp, Hans C M

2012-12-01

The aim of this study was to explore (a) whether and how consumers may (over-) interpret satiety claims, and (b) whether and to what extent consumers recognize that personal efforts are required to realize possible satiety-related or weight loss benefits. Following means-end chain theory, we explored for a number of satiety claims the extent of inference-making to higher-level benefits than actually stated in the claim, using internet-based questions and tasks. Respondents (N=1504) in U.K., France, Italy and Germany participated in the study. The majority of these respondents correctly interpret satiety-related claims; i.e. they largely limit their interpretation to what was actually stated. They do not expect a "magic bullet" effect, but understand that personal efforts are required to translate product attributes into potential weight control benefits. Less-restrained eaters were at lower risk for over-interpreting satiety-related claims, whilst respondents with a stronger belief that their weight is something that they can control accept more personal responsibility, and better understand that personal efforts are required to be effective in weight control. Overall, these results indicate there is likely to be a relatively low level of consumer misinterpretation of satiety-related claims on food products. Copyright © 2012 International Life Sciences Institute. Published by Elsevier Ltd.. All rights reserved.

Geospatial Analysis for Flood-Risk Management, Resilience, and US Policy

NASA Astrophysics Data System (ADS)

Pinter, N.; Hui, R.; Conrad, D. R.; Schaefer, K.

2016-12-01

The National Flood Insurance Program (NFIP) was established in 1968 to curtail unfettered development on US floodplains and spiraling taxpayer expenditures for disaster relief. Currently NFIP underwrites >5 million policies, providing >1.25 trillion in coverage, and taking in >3.5 billion in annual premiums. Cumulative flood-damage payouts to date exceed premiums collected by >$20 billion. Our group has obtained nationwide databases of NFIP flood-damage claims back to 1972, annual policies since 1994, and selective Federal Emergency Management Agency (FEMA) repetitive losses. Attributes include property, claims, and loss characteristics. Other attributes were stripped to maintain policyholder anonymity. At present, locations are to the nearest 0.1° lat/long, zip code, and by community. We combine NFIP data with GIS information from a variety of other sources. Over the past 44 years, 1,625,470 non-zero flood claims are documented. Numbers of claims and losses have increased over time, even with extreme events (Hurricanes Katrina and Sandy) excluded. Flood losses have occurred within 100-year floodplains (1% annual exceedance), in coastal hazard zones, and 25% of claims occur outside of mapped flood-hazard areas. We hypothesize that a many losses outside of FEMA's designated Special Flood Hazard Area (SFHA) correlate with (1) outdated map panels, (2) contrasting levels of enforcement and mitigation by state. Other distributed flood losses represent stormwater/drainage damage. Claim rates substantially exceed 1%, both in and outside the SFHA, and for "pre-FIRM" and "post-FIRM" structures. This suggests that ≥100-year floods are occurring more frequently than statutory frequencies suggest. For US homeowners, this suggests that flood insurance is a good deal in a variety of settings. The NFIP data analyzed here contrasts with our group's previous, largely model-driven research. Such empirical flood data exclude model assumptions, but add dizzying array of human and political factors into the resulting spatial and temporal patterns. Parsing out the hydrologic, climatic, social, and political factors influencing flood risk and resilience is crucial for sound management of NFIP and other programs. The US Congress will debate reauthorization and possible revision of NFIP in 2017.

The priority of Antonino D'Antona in describing rhabdomyolysis with acute kidney injury, following the Messina earthquake (December 28, 1908). Commentary.

PubMed

De Santo, Natale Gaspare; Bisaccia, Carmela; De Santo, Luca Salvatore

2016-01-01

Following the Messina-Reggio Calabria earthquake (December 28, 1908) outstanding medical reports were published by Franz von Colmers (1875-1960), Antonino D'Antona (1842-1913), and Rocco Caminiti (1868-1940). The reports of D'Antona and Caminiti were heretofore neglected. Colmers, D'Antona and Caminiti described crush-syndrome. D'Antona who cured patients in shock also described two deaths due to uraemia. This gives him a priority in the description of crush syndrome with renal injury which has been traditionally attributed to Bywaters and Beall.

A Multi-Attribute-Utility-Theory Model that Minimizes Interview-Data Requirements: A Consolidation of Space Launch Decisions.

DTIC Science & Technology

1994-12-01

satel~ lites on th" .gruunu" U, .U,- orbit affects the priority given to a new launch. Table 3.9 Launch Priorities Level Level Title Description 0.00 No...value of a satellite’s mission(s) relative to the misston(s) of other sate• lites As such the rating given may reflect an endre class of satellites for...Expected Remaining Lifetime 0 Years Assign a number between 0 and I that best describes the utility of a sate; lite ’,th Vh,,V- ,ta .=.... ,. A at these

Use of structured decision making to identify monitoring variables and management priorities for salt marsh ecosystems

USGS Publications Warehouse

Neckles, Hilary A.; Lyons, James E.; Guntenspergen, Glenn R.; Shriver, W. Gregory; Adamowicz, Susan C.

2015-01-01

Most salt marshes in the USA have been degraded by human activities, and coastal managers are faced with complex choices among possible actions to restore or enhance ecosystem integrity. We applied structured decision making (SDM) to guide selection of monitoring variables and management priorities for salt marshes within the National Wildlife Refuge System in the northeastern USA. In general, SDM is a systematic process for decomposing a decision into its essential elements. We first engaged stakeholders in clarifying regional salt marsh decision problems, defining objectives and attributes to evaluate whether objectives are achieved, and developing a pool of alternative management actions for achieving objectives. Through this process, we identified salt marsh attributes that were applicable to monitoring National Wildlife Refuges on a regional scale and that targeted management needs. We then analyzed management decisions within three salt marsh units at Prime Hook National Wildlife Refuge, coastal Delaware, as a case example of prioritizing management alternatives. Values for salt marsh attributes were estimated from 2 years of baseline monitoring data and expert opinion. We used linear value modeling to aggregate multiple attributes into a single performance score for each alternative, constrained optimization to identify alternatives that maximized total management benefits subject to refuge-wide cost constraints, and used graphical analysis to identify the optimal set of alternatives for the refuge. SDM offers an efficient, transparent approach for integrating monitoring into management practice and improving the quality of management decisions.

Review and resolution of some nomenclatural issues regarding the genus Psoroptes (Acari: Psoroptidae), scab-mites of domestic and wild mammals.

PubMed

OConnor, Barry M; Klimov, Pavel B

2015-07-01

Some classifications recognize a number of species in the scab-mite genus, Psoroptes, mites that are of considerable importance in livestock production and veterinary medicine. However, modern studies suggest that populations from some host species are not morphologically or genetically distinct, creating taxonomic confusion with older names, which treated mites from different hosts as separate species. We review the taxonomy and nomenclature of the genus and the two oldest binomens, most recently known as Psoroptes ovis and Psoroptes equi. Prior authors have attributed these names to various authorities, with most attributing both names to Hering (Nova Acta Phys-Med Acad Caesar Leopold-Carol Nat Curios 18(2):573-624, 1838). In particular, the priority between these names was recently a point of contention, with P. ovis being treated as junior synonym of P. equi. A review of all relevant nineteenth and twentieth century publications indicates, however, that these binomens should be cited as P. ovis (Viborg in Veterinair-Selskabets Skrifter 2:139-152, 1813) and P. equi (Raspail in Bull gener Theraput Med Chir 7:169-184, 1834), with the former having priority over the latter assuming their conspecificity. We also clarify attribution of the authorship and the type species of the genus Psoroptes.

'Appeals to nature' in marriage equality debates: A content analysis of newspaper and social media discourse.

PubMed

O'Connor, Cliodhna

2017-09-01

In May 2015, Ireland held a referendum to legalize same-sex marriage, which passed with 62% of the vote. This study explores the role played by 'appeals to nature' in the referendum debate. Little research has investigated how biological attributions are spontaneously generated in real-world discourse regarding sexual rights. Through content analysis of newspaper and Twitter discussion of the referendum, this study aims to (1) establish the frequency of appeals to nature and their distribution across the various 'sides' of the debate and (2) analyse the forms these natural claims took and the rhetorical functions they fulfilled. Appeals to nature occurred in a minority of media discussion of the referendum (13.6% of newspaper articles and .3% of tweets). They were more prominent in material produced by anti-marriage equality commentators. Biological attributions predominantly occurred in relation to parenthood, traditional marriage, gender, and homosexuality. The article analyses the rhetorical dynamics of these natural claims and considers the implications for marriage equality research and activism. The analysis suggests appeals to nature allow anti-marriage equality discourse adapt to a cultural context that proscribes outright disapproval of same-sex relationships. However, it also queries whether previous research has overemphasized the significance of biological attributions in discourse about groups' rights. © 2017 The British Psychological Society.

Sequencing actions: an information-search study of tradeoffs of priorities against spatiotemporal constraints.

PubMed

Gärling, T

1996-09-01

How people choose between sequences of actions was investigated in an everyday errand-planning task. In this task subjects chose the preferred sequence of performing a number of errands in a fictitious environment. Two experiments were conducted with undergraduate students serving as subjects. One group searched information about each alternative. The same information was directly available to another group. In Experiment 1 the results showed that for two errands subjects took into account all attributes describing the errands, thus suggesting a tradeoff between priority, wait time, and travel distance with priority being the most important. Consistent with this finding predominantly intraalternative information search was observed. These results were replicated in Experiment 2 for three errands. In addition choice outcomes, information search, and sequence of responding suggested that for more than two actions sequence choices are made in stages.

Virtual network embedding in cross-domain network based on topology and resource attributes

NASA Astrophysics Data System (ADS)

Zhu, Lei; Zhang, Zhizhong; Feng, Linlin; Liu, Lilan

2018-03-01

Aiming at the network architecture ossification and the diversity of access technologies issues, this paper researches the cross-domain virtual network embedding algorithm. By analysing the topological attribute from the local and global perspective of nodes in the virtual network and the physical network, combined with the local network resource property, we rank the embedding priority of the nodes with PCA and TOPSIS methods. Besides, the link load distribution is considered. Above all, We proposed an cross-domain virtual network embedding algorithm based on topology and resource attributes. The simulation results depicts that our algorithm increases the acceptance rate of multi-domain virtual network requests, compared with the existing virtual network embedding algorithm.

26 CFR 1.6664-2 - Underpayment.

Code of Federal Regulations, 2013 CFR

2013-04-01

... withheld at source on nonresident aliens and foreign corporations); (2) Payments of tax or estimated tax by... on nonresident aliens and foreign corporations), as payments of estimated tax, or as any other... taxable year claiming tax benefits attributable to the existence of the account. On March 21, 2005...

26 CFR 1.6664-2 - Underpayment.

Code of Federal Regulations, 2012 CFR

2012-04-01

... withheld at source on nonresident aliens and foreign corporations); (2) Payments of tax or estimated tax by... on nonresident aliens and foreign corporations), as payments of estimated tax, or as any other... taxable year claiming tax benefits attributable to the existence of the account. On March 21, 2005...

16 CFR 260.2 - Scope of guides.

Code of Federal Regulations, 2012 CFR

2012-01-01

... directly or by implication, through words, symbols, emblems, logos, depictions, product brand names, or... electronic mail. The guides apply to any claim about the environmental attributes of a product, package or service in connection with the sale, offering for sale, or marketing of such product, package or service...

45 CFR 149.100 - Amount of reimbursement.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS... reimbursement in the amount of 80 percent of the costs for health benefits (net of negotiated price concessions for health benefits) for claims incurred during the plan year that are attributed to health benefits...

Towards An Engineering Discipline of Computational Security

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

Mili, Ali; Sheldon, Frederick T; Jilani, Lamia Labed

2007-01-01

George Boole ushered the era of modern logic by arguing that logical reasoning does not fall in the realm of philosophy, as it was considered up to his time, but in the realm of mathematics. As such, logical propositions and logical arguments are modeled using algebraic structures. Likewise, we submit that security attributes must be modeled as formal mathematical propositions that are subject to mathematical analysis. In this paper, we approach this problem by attempting to model security attributes in a refinement-like framework that has traditionally been used to represent reliability and safety claims. Keywords: Computable security attributes, survivability, integrity,more » dependability, reliability, safety, security, verification, testing, fault tolerance.« less

An assessment of implementation and evaluation phases of strategic plans in Iranian hospitals

PubMed Central

Sadeghifar, Jamil; Tofighi, Shahram; Roshani, Mohamad; Toulideh, Zahra; Mohsenpour, Seyedramezan; Jafari, Mehdi

2017-01-01

Objectives: To assess the implementation and evaluation phases of strategic plans in selected hospitals. Methods: We conducted a cross-sectional study of implementation and evaluation of strategic plan in 24 hospitals in 2015, using a questionnaire which consisted of two separate sections for strategic implementation and strategic evaluation. Data were analyzed with SPSS version 18. Results: Nearly one-third of hospitals claimed that they allocate their budget based on priorities and strategic goals. However, it turned out that although goals had been set, no formal announcements had been made. Most of the hospitals stated that they used measures when evaluating the plan. For hospital staff, clarifying the hospital’s priorities was the most important advantage of a strategic plan. Conclusion: There is no clear definition for strategic management in Iranian hospitals, which results in chaotic implementation and control of strategic planning. PMID:29085637

A study in the founding of applied behavior analysis through its publications.

PubMed

Morris, Edward K; Altus, Deborah E; Smith, Nathaniel G

2013-01-01

This article reports a study of the founding of applied behavior analysis through its publications. Our methods included hand searches of sources (e.g., journals, reference lists), search terms (i.e., early, applied, behavioral, research, literature), inclusion criteria (e.g., the field's applied dimension), and (d) challenges to their face and content validity. Our results were 36 articles published between 1959 and 1967 that we organized into 4 groups: 12 in 3 programs of research and 24 others. Our discussion addresses (a) limitations in our method (e.g., the completeness of our search), (b) challenges to the validity of our methods and results (e.g., convergent validity), and (c) priority claims about the field's founding. We conclude that the claims are irresolvable because identification of the founding publications depends significantly on methods and because the field's founding was an evolutionary process. We close with suggestions for future research.

Financial protection against nuclear hazards: thirty years' experience under the Price-Anderson Act

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

Not Available

1984-01-01

Supplementing earlier reports on ways to provide financial protection against the potential hazards involved in the production of nuclear energy by analyzing the issues raised in the Silkwood v. Kerr-McGee Corporation decision, the author explores the impact of the case on the availability of funds to compensate the public and any increased exposure of the nuclear industry or the federal government to public liability. She concludes that the decision will have a significant impact on the day-to-day administration of claims, and could lead to higher premiums. The court would have to determine the priority given to claims in the eventmore » of a catastrophic accident, in which case the only significant impact would be under amendments to the Price-Anderson Act which resulted in elimination of its coverage or a substantial increase in or elimination of the limitation on liability.« less

A Study in the Founding of Applied Behavior Analysis Through Its Publications

PubMed Central

Morris, Edward K.; Altus, Deborah E.; Smith, Nathaniel G.

2013-01-01

This article reports a study of the founding of applied behavior analysis through its publications. Our methods included hand searches of sources (e.g., journals, reference lists), search terms (i.e., early, applied, behavioral, research, literature), inclusion criteria (e.g., the field's applied dimension), and (d) challenges to their face and content validity. Our results were 36 articles published between 1959 and 1967 that we organized into 4 groups: 12 in 3 programs of research and 24 others. Our discussion addresses (a) limitations in our method (e.g., the completeness of our search), (b) challenges to the validity of our methods and results (e.g., convergent validity), and (c) priority claims about the field's founding. We conclude that the claims are irresolvable because identification of the founding publications depends significantly on methods and because the field's founding was an evolutionary process. We close with suggestions for future research. PMID:25729133

Will my malpractice case be settled? The physician-defendant's voice in the decision.

PubMed

Archambault, William H

2007-05-01

Malpractice claims are an unavoidable part of the practice of clinical medicine. Physicians purchase professional liability insurance to protect themselves from financial and other adverse consequences of such claims. Insurance policies require the insurer to hire attorneys to represent, defend and advise physicians who are named as defendants in medical malpractice lawsuits. Insurance policies require insurers to pay the costs associated with defending the lawsuit and paying, within policy limits, any damages for which a physician is determined to be liable. The relationship between insurer, defense counsel and physician can be complicated by divergent interests, concerns and priorities. It is important for physicians to be knowledgeable consumers when they are in the market for malpractice coverage. Familiarity with types of coverage, controls placed on defense costs and policy terms that determine decision-making authority on settlement issues are essential to making an informed purchase of insurance coverage.

Quality Attributes for Mission Flight Software: A Reference for Architects

NASA Technical Reports Server (NTRS)

Wilmot, Jonathan; Fesq, Lorraine; Dvorak, Dan

2016-01-01

In the international standards for architecture descriptions in systems and software engineering (ISO/IEC/IEEE 42010), "concern" is a primary concept that often manifests itself in relation to the quality attributes or "ilities" that a system is expected to exhibit - qualities such as reliability, security and modifiability. One of the main uses of an architecture description is to serve as a basis for analyzing how well the architecture achieves its quality attributes, and that requires architects to be as precise as possible about what they mean in claiming, for example, that an architecture supports "modifiability." This paper describes a table, generated by NASA's Software Architecture Review Board, which lists fourteen key quality attributes, identifies different important aspects of each quality attribute and considers each aspect in terms of requirements, rationale, evidence, and tactics to achieve the aspect. This quality attribute table is intended to serve as a guide to software architects, software developers, and software architecture reviewers in the domain of mission-critical real-time embedded systems, such as space mission flight software.

Individualism-collectivism and personality.

PubMed

Triandis, H C

2001-12-01

This paper provides a review of the main findings concerning the relationship between the cultural syndromes of individualism and collectivism and personality. People in collectivist cultures, compared to people in individualist cultures, are likely to define themselves as aspects of groups, to give priority to in-group goals, to focus on context more than the content in making attributions and in communicating, to pay less attention to internal than to external processes as determinants of social behavior, to define most relationships with ingroup members as communal, to make more situational attributions, and tend to be self-effacing.

Reasoning about knowledge: Children's evaluations of generality and verifiability.

PubMed

Koenig, Melissa A; Cole, Caitlin A; Meyer, Meredith; Ridge, Katherine E; Kushnir, Tamar; Gelman, Susan A

2015-12-01

In a series of experiments, we examined 3- to 8-year-old children's (N=223) and adults' (N=32) use of two properties of testimony to estimate a speaker's knowledge: generality and verifiability. Participants were presented with a "Generic speaker" who made a series of 4 general claims about "pangolins" (a novel animal kind), and a "Specific speaker" who made a series of 4 specific claims about "this pangolin" as an individual. To investigate the role of verifiability, we systematically varied whether the claim referred to a perceptually-obvious feature visible in a picture (e.g., "has a pointy nose") or a non-evident feature that was not visible (e.g., "sleeps in a hollow tree"). Three main findings emerged: (1) young children showed a pronounced reliance on verifiability that decreased with age. Three-year-old children were especially prone to credit knowledge to speakers who made verifiable claims, whereas 7- to 8-year-olds and adults credited knowledge to generic speakers regardless of whether the claims were verifiable; (2) children's attributions of knowledge to generic speakers was not detectable until age 5, and only when those claims were also verifiable; (3) children often generalized speakers' knowledge outside of the pangolin domain, indicating a belief that a person's knowledge about pangolins likely extends to new facts. Findings indicate that young children may be inclined to doubt speakers who make claims they cannot verify themselves, as well as a developmentally increasing appreciation for speakers who make general claims. Copyright © 2015 Elsevier Inc. All rights reserved.

Reasoning about knowledge: Children’s evaluations of generality and verifiability

PubMed Central

Koenig, Melissa A.; Cole, Caitlin A.; Meyer, Meredith; Ridge, Katherine E.; Kushnir, Tamar; Gelman, Susan A.

2015-01-01

In a series of experiments, we examined 3- to 8-year-old children’s (N = 223) and adults’ (N = 32) use of two properties of testimony to estimate a speaker’s knowledge: generality and verifiability. Participants were presented with a “Generic speaker” who made a series of 4 general claims about “pangolins” (a novel animal kind), and a “Specific speaker” who made a series of 4 specific claims about “this pangolin” as an individual. To investigate the role of verifiability, we systematically varied whether the claim referred to a perceptually-obvious feature visible in a picture (e.g., “has a pointy nose”) or a non-evident feature that was not visible (e.g., “sleeps in a hollow tree”). Three main findings emerged: (1) Young children showed a pronounced reliance on verifiability that decreased with age. Three-year-old children were especially prone to credit knowledge to speakers who made verifiable claims, whereas 7- to 8-year-olds and adults credited knowledge to generic speakers regardless of whether the claims were verifiable; (2) Children’s attributions of knowledge to generic speakers was not detectable until age 5, and only when those claims were also verifiable; (3) Children often generalized speakers’ knowledge outside of the pangolin domain, indicating a belief that a person’s knowledge about pangolins likely extends to new facts. Findings indicate that young children may be inclined to doubt speakers who make claims they cannot verify themselves, as well as a developmentally increasing appreciation for speakers who make general claims. PMID:26451884

Priorities for injury prevention in women's Australian football: a compilation of national data from different sources.

PubMed

Fortington, Lauren V; Finch, Caroline F

2016-01-01

Participation in Australian football (AF) has traditionally been male dominated and current understanding of injury and priorities for prevention are based solely on reports of injuries in male players. There is evidence in other sports that indicates that injury types differ between males and females. With increasing participation in AF by females, it is important to consider their specific injury and prevention needs. This study aimed to provide a first injury profile from existing sources for female AF. Compilation of injury data from four prospectively recorded data sets relating to female AF: (1) hospital admissions in Victoria, 2008/09-13/14, n=500 injuries; (2) emergency department (ED) presentations in Victoria, 2008/09-2012/13, n=1,879 injuries; (3) insurance claims across Australia 2004-2013, n=522 injuries; (4) West Australian Women's Football League (WAWFL), 2014 season club data, n=49 injuries. Descriptive results are presented as injury frequencies, injury types and injury to body parts. Hospital admissions and ED presentations were dominated by upper limb injuries, representing 47% and 51% of all injuries, respectively, primarily to the wrist/hand at 32% and 40%. Most (65%) insurance claim injuries involved the lower limb, 27% of which were for knee ligament damage. A high proportion of concussions (33%) were reported in the club-collected data. The results provide the first compilation of existing data sets of women's AF injuries and highlight the need for a rigorous and systematic injury surveillance system to be instituted.

AIDS funding: competing needs and the politics of priorities.

PubMed

Krieger, N

1988-01-01

Despite the Department of Health and Human Service's 1983 claim that AIDS is the nation's "number one health priority," funding for AIDS research, prevention, and treatment remains inadequate. Worse, it is often marshaled from or juxtaposed against other necessary health allocations. Consequent AIDS-related resource crises include diverting funds for research on other diseases to AIDS investigations, propping up AIDS prevention efforts at the expense of traditional sexually transmitted disease control programs, and pitting the health needs of AIDS patients against the needs of those seeking other urgent health services, e.g., prenatal care. While this forced competition typically is blamed on fiscal constraints, examination of federal spending priorities suggests that it results principally from Reagan Administration policies. This Administration has consistently boosted military spending at the expense of social and health services, and has deliberately undermined efforts to obtain sufficient and new allocations for AIDS. In order to avert political divisions spurred by competition for currently scarce resources, AIDS and other health activists together must argue that excessive military allocations must be shifted to health research and services, and that a national health program must be implemented, if AIDS programs are to be funded appropriately without jeopardizing other necessary health initiatives.

Prevalence rates for depression by industry: a claims database analysis.

PubMed

Wulsin, Lawson; Alterman, Toni; Timothy Bushnell, P; Li, Jia; Shen, Rui

2014-11-01

To estimate and interpret differences in depression prevalence rates among industries, using a large, group medical claims database. Depression cases were identified by ICD-9 diagnosis code in a population of 214,413 individuals employed during 2002-2005 by employers based in western Pennsylvania. Data were provided by Highmark, Inc. (Pittsburgh and Camp Hill, PA). Rates were adjusted for age, gender, and employee share of health care costs. National industry measures of psychological distress, work stress, and physical activity at work were also compiled from other data sources. Rates for clinical depression in 55 industries ranged from 6.9 to 16.2 %, (population rate = 10.45 %). Industries with the highest rates tended to be those which, on the national level, require frequent or difficult interactions with the public or clients, and have high levels of stress and low levels of physical activity. Additional research is needed to help identify industries with relatively high rates of depression in other regions and on the national level, and to determine whether these differences are due in part to specific work stress exposures and physical inactivity at work. Claims database analyses may provide a cost-effective way to identify priorities for depression treatment and prevention in the workplace.

Proper Names: Reference and Attribution

ERIC Educational Resources Information Center

Maumus, Michael Fletcher

2012-01-01

In the wake of Saul Kripke's landmark "Naming and Necessity," the claim that proper names are directly referential expressions devoid of descriptive content has come to verge on philosophical commonplace. Nevertheless, the return to a purely referential semantics for proper names has coincided with the resurgence of the very puzzles…

48 CFR 5231.205-90 - Shipbuilding capability preservation agreements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... an incentive for a shipbuilder to obtain new private sector work, thereby reducing the Navy's cost of... agreement permits the contractor to claim certain indirect costs attributable to its private sector work as... subsection, means an additional indirect cost that results from performing private sector work described in a...

Everything You Ought to Know About the Liability Insurance Crisis but Didn't Know How to Ask.

ERIC Educational Resources Information Center

Direnfeld-Michael, Bonnie; Michael, David R.

1987-01-01

A great deal of the current liability insurance crisis can be attributed to the industry itself. This article discusses insurance cyles, cash flow underwriting, reinsurance, company "capacity", rates determination, "claims-made" coverage of accidents, and regulation of the industry. (JD)

Interpersonal Consequences of Sex-Typing and Androgyny: A Behavioral Analysis.

ERIC Educational Resources Information Center

Kelly, Jeffrey A.; And Others

New measures of sex role style assess the respondent's self-attribution of sex-typed interpersonal characteristics. In light of claims that androgynous roles are related to behavioral flexibility, the current study investigated the relationship between sex role orientations and performance in interpersonal situations. Males and females in each of…

The Folk Conception of Knowledge

ERIC Educational Resources Information Center

Starmans, Christina; Friedman, Ori

2012-01-01

How do people decide which claims should be considered mere beliefs and which count as knowledge? Although little is known about how people attribute knowledge to others, philosophical debate about the nature of knowledge may provide a starting point. Traditionally, a belief that is both true and justified was thought to constitute knowledge.…

Who Killed John Keats?

ERIC Educational Resources Information Center

Leal, Amy

2007-01-01

Two months before he died, John Keats claimed he had been poisoned. Although most scholars and biographers have attributed Keats's fears of persecution, betrayal, and murder to consumptive dementia, Keats's suspicions had begun long before 1820 and were not without some justification. In this article, the author talks about the death of John…

Interim evaluation of the effect of a new scrum law on neck and back injuries in rugby union.

PubMed

Gianotti, S; Hume, P A; Hopkins, W G; Harawira, J; Truman, R

2008-06-01

In January 2007 the International Rugby Board implemented a new law for scrum engagement aimed at improving player welfare by reducing impact force and scrum collapses. In New Zealand the new law was included in RugbySmart, an annual compulsory workshop for coaches and referees. To determine the effect of the new law on scrum-related moderate to serious neck and back injury claims in 2007. Claims filed with the Accident Compensation Corporation (the provider of no-fault injury compensation and rehabilitation in New Zealand) were combined with numbers of registered players to estimate moderate to serious scrum-related claims for players who take part in scrums (forwards). Poisson linear regression was used to compare the observed claims per 100 000 forwards for 2007 with the rate predicted from data for 2002-6. The observed and predicted claims per 100 000 forwards were 52 and 76, respectively (rate ratio 0.69; 90% CI 0.42 to 1.12). The likelihoods of substantial benefit (rate ratio <0.90) and harm (rate ratio >1.1) attributable to the scrum law were 82% and 5%, respectively. The decline in scrum-related injury claims is consistent with a beneficial effect of the new scrum law in the first year of its implementation. Another year of monitoring should provide more evidence for the efficacy of the new law.

Estimating organic, local, and other price premiums in the Hawaii fluid milk market.

PubMed

Loke, Matthew K; Xu, Xun; Leung, PingSun

2015-04-01

With retail scanner data, we applied hedonic price modeling to explore price premiums for organic, local, and other product attributes of fluid milk in Hawaii. Within the context of revealed preference, this analysis of organic and local attributes, under a single unified framework, is significant, as research in this area is deficient in the existing literature. This paper finds both organic and local attributes delivered price premiums over imported, conventional, whole fluid milk. However, the estimated price premium for organic milk (24.6%) is significantly lower than findings in the existing literature. Likewise, the price premium for the local attribute is estimated at 17.4%, again substantially lower compared with an earlier, stated preference study in Hawaii. Beyond that, we estimated a robust price premium of 19.7% for nutritional benefits claimed. The magnitude of this estimated coefficient reinforces the notion that nutrition information on food is deemed beneficial and valuable. Finally, package size measures the influence of product weight. With each larger package size, the estimate led to a corresponding larger price discount. This result is consistent with the practice of weight discounting that retailers usually offer with fresh packaged food. Additionally, we estimated a fairly high Armington elasticity of substitution, which suggests a relatively high degree of substitution between local and imported fluid milk when their relative price changes. Overall, this study establishes price premiums for organic, local, and nutrition benefits claimed for fluid milk in Hawaii. Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Mental Health Priorities: Stigma Elimination and Community Advocacy in College Settings

ERIC Educational Resources Information Center

Michaels, Patrick J.; Corrigan, Patrick W.; Kanodia, Nupur; Buchholz, Blythe; Abelson, Sara

2015-01-01

Low rates of psychological help-seeking among college students have been attributed to a lack of awareness about on-campus resources and to mental illness stigma. One mental health advocacy organization, Active Minds, collaborates with its university-recognized student-run on-campus chapters to promote service use and psychological healthy…

A GIS-BASED METHOD FOR MULTI-OBJECTIVE EVALUATION OF PARK VEGETATION. (R824766)

EPA Science Inventory

Abstract

In this paper we describe a method for evaluating the concordance between a set of mapped landscape attributes and a set of quantitatively expressed management priorities. The method has proved to be useful in planning urban green areas, allowing objectively d...

Experientially Learning and Teaching in a Student-Directed Classroom

ERIC Educational Resources Information Center

Breunig, Mary

2017-01-01

There exists a relatively coherent body of research relevant to problem-based and transformational learning but too few studies that have empirically explored the many anecdotal claims of the attributes of experiential, student-directed pedagogy. The purpose of this present study was to explore students' and professor experiences with/in a…

An Investigation of Lebanese G7-12 Students' Misconceptions and Difficulties in Genetics and Their Genetics Literacy

ERIC Educational Resources Information Center

Osman, Enja; BouJaoude, Saouma; Hamdan, Hiba

2017-01-01

Lebanese educators claim that middle and secondary school students exhibit poor understanding of genetics due to misconceptions and difficulties that hinder progression in conceptual understanding of major genetics concepts and phenomena across different grade levels. They attributed these problems to Lebanon's ill-structured genetics curriculum…

Inferencing Processes after Right Hemisphere Brain Damage: Effects of Contextual Bias

ERIC Educational Resources Information Center

Blake, Margaret Lehman

2009-01-01

Purpose: Comprehension deficits associated with right hemisphere brain damage (RHD) have been attributed to an inability to use context, but there is little direct evidence to support the claim. This study evaluated the effect of varying contextual bias on predictive inferencing by adults with RHD. Method: Fourteen adults with no brain damage…

Applying Econometrics to the Carbon Dioxide “Control Knob”

PubMed Central

Curtin, Timothy

2012-01-01

This paper tests various propositions underlying claims that observed global temperature change is mostly attributable to anthropogenic noncondensing greenhouse gases, and that although water vapour is recognized to be a dominant contributor to the overall greenhouse gas (GHG) effect, that effect is merely a “feedback” from rising temperatures initially resulting only from “non-condensing” GHGs and not at all from variations in preexisting naturally caused atmospheric water vapour (i.e., [H2O]). However, this paper shows that “initial radiative forcing” is not exclusively attributable to forcings from noncondensing GHG, both because atmospheric water vapour existed before there were any significant increases in GHG concentrations or temperatures and also because there is no evidence that such increases have produced measurably higher [H2O]. The paper distinguishes between forcing and feedback impacts of water vapour and contends that it is the primary forcing agent, at much more than 50% of the total GHG gas effect. That means that controlling atmospheric carbon dioxide is unlikely to be an effective “control knob” as claimed by Lacis et al. (2010). PMID:22629196

Applying econometrics to the carbon dioxide "control knob".

PubMed

Curtin, Timothy

2012-01-01

This paper tests various propositions underlying claims that observed global temperature change is mostly attributable to anthropogenic noncondensing greenhouse gases, and that although water vapour is recognized to be a dominant contributor to the overall greenhouse gas (GHG) effect, that effect is merely a "feedback" from rising temperatures initially resulting only from "non-condensing" GHGs and not at all from variations in preexisting naturally caused atmospheric water vapour (i.e., [H(2)O]). However, this paper shows that "initial radiative forcing" is not exclusively attributable to forcings from noncondensing GHG, both because atmospheric water vapour existed before there were any significant increases in GHG concentrations or temperatures and also because there is no evidence that such increases have produced measurably higher [H(2)O]. The paper distinguishes between forcing and feedback impacts of water vapour and contends that it is the primary forcing agent, at much more than 50% of the total GHG gas effect. That means that controlling atmospheric carbon dioxide is unlikely to be an effective "control knob" as claimed by Lacis et al. (2010).

Is there a 'new ethics of abortion'?

PubMed

Gillon, R

2001-10-01

This paper argues that the central issue in the abortion debate has not changed since 1967 when the English parliament enacted the Abortion Act. That central issue concerns the moral status of the human fetus. The debate here is not, it is argued, primarily a moral debate, but rather a metaphysical debate and/or a theological debate--though one with massive moral implications. It concerns the nature and attributes that an entity requires to have "full moral standing" or "moral inviolability" including a "right to life". It concerns the question when, in its development from newly fertilised ovum to unequivocally mature, autonomous morally inviolable person does a human being acquire that nature and those attributes, and thus a "right to life". The paper briefly reviews standard answers to these questions, outlining some problems associated with each. Finally there is a brief discussion of one way in which the abortion debate has changed since 1967--notably in the increasingly vociferous claim, especially from disability rights sectors, that abortion on grounds of fetal abnormality implies contempt for and rejection of disabled people--a claim that is rebutted.

Burden of Disease Attributed to Waterborne Transmission of Selected Enteric Pathogens, Australia, 2010.

PubMed

Gibney, Katherine B; O'Toole, Joanne; Sinclair, Martha; Leder, Karin

2017-06-01

AbstractUniversal access to safe drinking water is a global priority. To estimate the annual disease burden of campylobacteriosis, nontyphoidal salmonellosis, cryptosporidiosis, giardiasis, and norovirus attributable to waterborne transmission in Australia, we multiplied regional World Health Organization (WHO) estimates of the proportion of cases attributable to waterborne transmission by estimates of all-source disease burden for each study pathogen. Norovirus was attributed as causing the most waterborne disease cases (479,632; 95% uncertainty interval [UI]: 0-1,111,874) followed by giardiasis and campylobacteriosis. The estimated waterborne disability-adjusted life year (DALY) burden for campylobacteriosis (2,004; 95% UI: 0-5,831) was 7-fold greater than other study pathogens and exceeded the WHO guidelines for drinking water quality (1 × 10 -6 DALY per person per year) by 90-fold. However, these estimates include disease transmitted via either drinking or recreational water exposure. More precise country-specific and drinking water-specific attribution estimates would better define the health burden from drinking water and inform changes to treatment requirements.

Setting priorities for surveillance, prevention, and control of zoonoses in Bogotá, Colombia.

PubMed

Cediel, Natalia; Villamil, Luis Carlos; Romero, Jaime; Renteria, Libardo; De Meneghi, Daniele

2013-05-01

To establish priorities for zoonoses surveillance, prevention, and control in Bogotá, Colombia. A Delphi panel of experts in veterinary and human medicine was conducted using a validated prioritization method to assess the importance of 32 selected zoonoses. This exercise was complemented by a questionnaire survey, using the knowledge, attitudes, and practices (KAP) methodology, administered in 19 districts of Bogotá from September 2009 to April 2010 to an at-risk population (workers at veterinary clinics; pet shops; butcher shops; and traditional food markets that sell poultry, meat, cheese, and eggs). A risk indicator based on level of knowledge about zoonoses was constructed using categorical principal component and logistic regression analyses. Twelve experts participated in the Delphi panel. The diseases scored as highest priority were: influenza A(H1N1), salmonellosis, Escherichia coli infection, leptospirosis, and rabies. The diseases scored as lowest priority were: ancylostomiasis, scabies, ringworm, and trichinellosis. A total of 535 questionnaires were collected and analyzed. Respondents claimed to have had scabies (21%), fungi (8%), brucellosis (8%), and pulicosis (8%). Workers with the most limited knowledge on zoonoses and therefore the highest health risk were those who 1) did not have a professional education, 2) had limited or no zoonoses prevention training, and 3) worked in Usme, Bosa, or Ciudad Bolívar districts. According to the experts, influenza A(H1N1) was the most important zoonoses. Rabies, leptospirosis, brucellosis, and toxoplasmosis were identified as priority diseases by both the experts and the exposed workers. This is the first prioritization exercise focused on zoonoses surveillance, prevention, and control in Colombia. These results could be used to guide decision-making for resource allocation in public health.

Respirable Uranyl-Vanadate Containing Particulate Matter Derived from a Legacy Uranium Mine Site Exhibits Potentiated Cardiopulmonary Toxicity.

PubMed

Zychowski, Katherine E; Kodali, Vamsi; Harmon, Molly; Tyler, Christina; Sanchez, Bethany; Ordonez Suarez, Yoselin; Herbert, Guy; Wheeler, Abigail; Avasarala, Sumant; Cerrato, José M; Kunda, Nitesh K; Muttil, Pavan; Shuey, Chris; Brearley, Adrian; Ali, Abdul-Mehdi; Lin, Yan; Shoeb, Mohammad; Erdely, Aaron; Campen, Matthew J

2018-04-05

Exposure to windblown particulate matter (PM) arising from legacy uranium (U) mine sites in the Navajo Nation may pose a human health hazard due to their potentially high metal content, including U and vanadium (V). To assess the toxic impact of PM derived from Claim 28 (a priority U mine) compared to background PM, and consider the putative role of metal species U and V. Two representative sediment samples from Navajo Nation sites (Background PM and Claim 28 PM) were obtained, characterized in terms of chemistry and morphology, and fractioned to the respirable (≤10μm) fraction. Mice were dosed with either PM sample, uranyl acetate or vanadyl sulfate via aspiration (100µg), with assessments of pulmonary and vascular toxicity 24h later. PM samples were also examined for in vitro effects on cytotoxicity, oxidative stress, phagocytosis, and inflammasome induction. Claim 28 PM10 was highly enriched with U and V and exhibited a unique nanoparticle ultrastructure compared to background PM10. Claim 28 PM10 exhibited enhanced pulmonary and vascular toxicity relative to background PM10. Both U and V exhibited complementary pulmonary inflammatory potential, with U driving a classical inflammatory cytokine profile (elevated IL-1β, TNFα, KC/GRO) while V preferentially induced a different cytokine pattern (elevated IL-5, IL-6, IL-10). Claim 28 PM10 was more potent than background PM10 in terms of in vitro cytotoxicity, impairment of phagocytosis, and oxidative stress responses. Resuspended PM10 derived from U mine waste exhibit greater cardiopulmonary toxicity than background dusts. Rigorous exposure assessment is needed to gauge the regional health risks imparted by these unremediated sites.

Revised Risk Priority Number in Failure Mode and Effects Analysis Model from the Perspective of Healthcare System

PubMed Central

Rezaei, Fatemeh; Yarmohammadian, Mohmmad H.; Haghshenas, Abbas; Fallah, Ali; Ferdosi, Masoud

2018-01-01

Background: Methodology of Failure Mode and Effects Analysis (FMEA) is known as an important risk assessment tool and accreditation requirement by many organizations. For prioritizing failures, the index of “risk priority number (RPN)” is used, especially for its ease and subjective evaluations of occurrence, the severity and the detectability of each failure. In this study, we have tried to apply FMEA model more compatible with health-care systems by redefining RPN index to be closer to reality. Methods: We used a quantitative and qualitative approach in this research. In the qualitative domain, focused groups discussion was used to collect data. A quantitative approach was used to calculate RPN score. Results: We have studied patient's journey in surgery ward from holding area to the operating room. The highest priority failures determined based on (1) defining inclusion criteria as severity of incident (clinical effect, claim consequence, waste of time and financial loss), occurrence of incident (time - unit occurrence and degree of exposure to risk) and preventability (degree of preventability and defensive barriers) then, (2) risks priority criteria quantified by using RPN index (361 for the highest rate failure). The ability of improved RPN scores reassessed by root cause analysis showed some variations. Conclusions: We concluded that standard criteria should be developed inconsistent with clinical linguistic and special scientific fields. Therefore, cooperation and partnership of technical and clinical groups are necessary to modify these models. PMID:29441184

Implementing US-style anti-fraud laws in the Australian pharmaceutical and health care industries.

PubMed

Faunce, Thomas A; Urbas, Gregor; Skillen, Lesley

2011-05-02

This article critically analyses the prospects for introducing United States anti-fraud (or anti-false claims) laws in the Australian health care setting. Australian governments spend billions of dollars each year on medicines and health care. A recent report estimates that the money lost to corporate fraud in Australia is growing at an annual rate of 7%, but that only a third of the losses are currently being detected. In the US, qui tam provisions - the component of anti-fraud or anti-false claims laws involving payments to whistleblowers - have been particularly successful in providing critical evidence allowing public prosecutors to recover damages for fraud and false claims made by corporations in relation to federal and state health care programs. The US continues to strengthen such anti-fraud measures and to successfully apply them to a widening range of areas involving large public investment. Australia still suffers from the absence of any comprehensive scheme that not only allows treble damages recovery for fraud on the public purse, but crucially supports such actions by providing financial encouragement for whistleblowing corporate insiders to expose evidence of fraud. Potential areas of application could include direct and indirect government expenditure on health care service provision, pharmaceuticals, medical devices, defence, carbon emissions compensation and tobacco-related illness. The creation in Australia of an equivalent to US anti-false claims legislation should be a policy priority, particularly in a period of financial stringency.

Clinical safety and professional liability claims in Ophthalmology.

PubMed

Dolz-Güerri, F; Gómez-Durán, E L; Martínez-Palmer, A; Castilla Céspedes, M; Arimany-Manso, J

2017-11-01

Patient safety is an international public health priority. Ophthalmology scientific societies and organisations have intensified their efforts in this field. As a tool to learn from errors, these efforts have been linked to the management of medical professional liability insurance through the analysis of claims. A review is performed on the improvements in patient safety, as well as professional liability issues in Ophthalmology. There is a high frequency of claims and risk of economic reparation of damage in the event of a claim in Ophthalmology. Special complaints, such as wrong surgery or lack of information, have a high risk of financial compensation and need strong efforts to prevent these potentially avoidable events. Studies focused on pathologies or specific procedures provide information of special interest to sub-specialists. The specialist in Ophthalmology, like any other doctor, is subject to the current legal provisions and appropriate mandatory training in the medical-legal aspects of health care is essential. Professionals must be aware of the fundamental aspects of medical professional liability, as well as specific aspects, such as defensive medicine and clinical safety. The understanding of these medical-legal aspects in the routine clinical practice can help to pave the way towards a satisfactory and safe professional career, and help in increasing patient safety. The aim of this review is to contribute to this training, for the benefit of professionals and patients. Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

Nonacademic Attributes Predict Medical and Nursing Student Intentions to Emigrate or to Work Rurally: An Eight-Country Survey in Asia and Africa

PubMed Central

Silvestri, David M.; Blevins, Meridith; Wallston, Kenneth A.; Afzal, Arfan R.; Alam, Nazmul; Andrews, Ben; Derbew, Miliard; Kaur, Simran; Mipando, Mwapatsa; Mkony, Charles A.; Mwachaka, Philip M.; Ranjit, Nirju; Vermund, Sten H.

2017-01-01

We sought to identify independent, nonacademic predictors of medical and nursing student intent to migrate abroad or from rural to urban areas after graduation in low- and middle-income countries (LMIC). This was a cross-sectional survey of 3,199 first- and final-year medical and nursing students at 16 training institutions in eight LMIC. Questionnaires assessed demographics, career intentions, and preferences regarding selected career, location, and work-related attributes. Using principal component analysis, student preferences were reduced into four discrete categories of priorities: 1) work environment resources, 2) location livability, 3) altruistic job values, and 4) individualistic job values. Students' preferences were scored in each category. Using students' characteristics and priority scores, multivariable proportional odds models were used to derive independent predictors of intentions to emigrate for work outside the country, or to work in a rural area in their native country. Students prioritizing individualistic values more often planned international careers (adjusted odds ratio [aOR] = 1.44, 95% confidence interval [CI] = 1.16–1.78), whereas those prioritizing altruistic values preferred rural careers (aOR = 1.82, 95% CI = 1.50–2.21). Trainees prioritizing high-resource environments preferentially planned careers abroad (aOR = 1.38, 95% CI = 1.12–1.69) and were unlikely to seek rural work (aOR = 0.60, 95% CI = 0.49–0.73). Independent of their priorities, students with prolonged prior rural residence were unlikely to plan emigration (aOR = 0.67, 95% CI = 0.50–0.90) and were more likely to plan a rural career (aOR = 1.53, 95% CI = 1.16–2.03). We conclude that use of nonacademic attributes in medical and nursing admissions processes would likely increase retention in high-need rural areas and reduce emigration “brain drain” in LMIC. PMID:28719284

Re-examining the effects of noncontingent success on self-handicapping behaviour.

