Establishing a legal service for major trauma patients at a major trauma centre in the UK.

PubMed

Seligman, William H; Thompson, Julian; Thould, Hannah E; Tan, Charlotte; Dinsmore, Andrew; Lockey, David J

2017-09-01

Major trauma causes unanticipated critical illness and patients have often made few arrangements for what are sudden and life-changing circumstances. This can lead to financial, housing, insurance, legal and employment issues for patients and their families.A UK law firm worked with the major trauma services to develop a free and comprehensive legal service for major trauma patients and their families at a major trauma centre (MTC) in the UK. In 2013, a legal service was established at North Bristol NHS Trust. Referrals are made by trauma nurse practitioners and it operates within a strict ethical framework. A retrospective analysis of the activity of this legal service between September 2013 and October 2015 was undertaken. 66 major trauma patients were seen by the legal teams at the MTC. 535 hours of free legal advice were provided on non-compensation issues-an average of 8 hours per patient. This initiative confirms a demand for the early availability of legal advice for major trauma patients to address a range of non-compensation issues as well as for identification of potential compensation claims. The availability of advice at the MTC is convenient for relatives who may be spending the majority of their time with injured relatives in hospital. More data are needed to establish the rehabilitation and health effects of receiving non-compensation advice after major injury; however, the utilisation of this service suggests that it should be considered at the UK MTCs. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Effectiveness of UK provider financial incentives on quality of care: a systematic review.

PubMed

Mandavia, Rishi; Mehta, Nishchay; Schilder, Anne; Mossialos, Elias

2017-11-01

Provider financial incentives are being increasingly adopted to help improve standards of care while promoting efficiency. To review the UK evidence on whether provider financial incentives are an effective way of improving the quality of health care. Systematic review of UK evidence, undertaken in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. MEDLINE and Embase databases were searched in August 2016. Original articles that assessed the relationship between UK provider financial incentives and a quantitative measure of quality of health care were included. Studies showing improvement for all measures of quality of care were defined as 'positive', those that were 'intermediate' showed improvement in some measures, and those classified as 'negative' showed a worsening of measures. Studies showing no effect were documented as such. Quality was assessed using the Downs and Black quality checklist. Of the 232 published articles identified by the systematic search, 28 were included. Of these, nine reported positive effects of incentives on quality of care, 16 reported intermediate effects, two reported no effect, and one reported a negative effect. Quality assessment scores for included articles ranged from 15 to 19, out of a maximum of 22 points. The effects of UK provider financial incentives on healthcare quality are unclear. Owing to this uncertainty and their significant costs, use of them may be counterproductive to their goal of improving healthcare quality and efficiency. UK policymakers should be cautious when implementing these incentives - if used, they should be subject to careful long-term monitoring and evaluation. Further research is needed to assess whether provider financial incentives represent a cost-effective intervention to improve the quality of care delivered in the UK. © British Journal of General Practice 2017.

Why doctors consider leaving UK medicine: qualitative analysis of comments from questionnaire surveys three years after graduation

PubMed Central

Lambert, Trevor W; Goldacre, Michael J

2017-01-01

Objective To report the reasons why doctors are considering leaving medicine or the UK. Design Questionnaire survey. Setting UK. Participants Questionnaires were sent three years after graduation to all UK medical graduates of 2008 and 2012. Main outcome measures Comments from doctors about their main reasons for considering leaving medicine or the UK (or both). Results The response rate was 46.2% (5291/11,461). Among the 60% of respondents who were not definitely intent on remaining in UK medicine, 50% were considering working in medicine outside the UK and 10% were considering leaving medicine. Among those considering working in medicine outside the UK, the most commonly cited reasons were to gain wider experience, that things would be ‘better’ elsewhere and a negative view of the National Health Service and its culture, state and politics. Other reasons included better training or job opportunities, better pay and conditions, family reasons and higher expectations. Three years after graduation, doctors surveyed in 2015 were significantly more likely than doctors surveyed in 2011 to cite factors related to the National Health Service, to pay and conditions, to their expectations and to effects on work–life balance and patient care. Among those considering leaving medicine, the dominant reason for leaving medicine was a negative view of the National Health Service (mentioned by half of those in this group who commented). Three years after graduation, doctors surveyed in 2015 were more likely than doctors surveyed in 2011 to cite this reason, as well as excessive hours and workload, and financial reasons. Conclusions An increasingly negative view is held by many doctors of many aspects of the experience of being a junior doctor in the National Health Service, and the difficulty of delivering high-quality patient care within what many see as an under-funded system. Policy changes designed to encourage more doctors to remain should be motivated by a desire to address these concerns by introducing real improvements to resources, staffing and working conditions. PMID:29035667

Why doctors consider leaving UK medicine: qualitative analysis of comments from questionnaire surveys three years after graduation.

PubMed

Lambert, Trevor W; Smith, Fay; Goldacre, Michael J

2018-01-01

Objective To report the reasons why doctors are considering leaving medicine or the UK. Design Questionnaire survey. Setting UK. Participants Questionnaires were sent three years after graduation to all UK medical graduates of 2008 and 2012. Main outcome measures Comments from doctors about their main reasons for considering leaving medicine or the UK (or both). Results The response rate was 46.2% (5291/11,461). Among the 60% of respondents who were not definitely intent on remaining in UK medicine, 50% were considering working in medicine outside the UK and 10% were considering leaving medicine. Among those considering working in medicine outside the UK, the most commonly cited reasons were to gain wider experience, that things would be 'better' elsewhere and a negative view of the National Health Service and its culture, state and politics. Other reasons included better training or job opportunities, better pay and conditions, family reasons and higher expectations. Three years after graduation, doctors surveyed in 2015 were significantly more likely than doctors surveyed in 2011 to cite factors related to the National Health Service, to pay and conditions, to their expectations and to effects on work-life balance and patient care. Among those considering leaving medicine, the dominant reason for leaving medicine was a negative view of the National Health Service (mentioned by half of those in this group who commented). Three years after graduation, doctors surveyed in 2015 were more likely than doctors surveyed in 2011 to cite this reason, as well as excessive hours and workload, and financial reasons. Conclusions An increasingly negative view is held by many doctors of many aspects of the experience of being a junior doctor in the National Health Service, and the difficulty of delivering high-quality patient care within what many see as an under-funded system. Policy changes designed to encourage more doctors to remain should be motivated by a desire to address these concerns by introducing real improvements to resources, staffing and working conditions.

Standardised tobacco packaging: a health policy case study of corporate conflict expansion and adaptation.

PubMed

Hatchard, Jenny L; Fooks, Gary J; Gilmore, Anna B

2016-10-07

To investigate opposition to standardised tobacco packaging in the UK. To increase understanding of how transnational corporations are adapting to changes in their access to policymakers precipitated by Article 5.3 of the Framework Convention on Tobacco Control (FCTC). Case study web-based documentary analysis, using NVivo V.10. Examination of relationships between opponents of standardised packaging and transnational tobacco companies (TTCs) and of the volume, nature, transparency and timing of their activities. UK standardised packaging policy debate 2011-2013. Organisations selected on basis of opposition to, or facilitation thereof, standardised tobacco packaging in the UK; 422 associated documents. Excluding tobacco manufacturing and packaging companies (n=12), 109 organisations were involved in opposing standardised packaging, 82 (75%) of which had a financial relationship with 1 or more TTC. These 82 organisations (43 actively opposing the measure, 39 facilitating opposition) were responsible for 60% of the 404 activities identified, including the majority of public communications and research production. TTCs were directly responsible for 28% of total activities, predominantly direct lobbying, but also financially underwrote third party research, communication, mass recruitment and lobbying. Active organisations rarely reported any financial relationship with TTCs when undertaking opposition activities. The multifaceted opposition to standardised packaging was primarily undertaken by third parties with financial relationships with major tobacco manufacturers. Low levels of transparency regarding these links created a misleading impression of diverse and widespread opposition. Countries should strengthen implementation of Article 5.3 of the FCTC by systematically requiring conflict of interest declarations from all organisations participating in political or media debates on tobacco control. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

What Drives Country Differences in Cost of Alzheimer's Disease? An Explanation from Resource Use in the GERAS Study.

PubMed

Reed, Catherine; Happich, Michael; Argimon, Josep Maria; Haro, Josep Maria; Wimo, Anders; Bruno, Giuseppe; Dodel, Richard; Jones, Roy W; Vellas, Bruno; Belger, Mark

2017-01-01

Country differences in resource use and costs of Alzheimer's disease (AD) may be driven by differences in health care systems and resource availability. To compare country resource utilization drivers of societal costs for AD dementia over 18 months. GERAS is an observational study in France (n = 419), Germany (n = 550), and the UK (n = 526). Resource use of AD patients and caregivers contributing to >1% of total societal costs (year 2010) was assessed for country differences, adjusting for participant characteristics. Mean 18-month societal costs per patient were France €33,339, Germany €38,197, and UK €37,899 (£32,501). Caregiver time spent on basic and instrumental activities of daily living (ADL) contributed the most to societal costs (54% France, 64% Germany, 65% UK). Caregivers in France spent less time on ADL than UK caregivers and missed fewer work days than in other countries. Compared with other countries, patients in France used more community care services overall and were more likely to use home aid. Patients in Germany were least likely to use temporary accommodation or to be institutionalized at 18 months. UK caregivers spent the most time on instrumental ADL, UK patients used fewest outpatient resources, and UK patients/caregivers were most likely to receive financial support. Caregiver time on ADL contributed the most to societal costs and differed across countries, possibly due to use of community care services and institutionalization. Other resources had different patterns of use across countries, reflecting country-specific health and social care systems.

The Counseling Center Assessment of Psychological Symptoms (CCAPS-62): Acceptance, feasibility, and initial psychometric properties in a UK student population.

PubMed

Broglia, Emma; Millings, Abigail; Barkham, Michael

2017-09-01

The burden and severity of student mental health continue to increase in parallel with increasing financial pressures on students and services alike. There is a need for a student-specific measure of distress that acknowledges their unique context. This study examined the feasibility, acceptance, and initial psychometric properties of a US measure, the Counseling Center Assessment of Psychological Symptoms (CCAPS), in a UK student sample. A sample of 294 UK help-seeking students from two universities completed the CCAPS-62 and Clinical Outcomes in Routine Evaluation (CORE-10) as a comparator. The factor solution and reliability of the CCAPS-62 were examined. Correlations and clinical boundaries were determined between the CCAPS-62 subscales and CORE-10, and comparisons were made with US published norms. The CCAPS-62 demonstrated a strong factor solution that matched the intended subscales. All subscales had good reliability and correlated significantly with the CORE-10. The agreement on caseness between the two measures was 92.8% with 86.3% reaching clinical threshold on both the CCAPS-62 and CORE-10. Severity was most noticeable for academic distress, depression, anxiety, and social anxiety. Compared to US data, UK students showed higher clinical severity for all psychological symptoms. The CCAPS-62 is a reliable and psychometrically valid assessment measure to use with UK students without revision. The overall distress indicated is similar to that of the CORE-10, but the individual subscales are more informative of specific student concerns including academic distress, social anxiety, and substance abuse. Potential benefits of administering a student-focused assessment measure in student counselling services are discussed. University students attending counselling in the UK demonstrate clinical severity for academic distress, depression, anxiety, and social anxiety. Compared to university students in the US, UK students present with higher clinical severity on all contextual measures of student psychological distress. It is advantageous for university counselling services to administer a student-specific clinical measure over measures intended for the general clinical population. CCAPS-62 is an acceptable, feasible, and psychometrically valid measure of student psychological distress that can be used in the UK without revision. It is important for university counselling services to continue to provide support from therapists that are trained and experienced in the university context over services intended for the general clinical population. Copyright © 2017 John Wiley & Sons, Ltd.

The relation of depression and anxiety to life-stress and achievement in students.

PubMed

Andrews, Bernice; Wilding, John M

2004-11-01

An apparent increase in seriously disturbed students consulting student health services in the UK has led to concern that increasing financial difficulties and other outside pressures may affect student mental health and academic performance. The current research investigated whether student anxiety and depression increases after college entry, the extent to which adverse life experiences contribute to any increases, and the impact of adversity, anxiety and depression on exam performance. 351 UK-domiciled undergraduates completed questionnaires one month before university entry and mid-course. The Hospital Anxiety and Depression Scale (HADS: Zigmond & Snaith, 1983) was administered at both time points and a modified List of Threatening Experiences (Brugha, Bebbington, Tennant, & Hurry, 1985) was administered mid-course. By mid-course 9% of previously symptom-free students became depressed and 20% became anxious at a clinically significant level. Of those previously anxious or depressed 36% had recovered. After adjusting for pre-entry symptoms, financial difficulties made a significant independent contribution to depression and relationship difficulties independently predicted anxiety. Depression and financial difficulties mid-course predicted a decrease in exam performance from first to second year. This is the first study to confirm empirically that financial and other difficulties can increase British students' levels of anxiety and depression and that financial difficulties and depression can affect academic performance. However, university life may also have a beneficial effect for some students with pre-existing conditions. With widening participation in higher education, the results have important implications for educational and health policies.

The clinical, occupational and financial outcomes associated with a bespoke specialist clinic for military aircrew-a cohort study.

PubMed

Pavitt, A J; Pavitt, C W; Harron, K; Jones, M; Timperley, A C; Reid, A N C; Mcloughlin, D; d'Arcy, J; Nicol, E D

2016-05-01

To assess the clinical, occupational and financial outcomes of a new Clinical Aviation Medicine Service (CAMS) for UK military personnel. Consecutive patients over a 2 year period were included. Predictors of flying restrictions at referral and final outcome following consultation were modelled using logistic regression. National Health Service (NHS) Payment by Results tariffs and Defence capitation data were used to assess the financial impact of the service. Eight hundred and sixteen new referrals (94.5% male, median age 45 years (range 19-75)) were received and 1025 consultations performed. Cardiovascular disease was the commonest reason for referral. CAMS clinical activity cost at NHS tariff was £453 310 representing a saving of £316 173 (£137 137 delivery cost). In total, 310/816 (38%) patients had employment restrictions on referral and 49.0% of this group returned to full employment following their initial consultation. Compared with cardiology, general medicine and respiratory patients were more likely to have been occupationally restricted prior to referral (50 vs. 35%, OR 1.81; 95% CI 1.18-2.76, P values=0.006 and 53 vs. 35%, OR 2.12; 95% CI 1.15-3.90, P values = 0.016, respectively). Overall 581/816 (71.2%) of patients returned to unrestricted employment while 98/816 (12.0%) were unable to continue in any aircrew role. The service saved 7000 lost working days per year at an estimated occupational saving of ∼£1 million per annum. This bespoke service has allowed rapid, occupationally relevant clinical care to be delivered with both time and financial savings. The model may have significant occupational and financial relevance for other environmental and occupational medical organizations. © Crown copyright 2015.

The clinical, occupational and financial outcomes associated with a bespoke specialist clinic for military aircrew—a cohort study

PubMed Central

Pavitt, A.J.; Pavitt, C.W.; Harron, K.; Jones, M.; Timperley, A.C.; Reid, A.N.C.; Mcloughlin, D.; d'Arcy, J.

2016-01-01

Objectives: To assess the clinical, occupational and financial outcomes of a new Clinical Aviation Medicine Service (CAMS) for UK military personnel. Methods: Consecutive patients over a 2 year period were included. Predictors of flying restrictions at referral and final outcome following consultation were modelled using logistic regression. National Health Service (NHS) Payment by Results tariffs and Defence capitation data were used to assess the financial impact of the service. Results: Eight hundred and sixteen new referrals (94.5% male, median age 45 years (range 19–75)) were received and 1025 consultations performed. Cardiovascular disease was the commonest reason for referral. CAMS clinical activity cost at NHS tariff was £453 310 representing a saving of £316 173 (£137 137 delivery cost). In total, 310/816 (38%) patients had employment restrictions on referral and 49.0% of this group returned to full employment following their initial consultation. Compared with cardiology, general medicine and respiratory patients were more likely to have been occupationally restricted prior to referral (50 vs. 35%, OR 1.81; 95% CI 1.18–2.76, P values=0.006 and 53 vs. 35%, OR 2.12; 95% CI 1.15–3.90, P values = 0.016, respectively). Overall 581/816 (71.2%) of patients returned to unrestricted employment while 98/816 (12.0%) were unable to continue in any aircrew role. The service saved 7000 lost working days per year at an estimated occupational saving of ∼£1 million per annum. Conclusions: This bespoke service has allowed rapid, occupationally relevant clinical care to be delivered with both time and financial savings. The model may have significant occupational and financial relevance for other environmental and occupational medical organizations. PMID:26424788

Developing a sustainable energy strategy for a water utility. Part I: A review of the UK legislative framework.

PubMed

Zakkour, P D; Gaterell, M R; Griffin, P; Gochin, R J; Lester, J N

2002-10-01

Increasing political effort to improve water quality across the UK and Europe has led to water and sewerage companies investing heavily in high-tech wastewater treatment plants capable of producing high quality effluents. Consequently, amounts of bought-in electricity used for wastewater treatment has and will continue to increase significantly over coming years, while greater provision of enhanced sewage treatment also produces greater volumes of sewage sludge requiring treatment and disposal. Over the same period, tougher controls on the quality of biosolids applied to agricultural land have also been introduced, while there has been an international attempt to reduce the use of fossil-fuel derived power sources because of concerns over global warming. The latter has brought about the introduction of financial instruments, such as the Climate Change Levy, to curb energy use, promote energy efficiency and encourage the development of renewable energy technologies. These factors are set to drive-up the costs of providing adequate sewage treatment services, while at the same time, a tough regulatory line taken to control profits on regional monopolies held by the UK water companies will significantly reduce their revenues over the period 2000-05. The result is that, financially, UK water and sewerage companies face their most challenging period since privatisation in 1989. This paper briefly outlines the current regulations relating to water quality and energy use that will affect water company operations over coming years.

Facing the future: the effects of the impending financial drought on NHS finances and how UK radiology services can contribute to expected efficiency savings

PubMed Central

Grant, L; Appleby, J; Griffin, N; Adam, A; Gishen, P

2012-01-01

The recent turmoil within the banking sector has led to the development of the most significant recession since the “great depression” of the 1930s. Although the coalition government has promised to “guarantee that health spending increases in real terms in each year of Parliament”, this may still not be enough to meet future needs over the coming years due to increasing demand and cost pressures. The expected mismatch between actual National Health Service (NHS) funding post-2011 and that required to satisfy increasing demand has been estimated by the Department of Health to require efficiency savings representing up to one-fifth of the overall NHS budget. This paper explains the reasons behind the anticipated slowdown in the growth of real NHS funding, and how, as a discipline, radiology can increase the efficiency of the services it provides in anticipation of future financial austerity within the NHS. PMID:22167516

Innovative UK Approaches to Acquisition Management

DTIC Science & Technology

2009-05-01

Financial and Operational Imperatives Size of UK armed forces UK Industry ? Political influence PFI / PPP Increased Scrutiny - NAO “ Commercialisation “ of the...acquisition KNOWLEDGE (EXPERIENCE – Lessons learned) KNOWLEDGE (Training) KNOWLEDGE ( Education ) OPTIMAL OPERATIONAL PERFORMANCE Operational Capability UK

Paediatric post-burn scar management in the UK: a national survey.

PubMed

Liuzzi, Francesca; Chadwick, Sarah; Shah, Mamta

2015-03-01

Thermal injuries affect 250,000 people annually in the United Kingdom. As burn survival improves, good scar management is paramount to help individuals living with the resultant scars lead a life without restrictions. Post-burn hypertrophic scars can limit growth in children, interfere with function and cause psychological problems. In the current literature there is great variation in post-burn scar management across the world and in the evidence available for the efficacy of these management modalities. The aim of this study was to investigate the variances if any, in the management of post-burn scarring in children across the UK. A telephone survey of UK paediatric burn services was conducted to obtain information on post-burn scar management and advice given to patients/carers. Of the 19 burn services that participated, all advised moisturising of scars but with variable emphasis on massaging. Silicones and pressure therapy were used by 18 services but commencement of use varied from soon after healing to onset of hypertrophic scarring. Laser therapy, ultrasound therapy and steroid therapy were used sporadically. This study highlights the common modalities of post-burn scar management in children across the UK. However, there is marked variation in timing and selection of the commonly used modalities. Although this study did not investigate the outcomes of scar management, it clearly identifies the need for a well-designed multi-centred study to establish evidence-based best practice in the management of post-burn scarring in children as these modalities are time consuming and not without potential complications. Evidence based practice could potentially lead to significant financial savings to the health service. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Optimising UK urban road verge contributions to biodiversity and ecosystem services with cost-effective management.

PubMed

O'Sullivan, Odhran S; Holt, Alison R; Warren, Philip H; Evans, Karl L

2017-04-15

Urban road verges can contain significant biodiversity, contribute to structural connectivity between other urban greenspaces, and due to their proximity to road traffic are well placed to provide ecosystem services. Using the UK as a case study we review and critically evaluate a broad range of evidence to assess how this considerable potential can be enhanced despite financial, contractual and public opinion constraints. Reduced mowing frequency and other alterations would enhance biodiversity, aesthetics and pollination services, whilst delivering costs savings and potentially being publically acceptable. Retaining mature trees and planting additional ones is favourable to residents and would enhance biodiversity, pollution and climate regulation, carbon storage, and stormwater management. Optimising these services requires improved selection of tree species, and creating a more diverse tree stock. Due to establishment costs additional tree planting and maintenance could benefit from payment for ecosystem service schemes. Verges could also provide areas for cultivation of biofuels and possibly food production. Maximising the contribution of verges to urban biodiversity and ecosystem services is economical and becoming an increasingly urgent priority as the road network expands and other urban greenspace is lost, requiring enhancement of existing greenspace to facilitate sustainable urban development. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Exposing the impact of Citizens Advice Bureau services on health: a realist evaluation protocol.

PubMed

Forster, N; Dalkin, S M; Lhussier, M; Hodgson, P; Carr, S M

2016-01-20

Welfare advice services can be used to address health inequalities, for example, through Citizens Advice Bureau (CAB). Recent reviews highlight evidence for the impact of advice services in improving people's financial position and improving mental health and well-being, daily living and social relationships. There is also some evidence for the impact of advice services in increasing accessibility of health services, and reducing general practitioner appointments and prescriptions. However, direct evidence for the impact of advice services on lifestyle behaviour and physical health is currently much less well established. There is a need for greater empirical testing of theories around the specific mechanisms through which advice services and associated financial or non-financial benefits may generate health improvements. A realist evaluation will be conducted, operationalised in 5 phases: building the explanatory framework; refining the explanatory framework; testing the explanatory framework through empirical data (mixed methods); development of a bespoke data recording template to capture longer term impact; and verification of findings with a range of CAB services. This research will therefore aim to build, refine and test an explanatory framework about how CAB services can be optimally implemented to achieve health improvement. The study was approved by the ethics committee at Northumbria University, UK. Project-related ethical issues are described and quality control aspects of the study are considered. A stakeholder mapping exercise will inform the dissemination of results in order to ensure all relevant institutions and organisations are targeted. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Public acceptability of financial incentives to reward pregnant smokers who quit smoking: a United Kingdom-France comparison.

PubMed

Berlin, Noémi; Goldzahl, Léontine; Bauld, Linda; Hoddinott, Pat; Berlin, Ivan

2018-06-01

A substantial amount of research has been conducted on financial incentives to increase abstinence from smoking among pregnant smokers. If demonstrated to be effective, financial incentives could be proposed as part of health care interventions to help pregnant smokers quit. Public acceptability is important; as such interventions could be publicly funded. Concerns remain about the acceptability of these interventions in the general population. We aimed to assess the acceptability of financial incentives to reward pregnant smokers who stop smoking using a survey conducted in the UK and then subsequently in France, two developed countries with different cultural and social backgrounds. More French than British respondents agreed with financial incentives for rewarding quitting smoking during pregnancy, not smoking after delivery, keeping a smoke-free household, health service payment for meeting target and the maximum amount of the reward. However, fully adjusted models showed significant differences only for the two latter items. More British than French respondents were neutral toward financial incentives. Differences between the representative samples of French and British individuals demonstrate that implementation of financial incentive policies may not be transferable from one country to another.

Do health partnerships with organisations in lower income countries benefit the UK partner? A review of the literature.

PubMed

Jones, Felicity Ae; Knights, Daniel Ph; Sinclair, Vita Fe; Baraitser, Paula

2013-08-30

Health partnerships between institutions in the UK and Low or Lower- middle Income Countries are an increasingly important model of development, yet analysis of partnerships has focused on benefits and costs to the Low and Lower- Middle Income partner. We reviewed the evidence on benefits and costs of health partnerships to UK individuals, institutions & the NHS and sought to understand how volunteering within partnerships might impact on workforce development and service delivery. A systematic review of both published literature and grey literature was conducted. Content relating to costs or benefits to the UK at an individual, institutional or system level was extracted and analysed by thematic synthesis. The benefits of volunteering described were mapped to the key outcome indicators for five different UK professional development structures. A framework was developed to demonstrate the link between volunteer experience within partnerships and improved UK service delivery outcomes. The literature review (including citation mapping) returned 9 published papers and 32 pieces of grey literature that met all inclusion criteria. 95% of sources cited benefits and 32% cited costs. Most literature does not meet high standards of formal academic rigor. Forty initial individual benefits codes were elicited. These were then grouped into 7 key domains: clinical skills; management skills; communication & teamwork; patient experience & dignity; policy; academic skills; and personal satisfaction & interest. A high degree of concordance was shown between professional benefits cited and professional development indicators within UK work force development frameworks. A theoretical trajectory from volunteer experience to UK service delivery outcomes was demonstrated in most areas, but not all. 32% of sources cited costs, yielding 15 initial codes which were grouped into 5 domains: financial; reputational; health & security; loss of staff; and opportunity costs. There is little published or unpublished literature on the impact of volunteering within health partnerships to British individuals, institutions or the UK. The existing evidence base is descriptive and focuses on the benefits of volunteering. More work is required to quantify the costs and benefits of volunteering within health partnerships for individuals and institutions, and the associated challenges and barriers. Despite these limitations our analysis suggests that there is a strong theoretical argument that the skills acquired through volunteering are transferable to service delivery within the NHS and that the benefits to individuals and institutions could be maximised when volunteering is formally embedded within continuing professional development processes.

Cost-effectiveness of routine imaging of suspected appendicitis.

PubMed

D'Souza, N; Marsden, M; Bottomley, S; Nagarajah, N; Scutt, F; Toh, S

2018-01-01

Introduction The misdiagnosis of appendicitis and consequent removal of a normal appendix occurs in one in five patients in the UK. On the contrary, in healthcare systems with routine cross-sectional imaging of suspected appendicitis, the negative appendicectomy rate is around 5%. If we could reduce the rate in the UK to similar numbers, would this be cost effective? This study aimed to calculate the financial impact of negative appendicectomy at the Queen Alexandra Hospital and to explore whether a policy of routine imaging of such patients could reduce hospital costs. Materials and methods We performed a retrospective analysis of all appendicectomies over a 1-year period at our institution. Data were extracted on outcomes including appendix histology, operative time and length of stay to calculate the negative appendicectomy rate and to analyse costs. Results A total of 531 patients over 5 years of age had an appendicectomy. The negative appendicectomy rate was 22% (115/531). The additional financial costs of negative appendicectomy to the hospital during this period were £270,861. Universal imaging of all patients with right iliac fossa pain that could result in a 5% negative appendicectomy rate would cost between £67,200 and £165,600 per year but could save £33,896 (magnetic resonance imaging), £105,896 (computed tomography) or £132,296 (ultrasound) depending on imaging modality used. Conclusions Negative appendicectomy is still too frequent and results in additional financial burden to the health service. Routine imaging of patients with suspected appendicitis would not only reduce the negative appendicectomy rate but could lead to cost savings and a better service for our patients.

Greater physician involvement improves coding outcomes in endobronchial ultrasound-guided transbronchial needle aspiration procedures.

PubMed

Pillai, Anilkumar; Medford, Andrew R L

2013-01-01

Correct coding is essential for accurate reimbursement for clinical activity. Published data confirm that significant aberrations in coding occur, leading to considerable financial inaccuracies especially in interventional procedures such as endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Previous data reported a 15% coding error for EBUS-TBNA in a U.K. service. We hypothesised that greater physician involvement with coders would reduce EBUS-TBNA coding errors and financial disparity. The study was done as a prospective cohort study in the tertiary EBUS-TBNA service in Bristol. 165 consecutive patients between October 2009 and March 2012 underwent EBUS-TBNA for evaluation of unexplained mediastinal adenopathy on computed tomography. The chief coder was prospectively electronically informed of all procedures and cross-checked on a prospective database and by Trust Informatics. Cost and coding analysis was performed using the 2010-2011 tariffs. All 165 procedures (100%) were coded correctly as verified by Trust Informatics. This compares favourably with the 14.4% coding inaccuracy rate for EBUS-TBNA in a previous U.K. prospective cohort study [odds ratio 201.1 (1.1-357.5), p = 0.006]. Projected income loss was GBP 40,000 per year in the previous study, compared to a GBP 492,195 income here with no coding-attributable loss in revenue. Greater physician engagement with coders prevents coding errors and financial losses which can be significant especially in interventional specialties. The intervention can be as cheap, quick and simple as a prospective email to the coding team with cross-checks by Trust Informatics and against a procedural database. We suggest that all specialties should engage more with their coders using such a simple intervention to prevent revenue losses. Copyright © 2013 S. Karger AG, Basel.

Increased household financial strain, the Great Recession and child health-findings from the UK Millennium Cohort Study.

PubMed

McKenna, Caoimhe; Law, Catherine; Pearce, Anna

2017-03-09

There is a growing body of evidence associating financial strain (FS) with poor health but most of this research has been cross-sectional and adult-focused. During the 'Great Recession' many UK households experienced increased FS. The primary aim of this study was to determine the impact of increased FS on child health. We analysed the Millennium Cohort Study, a longitudinal study of children born in the UK between 2000 and 2002. Surveys at 7 years (T1, 2008) and 11 years (T2, 2012) spanned the 'Great Recession'. Three measures of increased FS were defined; 'became income poor' (self-reported household income dropped below the 'poverty line' between T1 and T2); 'developed difficulty managing' (parental report of being 'financially comfortable' at T1 and finding it 'difficult to manage' at T2); 'felt worse off' (parental report of feeling financially 'worse off' at T2 compared with T1). Poisson regression was used to estimate risk ratios (RR), adjusted risk ratios (aRR) and 95% CIs for six child health outcomes: measured overweight/obesity, problematic behaviour as scored by parents and teachers, and parental reports of fair/poor general health, long-standing illness and bedwetting at T2 (N=13 112). In subanalyses we limited our sample to those who were above the poverty line at T2. Compared with those who were not financially strained at both time points, children in households which experienced increased FS were at an increased risk of all unhealthy outcomes examined. In most cases, these increased risks persisted after adjustment for confounding and when limiting the sample to those above the poverty line. FS is associated with a range of new or continued poor child health outcomes. During times of widespread economic hardship, such as the 'Great Recession', measures should be taken to buffer children and their families from the impact of FS, and these should not be limited to those who are income poor. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

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

PubMed

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

2015-04-01

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

Financial appraisal of wet mesophilic AD technology as a renewable energy and waste management technology.

PubMed

Dolan, T; Cook, M B; Angus, A J

2011-06-01

Anaerobic digestion (AD) has the potential to support diversion of organic waste from landfill and increase renewable energy production. However, diffusion of this technology has been uneven, with countries such as Germany and Sweden taking the lead, but limited diffusion in other countries such as the UK. In this context, this study explores the financial viability of AD in the UK to offer reasons why it has not been more widely used. This paper presents a model that calculates the Internal Rate of Return (IRR) on a twenty year investment in a 30,000 tonnes per annum wet mesophilic AD plant in the UK for the treatment of source separated organic waste, which is judged to be a suitable technology for the UK climate. The model evaluates the financial significance of the different alternative energy outputs from this AD plant and the resulting economic subsidies paid for renewable energy. Results show that renewable electricity and renewable heat sales supported by renewable electricity and renewable heat tariffs generates the greatest IRR (31.26%). All other uses of biogas generate an IRR in excess of 15%, and are judged to be a financially viable investment. Sensitivity analysis highlights the financial significance of: economic incentive payments and a waste management gate fee; and demonstrates that the fate of the digestate by-product is a source of financial uncertainty for AD investors. Copyright © 2011 Elsevier B.V. All rights reserved.

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

ERIC Educational Resources Information Center

Van Hoorebeek, Mark; Marson, James

2005-01-01

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

Can It Really Be as Good as It Seems? The Financial Health of the UK HE Sector

ERIC Educational Resources Information Center

Palfreyman, David

2013-01-01

The accountants Grant Thornton (GT) do a welcome and nice piece of pro bono work by analysing the annual accounts of the UK's 160 (sic) HEIs and compiling a report on "The Financial Health of the Higher Education Sector"--this year entitled "The calm before the storm"! GT duly note that, if the US Department of Education's…

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

ERIC Educational Resources Information Center

Universities UK, 2010

2010-01-01

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

Citizens advice in primary care: a qualitative study of the views and experiences of service users and staff.

PubMed

Burrows, J; Baxter, S; Baird, W; Hirst, J; Goyder, E

2011-10-01

To examine the views and experiences of staff and users of Citizens Advice Bureau (CAB) services located in general practice, and to identify key factors perceived as contributing to the intervention's effectiveness. A qualitative study in an urban and rural primary care setting in the UK. Semi-structured, face-to-face interviews (n = 22) with primary care and practice staff, CAB advisors and 12 service users. Key positive service features reported by all groups were: the confidential, non-stigmatizing and familiar environment of a general practitioner's (GP) surgery; the ability to make appointments and experienced advisor availability and continuity. Outcomes for service users were described as financial gain, managed debt, and beneficial social and mental health impacts. Perceived staff benefits were appropriate referral and better use of GP consultation time. Welfare advice in primary care has financial benefits and was perceived by participants to offer health and other benefits to patients and staff. However, while perceptions of gain from the intervention were evident, demonstration of measurable health improvement and well-being presents challenges. Further empirical work is needed in order to explore these complex cause-effect links and the cost-effectiveness of the intervention. Copyright © 2011 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Maintaining pre-school children's health and wellbeing in the UK: a qualitative study of the views of migrant parents

PubMed Central

Condon, L.J.; McClean, S.

2017-01-01

Abstract Background There is evidence that key health behaviours of people who migrate deteriorate over time, which has a consequent impact upon the health of dependent children. As health in the early years sets the course for lifelong health, it is important to explore parents' views on maintaining children's health following migration. Methods Five focus groups were held with parents of preschool children who had migrated to the UK within the last 10 years (n = 28). Parents originated from Romania, Poland, Somalia and Pakistan, with one group of Roma Gypsy parents. Data collection took place in January to March 2015. Results All groups, apart from the Roma, perceived barriers to maintaining optimal health and well-being for their preschool children following migration to the UK. Eastern European parents experienced difficulties in ensuring family financial security, while parents from more established communities focused on barriers to children's exercise, play and nutrition. Conclusions This study highlights aspects of public health where migrants and their children can experience adverse effects in the UK. These findings have implications for policymakers, commissioners and providers of health services who aim to promote good health among preschool children. PMID:27591301

When politics meets science: What impact might Brexit have on organ donation and transplantation in the United Kingdom?

PubMed

Shapey, Iestyn M; Summers, Angela M; Simkin, Iain J; Augustine, Titus; van Dellen, David

2018-06-21

Brexit may lead to major political, societal, and financial changes-this has significant implications for a tax revenue funded healthcare system such as the United Kingdom's (UK) National Health Service. The complex relationship between European Union (EU) legislation and clinical practice of organ donation and transplantation is poorly understood. However, it is unclear what impact Brexit may have on organ donation and transplantation in the UK and EU. This work aims to describe the current legislative interactions affecting organ donation and transplantation regulation and governance within the UK and EU. We consider the potential impact of Brexit on the practical aspects of transplantation such organ-sharing networks, logistics, and the provision of health care for transplant patients when traveling to the EU from the UK and vice versa, as well as personnel, and research. Successful organ donation and transplantation practices rely on close collaboration and co-operation across Europe and throughout the United Kingdom. The continuation of such relationships, despite the proposed legislative change, will remain a vital and necessary component for the ongoing success of transplantation programs. © 2018 The Authors. Clinical Transplantation Published by John Wiley & Sons Ltd.

The impact of pay-for-performance on professional boundaries in UK general practice: an ethnographic study.

PubMed

Grant, Suzanne; Huby, Guro; Watkins, Francis; Checkland, Kath; McDonald, Ruth; Davies, Huw; Guthrie, Bruce

2009-03-01

The 2004 new General Medical Services (nGMS) contract exemplifies trends across the public services towards increased definition, measurement and regulation of professional work, with general practice income now largely dependent on the quality of care provided across a range of clinical and organisational indicators known collectively as the 'Quality and Outcomes Framework' (QOF). This paper reports an ethnographically based study of the impact of the new contract and the financial incentives contained within it on professional boundaries in UK general practice. The distribution of clinical and administrative work has changed significantly and there has been a new concentration of authority, with QOF decision making and monitoring being led by an internal QOF team of clinical and managerial staff who make the major practice-level decisions about QOF, monitor progress against targets, and intervene to resolve areas or indicators at risk of missing targets. General practitioners and nurses, however, appear to have accommodated these changes by re-creating long established narratives on professional boundaries and clinical hierarchies. This paper is concerned with the impact of these new arrangements on existing clinical hierarchies.

The Impact of Austerity on Mental Health Service Provision: A UK Perspective.

PubMed

Cummins, Ian

2018-06-01

This is a discussion paper which examines the impact of austerity policies on the provision of mental health services in the United Kingdom. Austerity is a shorthand for a series of policies introduced by the Conservative and Liberal Democrat Coalition government in the UK from 2010 onwards. In response to the fiscal crisis following the bail out of the banks in 2008, it was argued that significant reductions in public spending were required. The background to these policies is examined before a consideration of their impact on mental health services. These policies had a disproportionate impact on people living in poverty. People with health problems including mental problems are overrepresented in this group. At the same time, welfare and community services are under increasing financial pressures having to respond to increased demand within a context of reduced budgets. There is increasing recognition of the role that social factors and adverse childhood experiences have in the development and trajectory of mental health problems. Mental health social workers, alongside other professionals, seek to explain mental distress by the use of some variant of a biopsychosocial model. The extent of mental health problems as a one of their measures of the impact of inequality. More unequal societies create greater levels of distress. There is a social gradient in the extent of mental health problems-the impact of severe mental illness means that many individuals are unable to work or, if they can return to work, they find it difficult to gain employment because of discrimination. The paper concludes that austerity and associated policies have combined to increase the overall burden of mental distress and marginalisation within the UK.

Avoiding a bad apple: Insect pollination enhances fruit quality and economic value☆

PubMed Central

Garratt, M.P.D.; Breeze, T.D.; Jenner, N.; Polce, C.; Biesmeijer, J.C.; Potts, S.G.

2014-01-01

Insect pollination is important for food production globally and apples are one of the major fruit crops which are reliant on this ecosystem service. It is fundamentally important that the full range of benefits of insect pollination to crop production are understood, if the costs of interventions aiming to enhance pollination are to be compared against the costs of the interventions themselves. Most previous studies have simply assessed the benefits of pollination to crop yield and ignored quality benefits and how these translate through to economic values. In the present study we examine the influence of insect pollination services on farmgate output of two important UK apple varieties; Gala and Cox. Using field experiments, we quantify the influence of insect pollination on yield and importantly quality and whether either may be limited by sub-optimal insect pollination. Using an expanded bioeconomic model we value insect pollination to UK apple production and establish the potential for improvement through pollination service management. We show that insects are essential in the production of both varieties of apple in the UK and contribute a total of £36.7 million per annum, over £6 million more than the value calculated using more conventional dependence ratio methods. Insect pollination not only affects the quantity of production but can also have marked impacts on the quality of apples, influencing size, shape and effecting their classification for market. These effects are variety specific however. Due to the influence of pollination on both yield and quality in Gala, there is potential for insect pollination services to improve UK output by up to £5.7 million per annum. Our research shows that continued pollinator decline could have serious financial implications for the apple industry but there is considerable scope through management of wild pollinators or using managed pollinator augmentation, to improve the quality of production. Furthermore, we show that it is critically important to consider all production parameters including quality, varietal differences and management costs when valuing the pollination service of any crop so investment in pollinator management can be proportional to its contribution. PMID:24748698

Avoiding a bad apple: Insect pollination enhances fruit quality and economic value.

PubMed

Garratt, M P D; Breeze, T D; Jenner, N; Polce, C; Biesmeijer, J C; Potts, S G

2014-02-01

Insect pollination is important for food production globally and apples are one of the major fruit crops which are reliant on this ecosystem service. It is fundamentally important that the full range of benefits of insect pollination to crop production are understood, if the costs of interventions aiming to enhance pollination are to be compared against the costs of the interventions themselves. Most previous studies have simply assessed the benefits of pollination to crop yield and ignored quality benefits and how these translate through to economic values. In the present study we examine the influence of insect pollination services on farmgate output of two important UK apple varieties; Gala and Cox. Using field experiments, we quantify the influence of insect pollination on yield and importantly quality and whether either may be limited by sub-optimal insect pollination. Using an expanded bioeconomic model we value insect pollination to UK apple production and establish the potential for improvement through pollination service management. We show that insects are essential in the production of both varieties of apple in the UK and contribute a total of £36.7 million per annum, over £6 million more than the value calculated using more conventional dependence ratio methods. Insect pollination not only affects the quantity of production but can also have marked impacts on the quality of apples, influencing size, shape and effecting their classification for market. These effects are variety specific however. Due to the influence of pollination on both yield and quality in Gala, there is potential for insect pollination services to improve UK output by up to £5.7 million per annum. Our research shows that continued pollinator decline could have serious financial implications for the apple industry but there is considerable scope through management of wild pollinators or using managed pollinator augmentation, to improve the quality of production. Furthermore, we show that it is critically important to consider all production parameters including quality, varietal differences and management costs when valuing the pollination service of any crop so investment in pollinator management can be proportional to its contribution.

Patient choice and mobility in the UK health system: internal and external markets.

PubMed

Dusheiko, Mark

2014-01-01

The National Health Service (NHS) has been the body of the health care system in the United Kingdom (UK) for over 60 years and has sought to provide the population with a high quality service free of user charges for most services. The information age has seen the NHS rapidly transformed from a socialist, centrally planned and publicly provided system to a more market based system orientated towards patients as consumers. The forces of globalization have provided patients in the UK with greater choice in their health care provision, with NHS treatment now offered from any public or approved private provider and the possibility of treatment anywhere in the European Economic Area (EEA) or possibly further. The financial crisis, a large government deficit and austerity public spending policies have imposed a tight budget constraint on the NHS at a time of increasing demand for health care and population pressure. Hence, further rationing of care could imply that patients are incentivised to seek private treatment outside the constraints of the NHS, where the possibility of much greater choice exists in an increasingly globally competitive health care market. This chapter examines the evidence on the response of patients to the possibilities of increased choice and mobility within the internal NHS and external overseas health care markets. It also considers the relationships between patient mobility, health care provision and health policy. Patients are more mobile and willing to travel further to obtain better care outcomes and value for money, but are exposed to greater risk.

A survey of current and anticipated use of standard and specialist equipment by UK optometrists.

PubMed

Dabasia, Priya L; Edgar, David F; Garway-Heath, David F; Lawrenson, John G

2014-09-01

To investigate current and anticipated use of equipment and information technology (IT) in community optometric practice in the UK, and to elicit optometrists' views on adoption of specialist equipment and IT. An anonymous online questionnaire was developed, covering use of standard and specialist diagnostic equipment, and IT. The survey was distributed to a random sample of 1300 UK College of Optometrists members. Four hundred and thirty-two responses were received (response rate = 35%). Enhanced (locally commissioned) or additional/separately contracted services were provided by 73% of respondents. Services included glaucoma repeat measures (30% of respondents), glaucoma referral refinement (22%), fast-track referral for wet age-related macular degeneration (48%), and direct cataract referral (40%). Most respondents (88%) reported using non-contact/pneumo tonometry for intra-ocular pressure measurement, with 81% using Goldmann or Perkins tonometry. The most widely used item of specialist equipment was the fundus camera (74% of respondents). Optical Coherence Tomography (OCT) was used by 15% of respondents, up from 2% in 2007. Notably, 43% of those anticipating purchasing specialist equipment in the next 12 months planned to buy an OCT. 'Paperless' records were used by 39% of respondents, and almost 80% of practices used an electronic patient record/practice management system. Variations in responses between parts of the UK reflect differences in the provision of the General Ophthalmic Services contract or community enhanced services. There was general agreement that specialised equipment enhances clinical care, permits increased involvement in enhanced services, promotes the practice and can be used as a defence in clinico-legal cases, but initial costs and ongoing maintenance can be a financial burden. Respondents generally agreed that IT facilitates administrative flow and secure exchange of health information, and promotes a state-of-the-art practice image. However, use of IT may not save examination time; its dynamic nature necessitates frequent updates and technical support; the need for adequate training is an issue; and security of data is also a concern. UK optometrists increasingly employ modern equipment and IT services to enhance patient care and for practice management. While the clinical benefits of specialist equipment and IT are appreciated, questions remain as to whether the investment is cost-effective, and how specialist equipment and IT may be used to best advantage in community optometric practice. © 2014 The Authors. Ophthalmic and Physiological Optics published by John Wiley & Sons Ltd on behalf of College of Optometrists.

Waiting times for hospital admissions: the impact of GP fundholding.

PubMed

Propper, Carol; Croxson, Bronwyn; Shearer, Arran

2002-03-01

Waiting times for hospital care are a significant issue in the UK National Health Service (NHS). The reforms of the health service in 1990 gave a subset of family doctors (GP fundholders) both the ability to choose the hospital where their patients were treated and the means to pay for some services. One of the key factors influencing family doctors' choice of hospital was patient waiting time. However, without cash inducements, hospitals would get no direct reward from giving shorter waiting times to a subset of patients. Using a unique dataset, we investigate whether GP fundholders were able to secure shorter waiting times for their patients, whether they were able to do so in cases where they had no financial rewards to offer hospitals, and whether the impact of fundholding spilled over into shorter waiting times for all patients.

Responsibility for Financial Management in Primary Schools: Evidence from an English Local Authority

ERIC Educational Resources Information Center

Fitzgerald, Sarah; Drake, Julie

2013-01-01

Financial management in primary schools has changed in the UK with the introduction of the Schools Financial Value Standard (SFVS). There is increasing delegation of financial responsibility to the management team in the school, increasing the role of the head teacher and the governing body as part of overall responsibility for the strategic…

Pay-for-performance: too much of a good thing? A conversation with Martin Roland. Interview by Robert Galvin.

PubMed

Roland, Martin

2006-01-01

As the United States moves down the road of pay-for-performance (P4P), concerns about unintended consequences are foremost in the minds of policymakers. Initial results from the world's most ambitious P4P program, the United Kingdom's Quality and Outcomes Framework (QOF), indicate that while quality improvements exceeded expectations, so too did the amount of funds paid out, straining the National Health Service (NHS) budget. Martin Roland, one of the leading U.K. health services researchers and an adviser to the QOF, gives his views on what went right and what went wrong, and he offers his advice to the United States about using financial incentives to improve quality.

Students and Sex Work in the UK: Providers and Purchasers

ERIC Educational Resources Information Center

Roberts, Ron; Jones, Amy; Sanders, Teela

2013-01-01

Available evidence suggests that changes in the funding of UK higher education in recent years have been accompanied by an increased student presence in the sex industry, ostensibly for financial reasons and to make ends meet. The current study comprises a sample of students ("N" = 200) drawn from several universities in the UK. Data…

An Exploration of the Relationship between Training Grants and Profitability of UK Construction Companies

ERIC Educational Resources Information Center

Abdel-Wahab, Mohamed; Dainty, Andrew R. J.; Ison, Stephen G.; Hazlehurst, Guy

2008-01-01

A levy/grant system exists in the UK construction industry to provide financial support for companies undertaking training activities. With the current UK government skills policy, there is an emphasis on ensuring that training support provided to employers is aimed at enhancing companies' profitability. This paper explores the profitability of…

What is Good University Financial Management?

