[Changes in psychopathological symptoms during the waiting period for outpatient psychotherapy].

PubMed

Huckert, Thomas Frank; Hank, Petra; Krampen, Günter

2012-08-01

This study empirically tests symptom changes in a sample of 106 psychotherapy outpatients during a 6-month waiting period before treatment commencement. Using indirect measurement of change, the patients improve in psychopathological symptoms. Using direct measurement of change, 48% of the outpatients show no significant change in psychopathological symptoms. However, the symptoms of 29% improve and 23% worsen. Using multinomial logistic regression, group membership (no change, positive change, negative change) can be predicted by personality traits for 60% of the patients. Social trust negatively predicts changes for the worse. Liberal gender-role orientation positively predicts improvement. A positive self-concept of ability positively predicts changes for the worse. Moreover sociodemographic variables correctly predict group membership for 57% of the patients. Age positively predicts changes for the worse. Female gender negatively predicts improvement. © Georg Thieme Verlag KG Stuttgart · New York.

Waiting time distributions in financial markets

NASA Astrophysics Data System (ADS)

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

2002-05-01

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

Individual and system influences on waiting time for substance abuse treatment.

PubMed

Carr, Carey J A; Xu, Jiangmin; Redko, Cristina; Lane, D Timothy; Rapp, Richard C; Goris, John; Carlson, Robert G

2008-03-01

Waiting time is a contemporary reality of many drug abuse treatment programs, resulting in substantial problems for substance users and society. Individual and system factors that influence waiting time are diverse and may vary at different points in the treatment continuum. This study assessed waiting time preceding clinical assessment at a centralized intake unit and during the period after the assessment but before treatment entry. The present study included 577 substance abusers who were enrolled in a large clinical trial of two brief treatment interventions in a midsize metropolitan area in Ohio. Bivariate analyses identified individual and system factors that influenced preassessment and postassessment waiting time, as well as total wait to treatment services. Multivariate analyses demonstrated that longer wait time for an assessment is influenced by being court referred, less belief in having a substance abuse problem, and less desire for change. A shorter wait to actually enter treatment is predicted by having a case manager, being more ready for treatment, and having less severe employment and alcohol problems. The different influences present during the two waiting periods suggest that assessment and treatment programs need to implement system changes and entry enhancement interventions that are specific to the needs of substance abusers at each waiting period.

Randomized control trial follow-up: Online program and waiting period for unmarried parents in Title IV-D Court.

PubMed

Rudd, Brittany N; Poladian, Ani R; Holtzworth-Munroe, Amy; Applegate, Amy G; D'Onofrio, Brian M

2017-04-01

Despite a lack of research on parent programs for separating unmarried parents, many judicial officers mandate participation. Rudd, Holtzworth-Munroe, Reyome, Applegate, and D'Onofrio (2015) conducted the only randomized controlled trial of any online parent program for separating parents, ProudToParent.org (PTP), and related court processes (e.g., having a waiting period between the establishment of paternity and the court hearing regarding child related issues vs. having the hearing the same day). They recruited a unique sample of 182 cases in a Title IV-D Court (i.e., a court for primarily low income parents) (Authorization of Appropriations, 42 U.S.C. § 651, 2013), in which paternity was previously contested but subsequently established via court-ordered genetic testing. Unexpectedly, cases assigned to PTP and a waiting period were the least likely to reach agreement at their court hearing. In the current study, we extend these results to examine the impact of the study conditions on relitigation in the year following the court hearing; only 11.2% of cases filed a motion, and 7.8% had a hearing. The group that was least likely to reach full initial agreement (i.e., assigned to PTP and the waiting period) were the most likely to relitigate. Further, controlling for study conditions, reaching a full agreement in the Title IV-D court decreased the odds of having a court hearing in the following year. Reaching agreements on the specific issues involved in such cases (e.g., custody, child support) reduced the likelihood of both motions and hearings in the year after the Title IV-D hearings. The implications of these findings are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Time while waiting: patients' experiences of scheduled surgery.

PubMed

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

2014-12-01

Research on patients' experiences of wait time for scheduled surgery has centered predominantly on the relative tolerability of perceived wait time and impacts on quality of life. We explored patients' experiences of time while waiting for three types of surgery with varied wait times--hip or knee replacement, shoulder surgery, and cardiac surgery. Thirty-two patients were recruited by their surgeons. We asked participants about their perceptions of time while waiting in two separate interviews. Using interpretative phenomenological analysis (IPA), we discovered connections between participant suffering, meaningfulness of time, and agency over the waiting period and the lived duration of time experience. Our findings reveal that chronological duration is not necessarily the most relevant consideration in determining the quality of waiting experience. Those findings helped us create a conceptual framework for lived wait time. We suggest that clinicians and policy makers consider the complexity of wait time experience to enhance preoperative patient care. © The Author(s) 2014.

Waiting time effect of a GM type orifice pulse tube refrigerator

NASA Astrophysics Data System (ADS)

Zhu, Shaowei; Kakimi, Yasuhiro; Matsubara, Yoichi

In a general GM type orifice pulse tube refrigerator, there are two short periods during which both the high pressure valve and the low pressure valve are closed in one cycle. We call the short period `waiting time'. The pressure differences across the high pressure valve and the low pressure valve are decreased by using long waiting time. The pressure difference loss is decreased. Thus, the cooling capacity and the efficiency are increased, and the no-load temperature is decreased. The mechanism of the waiting time is discussed with numerical analysis and verified by experiments. Experiments show that there is an optimum waiting time for the no-load temperature, the cooling capacity and the efficiency, respectively. The no-load temperature of 40.3 K was achieved with a 90° waiting time. The cooling capacity of 58 W at 80 K was achieved with a 60° waiting time. The no-load temperature of 45.1 K and the cooling capacity of 45 W at 80 K were achieved with a 1° waiting time.

Valuation of Transactive Systems

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

Hammerstrom, Donald J.; Corbin, Charles D.; Fernandez, Nicholas

2016-05-12

characteristics of the transactive system mechanisms, which should be conveyed along with other valuation results. A valuation methodology is proposed. Some abstraction is necessarily retained so that the methodology may be applied for the many purposes of today’s valuations and across grid, building, societal, and other domains. The report’s methodology advocates separation of operational timescales from long-term growth timescales. Operational models are defined as the models that inform impacts within the relatively short, often yearlong, operational time periods. Growth models define how the scenarios evolve from one operational period to the next (e.g., from year to year). We believe the recommended methodology is a critical step toward collaborative community platforms, where analysts and decision makers alike could contribute and borrow content within their expertise. The report then asks, what is unique about valuations when systems become coordinated by transactive systems? In answer, accurate valuations of transactive systems require careful adherence to the dynamic interaction between a system’s responsive elements and the system’s operational objectives. In every transactive system mechanism, elements respond to incentives that become revealed to them, and certain operational objectives become explicitly incentivized by the transactive system mechanism. The transactive system mechanisms define the important coupling between the responsive elements and the system’s objectives.« less

Experiences of counselling in the emergency department during the waiting period: importance of family participation.

PubMed

Paavilainen, Eija; Salminen-Tuomaala, Mari; Kurikka, Sirpa; Paussu, Paula

2009-08-01

To describe patients' experiences of counselling, defined as information giving and advice by nursing staff, in the emergency department. A particular focus was on the waiting period and on the importance of family participation in counselling. Counselling is a widely studied topic in nursing. Too little is known about counselling in emergency departments and especially about participation of family members and suitability of counselling for the patient's life situation. Descriptive quantitative study. Data were collected by questionnaires from patients (n = 107) visiting a hospital emergency department. The data were subjected to statistical analysis. Forty-two per cent of patients arrived at the emergency department with a family member: spouse or cohabiting partner, mother, father or daughter. Patients were fairly satisfied with the counselling. The presence of a family member was important to the majority of patients (75%). About half of the patients wanted information concerning their illness, condition and treatment to be given to their family members. Those visiting the department with a family member were more satisfied with counselling and felt that it promoted their participation in care. It is to encourage patients' family members to participate in counselling situations in emergency departments. However, the type of information passed on to family members should be carefully discussed and prepared. Patients' family members seem to be important partners in counselling situations. The presence of family members supports patients in the emergency department during the waiting period and helps them orientate in their situation. When family members are present, issues which patients wish to discuss should be carefully planned. Family presence should be encouraged in emergency departments.

12 CFR 229.40 - Effect of merger transaction.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Effect of merger transaction. 229.40 Section... Effect of merger transaction. (a) In general. For purposes of this subpart, two or more banks that have engaged in a merger transaction may be considered to be separate banks for a period of one year following...

The effect of early education on patient anxiety while waiting for elective cardiac catheterization.

PubMed

Harkness, Karen; Morrow, Lydia; Smith, Kelly; Kiczula, Michele; Arthur, Heather M

2003-07-01

A supply-demand mismatch with respect to cardiac catheterization (CATH) often results in patients experiencing waiting times that vary from a few weeks to several months. Long delays can impose both physical and psychological distress for patients. The purpose of this study was to examine the effect of a psychoeducational nursing intervention at the beginning of the waiting period on patient anxiety during the waiting time for elective CATH. This was a 2-group randomized controlled trial. Intervention patients received a nurse-delivered, detailed information/education session within 2 weeks of being placed on the waiting list for elective CATH. Control group patients received usual care. The mean waiting time for CATH was 13.4+/-7.2 weeks, which did not differ between groups (P=0.509). Anxiety increased in both groups over the waiting time (P=0.028). Health-related quality of life deteriorated over the waiting time in both groups (P<0.05). On a visual analogue scale, there was a significant difference (P=0.002) between the intervention (4.0+/-2.7) and control (5.2+/-3.0) groups in self-reported anxiety 2 weeks prior to CATH. The waiting period prior to elective CATH has a negative impact on patients' perceived anxiety and quality of life and a simple intervention, provided at the beginning of the waiting period, may positively affect the experience of waiting.

Health care justice and its implications for current policy of a mandatory waiting period for elective tubal sterilization.