PubMed

Thompson, Ted

2004-06-01

Self-handicapping refers to the practice on the part of certain individuals to handicap their performance when poor performance is likely to reveal low ability. Noncontingent success (feedback that is inflated relative to performance) is more likely to promote self-handicapping behaviour than noncontingent failure (failure feedback based on false or misleading information). However, the reasons for the differing effects of these forms of performance feedback on self-handicapping behaviour remain obscure. The present study sought an explanation for the differing effects of these forms of performance feedback, testing the assumption that students high in self-handicapping behaviour would react more negatively following noncontingent success, reporting more unstable and external attributions, higher anxiety, and a greater propensity to claim handicaps than those low in self-handicapping behaviour. No differences were expected on any of these measures for high relative to low self-handicappers following either noncontingent failure or success. Participants were 72 undergraduate students, divided equally between high and low self-handicapping groups. High and low self-handicappers were assigned to one of three performance feedback conditions: noncontingent failure, success and noncontingent success. High and low self-handicappers were then given an opportunity to claim handicaps prior to completing measures of attributions and state anxiety. Subsequently, they completed 12 remote associate tasks, serving as an assessment of performance, and 16 unicursal tasks, assessing practice effort. Following noncontingent success, high self-handicappers reported greater anxiety, more unproductive attributions and claimed more handicaps than low self-handicappers. However no differences were evident for high and low self-handicappers following either noncontingent failure or success. High self-handicappers also performed poorly on the remote associates tasks and reduced practice effort on the unicursal tasks. These findings confirm the adverse effects of noncontingent success for high self-handicappers, while failing to provide evidence that noncontingent failure has any more adverse effects on high relative to low self-handicappers.

Assessing Progress, Impact, and Next Steps in Rolling Out Voluntary Medical Male Circumcision for HIV Prevention in 14 Priority Countries in Eastern and Southern Africa through 2014

PubMed Central

Kripke, Katharine; Samuelson, Julia; Schnure, Melissa; Dalal, Shona; Farley, Timothy; Hankins, Catherine; Thomas, Anne G.; Reed, Jason; Stegman, Peter; Bock, Naomi

2016-01-01

Background In 2007, the World Health Organization and the Joint United Nations Programme on HIV/AIDS (UNAIDS) identified 14 priority countries across eastern and southern Africa for scaling up voluntary medical male circumcision (VMMC) services. Several years into this effort, we reflect on progress. Methods Using the Decision Makers’ Program Planning Tool (DMPPT) 2.1, we assessed age-specific impact, cost-effectiveness, and coverage attributable to circumcisions performed through 2014. We also compared impact of actual progress to that of achieving 80% coverage among men ages 15–49 in 12 VMMC priority countries and Nyanza Province, Kenya. We populated the models with age-disaggregated VMMC service statistics and with population, mortality, and HIV incidence and prevalence projections exported from country-specific Spectrum/Goals files. We assumed each country achieved UNAIDS’ 90-90-90 treatment targets. Results More than 9 million VMMCs were conducted through 2014: 43% of the estimated 20.9 million VMMCs required to reach 80% coverage by the end of 2015. The model assumed each country reaches the UNAIDS targets, and projected that VMMCs conducted through 2014 will avert 240,000 infections by the end of 2025, compared to 1.1 million if each country had reached 80% coverage by the end of 2015. The median estimated cost per HIV infection averted was $4,400. Nyanza Province in Kenya, the 11 priority regions in Tanzania, and Uganda have reached or are approaching MC coverage targets among males ages 15–24, while coverage in other age groups is lower. Across all countries modeled, more than half of the projected HIV infections averted were attributable to circumcising 10- to 19-year-olds. Conclusions The priority countries have made considerable progress in VMMC scale-up, and VMMC remains a cost-effective strategy for epidemic impact, even assuming near-universal HIV diagnosis, treatment coverage, and viral suppression. Examining circumcision coverage by five-year age groups will inform countries’ decisions about next steps. PMID:27441648

Modeling healthcare authorization and claim submissions using the openEHR dual-model approach

PubMed Central

2011-01-01

Background The TISS standard is a set of mandatory forms and electronic messages for healthcare authorization and claim submissions among healthcare plans and providers in Brazil. It is not based on formal models as the new generation of health informatics standards suggests. The objective of this paper is to model the TISS in terms of the openEHR archetype-based approach and integrate it into a patient-centered EHR architecture. Methods Three approaches were adopted to model TISS. In the first approach, a set of archetypes was designed using ENTRY subclasses. In the second one, a set of archetypes was designed using exclusively ADMIN_ENTRY and CLUSTERs as their root classes. In the third approach, the openEHR ADMIN_ENTRY is extended with classes designed for authorization and claim submissions, and an ISM_TRANSITION attribute is added to the COMPOSITION class. Another set of archetypes was designed based on this model. For all three approaches, templates were designed to represent the TISS forms. Results The archetypes based on the openEHR RM (Reference Model) can represent all TISS data structures. The extended model adds subclasses and an attribute to the COMPOSITION class to represent information on authorization and claim submissions. The archetypes based on all three approaches have similar structures, although rooted in different classes. The extended openEHR RM model is more semantically aligned with the concepts involved in a claim submission, but may disrupt interoperability with other systems and the current tools must be adapted to deal with it. Conclusions Modeling the TISS standard by means of the openEHR approach makes it aligned with ISO recommendations and provides a solid foundation on which the TISS can evolve. Although there are few administrative archetypes available, the openEHR RM is expressive enough to represent the TISS standard. This paper focuses on the TISS but its results may be extended to other billing processes. A complete communication architecture to simulate the exchange of TISS data between systems according to the openEHR approach still needs to be designed and implemented. PMID:21992670

Priorities for injury prevention in women's Australian football: a compilation of national data from different sources

PubMed Central

Fortington, Lauren V; Finch, Caroline F

2016-01-01

Background/aim Participation in Australian football (AF) has traditionally been male dominated and current understanding of injury and priorities for prevention are based solely on reports of injuries in male players. There is evidence in other sports that indicates that injury types differ between males and females. With increasing participation in AF by females, it is important to consider their specific injury and prevention needs. This study aimed to provide a first injury profile from existing sources for female AF. Methods Compilation of injury data from four prospectively recorded data sets relating to female AF: (1) hospital admissions in Victoria, 2008/09–13/14, n=500 injuries; (2) emergency department (ED) presentations in Victoria, 2008/09–2012/13, n=1,879 injuries; (3) insurance claims across Australia 2004–2013, n=522 injuries; (4) West Australian Women's Football League (WAWFL), 2014 season club data, n=49 injuries. Descriptive results are presented as injury frequencies, injury types and injury to body parts. Results Hospital admissions and ED presentations were dominated by upper limb injuries, representing 47% and 51% of all injuries, respectively, primarily to the wrist/hand at 32% and 40%. Most (65%) insurance claim injuries involved the lower limb, 27% of which were for knee ligament damage. A high proportion of concussions (33%) were reported in the club-collected data. Conclusions The results provide the first compilation of existing data sets of women's AF injuries and highlight the need for a rigorous and systematic injury surveillance system to be instituted. PMID:27900171

Obesity and workers' compensation: results from the Duke Health and Safety Surveillance System.

PubMed

Ostbye, Truls; Dement, John M; Krause, Katrina M

2007-04-23

Obese individuals have increased morbidity and use of health services. Less is known about the effect of obesity on workers' compensation. The objective of this study was to determine the relationship between body mass index (BMI) (calculated as weight in kilograms divided by height in meters squared) and number and types of workers' compensation claims, associated costs, and lost workdays. Retrospective cohort study. Participants included 11 728 health care and university employees (34 858 full-time equivalents [FTEs]) with at least 1 health risk appraisal between January 1, 1997, and December 31, 2004. The main outcome measures were stratified rates of workers' compensation claims, associated costs, and lost workdays, calculated by BMI, sex, age, race/ethnicity, smoking status, employment duration, and occupational group. The body part affected, nature of the illness or injury, and cause of the illness or injury were also investigated. Multivariate Poisson regression models examined the effects of BMI, controlling for demographic and work-related variables. There was a clear linear relationship between BMI and rate of claims. Employees in obesity class III (BMI >/=40) had 11.65 claims per 100 FTEs, while recommended-weight employees had 5.80; the effect on lost workdays (183.63 vs 14.19 lost workdays per 100 FTEs), medical claims costs ($51 091 vs $7503 per 100 FTEs), and indemnity claims costs ($59 178 vs $5396 per 100 FTEs) was even stronger. The claims most strongly affected by BMI were related to the following: lower extremity, wrist or hand, and back (body part affected); pain or inflammation, sprain or strain, and contusion or bruise (nature of the illness or injury); and falls or slips, lifting, and exertion (cause of the illness or injury). The combination of obesity and high-risk occupation was particularly detrimental. Maintaining healthy weight not only is important to workers but should also be a high priority for their employers given the strong effect of BMI on workers' injuries. Complementing general interventions to make all workplaces safer, work-based programs targeting healthy eating and physical activity should be developed and evaluated.

Using Data Mining to Detect Health Care Fraud and Abuse: A Review of Literature

PubMed Central

Joudaki, Hossein; Rashidian, Arash; Minaei-Bidgoli, Behrouz; Mahmoodi, Mahmood; Geraili, Bijan; Nasiri, Mahdi; Arab, Mohammad

2015-01-01

Inappropriate payments by insurance organizations or third party payers occur because of errors, abuse and fraud. The scale of this problem is large enough to make it a priority issue for health systems. Traditional methods of detecting health care fraud and abuse are time-consuming and inefficient. Combining automated methods and statistical knowledge lead to the emergence of a new interdisciplinary branch of science that is named Knowledge Discovery from Databases (KDD). Data mining is a core of the KDD process. Data mining can help third-party payers such as health insurance organizations to extract useful information from thousands of claims and identify a smaller subset of the claims or claimants for further assessment. We reviewed studies that performed data mining techniques for detecting health care fraud and abuse, using supervised and unsupervised data mining approaches. Most available studies have focused on algorithmic data mining without an emphasis on or application to fraud detection efforts in the context of health service provision or health insurance policy. More studies are needed to connect sound and evidence-based diagnosis and treatment approaches toward fraudulent or abusive behaviors. Ultimately, based on available studies, we recommend seven general steps to data mining of health care claims. PMID:25560347

Prevalence rates for depression by industry: a claims database analysis

PubMed Central

Alterman, Toni; Bushnell, P. Timothy; Li, Jia; Shen, Rui

2015-01-01

Purpose To estimate and interpret differences in depression prevalence rates among industries, using a large, group medical claims database. Methods Depression cases were identified by ICD-9 diagnosis code in a population of 214,413 individuals employed during 2002–2005 by employers based in western Pennsylvania. Data were provided by Highmark, Inc. (Pittsburgh and Camp Hill, PA). Rates were adjusted for age, gender, and employee share of health care costs. National industry measures of psychological distress, work stress, and physical activity at work were also compiled from other data sources. Results Rates for clinical depression in 55 industries ranged from 6.9 to 16.2 %, (population rate = 10.45 %). Industries with the highest rates tended to be those which, on the national level, require frequent or difficult interactions with the public or clients, and have high levels of stress and low levels of physical activity. Conclusions Additional research is needed to help identify industries with relatively high rates of depression in other regions and on the national level, and to determine whether these differences are due in part to specific work stress exposures and physical inactivity at work. Clinical significance Claims database analyses may provide a cost-effective way to identify priorities for depression treatment and prevention in the workplace. PMID:24907896

Source-oriented risk assessment of inhalation exposure to ambient polycyclic aromatic hydrocarbons and contributions of non-priority isomers in urban Nanjing, a megacity located in Yangtze River Delta, China.

PubMed

Zhuo, Shaojie; Shen, Guofeng; Zhu, Ying; Du, Wei; Pan, Xuelian; Li, Tongchao; Han, Yang; Li, Bengang; Liu, Junfeng; Cheng, Hefa; Xing, Baoshan; Tao, Shu

2017-05-01

Sixteen U.S. EPA priority polycyclic aromatic hydrocarbons (PAHs) and eleven non-priority isomers including some dibenzopyrenes were analyzed to evaluate health risk attributable to inhalation exposure to ambient PAHs and contributions of the non-priority PAHs in a megacity Nanjing, east China. The annual average mass concentration of the total 16 EPA priority PAHs in air was 51.1 ± 29.8 ng/m 3 , comprising up to 93% of the mass concentration of all 27 PAHs, however, the estimated Incremental Lifetime Cancer Risk (ILCR) due to inhalation exposure would be underestimated by 63% on average if only accounting the 16 EPA priority PAHs. The risk would be underestimated by 13% if only particulate PAHs were considered, though gaseous PAHs made up to about 70% of the total mass concentration. During the last fifteen years, ambient Benzo[a]pyrene decreased significantly in the city which was consistent with the declining trend of PAHs emissions. Source contributions to the estimated ILCR were much different from the contributions for the total mass concentration, calling for the introduce of important source-oriented risk assessments. Emissions from gasoline vehicles contributed to 12% of the total mass concentration of 27 PAHs analyzed, but regarding relative contributions to the overall health risk, gasoline vehicle emissions contributed 45% of the calculated ILCR. Dibenzopyrenes were a group of non-priority isomers largely contributing to the calculated ILCR, and vehicle emissions were probably important sources of these high molecular weight isomers. Ambient dibenzo[a,l]pyrene positively correlated with the priority PAH Benzo[g,h,i]perylene. The study indicates that inclusion of non-priority PAHs could be valuable for both PAH source apportionment and health risk assessment. Copyright © 2017 Elsevier Ltd. All rights reserved.

20 CFR 725.702 - Claims for medical benefits only under section 11 of the Reform Act.

Code of Federal Regulations, 2011 CFR

2011-04-01

... to submit to a medical examination requested by an identified operator. The unreasonable refusal to..., to the date of filing which are attributable to medical care required as a result of the miner's... securing third party liability for medical care costs is authorized by this section. If a miner seeks...

20 CFR 725.702 - Claims for medical benefits only under section 11 of the Reform Act.

Code of Federal Regulations, 2010 CFR

2010-04-01

... to submit to a medical examination requested by an identified operator. The unreasonable refusal to..., to the date of filing which are attributable to medical care required as a result of the miner's... securing third party liability for medical care costs is authorized by this section. If a miner seeks...

31 CFR 535.540 - Disposition of certain tangible property.

Code of Federal Regulations, 2012 CFR

2012-07-01

... of time to obtain payment of any amounts owed by Iran or the Iranian entity, or adequate assurance of... monetary loss which may accrue to the United States from a decision by the Iran-U.S. Claims Tribunal that the United States is liable to Iran for damages that are in any way attributable to the issuance of...

26 CFR 1.6015-1 - Relief from joint and several liability on a joint return.

Code of Federal Regulations, 2010 CFR

2010-04-01

... they claim losses attributable to H's limited partnership interest in Partnership A. In January 2006... 26 Internal Revenue 13 2010-04-01 2010-04-01 false Relief from joint and several liability on a... joint and several liability on a joint return. (a) In general. (1) An individual who qualifies and...

Gaming the System: Culture, Process, and Perspectives Supporting a Game and App Design Curriculum

ERIC Educational Resources Information Center

Herro, Danielle

2015-01-01

Games and digital media experiences permeate the lives of youth. Researchers have argued the participatory attributes and cognitive benefits of gaming and media production for more than a decade, relying on socio-cultural theory to bolster their claims. Only recently have large-scale efforts ensued towards moving game play and design into formal…

31 CFR 535.540 - Disposition of certain tangible property.

Code of Federal Regulations, 2010 CFR

2010-07-01

... of time to obtain payment of any amounts owed by Iran or the Iranian entity, or adequate assurance of... monetary loss which may accrue to the United States from a decision by the Iran-U.S. Claims Tribunal that the United States is liable to Iran for damages that are in any way attributable to the issuance of...

31 CFR 535.540 - Disposition of certain tangible property.

Code of Federal Regulations, 2011 CFR

2011-07-01

... of time to obtain payment of any amounts owed by Iran or the Iranian entity, or adequate assurance of... monetary loss which may accrue to the United States from a decision by the Iran-U.S. Claims Tribunal that the United States is liable to Iran for damages that are in any way attributable to the issuance of...

Schools and Emotional and Behavioral Problems: A Comparison of School-Going and Homeschooled Children

ERIC Educational Resources Information Center

Guterman, Oz; Neuman, Ari

2017-01-01

Much attention has been focused recently on the deepening crisis in the education system. Researchers have attributed these problems to the school environment. One method for examining this claim is to compare specific emotional and behavior problems among children who attend schools and children who do not. This study examined three aspects of…

Empathy, Theory of Mind, and Individual Differences in the Appropriation Bias among 4- and 5-Year-Olds

ERIC Educational Resources Information Center

Ford, Ruth M.; Lobao, Sheila N.; Macaulay, Catrin; Herdman, Lynsey M.

2011-01-01

Evidence that young children often claim ownership of their partner's contributions to an earlier collaborative activity, the "appropriation bias", has been attributed to shared intentionality ("Cognitive Development" (1998) 13, 91-108). The current investigation explored this notion by examining individual differences in the bias among 4- and…

Weight Loss at a Cost: Implications of High-Protein, Low- Carbohydrate Diets.

ERIC Educational Resources Information Center

Gabel, Kathe A.; Lund, Robin J.

2002-01-01

Addresses three claims of high-protein, low-carbohydrate diets: weight loss is attributed to the composition of the diet; insulin promotes the storage of fat, thereby, by limiting carbohydrates, dieters will decrease levels of insulin and body fat; and weight loss is the result of fat loss. The paper examines relevant scientific reports and notes…

24 CFR 17.46 - Claims involving carriers or insurers.

Code of Federal Regulations, 2011 CFR

2011-04-01

... was issued, a separate demand should be made against the last carrier on each such document. (2) The demand should be made within 9 months of the date that delivery was made, or within 9 months of the date... attributable to packing, storage, or unpacking while in the custody of the Government, no demand need be made...

Economic costs of obesity in Thailand: a retrospective cost-of-illness study

PubMed Central

2014-01-01

Background Over the last decade, the prevalence of obesity (BMI ≥ 25 kg/m2) in Thailand has been rising rapidly and consistently. Estimating the cost of obesity to society is an essential step in setting priorities for research and resource use and helping improve public awareness of the negative economic impacts of obesity. This prevalence-based, cost-of-illness study aims to estimate the economic costs of obesity in Thailand. Methods The estimated costs in this study included health care cost, cost of productivity loss due to premature mortality, and cost of productivity loss due to hospital-related absenteeism. The Obesity-Attributable Fraction (OAF) was used to estimate the extent to which the co-morbidities were attributable to obesity. The health care cost of obesity was further estimated by multiplying the number of patients in each disease category attributable to obesity by the unit cost of treatment. The cost of productivity loss was calculated using the human capital approach. Results The health care cost attributable to obesity was estimated at 5,584 million baht or 1.5% of national health expenditure. The cost of productivity loss attributable to obesity was estimated at 6,558 million baht - accounting for 54% of the total cost of obesity. The cost of hospital-related absenteeism was estimated at 694 million baht, while the cost of premature mortality was estimated at 5,864 million baht. The total cost of obesity was then estimated at 12,142 million baht (725.3 million US$PPP, 16.74 baht =1 US$PPP accounting for 0.13% of Thailand’s Gross Domestic Product (GDP). Conclusions Obesity imposes a substantial economic burden on Thai society especially in term of health care costs. Large-scale comprehensive interventions focused on improving public awareness of the cost of and problems associated with obesity and promoting a healthy lifestyle should be regarded as a public health priority. PMID:24690106

Economic costs of obesity in Thailand: a retrospective cost-of-illness study.

PubMed

Pitayatienanan, Paiboon; Butchon, Rukmanee; Yothasamut, Jomkwan; Aekplakorn, Wichai; Teerawattananon, Yot; Suksomboon, Naeti; Thavorncharoensap, Montarat

2014-04-02

Over the last decade, the prevalence of obesity (BMI ≥ 25 kg/m2) in Thailand has been rising rapidly and consistently. Estimating the cost of obesity to society is an essential step in setting priorities for research and resource use and helping improve public awareness of the negative economic impacts of obesity. This prevalence-based, cost-of-illness study aims to estimate the economic costs of obesity in Thailand. The estimated costs in this study included health care cost, cost of productivity loss due to premature mortality, and cost of productivity loss due to hospital-related absenteeism. The Obesity-Attributable Fraction (OAF) was used to estimate the extent to which the co-morbidities were attributable to obesity. The health care cost of obesity was further estimated by multiplying the number of patients in each disease category attributable to obesity by the unit cost of treatment. The cost of productivity loss was calculated using the human capital approach. The health care cost attributable to obesity was estimated at 5,584 million baht or 1.5% of national health expenditure. The cost of productivity loss attributable to obesity was estimated at 6,558 million baht - accounting for 54% of the total cost of obesity. The cost of hospital-related absenteeism was estimated at 694 million baht, while the cost of premature mortality was estimated at 5,864 million baht. The total cost of obesity was then estimated at 12,142 million baht (725.3 million US$PPP, 16.74 baht =1 US$PPP accounting for 0.13% of Thailand's Gross Domestic Product (GDP). Obesity imposes a substantial economic burden on Thai society especially in term of health care costs. Large-scale comprehensive interventions focused on improving public awareness of the cost of and problems associated with obesity and promoting a healthy lifestyle should be regarded as a public health priority.

Attributional styles in boys with severe behaviour problems: a possible reason for lack of progress on a positive behaviour programme.

PubMed

Eslea, M

1999-03-01

The number of exclusions from British schools has been increasing in recent years: the vast majority are because of disruptive behaviour. Increasing the effectiveness of behaviour control is therefore a priority for educators. This study tests the hypothesis that children who do not respond well to a behaviour modification regime exhibit a depressed attributional style. The sample comprised 26 boys aged 7-11 in a special day school for children with behaviour problems. Participants were interviewed about positive and negative aspects of school life: responses were coded using the Leeds Attributional Coding System (Stratton et al., 1988). School records were then used to identify children making good progress through the Positive Behaviour Programme (N = 13) and those making little or no progress (N = 8). Mean proportions of stable, global, internal, personal and controllable attributions were compared by progress group (high/low) and outcome (positive/negative) using mixed-design ANOVA. High progress children made significantly more global and internal attributions for positive than for negative events, while low progress children made more personal attributions for negative than for positive events. A depressed attributional style may act as a barrier which hinders the generalisation and internalisation of traditional behaviour modification methods. Increased teacher-awareness of attribution could increase the effectiveness of remedial programmes.

Management of sacroiliac joint disruption and degenerative sacroiliitis with nonoperative care is medical resource-intensive and costly in a United States commercial payer population

PubMed Central

Ackerman, Stacey J; Polly, David W; Knight, Tyler; Holt, Tim; Cummings, John

2014-01-01

Introduction Low back pain is common and originates in the sacroiliac (SI) joint in 15%–30% of cases. Traditional SI joint disruption/degenerative sacroiliitis treatments include nonoperative care or open SI joint fusion. To evaluate the usefulness of newly developed minimally-invasive technologies, the costs of traditional treatments must be better understood. We assessed the costs of nonoperative care for SI joint disruption to commercial payers in the United States (US). Methods A retrospective study of claim-level medical resource use and associated costs used the MarketScan® Commercial Claims and Encounters as well as Medicare Supplemental Databases of Truven Healthcare. Patients with a primary ICD-9-CM diagnosis code for SI joint disruption (720.2, 724.6, 739.4, 846.9, or 847.3), an initial date of diagnosis from January 1, 2005 to December 31, 2007 (index date), and continuous enrollment for ≥1 year before and 3 years after the index date were included. Claims attributable to SI joint disruption with a primary or secondary ICD-9-CM diagnosis code of 71x.xx, 72x.xx, 73x.xx, or 84x.xx were identified; the 3-year medical resource use-associated reimbursement and outpatient pain medication costs (measured in 2011 US dollars) were tabulated across practice settings. A subgroup analysis was performed among patients with lumbar spinal fusion. Results The mean 3-year direct, attributable medical costs were $16,196 (standard deviation [SD] $28,592) per privately-insured patient (N=78,533). Among patients with lumbar spinal fusion (N=434), attributable 3-year mean costs were $91,720 (SD $75,502) per patient compared to $15,776 (SD $27,542) per patient among patients without lumbar spinal fusion (N=78,099). Overall, inpatient hospitalizations (19.4%), hospital outpatient visits and procedures (14.0%), and outpatient pain medications (9.6%) accounted for the largest proportion of costs. The estimated 3-year insurance payments attributable to SI joint disruption were $1.6 billion per 100,000 commercial payer beneficiaries. Conclusion The economic burden of SI joint disruption among privately-insured patients in the US is substantial, highlighting the need for more cost-effective therapies. PMID:24596468

Can one puff really make an adolescent addicted to nicotine? A critical review of the literature

PubMed Central

2010-01-01

Rationale In the past decade, there have been various attempts to understand the initiation and progression of tobacco smoking among adolescents. One line of research on these issues has made strong claims regarding the speed in which adolescents can become physically and mentally addicted to smoking. According to these claims, and in contrast to other models of smoking progression, adolescents can lose autonomy over their smoking behavior after having smoked one puff in their lifetime and never having smoked again, and can become mentally and physically "hooked on nicotine" even if they have never smoked a puff. Objectives To critically examine the conceptual and empirical basis for the claims made by the "hooked on nicotine" thesis. Method We reviewed the major studies on which the claims of the "hooked on nicotine" research program are based. Results The studies we reviewed contained substantive conceptual and methodological flaws. These include an untenable and idiosyncratic definition of addiction, use of single items or of very lenient criteria for diagnosing nicotine dependence, reliance on responders' causal attributions in determining physical and mental addiction to nicotine and biased coding and interpretation of the data. Discussion The conceptual and methodological problems detailed in this review invalidate many of the claims made by the "hooked on nicotine" research program and undermine its contribution to the understanding of the nature and development of tobacco smoking in adolescents. PMID:21067587

Climate change and mental health: risks, impacts and priority actions.

PubMed

Hayes, Katie; Blashki, G; Wiseman, J; Burke, S; Reifels, L

2018-01-01

This article provides an overview of the current and projected climate change risks and impacts to mental health and provides recommendations for priority actions to address the mental health consequences of climate change. The authors argue the following three points: firstly, while attribution of mental health outcomes to specific climate change risks remains challenging, there are a number of opportunities available to advance the field of mental health and climate change with more empirical research in this domain; secondly, the risks and impacts of climate change on mental health are already rapidly accelerating, resulting in a number of direct, indirect, and overarching effects that disproportionally affect those who are most marginalized; and, thirdly, interventions to address climate change and mental health need to be coordinated and rooted in active hope in order to tackle the problem in a holistic manner. This discussion paper concludes with recommendations for priority actions to address the mental health consequences of climate change.

Future Missions for Space Weather Specifications and Forecasts

NASA Astrophysics Data System (ADS)

Onsager, T. G.; Biesecker, D. A.; Anthes, R. A.; Maier, M. W.; Gallagher, F. W., III; St Germain, K.

2017-12-01

The progress of technology and the global integration of our economic and security infrastructures have introduced vulnerabilities to space weather that demand a more comprehensive ability to specify and to predict the dynamics of the space environment. This requires a comprehensive network of real-time space-based and ground-based observations with long-term continuity. In order to determine the most cost effective space architectures for NOAA's weather, space weather, and environmental missions, NOAA conducted the NOAA Satellite Observing System Architecture (NSOSA) study. This presentation will summarize the process used to document the future needs and the relative priorities for NOAA's operational space-based observations. This involves specifying the most important observations, defining the performance attributes at different levels of capability, and assigning priorities for achieving the higher capability levels. The highest priority observations recommended by the Space Platform Requirements Working Group (SPRWG) for improvement above a minimal capability level will be described. Finally, numerous possible satellite architectures have been explored to assess the costs and benefits of various architecture configurations.

Who's Missing the Point? A Commentary on Claims that Autistic Persons Have a Specific Deficit in Figurative Language Comprehension.

PubMed

Gernsbacher, Morton Ann; Pripas-Kapit, Sarah R

2012-01-01

It's become a caricature of autistic persons that they don't understand figurative language. Despite empirical evidence to the contrary, three of the four contributions to this special issue endorse this stereotype without question. And all four contributions attribute this supposed deficit to even shakier fallacies, such as the controversial claim that autistic people lack empathy or a 'theory of mind.' In this commentary, we begin by reviewing the literature more exhaustively than the other contributions, and we highlight a point that they missed: Autistic persons are likely to have difficulty comprehending figurative language if they also have difficulty comprehending language in general. There doesn't seem to be a specific deficit in figurative language unique to autism. We also tackle the claim that autistic people lack empathy. And we question the existence of a 'theory of mind area,' while demonstrating the pitfalls that ensnarl researchers when they strain to interpret differences between autistic and non-autistic brain activity as solely autistic deficits.

Authoring Issues beyond Tools

NASA Astrophysics Data System (ADS)

Spierling, Ulrike; Szilas, Nicolas

Authoring is still considered a bottleneck in successful Interactive Storytelling and Drama. The claim for intuitive authoring tools is high, especially for tools that allow storytellers and artists to define dynamic content that can be run with an AI-based story engine. We explored two concrete authoring processes in depth, using various Interactive Storytelling prototypes, and have provided feedback from the practical steps. The result is a presentation of general issues in authoring Interactive Storytelling, rather than of particular problems with a specific system that could be overcome by 'simply' designing the right interface. Priorities for future developments are also outlined.

Public preferences for prioritizing preventive and curative health care interventions: a discrete choice experiment.

PubMed

Luyten, Jeroen; Kessels, Roselinde; Goos, Peter; Beutels, Philippe

2015-03-01

Setting fair health care priorities counts among the most difficult ethical challenges our societies are facing. To elicit through a discrete choice experiment the Belgian adult population's (18-75 years; N = 750) preferences for prioritizing health care and investigate whether these preferences are different for prevention versus cure. We used a Bayesian D-efficient design with partial profiles, which enables considering a large number of attributes and interaction effects. We included the following attributes: 1) type of intervention (cure vs. prevention), 2) effectiveness, 3) risk of adverse effects, 4) severity of illness, 5) link between the illness and patient's health-related lifestyle, 6) time span between intervention and effect, and 7) patient's age group. All attributes were statistically significant contributors to the social value of a health care program, with patient's lifestyle and age being the most influential ones. Interaction effects were found, showing that prevention was preferred to cure for disease in young adults, as well as for severe and lethal disease in people of any age. However, substantial differences were found in the preferences of respondents from different age groups, with different lifestyles and different health states. Our study suggests that according to the Belgian public, contextual factors of health gains such as patient's age and health-related lifestyle should be considered in priority setting decisions. The studies, however, revealed substantial disagreement in opinion between different population subgroups. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Healthcare service utilisation costs attributable to rheumatoid arthritis in France: Analysis of a representative national claims database.

PubMed

Fautrel, Bruno; Cukierman, Gabrielle; Joubert, Jean-Michel; Laurendeau, Caroline; Gourmelen, Julie; Fagnani, Francis

2016-01-01

To estimate healthcare service utilisation costs of patients with rheumatoid arthritis in France and to estimate the fraction of these costs attributable to RA. The "Échantillon généraliste des bénéficiaires" (EGB) is a 1/97 random sample of the main national claims database covering the French population. A cohort of patients with rheumatoid arthritis was constituted of all adults benefiting from full coverage for rheumatoid arthritis (ICD-10 M05-06) on 1st january 2009. A control group matched for age and gender was identified. Health expenditures were assessed from the payer's perspective for the year 2010. The annual per capita reimbursed total health expenditure was €6,404 in 2010, an amount around two times higher than in the control group €3,095 (P<0.0001). The main contributors to this extra cost were outpatient care (+€2,407; 72.7%), including medication (+€1,686; 50.0%), and inpatient care (+€903; 27.3%). Patients treated by biological agents generated an age-adjusted per capita annual expenditure about three times higher than untreated patients (€15,757 versus €4,640). Only half of medical expenditure by patients with rheumatoid arthritis is attributable to their disease and use of biological agents has become a major driver of cost. Copyright © 2015 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

Against proportional shortfall as a priority-setting principle.

PubMed

Altmann, Samuel

2018-05-01

As the demand for healthcare rises, so does the need for priority setting in healthcare. In this paper, I consider a prominent priority-setting principle: proportional shortfall. My purpose is to argue that proportional shortfall, as a principle, should not be adopted. My key criticism is that proportional shortfall fails to consider past health.Proportional shortfall is justified as it supposedly balances concern for prospective health while still accounting for lifetime health, even though past health is deemed irrelevant. Accounting for this lifetime perspective means that the principle may indirectly consider past health by accounting for how far an individual is from achieving a complete, healthy life. I argue that proportional shortfall does not account for this lifetime perspective as it fails to incorporate the fair innings argument as originally claimed, undermining its purported justification.I go on to demonstrate that the case for ignoring past health is weak, and argue that past health is at least sometimes relevant for priority-setting decisions. Specifically, when an individual's past health has a direct impact on current or future health, and when one individual has enjoyed significantly more healthy life years than another.Finally, I demonstrate that by ignoring past illnesses, even those entirely unrelated to their current illness, proportional shortfall can lead to instances of double jeopardy, a highly problematic implication. These arguments give us reason to reject proportional shortfall. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A systematic review of controlled trials on visual stress using Intuitive Overlays or the Intuitive Colorimeter.

PubMed

Evans, Bruce J W; Allen, Peter M

2016-01-01

Claims that coloured filters aid reading date back 200 years and remain controversial. Some claims, for example, that more than 10% of the general population and 50% of people with dyslexia would benefit from coloured filters lack sound evidence and face validity. Publications with such claims typically cite research using methods that have not been described in the scientific literature and lack a sound aetiological framework. Notwithstanding these criticisms, some researchers have used more rigorous selection criteria and methods of prescribing coloured filters that were developed at a UK Medical Research Council unit and which have been fully described in the scientific literature. We review this research and disconfirm many of the more extreme claims surrounding this topic. This literature indicates that a minority subset of dyslexics (circa 20%) may have a condition described as visual stress which most likely results from a hyperexcitability of the visual cortex. Visual stress is characterised by symptoms of visual perceptual distortions, headaches, and eyestrain when viewing repetitive patterns, including lines of text. This review indicates that visual stress is distinct from, although sometimes co-occurs with, dyslexia. Individually prescribed coloured filters have been shown to improve reading performance in people with visual stress, but are unlikely to influence the phonological and memory deficits associated with dyslexia and therefore are not a treatment for dyslexia. This review concludes that larger and rigorous randomised controlled trials of interventions for visual stress are required. Improvements in the diagnosis of the condition are also a priority. Copyright © 2016. Published by Elsevier España, S.L.U.

How Are New Vaccines Prioritized in Low-Income Countries? A Case Study of Human Papilloma Virus Vaccine and Pneumococcal Conjugate Vaccine in Uganda.

PubMed

Wallace, Lauren; Kapirir, Lydia

2017-04-08

To date, research on priority-setting for new vaccines has not adequately explored the influence of the global, national and sub-national levels of decision-making or contextual issues such as political pressure and stakeholder influence and power. Using Kapiriri and Martin's conceptual framework, this paper evaluates priority setting for new vaccines in Uganda at national and sub-national levels, and considers how global priorities can influence country priorities. This study focuses on 2 specific vaccines, the human papilloma virus (HPV) vaccine and the pneumococcal conjugate vaccine (PCV). This was a qualitative study that involved reviewing relevant Ugandan policy documents and media reports, as well as 54 key informant interviews at the global level and national and sub-national levels in Uganda. Kapiriri and Martin's conceptual framework was used to evaluate the prioritization process. Priority setting for PCV and HPV was conducted by the Ministry of Health (MoH), which is considered to be a legitimate institution. While respondents described the priority setting process for PCV process as transparent, participatory, and guided by explicit relevant criteria and evidence, the prioritization of HPV was thought to have been less transparent and less participatory. Respondents reported that neither process was based on an explicit priority setting framework nor did it involve adequate representation from the districts (program implementers) or publicity. The priority setting process for both PCV and HPV was negatively affected by the larger political and economic context, which contributed to weak institutional capacity as well as power imbalances between development assistance partners and the MoH. Priority setting in Uganda would be improved by strengthening institutional capacity and leadership and ensuring a transparent and participatory processes in which key stakeholders such as program implementers (the districts) and beneficiaries (the public) are involved. Kapiriri and Martin's framework has the potential to guide priority setting evaluation efforts, however, evaluation should be built into the priority setting process a priori such that information on priority setting is gathered throughout the implementation cycle. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Developing the Systems Engineering Experience Accelerator (SEEA) Prototype and Roadmap

DTIC Science & Technology

2012-10-24

system attributes. These metrics track non-requirements performance, typically relate to production cost per unit, maintenance costs, training costs...immediately implement lessons learned from the training experience to the job, assuming the culture allows this. 1.3 MANAGEMENT PLAN/TECHNICAL OVERVIEW...resolving potential conflicts as they arise. Incrementally implement and continuously integrate capability in priority order, to ensure that final system

JPRS Report, East Europe

DTIC Science & Technology

1987-11-05

opinion research. practice in surveys. Poorly prepared surveys also affect They are inclined to attribute refusals more to the low the essential level of...order to achieve the most essential national the one hand, and on the other, on the right to elect the economic priorities, managers. Self-management... essential reproductive contribution to the through innovation. Under the circumstances, innova- implementation of SED economic strategy. This contri

The Relationship Between Perceptions of Wilderness Character and Attitudes Toward Management Intervention to Adapt Biophysical Resources to a Changing Climate and Nature Restoration at Sequoia and Kings Canyon National Parks.

PubMed

Watson, Alan; Martin, Steve; Christensen, Neal; Fauth, Gregg; Williams, Dan

2015-09-01

In a recent national survey of federal wilderness managers, respondents identified the high priority need for scientific information about public attitudes toward biophysical intervention to adapt to climate change and attitudes of the public toward restoration of natural conditions. In a survey of visitors to one National Park wilderness in California, visitors revealed that they largely do not support biophysical intervention in wilderness to mitigate the effects of climate change, but broad support for activities that restore natural conditions exists. In an attempt to understand how these attitudes vary among visitors, it was found that those visitors who most value naturalness aspects of wilderness character also most positively support restoration and are most negative toward climate change intervention practices. More information about visitor-defined wilderness character attributes is needed and strategic planning to guide intervention decisions and restoration should be a priority. In this study, it was found that wilderness character is largely defined by visitors based on its wildness attributes, which include natural sounds, low density of people, pure water, clean air, and the presence of humans substantially unnoticeable.

The Relationship Between Perceptions of Wilderness Character and Attitudes Toward Management Intervention to Adapt Biophysical Resources to a Changing Climate and Nature Restoration at Sequoia and Kings Canyon National Parks

NASA Astrophysics Data System (ADS)

Watson, Alan; Martin, Steve; Christensen, Neal; Fauth, Gregg; Williams, Dan

2015-09-01

In a recent national survey of federal wilderness managers, respondents identified the high priority need for scientific information about public attitudes toward biophysical intervention to adapt to climate change and attitudes of the public toward restoration of natural conditions. In a survey of visitors to one National Park wilderness in California, visitors revealed that they largely do not support biophysical intervention in wilderness to mitigate the effects of climate change, but broad support for activities that restore natural conditions exists. In an attempt to understand how these attitudes vary among visitors, it was found that those visitors who most value naturalness aspects of wilderness character also most positively support restoration and are most negative toward climate change intervention practices. More information about visitor-defined wilderness character attributes is needed and strategic planning to guide intervention decisions and restoration should be a priority. In this study, it was found that wilderness character is largely defined by visitors based on its wildness attributes, which include natural sounds, low density of people, pure water, clean air, and the presence of humans substantially unnoticeable.

26 CFR 48.6412-3 - Amount of tax paid on each article.

Code of Federal Regulations, 2010 CFR

2010-04-01

... article. (2) Price readjustments which cannot be attributed to specific articles as of the inventory date... 26 Internal Revenue 16 2010-04-01 2010-04-01 true Amount of tax paid on each article. 48.6412-3... article. (a) General rule. For purposes of making the claim for credit or refund under § 48.6412-1 in...

The UK Language Learning Crisis in the Public Media: A Critical Analysis

ERIC Educational Resources Information Center

Lanvers, Ursula; Coleman, James A.

2017-01-01

Low levels of foreign language learning in the United Kingdom have been attributed to a lack of interest and motivation which, it is claimed, is partly fostered by the media. The present study examines 90 UK newspaper articles that contributed to the public debate on the language learning crisis in the UK between February 2010 and February 2012.…

Cutaneous Leishmaniasis: The Truth about the 'Flesh-Eating Disease' in Syria.

PubMed

Mondragon-Shem, Karina; Acosta-Serrano, Alvaro

2016-06-01

Recent news headlines claimed that corpses thrown into Syrian streets are causing cutaneous leishmaniasis (CL) outbreaks. However, leishmaniasis is only transmitted by blood-feeding sandflies, not through human remains. High CL prevalence in Syria may instead be attributed to the absence of disease control programs due to the disruption of health services. Copyright © 2016 Elsevier Ltd. All rights reserved.

Is there a ‘new ethics of abortion'?

PubMed Central

Gillon, R.

2001-01-01

This paper argues that the central issue in the abortion debate has not changed since 1967 when the English parliament enacted the Abortion Act. That central issue concerns the moral status of the human fetus. The debate here is not, it is argued, primarily a moral debate, but rather a metaphysical debate and/or a theological debate—though one with massive moral implications. It concerns the nature and attributes that an entity requires to have "full moral standing" or "moral inviolability" including a "right to life". It concerns the question when, in its development from newly fertilised ovum to unequivocally mature, autonomous morally inviolable person does a human being acquire that nature and those attributes, and thus a "right to life". The paper briefly reviews standard answers to these questions, outlining some problems associated with each. Finally there is a brief discussion of one way in which the abortion debate has changed since 1967—notably in the increasingly vociferous claim, especially from disability rights sectors, that abortion on grounds of fetal abnormality implies contempt for and rejection of disabled people—a claim that is rebutted. Key Words: Abortion • moral status of fetus • abortion of abnormal fetuses PMID:11574651

Definitions and Developmental Processes in Research on Infant Morality

PubMed Central

Dahl, Audun

2016-01-01

Key terms in research on moral development also exist in everyday language. Tafreshi and her colleagues (2014) propose that researchers should use terms in ways consistent with their usage by non-researchers. This commentary questions this claim, and argues for the importance of providing clear and explicit definitions of terms such as “morality” and “innate,” of showing caution when attributing evaluations and judgments to infants, and of considering developmental processes preceding and succeeding the abilities demonstrated using looking-time and related measures. Progress is unlikely to result from conceptual analysis alone. However, conceptual clarity will make it easier to see what theories agree and disagree about as well as how opposing claims can be tested empirically. PMID:27570254

The double-edged sword of genetic accounts of criminality: causal attributions from genetic ascriptions affect legal decision making.

PubMed

Cheung, Benjamin Y; Heine, Steven J

2015-12-01

Much debate exists surrounding the applicability of genetic information in the courtroom, making the psychological processes underlying how people consider this information important to explore. This article addresses how people think about different kinds of causal explanations in legal decision-making contexts. Three studies involving a total of 600 Mechanical Turk and university participants found that genetic, versus environmental, explanations of criminal behavior lead people to view the applicability of various defense claims differently, perceive the perpetrator's mental state differently, and draw different causal attributions. Moreover, mediation and path analyses highlight the double-edged nature of genetic attributions-they simultaneously reduce people's perception of the perpetrator's sense of control while increasing people's tendencies to attribute the cause to internal factors and to expect the perpetrator to reoffend. These countervailing relations, in turn, predict sentencing in opposite directions, although no overall differences in sentencing or ultimate verdicts were found. © 2015 by the Society for Personality and Social Psychology, Inc.

Indications for spine surgery: validation of an administrative coding algorithm to classify degenerative diagnoses

PubMed Central

Lurie, Jon D.; Tosteson, Anna N.A.; Deyo, Richard A.; Tosteson, Tor; Weinstein, James; Mirza, Sohail K.

2014-01-01

Study Design Retrospective analysis of Medicare claims linked to a multi-center clinical trial. Objective The Spine Patient Outcomes Research Trial (SPORT) provided a unique opportunity to examine the validity of a claims-based algorithm for grouping patients by surgical indication. SPORT enrolled patients for lumbar disc herniation, spinal stenosis, and degenerative spondylolisthesis. We compared the surgical indication derived from Medicare claims to that provided by SPORT surgeons, the “gold standard”. Summary of Background Data Administrative data are frequently used to report procedure rates, surgical safety outcomes, and costs in the management of spinal surgery. However, the accuracy of using diagnosis codes to classify patients by surgical indication has not been examined. Methods Medicare claims were link to beneficiaries enrolled in SPORT. The sensitivity and specificity of three claims-based approaches to group patients based on surgical indications were examined: 1) using the first listed diagnosis; 2) using all diagnoses independently; and 3) using a diagnosis hierarchy based on the support for fusion surgery. Results Medicare claims were obtained from 376 SPORT participants, including 21 with disc herniation, 183 with spinal stenosis, and 172 with degenerative spondylolisthesis. The hierarchical coding algorithm was the most accurate approach for classifying patients by surgical indication, with sensitivities of 76.2%, 88.1%, and 84.3% for disc herniation, spinal stenosis, and degenerative spondylolisthesis cohorts, respectively. The specificity was 98.3% for disc herniation, 83.2% for spinal stenosis, and 90.7% for degenerative spondylolisthesis. Misclassifications were primarily due to codes attributing more complex pathology to the case. Conclusion Standardized approaches for using claims data to accurately group patients by surgical indications has widespread interest. We found that a hierarchical coding approach correctly classified over 90% of spine patients into their respective SPORT cohorts. Therefore, claims data appears to be a reasonably valid approach to classifying patients by surgical indication. PMID:24525995

Interrogating resilience in health systems development.

PubMed

van de Pas, Remco; Ashour, Majdi; Kapilashrami, Anuj; Fustukian, Suzanne

2017-11-01

The Fourth Global Symposium on Health Systems Research was themed around 'Resilient and responsive health systems for a changing world.' This commentary is the outcome of a panel discussion at the symposium in which the resilience discourse and its use in health systems development was critically interrogated. The 2014-15 Ebola outbreak in West-Africa added momentum for the wider adoption of resilient health systems as a crucial element to prepare for and effectively respond to crisis. The growing salience of resilience in development and health systems debates can be attributed in part to development actors and philanthropies such as the Rockefeller Foundation. Three concerns regarding the application of resilience to health systems development are discussed: (1) the resilience narrative overrules certain democratic procedures and priority setting in public health agendas by 'claiming' an exceptional policy space; (2) resilience compels accepting and maintaining the status quo and excludes alternative imaginations of just and equitable health systems including the socio-political struggles required to attain those; and (3) an empirical case study from Gaza makes the case that resilience and vulnerability are symbiotic with each other rather than providing a solution for developing a strong health system. In conclusion, if the normative aim of health policies is to build sustainable, universally accessible, health systems then resilience is not the answer. The current threats that health systems face demand us to imagine beyond and explore possibilities for global solidarity and justice in health. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Alfred binet and the concept of heterogeneous orders.