ERIC Educational Resources Information Center

Taylor, Mark P.

2013-01-01

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

Behavioural health consultants in integrated primary care teams: a model for future care.

PubMed

Dale, Hannah; Lee, Alyssa

2016-07-29

Significant challenges exist within primary care services in the United Kingdom (UK). These include meeting current demand, financial pressures, an aging population and an increase in multi-morbidity. Psychological services also struggle to meet waiting time targets and to ensure increased access to psychological therapies. Innovative ways of delivering effective primary care and psychological services are needed to improve health outcomes. In this article we argue that integrated care models that incorporate behavioural health care are part of the solution, which has seldom been argued in relation to UK primary care. Integrated care involves structural and systemic changes to the delivery of services, including the co-location of multi-disciplinary primary care teams. Evidence from models of integrated primary care in the United States of America (USA) and other higher-income countries suggest that embedding continuity of care and collaborative practice within integrated care teams can be effective in improving health outcomes. The Behavioural Health Consultant (BHC) role is integral to this, working psychologically to support the team to improve collaborative working, and supporting patients to make changes to improve their health across management of long-term conditions, prevention and mental wellbeing. Patients' needs for higher-intensity interventions to enable changes in behaviour and self-management are, therefore, more fully met within primary care. The role also increases accessibility of psychological services, delivers earlier interventions and reduces stigma, since psychological staff are seen as part of the core primary care service. Although the UK has trialled a range of approaches to integrated care, these fall short of the highest level of integration. A single short pilot of integrated care in the UK showed positive results. Larger pilots with robust evaluation, as well as research trials are required. There are clearly challenges in adopting such an approach, especially for staff who must adapt to working more collaboratively with each other and patients. Strong leadership is needed to assist in this, particularly to support organisations to adopt the shift in values and attitudes towards collaborative working. Integrated primary care services that embed behavioural health as part of a multi-disciplinary team may be part of the solution to significant modern day health challenges. However, developing this model is unlikely to be straight-forward given current primary care structures and ways of working. The discussion, developed in this article, adds to our understanding of what the BHC role might consist off and how integrated care may be supported by such behavioural health expertise. Further work is needed to develop this model in the UK, and to evaluate its impact on health outcomes and health care utilisation, and test robustly through research trials.

The state of primary care in the United States of America and lessons for primary care groups in the United Kingdom.

PubMed

Koperski, M

2000-04-01

The health care system of the United States of America (USA) is lavishly funded and those with adequate insurance usually receive excellent attention. However, the system is fragmented and inequitable. Health workers often find it difficult to separate vocational roles from business roles. Care tends to focus on the acute rather than the chronic, on 'episodes of illness' rather than 'person-centred' care, on short-term fixes rather than long-term approaches, on scientific/technical solutions rather than discourse or the 'art of healing', and on individual health rather than population health. The majority of US doctors are trained in the 'hightech' hospital paradigm and there is no equivalent of the United Kingdom (UK) general practitioner (GP), who lies at the hub of a primary health care team (PHCT) and who is charged with taking a long-term view, co-ordinating health care for individual patients, and acting as patient advocate without major conflicting financial incentives. However, primary care groups/trusts (PCGs) could learn from US management and training techniques, case management, NHS Direct equivalents, and the effects of poorly developed PHCTs. PCGs could develop the UK's own version of utilisation management. A cash-limited, unified budget within an underfunded National Health Service poses threats to general practice. In both the USA and the UK, primary care is a prominent tool in new attempts at cost control. PCGs offer the opportunity of better integration with public health and social services, but threaten GPs' role as independent advocates by giving them a rationing role. Managed care has forced a similar role onto our US counterparts with consequent public displeasure and professional disillusion. UK GPs will have to steer a careful course if they are to avoid a similar fate.

Cancer survivors' views of work 3 years post diagnosis: a UK perspective.

PubMed

Amir, Ziv; Neary, David; Luker, Karen

2008-07-01

The impact of cancer on people's working lives is an increasingly important concern but knowledge on this issue is very limited in the UK. Forty-one people of working age were purposively selected from the North Western Cancer Intelligence Service and interviewed by telephone to describe their experiences to returning to work following diagnosis and treatment. The data was subject to qualitative thematic analysis using NVIVO software. The results indicated the importance of returning to work from diagnosis and through treatment which was then followed by a re-assessment of work-life balance when people recovered from primary treatment and were back in employment. The principle motivations for returning to work were a quest for normality and financial pressures. One barrier to returning to work was the lack of medical advice from cancer specialists and general practitioners regarding the appropriate time to get back to work. A good relationship with their employer/manager was a major influence on returning to work and appeared to be related to duration of service rather than occupational status. These findings demonstrate the importance of paid work to people diagnosed with cancer and highlight the need to improve the support from medical professionals, especially oncology nurses.

Acceptability of financial incentives for breastfeeding: thematic analysis of readers' comments to UK online news reports.

PubMed

Giles, Emma L; Holmes, Matthew; McColl, Elaine; Sniehotta, Falko F; Adams, Jean M

2015-05-16

Whilst it is recommended that babies are breastfed exclusively for the first six months, many mothers do not maintain breastfeeding for this length of time. Previous research confirms that women and midwives value financial incentives for breastfeeding, but limited research has explored the wider acceptability of these interventions to the general public. This paper examines opinion towards financial incentives for breastfeeding using reader responses to UK on-line media coverage of a study undertaken in this area. This study used netnography to undertake a thematic analysis of 3,373 reader comments posted in response to thirteen articles, published in November 2013, which reported findings from a feasibility study of financial incentives for breastfeeding. All articles were published on one of six UK news websites that achieved a monthly audience of at least five million viewers across laptop and desktop computers and mobile devices during April-May 2013. Nine analytical themes were identified, with a majority view that financial incentives for breastfeeding are unacceptable. These themes cover a range of opinions: from negligent parents unable to take responsibility for their own actions; through to psychologically vulnerable members of society who should be protected from coercion and manipulation; to capable and responsible women who can, and should be allowed to, make their own decisions. Many views focused on the immediate costs of the intervention, concluding that this was something that was currently unaffordable to fund (e.g. by the NHS). Others contrasted the value of the incentive against other 'costs' of breastfeeding. There was some consideration of the issue of cost-effectiveness and cost-saving, where the potential future benefit from initial investment was identified. Many commenters identified that financial incentives do not address the many structural and cultural barriers to breastfeeding. Overall, those commenting on the on-line UK news articles viewed financial incentives for breastfeeding as unacceptable and that alternative, structural, interventions were likely to be more effective. Further consideration of how best to conduct internet-based qualitative research to elicit opinion towards public health issues is required.

Recession, debt and mental health: challenges and solutions

PubMed Central

2009-01-01

Background During the economic downturn, the link between recession and health has featured in many countries' media, political, and medical debate. This paper focuses on the previously neglected relationship between personal debt and mental health. Aims Using the UK as a case study, this paper considers the public health challenges presented by debt to mental health. We then propose solutions identified in workshops held during the UK Government's Foresight Review of Mental Capital and Wellbeing. Results Within their respective sectors, health professionals should receive basic ‘debt first aid’ training, whilst all UK financial sector codes of practice should – as a minimum – recognise the existence of customers with mental health problems. Further longitudinal research is also needed to ‘unpack’ the relationship between debt and mental health. Across sectors, a lack of co-ordinated activity across health, money advice, and creditor organisations remains a weakness. A renewed emphasis on co-ordinated ‘debt care pathways’ and better communication between local health and advice services is needed. Discussion The relationship between debt and mental health presents a contemporary public health challenge. Solutions exist, but will require action and investment at a time of competition for funds. PMID:22477896

Assessing strategic behaviour within the acute sector of the National Health Service.

PubMed

Chaston, I

1994-01-01

The creation of the internal market has merely been the latest progression in the change processes confronting the NHS over recent years as the UK Government searches for new ways of expanding patient output while concurrently restricting provision of additional financial resources. To assist in the implementation of change, acute sector providers have introduced managerial concepts from the private sector such as strategic planning. It is not clear, however, whether these techniques are appropriate or effective in the management of health-care services. A survey was undertaken to gain the perspectives of middle managers in acute units on the degree to which senior management involves them in determining performance goals and strategic plans. Results indicate that in most units, the orientation of senior management is to retain control over key issues associated with strategic planning and to minimize the degree to which the workforce is involved in any decision-making processes. Reviewing these results relative to the service-sector management theories concerning the options of industrializing or employee empowerment strategies indicates that senior management in the acute sector is operating a production-line service output philosophy. Although this orientation may meet the immediate needs of the UK Government, a review of how this strategic philosophy has severely weakened Western firms' position in world markets provides a basis for examining whether greater economic advantages might accrue to Britain by redirecting the management of change in the NHS towards a strategic philosophy based on employee empowerment.

"It pains me because as a woman you have to breastfeed your baby": decision-making about infant feeding among African women living with HIV in the UK.

PubMed

Tariq, Shema; Elford, Jonathan; Tookey, Pat; Anderson, Jane; de Ruiter, Annemiek; O'Connell, Rebecca; Pillen, Alexandra

2016-08-01

UK guidance advises HIV-positive women to abstain from breast feeding. Although this eliminates the risk of postnatal vertical transmission of HIV, the impact of replacement feeding on mothers is often overlooked. This qualitative study examines, for the first time in the UK, decision-making about infant feeding among African women living with HIV. Between 2010 and 2011, we conducted semistructured interviews with 23 HIV-positive African women who were pregnant or had recently given birth. We recruited participants from three HIV antenatal clinics in London. Women highlighted the cultural importance of breast feeding in African communities and the social pressure to breast feed, also describing fears that replacement feeding would signify their HIV status. Participants had significant concerns about physical and psychological effects of replacement feeding on their child and felt their identity as good mothers was compromised by not breast feeding. However, almost all chose to refrain from breast feeding, driven by the desire to minimise vertical transmission risk. Participants' resilience was strengthened by financial assistance with replacement feeding, examples of healthy formula-fed children and support from partners, family, peers and professionals. The decision to avoid breast feeding came at considerable emotional cost to participants. Professionals should be aware of the difficulties encountered by HIV-positive women in refraining from breast feeding, especially those from migrant African communities where breast feeding is culturally normative. Appropriate financial and emotional support increases women's capacity to adhere to their infant-feeding decisions and may reduce the emotional impact. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

quit4u: the effectiveness of combining behavioural support, pharmacotherapy and financial incentives to support smoking cessation.

PubMed

Ormston, R; van der Pol, M; Ludbrook, A; McConville, S; Amos, A

2015-02-01

The 'quit4u' stop smoking service (SSS) was developed by National Health Service (NHS) Tayside for smokers in deprived areas of Dundee (UK). quit4u combined behavioural support and pharmacotherapy with financial incentives for each week that participants remained quit. A quasi-experimental study was undertaken with smokers using quit4u between 2009 and 2011 compared with smokers using SSSs in the rest of Scotland. The outcome measures were: number of quit attempts; quit rates at 1, 3 and 12 months; cost-effectiveness. Mechanisms of change were explored through quantitative and qualitative research that explored the views and experiences of service users and professionals involved in quit4u. The number of quit attempts made using SSSs in deprived areas of NHS Tayside increased by 44% between 2007 and 2010. quit4u had significantly higher quit rates at 1 month (49.9% versus 33.7%), 3 months (30.7% versus 14.2%) and 12 months (9.3% versus 6.5%) compared with similar smokers using other SSSs. The incremental cost per quitter was £2296. A combination of elements kept clients engaged and supported quit attempts: carbon monoxide (CO) tests, financial incentives, high-quality pharmacy support, rolling groups and greater varenicline use. quit4u may provide an effective and cost-effective model for engaging and supporting smokers in deprived areas to quit. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Financial contribution to global surgery: an analysis of 160 international charitable organisations.

PubMed

Gutnik, Lily A; Yamey, Gavin; Dare, Anna J; Ramos, Margarita S; Riviello, Robert; Meara, John G; Shrime, Mark G

2015-04-27

The non-profit and volunteer sector provides substantial contributions to global health. Within the field of surgery, this sector has made notable service contributions in low-income and middle-income countries (LMICs) where access to surgical care is poor. Little is known about financing and funding flows to surgical care in LMICs from both domestic and international sources. Because an estimated 55% of surgical care delivered in LMICs is via charitable organisations, understanding the financial contributions of this sector could provide valuable insight into estimating funding flows and understanding financing priorities in global surgery. Between June, and September, 2014, we searched public online databases of registered charitable organisations in five high-income nations (the USA, the UK, Canada, Australia, and New Zealand) to identify organisations committed exclusively to surgical needs. Based on availability, the most current 5 years (2007-13) of financial data per organisation were collected. For each charitable organisation, we identified the type of surgical services provided. We examined revenues and expenditures for each organisation. 160 organisations representing 15 different surgical specialties were included in the analysis. Total aggregated revenue over the years 2008-2013 was US$3·3 billion. Total aggregated expenses for all 160 organisations amounted to US$3·0 billion. 28 ophthalmology organisations accounted for 45% of revenue and 49% of expenses. 15 cleft lip and palate organisations totalled 26% of both revenue and expenses. 19 organisations providing a mix of diverse surgical specialty services amounted to 14% of revenue and 16% of expenses. The remaining 15% of funds represented 12 specialties and 98 organisations. The US accounted for 77·7% of revenue and 80·8% of expenses. The UK accounted for 11·0% of revenue and 11·91% of expenses. Canada accounted for 1·85% of revenue and 2·01% of expenses. Australia and New Zealand accounted for 4·94% of revenue and 5·29% of expenses. Charitable organisations addressing surgical conditions primarily focus on elective surgical care and cover a broad range of subspecialties. The largest funding flows from charitable organisations are directed at ophthalmology, followed by cleft lip and palate surgery. However, there is a clear need for improved, transparent tracking of funds to global surgery via charitable organisations. None. Copyright © 2015 Elsevier Ltd. All rights reserved.

Can comprehensive specialised end-of-life care be provided at home? Lessons from a study of an innovative consultant-led community service in the UK.

PubMed

Noble, B; King, N; Woolmore, A; Hughes, P; Winslow, M; Melvin, J; Brooks, J; Bravington, A; Ingleton, C; Bath, P A

2015-03-01

The Midhurst Macmillan Specialist Palliative Care Service (MMSPCS) is a UK, medical consultant-led, multidisciplinary team aiming to provide round-the-clock advice and care, including specialist interventions, in the home, community hospitals and care homes. Of 389 referrals in 2010/11, about 85% were for cancer, from a population of about 155 000. Using a mixed method approach, the evaluation comprised: a retrospective analysis of secondary-care use in the last year of life; financial evaluation of the MMSPCS using an Activity Based Costing approach; qualitative interviews with patients, carers, health and social care staff and MMSPCS staff and volunteers; a postal survey of General Practices; and a postal survey of bereaved caregivers using the MMSPCS. The mean cost is about 3000 GBP (3461 EUR) per patient with mean cost of interventions for cancer patients in the last year of life 1900 GBP (2192 EUR). Post-referral, overall costs to the system are similar for MMSPCS and hospice-led models; however, earlier referral avoided around 20% of total costs in the last year of life. Patients and carers reported positive experiences of support, linked to the flexible way the service worked. Seventy-one per cent of patients died at home. This model may have application elsewhere. © 2014 The Authors. European Journal of Cancer Care published by John Wiley & Sons Ltd.

Can comprehensive specialised end-of-life care be provided at home? Lessons from a study of an innovative consultant-led community service in the UK

PubMed Central

Noble, B; King, N; Woolmore, A; Hughes, P; Winslow, M; Melvin, J; Brooks, J; Bravington, A; Ingleton, C; Bath, PA

2015-01-01

The Midhurst Macmillan Specialist Palliative Care Service (MMSPCS) is a UK, medical consultant-led, multidisciplinary team aiming to provide round-the-clock advice and care, including specialist interventions, in the home, community hospitals and care homes. Of 389 referrals in 2010/11, about 85% were for cancer, from a population of about 155 000. Using a mixed method approach, the evaluation comprised: a retrospective analysis of secondary-care use in the last year of life; financial evaluation of the MMSPCS using an Activity Based Costing approach; qualitative interviews with patients, carers, health and social care staff and MMSPCS staff and volunteers; a postal survey of General Practices; and a postal survey of bereaved caregivers using the MMSPCS. The mean cost is about 3000 GBP (3461 EUR) per patient with mean cost of interventions for cancer patients in the last year of life 1900 GBP (2192 EUR). Post-referral, overall costs to the system are similar for MMSPCS and hospice-led models; however, earlier referral avoided around 20% of total costs in the last year of life. Patients and carers reported positive experiences of support, linked to the flexible way the service worked. Seventy-one per cent of patients died at home. This model may have application elsewhere. PMID:24735122

Paediatric home care in the UK.

PubMed Central

Tatman, M A; Woodroffe, C

1993-01-01

Paediatric home care services in the UK were ascertained in 1991 and 1992. Respondents from 209 (97%) UK health districts and boards identified 62 general and 124 specialist paediatric home care services by January 1993, 15% having opened in the previous year. Of all UK children, 30% lived in a district with a general home care service. Five health regions had only specialist services. Districts differed widely in the availability of home care for different disorders. The home care services were small, general services employing a mean (SD) of 2.5 (1.6) whole time equivalent (WTE) nurses, and specialist services 1.3 (0.8) WTE nurses. Few services were available 24 hours a day. Funding arrangements were diverse and some services had difficulties in obtaining consumables and equipment for home use. Despite rapid growth there remains considerable scope for the development of paediatric home care throughout the UK. PMID:8285782

A Water Grid for the UK

NASA Astrophysics Data System (ADS)

Leathard, A.; Fowler, H. J.; Kilsby, C. G.

2009-04-01

Anthropogenically aggravated climate change associated with intensive expansion of the global economy has increased the demand for water whilst simultaneously altering natural variability in its distribution, straining water resources unsustainably and inequitably in many parts of the world, increasing drought risk, and encouraging decision-makers to reconsider the security of water supply. Indeed, in the absence of additional resource development, contemporary planning forecasts imply increased water stress across much of the United Kingdom. The regulatory authorities of the UK currently promote increased efficiency of water delivery and consumption combined with a portfolio of financial instruments as a means of reducing water stress, maintaining present levels of consumer service without significant further exploitation of the environment. Despite an increasingly sophisticated understanding of climate change and its effects, significant uncertainty remains in the quantification of its impacts on the water sector, and questions persist as to the effectiveness of such demand management measures compared to that of more traditional infrastructure improvements. Faced with possible futures provided for by detrimentally over-stressed resources, what opportunities remain for future strategic development in the UK? Is there a single national strategy that is both politically and socially acceptable? This ongoing study aims to evolve robust national adaptation strategies by quantifying the projected impacts of climate change across mainland UK using multi-model and perturbed-physics ensembles of projected future climate, encapsulating uncertainties in a scenario-driven integrated water resources model incorporating socio-economic elements.

A Pragmatic Randomised, Controlled Trial of Intensive Care follow up programmes in improving Longer-term outcomes from critical illness. The PRACTICAL study

PubMed Central

Cuthbertson, Brian H; Rattray, Janice; Johnston, Marie; Wildsmith, J Anthony; Wilson, Edward; Hernendez, Rodolfo; Ramsey, Craig; Hull, Alastair M; Norrie, John; Campbell, Marion

2007-01-01

Background A number of intensive care (ICU) patients experience significant problems with physical, psychological, and social functioning for some time after discharge from ICU. These problems have implications not just for patients, but impose a continuing financial burden for the National Health Service. To support recovery, a number of hospitals across the UK have developed Intensive Care follow-up clinics. However, there is a lack of evidence base to support these, and this study aims to test the hypothesis that intensive care follow up programmes are effective and cost-effective at improving physical and psychological quality of life in the year after intensive care discharge. Methods/Design This is a multi-centre, pragmatic, randomised controlled trial. Patients (n = 270) will be recruited prior to hospital discharge from three intensive care units in the UK, and randomised to one of two groups. The control group will receive standard in-hospital follow-up and the intervention group will participate in an ICU follow-up programme with clinic appointments 2–3 and 9 months after ICU discharge. The primary outcome measure is Health-related Quality of Life (HRQoL) 12 months after ICU discharge as measured by the Short Form-36. Secondary measures include: HRQoL at six months; Quality-adjusted life years using EQ-5D; posttraumatic psychopathology as measured by Davidson Trauma Scale; and anxiety and depression using the Hospital Anxiety and Depression Scale at both six and twelve months after ICU discharge. Contacts with health services in the twelve months after ICU discharge will be measured as part of the economic analysis. Discussion The provision of intensive care follow-up clinics within the UK has developed in an ad hoc manner, is inconsistent in both the number of hospitals offering such a service or in the type of service offered. This study provides the opportunity to evaluate such services both in terms of patient benefit and cost-effectiveness. The results of this study therefore will inform clinical practice and policy with regard to the appropriate development of such services aimed at improving outcomes after intensive care. Trial Registration ISRCTN24294750. PMID:17645791

Factors affecting hospital costs in lung cancer patients in the United Kingdom.

PubMed

Kennedy, Martyn P T; Hall, Peter S; Callister, Matthew E J

2016-07-01

Rising healthcare costs and financial constraints are increasing pressure on healthcare budgets. There is little published data on the healthcare costs of lung cancer in the UK, with international studies mostly small and limited by data collection methods. Accurate assessment of healthcare costs is essential for effective service planning. We conducted a retrospective, descriptive cohort study linking clinical data from a local electronic database of lung cancer patients at a large UK teaching hospital with recorded hospital income. Costs were adjusted to 2013-2014 prices. The study analysed secondary care costs of 3274 patients. Mean cumulative costs were £5852 (95% CI, £5694 to £6027) at 90 days and £10,009 (95% CI, £9717 to £10,278) at one year. The majority of costs (58.5%) were accumulated within the first 90 days, with acute inpatient costs the largest contributor at one year (42.1%). The strongest predictor of costs was active treatment, especially surgery. Costs were also affected by age, route to diagnosis, clinical stage and cell type. Successful early diagnosis initiatives that increase radical treatment rates and improve outcomes may significantly increase the secondary care costs of lung cancer management. The use of routine NHS clinical and financial data can enable efficient and effective analyses of large cohort health economic data. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The payment for performance model and its influence on British general practitioners' principles and practice.

PubMed

Norman, Armando Henrique; Russell, Andrew J; Macnaughton, Jane

2014-01-01

This article explores some effects of the British payment for performance model on general practitioners' principles and practice, which may contribute to issues related to financial incentive modalities and quality of primary healthcare services in low and middle-income countries. Aiming to investigate what general practitioners have to say about the effect of the British payment for performance on their professional ethos we carried out semi-structured interviews with 13 general practitioner educators and leaders working in academic medicine across the UK. The results show a shift towards a more biomedical practice model and fragmented care with nurse practitioners and other health care staff focused more on specific disease conditions. There has also been an increased medicalisation of the patient experience both through labelling and the tendency to prescribe medications rather than non-pharmacological interventions. Thus, the British payment for performance has gradually strengthened a scientific-bureaucratic model of medical practice which has had profound effects on the way family medicine is practiced in the UK.

Financial Education in Small Ethnic Minority Businesses in the UK

ERIC Educational Resources Information Center

Hussain, Javed; Matlay, Harry; Scott, Jonathan M.

2008-01-01

Purpose: The purpose of this paper is to set out to evaluate the financial education needs of ethnic minority SMEs in the West Midlands region of the United Kingdom. Design/methodology/approach: A postal survey was used to investigate the financial needs of owner/managers in 64 ethnic minority SMEs and a control sample of 23 non-ethnic SMEs.…

Designing Effective Programmes for Encouraging the Business Start-up Process: Lessons from UK Experience.

ERIC Educational Resources Information Center

Gibb, Allan A.

1987-01-01

Outlines programs in the United Kingdom (UK) designed to encourage the starting of small businesses. Successful programs help entrepreneurs obtain financial support, get business training, and develop a business plan. Recommends emphasis on personal competency and motivation training as well as shorter courses. (CH)

Ethical, legal and professional issues arising from social media coverage by UK Helicopter Emergency Medical Services.

PubMed

Steele, Sarah; Adcock, Christopher; Steel, Alistair

2016-01-01

Social media (SoMe) are gaining increasing acceptance among, and use by, healthcare service deliverers and workers. UK Helicopter Emergency Medical Services (HEMS) use SoMe to deliver service information and to fundraise, among other purposes. This article examines UK HEMS use of SoMe between January and February 2014 to determine the extent of adoption and to highlight trends in use. The database of the Association of Air Ambulances, crosschecked with UK Emergency Aviation, was used to identify flying, charitable UK HEMS. This search identified 28 UK HEMS, of which 24 services met the criteria for selection for review. Using information harvested from the public domain, we then systematically documented SoMe use by the services. SoMe use by UK HEMS is extensive but not uniform. All selected UK HEMS maintained websites with blogs, as well as Facebook, Twitter, Wikipedia and JustGiving profiles, with the majority of services using Ebay for Charity, LinkedIn and YouTube. Some HEMS also held a presence on Pinterest, Google+, Instagram and Flickr, with a minority of services maintaining their own Rich Site Summary (RSS) feed. The SoMe adopted, while varied, allowed for increased, and different forms of, information delivery by HEMS to the public, often in real time. Such use, though, risks breaching patient confidentiality and data protection requirements, especially when information is viewed cumulatively across platforms. There is an urgent need for the continued development of guidance in this unique setting to protect patients while UK HEMS promote and fundraise for their charitable activities. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

78 FR 5166 - BE-185: Quarterly Survey of Financial Services Transactions Between U.S. Financial Services...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-24

... BE-185: Quarterly Survey of Financial Services Transactions Between U.S. Financial Services Providers... Services Transactions between U.S. Financial Services Providers and Foreign Persons (BE-185). This.... person who: (a) Had sales of covered financial services to foreign persons that exceeded $20 million for...

Clinical leadership development in postgraduate medical education and training: policy, strategy, and delivery in the UK National Health Service.

PubMed

Aggarwal, Reena; Swanwick, Tim

2015-01-01

Achieving high quality health care against a background of continual change, increasing demand, and shrinking financial resource is a major challenge. However, there is significant international evidence that when clinicians use their voices and values to engage with system delivery, operational efficiency and care outcomes are improved. In the UK National Health Service, the traditional divide between doctors and managers is being bridged, as clinical leadership is now foregrounded as an important organizational priority. There are 60,000 doctors in postgraduate training (junior doctors) in the UK who provide the majority of front-line patient care and form an "operating core" of most health care organizations. This group of doctors is therefore seen as an important resource in initiating, championing, and delivering improvement in the quality of patient care. This paper provides a brief overview of leadership theories and constructs that have been used to develop a raft of interventions to develop leadership capability among junior doctors. We explore some of the approaches used, including competency frameworks, talent management, shared learning, clinical fellowships, and quality improvement. A new paradigm is identified as necessary to make a difference at a local level, which moves learning and leadership away from developing "leaders", to a more inclusive model of developing relationships between individuals within organizations. This shifts the emphasis from the development of a "heroic" individual leader to a more distributed model, where organizations are "leader-ful" and not just "well led" and leadership is centered on a shared vision owned by whole teams working on the frontline.

Evaluation of the incremental cost to the National Health Service of prescribing analogue insulin

PubMed Central

Holden, Sarah E; Poole, Chris D; Morgan, Christopher Ll

2011-01-01

Introduction Insulin analogues have become increasingly popular despite their greater cost compared with human insulin. The aim of this study was to calculate the incremental cost to the National Health Service (NHS) of prescribing analogue insulin preparations instead of their human insulin alternatives. Methods Open-source data from the four UK prescription pricing agencies from 2000 to 2009 were analysed. Cost was adjusted for inflation and reported in UK pounds at 2010 prices. Results Over the 10-year period, the NHS spent a total of £2732 million on insulin. The total annual cost increased from £156 million to £359 million, an increase of 130%. The annual cost of analogue insulin increased from £18.2 million (12% of total insulin cost) to £305 million (85% of total insulin cost), whereas the cost of human insulin decreased from £131 million (84% of total insulin cost) to £51 million (14% of total insulin cost). If it is assumed that all patients using insulin analogues could have received human insulin instead, the overall incremental cost of analogue insulin was £625 million. Conclusion Given the high marginal cost of analogue insulin, adherence to prescribing guidelines recommending the preferential use of human insulin would have resulted in considerable financial savings over the period. PMID:22021891

How the World Trade Organisation is shaping domestic policies in health care.

PubMed

Price, D; Pollock, A M; Shaoul, J

1999-11-27

High up on the agenda of the World Trade Organisation (WTO) is the privatisation of education, health, welfare, social housing and transport. The WTO's aim is to extend the free market in the provision of traditional public services. Governments in Europe and the US link the expansion of trade in public services to economic success, and with the backing of powerful medico-pharmaceutical, insurance, and service corporations, the race is on to capture the share of gross domestic product that governments currently spend on public services. They will open domestic European services and domestic markets to global competition by government procurement agreements, dispute-settlement procedures, and the investment rules of global financial institutions. The UK has already set up the necessary mechanisms: the introduction of private-sector accounting rules to public services; the funding of public-sector investment via private-public partnerships or the private finance initiative; and the change to capitation funding streams, which allows the substitution of private for public funds and services. We explain the implications of these changes for European public-health-care systems and the threat they pose to universal coverage, solidarity through risk-pooling, equity, comprehensive care, and democratic accountability.

Higher Education Funding Issues: U.S. / UK Comparison

ERIC Educational Resources Information Center

Orkodashvili, Mariam

2007-01-01

The paper compares and contrasts higher education funding sources and systems in the U.S. and the UK. The issues raised in the paper pertain to the major challenge of academia: finding financial support in times of limited resources and enhanced competition. The issues discussed throughout the paper are: funding and quality assessment of…

Students' Expectations of Debt in UK Higher Education

ERIC Educational Resources Information Center

Bachan, Ray

2014-01-01

The funding of students in UK higher education (HE) has undergone radical reform over the past two decades. Using a unique dataset, this paper investigates student expectations of debt. We find that a student's gender, ethnicity, and year of study play an important role in determining their expected debt. Students in receipt of financial support…

75 FR 22680 - Financial Management Service; Proposed Collection of Information: Annual Financial Statement of...

Federal Register 2010, 2011, 2012, 2013, 2014

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75 FR 35289 - International Services Surveys: BE-180, Benchmark Survey of Financial Services Transactions...

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77 FR 553 - Surety Companies Acceptable on Federal Bonds: Termination; Western Bonding Company

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-05

.... Department of the Treasury, Financial Management Service, Financial Accounting and Services Division, Surety..., 2011. Laura Carrico, Director, Financial Accounting and Services Division, Financial Management Service...: Termination; Western Bonding Company AGENCY: Financial Management Service, Fiscal Service, Department of the...

The case for Ofsmoke: the potential for price cap regulation of tobacco to raise £500 million per year in the UK.

PubMed

Branston, J Robert; Gilmore, Anna B

2014-01-01

A system of price-cap regulation has previously been suggested to address the market failure inherent to the tobacco industry. This would benefit public health directly (eg, by making it extremely difficult for the industry to sell cut-price cigarettes, or use price as a marketing strategy) and indirectly (eg, by reducing the available money the industry has for spending on marketing and lobbying). This paper explores the feasibility of applying such a scheme in the UK. The impact of price-capping is modelled using optimistic and conservative scenarios, each with different assumptions, and using 2009 and 2010 profit data for the major companies selling tobacco in the UK. The models are used to calculate by how much would profit be reduced through the imposition of price caps, and thus, how much revenue could be raised in additional taxes, assuming the end price the consumer pays does not change. Tobacco companies enjoy massive profit margins, up to 67%, in the UK. The optimistic scenario suggests a potential increase in UK tobacco tax revenue of £585.7 million in 2010 (£548.4 million in 2009), while the conservative model suggests an increase in revenue of £433.6 million in 2010 (£399.2 million in 2009). This would be approximately enough to fund, twice over, UK-wide antitobacco smuggling measures, and smoking cessation services in England, including the associated pharmacotherapies, to help people stop smoking. Applying a system of price-cap regulation in the UK would raise around £500 million per annum (US$750 million). This is likely to be an underestimate because of cautious assumptions used in the model. These significant financial benefits, in addition to the public health benefits that would be generated, suggest this is a policy that should be given serious consideration.

THE CASE FOR OFSMOKE: THE POTENTIAL FOR PRICE CAP REGULATION OF TOBACCO TO RAISE £500M PER YEAR IN THE UK

PubMed Central

Robert Branston, J.; Gilmore, Anna B.

2013-01-01

Objective A system of price-cap regulation has previously been suggested to address the market failure inherent to the tobacco industry. This would benefit public health directly (for example, by making it extremely difficult for the industry to sell cut price cigarettes or use price as a marketing strategy) and indirectly (for example, by reducing the money industry has available to spend on marketing and lobbying). This paper explores the feasibility of applying such a scheme in the UK. Methods The impact of price-capping is modelled using optimistic and conservative scenarios, each with different assumptions, and using 2009 and 2010 profit data for the major companies selling tobacco in the UK. The models are used to calculate by how much profit would be reduced through the imposition of price caps, and thus how much revenue could be raised in additional taxes, assuming the end price the consumer pays does not change. Results Tobacco companies enjoy massive profit margins, up to 67%, in the UK. The optimistic scenario suggests a potential increase in UK tobacco tax revenue of £585.7m in 2010 (£548.4m in 2009), while the conservative model suggests an increase in revenue of £433.6m in 2010 (£399.2m in 2009). This would be approximately enough to fund, twice over, UK wide anti-tobacco smuggling measures and smoking cessation services in England including the associated pharmacotherapies. Conclusions Applying a system of price cap regulation in the UK would raise around £500m per annum (US$750m). This is likely to be an under-estimate because of cautious assumptions used in the model. These significant financial benefits, in addition to the public health benefits that would be generated, suggest this is a policy that should be given serious consideration. PMID:23322310

Gambling problems and the impact of family in UK armed forces veterans.

PubMed

Dighton, Glen; Roberts, Elystan; Hoon, Alice E; Dymond, Simon

2018-05-09

Background and aims International evidence indicates elevated problem gambling rates in armed forces veterans compared with the general population. Gambling problems adversely impact one's family, and family-related variables may increase vulnerability to gambling-related harm. Little is known, however, about gambling problems in the United Kingdom (UK) veterans or to what extent family variables, such as parenting history and experience of domestic violence, influence veterans' gambling. Methods We compared veterans (n = 257) and sex- and age-matched controls (n = 514) drawn from the 2007 Adult Psychiatric Morbidity Survey on gambling, financial management, domestic violence, childhood parental presence, and experience of stressful life events. Veterans who left the military before or after 4 years of service were compared. Results Problem gambling was significantly more prevalent in veterans (1.4%) than non-veterans (0.2%), and the impact of gambling problems on the family was specific to male veterans, particularly those who had experienced a traumatic event after the age of 16, and those who were more likely to have been physically attacked by their partner. Overall, this study revealed that the UK armed forces veterans report a higher prevalence rate of problem gambling compared with non-veterans, with potential negative impact on family life.

Informal caregiving and intimate relationships: the experiences of spouses of UK military personnel.

PubMed

Thandi, Gursimran; Oram, S; Verey, A; Greenberg, N; Fear, N T

2017-08-01

Currently, there is no research available on the experiences of spouses providing informal care to wounded, injured or sick (WIS) UK military personnel. The aim of this study was to fill this gap by investigating the relationship experiences of non-military partners caring for WIS UK military personnel. Spouses of WIS military personnel (n=25) completed telephone interviews with the research team. The data were transcribed and analysed using thematic analysis. The transcripts were cross-coded and checked for inter-rater reliability. Six major themes were identified: (1) communication between couples, (2) adverse family environment, (3) reintegration, (4) intimacy, (5) financial uncertainty and (6) transition from partner to caregiver. Partners caring for injured/ill military personnel appear to be at risk of experiencing personal distress caused by impaired relationship functioning, which may lead to diminished physical and mental well-being. Partners of WIS military personnel experience significant levels of distress and burden associated with caregiving in the form of arguments with the military partner, problems in reintegration and a lack of physical and emotional intimacy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Dentistry as a business: in search of the moral high ground.

PubMed

Holt, Vernon P

2010-07-01

This paper has been developed from a version originally submitted as an assignment for the Faculty of General Dental Practice (UK) Certificate in Health Services Leadership and Management Course. It has been revised in the light of the independent review led by Professor Jimmy Steele into National Health Service dental services in England (generally referred to as the Steele Report), which has commented on many of the points dealt with here. The paper addresses issues arising from a moral tension often experienced by dentists between the professional desire to serve patients well and the necessity, as practice owners running a business, to survive financially. The need for honest and open recognition of what is truly achievable from the public purse is stressed. Rights and responsibilities are discussed in relation to professional practitioners, their patients, and society in general, in seeking the moral high ground under different funding arrangements. The paper concludes by stressing the need to offer improved health rather than palliation of disease.

77 FR 30050 - Financial Management Service Proposed Collection of Information: Resolution Authorizing Execution...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-21

... DEPARTMENT OF THE TREASURY Fiscal Service Financial Management Service Proposed Collection of... Depositary, Financial Agency, and Collateral Agreement AGENCY: Financial Management Service, Fiscal Service, Treasury. ACTION: Notice and request for comments. SUMMARY: The Financial Management Service, as part of...

A Water Grid for the UK

NASA Astrophysics Data System (ADS)

Leathard, A.; Fowler, H. J.; Kilsby, C. G.

2009-12-01

Anthropogenically aggravated climate change associated with intensive expansion of the global economy has increased the demand for water whilst simultaneously altering natural variability in its distribution, straining water resources unsustainably and inequitably in many parts of the world, increasing drought risk, and encouraging decision-makers to reconsider the security of water supply. Indeed, in the absence of additional resource development, contemporary planning forecasts imply increased water stress across much of the United Kingdom. Until recently the regulatory authorities of the UK promoted increased efficiency of water delivery and consumption combined with a portfolio of financial instruments as a means of reducing water stress, maintaining present levels of consumer service without significant further exploitation of the environment. However, despite an increasingly sophisticated understanding of climate change and its effects, significant uncertainty remains in the quantification of its impacts on the water sector, and questions persist as to the effectiveness of such demand management measures compared to that of more traditional infrastructure improvements. Faced with possible futures provided for by detrimentally over-stressed resources, what opportunities remain for future strategic development in the UK? Is there a single national strategy that is both politically and socially acceptable? Do the benefits of national water infrastructure projects outweigh their costs? This ongoing study aims to evolve robust national adaptation strategies by quantifying the projected impacts of climate change across mainland UK using multi-model and perturbed-physics ensembles of projected future climate, encapsulating uncertainties in a scenario-driven integrated water resources model incorporating socio-economic elements.

A partial solution: a local mental health authority for the UK.

PubMed

Hadley, Trevor R.; Goldman, Howard H.

1998-07-01

BACKGROUND: the structural problems of the mental health system in the UK have been analyzed by a number of authors over the past several years as the "reforms" of the health and social service systems have continued (Kavanagh and Knapp, 1995; Mechanic, 1995). In a recent article, Hadley and Goldman (1995) suggest that one possible solution to some of these issues may be the creation of a local mental health authority. Such an authority would consolidate the funding, authority and responsibility in a single entity. We believe this model, which is typical of many local public mental health systems in the US, is at least part of the solution to the current problem of financial and service fragmentation of the current system in the UK. The numerous "reforms" of the health and social service systems (which include the Community Care Act, the development of the Internal Market, GP fundholding and the purchaser-provider split) were not designed for the care of the mentally ill (Han, 1996). These policy changes in the design of health and social services have created a complicated and difficult context in which services must be delivered. Too many agencies play a significant role in the delivery and management of mental health services. Health authorities, social service agencies and GP fundholders are direct and indirect funders of the system while community care trusts, social service agencies and GPs are service providers (Hadley, 1996a). RESULTS AND A PROPOSAL: We believe that the development of local mental health authorities may be part of the solution to the structural and economic problems of the current system in the UK. It is not the answer to limited resources or limited skills, but can create a new structure, which will permit and encourage the cooperation and innovation that is now possible only with unusual effort. Local mental health authorities have a number of crucial characteristics, but, most importantly, they refocus the system on the provision of care to the seriously mentally ill. This is the expressed priority of government, advocates and providers, alike.These new entities could be created at either the purchaser or provider level or, as exists in a number of jurisdictions in the US, at both levels, where a single purchaser may be responsible for multiple consolidated providers. This combination is now the emerging model for innovative services in the US. In the UK, the development of a local mental health authority at the purchaser and/or provider level might be relatively simple. Although the creation of a statutory authority would require primary legislation and is therefore probably not a short-term solution, there appears to be a variety of administrative options that would have the same effect. IMPLICATIONS FOR HEALTH POLICY FORMULATION: The creation of a local mental health authority may be a necessary first step towards the development of a coordinated and comprehensive system of care. It seems likely that there is currently more "political" support for the development of a purchaser model but the development of a sophisticated purchsaer is also likely to take considerable time and effort. Although all the structural and policy problems of the mental health system in the UK will not all be solved by local mental health authorities, they may be beneficial if responsibility for mental illness care is to be centralized and fragmentation is to be reduced. Without making structural changes, the best efforts by clinicians, policymakers and managers are most likely to be in vain. Without a clear point of ultimate purchasing and service responsibility, the fragmentation and inefficiency of the current system will remain (Hadley et al., 1996).

76 FR 23859 - Financial Management Service Proposed Collection of Information; Financial Institution Agreement...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-28

... DEPARTMENT OF THE TREASURY Fiscal Service Financial Management Service Proposed Collection of... Management Service, Fiscal Service, Treasury. ACTION: Notice and request for comments. SUMMARY: The Financial... collection. By this notice, the Financial Management Service solicits comments concerning the FMS 458 and FMS...

Medico-legal significance of service difficulties and clinical errors in the management of patients with inflammatory bowel diseases.

PubMed

Farrukh, Affifa; Mayberry, John F

2015-03-01

There is a significant growth in medical litigation, and cases involving the care and management of patients with inflammatory bowel disease are becoming common. There is no central register of such cases, and the majority are settled before court proceedings. As a result, there is no specific case law related to such conditions, and secrecy usually surrounds the outcome with "no admission of guilt" by the defendant and a clause about non-disclosure and discussion linked to the financial compensation received by the claimant. This review discusses common areas of potential litigation. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Power and Control: Managing Agents for International Student Recruitment in Higher Education

ERIC Educational Resources Information Center

Huang, Iona Yuelu; Raimo, Vincenzo; Humfrey, Christine

2016-01-01

This multiple case-based study investigates the relationship between recruiting agents and the UK universities who act as their principals. The current extensive use of agents in UK higher education may be seen as an indicator of the financial impact made by international students. The study analyses the practice of agent management and explores…

A Review of the Case of a Levy-Grant Scheme (LGS) in the UK Construction Industry

ERIC Educational Resources Information Center

Abdel-Wahab, Mohamed; Dainty, Andrew; Ison, Stephen

2010-01-01

A Levy-Grant Scheme (LGS) has existed in the UK construction industry since 1964 to provide financial support for companies undertaking training activities. Despite the support of the LGS for various training activities, notably apprenticeships, the construction industry continues to suffer from both labour shortages and an under-investment in…

7 CFR 1700.33 - Financial Services Staff.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 11 2014-01-01 2014-01-01 false Financial Services Staff. 1700.33 Section 1700.33... AGRICULTURE GENERAL INFORMATION Agency Organization and Functions § 1700.33 Financial Services Staff. The Financial Services Staff evaluates the financial condition of financially troubled borrowers in order to...

7 CFR 1700.33 - Financial Services Staff.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 11 2012-01-01 2012-01-01 false Financial Services Staff. 1700.33 Section 1700.33... AGRICULTURE GENERAL INFORMATION Agency Organization and Functions § 1700.33 Financial Services Staff. The Financial Services Staff evaluates the financial condition of financially troubled borrowers in order to...

7 CFR 1700.33 - Financial Services Staff.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 11 2011-01-01 2011-01-01 false Financial Services Staff. 1700.33 Section 1700.33... AGRICULTURE GENERAL INFORMATION Agency Organization and Functions § 1700.33 Financial Services Staff. The Financial Services Staff evaluates the financial condition of financially troubled borrowers in order to...

7 CFR 1700.33 - Financial Services Staff.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 11 2013-01-01 2013-01-01 false Financial Services Staff. 1700.33 Section 1700.33... AGRICULTURE GENERAL INFORMATION Agency Organization and Functions § 1700.33 Financial Services Staff. The Financial Services Staff evaluates the financial condition of financially troubled borrowers in order to...

7 CFR 1700.33 - Financial Services Staff.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 11 2010-01-01 2010-01-01 false Financial Services Staff. 1700.33 Section 1700.33... AGRICULTURE GENERAL INFORMATION Agency Organization and Functions § 1700.33 Financial Services Staff. The Financial Services Staff evaluates the financial condition of financially troubled borrowers in order to...

International Students' Perceptions of Service Quality in the UK Banking Sector: An Exploratory Study

ERIC Educational Resources Information Center

Bond, Christopher; Hsu, Marc Ting-Chun

2011-01-01

This study reviews and evaluates international students' perceptions of UK banks. The specific research objectives were to identify international students' expectations and perceptions of service quality from UK banks and to assess the quality GAP or dissonance between these. A total of 297 international students studying in the UK responded to…

75 FR 54445 - Senior Executive Service; Financial Management Service Performance Review Board (PRB)

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-07

..., Management (Chief Financial Officer). Alfred J. Kopec, Assistant Commissioner, Business Architecture. Sheryl... DEPARTMENT OF THE TREASURY Fiscal Service Senior Executive Service; Financial Management Service Performance Review Board (PRB) AGENCY: Financial Management Service, Fiscal Service, Treasury. ACTION: Notice...

75 FR 22689 - Fiscal Service

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-29

... the U.S. Department of the Treasury, Financial Management Service, Financial Accounting and Services..., 2010. Sandra Paylor-Sanders, Acting Director, Financial Accounting and Services Division. [FR Doc. 2010... Bonding Company AGENCY: Financial Management Service, Fiscal Service, Department of the Treasury. ACTION...

77 FR 27021 - Proposed Information Collection; Comment Request; Quarterly Survey of Financial Services...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-08

... Request; Quarterly Survey of Financial Services Transactions Between U.S. Financial Services Providers [email protected] . SUPPLEMENTARY INFORMATION: I. Abstract Form BE-185, Quarterly Survey of Financial Services Transactions between U.S. Financial Services Providers and Foreign Persons, obtains quarterly data from U.S...

77 FR 32178 - Fiscal Service

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-31

... of the Treasury, Financial Management Service, Financial Accounting and Services Division, Surety... Carrico, Director, Financial Accounting and Services Division. [FR Doc. 2012-13044 Filed 5-30-12; 8:45 am...: Alterra Reinsurance USA, Inc. AGENCY: Financial Management Service, Fiscal Service, Department of the...

Acceptability of Parental Financial Incentives and Quasi-Mandatory Interventions for Preschool Vaccinations: Triangulation of Findings from Three Linked Studies.

PubMed

Adams, Jean; McNaughton, Rebekah J; Wigham, Sarah; Flynn, Darren; Ternent, Laura; Shucksmith, Janet

2016-01-01

Childhood vaccinations are a core component of public health programmes globally. Recent measles outbreaks in the UK and USA have prompted debates about new ways to increase uptake of childhood vaccinations. Parental financial incentives and quasi-mandatory interventions (e.g. restricting entry to educational settings to fully vaccinated children) have been successfully used to increase uptake of childhood vaccinations in developing countries, but there is limited evidence of effectiveness in developed countries. Even if confirmed to be effective, widespread implementation of these interventions is dependent on acceptability to parents, professionals and other stakeholders. We conducted a systematic review (n = 11 studies included), a qualitative study with parents (n = 91) and relevant professionals (n = 24), and an on-line survey with embedded discrete choice experiment with parents (n = 521) exploring acceptability of parental financial incentives and quasi-mandatory interventions for preschool vaccinations. Here we use Triangulation Protocol to synthesise findings from the three studies. There was a consistent recognition that incentives and quasi-mandatory interventions could be effective, particularly in more disadvantaged groups. Universal incentives were consistently preferred to targeted ones, but relative preferences for quasi-mandatory interventions and universal incentives varied between studies. The qualitative work revealed a consistent belief that financial incentives were not considered an appropriate motivation for vaccinating children. The costs of financial incentive interventions appeared particularly salient and there were consistent concerns in the qualitative work that incentives did not represent the best use of resources for promoting preschool vaccinations. Various suggestions for improving delivery of the current UK vaccination programme as an alternative to incentives and quasi-mandates were made. Parental financial incentives and quasi-mandatory interventions for increasing uptake of preschool vaccinations do not currently attract widespread enthusiastic support in the UK; but some potential benefits of these approaches are recognised.