PubMed

Moaddab, Amirhossein; McCullough, Laurence B; Chervenak, Frank A; Fox, Karin A; Aagaard, Kjersti Marie; Salmanian, Bahram; Raine, Susan P; Shamshirsaz, Alireza A

2015-06-01

Tubal sterilization during the immediate postpartum period is 1 of the most common forms of contraception in the United States. This time of the procedure has the advantage of 1-time hospitalization, which results in ease and convenience for the woman. The US Collaborative Review of Sterilization Study indicates the high efficacy and effectiveness of postpartum tubal sterilization. Oral and written informed consent is the ethical and legal standard for the performance of elective tubal sterilization for permanent contraception for all patients, regardless of source of payment. Current health care policy and practice regarding elective tubal sterilization for Medicaid beneficiaries places a unique requirement on these patients and their obstetricians: a mandatory waiting period. This requirement originates in decades-old legislation, which we briefly describe. We then introduce the concept of health care justice in professional obstetric ethics and explain how it originates in the ethical concepts of medicine as a profession and of being a patient and its deontologic and consequentialist dimensions. We next identify the implications of health care justice for the current policy of a mandatory 30-day waiting period. We conclude that Medicaid policy allocates access to elective tubal sterilization differently, based on source of payment and gender, which violates health care justice in both its deontologic and consequentialist dimensions. Obstetricians should invoke health care justice in women's health care as the basis for advocacy for needed change in law and health policy, to eliminate health care injustice in women's access to elective tubal sterilization. Copyright © 2015 Elsevier Inc. All rights reserved.

Waiting for thyroid surgery: a study of psychological morbidity and determinants of health associated with long wait times for thyroid surgery.

PubMed

Eskander, Antoine; Devins, Gerald M; Freeman, Jeremy; Wei, Alice C; Rotstein, Lorne; Chauhan, Nitin; Sawka, Anna M; Brown, Dale; Irish, Jonathan; Gilbert, Ralph; Gullane, Patrick; Higgins, Kevin; Enepekides, Danny; Goldstein, David

2013-02-01

Patients with thyroid pathology tend have longer surgical wait times. Uncertainty during this wait can have negative psychologically impact. This study aims to determine the degree of psychological morbidity in patients waiting for thyroid surgery. Prospectively assessing patients pre- and postoperative psychological morbidity (level 2c). Patients waiting for thyroidectomy were mailed a sociodemographic and four psychological morbidity questionnaires: Impact of Events Scale-Revised (IES-R), Illness Intrusiveness Ratings Scale (IIRS), Perceived Stress Scale (PSS) and Hospital Anxiety and Depression Scale (HADS). We assessed whether anxiety was related to length of wait and a number of clinical/sociodemographic factors. We achieved a 53% response rate over a 3-year period, with 176 patients providing complete preoperative data; and 74 (42%) completed postoperative data. The average age was 53 (± 12) years; 82% were female. Respondents with a suspicious or known malignancy waited an average of 107 days while those with benign neoplastic biopsies waited an average of 218 days for thyroidectomy. Respondents reported substantial psychological morbidity with high IES-R, IIRS, PSS, and HADS scores. There was no significant association between psychological morbidity and wait times, clinical or sociodemographic factors. Postoperative anxiety decreased significantly in all psychological morbidity measures except for the IIRS. Patients waiting for thyroid surgery have mild to moderate psychological morbidity and long wait times for surgery. These appear not to be related. Psychological morbidity decreases after surgery. Reducing wait time can potentially reduce the time that patients have to live with unnecessary stress and anxiety. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

Act-and-wait time-delayed feedback control of autonomous systems

NASA Astrophysics Data System (ADS)

Pyragas, Viktoras; Pyragas, Kestutis

2018-02-01

Recently an act-and-wait modification of time-delayed feedback control has been proposed for the stabilization of unstable periodic orbits in nonautonomous dynamical systems (Pyragas and Pyragas, 2016 [30]). The modification implies a periodic switching of the feedback gain and makes the closed-loop system finite-dimensional. Here we extend this modification to autonomous systems. In order to keep constant the phase difference between the controlled orbit and the act-and-wait switching function an additional small-amplitude periodic perturbation is introduced. The algorithm can stabilize periodic orbits with an odd number of real unstable Floquet exponents using a simple single-input single-output constraint control.

Waiting for transplant: physical, psychosocial, and nutritional status considerations for pediatric candidates and implications for care.

PubMed

Anthony, Samantha J; Annunziato, Rachel A; Fairey, Elise; Kelly, Vicky L; So, Stephanie; Wray, Jo

2014-08-01

The waiting period for an organ transplant has been described as a time of tremendous uncertainty and vulnerability, posing unique challenges and stressors for pediatric transplant candidates and their families. It has been identified as the most stressful stage of the transplant journey, yet little attention has been given to the physical, psychological, or social impact of the waiting period in the literature. In this review, we discuss the physical, nutritional, and psychosocial implications of the waiting period for child and adolescent transplant candidates and the impact on their parents and siblings. We identify areas for future research and provide recommendations for clinical practice to support children, adolescents, and families during the waiting period. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Two Effective Ways to Implement Wait Time. A Symposium on Wait Time.

ERIC Educational Resources Information Center

Swift, J. Nathan; And Others

The effects of instructional guides and a wait time feedback device (called a "Wait Timer") on the classroom interaction of middle school science teachers are examined. The Wait Timer, an unobtrusive indicator of wait time, is an automatic device that activates a light when a person speaks. The duration of the light at the end of a…

31 CFR 598.405 - Transactions incidental to a licensed transaction.

Code of Federal Regulations, 2013 CFR

2013-07-01

... transaction. 598.405 Section 598.405 Money and Finance: Treasury Regulations Relating to Money and Finance... REGULATIONS Interpretations § 598.405 Transactions incidental to a licensed transaction. Any transaction... transactions by specially designated narcotics traffickers and debits to accounts blocked pursuant to § 598.202...

31 CFR 598.405 - Transactions incidental to a licensed transaction.

Code of Federal Regulations, 2014 CFR

2014-07-01

... transaction. 598.405 Section 598.405 Money and Finance: Treasury Regulations Relating to Money and Finance... REGULATIONS Interpretations § 598.405 Transactions incidental to a licensed transaction. Any transaction... transactions by specially designated narcotics traffickers and debits to accounts blocked pursuant to § 598.202...

31 CFR 598.405 - Transactions incidental to a licensed transaction.

Code of Federal Regulations, 2012 CFR

2012-07-01

... transaction. 598.405 Section 598.405 Money and Finance: Treasury Regulations Relating to Money and Finance... REGULATIONS Interpretations § 598.405 Transactions incidental to a licensed transaction. Any transaction... transactions by specially designated narcotics traffickers and debits to accounts blocked pursuant to § 598.202...

31 CFR 598.405 - Transactions incidental to a licensed transaction.

Code of Federal Regulations, 2010 CFR

2010-07-01

... transaction. 598.405 Section 598.405 Money and Finance: Treasury Regulations Relating to Money and Finance... REGULATIONS Interpretations § 598.405 Transactions incidental to a licensed transaction. Any transaction... transactions by specially designated narcotics traffickers and debits to accounts blocked pursuant to § 598.202...

31 CFR 598.405 - Transactions incidental to a licensed transaction.

Code of Federal Regulations, 2011 CFR

2011-07-01

... transaction. 598.405 Section 598.405 Money and Finance: Treasury Regulations Relating to Money and Finance... REGULATIONS Interpretations § 598.405 Transactions incidental to a licensed transaction. Any transaction... transactions by specially designated narcotics traffickers and debits to accounts blocked pursuant to § 598.202...

The Function of Repetition in the Sales Transaction.

ERIC Educational Resources Information Center

von Raffler-Engel, Walburga; Weisberg, Michael

Research was conducted to study the speech in a sales transaction in a retail store under natural conditions. Fourteen sales transactions in a lighting fixture store were tape recorded, with the customer's knowledge, over a period of four days. Each talk was divided into three segments--speech preparatory, speech central, and speech final--and…

[Improving the CMP appointment waiting time for children and adolescents].

PubMed

Cani, Pascale

2014-01-01

The increasing activity of mental health centres for children and adolescents and longer waiting times in obtaining a first appointment have led an area of child psychiatry to question the organisation of new consultation applications. Two CMP in the sector had a waiting period of over 40 days for half of the patients. Two improvement actions were implemented:the implementation of organisation and reception nurses and the development of a new applications management process. The evaluation after one year showed a decrease of half of the appointment waiting time without changing the non showed up rate.

[Gender and age differences in waiting time on hospital waiting list.].

PubMed

Thornórðardóttir, Steinunn; Halldórsson, Matthías; Guðmundsson, Sigurður

2002-09-01

The size of waiting lists has traditionally been viewed as a fairly good measure of the quality of health care services. No statistical analysis exists in Iceland of the length of waiting times and the potential variation between groups of patients. This study was conducted within the office of the Directorate of Health in Iceland. This location was convenient since standardized information on waiting lists is collected by the office three times a year. Variations in waiting times were studied based on gender on the one hand and on age on the other. Data from the largest waiting lists, those amounting to 400 or more patients, were included in the study. The most frequently awaited operations were identified and the groups of people waiting for them analyzed. The departments and prospective operations included in the study were: Dept. of General Surgery at the University Hospital (UH) (laparoscopic gastro-oesophageal antireflux operation), Opthalmology at UH (phakoemulsification with implantation of artificial lens in posterior chamber), Orthopedic Surgery at UH (primary total prosthetic replacement of hip joint using sement), The Rehabilitation Center at Reykjalundur (rehabilitation, not specified), Ear, Nose and Throat (ENT) at UH (tonsillectomy), and Reconstructive Surgery at UH (reduction mammoplasty with transposition of areola). The lists were sorted by gender and age, with the latter consisting of two categories, older and younger patients. Every attempt was made as to ensure similar sample sizes for both age groups within each department. Finally, the median waiting time was determined and a Mann-Whitney test conducted in order to test for significance. The median waiting time for males at the General Surgery Dept. was 73 weeks as compared to 60 weeks for females. This was the only department where the median waiting time was significantly longer for males than for females (p<0.05). At three of the departments the older group had a longer median waiting time

[Women's satisfaction with waiting times for further investigation in breast cancer screening].

PubMed

Molina-Barceló, Ana; Salas Trejo, Dolores; Miranda García, Josefa

2011-01-01

To determine the factors associated with satisfaction with waiting times for further investigation in breast cancer screening. We carried out a cross-sectional study by telephone survey of a representative sample of women (N=316) participating in the breast cancer screening program of the autonomous region of Valencia (Spain) who required additional tests to confirm the diagnosis. Descriptive analysis was performed by contingency tables (p<0.05) and multivariate association by odds ratios (OR) of logistic regression models (95%CI). Satisfaction with the waiting time was 78.6%. A higher risk of dissatisfaction was found in women from a "high" social class (OR=3.17; 95% CI: 1.10-9.14), those who perceived that the waiting time was "more than 2 weeks", both "since the notification of the need for further investigation until completion of the first test" (OR=15,54; 95%CI: 5,87-41,12) and "since the completion of the last test until notification of the final result" (OR=11.57; 95% CI: 2.96-45.19), and in women who experienced the attention as "worse than expected" (OR=15.40; 95% CI: 1.41-168.64). The maximum waiting time acceptable to the highest percentage of women was "up to 1 week" for each waiting period (n=47, 73.5%; n=14, 45.2%). Waiting times of no more than 1 week and never more than 2 weeks for each waiting period are recommended. Women should be given an approximate waiting time, paying special attention to women aged 45 to 54 years attending their initial screening. 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

Should I stay or should I go? Hospital emergency department waiting times and demand.