PubMed

Michell, Joel

2012-01-01

In a comment, hitherto unremarked upon, Alfred Binet, well known for constructing the first intelligence scale, claimed that his scale did not measure intelligence, but only enabled classification with respect to a hierarchy of intellectual qualities. Attempting to understand the reasoning behind this comment leads to an historical excursion, beginning with the ancient mathematician, Euclid and ending with the modern French philosopher, Henri Bergson. As Euclid explained (Heath, 1908), magnitudes constituting a given quantitative attribute are all of the same kind (i.e., homogeneous), but his criterion covered only extensive magnitudes. Duns Scotus (Cross, 1998) included intensive magnitudes by considering differences, which raised the possibility (later considered by Sutherland, 2004) of ordered attributes with heterogeneous differences between degrees ("heterogeneous orders"). Of necessity, such attributes are non-measurable. Subsequently, this became a basis for the "quantity objection" to psychological measurement, as developed first by Tannery (1875a,b) and then by Bergson (1889). It follows that for attributes investigated in science, there are three structural possibilities: (1) classificatory attributes (with heterogeneous differences between categories); (2) heterogeneous orders (with heterogeneous differences between degrees); and (3) quantitative attributes (with thoroughly homogeneous differences between magnitudes). Measurement is possible only with attributes of kind (3) and, as far as we know, psychological attributes are exclusively of kinds (1) or (2). However, contrary to the known facts, psychometricians, for their own special reasons insist that test scores provide measurements.

Alfred Binet and the Concept of Heterogeneous Orders†

PubMed Central

Michell, Joel

2012-01-01

In a comment, hitherto unremarked upon, Alfred Binet, well known for constructing the first intelligence scale, claimed that his scale did not measure intelligence, but only enabled classification with respect to a hierarchy of intellectual qualities. Attempting to understand the reasoning behind this comment leads to an historical excursion, beginning with the ancient mathematician, Euclid and ending with the modern French philosopher, Henri Bergson. As Euclid explained (Heath, 1908), magnitudes constituting a given quantitative attribute are all of the same kind (i.e., homogeneous), but his criterion covered only extensive magnitudes. Duns Scotus (Cross, 1998) included intensive magnitudes by considering differences, which raised the possibility (later considered by Sutherland, 2004) of ordered attributes with heterogeneous differences between degrees (“heterogeneous orders”). Of necessity, such attributes are non-measurable. Subsequently, this became a basis for the “quantity objection” to psychological measurement, as developed first by Tannery (1875a,b) and then by Bergson (1889). It follows that for attributes investigated in science, there are three structural possibilities: (1) classificatory attributes (with heterogeneous differences between categories); (2) heterogeneous orders (with heterogeneous differences between degrees); and (3) quantitative attributes (with thoroughly homogeneous differences between magnitudes). Measurement is possible only with attributes of kind (3) and, as far as we know, psychological attributes are exclusively of kinds (1) or (2). However, contrary to the known facts, psychometricians, for their own special reasons insist that test scores provide measurements. PMID:22912619

Respect for persons permits prioritizing treatment for HIV/AIDS.

PubMed

Metz, Thaddeus

2008-08-01

I defend a certain claim about rationing in the context of HIV/AIDS, namely the 'priority thesis' that the state of a developing country with a high rate of HIV should provide highly active anti-retroviral treatment (HAART) to those who would die without it, even if doing so would require not treating most other life-threatening diseases. More specifically,I defend the priority thesis in a negative way by refuting two influential and important arguments against it inspired by the Kantian principle of respect for persons. The 'equality argument' more or less maintains that prioritizing treatment for HIV/AIDS would objectionably treat those who suffer from it as more important than those who do not. The 'responsibility argument' says, roughly, that to ration life-saving treatment by prioritizing those with HIV would wrongly fail to hold people responsible for their actions, since most people infected with HIV could have avoided the foreseeable harm of infection. While it appears that a Kantian must think that one of these two arguments is sound, I maintain that, in fact, respect for persons grounds neither the equality nor responsibility argument against prioritizing HAART and hence at least permits doing so. If this negative defence of the priority thesis succeeds, then conceptual space is opened up for the possibility that respect for persons requires prioritizing HAART which argument I sketch in the conclusion as something to articulate and defend in future work.

The "natural" aversion: the FDA's reluctance to define a leading food-industry marketing claim, and the pressing need for a workable rule.

PubMed

Farris, April L

2010-01-01

As of 2009, the "natural foods" industry has become a 22.3 billion dollar giant and "all-natural" is the second-leading marketing claim for all new food products. Even in such a flourishing market, the Food and Drug Administration (FDA) has never defined the term "natural" through rulemaking. FDA and the U.S. Department of Agriculture (USDA) have instead created separate, non-identical policy statements governing the use of the term "natural," and FDA has abandoned efforts to define "natural" through rulemaking in the face of more pressing priorities. In absence of any governing federal standard, consumer advocacy groups and warring food industries have attempted to define "natural" to fit their preferences through high-stakes litigation of state law claims, leaving courts free to apply diverging standards without the expertise of FDA. Recent case law from federal district courts and the Supreme Court leaves little hope that FDA's current policy statement will preempt state law causes of action. To prevent a potential patchwork of definitions varying by state, and to create a legitimate standard resting on informed scientific expertise rather than consumer whims, FDA should engage in rulemaking to define the term "natural." This paper concludes by sketching potential formulations for such a rule based on FDA's previous successful rule-making ventures and standards used by natural foods retailers.

New Directives in School Performance: The Legislature as Advocate and Guarantor. Report of the Joint Committee on School Performance to the Seventeenth Alaska Legislature.

ERIC Educational Resources Information Center

Alaska State Legislature, Juneau.

In its enabling legislation, the Alaska Joint Committee on School Performance was instructed to identify and recommend those subjects for priority legislative attention that might lead to improved school performance. The Committee's study found that inadequate school performance can be attributed to the following needs: (1) stricter school…

Lessons Learned From Joint Training Land Management

DTIC Science & Technology

2013-02-28

abandoned, military training areas are refugia for rare and endangered species (Warren and Buttner, 2007; Cizek et al, 2013). This has been attributed...2003). An emerging approach to overcome the difficulties faced with competing priorities for restoration focussed on individual species or other...diversity and richness declined sharply on the passage of tracked vehicle traffic they returned to the same or higher levels during a four year study

IQ Differences between the North and South of Italy: A Reply to Beraldo and Cornoldi, Belacchi, Giofre, Martini, and Tressoldi

ERIC Educational Resources Information Center

Lynn, Richard

2010-01-01

Beraldo (2010) and Cornoldi, Belacchi, Giofre, Martini, and Tressoldi (2010) (CBGMT) have eight criticisms of my paper (Lynn, 2010) claiming that the large north-south differences in per capita income in Italy are attributable to differences in the average levels of intelligence in the populations. CBGMT give results for seven data sets for IQs in…

Economic Burden of Irritable Bowel Syndrome with Diarrhea: Retrospective Analysis of a U.S. Commercially Insured Population.

PubMed

Buono, Jessica L; Mathur, Kush; Averitt, Amelia J; Andrae, David A

2017-04-01

The economic burden associated with irritable bowel syndrome with diarrhea (IBS-D) is not well understood. To (a) evaluate total annual all-cause, gastrointestinal (GI)-related, and symptom-related (i.e., IBS, diarrhea, abdominal pain) health care resource use and costs among IBS-D patients in a U.S. commercially insured population and (b) estimate incremental all-cause health care costs of IBS-D patients versus matched controls. Patients aged ≥ 18 years with 12 months of continuous medical and pharmacy benefit eligibility in 2013 were identified from the Truven Health MarketScan research database. The study sample included patients with ≥ 1 medical claim with an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis code in any position for IBS (ICD-9-CM 564.1x) and either (a) ≥ 2 claims for diarrhea (ICD-9-CM 787.91, 564.5x) on different service dates in 2013, or (b) ≥ 1 claim for diarrhea plus ≥ 1 claim for abdominal pain (ICD-9-CM 789.0x) on different service dates in 2013, or (c) ≥ 1 claim for diarrhea plus ≥ 1 pharmacy claim for a symptom-related prescription on different service dates in 2013. Controls included patients with no claims for IBS, diarrhea, abdominal pain, or symptom-related prescriptions in 2013. Controls were randomly selected and matched with IBS-D patients in a 1:1 ratio based on age (± 4 years), gender, geographic location, and health plan type. All-cause health care resource utilization included medical and pharmacy claims for health care services associated with any condition. Total health care costs were defined as the sum of health plan-paid and patient-paid direct health care costs from prescriptions and medical services, including inpatient, emergency department (ED), and physician office visits, and other outpatient services. A total cost approach was used to assess all-cause, GI-related, and symptom-related health care costs for IBS-D patients. An incremental cost approach via generalized linear models was used to assess the excess all-cause costs attributable to IBS-D after adjusting for demographics and general and GI comorbidities. Of 39,306 patients (n = 19,653 each for IBS-D and matched controls) included, mean (± SD) age was 47 (± 17) years and 76.5% were female. Compared with controls, IBS-D patients had a significantly higher mean annual number of hospitalizations, ED visits, office visits, and monthly (30-day) prescription fills. Mean annual all-cause health care costs for IBS-D patients were $13,038, with over half (58.4%) attributable to office visits and other outpatient services (e.g., diagnostic tests and laboratory or radiology services), and remaining costs attributable to prescriptions (19.5%), inpatient admissions (13.6%), and ED visits (8.5%). GI-related ($3,817) and symptom-related ($1,693) costs were also primarily driven by other outpatient service costs. After adjusting for demographics and comorbidities, incremental annual all-cause costs associated with IBS-D were $2,268 ($9,436 for IBS-D patients vs. $7,169 for matched controls; P < 0.001) per patient/year, of which 78% were from medical costs and 22% were from prescription costs. IBS-D was associated with a substantial burden in direct costs in this population. Compared with matched controls, IBS-D patients had greater medical service use and incurred significantly more annual all-cause health care costs, even after controlling for demographics and comorbidities. Incremental costs associated with IBS-D were primarily attributable to increased use of medical services rather than pharmacy costs. This study was funded by Allergan. The authors received no compensation related to the development of the manuscript. Buono and Andrae are employees of Allergan. Mathur is an employee of Axtria. Averitt was an employee of Axtria at the time this study was conducted. Data from this manuscript have previously been presented in poster format by Buono at the American College of Gastroenterology Annual Scientific Meeting; Honolulu, Hawaii; October 16-21, 2015. Mathur and Averitt were involved in conducting the study analyses. All authors were involved in the study design, interpretation of the data, and preparation of the manuscript. The authors take full responsibility for the scope, direction, and content of the manuscript and have approved the submitted manuscript.

Examining Whether Dental Therapists Constitute a Disruptive Innovation in US Dentistry

PubMed Central

2011-01-01

Dental therapists—midlevel dental providers who are roughly analogous to nurse practitioners in medicine—might constitute a disruptive innovation within US dentistry. Proponents tend to claim that dental therapists will provide more equitable access to dental care; opponents tend to view them from a perspective that focuses on retaining the current attributes of the dental profession. Therapists display traits similar to those of disruptive innovations: their attributes are different from dentists’, they may not initially be valued by current dental patients, they may appeal to current dental underutilizers, and they may transform the dental delivery system. Whether dental therapists constitute a disruptive innovation will only be determined retrospectively. PMID:21852623

Regional scale prioritisation for key ecosystem services, renewable energy production and urban development.

PubMed

Casalegno, Stefano; Bennie, Jonathan J; Inger, Richard; Gaston, Kevin J

2014-01-01

Although the importance of addressing ecosystem service benefits in regional land use planning and decision-making is evident, substantial practical challenges remain. In particular, methods to identify priority areas for the provision of key ecosystem services and other environmental services (benefits from the environment not directly linked to the function of ecosystems) need to be developed. Priority areas are locations which provide disproportionally high benefits from one or more service. Here we map a set of ecosystem and environmental services and delineate priority areas according to different scenarios. Each scenario is produced by a set of weightings allocated to different services and corresponds to different landscape management strategies which decision makers could undertake. Using the county of Cornwall, U.K., as a case study, we processed gridded maps of key ecosystem services and environmental services, including renewable energy production and urban development. We explored their spatial distribution patterns and their spatial covariance and spatial stationarity within the region. Finally we applied a complementarity-based priority ranking algorithm (zonation) using different weighting schemes. Our conclusions are that (i) there are two main patterns of service distribution in this region, clustered services (including agriculture, carbon stocks, urban development and plant production) and dispersed services (including cultural services, energy production and floods mitigation); (ii) more than half of the services are spatially correlated and there is high non-stationarity in the spatial covariance between services; and (iii) it is important to consider both ecosystem services and other environmental services in identifying priority areas. Different weighting schemes provoke drastic changes in the delineation of priority areas and therefore decision making processes need to carefully consider the relative values attributed to different services.

Regional Scale Prioritisation for Key Ecosystem Services, Renewable Energy Production and Urban Development

PubMed Central

Casalegno, Stefano; Bennie, Jonathan J.; Inger, Richard; Gaston, Kevin J.

2014-01-01

Although the importance of addressing ecosystem service benefits in regional land use planning and decision-making is evident, substantial practical challenges remain. In particular, methods to identify priority areas for the provision of key ecosystem services and other environmental services (benefits from the environment not directly linked to the function of ecosystems) need to be developed. Priority areas are locations which provide disproportionally high benefits from one or more service. Here we map a set of ecosystem and environmental services and delineate priority areas according to different scenarios. Each scenario is produced by a set of weightings allocated to different services and corresponds to different landscape management strategies which decision makers could undertake. Using the county of Cornwall, U.K., as a case study, we processed gridded maps of key ecosystem services and environmental services, including renewable energy production and urban development. We explored their spatial distribution patterns and their spatial covariance and spatial stationarity within the region. Finally we applied a complementarity-based priority ranking algorithm (zonation) using different weighting schemes. Our conclusions are that (i) there are two main patterns of service distribution in this region, clustered services (including agriculture, carbon stocks, urban development and plant production) and dispersed services (including cultural services, energy production and floods mitigation); (ii) more than half of the services are spatially correlated and there is high non-stationarity in the spatial covariance between services; and (iii) it is important to consider both ecosystem services and other environmental services in identifying priority areas. Different weighting schemes provoke drastic changes in the delineation of priority areas and therefore decision making processes need to carefully consider the relative values attributed to different services. PMID:25250775

Proper laboratory notebook practices: protecting your intellectual property.

PubMed

Nickla, Jason T; Boehm, Matthew B

2011-03-01

A laboratory notebook contains a wealth of knowledge that can be critical for establishing evidence in support of intellectual property rights and for refuting claims of research misconduct. The proper type, organization, use, maintenance, and storage of laboratory notebooks should be a priority for everyone at research institutions. Failure to properly document research activities can lead to serious problems, including the loss of valuable patent rights. Consequences of improper laboratory notebook practices can be harsh; numerous examples are described in court cases and journal articles, indicating a need for research institutions to develop strict policies on the proper use and storage of research documentation.

Lost in processing? Perceived healthfulness, taste and caloric content of whole and processed organic food.

PubMed

Prada, Marília; Garrido, Margarida V; Rodrigues, David

2017-07-01

The "organic" claim explicitly informs consumers about the food production method. Yet, based on this claim, people often infer unrelated food attributes. The current research examined whether the perceived advantage of organic over conventional food generalizes across different organic food types. Compared to whole organic foods, processed organic foods are less available, familiar and prototypical of the organic food category. In two studies (combined N = 258) we investigated how both organic foods types were perceived in healthfulness, taste and caloric content when compared to their conventional alternatives. Participants evaluated images of both whole (e.g., lettuce) and processed organic food exemplars (e.g., pizza), and reported general evaluations of these food types. The association of these evaluations with individual difference variables - self-reported knowledge and consumption of organic food, and environmental concerns - was also examined. Results showed that organically produced whole foods were perceived as more healthful, tastier and less caloric than those produced conventionally, thus replicating the well-established halo effect of the organic claim in food evaluation. The organic advantage was more pronounced among individuals who reported being more knowledgeable about organic food, consumed it more frequently, and were more environmentally concerned. The advantage of the organic claim for processed foods was less clear. Overall, processed organic (vs. conventional) foods were perceived as tastier, more healthful (Study 1) or equally healthful (Study 2), but also as more caloric. We argue that the features of processed food may modulate the impact of the organic claim, and outline possible research directions to test this assumption. Uncovering the specific conditions in which food claims bias consumer's perceptions and behavior may have important implications for marketing, health and public-policy related fields. Copyright © 2017 Elsevier Ltd. All rights reserved.

Arrival order and release from competition does not explain why haplochromine cichlids radiated in Lake Victoria.

PubMed

Muschick, Moritz; Russell, James M; Jemmi, Eliane; Walker, Jonas; Stewart, Kathlyn M; Murray, Alison M; Dubois, Nathalie; Stager, J Curt; Johnson, Thomas C; Seehausen, Ole

2018-05-16

The frequent occurrence of adaptive radiations on oceanic islands and in lakes is often attributed to ecological opportunity resulting from release from competition where arrival order among lineages predicts which lineage radiates. This priority effect occurs when the lineage that arrives first expands its niche breadth and diversifies into a set of ecological specialists with associated monopolization of the resources. Later-arriving species do not experience ecological opportunity and do not radiate. While theoretical support and evidence from microbial experiments for priority effects are strong, empirical evidence in nature is difficult to obtain. Lake Victoria (LV) is home to an exceptional adaptive radiation of haplochromine cichlid fishes, where 20 trophic guilds and several hundred species emerged in just 15 000 years, the age of the modern lake that was preceded by a complete desiccation lasting several thousand years. However, while about 50 other lineages of teleost fish also have established populations in the lake, none of them has produced more than two species and most of them did not speciate at all. Here, we test if the ancestors of the haplochromine radiation indeed arrived prior to the most competent potential competitors, 'tilapias' and cyprinids, both of which have made rapid radiations in other African lakes. We assess LV sediment core intervals from just before the desiccation and just after refilling for the presence of fossil fish teeth. We show that all three lineages were present when modern LV began to fill with water. We conclude that the haplochromines' extraordinary radiation unfolded in the presence of potentially competing lineages and cannot be attributed to a simple priority effect. © 2018 The Author(s).

Lewis M. Rutherfurd and the First Photograph of Solar Granulation

NASA Astrophysics Data System (ADS)

Harvey, J. W.; Briggs, John W.; Prosser, Sian

2017-08-01

A major astronomical controversy of the mid-19th century was discordant descriptions of the small scale structure of the solar surface. Visual observers contradicted each other by describing the surface as consisting of “corrugations”, “willow leaves”, “rice grains”, “cumuli”, “thatch”, “granules”, etc. Early photographs of the solar surface were not good enough to settle the controversy. The French astronomer Jules Janssen is credited with the first 1876 photographs that clearly showed what we now call solar granulation (1876, CRAS 82, 1363). Upon seeing these images, New Yorker Lewis M. Rutherfurd (1878, MNRAS 38, 410) praised the high quality of Janssen’s images but asserted that he had also photographed granulation as early as 1871 using collodion wet plates. He sent copies of his best photograph to the Royal Astronomical Society to support his assertion. Curious about his claim, Briggs and Harvey set up Rutherfurd’s 13-inch achromatic refractor on Kitt Peak and found that it easily showed well-resolved solar granulation, so his claim might well have been justified. But without his plates we could not confirm the claim. For 140 years the copies of Rutherfurd’s best solar photograph remained in the archives of the Royal Astronomical Society and were recently discovered by Prosser (RAS Photographs A3/001B and A3/002). By coincidence a few days later, Briggs found the original August 11, 1871 plate. Despite poor condition these photographs show solar granulation. There are at least two other possible early claimants (Reade; Vogel) but their plates are almost certainly lost. Rutherfurd was a master of astronomical instrumentation and photography. He was reticent about his work, letting results speak for themselves, so it is satisfying to find that he was justified in making his claim of priority.

Matters of Priority: Herbert Mayo, Charles Bell and Discoveries in the Nervous System

PubMed Central

Bradley, James

2014-01-01

Between 1822 and the late 1830s a highly personal priority dispute was fought between the celebrated surgeon and anatomist Sir Charles Bell and his ex-student Herbert Mayo. The dispute was over the motor and sensory functions of the Vth and VIIth cranial nerves. Over the course of the 1820s and the 1830s, the competing claims of Bell and Mayo were presented in newspapers, journals, and textbooks. But by the time of Bell’s death in 1842, Mayo had been discredited, a seemingly tragic footnote in the history of nervous discovery. And yet, with the benefit of hindsight, Bell’s case was at best disingenuous. His success was not due to any intrinsic scientific merit in his argument, but rather his ability to create a narrative that undermined the credibility of Mayo. However, only when Mayo’s public performances elided with Bell’s descriptions did this ploy succeed. As a result, the dispute illuminates the importance of credibility to the creation of an idealised scientific medical practitioner. PMID:25284895

What is the optimum social marketing mix to market energy conservation behaviour: an empirical study.

PubMed

Sheau-Ting, Low; Mohammed, Abdul Hakim; Weng-Wai, Choong

2013-12-15

This study attempts to identify the optimum social marketing mix for marketing energy conservation behaviour to students in Malaysian universities. A total of 2000 students from 5 major Malaysian universities were invited to provide their preferred social marketing mix. A choice-based conjoint analysis identified a mix of five social marketing attributes to promote energy conservation behaviour; the mix is comprised of the attributes of Product, Price, Place, Promotion, and Post-purchase Maintenance. Each attribute of the mix is associated with a list of strategies. The Product and Post-purchase Maintenance attributes were identified by students as the highest priority attributes in the social marketing mix for energy conservation behaviour marketing, with shares of 27.12% and 27.02%, respectively. The least preferred attribute in the mix is Promotion, with a share of 11.59%. This study proposes an optimal social marketing mix to university management when making decisions about marketing energy conservation behaviour to students, who are the primary energy consumers in the campus. Additionally, this study will assist university management to efficiently allocate scarce resources in fulfilling its social responsibility and to overcome marketing shortcomings by selecting the right marketing mix. Copyright © 2013 Elsevier Ltd. All rights reserved.

Commercial versus technical cues to position a new product: Do hedonic and functional/healthy packages differ?

PubMed

Vila-López, Natalia; Küster-Boluda, Inés

2018-02-01

Packaging attributes can be classified into two main blocks: visual/commercial attributes and informational/technical ones. In this framework, our objectives are: (i) to compare if both kinds of attributes lead to equal responses (consumers' attitudes improvement and product trial) and (ii) to compare if they work equally when a hedonic or a healthy new product is launched into the young market. An experimental design was defined to reach both objectives. Two packaging attributes were manipulated orthogonally to introduce greater variation in people's perceptions: a visual cue (the color) and an informative cue (the claim/label). A third variable was introduced: hedonic (candy bars) versus functional/healthy products (juice with fruit and milk). In a laboratory, 300 young consumers chose and evaluated one of the different packages that were simulated (using different colors and labels). Our results show that both kinds of attributes are significant, but visual cues were more strongly associated with young consumers' positive attitudes towards the product and their intention to buy than technical cues. Results do not differ between the product categories.7. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effects of comparative claims in prescription drug direct-to-consumer advertising on consumer perceptions and recall.

PubMed

O'Donoghue, Amie C; Williams, Pamela A; Sullivan, Helen W; Boudewyns, Vanessa; Squire, Claudia; Willoughby, Jessica Fitts

2014-11-01

Although pharmaceutical companies cannot make comparative claims in direct-to-consumer (DTC) ads for prescription drugs without substantial evidence, the U.S. Food and Drug Administration permits some comparisons based on labeled attributes of the drug, such as dosing. Researchers have examined comparative advertising for packaged goods; however, scant research has examined comparative DTC advertising. We conducted two studies to determine if comparative claims in DTC ads influence consumers' perceptions and recall of drug information. In Experiment 1, participants with osteoarthritis (n=1934) viewed a fictitious print or video DTC ad that had no comparative claim or made an efficacy comparison to a named or unnamed competitor. Participants who viewed print (but not video) ads with named competitors had greater efficacy and lower risk perceptions than participants who viewed unnamed competitor and noncomparative ads. In Experiment 2, participants with high cholesterol or high body mass index (n=5317) viewed a fictitious print or video DTC ad that had no comparative claim or made a comparison to a named or unnamed competitor. We varied the type of comparison (of indication, dosing, or mechanism of action) and whether the comparison was accompanied by a visual depiction. Participants who viewed print and video ads with named competitors had greater efficacy perceptions than participants who viewed unnamed competitor and noncomparative ads. Unlike Experiment 1, named competitors in print ads resulted in higher risk perceptions than unnamed competitors. In video ads, participants who saw an indication comparison had greater benefit recall than participants who saw dosing or mechanism of action comparisons. In addition, visual depictions of the comparison decreased risk recall for video ads. Overall, the results suggest that comparative claims in DTC ads could mislead consumers about a drug's efficacy and risk; therefore, caution should be used when presenting comparative claims in DTC ads. Published by Elsevier Ltd.

Active and passive surveillance of enoxaparin generics: a case study relevant to biosimilars.

PubMed

Grampp, Gustavo; Bonafede, Machaon; Felix, Thomas; Li, Edward; Malecki, Michael; Sprafka, J Michael

2015-03-01

This retrospective analysis assessed the capability of active and passive safety surveillance systems to track product-specific safety events in the USA for branded and generic enoxaparin, a complex injectable subject to immune-related and other adverse events (AEs). Analysis of heparin-induced thrombocytopenia (HIT) incidence was performed on benefit claims for commercial and Medicare supplemental-insured individuals newly treated with enoxaparin under pharmacy benefit (1 January 2009 - 30 June 2012). Additionally, spontaneous reports from the FDA AE Reporting System were reviewed to identify incidence and attribution of enoxaparin-related reports to specific manufacturers. Specific, dispensed products were identifiable from National Drug Codes only in pharmacy-benefit databases, permitting sensitive comparison of HIT incidence in nearly a third of patients treated with brand or generic enoxaparin. After originator medicine's loss of exclusivity, only 5% of spontaneous reports were processed by generic manufacturers; reports attributable to specific generics were approximately ninefold lower than expected based on market share. Claims data were useful for active surveillance of enoxaparin generics dispensed under pharmacy benefits but not for products administered under medical benefits. These findings suggest that the current spontaneous reporting system will not distinguish product-specific safety signals for products distributed by multiple manufacturers, including biosimilars.

Characterization and assessment of potential environmental risk of tailings stored in seven impoundments in the Aries river basin, Western Romania

PubMed Central

2013-01-01

Background The objective of this study was to examine the potential environmental risk of tailings resulted after precious and base metal ores processing, stored in seven impoundments located in the Aries river basin, Romania. The tailings were characterized by mineralogical and elemental composition, contamination indices, acid rock drainage generation potential and water leachability of hazardous/priority hazardous metals and ions. Multivariate statistical methods were used for data interpretation. Results Tailings were found to be highly contaminated with several hazardous/priority hazardous metals (As, Cu, Cd, Pb), and pose potential contamination risk for soil, sediments, surface and groundwater. Two out of the seven studied impoundments does not satisfy the criteria required for inert wastes, shows acid rock drainage potential and thus can contaminate the surface and groundwater. Three impoundments were found to be highly contaminated with As, Pb and Cd, two with As and other two with Cu. The tailings impoundments were grouped based on the enrichment factor, geoaccumulation index, contamination factor and contamination degree of 7 hazardous/priority hazardous metals (As, Cd, Cr, Cu, Ni, Pb, Zn) considered typical for the studied tailings. Principal component analysis showed that 47% of the elemental variability was attributable to alkaline silicate rocks, 31% to acidic S-containing minerals, 12% to carbonate minerals and 5% to biogenic elements. Leachability of metals and ions was ascribed in proportion of 61% to silicates, 11% to acidic minerals and 6% to the organic matter. A variability of 18% was attributed to leachability of biogenic elements (Na, K, Cl-, NO3-) with no potential environmental risk. Pattern recognition by agglomerative hierarchical clustering emphasized the grouping of impoundments in agreement with their contamination degree and acid rock drainage generation potential. Conclusions Tailings stored in the studied impoundments were found to be contaminated with some hazardous/ priority hazardous metals, fluoride and sulphate and thus presents different contamination risk for the environment. A long term monitoring program of these tailings impoundments and the expansion of the ecologization measures in the area is required. PMID:23311708

Identification and status revisited: the moderating role of self-enhancement and self-transcendence values.

PubMed

Roccas, Sonia

2003-06-01

Two studies examined the moderating role of the importance attributed to self-enhancement and self-transcendence values on the association of group status with identification. In the first study, students reported their personal value priorities, their identification with a group, and their perception of the status of that group. The more importance respondents attributed to self-enhancement and the less importance to self-transcendence, the more their identification with a group depended on the group's status. In the second study, the salience of self-enhancement and of self-transcendence values was experimentally manipulated. Identification with a group depended more on the status of that group when self-enhancement values were salient than when self-transcendence values were salient.

Employer health care plan design and its effect on plan costs.

PubMed

Custer, W S

1991-01-01

This study uses claims data from employers in the Houston Area Health Care Coalition (HAHCC) for 1985 through the first half of 1987 to examine the effect of health care plan attributes on health care costs. Plan attributes affect the site of care and the costs of care. Utilization review clearly was effective in reducing the demand for inpatient services, but that reduction was in large measure matched by increases in care in the outpatient setting. Restrictions on mental health benefits also shifted the site of care. In contrast, neither premium sharing nor the plan's deductible had a significant impact on total plan charges. The study results demonstrate the need to have a comprehensive cost management strategy.

Enhancing the prediction of self-handicapping.

PubMed

Harris, R N; Snyder, C R; Higgins, R L; Schrag, J L

1986-12-01

Levels of test anxiety, Type A and Type B coronary-prone behavior, fear of failure, and covert self-esteem were studied as predictors of self-handicapping performance attributions for college women who were placed in either a high- (N = 49) or low- (N = 49) evaluative test or task situation. We hypothesized that test anxiety. Type A or Type B level, and their interaction would account for reliable variance in the prediction of self-handicapping. However, we also theorized that underlying high fear of failure and low covert self-esteem would explain the self-handicapping claims of test-anxious and Type A subjects. The results indicated that only high levels of test anxiety and high levels of covert self-esteem were related to women's self-handicapping attributions.

Identifying public expectations of genetic biobanks.

PubMed

Critchley, Christine; Nicol, Dianne; McWhirter, Rebekah

2017-08-01

Understanding public priorities for biobanks is vital for maximising utility and efficiency of genetic research and maintaining respect for donors. This research directly assessed the relative importance the public place on different expectations of biobanks. Quantitative and qualitative results from a national sample of 800 Australians revealed that the majority attributed more importance to protecting privacy and ethical conduct than maximising new healthcare benefits, which was in turn viewed as more important than obtaining specific consent, benefit sharing, collaborating and sharing data. A latent class analysis identified two distinct classes displaying different patterns of expectations. One placed higher priority on behaviours that respect the donor ( n = 623), the other on accelerating science ( n = 278). Additional expectations derived from qualitative data included the need for biobanks to be transparent and to prioritise their research focus, educate the public and address commercialisation.

Reaching common ground: a patient-family-based conceptual framework of quality EOL care.

PubMed

Howell, Doris; Brazil, Kevin

2005-01-01

Improvement in the quality of end-of-life (EOL) care is a priority health care issue since serious deficiencies in quality of care have been reported across care settings. Increasing pressure is now focused on Canadian health care organizations to be accountable for the quality of palliative and EOL care delivered. Numerous domains of quality EOL care upon which to create accountability frameworks are now published, with some derived from the patient/family perspective. There is a need to reach common ground on the domains of quality EOL care valued by patients and families in order to develop consistent performance measures and set priorities for health care improvement. This paper describes a meta-synthesis study to develop a common conceptual framework of quality EOL care integrating attributes of quality valued by patients and their families.

The Born Rule and Free Will: why Libertarian Agent-Causal Free Will is not "antiscientific"

NASA Astrophysics Data System (ADS)

Kastner, Ruth E.

In the libertarian "agent causation" view of free will, free choices are attributable only to the choosing agent, as opposed to a specific cause or causes outside the agent. An often-repeated claim in the philosophical literature on free will is that agent causation necessarily implies lawlessness, and is therefore "antiscientific." That claim is critiqued and it is argued, on the contrary, that the volitional powers of a free agent need not be viewed as anomic, specifically with regard to the quantum statistical law (the Born Rule). Assumptions about the role and nature of causation, taken as bearing on volitional agency, are examined and found inadequate to the task. Finally, it is suggested that quantum theory may constitute precisely the sort of theory required for a nomic grounding of libertarian free will.

"Lost in a shopping mall" -- a breach of professional ethics.

PubMed

Crook, Lynn S; Dean, Martha C

1999-01-01

The "lost in a shopping mall" study has been cited to support claims that psychotherapists can implant memories of false autobiographical information of childhood trauma in their patients. The mall study originated in 1991 as 5 pilot experiments involving 3 children and 2 adult participants. The University of Washington Human Subjects Committee granted approval for the mall study on August 10, 1992. The preliminary results with the 5 pilot subjects were announced 4 days laters. An analysis of the mall study shows that beyond the external misrepresentions, internal scientific methodological errors cast doubt on the validity of the claims that have been attributed to the mall study within scholarly and legal arenas. The minimal involvement -- or, in some cases, negative impact -- of collegial consultation, acadmic supervision, and peer review throughout the evolution of the mall study are reviewed.

The role of causal criteria in causal inferences: Bradford Hill's "aspects of association".

PubMed

Ward, Andrew C

2009-06-17

As noted by Wesley Salmon and many others, causal concepts are ubiquitous in every branch of theoretical science, in the practical disciplines and in everyday life. In the theoretical and practical sciences especially, people often base claims about causal relations on applications of statistical methods to data. However, the source and type of data place important constraints on the choice of statistical methods as well as on the warrant attributed to the causal claims based on the use of such methods. For example, much of the data used by people interested in making causal claims come from non-experimental, observational studies in which random allocations to treatment and control groups are not present. Thus, one of the most important problems in the social and health sciences concerns making justified causal inferences using non-experimental, observational data. In this paper, I examine one method of justifying such inferences that is especially widespread in epidemiology and the health sciences generally - the use of causal criteria. I argue that while the use of causal criteria is not appropriate for either deductive or inductive inferences, they do have an important role to play in inferences to the best explanation. As such, causal criteria, exemplified by what Bradford Hill referred to as "aspects of [statistical] associations", have an indispensible part to play in the goal of making justified causal claims.

Validity and reliability of portfolio assessment of student competence in two dental school populations: a four-year study.

PubMed

Gadbury-Amyot, Cynthia C; McCracken, Michael S; Woldt, Janet L; Brennan, Robert L

2014-05-01

The purpose of this study was to empirically investigate the validity and reliability of portfolio assessment in two U.S. dental schools using a unified framework for validity. In the process of validation, it is not the test that is validated but rather the claims (interpretations and uses) about test scores that are validated. Kane's argument-based validation framework provided the structure for reporting results where validity claims are followed by evidence to support the argument. This multivariate generalizability theory study found that the greatest source of variance was attributable to faculty raters, suggesting that portfolio assessment would benefit from two raters' evaluating each portfolio independently. The results are generally supportive of holistic scoring, but analytical scoring deserves further research. Correlational analyses between student portfolios and traditional measures of student competence and readiness for licensure resulted in significant correlations between portfolios and National Board Dental Examination Part I (r=0.323, p<0.01) and Part II scores (r=0.268, p<0.05) and small and non-significant correlations with grade point average and scores on the Western Regional Examining Board (WREB) exam. It is incumbent upon the users of portfolio assessment to determine if the claims and evidence arguments set forth in this study support the proposed claims for and decisions about portfolio assessment in their respective institutions.

The role of causal criteria in causal inferences: Bradford Hill's "aspects of association"

PubMed Central

Ward, Andrew C

2009-01-01

As noted by Wesley Salmon and many others, causal concepts are ubiquitous in every branch of theoretical science, in the practical disciplines and in everyday life. In the theoretical and practical sciences especially, people often base claims about causal relations on applications of statistical methods to data. However, the source and type of data place important constraints on the choice of statistical methods as well as on the warrant attributed to the causal claims based on the use of such methods. For example, much of the data used by people interested in making causal claims come from non-experimental, observational studies in which random allocations to treatment and control groups are not present. Thus, one of the most important problems in the social and health sciences concerns making justified causal inferences using non-experimental, observational data. In this paper, I examine one method of justifying such inferences that is especially widespread in epidemiology and the health sciences generally – the use of causal criteria. I argue that while the use of causal criteria is not appropriate for either deductive or inductive inferences, they do have an important role to play in inferences to the best explanation. As such, causal criteria, exemplified by what Bradford Hill referred to as "aspects of [statistical] associations", have an indispensible part to play in the goal of making justified causal claims. PMID:19534788

Work-related injuries among commercial janitors in Washington State, comparisons by gender.

PubMed

Smith, Caroline K; Anderson, Naomi J

2017-09-01

We analyzed workers' compensation (WC) data to identify characteristics related to workers' compensation claim outcomes among janitorial service workers in Washington State. We analyzed WC data from the Washington State Department of Labor & Industries (L&I) State Fund (SF) from January 1, 2003 through December 31, 2013, for janitorial service workers employed in the National Occupational Research Agenda (NORA) Services Sector. We constructed multivariable models to identify factors associated with higher medical costs and increased time lost from work. There were 2,390 janitorial service compensable claims available for analysis. There were significant differences in injury type and other factors by gender, age, and language preference. Linguistic minority status was associated with longer time loss and higher median medical costs. Women were estimated to account for 35% of janitorial service workers but made up 55% of the compensable claims in this study. Janitorial service workers comprise a large vulnerable occupational group in the U.S. workforce. Identifying differences by injury type and potential inequitable outcomes by gender and language is important to ensuring equal treatment in the workers' compensation process. There were significant differences in injury and individual characteristics between men and women in this study. Women had twice the estimated rate of injury to men, and were more likely to require Spanish language materials. Improving communication for training and knowledge about the workers' compensation system appear to be high priorities in this population of injured janitorial service workers. Copyright © 2017 Elsevier Ltd and National Safety Council. All rights reserved.

Preventing the Emasculation of Warfare: Halting the Expansion of Human Rights Law into Armed Conflict

DTIC Science & Technology

2007-04-01

that society "givfes] priority to things that are coded culturally as masculine traits. See Amanda Morgan, The State and International Law (May 31...attributes as masculine or feminine, and current events—for example tough leadership, taking action and military security—are coded as ’ masculine ...importance of state sovereignty and consent. Professor Duncan Hollis points to 1 77 terrorism, hegemony , and globalization as three such issues

9 CFR 381.456 - Nutrient content claims for “light” or “lite.”

Code of Federal Regulations, 2011 CFR

2011-01-01

..., color, and prominence. (3) The terms “light” or “lite” may be used in the brand name of a product to... attribute of the product such as texture or color and the information (e.g., “light in color” or “light in... “texture”) is in the same style, color, and at least one-half the type size as the word “light” and in...

9 CFR 381.456 - Nutrient content claims for “light” or “lite.”

Code of Federal Regulations, 2012 CFR

2012-01-01

..., color, and prominence. (3) The terms “light” or “lite” may be used in the brand name of a product to... attribute of the product such as texture or color and the information (e.g., “light in color” or “light in... “texture”) is in the same style, color, and at least one-half the type size as the word “light” and in...

9 CFR 381.456 - Nutrient content claims for “light” or “lite.”

Code of Federal Regulations, 2014 CFR

2014-01-01

..., color, and prominence. (3) The terms “light” or “lite” may be used in the brand name of a product to... attribute of the product such as texture or color and the information (e.g., “light in color” or “light in... “texture”) is in the same style, color, and at least one-half the type size as the word “light” and in...

Health Benefits and Cost-Effectiveness of Brief Clinician Tobacco Counseling for Youth and Adults.

PubMed

Maciosek, Michael V; LaFrance, Amy B; Dehmer, Steven P; McGree, Dana A; Xu, Zack; Flottemesch, Thomas J; Solberg, Leif I

2017-01-01

To help clinicians and care systems determine the priority for tobacco counseling in busy clinic schedules, we assessed the lifetime health and economic value of annually counseling youth to discourage smoking initiation and of annually counseling adults to encourage cessation. We conducted a microsimulation analysis to estimate the health impact and cost effectiveness of both types of tobacco counseling in a US birth cohort of 4,000,000. The model used for the analysis was constructed from nationally representative data sets and structured literature reviews. Compared with no tobacco counseling, the model predicts that annual counseling for youth would reduce the average prevalence of smoking cigarettes during adult years by 2.0 percentage points, whereas annual counseling for adults will reduce prevalence by 3.8 percentage points. Youth counseling would prevent 42,686 smoking-attributable fatalities and increase quality-adjusted life years (QALYs) by 756,601 over the lifetime of the cohort. Adult counseling would prevent 69,901 smoking-attributable fatalities and increase QALYs by 1,044,392. Youth and adult counseling would yield net savings of $225 and $580 per person, respectively. If annual tobacco counseling was provided to the cohort during both youth and adult years, then adult smoking prevalence would be 5.5 percentage points lower compared with no counseling, and there would be 105,917 fewer smoking-attributable fatalities over their lifetimes. Only one-third of the potential health and economic benefits of counseling are being realized at current counseling rates. Brief tobacco counseling provides substantial health benefits while producing cost savings. Both youth and adult intervention are high-priority uses of limited clinician time. © 2017 Annals of Family Medicine, Inc.

Health Benefits and Cost-Effectiveness of Brief Clinician Tobacco Counseling for Youth and Adults

PubMed Central

Maciosek, Michael V.; LaFrance, Amy B.; Dehmer, Steven P.; McGree, Dana A.; Xu, Zack; Flottemesch, Thomas J.; Solberg, Leif I.

2017-01-01

PURPOSE To help clinicians and care systems determine the priority for tobacco counseling in busy clinic schedules, we assessed the lifetime health and economic value of annually counseling youth to discourage smoking initiation and of annually counseling adults to encourage cessation. METHODS We conducted a microsimulation analysis to estimate the health impact and cost effectiveness of both types of tobacco counseling in a US birth cohort of 4,000,000. The model used for the analysis was constructed from nationally representative data sets and structured literature reviews. RESULTS Compared with no tobacco counseling, the model predicts that annual counseling for youth would reduce the average prevalence of smoking cigarettes during adult years by 2.0 percentage points, whereas annual counseling for adults will reduce prevalence by 3.8 percentage points. Youth counseling would prevent 42,686 smoking-attributable fatalities and increase quality-adjusted life years (QALYs) by 756,601 over the lifetime of the cohort. Adult counseling would prevent 69,901 smoking-attributable fatalities and increase QALYs by 1,044,392. Youth and adult counseling would yield net savings of $225 and $580 per person, respectively. If annual tobacco counseling was provided to the cohort during both youth and adult years, then adult smoking prevalence would be 5.5 percentage points lower compared with no counseling, and there would be 105,917 fewer smoking-attributable fatalities over their lifetimes. Only one-third of the potential health and economic benefits of counseling are being realized at current counseling rates. CONCLUSIONS Brief tobacco counseling provides substantial health benefits while producing cost savings. Both youth and adult intervention are high-priority uses of limited clinician time. PMID:28376459

Hearts, guts and minds: somatisation in the military from 1900.

PubMed

Jones, Edgar; Wessely, Simon

2004-04-01

To identify patterns of somatisation in army personnel diagnosed with postcombat syndromes from the Boer War to the Gulf conflict. Using random samples of UK servicemen awarded war pensions, patterns of symptoms were compared and related to contemporary accounts. Somatic symptoms continued to be common during and after World War II, suggesting that their decline was not great as claimed. Although psychological presentations increased, they did not supplant conversion disorders. Somatoform disorders did not disappear from the military in a smooth progression as society's understanding of psychological issues advanced. Rather there was a change in physical focus from the heart to the gut as new medical priorities arose. Copyright 2004 Elsevier Inc.

Bioremediation of petroleum-contaminated soil: A Review

NASA Astrophysics Data System (ADS)

Yuniati, M. D.

2018-02-01

Petroleum is the major source of energy for various industries and daily life. Releasing petroleum into the environment whether accidentally or due to human activities is a main cause of soil pollution. Soil contaminated with petroleum has a serious hazard to human health and causes environmental problems as well. Petroleum pollutants, mainly hydrocarbon, are classified as priority pollutants. The application of microorganisms or microbial processes to remove or degrade contaminants from soil is called bioremediation. This microbiological decontamination is claimed to be an efficient, economic and versatile alternative to physicochemical treatment. This article presents an overview about bioremediation of petroleum-contaminated soil. It also includes an explanation about the types of bioremediation technologies as well as the processes.

Doctors and patients.

PubMed

Gillon, R

1986-02-15

Gillon outlines some prima facie moral duties of physicians to patients that have emerged from his previous articles in a series on philosophical medical ethics. These duties follow from four general ethical principles--respect for autonomy, beneficence, non-maleficence, and justice--plus the self-imposed supererogatory duty of medical beneficence. From these principles the author derives such duties as providing adequate information and advice on treatment options, encouraging patient participation leading to informed decisions, maintaining competence and exposing incompetence, admitting errors, disclosing personal medico-moral standards, and acknowledging that other interests may occasionally supersede those of the individual patient. Gillon concludes that, where self interest conflicts with medical beneficence, the claim of medicine as a profession requires that the patient's interests take priority.