Acceptability of Parental Financial Incentives and Quasi-Mandatory Interventions for Preschool Vaccinations: Triangulation of Findings from Three Linked Studies

PubMed Central

McNaughton, Rebekah J.; Wigham, Sarah; Flynn, Darren; Ternent, Laura; Shucksmith, Janet

2016-01-01

Background Childhood vaccinations are a core component of public health programmes globally. Recent measles outbreaks in the UK and USA have prompted debates about new ways to increase uptake of childhood vaccinations. Parental financial incentives and quasi-mandatory interventions (e.g. restricting entry to educational settings to fully vaccinated children) have been successfully used to increase uptake of childhood vaccinations in developing countries, but there is limited evidence of effectiveness in developed countries. Even if confirmed to be effective, widespread implementation of these interventions is dependent on acceptability to parents, professionals and other stakeholders. Methods We conducted a systematic review (n = 11 studies included), a qualitative study with parents (n = 91) and relevant professionals (n = 24), and an on-line survey with embedded discrete choice experiment with parents (n = 521) exploring acceptability of parental financial incentives and quasi-mandatory interventions for preschool vaccinations. Here we use Triangulation Protocol to synthesise findings from the three studies. Results There was a consistent recognition that incentives and quasi-mandatory interventions could be effective, particularly in more disadvantaged groups. Universal incentives were consistently preferred to targeted ones, but relative preferences for quasi-mandatory interventions and universal incentives varied between studies. The qualitative work revealed a consistent belief that financial incentives were not considered an appropriate motivation for vaccinating children. The costs of financial incentive interventions appeared particularly salient and there were consistent concerns in the qualitative work that incentives did not represent the best use of resources for promoting preschool vaccinations. Various suggestions for improving delivery of the current UK vaccination programme as an alternative to incentives and quasi-mandates were made. Conclusions Parental financial incentives and quasi-mandatory interventions for increasing uptake of preschool vaccinations do not currently attract widespread enthusiastic support in the UK; but some potential benefits of these approaches are recognised. PMID:27253196

Clinical leadership development in postgraduate medical education and training: policy, strategy, and delivery in the UK National Health Service

PubMed Central

Aggarwal, Reena; Swanwick, Tim

2015-01-01

Achieving high quality health care against a background of continual change, increasing demand, and shrinking financial resource is a major challenge. However, there is significant international evidence that when clinicians use their voices and values to engage with system delivery, operational efficiency and care outcomes are improved. In the UK National Health Service, the traditional divide between doctors and managers is being bridged, as clinical leadership is now foregrounded as an important organizational priority. There are 60,000 doctors in postgraduate training (junior doctors) in the UK who provide the majority of front-line patient care and form an “operating core” of most health care organizations. This group of doctors is therefore seen as an important resource in initiating, championing, and delivering improvement in the quality of patient care. This paper provides a brief overview of leadership theories and constructs that have been used to develop a raft of interventions to develop leadership capability among junior doctors. We explore some of the approaches used, including competency frameworks, talent management, shared learning, clinical fellowships, and quality improvement. A new paradigm is identified as necessary to make a difference at a local level, which moves learning and leadership away from developing “leaders”, to a more inclusive model of developing relationships between individuals within organizations. This shifts the emphasis from the development of a “heroic” individual leader to a more distributed model, where organizations are “leader-ful” and not just “well led” and leadership is centered on a shared vision owned by whole teams working on the frontline. PMID:29355184

25 CFR 20.600 - Who can apply for financial assistance or social services?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false Who can apply for financial assistance or social services... FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Administrative Procedures § 20.600 Who can apply for financial assistance or social services? (a) You can apply for financial assistance or social services under...

31 CFR Appendix G to Subpart A of... - Financial Management Service

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Financial Management Service G...—Financial Management Service 1. In general. This appendix applies to the Financial Management Service. 2. Public reading room. The public reading room for the Financial Management Service is maintained at the...

25 CFR 20.600 - Who can apply for financial assistance or social services?

Code of Federal Regulations, 2012 CFR

2012-04-01

... 25 Indians 1 2012-04-01 2011-04-01 true Who can apply for financial assistance or social services... FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Administrative Procedures § 20.600 Who can apply for financial assistance or social services? (a) You can apply for financial assistance or social services under...

25 CFR 20.600 - Who can apply for financial assistance or social services?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 1 2013-04-01 2013-04-01 false Who can apply for financial assistance or social services... FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Administrative Procedures § 20.600 Who can apply for financial assistance or social services? (a) You can apply for financial assistance or social services under...

25 CFR 20.600 - Who can apply for financial assistance or social services?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 25 Indians 1 2014-04-01 2014-04-01 false Who can apply for financial assistance or social services... FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Administrative Procedures § 20.600 Who can apply for financial assistance or social services? (a) You can apply for financial assistance or social services under...

25 CFR 20.600 - Who can apply for financial assistance or social services?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Who can apply for financial assistance or social services... FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Administrative Procedures § 20.600 Who can apply for financial assistance or social services? (a) You can apply for financial assistance or social services under...

45 CFR 304.22 - Federal financial participation in purchased support enforcement services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES FEDERAL FINANCIAL PARTICIPATION § 304.22 Federal financial participation in purchased support enforcement services. Federal financial participation is.... Support enforcement services which may be purchased with Federal financial participation are those for...

76 FR 63351 - Senior Executive Service; Financial Management Service Performance Review Board (PRB)

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-12

... DEPARTMENT OF THE TREASURY Senior Executive Service; Financial Management Service Performance Review Board (PRB) AGENCY: Financial Management Service, Treasury. ACTION: Notice. SUMMARY: This notice announces the appointment of members to the Financial Management Service (FMS) Performance Review Board (PRB...

77 FR 60177 - Senior Executive Service; Financial Management Service Performance Review Board (PRB)

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-02

... DEPARTMENT OF THE TREASURY Senior Executive Service; Financial Management Service Performance Review Board (PRB) AGENCY: Financial Management Service, Treasury. ACTION: Notice. SUMMARY: This notice announces the appointment of members to the Financial Management Service (FMS) Performance Review Board (PRB...

77 FR 37959 - Financial Management Service; Proposed Collection of Information: Pools and Associations-Annual...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-25

... DEPARTMENT OF THE TREASURY Fiscal Service Financial Management Service; Proposed Collection of Information: Pools and Associations--Annual Letter AGENCY: Financial Management Service, Fiscal Service, Treasury. ACTION: Notice and request for comments. SUMMARY: The Financial Management Service, as part of...

78 FR 15123 - Financial Management Service; Proposed Collection of Information: Accountable Official...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-08

... DEPARTMENT OF THE TREASURY Fiscal Service Financial Management Service; Proposed Collection of...) Program AGENCY: Financial Management Service, Fiscal Service, Treasury. ACTION: Notice and Request for comments. SUMMARY: The Financial Management Service, as part of its continuing effort to reduce paperwork...

Clinical directors' views of centralisation and commissioning of cleft services in the U.K.

PubMed

Searle, Aidan; Scott, Julia K; Sandy, Jonathan; Ness, Andrew; Waylen, Andrea

2015-01-22

To determine the views of Clinical Directors working in the United Kingdom (U.K.) Cleft Service with regard to centralisation, commissioning and impact on cleft service provision. In-depth qualitative interviews were conducted with 11 Clinical Directors representing regional cleft services. Interviews were transcribed verbatim, a coding frame was developed by two researchers and transcripts were coded using a thematic, 'interpretive' approach. Clinical Directors perceived the commissioning of cleft services in the U.K. to be dependent upon historical agreements and individual negotiation despite service centralisation. Furthermore, Clinical Directors perceived unfairness in the commissioning and funding of cleft services and reported inconsistencies in funding models and service costs that have implications for delivering an equitable cleft service with an effective Multidisciplinary Team. National Health Service (NHS) commissioning bodies can learn lessons from the centralisation of cleft care. Clinical Directors' accounts of their relationships with specialist commissioning bodies and their perspectives of funding cleft services may serve to increase parity and improve the commissioning of cleft services in the U.K.

75 FR 4450 - Financial Management Service; Proposed Collection of Information: Direct Deposit Sign-Up Form

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-27

... DEPARTMENT OF THE TREASURY Fiscal Service Financial Management Service; Proposed Collection of Information: Direct Deposit Sign-Up Form AGENCY: Financial Management Service, Fiscal Service, Treasury. ACTION: Notice and Request for comments. SUMMARY: The Financial Management Service, as part of its...

77 FR 43428 - Financial Management Service; Proposed Collection of Information: Minority Bank Deposit Program...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-24

... DEPARTMENT OF THE TREASURY Fiscal Service Financial Management Service; Proposed Collection of... Management Service, Fiscal Service, Treasury. ACTION: Notice and Request for comments. SUMMARY: The Financial... collection. By this notice, the Financial Management Service solicits comments concerning form FMS 3144...

76 FR 23860 - Financial Management Service Proposed Collection of Information: Schedule of Excess Risks

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-28

... DEPARTMENT OF THE TREASURY Fiscal Service Financial Management Service Proposed Collection of Information: Schedule of Excess Risks AGENCY: Financial Management Service, Fiscal Service, Treasury. ACTION: Notice and request for comments. SUMMARY: The Financial Management Service, as part of its continuing...

76 FR 23859 - Financial Management Service Proposed Collection of Information: CMIA Annual Report and Direct...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-28

... DEPARTMENT OF THE TREASURY Fiscal Service Financial Management Service Proposed Collection of Information: CMIA Annual Report and Direct Cost Claims AGENCY: Financial Management Service, Fiscal Service, Treasury. ACTION: Notice and request for comments. SUMMARY: The Financial Management Service, as part of...

75 FR 5849 - Financial Management Service; Proposed Collection of Information: Claim Against the United States...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-04

... DEPARTMENT OF THE TREASURY Fiscal Service Financial Management Service; Proposed Collection of... Management Service, Fiscal Service, Treasury. ACTION: Notice and Request for comments. SUMMARY: The Financial... collection. By this notice, the Financial Management Service solicits comments concerning the Form FMS-1133...

A systematic review of contemporary models of shared HIV care and HIV in primary care in high-income settings.

PubMed

Mapp, Fiona; Hutchinson, Jane; Estcourt, Claudia

2015-12-01

HIV shared care is uncommon in the UK although shared care could be a beneficial model of care. We review the literature on HIV shared care to determine current practice and clinical, economic and patient satisfaction outcomes. We searched MEDLINE, EMBASE, NICE Evidence, Cochrane collaboration, Google and websites of the British HIV Association, Aidsmap, Public Health England, World Health Organization and Terrence Higgins Trust using relevant search terms in August 2014. Studies published after 2000, from healthcare settings comparable to the UK that described links between primary care and specialised HIV services were included and compared using principles of the Critical Appraisal Skills Programme and Authority, Accuracy, Coverage, Objectivity, Date, Significance frameworks. Three of the nine included models reported clinical or patient satisfaction outcomes but data collection and analyses were inadequate. None reported economic outcomes although some provided financial costings. Facilitators of shared care included robust clinical protocols, training and timely communication. Few published examples of HIV shared care exist and quality of evidence is poor. There is no consistent association with improved clinical outcomes, cost effectiveness or acceptability. Models are context specific, driven by local need, although some generalisable features could inform novel service delivery. Further evaluative research is needed to determine optimal components of shared HIV care. © The Author(s) 2015.

The public health implications of United Kingdom offender healthcare policy: a holistic approach to achieve individual and societal gains.

PubMed

Senior, Jane; Shaw, Jenny

2011-01-01

In 2009, two seminal documents were published by the United Kingdom (UK) government concerning healthcare services for offenders. The Bradley review into diversion for people with mental health problems and learning disabilities emphasised a need to improve offender health, not least because of the high economic costs to society as a whole resulting from unresolved mental illness, physical ill-health and substance abuse problems commonly experienced by offenders. The Bradley review made wide-reaching recommendations for change, requiring strong partnership between health and justice agencies at both central government and local levels. A framework for the delivery of Bradley's recommendations has been set out in Improving health, supporting justice, the Department of Health's offender health strategy which sets out the direction of travel for the next 10 years. This paper discusses the reality of working toward improving health services for this marginalised group in the context of the influence of the current straitened financial climate on the allocation of resources to publically funded healthcare in the UK; it examines the historically based, and widely held, belief in the principle of "less eligibility" within our society, whereby there is much public and media resistance to allocating resources to improving care for offenders when other, more "deserving", groups are perceived to be in continuing need. Copyright © 2011 Elsevier Ltd. All rights reserved.

75 FR 4451 - Financial Management Service; Proposed Collection of Information: Final Rule-Management of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-27

... DEPARTMENT OF THE TREASURY Fiscal Service Financial Management Service; Proposed Collection of Information: Final Rule--Management of Federal Agency Disbursements. AGENCY: Financial Management Service, Fiscal Service, Treasury. ACTION: Notice and Request for comments. SUMMARY: The Financial Management...

77 FR 71035 - Financial Management Service; Proposed Collection of Information: Electronic Funds Transfer (EFT...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-28

... DEPARTMENT OF THE TREASURY Fiscal Service Financial Management Service; Proposed Collection of Information: Electronic Funds Transfer (EFT) Market Research Study AGENCY: Financial Management Service, Fiscal Service, Treasury. ACTION: Notice and Request for comments. SUMMARY: The Financial Management...

75 FR 42486 - Financial Management Service; Proposed Collection of Information: Authorization Agreement for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-21

... DEPARTMENT OF THE TREASURY Fiscal Service Financial Management Service; Proposed Collection of Information: Authorization Agreement for Preauthorized Payment (SF 5510) AGENCY: Financial Management Service, Fiscal Service, Treasury. ACTION: Notice and request for comments. SUMMARY: The Financial Management...

76 FR 38459 - Surety Companies Acceptable on Federal Bonds-Redomestication and Change in Business Address...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-30

... directed to the U.S. Department of the Treasury, Financial Management Service, Financial Accounting and...: June 22, 2011. Laura Carrico, Director, Financial Accounting and Services Division, Financial...: Financial Management Service, Fiscal Service, Department of the Treasury. ACTION: Notice. SUMMARY: This is...

75 FR 11228 - Surety Companies Acceptable on Federal Bonds: Pennsylvania Manufacturers Indemnity Company

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-10

... of the Treasury, Financial Management Service, Financial Accounting and Services Division, Surety... L. Cooper, Director, Financial Accounting and Services Division. [FR Doc. 2010-4938 Filed 3-9-10; 8...: Pennsylvania Manufacturers Indemnity Company AGENCY: Financial Management Service, Fiscal Service, Department...

42 CFR 441.484 - Financial management services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Financial management services. 441.484 Section 441... Optional Self-Directed Personal Assistance Services Program § 441.484 Financial management services. (a) States may choose to provide financial management services to participants, or their representatives, as...

42 CFR 441.484 - Financial management services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Financial management services. 441.484 Section 441... Optional Self-Directed Personal Assistance Services Program § 441.484 Financial management services. (a) States may choose to provide financial management services to participants, or their representatives, as...

42 CFR 441.484 - Financial management services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Financial management services. 441.484 Section 441... Optional Self-Directed Personal Assistance Services Program § 441.484 Financial management services. (a) States may choose to provide financial management services to participants, or their representatives, as...

42 CFR 441.484 - Financial management services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Financial management services. 441.484 Section 441... Optional Self-Directed Personal Assistance Services Program § 441.484 Financial management services. (a) States may choose to provide financial management services to participants, or their representatives, as...

76 FR 25782 - Financial Management Service; Proposed Collection of Information: List of Data (A) and List of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-05

... DEPARTMENT OF THE TREASURY Fiscal Service Financial Management Service; Proposed Collection of Information: List of Data (A) and List of Data (B) AGENCY: Financial Management Service, Fiscal Service, Treasury. ACTION: Notice and Request for comments. SUMMARY: The Financial Management Service, as part of...

Utilization of legal and financial services of partners in dementia care study.

PubMed

Shrestha, Srijana; Judge, Katherine S; Wilson, Nancy L; Moye, Jennifer A; Snow, A Lynn; Kunik, Mark E

2011-03-01

Financial and legal services are unique needs of persons with dementia and their caregivers. This study examines their need for legal and financial assistance and the kinds of legal and financial services provided within Partners in Dementia Care, a telephone-based, care coordination and support service intervention delivered through a partnership between Veterans Affairs (VA) medical centers and local Alzheimer's Association chapters. Based on comprehensive assessment, and needs prioritization, care coordinators collaboratively planned action steps (specific behavioral tasks) with each caregiver/person with dementia to address the dyad's identified unmet needs. Results show that 51 (54.8%) of 93 dyads reported a need for legal and financial services. Action steps related to legal and financial need included education or assistance with legal services (27.27%), nonhealth-related financial benefits (32.32%), health-related financial benefits (21.21%), financial management/planning (9.09%), and financial support (10.1%). Comparable numbers of action steps were directed to VA (41.4%) and non-VA (58.6%) services.

Differences by Degree: Evidence of the Net Financial Rates of Return to Undergraduate Study for England and Wales

ERIC Educational Resources Information Center

Walker, Ian; Zhu, Yu

2011-01-01

This paper provides estimates of the impact of higher education qualifications on the earnings of graduates in the U.K. by subject studied. We use data from the recent U.K. Labour Force Surveys which provide a sufficiently large sample to consider the effects of the subject studied, class of first degree, and postgraduate qualifications. Ordinary…

75 FR 61246 - Surety Companies Acceptable on Federal Bonds: Darwin National Assurance Company

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-04

... the U.S. Department of the Treasury, Financial Management Service, Financial Accounting and Services..., 2010. Laura Carrico, Director, Financial Accounting and Services Division, [FR Doc. 2010-24632 Filed 10... National Assurance Company AGENCY: Financial Management Service, Fiscal Service, Department of the Treasury...

Achieving workforce growth in UK nursing: policy options and implications.

PubMed

Buchan, James

2009-01-01

This paper examines how the National Health Service (NHS) in the UK achieved significant nursing workforce growth during the period between 2000 and 2006 and discusses the policy implications of the methods used to achieve this staffing growth. Data analysis, literature review and policy analysis. NHS nurse staffing growth was approximately 25% over the period 1997-2007, with most growth occurring in the years between 1999 and 2005. Whilst increases in intakes to home-based pre-registration education was a factor in achieving growth, the pace and level of growth which occurred was only possible by using active international recruitment, which was adopted as a deliberate national policy. The numbers of nurses and midwives entering the UK from other countries increased rapidly from 1999 onwards, to a peak in 2002, and then reduced markedly in the period from 2005 onwards. The policy of supporting international recruitment shifted rapidly in late 2005/2006 when financial difficulties hit the NHS and staffing growth was curtailed. Active international recruitment can contribute to health sector staffing growth, assuming the recruiting country has the resources to recruit and can tap into international markets, but it may not be effective in addressing all types of skills shortages. If it is not well linked to other components of workforce planning it may cause difficulties of over expansion, as well as raising broader issues of the ethics and impact.

Twenty-first-century medical microbiology services in the UK.

PubMed

Duerden, Brian

2005-12-01

With infection once again a high priority for the UK National Health Service (NHS), the medical microbiology and infection-control services require increased technology resources and more multidisciplinary staff. Clinical care and health protection need a coordinated network of microbiology services working to consistent standards, provided locally by NHS Trusts and supported by the regional expertise and national reference laboratories of the new Health Protection Agency. Here, I outline my thoughts on the need for these new resources and the ways in which clinical microbiology services in the UK can best meet the demands of the twenty-first century.

Depression in South Asian women living in the UK: a review of the literature with implications for service provision.

PubMed

Hussain, Feryad; Cochrane, Ray

2004-06-01

Research has shown that South Asian people in the UK underutilize health services compared with White people. Also, where services are accessed, they may not adequately meet cultural and religious needs. In exploring the relationship between the cultural and religious beliefs of South Asian service users about perceptions, beliefs about aetiology, cause and treatment of mental illness, past studies have illustrated a wide range of expectations, experiences, beliefs and attitudes. This article reviews research on depression in South Asian women in the UK, highlighting implications for services.

12 CFR 716.14 - Exceptions to notice and opt out requirements for processing and servicing transactions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... or processing a financial product or service that a consumer requests or authorizes; (2) Maintaining... maintain the consumer's account in the ordinary course of providing the financial service or financial... transaction, or information on the status or value of the financial service or financial product to the...

Prioritising wheelchair services for children: a pilot discrete choice experiment to understand how child wheelchair users and their parents prioritise different attributes of wheelchair services.

PubMed

Bray, Nathan; Yeo, Seow Tien; Noyes, Jane; Harris, Nigel; Edwards, Rhiannon Tudor

2016-01-01

Approximately 95 million children worldwide are disabled; 10 % use a wheelchair. In the UK, an estimated 770,000 children are disabled. National Health Service Wheelchair Services are the largest provider of wheelchairs in the UK; however, recent reports have highlighted issues with these services. This study explores the use of discrete choice experiment methods to inform wheelchair service provision for disabled children based on service user preferences. The aim was to explore how disabled children and their parents prioritise different attributes of wheelchair services. The secondary aims were to compare priorities between parents and disabled children and to explore marginal rate of substitution for incremental changes in attributes. Discrete choice experiments are a method of attribute-based stated preference valuation used by health economists to understand how individuals prioritise different attributes of healthcare services and treatments. We conducted the first pilot discrete choice experiment to explore how disabled children (aged 11 to 18) and their parents prioritise different attributes of hypothetical wheelchair services. Eleven disabled children (aged 11 to 18) and 30 parents of disabled children completed eight pairwise choice tasks based on five service attributes: wheelchair assessment, cost contribution, training, delivery time and frequency of review. Data were analysed using conditional logistic regression. For each pairwise choice, the participants were asked to choose which service scenario (A or B) they preferred. Comprehensiveness of wheelchair assessment and wheelchair delivery time significantly ( P  < 0.05) affected service preferences of children ( β -coefficients = 1.43 [95 % bootstrapped CI = 1.42 to 2.08] and -0.92 [95 % bootstrapped CI = -1.41 to -0.84], respectively) and parents ( β -coefficients = 1.53 [95 % bootstrapped CI = 1.45 to 2.16] and -1.37 [95 % bootstrapped CI = -1.99 to -1.31], respectively). Parents were willing to contribute more financially to receive preferred services, although this was non-significant. Both samples placed the greatest importance on holistic wheelchair assessments encompassing more than health. The National Health Service should consider using discrete choice experiment methods to examine wheelchair service preferences of disabled children (aged 11 and over) and their parents on a wider scale; however, care must be taken to ensure that this method is used appropriately.

77 FR 75263 - Surety Companies Acceptable on Federal Bonds: Termination; ULLICO Casualty Company

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-19

.... Department of the Treasury, Financial Management Service, Financial Accounting and Services Division, Surety... McIntyre, Acting Director, Financial Accounting and Services Division. [FR Doc. 2012-30422 Filed 12-18-12...: Termination; ULLICO Casualty Company AGENCY: Financial Management Service, Fiscal Service, Department of the...

Setting the stage for the EPOS ERIC: Integration of the legal, governance and financial framework

NASA Astrophysics Data System (ADS)

Atakan, Kuvvet; Bazin, Pierre-Louis; Bozzoli, Sabrina; Freda, Carmela; Giardini, Domenico; Hoffmann, Thomas; Kohler, Elisabeth; Kontkanen, Pirjo; Lauterjung, Jörn; Pedersen, Helle; Saleh, Kauzar; Sangianantoni, Agata

2017-04-01

EPOS - the European Plate Observing System - is the ESFRI infrastructure serving the need of the solid Earth science community at large. The EPOS mission is to create a single sustainable, and distributed infrastructure that integrates the diverse European Research Infrastructures for solid Earth science under a common framework. Thematic Core Services (TCS) and Integrated Core Services (Central Hub, ICS-C and Distributed, ICS-D) are key elements, together with NRIs (National Research Infrastructures), in the EPOS architecture. Following the preparatory phase, EPOS has initiated formal steps to adopt an ERIC legal framework (European Research Infrastructure Consortium). The statutory seat of EPOS will be in Rome, Italy, while the ICS-C will be jointly operated by France, UK and Denmark. The TCS planned so far cover: seismology, near-fault observatories, GNSS data and products, volcano observations, satellite data, geomagnetic observations, anthropogenic hazards, geological information modelling, multiscale laboratories and geo-energy test beds for low carbon energy. In the ERIC process, EPOS and all its services must achieve sustainability from a legal, governance, financial, and technical point of view, as well as full harmonization with national infrastructure roadmaps. As EPOS is a distributed infrastructure, the TCSs have to be linked to the future EPOS ERIC from legal and governance perspectives. For this purpose the TCSs have started to organize themselves as consortia and negotiate agreements to define the roles of the different actors in the consortium as well as their commitment to contribute to the EPOS activities. The link to the EPOS ERIC shall be made by service agreements of dedicated Service Providers. A common EPOS data policy has also been developed, based on the general principles of Open Access and paying careful attention to licensing issues, quality control, and intellectual property rights, which shall apply to the data, data products, software and services (DDSS) accessible through EPOS. From a financial standpoint, EPOS elaborated common guidelines for all institutions providing services, and selected a costing model and funding approach which foresees a mixed support of the services via national contributions and ERIC membership fees. In the EPOS multi-disciplinary environment, harmonization and integration are required at different levels and with a variety of different stakeholders; to this purpose, a Service Coordination Board (SCB) and technical Harmonization Groups (HGs) were established to develop the EPOS metadata standards with the EPOS Integrated Central Services, and to harmonize data and product standards with other projects at European and international level, including e.g. ENVRI+, EUDAT and EarthCube (US).

The EMBL-EBI bioinformatics web and programmatic tools framework.

PubMed

Li, Weizhong; Cowley, Andrew; Uludag, Mahmut; Gur, Tamer; McWilliam, Hamish; Squizzato, Silvano; Park, Young Mi; Buso, Nicola; Lopez, Rodrigo

2015-07-01

Since 2009 the EMBL-EBI Job Dispatcher framework has provided free access to a range of mainstream sequence analysis applications. These include sequence similarity search services (https://www.ebi.ac.uk/Tools/sss/) such as BLAST, FASTA and PSI-Search, multiple sequence alignment tools (https://www.ebi.ac.uk/Tools/msa/) such as Clustal Omega, MAFFT and T-Coffee, and other sequence analysis tools (https://www.ebi.ac.uk/Tools/pfa/) such as InterProScan. Through these services users can search mainstream sequence databases such as ENA, UniProt and Ensembl Genomes, utilising a uniform web interface or systematically through Web Services interfaces (https://www.ebi.ac.uk/Tools/webservices/) using common programming languages, and obtain enriched results with novel visualisations. Integration with EBI Search (https://www.ebi.ac.uk/ebisearch/) and the dbfetch retrieval service (https://www.ebi.ac.uk/Tools/dbfetch/) further expands the usefulness of the framework. New tools and updates such as NCBI BLAST+, InterProScan 5 and PfamScan, new categories such as RNA analysis tools (https://www.ebi.ac.uk/Tools/rna/), new databases such as ENA non-coding, WormBase ParaSite, Pfam and Rfam, and new workflow methods, together with the retirement of depreciated services, ensure that the framework remains relevant to today's biological community. © The Author(s) 2015. Published by Oxford University Press on behalf of Nucleic Acids Research.

Overactive, Overwrought or Overdrawn? The Role of Personality in Undergraduate Financial Knowledge, Decision-Making and Debt

ERIC Educational Resources Information Center

Harrison, Neil; Chudry, Farooq

2011-01-01

The financial situation of undergraduate students remains a high-profile issue within the UK higher education sector, not least due to its perceived relationship with retention, well-being and success. This article probes this question from a new direction, using concepts and approaches from the field of applied psychology to examine how students…

Students' Production of Curricular Knowledge: Perspectives on Empowerment in Financial Capability Education

ERIC Educational Resources Information Center

Farnsworth, Valerie; Davis, Pauline; Kalambouka, Afroditi; Ralph, Susan; Shi, Xin; Farrell, Peter

2011-01-01

The aim of this article is to extend our understanding of the relationship between knowledge of personal finance and empowerment. The analysis is based on interview data obtained as part of a longitudinal study of students, aged 16-19, who completed a financial capability course in the UK. The analysis presents a set of cultural models or…

Quality or financing: what drives design of the health care system?

PubMed Central

McLoughlin, V; Leatherman, S

2003-01-01



 The scope and scale of problems in the quality of health service provision have been increasingly recognised in recent years. Policy and planning for financing are usually concerned with how funding is made available and allocated, rather than with what is being achieved, including the quality of health services delivered. A fundamental challenge is how to improve the delivery of health services to achieve improved patient outcomes and to optimize financial outcomes. To accomplish this it is essential that the debates on quality of care and financing are aligned. Approaches to improving the quality of care are drawn from Australia, the US, and the UK. Financing arrangments for care at a national level have a bearing on how payment incentives can be used to promote or impede quality. The level of overall expenditure is obviously important, as are the mechanisms for payment. Long term programs to build knowledge, standardise processes, provide credible performance data and foster accountability are required to ensure that further investments lead to improvement in care. PMID:12679511

Can Six Sigma be the "cure" for our "ailing" NHS?

PubMed

Antony, Jiju; Downey-Ennis, Kay; Antony, Frenie; Seow, Chris

2007-01-01

The purpose of this research is to analyse whether Six Sigma business strategy can be used to improve the financial and operational performance of the NHS. The paper will also look at some of the major challenges and barriers in the implementation of this powerful process improvement strategy within the healthcare sector. This paper discusses whether Six Sigma DMAIC methodology can be a useful and disciplined approach to tackle process- and quality-related problems in the NHS. The paper presents some key findings from other researchers in the field, followed by some comments on whether Six Sigma is a useful approach to be considered by the NHS for cost reduction and defect reduction strategies. The paper illustrates the point that Six Sigma is not confined just to manufacturing industry, rather it is equally applicable to service industry, especially the healthcare and financial sectors. The application of Six Sigma in the UK health sector is relatively new and the purpose of the paper is to increase the awareness of this powerful business strategy in healthcare discipline.

A survey of the opinions of recent veterinary graduates and employers regarding early career business skills.

PubMed

Bachynsky, E A; Dale, V H M; Kinnison, T; Gazzard, J; Baillie, S

2013-06-08

A questionnaire was designed to assess recent veterinary graduates' proficiency in early career business skills, from the perspectives of graduates of 2006-2008 and employers of recent graduates in the UK. Recent graduates perceived themselves to be generally more competent in financial matters than employers considered them to be. However, when specific skills were assessed, graduates felt less prepared than employers considered them to be competent. Overall, graduates and employers rated recent graduates' preparedness/competence as poor to average for all skills, which were regarded as having average to high importance. Both groups commented on the difficulties faced by new graduates in terms of client communication (generally and financially), and having the confidence to charge clients appropriately for veterinary services. The results of this study indicate that veterinary schools need to take a more active role in the teaching of basic finance skills in order to equip graduates with essential early career competencies. It is anticipated that the information reported will help inform undergraduate curriculum development and highlight the need for increased training at the continuing education level.

78 FR 8596 - Hartford Financial Services Group, Inc., Commercial/Actuarial/ Information Delivery Services (IDS...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-06

... Delivery Services (IDS)/Corporate & Financial Reporting group, Hartford, Connecticut (The Hartford-IDS... technology applications for corporate, regulatory, and financial reporting. Pursuant to 29 CFR 90.18(c...., Commercial/Actuarial/Information Delivery Services (IDS)/ Corporate & Financial Reporting group, Hartford...

32 CFR 299.4 - Responsibilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) Compiling the annual FOIA report. (c) The Chief, Accounting and Financial Services (DF22) is responsible for... Financial Services, payment may be received directly in Accounting and Financial Services. Such payment may... initiated by Accounting and Financial Services; and (4) Issuing a prompt reimbursement of overpaid fees to...

JPRS Report, East Europe.

DTIC Science & Technology

1991-06-28

Interviewed [TRUD 21 Jun] 4 Ecoglasnost Clarifies Its Character [DEMOKRÄTSIYA 21 Jun] 5 UK Cluff Company To Drill for Oil [BTA] 5 Financial...really independent, not involved with the executive power, and always in opposition, they said in conclusion. UK Cluff Company To Drill for Oil ...prospect oil on Bulgaria’s territory under a contract which was signed today by Prof. Vasil Balinov, chairman of the Committee on Geology and Mineral

Being an identity-release donor: a qualitative study exploring the motivations, experiences and future expectations of current UK egg donors.

PubMed

Graham, Susanna; Jadva, Vasanti; Freeman, Tabitha; Ahuja, Kamal; Golombok, Susan

2016-12-01

The objective of this study was to examine the motivations, experiences and future expectations of identity-release egg donors in the UK following the removal of donor anonymity and the increase in financial compensation for egg donation. This exploratory, in-depth qualitative study comprised semi-structured interviews with 11 women who had attended an egg donation screening appointment at a UK clinic during a four-month period in 2014. Interviews were conducted two to six weeks after the woman had donated or had withdrawn/been rejected from the donation process. Participants' primary motivation for donating was to help infertile women have their 'own child', and the recent increase in financial compensation did not seem to play a significant role in their decision. All were happy to be identifiable and contacted by children born as a result of their donation. However, some were hesitant about providing non-identifying information about themselves for these offspring and wished for further information about the recipient(s) of their eggs and the outcome of their donation. Whilst this study was limited due to the small sample size, it is the first study of UK egg donors following the rise in donor compensation and suggests that other strategies may be more effective in increasing donor numbers.

Financial Services and the Internet: What Does Cyberspace Mean for the Financial Services Industry?

ERIC Educational Resources Information Center

Birch, David; Young, Michael A.

1997-01-01

More than 30 million households own PCs and more than 20% of these use PCs to manage their finances. This article examines the Internet and financial services, consumer needs, and differentiation in service products and predicts future trends in retail financial services (cheaper niche products, cross-border selling, selling knowledge, payments,…

17 CFR 160.14 - Exceptions to notice and opt out requirements for processing and servicing transactions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... or authorizes, or in connection with: (1) Processing or servicing a financial product or service that... persons engaged in carrying out the financial transaction or providing the product or service; or (2...'s account in the ordinary course of providing the financial service or financial product; (ii) To...

UK role 4 military infection services: past, present and future.

PubMed

Dufty, Ngozi E; Bailey, M S

2013-09-01

NATO describes 'Role 4' military medical services as those provided for the definitive care of patients who cannot be treated within a theatre of operations and these are usually located in a military force's country of origin and may include the involvement of civilian medical services. The UK Defence Medical Services have a proud history of developing and providing clinical services in infectious diseases and tropical medicine, sexual health and HIV medicine, and medical microbiology and virology. These UK Role 4 Military Infection Services have adapted well to recent overseas deployments, but new challenges will arise due to current military cutbacks and a greater diversity of contingency operations in the future. Further evidence-based development of these services will require leadership by military clinicians and improved communication and support for 'reach-back' services.

77 FR 10806 - Surety Companies Acceptable on Federal Bonds: Termination; First Sealord Surety, Inc.

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-23

... 20782. Dated: February 10, 2012. Laura Carrico, Director, Financial Accounting and Services Division...: Termination; First Sealord Surety, Inc. AGENCY: Financial Management Service, Fiscal Service, Department of... be directed to the U.S. Department of the Treasury, Financial Management Service, Financial...

75 FR 60865 - Surety Companies Acceptable on Federal Bonds: Amendment-Allegheny Casualty Company

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-01

... 20782. Dated: September 24, 2010. Laura Carrico, Director, Financial Accounting and Services Division...-- Allegheny Casualty Company AGENCY: Financial Management Service, Fiscal Service, Department of the Treasury... notice may be directed to the U.S. Department of the Treasury, Financial Management Service, Financial...

75 FR 22689 - Surety Companies Acceptable on Federal Bonds: General Casualty Company of Wisconsin

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-29

... to the U.S. Department of the Treasury, Financial Management Service, Financial Accounting and...: April 13, 2010. Sandra Paylor-Sanders, Acting Director, Financial Accounting and Services Division. [FR... Casualty Company of Wisconsin AGENCY: Financial Management Service, Fiscal Service, Department of the...

76 FR 77590 - Financial Management Service; Proposed Collection of Information: Request for Payment of Federal...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-13

... DEPARTMENT OF THE TREASURY Fiscal Service Financial Management Service; Proposed Collection of Information: Request for Payment of Federal Benefit by Check, EFT Waiver Form AGENCY: Financial Management... to Financial Management Service, 3700 East West Highway, Records and Information Management Branch...

Exploration of Counsellors' Perceptions of the Redesigned Service Pathways: A Qualitative Study of a UK University Student Counselling Service

ERIC Educational Resources Information Center

Randall, Eve M.; Bewick, Bridgette M.

2016-01-01

To address the mental health needs of students, UK universities offer bespoke student counselling services. Economic pressures have led services to find innovative ways of redesigning their service pathway. Few studies have investigated staff perceptions of these changes. The aim of this study was to investigate perceptions of staff employed as…

Unintended Consequences of Incentive Provision for Behaviour Change and Maintenance around Childbirth

PubMed Central

Thomson, Gill; Morgan, Heather; Crossland, Nicola; Bauld, Linda; Dykes, Fiona; Hoddinott, Pat

2014-01-01

Financial (positive or negative) and non-financial incentives or rewards are increasingly used in attempts to influence health behaviours. While unintended consequences of incentive provision are discussed in the literature, evidence syntheses did not identify any primary research with the aim of investigating unintended consequences of incentive interventions for lifestyle behaviour change. Our objective was to investigate perceived positive and negative unintended consequences of incentive provision for a shortlist of seven promising incentive strategies for smoking cessation in pregnancy and breastfeeding. A multi-disciplinary, mixed-methods approach included involving two service-user mother and baby groups from disadvantaged areas with experience of the target behaviours as study co-investigators. Systematic reviews informed the shortlist of incentive strategies. Qualitative semi-structured interviews and a web-based survey of health professionals asked open questions on positive and negative consequences of incentives. The participants from three UK regions were a diverse sample with and without direct experience of incentive interventions: 88 pregnant women/recent mothers/partners/family members; 53 service providers; 24 experts/decision makers and interactive discussions with 63 conference attendees. Maternity and early years health professionals (n = 497) including doctors, midwives, health visitors, public health and related staff participated in the survey. Qualitative analysis identified ethical, political, cultural, social and psychological implications of incentive delivery at population and individual levels. Four key themes emerged: how incentives can address or create inequalities; enhance or diminish intrinsic motivation and wellbeing; have a positive or negative effect on relationships with others within personal networks or health providers; and can impact on health systems and resources by raising awareness and directing service delivery, but may be detrimental to other health care areas. Financial incentives are controversial and generated emotive and oppositional responses. The planning, design and delivery of future incentive interventions should evaluate unexpected consequences to inform the evidence for effectiveness, cost-effectiveness and future implementation. PMID:25357121

Unintended consequences of incentive provision for behaviour change and maintenance around childbirth.

PubMed

Thomson, Gill; Morgan, Heather; Crossland, Nicola; Bauld, Linda; Dykes, Fiona; Hoddinott, Pat; Dombrowski, Stephan; MacLennan, Graeme; Rothnie, Kieran; Stewart, Fiona; Farrar, Shelley; Yi, Deokhee; Hislop, Jenni; Ludbrook, Anne; Campbell, Marion; Moran, Victoria Hall; Sniehotta, Falko; Tappin, David

2014-01-01

Financial (positive or negative) and non-financial incentives or rewards are increasingly used in attempts to influence health behaviours. While unintended consequences of incentive provision are discussed in the literature, evidence syntheses did not identify any primary research with the aim of investigating unintended consequences of incentive interventions for lifestyle behaviour change. Our objective was to investigate perceived positive and negative unintended consequences of incentive provision for a shortlist of seven promising incentive strategies for smoking cessation in pregnancy and breastfeeding. A multi-disciplinary, mixed-methods approach included involving two service-user mother and baby groups from disadvantaged areas with experience of the target behaviours as study co-investigators. Systematic reviews informed the shortlist of incentive strategies. Qualitative semi-structured interviews and a web-based survey of health professionals asked open questions on positive and negative consequences of incentives. The participants from three UK regions were a diverse sample with and without direct experience of incentive interventions: 88 pregnant women/recent mothers/partners/family members; 53 service providers; 24 experts/decision makers and interactive discussions with 63 conference attendees. Maternity and early years health professionals (n = 497) including doctors, midwives, health visitors, public health and related staff participated in the survey. Qualitative analysis identified ethical, political, cultural, social and psychological implications of incentive delivery at population and individual levels. Four key themes emerged: how incentives can address or create inequalities; enhance or diminish intrinsic motivation and wellbeing; have a positive or negative effect on relationships with others within personal networks or health providers; and can impact on health systems and resources by raising awareness and directing service delivery, but may be detrimental to other health care areas. Financial incentives are controversial and generated emotive and oppositional responses. The planning, design and delivery of future incentive interventions should evaluate unexpected consequences to inform the evidence for effectiveness, cost-effectiveness and future implementation.

The Evidence Information Service as a New Platform for Supporting Evidence-Based Policy: A Consultation of UK Parliamentarians

ERIC Educational Resources Information Center

Lawrence, Natalia S.; Chambers, Jemma C.; Morrison, Sinead M.; Bestmann, Sven; O'Grady, Gerard; Chambers, Christopher D.; Kythreotis, Andrew

2017-01-01

The value of evidence-based policy is well established, yet major hurdles remain in connecting policymakers with the wider research community. Here we assess whether a UK Evidence Information Service (EIS) could facilitate interaction between parliamentarians and research professionals. Fifty-six UK parliamentarians were interviewed to gauge the…

78 FR 17234 - Negotiated Service Agreement

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-20

... Postal Service filing concerning an amendment to Discover Financial Services Negotiated Service Agreement... U.S.C. 3622 and 3642, as well as 39 CFR 3010 and 3020, et seq., to add a Discover Financial Services... Request to Add Discover Financial Services Negotiated Service Agreement to the Market-Dominant Product...

76 FR 25783 - Surety Companies Acceptable on Federal Bonds; Name Change: Odyssey America Reinsurance Corporation

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-05

... directed to the U.S. Department of the Treasury, Financial Management Service, Financial Accounting and...: April 22, 2011. Laura Carrico, Director, Financial Accounting and Services Division. [FR Doc. 2011-10773... Change: Odyssey America Reinsurance Corporation AGENCY: Financial Management Service, Fiscal Service...

75 FR 36153 - Surety Companies Acceptable On Federal Bonds-Change in Business Address and Redomestication...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-24

... 20782. Dated: June 10, 2010. William J. Erie, Acting Director, Financial Accounting and Services...; LM Insurance Corporation AGENCY: Financial Management Service, Fiscal Service, Department of the... Notice may be directed to the U.S. Department of the Treasury, Financial Management Service, Financial...

76 FR 60603 - Surety Companies Acceptable on Federal Bonds: Termination; Minnesota Surety and Trust Company

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-29

... 20782. Dated: September 15, 2011. Laura Carrico, Director, Financial Accounting and Services Division...: Termination; Minnesota Surety and Trust Company AGENCY: Financial Management Service, Fiscal Service... notice may be directed to the U.S. Department of the Treasury, Financial Management Service, Financial...

31 CFR 537.305 - Exportation or reexportation of financial services to Burma.

Code of Federal Regulations, 2010 CFR

2010-07-01

... financial services to Burma. 537.305 Section 537.305 Money and Finance: Treasury Regulations Relating to... SANCTIONS REGULATIONS General Definitions § 537.305 Exportation or reexportation of financial services to Burma. The term exportation or reexportation of financial services to Burma means: (a) The transfer of...

75 FR 43557 - TA-W-73,682, Hartford Financial Services Group, Incorporated, Medical Bill Processing and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-26

... Leased Workers From Beeline: Aurora, IL; TA-W-73,682A, Hartford Financial Services Group, Incorporated..., applicable to workers of Hartford Financial Services Group, Incorporated, Medical Bill Processing and Production Center Support, Aurora, Illinois and Hartford Financial Services Group, Incorporated, Medical Bill...

12 CFR 721.3 - What categories of activities are preapproved as incidental powers necessary or requisite to...

Code of Federal Regulations, 2010 CFR

2010-01-01

..., employees and data processing. (e) Financial counseling services. Financial counseling services means advice... financial matters. Financial counseling services may include income tax preparation service, electronic tax filing for your members, counseling regarding estate and retirement planning, investment counseling, and...

76 FR 57907 - Indorsement and Payment of Checks Drawn on the United States Treasury

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-19

... Checks Drawn on the United States Treasury AGENCY: Financial Management Service, Fiscal Service, Treasury...), Financial Management Service (FMS), to direct Federal Reserve Banks to debit a financial institution's... the Treasury (Treasury), Financial Management Service (FMS),\\1\\ is amending its regulation at 31 CFR...

75 FR 77044 - Financial Management Service; Privacy Act of 1974, as Amended; System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-10

... DEPARTMENT OF THE TREASURY Financial Management Service; Privacy Act of 1974, as Amended; System of Records AGENCY: Financial Management Service, Treasury. ACTION: Withdrawal of a Privacy Act Notice... behalf of the Financial Management Service. DATES: December 10, 2010. FOR FURTHER INFORMATION CONTACT...

31 CFR Appendix G to Subpart C of... - Financial Management Service

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Financial Management Service G... Management Service 1. In general. This appendix applies to the Financial Management Service. It sets forth... requests for notification and access to records and accountings of disclosures for the Financial Management...

Integration of production and financial models to analyse the financial impact of livestock diseases: a case study of Schmallenberg virus disease on British and French dairy farms

PubMed Central

Häsler, Barbara; Alarcon, Pablo; Raboisson, Didier; Waret-Szkuta, Agnes; Rushton, Jonathan

2015-01-01

Aims and objectives The aim of the study was to investigate and compare the financial impact of Schmallenberg disease for different dairy production types in the United Kingdom and France. Materials and methods Integrated production and financial models for dairy cattle were developed and applied to Schmallenberg virus (SBV) disease in a British and French context. The five main production systems that prevail in these two countries were considered. Their respective gross margins measuring the holding's profitability were calculated based on public benchmarking, literature and expert opinion data. A partial budget analysis was performed within each production model to estimate the impact of SBV in the systems modelled. Two disease scenarios were simulated: low impact and high impact. Results The model gross margin obtained per cow space and year ranged from £1014 to £1484 for the UK and from £1037 to £1890 for France depending on the production system considered. In the UK, the net SBV disease costs in £/cow space/year for an average dairy farm with 100 milking spaces were estimated between £16.3 and £51.4 in the high-impact scenario and between £8.2 and £25.9 in the low-impact scenario. For France, the net SBV disease costs in £/cow space/year ranged from £19.6 to £48.6 in the high-impact scenario and £9.7 to £22.8 in the low-impact scenario, respectively. Conclusion The study illustrates how the combination of production and financial models allows assessing disease impact taking into account differing management and husbandry practices and associated price structures in the dairy sector. It supports decision-making of farmers and veterinarians who are considering disease control measures as it provides an approach to estimate baseline disease impact in common dairy production systems in the UK and France. PMID:26392883

75 FR 1683 - Financial Management Service; Proposed Collection of Information: Assignment Form

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-12

... DEPARTMENT OF THE TREASURY Fiscal Service Financial Management Service; Proposed Collection of Information: Assignment Form AGENCY: Financial Management Service, Fiscal Service, Treasury. ACTION: Notice... Management Service, Records and Information Management Branch, Room 135, 3700 East West Highway, Hyattsville...