PubMed

Sivey, Peter

2018-03-01

In the absence of the price mechanism, hospital emergency departments rely on waiting times, alongside prioritisation mechanisms, to restrain demand and clear the market. This paper estimates by how much the number of treatments demanded is reduced by a higher waiting time. I use variation in waiting times for low-urgency patients caused by rare and resource-intensive high-urgency patients to estimate the relationship. I find that when waiting times are higher, more low-urgency patients are deterred from treatment and leave the hospital during the waiting period without being treated. The waiting time elasticity of demand for low-urgency patients is approximately -0.25 and is highest for the lowest-urgency patients. Copyright © 2017 John Wiley & Sons, Ltd.

Information transfer during the timber transaction period in West Virginia. USA

Treesearch

David W. McGill; Daniel J. Magill; James Kochenderfer; W. Mark Ford; Tom Schuler

2006-01-01

Timber harvesting has long-lasting impacts on the productivity and aesthetics of private forests. In many instances, landowners who possess high quality timber are at a competitive disadvantage during timber transactions--the time between a decision by the landowner to sell timber and the completion of the timber harvesting operation--as they may lack understanding of...

International comparisons of waiting times in health care--limitations and prospects.

PubMed

Viberg, Nina; Forsberg, Birger C; Borowitz, Michael; Molin, Roger

2013-09-01

Long waiting times for health care is an important health policy issue in many countries, and many have introduced some form of national waiting time guarantees. International comparison of waiting times are critical for countries to improve policy and for patients to be able to make informed choices, especially in Europe, where patients have the right to seek care in other countries if there is undue delay. The objective of this study was to describe how countries measure waiting times and to assess whether waiting times can be compared internationally. Twenty-three OECD countries were included. Information was collected through scientific articles, official and unofficial documents and web pages. Fifteen of the 23 countries monitor and publish national waiting time statistics and have some form of waiting time guarantees. There are significant differences in how waiting times are measured: whether they measure the "ongoing" or "completed" waiting period what kind of care the patient is waiting for; the parameters used; and where in the patient journey the measurement begins. Current national waiting time statistics are of limited use for comparing health care availability among the various countries due to the differences in measurements and data collection. Different methodological issues must be taken into account when making such cross-country comparisons. Within the given context of national sovereignty of health systems it would be desirable if countries could collaborate in order to facilitate international comparisons. Such comparisons would be of benefit to all involved in the process of continuous improvement of health services. They would also benefit patients who seek cross-border alternatives for their care. Copyright © 2013 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Effect of emergency physician burnout on patient waiting times.

PubMed

De Stefano, Carla; Philippon, Anne-Laure; Krastinova, Evguenia; Hausfater, Pierre; Riou, Bruno; Adnet, Frederic; Freund, Yonathan

2018-04-01

Burnout is common in emergency physicians. This syndrome may negatively affect patient care and alter work productivity. We seek to assess whether burnout of emergency physicians impacts waiting times in the emergency department. Prospective study in an academic ED. All patients who visited the main ED for a 4-month period in 2016 were included. Target waiting times are assigned by triage nurse to patients on arrival depending on their severity. The primary endpoint was an exceeded target waiting time for ED patients. All emergency physicians were surveyed by a psychologist to assess their level of burnout using the Maslach Burnout Inventory. We defined the level of burnout of the day in the ED as the mean burnout level of the physicians working that day (8:30 to the 8:30 the next day). A logistic regression model was performed to assess whether burnout level of the day was independently associated with prolonged waiting times, along with previously reported predictors. Target waiting time was exceeded in 7524 patients (59%). Twenty-six emergency physicians were surveyed. Median burnout score was 35 [Interquartile (24-49)]. A burnout level of the day higher than 35 was independently associated with an exceeded target waiting time (adjusted odds ratio 1.54, 95% confidence interval 1.39-1.70), together with previously reported predictors (i.e., day of the week, time of the day, trauma, age and daily census). Burnout of emergency physicians was independently associated with a prolonged waiting time for patients visiting the ED.

Wait times in the emergency department for patients with mental illness

PubMed Central

Atzema, Clare L.; Schull, Michael J.; Kurdyak, Paul; Menezes, Natasja M.; Wilton, Andrew S.; Vermuelen, Marian J.; Austin, Peter C.

2012-01-01

Background: It has been suggested that patients with mental illness wait longer for care than other patients in the emergency department. We determined wait times for patients with and without mental health diagnoses during crowded and noncrowded periods in the emergency department. Methods: We conducted a population-based retrospective cohort analysis of adults seen in 155 emergency departments in Ontario between April 2007 and March 2009. We compared wait times and triage scores for patients with mental illness to those for all other patients who presented to the emergency department during the study period. Results: The patients with mental illness (n = 51 381) received higher priority triage scores than other patients, regardless of crowding. The time to assessment by a physician was longer overall for patients with mental illness than for other patients (median 82, interquartile range [IQR] 41–147 min v. median 75 [IQR 36–140] min; p < 0.001). The median time from the decision to admit the patient to hospital to ward transfer was markedly shorter for patients with mental illness than for other patients (median 74 [IQR 15–215] min v. median 152 [IQR 45–605] min; p < 0.001). After adjustment for other variables, patients with mental illness waited 10 minutes longer to see a physician compared with other patients during noncrowded periods (95% confidence interval [CI] 8 to 11), but they waited significantly less time than other patients as crowding increased (mild crowding: −14 [95% CI −12 to −15] min; moderate crowding: −38 [95% CI −35 to −42] min; severe crowding: −48 [95% CI −39 to −56] min; p < 0.001). Interpretation: Patients with mental illness were triaged appropriately in Ontario’s emergency departments. These patients waited less time than other patients to see a physician under crowded conditions and only slightly longer under noncrowded conditions. PMID:23148052

Third degree waiting time discrimination: optimal allocation of a public sector healthcare treatment under rationing by waiting.

PubMed

Gravelle, Hugh; Siciliani, Luigi

2009-08-01

In many public healthcare systems treatments are rationed by waiting time. We examine the optimal allocation of a fixed supply of a given treatment between different groups of patients. Even in the absence of any distributional aims, welfare is increased by third degree waiting time discrimination: setting different waiting times for different groups waiting for the same treatment. Because waiting time imposes dead weight losses on patients, lower waiting times should be offered to groups with higher marginal waiting time costs and with less elastic demand for the treatment.

17 CFR 37.8 - Information relating to transactions on derivatives transaction execution facilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... transactions on derivatives transaction execution facilities. 37.8 Section 37.8 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION DERIVATIVES TRANSACTION EXECUTION FACILITIES § 37.8 Information relating to transactions on derivatives transaction execution facilities. (a) Special calls for...

12 CFR 370.7 - Assessment for the Transaction Account Guarantee Program.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 4 2011-01-01 2011-01-01 false Assessment for the Transaction Account... AND STATEMENTS OF GENERAL POLICY TEMPORARY LIQUIDITY GUARANTEE PROGRAM § 370.7 Assessment for the Transaction Account Guarantee Program. (a) Waiver of assessment for certain initial periods. No eligible...

12 CFR 370.7 - Assessment for the Transaction Account Guarantee Program.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 12 Banks and Banking 5 2012-01-01 2012-01-01 false Assessment for the Transaction Account... AND STATEMENTS OF GENERAL POLICY TEMPORARY LIQUIDITY GUARANTEE PROGRAM § 370.7 Assessment for the Transaction Account Guarantee Program. (a) Waiver of assessment for certain initial periods. No eligible...

12 CFR 370.7 - Assessment for the Transaction Account Guarantee Program.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 12 Banks and Banking 5 2013-01-01 2013-01-01 false Assessment for the Transaction Account... AND STATEMENTS OF GENERAL POLICY TEMPORARY LIQUIDITY GUARANTEE PROGRAM § 370.7 Assessment for the Transaction Account Guarantee Program. (a) Waiver of assessment for certain initial periods. No eligible...

12 CFR 370.7 - Assessment for the Transaction Account Guarantee Program.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 12 Banks and Banking 5 2014-01-01 2014-01-01 false Assessment for the Transaction Account... AND STATEMENTS OF GENERAL POLICY TEMPORARY LIQUIDITY GUARANTEE PROGRAM § 370.7 Assessment for the Transaction Account Guarantee Program. (a) Waiver of assessment for certain initial periods. No eligible...

Indication criteria for cataract extraction and gender differences in waiting time.

PubMed

Smirthwaite, Goldina; Lundström, Mats; Albrecht, Susanne; Swahnberg, Katarina

2014-08-01

The purpose of this study was to investigate national indication criteria tool for cataract extraction (NIKE), a clinical tool for establishing levels of indications for cataract surgery, in relation to gender differences in waiting times for cataract extraction (CE). Data were collected by The Swedish National Cataract Register (NCR). Eye clinics report to NCR voluntarily and on regular basis (98% coverage). Comparisons regarding gender difference in waiting times were performed between NIKE-categorized and non-NIKE-categorized patients, as well as between different indication groups within the NIKE-system. All calculations were performed in spss version 20. Multivariate analyses were carried out using logistic regression, and single variable analyses were carried out by Student's t-test or chi square as appropriate. Gender, age, visual acuity and NIKE-categorization were associated with waiting time. Female patients had a longer waiting time to CE than male, both within and outside the NIKE-system. Gender difference in waiting time was somewhat larger among patients who had not been categorized by NIKE. In the non-NIKE-categorized group, women waited 0.20 months longer than men. In the group which was NIKE-categorized, women waited 0.18 months longer than men. It is reasonable to assume that prioritizing patients by means of NIKE helps to reduce the gender differences in waiting time. Gender differences in waiting time have decreased as NIKE was introduced and there may be a variety of explanations for this. However, with the chosen study design, we could not distinguish between effects related to NIKE and those due to other factors which occurred during the study period. © 2013 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Waiting time for cataract surgery and its influence on patient attitudes.