The Fraction of Cancer Attributable to Ways of Life, Infections, Occupation, and Environmental Agents in Brazil in 2020

PubMed Central

Azevedo e Silva, Gulnar; de Moura, Lenildo; Curado, Maria Paula; Gomes, Fabio da Silva; Otero, Ubirani; de Rezende, Leandro Fórnias Machado; Daumas, Regina Paiva; Guimarães, Raphael Mendonça; Meira, Karina Cardoso; Leite, Iuri da Costa; Valente, Joaquim Gonçalves; Moreira, Ronaldo Ismério; Koifman, Rosalina; Malta, Deborah Carvalho; Mello, Marcia Sarpa de Campos; Guedes, Thiago Wagnos Guimarães; Boffetta, Paolo

2016-01-01

Many human cancers develop as a result of exposure to risk factors related to the environment and ways of life. The aim of this study was to estimate attributable fractions of 25 types of cancers resulting from exposure to modifiable risk factors in Brazil. The prevalence of exposure to selected risk factors among adults was obtained from population-based surveys conducted from 2000 to 2008. Risk estimates were based on data drawn from meta-analyses or large, high quality studies. Population-attributable fractions (PAF) for a combination of risk factors, as well as the number of preventable deaths and cancer cases, were calculated for 2020. The known preventable risk factors studied will account for 34% of cancer cases among men and 35% among women in 2020, and for 46% and 39% deaths, respectively. The highest attributable fractions were estimated for tobacco smoking, infections, low consumption of fruits and vegetables, excess weight, reproductive factors, and physical inactivity. This is the first study to systematically estimate the fraction of cancer attributable to potentially modifiable risk factors in Brazil. Strategies for primary prevention of tobacco smoking and control of infection and the promotion of a healthy diet and physical activity should be the main priorities in policies for cancer prevention in the country. PMID:26863517

Visual Attention Allocation Between Robotic Arm and Environmental Process Control: Validating the STOM Task Switching Model

NASA Technical Reports Server (NTRS)

Wickens, Christopher; Vieanne, Alex; Clegg, Benjamin; Sebok, Angelia; Janes, Jessica

2015-01-01

Fifty six participants time shared a spacecraft environmental control system task with a realistic space robotic arm control task in either a manual or highly automated version. The former could suffer minor failures, whose diagnosis and repair were supported by a decision aid. At the end of the experiment this decision aid unexpectedly failed. We measured visual attention allocation and switching between the two tasks, in each of the eight conditions formed by manual-automated arm X expected-unexpected failure X monitoring- failure management. We also used our multi-attribute task switching model, based on task attributes of priority interest, difficulty and salience that were self-rated by participants, to predict allocation. An un-weighted model based on attributes of difficulty, interest and salience accounted for 96 percent of the task allocation variance across the 8 different conditions. Task difficulty served as an attractor, with more difficult tasks increasing the tendency to stay on task.

An environmental decision framework applied to marine engine control technologies.

PubMed

Corbett, James J; Chapman, David

2006-06-01

This paper develops a decision framework for considering emission control technologies on marine engines, informed by standard decision theory, with an open structure that may be adapted by operators with specific vessel and technology attributes different from those provided here. Attributes relate objectives important to choosing control technologies with specific alternatives that may meet several of the objectives differently. The transparent framework enables multiple stakeholders to understand how different subjective judgments and varying attribute properties may result in different technology choices. Standard scoring techniques ensure that attributes are not biased by subjective scoring and that weights are the primary quantitative input where subjective preferences are exercised. An expected value decision structure is adopted that considers probabilities (likelihood) that a given alternative can meet its claims; alternative decision criteria are discussed. Capital and annual costs are combined using a net present value approach. An iterative approach is advocated that allows for screening and disqualifying alternatives that do not meet minimum conditions for acceptance, such as engine warranty or U.S. Coast Guard requirements. This decision framework assists vessel operators in considering explicitly important attributes and in representing choices clearly to other stakeholders concerned about reducing air pollution from vessels. This general decision structure may also be applied similarly to other environmental controls in marine applications.

Financial and recovery worry one year after traumatic injury: A prognostic, registry-based cohort study.

PubMed

Ioannou, L; Cameron, P A; Gibson, S J; Ponsford, J; Jennings, P A; Georgiou-Karistianis, N; Giummarra, M J

2018-05-01

Levels of stress post-injury, especially after compensable injury, are known to be associated with worse long-term recovery. It is therefore important to identify how, and in whom, worry and stress manifest post-injury. This study aimed to identify demographic, injury, and compensation factors associated with worry about financial and recovery outcomes 12 months after traumatic injury. Participants (n = 433) were recruited from the Victorian Orthopaedic Trauma Outcomes Registry and Victorian State Trauma Registry after admission to a major trauma hospital in Melbourne, Australia. Participants completed questionnaires about pain, compensation experience and psychological wellbeing as part of a registry-based observational study. Linear regressions showed that demographic and injury factors accounted for 11% and 13% of variance in financial and recovery worry, respectively. Specifically, lower education, discharge to inpatient rehabilitation, attributing fault to another and having a compensation claim predicted financial worry. Worry about recovery was only predicted by longer hospital stay and attributing fault to another. In all participants, financial and recovery worry were associated with worse pain (severity, interference, catastrophizing, kinesiophobia, self-efficacy), physical (disability, functioning) and psychological (anxiety, depression, PTSD, perceived injustice) outcomes 12 months post-injury. In participants who had transport (n = 135) or work (n = 22) injury compensation claims, both financial and recovery worry were associated with sustaining permanent impairments, and reporting negative compensation system experience 12 months post-injury. Financial worry 12 months post-injury was associated with not returning to work by 3-6 months post-injury, whereas recovery worry was associated with attributing fault to another, and higher healthcare use at 6-12 months post-injury. These findings highlight the important contribution of factors other than injury severity, to worry about finances and recovery post-injury. Having a compensation claim, failure to return to work and experiencing pain and psychological symptoms also contribute to elevated worry. As these factors explained less than half of the variance in worry, however, other factors not measured in this study must play a role. As worry may increase the risk of developing secondary mental health conditions, timely access to financial, rehabilitation and psychological supports should be provided to people who are not coping after injury. Copyright © 2018 Elsevier Ltd. All rights reserved.

Sustainable Urban Forestry Potential Based Quantitative And Qualitative Measurement Using Geospatial Technique

NASA Astrophysics Data System (ADS)

Rosli, A. Z.; Reba, M. N. M.; Roslan, N.; Room, M. H. M.

2014-02-01

In order to maintain the stability of natural ecosystems around urban areas, urban forestry will be the best initiative to maintain and control green space in our country. Integration between remote sensing (RS) and geospatial information system (GIS) serves as an effective tool for monitoring environmental changes and planning, managing and developing a sustainable urbanization. This paper aims to assess capability of the integration of RS and GIS to provide information for urban forest potential sites based on qualitative and quantitative by using priority parameter ranking in the new township of Nusajaya. SPOT image was used to provide high spatial accuracy while map of topography, landuse, soils group, hydrology, Digital Elevation Model (DEM) and soil series data were applied to enhance the satellite image in detecting and locating present attributes and features on the ground. Multi-Criteria Decision Making (MCDM) technique provides structural and pair wise quantification and comparison elements and criteria for priority ranking for urban forestry purpose. Slope, soil texture, drainage, spatial area, availability of natural resource, and vicinity of urban area are criteria considered in this study. This study highlighted the priority ranking MCDM is cost effective tool for decision-making in urban forestry planning and landscaping.

A quality function deployment framework for the service quality of health information websites.

PubMed

Chang, Hyejung; Kim, Dohoon

2010-03-01

This research was conducted to identify both the users' service requirements on health information websites (HIWs) and the key functional elements for running HIWs. With the quality function deployment framework, the derived service attributes (SAs) are mapped into the suppliers' functional characteristics (FCs) to derive the most critical FCs for the users' satisfaction. Using the survey data from 228 respondents, the SAs, FCs and their relationships were analyzed using various multivariate statistical methods such as principal component factor analysis, discriminant analysis, correlation analysis, etc. Simple and compound FC priorities were derived by matrix calculation. Nine factors of SAs and five key features of FCs were identified, and these served as the basis for the house of quality model. Based on the compound FC priorities, the functional elements pertaining to security and privacy, and usage support should receive top priority in the course of enhancing HIWs. The quality function deployment framework can improve the FCs of the HIWs in an effective, structured manner, and it can also be utilized for critical success factors together with their strategic implications for enhancing the service quality of HIWs. Therefore, website managers could efficiently improve website operations by considering this study's results.

Abortion Providers' Experiences with Medicaid Abortion Coverage Policies: A Qualitative Multistate Study

PubMed Central

Dennis, Amanda; Blanchard, Kelly

2013-01-01

Objective To evaluate the implementation of state Medicaid abortion policies and the impact of these policies on abortion clients and abortion providers. Data Source From 2007 to 2010, in-depth interviews were conducted with representatives of 70 abortion-providing facilities in 15 states. Study Design In-depth interviews focused on abortion providers' perceptions regarding Medicaid and their experiences working with Medicaid and securing reimbursement in cases that should receive federal funding: rape, incest, and life endangerment. Data Extraction Data were transcribed verbatim before being coded. Principal Findings In two study states, abortion providers reported that 97 percent of submitted claims for qualifying cases were funded. Success receiving reimbursement was attributed to streamlined electronic billing procedures, timely claims processing, and responsive Medicaid staff. Abortion providers in the other 13 states reported reimbursement for 36 percent of qualifying cases. Providers reported difficulties obtaining reimbursement due to unclear rejections of qualifying claims, complex billing procedures, lack of knowledgeable Medicaid staff with whom billing problems could be discussed, and low and slow reimbursement rates. Conclusions Poor state-level implementation of Medicaid coverage of abortion policies creates barriers for women seeking abortion. Efforts to ensure policies are implemented appropriately would improve women's health. PMID:22742741

Specious causal attributions in the social sciences: the reformulated stepping-stone theory of heroin use as exemplar.

PubMed

Baumrind, D

1983-12-01

The claims based on causal models employing either statistical or experimental controls are examined and found to be excessive when applied to social or behavioral science data. An exemplary case, in which strong causal claims are made on the basis of a weak version of the regularity model of cause, is critiqued. O'Donnell and Clayton claim that in order to establish that marijuana use is a cause of heroin use (their "reformulated stepping-stone" hypothesis), it is necessary and sufficient to demonstrate that marijuana use precedes heroin use and that the statistically significant association between the two does not vanish when the effects of other variables deemed to be prior to both of them are removed. I argue that O'Donnell and Clayton's version of the regularity model is not sufficient to establish cause and that the planning of social interventions both presumes and requires a generative rather than a regularity causal model. Causal modeling using statistical controls is of value when it compels the investigator to make explicit and to justify a causal explanation but not when it is offered as a substitute for a generative analysis of causal connection.

The misidentification syndromes as mindreading disorders.

PubMed

Hirstein, William

2010-01-01

The patient with Capgras' syndrome claims that people very familiar to him have been replaced by impostors. I argue that this disorder is due to the destruction of a representation that the patient has of the mind of the familiar person. This creates the appearance of a familiar body and face, but without the familiar personality, beliefs, and thoughts. The posterior site of damage in Capgras' is often reported to be the temporoparietal junction, an area that has a role in the mindreading system, a connected system of cortical areas that allow us to attribute mental states to others. Just as the Capgras' patient claims that that man is not his father, the patient with asomatognosia claims that his arm is not really his. A similar account applies here, in that a nearby brain area, the supramarginal gyrus, is damaged. This area works in concert with the temporoparietal junction and other areas to produce a large representation of a mind inside a body situated in an environment. Damage to the mind-representing part of this system (coupled with damage to executive processes in the prefrontal lobes) causes Capgras' syndrome, whereas damage to the body-representing part of this system (also coupled with executive damage) causes asomatognosia.

Abortion providers' experiences with Medicaid abortion coverage policies: a qualitative multistate study.

PubMed

Dennis, Amanda; Blanchard, Kelly

2013-02-01

To evaluate the implementation of state Medicaid abortion policies and the impact of these policies on abortion clients and abortion providers. From 2007 to 2010, in-depth interviews were conducted with representatives of 70 abortion-providing facilities in 15 states. In-depth interviews focused on abortion providers' perceptions regarding Medicaid and their experiences working with Medicaid and securing reimbursement in cases that should receive federal funding: rape, incest, and life endangerment. Data were transcribed verbatim before being coded. In two study states, abortion providers reported that 97 percent of submitted claims for qualifying cases were funded. Success receiving reimbursement was attributed to streamlined electronic billing procedures, timely claims processing, and responsive Medicaid staff. Abortion providers in the other 13 states reported reimbursement for 36 percent of qualifying cases. Providers reported difficulties obtaining reimbursement due to unclear rejections of qualifying claims, complex billing procedures, lack of knowledgeable Medicaid staff with whom billing problems could be discussed, and low and slow reimbursement rates. Poor state-level implementation of Medicaid coverage of abortion policies creates barriers for women seeking abortion. Efforts to ensure policies are implemented appropriately would improve women's health. © Health Research and Educational Trust.

How Christians reconcile their personal political views and the teachings of their faith: Projection as a means of dissonance reduction

PubMed Central

Ross, Lee D.; Lelkes, Yphtach; Russell, Alexandra G.

2012-01-01

The present study explores the dramatic projection of one's own views onto those of Jesus among conservative and liberal American Christians. In a large-scale survey, the relevant views that each group attributed to a contemporary Jesus differed almost as much as their own views. Despite such dissonance-reducing projection, however, conservatives acknowledged the relevant discrepancy with regard to “fellowship” issues (e.g., taxation to reduce economic inequality and treatment of immigrants) and liberals acknowledged the relevant discrepancy with regard to “morality” issues (e.g., abortion and gay marriage). However, conservatives also claimed that a contemporary Jesus would be even more conservative than themselves on the former issues whereas liberals claimed that Jesus would be even more liberal than themselves on the latter issues. Further reducing potential dissonance, liberal and conservative Christians differed markedly in the types of issues they claimed to be more central to their faith. A concluding discussion considers the relationship between individual motivational processes and more social processes that may underlie the present findings, as well as implications for contemporary social and political conflict. PMID:22308413

Consumer Behavior Under Conflicting Information Provided by Interested Parties: Implications for Equilibrium in the Market for Credence Goods.

PubMed

Russo, Carlo; Tufi, Eleonora

2016-01-01

Incomplete information in food consumption is a relevant topic in agricultural economics. This paper proposes a theoretical model describing consumer behavior, market equilibrium and public intervention in an industry where consumers must rely on the information of interested parties such as producers or associations. We provide simple game theory model showing the link between price competition and the strategic use of information. If information are unverifiable (as in the case of credence attributes) firms may have no incentive to advertise true claims and consumer decisions may be biased. Our model incorporates the opportunistic behavior of self-interested information providers. The result is a model of competition in prices and information finding a potential for market failure and public intervention. In the paper we discuss the efficiency of three possible regulations: banning false claims, subsidizing advertising campaigns, and public statement if favor of true claims. In that context, some recent patents related to both the regulatory compliance in communication and to the reduction of asymmetric information between producers and consumers have been considered. Finally, we found that the efficiency of these policy tools is affected by the reputation of trustworthiness of the firms.

Research and Development for Digital Voice Processing.

DTIC Science & Technology

1986-10-01

9.6 kbps. Analysis of the DRT data shows that the psychoacousticly based "channel vocoder" has difficulty with the speech attributes sustention and...thought as fought or did a-b--d (graveness). Sustention -absent or "interrupted" correlates to an abrupt onset of energy across the the full spectrum with...system, Table 4.1 presents the board number(s), a description, memory address(es), interrupt vectcr location(s), and bus priority. Note that several

Abandoned Uranium Mine (AUM) Trust Mine Points, Navajo Nation, 2016, US EPA Region 9

EPA Pesticide Factsheets

This GIS dataset contains point features that represent mines included in the Navajo Environmental Response Trust. This mine category also includes Priority mines. USEPA and NNEPA prioritized mines based on gamma radiation levels, proximity to homes and potential for water contamination identified in the preliminary assessments. Attributes include mine names, reclaimed status, links to US EPA AUM reports, and the region in which the mine is located. This dataset contains 19 features.

Civilian Combatants, Military Professionals? American Officer Judgments

DTIC Science & Technology

2010-09-01

basis to claim a corporate identity for these employees of PMFs. On the other hand, there is a prima facie case to be made that the employees of this...of social obligation to utilize this craft for the benefit of society.’ 3 Mercenaries ‘who fight for employers other than their home state’s...report by the Congressional Research Service, ‘conduct that violates international obligations is attributable to a State if it is committed by the

The relationships of physician practice characteristics to quality of care and costs.

PubMed

Kralewski, John; Dowd, Bryan; Knutson, David; Tong, Junliang; Savage, Megan

2015-06-01

Medical group practices are central to many of the proposals for health care reform, but little is known about the relationship between practice-level characteristics and the quality and cost of care. Practice characteristics from a 2009 national survey of 211 group practices were linked to Medicare claims data for beneficiaries attributed to the practices. Multivariate regression was used to examine the relationship between practice characteristics and claims-computable measures of screening and monitoring, avoidable utilization, risk-adjusted per-beneficiary per-year (PBPY) costs, and the practice's net revenue. Several characteristics of group practices are predictive of screening and monitoring measures. Those measures, in turn, are predictive of lower values of avoidable utilization measures that contribute to higher PBPY costs. The effects of group practice characteristics on avoidable utilization, cost, and practice net revenue appear to work primarily through improved screening and monitoring. Practice characteristics influence costs indirectly through a set of statistically significant relationships among screening and monitoring measures and avoidable utilization. However, these relationships are not the only pathways connecting practice characteristics to cost and those additional pathways contain substantial "noise" adding uncertainty to the estimated direct effects. Some of the attributes thought to be important characteristics of accountable care organizations and medical homes appear to be associated with lower quality and no improvement in cost. © Health Research and Educational Trust.

Managing Dive Tourism for the Sustainable Use of Coral Reefs: Validating Diver Perceptions of Attractive Site Features

NASA Astrophysics Data System (ADS)

Uyarra, Maria C.; Watkinson, Andrew R.; Côté, Isabelle M.

2009-01-01

It has been argued that strategies to manage natural areas important for tourism and recreation should integrate an understanding of tourist preferences for specific natural features. However, the accuracy of tourist recalled perceptions of environmental attributes, which are usually derived from post hoc surveys and used to establish management priorities, is currently unmeasured. We tested the validity of the relationship between tourist-stated preferences and actual condition of coral reefs around the Caribbean island of Bonaire. Using standardized questionnaires, we asked 200 divers to select their most and least favorite dive sites and the attributes that contributed to that selection. We also carried out ecological surveys at 76 of the 81 dives sites around the island to assess the actual conditions of the attributes indicated as important for site selection. Fish- and coral-related attributes were key features affecting dive enjoyment. In general, divers appeared to be able to perceive differences between sites in the true condition of biological attributes such as fish species richness, total number of fish schools, live coral cover, coral species richness, and reef structural complexity, although men and women divers differed in their ability to perceive/recall some of the attributes. Perceived differences in environmental attributes, such as surface conditions, underwater current, and the likelihood of encountering rare fish and sea turtles, were not empirically validated. The fact that divers perceive correctly differences in the condition of some of the key biological attributes that affect dive enjoyment reinforces the need to maintain overall reef condition at satisfactory levels. However, variation in accuracy of perceptions owing to demographic factors and attribute type suggests the need for caution when using public perceptions to develop environmental management strategies, particularly for coral reefs.

Managing dive tourism for the sustainable use of coral reefs: validating diver perceptions of attractive site features.

PubMed

Uyarra, Maria C; Watkinson, Andrew R; Côté, Isabelle M

2009-01-01

It has been argued that strategies to manage natural areas important for tourism and recreation should integrate an understanding of tourist preferences for specific natural features. However, the accuracy of tourist recalled perceptions of environmental attributes, which are usually derived from post hoc surveys and used to establish management priorities, is currently unmeasured. We tested the validity of the relationship between tourist-stated preferences and actual condition of coral reefs around the Caribbean island of Bonaire. Using standardized questionnaires, we asked 200 divers to select their most and least favorite dive sites and the attributes that contributed to that selection. We also carried out ecological surveys at 76 of the 81 dives sites around the island to assess the actual conditions of the attributes indicated as important for site selection. Fish- and coral-related attributes were key features affecting dive enjoyment. In general, divers appeared to be able to perceive differences between sites in the true condition of biological attributes such as fish species richness, total number of fish schools, live coral cover, coral species richness, and reef structural complexity, although men and women divers differed in their ability to perceive/recall some of the attributes. Perceived differences in environmental attributes, such as surface conditions, underwater current, and the likelihood of encountering rare fish and sea turtles, were not empirically validated. The fact that divers perceive correctly differences in the condition of some of the key biological attributes that affect dive enjoyment reinforces the need to maintain overall reef condition at satisfactory levels. However, variation in accuracy of perceptions owing to demographic factors and attribute type suggests the need for caution when using public perceptions to develop environmental management strategies, particularly for coral reefs.

The association between attributions of responsibility for motor vehicle accidents and patient satisfaction: a study within a no-fault injury compensation system.

PubMed

Thompson, Jason; Berk, Michael; O'Donnell, Meaghan; Stafford, Lesley; Nordfjaern, Trond

2015-05-01

This study set out to test the relationship between attributions of responsibility for motor vehicle accidents and satisfaction with personal injury compensation systems. The study analysed survey data from 1394 people injured in a motor vehicle accident who were compensated under a no-fault personal injury compensation system. Patients' ratings of satisfaction with the compensation system across five domains (resolves your issues, keeps you up-to-date, treats you as an individual, cares about you, and overall satisfaction) were analysed alongside patient attributions of responsibility for their accident (not responsible, partly responsible, totally responsible). Postaccident physical and mental health status, age, gender, and duration of compensation claim were controlled for in the analysis. A multivariate analysis of covariance indicated attributions of responsibility for accidents were significantly associated with levels of patient satisfaction across all five domains under study (F (10, 2084) = 3.7, p<0.001, η(2)  =0.02). Despite access to virtually indistinguishable services, patients who attributed responsibility for their accidents to others were significantly less satisfied with the injury compensation system than those who attributed responsibility to themselves. Satisfaction with no-fault motor vehicle injury compensation services are associated with patients' attributions of responsibility for their accident. Compensation systems and other rehabilitation services monitoring patient satisfaction should adjust for attributions of responsibility when assessing levels of patient satisfaction between time periods, services, or injured populations. Differences in levels of patient satisfaction observed between compensation or rehabilitation populations may reflect differences in attributions of responsibility for accidents rather than objective service quality. © The Author(s) 2014.

The first eukaryote cell: an unfinished history of contestation.

PubMed

O'Malley, Maureen A

2010-09-01

The eukaryote cell is one of the most radical innovations in the history of life, and the circumstances of its emergence are still deeply contested. This paper will outline the recent history of attempts to reveal these origins, with special attention to the argumentative strategies used to support claims about the first eukaryote cell. I will focus on two general models of eukaryogenesis: the phagotrophy model and the syntrophy model. As their labels indicate, they are based on claims about metabolic relationships. The first foregrounds the ability to consume other organisms; the second the ability to enter into symbiotic metabolic arrangements. More importantly, however, the first model argues for the autogenous or self-generated origins of the eukaryote cell, and the second for its exogenous or externally generated origins. Framing cell evolution this way leads each model to assert different priorities in regard to cell-biological versus molecular evidence, cellular versus environmental influences, plausibility versus evolutionary probability, and irreducibility versus the continuity of cell types. My examination of these issues will conclude with broader reflections on the implications of eukaryogenesis studies for a philosophical understanding of scientific contestation. Copyright © 2010 Elsevier Ltd. All rights reserved.

Messy entanglements: research assemblages in heart transplantation discourses and practices

PubMed Central

Shildrick, Margrit; Carnie, Andrew; Wright, Alexa; McKeever, Patricia; Jan, Emily Huan-Ching; De Luca, Enza; Bachmann, Ingrid; Abbey, Susan; Dal Bo, Dana; Poole, Jennifer; El-Sheikh, Tammer; Ross, Heather

2018-01-01

The paper engages with a variety of data around a supposedly single biomedical event, that of heart transplantation. In conventional discourse, organ transplantation constitutes an unproblematised form of spare part surgery in which failing biological components are replaced by more efficient and enduring ones, but once that simple picture is complicated by employing a radically interdisciplinary approach, any biomedical certainty is profoundly disrupted. Our aim, as a cross-sectorial partnership, has been to explore the complexities of heart transplantation by explicitly entangling research from the arts, biosciences and humanities without privileging any one discourse. It has been no easy enterprise yet it has been highly productive of new insights. We draw on our own ongoing funded research with both heart donor families and recipients to explore our different perceptions of what constitutes data and to demonstrate how the dynamic entangling of multiple data produces a constitutive assemblage of elements in which no one can claim priority. Our claim is that the use of such research assemblages and the collaborations that we bring to our project breaks through disciplinary silos to enable a fuller comprehension of the significance and experience of heart transplantation in both theory and practice. PMID:28972037

A few of my favorite things: circumscribed interests in autism are not accompanied by increased attentional salience on a personalized selective attention task.

PubMed

Parsons, Owen E; Bayliss, Andrew P; Remington, Anna

2017-01-01

Autistic individuals commonly show circumscribed or "special" interests: areas of obsessive interest in a specific category. The present study investigated what impact these interests have on attention, an aspect of autistic cognition often reported as altered. In neurotypical individuals, interest and expertise have been shown to result in an automatic attentional priority for related items. Here, we examine whether this change in salience is also seen in autism. Adolescents and young adults with and without autism performed a personalized selective attention task assessing the level of attentional priority afforded to images related to the participant's specific interests. In addition, participants performed a similar task with generic images in order to isolate any effects of interest and expertise. Crucially, all autistic and non-autistic individuals recruited for this study held a strong passion or interest. As such, any differences in attention could not be solely attributed to differing prevalence of interests in the two groups. In both tasks, participants were asked to perform a central target-detection task while ignoring irrelevant distractors (related or unrelated to their interests). The level of distractor interference under various task conditions was taken as an indication of attentional priority. Neurotypical individuals showed the predicted attentional priority for the circumscribed interest images but not generic items, reflecting the impact of their interest and expertise. Contrary to predictions, autistic individuals did not show this priority: processing the interest-related stimuli only when task demands were low. Attention to images unrelated to circumscribed interests was equivalent in the two groups. These results suggest that despite autistic individuals holding an intense interest in a particular class of stimuli, there may be a reduced impact of this prior experience and expertise on attentional processing. The implications of this absence of automatic priority are discussed in terms of the behaviors associated with the condition.

Research Questions and Priorities for Tuberculosis: A Survey of Published Systematic Reviews and Meta-Analyses

PubMed Central

Nicolau, Ioana; Ling, Daphne; Tian, Lulu; Lienhardt, Christian; Pai, Madhukar

2012-01-01

Background Systematic reviews are increasingly informing policies in tuberculosis (TB) care and control. They may also be a source of questions for future research. As part of the process of developing the International Roadmap for TB Research, we did a systematic review of published systematic reviews on TB, to identify research priorities that are most frequently suggested in reviews. Methodology/Principal Findings We searched EMBASE, MEDLINE, Web of Science, and the Cochrane Library for systematic reviews and meta-analyses on any aspect of TB published between 2005 and 2010. One reviewer extracted data and a second reviewer independently extracted data from a random subset of included studies. In total, 137 systematic reviews, with 141 research questions, were included in this review. We used the UK Health Research Classification System (HRCS) to help us classify the research questions and priorities. The three most common research topics were in the area of detection, screening and diagnosis of TB (32.6%), development and evaluation of treatments and therapeutic interventions (23.4%), and TB aetiology and risk factors (19.9%). The research priorities determined were mainly focused on the discovery and evaluation of bacteriological TB tests and drug-resistant TB tests and immunological tests. Other important topics of future research were genetic susceptibility linked to TB and disease determinants attributed to HIV/TB. Evaluation of drug treatments for TB, drug-resistant TB and HIV/TB were also frequently proposed research topics. Conclusions Systematic reviews are a good source of key research priorities. Findings from our survey have informed the development of the International Roadmap for TB Research by the TB Research Movement. PMID:22848764

03pd0676

NASA Image and Video Library

2003-03-07

File name :DSC_0749.JPG File size :1.1MB(1174690Bytes) Date taken :2003/03/07 13:51:29 Image size :2000 x 1312 Resolution :300 x 300 dpi Number of bits :8bit/channel Protection attribute :Off Hide Attribute :Off Camera ID :N/A Camera :NIKON D1H Quality mode :FINE Metering mode :Matrix Exposure mode :Shutter priority Speed light :No Focal length :20 mm Shutter speed :1/500second Aperture :F11.0 Exposure compensation :0 EV White Balance :Auto Lens :20 mm F 2.8 Flash sync mode :N/A Exposure difference :0.0 EV Flexible program :No Sensitivity :ISO200 Sharpening :Normal Image Type :Color Color Mode :Mode II(Adobe RGB) Hue adjustment :3 Saturation Control :N/A Tone compensation :Normal Latitude(GPS) :N/A Longitude(GPS) :N/A Altitude(GPS) :N/A

03pd0517

NASA Image and Video Library

2002-02-19

File name :DSC_0028.JPG File size :2.8MB(2950833Bytes) Date taken :2002/02/19 09:49:01 Image size :3008 x 2000 Resolution :300 x 300 dpi Number of bits :8bit/channel Protection attribute :Off Hide Attribute :Off Camera ID :N/A Camera :NIKON D100 Quality mode :N/A Metering mode :Matrix Exposure mode :Shutter priority Speed light :Yes Focal length :24 mm Shutter speed :1/60second Aperture :F3.5 Exposure compensation :0 EV White Balance :N/A Lens :N/A Flash sync mode :N/A Exposure difference :N/A Flexible program :N/A Sensitivity :N/A Sharpening :N/A Image Type :Color Color Mode :N/A Hue adjustment :N/A Saturation Control :N/A Tone compensation :N/A Latitude(GPS) :N/A Longitude(GPS) :N/A Altitude(GPS) :N/A

03pd0535

NASA Image and Video Library

2002-02-24

File name :DSC_0047.JPG File size :2.8MB(2931574Bytes) Date taken :2002/02/24 10:06:57 Image size :3008 x 2000 Resolution :300 x 300 dpi Number of bits :8bit/channel Protection attribute :Off Hide Attribute :Off Camera ID :N/A Camera :NIKON D100 Quality mode :N/A Metering mode :Matrix Exposure mode :Shutter priority Speed light :Yes Focal length :24 mm Shutter speed :1/180second Aperture :F20.0 Exposure compensation :+0.3 EV White Balance :N/A Lens :N/A Flash sync mode :N/A Exposure difference :N/A Flexible program :N/A Sensitivity :N/A Sharpening :N/A Image Type :Color Color Mode :N/A Hue adjustment :N/A Saturation Control :N/A Tone compensation :N/A Latitude(GPS) :N/A Longitude(GPS) :N/A Altitude(GPS) :N/A

"Weekend effect" on stroke mortality revisited: Application of a claims-based stroke severity index in a population-based cohort study.

PubMed

Hsieh, Cheng-Yang; Lin, Huey-Juan; Chen, Chih-Hung; Li, Chung-Yi; Chiu, Meng-Jun; Sung, Sheng-Feng

2016-06-01

Previous studies have yielded inconsistent results on whether weekend admission is associated with increased mortality after stroke, partly because of differences in case mix. Claims-based studies generally lack sufficient information on disease severity and, thus, suffer from inadequate case-mix adjustment. In this study, we examined the effect of weekend admission on 30-day mortality in patients with ischemic stroke by using a claims-based stroke severity index.This was an observational study using a representative sample of the National Health Insurance claims data linked to the National Death Registry. We identified patients hospitalized for ischemic stroke, and examined the effect of weekend admission on 30-day mortality with vs without adjustment for stroke severity by using multilevel logistic regression analysis adjusting for patient-, physician-, and hospital-related factors. We analyzed 46,007 ischemic stroke admissions, in which weekend admissions accounted for 23.0%. Patients admitted on weekends had significantly higher 30-day mortality (4.9% vs 4.0%, P < 0.001) and stroke severity index (7.8 vs 7.4, P < 0.001) than those admitted on weekdays. In multivariate analysis without adjustment for stroke severity, weekend admission was associated with increased 30-day mortality (odds ratio (OR), 1.20; 95% confidence interval [CI], 1.08-1.34). This association became null after adjustment for stroke severity (OR, 1.07; 95% CI, 0.95-1.20).The "weekend effect" on stroke mortality might be attributed to higher stroke severity in weekend patients. While claims data are useful for examining stroke outcomes, adequate adjustment for stroke severity is warranted.

Lessons Learned: A Strategic Alliance to Improve Elementary Physical Education in an Urban School District.

PubMed

Thompson, Hannah R; Haguewood, Robin; Tantoco, Nicole; Madsen, Kristine A

2015-01-01

Physical education (PE) can help to achieve important public health goals, but is often under-prioritized and lacking in schools. To detail the actions, impact, and successes of a strategic alliance formed by three collaborating organizations to improve PE in a large California school district. Semistructured interviews with alliance members, principals, and teachers in 20 elementary schools, 3 years after the alliance formation. Interviewees reported district-level increases in priority and funding for PE and attributed improvements to the alliance's collection and dissemination of local data on the status of PE. Common goals, trust, and open communication within the alliance were seen as critical to the alliance's success. However, changes in district- or school-level accountability measures for PE were not reported. This strategic alliance succeeded in promoting district-level priority and funding for PE. Ongoing alliance work will focus on increasing accountability measures for PE, which may take longer to implement.

Air pollution from household solid fuel combustion in India: an overview of exposure and health related information to inform health research priorities.

PubMed

Balakrishnan, Kalpana; Ramaswamy, Padmavathi; Sambandam, Sankar; Thangavel, Gurusamy; Ghosh, Santu; Johnson, Priscilla; Mukhopadhyay, Krishnendu; Venugopal, Vidhya; Thanasekaraan, Vijayalakshmi

2011-01-01

Environmental and occupational risk factors contribute to nearly 40% of the national burden of disease in India, with air pollution in the indoor and outdoor environment ranking amongst leading risk factors. It is now recognized that the health burden from air pollution exposures that primarily occur in the rural indoors, from pollutants released during the incomplete combustion of solid fuels in households, may rival or even exceed the burden attributable to urban outdoor exposures. Few environmental epidemiological efforts have been devoted to this setting, however. We provide an overview of important available information on exposures and health effects related to household solid fuel use in India, with a view to inform health research priorities for household air pollution and facilitate being able to address air pollution within an integrated rural-urban framework in the future.

Value self-confrontation as a method to aid in weight loss.

PubMed

Schwartz, S H; Inbar-Saban, N

1988-03-01

The impact on weight loss of an adaptation of the Rokeach (1973) value self-confrontation method was investigated in a field experiment. This method confronts people who have ranked their own values with information about the value priorities that discriminate between a positive and a negative reference group. A preliminary study revealed that successful weight losers differ from unsuccessful weight losers in valuing "wisdom" more than "happiness." Eighty-seven overweight adults were randomly assigned to one of three conditions: value self-confrontation, group discussion, or non-treatment control. Value self-confrontation subjects lost more weight than the other subjects over 2 months, and this weight loss persisted for an additional year. Changes in value priorities during the first 2 months suggest that weight loss was mediated by an increase in the importance attributed to wisdom relative to happiness. Implications for the theory of value-behavior relations and for practical application in weight loss programs are discussed.

More on the lambda 2800 A 'interstellar extinction' feature

NASA Astrophysics Data System (ADS)

McLachlan, A.; Nandy, K.

1985-02-01

In a response made to a recent letter by Karim et al. (1984), it is shown that the examples of interstellar absorption at 2800 A that they attribute to proteinaceous material can all be attributed to overexposure of IUE detectors. It is pointed out that stars in the Large Magellanic Cloud show pronounced absorption at 2800 A which cannot be due to interstellar protein since there is no associated absorption at 2200 A; this lack of absorption cannot be due to presence of graphite, whose absorption is weak in the Cloud. The claim by Karim et al. that the spectra of eight stars show 2800 A absorption and that these spectra are saturation-free is considered, and it is shown that data processing problems at IUE ground stations make these spectra unreliable.

Is the jury still out on PFI contracts?

PubMed

Baillie, Jonathan

2012-02-01

Last September Andrew Lansley claimed that some NHS Trusts occupying PFI healthcare facilities had been 'landed with deals they could not afford', seemingly attributing much of the blame for a scenario where the Department of Health said 22 Trusts in England alone could be at significant financial risk to Labour, which, in the 1990s, greatly expanded a public/private funding partnership originally introduced by the Tories a decade earlier. Two key factors critics claim have put such Trusts 'at risk' are the 'inflexibility' of some PFI contracts, which makes varying terms difficult mid-contract, and the fact that many of the earlier deals were inexpertly negotiated by the 'public sector side'. HEJ editor Jonathan Baillie sought the views of Malcolm Austwick, a partner at top commercial law firm, DAC Beachcroft (see panel below), with extensive experience in the legal complexities of PFI, on whether or not the initiative's 'pros' do indeed outweigh the 'cons'.

Healthcare resource use and economic burden attributable to respiratory syncytial virus in the United States: a claims database analysis.

PubMed

Amand, Caroline; Tong, Sabine; Kieffer, Alexia; Kyaw, Moe H

2018-04-20

Despite several studies that have estimated the economic impact of Respiratory Syncytial Virus (RSV) in infants, limited data are available on healthcare resource use and costs attributable to RSV across age groups. The aim of this study was to quantify age-specific RSV-related healthcare resource use and costs on the US healthcare system. This retrospective case-control study identified patients aged ≥1 year with an RSV event in the Truven Health Marketscan® Commercial Claims and Encounters and Medicare Supplemental and Coordination of Benefits databases between August 31, 2012 and August 1, 2013. RSV patients were matched 1:1 with non-RSV controls for age, gender, region, healthcare plan and index date (n = 11,432 in each group). Stratified analyses for healthcare resource use and costs were conducted by age groups. RSV-attributable resource use and costs were assessed based on the incremental differences between RSV cases and controls using multivariate analysis. RSV patients had a higher healthcare resource use (hospital stays, emergency room/urgent care visits, ambulatory visits and outpatient visits) than non-RSV matched controls for all age groups (all p < 0.0001), particularly in the elderly age groups with RSV (1.9 to 3 days length of stay, 0.4 to 0.5 more ER/UC visits, 0.7 to 2.7 more ambulatory visits, 12.1 to 18.6 more outpatient visits and 9.5 to 14.6 more prescriptions than elderly in the control groups). The incremental difference in adjusted mean annual costs between RSV and non-RSV controls was higher in elderly (≥65; $12,030 to $23,194) than in those aged < 65 years ($2251 to $5391). Among children, adjusted costs attributable to RSV were higher in children aged 5-17 years ($3192), than those 1-4 years ($2251 to $2521). Our findings showed a substantial annual RSV-attributable healthcare resource use and costs in the US across age groups, with the highest burden in those aged ≥65 years. These data can be used in cost-effectiveness analyses, and may be useful for policymakers to guide future RSV vaccination and other prevention programs.

Hydrologic and water-quality rehabilitation of environments for suitable fish habitat

NASA Astrophysics Data System (ADS)

Zhao, C. S.; Yang, S. T.; Xiang, H.; Liu, C. M.; Zhang, H. T.; Yang, Z. L.; Zhang, Y.; Sun, Y.; Mitrovic, S. M.; Yu, Q.; Lim, R. P.

2015-11-01

Aquatic ecological rehabilitation is attracting increasing public and research attention, but without knowledge of the responses of aquatic species to their habitats the success of habitat restoration is uncertain. Thus efficient study of species response to habitat, through which to prioritize the habitat factors influencing aquatic ecosystems, is highly important. However many current models have too high requirement for assemblage information and have great bias in results due to consideration of only the species' attribute of presence/absence, abundance or biomass, thus hindering the wider utility of these models. This paper, using fish as a case, presents a framework for identification of high-priority habitat factors based on the responses of aquatic species to their habitats, using presence/absence, abundance and biomass data. This framework consists of four newly developed sub-models aiming to determine weightings for the evaluation of species' contributions to their communities, to quantitatively calculate an integrated habitat suitability index for multi-species based on habitat factors, to assess the suitable probability of habitat factors and to assess the rehabilitation priority of habitat factors. The framework closely links hydrologic, physical and chemical habitat factors to fish assemblage attributes drawn from monitoring datasets on hydrology, water quality and fish assemblages at a total of 144 sites, where 5084 fish were sampled and tested. Breakpoint identification techniques based on curvature in cumulated dominance along with a newly developed weighting calculation model based on theory of mass systems were used to help identify the dominant fish, based on which the presence and abundance of multiple fish were normalized to estimate the integrated habitat suitability index along gradients of various factors, based on their variation with principal habitat factors. Then, the appropriate probability of every principal habitat factor was estimated and graded, and the priority of habitat factors for rehabilitation was determined. Application of the model to Jinan City, a pilot city for the construction of a civilized and ecological city in China, proved effective, revealing that carbonate is the poorest habitat factor and has the highest priority for ecological rehabilitation. This was tested using two methods: alternative priority models and a dataset of all habitat factors in place of only the principal habitat factors. We also found that hydrological factors have higher priority than the water quality factors at the levels of both the whole city and its subordinate eco-regions and therefore that hydrological factors deserve special attention in the future ecosystem rehabilitation. Further, the current habitat state makes nearly half of the habitats in Jinan City undesirable for fish communities, largely due to long-term agricultural practices. Spatially, rivers in the mountainous region south of Jinan city and adjacent to the urban area and rivers in the agricultural region north of the city should be emphasized in future habitat rehabilitation. All of these findings have substantial ramifications for the rehabilitation of aquatic ecosystems in Jinan City as a reference for river ecological remediation in rivers with scarce ecological data worldwide.

Estimating local, organic, and other price premiums of shell eggs in Hawaii.

PubMed

Loke, Matthew K; Xu, Xun; Leung, PingSun

2016-05-01

Hedonic modeling and retail scanner data were utilized to investigate the influence of local, organic, nutrition benefits, and other attributes of shell eggs on retail price premium in Hawaii. Within a revealed preference framework, the analysis of local and organic attributes, simultaneously, under a single unified setting is important, as such work is highly deficient in the published literature. This paper finds high to moderate price premiums in four key attributes of shell eggs - organic (64%), local (40%), nutrition benefits claimed (33%), and brown shell (18.4%). Large and extra-large sized eggs also experience price premiums over medium sized eggs. With each larger packing size, the estimated coefficients were negative, indicating a price discount, relative to the baseline packing size. However, there is no evidence to support the overwhelming influence of "local" over "organic", as hypothesized in other research work. Overall, the findings in this paper suggest industry producers and retailers should highlight and market effusively the primary attributes of their shell eggs, including "local", to remain competitive in the marketplace. Effective communication channels are crucial to delivering the product information, capturing the attention of consumers, and securing retail sales. © 2016 Poultry Science Association Inc.

Morphological biosignatures and the search for life on Mars.

PubMed

Cady, Sherry L; Farmer, Jack D; Grotzinger, John P; Schopf, J William; Steele, Andrew

2003-01-01

This report provides a rationale for the advances in instrumentation and understanding needed to assess claims of ancient and extraterrestrial life made on the basis of morphological biosignatures. Morphological biosignatures consist of bona fide microbial fossils as well as microbially influenced sedimentary structures. To be recognized as evidence of life, microbial fossils must contain chemical and structural attributes uniquely indicative of microbial cells or cellular or extracellular processes. When combined with various research strategies, high-resolution instruments can reveal such attributes and elucidate how morphological fossils form and become altered, thereby improving the ability to recognize them in the geological record on Earth or other planets. Also, before fossilized microbially influenced sedimentary structures can provide evidence of life, criteria to distinguish their biogenic from non-biogenic attributes must be established. This topic can be advanced by developing process-based models. A database of images and spectroscopic data that distinguish the suite of bona fide morphological biosignatures from their abiotic mimics will avoid detection of false-positives for life. The use of high-resolution imaging and spectroscopic instruments, in conjunction with an improved knowledge base of the attributes that demonstrate life, will maximize our ability to recognize and assess the biogenicity of extraterrestrial and ancient terrestrial life.

Variations in hospitalization rates among nursing home residents: the role of facility and market attributes.

PubMed

Carter, Mary W; Porell, Frank W

2003-04-01

This study examined the contribution of facility-level and area market-level attributes to variations in hospitalization rates among nursing home residents. Three years (1991-1994) of state quarterly Medicaid case-mix reimbursement data from 527 nursing homes (NH) in Massachusetts were linked with Medicare Provider Analysis and Review hospital claims and nursing facility attribute data to produce a longitudinal, analytical file containing 72,319 person-quarter observations. Logistic regression models were used to estimate the influence of facility-level and market-level factors on hospital use, after controlling for individual-level resident attributes, including: NH diagnoses, resident-level quality of care indicators, and diagnostic cost grouping classification from previous hospital stays. Multivariate findings suggest that resident heterogeneity alone does not account for the wide variations in hospitalization rates across nursing homes. Instead, facility characteristics such as profit status, nurse staffing patterns, NH size, chain affiliation, and percentage of Medicaid and Medicare reimbursed days significantly influence NH residents' risk of hospitalization. Broader area market factors also appear to contribute to variations in hospitalization rates. Variations in hospitalization rates may reflect underutilization, as well as overutilization. Continued efforts toward identifying medically necessary hospitalizations are needed.

Occupational lead poisoning in Ohio: surveillance using workers' compensation data.

PubMed

Seligman, P J; Halperin, W E; Mullan, R J; Frazier, T M

1986-11-01

To determine the utility of workers' compensation (WC) data in a system for the surveillance of occupational lead poisoning, we reviewed workers' compensation claims for lead poisoning in Ohio. For the period 1979 through 1983, 92 (81 per cent) of the 114 claims attributed to lead met our case definition of lead poisoning. The likelihood that a company had a case of lead poisoning was strongly correlated with the number of claims against the company. Thirty companies accounted for the 92 cases; two companies accounted for 49 per cent of these. Inspection by the Occupational Safety and Health Administration (OSHA) occurred at 14 of these companies, all of which were cited for violations of the OSHA lead standard. Comparison of the Standard Industrial Classification (SIC) codes for the 14 companies inspected by OSHA with the 15 companies not inspected by OSHA revealed that OSHA inspected battery manufacturers, non-ferrous foundries, secondary smelters, and primary lead smelters, but not bridge painters, manufacturers of electronic components, mechanical power transmission equipment, pumps, and paints, nor a sheriff's office where firing range slugs were remelted to make new bullets. Neither the number of cases of lead poisoning at a company nor the size of a company was related to the likelihood of being inspected by OSHA. Claims for WC appear to be a useful adjunct to an occupational lead poisoning surveillance system; their usefulness should be compared to that of other systems such as laboratory reports of elevated blood lead levels in adults.