Standardised tobacco packaging: a health policy case study of corporate conflict expansion and adaptation

PubMed Central

Hatchard, Jenny L; Fooks, Gary J; Gilmore, Anna B

2016-01-01

Objectives To investigate opposition to standardised tobacco packaging in the UK. To increase understanding of how transnational corporations are adapting to changes in their access to policymakers precipitated by Article 5.3 of the Framework Convention on Tobacco Control (FCTC). Design Case study web-based documentary analysis, using NVivo V.10. Examination of relationships between opponents of standardised packaging and transnational tobacco companies (TTCs) and of the volume, nature, transparency and timing of their activities. Setting UK standardised packaging policy debate 2011–2013. Participants Organisations selected on basis of opposition to, or facilitation thereof, standardised tobacco packaging in the UK; 422 associated documents. Results Excluding tobacco manufacturing and packaging companies (n=12), 109 organisations were involved in opposing standardised packaging, 82 (75%) of which had a financial relationship with 1 or more TTC. These 82 organisations (43 actively opposing the measure, 39 facilitating opposition) were responsible for 60% of the 404 activities identified, including the majority of public communications and research production. TTCs were directly responsible for 28% of total activities, predominantly direct lobbying, but also financially underwrote third party research, communication, mass recruitment and lobbying. Active organisations rarely reported any financial relationship with TTCs when undertaking opposition activities. Conclusions The multifaceted opposition to standardised packaging was primarily undertaken by third parties with financial relationships with major tobacco manufacturers. Low levels of transparency regarding these links created a misleading impression of diverse and widespread opposition. Countries should strengthen implementation of Article 5.3 of the FCTC by systematically requiring conflict of interest declarations from all organisations participating in political or media debates on tobacco control. PMID:27855104

Addressing oil price changes through business profitability in oil and gas industry in the United Kingdom.

PubMed

Vătavu, Sorana; Lobonț, Oana-Ramona; Para, Iulia; Pelin, Andrei

2018-01-01

In this paper, we investigate how crude oil price and volume traded affected the profitability of oil and gas companies in the United Kingdom (UK) since the financial crisis started in 2008. The study benefit from insights of the financial statements, to develop a model that focuses on how changes in oil price impact corporate performance. In order to observe the financial indicators that influence the performance, as well as the effects that changes in oil prices and demand of crude oil have on the profitability of oil and gas companies, we apply comparative regression analysis, including the generalised method of moments estimation technique for panel data set. The sample is consisting of 31 oil and gas companies in the UK, and the period analysed is 2006-2014. Results show that profitable oil and gas companies managed to face the drop in oil price and recover, characterized by significant cash flows and stock turnover, efficient use of assets, and high solvency rates. Although the oil price and volume traded do not significantly affect profitability and other financial ratios, if the oil price continues to decrease, it would permanently alter both the UK economy and oil and gas companies. In order to survive, companies make drastic cuts and defer essential investments, often at the long-term expense of asset performance. This study is important in a world where the energy consumption steadily grew over time. However, the renewable energy is cheaper and more environmentally friendly, and thus, countries where oil and gas industry is one of the most popular sectors face an economic decline. These results could be useful for investors, managers or decision makers, reclaiming strategic decisions in the current uncertain and volatile environment.

Clinical-outcome-based demand management in health services.

PubMed

Brogan, C; Lawrence, D; Mayhew, L

2008-01-01

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

The impact of Thatcherism on health and well-being in Britain.

PubMed

Scott-Samuel, Alex; Bambra, Clare; Collins, Chik; Hunter, David J; McCartney, Gerry; Smith, Kat

2014-01-01

Margaret Thatcher (1925-2013) was the United Kingdom's prime minister from 1979 to 1990. Her informal transatlantic alliance with U.S. President Ronald Reagan from 1981 to 1989 played an important role in the promotion of an international neoliberal policy agenda that remains influential today. Her critique of UK social democracy during the 1970s and her adoption of key neoliberal strategies, such as financial deregulation, trade liberalization, and the privatization of public goods and services, were popularly labeled Thatcherism. In this article, we consider the nature of Thatcherism and its impact on health and well-being during her period as prime minister and, to a lesser extent, in the years that follow; we focus mainly on Great Britain (England, Scotland, and Wales). Thatcher's policies were associated with substantial increases in socioeconomic and health inequalities: these issues were actively marginalized and ignored by her governments. In addition, her public-sector reforms applied business principles to the welfare state and prepared the National Health Service for subsequent privatization.

Addressing the knowledge gap: sexual violence and harassment in the UK Armed Forces.

PubMed

Godier, Lauren R; Fossey, M

2017-09-06

Despite media interest in alleged sexual violence and harassment in the UK military, there remains a paucity of UK-based peer-reviewed research in this area. Ministry of Defence and service-specific reports support the suggestion that UK service personnel may be at risk of experiencing sexual harassment. These reports however highlight a reluctance by service personnel to report sexual harassment through official channels. In this article, we discuss the paucity of UK-based research pertaining to the prevalence and impact of sexual harassment in the military, explore potential reasons for this gap in knowledge and outline future directions and priorities for academic research. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

75 FR 37881 - Surety Companies Acceptable on Federal Bonds-Change in State of Incorporation United States...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-30

..., Financial Management Service, Financial Accounting and Services Division, Surety Bond Branch, 3700 East-West..., Financial Accounting and Services Division. [FR Doc. 2010-15614 Filed 6-29-10; 8:45 am] BILLING CODE 4810-35... State of Incorporation United States Fidelity and Guaranty Company AGENCY: Financial Management Service...

77 FR 64358 - Investigations Regarding Eligibility To Apply for Worker Adjustment Assistance

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-19

... (Company). 82048 Hartford Financial Services Windsor, CT 10/04/12 10/03/12 Group, Inc. (Company). 82049 Hartford Financial Services Simsbury, CT 10/04/12 10/03/12 Group, Inc. (Company). 82050 Hartford Financial Services Simsbury, CT 10/04/12 10/03/12 Group, Inc. (Company). 82051 Hartford Financial Services Clinton...

Knowledge Construction and Personal Relationship: Insights about a UK University Mentoring and Coaching Service

ERIC Educational Resources Information Center

Hargreaves, Eleanore

2010-01-01

This article examines interview data from 12 mentors/coaches and eight of their clients in order to explore a mentoring and coaching service among UK university staff. Both mentors/coaches and clients were administrative or academic employees of the Institute of Education or affiliated colleges at London University, UK. Their roles related to the…

The perceived impact of the National Health Service on personalised nutrition service delivery among the UK public.

PubMed

Fallaize, Rosalind; Macready, Anna L; Butler, Laurie T; Ellis, Judi A; Berezowska, Aleksandra; Fischer, Arnout R H; Walsh, Marianne C; Gallagher, Caroline; Stewart-Knox, Barbara J; Kuznesof, Sharon; Frewer, Lynn J; Gibney, Mike J; Lovegrove, Julie A

2015-04-28

Personalised nutrition (PN) has the potential to reduce disease risk and optimise health and performance. Although previous research has shown good acceptance of the concept of PN in the UK, preferences regarding the delivery of a PN service (e.g. online v. face-to-face) are not fully understood. It is anticipated that the presence of a free at point of delivery healthcare system, the National Health Service (NHS), in the UK may have an impact on end-user preferences for deliverances. To determine this, supplementary analysis of qualitative data obtained from focus group discussions on PN service delivery, collected as part of the Food4Me project in the UK and Ireland, was undertaken. Irish data provided comparative analysis of a healthcare system that is not provided free of charge at the point of delivery to the entire population. Analyses were conducted using the 'framework approach' described by Rabiee (Focus-group interview and data analysis. Proc Nutr Soc 63, 655-660). There was a preference for services to be led by the government and delivered face-to-face, which was perceived to increase trust and transparency, and add value. Both countries associated paying for nutritional advice with increased commitment and motivation to follow guidelines. Contrary to Ireland, however, and despite the perceived benefit of paying, UK discussants still expected PN services to be delivered free of charge by the NHS. Consideration of this unique challenge of free healthcare that is embedded in the NHS culture will be crucial when introducing PN to the UK.

78 FR 31629 - Treasury Order Establishing the Bureau of the Fiscal Service

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-24

... within the Department the Bureau of the Fiscal Service, consolidating the Financial Management Service... Public Debt and the Financial Management Service as the Bureau of the Fiscal Service. The Order delegates... Commissioner of the Public Debt and the Commissioner, Financial Management Service. The Order also provides for...

25 CFR 20.102 - What is the Bureau's policy in providing financial assistance and social services under this part?

Code of Federal Regulations, 2010 CFR

2010-04-01

..., DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Definitions... this part to eligible Indians when comparable financial assistance or social services are either not... 25 Indians 1 2010-04-01 2010-04-01 false What is the Bureau's policy in providing financial...

34 CFR 361.54 - Participation of individuals in cost of services based on financial need.

Code of Federal Regulations, 2010 CFR

2010-07-01

... types of vocational rehabilitation services for which the unit has established a financial needs test... service. (3) The designated State unit may not apply a financial needs test, or require the financial... 34 Education 2 2010-07-01 2010-07-01 false Participation of individuals in cost of services based...

75 FR 44307 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-28

... expand the capacity of financial institutions to provide credit, capital and financial services to...), which provide credit, capital, financial services, and development services to these markets. The CDFI... Clearance Officer: Ashanti McCallum, Community Development Financial Institutions Fund, Department of the...

78 FR 773 - Hartford Financial Services Group, Inc., Commercial/Actuarial/Information Delivery Services (IDS...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-04

...., Commercial/ Actuarial/Information Delivery Services (IDS)/Corporate & Financial Reporting group, Hartford... financial reporting. The group develops databases for creating reports for corporate, regulatory, and... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-81,815] Hartford Financial...

Nurturing the H in HR: Using Action Learning to Build Organisation Development Capability in the UK Civil Service

ERIC Educational Resources Information Center

Hale, Richard; Saville, Martin

2014-01-01

In the UK, the Civil Service Reform Plan is being implemented with urgency. This requires Civil Service departments and agencies to reform their structures and ways of working in order to deliver effective services in a climate of economic austerity and rapid social and technological change. Historically, Human Resource (HR) professionals have…

Austerity: a failed experiment on the people of Europe.

PubMed

McKee, Martin; Karanikolos, Marina; Belcher, Paul; Stuckler, David

2012-08-01

Many governments in Europe, either of their own volition or at the behest of the international financial institutions, have adopted stringent austerity policies in response to the financial crisis. By contrast, the USA launched a financial stimulus. The results of these experiments are now clear: the American economy is growing and those European countries adopting austerity, including the UK, Ireland, Greece, Portugal and Spain, are stagnating and struggling to repay rising debts. An initial recovery in the UK was halted once austerity measures hit. However, austerity has been not only an economic failure, but also a health failure, with increasing numbers of suicides and, where cuts in health budgets are being imposed, increasing numbers of people being unable to access care. Yet their stories remain largely untold. Here, we argue that there is an alternative to austerity, but that ideology is triumphing over evidence. Our paper was written to contribute to discussions among health policy leaders in Europe that will take place at the 15th European Health Forum at Gastein in October 2012, as its theme 'Crisis and Opportunity - Health in an Age of Austerity'.

System Dynamics and Management Science Approaches Toward Increasing Acquisition Process Efficiency

DTIC Science & Technology

2014-04-30

research programme, Summary of Research Report 126, ISBN 978-1-85908-475-5, The Association of Chartered Certified Accountants ( ACCA ), London, UK...2003). Especially in a time of financial shortfalls and cuts in public budgets together with increasing infrastructure costs, PPPs become a popular...models can be found for example in (Lyneis, 2007; Garcia, 2009; Sterman, 2000). Benefits of the Project Client and the Financial Aspects The next

Illiteracy, Financial Services and Social Exclusion.

ERIC Educational Resources Information Center

Hajaj, Khaldoun

Despite calls by consumer advocates for Australia's governments and financial services institutions to provide consumers with resources to help them understand how the financial services sector operates, financial education remains something that most Australians gain by default. Research conducted in the United Kingdom and United States, has…

75 FR 27239 - Federal Government Participation in the Automated Clearing House

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-14

... Participation in the Automated Clearing House AGENCY: Financial Management Service, Fiscal Service, Treasury..., Financial Management Service (Service) is proposing to amend our regulation governing the use of the... must include the agency name (``Financial Management Service'') and docket number FISCAL-FMS-2009- 0001...

Evolvement of Uniformity and Volatility in the Stressed Global Financial Village

PubMed Central

Kenett, Dror Y.; Raddant, Matthias; Lux, Thomas; Ben-Jacob, Eshel

2012-01-01

Background In the current era of strong worldwide market couplings the global financial village became highly prone to systemic collapses, events that can rapidly sweep throughout the entire village. Methodology/Principal Findings We present a new methodology to assess and quantify inter-market relations. The approach is based on the correlations between the market index, the index volatility, the market Index Cohesive Force and the meta-correlations (correlations between the intra-correlations.) We investigated the relations between six important world markets—U.S., U.K., Germany, Japan, China and India—from January 2000 until December 2010. We found that while the developed “western” markets (U.S., U.K., Germany) are highly correlated, the interdependencies between these markets and the developing “eastern” markets (India and China) are volatile and with noticeable maxima at times of global world events. The Japanese market switches “identity”—it switches between periods of high meta-correlations with the “western” markets and periods when it behaves more similarly to the “eastern” markets. Conclusions/Significance The methodological framework presented here provides a way to quantify the evolvement of interdependencies in the global market, evaluate a world financial network and quantify changes in the world inter market relations. Such changes can be used as precursors to the agitation of the global financial village. Hence, the new approach can help to develop a sensitive “financial seismograph” to detect early signs of global financial crises so they can be treated before they develop into worldwide events. PMID:22347444

An open and transparent process to select ELIXIR Node Services as implemented by ELIXIR-UK

PubMed Central

Hancock, John M.; Game, Alf; Ponting, Chris P.; Goble, Carole A.

2017-01-01

ELIXIR is the European infrastructure established specifically for the sharing and sustainability of life science data. To provide up-to-date resources and services, ELIXIR needs to undergo a continuous process of refreshing the services provided by its national Nodes. Here we present the approach taken by ELIXIR-UK to address the advice by the ELIXIR Scientific Advisory Board that Nodes need to develop “ mechanisms to ensure that each Node continues to be representative of the Bioinformatics efforts within the country”. ELIXIR-UK put in place an open and transparent process to identify potential ELIXIR resources within the UK during late 2015 and early to mid-2016. Areas of strategic strength were identified and Expressions of Interest in these priority areas were requested from the UK community. Criteria were established, in discussion with the ELIXIR Hub, and prospective ELIXIR-UK resources were assessed by an independent committee set up by the Node for this purpose. Of 19 resources considered, 14 were judged to be immediately ready to be included in the UK ELIXIR Node’s portfolio. A further five were placed on the Node’s roadmap for future consideration for inclusion. ELIXIR-UK expects to repeat this process regularly to ensure its portfolio continues to reflect its community’s strengths. PMID:28149502

An open and transparent process to select ELIXIR Node Services as implemented by ELIXIR-UK.

PubMed

Hancock, John M; Game, Alf; Ponting, Chris P; Goble, Carole A

2016-01-01

ELIXIR is the European infrastructure established specifically for the sharing and sustainability of life science data. To provide up-to-date resources and services, ELIXIR needs to undergo a continuous process of refreshing the services provided by its national Nodes. Here we present the approach taken by ELIXIR-UK to address the advice by the ELIXIR Scientific Advisory Board that Nodes need to develop " mechanisms to ensure that each Node continues to be representative of the Bioinformatics efforts within the country". ELIXIR-UK put in place an open and transparent process to identify potential ELIXIR resources within the UK during late 2015 and early to mid-2016. Areas of strategic strength were identified and Expressions of Interest in these priority areas were requested from the UK community. Criteria were established, in discussion with the ELIXIR Hub, and prospective ELIXIR-UK resources were assessed by an independent committee set up by the Node for this purpose. Of 19 resources considered, 14 were judged to be immediately ready to be included in the UK ELIXIR Node's portfolio. A further five were placed on the Node's roadmap for future consideration for inclusion. ELIXIR-UK expects to repeat this process regularly to ensure its portfolio continues to reflect its community's strengths.

Perceived financial retirement preparedness and its correlates: a national study in Israel.

PubMed

Segel-Karpas, Dikla; Werner, Perla

2014-01-01

Studies suggest that a large proportion of adults do not manage to save enough for retirement. Correlates of retirement saving behaviors have yet to be fully understood. The goal of this study was to examine perceived financial preparedness for retirement and its correlates. We studied the effect of perceived financial knowledge and involvement, social and institutional support, and attitudes toward retirement in a national sample of 227 non-retired Israeli adults (mean age = 44; 53% female; 81% Jewish). Results indicated that only about 20% perceived themselves as financially prepared for retirement. The main correlates of financial preparedness were financial knowledge and involvement in financial activities. The results show that a large proportion of the Israeli population feel underprepared for retirement. Those who perceive themselves as having high levels of financial knowledge are less predisposed to feel underprepared. Future research should examine the relationship between perceived financial preparedness and actual savings. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

An acoustic energy framework for predicting combustion-driven acoustic instabilities in premixed gas-turbines

NASA Astrophysics Data System (ADS)

Ibrahim, Zuhair M. A.

The purpose of this study was to discover and assess student financial services delivered to students enrolled at East Tennessee State University. The research was undertaken for institutional self-improvement. The research explored changes that have occurred in student financial services in the dynamic higher education market. The research revealed universities pursued best practices for the delivery of student financial services through expanded employee knowledge, restructured organizations, and integrated information technologies. The research was conducted during October and November, 2006. The data were gathered from an online student survey of student financial services. The areas researched included: the Bursar office, the Financial Aid office, and online services. The results of the data analysis revealed problems with the students' perceived quality of existing financial services and the additional services students desire. The research focused on student perceptions of the quality of financial services by age and gender classifications and response categories. Although no statistically significant difference was found between the age-gender classifications on the perception of the quality of the financial services studied, the research adds to our understanding of student financial services at East Tennessee State University. Recommendation for continued research included annual surveys of segmented student populations that include ethnicity, age, gender, and educational level. The research would be used for continuous improvement efforts and student relationship management. Also additional research was recommended for employee learning in relation to the institution's mission, goals, and values.

12 CFR 1806.201 - Measuring and reporting Qualified Activities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Period; (4) Financial Services and Targeted Financial Services based on the predetermined amounts as may be set forth by the Fund in the applicable NOFA; and (5) Financial Services (other than those for.... 1806.201 Section 1806.201 Banks and Banking COMMUNITY DEVELOPMENT FINANCIAL INSTITUTIONS FUND...

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

PubMed

Farrelly, Paul J; Losty, Paul D

2015-09-01

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

The Evolution of Student Services in the UK

ERIC Educational Resources Information Center

Morgan, Michelle

2012-01-01

There is limited literature that looks at the evolution of student services in the UK and their effectiveness in providing student support. Student support is broadly defined as all services that support students to learn. Academic and non-academic support are essential mechanisms in providing holistic student support. In this article, the author…

76 FR 38059 - Defining Larger Participants in Certain Consumer Financial Products and Services Markets

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-29

... and Services Markets AGENCY: Bureau of Consumer Financial Protection. ACTION: Notice and Request for... other markets for consumer financial products or services, the supervision program generally will apply... consumers and to the consumer financial markets.\\5\\ In implementing this supervision program, the CFPB may...

31 CFR 537.202 - Prohibited exportation or reexportation of financial services to Burma.

Code of Federal Regulations, 2010 CFR

2010-07-01

... reexportation of financial services to Burma. 537.202 Section 537.202 Money and Finance: Treasury Regulations... permit granted prior to July 29, 2003, the exportation or reexportation of financial services to Burma... BURMESE SANCTIONS REGULATIONS Prohibitions § 537.202 Prohibited exportation or reexportation of financial...

An exploratory survey of Spanish and English nursing students' views on studying or working abroad.

PubMed

Goodman, Benny; Jones, Ray; Sanchón Macias, Marivi

2008-04-01

Student mobility within Europe is encouraged by the EU's 'Bologna process' and financially supported by the Socrates programme. However, relatively few UK nursing students travel to Europe for study. To compare the willingness to study or work abroad and the perceived barriers and benefits of doing so, amongst students in England and Spain. Third year nursing students completed a 15 item questionnaire on work and study abroad. Spanish students were younger than UK students, had fewer family commitments, and better language skills. There was little difference between Spanish and UK students in wanting to study abroad, UK students named English speaking countries as likely destinations. Spanish students named Italy; the UK and USA were also popular. Perceived barriers for UK students were funding, family, and language. Family commitments were not a major problem for Spanish students. Spanish were more likely than English students to see language as a problem. UK and Spanish Nursing students are equally enthusiastic about studying or working abroad but UK students have limited language skills, are less able to access Socrates funding for European destinations, and given their age and family commitments, funding is a barrier for 'non-Socrates' destinations.

31 CFR 560.427 - Exportation, reexportation, sale or supply of financial services to Iran or the Government of Iran.

Code of Federal Regulations, 2014 CFR

2014-07-01

... supply of financial services to Iran or the Government of Iran. 560.427 Section 560.427 Money and Finance..., reexportation, sale or supply of financial services to Iran or the Government of Iran. (a) The prohibition on the exportation, reexportation, sale or supply of financial services to Iran or the Government of Iran...

31 CFR 560.427 - Exportation, reexportation, sale or supply of financial services to Iran or the Government of Iran.

Code of Federal Regulations, 2013 CFR

2013-07-01

... supply of financial services to Iran or the Government of Iran. 560.427 Section 560.427 Money and Finance..., reexportation, sale or supply of financial services to Iran or the Government of Iran. (a) The prohibition on the exportation, reexportation, sale or supply of financial services to Iran or the Government of Iran...

Perinatal mental health service provision in Switzerland and in the UK.

PubMed

Amiel Castro, Rita T; Schroeder, Katrin; Pinard, Claudia; Blöchlinger, Patricia; Künzli, Hansjörg; Riecher-Rössler, Anita; Kammerer, Martin

2015-01-01

The epidemiology of maternal perinatal-psychiatric disorders as well as their effect on the baby is well recognised. Increasingly well researched specialised treatment methods can reduce maternal morbidity, positively affect mother-baby bonding and empower women's confidence as a mother. Here, we aimed to compare guidelines and the structure of perinatal-psychiatric service delivery in the United Kingdom and in Switzerland from the government's perspective. Swiss cantons provided information regarding guidelines and structure of service delivery in 2000. A subsequent survey using the same questionnaire was carried out in 2007. In the UK, similar information was accessed through published reports from 2000-2012. Guidelines for perinatal psychiatry exist in the UK, whereas in Switzerland in 2000 none of the 26 cantons had guidelines, and in 2007 only one canton did. Joint mother-baby admissions on general psychiatric wards were offered by 92% of the Swiss cantons. In the UK, pregnant women and joint mother-baby admissions are only advised onto specialised perinatal-psychiatric units. In Switzerland, in 2007, three specialised units (max. 24 beds) were in place corresponding to 1 unit per 2.5 million people, while in the UK there were 22 mother-baby units (168 beds) in 2012 (1 unit per 2.8 million). In the UK, less than 50% of trusts provided specialised perinatal-psychiatric health care. The main difference between the UK and Switzerland was the absence of guidelines, regular assessment and plans for future development of perinatal psychiatry in Switzerland. There are still geographical differences in the provision of perinatal-psychiatric services in the UK.

A survey of burn professionals regarding the mental health services available to burn survivors in the United States and United Kingdom.

PubMed

Lawrence, John W; Qadri, Ali; Cadogan, Julia; Harcourt, Diana

2016-06-01

This investigation surveyed burn health professionals in the UK and US to investigate the psychosocial issues facing burn survivors and the psychological services available to them through their burns service. One hundred and sixty six burn care professionals (132 from the United States and 34 from the United Kingdom) from 76 different hospitals (60 in the US and 16 in the UK) completed an online survey. Mental health practitioners (MHPs) answered questions regarding their psychotherapy practice with burn survivors. Respondents reported that psychosocial issues are common among burn survivors. Burn teams in the UK were more likely than those in the US to include psychologists, but social workers were more common in the US. Participants reported that routine screening for psychosocial issues was more common in the UK than the US, and indicated it was easier for burn survivors to access mental health care after discharge in the UK. Burn services in both countries routinely referred burn survivors to support organizations such as the Phoenix Society or Changing Faces. The preferred mental health treatment modality in the UK was psychotherapy without medications. Reported psychotropic medications use was more common in the US. MHPs had two primary orientations - eclectic and cognitive behavioral therapy. Among MHPs there was a modest tendency to favor evidence-based interventions. The provision of mental health services varies between these two countries. Creating international standards for assessing and treating psychosocial complications of burns could facilitate the improvement of burn mental health services. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Investigating the Impact of Working in Multi-Agency Service Delivery Settings in the UK on Early Years Practitioners' Beliefs and Practices

ERIC Educational Resources Information Center

Anning, Angela

2005-01-01

In the UK Centres of Excellence were funded by the DfES to model high quality, multi-agency, early years services for young children and their families. They were precursors to Children's Centres to be established across the UK. Early Excellence Centres were evaluated at national and local levels. This article will draw on data from local…

76 FR 14592 - Surety Companies Doing Business With the United States

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-17

... Business With the United States AGENCY: Financial Management Service, Fiscal Service, Treasury. ACTION..., Financial Management Service (Treasury), administers the Federal corporate surety program. Treasury issues.... ADDRESSES: The Financial Management Service participates in the U.S. government's eRulemaking Initiative by...

School-linked sexual health services for young people (SSHYP): a survey and systematic review concerning current models, effectiveness, cost-effectiveness and research opportunities.

PubMed

Owen, J; Carroll, C; Cooke, J; Formby, E; Hayter, M; Hirst, J; Lloyd Jones, M; Stapleton, H; Stevenson, M; Sutton, A

2010-06-01

Report based on a service-mapping study and a systematic review concerning sexual health services for young people, either based in or closely linked to schools. To identify current forms of school-based sexual health services (SBSHS) and school-linked sexual health services (SLSHS) in the UK, review and synthesise existing evidence from qualitative and quantitative studies concerning the effectiveness, acceptability and cost-effectiveness of these types of service and to identify potential areas for further research. Electronic databases were searched from 1985 onwards. For published material: the Cochrane Library (1991-), MEDLINE, PREMEDLINE (2007-), CINAHL, EMBASE, AMED, ASSIA (1987-), IBSS, ERIC, PsycINFO, Science Citation Index (SCI) and Social Sciences Citation Index. For unpublished material and grey literature: the Social Care Institute of Excellence Research Register; the National Research Register (1997-), ReFeR; Index to Theses, and HMIC. A service-mapping questionnaire was circulated to school nurses in all parts of the UK, and semistructured telephone interviews with service coordinators in NHS and local authority (LA) roles were conducted. An evidence synthesis was performed based on a systematic review of the quantitative evidence about service effectiveness, qualitative evidence about user and professional views and a mixed-methods synthesis. A proof-of-concept model for assessing cost-effectiveness was drawn up. Three broad types of UK sexual health service provision were identified. Firstly, SBSHS staffed by school nurses, offering 'minimal' or 'basic' levels of service. Secondly, SBSHS and SLSHS staffed by a multiprofessional team, but not medical practitioners, offering 'basic' or 'intermediate' levels of service. Thirdly, SBSHS and SLSHS staffed by a multiprofessional team, including medical practitioners offering 'intermediate' or 'comprehensive' levels of service. The systematic review showed that SBSHS are not associated with higher rates of sexual activity among young people, nor with an earlier age of first intercourse. There was evidence to show positive effects in terms of reductions in births to teenage mothers, and in chlamydial infection rates among young men, although this evidence coming primarily from the USA. Therefore, the findings need to be tested in relation to UK-based services. Also evidence to suggest that broad-based, holistic service models, not restricted to sexual health, offer the strongest basis for protecting young people's privacy and confidentiality, countering perceived stigmatisation, offering the most comprehensive range of products and services, and maximising service uptake. Findings from the mapping study also indicate that broad-based services, which include medical practitioner input within a multiprofessional team, meet the stated preferences of staff and of young people most clearly. Partnership-based developments of this kind also conform to the broad policy principles embodied in the Every Child Matters framework in the UK and allied policy initiatives. However, neither these service models nor narrower ones have been rigorously evaluated in terms of their impact on the key outcomes of conception rates and sexually transmitted infection (STI) rates, in the UK or in other countries. Therefore, appropriate data were not found to support cost-effectiveness modelling. Low response rate to the questionnaire. Scotland, Wales and Northern Ireland were under-represented. Also, the distinction made in the questionnaire between 'general health' and 'sexual health' services did not prove robust. There is no single, dominant service model in the UK. The systematic review demonstrated that the evidence base for these services remains limited and uneven, and draws largely on US studies. Qualitative research is needed to develop robust process and outcome indicators for the evaluation of SLSHS/SBSHS in the UK. These indicators could then be used both in local evaluations, and in large, longitudinal studies of service effectiveness and cost-effectiveness. Future research should examine the impact of the differing types of services currently evolving in the UK, encompassing school-based and school-linked models, as well as models with and without medical practitioner involvement.

39 CFR 233.5 - Requesting financial records from a financial institution.

Code of Federal Regulations, 2012 CFR

2012-07-01

... address, and business phone number; (ii) The identity of the customer or customers to whom the records... 39 Postal Service 1 2012-07-01 2012-07-01 false Requesting financial records from a financial... INSPECTION SERVICE AUTHORITY § 233.5 Requesting financial records from a financial institution. (a...

39 CFR 233.5 - Requesting financial records from a financial institution.

Code of Federal Regulations, 2014 CFR

2014-07-01

... address, and business phone number; (ii) The identity of the customer or customers to whom the records... 39 Postal Service 1 2014-07-01 2014-07-01 false Requesting financial records from a financial... INSPECTION SERVICE AUTHORITY § 233.5 Requesting financial records from a financial institution. (a...

39 CFR 233.5 - Requesting financial records from a financial institution.

Code of Federal Regulations, 2013 CFR

2013-07-01

... address, and business phone number; (ii) The identity of the customer or customers to whom the records... 39 Postal Service 1 2013-07-01 2013-07-01 false Requesting financial records from a financial... INSPECTION SERVICE AUTHORITY § 233.5 Requesting financial records from a financial institution. (a...

39 CFR 233.5 - Requesting financial records from a financial institution.

Code of Federal Regulations, 2011 CFR

2011-07-01

... address, and business phone number; (ii) The identity of the customer or customers to whom the records... 39 Postal Service 1 2011-07-01 2011-07-01 false Requesting financial records from a financial... INSPECTION SERVICE AUTHORITY § 233.5 Requesting financial records from a financial institution. (a...

39 CFR 10.4 - Financial disclosure reports.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Financial disclosure reports. 10.4 Section 10.4 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE RULES OF CONDUCT FOR POSTAL SERVICE GOVERNORS (ARTICLE X) § 10.4 Financial disclosure reports. (a) Requirement of...

Sheep farmer opinions on the current and future role of veterinarians in flock health management on sheep farms: A qualitative study

PubMed Central

Kaler, Jasmeet; Green, L.E.

2013-01-01

A 2009 UK Government report on veterinary expertise in food animal production highlighted that there was insufficient herd health expertise among veterinarians and lack of appropriate business models to deliver veterinary services to the livestock sector. Approximately two thirds of sheep farmers only contact their veterinarian for emergencies and one fifth have all year round contact. The aim of the current study was to understand sheep farmers’ perception, the current and future role of veterinarians in flock health management using qualitative methodology. The eligibility criteria were male farmers with a flock size of at least 200 adult sheep. Seven focus groups of farmers (n = 45) stratified by three regions and two age groups (≤50 and >50) were conducted. Thematic analysis of the discussions indicated that most farmers considered and used their veterinarian as a fire-fighter, whilst other advice was gathered free of charge when the veterinarian was on the farm for other reasons (typically seeing cattle) or by telephone. A small group of farmers were using their veterinarian or a sheep consultant proactively with regular contact and found this financially beneficial. Farmers indicated that the key barriers to using a veterinarian proactively were inconsistent service, high turnover of veterinarians, lack of expertise of sheep farming among veterinarians and concern about independence of advice. Although economics was also mentioned as a key barrier to using veterinarians more proactively, most farmers did not know where they gained and lost income from their flock; there was heavy reliance on the single farm payment scheme (SPS) and very few farmers kept records from which they could investigate where there were inefficiencies in production. Overall sheep farmers considered sheep farming complex and that each farm was unique and that they themselves were the experts to manage their flock. We conclude that there is an impasse: veterinarians might need to provide consistency and wide expertise beyond knowledge of disease and a model of how flock planning would be financially beneficial but until sheep farmers keep production records flock health planning cannot be rigorous and the financial benefits cannot be evaluated. Given the reliance on SPS by farmers an alternative model would be to require farmers to keep production records to comply with SPS. This might lead to flock health planning being adopted at a faster rate and so develop the UK sheep industry and make it more environmentally sustainable by reducing waste from disease and low productivity. PMID:24120236

Sheep farmer opinions on the current and future role of veterinarians in flock health management on sheep farms: a qualitative study.

PubMed

Kaler, Jasmeet; Green, L E

2013-11-01

A 2009 UK Government report on veterinary expertise in food animal production highlighted that there was insufficient herd health expertise among veterinarians and lack of appropriate business models to deliver veterinary services to the livestock sector. Approximately two thirds of sheep farmers only contact their veterinarian for emergencies and one fifth have all year round contact. The aim of the current study was to understand sheep farmers' perception, the current and future role of veterinarians in flock health management using qualitative methodology. The eligibility criteria were male farmers with a flock size of at least 200 adult sheep. Seven focus groups of farmers (n=45) stratified by three regions and two age groups (≤50 and >50) were conducted. Thematic analysis of the discussions indicated that most farmers considered and used their veterinarian as a fire-fighter, whilst other advice was gathered free of charge when the veterinarian was on the farm for other reasons (typically seeing cattle) or by telephone. A small group of farmers were using their veterinarian or a sheep consultant proactively with regular contact and found this financially beneficial. Farmers indicated that the key barriers to using a veterinarian proactively were inconsistent service, high turnover of veterinarians, lack of expertise of sheep farming among veterinarians and concern about independence of advice. Although economics was also mentioned as a key barrier to using veterinarians more proactively, most farmers did not know where they gained and lost income from their flock; there was heavy reliance on the single farm payment scheme (SPS) and very few farmers kept records from which they could investigate where there were inefficiencies in production. Overall sheep farmers considered sheep farming complex and that each farm was unique and that they themselves were the experts to manage their flock. We conclude that there is an impasse: veterinarians might need to provide consistency and wide expertise beyond knowledge of disease and a model of how flock planning would be financially beneficial but until sheep farmers keep production records flock health planning cannot be rigorous and the financial benefits cannot be evaluated. Given the reliance on SPS by farmers an alternative model would be to require farmers to keep production records to comply with SPS. This might lead to flock health planning being adopted at a faster rate and so develop the UK sheep industry and make it more environmentally sustainable by reducing waste from disease and low productivity. Copyright © 2013 Elsevier B.V. All rights reserved.

12 CFR 712.5 - What activities and services are preapproved for CUSOs?

Code of Federal Regulations, 2010 CFR

2010-01-01

... processing; (7) Wire transfer services; and (8) Cyber financial services; (f) Financial counseling services..., and other personnel benefit plans; (2) Estate planning; (3) Financial planning and counseling; (4) Income tax preparation; (5) Investment counseling; (6) Retirement counseling; and (7) Business counseling...

77 FR 40148 - Proposed Collection of Information: ACH Vendor/Miscellaneous Payment Enrollment Form

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-06

.../Miscellaneous Payment Enrollment Form AGENCY: Financial Management Service, Fiscal Service, Treasury. ACTION: Notice and request for comments. SUMMARY: The Financial Management Service, as part of its continuing... Financial Management Service solicits comments concerning the SF 3881 ``ACH Vendor/Miscellaneous Payment...

75 FR 80335 - Federal Government Participation in the Automated Clearing House

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-22

... Participation in the Automated Clearing House AGENCY: Financial Management Service, Fiscal Service, Treasury. ACTION: Interim final rule. SUMMARY: The Department of the Treasury, Financial Management Service (FMS... include the agency name (``Financial Management Service'') and docket number FISCAL-FMS-2010- 0003 for...

The next challenge for psycho-oncology in the UK: targeting service quality and outcomes.

PubMed

King, Alex

2016-12-01

The acceptance and provision of psychosocial cancer care in the UK is moving forward positively, aided by patient advocacy and psychologically minded healthcare policies. The unfolding challenge now is of targeting the quality and outcomes of clinical psycho-oncology services. This report outlines the clinically led development of UK-focused guidance to challenge psycho-oncology services to achieve and demonstrate their potential. It discusses how the guidance was particularly framed to encourage small, low-resource services, and outlines the potential benefits for patients. Overall, setting ourselves the challenge of quality on the same terms as physical healthcare, we can shape a direct path to achieving parity of esteem in mental with physical healthcare.

A qualitative exploration of psychosocial specialists' experiences of providing support in UK burn care services.

PubMed

Guest, Ella; Griffiths, Catrin; Harcourt, Diana

2018-01-01

A burn can have a significant and long-lasting psychosocial impact on a patient and their family. The National Burn Care Standards (2013) recommend psychosocial support should be available in all UK burn services; however, little is known about how it is provided. The current study aimed to explore experiences of psychosocial specialists working in UK burn care, with a focus on the challenges they experience in their role. Semi-structured telephone interviews with eight psychosocial specialists (two psychotherapists and six clinical psychologists) who worked within UK burn care explored their experiences of providing support to patients and their families. Thematic analysis revealed two main themes: burn service-related experiences and challenges reflected health professionals having little time and resources to support all patients; reduced patient attendance due to them living large distances from service; psychosocial appointments being prioritised below wound-related treatments; and difficulties detecting patient needs with current outcome measures. Therapy-related experiences and challenges outlined the sociocultural and familial factors affecting engagement with support, difficulties treating patients with pre-existing mental health conditions within the burn service and individual differences in the stage at which patients are amenable to support. Findings provide an insight into the experiences of psychosocial specialists working in UK burn care and suggest a number of ways in which psychosocial provision in the NHS burn service could be developed.

Heritage Quay: What Will You Discover? Transforming the Archives of the University of Huddersfield, Yorkshire, UK

ERIC Educational Resources Information Center

Wickham, M. Sarah

2015-01-01

The University of Huddersfield presents a key case study of the transformation of its Archives Service, using the newly-developed Staff/Space/Collections dependency model for archives and the lessons of the UK's Customer Service Excellence (CSE) scheme in order to examine and illustrate service development. Heritage Lottery Fund (HLF) and…

77 FR 11195 - Surety Companies Acceptable on Federal Bonds-Name Change and Change in State of Incorporation...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-24

..., Financial Management Service, Financial Accounting and Services Division, Surety Bond Branch, 3700 East-West Highway, Room 6F01, Hyattsville, MD 20782. Dated: February 15, 2012. Laura Carrico, Director, Financial... Change and Change in State of Incorporation: Nations Bonding Company AGENCY: Financial Management Service...

31 CFR 5.9 - When will Treasury entities transfer a Treasury debt to the Treasury Department's Financial...

Code of Federal Regulations, 2010 CFR

2010-07-01

... a Treasury debt to the Treasury Department's Financial Management Service for collection? 5.9... Treasury Department's Financial Management Service for collection? (a) Treasury entities will transfer any eligible debt that is more than 180 days delinquent to the Financial Management Service for debt collection...

26 CFR 54.4975-6 - Statutory exemptions for office space or services and certain transactions involving financial...

Code of Federal Regulations, 2010 CFR

2010-04-01

... services and certain transactions involving financial institutions. 54.4975-6 Section 54.4975-6 Internal... transactions involving financial institutions. (a) Exemption for office space or services—(1) In general... imposed by section 4975 the provision of certain ancillary services by a bank or similar financial...

The UK Human Genome Mapping Project online computing service.

PubMed

Rysavy, F R; Bishop, M J; Gibbs, G P; Williams, G W

1992-04-01

This paper presents an overview of computing and networking facilities developed by the Medical Research Council to provide online computing support to the Human Genome Mapping Project (HGMP) in the UK. The facility is connected to a number of other computing facilities in various centres of genetics and molecular biology research excellence, either directly via high-speed links or through national and international wide-area networks. The paper describes the design and implementation of the current system, a 'client/server' network of Sun, IBM, DEC and Apple servers, gateways and workstations. A short outline of online computing services currently delivered by this system to the UK human genetics research community is also provided. More information about the services and their availability could be obtained by a direct approach to the UK HGMP-RC.

Bibliotherapy for mental health service users Part 2: a survey of psychiatric libraries in the UK.

PubMed

Fanner, Deborah; Urqhuart, Christine

2009-06-01

UK health policy advocates a patient-centred approach to patient care. Library services could serve the rehabilitation needs of mental health service users through bibliotherapy (the use of written, audio or e-learning materials to provide therapeutic support). Part 2 of this two-part paper assesses the views of psychiatric libraries in the UK on providing access to service users and possible services provided. An e-mail questionnaire survey of psychiatric library members of the psychiatric lending co-operative scheme (n = 100) obtained a response rate of 55%, mostly from libraries based in hospitals. At present, libraries funded by the health service provide minimal facilities for service users. Librarians are uncertain about the benefits and practicalities of providing access to service users. In order to implement change, information providers across the National Health Service (NHS) will need to work collaboratively to overcome attitudinal and institutional barriers, including the key issue of funding.

77 FR 22066 - Proposed Collection of Information: “Notice of Reclamation Electronic Funds Transfer, Federal...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-12

... Transfer, Federal Recurring Payments'' AGENCY: Financial Management Service, Fiscal Service, Treasury. ACTION: Notice and request for comments. SUMMARY: The Financial Management Service, as part of its... Financial Management Service solicits comments concerning forms FMS-I33, ``Notice of Reclamation. Electronic...

Creating an integrated clinical enterprise at the University of Kentucky: the emergence of UK HealthCare.

PubMed

Karpf, Michael; Perman, Jay; Lofgren, Richard; Melgar, Sergio; Butler, Frank; Day, Zed; Clark, Murray; Claypool, Joseph O; Gilbert, Peter; Gombeski, William; Higdon, Courtney M

2007-12-01

If the medical system in the United States is to change, as has been recommended, academic medical centers must, in fact, lead this change process. To prepare for the future, the University of Kentucky decided to move aggressively toward developing an integrated clinical enterprise branded as UK HealthCare, where leadership of the various components of the academic medical center make strategic and financial decisions together to achieve common organizational goals. The authors discuss senior leadership's development of the vision for the enterprise and the governance structure that was established to engage board members and faculty of the institution. They examine the rigorous strategic, facilities, financial, and academic planning that ensued, and the early successes achieved. The authors introduce some of the lessons learned by the organization during the emergence of UK HealthCare and describe the corporate structure and senior management team that was established to support the quick and efficient implementation of the planning strategies. It was this corporate structure and senior management team which has proven to be an effective agent of change and a key to the successful development of a truly integrated clinical enterprise.

Politics, policy and payment--facilitators or barriers to person-centred rehabilitation?

PubMed

Turner-Stokes, Lynne

This paper explores the tensions between politics and payment in providing affordable services that satisfy the public demand for patient-centred care. The two main approaches taken by the UK Government to curtail the spiralling costs of healthcare have been to focus development in priority areas and to cap spending through the introduction of a fixed-tariff episode-based funding system. The National Service Framework for Long Term Neurological Conditions embraces many laudable principles of person-centred management, but the 'one-size-fits all' approach to reimbursement potentially cuts right across these. A series of tools have been developed to determine complexity of rehabilitation needs that will support the development of banded tariffs. A practical approach is also offered to demonstrate the cost-efficiency of rehabilitation services for people with complex needs, and help to ensure that they are not excluded from treatment because of their higher treatment costs. Whilst responding to public demand for person-centred care, we must recognize the current financial pressure on healthcare systems. Clinicians will have greater credibility if they routinely collect and share outcomes that demonstrate the economic benefits of intervention, as well the impact on health, function and quality of life.

Indicator-based systems of performance management in the National Health Service: a comparison of the perceptions of local- and national-level managers.

PubMed

Jones, G T

2000-02-01

Historically, the UK Government has policed the use of National Health Service (NHS) resources through the centralization of control. With the majority of resource-draining decisions being taken by clinicians, however, professional financial accountability is becoming more important within the NHS management structure. Variations in clinical performance can be monitored through the use of performance indicators, although these are not without their problems. The use of league tables of such indicators in the national press is now infamous and there is much anecdotal evidence about the intraorganizational conflict arising from the use of such tables. A questionnaire survey and interview study of clinical directors, clinical service directors and business managers in several Scottish NHS Trusts was undertaken to ascertain the perceptions of local-level managers on the issue of performance indicators. Interviews were also carried out with a number of personnel in the Scottish Office Department of Economics and Information, the Division of Health Gain and the Finance Directorate. This paper explores the differences between the perceptions of the managers at these two levels of the NHS with regards to issues of performance measurement, intraorganizational conflict and corporate vision.

77 FR 553 - Surety Companies Acceptable on Federal Bonds: Amendment-Evergreen National Indemnity Company

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-05

..., Financial Accounting and Services Division, Surety Bond Branch, 3700 East-West Highway, Room 6F01, Hyattsville, MD 20782. Dated: December 20, 2011. Laura Carrico, Director, Financial Accounting and Services...-- Evergreen National Indemnity Company AGENCY: Financial Management Service, Fiscal Service, Department of the...

77 FR 8956 - Surety Companies Acceptable on Federal Bonds: Grange Mutual Casualty Company

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-15

... . Questions concerning this Notice may be directed to the U.S. Department of the Treasury, Financial Management Service, Financial Accounting and Services Division, Surety Bond Branch, 3700 East-West Highway... Mutual Casualty Company AGENCY: Financial Management Service, Fiscal Service, Department of the Treasury...

77 FR 29472 - Surety Companies Acceptable on Federal Bonds-Termination: Atlantic Bonding Company, Inc.

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-17

..., Financial Accounting and Services Division, Surety Bond Branch, 3700 East-West Highway, Room 6F01, Hyattsville, MD 20782. Dated: May 8, 2012. Laura Carrico, Director, Financial Accounting and Services Division...--Termination: Atlantic Bonding Company, Inc. AGENCY: Financial Management Service, Fiscal Service, Department...

32 CFR Appendix B to Part 231 - In-Store Banking

Code of Federal Regulations, 2010 CFR

2010-07-01

... shall work directly with the on-base financial institution to obtain the requested services. Where there... solicitation letter shall identify the financial services being requested and classify these services as either... parties involved. b. The financial services to be provided, and c. The logistical support arrangements to...

77 FR 31441 - Proposed Collection of Information: States Where Licensed for Surety

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-25

... Licensed for Surety AGENCY: Financial Management Service, Fiscal Service, Treasury. ACTION: Notice and request for comments. SUMMARY: The Financial Management Service, as part of its continuing effort to... Paperwork Reduction Act of 1995, (44 U.S.C. 3506(c)(2)(A)), the Financial Management Service solicits...

76 FR 60602 - Proposed Collection of Information: Annual Letters-Certificates of Authority (A) and Admitted...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-29

...--Certificates of Authority (A) and Admitted Reinsurer (B) AGENCY: Financial Management Service, Fiscal Service, Treasury. ACTION: Notice and request for comments. SUMMARY: The Financial Management Service, as part of... notice, the Financial Management Service solicits comments concerning the ``Annual Letters-- Certificates...

A Knowledge Management Model for Firms in the Financial Services Industry

ERIC Educational Resources Information Center

Held, Carsten; Duncan, Glen; Yanamandram, Venkat

2013-01-01

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

75 FR 95 - Endorsement and Payment of Checks Drawn on the United States Treasury

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-04

... Checks Drawn on the United States Treasury AGENCY: Financial Management Service, Fiscal Service, Treasury..., Financial Management Service (FMS), is proposing to amend its regulation governing the endorsement and... Financial Management Service (FMS) participates in the U.S. government's eRulemaking Initiative by...