PubMed

Chan, Frank Wan-kin; Fan, Alex Hoi; Wong, Fiona Yan-yan; Lam, Philip Tsze-ho; Yeoh, Eng-kiong; Yam, Carrie Ho-kwan; Griffiths, Sian; Lam, Dennis Shun-chiu; Congdon, Nathan

2009-08-01

To characterize willingness to pay for private operations and preferred waiting time among patients awaiting cataract surgery in Hong Kong. This was a cross-sectional survey. Subjects randomly selected from cataract surgical waiting lists in Hong Kong (n = 467) underwent a telephone interview based on a structured, validated questionnaire. Data were collected on private insurance coverage, preferred waiting time, amount willing to pay for surgery, and self-reported visual function and health status. Among 300 subjects completing the interview, 144 (48.2%) were 76 years of age or older, 177 (59%) were women, and mean time waiting for surgery was 17 +/- 15 months. Among 220 subjects (73.3%) willing to pay anything for surgery, the mean amount was US$552 +/- 443. With adjustment for age, education, and monthly household income, subjects willing to pay anything were less willing to wait 12 months for surgery (OR = 4.34; P = 0.002), more likely to know someone having had cataract surgery (OR = 2.20; P = 0.03), and more likely to use their own savings to pay for the surgery (OR = 2.21; P = 0.04). Subjects considering private cataract surgery, knowing people who have had cataract surgery, using nongovernment sources to pay for surgery, and having lower visual function were willing to pay more. Many patients wait significant periods for cataract surgery in Hong Kong, and are willing to pay substantial amounts for private operations. These results may have implications for other countries with cataract waiting lists.

46 CFR 9.10 - Waiting time.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

46 CFR 9.10 - Waiting time.

Code of Federal Regulations, 2012 CFR

2012-10-01

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

46 CFR 9.10 - Waiting time.

Code of Federal Regulations, 2011 CFR

2011-10-01

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

Consumer behaviour in the waiting area.

PubMed

Mobach, Mark P

2007-02-01

To determine consumer behaviour in the pharmacy waiting area. The applied methods for data-collection were direct observations. Three Dutch community pharmacies were selected for the study. The topics in the observation list were based on available services at each waiting area (brochures, books, illuminated new trailer, children's play area, etc.). Per patient each activity was registered, and at each pharmacy the behaviour was studied for 2 weeks. Most patients only waited during the waiting time at the studied pharmacies. Few consumers obtained written information during their wait. The waiting area may have latent possibilities to expand the information function of the pharmacy and combine this with other activities that distract the consumer from the wait. Transdisciplinary research, combining knowledge from pharmacy practice research with consumer research, has been a useful approach to add information on queueing behaviour of consumers.

Can We Predict Patient Wait Time?

PubMed

Pianykh, Oleg S; Rosenthal, Daniel I

2015-10-01

The importance of patient wait-time management and predictability can hardly be overestimated: For most hospitals, it is the patient queues that drive and define every bit of clinical workflow. The objective of this work was to study the predictability of patient wait time and identify its most influential predictors. To solve this problem, we developed a comprehensive list of 25 wait-related parameters, suggested in earlier work and observed in our own experiments. All parameters were chosen as derivable from a typical Hospital Information System dataset. The parameters were fed into several time-predicting models, and the best parameter subsets, discovered through exhaustive model search, were applied to a large sample of actual patient wait data. We were able to discover the most efficient wait-time prediction factors and models, such as the line-size models introduced in this work. Moreover, these models proved to be equally accurate and computationally efficient. Finally, the selected models were implemented in our patient waiting areas, displaying predicted wait times on the monitors located at the front desks. The limitations of these models are also discussed. Optimal regression models based on wait-line sizes can provide accurate and efficient predictions for patient wait time. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Reading and Television Viewing Habits of American Adults during Time Spent in Waiting Rooms.

ERIC Educational Resources Information Center

Spirn, Sharon L.

In order to determine the reading and television viewing habits of American adults during time spent in waiting rooms, a study observed 100 adults waiting outside the Emergency Treatment Room of John F. Kennedy Hospital in Edison, New Jersey, over a four-week period. Results revealed that more of these adults chose to watch television as an…

'Waiting for' and 'waiting in' public and private hospitals: a qualitative study of patient trust in South Australia.

PubMed

Ward, Paul R; Rokkas, Philippa; Cenko, Clinton; Pulvirenti, Mariastella; Dean, Nicola; Carney, A Simon; Meyer, Samantha

2017-05-05

Waiting times for hospital appointments, treatment and/or surgery have become a major political and health service problem, leading to national maximum waiting times and policies to reduce waiting times. Quantitative studies have documented waiting times for various types of surgery and longer waiting times in public vs private hospitals. However, very little qualitative research has explored patient experiences of waiting, how this compares between public and private hospitals, and the implications for trust in hospitals and healthcare professionals. The aim of this paper is to provide a deep understanding of the impact of waiting times on patient trust in public and private hospitals. A qualitative study in South Australia, including 36 in-depth interviews (18 from public and 18 from private hospitals). Data collection occurred in 2012-13, and data were analysed using pre-coding, followed by conceptual and theoretical categorisation. Participants differentiated between experiences of 'waiting for' (e.g. for specialist appointments and surgery) and 'waiting in' (e.g. in emergency departments and outpatient clinics) public and private hospitals. Whilst 'waiting for' public hospitals was longer than private hospitals, this was often justified and accepted by public patients (e.g. due to reduced government funding), therefore it did not lead to distrust of public hospitals. Private patients had shorter 'waiting for' hospital services, increasing their trust in private hospitals and distrust of public hospitals. Public patients also recounted many experiences of longer 'waiting in' public hospitals, leading to frustration and anxiety, although they rarely blamed or distrusted the doctors or nurses, instead blaming an underfunded system and over-worked staff. Doctors and nurses were seen to be doing their best, and therefore trustworthy. Although public patients experienced longer 'waiting for' and 'waiting in' public hospitals, it did not lead to widespread distrust

Ramsey waits: allocating public health service resources when there is rationing by waiting.

PubMed

Gravelle, Hugh; Siciliani, Luigi

2008-09-01

The optimal allocation of a public health care budget across treatments must take account of the way in which care is rationed within treatments since this will affect their marginal value. We investigate the optimal allocation rules for public health care systems where user charges are fixed and care is rationed by waiting. The optimal waiting time is higher for treatments with demands more elastic to waiting time, higher costs, lower charges, smaller marginal welfare loss from waiting by treated patients, and smaller marginal welfare losses from under-consumption of care. The results hold for a wide range of welfarist and non-welfarist objective functions and for systems in which there is also a private health care sector. They imply that allocation rules based purely on cost effectiveness ratios are suboptimal because they assume that there is no rationing within treatments.

Adaptive salinity management in the Murray-Darling Basin: a transaction cost study

NASA Astrophysics Data System (ADS)

Loch, A. J.

2017-12-01

Transaction costs hinder or promote effective management of common good resource intertemporal externalities. Appropriate policy choices may reduce externalities and improve social welfare, and transaction cost analysis can help to evaluate policy choices. However, without measurement of relevant transaction costs such policy evaluation remains challenging. This article uses a time series dataset of salinity management program to test theory aimed at transaction cost-based policy evaluation and adaptive resource management over a period of 30 years worth of data. We identify peaks and troughs in transaction costs over time, lag-effects in program expenditure, and calculate the decay in transaction cost impacts. We conclude that Australian salinity management programs are achieving flexible institutional outcomes and effective policy arrangements with long-term benefits. Proposed changes to the program moving forward add weight to our assertions of adaptive strategies, and illustrate the value of the novel data-driven tracnsaction cost analysis approach for other jurisdictions.

31 CFR 510.404 - Transactions ordinarily incident to a licensed transaction authorized.

Code of Federal Regulations, 2013 CFR

2013-07-01

... licensed transaction authorized. 510.404 Section 510.404 Money and Finance: Treasury Regulations Relating... KOREA SANCTIONS REGULATIONS Interpretations § 510.404 Transactions ordinarily incident to a licensed... blocked pursuant to § 510.201(b); or (b) An ordinarily incident transaction, not explicitly authorized...

31 CFR 510.404 - Transactions ordinarily incident to a licensed transaction authorized.

Code of Federal Regulations, 2011 CFR

2011-07-01

... licensed transaction authorized. 510.404 Section 510.404 Money and Finance: Treasury Regulations Relating... KOREA SANCTIONS REGULATIONS Interpretations § 510.404 Transactions ordinarily incident to a licensed... blocked pursuant to § 510.201(b); or (b) An ordinarily incident transaction, not explicitly authorized...

31 CFR 510.404 - Transactions ordinarily incident to a licensed transaction authorized.

Code of Federal Regulations, 2014 CFR

2014-07-01

... licensed transaction authorized. 510.404 Section 510.404 Money and Finance: Treasury Regulations Relating... KOREA SANCTIONS REGULATIONS Interpretations § 510.404 Transactions ordinarily incident to a licensed... blocked pursuant to § 510.201(b); or (b) An ordinarily incident transaction, not explicitly authorized...

SU-F-P-20: Predicting Waiting Times in Radiation Oncology Using Machine Learning

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

Joseph, A; Herrera, D; Hijal, T

Purpose: Waiting times remain one of the most vexing patient satisfaction challenges facing healthcare. Waiting time uncertainty can cause patients, who are already sick or in pain, to worry about when they will receive the care they need. These waiting periods are often difficult for staff to predict and only rough estimates are typically provided based on personal experience. This level of uncertainty leaves most patients unable to plan their calendar, making the waiting experience uncomfortable, even painful. In the present era of electronic health records (EHRs), waiting times need not be so uncertain. Extensive EHRs provide unprecedented amounts ofmore » data that can statistically cluster towards representative values when appropriate patient cohorts are selected. Predictive modelling, such as machine learning, is a powerful approach that benefits from large, potentially complex, datasets. The essence of machine learning is to predict future outcomes by learning from previous experience. The application of a machine learning algorithm to waiting time data has the potential to produce personalized waiting time predictions such that the uncertainty may be removed from the patient’s waiting experience. Methods: In radiation oncology, patients typically experience several types of waiting (eg waiting at home for treatment planning, waiting in the waiting room for oncologist appointments and daily waiting in the waiting room for radiotherapy treatments). A daily treatment wait time model is discussed in this report. To develop a prediction model using our large dataset (with more than 100k sample points) a variety of machine learning algorithms from the Python package sklearn were tested. Results: We found that the Random Forest Regressor model provides the best predictions for daily radiotherapy treatment waiting times. Using this model, we achieved a median residual (actual value minus predicted value) of 0.25 minutes and a standard deviation residual of 6

Impact of visual art on patient behavior in the emergency department waiting room.

PubMed

Nanda, Upali; Chanaud, Cheryl; Nelson, Michael; Zhu, Xi; Bajema, Robyn; Jansen, Ben H

2012-07-01

Wait times have been reported to be one of the most important concerns for people visiting emergency departments (EDs). Affective states significantly impact perception of wait time. There is substantial evidence that art depicting nature reduces stress levels and anxiety, thus potentially impacting the waiting experience. To analyze the effect of visual art depicting nature (still and video) on patients' and visitors' behavior in the ED. A pre-post research design was implemented using systematic behavioral observation of patients and visitors in the ED waiting rooms of two hospitals over a period of 4 months. Thirty hours of data were collected before and after new still and video art was installed at each site. Significant reduction in restlessness, noise level, and people staring at other people in the room was found at both sites. A significant decrease in the number of queries made at the front desk and a significant increase in social interaction were found at one of the sites. Visual art has positive effects on the ED waiting experience. Copyright © 2012 Elsevier Inc. All rights reserved.