Analysis of 44 Cases before the Landlord and Tenant Board Involving Bed Bug Infestations in Ontario, Canada: Focus on Adjudicator Decisions Based on Entomological/Pest Management Evidence and Accountability under the Residential Tenancy Act and Other Applicable Legislation.

PubMed

Bryks, Sam

2011-07-19

The resurgence of bed bugs in major urban centres in North America has resulted in conflict between landlords and tenants. This is commonly focused on attribution of blame for source of infestation, on responsibility, on costs for preparation, treatment and losses, and for compensation as rent abatement and/or alternative temporary housing. In Ontario, Canada, these issues are often decided by adjudicators at the Landlord and Tenant Board hearing claims, counter-claims and defense by legal representation (lawyers and paralegals) as well as through mediation. Evidence in these hearings may include photographs, invoices for costs as well as testimony by tenants, landlords and "expert witnesses" who are most often pest control firms representing their landlord clients. A total of 44 Landlord and Tenant Board adjudicated cases available online were analyzed. The analysis included elements of the decisions such as adjudicator, claimant (landlord or tenant), basis of claim, review of evidence, amount of claim, amount awarded, and evaluation of the quality of the evidence. The results of the analysis of these findings are discussed. Recommendations for improvement of adjudicator decisions on the basis of knowledge of bed bug biology and Integrated Pest Management best practices are presented as well as the importance of education of tenants and landlords to a process of mutual trust, support and accountability.

Analysis of 44 Cases before the Landlord and Tenant Board Involving Bed Bug Infestations in Ontario, Canada: Focus on Adjudicator Decisions Based on Entomological/Pest Management Evidence and Accountability under the Residential Tenancy Act and Other Applicable Legislation

PubMed Central

Bryks, Sam

2011-01-01

The resurgence of bed bugs in major urban centres in North America has resulted in conflict between landlords and tenants. This is commonly focused on attribution of blame for source of infestation, on responsibility, on costs for preparation, treatment and losses, and for compensation as rent abatement and/or alternative temporary housing. In Ontario, Canada, these issues are often decided by adjudicators at the Landlord and Tenant Board hearing claims, counter-claims and defense by legal representation (lawyers and paralegals) as well as through mediation. Evidence in these hearings may include photographs, invoices for costs as well as testimony by tenants, landlords and “expert witnesses” who are most often pest control firms representing their landlord clients. A total of 44 Landlord and Tenant Board adjudicated cases available online were analyzed. The analysis included elements of the decisions such as adjudicator, claimant (landlord or tenant), basis of claim, review of evidence, amount of claim, amount awarded, and evaluation of the quality of the evidence. The results of the analysis of these findings are discussed. Recommendations for improvement of adjudicator decisions on the basis of knowledge of bed bug biology and Integrated Pest Management best practices are presented as well as the importance of education of tenants and landlords to a process of mutual trust, support and accountability. PMID:26467732

Provider Behavior Under Global Budgeting and Policy Responses: An Observational Study on Eye Care Services in Taiwan.

PubMed

Chang, Chao-Kai; Xirasagar, Sudha; Chen, Brian; Hussey, James R; Wang, I-Jong; Chen, Jen-Chieh; Lian, Ie-Bin

2015-01-01

Third-party payer systems are consistently associated with health care cost escalation. Taiwan's single-payer, universal coverage National Health Insurance (NHI) adopted global budgeting (GB) to achieve cost control. This study captures ophthalmologists' response to GB, specifically service volume changes and service substitution between low-revenue and high-revenue services following GB implementation, the subsequent Bureau of NHI policy response, and the policy impact. De-identified eye clinic claims data for the years 2000, 2005, and 2007 were analyzed to study the changes in Simple Claim Form (SCF) claims versus Special Case Claims (SCCs). The 3 study years represent the pre-GB period, post-GB but prior to region-wise service cap implementation period, and the post-service cap period, respectively. Repeated measures multilevel regression analysis was used to study the changes adjusting for clinic characteristics and competition within each health care market. SCF service volume (low-revenue, fixed-price patient visits) remained constant throughout the study period, but SCCs (covering services involving variable provider effort and resource use with flexibility for discretionary billing) increased in 2005 with no further change in 2007. The latter is attributable to a 30% cap negotiated by the NHI Bureau with the ophthalmology association and enforced by the association. This study demonstrates that GB deployed with ongoing monitoring and timely policy responses that are designed in collaboration with professional stakeholders can contain costs in a health insurance-financed health care system. © The Author(s) 2015.

Provider Behavior Under Global Budgeting and Policy Responses

PubMed Central

Chang, Chao-Kai; Xirasagar, Sudha; Chen, Brian; Hussey, James R.; Wang, I-Jong; Chen, Jen-Chieh; Lian, Ie-Bin

2015-01-01

Third-party payer systems are consistently associated with health care cost escalation. Taiwan’s single-payer, universal coverage National Health Insurance (NHI) adopted global budgeting (GB) to achieve cost control. This study captures ophthalmologists’ response to GB, specifically service volume changes and service substitution between low-revenue and high-revenue services following GB implementation, the subsequent Bureau of NHI policy response, and the policy impact. De-identified eye clinic claims data for the years 2000, 2005, and 2007 were analyzed to study the changes in Simple Claim Form (SCF) claims versus Special Case Claims (SCCs). The 3 study years represent the pre-GB period, post-GB but prior to region-wise service cap implementation period, and the post-service cap period, respectively. Repeated measures multilevel regression analysis was used to study the changes adjusting for clinic characteristics and competition within each health care market. SCF service volume (low-revenue, fixed-price patient visits) remained constant throughout the study period, but SCCs (covering services involving variable provider effort and resource use with flexibility for discretionary billing) increased in 2005 with no further change in 2007. The latter is attributable to a 30% cap negotiated by the NHI Bureau with the ophthalmology association and enforced by the association. This study demonstrates that GB deployed with ongoing monitoring and timely policy responses that are designed in collaboration with professional stakeholders can contain costs in a health insurance–financed health care system. PMID:26324511

Direct-to-consumer advertising for bleeding disorders: a content analysis and expert evaluation of advertising claims.

PubMed

Abel, G A; Neufeld, E J; Sorel, M; Weeks, J C

2008-10-01

In the United States, the Food and Drug Administration (FDA) requires that all direct-to-consumer advertising (DTCA) contain both an accurate statement of a medication's effects ('truth') and an even-handed discussion of its benefits and risks/adverse effects ('fair balance'). DTCA for medications to treat rare diseases such as bleeding disorders is unlikely to be given high priority for FDA review. We reviewed all DTCA for bleeding disorder products appearing in the patient-directed magazine HemeAware from January 2004 to June 2006. We categorized the information presented in each advertisement as benefit, risk/adverse effect, or neither, and assessed the amount of text and type size devoted to each. We also assessed the readability of each type of text using the Flesch Reading Ease Score (FRES, where a score of >or=65 is considered of average readability), and assessed the accuracy of the advertising claims utilizing a panel of five bleeding disorder experts. A total of 39 unique advertisements for 12 products were found. On average, approximately twice the amount of text was devoted to benefits as compared with risks/adverse effects, and the latter was more difficult to read [FRES of 32.0 for benefits vs. 20.5 for risks/adverse effects, a difference of 11.5 (95% CI: 4.5-18.5)]. Only about two-thirds of the advertising claims were considered by a majority of the experts to be based on at least low-quality evidence. As measured by our methods, print DTCA for bleeding disorders may not reach the FDA's standards of truth and fair balance.

Figure-ground segregation modulates apparent motion.

PubMed

Ramachandran, V S; Anstis, S

1986-01-01

We explored the relationship between figure-ground segmentation and apparent motion. Results suggest that: static elements in the surround can eliminate apparent motion of a cluster of dots in the centre, but only if the cluster and surround have similar "grain" or texture; outlines that define occluding surfaces are taken into account by the motion mechanism; the brain uses a hierarchy of precedence rules in attributing motion to different segments of the visual scene. Being designated as "figure" confers a high rank in this scheme of priorities.

History and future of the scientific consensus on anthropogenic global warming

NASA Astrophysics Data System (ADS)

Reusswig, Fritz

2013-09-01

The article by Cook et al offers an interesting new methodological approach to the debate about (supposedly lacking) scientific consensus on global warming, showing that contrarian claims that there was no such consensus are clearly misleading. But once the attribution issue can be regarded as settled, new questions and controversies arise. They ultimately result from the different technological and organizational pathways towards a new global society model that takes its adverse climate change effects into account and seeks for new, but also risky solutions.

Development of Intake Retention, and Excretion Fractions used in Bioassay Programs for Metallic Nanoparticle Aerosols Produced in Modern Munitions Development

DTIC Science & Technology

2014-03-01

potential toxicological effects of tungsten-compounds are often attributed to the presence of cobalt and or chromium which are frequently contained in...rat test subjects.4 These claims were later put in doubt because of the substantial presents of chromium and cobalt in the tungsten alloy. Very little...biokinetics of aluminum follow similar trends as other trivalent metals. Of specific importance to this work, Priest made the assertion that

Motor Vehicle Accidents: The Family Practitioner's Role in Their Management

PubMed Central

Knight, Peter R.; Thomas, Edward J.

1980-01-01

The modern epidemic of motor vehicle accidents claims more lives, creates more morbidity and causes more property damage every successive year. Prevention is a responsibility of every family practitioner as he prescribes and counsels in his office. He has a limited role at an accident scene, but here he supports the patient and may assist personnel of ambulance, police or fire services. In the receiving hospital emergency room the priorities of emergency care, investigations and the indications for transfer of the patient to another facility are discussed. If the victim dies, the relatives' mourning is helped by organ donation and the initiative of the family practitioner in these circumstances may help many people. ImagesFig. 3 PMID:21293698

Medical ethics and new public management in Sweden.

PubMed

Hansson, Sven Ove

2014-07-01

In order to shorten queues to healthcare, the Swedish government has introduced a yearly "queue billion" that is paid out to the county councils in proportion to how successful they are in reducing queues. However, only the queues for first visits are covered. Evidence has accumulated that queues for return visits have become longer. This affects the chronically and severely ill. Swedish physicians, and the Swedish Medical Association, have strongly criticized the queue billion and have claimed that it conflicts with medical ethics. Instead they demand that their professional judgments on priority setting and medical urgency be respected. This discussion provides an interesting illustration of some of the limitations of new public management and also more generally of the complicated relationships between medical ethics and public policy.

Bangladesh intensifies prevention efforts.

PubMed

1993-01-01

Dr. Michael H. Merson, Executive Director of the World Health Organization (WHO) Global Program on AIDS, at an AIDS seminar July 12, called for concerted and coordinated action to prevent a major AIDS epidemic in Bangladesh. Although the WHO office in Bangladesh claims that AIDS prevention efforts have intensified over the past year, initial measures were slow in coming. Bangladesh has only recently viewed AIDS prevention as a priority and is beginning to commit resources and political will; nongovernmental, community, professional, and private organizations are also rising to the occasion. Of particular importance is the interparty censuses on AIDS which has developed and the broad involvement in the national AIDS committee. A Woman's Committee is also studying how to convey AIDS prevention messages to women.

The Associations between Yelp Online Reviews and Vape Shops Closing or Remaining Open One Year Later.

PubMed

Kong, Grace; Unger, Jennifer; Baezconde-Garbanati, Lourdes; Sussman, Steve

2017-01-01

Vape shops are popular brick-and-mortar stores that sell e-cigarette products but are not understood well. Previous analysis of Yelp reviews of vape shops located in various ethnic neighborhoods in Los Angeles, California in 2014 identified characteristics of vape shop as delineated by consumers. In this study, we assessed the associations between these characteristics and vape shops going out of business in 2015. Content analysis of Yelp reviews of 72 vape shops in 2014 identified 1) general characteristics of the reviews/reviewers, 2) vape shop, staff, and marketing attributes, 3) physical environment, and 4) health claims. In 2015, in-person visits confirmed that 22% of these vape shops closed permanently. We analyzed whether characteristics/attributes identified in 2014 associated with stores remaining open (n = 56) or permanently closing (n = 16) in 2015. Univariate findings showed that open vape shops relative to closed shops had greater 1) number of reviews, 2) rebuilds/fixings, 3) ratings of staff attributes as "helpful/patient/respectful," and 4) report of the physical environment as "bar type." Bar type vape shops and those with rebuilding/fixing capabilities were associated with staying open, suggesting the popularity of these attributes. Yelp consumer reviews is a useful research tool to identify consumer-determined important sustaining attributes of vape shops and may be used to identify aspects of enduring shops that need regulations.

Economic burden of irritable bowel syndrome with constipation: a retrospective analysis of health care costs in a commercially insured population.

PubMed

Doshi, Jalpa A; Cai, Qian; Buono, Jessica L; Spalding, William M; Sarocco, Phil; Tan, Hiangkiat; Stephenson, Judith J; Carson, Robyn T

2014-04-01

The prevalence of irritable bowel syndrome with constipation (IBS-C) is estimated to be between 4.3% and 5.2% among adults in the United States. Little is known about the health care resource utilization and costs associated with IBS-C. To (a) evaluate the annual total all-cause, gastrointestinal (GI)-related, and IBS-C-related health care costs among IBS-C patients seeking medical care in a commercially insured population and (b) estimate the incremental all-cause health care costs among IBS-C patients relative to matched controls. Patients aged ≥ 18 years with continuous medical and pharmacy benefit eligibility in 2010 were identified from the HealthCore Integrated Research Database, which consists of administrative claims from 14 geographically dispersed U.S. health plans representing 45 million lives. IBS-C patients were defined as those with ≥ 1 medical claim with an ICD-9-CM diagnosis code in any position for IBS (ICD-9-CM 564.1x) and either ≥ 2 medical claims for constipation (ICD-9-CM 564.0x) on different service dates or ≥ 1 medical claim for constipation plus ≥ 1 pharmacy claim for a constipation-related prescription on different dates of service during the study period. Controls were defined as patients without any medical claims for IBS, constipation, abdominal pain, or bloating or pharmacy claims for constipation-related prescriptions. Controls were randomly selected and matched with IBS-C patients in a 1:1 ratio based on age (± 4 years), gender, health plan region, and health plan type. Patients with diagnoses or prescriptions suggesting mixed IBS, IBS with diarrhea, chronic diarrhea, or drug-induced constipation were excluded. Total health care costs in 2010 U.S. dollars were defined as the sum of health plan and patient paid costs for prescriptions and medical services, including inpatient visits, emergency room (ER) visits, physician office visits, and other outpatient services. The total cost approach was used to assess total all-cause or disease-specific health care costs for patients with IBS-C, while the incremental cost approach was used to examine the excess all-cause costs of IBS-C by comparing IBS-C patients with matched controls. Generalized linear models with bootstrapping were used to assess the incremental all-cause costs attributable solely to IBS-C after adjusting for demographics, Elixhauser Comorbidity Index (ECI) score, and other general and GI-related comorbidities not included in the ECI score. A total of 7,652 patients (n = 3,826 each in the IBS-C and control cohorts) were included in the analysis. The mean (± SD) age was 48 (± 17) years, and 83.6% were female. The mean annual all-cause health care costs for IBS-C patients were $11,182, with over half (53.7%) of the costs attributable to outpatient services, including physician office visits and other outpatient services (13.1% and 40.6%, respectively). Remaining total all-cause costs were attributable to hospitalizations (21.8%), prescriptions (19.1%), and ER visits (5.4%). GI-related costs ($4,456) comprised 39.8% of total all-cause costs, while IBS-C-related costs ($1,335) accounted for 11.9% and were primarily driven by costs of other outpatient services (50.3%). After adjusting for demographics and comorbidities, the incremental annual all-cause health care costs associated with IBS-C were $3,856 ($8,621 for IBS-C patients vs. $4,765 for controls, P less than 0.01) per patient per year, of which 78.1% of the incremental costs were due to medical services, and 21.9% were due to prescription fills. IBS-C imposes a substantial economic burden in terms of direct health care costs in a commercially insured population. Compared with matched controls, IBS-C patients incurred significantly higher total annual all-cause health care costs even after controlling for general and GI-related comorbidities. Incremental all-cause costs associated with IBS-C were mainly driven by costs related to more frequent use of medical services as opposed to prescriptions.

Team behavioral norms: a shared vision for a healthy patient care workplace.

PubMed

Parsons, Mickey L; Clark, Paul; Marshall, Michelle; Cornett, Patricia A

2007-01-01

Leaders are bombarded with healthy workplace articles and advice. This article outlines a strategy for laying the foundation for healthy patient care workplaces at the pivotal unit level. This process facilitates the nursing unit staff to create and implement a shared vision for staff working relationships. Fourteen acute care hospital units, all participants in a healthy workplace intervention, were selected for this analysis because they chose team behavioral norms as a top priority to begin to implement their vision for a desired future for their units, a healthy workplace. These units developed specific team behavioral norms for their expectations of each other. The findings revealed 3 major norm themes and attributes: norms for effective communication, positive attitude, and accountability. Attributes of each norm are described to assist nurses to positively influence their core unit work culture.

A Quality Function Deployment Framework for the Service Quality of Health Information Websites

PubMed Central

Kim, Dohoon

2010-01-01

Objectives This research was conducted to identify both the users' service requirements on health information websites (HIWs) and the key functional elements for running HIWs. With the quality function deployment framework, the derived service attributes (SAs) are mapped into the suppliers' functional characteristics (FCs) to derive the most critical FCs for the users' satisfaction. Methods Using the survey data from 228 respondents, the SAs, FCs and their relationships were analyzed using various multivariate statistical methods such as principal component factor analysis, discriminant analysis, correlation analysis, etc. Simple and compound FC priorities were derived by matrix calculation. Results Nine factors of SAs and five key features of FCs were identified, and these served as the basis for the house of quality model. Based on the compound FC priorities, the functional elements pertaining to security and privacy, and usage support should receive top priority in the course of enhancing HIWs. Conclusions The quality function deployment framework can improve the FCs of the HIWs in an effective, structured manner, and it can also be utilized for critical success factors together with their strategic implications for enhancing the service quality of HIWs. Therefore, website managers could efficiently improve website operations by considering this study's results. PMID:21818418

Patients' self-interested preferences: empirical evidence from a priority setting experiment.

PubMed

Alvarez, Begoña; Rodríguez-Míguez, Eva

2011-04-01

This paper explores whether patients act according to self-interest in priority setting experiments. The analysis is based on a ranking experiment, conducted in Galicia (Spain), to elicit preferences regarding the prioritization of patients on a waiting list for an elective surgical intervention (prostatectomy for benign prostatic hyperplasia). Participants were patients awaiting a similar intervention and members of the general populations. All of them were asked to rank hypothetical patients on a waiting list. A rank-ordered logit was then applied to their responses in order to obtain a prioritization scoring system. Using these estimations, we first test for differences in preferences between patients and general population. Second, we implement a procedure based on the similarity between respondents (true patients) and the hypothetical scenarios they evaluate (hypothetical patients) to analyze whether patients provide self-interested rankings. Our results show that patient preferences differ significantly from general population preferences. The findings also indicate that, when patients rank the hypothetical scenarios on the waiting list, they consider not only the explicit attributes but also the similarity of each scenario to their own. In particular, they assign a higher priority to scenarios that more closely match their own states. We also find that such a preference structure increases their likelihood of reporting "irrational" answers. Copyright © 2011 Elsevier Ltd. All rights reserved.

The No-Destination Ship of Priority-Setting in Healthcare: A Call for More Democracy.

PubMed

Seixas, Brayan V

2017-10-11

In dealing with scarcity of resources within healthcare systems, decision-makers inevitably have to make choices about which services to fund. Setting priorities represents a challenging task that requires systematic, explicit and transparent methodologies with focus on economic efficiency. In addition, the engagement of the general public in the process of decision-making has been regarded as one of the most important aspects of the management of publicly-funded health systems in liberal democracies. In the current essay, we aim to discuss the problematics of public engagement in the process of resource allocation and priority-setting within the context of publiclyfunded health systems. Our central argument is that although there may be a conflict between democratic mechanisms of citizen participation and economic efficiency, in the extra-welfarist sense, expected for/from the system, the solution for this tension does not seem to rely on more or novel authoritative technocratic approaches, but rather on the deepening and betterment of democratic participation. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Decision Making and Priority Setting: The Evolving Path Towards Universal Health Coverage.

PubMed

Paolucci, Francesco; Redekop, Ken; Fouda, Ayman; Fiorentini, Gianluca

2017-12-01

Health technology assessment (HTA) is widely viewed as an essential component in good universal health coverage (UHC) decision-making in any country. Various HTA tools and metrics have been developed and refined over the years, including systematic literature reviews (Cochrane), economic modelling, and cost-effectiveness ratios and acceptability curves. However, while the cost-effectiveness ratio is faithfully reported in most full economic evaluations, it is viewed by many as an insufficient basis for reimbursement decisions. Emotional debates about the reimbursement of cancer drugs, orphan drugs, and end-of-life treatments have revealed fundamental disagreements about what should and should not be considered in reimbursement decisions. Part of this disagreement seems related to the equity-efficiency tradeoff, which reflects fundamental differences in priorities. All in all, it is clear that countries aiming to improve UHC policies will have to go beyond the capacity building needed to utilize the available HTA toolbox. Multi-criteria decision analysis (MCDA) offers a more comprehensive tool for reimbursement decisions where different weights of different factors/attributes can give policymakers important insights to consider. Sooner or later, every country will have to develop their own way to carefully combine the results of those tools with their own priorities. In the end, all policymaking is based on a mix of facts and values.

Emerging and continuing trends in vaccine opposition website content.

PubMed

Bean, Sandra J

2011-02-24

Anti-vaccination websites appeal to persons searching the Internet for vaccine information that reinforces their predilection to avoid vaccination for themselves or their children. Few published studies have systematically examined these sites. The aim of this study was to employ content analysis as a useful tool for examining and comparing anti-vaccination websites for recurring and changing emphases in content, design, and credibility themes since earlier anti-vaccination website content analyses were conducted. Between February and May 2010, using a commonly available search engine followed by a deep web search, 25 websites that contained anti-vaccination content were reviewed and analyzed for 24 content, 14 design, and 13 credibility attributes. Although several content claims remained similar to earlier analyses, two new themes emerged: (1) the 2009 H1N1 epidemic threat was "manufactured," and (2) the increasing presence of so-called "expert" testimony in opposing vaccination. Anti-vaccination websites are constantly changing in response to the trends in public health and the success of vaccination. Monitoring the changes can permit public health workers to mount programs more quickly to counter the opposition arguments. Additionally, opposition claims commonly appeal to emotions whereas the supporting claims appeal to reason. Effective vaccine support may be better served by including more emotionally compelling content. Copyright © 2011 Elsevier Ltd. All rights reserved.

Health, economic crisis, and austerity: A comparison of Greece, Finland and Iceland.

PubMed

Tapia Granados, José A; Rodriguez, Javier M

2015-07-01

Reports have attributed a public health tragedy in Greece to the Great Recession and the subsequent application of austerity programs. It is also claimed that the comparison of Greece with Iceland and Finland-where austerity policies were not applied-reveals the harmful effect of austerity on health and that by protecting spending in health and social budgets, governments can offset the harmful effects of economic crises on health. We use data on life expectancy, mortality rates, incidence of infectious diseases, rates of vaccination, self-reported health and other measures to examine the evolution of population health and health services performance in Greece, Finland and Iceland since 1990-2011 or 2012-the most recent years for which data are available. We find that in the three countries most indicators of population health continued improving after the Great Recession started. In terms of population health and performance of the health care system, in the period after 2007 for which data are available, Greece did as good as Iceland and Finland. The evidence does not support the claim that there is a health crisis in Greece. On the basis of the extant evidence, claims of a public health tragedy in Greece seem overly exaggerated. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The challenge of health & environment: profiling risks & strategic priorities for now & the future.

PubMed

Narain, Jai P

2012-08-01

A substantial burden of communicable and non-communicable diseases in the developing countries is attributable to environmental risk factors. WHO estimates that the environmental factors are responsible for an estimated 24 per cent of the global burden of disease in terms of healthy life years lost and 23 per cent of all deaths; children being the worst sufferers. Given that the environment is linked with most of the Millennium Development Goals (MDGs), without proper attention to the environmental risk factors and their management, it will be difficult to achieve many MDGs by 2015. The impact of environmental degradation on health may continue well into the future and the situation in fact, is likely to get worse. In order to address this challenge, two facts are worth noting. First, that much of the environmental disease burden is attributable to a few critical risk factors which include unsafe water and sanitation, exposure to indoor smoke from cooking fuel, outdoor air pollution, exposure to chemicals such as arsenic, and climate change. Second, that environment and health aspects must become, as a matter of urgency, a national priority, both in terms of policy and resources allocation. To meet the challenge of health and environment now and in the future, the following strategic approaches must be considered which include conducting environmental and health impact assessments; strengthening national environmental health policy and infrastructure; fostering inter-sectoral co-ordination and partnerships; mobilizing public participation; and enhancing the leadership role of health in advocacy, stewardship and capacity building.

Penalty-rewards contrast analysis (PRCA) on the KL monorail services

NASA Astrophysics Data System (ADS)

Muda, Nora; Suradi, Nur Riza; Mat Roji, Noor Sulawati

2013-04-01

Changes in living standards, tastes, views and education has changed the lifestyles where people are more emphasizing on quality and satisfaction with public amenities provided. One of the services provided is the KL Monorail; a public transport service which is based on a single beam track in the city that connects the north and center of Kuala Lumpur. Therefore, this study measures the customer satisfaction on the KL Monorail services and to identify the factors that should be given priority in improving their service levels. There were seven attributes being studied, namely the informations, the situation at the station, the situation in the KL Monorail, customer service, safety, efficiency and other aspects. The analysis found that the overall customer satisfactionis mean is 4.86. Based on the measurement of Penalty-Reward Contrast Analysis (PRCA), most of the KL Monorail service attribute are at moderate level of satisfaction except for the attributes at the station that have lower level of satisfaction. Therefore, a remedial actions or planning is needed to improve the customer satisfaction on the KL Monorail services.

Why are hospital-based nursing homes so costly? Relative importance of acuity and treatment setting.

PubMed

Pizer, Steven D; White, Alan J; White, Chapin

2002-05-01

To determine the extent to which higher costs in hospital-based skilled nursing facilities (HBSNF) can be explained by observable resident characteristics and unobservable selection effects, implying a design shortcoming of the skilled nursing facility prospective payment system (SNF PPS) implemented for Medicare-covered stays by the Balanced Budget Act of 1997 (BBA 1997). Data on resident characteristics from the Minimum Data Set (MDS) are combined with staff time costs from the Centers for Medicare and Medicaid Services' (CMS, formerly HCFA) 1995 and 1997 SNF Staff Time Measurement (STM) studies and nontherapy ancillary claim costs extracted from CMS SNF claim records. An endogenous switching model was estimated to measure the effect on costs of the relatively high acuity of HBSNF residents, net of differences purely attributable to the treatment setting. It was found that virtually the entire HBSNF differential is attributable to setting effects with resident characteristics and selection effects playing a negligible role. In addition, it was found that marginal costs associated with particular services and conditions are often lower in hospital-based than in freestanding facilities. HBSNFs incur high costs regardless of the characteristics of their residents. Their high fixed costs accompany relatively low marginal costs associated with admitting high-acuity residents. Consequently, a PPS casemix system that depends on resident characteristics and excludes consideration of facility characteristics (as mandated by BBA 1997) need not unfairly penalize HBSNFs, provided a powerful casemix system is used and HBSNFs specialize in the care of high-acuity residents.

Data mining of text as a tool in authorship attribution

NASA Astrophysics Data System (ADS)

Visa, Ari J. E.; Toivonen, Jarmo; Autio, Sami; Maekinen, Jarno; Back, Barbro; Vanharanta, Hannu

2001-03-01

It is common that text documents are characterized and classified by keywords that the authors use to give them. Visa et al. have developed a new methodology based on prototype matching. The prototype is an interesting document or a part of an extracted, interesting text. This prototype is matched with the document database of the monitored document flow. The new methodology is capable of extracting the meaning of the document in a certain degree. Our claim is that the new methodology is also capable of authenticating the authorship. To verify this claim two tests were designed. The test hypothesis was that the words and the word order in the sentences could authenticate the author. In the first test three authors were selected. The selected authors were William Shakespeare, Edgar Allan Poe, and George Bernard Shaw. Three texts from each author were examined. Every text was one by one used as a prototype. The two nearest matches with the prototype were noted. The second test uses the Reuters-21578 financial news database. A group of 25 short financial news reports from five different authors are examined. Our new methodology and the interesting results from the two tests are reported in this paper. In the first test, for Shakespeare and for Poe all cases were successful. For Shaw one text was confused with Poe. In the second test the Reuters-21578 financial news were identified by the author relatively well. The resolution is that our text mining methodology seems to be capable of authorship attribution.

Developing a Roadmap for Improving Neglected and Underutilized Crops: A Case Study of South Africa

PubMed Central

Mabhaudhi, Tafadzwanashe; Chimonyo, Vimbayi G. P.; Chibarabada, Tendai P.; Modi, Albert T.

2017-01-01

Reports of neglected and underutilized crops' (NUS) potential remain mostly anecdotal with limited and often incoherent research available to support them. This has been attributed to lack of clear research goals, limited funding directed at NUS and journal apathy toward publishing work on NUS. The latter points also explain the lack of interest from emerging and established researchers. Additionally, the NUS community's inability to articulate a roadmap for NUS' promotion may have unintentionally contributed to this. The current study is a sequel to an initial study that assessed the status of NUS in South Africa. The objective of this follow-up study was then to (i) identify priority NUS, and (ii) articulate a strategy and actionable recommendations for promoting NUS in South Africa. The study identified 13 priority NUS, categorized into cereals, legumes, root, and tuber crops and leafy vegetables based on drought and heat stress tolerance and nutritional value. It is recommended that the available limited resources should be targeted on improving these priority NUS as they offer the best prospects for success. Focus should be on developing value chains for the priority NUS. This should be underpinned by science to provide evidence-based outcomes. This would assist to attract more funding for NUS research, development and innovation in South Africa. It is envisaged that through this roadmap, NUS could be transformed from the peripheries into mainstream agriculture. This study provides a template for developing a roadmap for promoting NUS that could be transposed and replicated among the 14 other southern African states. PMID:29312397

Do the EMA accelerated assessment procedure and the FDA priority review ensure a therapeutic added value? 2006-2015: a cohort study.

PubMed

Boucaud-Maitre, Denis; Altman, Jean-Jacques

2016-10-01

The Food and Drug Administration (FDA) and the European Medicines Agency (EMA) have both implemented procedures in order to shorten review time for marketing authorizations with potential therapeutic added value, called priority review and accelerated assessment procedure, respectively. The aim of this study is to compare the new molecular entities (NME) assessed in shorter review time by both agencies and to investigate whether granting a shorter review time status subsequently predicts its therapeutic value attributed by a health technology assessment agency, the French Haute Autorité de Santé (HAS). All NME approved by the EMA and the FDA with a therapeutic added value between 2007 and June 30, 2015 were extracted. We assessed the sensibility, the positive predictive value, and the EMA review time. One hundred seventy-eight NME were approved by the FDA and the EMA and a therapeutic value was available for 160 NME. Eighty-eight (55.0 %) NME were on FDA priority review, 24 (15.0 %) on EMA accelerated procedure and 43 (26.9 %) were considered of high clinical added value. The sensibility was 86.0 % for the FDA and 30.2 % for the EMA. The positive predictive value was, respectively, 42.0 and 54.2 %. Twenty-five NME on FDA priority review and of high therapeutic added value were not on EMA accelerated assessment procedure, leading to a supplementary mean EMA review time of 146 days. The EMA was restrictive to grant a shorten review time status for products with therapeutic interest during the study period.

Relationship between attributional style, perceived control, self-esteem, and depressive mood in a nonclinical sample: a structural equation-modelling approach.

PubMed

Ledrich, Julie; Gana, Kamel

2013-12-01

The aim of this study was to examine the intricate relationship between some personality traits (i.e., attributional style, perceived control over consequences, self-esteem), and depressive mood in a nonclinical sample (N= 334). Method. Structural equation modelling was used to estimate five competing models: two vulnerability models describing the effects of personality traits on depressive mood, one scar model describing the effects of depression on personality traits, a mixed model describing the effects of attributional style and perceived control over consequences on depressive mood, which in turn affects self-esteem, and a reciprocal model which is a non-recursive version of the mixed model that specifies bidirectional effects between depressive mood and self-esteem. The best-fitting model was the mixed model. Moreover, we observed a significant negative effect of depression on self-esteem, but no effect in the opposite direction. These findings provide supporting arguments against the continuum model of the relationship between self-esteem and depression, and lend substantial support to the scar model, which claims that depressive mood damages and erodes self-esteem. In addition, the 'depressogenic' nature of the pessimistic attributional style, and the 'antidepressant' nature of perceived control over consequences plead in favour of the vulnerability model. © 2012 The British Psychological Society.

Estimating the burden of disease attributable to physical inactivity in South Africa in 2000.

PubMed

Joubert, Jané; Norman, Rosana; Lambert, Estelle V; Groenewald, Pam; Schneider, Michelle; Bull, Fiona; Bradshaw, Debbie

2007-08-01

To quantify the burden of disease attributable to physical inactivity in persons 15 years or older, by age group and sex, in South Africa for 2000. The global comparative risk assessment (CRA) methodology of the World Health Organization was followed to estimate the disease burden attributable to physical inactivity. Levels of physical activity for South Africa were obtained from the World Health Survey 2003. A theoretical minimum risk exposure of zero, associated outcomes, relative risks, and revised burden of disease estimates were used to calculate population-attributable fractions and the burden attributed to physical inactivity. Monte Carlo simulation-modelling techniques were used for the uncertainty analysis. South Africa. Adults >or= 15 years. Deaths and disability-adjusted life years (DALYs) from ischaemic heart disease, ischaemic stroke, breast cancer, colon cancer, and type 2 diabetes mellitus. Overall in adults >or= 15 years in 2000, 30% of ischaemic heart disease, 27% of colon cancer, 22% of ischaemic stroke, 20% of type 2 diabetes, and 17% of breast cancer were attributable to physical inactivity. Physical inactivity was estimated to have caused 17,037 (95% uncertainty interval 11,394 - 20,407), or 3.3% (95% uncertainty interval 2.2 - 3.9%) of all deaths in 2000, and 176,252 (95% uncertainty interval 133,733 - 203,628) DALYs, or 1.1% (95% uncertainty interval 0.8 - 1.3%) of all DALYs in 2000. Compared with other regions and the global average, South African adults have a particularly high prevalence of physical inactivity. In terms of attributable deaths, physical inactivity ranked 9th compared with other risk factors, and 12th in terms of DALYs. There is a clear need to assess why South Africans are particularly inactive, and to ensure that physical activity/inactivity is addressed as a national health priority.

Cancer incidence attributable to insufficient fruit and vegetable consumption in Alberta in 2012

PubMed Central

Grundy, Anne; Poirier, Abbey E.; Khandwala, Farah; McFadden, Alison; Friedenreich, Christine M.; Brenner, Darren R.

2016-01-01

Background: Sufficient fruit and vegetable consumption (≥ 5 servings/d) has been associated with a probable decreased risk for cancers of the oral cavity, pharynx, larynx, esophagus, stomach and lung (fruit only). The purpose of this study was to estimate the proportion and absolute number of cancer cases in Alberta in 2012 that were attributable to insufficient fruit and vegetable consumption. Methods: The numbers and proportions of cancers attributable to insufficient fruit and vegetable consumption were estimated using the population attributable risk. Relative risks were obtained from international collaborative panels and peer-reviewed literature. Prevalence data for insufficient fruit and vegetable consumption in Alberta were obtained from the Canadian Community Health Survey (2003, 2004, 2005, 2007/08). Age-, site- and sex-specific cancer incidence data for 2012 were obtained from the Alberta Cancer Registry. Results: The proportion of men consuming 5 or more servings of fruits and vegetables per day ranged from 25.9%-30.4% across age groups; the range among women was 46.8%-51.5% across age groups. The proportion of cancers attributable to insufficient fruit and vegetable consumption in Alberta was highest for esophageal cancer (40.0%) and lowest for lung cancer (3.3%). Overall, 290 cancer cases (1.8%) in Alberta in 2012 were attributable to insufficient fruit and vegetable consumption. Interpretation: Almost 2% of cancers in Alberta can be attributed to insufficient fruit and vegetable consumption. A diet rich in fruits and vegetables has benefits for the prevention of cancer and other chronic diseases; thus, increasing the proportion of Albertans who meet cancer prevention guidelines for fruit and vegetable consumption is a priority. PMID:28018892

Leveraging the Health and Retirement Study To Advance Palliative Care Research

PubMed Central

Langa, Kenneth M.; Smith, Alexander K.; Cagle, John; Ornstein, Katherine; Silveira, Maria J.; Nicholas, Lauren; Covinsky, Kenneth E.; Ritchie, Christine S.

2014-01-01

Abstract Background: The critical need to expand and develop the palliative care evidence base was recently highlighted by the Journal of Palliative Medicine's series of articles describing the Research Priorities in Geriatric Palliative Care. The Health and Retirement Study (HRS) is uniquely positioned to address many priority areas of palliative care research. This nationally representative, ongoing, longitudinal study collects detailed survey data every 2 years, including demographics, health and functional characteristics, information on family and caregivers, and personal finances, and also conducts a proxy interview after each subject's death. The HRS can also be linked with Medicare claims data and many other data sources, e.g., U.S. Census, Dartmouth Atlas of Health Care. Setting: While the HRS offers innumerable research opportunities, these data are complex and limitations do exist. Therefore, we assembled an interdisciplinary group of investigators using the HRS for palliative care research to identify the key palliative care research gaps that may be amenable to study within the HRS and the strengths and weaknesses of the HRS for each of these topic areas. Conclusion: In this article we present the work of this group as a potential roadmap for investigators contemplating the use of HRS data for palliative care research. PMID:24694096

Disability and capability: exploring the usefulness of Martha Nussbaum's capabilities approach for the UN disability rights convention.

PubMed

Harnacke, Caroline

2013-01-01

I explore the usefulness of Martha Nussbaum's capabilities approach in regard to the UN Convention on the Rights of Persons with Disabilities (CRPD). The CRPD aims at empowering people with disabilities by granting them a number of civil and political, but also economic, social and cultural rights. Implementing the CRPD will clearly be politically challenging and also very expensive for states. Thus, questions might arise as to whether the requirements set in the CRPD can be justified from an ethical perspective. I will first investigate if Nussbaum's capabilities approach provides support for the rights claimed in the CRPD. Second, I will investigate to what extent Nussbaum's capabilities approach is a useful tool to set priorities among rights in the course of the implementation of the convention. This is an urgent question because seen realistically, it will not be possible to realize all rights at once and thus some rights need to receive greater priority than others. I will argue that the capabilities approach can be regarded as supporting the rights specified in the CRPD, but that it proves unable to guide the implementation process due to an insufficient grounding of the capabilities. Employing the capabilities approach thus leads to only limited results. © 2013 American Society of Law, Medicine & Ethics, Inc.

Two character traits associated with adherence to long term therapies.

PubMed

Reach, Gérard

2012-10-01

Adherence is defined as the adequacy between the behaviours of patients and their medical prescriptions. Adherence is a general behaviour, which can explain why patients in the placebo arm of randomised clinical trials have a lower mortality rate when they are adherent. We propose that this behaviour is related to two character traits: patience (capacity to give priority to the future) and, more provocatively, obedience. To support this claim, we bring arguments from the literature and from two published personal studies. We previously showed that type 2 diabetic patients who respond as non-adherers to a questionnaire on adherence to medication and to whom one proposes a fictitious monetary choice between receiving 500 euros today or waiting one year to receive 1500 euros never make the remote choice. We also showed that obese diabetic patients who declare that they do not fasten their seat belt when they are seated in the rear of a car are more often non-adherent concerning medication than those patients who claim that they follow this road safety recommendation. Thus, one of the roles of empowerment and patient education could be to encourage the patients, if they wish it, to replace passive adherence behaviours with conscious active choices. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Pork as a Source of Omega-3 (n-3) Fatty Acids

PubMed Central

Dugan, Michael E.R.; Vahmani, Payam; Turner, Tyler D.; Mapiye, Cletos; Juárez, Manuel; Prieto, Nuria; Beaulieu, Angela D.; Zijlstra, Ruurd T.; Patience, John F.; Aalhus, Jennifer L.

2015-01-01

Pork is the most widely eaten meat in the world, but typical feeding practices give it a high omega-6 (n-6) to omega-3 (n-3) fatty acid ratio and make it a poor source of n-3 fatty acids. Feeding pigs n-3 fatty acids can increase their contents in pork, and in countries where label claims are permitted, claims can be met with limited feeding of n-3 fatty acid enrich feedstuffs, provided contributions of both fat and muscle are included in pork servings. Pork enriched with n-3 fatty acids is, however, not widely available. Producing and marketing n-3 fatty acid enriched pork requires regulatory approval, development costs, quality control costs, may increase production costs, and enriched pork has to be tracked to retail and sold for a premium. Mandatory labelling of the n-6/n-3 ratio and the n-3 fatty acid content of pork may help drive production of n-3 fatty acid enriched pork, and open the door to population-based disease prevention polices (i.e., food tax to provide incentives to improve production practices). A shift from the status-quo, however, will require stronger signals along the value chain indicating production of n-3 fatty acid enriched pork is an industry priority. PMID:26694475

The Impact of Heat Waves on Occurrence and Severity of Construction Accidents.

PubMed

Rameezdeen, Rameez; Elmualim, Abbas

2017-01-11

The impact of heat stress on human health has been extensively studied. Similarly, researchers have investigated the impact of heat stress on workers' health and safety. However, very little work has been done on the impact of heat stress on occupational accidents and their severity, particularly in South Australian construction. Construction workers are at high risk of injury due to heat stress as they often work outdoors, undertake hard manual work, and are often project based and sub-contracted. Little is known on how heat waves could impact on construction accidents and their severity. In order to provide more evidence for the currently limited number of empirical investigations on the impact of heat stress on accidents, this study analysed 29,438 compensation claims reported during 2002-2013 within the construction industry of South Australia. Claims reported during 29 heat waves in Adelaide were compared with control periods to elicit differences in the number of accidents reported and their severity. The results revealed that worker characteristics, type of work, work environment, and agency of accident mainly govern the severity. It is recommended that the implementation of adequate preventative measures in small-sized companies and civil engineering sites, targeting mainly old age workers could be a priority for Work, Health and Safety (WHS) policies.

The Impact of Heat Waves on Occurrence and Severity of Construction Accidents

PubMed Central

Rameezdeen, Rameez; Elmualim, Abbas

2017-01-01

The impact of heat stress on human health has been extensively studied. Similarly, researchers have investigated the impact of heat stress on workers’ health and safety. However, very little work has been done on the impact of heat stress on occupational accidents and their severity, particularly in South Australian construction. Construction workers are at high risk of injury due to heat stress as they often work outdoors, undertake hard manual work, and are often project based and sub-contracted. Little is known on how heat waves could impact on construction accidents and their severity. In order to provide more evidence for the currently limited number of empirical investigations on the impact of heat stress on accidents, this study analysed 29,438 compensation claims reported during 2002–2013 within the construction industry of South Australia. Claims reported during 29 heat waves in Adelaide were compared with control periods to elicit differences in the number of accidents reported and their severity. The results revealed that worker characteristics, type of work, work environment, and agency of accident mainly govern the severity. It is recommended that the implementation of adequate preventative measures in small-sized companies and civil engineering sites, targeting mainly old age workers could be a priority for Work, Health and Safety (WHS) policies. PMID:28085067

Pork as a Source of Omega-3 (n-3) Fatty Acids.

PubMed

Dugan, Michael E R; Vahmani, Payam; Turner, Tyler D; Mapiye, Cletos; Juárez, Manuel; Prieto, Nuria; Beaulieu, Angela D; Zijlstra, Ruurd T; Patience, John F; Aalhus, Jennifer L

2015-12-16

Pork is the most widely eaten meat in the world, but typical feeding practices give it a high omega-6 (n-6) to omega-3 (n-3) fatty acid ratio and make it a poor source of n-3 fatty acids. Feeding pigs n-3 fatty acids can increase their contents in pork, and in countries where label claims are permitted, claims can be met with limited feeding of n-3 fatty acid enrich feedstuffs, provided contributions of both fat and muscle are included in pork servings. Pork enriched with n-3 fatty acids is, however, not widely available. Producing and marketing n-3 fatty acid enriched pork requires regulatory approval, development costs, quality control costs, may increase production costs, and enriched pork has to be tracked to retail and sold for a premium. Mandatory labelling of the n-6/n-3 ratio and the n-3 fatty acid content of pork may help drive production of n-3 fatty acid enriched pork, and open the door to population-based disease prevention polices (i.e., food tax to provide incentives to improve production practices). A shift from the status-quo, however, will require stronger signals along the value chain indicating production of n-3 fatty acid enriched pork is an industry priority.

Front of package symbols as a tool to promote healthier food choices in Slovenia: Accompanying explanatory claim can considerably influence the consumer's preferences.

PubMed

Miklavec, Krista; Pravst, Igor; Raats, Monique M; Pohar, Jure

2016-12-01

Many nutrition and/or health symbols were introduced in different countries in the past years and Slovenia is no exception. The objective of our study was to examine familiarity with and perception of the Protective Food symbol (PF symbol) in Slovenia and to investigate consumers' associations related to the symbol, and the influence of symbols' appearance on their preferences. The study was conducted through online questionnaire with incorporated word-association tasks and conjoint analysis; GfK consumer panel and social media (Facebook) were used for recruitment of Slovenian adults (n=1050; 534 men, 516 women). The majority (78%) of the participants reported they had previously seen the PF symbol, and 64% declared familiarity with it. Familiarity was verified using a word-association task in which we analysed the nature of the symbol's description, distinguishing the description of symbol's visual appearance or its meaning. In this task, 73% of the participants described the symbol's meaning with reference to health or a healthy lifestyle, confirming their familiarity with it. Women and those responsible for grocery shopping were significantly more familiar with the symbol. The impact of the symbol's appearance on consumers' preferences was investigated using conjoint analysis consisting of two attributes - three different symbols found on foods in Slovenia (PF symbol, Choices Programme symbol and Keyhole symbol), and accompanying worded claims. Although worded claims had less relative importance (29.5%) than the symbols (70.5%), we show that careful choice of the wording can affect consumers' preferences considerably. The lowest part-worth utility was observed without an accompanying claim, and the highest for the claim directly communicating health ("Protects your health"). The fact that most participants are well familiar with the PF symbol indicates the symbol's potential to promote healthier food choices, which could be further improved by an accompanying worded claim that clearly describes its meaning. In addition, the use of Facebook ads is shown to be a useful alternative recruitment method for research with consumers. Copyright © 2016 Elsevier Ltd. All rights reserved.