45 CFR 201.6 - Withholding of payment; reduction of Federal financial participation in the costs of social...

Code of Federal Regulations, 2011 CFR

2011-10-01

... financial participation in the costs of social services and training. 201.6 Section 201.6 Public Welfare... Federal financial participation in the costs of social services and training. (a) When withheld. Further... (AABD) of the Act, Federal financial participation in the costs of social services and training approved...

45 CFR 201.6 - Withholding of payment; reduction of Federal financial participation in the costs of social...

Code of Federal Regulations, 2013 CFR

2013-10-01

... financial participation in the costs of social services and training. 201.6 Section 201.6 Public Welfare... Federal financial participation in the costs of social services and training. (a) When withheld. Further... (AABD) of the Act, Federal financial participation in the costs of social services and training approved...

45 CFR 201.6 - Withholding of payment; reduction of Federal financial participation in the costs of social...

Code of Federal Regulations, 2010 CFR

2010-10-01

... financial participation in the costs of social services and training. 201.6 Section 201.6 Public Welfare... Federal financial participation in the costs of social services and training. (a) When withheld. Further... (AABD) of the Act, Federal financial participation in the costs of social services and training approved...

The Financial Benefits of Various Catastrophic Failure Prevention Strategies in a Wind Farm: Two market studies (UK-Spain)

NASA Astrophysics Data System (ADS)

Yürüşen, N. Y.; Tautz-Weinert, J.; Watson, S. J.; Melero, J. J.

2017-11-01

Operation of wind farms is driven by the overall aim of minimising costs while maximising energy sales. However, in certain circumstances investments are required to guarantee safe operation and survival of an asset. In this paper, we discuss the merits of various catastrophic failure prevention strategies in a Spanish wind farm. The wind farm operator was required to replace blades in two phases: temporary and final repair. We analyse the power performance of the turbine in the different states and investigate four scenarios with different timing of temporary and final repair during one year. The financial consequences of the scenarios are compared with a baseline by using a discounted cash flow analysis that considers the wholesale electricity market selling prices and interest rates. A comparison with the UK electricity market is conducted to highlight differences in the rate of return in the two countries.

A statistical analysis of UK financial networks

NASA Astrophysics Data System (ADS)

Chu, J.; Nadarajah, S.

2017-04-01

In recent years, with a growing interest in big or large datasets, there has been a rise in the application of large graphs and networks to financial big data. Much of this research has focused on the construction and analysis of the network structure of stock markets, based on the relationships between stock prices. Motivated by Boginski et al. (2005), who studied the characteristics of a network structure of the US stock market, we construct network graphs of the UK stock market using same method. We fit four distributions to the degree density of the vertices from these graphs, the Pareto I, Fréchet, lognormal, and generalised Pareto distributions, and assess the goodness of fit. Our results show that the degree density of the complements of the market graphs, constructed using a negative threshold value close to zero, can be fitted well with the Fréchet and lognormal distributions.

Do health-related labour costs weaken the competitiveness of the economy?

PubMed

Häussler, Bertram; Ecker, Thomas; Schneider, Markus

2006-12-01

At least in Germany, it is widely assumed that healthcare-related labour costs weaken the competitiveness of national industries. However, there is a lack of knowledge about the amount of employers' financial burden in Germany and in other competing countries, as well as the impact on market prices of German goods. To quantify the health-related labour costs for employers in seven countries and different industries, and identify the effects of current reforms in Germany on the financial burden of employers. We calculated the spending on health in Germany and the burden on German employers (by branch of production). We then compared the total burden with that of six other countries. A univariate analysis was then conducted to examine the connection between health-related labour costs and employment. In 2000, employers paid 41.2% of the total of 283.3 billion spent on health matters in Germany. These total costs account for 3.2% of the gross output (UK: 1.8%, Switzerland: 1.9%, Poland: 2.1%, US: 3.2%, France: 3.6%, The Netherlands: 3.7%). Health-related labour costs account for 10.6% of the total labour costs. The health-related labour costs per employee are on average 3013 (from 2752 to 4793 in healthcare and the chemical industry, respectively). In the UK and the US there are corresponding labour costs of 1836 and 4256 per employee, respectively. The current health reform (2003) would reduce the labour costs by only 0.7% after 4 years (based on 2000, with all factors remaining constant). Employment increased by 3.7% from 1995 to 2000 (textile industry: -26.8%, vehicle manufacture: +18.3%). There is no empirical connection between employment and health-related labour costs. Labour costs increased by a higher amount than the health-related labour costs. The burden on German employers is moderate when compared internationally. The current reform of the German health system is not expected to improve companies' financial situation or German competitiveness. Restrictions on the range of medical services would provide a relatively small amount of relief for employers.

Adult Financial Capability Framework. Second Edition

ERIC Educational Resources Information Center

Basic Skills Agency, 2006

2006-01-01

Both the Financial Services Authority and the Basic Skills Agency are committed to supporting those individuals and organisations working to improve the financial capability of themselves and others. The development of the National Strategy for Financial Capability, coordinated by the Financial Services Authority, and the commissioning of a…

Increased household financial strain, the Great Recession and child health—findings from the UK Millennium Cohort Study

PubMed Central

Law, Catherine; Pearce, Anna

2017-01-01

Background There is a growing body of evidence associating financial strain (FS) with poor health but most of this research has been cross-sectional and adult-focused. During the ‘Great Recession’ many UK households experienced increased FS. The primary aim of this study was to determine the impact of increased FS on child health. Methods We analysed the Millennium Cohort Study, a longitudinal study of children born in the UK between 2000 and 2002. Surveys at 7 years (T1, 2008) and 11 years (T2, 2012) spanned the ‘Great Recession’. Three measures of increased FS were defined; ‘became income poor’ (self-reported household income dropped below the ‘poverty line’ between T1 and T2); ‘developed difficulty managing’ (parental report of being ‘financially comfortable’ at T1 and finding it ‘difficult to manage’ at T2); ‘felt worse off’ (parental report of feeling financially ‘worse off’ at T2 compared with T1). Poisson regression was used to estimate risk ratios (RR), adjusted risk ratios (aRR) and 95% CIs for six child health outcomes: measured overweight/obesity, problematic behaviour as scored by parents and teachers, and parental reports of fair/poor general health, long-standing illness and bedwetting at T2 (N=13 112). In subanalyses we limited our sample to those who were above the poverty line at T2. Results Compared with those who were not financially strained at both time points, children in households which experienced increased FS were at an increased risk of all unhealthy outcomes examined. In most cases, these increased risks persisted after adjustment for confounding and when limiting the sample to those above the poverty line. Conclusions FS is associated with a range of new or continued poor child health outcomes. During times of widespread economic hardship, such as the ‘Great Recession’, measures should be taken to buffer children and their families from the impact of FS, and these should not be limited to those who are income poor. PMID:28280000

Pre-Service Primary Teachers' Conceptions of Creativity in Mathematics

ERIC Educational Resources Information Center

Bolden, David S.; Harries, Tony V.; Newton, Douglas P.

2010-01-01

Teachers in the UK and elsewhere are now expected to foster creativity in young children (NACCCE, 1999; Ofsted, 2003; DfES, 2003; DfES/DCMS, 2006). Creativity, however, is more often associated with the arts than with mathematics. The aim of the study was to explore and document pre-service (in the UK, pre-service teachers are referred to as…

History of UK contribution to astronautics: Politics and government

NASA Astrophysics Data System (ADS)

Hicks CB, Colin

2009-12-01

In all developed countries, once it emerged from the amateur era, Space (and especially rocketry) moved on the public agenda because of its potential significance for both the civil and military policies of governments (coupled with its appetite for new money). In the UK the policy treatment of Space broadly paralleled that in other countries until the post-Empire trauma, the burn-out of the White-Hot Technological revolution of Harold Wilson, and the financial crises of the 1970s exhausted the public appetite for large scale publicly funded projects in high technology. The culmination for Space of these pressures came in 1986-1987 when the UK rejected the emerging international consensus and, almost alone, stayed outside the manned space commitments which developed into the International Space Station. In this paper, Colin Hicks will review the UK political developments which led up to the 1986-1987 decision and how the politics and organisation of UK space activity have developed since then to the point where in 2008 a major government review of the UK involvement in manned space was commissioned.

78 FR 60695 - Regulatory Reorganization; Administrative Changes to Regulations Due to the Consolidation of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-02

... Consolidation of the Financial Management Service and the Bureau of the Public Debt Into the Bureau of the... Service''). The new bureau consolidated the bureaus formerly known as the Financial Management Service... delegated to the Commissioner of the Public Debt and the Commissioner, Financial Management Service. The...

Financial Management at the American Forces Information Service.

DTIC Science & Technology

1997-05-07

The Federal Financial Management Act of 1994, Public Law 103-356, requires DoD to provide FY 1996 consolidated financial statements to the Office of...Management and Budget. Financial data from the American Forces Information Service will be included in the DoD FY 1996 consolidated financial statements . In

Psychosocial risk factors for coronary heart disease in UK South Asian men and women.

PubMed

Williams, E D; Steptoe, A; Chambers, J C; Kooner, J S

2009-12-01

South Asian people in the UK and other western countries have elevated rates of coronary heart disease (CHD). Psychosocial factors contribute to CHD risk, but information about psychosocial risk profiles in UK South Asians is limited. This study aimed to examine the profile of conventional and novel psychosocial risk factors in South Asian compared with white men and women. Using a cross-sectional population study design, psychosocial profiles were assessed in 1130 South Asian and 818 white European healthy men and women aged between 35 and 75 years, who had previously participated in a cardiovascular risk assessment programme in West London. Psychosocial factors potentially contributing to CHD risk were assessed using standardised questionnaires. UK South Asians reported significantly higher psychosocial adversity compared with UK whites. South Asian men and women experienced greater chronic stress, in the form of financial strain, residential crowding, family conflict, social deprivation and discrimination, than white Europeans. They had larger social networks, but reported lower social support and greater depression and hostility. These effects were largely independent of socioeconomic status. UK South Asians experience significant psychosocial adversity compared with UK white Europeans. This is consistent with the heightened vulnerability to CHD observed in this population.

An analysis of UK waste minimization clubs: key requirements for future cost effective developments.

PubMed

Phillips, P S; Pratt, R M; Pike, K

2001-01-01

The UK waste strategy is based upon use of the best practicable environmental option (BPEO), by those making waste management decisions. BPEO is supported by the use of the waste hierarchy, with its range of preferable options for dealing with waste, and the proximity principle, where waste is treated/disposed of as close to its point of origin as possible. The national waste strategy emphasizes the key role of waste minimization and encourages industry, commerce and the public to move towards sustainable waste management practice for economic and environmental reasons. Waste minimization clubs have been used, since the early 1990s, to demonstrate to industry/commerce that reducing waste production can lead to significant financial savings. There have been around 75 such clubs in the UK and they receive support from a wide range of agencies, including the Environmental Technology Best Practice Program. The early Demonstration Clubs had significant savings to cost ratios, e.g. Aire and Calder at 8.4, but had very high costs, e.g. Aire and Calder at 400,000 pounds. It is acknowledged that the number of clubs will have to be approximately doubled in the next few years so as to have an adequate coverage of the UK. There are at present, marked regional variations in club development and cognizance needs to be taken, by facilitators, of the need for extensive coverage of the UK. Future clubs will probably have to operate in a financially constrained climate and they need to be designed to deliver significant savings and waste reduction at low cost. To aid future club design, final reports of all projects should report in a standard manner so that cost benefit analysis can be used to inform facilitators about the most effective club type. rights reserved.

7 CFR 295.7 - Indexes.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., Alexandria, Va. 22302-1500. (b) Director, Financial Management, Food and Nutrition Service, USDA, 300..., Financial and Administrative Management, Food and Nutrition Service, USDA, 77 W. Jackson Blvd., Chicago, Illinois 60604-3507. (e) Director, Financial Management, Food and Nutrition Service, USDA, 1100 Commerce St...

77 FR 47045 - Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-07

... the Collection of Qualitative Feedback on the Service Delivery of the Consumer Financial Protection... of Qualitative Feedback on the Service Delivery of the Consumer Financial Protection Bureau... Qualitative Feedback on the Service Delivery of the Consumer Financial Protection Bureau. OMB Control Number...

19 CFR 24.26 - Automated Clearinghouse credit.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Financial Management Services Center, U.S. Customs Service, 6026 Lakeside Boulevard, Indianapolis, Indiana... information, the Financial Management Services Center will provide the payer with specific ACH credit routing... validate the routing instructions. When the routing instructions are validated, the Financial Management...

19 CFR 24.26 - Automated Clearinghouse credit.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Financial Management Services Center, U.S. Customs Service, 6026 Lakeside Boulevard, Indianapolis, Indiana... information, the Financial Management Services Center will provide the payer with specific ACH credit routing... validate the routing instructions. When the routing instructions are validated, the Financial Management...

Devalued, deskilled and diversified: explaining the proliferation of the strip industry in the UK.

PubMed

Sanders, Teela; Hardy, Kate

2012-09-01

This paper looks beyond the debates that focus on the objectification of the female body to examine the question as to why strip clubs have proliferated and found a permanent place in the night-time economy in the UK. Using empirical qualitative and quantitative data from the largest study into the strip industry in the UK to date, we challenge the common assumption that 'demand' is responsible for the rise in erotic dance. Instead, we argue that the proliferation of strip clubs is largely due to the internal economic structures of the industry which have developed partly in response to the financial crisis beginning in 2008. First, we argue that clubs profit from individual dancers through an exploitative system of fees and fines, rendering a strip club business a low cost investment with high returns and little risk to club owners. Second, we note that the last decade has seen diversification of the industry accompanied by deskilling and devaluing of dancing and dancers' labour. Third, we demonstrate that despite the negative effects of these changes on workers, there has been an expansion of the industry as the ability to make profit, even during a financial crisis was ensured through the transferral of risk to workers. Overall, we suggest that far from proliferating as a response to demand, the industry has maintained its market presence due to its ability to establish highly financially exploitation employment relationships with dancers at a time of economic fragility. © London School of Economics and Political Science 2012.

A comparative study of behavioral and psychological signs and symptoms of dementia in patients with dementia referred to psychogeriatric services in Korea and the United Kingdom.

PubMed

Shah, Ajit; Ellanchenny, Nalini; Suh, Guk-Hee

2004-06-01

There is a paucity of cross-cultural studies of behavioral and psychological symptoms of dementia (BPSD). BPSD were examined in a consecutive series of referrals to a psychogeriatric service in the United Kingdom (U.K.) and in Korea, using the BEHAVE-AD, the Cornell Scale for Depression in Dementia and the Mini-mental State Examination (MMSE). The U.K. service served a well-defined geographical catchment area with a multidisciplinary team and emphasis on home assessments. The Korean service was a nationwide service with limited community resources. The correlates of individual BPSD in each country and the differences between the two countries were examined. Koreans were younger, were more likely to be married, less likely to be single, had a greater number of people in their household and were more likely to live in their own homes than the U.K. sample. Koreans were more likely to be referred by general psychiatrists or family members, and the U.K. sample was more likely to be referred by general practitioners. Koreans were more likely to have Alzheimer's disease and the U.K. sample to have vascular dementia. The Korean sample had a lower MMSE score than the U.K. sample. In both countries, the total BEHAVE-AD score and most subscale scores were negatively correlated with the MMSE score. The total BEHAVE-AD score and all subscale scores were higher in the Korean sample than in the U.K. sample. The prevalence of all BPSD measured with the BEHAVE-AD were higher in the Korean sample (except aggressivity). These differences may be explained by differing interpretation and administration of the measurement instruments, models of service delivery, availability of primary and secondary care services, health seeking behavior of patients and families, cultural influences, and knowledge, expectations and recognition of BPSD by professionals in primary and secondary care. However, despite this, there was possible evidence of genuine differences worthy of further cross-cultural population-based epidemiological study of BPSD between these two countries.

Operation GRITROCK: the Defence Medical Services' story and emerging lessons from supporting the UK response to the Ebola crisis.

PubMed

Bricknell, Martin; Hodgetts, T; Beaton, K; McCourt, A

2016-06-01

This paper is a record of the UK Defence Medical Services (DMS) contribution to the UK response to the Ebola crisis in West Africa from the start of planning in July 2014 to the closure of the Ministry of Defence Ebola Virus Disease Treatment Unit at the end of June 2015. The context and wider UK government decisions are summarised. This paper describes the decisions and processes that resulted in the deployment of a DMS delivered Ebola Treatment Unit in conjunction with the Department for International Development and Save the Children. It covers arrangements for medical care for disease and non-battle injury, the Air Transportable Isolator and Force Health Protection policy, and finally, considers the medical lessons from this deployment. The core message is that the UK DMS are the only part of the UK health sector that is trained, equipped, manned and available to rapidly deploy and operate a complete medical unit as part of an international response to a health crisis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Increasing awareness of gynaecological cancer symptoms: a GP perspective.

PubMed

Evans, Ruth E C; Morris, Melanie; Sekhon, Mandeep; Buszewicz, Marta; Walter, Fiona M; Waller, Jo; Simon, Alice E

2014-06-01

In the UK there has been an effort, through the National Awareness and Early Diagnosis Initiative (NAEDI), to increase early stage diagnoses and ultimately cancer survival. Encouraging early symptom presentation through awareness-raising activities in primary care is one method to achieve this goal. Understanding GPs' views about this type of activity, however, is crucial prior to implementation. To describe GPs' attitudes to raising public awareness of gynaecological cancers, and their views about the potential impact on primary care services. An online survey with a convenience sample recruited from 1860 UK general practices. An invitation was emailed to GPs via practice managers and included a weblink to a draft education leaflet and an online survey about the impact of sending a leaflet giving information about symptoms associated with gynaecological cancers to all women on GPs' lists. Participants could offer additional free text comments which were coded using content analysis. A total of 621 GPs participated. Most (77%, 477) felt that raising awareness of cancers was important. Only half (50%, 308), however, indicated that they would distribute such a leaflet from their practice. Barriers to implementation included concerns about financial costs; emotional impact on patients; increased demand for appointments and diagnostic services, such as ultrasound. GPs were generally positive about an intervention to improve patients' awareness of gynaecological cancers, but had concerns about increasing rates of presentation. There is a need for research quantifying the benefits of earlier diagnosis against resource costs such as increased consultations, investigations, and referrals. © British Journal of General Practice 2014.

Increasing awareness of gynaecological cancer symptoms: a GP perspective

PubMed Central

Evans, Ruth EC; Morris, Melanie; Sekhon, Mandeep; Buszewicz, Marta; Walter, Fiona M; Waller, Jo; Simon, Alice E

2014-01-01

Background In the UK there has been an effort, through the National Awareness and Early Diagnosis Initiative (NAEDI), to increase early stage diagnoses and ultimately cancer survival. Encouraging early symptom presentation through awareness-raising activities in primary care is one method to achieve this goal. Understanding GPs’ views about this type of activity, however, is crucial prior to implementation. Aim To describe GPs’ attitudes to raising public awareness of gynaecological cancers, and their views about the potential impact on primary care services. Design and setting An online survey with a convenience sample recruited from 1860 UK general practices. Method An invitation was emailed to GPs via practice managers and included a weblink to a draft education leaflet and an online survey about the impact of sending a leaflet giving information about symptoms associated with gynaecological cancers to all women on GPs’ lists. Participants could offer additional free text comments which were coded using content analysis. Results A total of 621 GPs participated. Most (77%, 477) felt that raising awareness of cancers was important. Only half (50%, 308), however, indicated that they would distribute such a leaflet from their practice. Barriers to implementation included concerns about financial costs; emotional impact on patients; increased demand for appointments and diagnostic services, such as ultrasound. Conclusions GPs were generally positive about an intervention to improve patients’ awareness of gynaecological cancers, but had concerns about increasing rates of presentation. There is a need for research quantifying the benefits of earlier diagnosis against resource costs such as increased consultations, investigations, and referrals. PMID:24868075

Effectiveness and acceptability of parental financial incentives and quasi-mandatory schemes for increasing uptake of vaccinations in preschool children: systematic review, qualitative study and discrete choice experiment.

PubMed

Adams, Jean; Bateman, Belinda; Becker, Frauke; Cresswell, Tricia; Flynn, Darren; McNaughton, Rebekah; Oluboyede, Yemi; Robalino, Shannon; Ternent, Laura; Sood, Benjamin Gardner; Michie, Susan; Shucksmith, Janet; Sniehotta, Falko F; Wigham, Sarah

2015-11-01

Uptake of preschool vaccinations is less than optimal. Financial incentives and quasi-mandatory policies (restricting access to child care or educational settings to fully vaccinated children) have been used to increase uptake internationally, but not in the UK. To provide evidence on the effectiveness, acceptability and economic costs and consequences of parental financial incentives and quasi-mandatory schemes for increasing the uptake of preschool vaccinations. Systematic review, qualitative study and discrete choice experiment (DCE) with questionnaire. Community, health and education settings in England. Qualitative study - parents and carers of preschool children, health and educational professionals. DCE - parents and carers of preschool children identified as 'at high risk' and 'not at high risk' of incompletely vaccinating their children. Qualitative study - focus groups and individual interviews. DCE - online questionnaire. The review included studies exploring the effectiveness, acceptability or economic costs and consequences of interventions that offered contingent rewards or penalties with real material value for preschool vaccinations, or quasi-mandatory schemes that restricted access to 'universal' services, compared with usual care or no intervention. Electronic database, reference and citation searches were conducted. Systematic review - there was insufficient evidence to conclude that the interventions considered are effective. There was some evidence that the quasi-mandatory interventions were acceptable. There was insufficient evidence to draw conclusions on economic costs and consequences. Qualitative study - there was little appetite for parental financial incentives. Quasi-mandatory schemes were more acceptable. Optimising current services was consistently preferred to the interventions proposed. DCE and questionnaire - universal parental financial incentives were preferred to quasi-mandatory interventions, which were preferred to targeted incentives. Those reporting that they would need an incentive to vaccinate their children completely required around £110. Those who did not felt that the maximum acceptable incentive was around £70. Systematic review - a number of relevant studies were excluded as they did not meet the study design inclusion criteria. Qualitative study - few partially and non-vaccinating parents were recruited. DCE and questionnaire - data were from a convenience sample. There is little current evidence on the effectiveness or economic costs and consequences of parental financial incentives and quasi-mandatory interventions for preschool vaccinations. Universal incentives are likely to be more acceptable than targeted ones. Preferences concerning incentives versus quasi-mandatory interventions may depend on the context in which these are elicited. Further evidence is required on (i) the effectiveness and optimal configuration of parental financial incentive and quasi-mandatory interventions for preschool vaccinations - if effectiveness is confirmed, further evidence is required on how to communicate this to stakeholders and the impact on acceptability; and (ii) the acceptability of parental financial incentive and quasi-mandatory interventions for preschool vaccinations to members of the population who are not parents of preschool children or relevant health professionals. Further consideration should be given to (i) incorporating reasons for non-vaccination into new interventions for promoting vaccination uptake; and (ii) how existing services can be optimised. This study is registered as PROSPERO CRD42012003192. The National Institute for Health Research Health Technology Assessment programme.

Why do dentists struggle with removable partial denture design? An assessment of financial and educational issues.

PubMed

Lynch, C D; Allen, P F

2006-03-11

Published studies in the international dental literature illustrate that the quality of prescription and fabrication of cobalt-chromium removable partial dentures (CCRPDs) by general dental practitioners frequently fail to comply with ethical and legal requirements. The reasons cited for this in the past have broadly related to either financial or educational issues. The aim of this investigation is to determine the effect of financial and educational factors on the quality of CCRPD design and fabrication by general dental practitioners. This investigation was completed in two parts. (1) A pre-piloted pro-forma was distributed to a number of dental laboratories throughout the UK and Ireland. These sought information relating to the quality of written instructions for CCRPDs received by these laboratories, and details of the remunerative scheme under which they were being provided. Three categories of remunerative scheme were considered, private CCRPDs in Ireland, private CCRPDs in the UK, and CCRPDs being provided by salaried NHS practitioners. (2) A pre-piloted questionnaire was distributed to vocational dental practitioners in the UK and Ireland. This sought information relating to their attitudes, opinions, and educational and clinical experiences of CCRPD design and fabrication. (1) Three hundred completed pro-formas were returned from dental laboratories, 100 of which related to each of the three remunerative schemes. Poor or no written instructions were provided in 47% (n = 47) of CCRPD cases funded privately in the UK, 46% (n = 46) of CCRPD cases funded privately in Ireland, and 50% (n = 50) of CCRPDs being provided by salaried NHS practitioners. (2) One hundred and seven completed questionnaires were returned from vocational trainees. Vocational dental practitioners had completed fewer CCRPDs during VT than in dental school (dental school: median = 4, inter-quartile range = 3 to 5; VT: median = 2, inter-quartile range = 1 to 4). One-fifth of respondents (n = 22) had not completed any CCRPDs during VT. Nine per cent of VT practices (n = 10) had a surveyor on their premises. Only 15% (n = 16) of respondents felt the time they had spent in VT had increased their confidence in the design of CCRPDs. Financial factors did not have as significant an effect on the quality of prescription and fabrication of CCRPDs as did educational factors. Serious deficiencies in the teaching of CCRPDs during vocational training were identified.

FY 1997 Financial Reporting by The Defense Automated Printing Service.

DTIC Science & Technology

1998-09-23

it •T o7’v ort FY 1997 FINANCIAL REPORTING BY THE DEFENSE AUTOMATED PRINTING SERVICE Report No. 98-201 September 23, 1998 Office of the Inspector...ACCOUNTING SERVICE DIRECTOR, DEFENSE LOGISTICS AGENCY DIRECTOR, DEFENSE AUTOMATED PRINTING SERVICE SUBJECT: Audit Report on FY 1997 Financial Reporting by the...General for Auditing Office of the Inspector General, DoD Report No. 98-201 September 23, 1998 (Project No. 8FJ-2002.04) FY 1997 Financial Reporting by the

15 CFR 801.10 - Rules and regulations for the BE-120, Benchmark Survey of Transactions in Selected Services and...

Code of Federal Regulations, 2012 CFR

2012-01-01

... engineering services; industrial-type maintenance, installation, alteration, and training services; legal... services; (17) Financial services (purchases only); (18) Industrial engineering services; (19) Industrial...; educational and training services; engineering, architectural, and surveying services; financial services...

Money, Finance and the Personalisation Agenda for People with Learning Disabilities in the UK: Some Emerging Issues

ERIC Educational Resources Information Center

Abbott, David; Marriott, Anna

2013-01-01

In the UK, policy on adult social care places an emphasis on maximising choice and control for service users, including people with learning disabilities. The shift from the provision of organised services for groups of people to offering individual and personal budgets and pots of money for people to buy their own services has major implications…

Rocuronium Versus Suxamethonium: A Survey of First-line Muscle Relaxant Use in UK Prehospital Rapid Sequence Induction.

PubMed

Hartley, Emma L; Alcock, Roger

2015-04-01

Prehospital anaesthesia in the United Kingdom (UK) is provided by Helicopter Emergency Medical Service (HEMS) and British Association for Immediate Care (BASICS), a road-based service. Muscle relaxation in rapid sequence induction (RSI) has been traditionally undertaken with the use of suxamethonium; however, rocuronium at higher doses has comparable intubating conditions with fewer side effects. The aim of this survey was to establish how many prehospital services in the UK are now using rocuronium as first line in RSI. An online survey was constructed identifying choice of first-line muscle relaxant for RSI and emailed to lead clinicians for BASICS and HEMS services across the UK. If rocuronium was used, further questions regarding optimal dose, sugammadex, contraindications, and difference in intubating conditions were asked. A total of 29 full responses (93.5%) were obtained from 31 services contacted. Suxamethonium was used first line by 17 prehospital services (58.6%) and rocuronium by 12 (41.4%). In 11 services (91.7%), a dose of 1 mg/kg of rocuronium was used, and in one service, 1.2 mg/kg (8.3%) was used. No services using rocuronium carried sugammadex. In five services, slower relaxation time was found using rocuronium (41.7%), and in seven services, no difference in intubation conditions were noted (58.3%). Contraindications to rocuronium use included high probability of difficult airway and anaphylaxis. Use of rocuronium as first-line muscle relaxant in prehospital RSI is increasing. Continued auditing of practice will ascertain which services have adopted change and identify if complications of failed intubation increase as a result.

A Peer-Based Financial Planning & Education Service Program: An Innovative Pedagogic Approach

ERIC Educational Resources Information Center

Goetz, Joseph W.; Durband, Dorothy B.; Halley, Ryan E.; Davis, Kimberlee

2011-01-01

This paper presents a peer-based financial planning and education program as a strategy to address the lack of financial literacy among college students and provide an experiential learning opportunity for students majoring in financial planning or other financial services-related disciplines. Benefits of such programs to campus communities are…

31 CFR 212.6 - Rules and procedures to protect benefits.

Code of Federal Regulations, 2013 CFR

2013-07-01

... process. The financial institution shall perform the account review only one time upon the first service... (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE GARNISHMENT OF ACCOUNTS... during the lookback period. (a) Protected amount. The financial institution shall immediately calculate...

Mobile phone collection, reuse and recycling in the UK.

PubMed

Ongondo, F O; Williams, I D

2011-06-01

Mobile phones are the most ubiquitous electronic product on the globe. They have relatively short lifecycles and because of their (perceived) in-built obsolescence, discarded mobile phones represent a significant and growing problem with respect to waste electrical and electronic equipment (WEEE). An emerging and increasingly important issue for industry is the shortage of key metals, especially the types of metals found in mobile phones, and hence the primary aim of this timely study was to assess and evaluate the voluntary mobile phone takeback network in the UK. The study has characterised the information, product and incentives flows in the voluntary UK mobile phone takeback network and reviewed the merits and demerits of the incentives offered. A survey of the activities of the voluntary mobile phone takeback schemes was undertaken in 2008 to: identify and evaluate the takeback schemes operating in the UK; determine the target groups from whom handsets are collected; and assess the collection, promotion and advertising methods used by the schemes. In addition, the survey sought to identify and critically evaluate the incentives offered by the takeback schemes, evaluate their ease and convenience of use; and determine the types, qualities and quantities of mobile phones they collect. The study has established that the UK voluntary mobile phone takeback network can be characterised as three distinctive flows: information flow; product flow (handsets and related accessories); and incentives flow. Over 100 voluntary schemes offering online takeback of mobile phone handsets were identified. The schemes are operated by manufacturers, retailers, mobile phone network service operators, charities and by mobile phone reuse, recycling and refurbishing companies. The latter two scheme categories offer the highest level of convenience and ease of use to their customers. Approximately 83% of the schemes are either for-profit/commercial-oriented and/or operate to raise funds for charities. The voluntary schemes use various methods to collect mobile phones from consumers, including postal services, courier and in-store. The majority of schemes utilise and finance pre-paid postage to collect handsets. Incentives offered by the takeback schemes include monetary payments, donation to charity and entry into prize draws. Consumers from whom handsets and related equipment are collected include individuals, businesses, schools, colleges, universities, charities and clubs with some schemes specialising on collecting handsets from one target group. The majority (84.3%) of voluntary schemes did not provide information on their websites about the quantities of mobile phones they collect. The operations of UK takeback schemes are decentralised in nature. Comparisons are made between the UK's decentralised collection system versus Australia's centralised network for collection of mobile phones. The significant principal conclusions from the study are: there has been a significant rise in the number of takeback schemes operating in the UK since the initial scheme was launched in 1997; the majority of returned handsets seem to be of low quality; and there is very little available information on the quantities of mobile phones collected by the various schemes. Irrespective of their financial motives, UK takeback schemes increasingly play an important role in sustainable waste management by diverting EoL mobile phones from landfills and encouraging reuse and recycling. Recommendations for future actions to improve the management of end-of-life mobile phone handsets and related accessories are made. Copyright © 2011 Elsevier Ltd. All rights reserved.

Incentive payments are not related to expected health gain in the pay for performance scheme for UK primary care: cross-sectional analysis

PubMed Central

2012-01-01

Background The General Medical Services primary care contract for the United Kingdom financially rewards performance in 19 clinical areas, through the Quality and Outcomes Framework. Little is known about how best to determine the size of financial incentives in pay for performance schemes. Our aim was to test the hypothesis that performance indicators with larger population health benefits receive larger financial incentives. Methods We performed cross sectional analyses to quantify associations between the size of financial incentives and expected health gain in the 2004 and 2006 versions of the Quality and Outcomes Framework. We used non-parametric two-sided Spearman rank correlation tests. Health gain was measured in expected lives saved in one year and in quality adjusted life years. For each quality indicator in an average sized general practice we tested for associations first, between the marginal increase in payment and the health gain resulting from a one percent point improvement in performance and second, between total payment and the health gain at the performance threshold for maximum payment. Results Evidence for lives saved or quality adjusted life years gained was found for 28 indicators accounting for 41% of the total incentive payments. No statistically significant associations were found between the expected health gain and incentive gained from a marginal 1% increase in performance in either the 2004 or 2006 version of the Quality and Outcomes Framework. In addition no associations were found between the size of financial payment for achievement of an indicator and the expected health gain at the performance threshold for maximum payment measured in lives saved or quality adjusted life years. Conclusions In this subgroup of indicators the financial incentives were not aligned to maximise health gain. This disconnection between incentive and expected health gain risks supporting clinical activities that are only marginally effective, at the expense of more effective activities receiving lower incentives. When designing pay for performance programmes decisions about the size of the financial incentive attached to an indicator should be informed by information on the health gain to be expected from that indicator. PMID:22507660

78 FR 12372 - UBS AG, et al.; Notice of Application and Temporary Order

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-22

... financial planning and wealth management consulting, asset-based and advisory services and transaction-based... Limited (``ESC GP''); UBS Financial Services Inc. (``UBSFS''); UBS Alternative and Quantitative... Switzerland, is a Swiss-based global financial services firm. UBS AG and its subsidiaries provide global...

Acceptability of financial incentives or quasi-mandatory schemes to increase uptake of immunisations in preschool children in the United Kingdom: Qualitative study with parents and service delivery staff.

PubMed

McNaughton, Rebekah Jayne; Adams, Jean; Shucksmith, Janet

2016-04-27

Since the 1990 s strenuous attempts have been made to rebuild trust in childhood immunisations. This study aimed to understand if financial incentives (FI) or quasi-mandatory schemes (QMS), e.g. mandating immunisations for entry to universal services such as day care or school, might be acceptable interventions to increase immunisations uptake for preschool children. Parents and carers of preschool children (n=91); health and other professionals (n=18); and those responsible for developing and commissioning immunisation services (n=6) took part in the study. Qualitative methods were employed to explore the acceptability of FI/QMS with stakeholders. Framework analysis was used to develop a coding framework that was applied to the whole dataset. Interpretations of the emergent themes were verified between researchers and presented to the project's Parent Reference Group to ensure coherence and relevance. (1) FI: parents and professionals felt introducing FI was inappropriate. It was acknowledged FI may encourage families living in disadvantage to prioritise immunisation, but unintended consequences could outweigh any advantage. FI essentially changes behaviour into a cash transaction which many equated to bribery that could inadvertently create inequalities. (2) QMS: parents and professionals highlighted the positives of introducing QMS, stating it felt natural, fair and less likely to create inequality. Despite QMS' potential to positively impact on uptake there were concerns about the implementation and workability of such schemes. FI for preschool immunisation may not be acceptable, within a UK context. Introducing FI could have detrimental effects on uptake if it were associated with bribery and coercion. Quasi-mandatory schemes, mandating immunisation for universal service entry, was the most acceptable option and could contribute to the normalising of immunisation. Future work would be needed to assess how this could be successfully implemented and if it did indeed increase uptake. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

29 CFR 2550.408b-6 - Statutory exemption for ancillary services by a bank or similar financial institution.

Code of Federal Regulations, 2010 CFR

2010-07-01

....408b-6 Statutory exemption for ancillary services by a bank or similar financial institution. (a) In... service is consistent with sound banking and financial practice, as determined by Federal or State... 29 Labor 9 2010-07-01 2010-07-01 false Statutory exemption for ancillary services by a bank or...

77 FR 34127 - Financial Management Service; Proposed Collection of Information: Electronic Transfer Account...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-08

... Information: Electronic Transfer Account (ETA) Financial Agency Agreement AGENCY: Financial Management Service... of information described below: Title: Electronic Transfer Account (ETA) Financial Agency Agreement... public and other Federal agencies to take this opportunity to comment on a continuing information...

19 CFR Appendix to Part 181 - Rules of Origin Regulations

Code of Federal Regulations, 2013 CFR

2013-04-01

... identified separately for sales promotion, marketing and after-sales service of goods on the financial... promotion, marketing and after-sales service of goods on the financial statements or cost accounts of the... sales promotion, marketing and after-sales service of goods on the financial statements or cost accounts...

19 CFR Appendix to Part 181 - Rules of Origin Regulations

Code of Federal Regulations, 2012 CFR

2012-04-01

... identified separately for sales promotion, marketing and after-sales service of goods on the financial... promotion, marketing and after-sales service of goods on the financial statements or cost accounts of the... sales promotion, marketing and after-sales service of goods on the financial statements or cost accounts...

19 CFR Appendix to Part 181 - Rules of Origin Regulations

Code of Federal Regulations, 2011 CFR

2011-04-01

... identified separately for sales promotion, marketing and after-sales service of goods on the financial... promotion, marketing and after-sales service of goods on the financial statements or cost accounts of the... sales promotion, marketing and after-sales service of goods on the financial statements or cost accounts...

19 CFR Appendix to Part 181 - Rules of Origin Regulations

Code of Federal Regulations, 2014 CFR

2014-04-01

... identified separately for sales promotion, marketing and after-sales service of goods on the financial... promotion, marketing and after-sales service of goods on the financial statements or cost accounts of the... sales promotion, marketing and after-sales service of goods on the financial statements or cost accounts...

77 FR 12910 - Surety Companies Acceptable on Federal Bonds-Name Change: White Mountains Reinsurance Company of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-02

... . Questions concerning this notice may be directed to the U.S. Department of the Treasury, Financial Management Service, Financial Accounting and Services Division, Surety Bond Branch, 3700 East-West Highway... Change: White Mountains Reinsurance Company of America AGENCY: Financial Management Service, Fiscal...

77 FR 50083 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-20

...: Bureau of Economic Analysis. Title: Quarterly Survey of Financial Services Transactions between U.S. Financial Services Providers and Foreign Persons. OMB Control Number: 0608-0065. Form Number(s): BE-185.... Needs and Uses: The data are needed to monitor U.S. international trade in financial services, analyze...

17 CFR 204.55 - Change in notification to Financial Management Service.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 2 2010-04-01 2010-04-01 false Change in notification to Financial Management Service. 204.55 Section 204.55 Commodity and Securities Exchanges SECURITIES AND... Financial Management Service. After the Commission sends FMS notification of an individual's liability for a...

76 FR 42765 - Privacy Act of 1974; Amended System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-19

... the Privacy Act of 1974, as amended, the Financial Management Service gives notice of a proposed... Records--Treasury/Financial Management Service.'' DATES: Comments must be received no later than August 18... Genova, Deputy Chief Information Officer, Financial Management Service, 401 14th Street, SW., Washington...

78 FR 13760 - Proposed Collection of Information: Application Form for U.S. Department of the Treasury Stored...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-28

... U.S. Department of the Treasury Stored Value Card (SVC) Program AGENCY: Financial Management Service, Fiscal Service, Treasury. ACTION: Notice and request for comments. SUMMARY: The Financial Management... written comments to Financial Management Service, Records and Information Management Branch, Room 135...

45 CFR 304.22 - Federal financial participation in purchased support enforcement services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... support enforcement services. 304.22 Section 304.22 Public Welfare Regulations Relating to Public Welfare... FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES FEDERAL FINANCIAL PARTICIPATION § 304.22 Federal... which Federal financial participation is otherwise available under § 304.20 and which are included under...

Tackling fuel poverty through facilitating energy tariff switching: a participatory action research study in vulnerable groups.

PubMed

Lorenc, A; Pedro, L; Badesha, B; Dize, C; Fernow, I; Dias, L

2013-10-01

A fifth of UK households live in fuel poverty, with significant health risks. Recent government strategy integrates public health with local government. This study examined barriers to switching energy tariffs and the impact of an energy tariff switching 'intervention' on vulnerable peoples' likelihood to, success in, switching tariffs. Participatory Action Research (PAR), conducted in West London. Community researchers from three voluntary/community organisations (VCOs) collaborated in recruitment, study design, data collection and analysis. VCOs recruited 151 participants from existing service users in three groups: Black and Minority Ethnic (BME) communities, older people (>75 yrs) and families with young children. Researchers conducted two semi-structured interviews with each participant, a week apart. The first interview asked about demographics, current energy supplier, financial situation, previous experience of tariff-switching and barriers to switching. Researchers then provided the 'intervention' - advice on tariff-switching, printed materials, access to websites. The second interview explored usefulness of the 'intervention', other information used, remaining barriers and information needs. Researchers kept case notes and a reflective log. Data was analysed thematically and collaboratively between the research coordinator and researchers. Quantitative data was analysed using SPSS, with descriptive statistics and Chi-squared tests. A total of 151 people were interviewed: 47 older people over 75 years, 51 families with young children, 51 BME (two were missing demographics). The majority were not White British or UK-born. Average household weekly income was £230. Around half described 'difficult' financial situations, 94% were receiving state benefits and 62% were in debt. Less than a third had tried to find a better energy deal; knowledge was the main barrier. After the intervention 19 people tried to switch, 13 did. Young families were most likely to switch, older people least. The main reasons for not switching were apathy ('can't be bothered'), lack of time, fear or scepticism and loyalty. Older people were particularly affected by apathy and scepticism. The personalized advice and help with websites was especially valued. Low-income consumers appear to have considerable apathy to switching energy tariffs, despite potential savings and health benefits, in part due to their complex lives in which switching is not a priority. An independent, one-on-one, personalized 'intervention' encouraged switching, particularly for young families. However, older people still experience significant barriers to switching with specific interventions needed, which take account of their status quo bias, energy use habits and scepticism. The recent integration of public health and local government in the UK may provide the ideal environment for providing similar services which are desperately needed to reduce fuel poverty in these groups in line with the new Public Health Strategy. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Hospital Financial Conditions and the Provision of Unprofitable Services

PubMed Central

Bazzoli, Gloria J.; Hsieh, Hui-Min

2011-01-01

Increases in hospital financial pressure resulting from public and private payment policy may substantially reduce a hospital’s ability to provide certain services that are not well compensated or are frequently used by the uninsured. The objective of this study is to examine the impact of hospital financial condition on the provision of these unprofitable services for the insured and uninsured. Economic theory provides the conceptual underpinnings for the analysis, and a longitudinal empirical analysis is conducted for an eight-year study period. The results indicate that not-for-profit hospitals with strong financial performance provide more unprofitable services for the insured and uninsured than do not-for-profit hospitals with weaker condition. For-profit hospital provision of these services is not influenced by their financial condition and instead may reflect actions to meet community expectations or to offer a sufficiently broad service array to maintain the business of insured patients. PMID:21625342

Financial Advice: Who Pays

ERIC Educational Resources Information Center

Finke, Michael S.; Huston, Sandra J.; Winchester, Danielle D.

2011-01-01

Using a cost-benefit framework for financial planning services and proprietary data collected in the summer of 2008, the client characteristics that are associated with the likelihood of paying for professional financial advice, as well as the type of financial services purchased, are identified. Results indicate that respondents who pay for…

UK podiatrists' experiences of podiatry services for people living with arthritis: a qualitative investigation.

PubMed

McCulloch, Louise; Borthwick, Alan; Redmond, Anthony; Edwards, Katherine; Pinedo-Villanueva, Rafael; Prieto-Alhambra, Daniel; Judge, Andrew; Arden, Nigel K; Bowen, Catherine J

2018-01-01

Provision of podiatry services, like other therapies in the UK, is an area that lacks guidance by the National Institute for Health and Care Excellence. Many individuals living with arthritis in the UK are not eligible to access NHS podiatry services. The primary aim of this investigation was to understand the views of podiatry clinicians on their experiences of referral, access, provision and treatment for foot problems for patients who have arthritis. Focus groups were undertaken to explore, in-depth, individual views of podiatrists working in the UK to gain feedback on experiences of barriers and facilitators to referral, access, provision and treatment for foot problems for individuals living with arthritis. A purposive sampling strategy was adopted and two, semi-structured, focus group interviews conducted, involving 12 podiatrists from both NHS and independent sectors. To account for geographical variations one focus group took place in each of 2 predetermined 'zones' of the UK; Yorkshire and Hampshire. Thematic analysis was employed to identify key meanings and report patterns within the data. The key themes derived from the podiatry clinician focus groups suggest a variety of factors influencing demand for, and burden of, foot pain within the UK. Participants expressed frustration on having a service that accepts and treats patients according to their condition, rather than their complaint. Additionally, concern was conveyed over variations in the understanding of stakeholders' views of what podiatry is and what podiatrists aim to achieve for patients. Podiatrists interviewed believed that many individuals living with arthritis in the UK are not eligible to access NHS podiatry services and that this may be, in part, due to confusion over what is known about podiatry and access criteria. Essentially, podiatrists interviewed called for a timely renaissance of current systems, to newer models of care that meet the foot care needs of individual patients' circumstances and incorporate national multi-disciplinary guidance. Through this project, we have formulated key recommendations that are directed towards improving what other stakeholders (including GPs, commissioners and users of podiatry services) know about the effectiveness of podiatry and also to futureproof the profession of podiatry.

Access to HIV community services by vulnerable populations: evidence from an enhanced HIV/AIDS surveillance system.

PubMed

Madden, H C E; Phillips-Howard, P A; Hargreaves, S C; Downing, J; Bellis, M A; Vivancos, R; Morley, C; Syed, Q; Cook, P A

2011-05-01

HIV disproportionately affects vulnerable populations such as black and minority ethnic groups, men who have sex with men (MSM) and migrants, in many countries including those in the UK. Community organisations in the UK are charitable non-governmental organisations with a proportion of the workforce who volunteer, and provide invaluable additional support for people living with HIV (PLWHIV). Information on their contribution to HIV care in vulnerable groups is relatively sparse. Data generated from an enhanced HIV surveillance system in North West England, UK, was utilised for this study. We aimed to determine the characteristics of individuals who chose to access community services in addition to clinical services (1375 out of 4195 records of PLWHIV in clinical services). Demographic information, risk factors including residency status, uniquely gathered in this region, and deprivation scores were examined. Multivariate logistic regression modelling was conducted to predict the relative effect of patient characteristics on attendance at community services. Attendance at community services was highest in those living in the most, compared with least, deprived areas (p<0.001), and was most evident in MSM and heterosexuals. Compared to white UK nationals attendance was significantly higher in non-UK nationals of uncertain residency status (Adjusted odds ratio [AOR] = 21.91, 95% confidence interval [CI] 10.48-45.83; p<0.001), refugees (AOR = 5.75, 95% CI 3.3-10.03; p<0.001), migrant workers (AOR = 5.48, 95% CI 2.22-13.51; p<0.001) and temporary visitors (AOR = 3.44, 95% CI 1.68-7.05; p<0.001). Community services, initially established predominantly to support MSM, have responded to the changing demography of HIV and reach the most vulnerable members of society. Consequent to their support of migrant populations, community services are vital for the management of HIV in black and minority groups. Paradoxically, this coincides with increasing funding pressures on these services.

39 CFR 3050.40 - Additional financial reporting.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Additional financial reporting. 3050.40 Section... financial reporting. (a) In general. The Postal Service shall file with the Commission: (1) Within 40 days...), beginning with the annual report for fiscal year 2010. (c) Financial reporting. The reports required by...

Financial Management of Libraries: Past Trends and Future Prospects.

ERIC Educational Resources Information Center

Roberts, Stephen A.

2003-01-01

The financial environment within library and information services is reviewed and a structure for financial management is presented based on funding source and level of commercial activity. Objectives for financial management of library and information services is developed and reviewed in light of future trends and stakeholder perspectives.…

Exploring the evidence base for Tier 3 specialist weight management interventions for children aged 2-18 years in the UK: a rapid systematic review.