Personality-Relationship transaction in young adulthood.

PubMed

Neyer, F J; Asendorpf, J B

2001-12-01

Personality and social relationships were assessed twice across a 4-year period in a general population sample of 489 German young adults. Two kinds of personality-relationship transaction were observed. First, mean-level change in personality toward maturity (e.g., increase in Conscientiousness and decrease in Neuroticism) was moderated by the transition to partnership but was independent of other developmental transitions. Second, individual differences in personality traits predicted social relationships much better than vice versa. Specifically, once initial correlations were controlled for, Extraversion, Shyness, Neuroticism, self-esteem, and Agreeableness predicted change in various qualities of relationships (especially with friends and colleagues), whereas only quality of relationships with preschool children predicted later Extraversion and Neuroticism. Consequences for the transactional view of personality in young adulthood are discussed.

An empirical analysis of the impact of choice on waiting times.

PubMed

Siciliani, Luigi; Martin, Steve

2007-08-01

Policy-makers often claim that enhancing patient choice induces more competition among hospitals and may therefore reduce waiting times. This paper tests this claim using 120 English NHS hospitals over the period 1999-2001. Several proxies for the degree of choice (or competition) are constructed including: (a) the number of hospitals within the catchment area of each hospital; (b) the number of hospitals in the catchment area of each hospital standardised by the population of the catchment area; (c) the inverse of the Herfindahl index (or 'the number of effective competitors'). Several control variables are included: the availability of doctors, junior doctors, nurses, and other personnel; the availability of acute beds; the emergency admission rate; the day-case rate; the average length of inpatient stay; an indicator of case-mix; and mortality and re-admission rates. We find that more choice is significantly associated with lower waiting times at the sample mean (five hospitals) although the quantitative effect is modest: an extra hospital in a catchment area will only reduce waiting by at most a few days (or 1-2% reduction in waiting). There is also some evidence that increases in choice can boost waiting times when the degree of choice is very high (i.e. more than 11 hospitals are included in the catchment area). Copyright 2007 John Wiley & Sons, Ltd.

17 CFR 37.8 - Information relating to transactions on derivatives transaction execution facilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Information relating to transactions on derivatives transaction execution facilities. 37.8 Section 37.8 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION DERIVATIVES TRANSACTION EXECUTION FACILITIES § 37.8...

Interest of waiting time for spontaneous early reconnection after cavotricuspid isthmus ablation: A monocentric randomized trial.

PubMed

Marchandise, Sébastien; Scavée, Christophe; Barbraud, Cynthia; de Meester de Ravenstein, Christophe; Balola Bagalwa, Mittérand; Goesaert, Cédric; Reis-Pinheiro, Ivone; le Polain de Waroux, Jean-Benoit

2017-12-01

The aim of this study was to determine the rate of recurrent atrial flutter (AFl) after isolated cavotricuspid isthmus (CTI) ablation and to evaluate the impact of a waiting period with the search for early resumption of the CTI block on the long-term outcome. Three hundred and nineteen consecutive patients referred for typical AFl ablation were randomly assigned to CTI ablation with continuous reevaluation of the CTI block during 30 minutes and early reablation if needed (waiting time [WT] + group, n  =  155) or to CTI ablation with no waiting period after proven bidirectional CTI block (WT - group, n  =  164). All patients were regularly followed-up. In the WT+ group, 10 patients (6%) presented a recovery across the CTI (time to recovery: 17 ± 7') and were reablated at the end of the waiting period. After a median follow-up of 21 months, the rate of recurrent AFl was significantly higher in the WT - group as compared to the WT+ group (11.6% [19/164] vs 2.5% [4/155], respectively; P  =  0.007). However, no significant differences in the subsequent rate of AF were observed between the two groups (29% [WT -] vs 32% [WT+], P  =  0.66). During the follow-up, 28 patients from the WT - group underwent a second ablation procedure (16 AFl redo and 12 AF ablation) versus 10 patients form the WT+ group (three AFl redo and seven AF ablation). Waiting 30 minutes after CTI ablation to check for early resumption and early reablation allows for decreasing significantly the rate of recurrent atrial flutter. © 2017 Wiley Periodicals, Inc.

27 CFR 478.126 - Furnishing transaction information.

Code of Federal Regulations, 2011 CFR

2011-04-01

... issued by the Director of Industry Operations, and until notified to the contrary in writing by such officer, submit on Form 4483, Report of Firearms Transactions, for the periods and at the times specified in the letter issued by the Director of Industry Operations, all record information required by this...

27 CFR 478.126 - Furnishing transaction information.

Code of Federal Regulations, 2010 CFR

2010-04-01

... issued by the Director of Industry Operations, and until notified to the contrary in writing by such officer, submit on Form 4483, Report of Firearms Transactions, for the periods and at the times specified in the letter issued by the Director of Industry Operations, all record information required by this...

16 CFR 801.90 - Transactions or devices for avoidance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... observe the waiting period. 2. Suppose “A” wholly owns and operates a chain of twenty retail hardware... fair market value of the assets of the twenty store corporations is in excess of $50 million (as...

2 CFR 180.210 - Which nonprocurement transactions are covered transactions?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 2 Grants and Agreements 1 2010-01-01 2010-01-01 false Which nonprocurement transactions are covered transactions? 180.210 Section 180.210 Grants and Agreements OFFICE OF MANAGEMENT AND BUDGET GOVERNMENTWIDE GUIDANCE FOR GRANTS AND AGREEMENTS Reserved OMB GUIDELINES TO AGENCIES ON GOVERNMENTWIDE DEBARMENT...

IS WAITING THE HARDEST PART? A CRITICAL STUDY OF THE EXPERIENCE OF WOMEN AWAITING BREAST BIOPSY RESULTS.

PubMed

Hodgkinson, T; Govender, C; Rayne, S

2017-06-01

Most previous research efforts have focused on the psychological effects of receiving a cancer diagnosis rather than the period of waiting for definitive Results. Early detection of cancer is directly linked to successful treatment regimes, yet these procedures evoke significant anxiety in patients. The long wait for medical test Results in state health institutions, with one of the possible outcomes being a cancer diagnosis, means that the days of waiting can induce emotional distress before the diagnosis has even been given. Eight research collaborators were invited to, in their own voice, shed light on their individual experiences while waiting for their biopsy Results to gain an understanding of the experiences of each collaborator by letting her tell her story and to explore the possibility of shared experience between collaborators. Research collaborators at a local, government hospital kept a journal for the two-week waiting period for their biopsy Results. Shortly before receiving their Results, they took part in a short semi-structured interview to inquire about their waiting. The theoretical framework used for data interpretation is critical theory focusing on the structures within society and healthcare systems that impact on the experience of waiting. The undercurrent of critical commentary about the roles of the gender, economic, political and cultural factors that contribute to the screening experience for women in South Africa helps to shed light on the complex forces at play within the procedures. The Results indicate that for some women waiting provokes significant psychological stress which manifests in multiple psychological processes including the psychological bracing phenomenon, denial, suppression and negation of their emotional experience all perpetuated by the structures of power within the health care system. More understanding of the psychological experience of awaiting a cancer diagnosis is required and there is an important place for

Waiting time for radiotherapy in women with cervical cancer

PubMed Central

do Nascimento, Maria Isabel; Azevedo e Silva, Gulnar

2016-01-01

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

31 CFR 594.405 - Transactions incidental to a licensed transaction.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Transactions incidental to a licensed transaction. 594.405 Section 594.405 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY GLOBAL TERRORISM SANCTIONS...

31 CFR 594.405 - Transactions incidental to a licensed transaction.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Transactions incidental to a licensed transaction. 594.405 Section 594.405 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY GLOBAL TERRORISM SANCTIONS...

The 2012 SAGE wait times program: Survey of Access to GastroEnterology in Canada

PubMed Central

Leddin, Desmond; Armstrong, David; Borgaonkar, Mark; Bridges, Ronald J; Fallone, Carlo A; Telford, Jennifer J; Chen, Ying; Colacino, Palma; Sinclair, Paul

2013-01-01

BACKGROUND: Periodically surveying wait times for specialist health services in Canada captures current data and enables comparisons with previous surveys to identify changes over time. METHODS: During one week in April 2012, Canadian gastroenterologists were asked to complete a questionnaire (online or by fax) recording demographics, reason for referral, and dates of referral and specialist visits for at least 10 consecutive new patients (five consultations and five procedures) who had not been seen previously for the same indication. Wait times were determined for 18 indications and compared with those from similar surveys conducted in 2008 and 2005. RESULTS: Data regarding adult patients were provided by 173 gastroenterologists for 1374 consultations, 540 procedures and 293 same-day consultations and procedures. Nationally, the median wait times were 92 days (95% CI 85 days to 100 days) from referral to consultation, 55 days (95% CI 50 days to 61 days) from consultation to procedure and 155 days (95% CI 142 days to 175 days) (total) from referral to procedure. Overall, wait times were longer in 2012 than in 2005 (P<0.05); the wait time to same-day consultation and procedure was shorter in 2012 than in 2008 (78 days versus 101 days; P<0.05), but continued to be longer than in 2005 (P<0.05). The total wait time remained longest for screening colonoscopy, increasing from 201 days in 2008 to 279 days in 2012 (P<0.05). DISCUSSION: Wait times for gastroenterology services continue to exceed recommended targets, remain unchanged since 2008 and exceed wait times reported in 2005. PMID:23472243

31 CFR 539.403 - Transactions incidental to a licensed transaction.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Transactions incidental to a licensed transaction. 539.403 Section 539.403 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY WEAPONS OF MASS DESTRUCTION TRADE...

Fault-tolerant wait-free shared objects

NASA Technical Reports Server (NTRS)

Jayanti, Prasad; Chandra, Tushar D.; Toueg, Sam

1992-01-01

A concurrent system consists of processes communicating via shared objects, such as shared variables, queues, etc. The concept of wait-freedom was introduced to cope with process failures: each process that accesses a wait-free object is guaranteed to get a response even if all the other processes crash. However, if a wait-free object 'crashes,' all the processes that access that object are prevented from making progress. In this paper, we introduce the concept of fault-tolerant wait-free objects, and study the problem of implementing them. We give a universal method to construct fault-tolerant wait-free objects, for all types of 'responsive' failures (including one in which faulty objects may 'lie'). In sharp contrast, we prove that many common and interesting types (such as queues, sets, and test&set) have no fault-tolerant wait-free implementations even under the most benign of the 'non-responsive' types of failure. We also introduce several concepts and techniques that are central to the design of fault-tolerant concurrent systems: the concepts of self-implementation and graceful degradation, and techniques to automatically increase the fault-tolerance of implementations. We prove matching lower bounds on the resource complexity of most of our algorithms.