Ordinary risks and accepted fictions: how contrasting and competing priorities work in risk assessment and mental health care planning.

PubMed

Coffey, Michael; Cohen, Rachel; Faulkner, Alison; Hannigan, Ben; Simpson, Alan; Barlow, Sally

2017-06-01

Communication and information sharing are considered crucial to recovery-focused mental health services. Effective mental health care planning and coordination includes assessment and management of risk and safety. Using data from our cross-national mixed-method study of care planning and coordination, we examined what patients, family members and workers say about risk assessment and management and explored the contents of care plans. Thematic analysis of qualitative research interviews (n = 117) with patients, family members and workers, across four English and two Welsh National Health Service sites. Care plans were reviewed (n = 33) using a structured template. Participants have contrasting priorities in relation to risk. Patients see benefit in discussions about risk, but cast the process as a worker priority that may lead to loss of liberty. Relationships with workers are key to family members and patients; however, worker claims of involving people in the care planning process do not extend to risk assessment and management procedures for fear of causing upset. Workers locate risk as coming from the person rather than social or environmental factors, are risk averse and appear to prioritize the procedural aspects of assessment. Despite limitations, risk assessment is treated as legitimate work by professionals. Risk assessment practice operates as a type of fiction in which poor predictive ability and fear of consequences are accepted in the interests of normative certainty by all parties. As a consequence, risk adverse options are encouraged by workers and patients steered away from opportunities for ordinary risks thereby hindering the mobilization of their strengths and abilities. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

A primer on potential impacts, management priorities, and future directions for Elodea spp. in high latitude systems: learning from the Alaskan experience

USGS Publications Warehouse

Carey, Michael P.; Sethi, Suresh A; Larsen, Sabrina J; Rich, Cecil F

2016-01-01

Invasive species introductions in Arctic and Subarctic ecosystems are growing as climate change manifests and human activity increases in high latitudes. The aquatic plants of the genus Elodea are potential invaders to Arctic and Subarctic ecosystems circumpolar and at least one species is already established in Alaska, USA. To illustrate the problems of preventing, eradicating, containing, and mitigating aquatic, invasive plants in Arctic and Subarctic ecosystems, we review the invasion dynamics of Elodea and provide recommendations for research and management efforts in Alaska. Foremost, we conclude the remoteness of Arctic and Subarctic systems such as Alaska is no longer a protective attribute against invasions, as transportation pathways now reach throughout these regions. Rather, high costs of operating in remote Arctic and Subarctic systems hinders detection of infestations and limits eradication or mitigation, emphasizing management priorities of prevention and containment of aquatic plant invaders in Alaska and other Arctic and Subarctic systems.

Automatic health record review to help prioritize gravely ill Social Security disability applicants.

PubMed

Abbott, Kenneth; Ho, Yen-Yi; Erickson, Jennifer

2017-07-01

Every year, thousands of patients die waiting for disability benefits from the Social Security Administration. Some qualify for expedited service under the Compassionate Allowance (CAL) initiative, but CAL software focuses exclusively on information from a single form field. This paper describes the development of a supplemental process for identifying some overlooked but gravely ill applicants, through automatic annotation of health records accompanying new claims. We explore improved prioritization instead of fully autonomous claims approval. We developed a sample of claims containing medical records at the moment of arrival in a single office. A series of tools annotated both patient records and public Web page descriptions of CAL medical conditions. We trained random forests to identify CAL patients and validated each model with 10-fold cross validation. Our main model, a general CAL classifier, had an area under the receiver operating characteristic curve of 0.915. Combining this classifier with existing software improved sensitivity from 0.960 to 0.994, detecting every deceased patient, but reducing positive predictive value to 0.216. True positive CAL identification is a priority, given CAL patient mortality. Mere prioritization of the false positives would not create a meaningful burden in terms of manual review. Death certificate data suggest the presence of truly ill patients among putative false positives. To a limited extent, it is possible to identify gravely ill Social Security disability applicants by analyzing annotations of unstructured electronic health records, and the level of identification is sufficient to be useful in prioritizing case reviews. Published by Oxford University Press on behalf of the American Medical Informatics Association 2017. This work is written by US Government employees and is in the public domain in the US.

[The analysis of the judicial practice of treating the civil lawsuits concerning the inadequate dental health service appeals launched by the patients in the Russian Federation during the period from 1993 to 2017].

PubMed

Andreeva, S N; Gusarov, A A; Fetisov, V A

2018-01-01

The objective of the present study was to elucidate the characteristic features and peculiarities in the dynamic of the civil legal proceedings concerning the quality of the stomatological aid to the population of the Russian Federation during the period from 1993 to 2017. We have undertaken the analysis of the official sources containing the court reports on the statements of claim launched by the patients. The study gave evidence of the currently well apparent sustained tendency toward the increase in the number of such civil lawsuits. The probabilities of legal proceedings in connection with the unfavourable outcomes of the dental treatment are roughly identical in all areas of the stomatological practice. The maximum number of the respective civil lawsuits arise from the claims of the patients against the dental surgeons employed by the healthcare settings designated as the limited liability companies. The majority of the statements of case coming from the patients contain the demanding financial claims for the compensation of the moral damage. It is concluded that the aforementioned tendencies in the strategy of the development of the stomatological aid for the population of the Russian Federation dictate the necessity of the priority development of the quality standards (including the clinical guidelines, protocols, etc.) designed to improve the medical assistance for the patients presenting with dental problems, the modernization of the validated methods for the evaluation of the effectiveness of the stomatological aid for the population, the implementation of the measures needed to introduce the mechanisms of professional liability insurance into the routine stomatological practice. These measures are believed to allow to meet the demand of the population of this country for the high-quality stomatological services.

Geographic variation in fee-for-service medicare beneficiaries' medical costs is largely explained by disease burden.

PubMed

Reschovsky, James D; Hadley, Jack; Romano, Patrick S

2013-10-01

Control for area differences in population health (casemix adjustment) is necessary to measure geographic variations in medical spending. Studies use various casemix adjustment methods, resulting in very different geographic variation estimates. We study casemix adjustment methodological issues and evaluate alternative approaches using claims from 1.6 million Medicare beneficiaries in 60 representative communities. Two key casemix adjustment methods-controlling for patient conditions obtained from diagnoses on claims and expenditures of those at the end of life-were evaluated. We failed to find evidence of bias in the former approach attributable to area differences in physician diagnostic patterns, as others have found, and found that the assumption underpinning the latter approach-that persons close to death are equally sick across areas-cannot be supported. Diagnosis-based approaches are more appropriate when current rather than prior year diagnoses are used. Population health likely explains more than 75% to 85% of cost variations across fixed sets of areas.

Is it acceptable to use animals to model obese humans? A critical discussion of two arguments against the use of animals in obesity research.

PubMed

Lund, Thomas Bøker; Sørensen, Thorkild I A; Olsson, I Anna S; Hansen, Axel Kornerup; Sandøe, Peter

2014-05-01

Animal use in medical research is widely accepted on the basis that it may help to save human lives and improve their quality of life. Recently, however, objections have been made specifically to the use of animals in scientific investigation of human obesity. This paper discusses two arguments for the view that this form of animal use, unlike some other forms of animal-based medical research, cannot be defended. The first argument leans heavily on the notion that people themselves are responsible for developing obesity and so-called 'lifestyle' diseases; the second involves the claim that animal studies of obesity's causes and therapies distract attention from preventive efforts. Drawing on both empirical data and moral reasoning, we argue that the relevant attributions of responsibility and claims about distraction are not plausible, and that, therefore, there is no reason to single out the use of animals in obesity research as especially problematic.

Microdynamics of the piezo-driven pipettes in ICSI.

PubMed

Ediz, Kerem; Olgac, Nejat

2004-07-01

Undesirably low success rates have been reported in the intracytoplasmic sperm injection procedure. Recently a method using piezo-driven pipettes with a very small mercury column contributed substantial improvements in this process. Despite the toxicity of mercury, this new procedure is commonly utilized in many laboratories. However, there is no study available to date on the micromechanics of this procedure. The underlying principles of piercing are not clear for both cases, with and without the mercury. Presently, the pressure burst, which is caused by the abrupt axial motion of the mercury column, is attributed to this effect. Here, we take the mercury-filled pipettes and try to understand the governing physics. The findings point out the occurrence of considerable lateral tip oscillations of the injection pipette as the piezoelectric pulse train is introduced. We claim that the lateral dynamics play an important role in the piercing and should be considered to enlighten the process and the effects of the mercury. These claims are analytically studied and experimentally verified.

Personal Electronic Devices and Their Interference with Aircraft Systems

NASA Technical Reports Server (NTRS)

Ross, Elden; Ely, Jay J. (Technical Monitor)

2001-01-01

A compilation of data on personal electronic devices (PEDs) attributed to having created anomalies with aircraft systems. Charts and tables display 14 years of incidents reported by pilots to the Aviation Safety Reporting System (ASRS). Affected systems, incident severity, sources of anomaly detection, and the most frequently identified PEDs are some of the more significant data. Several reports contain incidents of aircraft off course when all systems indicated on course and of critical events that occurred during landings and takeoffs. Additionally, PEDs that should receive priority in testing are identified.

Improved hybridization of Fuzzy Analytic Hierarchy Process (FAHP) algorithm with Fuzzy Multiple Attribute Decision Making - Simple Additive Weighting (FMADM-SAW)

NASA Astrophysics Data System (ADS)

Zaiwani, B. E.; Zarlis, M.; Efendi, S.

2018-03-01

In this research, the improvement of hybridization algorithm of Fuzzy Analytic Hierarchy Process (FAHP) with Fuzzy Technique for Order Preference by Similarity to Ideal Solution (FTOPSIS) in selecting the best bank chief inspector based on several qualitative and quantitative criteria with various priorities. To improve the performance of the above research, FAHP algorithm hybridization with Fuzzy Multiple Attribute Decision Making - Simple Additive Weighting (FMADM-SAW) algorithm was adopted, which applied FAHP algorithm to the weighting process and SAW for the ranking process to determine the promotion of employee at a government institution. The result of improvement of the average value of Efficiency Rate (ER) is 85.24%, which means that this research has succeeded in improving the previous research that is equal to 77.82%. Keywords: Ranking and Selection, Fuzzy AHP, Fuzzy TOPSIS, FMADM-SAW.

Visual Assessment on Coastal Cruise Tourism: A Preliminary Planning Using Importance Performance Analysis

NASA Astrophysics Data System (ADS)

Trisutomo, S.

2017-07-01

Importance-Performance Analysis (IPA) has been widely applied in many cases. In this research, IPA was applied to measure perceive on coastal tourism objects and its possibility to be developed as coastal cruise tourism in Makassar. Three objects, i.e. Akkarena recreational site, Losari public space at waterfront, and Paotere traditional Phinisi ships port, were selected and assessed visually from water area by a group of purposive resource persons. The importance and performance of 10 attributes of each site were scored using Likert scale from 1 to 5. Data were processed by SPSS-21 than resulted Cartesian graph which the scores were divided in four quadrants: Quadrant I concentric here, Quadrant II keep up the good work, Quadrant III low priority, and Quadrant IV possible overkill. The attributes in each quadrant could be considered as the platform for preliminary planning of coastal cruise tour in Makassar

Adherence and complementary and alternative medicine use among Honduran people with epilepsy.

PubMed

Durón, Reyna M; Medina, Marco T; Nicolás, Orlinder; Varela, Francis E; Ramírez, Francisco; Battle, Sean J; Thompson, Arnold; Rodríguez, Luis C; Oseguera, Conrado; Aguilar-Estrada, Rafael L; Pietsch-Escueta, Susan; Collins, Julianne S; Holden, Kenton R

2009-04-01

Adherence to antiepileptic drugs (AEDs) and use of complementary and alternative medicine (CAM) among Hondurans with epilepsy were evaluated. Our epilepsy cohort of 274 outpatients was surveyed to determine demographics, epilepsy treatment history, adherence, and use of CAM. Nonadherence to epilepsy therapy was reported by 121, with unavailability of AEDs (48%) the most common reason. CAM was reportedly used by 141, with prayer, herbs, and potions being common. Forty-nine rural Miskito Hondurans without epilepsy were also interviewed to gain an understanding of their beliefs and longstanding practices regarding epilepsy. Seventeen (34.7%) attributed epilepsy to the supernatural; only three knew of an AED. Widespread nonadherence to evidence-based epilepsy treatments in Honduras can be attributed to inadequate education, AED unavailability, insufficient resources, cultural beliefs, and wide use of CAM. A comprehensive epilepsy education program and improved access to evidence-based AEDs represent initial priorities to improve the Honduran epilepsy treatment gap.

[Justice concern, perceived procedural justice, and subjective validity of the results in the labor tribunal system in Japan: A comparison of parties between labors and employers].

PubMed

Imazai, Kei-Ichiro

2015-06-01

The labor tribunal system, which is a form of alternative dispute resolution rather than a type of lawsuit, requires both parties' agreements to settle disputes and maintains a high settlement rate. As most of parties involved in the system are said to expect that labor problems should be settled fairly, it is assumed that they will readily accept the results of fair procedures. However, it seems that laborers who submit claims for compensation have a different concept of justice than employers or company employees in charge of settlements and this determines the attitudes toward the results. This study conducted a survey of participants in the labor tribunal system, and suggest that laborers attribute the validity of this system's results directly to judges, while company representatives attribute it to the procedure conducted by the judges.

;Agreement; in the IPCC Confidence measure

NASA Astrophysics Data System (ADS)

Rehg, William; Staley, Kent

2017-02-01

The Intergovernmental Panel on Climate Change (IPCC) has, in its most recent Assessment Report (AR5), articulated guidelines for evaluating and communicating uncertainty that include a qualitative scale of confidence. We examine one factor included in that scale: the "degree of agreement." Some discussions of the degree of agreement in AR5 suggest that the IPCC is employing a consensus-oriented social epistemology. We consider the application of the degree of agreement factor in practice in AR5. Our findings, though based on a limited examination, suggest that agreement attributions do not so much track the overall consensus among investigators as the degree to which relevant research findings substantively converge in offering support for IPCC claims. We articulate a principle guiding confidence attributions in AR5 that centers not on consensus but on the notion of support. In concluding, we tentatively suggest a pluralist approach to the notion of support.

Project-based learning as a contributing factor to graduates' work readiness

NASA Astrophysics Data System (ADS)

Jollands, Margaret; Jolly, Lesley; Molyneaux, Tom

2012-05-01

This paper explores what work readiness means for two cohorts of graduate engineers, one from a traditional curriculum, the second from a largely project-based curriculum. Professional bodies and employers have defined a set of attributes for engineering graduates so that graduates will be 'work ready'. Problem-based learning (PBL) is claimed to be a suitable approach to develop such skills. The graduates were interviewed some months after starting work, along with their managers. All the graduates recognised the benefits of taking PBL subjects as well as vacation work, with success in communication attributed more to PBL. Both cohorts had similar learning outcomes, high skill levels in project management, problem solving, communication skills, research and sustainability. A skills gap in ethics was identified for both cohorts of graduates and their managers. Further work is planned to link skill development with undergraduate learning experience.

Perceptual Learning and Attention: Reduction of Object Attention Limitations with Practice

PubMed Central

Dosher, Barbara Anne; Han, Songmei; Lu, Zhong-Lin

2012-01-01

Perceptual learning has widely been claimed to be attention driven; attention assists in choosing the relevant sensory information and attention may be necessary in many cases for learning. In this paper, we focus on the interaction of perceptual learning and attention – that perceptual learning can reduce or eliminate the limitations of attention, or, correspondingly, that perceptual learning depends on the attention condition. Object attention is a robust limit on performance. Two attributes of a single attended object may be reported without loss, while the same two attributes of different objects can exhibit a substantial dual-report deficit due to the sharing of attention between objects. The current experiments document that this fundamental dual-object report deficit can be reduced, or eliminated, through perceptual learning that is partially specific to retinal location. This suggests that alternative routes established by practice may reduce the competition between objects for processing resources. PMID:19796653

Patients' preferences for primary health care - a systematic literature review of discrete choice experiments.

PubMed

Kleij, Kim-Sarah; Tangermann, Ulla; Amelung, Volker E; Krauth, Christian

2017-07-11

Primary care is a key element of health care systems and addresses the main health problems of the population. Due to the demographic change, primary care even gains in importance. The knowledge of the patients' preferences can help policy makers as well as physicians to set priorities in their effort to make health care delivery more responsive to patients' needs. Our objective was to describe which aspects of primary care were included in preference studies and which of them were the most preferred aspects. In order to elicit the preferences for primary care, a systematic literature search was conducted. Two researchers searched three electronic databases (PubMed, Scopus, and PsycINFO) and conducted a narrative synthesis. Inclusion criteria were: focus on primary health care delivery, discrete choice experiment as elicitation method, and studies published between 2006 and 2015 in English language. We identified 18 studies that elicited either the patients' or the population's preferences for primary care based on a discrete choice experiment. Altogether the studies used 16 structure attributes, ten process attributes and four outcome attributes. The most commonly applied structure attribute was "Waiting time till appointment", the most frequently used process attribute was "Shared decision making / professional's attention paid to your views". "Receiving the 'best' treatment" was the most commonly applied outcome attribute. Process attributes were most often the ones of highest importance for patients or the population. The attributes and attribute levels used in the discrete choice experiments were identified by literature research, qualitative research, expert interviews, or the analysis of policy documents. The results of the DCE studies show different preferences for primary health care. The diversity of the results may have several reasons, such as the method of analysis, the selection procedure of the attributes and their levels or the specific research question of the study. As the results of discrete choice experiments depend on many different factors, it is important for a better comprehensibility of the studies to transparently report the steps undertaken in a study as well as the interim results regarding the identification of attributes and levels.

Perceived Mortality and Perceived Morality: Perceptions of Value-Orientation Are More Likely When a Decision Is Preceded by a Mortality Reminder

PubMed Central

Nordmo, Mads; Norman, Elisabeth

2016-01-01

The questions addressed in this paper are whether and how reported mortality reminders can function as an indication of sincerity when communicating ambiguously motivated decisions. In two experiments, participants were exposed to a fictitious CEO who announced a decision to implement new organizational measures that were both environmentally and financially beneficial. In the experimental condition, the CEO attributed her new ideas to a recent mortality reminder. In the active control condition, the CEO attributed her decision to a non-lethal dentistry health scare, and in the passive control condition the CEO did not give any account of events preceding her decision. When a CEO implemented new corporate initiatives after a mortality reminder, her motivation for doing so was perceived as somewhat more motivated by intrinsic values, and significantly less motivated by financial gains. This change in attribution patterns was demonstrated to be indirectly related to a positive evaluation of the CEO, as well as an increased willingness to pay for the organization’s services. The second experiment further demonstrated that the reduced attribution to financial motivation associated with mortality awareness persisted even when the CEO in question was known for placing a high personal priority on financial goal attainment. The findings underscore the importance of perceived value-oriented motivation when communicating climate change mitigating policies, and the role of mortality awareness as one of many ways to induce such attributions. PMID:26973555

Perceived Mortality and Perceived Morality: Perceptions of Value-Orientation Are More Likely When a Decision Is Preceded by a Mortality Reminder.

PubMed

Nordmo, Mads; Norman, Elisabeth

2016-01-01

The questions addressed in this paper are whether and how reported mortality reminders can function as an indication of sincerity when communicating ambiguously motivated decisions. In two experiments, participants were exposed to a fictitious CEO who announced a decision to implement new organizational measures that were both environmentally and financially beneficial. In the experimental condition, the CEO attributed her new ideas to a recent mortality reminder. In the active control condition, the CEO attributed her decision to a non-lethal dentistry health scare, and in the passive control condition the CEO did not give any account of events preceding her decision. When a CEO implemented new corporate initiatives after a mortality reminder, her motivation for doing so was perceived as somewhat more motivated by intrinsic values, and significantly less motivated by financial gains. This change in attribution patterns was demonstrated to be indirectly related to a positive evaluation of the CEO, as well as an increased willingness to pay for the organization's services. The second experiment further demonstrated that the reduced attribution to financial motivation associated with mortality awareness persisted even when the CEO in question was known for placing a high personal priority on financial goal attainment. The findings underscore the importance of perceived value-oriented motivation when communicating climate change mitigating policies, and the role of mortality awareness as one of many ways to induce such attributions.

Work-related mortality in England and Wales, 1979-2000.

PubMed

Coggon, David; Harris, E Clare; Brown, Terry; Rice, Simon; Palmer, Keith T

2010-12-01

To explore time trends in deaths attributable to work in England and Wales, and identify priorities for prevention, we conducted a proportional analysis of mortality by occupation over a 22-year period. Analysis was based on deaths in men aged 20-74 years during 1979-1980 and 1982-2000 with a recorded occupation. Proportional mortality ratios, standardised for age and social class, were calculated for pre-specified combinations of occupation and cause of death, for which excess mortality could reasonably be attributed to work. Differences between observed and expected numbers of deaths by cause and occupation were expressed as annual excess death rates. Mortality attributable to work declined substantially over the period of study, with total excess death rates of 733.2 per year during 1979-1990 and 471.7 per year during 1991-2000. The largest contributing hazards were chronic obstructive pulmonary disease and pneumoconiosis in coal miners, pleural cancer from asbestos, and motor vehicle accidents in lorry drivers. In contrast to most other hazards, there was no clear decline in excess mortality attributable to asbestos, or in deaths from sino-nasal cancer associated with exposure to wood dust. The overall decline in mortality attributable to work is likely to reflect reduced employment in more hazardous occupations, as well as improvements in working conditions. It is imperative to ensure that occupational exposures to asbestos and wood dust are now adequately controlled. Further research is needed on accidents involving lorries with the aim of developing more effective strategies for the prevention of injury.

Feeling safe during an inpatient hospitalization: a concept analysis.

PubMed

Mollon, Deene

2014-08-01

This paper aims to explore the critical attributes of the concept feeling safe. The safe delivery of care is a high priority; however; it is not really known what it means to the patient to 'feel safe' during an inpatient hospitalization. This analysis explores the topic of safety from the patient's perspective. Concept analysis. The data bases of CINAHL, Medline, PsychInfo and Google Scholar for the years 1995-2012 were searched using the terms safe and feeling safe. The eight-step concept analysis method of Walker and Avant was used to analyse the concept of feeling safe. Uses and defining attributes, as well as identified antecedents, consequences and empirical referents, are presented. Case examples are provided to assist in the understanding of defining attributes. Feeling safe is defined as an emotional state where perceptions of care contribute to a sense of security and freedom from harm. Four attributes were identified: trust, cared for, presence and knowledge. Relationship, environment and suffering are the antecedents of feeling safe, while control, hope and relaxed or calm are the consequences. Empirical referents and early development of a theory of feeling safe are explored. This analysis begins the work of synthesizing qualitative research already completed around the concept of feeling safe by defining the key attributes of the concept. Support for the importance of developing patient-centred models of care and creating positive environments where patients receive high-quality care and feel safe is provided. © 2014 John Wiley & Sons Ltd.

The Associations between Yelp Online Reviews and Vape Shops Closing or Remaining Open One Year Later

PubMed Central

Kong, Grace; Unger, Jennifer; Baezconde-Garbanati, Lourdes; Sussman, Steve

2017-01-01

INTRODUCTION Vape shops are popular brick-and-mortar stores that sell e-cigarette products but are not understood well. Previous analysis of Yelp reviews of vape shops located in various ethnic neighborhoods in Los Angeles, California in 2014 identified characteristics of vape shop as delineated by consumers. In this study, we assessed the associations between these characteristics and vape shops going out of business in 2015. METHODS Content analysis of Yelp reviews of 72 vape shops in 2014 identified 1) general characteristics of the reviews/reviewers, 2) vape shop, staff, and marketing attributes, 3) physical environment, and 4) health claims. In 2015, in-person visits confirmed that 22% of these vape shops closed permanently. We analyzed whether characteristics/attributes identified in 2014 associated with stores remaining open (n = 56) or permanently closing (n = 16) in 2015. RESULTS Univariate findings showed that open vape shops relative to closed shops had greater 1) number of reviews, 2) rebuilds/fixings, 3) ratings of staff attributes as “helpful/patient/respectful,” and 4) report of the physical environment as “bar type.” CONCLUSIONS Bar type vape shops and those with rebuilding/fixing capabilities were associated with staying open, suggesting the popularity of these attributes. Yelp consumer reviews is a useful research tool to identify consumer-determined important sustaining attributes of vape shops and may be used to identify aspects of enduring shops that need regulations. PMID:29057379

Informing vaccine decision-making: A strategic multi-attribute ranking tool for vaccines-SMART Vaccines 2.0.

PubMed

Knobler, Stacey; Bok, Karin; Gellin, Bruce

2017-01-20

SMART Vaccines 2.0 software is being developed to support decision-making among multiple stakeholders in the process of prioritizing investments to optimize the outcomes of vaccine development and deployment. Vaccines and associated vaccination programs are one of the most successful and effective public health interventions to prevent communicable diseases and vaccine researchers are continually working towards expanding targets for communicable and non-communicable diseases through preventive and therapeutic modes. A growing body of evidence on emerging vaccine technologies, trends in disease burden, costs associated with vaccine development and deployment, and benefits derived from disease prevention through vaccination and a range of other factors can inform decision-making and investment in new and improved vaccines and targeted utilization of already existing vaccines. Recognizing that an array of inputs influences these decisions, the strategic multi-attribute ranking method for vaccines (SMART Vaccines 2.0) is in development as a web-based tool-modified from a U.S. Institute of Medicine Committee effort (IOM, 2015)-to highlight data needs and create transparency to facilitate dialogue and information-sharing among decision-makers and to optimize the investment of resources leading to improved health outcomes. Current development efforts of the SMART Vaccines 2.0 framework seek to generate a weighted recommendation on vaccine development or vaccination priorities based on population, disease, economic, and vaccine-specific data in combination with individual preference and weights of user-selected attributes incorporating valuations of health, economics, demographics, public concern, scientific and business, programmatic, and political considerations. Further development of the design and utility of the tool is being carried out by the National Vaccine Program Office of the Department of Health and Human Services and the Fogarty International Center of the National Institutes of Health. We aim to demonstrate the utility of SMART Vaccines 2.0 through the engagement of a community of relevant stakeholders and to identify a limited number of pilot projects to determine explicitly defined attribute preferences and the related data and model requirements that are responsive to user needs and able to improve the use of evidence for vaccine-related decision-making and consequential priorities of vaccination options. Copyright © 2016 Elsevier Ltd. All rights reserved.

The United States pork niche market phenomenon.

PubMed

Honeyman, M S; Pirog, R S; Huber, G H; Lammers, P J; Hermann, J R

2006-08-01

After the broad industrialization of the US pork industry, there has been a development of niche markets for export and domestic pork; that is, there is a pork niche market phenomenon. The US pork niche market phenomenon is characterized, and 2 of the major markets are explained in detail. With the Midwest's tradition of a diversified family-based agriculture and record low hog prices of the late 1990s, the conditions were conducive for this phenomenon to develop. Pork niche markets utilize various sales methods including Internet sales, local abattoir sales, direct marketing, farmer networks, and targeting to organized groups. In 2003, there were approximately 35 to 40 active pork niche marketing efforts in Iowa. The Berkshire breed is an example of a swine breed that has had a recent resurgence because of niche markets. Berkshire pork is known for tenderness and excellent quality. Berkshire registrations have increased 4-fold in the last 10 yr. One of the larger niche marketers of "natural pork" is Niman Ranch Pork, which has more than 400 farmer-producers and processes about 2,500 pigs weekly. Many US consumers of pork are interested in issues concerning the environment, food safety, pig welfare, and pig farm ownership and structure. These consumers may be willing to pay more for pork from farmers who are also concerned about these issues. Small- and medium-sized swine farmers are active in pork niche markets. Niche markets claim product differentiation by superior or unique product quality and social attributes. Quality attributes include certain swine breeds, and meat quality, freshness, taste or flavor, and tenderness. Social or credence attributes often are claimed and include freedom from antibiotics and growth promotants; local family farm production; natural, organic, outdoor, or bedded rearing; humane rearing; known origin; environmentally friendly production; and the absence of animal by-products in the feed. Niche pork markets and alternative swine production practices offer an unusual contrast to commodity pork markets and industrial confinement swine production. Because they strive to have these attributes in their product, the niche pork market producers are a distinct clientele group. If niche pork markets continue to flourish, the markets and the producers that supply them will be a viable sector in a diverse US pork industry.

A miniaturized electrochemical toxicity biosensor based on graphene oxide quantum dots/carboxylated carbon nanotubes for assessment of priority pollutants.

PubMed

Zhu, Xiaolin; Wu, Guanlan; Lu, Nan; Yuan, Xing; Li, Baikun

2017-02-15

The study presented a sensitive and miniaturized cell-based electrochemical biosensor to assess the toxicity of priority pollutants in the aquatic environment. Human hepatoma (HepG2) cells were used as the biological recognition agent to measure the changes of electrochemical signals and reflect the cell viability. The graphene oxide quantum dots/carboxylated carbon nanotubes hybrid was developed in a facile and green way. Based on the hybrid composite modified pencil graphite electrode, the cell culture and detection vessel was miniaturized to a 96-well plate instead of the traditional culture dish. In addition, three sensitive electrochemical signals attributed to guanine/xanthine, adenine, and hypoxanthine were detected simultaneously. The biosensor was used to evaluate the toxicity of six priority pollutants, including Cd, Hg, Pb, 2,4-dinitrophenol, 2,4,6-trichlorophenol, and pentachlorophenol. The 24h IC 50 values obtained by the electrochemical biosensor were lower than those of conventional MTT assay, suggesting the enhanced sensitivity of the electrochemical assay towards heavy metals and phenols. This platform enables the label-free and sensitive detection of cell physiological status with multi-parameters and constitutes a promising approach for toxicity detection of pollutants. It makes possible for automatical and high-throughput analysis on nucleotide catabolism, which may be critical for life science and toxicology. Copyright © 2016 Elsevier B.V. All rights reserved.

Ranking Fragment Ions Based on Outlier Detection for Improved Label-Free Quantification in Data-Independent Acquisition LC-MS/MS

PubMed Central

Bilbao, Aivett; Zhang, Ying; Varesio, Emmanuel; Luban, Jeremy; Strambio-De-Castillia, Caterina; Lisacek, Frédérique; Hopfgartner, Gérard

2016-01-01

Data-independent acquisition LC-MS/MS techniques complement supervised methods for peptide quantification. However, due to the wide precursor isolation windows, these techniques are prone to interference at the fragment ion level, which in turn is detrimental for accurate quantification. The “non-outlier fragment ion” (NOFI) ranking algorithm has been developed to assign low priority to fragment ions affected by interference. By using the optimal subset of high priority fragment ions these interfered fragment ions are effectively excluded from quantification. NOFI represents each fragment ion as a vector of four dimensions related to chromatographic and MS fragmentation attributes and applies multivariate outlier detection techniques. Benchmarking conducted on a well-defined quantitative dataset (i.e. the SWATH Gold Standard), indicates that NOFI on average is able to accurately quantify 11-25% more peptides than the commonly used Top-N library intensity ranking method. The sum of the area of the Top3-5 NOFIs produces similar coefficients of variation as compared to the library intensity method but with more accurate quantification results. On a biologically relevant human dendritic cell digest dataset, NOFI properly assigns low priority ranks to 85% of annotated interferences, resulting in sensitivity values between 0.92 and 0.80 against 0.76 for the Spectronaut interference detection algorithm. PMID:26412574

Pharmaceutical priority setting and the use of health economic evaluations: a systematic literature review.

PubMed

Erntoft, Sandra

2011-06-01

To investigate which factors and criteria are used in priority setting of pharmaceuticals, in what contexts health economic evaluations are used, and barriers to the use of health economic evaluations at micro, meso, and macro health-care levels. The search for empirical articles was based on the MeSH index (Medical Substance Heading), including the search terms "economic evaluation," "cost-effectiveness analysis," "cost-utility analysis," "cost-benefit analysis," "pharmacoeconomic," AND "drug cost(s)," AND "eligibility determination," AND "decision-making," AND "rationing," AND formulary. The following databases were searched: PubMed, EconLit, Cochrane, Web of Science, CINAHL, and PsycINFO. More than 3100 studies were identified, 31 of which were included in this review. The use of health economic evaluations at all three health-care levels was investigated in three countries (United States [US], United Kingdom [UK], and Sweden). Postal and telephone survey methods dominated (n = 17) followed by interviews (n = 13), document analysis (n = 10), and observations of group deliberations (n = 9). The cost-effectiveness criterion was most important at the macro level. A number of contextual uses of health economic evaluations were identified, including importantly the legitimizing of decisions, structuring the priority-setting process, and requesting additional budgets to finance expensive pharmaceuticals. Factors that seem to support the increased use of health economic evaluations are well-developed frameworks for evaluations, the presence of health economic skills, and an explicit priority-setting process. Differences in how economic evaluations are used at macro, meso, and micro levels are attributed to differences in the preconditions at each level. Copyright © 2011 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Uses of research evidence among US state legislators who prioritize behavioral health issues

PubMed Central

Purtle, Jonathan; Dodson, Elizabeth A.; Brownson, Ross C.

2016-01-01

Objective Disseminating behavioral health (BH) research to legislators (i.e., elected policy makers) is widely acknowledged as a priority, but little is known about how research evidence is used and sought by this audience. The primary aim of this exploratory study was to identify the research dissemination preferences and research seeking practices of legislators who prioritize BH issues and describe the role research plays in determining their policy priorities. The secondary aim was to assess if these legislators differ from legislators who do not prioritize BH issues. Methods A telephone-based survey was conducted with 862 US state legislators (response rate 50%). A validated survey instrument was used to assess legislators’ priorities and the factors that determine them, research dissemination preferences, and research seeking practices. Bivariate analyses were conducted to characterize the study population and compare legislators who prioritized BH issues to legislators who did not. Results Legislators who prioritized BH issues were significantly more likely to identify research evidence as a factor that determined policy priorities than legislators who did not prioritize these issues (odds ratio=1.91, 95% CI=1.25–2.90, p=.002). Legislators who prioritized BH issues also attributed more importance to 10-of-12 features of disseminated research (e.g., research being unbiased [p=.014], research telling a story [p=.033]) and engaged in 8-of-11 research seeking and utilization practices (e.g., attending research presentations [p=.012]) more often. Conclusions Legislators who prioritize BH issues actively seek, have distinct preferences for, and are particularly influenced by research evidence. Testing legislator-focused BH research dissemination strategies is an area for future research. PMID:27364817

Investigating into composition, distribution, sources and health risk of phthalic acid esters in street dust of Xi'an City, Northwest China.

PubMed

Wang, Lijun; Zhang, Wenjuan; Tao, Wendong; Wang, Li; Shi, Xingmin; Lu, Xinwei

2017-08-01

Phthalic acid esters (PAEs) are widely used as plasticizers and in consumer products, which may enter the environment and present risks to human health. U.S. EPA classifies six PAEs as priority pollutants, which could be accumulated in street dust at the interface of atmosphere, biosphere and geosphere. This study collected a total of 58 street dust samples from Xi'an City in Northwest China and analyzed for concentrations of the priority PAEs. Composition, distribution, sources and health risk of the PAEs were further examined. All the priority PAEs were detected in the street dust. The concentrations of individual PAEs varied between not detected and 183.19 mg/kg. The sum of the 6 priority PAEs (∑6PAEs) ranged from 0.87 to 250.30 mg/kg with a mean of 40.48 mg/kg. The most abundant PAEs in the street dust were di-n-butyl phthalate and di (2-ethylhexyl) phthalate (DEHP). Higher concentrations of ∑6PAEs in the street dust were found in the south and west parts of Xi'an City as well as its urban center, which were possibly attributed to the prevailing northerly Asian winter monsoon. The PAEs in the street dust originated mainly from wide application of plasticizers as well as cosmetics and personal care products. The main pathways of human exposure to PAEs in the street dust were ingestion and dermal adsorption of dust particles. The non-cancer risk of human exposure to PAEs in the street dust was relatively low, while the risk to children was higher than that to adults. The cancer risk of human exposure to DEHP in the street dust was lower than the standard limit value of 10 -6 .

Documenting Biogeographical Patterns of African Timber Species Using Herbarium Records: A Conservation Perspective Based on Native Trees from Angola

PubMed Central

Romeiras, Maria M.; Figueira, Rui; Duarte, Maria Cristina; Beja, Pedro; Darbyshire, Iain

2014-01-01

In many tropical regions the development of informed conservation strategies is hindered by a dearth of biodiversity information. Biological collections can help to overcome this problem, by providing baseline information to guide research and conservation efforts. This study focuses on the timber trees of Angola, combining herbarium (2670 records) and bibliographic data to identify the main timber species, document biogeographic patterns and identify conservation priorities. The study recognized 18 key species, most of which are threatened or near-threatened globally, or lack formal conservation assessments. Biogeographical analysis reveals three groups of species associated with the enclave of Cabinda and northwest Angola, which occur primarily in Guineo-Congolian rainforests, and evergreen forests and woodlands. The fourth group is widespread across the country, and is mostly associated with dry forests. There is little correspondence between the spatial pattern of species groups and the ecoregions adopted by WWF, suggesting that these may not provide an adequate basis for conservation planning for Angolan timber trees. Eight of the species evaluated should be given high conservation priority since they are of global conservation concern, they have very restricted distributions in Angola, their historical collection localities are largely outside protected areas and they may be under increasing logging pressure. High conservation priority was also attributed to another three species that have a large proportion of their global range concentrated in Angola and that occur in dry forests where deforestation rates are high. Our results suggest that timber tree species in Angola may be under increasing risk, thus calling for efforts to promote their conservation and sustainable exploitation. The study also highlights the importance of studying historic herbarium collections in poorly explored regions of the tropics, though new field surveys remain a priority to update historical information. PMID:25061858

Documenting biogeographical patterns of African timber species using herbarium records: a conservation perspective based on native trees from Angola.

PubMed

Romeiras, Maria M; Figueira, Rui; Duarte, Maria Cristina; Beja, Pedro; Darbyshire, Iain

2014-01-01

In many tropical regions the development of informed conservation strategies is hindered by a dearth of biodiversity information. Biological collections can help to overcome this problem, by providing baseline information to guide research and conservation efforts. This study focuses on the timber trees of Angola, combining herbarium (2670 records) and bibliographic data to identify the main timber species, document biogeographic patterns and identify conservation priorities. The study recognized 18 key species, most of which are threatened or near-threatened globally, or lack formal conservation assessments. Biogeographical analysis reveals three groups of species associated with the enclave of Cabinda and northwest Angola, which occur primarily in Guineo-Congolian rainforests, and evergreen forests and woodlands. The fourth group is widespread across the country, and is mostly associated with dry forests. There is little correspondence between the spatial pattern of species groups and the ecoregions adopted by WWF, suggesting that these may not provide an adequate basis for conservation planning for Angolan timber trees. Eight of the species evaluated should be given high conservation priority since they are of global conservation concern, they have very restricted distributions in Angola, their historical collection localities are largely outside protected areas and they may be under increasing logging pressure. High conservation priority was also attributed to another three species that have a large proportion of their global range concentrated in Angola and that occur in dry forests where deforestation rates are high. Our results suggest that timber tree species in Angola may be under increasing risk, thus calling for efforts to promote their conservation and sustainable exploitation. The study also highlights the importance of studying historic herbarium collections in poorly explored regions of the tropics, though new field surveys remain a priority to update historical information.

Comment on "Water-processed carbon nanotube/graphene hybrids with enhanced field emission properties" [AIP Advances 5, 097130 (2015)

NASA Astrophysics Data System (ADS)

Rani, Reena; Bhatia, Ravi

2018-03-01

In their research paper, M. Song et al. [AIP ADVANCES 5, 097130 (2015)] have claimed to have achieved enhanced field emission (FE) characteristics of carbon nanotubes (CNT)/graphene hybrids experimentally, exhibiting improved FE parameters e.g. turn-on electric field of 0.79 V/μm, threshold electric field of 1.05 V/μm, maximum emission current density (Jmax) of 5.76 mA/cm2, and field enhancement factor (β) of ˜1.3 × 104. The authors have emphasized on the surprisingly high value of β to be the basis of their claim of achieving superior FE performance which is further attributed to the optimized mass ratio CNT/ graphene, which is 5:1 in the present case. However, the claim based upon high value of β is misleading because it does not corroborate with the obtained Jmax parameter. Also, the obtained value of J is quite low in the mentioned study as compared to the reported values. For an instance, Sameera et al. [J. Appl. Phys. 111, 044307 (2012) & Appl. Phys. Lett. 102, 033102 (2013)] have reported FE properties of CNT composites and reduced graphene oxide with Jmax and β values of the order of ˜102 mA/cm2 and 6 × 103, respectively. Therefore, the conclusions drawn by M. Song et al. [AIP ADVANCES 5, 097130 (2015)] in their paper do no hold.

SEE: structured representation of scientific evidence in the biomedical domain using Semantic Web techniques

PubMed Central

2014-01-01

Background Accounts of evidence are vital to evaluate and reproduce scientific findings and integrate data on an informed basis. Currently, such accounts are often inadequate, unstandardized and inaccessible for computational knowledge engineering even though computational technologies, among them those of the semantic web, are ever more employed to represent, disseminate and integrate biomedical data and knowledge. Results We present SEE (Semantic EvidencE), an RDF/OWL based approach for detailed representation of evidence in terms of the argumentative structure of the supporting background for claims even in complex settings. We derive design principles and identify minimal components for the representation of evidence. We specify the Reasoning and Discourse Ontology (RDO), an OWL representation of the model of scientific claims, their subjects, their provenance and their argumentative relations underlying the SEE approach. We demonstrate the application of SEE and illustrate its design patterns in a case study by providing an expressive account of the evidence for certain claims regarding the isolation of the enzyme glutamine synthetase. Conclusions SEE is suited to provide coherent and computationally accessible representations of evidence-related information such as the materials, methods, assumptions, reasoning and information sources used to establish a scientific finding by adopting a consistently claim-based perspective on scientific results and their evidence. SEE allows for extensible evidence representations, in which the level of detail can be adjusted and which can be extended as needed. It supports representation of arbitrary many consecutive layers of interpretation and attribution and different evaluations of the same data. SEE and its underlying model could be a valuable component in a variety of use cases that require careful representation or examination of evidence for data presented on the semantic web or in other formats. PMID:25093070

SEE: structured representation of scientific evidence in the biomedical domain using Semantic Web techniques.

PubMed

Bölling, Christian; Weidlich, Michael; Holzhütter, Hermann-Georg

2014-01-01

Accounts of evidence are vital to evaluate and reproduce scientific findings and integrate data on an informed basis. Currently, such accounts are often inadequate, unstandardized and inaccessible for computational knowledge engineering even though computational technologies, among them those of the semantic web, are ever more employed to represent, disseminate and integrate biomedical data and knowledge. We present SEE (Semantic EvidencE), an RDF/OWL based approach for detailed representation of evidence in terms of the argumentative structure of the supporting background for claims even in complex settings. We derive design principles and identify minimal components for the representation of evidence. We specify the Reasoning and Discourse Ontology (RDO), an OWL representation of the model of scientific claims, their subjects, their provenance and their argumentative relations underlying the SEE approach. We demonstrate the application of SEE and illustrate its design patterns in a case study by providing an expressive account of the evidence for certain claims regarding the isolation of the enzyme glutamine synthetase. SEE is suited to provide coherent and computationally accessible representations of evidence-related information such as the materials, methods, assumptions, reasoning and information sources used to establish a scientific finding by adopting a consistently claim-based perspective on scientific results and their evidence. SEE allows for extensible evidence representations, in which the level of detail can be adjusted and which can be extended as needed. It supports representation of arbitrary many consecutive layers of interpretation and attribution and different evaluations of the same data. SEE and its underlying model could be a valuable component in a variety of use cases that require careful representation or examination of evidence for data presented on the semantic web or in other formats.

Self-handicapping status, claimed self-handicaps and reduced practice effort following success and failure feedback.

PubMed

Thompson, T; Richardson, A

2001-03-01

Self-handicapping involves the strategic establishment of an impediment or obstacle to success prior to a performance situation which thereby provides a convenient excuse for poor performance. The study sought to establish that relative to low trait self-handicappers, high trait self-handicappers exposed to failure in an intellectually evaluative situation will (a) pre-emptively claim more handicaps, and (b) behaviourally self-handicap through reduced practice effort, and (c) report greater anxiety and negative affect relative to low trait self-handicappers. Participants were 72 undergraduate students, divided equally between high and low self-handicapping groups. This study utilised a 2 (self-handicapping status: high, low) x 3 (performance feedback: fail, low task importance; fail, high task importance; success) between-subjects factorial design to investigate claimed and behavioural self-handicapping through reduced practice effort. This was done by manipulating performance outcome and perceived task importance. Relative to low trait self-handicappers, high trait high self-handicappers claimed more handicaps and engaged in greater behavioural self-handicapping following failure when working on tasks that were described as potentially diagnostic of low ability. While low self-handicappers internalised their success more than their failure in the high task importance condition, high self-handicappers were undifferentiated in their attributions across performance conditions. Greater anxiety and greater negative affect were also characteristic of high self-handicappers. The study highlights the self-protective benefit of self-handicapping in sparing the individual from conclusions of low ability, and the failure of high self-handicappers to fully internalise their success. These elements and the role of uncertain estimates of ability are discussed in considering implications for intervention.

Treatment persistence & health care costs of adult MDD patients treated with escitalopram vs. citalopram in a medicaid population.