PubMed

Brown, Tamara; O'Malley, Claire; Blackshaw, Jamie; Coulton, Vicki; Tedstone, Alison; Summerbell, Carolyn; Ells, Louisa J

2017-12-08

The impact of specialist weight management services (Tier 3) for children with severe and complex obesity in the UK is unclear. This review aims to examine the impact of child Tier 3 services in the UK, exploring service characteristics and implications for practice. Rapid systematic review of any study examining specialist weight management interventions in any UK setting including children (2-18 years) with a body mass index >99.6th centile or >98th centile with comorbidity. Twelve studies (five RCTs and seven uncontrolled) were included in a variety of settings. Study quality was moderate or low and mean baseline body mass index z-score ranged from 2.7 to 3.6 units. Study samples were small and children were predominantly older (10-14 years), female and white. Multidisciplinary team composition and eligibility criteria varied; dropout ranged from 5 to 43%. Improvements in zBMI over 1-24 months ranged from -0.13 to -0.41 units. Specialist weight management interventions for children with severe obesity demonstrated a reduction in zBMI, across a variety of UK settings. Studies were heterogeneous in content and thus conclusions on service design cannot be drawn. There is a paucity of evidence for Tier 3 services for children, and further research is required. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

15 CFR 801.10 - Rules and regulations for the BE-120, Benchmark Survey of Transactions in Selected Services and...

Code of Federal Regulations, 2010 CFR

2010-01-01

...; educational and training services; engineering, architectural, and surveying services; financial services (purchases only, by companies or parts of companies that are not financial services providers); industrial engineering services; industrial-type maintenance, installation, alteration, and training services; legal...

15 CFR 801.10 - Rules and regulations for the BE-120, Benchmark Survey of Transactions in Selected Services and...

Code of Federal Regulations, 2011 CFR

2011-01-01

...; educational and training services; engineering, architectural, and surveying services; financial services (purchases only, by companies or parts of companies that are not financial services providers); industrial engineering services; industrial-type maintenance, installation, alteration, and training services; legal...

7 CFR 91.18 - Financial interest of a scientist.

Code of Federal Regulations, 2013 CFR

2013-01-01

... SERVICES AND GENERAL INFORMATION Laboratory Service § 91.18 Financial interest of a scientist. No scientist shall perform a laboratory analysis on any product in which he is directly or indirectly financially...

Service use and financial performance in a replication program on adult day centers.

PubMed

Reifler, B V; Cox, N J; Jones, B N; Rushing, J; Yates, K

1999-01-01

The authors describe results from Partners in Caregiving: The Dementia Services Program, and present information on service utilization and financial performance among a group of 48 adult day centers across the United States from 1992 to 1996. Centers, with nonrandom assignment, received either grant support (average value: $93,000) or intensive technical assistance (average value: $39,000). Sites reported baseline data and submitted utilization information (enrollment and census) and financial data (revenue and expenses) quarterly. Overall, there were significant increases in enrollment, census, and financial performance (percent of cash expenses met through operating revenue) over the 4-year period. The grant-supported and technical-assistance sites had similar rates of improvement. Results provide data on service utilization and financial performance and demonstrate gains that can be achieved in these areas through improved marketing and financial management.

77 FR 20123 - Proposed Collection of Information: Claims Against the United States for Amounts Due in the Case...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-03

... United States for Amounts Due in the Case of a Deceased Creditor AGENCY: Financial Management Service, Fiscal Service, Treasury. ACTION: Notice and request for comments. SUMMARY: The Financial Management... collection. By this notice, the Financial Management Service solicits comments concerning ``Claims Against...

The epidemiology, healthcare and societal burden and costs of asthma in the UK and its member nations: analyses of standalone and linked national databases.

PubMed

Mukherjee, Mome; Stoddart, Andrew; Gupta, Ramyani P; Nwaru, Bright I; Farr, Angela; Heaven, Martin; Fitzsimmons, Deborah; Bandyopadhyay, Amrita; Aftab, Chantelle; Simpson, Colin R; Lyons, Ronan A; Fischbacher, Colin; Dibben, Christopher; Shields, Michael D; Phillips, Ceri J; Strachan, David P; Davies, Gwyneth A; McKinstry, Brian; Sheikh, Aziz

2016-08-29

There are a lack of reliable data on the epidemiology and associated burden and costs of asthma. We sought to provide the first UK-wide estimates of the epidemiology, healthcare utilisation and costs of asthma. We obtained and analysed asthma-relevant data from 27 datasets: these comprised national health surveys for 2010-11, and routine administrative, health and social care datasets for 2011-12; 2011-12 costs were estimated in pounds sterling using economic modelling. The prevalence of asthma depended on the definition and data source used. The UK lifetime prevalence of patient-reported symptoms suggestive of asthma was 29.5 % (95 % CI, 27.7-31.3; n = 18.5 million (m) people) and 15.6 % (14.3-16.9, n = 9.8 m) for patient-reported clinician-diagnosed asthma. The annual prevalence of patient-reported clinician-diagnosed-and-treated asthma was 9.6 % (8.9-10.3, n = 6.0 m) and of clinician-reported, diagnosed-and-treated asthma 5.7 % (5.7-5.7; n = 3.6 m). Asthma resulted in at least 6.3 m primary care consultations, 93,000 hospital in-patient episodes, 1800 intensive-care unit episodes and 36,800 disability living allowance claims. The costs of asthma were estimated at least £1.1 billion: 74 % of these costs were for provision of primary care services (60 % prescribing, 14 % consultations), 13 % for disability claims, and 12 % for hospital care. There were 1160 asthma deaths. Asthma is very common and is responsible for considerable morbidity, healthcare utilisation and financial costs to the UK public sector. Greater policy focus on primary care provision is needed to reduce the risk of asthma exacerbations, hospitalisations and deaths, and reduce costs.

Lessons from BLAT.

PubMed

Clarke, W D

1980-01-01

As acronyms go, BLAT has little to commend it. It has been likened to the sort of expletive beloved by children's comics and can be roughly translated into Polish. The latter, with its allusion to a lady of the streets, is not totally inaccurate, as BLAT is at the service of the medical and health professions. BLAT actually stands for The British Life Assurance Trust, and it represents the coming together in 1966 of the British Medical Association and the British Life Offices, for the purpose of establishing a charitable trust to promote innovation in health and medical education. BMA requires no explanation; BLO is the professional organization of the companies who make up the life assurance industry in the UK. Health is the obvious common ground between the two parent bodies, with the facetious claiming that both have a common financial interest in keeping people alive: the one to maintain the patient list, the other to maintain the premium paying list.(1.)

Toward greener dialysis: a case study to illustrate and encourage the salvage of reject water.

PubMed

Connor, Andrew; Milne, Steve; Owen, Andrew; Boyle, Gerard; Mortimer, Frances; Stevens, Paul

2010-06-01

Climate change is now considered to be a major global public health concern. However, the very provision of health care itself has a significant impact upon the environment. Action must be taken to reduce this impact. Water is a precious and finite natural resource. Vast quantities of high-grade water are required to provide haemodialysis. The reverse osmosis systems used in the purification process reject approximately two-thirds of the water presented to them. Therefore, around 250 litres of 'reject water' result from the production of the dialysate required for one treatment. This good quality reject water is lost-to-drain in the vast majority of centres worldwide. Simple methodologies exist to recycle this water for alternative purposes. We describe here a case study of the only UK renal service we know to have implemented such water-saving methodologies. We outline the benefits in terms of financial and environmental savings.

Provision of medical student teaching in UK general practices: a cross-sectional questionnaire study

PubMed Central

Harding, Alex; Rosenthal, Joe; Al-Seaidy, Marwa; Gray, Denis Pereira; McKinley, Robert K

2015-01-01

Background Health care is increasingly provided in general practice. To meet this demand, the English Department of Health recommends that 50% of all medical students should train for general practice after qualification. Currently 19% of medical students express general practice as their first career choice. Undergraduate exposure to general practice positively influences future career choice. Appropriate undergraduate exposure to general practice is therefore highly relevant to workforce planning Aim This study seeks to quantify current exposure of medical students to general practice and compare it with past provision and also with postgraduate provision. Design and setting A cross-sectional questionnaire in the UK. Method A questionnaire regarding provision of undergraduate teaching was sent to the general practice teaching leads in all UK medical schools. Information was gathered on the amount of undergraduate teaching, how this was supported financially, and whether there was an integrated department of general practice. The data were then compared with results from previous studies of teaching provision. The provision of postgraduate teaching in general practice was also examined. Results General practice teaching for medical students increased from <1.0% of clinical teaching in 1968 to 13.0% by 2008; since then, the percentage has plateaued. The total amount of general practice teaching per student has fallen by 2 weeks since 2002. Medical schools providing financial data delivered 14.6% of the clinical curriculum and received 7.1% of clinical teaching funding. The number of departments of general practice has halved since 2002. Provision of postgraduate teaching has tripled since 2000. Conclusion Current levels of undergraduate teaching in general practice are too low to fulfil future workforce requirements and may be falling. Financial support for current teaching is disproportionately low and the mechanism counterproductive. Central intervention may be required to solve this. PMID:26009536

A study of HIV positive undocumented African migrants' access to health services in the UK.

PubMed

Whyte, James; Whyte, Maria D; Hires, Kimberly

2015-01-01

Newly immigrated persons, whatever their origin, tend to fall in the lower socioeconomic levels. In fact, failure of an asylum application renders one destitute in a large proportion of cases, often resulting in a profound lack of access to basic necessities. With over a third of HIV positive failed asylum seekers reporting no income, and the remainder reporting highly limited resources, poverty is a reality for the vast majority. The purpose of the study was to determine the basic social processes that guide HIV positive undocumented migrant's efforts to gain health services in the UK. The study used the Grounded Theory Approach. Theoretical saturation occurred after 16 participants were included in the study. The data included reflections of the prominent factors related to the establishment of a safe and productive life and the ability of individuals to remain within the UK. The data reflected heavily upon the ability of migrants to enter the medical care system during their asylum period, and on an emerging pattern of service denial after loss on immigration appeal. The findings of this study are notable in that they have demonstrated sequence of events along a timeline related to the interaction between the asylum process and access to health-related services. The results reflect that African migrants maintain a degree of formal access to health services during the period that they possess legal access to services and informal access after the failure of their asylum claim. The purpose of this paper is to examine the basic social processes that characterize efforts to gain access to health services among HIV positive undocumented African migrants to the UK. The most recent estimates indicate that there are a total of 618,000 migrants who lack legal status within the UK. Other studies have placed the number of undocumented migrants within the UK in the range of 525,000-950,000. More than 442,000 are thought to dwell in the London metropolitan area. Even in cases where African migrants enter the UK legally, they often face considerable difficulty in their quest to gain legal employment due to barriers inherent to the system that grants work permits. With over a third of HIV positive failed asylum seekers reporting no income, and the remainder reporting highly limited resources, poverty is a reality for the vast majority.

Contemporary women's secure psychiatric services in the United Kingdom: A qualitative analysis of staff views.

PubMed

Walker, T; Edge, D; Shaw, J; Wilson, H; McNair, L; Mitchell, H; Gutridge, K; Senior, J; Sutton, M; Meacock, R; Abel, K

2017-11-01

WHAT IS KNOWN ON THE SUBJECT?: Three pilot UK-only Women's Enhanced Medium Secure Services (WEMSS) was opened in 2007 to support women's movement from high secure care and provide a bespoke, women-only service. Evidence suggests that women's secure services are particularly challenging environments to work in and staffing issues (e.g., high turnover) can cause difficulties in establishing a therapeutic environment. Research in this area has focused on the experiences of service users. Studies which have examined staff views have focused on their feelings towards women in their care and the emotional burden of working in women's secure services. No papers have made a direct comparison between staff working in different services. WHAT DOES THIS STUDY ADD TO EXISTING KNOWLEDGE?: This is the first study to explore the views and experiences of staff in the three UK WEMSS pilot services and contrast them with staff from women's medium secure services. Drawing upon data from eighteen semi-structured interviews (nine WEMSS, nine non-WEMSS), key themes cover staff perceptions of factors important for women's recovery and their views on operational aspects of services. This study extends our understanding of the experiences of staff working with women in secure care and bears relevance for staff working internationally, as well as in UK services. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The study reveals the importance of induction and training for bank and agency staff working in women's secure services. Further, regular clinical supervision should be mandatory for all staff so they are adequately supported. Introduction Women's Enhanced Medium Secure Services (WEMSS) is bespoke, gender-sensitive services which opened in the UK in 2007 at three pilot sites. This study is the first of its kind to explore the experiences of WEMSS staff, directly comparing them to staff in a standard medium secure service for women. The literature to date has focused on the experiences of service users or staff views on working with women in secure care. Aim This qualitative study, embedded in a multimethod evaluation of WEMSS, aimed to explore the views and experiences of staff in WEMSS and comparator medium secure services. Methods Qualitative interviews took place with nine WEMSS staff and nine comparator medium secure staff. Interviews focused on factors important for recovery, barriers to facilitating recovery and operational aspects of the service. Discussion This study provides a rare insight into the perspectives of staff working in UK women's secure services, an under-researched area in the UK and internationally. Findings suggest that the success of services, including WEMSS, is compromised by operational factors such as the use of bank staff. Implications for practice Comprehensive training and supervision should be mandatory for all staff, so best practice is met and staff adequately supported. © 2017 John Wiley & Sons Ltd.

Missile Defense Agency (MDA) Annual Small Business Conference

DTIC Science & Technology

2010-05-27

Technology Mission Oriented Business Integrated Services (MOBIS) Professional Engineering Services (PES) Environmental Services Advertising & Integrated ... Marketing Solutions (AIMS) Financial and Business Solutions (FABS) Financial and Business Solutions (FABS) Human Resources and EEO Services Temporary

Mobile phone collection, reuse and recycling in the UK

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

Ongondo, F.O.; Williams, I.D., E-mail: idw@soton.ac.uk

Highlights: > We characterized the key features of the voluntary UK mobile phone takeback network via a survey. > We identified 3 flows: information; product (handsets and accessories); and incentives. > There has been a significant rise in the number of UK takeback schemes since 1997. > Most returned handsets are low quality; little data exists on quantities of mobile phones collected. > Takeback schemes increasingly divert EoL mobile phones from landfill and enable reuse/recycling. - Abstract: Mobile phones are the most ubiquitous electronic product on the globe. They have relatively short lifecycles and because of their (perceived) in-built obsolescence,more » discarded mobile phones represent a significant and growing problem with respect to waste electrical and electronic equipment (WEEE). An emerging and increasingly important issue for industry is the shortage of key metals, especially the types of metals found in mobile phones, and hence the primary aim of this timely study was to assess and evaluate the voluntary mobile phone takeback network in the UK. The study has characterised the information, product and incentives flows in the voluntary UK mobile phone takeback network and reviewed the merits and demerits of the incentives offered. A survey of the activities of the voluntary mobile phone takeback schemes was undertaken in 2008 to: identify and evaluate the takeback schemes operating in the UK; determine the target groups from whom handsets are collected; and assess the collection, promotion and advertising methods used by the schemes. In addition, the survey sought to identify and critically evaluate the incentives offered by the takeback schemes, evaluate their ease and convenience of use; and determine the types, qualities and quantities of mobile phones they collect. The study has established that the UK voluntary mobile phone takeback network can be characterised as three distinctive flows: information flow; product flow (handsets and related accessories); and incentives flow. Over 100 voluntary schemes offering online takeback of mobile phone handsets were identified. The schemes are operated by manufacturers, retailers, mobile phone network service operators, charities and by mobile phone reuse, recycling and refurbishing companies. The latter two scheme categories offer the highest level of convenience and ease of use to their customers. Approximately 83% of the schemes are either for-profit/commercial-oriented and/or operate to raise funds for charities. The voluntary schemes use various methods to collect mobile phones from consumers, including postal services, courier and in-store. The majority of schemes utilise and finance pre-paid postage to collect handsets. Incentives offered by the takeback schemes include monetary payments, donation to charity and entry into prize draws. Consumers from whom handsets and related equipment are collected include individuals, businesses, schools, colleges, universities, charities and clubs with some schemes specialising on collecting handsets from one target group. The majority (84.3%) of voluntary schemes did not provide information on their websites about the quantities of mobile phones they collect. The operations of UK takeback schemes are decentralised in nature. Comparisons are made between the UK's decentralised collection system versus Australia's centralised network for collection of mobile phones. The significant principal conclusions from the study are: there has been a significant rise in the number of takeback schemes operating in the UK since the initial scheme was launched in 1997; the majority of returned handsets seem to be of low quality; and there is very little available information on the quantities of mobile phones collected by the various schemes. Irrespective of their financial motives, UK takeback schemes increasingly play an important role in sustainable waste management by diverting EoL mobile phones from landfills and encouraging reuse and recycling. Recommendations for future actions to improve the management of end-of-life mobile phone handsets and related accessories are made.« less

Success is in the bank

NASA Astrophysics Data System (ADS)

de Vincent-Humphreys, Rupert

2008-05-01

As the nation's central bank, the Bank of England is committed to promoting and maintaining monetary and financial stability. Broadly speaking, this means that it sets the interest rate at a level such that the economy should meet the UK government's 2% inflation target in the medium term, and it analyses the financial system to identify and reduce systemic risks to the country's financial infrastructure. The Bank also performs several other critical functions, including managing the approximately £42bn worth of banknotes in circulation and managing the nation's foreign-currency reserves - a multicurrency fund worth some £23bn. As a physicist, I find that I can make a full contribution to this work.

An Agenda for Action To Achieve the Information Society in the UK.

ERIC Educational Resources Information Center

Oppenheim, Charles

1996-01-01

Discusses the development a national information policy in the United Kingdom (UK): policies for national information infrastructures, electronic information services, privacy and data protection, copyright, public and national libraries; reviews problems inhibiting Internet use; compares the UK's and the European Commission's approaches to…

In the Service of Technocratic Managerialism? History in UK Universities

ERIC Educational Resources Information Center

Donnelly, Mark; Norton, Claire

2017-01-01

This article discusses the conceptualisation, organisation and philosophical orientation of academic history culture in UK higher education. It problematises the extent to which a dominant history culture in UK universities implies and uncritically reproduces normative understandings about the subject; about its epistemological standing,…

7 CFR 91.18 - Financial interest of a scientist.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 3 2010-01-01 2010-01-01 false Financial interest of a scientist. 91.18 Section 91.18... SERVICES AND GENERAL INFORMATION Laboratory Service § 91.18 Financial interest of a scientist. No scientist shall perform a laboratory analysis on any product in which he is directly or indirectly financially...

7 CFR 91.18 - Financial interest of a scientist.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 3 2011-01-01 2011-01-01 false Financial interest of a scientist. 91.18 Section 91.18... SERVICES AND GENERAL INFORMATION Laboratory Service § 91.18 Financial interest of a scientist. No scientist shall perform a laboratory analysis on any product in which he is directly or indirectly financially...

Nonverbal contention and contempt in U.K. parliamentary oversight hearings on fiscal and monetary policy.

PubMed

Schonhardt-Bailey, Cheryl

2017-01-01

In parliamentary committee oversight hearings on fiscal policy, monetary policy, and financial stability, where verbal deliberation is the focus, nonverbal communication may be crucial in the acceptance or rejection of arguments proffered by policymakers. Systematic qualitative coding of these hearings in the 2010-15 U.K. Parliament finds the following: (1) facial expressions, particularly in the form of anger and contempt, are more prevalent in fiscal policy hearings, where backbench parliamentarians hold frontbench parliamentarians to account, than in monetary policy or financial stability hearings, where the witnesses being held to account are unelected policy experts; (2) comparing committees across chambers, hearings in the House of Lords committee yield more reassuring facial expressions relative to hearings in the House of Commons committee, suggesting a more relaxed and less adversarial context in the former; and (3) central bank witnesses appearing before both the Lords and Commons committees tend toward expressions of appeasement, suggesting a willingness to defer to Parliament.

UK Health and Social Care Case Studies: Iterative Technology Development.

PubMed

Blanchard, Adie; Gilbert, Laura; Dawson, Tom

2017-01-01

As a result of increasing demand in the face of reducing resources, technology has been implemented in many social and health care services to improve service efficiency. This paper outlines the experiences of deploying a 'Software as a Service' application in the UK social and health care sectors. The case studies demonstrate that every implementation is different, and unique to each organisation. Technology design and integration can be facilitated by ongoing engagement and collaboration with all stakeholders, flexible design, and attention to interoperability to suit services and their workflows.

Full Service Extended Schools and Educational Inequality in Urban Contexts--New Opportunities for Progress?

ERIC Educational Resources Information Center

Raffo, Carlo; Dyson, Alan

2007-01-01

This paper examines the extent to which the UK government's full service extended schools programme has the capacity to ameliorate educational inequality in urban contexts. It starts by examining a variety of explanatory narratives for educational inequality in urban contexts in the UK and suggests that the dynamics of social exclusion created by…

Crossing the Binary Line: The Founding of the Polytechnic in Colonial Hong Kong

ERIC Educational Resources Information Center

Wong, Ting-Hong

2014-01-01

Using the case of the Hong Kong Polytechnic (HKP), this paper examines academic drift in colonial settings. The HKP, like polytechnics in the UK, was supposedly a service sector institution. Under the binary system in the UK, schools in the service division were governed by the state educational bureaucracy, while the universities--the autonomous…

The epidemiology of sexually transmitted infections in the UK: impact of behavior, services and interventions.

PubMed

Hughes, Gwenda; Field, Nigel

2015-01-01

Sexually transmitted infections (STIs) are a major public health concern. The UK has some of the most advanced STI surveillance systems globally. This article uses national surveillance data to describe remarkable changes in STI epidemiology in the UK over the last century and explores the behavioral and demographic shifts that may explain these trends. The past 10 years have seen considerable improvements in STI service provision and the introduction of national public health interventions. However, sexual health inequalities persist and men who have sex with men, young adults and black ethnic minorities remain a priority for interventions. Technological advances in testing and a shift in sexual health service commissioning arrangements will present both opportunities and challenges in future.

76 FR 4349 - Change in Bank Control Notices; Acquisitions of Shares of a Bank or Bank Holding Company

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-25

....; TCG Financial Services, L.P;, Carlyle Financial Services, Ltd.; TC Group Cayman Investment Holdings, L.P.; TCG Holdings Cayman II, L.P.; DBD Cayman, Limited; TCG Financial Services Investment Holdings, L...'Aniello; William E. Conway, Jr.; David M. Rubenstein, all in Washington, D.C.; and Carlyle Investment...

2001 Industry Studies: Financial Services

DTIC Science & Technology

2001-01-01

financial services firms are also positioning to compete here and abroad with international firms. Advances in information technology continue to provide...future. A veritable revolution is taking place within the financial services industry. Globalization, information technology and continuing... technological infrastructure that must be protected. Industry vulnerabilities will continue to increase as use of the Internet , e-commerce, and e-banking become

A Management Study of the MCPS Accounting System and Certain Related Financial Services Functions. Final Report.

ERIC Educational Resources Information Center

Young (Arthur) and Co., Washington, DC.

Several years ago, Montgomery County Public Schools (MCPS) began a Management Operations Review and Evaluation (MORE) of the entire school system, excluding school-based instruction. This MORE study is an evaluation of MCPS's current accounting system and certain related financial services functions within the Department of Financial Services. In…

Asset-building, financial self-management service model: piecing together consumer financial independence.

PubMed

Swarbrick, Margaret

2006-10-01

This program represents an innovative approach to traditional money-management services. This asset-building, financial self-management service model has the potential to positively affect recovery, self-sufficiency, and community integration for people with mental illnesses. It is hoped this program will be replicated by other providers in a way that may effect systems change.

Perceptions of the Software Skills of Graduates by Employers in the Financial Services Industry

ERIC Educational Resources Information Center

Kyng, Tim; Tickle, Leonie; Wood, Leigh N.

2013-01-01

Software, particularly spreadsheet software, is ubiquitous in the financial services workplace. Yet little is known about the extent to which universities should, and do, prepare graduates for this aspect of the modern workplace. We have investigated this issue through a survey of financial services employers of graduates, the results of which are…

Effect of financial incentives on ethnic disparities in smoking cessation interventions in primary care: cross-sectional study.

PubMed

Hamilton, F L; Laverty, A A; Vamos, E P; Majeed, A; Millett, C

2013-03-01

Smoking cessation interventions are underprovided in primary care. Financial incentives may help address this. However, few studies in the UK have examined their impact on disparities in the delivery of smoking cessation interventions. Cross-sectional study using 2007 data from 29 general practices in Wandsworth, London, UK. We used logistic regression to examine associations between disease group [cardiovascular disease (CVD), respiratory disease, depression or none of these diseases], ethnicity and smoking outcomes following the introduction of the Quality and Outcomes Framework in 2004. Significantly, more CVD patients had smoking status ascertained compared with those with respiratory disease (89 versus 72%), but both groups received similar levels of cessation advice (93 and 89%). Patients with depression or none of the diseases were less likely to have smoking status ascertained (60% for both groups) or to receive advice (80 and 75%). Smoking prevalence was high, especially for patients with depression (44%). White British patients had higher rates of smoking than most ethnic groups, but black Caribbean men with depression had the highest smoking prevalence (62%). Smoking rates remain high, particularly for white British and black Caribbean patients. Extending financial incentives to include recording of ethnicity and rewarding quit rates may further improve smoking cessation outcomes in primary care.

AICPA allows low-cost options for compiled financial statements.

PubMed

Reinstein, Alan; Luecke, Randall W

2002-02-01

The AICPA Accounting and Review Services Committee's (ARSC) SSARS No. 8, Amendment to Statement on Standards for Accounting and Review Services No. 1, Compilation and Review of Financial Statements, issued in October 2000, allows financial managers to provide plain-paper, compiled financial statements for the exclusive use of management. Such financial statements were disallowed in 1979 when the AICPA issued SSARS No. 1, Compilation and Review of Financial Statements. With the issuance of SSARS No. 8, financial managers can prepare plain-paper, compiled financial statements when third parties are not expected to rely on the financial statements, management acknowledges such restrictions in writing, and management acknowledges its primary responsibility for the adequacy of the financial statements.

The U.K. service level audit of insulin pump therapy in adults.

PubMed

White, H D; Goenka, N; Furlong, N J; Saunders, S; Morrison, G; Langridge, P; Paul, P; Ghatak, A; Weston, P J

2014-04-01

The National Institute for Health and Clinical Excellence (NICE) published guidelines for the use of continuous subcutaneous insulin infusion in 2008 (technology appraisal 151). The first U.K.-wide insulin pump audit took place in 2012 with the aim of determining adherence to the guidance issued in NICE technology appraisal 151. The results of the adult service level audit are reported here. All centres providing continuous subcutaneous insulin infusion services to adults with diabetes in the U.K. were invited to participate. Audit metrics were aligned to technology appraisal 151. Data entry took place online using a DiabetesE formatted data collection tool. One hundred and eighty-three centres were identified as delivering adult continuous subcutaneous insulin infusion services in the U.K., of which 178 (97.3%) participated in the audit. At the time of the audit, 13 428 adults were using insulin pump therapy, giving an estimated prevalence of use of 6%. Ninety-three per cent of centres did not report any barriers in obtaining funding for patients who fulfilled NICE criteria. The mean number of consultant programmed activities dedicated to continuous subcutaneous insulin infusion services was 0.96 (range 0-8), mean whole-time equivalent diabetes specialist nurses was 0.62 (range 0-3) and mean whole-time equivalent dietitian services was 0.3 (range 0-2), of which 39, 61 and 60%, respectively, were not formally funded. The prevalence of continuous subcutaneous insulin infusion use in the U.K. falls well below the expectation of NICE (15-20%) and that of other European countries (> 15%) and the U.S.A. (40%). This may be attributable, in part, to lack of healthcare professional time needed for identification and training of new pump therapy users. © 2013 The Authors. Diabetic Medicine © 2013 Diabetes UK.

Market-based demand forecasting promotes informed strategic financial planning.

PubMed

Beech, A J

2001-11-01

Market-based demand forecasting is a method of estimating future demand for a healthcare organization's services by using a broad range of data that describe the nature of demand within the organization's service area. Such data include the primary and secondary service areas, the service-area populations by various demographic groupings, discharge utilization rates, market size, and market share by service line and organizationwide. Based on observable market dynamics, strategic planners can make a variety of explicit assumptions about future trends regarding these data to develop scenarios describing potential future demand. Financial planners then can evaluate each scenario to determine its potential effect on selected financial and operational measures, such as operating margin, days cash on hand, and debt-service coverage, and develop a strategic financial plan that covers a range of contingencies.

A Comparative Study of Financial Data Sources for Critical Access Hospitals: Audited Financial Statements, the Medicare Cost Report, and the Internal Revenue Service Form 990

ERIC Educational Resources Information Center

Ozmeral, Alisha Bhadelia; Reiter, Kristin L.; Holmes, George M.; Pink, George H.

2012-01-01

Purpose: Medicare Cost Reports (MCR), Internal Revenue Service Form 990s (IRS 990), and Audited Financial Statements (AFS) vary in their content, detail, purpose, timeliness, and certification. The purpose of this study was to compare selected financial data elements and characterize the extent of differences in financial data and ratios across…

Development and evaluation of an online, interactive information and advice tool for pre-registration nursing students.

PubMed

Ryan, Gemma Sinead; Davies, Fiona

2016-03-01

Attrition rates for student nurses on academic programmes is a challenge for UK Higher Education Institutions. Reasons for leaving a programme of study include personal, financial issues or practice placement experiences. Research has shown systematic and integrated support mechanisms may improve attrition rates and student experience. This project explored the sources of, and support needs of nursing and allied health students, develop and evaluate and interactive online tool: 'SignpOSt'. Enabling students to access 'the right support, at the right time, from the right place'. Focus groups were carried out with 14, 3rd year students and 8 academic staff including personal tutors, programme/module leaders. Thematic analysis of transcribed data under four key themes for support and advice: 1. Financial 2. Programme 3. Personal 4. Study/academic, found poor student knowledge and little clarity of responsibilities of academic staff and services leads to students sourcing support from the wrong place at the wrong time. Students valued the speed and accessibility of information from informal, programme specific Facebook groups. Conversely, there were also concerns about the accuracy of these. Further research into the use of informal Facebook groups may be useful along with additional evaluation of the SOS tool. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

PubMed

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

2018-05-17

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

Exploring the potential of Product Service Systems to achieve household waste prevention on new housing developments in the UK.

PubMed

Gottberg, Annika; Longhurst, Philip J; Cook, Matthew B

2010-03-01

Product service systems (PSS) are cleaner product concepts which have been developed to achieve improvements in resource productivity which may be realized from modern trends in service delivery. However, there is a paucity of research on the waste prevention performance of PSS in UK household markets. This paper reports the findings of exploratory research which begins to address this gap in knowledge. An exploratory waste prevention assessment was completed on four experimental PSS which were developed in conjunction with a major UK house-builder for delivery on their new housing developments. The results of the assessment show that the selected PSS concepts have potential to prevent high value and harmful Waste Electrical and Electronic Equipment (WEEE) arising in UK household waste streams. Consistent with the canon of exploratory research, the assessment also identifies a number of factors which are thought to influence PSS waste prevention performance. It is recognized that further research is needed to gain an in-depth understanding of these factors as well as to define policy measures which enable the conditions in which PSS prevent household waste on new housing developments in the UK to be created.

New UK graduates' knowledge of training and service provision within restorative dentistry - a survey.

PubMed

Kalsi, A S; Kochhar, S; Lewis, N J; Hemmings, K W

2017-06-09

Objective To assess new UK graduates' knowledge of training and service provision within restorative dentistry.Design A national descriptive cross-sectional survey.Subjects and methods An online survey assessing clinicians' knowledge of restorative dentistry, who had graduated within the last four years in the UK, was distributed across the UK via postgraduate dental deaneries. One-hundred responses were accepted as a sample of a potential population of 4,000.Main outcome measure How well respondents understood the service provision and training aspects of the specialty of restorative dentistry.Results The responses were received from graduates from a variety of dental schools across the UK. Of those respondents, 41 reported receiving career guidance within restorative dentistry. 45 new graduates were confident in their understanding of the specialty, while 53 were confident in the differences between restorative dentistry and monospecialty training. The respondents appeared unaware regarding treatment priorities within restorative dentistry departments. Most respondents felt that receiving teaching on restorative dentistry as a specialty and career pathway would be beneficial.Conclusion The results suggest that new graduates may benefit from clarification regarding the specialty of restorative dentistry, however, caution must be taken due to the limitations of the study.

The use of standard contracts in the English National Health Service: a case study analysis.

PubMed

Petsoulas, Christina; Allen, Pauline; Hughes, David; Vincent-Jones, Peter; Roberts, Jennifer

2011-07-01

The use of contracts is vital to market transactions. The introduction of market reforms in health care in the U.K. and other developed countries twenty years ago meant greater use of contracts. In the U.K., health care contracting was widely researched in the 1990s. Yet, despite the changing policy context, the subject has attracted less interest in recent years. This paper seeks to fill a gap by reporting findings from a study of contracting in the English National Health Service (NHS) after the introduction of the national standard contract in 2007. By using economic and socio-legal theories and two case studies we examine the way in which the new contract was implemented in practice and the extent to which implementation conformed to policy intentions and to our theoretical predictions. Data were collected using non-participant observation of 36 contracting meetings, 24 semi-structured interviews, and analysis of documents. We found that despite efforts to introduce a more detailed ('complete') contract, in practice, purchasers and providers often reverted to a more relational style of contracting. Frequently reliance on the NHS hierarchy proved to be indispensable; in particular, formal dispute resolution was avoided and financial risk was re-allocated in compromises that sometimes ignored contractual provisions. Serious data deficiencies and shortages of skilled personnel still caused major difficulties. We conclude that contracting for health care continues to raise serious problems, which may be exacerbated by the impending transfer of responsibility to groups of general practitioners (GPs) who generally lack experience and expertise in large-scale, secondary care contracting. Copyright © 2011 Elsevier Ltd. All rights reserved.

Comment.

PubMed

Cossey, D

1993-01-01

In the UK, the Chairwoman of the Family Planning Association (FPA) praises the staff and volunteers with whom she has worked for their incessant inability to meet the many challenges they face. During her 6 years, however, the FPA had to reduce the number of regional offices and staff. It did not need to reduce salaries, however. FPA membership directly elects the National Executive Council which is now smaller. FPA is exploring new sources of funding and is adapting to the purchaser/provider relationship in the statutory sector, resulting in its successful financial strategy. The Department of Health helps in maintaining FPA's ability to continue to operate. The Chairwoman sees indications of needing to fight old battles again, e.g., some officials have suggested limiting the range of oral contraceptives available from prescription by the National Health Services (NHS) which would be the end of almost 20 years of free contraception and free choice under the NHS. The government is not open to including sex education the school curriculum. The NHS gives the impression in its report "The Health of the Nation" that it is committed to reducing adolescent pregnancies among the youngest teenagers and to recognizing the importance of good policies on sexual health. Yet, its actions exhibit no compassion for single parents. Participants at FPA's 1992 conference agree that variety, quality, and sensitivity of family planning provisions are needed and that family planning clinics and general practitioners should work together. FPA has contributed to the UK the clinic network; the concept of family planning being an integral part of a comprehensive health service; and the notion that family planning includes contraception, empowerment of women, sexual health, rights, and responsibilities. FPA should reaffirm these ideas and secure the future for informed choice and planned pregnancy.

Modelling inflation in transportation, comunication and financial services using B-Spline time series model

NASA Astrophysics Data System (ADS)

Suparti; Prahutama, Alan; Santoso, Rukun

2018-05-01

Inflation is an increase in the price of goods and services in general where the goods and services are the basic needs of society or the decline of the selling power of a country’s currency. Significant inflationary increases occurred in 2013. This increase was contributed by a significant increase in some inflation sectors / groups i.e transportation, communication and financial services; the foodstuff sector, and the housing, water, electricity, gas and fuel sectors. However, significant contributions occurred in the transportation, communications and financial services sectors. In the model of IFIs in the transportation, communication and financial services sector use the B-Spline time series approach, where the predictor variable is Yt, whereas the predictor is a significant lag (in this case Yt-1). In modeling B-spline time series determined the order and the optimum knot point. Optimum knot determination using Generalized Cross Validation (GCV). In inflation modeling for transportation sector, communication and financial services obtained model of B-spline order 2 with 2 points knots produce MAPE less than 50%.

Financial Aid as a Service: A Review of Operations.

ERIC Educational Resources Information Center

Adams, Judith

A study was undertaken at Macomb Community College (MCC), in Michigan, to review the effectiveness of the college's financial aid department. Data were gathered from a search of the literature related to financial aid services and a review of comments and findings from MCC alumni and financial aid surveys. In addition, surveys were conducted of…

Financial considerations in the conduct of multi-centre randomised controlled trials: evidence from a qualitative study.

PubMed

Snowdon, Claire; Elbourne, Diana R; Garcia, Jo; Campbell, Marion K; Entwistle, Vikki A; Francis, David; Grant, Adrian M; Knight, Rosemary C; McDonald, Alison M; Roberts, Ian

2006-12-21

Securing and managing finances for multicentre randomised controlled trials is a highly complex activity which is rarely considered in the research literature. This paper describes the process of financial negotiation and the impact of financial considerations in four UK multicentre trials. These trials had met, or were on schedule to meet, recruitment targets agreed with their public-sector funders. The trials were considered within a larger study examining factors which might be associated with trial recruitment (STEPS). In-depth semi-structured telephone interviews were conducted in 2003-04 with 45 individuals with various responsibilities to one of the four trials. Interviewees were recruited through purposive and then snowball sampling. Interview transcripts were analysed with the assistance of the qualitative package Atlas-ti. The data suggest that the UK system of dividing funds into research, treatment and NHS support costs brought the trial teams into complicated negotiations with multiple funders. The divisions were somewhat malleable and the funding system was used differently in each trial. The fact that all funders had the potential to influence and shape the trials considered here was an important issue as the perspectives of applicants and funders could diverge. The extent and range of industry involvement in non-industry-led trials was striking. Three broad periods of financial work (foundation, maintenance, and resourcing completion) were identified. From development to completion of a trial, the trialists had to be resourceful and flexible, adapting to changing internal and external circumstances. In each period, trialists and collaborators could face changing costs and challenges. Each trial extended the recruitment period; three required funding extensions from MRC or HTA. This study highlights complex financial aspects of planning and conducting trials, especially where multiple funders are involved. Recognition of the importance of financial stability and of the need for appropriate training in this area should be paralleled by further similar research with a broader range of trials, aimed at understanding and facilitating the conduct of clinical research.

Spatio-temporal Assessment Of The Land Use Implications Of Solar PV And Bioenergy Deployment In The UK TM Energy Model

NASA Astrophysics Data System (ADS)

Sobral Mourao, Z.; Konadu, D. D.; Skelton, S.; Lupton, R.

2015-12-01

The UK TIMES model (UKTM) succeeds the UK MARKAL as the underlying model of the UK Department of Energy and Climate Change (DECC) for long term energy system planning and policy development. It generates energy system pathways which achieve the 80% greenhouse gas (GHG) emissions reduction target by 2050, stipulated in the UK Climate Change Act (2008), at the least possible cost. Some of these pathways prescribe large-scale deployment of solar PV and indigenously sourced bioenergy, which are land intensive and could result in significant land use transitions; but would this create competition and stress for UK land use? To answer the above question, this study uses an integrated spatio-temporal modelling approach, ForeseerTM, which characterises the interdependencies between the energy and land systems by evaluating the land required under each pathways for solar PV and bioenergy, based on scenarios of a range of PV conversion efficiencies, and energy crop yield projections. The outcome is compared with availability of suitable locations for solar PV and sustainable limits of agricultural land appropriation for bioenergy production to assess potential stresses and competition with other land use services. Preliminary results show UKTM pathways could pose significant impact on the UK land use system. Bioenergy deployment could potentially compete with other land services by taking up a significant part of the available UK agricultural land thus competing directly with food production, most notably livestock production. For pathways with significant solar PV deployment, direct competition would not be focussed on the high quality land used for food crop production but rather for land used for livestock production and other ecosystem services.

75 FR 32181 - Change in Bank Control Notices; Acquisition of Shares of Bank or Bank Holding Companies

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-07

... Investment Management, L.L.C.; TC Group, L.L.C.; and TCG Holdings, L.L.C., all of Wilmington, Delaware; to... Partners, L.P.; TCG Financial Services, L.P.; Carlyle Financial Services, Ltd.; TC Group Cayman Investment Holdings, L.P.; TCG Holdings Cayman II, L.P.; DBD Cayman, Limited; TCG Financial Services Investment...

Factor structure of the Essen Climate Evaluation Schema measure of social climate in a UK medium-security setting.

PubMed

Milsom, Sophia A; Freestone, Mark; Duller, Rachel; Bouman, Marisa; Taylor, Celia

2014-04-01

Social climate has an influence on a number of treatment-related factors, including service users' behaviour, staff morale and treatment outcomes. Reliable assessment of social climate is, therefore, beneficial within forensic mental health settings. The Essen Climate Evaluation Schema (EssenCES) has been validated in forensic mental health services in the UK and Germany. Preliminary normative data have been produced for UK high-security national health services and German medium-security and high-security services. We aim to validate the use of the EssenCES scale (English version) and provide preliminary normative data in UK medium-security hospital settings. The EssenCES scale was completed in a medium-security mental health service as part of a service-wide audit. A total of 89 patients and 112 staff completed the EssenCES. The three-factor structure of the EssenCES and its internal construct validity were maintained within the sample. Scores from this medium-security hospital sample were significantly higher than those from earlier high-security hospital data, with three exceptions--'patient cohesion' according to the patients and 'therapeutic hold' according to staff and patients. Our data support the use of the EssenCES scale as a valid measure for assessing social climate within medium-security hospital settings. Significant differences between the means of high-security and medium-security service samples imply that degree of security is a relevant factor affecting the ward climate and that in monitoring quality of secure services, it is likely to be important to apply different scores to reflect standards. Copyright © 2013 John Wiley & Sons, Ltd.

Does money or the law reduce doctors' working hours in the UK?

PubMed

Moreton, Adam; Collier, Andrew

2015-08-01

What can be learned from a 45-year journey to reduced junior doctors' working hours? The authors investigated the impact of financially punitive measures (the 2001 New Deal contract) and legislation (Working Time Regulations) on the average working week for doctors-in-training.

Benchmarking of venous thromboembolism prophylaxis practice with ENT.UK guidelines.

PubMed

Al-Qahtani, Ali S

2017-05-01

The aim of this study was to benchmark our guidelines of prevention of venous thromboembolism (VTE) in ENT surgical population against ENT.UK guidelines, and also to encourage healthcare providers to utilize benchmarking as an effective method of improving performance. The study design is prospective descriptive analysis. The setting of this study is tertiary referral centre (Assir Central Hospital, Abha, Saudi Arabia). In this study, we are benchmarking our practice guidelines of the prevention of VTE in the ENT surgical population against that of ENT.UK guidelines to mitigate any gaps. ENT guidelines 2010 were downloaded from the ENT.UK Website. Our guidelines were compared with the possibilities that either our performance meets or fall short of ENT.UK guidelines. Immediate corrective actions will take place if there is quality chasm between the two guidelines. ENT.UK guidelines are evidence-based and updated which may serve as role-model for adoption and benchmarking. Our guidelines were accordingly amended to contain all factors required in providing a quality service to ENT surgical patients. While not given appropriate attention, benchmarking is a useful tool in improving quality of health care. It allows learning from others' practices and experiences, and works towards closing any quality gaps. In addition, benchmarking clinical outcomes is critical for quality improvement and informing decisions concerning service provision. It is recommended to be included on the list of quality improvement methods of healthcare services.

Current Capabilities, Requirements and a Proposed Strategy for Interdependency Analysis in the UK

NASA Astrophysics Data System (ADS)

Bloomfield, Robin; Chozos, Nick; Salako, Kizito

The UK government recently commissioned a research study to identify the state-of-the-art in Critical Infrastructure modelling and analysis, and the government/industry requirements for such tools and services. This study (Cetifs) concluded with a strategy aiming to bridge the gaps between the capabilities and requirements, which would establish interdependency analysis as a commercially viable service in the near future. This paper presents the findings of this study that was carried out by CSR, City University London, Adelard LLP, a safety/security consultancy and Cranfield University, defense academy of the UK.

Science minister unveils reforms to facilities council

NASA Astrophysics Data System (ADS)

Banks, Michael

2010-04-01

The UK's science minister Lord Dray son has announced a series of measures to prevent the Science and Technology Facilities Council (STFC) from being dogged by further financial crises. They include a plan for the STFC's budget for large facilities, such as the Diamond synchrotron and the ISIS neutron-scattering lab, to be allocated and managed separately from its budget for grants. Drayson was forced to review the STFC after the council announced last December that the UK would have to pull out of 25 international science projects because of a £40m shortfall in funding.

Determinants of self-rated health in elderly populations in urban areas in Slovenia, Lithuania and UK: findings of the EURO-URHIS 2 survey.

PubMed

Stanojevic Jerkovic, Olivera; Sauliune, Skirmante; Šumskas, Linas; Birt, Christopher A; Kersnik, Janko

2017-05-01

Ageing imposes extra financial burdens on social and health services in developed countries. Self-rated health (SRH) is considered to be both a reliable measurement of overall health status including morbidity and mortality and an important predictor of hospitalization, functional impairment and greater demand for health-care services in the elderly. Our aim was to identify factors associated with poor SRH in elderly populations and investigate possible differences between urban areas in Slovenia, Lithuania and UK. Data were obtained from population-based surveys from the European Urban Health Indicator System Part 2 project. The stratified representative sample (41% men and 59% women) consisted of a total of 2547 respondents aged ≥65 from the urban areas in the three countries. The prevalence of poor SRH was highest in Lithuanian urban areas. The strongest factors associated with poor SRH were low education [OR (odds ratio) 4.3, 95% CI (confidence interval) 2.5-7.3, P < 0.001], restriction of activities attributable to a chronic disease (OR 2.6, 95% CI 2.2-3.0, P < 0.001), inadequate physical activity (OR 1.7, 95% CI 1.2-2.5, P = 0.007) and poor mental health (OR 1.1, 95% CI 1.1-1.2, P < 0.001). The main factors associated with poor SRH by country included the following: living alone (Slovenia) (OR 2.0, 95% CI 1.1-3.7, P = 0,023), female sex (Lithuania) (OR 2.0, 95% CI 1.0-4.2, P = 0.058) and inadequate physical activity (UK) (OR 2.2, 95% CI 1.3-3.6, P = 0,003). Despite different levels of poor SRH, the factors associated with poor SRH were similar for the urban areas of the three countries. Factors associated with poor SRH in the urban areas could also reflect either cultural differences or specific situations for elderly in that country, which need further research. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Impact of perceived importance of ecosystem services and stated financial constraints on willingness to pay for riparian meadow restoration in Flanders (Belgium).

PubMed

Chen, Wendy Y; Aertsens, Joris; Liekens, Inge; Broekx, Steven; De Nocker, Leo

2014-08-01

The strategic importance of ecosystem service valuation as an operational basis for policy decisions on natural restoration has been increasingly recognized in order to align the provision of ecosystem services with the expectation of human society. The contingent valuation method (CVM) is widely used to quantify various ecosystem services. However, two areas of concern arise: (1) whether people value specific functional ecosystem services and overlook some intrinsic aspects of natural restoration, and (2) whether people understand the temporal dimension of ecosystem services and payment schedules given in the contingent scenarios. Using a peri-urban riparian meadow restoration project in Flanders, Belgium as a case, we explored the impacts of residents' perceived importance of various ecosystem services and stated financial constraints on their willingness-to-pay for the proposed restoration project employing the CVM. The results indicated that people tended to value all the benefits of riparian ecosystem restoration concurrently, although they accorded different importances to each individual category of ecosystem services. A longer payment scheme can help the respondents to think more about the flow of ecosystem services into future generations. A weak temporal embedding effect can be detected, which might be attributed to respondents' concern about current financial constraints, rather than financial bindings associated with their income and perceived future financial constraints. This demonstrates the multidimensionality of respondents' financial concerns in CV. This study sheds light on refining future CV studies, especially with regard to public expectation of ecosystem services and the temporal dimension of ecosystem services and payment schedules.