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

MedlinePlus

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

31 CFR 800.302 - Transactions that are not covered transactions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... transaction is solely for the purpose of passive investment. (See § 800.223.) Example 1. In an open market purchase solely for the purpose of passive investment, Corporation A, a foreign person, acquires seven... purpose of passive investment and is a covered transaction. Example 3. Corporation A, a foreign person...

5 CFR 919.205 - Why is it important if a particular transaction is a covered transaction?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Why is it important if a particular transaction is a covered transaction? 919.205 Section 919.205 Administrative Personnel OFFICE OF PERSONNEL... (NONPROCUREMENT) Covered Transactions § 919.205 Why is it important if a particular transaction is a covered...

17 CFR 229.404 - (Item 404) Transactions with related persons, promoters and certain control persons.

Code of Federal Regulations, 2010 CFR

2010-04-01

... time during the past five fiscal years shall: (i) State the names of the promoter(s), the nature and... beginning of the registrant's last fiscal year, or any currently proposed transaction, in which the... question, which shall include: a. In the case of any lease or other transaction providing for periodic...

Transactions in domain-specific information systems

NASA Astrophysics Data System (ADS)

Zacek, Jaroslav

2017-07-01

Substantial number of the current information system (IS) implementations is based on transaction approach. In addition, most of the implementations are domain-specific (e.g. accounting IS, resource planning IS). Therefore, we have to have a generic transaction model to build and verify domain-specific IS. The paper proposes a new transaction model for domain-specific ontologies. This model is based on value oriented business process modelling technique. The transaction model is formalized by the Petri Net theory. First part of the paper presents common business processes and analyses related to business process modeling. Second part defines the transactional model delimited by REA enterprise ontology paradigm and introduces states of the generic transaction model. The generic model proposal is defined and visualized by the Petri Net modelling tool. Third part shows application of the generic transaction model. Last part of the paper concludes results and discusses a practical usability of the generic transaction model.

Sci-Fri AM: Quality, Safety, and Professional Issues 04: Predicting waiting times in Radiation Oncology using machine learning

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

Joseph, Ackeem; Herrera, David; Hijal, Tarek

We describe a method for predicting waiting times in radiation oncology. Machine learning is a powerful predictive modelling tool that benefits from large, potentially complex, datasets. The essence of machine learning is to predict future outcomes by learning from previous experience. The patient waiting experience remains one of the most vexing challenges facing healthcare. Waiting time uncertainty can cause patients, who are already sick and in pain, to worry about when they will receive the care they need. In radiation oncology, patients typically experience three types of waiting: Waiting at home for their treatment plan to be prepared Waiting inmore » the waiting room for daily radiotherapy Waiting in the waiting room to see a physician in consultation or follow-up These waiting periods are difficult for staff to predict and only rough estimates are typically provided, based on personal experience. In the present era of electronic health records, waiting times need not be so uncertain. At our centre, we have incorporated the electronic treatment records of all previously-treated patients into our machine learning model. We found that the Random Forest Regression model provides the best predictions for daily radiotherapy treatment waiting times (type 2). Using this model, we achieved a median residual (actual minus predicted value) of 0.25 minutes and a standard deviation residual of 6.5 minutes. The main features that generated the best fit model (from most to least significant) are: Allocated time, median past duration, fraction number and the number of treatment fields.« less

5 CFR 919.215 - Which nonprocurement transactions are not covered transactions?

Code of Federal Regulations, 2010 CFR

2010-01-01

... foreign government or foreign governmental entity; (2) A public international organization; (3) An entity... wholly or partially of one or more foreign governments or foreign governmental entities. (b) A benefit to... governmental operations. (g) Any other transaction if the application of an exclusion to the transaction is...

31 CFR 538.405 - Transactions incidental to a licensed transaction authorized.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Transactions incidental to a licensed transaction authorized. 538.405 Section 538.405 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY SUDANESE SANCTIONS...

31 CFR 545.403 - Transactions incidental to a licensed transaction authorized.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Transactions incidental to a licensed transaction authorized. 545.403 Section 545.403 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY TALIBAN (AFGHANISTAN...

31 CFR 538.405 - Transactions incidental to a licensed transaction authorized.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Transactions incidental to a licensed transaction authorized. 538.405 Section 538.405 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY SUDANESE SANCTIONS...

31 CFR 546.404 - Transactions ordinarily incident to a licensed transaction.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Transactions ordinarily incident to a licensed transaction. 546.404 Section 546.404 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY DARFUR SANCTIONS...

31 CFR 537.404 - Transactions incidental to a licensed transaction authorized.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Transactions incidental to a licensed transaction authorized. 537.404 Section 537.404 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY BURMESE SANCTIONS...

Frequency and Outcomes of a Symptom-Free Waiting Period After Sport-Related Concussion.

PubMed

Pfaller, Adam Y; Nelson, Lindsay D; Apps, Jennifer N; Walter, Kevin D; McCrea, Michael A

2016-11-01

Guidelines and practices for the management of sport-related concussion (SRC) have evolved swiftly over the past 2 decades. Despite common recommendations for a symptom-free waiting period (SFWP) before returning to sport, past reports have suggested poor utilization rates for this intervention. To obtain current estimates of the utilization and characterization of SFWPs with high school and collegiate athletes. Descriptive epidemiology study. Data were extracted from a larger prospective study that followed athletes with SRC across 13 institutions in southeastern Wisconsin from 2012 to 2014. Participants included 143 contact and collision sport athletes who were followed serially through their recoveries after SRCs. In the current study sample, 99.3% of athletes used an SFWP. The mean self-reported symptom duration was 6.35 days (median, 5 days), with 72.7% reporting symptom recovery within 1 week of injury, 93.7% within 2 weeks, and 99.3% within 30 days. Rate of same-season repeat concussion was low (3.8%) and was similar to or lower than the overall rate of concussion (4.3%). Five same-season repeat concussions occurred at a range of 8 to 42 days after initial injuries. In comparison with prior published data collected from 1999 to 2004, utilization and duration of SFWPs were higher in the current study samples (99.3% vs 60.3% of athletes reported an SFWP; mean duration, 6.1 vs 3.2 days), and athletes were withheld from sports for more days than previously reported (12.3 vs 7.4 days). Rate of same-season repeat concussion was equivalent to that of prior published data. The findings support improved adherence to clinical management guidelines through increased utilization of SFWPs after SRC. © 2016 The Author(s).

Polymorphous Computing Architectures

DTIC Science & Technology

2007-12-12

provide a multiprocessor implementation. In this work, we introduce the Atomos transactional programming language, which is the first to include...implicit transactions, strong atomicity, and a scalable multiprocessor implementation [47]. Atomos is derived from Java, but replaces its synchronization...and conditional waiting constructs with transactional alternatives. The Atomos conditional waiting proposal is tailored to allow efficient

22 CFR 208.215 - Which nonprocurement transactions are not covered transactions?

Code of Federal Regulations, 2010 CFR

2010-04-01

... transactions: (a) A direct award to— (1) A foreign government or foreign governmental entity; (2) A public international organization; (3) An entity owned (in whole or in part) or controlled by a foreign government; or... covered transactions? 208.215 Section 208.215 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT...

31 CFR 593.404 - Transactions ordinarily incident to a licensed transaction.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Transactions ordinarily incident to a licensed transaction. 593.404 Section 593.404 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY FORMER LIBERIAN REGIME OF...

31 CFR 593.404 - Transactions ordinarily incident to a licensed transaction.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Transactions ordinarily incident to a licensed transaction. 593.404 Section 593.404 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY FORMER LIBERIAN REGIME OF...

31 CFR 593.404 - Transactions ordinarily incident to a licensed transaction.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Transactions ordinarily incident to a licensed transaction. 593.404 Section 593.404 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY FORMER LIBERIAN REGIME OF...

31 CFR 593.404 - Transactions ordinarily incident to a licensed transaction.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Transactions ordinarily incident to a licensed transaction. 593.404 Section 593.404 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY FORMER LIBERIAN REGIME OF...

31 CFR 593.404 - Transactions ordinarily incident to a licensed transaction.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Transactions ordinarily incident to a licensed transaction. 593.404 Section 593.404 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY FORMER LIBERIAN REGIME OF...

Premerger notification: reporting and waiting period requirements--FTC. Notice of adoption of formal interpretation and request for comments.

PubMed

Clark, D S

1998-10-13

The Premerger Notification Office ("PNO") of the Federal Trade Commission ("FTC"), with the concurrence of the Assistant Attorney General in charge of the Antitrust Division of the Department of Justice ("DOJ"), is adopting a Formal Interpretation of the Hart-Scott-Rodino Act, which requires certain persons planning certain mergers, consolidations, or other acquisitions to report information about the proposed transactions to the FTC and DOJ. The Interpretation concerns the reportability of certain transactions involving a Limited Liability Company ("LLC"), a relatively new form of entity authorized by state statutes. Under the Interpretation, the formation of an LLC will be reportable if it will unite two or more pre-existing businesses under common control. Similarly, acquisitions of existing LLC membership interests will be reportable if they would have the effect of uniting two or more pre-existing businesses under common control.

What is the current evidence of the impact on quality of life whilst waiting for management/treatment of orthopaedic/musculoskeletal complaints? A systematic scoping review.

PubMed

Morris, Joanne; Twizeyemariya, Asterie; Grimmer, Karen

2018-04-02

To describe quality of life (QoL) outcome measures that are reported in the literature in patients waiting for outpatient orthopaedic/musculoskeletal specialist care and how waiting impacts on QoL in these terms. A subset of studies reporting on QoL outcome measures were extracted from literature identified in a recent scoping search of Medline, Embase, Pubmed, NHS Economic Evaluation Database (Prospero registration CRD42016047332). The systematic scoping search examined impacts on patients waiting for orthopaedic specialist care. Two independent reviewers ranked study design using the National Health and Medical Research Council aetiology evidence hierarchy, and appraised study quality using Critical Appraisal Skills Programme tools. QoL measures were mapped against waiting period timepoints. The scoping search yielded 142 articles, of which 18 reported on impact on QoL. These studies reported only on patients waiting for hip and/or knee replacement surgery. The most recent study reported on data collected in 2006/7. The Western Ontario and McMaster Universities Arthritis Index and the SF-36 were the most commonly reported QoL measures. QoL was measured at variable timepoints in the waiting period (from a few weeks to greater than 12 months). The impact of waiting on QoL was inconsistent. The evidence base was over 10 years old, reported only on patients with hip and knee problems, and on limited QoL outcome measures, and with inconsistent findings. A better understanding of the impact on QoL for patients waiting for specialist care could be gained by using standard timepoints in the waiting period, patients with other orthopaedic conditions, comprehensive QoL measures, as well as expectations, choices and perspectives of patients waiting for specialist care.