PubMed

Wu, Eric Q; Ben-Hamadi, Rym; Lu, Mei; Beaulieu, Nicolas; Yu, Andrew P; Erder, M Haim

2012-01-01

Compare treatment persistence and health care costs of major depressive disorder (MDD) Medicaid patients treated with escitalopram versus citalopram. Retrospective analysis of Medicaid administrative claims data. Analyzed administrative claims data from the Florida Medicaid program (07/2002-06/2006) for patients ages 18-64 years with 21 inpatient claim or 2 independent medical claims for MDD. Outcomes included discontinuation and switching rates and prescription drug, medical, and total health care costs, all-cause and related to mental disorder. Contingency table analysis and survival analysis were used to compare outcomes between treatment groups, using both unadjusted analysis and multivariate analysis adjusting for baseline characteristics. The study included 2,650 patients initiated on escitalopram and 630 patients initiated on citalopram. Patients treated with escitalopram were less likely to discontinue the index drug (63.7% vs. 68.9%, P=0.015) or to switch to another second-generation antidepressant (14.9% vs. 18.4%, P=0.029) over the six months post-index date. Patients treated with escitalopram had $1,014 lower total health care costs (P=0.032) and $519 lower health care costs related to mental disorder (P=0.023). More than half of the total cost difference was attributable to savings in inpatient hospitalizations related to mental disorder ($571, P=0.003) and to outpatient costs ($53, P<0.001). Escitalopram therapy was also associated with $736 lower medical costs related to mental disorder (P=0.009). In the Florida Medicaid program, compared to adult MDD patients initiated on citalopram, escitalopram patients have better treatment persistence and lower total health care costs due to any cause and due to mental disorder, mostly driven by lower hospitalization costs related to mental disorder.

Learning essentials: what graduates of mental health nursing programmes need to know from an industry perspective.

PubMed

McAllister, Margaret; Happell, Brenda; Flynn, Trudi

2014-12-01

To explore the perspectives of nursing directors in mental health in Queensland, Australia, regarding the skills and attributes of graduates of comprehensive nursing programme to provide an industry perspective and thus augment knowledge from theoretical and professional dimensions. There is a worldwide shortage of appropriately qualified nurses with the knowledge, skills and attitudes to work effectively in mental health services. Within Australia, this has been well documented since the introduction of comprehensive nursing education. The underrepresentation of mental health content in undergraduate curricula has been identified as the primary reason for nursing graduates not being adequately prepared for practice in this field. To date, this issue has primarily been addressed from the perspective of university academics, with the voice of industry relatively silent in the published literature. Qualitative exploratory. In-depth telephone interviews with Director of Nursing (Mental Health) in Queensland, Australia. The concerns of participants were expressed in six main themes: (1) foundational knowledge of mental health and disorders, (2) recovery-oriented skills, (3) physical as well as mental health skills, (4) therapeutic strategies, (5) resilience and self-development and (6) advanced knowledge and skills. The education of comprehensive nursing education needs to be reviewed as a matter of priority to ensure graduates with the attributes required to provide high-quality care for consumers of mental health services. A skilled and knowledgeable workforce is an essential component of high-quality mental health services. Research highlighting the current deficits and issues is therefore of the highest priority. © 2014 John Wiley & Sons Ltd.

Medical cost of type 2 diabetes attributable to physical inactivity in the United States in 2012.

PubMed

Shah, Priyank; Shamoon, Fayez; Bikkina, Mahesh; Kohl, Harold W

Type 2 diabetes has grown to epidemic proportions in the U.S. and physical activity levels in the population continues to remain low, although it is one of the primary preventive strategies for diabetes. The objectives of this study were to estimate the direct medical costs of type 2 diabetes attributable to not meeting physical activity Guidelines and to physical inactivity in the U.S. in 2012. This was a cross sectional study that used physical activity prevalence data from the Behavioral Risk Factor Surveillance System to estimate the population attributable risk percentage for type 2 diabetes. These data were combined with the prevalence and cost data of type 2 diabetes to estimate the cost of type 2 diabetes attributable to not meeting physical activity Guidelines and to inactivity in 2012. The cost of type 2 diabetes in the U.S. in 2012, attributable to not meeting physical activity guidelines was estimated to be $18.3 billion, and that attributable to physical inactivity was estimated to be $4.65 billion. Based on sensitivity analyses, these estimates ranged from $10.19 billion to $27.43 billion for not meeting physical activity guidelines and $2.59 billion-$6.98 billion for physical inactivity in the year 2012. This study shows that billions of dollars could be saved annually just in terms of type 2 diabetes cost in the U.S., if the entire adult population met physical activity guidelines. Physical activity promotion, particularly at the environmental and policy level should be a priority in the population. Copyright © 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Nonthermal food processing alternatives and their effects on taste and flavor compounds of beverages.

PubMed

Ortega-Rivas, Enrique; Salmerón-Ochoa, Iván

2014-01-01

Food drinks are normally processed to increase their shelf-life and facilitate distribution before consumption. Thermal pasteurization is quite efficient in preventing microbial spoilage of many types of beverages, but the applied heat may also cause undesirable biochemical and nutritious changes that may affect sensory attributes of the final product. Alternative methods of pasteurization that do not include direct heat have been investigated in order to obtain products safe for consumption, but with sensory attributes maintained as unchanged as possible. Food scientists interested in nonthermal food preservation technologies have claimed that such methods of preserving foods are equally efficient in microbial inactivation as compared with conventional thermal means of food processing. Researchers in the nonthermal food preservation area also affirm that alternative preservation technologies will not affect, as much as thermal processes, nutritional and sensory attributes of processed foods. This article reviews research in nonthermal food preservation, focusing on effects of processing of food drinks such as fruit juices and dairy products. Analytical techniques used to identify volatile flavor-aroma compounds will be reviewed and comparative effects for both thermal and nonthermal preservation technologies will be discussed.

Impacts on quality of life related to dental caries in a national representative sample of Thai 12- and 15-year-olds.

PubMed

Krisdapong, S; Prasertsom, P; Rattanarangsima, K; Sheiham, A

2013-01-01

Dental caries is generally given the highest priority in national oral health services for school-aged populations. Yet, there is no study exploring the impacts on quality of life specifically related to dental caries in national samples of school-aged children. This study assessed prevalence and characteristics of oral impacts attributed to dental caries on quality of life and compared them with overall oral health impacts. In addition, associations of oral impacts attributed to dental caries and dental caries status were investigated. A national representative sample of 1,063 12- and 811 15-year-olds completed a sociodemographic and behavioural questionnaire, and were orally examined and interviewed about oral health-related quality of life using the Child-OIDP or OIDP indexes, respectively. Associations of condition-specific impacts (CS impacts) attributed to dental caries with components of DMF were investigated using χ(2) tests and multivariate logistic regressions. CS impacts attributed to dental caries were reported by nearly half the children and such impacts accounted for half of overall oral impacts from all oral conditions. The majority of impacts were of little intensity and affected only 1-2 daily performances, particularly performances on Eating, Emotional stability and Cleaning teeth. CS impacts were significantly positively associated with number of decayed teeth, and strongly associated with severe decay. Copyright © 2012 S. Karger AG, Basel.

Physical inactivity: direct cost to a health plan.

PubMed

Garrett, Nancy A; Brasure, Michelle; Schmitz, Kathryn H; Schultz, Monica M; Huber, Michael R

2004-11-01

The purpose of this study was to estimate the total medical expenditures attributable to physical inactivity patterns among members of a large health plan, Blue Cross Blue Shield of Minnesota. The study used a cost-of-illness approach to attribute medical and pharmacy costs for specific diseases to physical inactivity in 2000. Relative risks come from the scientific literature, demonstrating that heart disease, stroke, hypertension, type 2 diabetes, colon cancer, breast cancer, osteoporosis, depression, and anxiety are directly related to individual physical activity patterns in adults. Data sources were the 2000 Behavioral Risk Factor Surveillance System and medical claims incurred in 2000 among 1.5 million health plan members aged > or =18 years. Primary analysis was completed in 2002. Nearly 12% of depression and anxiety and 31% of colon cancer, heart disease, osteoporosis, and stroke cases were attributable to physical inactivity. Heart disease was the most expensive outcome of physical inactivity within the health plan population, costing US dollar 35.3 million in 2000. Total health plan expenditures attributable to physical inactivity were US dollar 83.6 million, or US dollar 56 per member. This study confirms the growing body of research quantifying physical inactivity as a serious and expensive public health problem. The costs associated with physical inactivity are borne by taxpayers, employers, and individuals in the form of higher taxes to subsidize public insurance programs and increased health insurance premiums.

What is a benefit in relation to food consumption?

PubMed

Przyrembel, Hildegard; Kleiner, Juliane

2008-08-15

The identification and characterization of benefits as a consequence of consumption of food, food constituents or nutrients used to be neglected in comparison to the assessment of risks because the safety of food had priority. Interest in benefit assessment is the consequence of the realisation that both adverse and positive effects on health can follow the consumption of the same food or food constituent and that a balance between the two should be the aim. Moreover, proven benefits in connection with food are the basis of health related claims on food labels. Benefit assessment should follow a procedure which is parallel to structured risk assessment and apply the same stringent criteria with respect to substantiation. Benefits will consist of either the reduction of the probability of adverse health effects or the increase of the probability of positive health effects.

Risk and panic in late modernity: implications of the converging sites of social anxiety.

PubMed

Hier, Sean P

2003-03-01

Comparing moral panic with the potential catastrophes of the risk society, Sheldon Ungar contends that new sites of social anxiety emerging around nuclear, medical, environmental and chemical threats have thrown into relief many of the questions motivating moral panic research agendas. He argues that shifting sites of social anxiety necessitate a rethinking of theoretical, methodological and conceptual issues related to processes of social control, claims making and general perceptions of public safety. This paper charts an alternative trajectory, asserting that analytic priority rests not with an understanding of the implications of changing but converging sites of social anxiety. Concentrating on the converging sites of social anxiety in late modernity, the analysis forecasts a proliferation of moral panics as an exaggerated symptom of the heightened sense of uncertainty purported to accompany the ascendency of the risk society.

Priority-setting in New Zealand: translating principles into practice.

PubMed

Ashton, T; Cumming, J; Devlin, N

2000-07-01

In May 1998 the New Zealand Health Funding Authority released a discussion paper which proposed a principles-based approach to setting purchasing priorities that incorporates the economic methods of programme budgeting and marginal analysis, and cost-utility analysis. The principles upon which the process was to be based are effectiveness, cost, equity of health outcomes, Maori health and acceptability. This essay describes and critiques issues associated with translating the principles into practice, most particularly the proposed methods for evaluating the effectiveness and measuring the cost of services. It is argued that the proposals make an important contribution towards the development of a method for prioritizing services which challenges our thinking about those services and their goals, and which is systematic, explicit, and transparent. The shift towards 'thinking at the margin' and systematically reviewing the value for money of competing claims on resources is likely to improve the quality of decision-making compared with the status quo. This does not imply that prioritization can, or should, be undertaken by means of any simple formula. Any prioritization process should always be guided by informed judgement. The approach is more appropriate for some services than for others. Key methodological issues that need further consideration include the choice of instrument for measuring health gains, the identification of marginal services, how to combine qualitative and quantitative information, and how to ensure consistency across different levels of decision-making.

Avoiding revenue loss due to 'lesser of' contract clauses.

PubMed

Stodolak, Frederick; Gutierrez, Henry

2014-08-01

Finance managers seeking to avoid lost revenue attributable to lesser-of-charge-or-fixed-fee (lesser-of) clauses in their contracts should: Identify payer contracts that contain lesser-of clauses. Prepare lesser-of lost-revenue reports for non-bundled and bundled rates. For claims with covered charges below the bundled rate, identify service codes associated with the greatest proportion of total gross revenue and determine new, higher charge levels for those codes. Establish an approach for setting charges for non-bundled fee schedules to address lost-revenue-related issues. Incorporate changes into overall strategic or hospital zero-based pricing modeling and parameters.

Cancer incidence attributable to air pollution in Alberta in 2012

PubMed Central

Poirier, Abbey E.; Grundy, Anne; Khandwala, Farah; Friedenreich, Christine M.; Brenner, Darren R.

2017-01-01

Background: The International Agency for Research on Cancer has classified outdoor air pollution (fine particulate matter [PM2.5]) as a Group 1 lung carcinogen in humans. We aimed to estimate the proportion of lung cancer cases attributable to PM2.5 exposure in Alberta in 2012. Methods: Annual average concentrations of PM2.5 in 2011 for 22 communities across Alberta were extracted from the Clean Air Strategic Alliance Data Warehouse and were population-weighted across the province. Using 7.5 µg/m3 and 3.18 µg/m3 as the annual average theoretical minimum risk concentrations of PM2.5, we estimated the proportion of the population above this cut-off to determine the population attributable risk of lung cancer due to PM2.5 exposure. Results: The mean population-weighted concentration of PM2.5 for Alberta in 2011 was 10.03 µg/m3. We estimated relative risks of 1.02 and 1.06 for theoretical minimum risk PM2.5 concentration thresholds of 7.5 µg/m3 and 3.18 µg/m3, respectively. About 1.87%-5.69% of incident lung cancer cases in Alberta were estimated to be attributable to PM2.5 exposure. Interpretation: Our estimate of attributable burden is low compared to that reported in studies in other areas of the world owing to the relatively low levels of PM2.5 recorded in Alberta. Reducing PM2.5 emissions in Alberta should continue to be a priority to help decrease the burden of lung cancer in the population. PMID:28659352

Context Relevant Prediction Model for COPD Domain Using Bayesian Belief Network

PubMed Central

Saleh, Lokman; Ajami, Hicham; Mili, Hafedh

2017-01-01

In the last three decades, researchers have examined extensively how context-aware systems can assist people, specifically those suffering from incurable diseases, to help them cope with their medical illness. Over the years, a huge number of studies on Chronic Obstructive Pulmonary Disease (COPD) have been published. However, how to derive relevant attributes and early detection of COPD exacerbations remains a challenge. In this research work, we will use an efficient algorithm to select relevant attributes where there is no proper approach in this domain. Such algorithm predicts exacerbations with high accuracy by adding discretization process, and organizes the pertinent attributes in priority order based on their impact to facilitate the emergency medical treatment. In this paper, we propose an extension of our existing Helper Context-Aware Engine System (HCES) for COPD. This project uses Bayesian network algorithm to depict the dependency between the COPD symptoms (attributes) in order to overcome the insufficiency and the independency hypothesis of naïve Bayesian. In addition, the dependency in Bayesian network is realized using TAN algorithm rather than consulting pneumologists. All these combined algorithms (discretization, selection, dependency, and the ordering of the relevant attributes) constitute an effective prediction model, comparing to effective ones. Moreover, an investigation and comparison of different scenarios of these algorithms are also done to verify which sequence of steps of prediction model gives more accurate results. Finally, we designed and validated a computer-aided support application to integrate different steps of this model. The findings of our system HCES has shown promising results using Area Under Receiver Operating Characteristic (AUC = 81.5%). PMID:28644419

John Dalton and the origin of the atomic theory: reassessing the influence of Bryan Higgins.

PubMed

Grossman, Mark I

2017-12-01

During the years 1814-1819, William Higgins, an Irish chemist who worked at the Dublin Society, claimed he had anticipated John Dalton in developing the atomic theory and insinuated that Dalton was a plagiarist. This essay focuses not on William Higgins, but on his uncle Bryan Higgins, a well-known chemist of his day, who had developed his own theories of caloric and chemical combination, similar in many respects to that of Dalton. New evidence is first introduced addressing Bryan's disappearance from the scientific community after 1803. In his later years, Bryan apparently suffered from a condition resulting in a decline in his mental health, which explains why he never lodged any priority claims of his own against Dalton, or defended those of his nephew. Dalton's mention of Bryan's name in Part II of A New System of Chemical Philosophy, his laboratory notebook entries, and a fresh look at his correspondence with chemist Thomas Charles Hope indicate that Dalton adopted a Higgins-like caloric model in 1803. Together these factors provide evidence to support the argument that Dalton learned of Bryan's theories via a meeting he had with William Allen on 10 July 1803. Existing evidence related to the origin of the atomic theory is worthy of re-examination in light of Dalton's possible prior knowledge of Bryan's work.

Nursing's ways of knowing and dual process theories of cognition.

PubMed

Paley, John; Cheyne, Helen; Dalgleish, Len; Duncan, Edward A S; Niven, Catherine A

2007-12-01

This paper is a comparison of nursing's patterns of knowing with the systems identified by cognitive science, and evaluates claims about the equal-status relation between scientific and non-scientific knowledge. Ever since Carper's seminal paper in 1978, it has been taken for granted in the nursing literature that there are ways of knowing, or patterns of knowing, that are not scientific. This idea has recently been used to argue that the concept of evidence, typically associated with evidence-based practice, is inappropriately restricted because it is identified exclusively with scientific research. The paper reviews literature in psychology which appears to draw a comparable distinction between rule-based, analytical cognitive processes and other forms of cognitive processing which are unconscious, holistic and intuitive. There is a convincing parallel between the 'patterns of knowing' distinction in nursing and the 'cognitive processing' distinction in psychology. However, there is an important difference in the way the relation between different forms of knowing (or cognitive processing) is depicted. In nursing, it is argued that the different patterns of knowing have equal status and weight. In cognitive science, it is suggested that the rule-based, analytical form of cognition has a supervisory and corrective function with respect to the other forms. Scientific reasoning and evidence-based knowledge have epistemological priority over the other forms of nursing knowledge. The implications of this claim for healthcare practice are briefly indicated.

Burden of Mortality Attributable to Diagnosed Diabetes: A Nationwide Analysis Based on Claims Data From 65 Million People in Germany.

PubMed

Jacobs, Esther; Hoyer, Annika; Brinks, Ralph; Kuss, Oliver; Rathmann, Wolfgang

2017-12-01

In Germany, as in many other countries, nationwide data on mortality attributable to diagnosed diabetes are not available. This study estimated the absolute number of excess deaths associated with diabetes (all types) and type 2 diabetes in Germany. A prevalence approach that included nationwide routine data from 64.9 million people insured in the German statutory health insurance system in 2010 was used for the calculation. Because nationwide data on diabetes mortality are lacking in Germany, the mortality rate ratio from the Danish National Diabetes Register was used. The absolute number of excess deaths associated with diabetes was calculated as the number of deaths due to diabetes minus the number of deaths due to diabetes with a mortality that was as high as in the population without diabetes. Furthermore, the mortality population-attributable fraction was calculated. A total of 174,627 excess deaths were due to diabetes in 2010, including 137,950 due to type 2 diabetes. Overall, 21% of all deaths in Germany were attributable to diabetes and 16% were attributable to type 2 diabetes. Most of the excess deaths (34% each) occurred in the 70- to 89-year-old age-group. In this first nationwide calculation of excess deaths related to diabetes in Germany, the results suggest that the official German estimates that rely on information from death certificates are grossly underestimated. Countries without national cohorts or diabetes registries could easily use this method to estimate the number of excess deaths due to diabetes. © 2017 by the American Diabetes Association.

Setting health research priorities using the CHNRI method: VII. A review of the first 50 applications of the CHNRI method.

PubMed

Rudan, Igor; Yoshida, Sachiyo; Chan, Kit Yee; Sridhar, Devi; Wazny, Kerri; Nair, Harish; Sheikh, Aziz; Tomlinson, Mark; Lawn, Joy E; Bhutta, Zulfiqar A; Bahl, Rajiv; Chopra, Mickey; Campbell, Harry; El Arifeen, Shams; Black, Robert E; Cousens, Simon

2017-06-01

Several recent reviews of the methods used to set research priorities have identified the CHNRI method (acronym derived from the "Child Health and Nutrition Research Initiative") as an approach that clearly became popular and widely used over the past decade. In this paper we review the first 50 examples of application of the CHNRI method, published between 2007 and 2016, and summarize the most important messages that emerged from those experiences. We conducted a literature review to identify the first 50 examples of application of the CHNRI method in chronological order. We searched Google Scholar, PubMed and so-called grey literature. Initially, between 2007 and 2011, the CHNRI method was mainly used for setting research priorities to address global child health issues, although the first cases of application outside this field (eg, mental health, disabilities and zoonoses) were also recorded. Since 2012 the CHNRI method was used more widely, expanding into the topics such as adolescent health, dementia, national health policy and education. The majority of the exercises were focused on issues that were only relevant to low- and middle-income countries, and national-level applications are on the rise. The first CHNRI-based articles adhered to the five recommended priority-setting criteria, but by 2016 more than two-thirds of all conducted exercises departed from recommendations, modifying the CHNRI method to suit each particular exercise. This was done not only by changing the number of criteria used, but also by introducing some entirely new criteria (eg, "low cost", "sustainability", "acceptability", "feasibility", "relevance" and others). The popularity of the CHNRI method in setting health research priorities can be attributed to several key conceptual advances that have addressed common concerns. The method is systematic in nature, offering an acceptable framework for handling many research questions. It is also transparent and replicable, because it clearly defines the context and priority-setting criteria. It is democratic, as it relies on "crowd-sourcing". It is inclusive, fostering "ownership" of the results by ensuring that various groups invest in the process. It is very flexible and adjustable to many different contexts and needs. Finally, it is simple and relatively inexpensive to conduct, which we believe is one of the main reasons for its uptake by many groups globally, particularly those in low- and middle-income countries.

Engaging with Comparative Risk Appraisals: Public Views on Policy Priorities for Environmental Risk Governance.

PubMed

Rocks, Sophie A; Schubert, Iljana; Soane, Emma; Black, Edgar; Muckle, Rachel; Petts, Judith; Prpich, George; Pollard, Simon J

2017-09-01

Communicating the rationale for allocating resources to manage policy priorities and their risks is challenging. Here, we demonstrate that environmental risks have diverse attributes and locales in their effects that may drive disproportionate responses among citizens. When 2,065 survey participants deployed summary information and their own understanding to assess 12 policy-level environmental risks singularly, their assessment differed from a prior expert assessment. However, participants provided rankings similar to those of experts when these same 12 risks were considered as a group, allowing comparison between the different risks. Following this, when individuals were shown the prior expert assessment of this portfolio, they expressed a moderate level of confidence with the combined expert analysis. These are important findings for the comprehension of policy risks that may be subject to augmentation by climate change, their representation alongside other threats within national risk assessments, and interpretations of agency for public risk management by citizens and others. © 2017 The Authors Risk Analysis published by Wiley Periodicals, Inc. on behalf of Society for Risk Analysis.

Federal Great Lakes fishery research objectives, priorities, and projects

USGS Publications Warehouse

Tait, Howard D.

1973-01-01

Fishery productivity of the Great Lakes has declined drastically since settlement of the area. Premium quality fishes of the Great Lakes such as whitefish, lake trout, and walleyes have been replaced by less desired species. This change is attributed to selective overfishing, pollution, and the extreme instability of fish populations. Sea lamprey predation is still a vexing problem but progress is being made in controlling this parasite. The federal fishery research program with headquarters in Ann Arbor, Michigan, has the objective of providing baseline information, needed in resource use decisions, about the fishes of the Great Lakes. Studies of the habitat requirements of fish are high priority. The program includes fish population assessments, studies of the effects of mercury and other contaminants on fish, thermal effects studies, and general investigation of the impact of engineering projects on Great Lakes fisheries. The work is closely coordinated with state and Canadian agencies through the Great Lakes Fishery Commission. Four small research vessels and four field stations are utilized with a staff of 90 and an annual budget of about $1.5 million.

Stroke mortality in Tennessee: an eco-epidemiologic perspective.

PubMed

Flowers, Joanne; Vutla, Balaji; Aldrich, Tim E

2008-04-01

Prevention of stroke mortality in Tennessee is a statewide public health priority. These analyses describe how the distribution of Caucasian stroke mortality is greater among the state's Appalachian Counties. For African-American residents, the elevated stroke mortality risk is not distinctive for geographic regions, although Upper East Tennessee rates are elevated. If the Caucasian criteria for assigning "high" rates were used with African-American stroke mortality data, the entire state would be designated as having elevated levels for stroke mortality. Race-gender specific analyses at the county-level (ecological attributes) illustrate the greater risks for "high" county-level stroke mortality rates are present for urban and poor communities in our state. African-American males are a clear exception, where the poorer, rural communities show a protective effect for "high" county-level stroke mortality rates. We support implementing stroke prevention programming and public health interventions based on the mortality data distributions; compatible statewide initiatives are underway We recommend strategic over-sampling of the state's priority populations for stroke risk to facilitate the monitoring of prevention and intervention program impacts over time.

Elucidation of several neglected reactions in the GC-MS identification of sialic acids as heptafluorobutyrates calls for an urgent reassessment of previous claims.

PubMed

Rota, Paola; Anastasia, Luigi; Allevi, Pietro

2015-05-07

The current analytical protocol used for the GC-MS determination of free or 1,7-lactonized natural sialic acids (Sias), as heptafluorobutyrates, overlooks several transformations. Using authentic reference standards and by combining GC-MS and NMR analyses, flaws in the analytical protocol were pinpointed and elucidated, thus establishing the scope and limitations of the method. It was demonstrated that (a) Sias 1,7-lactones, even if present in biological samples, decompose under the acidic hydrolysis conditions used for their release; (b) Sias 1,7-lactones are unpredicted artifacts, accidentally generated from their parent acids; (c) the N-acetyl group is quantitatively exchanged with that of the derivatizing perfluorinated anhydride; (d) the partial or complete failure of the Sias esterification-step with diazomethane leads to the incorrect quantification and structure attribution of all free Sias. While these findings prompt an urgent correction and improvement of the current analytical protocol, they could be instrumental for a critical revision of many incorrect claims reported in the literature.

Moving from rational to normative ideologies of control over public involvement: A case of continued managerial dominance.

PubMed

Croft, Charlotte; Currie, Graeme; Staniszewska, Sophie

2016-08-01

Public Involvement (PI) is a strategic priority in global healthcare settings, yet can be seen as peripheral during decision making processes. Whilst extant research acknowledges variations in how policy is translated into practice, the majority attribute it to the limiting influence of professional hierarchies on the perceived 'legitimacy' of PI. Drawing on examples of three commissioning organisations within the English NHS, we outline how the variance in policy implementation for PI can be attributed to influence from the managers rather than professionals. In doing so we explore how rational ideologies of managerial control negatively impact PI. However, we also illustrate how PI alluded to in policy can be more successfully realised when organisational managers enact normative ideologies of control. Notwithstanding this assertion, we argue managerial domination exists even in the case of normative ideologies of control, to the detriment of more radical PI in service development. Copyright © 2016 Elsevier Ltd. All rights reserved.

NASA Fundamental Remote Sensing Science Research Program

NASA Technical Reports Server (NTRS)

1984-01-01

The NASA Fundamental Remote Sensing Research Program is described. The program provides a dynamic scientific base which is continually broadened and from which future applied research and development can draw support. In particular, the overall objectives and current studies of the scene radiation and atmospheric effect characterization (SRAEC) project are reviewed. The SRAEC research can be generically structured into four types of activities including observation of phenomena, empirical characterization, analytical modeling, and scene radiation analysis and synthesis. The first three activities are the means by which the goal of scene radiation analysis and synthesis is achieved, and thus are considered priority activities during the early phases of the current project. Scene radiation analysis refers to the extraction of information describing the biogeophysical attributes of the scene from the spectral, spatial, and temporal radiance characteristics of the scene including the atmosphere. Scene radiation synthesis is the generation of realistic spectral, spatial, and temporal radiance values for a scene with a given set of biogeophysical attributes and atmospheric conditions.

Midlatitude Summer Drying: An Underestimated Threat in CMIP5 Models?

NASA Astrophysics Data System (ADS)

Douville, H.; Plazzotta, M.

2017-10-01

Early assessments of the hydrological impacts of global warming suggested both an intensification of the global water cycle and an expansion of dry areas. Yet these alarming conclusions were challenged by a number of latter studies emphasizing the lack of evidence in observations and historical simulations, as well as the large uncertainties in climate projections from the fifth phase of the Coupled Model Intercomparison Project (CMIP5). Here several aridity indices and a two-tier attribution strategy are used to demonstrate that a summer midlatitude drying has recently emerged over the northern continents, which is mainly attributable to anthropogenic climate change. This emerging signal is shown to be the harbinger of a long-term drying in the CMIP5 projections. Linear trends in the observed aridity indices can therefore be used as observational constraints and suggest that the projected midlatitude summer drying was underestimated by most CMIP5 models. Mitigating global warming therefore remains a priority to avoid dangerous impacts on global water and food security.

Micro Data Analysis of Medical and Long-Term Care Utilization Among the Elderly in Japan

PubMed Central

Hashimoto, Hideki; Horiguchi, Hiromasa; Matsuda, Shinya

2010-01-01

Japan is currently experiencing the most rapid population aging among all OECD countries. Increasing expenditures on medical care in Japan have been attributed to the aging of the population. Authors in the recent debate on end-of-life care and long-term care (LTC) cost in the United States and Europe have attributed time to death and non-medical care cost for the aged as a source of rising expenditures. In this study, we analyzed a large sample of local public insurance claim data to investigate medical and LTC expenditures in Japan. We examined the impact of aging, time to death, survivorship, and use of LTC on medical care expenditure for people aged 65 and above. On the basis of these findings, we conclude that age is a contributing factor to the rising expenditures on LTC, and that the contribution of aging to rising medical care expenditures should be distinguished according to survivorship. PMID:20948944

Intransparent German number words complicate transcoding - a translingual comparison with Japanese.

PubMed

Moeller, Korbinian; Zuber, Julia; Olsen, Naoko; Nuerk, Hans-Christoph; Willmes, Klaus

2015-01-01

Superior early numerical competencies of children in several Asian countries have (amongst others) been attributed to the higher transparency of their number word systems. Here, we directly investigated this claim by evaluating whether Japanese children's transcoding performance when writing numbers to dictation (e.g., "twenty five" → 25) was less error prone than that of German-speaking children - both in general as well as when considering language-specific attributes of the German number word system such as the inversion property, in particular. In line with this hypothesis we observed that German-speaking children committed more transcoding errors in general than their Japanese peers. Moreover, their error pattern reflected the specific inversion intransparency of the German number-word system. Inversion errors in transcoding represented the most prominent error category in German-speaking children, but were almost absent in Japanese-speaking children. We conclude that the less transparent German number-word system complicates the acquisition of the correspondence between symbolic Arabic numbers and their respective verbal number words.

Risk assessment in the upstream crude oil supply chain: Leveraging analytic hierarchy process

NASA Astrophysics Data System (ADS)

Briggs, Charles Awoala

For an organization to be successful, an effective strategy is required, and if implemented appropriately the strategy will result in a sustainable competitive advantage. The importance of decision making in the oil industry is reflected in the magnitude and nature of the industry. Specific features of the oil industry supply chain, such as its longer chain, the complexity of its transportation system, its complex production and storage processes, etc., pose challenges to its effective management. Hence, understanding the risks, the risk sources, and their potential impacts on the oil industry's operations will be helpful in proposing a risk management model for the upstream oil supply chain. The risk-based model in this research uses a three-level analytic hierarchy process (AHP), a multiple-attribute decision-making technique, to underline the importance of risk analysis and risk management in the upstream crude oil supply chain. Level 1 represents the overall goal of risk management; Level 2 is comprised of the various risk factors; and Level 3 represents the alternative criteria of the decision maker as indicated on the hierarchical structure of the crude oil supply chain. Several risk management experts from different oil companies around the world were surveyed, and six major types of supply chain risks were identified: (1) exploration and production, (2) environmental and regulatory compliance, (3) transportation, (4) availability of oil, (5) geopolitical, and (6) reputational. Also identified are the preferred methods of managing risks which include; (1) accept and control the risks, (2) avoid the risk by stopping the activity, or (3) transfer or share the risks to other companies or insurers. The results from the survey indicate that the most important risk to manage is transportation risk with a priority of .263, followed by exploration/production with priority of .198, with an overall inconsistency of .03. With respect to major objectives the most preferred risk management policy option based on the result of the composite score is accept and control risk with a priority of .446, followed by transfer or share risk with a priority of .303. The least likely option is to terminate or forgo activity with a priority of .251.

Social factors and private benefits influence landholders' riverine restoration priorities in tropical Australia.

PubMed

Januchowski-Hartley, Stephanie Renee; Moon, Katie; Stoeckl, Natalie; Gray, Sally

2012-11-15

Private land conservation is an essential component of conservation that requires organizing both protection and restoration actions accordingly. Yet private land conservation programs are often formulated to generate public benefits, with inadequate consideration of costs or benefits to private landholders. Landholders' willingness to participate in conservation programs depends on a complex set of social factors, and the benefits they expect from participation. However, these two attributes are commonly evaluated independent of one another. We addressed this limitation through interviews aimed at determining landholders': 1) willingness to participate in restoration programs; 2) barriers to participation; 3) prioritization of proposed riverine restoration actions; 4) expected public or private benefits for undertaking proposed riverine restoration actions; and 5) most preferred incentive for undertaking proposed restoration actions on their land. Our results revealed four main findings. First, landholders stated that biases towards ecological rather than production outcomes, impractical programs, and government mistrust (structural factors) were the major barriers that prevented them from participating in riverine restoration on their land. Second, private benefits influenced landholders' willingness to engage riverine restoration. Third, 'a sense of stewardship and improved landscape aesthetics' (an internal factor) was the most commonly reported private benefit. Fourth, the most preferred incentives for high priority restoration actions were cash for on-ground works, extension and community recognition. We highlight the importance of designing private land conservation programs that align with landholders' priorities and deliver public benefits. Copyright © 2012 Elsevier Ltd. All rights reserved.

Environmental Risks to Public Health in the United Arab Emirates: A Quantitative Assessment and Strategic Plan

PubMed Central

Farah, Zeinab S.

2012-01-01

Background: Environmental risks to health in the United Arab Emirates (UAE) have shifted rapidly from infectious to noninfectious diseases as the nation has developed at an unprecedented rate. In response to public concerns over newly emerging environmental risks, the Environment Agency–Abu Dhabi commissioned a multidisciplinary environmental health strategic planning project. Objectives: In order to develop the environmental health strategic plan, we sought to quantify the illnesses and premature deaths in the UAE attributable to 14 environmental pollutant categories, prioritize these 14 risk factors, and identify interventions. Methods: We estimated the disease burden imposed by each risk factor using an attributable fraction approach, and we prioritized the risks using an empirically tested stakeholder engagement process. We then engaged government personnel, scientists, and other stakeholders to identify interventions. Results: The UAE’s environmental disease burden is low by global standards. Ambient air pollution is the leading contributor to premature mortality [~ 650 annual deaths; 95% confidence interval (CI): 140, 1,400]. Risk factors leading to > 10,000 annual health care facility visits included occupational exposures, indoor air pollution, drinking water contamination, seafood contamination, and ambient air pollution. Among the 14 risks considered, on average, outdoor air pollution was ranked by the stakeholders as the highest priority (mean rank, 1.4; interquartile range, 1–2) and indoor air pollution as the second-highest priority (mean rank 3.3; interquartile range, 2–4). The resulting strategic plan identified 216 potential interventions for reducing environmental risks to health. Conclusions: The strategic planning exercise described here provides a framework for systematically deciding how to invest public funds to maximize expected returns in environmental health, where returns are measured in terms of reductions in a population’s environmental burden of disease. PMID:22357098

Understanding current causes of women's underrepresentation in science.

PubMed

Ceci, Stephen J; Williams, Wendy M

2011-02-22

Explanations for women's underrepresentation in math-intensive fields of science often focus on sex discrimination in grant and manuscript reviewing, interviewing, and hiring. Claims that women scientists suffer discrimination in these arenas rest on a set of studies undergirding policies and programs aimed at remediation. More recent and robust empiricism, however, fails to support assertions of discrimination in these domains. To better understand women's underrepresentation in math-intensive fields and its causes, we reprise claims of discrimination and their evidentiary bases. Based on a review of the past 20 y of data, we suggest that some of these claims are no longer valid and, if uncritically accepted as current causes of women's lack of progress, can delay or prevent understanding of contemporary determinants of women's underrepresentation. We conclude that differential gendered outcomes in the real world result from differences in resources attributable to choices, whether free or constrained, and that such choices could be influenced and better informed through education if resources were so directed. Thus, the ongoing focus on sex discrimination in reviewing, interviewing, and hiring represents costly, misplaced effort: Society is engaged in the present in solving problems of the past, rather than in addressing meaningful limitations deterring women's participation in science, technology, engineering, and mathematics careers today. Addressing today's causes of underrepresentation requires focusing on education and policy changes that will make institutions responsive to differing biological realities of the sexes. Finally, we suggest potential avenues of intervention to increase gender fairness that accord with current, as opposed to historical, findings.

The prevalence of complications and healthcare costs during pregnancy.

PubMed

Law, Amy; McCoy, Mark; Lynen, Richard; Curkendall, Suellen M; Gatwood, Justin; Juneau, Paul L; Landsman-Blumberg, Pamela

2015-01-01

To study the economic burden of pregnancy in the US, common complications during pregnancy, and the incremental costs attributable to these complications. A retrospective comparative cohort study was conducted of pregnant women aged 15-49 years using de-identified medical and pharmacy claims from the Truven Health MarketScan Commercial Claims and Encounters database incurred between January 1, 2007 and December 31, 2011. The total healthcare costs are reported (adjusted to 2011 dollars) from the date of the first pregnancy-related claim through to 3 months post-delivery and these costs were compared to matched controls of non-pregnant women. Pregnancy-related complications were categorized, and the incremental costs associated with each complication were estimated using multivariate analyses. A total of 322,141 eligible women with live births were studied. Compared to matched controls, the average costs of care for pregnant women were nearly $13,000 higher through 3 months post-delivery. A total of 46.9% of women had at least one pre-specified pregnancy complication; the most commonly observed were fetal abnormality (24.7%) and early or threatened labor (16.3%). Multiple gestation (1.9%) resulted in the highest adjusted incremental cost ($12,212; 95% CI = 11,298, 13,216); hypertension ($6152; 95% CI = 5312, 6992) and diabetes ($5081; 95% CI = 4244, 5918) were also among those complications that led to high incremental costs of care. Pregnancy and delivery are frequently compounded by complications that lead to increased costs and resource utilization.

A retrospective analysis of the duration of oral antibiotic therapy for the treatment of acne among adolescents: investigating practice gaps and potential cost-savings.

PubMed

Lee, Young H; Liu, Guodong; Thiboutot, Diane M; Leslie, Douglas L; Kirby, Joslyn S

2014-07-01

Duration of oral antibiotic therapy in acne has not been widely studied. Recent guidelines suggest it should be limited to 3 to 6 months. We sought to compare the duration of oral antibiotic use with recent guidelines and determine the potential cost-savings related to shortened durations. This is a retrospective cohort study from the MarketScan Commercial Claims and Encounters database. Claims data were used to determine duration and costs of antibiotic therapy. The mean course duration was 129 days. The majority (93%) of courses were less than 9 months. Among the 31,634 courses, 18,280 (57.8%) did not include concomitant topical retinoid therapy. The mean (95% confidence interval) duration with and without topical retinoid use was 133 (131.5-134.7) days and 127 (125.4-127.9) days, respectively. The mean excess direct cost of antibiotic treatment for longer than 6 months was $580.99/person. Claims cannot be attributed to a specific diagnosis or provider. The database does not provide information on acne severity. Duration of antibiotic use is decreasing when compared with previous data. However, 5547 (17.53%) courses exceeded 6 months, highlighting an opportunity for reduced antibiotic use. If courses greater than 6 months were shortened to 6 months, savings would be $580.99/person. Copyright © 2014 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Restricting patients' medication supply to one month: saving or wasting money?

PubMed

Domino, Marisa Elena; Olinick, Joshua; Sleath, Betsy; Leinwand, Sharman; Byrns, Patricia J; Carey, Tim

2004-07-01

A state Medicaid program's pharmacy expenditures associated with dispensing one- and three-month supplies of drugs were examined. We simulated the effect of a policy change from a maximum of a 100-day supply of prescription medication to one where only a 34-day supply was allowed. All North Carolina prescription claims from Medicaid enrollees who filled a prescription for at least one of six medication categories during fiscal years 1999 and 2000 were included. The six categories were angiotensin-converting-enzyme inhibitors, antiulcers, antipsychotics, nonsteroidal antiinflammatory drugs, selective serotonin-reuptake inhibitors, and sulfonylureas. The dollar value of the medication wasted, the amount of medication wastage diverted after a change to a shorter prescription length, and the total costs incurred by the increases in prescription refills were calculated. For each therapeutic category, 255,000-783,000 prescription drug claims were analyzed. No valid drug claims were excluded for any reason. Although 5-14% of total drug wastage, attributed to switches of drug therapy, could be saved by dispensing a 34-day supply, this saving could not make up for a larger increase in dispensing costs, as consumers would fill prescriptions more often. In addition, reducing the amount of drug dispensed each time may be costly to consumers through increased transportation and other expenses. Simulated calculation showed that the cost of drug therapy to North Carolina's Medicaid program would probably increase if 34-day rather than 100-day supplies of medications are dispensed to patients.

Will the new Consumer Protection Act prevent harm to nutritional supplement users?

PubMed

Gabriels, Gary; Lambert, Mike; Smith, Pete; Hiss, Donavon

2011-07-25

BACKGROUND. There is no clear distinction between the regulation of food, supplements and medicines in South Africa. Consequently, grey areas exist in implementing the legislation, particularly in the supplement industry. The increase in supplement sales in South Africa can be attributed to aggressive marketing by manufacturers whose claims are not always supported by published peer-reviewed evidence. Such claims often go unchecked, resulting in consumers being mislead about the role of supplements. As a result of poor regulation, contaminants or adulterants in supplements may also cause insidious effects unrelated to the listed ingredients. AIM. To assess the regulations, legislation, and claims associated with nutritional supplement products in South Africa. METHOD. Peer-reviewed literature and the relevant South African statutes were consulted. RESULTS. The National Health Act incorporates the Medicine Control Council, which is charged with ensuring the safety, quality and effectiveness of medicines, and related matters, including complementary/alternative medicines. The South African Institute for Drug-Free Sport and Amendment Act provides for testing athletes for using banned substances, but currently does not concern itself with monitoring nutritional supplements for contaminants or adulterants that may cause a positive drug test, which has implications for sports participants and also the health of the general population. The implementation of the Consumer Protection Act 68 of 2008 (CPA) could protect consumer rights if it is administered and resourced appropriately. CONCLUSION. The CPA should promote greater levels of policy development, regulatory enforcement, and consumer education of South Africa's supplement industry.

[Criminal claims about medical professional liability in the Instituto de Medicina Legal of Lima, Peru].

PubMed

Navarro-Sandoval, Cleyber; Arones-Guevara, Shermany; Carrera-Palao, Rosa; Casana-Jara, Kelly; Colque-Jaliri, Tomasa

2013-07-01

To determine the characteristics of the criminal complaints claining medical professional liability, based on the expert reports issued by the Forensic Examination Division of Lima, Peru. A cross-sectional study was carried out, which included all the expert reports issued between 2005 and 2010 at the Forensic Examination Division of Lima, Peru. A descriptive analysis of each of the variables was performed. 60.3% (495/821) of the criminal complaints for medical professional liability were valued as being in accordance with the lex artis while 16.8% (138/821) were not in accordance with the lex artis. In 13% (107/821) of the cases, conclusions could not be drawn;in 9.9% (81/821) of the cases, the conclusions in the expert report did not include an valuations of the medical act.The cases in which the injury was attributed to the process of the disease itself accounted for 80.9% (502/620), and those in which in the injury was considered a result of the health care received were 19.0% (118/620). The distribution of the cause of the injury based on accordance with the lex artis showed significant differences. In our country, the number of claims for claimed medical liability is increasing, predominantly in relation to surgical specialties, where a medical act is more likely to be considered not in accordance with the lex artis. In addition, in a significant percentage of cases, no conclusions are drawn about the medical act.

Risks and benefits of hormone therapy: has medical dogma now been overturned?

PubMed

Shapiro, S; de Villiers, T J; Pines, A; Sturdee, D W; Baber, R J; Panay, N; Stevenson, J C; Mueck, A O; Burger, H G

2014-06-01

In an integrated overview of the benefits and risks of menopausal hormone therapy (HT), the Women's Health Initiative (WHI) investigators have claimed that their 'findings … do not support use of this therapy for chronic disease prevention'. In an accompanying editorial, it was claimed that 'the WHI overturned medical dogma regarding menopausal [HT]'. To evaluate those claims. Epidemiological criteria of causation were applied to the evidence. A 'global index' purporting to summarize the overall benefit versus the risk of HT was not valid, and it was biased. For coronary heart disease, an increased risk in users of estrogen plus progestogen (E + P), previously reported by the WHI, was not confirmed. The WHI study did not establish that E+ P increases the risk of breast cancer; the findings suggest that unopposed estrogen therapy (ET) does not increase the risk, and may even reduce it. The findings for stroke and pulmonary embolism were compatible with an increased risk, and among E+ P users there were credible reductions in the risk of colorectal and endometrial cancer. For E+ P and ET users, there were credible reductions in the risk of hip fracture. Under 'worst case' and 'best case' assumptions, the changes in the incidence of the outcomes attributable to HT were minor. Over-interpretation and misrepresentation of the WHI findings have damaged the health and well-being of menopausal women by convincing them and their health professionals that the risks of HT outweigh the benefits.

Categorical ethnicity and mental health literacy in New Zealand.

PubMed

Marie, Dannette; Forsyth, Darryl K; Miles, Lynden K

2004-08-01

Public social policies in New Zealand assume that there are fundamental differences between Maori views of health phenomena and non-Maori perceptions. The biomedical model and a Maori model known as Te Whare Tapa Wha are commonly employed to characterise these differences. Using the categorical ethnicity demarcation 'Maori/non-Maori' we investigate this claim with respect to mental health literacy about depression. Participants were randomly selected from the General and Maori Electoral Rolls and recruited by post (N=205). A vignette methodology was employed and involved the development of a fictional character as a target stimulus who exhibited the minimum DSM-IV-R criteria for a major depressive disorder. Participants responded to items regarding problem recognition, well-being, causal attributions, treatment preferences, and likely prognosis. The majority of Maori and non-Maori participants correctly identified the problem the vignette character was experiencing and nominated congruent attributions for the causes of the problem. In relation to treatment strategies and likely prognosis, independent of self-assigned ethnicity, participants rated professional treatments above alternative options. Overall the categorical ethnicity distinction 'Maori and non-Maori' produced no systematic variation with regards to individual evaluative responses about a major depressive disorder. Contrary to the embedded assumption within New Zealand's public health strategies that there are essential differences between the way Maori and non-Maori view health problems, and that the categorical ethnicity demarcation reliably reflects these differences, we found no evidence for the veracity of this claim using a major depressive disorder as a target for judgements. Alternative explanations are canvassed as to why this assumption about fundamental differences based on categorical ethnicity has gained ascendancy and prominence within the sphere of New Zealand health.