Impact of Perceived Importance of Ecosystem Services and Stated Financial Constraints on Willingness to Pay for Riparian Meadow Restoration in Flanders (Belgium)

NASA Astrophysics Data System (ADS)

Chen, Wendy Y.; Aertsens, Joris; Liekens, Inge; Broekx, Steven; De Nocker, Leo

2014-08-01

The strategic importance of ecosystem service valuation as an operational basis for policy decisions on natural restoration has been increasingly recognized in order to align the provision of ecosystem services with the expectation of human society. The contingent valuation method (CVM) is widely used to quantify various ecosystem services. However, two areas of concern arise: (1) whether people value specific functional ecosystem services and overlook some intrinsic aspects of natural restoration, and (2) whether people understand the temporal dimension of ecosystem services and payment schedules given in the contingent scenarios. Using a peri-urban riparian meadow restoration project in Flanders, Belgium as a case, we explored the impacts of residents' perceived importance of various ecosystem services and stated financial constraints on their willingness-to-pay for the proposed restoration project employing the CVM. The results indicated that people tended to value all the benefits of riparian ecosystem restoration concurrently, although they accorded different importances to each individual category of ecosystem services. A longer payment scheme can help the respondents to think more about the flow of ecosystem services into future generations. A weak temporal embedding effect can be detected, which might be attributed to respondents' concern about current financial constraints, rather than financial bindings associated with their income and perceived future financial constraints. This demonstrates the multidimensionality of respondents' financial concerns in CV. This study sheds light on refining future CV studies, especially with regard to public expectation of ecosystem services and the temporal dimension of ecosystem services and payment schedules.

The secret garden? Elite metropolitan geographies in the contemporary UK.

PubMed

Cunningham, Niall; Savage, Mike

2015-05-01

There is an enduring, indeed increasing awareness of the role of spatial location in defining and reinforcing inequality in this country and beyond. In the UK, much of the debate around these issues has focussed on the established trope of a long-standing 'north-south divide', a divide which appears to have deepened in recent decades with the inexorable de-industrialisation of northern Britain presented in stark counterpoint to the burgeoning concentration of wealth in London and the south-east, driven by the financial and ancillary services sectors. Due to a lack of available data, such debates have tended to focus solely on economic inequalities between places, and until now there was little understanding of how these disparities played out in the social and cultural domains. This paper significantly advances our understanding of the true meaning of spatial inequality in the UK by broadening that definition to encompass not only the economic, but also the social and cultural arenas, using data available from the BBC's Great British Class Survey experiment. We argue that these data shine a light not only on the economic inequalities between different parts of the country which existing debates have already uncovered but to understand how these are both reinforced and mediated across the social and cultural dimensions. Fundamentally, we concur with a great many others in seeing London and the south-east as a vortex for economic accumulation but it is also much more than that; it is a space where the coming together of intense economic, social and cultural resources enables the crystallisation of particular and nuanced forms of elite social class formations, formations in which place is not incidental but integral to their very existence.

The secret garden? Elite metropolitan geographies in the contemporary UK

PubMed Central

Cunningham, Niall; Savage, Mike

2015-01-01

There is an enduring, indeed increasing awareness of the role of spatial location in defining and reinforcing inequality in this country and beyond. In the UK, much of the debate around these issues has focussed on the established trope of a long-standing ‘north-south divide’, a divide which appears to have deepened in recent decades with the inexorable de-industrialisation of northern Britain presented in stark counterpoint to the burgeoning concentration of wealth in London and the south-east, driven by the financial and ancillary services sectors. Due to a lack of available data, such debates have tended to focus solely on economic inequalities between places, and until now there was little understanding of how these disparities played out in the social and cultural domains. This paper significantly advances our understanding of the true meaning of spatial inequality in the UK by broadening that definition to encompass not only the economic, but also the social and cultural arenas, using data available from the BBC's Great British Class Survey experiment. We argue that these data shine a light not only on the economic inequalities between different parts of the country which existing debates have already uncovered but to understand how these are both reinforced and mediated across the social and cultural dimensions. Fundamentally, we concur with a great many others in seeing London and the south-east as a vortex for economic accumulation but it is also much more than that; it is a space where the coming together of intense economic, social and cultural resources enables the crystallisation of particular and nuanced forms of elite social class formations, formations in which place is not incidental but integral to their very existence. PMID:26640301

A Tale from Three Countries: The Classroom Management Practices of Pre-Service Teachers from Australia, Canada and the United Kingdom

ERIC Educational Resources Information Center

Woodcock, Stuart; Reupert, Andrea

2017-01-01

The purpose of this research was to (i) identify Australian, Canadian and United Kingdom (UK) pre-service teachers' use, confidence and success of various classroom management strategies and (ii) to ascertain any significant differences between the three cohorts. Significant differences were found amongst the cohort with the UK pre-service…

Mental Health Chaplains: Practitioners' Perspectives on Their Value, Purpose and Function in the UK National Health Service

ERIC Educational Resources Information Center

Gubi, Peter Madsen; Smart, Harry

2016-01-01

There is limited research into the value, purpose and function of Mental Health (MH) Chaplains. Yet, they are employed within National Health Service Trusts in the UK. Eight MH Chaplains were interviewed to explore how they see their value, purpose and function. The data were analysed using interpretative phenomenological analysis. The data reveal…

The future of flood insurance in the UK

NASA Astrophysics Data System (ADS)

Horn, Diane

2013-04-01

Approximately one in seven properties in the UK (3.6 million homes and businesses) are at risk of flooding. The Adaptation Sub-Committee of the UK Committee on Climate Change reported in 2012 that development on the floodplain grew at a faster rate than elsewhere in England over the past ten years, with one in five properties in the floodplain in areas of significant risk. They concluded that current levels of investment will not keep pace with the increasing risk, noting that without additional action, climate change could almost double the number of properties at significant risk by 2035. Flood insurance can contribute to risk reduction by using pricing or restrictions on availability of cover to discourage new development in flood risk areas, or to encourage the uptake of flood resilience measures. The UK insurance market currently offers flood cover as a standard feature of domestic and small business policies, with central government providing physical protection backed up by financial protection provided by the insurance industry. This approach is unusual in not passing all or part of the flood risk to government schemes. At present, flood insurance in the UK is conducted under a series of informal agreements established between the insurance industry and the Government known as the Statement of Principles. Members of the Association of British Insurers (ABI) currently agree to cover homes at risk of flooding in return for government commitment to manage flood risk. However, this arrangement is now under threat, as the insurance industry is increasingly reluctant to bear the financial burden of flooding alone. The current Statement of Principles ends on 30 June 2013 and will not be renewed. High-risk properties may be unable to obtain insurance after the Statement of Principles expires. Unusually, insurers are arguing against a free market solution, arguing that no country in the world provides universal flood cover without some form of government-led support. The UK insurance industry prefers a risk-pooling approach, while to date the government has not taken a position on the future of flood insurance after 2013.

Goal setting practice in services delivering community-based stroke rehabilitation: a United Kingdom (UK) wide survey.

PubMed

Scobbie, Lesley; Duncan, Edward A; Brady, Marian C; Wyke, Sally

2015-01-01

We investigated the nature of services providing community-based stroke rehabilitation across the UK, and goal setting practice used within them, to inform evaluation of a goal setting and action planning (G-AP) framework. We designed, piloted and electronically distributed a survey to health professionals working in community-based stroke rehabilitation settings across the UK. We optimised recruitment using a multi-faceted strategy. Responses were analysed from 437 services. Services size, composition and input was highly variable; however, most were multi-disciplinary (82%; n = 335/407) and provided input to a mixed diagnostic group of patients (71%; n = 312/437). Ninety one percent of services (n = 358/395) reported setting goals with "all" or "most" stroke survivors. Seventeen percent (n = 65/380) reported that no methods were used to guide goal setting practice; 47% (n = 148/315) reported use of informal methods only. Goal setting practice varied, e.g. 98% of services (n = 362/369) reported routinely asking patients about goal priorities; 39% (n = 141/360) reported routinely providing patients with a copy of their goals. Goal setting is embedded within community-based stroke rehabilitation; however, practice varies and is potentially sub-optimal. Further evaluation of the G-AP framework is warranted to inform optimal practice. Evaluation design will take account of the diverse service models that exist. Implications for Rehabilitation Community-based stroke rehabilitation services across the UK are diverse and tend to see a mixed diagnostic group of patients. Goal setting is implemented routinely within community-based stroke rehabilitation services; however, practice is variable and potentially sub-optimal. Further evaluation of the G-AP framework is warranted to assess its effectiveness in practice.

Supporting Research: Environments, Administration and Libraries

ERIC Educational Resources Information Center

MacColl, John; Jubb, Michael

2011-01-01

Last year, OCLC Research and the UK's Research Information Network (RIN) undertook a pair of parallel studies in the US and the UK on the theme of research support services in universities (Kroll and Forsman 2010; CIBER 2010). In the US, the library and scholarly information consultancy Kroll Research Associates was commissioned, and in the UK the…

Knowing Your "Lemons": Quality Uncertainty in UK Higher Education

ERIC Educational Resources Information Center

Cooper, Paul

2007-01-01

In the UK and elsewhere, higher education is increasingly and controversially being construed, especially within political discourse, as a marketised commodity service to paying customers. Notions of quality, broadly construed, will be of central significance in the development of new markets in higher education in the UK and beyond. Drawing upon…

Standards of care provided by early pregnancy assessment units (EPAU): a UK-wide survey.

PubMed

Poddar, A; Tyagi, J; Hawkins, E; Opemuyi, I

2011-10-01

Standards of services provided by the EPAUs across the UK vary from one unit to another. The aim of this purposive sampling self-administered survey was to assess these standards against a benchmark set by the Royal College of Obstetricians and Gynaecologists (RCOG). These standards were set out in a report by a RCOG working party (2008). Out of 181 units contacted in this survey, 140 units responded. We looked at the setup of the EPAU, services offered, accessibility and protocols for management of miscarriage and ectopic pregnancy. The survey shows that there is a considerable variation in the management protocols and the quality of services offered by the EPAUs in the UK. Many units do not meet the standards set by the RCOG.

A new day for patient financial services.

PubMed

Canfield, David P; Johnston, Scott

2002-09-01

The patient financial services (PFS) department plays a crucial role in the financial health of a provider organization. Complete, accurate data are a competitive advantage. Data should be obtained and validated as early as possible in the process of providing a healthcare service. A redefined revenue cycle should emphasize interdepartmental collaboration, technology, and patient satisfaction. The PFS department should expand its role to emphasize the merging of clinical and financial data in support of the organization's goals. PFS professionals require educational and career opportunities to fulfill the PFS department's expanded role.

47 CFR 76.1002 - Specific unfair practices prohibited.

Code of Federal Regulations, 2010 CFR

2010-10-01

... reasonable requirements for creditworthiness, offering of service, and financial stability and standards... classes of service in pricing based on credit considerations or financial stability, although any such... technology. Vendors are not permitted to manifest factors such as creditworthiness or financial stability in...

31 CFR 203.12 - EFTPS interest assessments.

Code of Federal Regulations, 2012 CFR

2012-07-01

... SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE PAYMENT OF FEDERAL TAXES AND THE TREASURY...) Circumstances subject to interest assessments. Treasury may assess interest on a financial institution in... tax payment instructions to the financial institution was timely and that the taxpayer satisfied the...

31 CFR 203.12 - EFTPS interest assessments.

Code of Federal Regulations, 2013 CFR

2013-07-01

... SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE PAYMENT OF FEDERAL TAXES AND THE TREASURY...) Circumstances subject to interest assessments. Treasury may assess interest on a financial institution in... tax payment instructions to the financial institution was timely and that the taxpayer satisfied the...

31 CFR 203.12 - EFTPS interest assessments.

Code of Federal Regulations, 2011 CFR

2011-07-01

... SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE PAYMENT OF FEDERAL TAXES AND THE TREASURY...) Circumstances subject to interest assessments. Treasury may assess interest on a financial institution in... tax payment instructions to the financial institution was timely and that the taxpayer satisfied the...

33 CFR 138.150 - Service of process.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION FINANCIAL RESPONSIBILITY FOR WATER POLLUTION (VESSELS) AND OPA 90 LIMITS OF LIABILITY (VESSELS AND DEEPWATER PORTS) Financial Responsibility for Water Pollution (Vessels) § 138.150 Service of process. (a) When executing the forms required by this subpart...

33 CFR 138.150 - Service of process.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION FINANCIAL RESPONSIBILITY FOR WATER POLLUTION (VESSELS) AND OPA 90 LIMITS OF LIABILITY (VESSELS AND DEEPWATER PORTS) Financial Responsibility for Water Pollution (Vessels) § 138.150 Service of process. (a) When executing the forms required by this subpart...

33 CFR 138.150 - Service of process.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION FINANCIAL RESPONSIBILITY FOR WATER POLLUTION (VESSELS) AND OPA 90 LIMITS OF LIABILITY (VESSELS AND DEEPWATER PORTS) Financial Responsibility for Water Pollution (Vessels) § 138.150 Service of process. (a) When executing the forms required by this subpart...

33 CFR 138.150 - Service of process.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION FINANCIAL RESPONSIBILITY FOR WATER POLLUTION (VESSELS) AND OPA 90 LIMITS OF LIABILITY (VESSELS AND DEEPWATER PORTS) Financial Responsibility for Water Pollution (Vessels) § 138.150 Service of process. (a) When executing the forms required by this subpart...

Supporting Youth Transitioning out of Foster Care. Issue Brief 2: Financial Literacy and Asset Building Programs. OPRE Report No. 2014-69

ERIC Educational Resources Information Center

Edelstein, Sara; Lowenstein, Christopher

2014-01-01

This issue brief is one of three that focus on programs providing services to youth transitioning out of foster care in three common service domains: education, employment, and financial literacy and asset building. This brief highlights why financial literacy and asset building services are important to youth currently or formerly in foster care,…

Retrospective financial analysis of medication therapy management services from the pharmacy's perspective.

PubMed

McDonough, Randal P; Harthan, Aaron A; McLeese, Kelly E; Doucette, William R

2010-01-01

To determine the net financial gain or loss for medication therapy management (MTM) services provided to patients by an independent community pharmacy during 16 months of operation. Retrospective study. Independent community pharmacy in Iowa City, IA, from September 1, 2006, to December 31, 2007. Patients receiving MTM services during the specified period who had proper documentation of reimbursement for the services. MTM services were provided to the patient and documented by the pharmacist or student pharmacist. Net financial gains or losses for providing MTM services. Sensitivity analyses included costs that might be incurred under various conditions of operation. 103 initial and 88 follow-up MTM visits were conducted during a 16-month time period. The total cost for these services to the pharmacy was $11,191.72. Total revenue from these services was $11,195.00; therefore, the pharmacy experienced a net financial gain of $3.28. Sensitivity analyses were conducted, revealing the net gain/loss to the pharmacy if a student pharmacist was used and the net gain/loss if the pharmacist needed extra training to provide the services. Using a student pharmacist resulted in a net gain of $6,308.48, while extra training for the pharmacist resulted in a net loss of $1,602.72. The MTM service programs showed a positive financial gain after 16 months of operation, which should encourage pharmacists to incorporate these services into their practice.

The Study on Financial Supervision for Chinese Financial Industry under Mixed Operation

NASA Astrophysics Data System (ADS)

Wei, Song

Financial mixed operation refers to that financial institution can offer all financial services (banking, securities, insurance, and trust) and engage in industrial businesses by holding the share ownership. Because of self interests, risk diversification, the change of competition condition, and clients' needs of the diversity of financial products and services, commercial banks make it possible for the mixed operation to be the optimal choice of the banking businesses under dynamic conditions in globalized competition, which results in the diversity and integration of banking businesses.

Governance and Trust in Higher Education

ERIC Educational Resources Information Center

Vidovich, Lesley; Currie, Jan

2011-01-01

The adoption of more corporate models of governance is a contemporary trend in higher education. In the early 2000s, the Australian Government legislated national governance protocols for universities, using the policy lever of financial sanctions. These more corporate-style governance protocols followed similar changes in the UK, consistent with…

Organisational Blogging: The Problem of Engagement

ERIC Educational Resources Information Center

Baxter, Gavin J.; Connolly, Thomas; Stansfield, Mark

2011-01-01

This paper investigates the implementation and use of an internal organisational blog by several departments in the HR division in a large public sector financial organisation in the UK. This qualitative study adopts a case study approach and examines the experiences of staff using the blog to explore whether it can facilitate organisational…

Co-movement measure of information transmission on international equity markets

NASA Astrophysics Data System (ADS)

Al Rahahleh, Naseem; Bhatti, M. Ishaq

2017-03-01

Recently, Bhatti and Nguyen (2012) used EVT and various stochastic copulas to study the cross-country co-movements diversification and asset pricing allocation. Weiss (2013) observed that Dynamic Conditional Correlation (DCC) models outperform various copula models. This paper attempts to contribute to the literature on multivariate models for capturing forward and backward return co-movement, spillover effects and volatility linkages. It reflects cross-country forward and backward co-movements more clearly among various coupled international stock markets relating to information transmission and price discovery for making investment decisions. Given the reality of fat-tail or skewed distribution of financial data, this paper proposes the use of VECM-DCC and VAR-DCC models which capture dynamic dependences between the Australian and other selected international financial stock markets. We observe that the return co-movement effects between Australian and Asian countries are bidirectional ((AUS ↔ Hong Kong), (AUS ↔ Japan)) with the exception of Taiwan (AUS → Taiwan). We also observe that the volatility spillover between the Australian and both the UK and the US markets are bidirectional with a larger volatility spillover from both toward the AUS market. Further, the UK market has a higher volatility spillover on the Australian market compared to the US market and the US market has a higher volatility spillover on the UK than that of the Australian market.

Perceptions of the software skills of graduates by employers in the financial services industry

NASA Astrophysics Data System (ADS)

Kyng, Tim; Tickle, Leonie; Wood, Leigh N.

2013-12-01

Software, particularly spreadsheet software, is ubiquitous in the financial services workplace. Yet little is known about the extent to which universities should, and do, prepare graduates for this aspect of the modern workplace. We have investigated this issue through a survey of financial services employers of graduates, the results of which are reported in this paper, as well as surveys of university graduates and academics, reported previously. Financial services employers rate software skills as important, would like their employees to be more highly skilled in the use of such software, and tend to prefer 'on-the-job' training rather than university training for statistical, database and specialized actuarial/financial software. There is a perception among graduates that employers do not provide adequate formal workplace training in the use of technical software.

42 CFR 441.484 - Financial management services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Financial management services. 441.484 Section 441.484 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... for each participant's budget. (4) Track and report disbursements and balances of participant funds...

The impact of General Dental Council registration and continuing professional development on UK dental care professionals: (1) dental nurses.

PubMed

Turner, S; Ross, M K; Ibbetson, R J

2012-07-27

To investigate the impact of GDC registration and mandatory CPD on dental nurses' views, job satisfaction and intention to leave. Postal/online survey, conducted in parallel with a survey of dental technicians. UK private and NHS practices, community services, dental hospitals. Representative sample of General Dental Council registrants. Job satisfaction; intention to leave profession (dependent variable in regression analysis). Eleven were ineligible (left profession, moved abroad); 267 (44% of those eligible) responded, all female. Respondents' mean age was 38.2 years (sd 10.74). The general principle of registration was endorsed by 67%, and compulsory registration by 51%, but the fee level by only 6%. Most nurses did not feel that registration had affected their view of dental nursing as a career (56%), their role (74%) or status (86%) within the dental team, or that CPD helped them to do their job better (76%). Fifty-six percent were not satisfied with their job, and 22% intended to leave the profession. Intention to leave was predicted by younger age and greater dissatisfaction with physical working conditions and opportunities to progress. Widely held criticisms regarding the costs and relevance of registration and CPD coupled with a potentially high level of attrition from the profession suggest a review of the fee and salary structure and greater financial support for CPD is warranted.

78 FR 13677 - Office of the Assistant Secretary for Financial Resources, Office of Grants and Acquisition...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-28

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Assistant Secretary for Financial Resources... of the Department of Health and Human Services FY 2011 Service Contract Inventory AGENCY: Department of Health and Human Services. ACTION: Notice of Public Availability of FY 2011 Service Contract...

76 FR 5814 - Office of the Assistant Secretary for Financial Resources, Office of Grants and Acquisition...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-02

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Assistant Secretary for Financial Resources... of the Department of Health and Human Services FY 2010 Service Contract Inventory AGENCY: Department of Health and Human Services. ACTION: Notice of public availability of FY 2010 Service Contract...

31 CFR 223.8 - Financial reports.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Financial reports. 223.8 Section 223.8 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE SURETY COMPANIES DOING BUSINESS WITH THE UNITED...

31 CFR 210.8 - Financial institutions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Financial institutions. 210.8 Section 210.8 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE FEDERAL GOVERNMENT PARTICIPATION IN THE AUTOMATED...

31 CFR 223.8 - Financial reports.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance:Treasury 2 2012-07-01 2012-07-01 false Financial reports. 223.8 Section 223.8 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE SURETY COMPANIES DOING BUSINESS WITH THE UNITED...

31 CFR 223.8 - Financial reports.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance:Treasury 2 2013-07-01 2013-07-01 false Financial reports. 223.8 Section 223.8 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE SURETY COMPANIES DOING BUSINESS WITH THE UNITED...

31 CFR 223.8 - Financial reports.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 2 2011-07-01 2011-07-01 false Financial reports. 223.8 Section 223.8 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE SURETY COMPANIES DOING BUSINESS WITH THE UNITED...

75 FR 75897 - Electronic Funds Transfer of Depository Taxes

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-07

... the Financial Management Service to discontinue the system that processes FTD coupons, the temporary... Financial Management Service (FMS) considered current market conditions. In the last 18 months, more than 100 financial institutions, large and small, have stopped accepting FTD coupons. In many states, few...

Portugal's 2001 Drugs Liberalisation Policy: A UK Service Provider's Perspective on the Psychoactive Substances Act (2016)

ERIC Educational Resources Information Center

Banbury, Samantha; Lusher, Joanne; Guedelha, Francisco

2018-01-01

The Misuse of Drugs Act (1971) and the Psychoactive Substances Act (2016) both reinforce the criminalisation of drug use in the UK. The Psychoactive Substances Act (2016) has been developed to control and monitor the use of legal highs, particularly in institutions. This study aimed to establish drug service providers' viewpoints on how effective…

Longitudinal analysis of high-technology medical services and hospital financial performance.

PubMed

Zengul, Ferhat D; Weech-Maldonado, Robert; Ozaydin, Bunyamin; Patrician, Patricia A; OʼConnor, Stephen J

U.S. hospitals have been investing in high-technology medical services as a strategy to improve financial performance. Despite the interest in high-tech medical services, there is not much information available about the impact of high-tech services on financial performance. The aim of this study was to examine the impact of high-tech medical services on financial performance of U.S. hospitals by using the resource-based view of the firm as a conceptual framework. Fixed-effects regressions with 2 years lagged independent variables using a longitudinal panel sample of 3,268 hospitals (2005-2010). It was hypothesized that hospitals with rare or large numbers (breadth) of high-tech medical services will experience better financial performance. Fixed effects regression results supported the link between a larger breadth of high-tech services and total margin, but only among not-for-profit hospitals. Both breadth and rareness of high-tech services were associated with high total margin among not-for-profit hospitals. Neither breadth nor rareness of high-tech services was associated with operating margin. Although breadth and rareness of high-tech services resulted in lower expenses per inpatient day among not-for-profit hospitals, these lower costs were offset by lower revenues per inpatient day. Enhancing the breadth of high-tech services may be a legitimate organizational strategy to improve financial performance, especially among not-for-profit hospitals. Hospitals may experience increased productivity and efficiency, and therefore lower inpatient operating costs, as a result of newer technologies. However, the negative impact on operating revenue should caution hospital administrators about revenue reducing features of these technologies, which may be related to the payer mix that these technologies may attract. Therefore, managers should consider both the cost and revenue implications of these technologies.

25 CFR 20.200 - What contact will the Bureau maintain with State, tribal, county, local, and other Federal agency...

Code of Federal Regulations, 2010 CFR

2010-04-01

..., DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Welfare Reform... agency programs? We will coordinate all financial assistance and social services programs with state... social services program avoids duplication of assistance. ...

25 CFR 20.200 - What contact will the Bureau maintain with State, tribal, county, local, and other Federal agency...

Code of Federal Regulations, 2011 CFR

2011-04-01

..., DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Welfare Reform... agency programs? We will coordinate all financial assistance and social services programs with state... social services program avoids duplication of assistance. ...

25 CFR 20.200 - What contact will the Bureau maintain with State, tribal, county, local, and other Federal agency...

Code of Federal Regulations, 2013 CFR

2013-04-01

..., DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Welfare Reform... agency programs? We will coordinate all financial assistance and social services programs with state... social services program avoids duplication of assistance. ...

25 CFR 20.200 - What contact will the Bureau maintain with State, tribal, county, local, and other Federal agency...

Code of Federal Regulations, 2012 CFR

2012-04-01

..., DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Welfare Reform... agency programs? We will coordinate all financial assistance and social services programs with state... social services program avoids duplication of assistance. ...

25 CFR 20.200 - What contact will the Bureau maintain with State, tribal, county, local, and other Federal agency...

Code of Federal Regulations, 2014 CFR

2014-04-01

..., DEPARTMENT OF THE INTERIOR HUMAN SERVICES FINANCIAL ASSISTANCE AND SOCIAL SERVICES PROGRAMS Welfare Reform... agency programs? We will coordinate all financial assistance and social services programs with state... social services program avoids duplication of assistance. ...

76 FR 37890 - Certification Pursuant to Energy Policy Act of 2005

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-28

... AGENCY: Financial Management Service, Fiscal Service, Treasury. ACTION: Notice. SUMMARY: The Energy... CONTACT: Teresa Dawson, Senior Counsel, Financial Management Service, 401 14th Street, SW., Washington, DC... October 2006 the Minerals Management Service (MMS) of the United States Department of the Interior entered...

Cutting costs in your own backyard: opportunities in financial services.

PubMed

van Londen, Jan; Zimmerman, Paul

2012-03-01

Hospitals looking to reduce cost and improve performance in financial services should focus on these areas: Treasury banking services costs and fees. The possibility of a revenue-generating vendor payment solution. The accounts payable process.

Financial management services in consumer-directed programs.

PubMed

Scherzer, Teresa; Wong, Alice; Newcomer, Robert

2007-01-01

Shifting from an agency-based model of personal assistance services to consumer direction has important consequences for both recipients and workers. In consumer direction, recipients assume the responsibilities of employing their attendants--for both self-directing their supportive services and being responsible for numerous fiscal responsibilities. Many states have eased these fiscal responsibilities among recipients in publicly financed personal care programs by using Financial Management Services (also known as fiscal intermediaries). This article introduces the major types of Financial Management Services organizations used by Medicaid consumer-directed personal care programs, and examines the extent to which the varied approaches can and do serve the needs of both recipients and workers. Despite the expansion of consumer-directed programs and the accompanying emergence of Financial Management Services, these organizations have not been extensively studied or evaluated. The paper concludes with a discussion of the challenges, opportunities, and policy implications of the current practice; and suggests directions for future research.

The impact of the 2008/2009 financial crisis on specialist physician activity in Canada.

PubMed

Lavergne, M Ruth; Hedden, Lindsay; Law, Michael R; McGrail, Kim; Ahuja, Megan; Barer, Morris

2018-06-19

Fee-for-service physicians are responsible for planning for their retirements, and there is no mandated retirement age. Changes in financial markets may influence how long they remain in practice and how much they choose to work. The 2008 crisis provides a natural experiment to analyze elasticity in physician service supply in response to dramatic financial market changes. We examined quarterly fee-for-service data for specialist physicians over the period from 1999/2000 to 2013/2014 in Canada. We used segmented regression to estimate changes in the number of physicians receiving payments, per-physician service counts, and per-physician payments following the 2008 financial crisis and explored whether patterns differed by physician age. The number of specialist physicians increased more rapidly in the period since 2008 than in earlier years, but increases were largest within the youngest age group, and we observed no evidence of delayed retirement among older physicians. Where changes in service volume and payments were observed, they occurred across all ages and not immediately following the 2008 financial crisis. We conclude that any response to the financial crisis was small compared with demographic shifts in the physician population and changes in payments per service over the same time period. Copyright © 2018 John Wiley & Sons, Ltd.

A Policy of Vulnerability or Agency? Refugee Young People's Opportunities in Accessing Further and Higher Education in the UK

ERIC Educational Resources Information Center

Gateley, D. E.

2015-01-01

The UK government's austerity cuts have negatively impacted many voluntary-sector interventions that provided support to refugees. One such intervention, the Refugee Integration and Employment Service (RIES), is discussed in this paper. The RIES was a UK Border Agency-funded integration programme for recognised refugees and operated through…

Financial Services Marketing.

ERIC Educational Resources Information Center

Olson, Lucretia Maria

This manual contains student assignments in the financial services area of the marketing process. The individualized competency-based materials are intended to enhance and supplement instruction or to provide the basis for a course of instruction by the teacher-coordinator. Information on skills needed in jobs in financial marketing is first…

78 FR 79412 - Privacy Act of 1974; System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-30

... Defense Finance and Accounting Service proposes to alter a system of records, T7205, General Accounting and Finance System--Report Database for Financial Statements, in its inventory of record systems... transaction-driven financial statements in support of Defense Finance and Accounting Service financial mission...

Piloting the older adult financial exploitation measure in adult safeguarding services.

PubMed

Phelan, A; Fealy, G; Downes, C

Financial abuse is arguably the most complex form of elder abuse as it may occur remote to the older person and it is impacted by issues such as cultural values, perpetrator intent and family expectations. Financial abuse may not be recognised by either the older person or the perpetrator, thus, its prevention, early identification and amelioration are important. The (Irish) National Centre for the Protection of Older People undertook a study to determine the appropriateness of the Older Adult Financial Exploitation Measure for use by the national safeguarding older person services. Findings from a small pilot study involving 16 safeguarding staff's use of the Older Adult Financial Exploitation Measure with 52 community dwelling older people referred to their service demonstrate a higher suspicion of financial abuse as well as identifying multiple instances of possible financial exploitation in a single individual. Thus, the Older Adult Financial Exploitation Measure is considered appropriate to assist safeguarding personnel's assessment of older people related to a suspicion of financial abuse. Copyright © 2017 Elsevier B.V. All rights reserved.

The UK Haemophilia Doctors Organisation triennial audit of UK Comprehensive Care Haemophilia Centres.

PubMed

Wilde, J T

2012-07-01

Under the auspices of the United Kingdom Haemophilia Doctors Organisation (UKHCDO) the UK Comprehensive Care Haemophilia Centres (CCCs) have undergone a three yearly formal audit assessment since 1993. This report describes the evolution of the audit process and details the findings of the most recent audit round, the sixth since inception. The audit reports from the 2009 audit round were reviewed by the audit organizing group and a structured analysis of the data was compiled. CCCs in the UK offer a high standard of comprehensive care services. The main areas of concern were the state of the premises (seven centres), lack of dental services (seven centres), physiotherapy (seven centres) and social work support (11 centres). Major concerns were identified at eight centres requiring a formal letter from the chairman of UKHCDO to the chief executive of the host trust. Since inception of the triennial audit process centre report recommendations have resulted in major improvements in the services available at UK CCCs. The audit process is considered to be a highly effective means of improving the quality of care for patients with bleeding disorders and can be used as a model for the introduction of a similar process in other countries. © 2012 Blackwell Publishing Ltd.

The impact of CFS/ME on employment and productivity in the UK: a cross-sectional study based on the CFS/ME national outcomes database.

PubMed

Collin, Simon M; Crawley, Esther; May, Margaret T; Sterne, Jonathan A C; Hollingworth, William

2011-09-15

Few studies have investigated factors associated with discontinuation of employment in patients with CFS/ME or quantified its impact on productivity. We used patient-level data from five NHS CFS/ME services during the period 01/04/2006-31/03/2010 collated in the UK CFS/ME National Outcomes Database. We used logistic regression to identify factors associated with discontinuation of employment. We estimated UK-wide productivity costs using patient-level data on duration of illness before assessment by a CFS/ME service, duration of unemployment, age, sex and numbers of patients, in conjunction with Office for National Statistics income and population data. Data were available for 2,170 patients, of whom 1,669 (76.9%) were women. Current employment status was recorded for 1,991 patients (91.8%), of whom 811 patients (40.7%) were currently employed and 998 (50.1%) had discontinued their employment "because of fatigue-related symptoms". Older age, male sex, disability, fatigue, pain, and duration of illness were associated with cessation of employment. In a multivariable model, age, male sex, and disability remained as independent predictors. Total productivity costs among the 2,170 patients due to discontinuation of employment in the years preceding assessment by a specialist CFS/ME service (median duration of illness=36 months) were £49.2 million. Our sample was equivalent to 4,424 UK adults accessing specialist services each year, representing productivity costs to the UK economy of £102.2 million. Sensitivity analyses suggested a range between £75.5-£128.9 million. CFS/ME incurs huge productivity costs amongst the small fraction of adults with CFS/ME who access specialist services.

The UK Out of Hospital Cardiac Arrest Outcome (OHCAO) project.

PubMed

Perkins, Gavin D; Brace-McDonnell, Samantha J

2015-10-01

Reducing premature death is a key priority for the UK National Health Service (NHS). NHS Ambulance services treat approximately 30 000 cases of suspected cardiac arrest each year but survival rates vary. The British Heart Foundation and Resuscitation Council (UK) have funded a structured research programme--the Out of Hospital Cardiac Arrest Outcomes (OHCAO) programme. The aim of the project is to establish the epidemiology and outcome of OHCA, explore sources of variation in outcome and establish the feasibility of setting up a national OHCA registry. This is a prospective observational study set in UK NHS Ambulance Services. The target population will be adults and children sustaining an OHCA who are attended by an NHS ambulance emergency response and where resuscitation is attempted. The data collected will be characterised broadly as system characteristics, emergency medical services (EMS) dispatch characteristics, patient characteristics and EMS process variables. The main outcome variables of interest will be return of spontaneous circulation and medium-long-term survival (30 days to 10-year survival). Ethics committee permissions were gained and the study also has received approval from the Confidentiality Advisory Group Ethics and Confidentiality committee which provides authorisation to lawfully hold identifiable data on patients without their consent. To identify the key characteristics contributing to better outcomes in some ambulance services, reliable and reproducible systems need to be established for collecting data on OHCA in the UK. Reports generated from the registry will focus on data completeness, timeliness and quality. Subsequent reports will summarise demographic, patient, process and outcome variables with aim of improving patient care through focus quality improvement initiatives. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Clinical and imaging services for TIA and minor stroke: results of two surveys of practice across the UK

PubMed Central

Brazzelli, Miriam; Shuler, Kirsten; Quayyum, Zahid; Hadley, Donald; Muir, Keith; McNamee, Paul; De Wilde, Janet; Dennis, Martin; Sandercock, Peter; Wardlaw, Joanna M

2013-01-01

Objectives Transient ischaemic attack (TIA) is a medical emergency requiring rapid access to effective, organised, stroke prevention. There are about 90 000 TIAs per year in the UK. We assessed whether stroke-prevention services in the UK meet Government targets. Design Cross-sectional survey. Setting All UK clinical and imaging stroke-prevention services. Intervention Electronic structured survey delivered over the web with automatic recording of responses into a database; reminders to non-respondents. The survey sought information on clinic frequency, staff, case-mix, details of brain and carotid artery imaging, medical and surgical treatments. Results 114 stroke clinical and 146 imaging surveys were completed (both response rates 45%). Stroke-prevention services were available in most (97%) centres but only 31% operated 7 days/week. Half of the clinic referrals were TIA mimics, most patients (75%) were prescribed secondary prevention prior to clinic referral, and nurses performed the medical assessment in 28% of centres. CT was the most common and fastest first-line investigation; MR, used in 51% of centres, mostly after CT, was delayed up to 2 weeks in 26%; 51% of centres omitted blood-sensitive (GRE/T2*) MR sequences. Carotid imaging was with ultrasound in 95% of centres and 59% performed endarterectomy within 1 week of deciding to operate. Conclusions Stroke-prevention services are widely available in the UK. Delays to MRI, its use in addition to CT while omitting key sequences to diagnose haemorrhage, limit the potential benefit of MRI in stroke prevention, but inflate costs. Assessing TIA mimics requires clinical neurology expertise yet nurses run 28% of clinics. Further improvements are still required for optimal stroke prevention. PMID:23929917

42 CFR 441.310 - Limits on Federal financial participation (FFP).

Code of Federal Regulations, 2011 CFR

2011-10-01

... APPLICABLE TO SPECIFIC SERVICES Home and Community-Based Services: Waiver Requirements § 441.310 Limits on Federal financial participation (FFP). (a) FFP for home and community-based services listed in § 440.180... and community-based services provided to individuals aged 22 through 64 diagnosed as chronically...

78 FR 19005 - Notice of Service Area Designation

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-28

... regulations have full force and effect when extending the BIA financial assistance and/or social services into... notice, under the regulations, of the service area designation for the Pit River Tribe that is recognized... . SUPPLEMENTARY INFORMATION: In accordance with 25 CFR part 20, Financial Assistance and Social Services Programs...

Reducing emergency bed-days for older people? Network governance lessons from the 'Improving the Future for Older People' programme.

PubMed

Sheaff, Rod; Windle, Karen; Wistow, Gerald; Ashby, Sue; Beech, Roger; Dickinson, Angela; Henderson, Catherine; Knapp, Martin

2014-04-01

In 2007, the UK government set performance targets and public service agreements to control the escalation of emergency bed-days. Some years earlier, nine English local authorities had each created local networks with their health and third sector partners to tackle this increase. These networks formed the 'Improving the Future for Older People' initiative (IFOP), one strand of the national 'Innovation Forum' programme, set up in 2003. The nine sites set themselves one headline target to be achieved jointly over three years; a 20 per cent reduction in the number of emergency bed-days used by people aged 75 and over. Three ancillary targets were also monitored: emergency admissions, delayed discharges and project sustainability. Collectively the sites exceeded their headline target. Using a realistic evaluation approach, we explored which aspects of network governance appeared to have contributed to these emergency bed-day reductions. We found no simple link between network governance type and outcomes. The governance features associated with an effective IFOP network appeared to suggest that the selection and implementation of a small number of evidence-based services was central to networks' effectiveness. Each service needed to be coordinated by a network-based strategic group and hierarchically implemented at operational level by the responsible network member. Having a network-based implementation group with a 'joined-at-the-top' governance structure also appeared to promote network effectiveness. External factors, including NHS incentives, health reorganisations and financial targets similarly contributed to differences in performance. Targets and financial incentives could focus action but undermine horizontal networking. Local networks should specify which interventions network structures are intended to deliver. Effective projects are those likely to be evidence based, unique to the network and difficult to implement through vertical structures alone. Copyright © 2014 Elsevier Ltd. All rights reserved.

75 FR 19986 - Revision of Agency Information Collection for Financial Assistance and Social Services

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-16

... Services, 25 CFR 20.'' The information collection is currently authorized by OMB Control Number 1076-0017... Number: 1076-0017. Title: Financial Assistance and Social Services, 25 CFR Part 20. Brief Description of...

Evaluating the enhancement and improvement of China's technology and financial services platform innovation strategy.

PubMed

Wu, Ching-Sung; Hu, Kuang-Hua; Chen, Fu-Hsiang

2016-01-01

The development of high-tech industry has been prosperous around the world in past decades, while technology and finance have already become the most significant issues in the information era. While high-tech firms are a major force behind a country's economic development, it requires a lot of money for the development process, as well as the financing difficulties for its potential problems, thus, how to evaluate and establish appropriate technology and financial services platforms innovation strategy has become one of the most critical and difficult issues. Moreover, how the chosen intertwined financial environment can be optimized in order that high-tech firms financing problems can be decided has seldom been addressed. Thus, this research aims to establish a technology and financial services platform innovation strategy improvement model, as based on the hybrid MADM model, which addresses the main causal factors and amended priorities in order to strengthen ongoing planning. A DEMATEL technique, as based on Analytic Network Process, as well as modified VIKOR, will be proposed for selecting and re-configuring the aspired technology and financial services platform. An empirical study, as based on China's technology and financial services platform innovation strategy, will be provided for verifying the effectiveness of this proposed methodology. Based on expert interviews, technology and financial services platforms innovation strategy improvement should be made in the following order: credit guarantee platform ( C )_credit rating platform ( B )_investment and finance platform ( A ).

Wellness Programs With Financial Incentives Through Disparities Lens.

PubMed

Cuellar, Alison; LoSasso, Anthony T; Shah, Mona; Atwood, Alicia; Lewis-Walls, Tanya R

2018-02-01

To examine wellness programs with financial incentives and their effect on disparities in preventive care. Financial incentives were introduced by 15 large employers, from 2010 to 2013. Fifteen private employers. A total of 299 436 employees and adult dependents. Preventive services and participation in financial incentives. Multivariate linear regression. Disparities in preventive services widened after introduction of financial incentives. Asians were 3% more likely and African Americans were 3% less likely to receive wellness rewards than whites and non-Hispanics, controlling for other factors. Federal law limits targeting of wellness financial incentives by subgroups; thus, employers should consider outreach and culturally appropriate messaging.

9 CFR 354.24 - Financial interest of inspectors.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Financial interest of inspectors. 354... INSPECTION AND CERTIFICATION VOLUNTARY INSPECTION OF RABBITS AND EDIBLE PRODUCTS THEREOF Performance of Services § 354.24 Financial interest of inspectors. No inspector shall render service on any product in...

9 CFR 590.120 - Financial interest of inspectors.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) Performance of Service § 590.120 Financial interest of inspectors. No inspector shall inspect any product in... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Financial interest of inspectors. 590.120 Section 590.120 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF...

39 CFR 3050.35 - Financial reports.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Financial reports. 3050.35 Section 3050.35 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL PERIODIC REPORTING § 3050.35 Financial reports. (a) The... Submission and supporting workpapers, including Summary Tables SE 1, 2, and 6 (within 7 days of the...

39 CFR 3050.35 - Financial reports.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 39 Postal Service 1 2014-07-01 2014-07-01 false Financial reports. 3050.35 Section 3050.35 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL PERIODIC REPORTING § 3050.35 Financial reports. (a) The... Submission and supporting workpapers, including Summary Tables SE 1, 2, and 6 (within 7 days of the...

39 CFR 3050.35 - Financial reports.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Financial reports. 3050.35 Section 3050.35 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL PERIODIC REPORTING § 3050.35 Financial reports. (a) The... Submission and supporting workpapers, including Summary Tables SE 1, 2, and 6 (within 7 days of the...

39 CFR 3050.35 - Financial reports.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 39 Postal Service 1 2013-07-01 2013-07-01 false Financial reports. 3050.35 Section 3050.35 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL PERIODIC REPORTING § 3050.35 Financial reports. (a) The... Submission and supporting workpapers, including Summary Tables SE 1, 2, and 6 (within 7 days of the...

39 CFR 3050.35 - Financial reports.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Financial reports. 3050.35 Section 3050.35 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL PERIODIC REPORTING § 3050.35 Financial reports. (a) The... Submission and supporting workpapers, including Summary Tables SE 1, 2, and 6 (within 7 days of the...

Risk, Reward, and Regulations: Reshaping the Financial Services Industry.

ERIC Educational Resources Information Center

Saul, Ralph S.

1984-01-01

Deregulation has had much to do with the competitive drive and vitality of financial services within the United States. The risks and rewards of deregulation for financial institutions are discussed, and principles which should serve as a guide in building any new regulatory structure are examined. (RM)

77 FR 26796 - Order of Suspension of Trading; Airtrax, Inc., Amedia Networks, Inc., American Business Financial...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-07

... SECURITIES AND EXCHANGE COMMISSION [File No. 500-1] Order of Suspension of Trading; Airtrax, Inc., Amedia Networks, Inc., American Business Financial Services, Inc., Appalachian Bancshares, Inc., and... information concerning the securities of American Business Financial Services, Inc. because it has not filed...

25 CFR 900.44 - What minimum general standards apply to all Indian tribe or tribal organization financial...

Code of Federal Regulations, 2014 CFR

2014-04-01

... or tribal organization financial management systems when carrying out a self-determination contract... organization financial management systems when carrying out a self-determination contract? The fiscal control... SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES CONTRACTS UNDER THE INDIAN SELF-DETERMINATION AND...

25 CFR 900.44 - What minimum general standards apply to all Indian tribe or tribal organization financial...

Code of Federal Regulations, 2013 CFR

2013-04-01

... or tribal organization financial management systems when carrying out a self-determination contract... organization financial management systems when carrying out a self-determination contract? The fiscal control... SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES CONTRACTS UNDER THE INDIAN SELF-DETERMINATION AND...

25 CFR 900.44 - What minimum general standards apply to all Indian tribe or tribal organization financial...

Code of Federal Regulations, 2012 CFR

2012-04-01

... or tribal organization financial management systems when carrying out a self-determination contract... organization financial management systems when carrying out a self-determination contract? The fiscal control... SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES CONTRACTS UNDER THE INDIAN SELF-DETERMINATION AND...

25 CFR 900.44 - What minimum general standards apply to all Indian tribe or tribal organization financial...

Code of Federal Regulations, 2011 CFR

2011-04-01

... or tribal organization financial management systems when carrying out a self-determination contract... organization financial management systems when carrying out a self-determination contract? The fiscal control... SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES CONTRACTS UNDER THE INDIAN SELF-DETERMINATION AND...

25 CFR 900.44 - What minimum general standards apply to all Indian tribe or tribal organization financial...

Code of Federal Regulations, 2010 CFR

2010-04-01

... or tribal organization financial management systems when carrying out a self-determination contract... organization financial management systems when carrying out a self-determination contract? The fiscal control... SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES CONTRACTS UNDER THE INDIAN SELF-DETERMINATION AND...

31 CFR 203.8 - Application of part and procedural instructions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... binding on financial institutions that process Federal tax payments or maintain a TT&L account, TIP main... (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE PAYMENT OF FEDERAL TAXES... originating Federal tax payments, the financial institution agrees to be bound by this part and by procedural...

31 CFR 203.8 - Application of part and procedural instructions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... binding on financial institutions that process Federal tax payments or maintain a TT&L account, TIP main... (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE PAYMENT OF FEDERAL TAXES... originating Federal tax payments, the financial institution agrees to be bound by this part and by procedural...

31 CFR 203.8 - Application of part and procedural instructions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... binding on financial institutions that process Federal tax payments or maintain a TT&L account, TIP main... (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE PAYMENT OF FEDERAL TAXES... originating Federal tax payments, the financial institution agrees to be bound by this part and by procedural...

75 FR 745 - Offset of Tax Refund Payments To Collect Past-Due, Legally Enforceable Nontax Debt; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-06

... Payments To Collect Past-Due, Legally Enforceable Nontax Debt; Correction AGENCY: Financial Management... the Treasury, Financial Management Service published a document in the Federal Register on Monday.... SUPPLEMENTARY INFORMATION: The Department of the Treasury, Financial Management Service published a document in...

77 FR 22067 - Proposed Collection of Information: Trace Request for Electronic Funds Transfer (EFT) Payment...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-12

... Electronic Funds Transfer (EFT) Payment; and Trace Request Direct Deposit AGENCY: Financial Management... collection. By this notice, the Financial Management Service solicits comments concerning forms FMS-150.1... comments to Financial Management Service, 3700 East West Highway, Records and Information Management Branch...

76 FR 54998 - Request for Information on Consumer Financial Products and Services Offered to Servicemembers

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-06

... public disclosure. Sensitive personal information such as account numbers or Social Security numbers... in person and online? 4. What programs, policies, accommodations, or benefits do financial service... protections and fraud protections. 5. What unique assistance, if any, is currently offered by financial...