Customer Engagement in AEP gridSMART Residential Transactive System

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

Widergren, Steven E.; Marinovici, Maria C.; Fuller, Jason C.

— In 2013, AEP Ohio (AEP) operated a 5-minute real-time price (RTP) electricity market system on 4 distribution feeders as part of their gridSMART® demonstration project. The RTP households were billed for their electricity usage according to an RTP tariff approved by the Public Utility Commission of Ohio. They were given the incentive that their annual bill would be no greater than if they were on the flat-rate tariff, but they had financial incentives to shift consumption from high price periods to low price periods. Incentives were also available for response under high prices from local events, such as reachingmore » the distribution feeder capacity or a critical peak pricing event. An analysis of this transactive system experiment was completed in early 2014. This paper describes the incentive provided to the customer, the nature of their interaction with the smart thermostat that provided automated response to the transactive signal, and their level of satisfaction with the program.« less

Waiting for a kidney transplant: the experience of patients with end-stage renal disease in South Korea.

PubMed

Chong, Hye Jin; Kim, Hyun Kyung; Kim, Sung Reul; Lee, Sik

2016-04-01

To explore the experiences of Korean patients with end-stage renal disease awaiting kidney transplantation. The need for kidney transplantation has increased worldwide, while the number of kidney donors has not increased commensurately. This mismatch is a serious issue in South Korea. Prolonged waits for transplantation may cause physical and psychosocial issues and lead to poor outcomes. Nevertheless, the experience of waiting for kidney transplantation in South Korea has never been explored in depth. A qualitative descriptive design was used. The participants were eight patients diagnosed with end-stage renal disease on the waiting list for kidney transplantation in South Korea. Data were collected through individual in-depth interviews. All conversations during interviews were recorded and transcribed verbatim. Transcribed data were analysed using conventional content analysis. The experience of waiting for kidney transplantation consisted of six categories: (1) the light at the end of the tunnel, (2) being on call without any promise, (3) a tough tug of war between excitement and frustration, (4) doubts in the complexity, (5) A companion on the hard journey and (6) getting ready for D-day. Kidney transplantation candidates experience psychosocial difficulties and concerns while waiting for long periods of time without any assurance of resolution. Systematic education and psychosocial support from health care professionals and family members help patients get through what they describe as a difficult journey. Comprehensive management programs for kidney transplantation candidates are needed. Health care professionals need to recognise the psychosocial concerns of patients awaiting kidney transplantation. Clinicians should provide patients with information and support throughout the waiting period. © 2016 John Wiley & Sons Ltd.

Identifying Bitcoin users by transaction behavior

NASA Astrophysics Data System (ADS)

Monaco, John V.

2015-05-01

Digital currencies, such as Bitcoin, offer convenience and security to criminals operating in the black marketplace. Some Bitcoin marketplaces, such as Silk Road, even claim anonymity. This claim contradicts the findings in this work, where long term transactional behavior is used to identify and verify account holders. Transaction timestamps and network properties observed over time contribute to this finding. The timestamp of each transaction is the result of many factors: the desire purchase an item, daily schedule and activities, as well as hardware and network latency. Dynamic network properties of the transaction, such as coin flow and the number of edge outputs and inputs, contribute further to reveal account identity. In this paper, we propose a novel methodology for identifying and verifying Bitcoin users based on the observation of Bitcoin transactions over time. The behavior we attempt to quantify roughly occurs in the social band of Newell's time scale. A subset of the Blockchain 230686 is taken, selecting users that initiated between 100 and 1000 unique transactions per month for at least 6 different months. This dataset shows evidence of being nonrandom and nonlinear, thus a dynamical systems approach is taken. Classification and authentication accuracies are obtained under various representations of the monthly Bitcoin samples: outgoing transactions, as well as both outgoing and incoming transactions are considered, along with the timing and dynamic network properties of transaction sequences. The most appropriate representations of monthly Bitcoin samples are proposed. Results show an inherent lack of anonymity by exploiting patterns in long-term transactional behavior.

Stochastic nature of series of waiting times.

PubMed

Anvari, Mehrnaz; Aghamohammadi, Cina; Dashti-Naserabadi, H; Salehi, E; Behjat, E; Qorbani, M; Nezhad, M Khazaei; Zirak, M; Hadjihosseini, Ali; Peinke, Joachim; Tabar, M Reza Rahimi

2013-06-01

Although fluctuations in the waiting time series have been studied for a long time, some important issues such as its long-range memory and its stochastic features in the presence of nonstationarity have so far remained unstudied. Here we find that the "waiting times" series for a given increment level have long-range correlations with Hurst exponents belonging to the interval 1/2waiting time distribution. We find that the logarithmic difference of waiting times series has a short-range correlation, and then we study its stochastic nature using the Markovian method and determine the corresponding Kramers-Moyal coefficients. As an example, we analyze the velocity fluctuations in high Reynolds number turbulence and determine the level dependence of Markov time scales, as well as the drift and diffusion coefficients. We show that the waiting time distributions exhibit power law tails, and we were able to model the distribution with a continuous time random walk.

Stochastic nature of series of waiting times

NASA Astrophysics Data System (ADS)

Anvari, Mehrnaz; Aghamohammadi, Cina; Dashti-Naserabadi, H.; Salehi, E.; Behjat, E.; Qorbani, M.; Khazaei Nezhad, M.; Zirak, M.; Hadjihosseini, Ali; Peinke, Joachim; Tabar, M. Reza Rahimi

2013-06-01

Although fluctuations in the waiting time series have been studied for a long time, some important issues such as its long-range memory and its stochastic features in the presence of nonstationarity have so far remained unstudied. Here we find that the “waiting times” series for a given increment level have long-range correlations with Hurst exponents belonging to the interval 1/2waiting time distribution. We find that the logarithmic difference of waiting times series has a short-range correlation, and then we study its stochastic nature using the Markovian method and determine the corresponding Kramers-Moyal coefficients. As an example, we analyze the velocity fluctuations in high Reynolds number turbulence and determine the level dependence of Markov time scales, as well as the drift and diffusion coefficients. We show that the waiting time distributions exhibit power law tails, and we were able to model the distribution with a continuous time random walk.

Learning to wait: A laboratory investigation

USGS Publications Warehouse

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

2009-01-01

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

The impact of waiting for intervention on costs and effectiveness: the case of transcatheter aortic valve replacement.

PubMed

Ribera, Aida; Slof, John; Ferreira-González, Ignacio; Serra, Vicente; García-Del Blanco, Bruno; Cascant, Purificació; Andrea, Rut; Falces, Carlos; Gutiérrez, Enrique; Del Valle-Fernández, Raquel; Morís-de laTassa, César; Mota, Pedro; Oteo, Juan Francisco; Tornos, Pilar; García-Dorado, David

2017-11-23

The economic crisis in Europe might have limited access to some innovative technologies implying an increase of waiting time. The purpose of the study is to evaluate the impact of waiting time on the costs and benefits of transcatheter aortic valve replacement (TAVR) for the treatment of severe aortic stenosis. This is a cost-utility analysis from the perspective of the Spanish National Health Service. Results of two prospective hospital registries (158 and 273 consecutive patients) were incorporated into a probabilistic Markov model to compare quality adjusted life years (QALYs) and costs for TAVR after waiting for 3-12 months, relative to immediate TAVR. We simulated a cohort of 1000 patients, male, and 80 years old; other patient profiles were assessed in sensitivity analyses. As waiting time increased, costs decreased at the expense of lower survival and loss of QALYs, leading to incremental cost-effectiveness ratios for eliminating waiting lists of about 12,500 € per QALY. In subgroup analyses prioritization of patients for whom higher benefit was expected led to a smaller loss of QALYs. Concerning budget impact, long waiting lists reduced spending considerably and permanently. A shorter waiting time is likely to be cost-effective (considering commonly accepted willingness-to-pay thresholds in Europe) relative to 3 months or longer waiting periods. If waiting lists are nevertheless seen as unavoidable due to severe but temporary budgetary restrictions, prioritizing patients for whom higher benefit is expected appears to be a way of postponing spending without utterly sacrificing patients' survival and quality of life.

31 CFR 551.404 - Transactions ordinarily incident to a licensed transaction authorized.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Transactions ordinarily incident to a licensed transaction authorized. 551.404 Section 551.404 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY SOMALIA...

Electron Waiting Times of a Cooper Pair Splitter

NASA Astrophysics Data System (ADS)

Walldorf, Nicklas; Padurariu, Ciprian; Jauho, Antti-Pekka; Flindt, Christian

2018-02-01

Electron waiting times are an important concept in the analysis of quantum transport in nanoscale conductors. Here we show that the statistics of electron waiting times can be used to characterize Cooper pair splitters that create spatially separated spin-entangled electrons. A short waiting time between electrons tunneling into different leads is associated with the fast emission of a split Cooper pair, while long waiting times are governed by the slow injection of Cooper pairs from a superconductor. Experimentally, the waiting time distributions can be measured using real-time single-electron detectors in the regime of slow tunneling, where conventional current measurements are demanding. Our work is important for understanding the fundamental transport processes in Cooper pair splitters and the predictions may be verified using current technology.

21 CFR 1310.08 - Excluded transactions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... including anhydrous hydrogen chloride. (b) Exports, transshipments, and international transactions of hydrochloric (including anhydrous hydrogen chloride) and sulfuric acids, except for exports, transshipments and... less, and no greater than one package per transaction. (g) Import transactions of anhydrous hydrogen...

21 CFR 1310.08 - Excluded transactions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... including anhydrous hydrogen chloride. (b) Exports, transshipments, and international transactions of hydrochloric (including anhydrous hydrogen chloride) and sulfuric acids, except for exports, transshipments and... less, and no greater than one package per transaction. (g) Import transactions of anhydrous hydrogen...

21 CFR 1310.08 - Excluded transactions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... including anhydrous hydrogen chloride. (b) Exports, transshipments, and international transactions of hydrochloric (including anhydrous hydrogen chloride) and sulfuric acids, except for exports, transshipments and... less, and no greater than one package per transaction. (g) Import transactions of anhydrous hydrogen...

21 CFR 1310.08 - Excluded transactions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... including anhydrous hydrogen chloride. (b) Exports, transshipments, and international transactions of hydrochloric (including anhydrous hydrogen chloride) and sulfuric acids, except for exports, transshipments and... less, and no greater than one package per transaction. (g) Import transactions of anhydrous hydrogen...