Ten-year health service use outcomes in a population-based cohort of 21,000 injured adults: the Manitoba injury outcome study.

PubMed Central

Cameron, C. M.; Purdie, D. M.; Kliewer, E. V.; McClure, R. J.

2006-01-01

OBJECTIVE: To quantify long-term health service use (HSU) following non-fatal injury in adults. METHODS: A retrospective, population-based, matched cohort study identified an inception cohort (1988-91) of injured people who had been hospitalized (ICD-9-CM 800-995) aged 18-64 years (n = 21 032) and a matched non-injured comparison group (n = 21 032) from linked administrative data from Manitoba, Canada. HSU data (on hospitalizations, cumulative length of stay, physician claims and placements in extended care services) were obtained for the 12 months before and 10 years after the injury. Negative binomial and Poisson regressions were used to quantify associations between injury and long-term HSU. FINDINGS: Statistically significant differences in the rates of HSU existed between the injured and non-injured cohorts for the pre-injury year and every year of the follow-up period. After controlling for pre-injury HSU, the attributable risk percentage indicated that 38.7% of all post-injury hospitalizations (n = 25 183), 68.9% of all years spent in hospital (n = 1031), 21.9% of physician claims (n = 269 318) and 77.1% of the care home placements (n = 189) in the injured cohort could be attributed to being injured. CONCLUSION: Many people who survive the initial period following injury, face long periods of inpatient care (and frequent readmissions), high levels of contact with physicians and an increased risk of premature placement in institutional care. Population estimates of the burden of injury could be refined by including long-term non-fatal health consequences and controlling for the effect of pre-injury comorbidity. PMID:17128360

Towards incorporating affective computing to virtual rehabilitation; surrogating attributed attention from posture for boosting therapy adaptation

NASA Astrophysics Data System (ADS)

Rivas, Jesús J.; Heyer, Patrick; Orihuela-Espina, Felipe; Sucar, Luis Enrique

2015-01-01

Virtual rehabilitation (VR) is a novel motor rehabilitation therapy in which the rehabilitation exercises occurs through interaction with bespoken virtual environments. These virtual environments dynamically adapt their activity to match the therapy progress. Adaptation should be guided by the cognitive and emotional state of the patient, none of which are directly observable. Here, we present our first steps towards inferring non-observable attentional state from unobtrusively observable seated posture, so that this knowledge can later be exploited by a VR platform to modulate its behaviour. The space of seated postures was discretized and 648 pictures of acted representations were exposed to crowd-evaluation to determine attributed state of attention. A semi-supervised classifier based on Na¨ıve Bayes with structural improvement was learnt to unfold a predictive relation between posture and attributed attention. Internal validity was established following a 2×5 cross-fold strategy. Following 4959 votes from crowd, classification accuracy reached a promissory 96.29% (µ±σ = 87.59±6.59) and F-measure reached 82.35% (µ ± σ = 69.72 ± 10.50). With the afforded rate of classification, we believe it is safe to claim posture as a reliable proxy for attributed attentional state. It follows that unobtrusively monitoring posture can be exploited for guiding an intelligent adaptation in a virtual rehabilitation platform. This study further helps to identify critical aspects of posture permitting inference of attention.

Interconnected microbiomes and resistomes in low-income human habitats

PubMed Central

Pehrsson, Erica C.; Tsukayama, Pablo; Patel, Sanket; Mejía-Bautista, Melissa; Sosa-Soto, Giordano; Navarrete, Karla M.; Calderon, Maritza; Cabrera, Lilia; Hoyos-Arango, William; Bertoli, M. Teresita; Berg, Douglas E.; Gilman, Robert H.; Dantas, Gautam

2016-01-01

Summary Antibiotic-resistant infections annually claim hundreds of thousands of lives worldwide. This problem is exacerbated by resistance gene exchange between pathogens and benign microbes from diverse habitats. Mapping resistance gene dissemination between humans and their environment is a public health priority. We characterized the bacterial community structure and resistance exchange networks of hundreds of interconnected human fecal and environmental samples from two low-income Latin American communities. We found that resistomes across habitats are generally structured by bacterial phylogeny along ecological gradients, but identified key resistance genes that cross habitat boundaries and determined their association with mobile genetic elements. We also assessed the effectiveness of widely-used excreta management strategies in reducing fecal bacteria and resistance genes in these settings representative of low- and middle-income countries. Our results lay the foundation for quantitative risk assessment and surveillance of resistance dissemination across interconnected habitats in settings representing over two-thirds of the world’s population. PMID:27172044

Consumer-defined health plans: emerging challenges from tort and contract.

PubMed

Morreim, E Haavi

2006-01-01

The emergence of Consumer-Defined Health Plans with large deductibles means that many people will be financially responsible for all or most of their healthcare during any given year. This increasing exposure to costs will bring important changes in the physician-patient relationship, as patients seek more information about the care their physicians propose. Litigation can be anticipated in two areas. First, in tort law, informed consent claims may allege that providers failed to disclose the likely costs and medical importance of their care. Second, in contract law, patients may challenge the reasonableness of the prices they are charged. This Article explores potential causes of action in both areas. Ultimately, increasing transparency of pricing may lend greater rationality not only to pricing structures but also, it is to be hoped, to healthcare itself, as cost-worthiness of care assumes higher priority in medical decisionmaking.

Knowledge, Belief, and Science Education

NASA Astrophysics Data System (ADS)

Ferreira, Tiago Alfredo S.; El-Hani, Charbel N.; da Silva-Filho, Waldomiro José

2016-10-01

This article intends to show that the defense of "understanding" as one of the major goals of science education can be grounded on an anti-reductionist perspective on testimony as a source of knowledge. To do so, we critically revisit the discussion between Harvey Siegel and Alvin Goldman about the goals of science education, especially where it involves arguments based on the epistemology of testimony. Subsequently, we come back to a discussion between Charbel N. El-Hani and Eduardo Mortimer, on the one hand, and Michael Hoffmann, on the other, striving to strengthen the claim that rather than students' belief change, understanding should have epistemic priority as a goal of science education. Based on these two lines of discussion, we conclude that the reliance on testimony as a source of knowledge is necessary to the development of a more large and comprehensive scientific understanding by science students.

On the post mitigation impact risk assessment of possible targets for an asteroid deflection demonstration mission in the NEOShield project.

NASA Astrophysics Data System (ADS)

Eggl, Siegfried

2014-05-01

Mankind believes to have the capabilities to avert potentially disastrous asteroid impacts. Yet, only the realization of a mitigation demonstration mission can confirm such a claim. The NEOShield project, an international collaboration under European leadership, aims to draw a comprehensive picture of the scientific as well as technical requirements to such an endeavor. One of the top priorities of such a demonstration mission is, of course, that a previously harmless target asteroid shall not be turned into a potentially hazardous object. Given the inherently large uncertainties in an asteroid's physical parameters, as well as the additional uncertainties introduced during the deflection attempt, an in depth analysis of the change in asteroid impact probabilities after a deflection event becomes necessary. We present a post mitigation impact risk analysis of a list of potential deflection test missions and discuss the influence of orbital, physical and mitigation induced uncertainties.

Total Health-Related Costs Due to Absenteeism, Presenteeism, and Medical and Pharmaceutical Expenses in Japanese Employers

PubMed Central

Nagata, Tomohisa; Mori, Koji; Ohtani, Makoto; Nagata, Masako; Kajiki, Shigeyuki; Fujino, Yoshihisa; Matsuda, Shinya; Loeppke, Ronald

2018-01-01

Objective: This study aimed to examine a detailed breakdown of costs (absenteeism, presenteeism, and medical/pharmaceutical expenses), of the employees in four pharmaceutical companies in Japan. Methods: This is a cross-sectional study. Absenteeism and presenteeism were measured by a self-administered questionnaire for workers, and their costs were estimated using the human capital approach. Presenteeism was evaluated by the degree affected quality and quantity of work. Medical and pharmaceutical expenses were obtained by insurance claims. Results: The monetary value due to absenteeism was $520 per person per year (11%), that of presenteeism was $3055 (64%), and medical/pharmaceutical expenses were $1165 (25%). Two of the highest total cost burdens from chronic illness were related to mental (behavioral) health conditions and musculoskeletal disorders. Conclusion: A total cost approach can help employers set priorities for occupational health, safety, and population health management initiatives. PMID:29394196

Occupational health crossing borders part 2: Comparison of 18 occupational health systems across the globe.

PubMed

Radon, Katja; Ehrenstein, Vera; Nowak, Dennis; Bigaignon-Cantineau, Janine; Gonzalez, Maria; Vellore, Arun Dev; Zamora, Veronica Enzina; Gupta, Neeraj; Huang, Lirong; Kandkers, Salamat; Lanza, Ana María Menchú; Garcia, Leila Posenato; Patsis, Keti Stylianos; Rojas, Ana Maria Sanchez; Shoma, Ashraf; Verbeek, Jos

2010-01-01

Occupational health and safety (OHS) is considered one of the most important factors for a sustainable development; however, it is often considered a luxury by decision-makers. This article compares OHS systems of 18 countries at different stages of development. In an international summer school, structure of the national OHS system, definition of occupational accidents and diseases, procedures for compensation claims, outcome (expressed as incidence of occupational accidents) and training opportunities were presented. National OHS systems ranged from non-existent to systems implemented almost 200 years ago. Priorities, incidence of occupational accidents and training opportunities varied. Common problems included the lack of OHS service for small enterprises and in rural areas. International training programs like this summer school might enhance the exchange about OHS opportunities around the globe and contribute to improved workers health. (c) 2009 Wiley-Liss, Inc.

Exploring regional stakeholder needs and requirements in terms of Extreme Weather Event Attribution

NASA Astrophysics Data System (ADS)

Schwab, M.; Meinke, I.; Vanderlinden, J. P.; Touili, N.; Von Storch, H.

2015-12-01

Extreme event attribution has increasingly received attention in the scientific community. It may also serve decision-making at the regional level where much of the climate change impact mitigation takes place. Nevertheless, there is, to date, little known about the requirements of regional actors in terms of extreme event attribution. We have therefore analysed these at the example of regional decision-makers for climate change-related activities and/or concerned with storm surge risks at the German Baltic Sea and heat wave risks in the Greater Paris area. In order to explore if stakeholders find scientific knowledge from extreme event attribution useful and how this information might be relevant to their decision-making, we consulted a diverse set of actors engaged in the assessment, mitigation and communication of storm surge, heat wave, and climate change-related risks. Extreme event attribution knowledge was perceived to be most useful to public and political awareness-raising, but was of little or no relevance for the consulted stakeholders themselves. It was not acknowledged that it would support adaptation planning as sometimes argued in the literature. The consulted coastal protection, health, and urban adaptation planners rather needed reliable statements about possible future changes in extreme events than causal statements about past events. To enhance salience, a suitable product of event attribution should be linked to regional problems, vulnerabilities, and impacts of climate change. Given that the tolerance of uncertainty is rather low, most of the stakeholders also claimed that a suitable product of event attribution is to be received from a trusted "honest broker" and published rather later, but with smaller uncertainties than vice versa. Institutional mechanisms, like regional climate services, which enable and foster communication, translation and mediation across the boundaries between knowledge and action can help fulfill such requirements. This is of particular importance for extreme event attribution which is often understood as science producing complex and abstract information attached to large uncertainties. They can serve as an interface for creating the necessary mutual understanding by being in a continuous dialogue with both science and stakeholders.

Open-Minded Midwifes, Literate Butchers, and Greedy Hooligans-The Independent Contributions of Stereotype Valence and Consistency on Evaluative Judgments.

PubMed

Schubert, Lisa; Körner, Anita; Lindau, Berit; Strack, Fritz; Topolinski, Sascha

2017-01-01

Do people evaluate an open-minded midwife less positively than a caring midwife? Both open-minded and caring are generally seen as positive attributes. However, consistency varies-the attribute caring is consistent with the midwife stereotype while open-minded is not. In general, both stimulus valence and consistency can influence evaluations. Six experiments investigated the respective influence of valence and consistency on evaluative judgments in the domain of stereotyping. In an impression formation paradigm, valence and consistency of stereotypic information about target persons were manipulated orthogonally and spontaneous evaluations of these target persons were measured. Valence reliably influenced evaluations. However, for strongly valenced stereotypes, no effect of consistency was observed. Parameters possibly preventing the occurrence of consistency effects were ruled out, specifically, valence of inconsistent attributes, processing priority of category information, and impression formation instructions. However, consistency had subtle effects on evaluative judgments if the information about a target person was not strongly valenced and experimental conditions were optimal. Concluding, in principle, both stereotype valence and consistency can play a role in evaluative judgments of stereotypic target persons. However, the more subtle influence of consistency does not seem to substantially influence evaluations of stereotyped target persons. Implications for fluency research and stereotype disconfirmation are discussed.

Physicians' professionalism at primary care facilities from patients' perspective: The importance of doctors' communication skills.

PubMed

Sari, Merry Indah; Prabandari, Yayi Suryo; Claramita, Mora

2016-01-01

Professionalism is the core duty of a doctor to be responsible to the society. Doctors' professionalism depicts an internalization of values and mastery of professionals' standards as an important part in shaping the trust between doctors and patients. Professionalism consists of various attributes in which current literature focused more on the perspective of the health professionals. Doctors' professionalism may influence patients' satisfaction, and therefore, it is important to know from the patients' perspectives what was expected of medical doctors' professionalism. This study was conducted to determine the attributes of physician professionalism from the patient's perspective. This was a qualitative research using a phenomenology study design. In-depth interviews were conducted with 18 patients with hypertension and diabetes who had been treated for at least 1 year in primary care facilities in the city of Yogyakarta, Indonesia. The results of the interview were transcribed, encoded, and then classified into categories. Communication skills were considered as the top priority of medical doctors' attributes of professionalism in the perspectives of the patients. This study revealed that communication skill is the most important aspects of professionalism which greatly affected in the process of health care provided by the primary care doctors. Doctor-patient communication skills should be intensively trained during both basic and postgraduate medical education.

Open-Minded Midwifes, Literate Butchers, and Greedy Hooligans—The Independent Contributions of Stereotype Valence and Consistency on Evaluative Judgments

PubMed Central

Schubert, Lisa; Körner, Anita; Lindau, Berit; Strack, Fritz; Topolinski, Sascha

2017-01-01

Do people evaluate an open-minded midwife less positively than a caring midwife? Both open-minded and caring are generally seen as positive attributes. However, consistency varies—the attribute caring is consistent with the midwife stereotype while open-minded is not. In general, both stimulus valence and consistency can influence evaluations. Six experiments investigated the respective influence of valence and consistency on evaluative judgments in the domain of stereotyping. In an impression formation paradigm, valence and consistency of stereotypic information about target persons were manipulated orthogonally and spontaneous evaluations of these target persons were measured. Valence reliably influenced evaluations. However, for strongly valenced stereotypes, no effect of consistency was observed. Parameters possibly preventing the occurrence of consistency effects were ruled out, specifically, valence of inconsistent attributes, processing priority of category information, and impression formation instructions. However, consistency had subtle effects on evaluative judgments if the information about a target person was not strongly valenced and experimental conditions were optimal. Concluding, in principle, both stereotype valence and consistency can play a role in evaluative judgments of stereotypic target persons. However, the more subtle influence of consistency does not seem to substantially influence evaluations of stereotyped target persons. Implications for fluency research and stereotype disconfirmation are discussed. PMID:29062289

Attributable Cost of Clostridium difficile Infection in Pediatric Patients.

PubMed

Mehrotra, Preeti; Jang, Jisun; Gidengil, Courtney; Sandora, Thomas J

2017-12-01

OBJECTIVES The attributable cost of Clostridium difficile infection (CDI) in children is unknown. We sought to determine a national estimate of attributable cost and length of stay (LOS) of CDI occurring during hospitalization in children. DESIGN AND METHODS We analyzed discharge records of patients between 2 and 18 years of age from the Agency for Healthcare Research and Quality (AHRQ) Kids' Inpatient Database. We created a logistic regression model to predict CDI during hospitalization based on demographic and clinical characteristics. Predicted probabilities from the logistic regression model were then used as propensity scores to match 1:2 CDI to non-CDI cases. Charges were converted to costs and compared between patients with CDI and propensity-score-matched controls. In a sensitivity analysis, we adjusted for LOS as a confounder by including it in both the propensity score and a generalized linear model predicting cost. RESULTS We identified 8,527 pediatric hospitalizations (0.53%) with a diagnosis of CDI and 1,597,513 discharges without CDI. In our matched cohorts, the attributable cost of CDI occurring during a hospitalization ranged from $1,917 to $8,317, depending on whether model was adjusted for LOS. When not adjusting for LOS, CDI-associated hospitalizations cost 1.6 times more than non-CDI associated hospitalizations. Attributable LOS of CDI was approximately 4 days. CONCLUSIONS Clostridium difficile infection in hospitalized children is associated with an economic burden similar to adult estimates. This finding supports a continued focus on preventing CDI in children as a priority. Pediatric CDI cost analyses should account for LOS as an important confounder of cost. Infect Control Hosp Epidemiol 2017;38:1472-1477.

Undernutrition as an underlying cause of child deaths associated with diarrhea, pneumonia, malaria, and measles.

PubMed

Caulfield, Laura E; de Onis, Mercedes; Blössner, Monika; Black, Robert E

2004-07-01

Previous analyses derived the relative risk (RR) of dying as a result of low weight-for-age and calculated the proportion of child deaths worldwide attributable to underweight. The objectives were to examine whether the risk of dying because of underweight varies by cause of death and to estimate the fraction of deaths by cause attributable to underweight. Data were obtained from investigators of 10 cohort studies with both weight-for-age category (<-3 SDs, -3 to <-2 SDs, -2 to <-1 SD, and >-1 SD) and cause of death information. All 10 studies contributed information on weight-for-age and risk of diarrhea, pneumonia, and all-cause mortality; however, only 6 studies contributed information on deaths because of measles, and only 3 studies contributed information on deaths because of malaria or fever. With use of weighted random effects models, we related the log mortality rate by cause and anthropometric status in each study to derive cause-specific RRs of dying because of undernutrition. Prevalences of each weight-for-age category were obtained from analyses of 310 national nutrition surveys. With use of the RR and prevalence information, we then calculated the fraction of deaths by cause attributable to undernutrition. The RR of mortality because of low weight-for-age was elevated for each cause of death and for all-cause mortality. Overall, 52.5% of all deaths in young children were attributable to undernutrition, varying from 44.8% for deaths because of measles to 60.7% for deaths because of diarrhea. A significant proportion of deaths in young children worldwide is attributable to low weight-for-age, and efforts to reduce malnutrition should be a policy priority.

Promising ethical arguments for product differentiation in the organic food sector. A mixed methods research approach.

PubMed

Zander, Katrin; Stolz, Hanna; Hamm, Ulrich

2013-03-01

Ethical consumerism is a growing trend worldwide. Ethical consumers' expectations are increasing and neither the Fairtrade nor the organic farming concept covers all the ethical concerns of consumers. Against this background the aim of this research is to elicit consumers' preferences regarding organic food with additional ethical attributes and their relevance at the market place. A mixed methods research approach was applied by combining an Information Display Matrix, Focus Group Discussions and Choice Experiments in five European countries. According to the results of the Information Display Matrix, 'higher animal welfare', 'local production' and 'fair producer prices' were preferred in all countries. These three attributes were discussed with Focus Groups in depth, using rather emotive ways of labelling. While the ranking of the attributes was the same, the emotive way of communicating these attributes was, for the most part, disliked by participants. The same attributes were then used in Choice Experiments, but with completely revised communication arguments. According to the results of the Focus Groups, the arguments were presented in a factual manner, using short and concise statements. In this research step, consumers in all countries except Austria gave priority to 'local production'. 'Higher animal welfare' and 'fair producer prices' turned out to be relevant for buying decisions only in Germany and Switzerland. According to our results, there is substantial potential for product differentiation in the organic sector through making use of production standards that exceed existing minimum regulations. The combination of different research methods in a mixed methods approach proved to be very helpful. The results of earlier research steps provided the basis from which to learn - findings could be applied in subsequent steps, and used to adjust and deepen the research design. Copyright © 2012 Elsevier Ltd. All rights reserved.

Choice of satellite imagery and attribution of changes to disturbance type strongly affects forest carbon balance estimates.

PubMed

Mascorro, Vanessa S; Coops, Nicholas C; Kurz, Werner A; Olguín, Marcela

2015-12-01

Remote sensing products can provide regular and consistent observations of the Earth´s surface to monitor and understand the condition and change of forest ecosystems and to inform estimates of terrestrial carbon dynamics. Yet, challenges remain to select the appropriate satellite data source for ecosystem carbon monitoring. In this study we examine the impacts of three attributes of four remote sensing products derived from Landsat, Landsat-SPOT, and MODIS satellite imagery on estimates of greenhouse gas emissions and removals: (1) the spatial resolution (30 vs. 250 m), (2) the temporal resolution (annual vs. multi-year observations), and (3) the attribution of forest cover changes to disturbance types using supplementary data. With a spatially-explicit version of the Carbon Budget Model of the Canadian Forest Sector (CBM-CFS3), we produced annual estimates of carbon fluxes from 2002 to 2010 over a 3.2 million ha forested region in the Yucatan Peninsula, Mexico. The cumulative carbon balance for the 9-year period differed by 30.7 million MgC (112.5 million Mg CO 2e ) among the four remote sensing products used. The cumulative difference between scenarios with and without attribution of disturbance types was over 5 million Mg C for a single Landsat scene. Uncertainty arising from activity data (rates of land-cover changes) can be reduced by, in order of priority, increasing spatial resolution from 250 to 30 m, obtaining annual observations of forest disturbances, and by attributing land-cover changes by disturbance type. Even missing a single year in the land-cover observations can lead to substantial errors in ecosystems with rapid forest regrowth, such as the Yucatan Peninsula.

Health priorities and public preferences: the relative importance of past health experience and future health prospects.

PubMed

Dolan, Paul; Tsuchiya, Aki

2005-07-01

We explore people's choices where the preference for those with worse future health prospects and the preference for the young over the old conflict. The empirical study used scenarios with four attributes: past years, past health, future years without treatment, and future health without treatment. One hundred respondents ranked various patient groups described in these terms. The results suggest a strong effect of past years: younger groups (40-year-olds) were always chosen over older ones (60-year-olds). Past health was significant in one question but not the other and future health and years without treatment were both non-significant.

Health care workforce crisis in Australia: too few or too disabled?

PubMed

Scott, Ian A

2009-06-15

A key challenge for the Australian health care system is ensuring that the numbers, distribution and skill set of the health care workforce are adequate to meet the emerging health needs of an ageing population with increasingly high expectations of health care. Professional and government responses have given priority to increasing the overall numbers of practising clinicians by investment in additional training places. Another approach is to enhance productivity of the existing workforce by activating strategies of professional enablement that remove constraints imposed on clinicians by inefficient work practices and inappropriate training programs, maladaptive organisational attributes, misdirected financial and non-financial incentives, and adverse sociopolitical influences.

Terrestrial record of the solar system's oscillation about the galactic plane

NASA Technical Reports Server (NTRS)

Stothers, R. B.

1985-01-01

A new study is presented of the observational evidence pertaining to the theory which attributes the episodic component of the earth's impact cratering record over the past 600 Myr to gravitational encounters between the solar system and interstellar clouds that cause comets to fall into the solar system and impact the earth. Contrary to a claim by Thaddeus and Chanan (1985), the vertical scale height of the clouds seems to be sufficently small and the sun's vertical trajectory sufficiently large for the modulating effect of the sun's galactovertical motion to be detectable in the terrestrial record of impact cratering with at least a 50 percent a priori probability.

Science knowledge and biblical literalism.

PubMed

Zigerell, L J

2012-04-01

Biblical literalists are often described as scientific illiterates, but little if any empirical research has tested this claim. Analysis of a sixteen-item battery from the 2008 US General Social Survey revealed that literalists possess less science knowledge than those with other views of Scripture, but that much of this deficit can be attributed to demographic factors and unequal educational attainment. The marginal direct effect of biblical belief suggests that literalism is not incompatible with knowledge of science and, therefore, the best avenue for increasing science knowledge among literalists may be to foster interest in science and design science courses to attenuate any perceived conflict between science and religion.

The American compensation phenomenon.

PubMed

Bale, A

1990-01-01

In this article, the author defines the occupational safety and health domain, characterizes the distinct compensation phenomenon in the United States, and briefly reviews important developments in the last decade involving Karen Silkwood, intentional torts, and asbestos litigation. He examines the class conflict over the value and meaning of work-related injuries and illnesses involved in the practical activity of making claims and turning them into money through compensation inquiries. Juries, attributions of fault, and medicolegal discourse play key roles in the compensation phenomenon. This article demonstrates the extensive, probing inquiry through workers' bodies constituted by the American compensation phenomenon into the moral basis of elements of the system of production.

Search for a periodic signal from Cygnus X-3 usingmuons observed underground in the Frejus detector (4800 mwe)

NASA Technical Reports Server (NTRS)

Bareyre, P.; Barloutaud, R.; Becker, K. H.; Behr, L.; Berger, C.; Bland, R. W.; Chardin, G.; Daum, H. J.; Degrange, B.; Demski, S.

1986-01-01

Periodic signals from Cygnus X-3 in the ultra high energy range were recently reported by air shower arrays and attributed to gamma rays. Although gamma rays are expected to produce muon-poor showers, the preceding observations have stimulated similar studies based on underground muons. Two groups have claimed a significant underground signal coming from Cygnus X-3. The results are, however, extremely difficult to explain in the present framework of particle physics, and clearly need confirmation. The preliminary results obtained from the Frejus underground detector during its first 16 months of operation (March 1984 to June 1985) are presented.

Emergency Mental Health Services for Children After the Terrorist Attacks of September 11, 2001.

PubMed

Bruckner, Tim A; Kim, Yonsu; Lubens, Pauline; Singh, Amrita; Snowden, Lonnie; Chakravarthy, Bharath

2016-01-01

Much literature documents elevated psychiatric symptoms among adults after the terrorist attacks of September 11, 2001 (9/11). We, however, know of no research in children that examines emergency mental health services following 9/11. We test whether children's emergency services for crisis mental health care rose above expected values in September 2001. We applied time-series methods to California Medicaid claims (1999-2003; N = 127,200 visits). Findings in California indicate an 8.7% increase of children's emergency mental health visits statistically attributable to 9/11. Non-Hispanic white more than African American children account for this acute rise in emergency services.

Increased co-first authorships in biomedical and clinical publications: a call for recognition.

PubMed

Conte, Marisa L; Maat, Stacy L; Omary, M Bishr

2013-10-01

There has been a dramatic increase in the number and percentage of publications in biomedical and clinical journals in which two or more coauthors claim first authorship, with a change in some journals from no joint first authorship in 1990 to co-first authorship of >30% of all research publications in 2012. As biomedical and clinical research become increasingly complex and team-driven, and given the importance attributed to first authorship by grant reviewers and promotion and tenure committees, the time is ripe for journals, bibliographic databases, and authors to highlight equal first author contributions of published original research.

Sex differences in processing printed advertisements.

PubMed

Putrevu, Sanjay

2004-06-01

The success of using biological sex to divide or segment markets requires a thorough understanding of how men and women process and respond to advertisements and other persuasive communications. Toward this end, this research (N=64; 32 men and 32 women) studied how college-age men and women respond to printed advertisements. There were no differences between the sexes in recall and recognition of claims in advertisements, but men and women generated different types of message relevant thoughts-women generated more category thoughts and men generated more attribute thoughts, suggesting that, while women and men might not differ in the depth of processing, they might use different processing styles.

Biological citizenship: the science and politics of Chernobyl-exposed populations.

PubMed

Petryna, Adriana

2004-01-01

In the transition out of socialism to market capitalism, bodies, populations, and categories of citizenship have been reordered. The rational-technical management of group affected by the Chernobyl disaster in Ukraine is a window into this contested process. Chernobyl exemplifies a moment when scientific knowability collapsed and new maps and categories of entitlement emerged. Older models of welfare rely on precise definitions situating citizens and their attributes on a cross-mesh of known categories upon which claims rights are based. Here one observes how ambiguities related to categorizing suffering created a political field in which a state, forms of citizenship, and informal economies were remade.

Political priority in the global fight against non-communicable diseases.

PubMed

Maher, Anthony; Sridhar, Devi

2012-12-01

The prevalence of non-communicable diseases (NCDs) - such as cancer, diabetes, cardiovascular disease, and chronic respiratory diseases - is surging globally. Yet despite the availability of cost-effective interventions, NCDs receive less than 3% of annual development assistance for health to low and middle income countries. The top donors in global health - including the Bill and Melinda Gates Foundation, the US Government, and the World Bank - together commit less than 2% of their budgets to the prevention and control of NCDs. Why is there such meagre funding on the table for the prevention and control of NCDs? Why has a global plan of action aimed at halting the spread of NCDs been so difficult to achieve? This paper aims to tackle these two interrelated questions by analysing NCDs through the lens of Jeremy Shiffman's 2009 political priority framework. We define global political priority as 'the degree to which international and national political leaders actively give attention to an issue, and back up that attention with the provision of financial, technical, and human resources that are commensurate with the severity of the issue'. Grounded in social constructionism, this framework critically examines the relationship between agenda setting and 'objective' factors in global health, such as the existence of cost-effective interventions and a high mortality burden. From a methodological perspective, this paper fits within the category of discipline configurative case study. We support Shiffman's claim that strategic communication - or ideas in the form of issue portrayals - ought to be a core activity of global health policy communities. But issue portrayals must be the products of a robust and inclusive debate. To this end, we also consider it essential to recognise that issue portrayals reach political leaders through a vast array of channels. Raising the political priority of NCDs means engaging with the diverse ways in which actors express concern for the global proliferation of these diseases. Ultimately, our political interactions amount to struggles for influence, and determining which issues to champion in the midst of these struggles - and which to disregard - is informed by subjectively held notions of the right, the good, and the just. Indeed, the very act of choosing which issues to prioritise in our daily lives forces us to evaluate our values and aspirations as individual agents against the shared values that structure the societies in which we live.

Prioritising patients for bariatric surgery: building public preferences from a discrete choice experiment into public policy

PubMed Central

Whitty, Jennifer A; Ratcliffe, Julie; Kendall, Elizabeth; Burton, Paul; Wilson, Andrew; Littlejohns, Peter; Harris, Paul; Krinks, Rachael; Scuffham, Paul A

2015-01-01

Objectives To derive priority weights for access to bariatric surgery for obese adults, from the perspective of the public. Setting Australian public hospital system. Participants Adults (N=1994), reflecting the age and gender distribution of Queensland and South Australia. Primary and secondary outcome measures A discrete choice experiment in which respondents indicated which of two individuals with different characteristics should be prioritised for surgery in repeated hypothetical choices. Potential surgery recipients were described by seven key characteristics or attributes: body mass index (BMI), presence of comorbid conditions, age, family history, commitment to lifestyle change, time on the surgical wait list and chance of maintaining weight loss following surgery. A multinomial logit model was used to evaluate preferences and derive priority weights (primary analysis), with a latent class model used to explore respondent characteristics that were associated with variation in preference across the sample (see online supplementary analysis). Results A preference was observed to prioritise individuals who demonstrated a strong commitment to maintaining a healthy lifestyle as well as individuals categorised with very severe (BMI≥50 kg/m2) or (to a lesser extent) severe (BMI≥40 kg/m2) obesity, those who already have obesity-related comorbidity, with a family history of obesity, with a greater chance of maintaining weight loss or who had spent a longer time on the wait list. Lifestyle commitment was considered to be more than twice as important as any other criterion. There was little tendency to prioritise according to the age of the recipient. Respondent preferences were dependent on their BMI, previous experience with weight management surgery, current health state and education level. Conclusions This study extends our understanding of the publics’ preferences for priority setting to the context of bariatric surgery, and derives priority weights that could be used to assist bodies responsible for commissioning bariatric services. PMID:26474940

The role of outputs and outcomes in purchaser accountability: reflecting on New Zealand experiences.

PubMed

Cumming, J; Scott, C D

1998-10-01

Recent reforms in a number of countries' health systems have led to the separation of funder, purchaser and provider roles and the strengthening of funders' and purchasers' positions relative to providers. One of the aims of such reforms is to improve accountability. This paper reports on experiences in New Zealand where, in addition to improving the accountability of providers, purchaser accountability has also been a key policy issue. Attempts have been made in New Zealand to develop a funder-purchaser accountability framework based on a mix of outcomes, outputs and inputs. This paper discusses the roles that each might play in contracts and accountability relationships between funders and purchasers. The paper concludes that holding purchasers accountable for outcomes is likely to prove difficult and controversial, because of problems of attribution and because New Zealand funders in recent years have played an important role in determining the priority outputs and inputs which must be purchased. The paper suggests that accountability is more appropriate at the output and process level, in addition to holding purchasers accountable for the ways in which they make decisions and undertake contracting roles. Holding purchasers accountable for purchasing outputs and processes, however, requires greater commitment on the part of the funder to setting priorities more clearly; specifying the range and level of outputs to be purchased and the terms of access to those services; and funding services to this level. The international attention currently being paid to the development of practice guidelines and priority criteria also suggests that holding purchasers accountable for a form of inputs may become an increasingly common practice in future. From 1 July 1998, New Zealand will introduce a priority criteria system for determining access to elective surgery; accountability is thus becoming focused on inputs in the form of patient characteristics. This approach will greatly assist in promoting accountability.

[Mesothelioma in construction workers: risk estimate, lung content of asbestos fibres, claims for compensation for occupational disease in the Veneto Region mesothelioma register].

PubMed

Merler, E; Bressan, Vittoria; Somigliana, Anna

2009-01-01

Work in the construction industry is causing the highest number of mesotheliomas among the residents of the Veneto Region (north-east Italy, 4,5 million inhabitants). To sum up the results on occurrence, asbestos exposure, lung fibre content analyses, and compensation for occupational disease. Case identification and asbestos exposure classification: active search of mesotheliomas that were diagnosed via histological or cytological examinations occurring between 1987 and 2006; a probability of asbestos exposure was attributed to each case, following interviews with the subjects or their relatives and collection of data on the jobs held over their lifetime. Risk estimate among construction workers: the ratio between cases and person-years, the latter derived from the number of construction workers reported by censuses. Lung content of asbestos fibres: examination of lung specimens by Scanning Electron Microscope to determine number and type of fibres. Claims for compensation and compensation awarded: data obtained from the National Institute for Insurance against Occupational Diseases available for the period 1999-2006. of 952 mesothelioma cases classified as due to asbestos exposure, 251 were assigned to work in the construction industry (21 of which due to domestic of environmental exposures), which gives a rate of 4.1 (95% CI 3.6-4.8) x 10(5) x year among construction workers. The asbestos fibre content detected in the lungs of 11 construction workers showed a mean of 1.7 x 10(6) fibres/g dry tissue (range 350,000-3 million) for fibres > 1 micro, almost exclusively due to amphibole fibres. 62% of the claims for compensation were granted but the percentage fell to less than 40% when claims were submitted by a relative, after the death of the subject. The prevalence of mesothelioma occurring among construction workers is high and is associated with asbestos exposure; the risk is underestimated by the subjects and their relatives. All mesotheliomas occurring among construction workers should be granted compensation for occupational disease.

Armed and attentive: holding a weapon can bias attentional priorities in scene viewing.

PubMed

Biggs, Adam T; Brockmole, James R; Witt, Jessica K

2013-11-01

The action-specific perception hypothesis (Witt, Current Directions in Psychological Science 20: 201-206, 2011) claims that the environment is represented with respect to potential interactions for objects present within said environment. This investigation sought to extend the hypothesis beyond perceptual mechanisms and assess whether action-specific potential could alter attentional allocation. To do so, we examined a well-replicated attention bias in the weapon focus effect (Loftus, Loftus, & Messo, Law and Human Behaviour 1, 55-62, 1987), which represents the tendency for observers to attend more to weapons than to neutral objects. Our key manipulation altered the anticipated action-specific potential of observers by providing them a firearm while they freely viewed scenes with and without weapons present. We replicated the original weapon focus effect using modern eye tracking and confirmed that the increase in time looking at weapons comes at a cost of less time spent looking at faces. Additionally, observers who held firearms while viewing the various scenes showed a general bias to look at faces over objects, but only if the firearm was in a readily usable position (i.e., pointed at the scenes rather than holstered at one's side). These two effects, weapon focus and the newly found bias to look more at faces when armed, canceled out one another without interacting. This evidence confirms that the action capabilities of the observer alter more than just perceptual mechanisms and that holding a weapon can change attentional priorities. Theoretical and real-world implications are discussed.

Deaths and Medical Visits Attributable to Environmental Pollution in the United Arab Emirates

PubMed Central

MacDonald Gibson, Jacqueline; Thomsen, Jens; Launay, Frederic; Harder, Elizabeth; DeFelice, Nicholas

2013-01-01

Background This study estimates the potential health gains achievable in the United Arab Emirates (UAE) with improved controls on environmental pollution. The UAE is an emerging economy in which population health risks have shifted rapidly from infectious diseases to chronic conditions observed in developed nations. The UAE government commissioned this work as part of an environmental health strategic planning project intended to address this shift in the nature of the country’s disease burden. Methods and Findings We assessed the burden of disease attributable to six environmental exposure routes outdoor air, indoor air, drinking water, coastal water, occupational environments, and climate change. For every exposure route, we integrated UAE environmental monitoring and public health data in a spatially resolved Monte Carlo simulation model to estimate the annual disease burden attributable to selected pollutants. The assessment included the entire UAE population (4.5 million for the year of analysis). The study found that outdoor air pollution was the leading contributor to mortality, with 651 attributable deaths (95% confidence interval [CI] 143–1,440), or 7.3% of all deaths. Indoor air pollution and occupational exposures were the second and third leading contributors to mortality, with 153 (95% CI 85–216) and 46 attributable deaths (95% CI 26–72), respectively. The leading contributor to health-care facility visits was drinking water pollution, to which 46,600 (95% CI 15,300–61,400) health-care facility visits were attributed (about 15% of the visits for all the diseases considered in this study). Major study limitations included (1) a lack of information needed to translate health-care facility visits to quality-adjusted-life-year estimates and (2) insufficient spatial coverage of environmental data. Conclusions Based on international comparisons, the UAE’s environmental disease burden is low for all factors except outdoor air pollution. From a public health perspective, reducing pollutant emissions to outdoor air should be a high priority for the UAE’s environmental agencies. PMID:23469200

Deaths and medical visits attributable to environmental pollution in the United Arab Emirates.

PubMed

MacDonald Gibson, Jacqueline; Thomsen, Jens; Launay, Frederic; Harder, Elizabeth; DeFelice, Nicholas

2013-01-01

This study estimates the potential health gains achievable in the United Arab Emirates (UAE) with improved controls on environmental pollution. The UAE is an emerging economy in which population health risks have shifted rapidly from infectious diseases to chronic conditions observed in developed nations. The UAE government commissioned this work as part of an environmental health strategic planning project intended to address this shift in the nature of the country's disease burden. We assessed the burden of disease attributable to six environmental exposure routes outdoor air, indoor air, drinking water, coastal water, occupational environments, and climate change. For every exposure route, we integrated UAE environmental monitoring and public health data in a spatially resolved Monte Carlo simulation model to estimate the annual disease burden attributable to selected pollutants. The assessment included the entire UAE population (4.5 million for the year of analysis). The study found that outdoor air pollution was the leading contributor to mortality, with 651 attributable deaths (95% confidence interval [CI] 143-1,440), or 7.3% of all deaths. Indoor air pollution and occupational exposures were the second and third leading contributors to mortality, with 153 (95% CI 85-216) and 46 attributable deaths (95% CI 26-72), respectively. The leading contributor to health-care facility visits was drinking water pollution, to which 46,600 (95% CI 15,300-61,400) health-care facility visits were attributed (about 15% of the visits for all the diseases considered in this study). Major study limitations included (1) a lack of information needed to translate health-care facility visits to quality-adjusted-life-year estimates and (2) insufficient spatial coverage of environmental data. Based on international comparisons, the UAE's environmental disease burden is low for all factors except outdoor air pollution. From a public health perspective, reducing pollutant emissions to outdoor air should be a high priority for the UAE's environmental agencies.

Behavioral health services utilization among older adults identified within a state abuse hotline database.

PubMed

Schonfeld, Lawrence; Larsen, Rebecca G; Stiles, Paul G

2006-04-01

This study examined the extent to which older adults identified in a statewide abuse hotline registry utilized behavioral health services. This is important as mental health issues have been identified as a high priority for filling gaps in services for victims of mistreatment. We compared Medicaid and Medicare claims data for two groups of older adults: those using health services and identified within a statewide abuse hotline information system and those claimants not identified within the hotline database. Behavioral health service use was greater among those identified in the abuse hotline database. The penetration rate (percentage of service users out of all enrollees) for Medicaid behavioral health service claims was more than twice that of other service users, with costs of services about 30% greater. Analyses of Medicare data revealed that the penetration rate for those in the hotline data was almost 6 times greater at approximately twice the cost compared to other service users. The results provide evidence for previous assumptions that mistreated individuals experience a higher rate of behavioral health disorders. As mental health screening by adult protective services is rarely conducted, the results suggest the need to train investigators and other service providers to screen older adults for behavioral health and substance-abuse issues as well as physical signs of abuse. Further research on the relationship of abuse to behavioral health might focus on collection of additional data involving more specific victim-related characteristics and comparisons of cases of mistreatment versus self-neglect.

Eliciting preferences for priority setting in genetic testing: a pilot study comparing best-worst scaling and discrete-choice experiments.

PubMed

Severin, Franziska; Schmidtke, Jörg; Mühlbacher, Axel; Rogowski, Wolf H

2013-11-01

Given the increasing number of genetic tests available, decisions have to be made on how to allocate limited health-care resources to them. Different criteria have been proposed to guide priority setting. However, their relative importance is unclear. Discrete-choice experiments (DCEs) and best-worst scaling experiments (BWSs) are methods used to identify and weight various criteria that influence orders of priority. This study tests whether these preference eliciting techniques can be used for prioritising genetic tests and compares the empirical findings resulting from these two approaches. Pilot DCE and BWS questionnaires were developed for the same criteria: prevalence, severity, clinical utility, alternatives to genetic testing available, infrastructure for testing and care established, and urgency of care. Interview-style experiments were carried out among different genetics professionals (mainly clinical geneticists, researchers and biologists). A total of 31 respondents completed the DCE and 26 completed the BWS experiment. Weights for the levels of the six attributes were estimated by conditional logit models. Although the results derived from the DCE and BWS experiments differed in detail, we found similar valuation patterns in the DCE and BWS experiments. The respondents attached greatest value to tests with high clinical utility (defined by the availability of treatments that reduce mortality and morbidity) and to testing for highly prevalent conditions. The findings from this study exemplify how decision makers can use quantitative preference eliciting methods to measure aggregated preferences in order to prioritise alternative clinical interventions. Further research is necessary to confirm the survey results.

Understanding current causes of women's underrepresentation in science

PubMed Central

Williams, Wendy M.

2011-01-01

Explanations for women's underrepresentation in math-intensive fields of science often focus on sex discrimination in grant and manuscript reviewing, interviewing, and hiring. Claims that women scientists suffer discrimination in these arenas rest on a set of studies undergirding policies and programs aimed at remediation. More recent and robust empiricism, however, fails to support assertions of discrimination in these domains. To better understand women's underrepresentation in math-intensive fields and its causes, we reprise claims of discrimination and their evidentiary bases. Based on a review of the past 20 y of data, we suggest that some of these claims are no longer valid and, if uncritically accepted as current causes of women's lack of progress, can delay or prevent understanding of contemporary determinants of women's underrepresentation. We conclude that differential gendered outcomes in the real world result from differences in resources attributable to choices, whether free or constrained, and that such choices could be influenced and better informed through education if resources were so directed. Thus, the ongoing focus on sex discrimination in reviewing, interviewing, and hiring represents costly, misplaced effort: Society is engaged in the present in solving problems of the past, rather than in addressing meaningful limitations deterring women's participation in science, technology, engineering, and mathematics careers today. Addressing today's causes of underrepresentation requires focusing on education and policy changes that will make institutions responsive to differing biological realities of the sexes. Finally, we suggest potential avenues of intervention to increase gender fairness that accord with current, as opposed to historical, findings. PMID:21300892

A survey of sports drinks consumption among adolescents.

PubMed

Broughton, D; Fairchild, R M; Morgan, M Z

2016-06-24

Background Sports drinks intended to improve performance and hydrate athletes taking part in endurance sport are being marketed to children, for whom these products are not intended. Popularity among children has grown exponentially. Worryingly they consume them socially, as well as during physical activity. Sports drinks are high in sugar and are acidic. Product marketing ignores the potential harmful effects of dental caries and erosion.Objective To investigate the use of sports drinks by children.Method One hundred and eighty-three self-complete questionnaires were distributed to four schools in South Wales. Children in high school years 8 and 9 (aged 12-14) were recruited to take part. Questions focused on use of sports drinks, type consumed, frequency of and reason for consumption and where drinks were purchased.Results One hundred and sixty children responded (87% response rate): 89.4% (143) claimed to drink sports drinks, half drinking them at least twice a week. Lucozade Sport(™) was the most popular brand. The main reason for consuming the drinks was attributed to the 'nice taste' (90%, 129/143). Most respondents purchased the drinks from local shops (80.4%, 115) or supermarkets (54.5%, 78). More boys claimed to drink sports drinks during physical activity (77.9% versus 48.6% girls, P <0.001). Whereas more girls claimed to drink them socially (51.4% versus 48.5% boys, NS).Conclusion A high proportion of children consumed sports drinks regularly and outside of sporting activity. Dental health professionals should be aware of the popularity of sports drinks with children when giving health education advice or designing health promotion initiatives.