Hitting and missing targets by ambulance services for emergency calls: effects of different systems of performance measurement within the UK

PubMed Central

Bevan, Gwyn; Hamblin, Richard

2009-01-01

Following devolution, differences developed between UK countries in systems of measuring performance against a common target that ambulance services ought to respond to 75% of calls for what may be immediately life threatening emergencies (category A calls) within 8 minutes. Only in England was this target integral to a ranking system of ‘star rating’, which inflicted reputational damage on services that failed to hit targets, and only in England has this target been met. In other countries, the target has been missed by such large margins that services would have been publicly reported as failing, if they had been covered by the English system of star ratings. The paper argues that this case-study adds to evidence from comparisons of different systems of hospital performance measurement that, to have an effect, these systems need to be designed to inflict reputational damage on those that have performed poorly; and it explores implications of this hypothesis. The paper also asks questions about the adequacy of systems of performance measurement of ambulance services in UK countries. PMID:19381327

Volunteer activity in specialist paediatric palliative care: a national survey

PubMed Central

Burbeck, Rachel; Low, Joe; Sampson, Elizabeth L; Scott, Rosalind; Bravery, Ruth; Candy, Bridget

2015-01-01

Objective To assess the involvement of volunteers with direct patient/family contact in UK palliative care services for children and young people. Method Cross-sectional survey using a web-based questionnaire. Setting UK specialist paediatric palliative care services. Participants Volunteer managers/coordinators from all UK hospice providers (n=37) and one National Health Service palliative care service involving volunteers (covering 53 services in total). Main outcomes Service characteristics, number of volunteers, extent of volunteer involvement in care services, use of volunteers’ professional skills and volunteer activities by setting. Results A total of 21 providers covering 31 hospices/palliative care services responded (30 evaluable responses). Referral age limit was 16–19 years in 23 services and 23–35 years in seven services; three services were Hospice at Home or home care only. Per service, there was a median of 25 volunteers with direct patient/family contact. Services providing only home care involved fewer volunteers than hospices with beds. Volunteers entirely ran some services, notably complementary therapy and pastoral/faith-based care. Complementary therapists, school teachers and spiritual care workers most commonly volunteered their professional skills. Volunteers undertook a wide range of activities including emotional support and recreational activities with children and siblings. Conclusions This is the most detailed national survey of volunteer activity in palliative care services for children and young people to date. It highlights the range and depth of volunteers’ contribution to specialist paediatric palliative care services and will help to provide a basis for future research, which could inform expansion of volunteers’ roles. PMID:24644170

Complexity of major UK companies between 2006 and 2010: Hierarchical structure method approach

NASA Astrophysics Data System (ADS)

Ulusoy, Tolga; Keskin, Mustafa; Shirvani, Ayoub; Deviren, Bayram; Kantar, Ersin; Çaǧrı Dönmez, Cem

2012-11-01

This study reports on topology of the top 40 UK companies that have been analysed for predictive verification of markets for the period 2006-2010, applying the concept of minimal spanning tree and hierarchical tree (HT) analysis. Construction of the minimal spanning tree (MST) and the hierarchical tree (HT) is confined to a brief description of the methodology and a definition of the correlation function between a pair of companies based on the London Stock Exchange (LSE) index in order to quantify synchronization between the companies. A derivation of hierarchical organization and the construction of minimal-spanning and hierarchical trees for the 2006-2008 and 2008-2010 periods have been used and the results validate the predictive verification of applied semantics. The trees are known as useful tools to perceive and detect the global structure, taxonomy and hierarchy in financial data. From these trees, two different clusters of companies in 2006 were detected. They also show three clusters in 2008 and two between 2008 and 2010, according to their proximity. The clusters match each other as regards their common production activities or their strong interrelationship. The key companies are generally given by major economic activities as expected. This work gives a comparative approach between MST and HT methods from statistical physics and information theory with analysis of financial markets that may give new valuable and useful information of the financial market dynamics.

The Reality of Rhetoric in Information Systems Adoption: A Case Study Investigation of the Uk National Health Service

NASA Astrophysics Data System (ADS)

Khan, Imran; Ferneley, Elaine

The UK National Health Service is undergoing a tremendous IS -led change, the purpose of which is to create a service capable of meeting the demands of the 21st century. The aim of this paper is to examine the extent to which persuasive discourse, or rhetoric, influences and affects the adoption of information systems within the health sector. It seeks to explore the ways in which various actors use rhetoric to advance their own agendas and the impact this has on the system itself. As such, the paper seeks to contribute to diffusion research through the use of a case study analysis of the implementation of an Electronic Single Patient Care Record system within one UK Health Service Trust. The findings of the paper suggest that rhetoric is an important and effective persuasive tool, employed by system trainers to coax users into not only adopting the system but also using the system in a predefined manner.

Supporting UK adaptation: building services for the next set of UK climate projections

NASA Astrophysics Data System (ADS)

Fung, Fai; Lowe, Jason

2016-04-01

As part of the Climate Change Act 2008, the UK Government sets out a national adaptation programme to address the risks and opportunities identified in a national climate change risk assessment (CCRA) every five years. The last risk assessment in 2012 was based on the probabilistic projections for the UK published in 2009 (UKCP09). The second risk assessment will also use information from UKCP09 alongside other evidence on climate projections. However, developments in the science of climate projeciton, and evolving user needs (based partly on what has been learnt about the diverse user requirements of the UK adaptation community from the seven years of delivering and managing UKCP09 products, market research and the peer-reviewed literature) suggest now is an appropriate time to update the projections and how they are delivered. A new set of UK climate projections are now being produced to upgrade UKCP09 to reflect the latest developments in climate science, the first phase of which will be delivered in 2018 to support the third CCRA. A major component of the work is the building of a tailored service to support users of the new projections during their development and to involve users in key decisions so that the projections are of most use. We will set out the plan for the new climate projections that seek to address the evolving user need. We will also present a framework which aims to (i) facilitate the dialogue between users, boundary organisations and producers, reflecting their different decision-making roles (ii) produce scientifically robust, user-relevant climate information (iii) provide the building blocks for developing further climate services to support adaptation activities in the UK.

Physical employment standards for U.K. fire and rescue service personnel.

PubMed

Blacker, S D; Rayson, M P; Wilkinson, D M; Carter, J M; Nevill, A M; Richmond, V L

2016-01-01

Evidence-based physical employment standards are vital for recruiting, training and maintaining the operational effectiveness of personnel in physically demanding occupations. (i) Develop criterion tests for in-service physical assessment, which simulate the role-related physical demands of UK fire and rescue service (UK FRS) personnel. (ii) Develop practical physical selection tests for FRS applicants. (iii) Evaluate the validity of the selection tests to predict criterion test performance. Stage 1: we conducted a physical demands analysis involving seven workshops and an expert panel to document the key physical tasks required of UK FRS personnel and to develop 'criterion' and 'selection' tests. Stage 2: we measured the performance of 137 trainee and 50 trained UK FRS personnel on selection, criterion and 'field' measures of aerobic power, strength and body size. Statistical models were developed to predict criterion test performance. Stage 3: matter experts derived minimum performance standards. We developed single person simulations of the key physical tasks required of UK FRS personnel as criterion and selection tests (rural fire, domestic fire, ladder lift, ladder extension, ladder climb, pump assembly, enclosed space search). Selection tests were marginally stronger predictors of criterion test performance (r = 0.88-0.94, 95% Limits of Agreement [LoA] 7.6-14.0%) than field test scores (r = 0.84-0.94, 95% LoA 8.0-19.8%) and offered greater face and content validity and more practical implementation. This study outlines the development of role-related, gender-free physical employment tests for the UK FRS, which conform to equal opportunities law. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Counselling for Depression: A Response to Counselling Education in the Twenty-First Century. Ethical Conflicts for a Counselling Approach Operating within a Medicalised Bureaucratic Health Service

ERIC Educational Resources Information Center

Proctor, Gillian; Hayes, Catherine

2017-01-01

In this article, we consider the ethical issues arising from training counsellors in "Counselling for Depression" in the UK. We describe Counselling for Depression (CfD), a competency-based approach to counselling accredited by the Improving Access to Psychological Therapies (IAPT) agenda in the National Health Service in the UK. We…

How will Brexit affect health and health services in the UK? Evaluating three possible scenarios.

PubMed

Fahy, Nick; Hervey, Tamara; Greer, Scott; Jarman, Holly; Stuckler, David; Galsworthy, Mike; McKee, Martin

2017-11-04

The process of leaving the European Union (EU) will have profound consequences for health and the National Health Service (NHS) in the UK. In this paper, we use the WHO health system building blocks framework to assess the likely effects of three scenarios we term soft Brexit, hard Brexit, and failed Brexit. We conclude that each scenario poses substantial threats. The workforce of the NHS is heavily reliant on EU staff. Financing of health care for UK citizens in the EU and vice versa is threatened, as is access to some capital funds, while Brexit threatens overall economic performance. Access to pharmaceuticals, technology, blood, and organs for transplant is jeopardised. Information used for international comparisons is threatened, as is service delivery, especially in Northern Ireland. Governance concerns relate to public health, competition and trade law, and research. However, we identified a few potential opportunities for improvement in areas such as competition law and flexibility of training, should the UK Government take them. Overall, a soft version of Brexit would minimise health threats whereas failed Brexit would be the riskiest outcome. Effective parliamentary scrutiny of policy and legal changes will be essential, but the scale of the task risks overwhelming parliament and the civil service. Copyright © 2017 Elsevier Ltd. All rights reserved.

Falls prevention and support: translating research, integrating services and promoting the contribution of service users for quality and innovative programmes of care.

PubMed

Gormley, Kevin J

2011-12-01

Falls are a significant threat to the safety, health and independence of older citizens. Despite the substantial evidence that is available around effective falls prevention programmes and interventions, their translation into falls reduction programmes and policies has yet to be fully realised. While hip fracture rates are decreasing, the number and incidence of fall-related hospital admissions among older people continue to rise. Given the demographic trends that highlight increasing numbers of older people in the UK, which is broadly reflected internationally, there is a financial and social imperative to minimise the rate of falls and associated injuries. Falling is closely aligned to growing older (Slips, Trips and Falls Update: From Acute and Community Hospitals and Mental Health Units in England and Wales, Department of Health, HMSO, London, 2010). According to the World Health Organization, around 30% of older people aged over 65 and 50% of those over 80 will fall each year (Falls Fact Sheet Number 344, WHO, Geneva, 2010). Falls happen as a result of many reasons and can have harmful consequences, including loss of mobility and independence, confidence and in many cases even death (Cochrane Database Syst Rev 15, 2009, 146; Slips, Trips and Falls Update: From Acute and Community Hospitals and Mental Health Units in England and Wales, Department of Health, HMSO, London, 2010; Falling Standards, Broken Promises: Report of the National Audit of Falls and Bone Health in Older People 2010, Health Care Quality Improvement Partnership, London, 2011). What is neither fair nor correct is the common belief by old and young alike that falls are just another inconvenience to put up with. The available evidence justifiably supports the view that well-organised services, based upon national standards and expert guidance, can prevent future falls among older people and reduce death and disability from fractures. This paper will draw from the UK, as an exemplar for policy and practice, to discuss the strategic direction of falls prevention programmes for older people and the partnerships that need to exist between researchers, service providers and users of services to translate evidence to the clinical setting. Second, it will propose some mechanisms for disseminating evidence to healthcare professionals and other stakeholders, to improve the quality and capacity of the clinical workforce. © 2011 Blackwell Publishing Ltd.

The financial value of services provided by a rural community health fair.

PubMed

Dulin, Mary Katherine; Olive, Kenneth E; Florence, Joseph A; Sliger, Carolyn

2006-11-01

There has been little discussion in the literature regarding the financial value of the services provided to the participants in health fairs. This article examines the financial value of preventive services provided through a community health fair in an economically depressed area of southwest Virginia. Current Procedural Terminology codes were assigned to the services provided in order to estimate costs participants might incur for such services. An average 50-year-old man would have paid up to $320 to obtain commonly recommended preventive services available free at the fair. An average 50-year-old woman would have paid up to $495. Overall, over $58,000 in services were provided through the health fair. This community health fair provided preventive services that many participants otherwise might have found to be cost-prohibitive.

The untimely death of the UK Donation Ethics Committee.

PubMed

Shaw, David

2017-01-01

This brief report describes the contribution of the UK Donation Ethics Committee to organ donation and transplantation in the UK, and explains why the committee has met an early demise. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Accountability for Public Expenditure under "Building Schools for the Future"

ERIC Educational Resources Information Center

Shaoul, Jean; Stafford, Anne; Stapleton, Pamela

2010-01-01

This paper examines the disclosure and reporting of expenditure under the UK government's "Building Schools for the Future" programme. The study finds that there is little detailed and useful financial reporting, and the public's right to know under Freedom of Information Act 2000 is very limited. The lack of such information makes it…

Economic "Revelations" and the Metaphors of the Meltdown: An Educational Deconstruction

ERIC Educational Resources Information Center

Stronach, Ian; Clarke, John; Frankham, Jo

2014-01-01

This article subjects contemporary informed discourse on the Credit Crunch/Great Recession/Long Recession to educational analysis and deconstruction. Such pro-capitalist but not uncritical discourse is well represented by the UK "Financial Times", whose columns between 2008 and 2012 comprise most of our data. We argue that the metaphors…

Effective Evaluation of Training and Development in Higher Education.

ERIC Educational Resources Information Center

Thackwray, Bob

This book examines approaches, techniques, and instruments that relate to the evaluation of training and development in the context of higher education in the United Kingdom (UK), focusing on the importance of identifying the purpose of the evaluation as an initial step. Some financial evaluation methods are also considered. It is suggested that…

Aligning Corporate and Financial Plans in Teaching Intensive Universities

ERIC Educational Resources Information Center

Sharpe, Rhona

2018-01-01

With recent changes in how UK higher education is funded, universities are operating in a context in which finances are uncertain. It is more important than ever that university leaders are able to manage the finances of their organisations in ways which both provide long-term security and allow for investment in strategically important…

Does non-medical prescribing make a difference to patients?

PubMed

Carey, Nicola; Stenner, Karen

This article examines the literature on non-medical prescribing to establish its impact on UK healthcare. It discusses how better access to medication through non-medical prescribing can improve patient safety and patient-centred care, and how nurse prescribing can help ensure quality of care in the NHS during the current financial crisis.

PSTT... Have You Heard?

ERIC Educational Resources Information Center

Schofield, Kathy

2014-01-01

Kathy Schofield explains how the Primary Science Teaching Trust (PSTT) came into being and how it continues to enhance science for primary teachers and children. The Primary Science Teaching Trust provides financial assistance to help improve the learning and teaching of science in the U.K. The Trust was established in April 1997 as an independent…

Learning as Relational: Intersubjectivity and Pedagogy in Higher Education

ERIC Educational Resources Information Center

Murphy, Mark; Brown, Tony

2012-01-01

The decision to make the UK student population financially responsible for their own university education has major implications for the future of higher education provision. Chief among these implications will undoubtedly be a much stronger emphasis on the student experience, not least the experience of the teaching and learning environment.…

Students' Perceptions of the Introduction of a Blended Learning Environment: An Exploratory Case Study

ERIC Educational Resources Information Center

Osgerby, Julia

2013-01-01

Virtual Learning Environments (VLE) provide the opportunity to deliver blended learning approaches that combine mixes of Information and Communications Technology (ICT) with various delivery methods and media. In 2008 and 2009, the University of Winchester in the UK redesigned a variety of accounting and financial management modules for…

Think before You Cut

ERIC Educational Resources Information Center

Pettifor, Ann

2010-01-01

With the main political parties set on reducing public spending, one might be forgiven for supposing that "savage" cuts are the only way forward. However, the author believes there are alternatives, and that is why public education about the financial system is so important. Today, UK is trying to clear up a mess--a mess made by the…

Literacy Changes Lives 2014: A New Perspective on Health, Employment and Crime

ERIC Educational Resources Information Center

Morrisroe, Joe

2014-01-01

Since 2008, the financial crisis has had a profound social and economic impact on the UK's most vulnerable communities. Literacy influences individual capability in all spheres of life. In times of economic instability, low literacy makes individuals and communities more vulnerable to inequality, increasing the risk of social exclusion and…

49 CFR 37.155 - Factors in decision to grant an undue financial burden waiver.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Service § 37.155 Factors in decision to grant an undue financial burden waiver. (a) In making an undue... reduction in service, measured by service miles; (2) Average number of trips made by the entity's general... and quality of available resources for complementary paratransit service; and (10) Unique...

31 CFR 536.505 - Entries in certain accounts for normal service charges authorized.

Code of Federal Regulations, 2010 CFR

2010-07-01

... § 536.505 Entries in certain accounts for normal service charges authorized. (a) U.S. financial... or reimbursement for normal service charges owed to such U.S. financial institution by the owner of such blocked account. (b) As used in this section, the term normal service charge shall include charges...

Encouraging smoking cessation among disadvantaged groups: a qualitative study of the financial aspects of cessation.

PubMed

Bonevski, Billie; Bryant, Jamie; Paul, Christine

2011-07-01

This study aimed to explore perceptions about financial aspects of smoking cessation among a group of disadvantaged welfare agency clients and their carers. Qualitative focus groups and in-depth interviews were supplemented with participant exit surveys about preferred smoking cessation strategies. Each discussion was audiotaped, transcribed and analysed using a thematic analysis. The setting was six non-government community welfare service organisations operating in New South Wales, Australia. Eleven social services offered by these organisations participated. Thirty two clients participated in six client focus groups, 35 staff participated in six staff focus groups and eight manager telephone interviews were conducted. Clients indicated that the cost of nicotine replacement therapy was a barrier to its use and that financial incentives were acceptable. Of the 16 possible strategies listed in the exit survey, the three selected as the most preferred by clients incorporated financial or non-financial assistance. By contrast, staff and managers selected financial and non-financial incentives as the least preferred and least feasible strategies. The study found high acceptance of incentives as a smoking cessation strategy among a disadvantaged group of non-government welfare service clients. The comparatively low level of desirability and feasibility from the perspective of service staff and managers suggests implementation of such an approach within the community service setting requires careful further testing. © 2010 Australasian Professional Society on Alcohol and other Drugs.

Requirements of health policy and services journals for authors to disclose financial and non-financial conflicts of interest: a cross-sectional study.

PubMed

Khamis, Assem M; Hakoum, Maram B; Bou-Karroum, Lama; Habib, Joseph R; Ali, Ahmed; Guyatt, Gordon; El-Jardali, Fadi; Akl, Elie A

2017-09-19

The requirements of the health policy and services journals for authors to report their financial and non-financial conflicts of interest (COI) are unclear. The present article aims to assess the requirements of health policy and services journals for authors to disclose their financial and non-financial COIs. This is a cross-sectional study of journals listed by the Web of Science under the category of 'Health Policy and Services'. We reviewed the 'Instructions for Authors' on the journals' websites and then simulated the submission of a manuscript to obtain any additional relevant information made available during that step. We abstracted data in duplicate and independently using a standardised form. Out of 72 eligible journals, 67 (93%) had a COI policy. A minority of policies described how the disclosed COIs of authors would impact the editorial process (34%). None of the policies had clear-cut criteria for rejection based on the content of the disclosure. Approximately a fifth of policies (21%) explicitly stated that inaccurate or incomplete disclosures might lead to manuscript rejection or retraction. No policy described whether the journal would verify the accuracy or completeness of authors' disclosed COIs. Most journals' policies (93%) required the disclosure of at least one form of financial COI. While the majority asked for specification of source of payment (71%), a minority asked for the amount (18%). Overall, 81% of policies explicitly required disclosure of non-financial COIs. A majority of health policy and services journal policies required the disclosure of authors' financial and non-financial COIs, but few required details on disclosed COIs. Health policy journals should provide specific definitions and instructions for disclosing non-financial COIs. A framework providing clear typology and operational definitions of the different types of COIs will facilitate both their disclosure by authors and reviewers and their assessment and management by the editorial team and the readers.

Public Libraries in an Age of Financial Complexity: Toward Enhancing Community Financial Literacy

ERIC Educational Resources Information Center

Smith, Catherine Arnott; Eschenfelder, Kristin

2013-01-01

This report describes several linked empirical studies that examine the activities of public libraries in increasing the financial literacy of their service population. A qualitative field study examines librarians' perceptions of the challenges in offering information and services in this domain; a second set of interviews centers on the…

25 CFR 20.313 - How will the Bureau compute financial assistance payments?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false How will the Bureau compute financial assistance payments? 20.313 Section 20.313 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES... will the Bureau compute financial assistance payments? (a) The social services worker will compute...

Ohio Financial Services and Risk Management. Technical Competency Profile (TCP).

ERIC Educational Resources Information Center

Ray, Gayl M.; Wilson, Nick; Mangini, Rick

This document describes the essential competencies from secondary through post-secondary associate degree programs for a career in financial services and risk management. Ohio College Tech Prep Program standards are described, and a key to profile codes is provided. Sample occupations in this career area, such as financial accountant, loan…

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

PubMed

Tighe, Patrick A

2016-01-01

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

Good intentions, increased inequities: developing social care services in Emergency Departments in the UK.

PubMed

Bywaters, Paul; McLeod, Eileen; Fisher, Joanne; Cooke, Matthew; Swann, Garry

2011-09-01

Addressing the quality of services provided in Emergency Departments (EDs) has been a central area of development for UK government policy since 1997. Amongst other aspects of this concern has been the recognition that EDs constitute a critical boundary between the community and the hospital and a key point for the identification of social care needs. Consequently, EDs have become the focus for a variety of service developments which combine the provision of acute medical and nursing assessment and care with a range of activities in which social care is a prominent feature. One approach to this has been the establishment of multidisciplinary teams aiming to prevent re-attendance or admission, re-direct patients to other services, or speed patients through EDs with the aim of providing improved quality of care. This study, carried out between September 2007 and April 2008, was the first UK national survey of social care initiatives based in EDs and aimed to determine the objectives, organisation, extent, functions, funding and evidence on outcomes of such interventions. Eighty-three per cent of UK Type I and II EDs responded to the survey. Approximately, one-third of EDs had embedded social care teams, with two-thirds relying on referrals to external social care services. These teams varied in their focus, size and composition, leadership, availability, funding and permanence. As a result, the unintended effect has been to increase inequities in access to social care services through EDs. Three further conclusions are drawn about policy led, locally-based service development. This survey adds to international evidence pointing to the potential benefits of a variety of social care interventions being based in EDs and justifies the establishment of a research programme which can provide answers to key outstanding questions. © 2011 Blackwell Publishing Ltd.

Shifting the focus: outcomes of care for older people.

PubMed

Heath, Hazel; Phair, Lynne

2009-06-01

Internationally there is commitment to work towards eradicating the abuse of older people and to develop services that promote their equality, dignity and human rights. The emphasis on service users is gradually increasing and, along with this, the focus within health and social care policy, service provision and professional practice is shifting. In UK health and social care policy the emphasis on service structure and provision is being replaced by a focus on outcomes for service users, including outcomes which patients themselves evaluate. The focus of UK Adult Protection services is also shifting from intervention to prevention through developing greater understanding of the factors which contribute to abuse, changing attitudes towards entrenched poor care, identifying preventative services and safeguarding vulnerable adults. Nursing literature is also beginning to acknowledge the evolution of an outcomes focus. This paper discusses the shifting emphasis in UK health and social care in the safeguarding of vulnerable people and in nursing practice. It offers an overview of literature on outcomes. The paper then describes a research study which sought to identify outcomes of care for older people living in UK care homes. The outcomes framework developed through the research is offered, along with a discussion of the advantages of an outcome-focused approach to care and some of the remaining challenges. A case example is offered to illustrate an outcomes-focused approach. Finally, the paper draws conclusions on how shifting the focus of care delivery from traditional problem-orientated approaches and ritualized practice towards the outcomes of care that individual older people choose and evaluate for themselves offers potential towards eradicating abuse and neglect in formal care settings. © 2009 Blackwell Publishing Ltd.

An economic evaluation of anonymised information sharing in a partnership between health services, police and local government for preventing violence-related injury.

PubMed

Florence, Curtis; Shepherd, Jonathan; Brennan, Iain; Simon, Thomas R

2014-04-01

To assess the costs and benefits of a partnership between health services, police and local government shown to reduce violence-related injury. Benefit-cost analysis. Anonymised information sharing and use led to a reduction in wounding recorded by the police that reduced the economic and social costs of violence by £6.9 million in 2007 compared with the costs the intervention city, Cardiff UK, would have experienced in the absence of the programme. This includes a gross cost reduction of £1.25 million to the health service and £1.62 million to the criminal justice system in 2007. By contrast, the costs associated with the programme were modest: setup costs of software modifications and prevention strategies were £107 769, while the annual operating costs of the system were estimated as £210 433 (2003 UK pound). The cumulative social benefit-cost ratio of the programme from 2003 to 2007 was £82 in benefits for each pound spent on the programme, including a benefit-cost ratio of 14.80 for the health service and 19.1 for the criminal justice system. Each of these benefit-cost ratios is above 1 across a wide range of sensitivity analyses. An effective information-sharing partnership between health services, police and local government in Cardiff, UK, led to substantial cost savings for the health service and the criminal justice system compared with 14 other cities in England and Wales designated as similar by the UK government where this intervention was not implemented.

Does the private sector receive an excessive return from investments in health care infrastructure projects? Evidence from the UK.

PubMed

Vecchi, Veronica; Hellowell, Mark; Gatti, Stefano

2013-05-01

This paper is concerned with the cost-efficiency of Private Finance Initiatives (PFIs) in the delivery of hospital facilities in the UK. We outline a methodology for identifying the "fair" return on equity, based on the Weighted Average Cost of Capital (WACC) of each investor. We apply this method to assess the expected returns on a sample of 77 contracts signed between 1997 and 2011 by health care provider organisations in the UK. We show that expected returns are in general in excess of the WACC benchmarks. The findings highlight significant problems in current procurement practices and the methodologies by which bids are assessed. To minimise the financial impact of hospital investments on health care systems, a regulatory regime must ensure that expected returns are set at the "fair" rate. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Depression, financial problems and other reasons for suspending medical studies, and requested support services: findings from a qualitative study.

PubMed

Soh, Nerissa; Ma, Colleen; Lampe, Lisa; Hunt, Glenn; Malhi, Gin; Walter, Garry

2012-12-01

This study aimed to qualitatively explore medical students' reasons for suspending, or thinking of suspending, their studies and the types of support services they request. Data were collected through an anonymous online survey. Medical students' responses to open-ended questions were analyzed thematically. Responses were received from 475 students. Financial problems, doubts as to whether medicine was the right vocation, and depression were the most commonly reported themes. Students endorsed a wide range of other pressures and concerns, barriers to obtaining assistance, and also suggested solutions and services to address their concerns. Medical students' financial concerns and potential depressive symptoms should be addressed by university and faculty support services. Government financial support mechanisms for students should also be reviewed. Students' suggestions of the types of services and their location must be borne in mind when allocating resources.

The future of UK/Irish surgery: A European solution.

PubMed

Varzgalis, M; Kerin, M J; Sweeney, K J

2015-11-01

The United Kingdom (UK) and Republic of Ireland (ROI) hospital systems are dependent on junior doctors for their functionality however it is increasingly difficult to recruit UK/ROI trained doctors to fill these posts. Directive 2005/36/EC, which came into force in 2007, is the principal European legislation on the recognition of equivalence of professional qualifications across Europe. European trained doctors are therefore attractive candidates for junior doctor posts. However, although their training is recognised as equivalent by the Irish Medical Council (IMC) and General Medical Council (GMC) they are not being appointed to equivalent posts by the Health Service Executive (HSE) or National Health Service (NHS). With the influence of European Union (EU) centralisation, modification of UK/ROI consultant grade is imminent, possibly to pyramidal structure of the Continental European model with clearer lines of corporate responsibility. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

Financial Analysis of Behavioral Health Services in a Pediatric Endocrinology Clinic.

PubMed

Yarbro, Jessica L; Mehlenbeck, Robyn

2016-09-01

This article addresses a current need in psychological practice by describing a financially feasible model that moves toward integrated care of behavioral health services in a pediatric endocrinology clinic. Financial information (costs and revenue associated with behavioral health services) for the clinic, over an 18-month period (July 2012 to December 2013), was obtained through the hospital's financial department. The clinic meets one half day per week. Over the 18-month period, the behavioral health services generated a net gain of $3661.45 in the favor of the clinic. We determined that the psychologist and clinical psychology residents needed to see a total of four patients per half-day clinic for the clinic to "break-even." We describe one financially feasible way of integrating behavioral health services into a pediatric endocrinology clinic in the hope that this will be generalizable to other medical settings. © The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Financial abuse of older people by a family member: a difficult terrain for service providers in Australia.

PubMed

Adams, Valerie Margaret; Bagshaw, Dale; Wendt, Sarah; Zannettino, Lana

2014-01-01

Financial abuse by a family member is the most common form of abuse experienced by older Australians, and early intervention is required. National online surveys of 228 chief executive officers and 214 aged care service providers found that, while they were well placed to recognize financial abuse, it was often difficult to intervene successfully. Problems providers encountered included difficulties in detecting abuse, the need for consent before they could take action, the risk that the abusive family member would withdraw the client from the service, and a lack of resources to deal with the complexities inherent in situations of financial abuse.

Food production and service in UK hospitals.

PubMed

Ahmed, Mohamed; Jones, Eleri; Redmond, Elizabeth; Hewedi, Mahmoud; Wingert, Andreas; Gad El Rab, Mohamed

2015-01-01

The purpose of this paper is to apply value stream mapping holistically to hospital food production/service systems focused on high-quality food. Multiple embedded case study of three (two private-sector and one public-sector) hospitals in the UK. The results indicated various issues affecting hospital food production including: the menu and nutritional considerations; food procurement; food production; foodservice; patient perceptions/expectations. Value stream mapping is a new approach for food production systems in UK hospitals whether private or public hospitals. The paper identifies opportunities for enhancing hospital food production systems. The paper provides a theoretical basis for process enhancement of hospital food production and the provision of high-quality hospital food.

10 CFR 800.300 - Loan servicing.

Code of Federal Regulations, 2010 CFR

2010-01-01

... consideration to the experience of the agent in providing financial services to minority business enterprises..., broker, or other financial institution or entity) having the capability, and legally qualified, to service the loan consistently with the requirements of this regulation, which contracts with DOE to act as...

77 FR 17529 - Request for Comments-Financial Eligibility Screening and Online Intake

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-26

... LEGAL SERVICES CORPORATION Request for Comments--Financial Eligibility Screening and Online Intake AGENCY: Legal Services Corporation. ACTION: Notice; request for comments. SUMMARY: The Legal Services... through online systems. DATES: Written comments will be accepted until April 25, 2012. ADDRESSES: Written...

The concept of outcome.

PubMed

Hunt, S

1997-01-01

The Enuresis Resource and Information Centre in the UK has recently launched a second edition of Guidelines on Minimum Standards of Practice in the Treatment of Enuresis. The purpose of the Guidelines is to provide a blueprint for service delivery in the UK, leading to enuresis services that offer effective, accessible and dependable treatment. In particular, these Guidelines propose minimum and target standards that enuresis services should aim to achieve, relating to referral, assessment and treatment, as well as catchment area appointments, research and referral. In addition, the Guidelines may be used to provide a framework within which enuresis services can be audited and evaluated. Successive cycles of observation, appraisal and action should encourage a continual improvement process in each clinic, resulting in a progressive development of the service offered.

Financial Management: Major Deficiencies in Financial Reporting for Other Defense Organizations-General Funds

DTIC Science & Technology

2002-05-31

explains major financial reporting deficiencies that diminish the quality and utility of the Other Defense Organizations-General Funds financial reports...Accounting Service have taken steps to improve the financial reporting process of the Other Defense Organizations, deficiencies related to financial

Are financial incentives cost-effective to support smoking cessation during pregnancy?

PubMed

Boyd, Kathleen A; Briggs, Andrew H; Bauld, Linda; Sinclair, Lesley; Tappin, David

2016-02-01

To investigate the cost-effectiveness of up to £400 worth of financial incentives for smoking cessation in pregnancy as an adjunct to routine health care. Cost-effectiveness analysis based on a Phase II randomized controlled trial (RCT) and a cost-utility analysis using a life-time Markov model. The RCT was undertaken in Glasgow, Scotland. The economic analysis was undertaken from the UK National Health Service (NHS) perspective. A total of 612 pregnant women randomized to receive usual cessation support plus or minus financial incentives of up to £400 vouchers (US $609), contingent upon smoking cessation. Comparison of usual support and incentive interventions in terms of cotinine-validated quitters, quality-adjusted life years (QALYs) and direct costs to the NHS. The incremental cost per quitter at 34-38 weeks pregnant was £1127 ($1716).This is similar to the standard look-up value derived from Stapleton & West's published ICER tables, £1390 per quitter, by looking up the Cessation in Pregnancy Incentives Trial (CIPT) incremental cost (£157) and incremental 6-month quit outcome (0.14). The life-time model resulted in an incremental cost of £17 [95% confidence interval (CI) = -£93, £107] and a gain of 0.04 QALYs (95% CI = -0.058, 0.145), giving an ICER of £482/QALY ($734/QALY). Probabilistic sensitivity analysis indicates uncertainty in these results, particularly regarding relapse after birth. The expected value of perfect information was £30 million (at a willingness to pay of £30 000/QALY), so given current uncertainty, additional research is potentially worthwhile. Financial incentives for smoking cessation in pregnancy are highly cost-effective, with an incremental cost per quality-adjusted life years of £482, which is well below recommended decision thresholds. © 2015 Society for the Study of Addiction.

An evaluation system for financial compensation in traditional Chinese medicine services.

PubMed

Dou, Lei; Yin, Ai-Tian; Hao, Mo; Lu, Jun

2015-10-01

To describe the major factors influencing financial compensation in traditional Chinese medicine (TCM) and prioritize what TCM services should be compensated for. Two structured questionnaires-a TCM service baseline questionnaire and a service cost questionnaire-were used to collect information from TCM public hospitals on TCM services provided in certain situations and service cost accounting. The cross-sectional study examined 110 TCM services provided in four county TCM public hospitals in Shandong province. From the questionnaire data, a screening index system was established via expert consultation and brainstorming. Comprehensive evaluation of TCM services was performed using the analytic hierarchy process method. Weighted coefficients were used to measure the importance of each criterion, after which comprehensive evaluation scores for each service were ranked to indicate what services should receive priority for financial compensation. Economy value, social value, and efficacy value were the three main criteria for screening for what TCM services should be compensated for. The economy value local weight had the highest value (0.588), of which the profit sub-criterion (0.278) was the most important for TCM financial compensation. Moxibustion was tied for the highest comprehensive evaluation scores, at 0.65 while Acupuncture and Massage Therapy were tied for the second and third highest, with 0.63 and 0.58, respectively. Government and policymakers should consider offer financial compensation to Moxibustion, Acupuncture, Massage Therapy, and TCM Orthopedics as priority services. In the meanwhile, it is essential to correct the unreasonable pricing, explore compensation methods, objects and payment, and revise and improve the accounting system for the costs of TCM services. Copyright © 2015 Elsevier Ltd. All rights reserved.

31 CFR 595.505 - Entries in certain accounts for normal service charges authorized.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Entries in certain accounts for normal service charges authorized. (a) U.S. financial institutions are... reimbursement for normal service charges owed to such U.S. financial institution by the owner of such blocked account. (b) As used in this section, the term normal service charge shall include charges in payment or...

31 CFR 538.504 - Entries in certain accounts for normal service charges authorized.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Entries in certain accounts for normal service charges authorized. (a) U.S. financial institutions are... reimbursement for normal service charges owed to such U.S. financial institution by the owner of such blocked account. (b) As used in this section, the term normal service charge shall include charges in payment or...

Wildfire in the United Kingdom: status and key issues

Treesearch

Julia McMorrow

2011-01-01

This paper reviews the status of wildfire risk in the United Kingdom and examines some of the key issues in U.K. wildfire management. Wildfires challenge the resources of U.K. Fire and Rescue Services (FRSs), especially in dry years, yet FRSs are poorly equipped and trained to deal with wildfire. A brief geography of U.K. wildfires is presented using fire statistics...

PREFACE: Soil Change Matters 2014

NASA Astrophysics Data System (ADS)

2015-07-01

The opinions expressed and arguments employed in this publication are the sole responsibility of the authors and do not necessarily reflect those of the OECD or of the governments of its Member countries. The Workshop was sponsored by the OECD Co-operative Research Programme on Biological Resource Management for Sustainable Agricultural Systems, whose financial support made it possible for eight of the invited speakers to participate in the Workshop. We would like to thank the Organising Committee, the Scientific Committee and the financial support from the conference sponsors and funding from the Government of Victoria that allowed the success of the Soil Change Matters Workshop. Organising Committee (Department of Economic Development, Jobs, Transport and Resources unless otherwise noted): • Richard MacEwan (Convenor) • Jennifer Alexander • Helaina Black (James Hutton Institute, UK) • Doug Crawford • Phil Dyson (North Central CMA) • Jane Fisher • Gemma Heemskerk • Jonathan Hopley • Pauline Mele • Rebecca Mitchell • David Rees • Dugal Wallace • Dale Webster Scientific Committee (Department of Economic Development, Jobs, Transport and Resources unless otherwise noted): • Mr Richard MacEwan • Dr Dominique Arrouays (National Institute of Agronomic Research, France) • Helaina Black (James Hutton Institute, UK) • Mr Doug Crawford • Dr Ben Marchant (Geoscience, UK) • Dr Pauline Mele • Dr Budiman Minasny (University of Sydney, NSW) • Professor Dan Richter (Duke University, USA) • Mr Nathan Robinson Thanks are given to the authors and to the anonymous referees for the papers included here.

Financial incentives to encourage healthy behaviour: an analysis of U.K. media coverage.

PubMed

Parke, Hannah; Ashcroft, Richard; Brown, Rebecca; Marteau, Theresa M; Seale, Clive

2013-09-01

Policies to use financial incentives to encourage healthy behaviour are controversial. Much of this controversy is played out in the mass media, both reflecting and shaping public opinion. To describe U.K. mass media coverage of incentive schemes, comparing schemes targeted at different client groups and assessing the relative prominence of the views of different interest groups. Thematic content analysis. National and local news coverage in newspapers, news media targeted at health-care providers and popular websites between January 2005 and February 2010. U.K. mass media. The study included 210 articles. Fifteen separate arguments favourable towards schemes, and 19 unfavourable, were identified. Overall, coverage was more favourable than unfavourable, although most articles reported a mix of views. Arguments about the prevalence and seriousness of the health problems targeted by incentive schemes were uncontested. Moral and ethical objections to such schemes were common, focused in particular on recipients such as drug users or the overweight who were already stereotyped as morally deficient, and these arguments were largely uncontested. Arguments about the effectiveness of schemes and their potential for benefit or harm were areas of greater contestation. Government, public health and other health-care provider interests dominated favourable coverage; opposition came from rival politicians, taxpayers' representatives, certain charities and from some journalists themselves. Those promoting incentive schemes for people who might be regarded as 'undeserving' should plan a media strategy that anticipates their public reception. © 2011 John Wiley & Sons Ltd.

Financial incentives to encourage healthy behaviour: an analysis of UK media coverage

PubMed Central

Parke, Hannah; Ashcroft, Richard; Brown, Rebecca; Marteau, Theresa M; Seale, Clive

2011-01-01

Abstract Background  Policies to use financial incentives to encourage healthy behaviour are controversial. Much of this controversy is played out in the mass media, both reflecting and shaping public opinion. Objective  To describe UK mass media coverage of incentive schemes, comparing schemes targeted at different client groups and assessing the relative prominence of the views of different interest groups. Design  Thematic content analysis. Subjects  National and local news coverage in newspapers, news media targeted at health‐care providers and popular websites between January 2005 and February 2010. Setting  UK mass media. Results  The study included 210 articles. Fifteen separate arguments favourable towards schemes, and 19 unfavourable, were identified. Overall, coverage was more favourable than unfavourable, although most articles reported a mix of views. Arguments about the prevalence and seriousness of the health problems targeted by incentive schemes were uncontested. Moral and ethical objections to such schemes were common, focused in particular on recipients such as drug users or the overweight who were already stereotyped as morally deficient, and these arguments were largely uncontested. Arguments about the effectiveness of schemes and their potential for benefit or harm were areas of greater contestation. Government, public health and other health‐care provider interests dominated favourable coverage; opposition came from rival politicians, taxpayers’ representatives, certain charities and from some journalists themselves. Conclusions  Those promoting incentive schemes for people who might be regarded as ‘undeserving’ should plan a media strategy that anticipates their public reception. PMID:21771227

Taking Ownership of the Future: The National Strategy for Financial Literacy, 2006

ERIC Educational Resources Information Center

US Financial Literacy and Education Commission, 2006

2006-01-01

Today's increasingly complex financial services market offers consumers a vast array of products, services, and providers to choose from to meet their financial needs. While this degree of choice provides consumers with a great number of options, it also requires that they be equipped with the information, knowledge, and skills to evaluate their…

Investigating Customers' Experiences with Their Financial Services Customer Education Programs as It Impacts Customer Loyalty to the Financial Firm

ERIC Educational Resources Information Center

Islam, Kaliym A.

2017-01-01

The problem addressed in this study was that customer education programs are intended to strengthen customer loyalty; however, research on the effects of customer education on customer loyalty remains insufficient. This phenomenological study investigated how the lived experiences of customers' participating in financial services' customer…

Financial Management for the Office of the Civilian Health and Medical Program of the Uniformed Services

DTIC Science & Technology

1996-12-27

consolidated financial statements for FY 1996. The Office of Civilian Health and Medical Program of the Uniformed Services (OCHAMPUS), part of the FY 1995...12.3 billion Defense Health Program, is one of the entities that DoD will include in its FY 1996 consolidated financial statements . The OCHAMPUS

Training Social Workers and Human Service Professionals to Address the Complex Financial Needs of Clients

ERIC Educational Resources Information Center

Frey, Jodi Jacobson; Hopkins, Karen; Osteen, Philip; Callahan, Christine; Hageman, Sally; Ko, Jungyai

2017-01-01

In social work and other community-based human services settings, clients often present with complex financial problems. As a need for more formal training is beginning to be addressed, evaluation of existing training is important, and this study evaluates outcomes from the Financial Stability Pathway (FSP) project. Designed to prepare…

50 CFR 296.5 - Instructions for filing claims.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Section 296.5 Wildlife and Fisheries NATIONAL MARINE FISHERIES SERVICE, NATIONAL OCEANIC AND ATMOSPHERIC... person. The fifteen-day report must be made to the Chief, Financial Services Division, National Marine... determined by the date of the postmark) to the Chief, Financial Services Division, National Marine Fisheries...

50 CFR 296.5 - Instructions for filing claims.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Section 296.5 Wildlife and Fisheries NATIONAL MARINE FISHERIES SERVICE, NATIONAL OCEANIC AND ATMOSPHERIC... person. The fifteen-day report must be made to the Chief, Financial Services Division, National Marine... determined by the date of the postmark) to the Chief, Financial Services Division, National Marine Fisheries...

Student Centered Financial Services: Innovations That Succeed

ERIC Educational Resources Information Center

Sinsabaugh, Nancy, Ed.

2007-01-01

This collection of best practices shares how 18 higher education institutions across the country have successfully evaluated and redesigned their student financial services programs to improve services to students and their parents and find cost savings for the institution. This volume illustrates how other institutions have successfully tackled…

Volunteer activity in specialist paediatric palliative care: a national survey.

PubMed

Burbeck, Rachel; Low, Joe; Sampson, Elizabeth L; Scott, Rosalind; Bravery, Ruth; Candy, Bridget

2015-09-01

To assess the involvement of volunteers with direct patient/family contact in UK palliative care services for children and young people. Cross-sectional survey using a web-based questionnaire. UK specialist paediatric palliative care services. Volunteer managers/coordinators from all UK hospice providers (n=37) and one National Health Service palliative care service involving volunteers (covering 53 services in total). Service characteristics, number of volunteers, extent of volunteer involvement in care services, use of volunteers' professional skills and volunteer activities by setting. A total of 21 providers covering 31 hospices/palliative care services responded (30 evaluable responses). Referral age limit was 16-19 years in 23 services and 23-35 years in seven services; three services were Hospice at Home or home care only. Per service, there was a median of 25 volunteers with direct patient/family contact. Services providing only home care involved fewer volunteers than hospices with beds. Volunteers entirely ran some services, notably complementary therapy and pastoral/faith-based care. Complementary therapists, school teachers and spiritual care workers most commonly volunteered their professional skills. Volunteers undertook a wide range of activities including emotional support and recreational activities with children and siblings. This is the most detailed national survey of volunteer activity in palliative care services for children and young people to date. It highlights the range and depth of volunteers' contribution to specialist paediatric palliative care services and will help to provide a basis for future research, which could inform expansion of volunteers' roles. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Investments in cancer research awarded to UK institutions and the global burden of cancer 2000-2013: a systematic analysis.

PubMed

Maruthappu, Mahiben; Head, Michael G; Zhou, Charlie D; Gilbert, Barnabas J; El-Harasis, Majd A; Raine, Rosalind; Fitchett, Joseph R; Atun, Rifat

2017-04-20

To systematically categorise cancer research investment awarded to United Kingdom (UK) institutions in the period 2000-2013 and to estimate research investment relative to disease burden as measured by mortality, disability-adjusted life years (DALYs) and years lived with disability (YLDs). Systematic analysis of all open-access data. Public and philanthropic funding to all UK cancer research institutions, 2000-2013. Number and financial value of cancer research investments reported in 2013 UK pounds (UK£). Mortality, DALYs and YLDs data were acquired from the Global Burden of Disease Study. A compound metric was adapted to estimate research investment relative to disease burden as measured by mortality, DALYs and YLDs. We identified 4299 funded studies with a total research investment of £2.4 billion. The highest fundings by anatomical sites were haematological, breast, prostate, colorectal and ovarian cancers. Relative to disease burden as determined by a compound metric combining mortality, DALYs and YLDs, gender-specific cancers were found to be highest funded-the five sites that received the most funding were prostate, ovarian, breast, mesothelioma and testicular cancer; the least well-funded sites were liver, thyroid, lung, upper gastrointestinal (GI) and bladder. Preclinical science accounted for 66.2% of award numbers and 62.2% of all funding. The top five areas of primary research focus by funding were pathogenesis, drug therapy, diagnostic, screening and monitoring, women's health and immunology. The largest individual funder was the Medical Research Council. In combination, the five lowest funded site-specific cancers relative to disease burden account for 47.9%, 44.3% and 20.4% of worldwide cancer mortality, DALYs and YLDs. Research funding for cancer is not allocated according to relative disease burden. These findings are in line with earlier published studies. Funding agencies and industry should openly document their research investments to improve better targeting of research investment. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Financial considerations in the conduct of multi-centre randomised controlled trials: evidence from a qualitative study

PubMed Central

Snowdon, Claire; Elbourne, Diana R; Garcia, Jo; Campbell, Marion K; Entwistle, Vikki A; Francis, David; Grant, Adrian M; Knight, Rosemary C; McDonald, Alison M; Roberts, Ian

2006-01-01

Background Securing and managing finances for multicentre randomised controlled trials is a highly complex activity which is rarely considered in the research literature. This paper describes the process of financial negotiation and the impact of financial considerations in four UK multicentre trials. These trials had met, or were on schedule to meet, recruitment targets agreed with their public-sector funders. The trials were considered within a larger study examining factors which might be associated with trial recruitment (STEPS). Methods In-depth semi-structured telephone interviews were conducted in 2003–04 with 45 individuals with various responsibilities to one of the four trials. Interviewees were recruited through purposive and then snowball sampling. Interview transcripts were analysed with the assistance of the qualitative package Atlas-ti. Results The data suggest that the UK system of dividing funds into research, treatment and NHS support costs brought the trial teams into complicated negotiations with multiple funders. The divisions were somewhat malleable and the funding system was used differently in each trial. The fact that all funders had the potential to influence and shape the trials considered here was an important issue as the perspectives of applicants and funders could diverge. The extent and range of industry involvement in non-industry-led trials was striking. Three broad periods of financial work (foundation, maintenance, and resourcing completion) were identified. From development to completion of a trial, the trialists had to be resourceful and flexible, adapting to changing internal and external circumstances. In each period, trialists and collaborators could face changing costs and challenges. Each trial extended the recruitment period; three required funding extensions from MRC or HTA. Conclusion This study highlights complex financial aspects of planning and conducting trials, especially where multiple funders are involved. Recognition of the importance of financial stability and of the need for appropriate training in this area should be paralleled by further similar research with a broader range of trials, aimed at understanding and facilitating the conduct of clinical research. PMID:17184521