[Influence of waiting time on patient and companion satisfaction].

PubMed

Fontova-Almató, A; Juvinyà-Canal, D; Suñer-Soler, R

2015-01-01

To evaluate patient and companion satisfaction of a hospital Emergency Department and its relationship with waiting time. Prospective, observational study. Hospital de Figueres Emergency Department (Girona, Spain). sociodemographic characteristics, satisfaction level, real and perceived waiting time for triage and being seen by a physician. A total of 285 responses were received from patients and companions. The mean age of the patients and companions (n=257) was 54.6years (SD=18.3). The mean overall satisfaction (n=273) was 7.6 (SD=2.2). Lower perceived waiting time until nurse triage was related to higher overall satisfaction (Spearman rho (ρ)=-0.242, P<.001), and lower perceived waiting time until being seen by physician, with a higher overall satisfaction (ρ=-0.304; P<.001). Users who were informed about estimated waiting time showed higher satisfaction than those who were not informed (P=.001). Perceived waiting time and the information about estimated waiting time determined overall satisfaction. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

26 CFR 1.1221-2 - Hedging transactions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... another position such as a purchased option, then it may be a hedging transaction. (4) Recycling. A... liability as a hedge of another asset or liability (recycling). (5) Transactions not entered into primarily... enters into a hedging transaction (including recycling an existing hedging transaction) must clearly...

26 CFR 1.1221-2 - Hedging transactions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... another position such as a purchased option, then it may be a hedging transaction. (4) Recycling. A... liability as a hedge of another asset or liability (recycling). (5) Transactions not entered into primarily... enters into a hedging transaction (including recycling an existing hedging transaction) must clearly...

26 CFR 1.1221-2 - Hedging transactions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... another position such as a purchased option, then it may be a hedging transaction. (4) Recycling. A... liability as a hedge of another asset or liability (recycling). (5) Transactions not entered into primarily... enters into a hedging transaction (including recycling an existing hedging transaction) must clearly...

26 CFR 1.1221-2 - Hedging transactions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... another position such as a purchased option, then it may be a hedging transaction. (4) Recycling. A... liability as a hedge of another asset or liability (recycling). (5) Transactions not entered into primarily... enters into a hedging transaction (including recycling an existing hedging transaction) must clearly...

26 CFR 1.1221-2 - Hedging transactions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... another position such as a purchased option, then it may be a hedging transaction. (4) Recycling. A... liability as a hedge of another asset or liability (recycling). (5) Transactions not entered into primarily... enters into a hedging transaction (including recycling an existing hedging transaction) must clearly...

Waiting for hip arthroplasty: economic costs and health outcomes.

PubMed

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

2005-12-01

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

34 CFR 85.205 - Why is it important if a particular transaction is a covered transaction?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 1 2010-07-01 2010-07-01 false Why is it important if a particular transaction is a covered transaction? 85.205 Section 85.205 Education Office of the Secretary, Department of Education GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Covered Transactions § 85.205 Why is it important if a...

21 CFR 1404.205 - Why is it important if a particular transaction is a covered transaction?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Why is it important if a particular transaction is a covered transaction? 1404.205 Section 1404.205 Food and Drugs OFFICE OF NATIONAL DRUG CONTROL POLICY GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Covered Transactions § 1404.205 Why is it...

[Waiting list in general and digestive surgery: patient expectations, quality of life during waiting time and overall satisfaction].

PubMed

Parés, D; Duran, E; Hermoso, J; Comajuncosas, J; Gris, P; Lopez-Negre, J L; Urgellés, J; Orbeal, R; Vallverdú, H; Jimeno, J

2013-01-01

The structural resources of the National Health system are limited, and therefore early surgery cannot be performed on all patients. The objective was to analyse the satisfaction perceived by the patient as regards the delay of treatment by waiting list of three types of surgery. The influence of expectations on waiting times, and impaired quality of life due to the clinical symptoms during the delay, were studied. A prospective study was conducted using a postal questionnaire. We compared the expectations (scale of 1 to 5), the impact on quality of life for symptoms (scale of 1 to 5) and the level of patient satisfaction (scale of 1 to 5) with respect to time on the waitng list for cholelithiasis, inguinal hernia and haemorrhoids. The predictors of patient dissatisfaction were analysed. A total of 57 patients were included. When comparing the characteristics of patients with and without satisfaction over time on the waiting list, days on the waiting list (P=.044), the change in the quality of life due to the symptoms (P=.028), and expectations (P<.001) were significantly different between the two groups. In the multivariate analysis, the expectation was associated with patient dissatisfaction as regards the time on waiting list (OR: 3.14 95% CI: 5.91 to 220.73, P<.001). The level of patient dissatisfaction is associated with expectations about time in waiting list. Copyright © 2012 SECA. Published by Elsevier Espana. All rights reserved.

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

PubMed

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

2015-04-05

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

12 CFR 303.62 - Transactions requiring prior approval.

Code of Federal Regulations, 2010 CFR

2010-01-01

... merger transaction that consists of the acquisition by an out of state bank of a branch without... FILING PROCEDURES Merger Transactions § 303.62 Transactions requiring prior approval. (a) Merger transactions. The following merger transactions require the prior written approval of the FDIC under this...

Transactive memory systems scale for couples: development and validation

PubMed Central

Hewitt, Lauren Y.; Roberts, Lynne D.

2015-01-01

People in romantic relationships can develop shared memory systems by pooling their cognitive resources, allowing each person access to more information but with less cognitive effort. Research examining such memory systems in romantic couples largely focuses on remembering word lists or performing lab-based tasks, but these types of activities do not capture the processes underlying couples’ transactive memory systems, and may not be representative of the ways in which romantic couples use their shared memory systems in everyday life. We adapted an existing measure of transactive memory systems for use with romantic couples (TMSS-C), and conducted an initial validation study. In total, 397 participants who each identified as being a member of a romantic relationship of at least 3 months duration completed the study. The data provided a good fit to the anticipated three-factor structure of the components of couples’ transactive memory systems (specialization, credibility and coordination), and there was reasonable evidence of both convergent and divergent validity, as well as strong evidence of test–retest reliability across a 2-week period. The TMSS-C provides a valuable tool that can quickly and easily capture the underlying components of romantic couples’ transactive memory systems. It has potential to help us better understand this intriguing feature of romantic relationships, and how shared memory systems might be associated with other important features of romantic relationships. PMID:25999873

Trans-acting translational regulatory RNA binding proteins.

PubMed

Harvey, Robert F; Smith, Tom S; Mulroney, Thomas; Queiroz, Rayner M L; Pizzinga, Mariavittoria; Dezi, Veronica; Villenueva, Eneko; Ramakrishna, Manasa; Lilley, Kathryn S; Willis, Anne E

2018-05-01

The canonical molecular machinery required for global mRNA translation and its control has been well defined, with distinct sets of proteins involved in the processes of translation initiation, elongation and termination. Additionally, noncanonical, trans-acting regulatory RNA-binding proteins (RBPs) are necessary to provide mRNA-specific translation, and these interact with 5' and 3' untranslated regions and coding regions of mRNA to regulate ribosome recruitment and transit. Recently it has also been demonstrated that trans-acting ribosomal proteins direct the translation of specific mRNAs. Importantly, it has been shown that subsets of RBPs often work in concert, forming distinct regulatory complexes upon different cellular perturbation, creating an RBP combinatorial code, which through the translation of specific subsets of mRNAs, dictate cell fate. With the development of new methodologies, a plethora of novel RNA binding proteins have recently been identified, although the function of many of these proteins within mRNA translation is unknown. In this review we will discuss these methodologies and their shortcomings when applied to the study of translation, which need to be addressed to enable a better understanding of trans-acting translational regulatory proteins. Moreover, we discuss the protein domains that are responsible for RNA binding as well as the RNA motifs to which they bind, and the role of trans-acting ribosomal proteins in directing the translation of specific mRNAs. This article is categorized under: RNA Interactions with Proteins and Other Molecules > RNA-Protein Complexes Translation > Translation Regulation Translation > Translation Mechanisms. © 2018 Medical Research Council and University of Cambridge. WIREs RNA published by Wiley Periodicals, Inc.

12 CFR 226.8 - Identification of transactions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... either the date of the transaction or the date of debiting the transaction to the consumer's account are... consumer, if the number or symbol reasonably identifies that transaction with that creditor, and if the... the consumer with point-of-sale documentation for that transaction; and (4) the creditor treats an...

21 CFR 1404.970 - Nonprocurement transaction.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Nonprocurement transaction. 1404.970 Section 1404.970 Food and Drugs OFFICE OF NATIONAL DRUG CONTROL POLICY GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Definitions § 1404.970 Nonprocurement transaction. (a) Nonprocurement transaction means any...

31 CFR 510.201 - Prohibited transactions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Prohibited transactions. 510.201 Section 510.201 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE... § 510.201 Prohibited transactions. (a) All transactions prohibited pursuant to Executive Order 13466 are...

31 CFR 510.201 - Prohibited transactions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Prohibited transactions. 510.201 Section 510.201 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE... § 510.201 Prohibited transactions. (a) All transactions prohibited pursuant to Executive Order 13466 are...

31 CFR 510.201 - Prohibited transactions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Prohibited transactions. 510.201 Section 510.201 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE... § 510.201 Prohibited transactions. (a) All transactions prohibited pursuant to Executive Order 13466 are...

17 CFR 5.2 - Prohibited transactions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 17 Commodity and Securities Exchanges 1 2011-04-01 2011-04-01 false Prohibited transactions. 5.2 Section 5.2 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION OFF-EXCHANGE FOREIGN CURRENCY TRANSACTIONS § 5.2 Prohibited transactions. (a) Scope. The provisions of this section shall be...

Reducing wait time in a hospital pharmacy to promote customer service.

PubMed

Slowiak, Julie M; Huitema, Bradley E; Dickinson, Alyce M

2008-01-01

The purpose of this study was to compare the effects of 2 different interventions on wait times at a hospital outpatient pharmacy: (1) giving feedback to employees about customer satisfaction with wait times and (2) giving a combined intervention package that included giving more specific feedback about actual wait times and goal setting for wait time reduction in addition to the customer satisfaction feedback. The relationship between customer satisfaction ratings and wait times was examined to determine whether wait times affected customer service satisfaction. Participants were 10 employees (4 pharmacists and 6 technicians) of an outpatient pharmacy. Wait times and customer satisfaction ratings were collected for "waiting customers." An ABCBA' within-subjects design was used to assess the effects of the interventions on both wait time and customer satisfaction, where A was the baseline (no feedback and no goal setting); B was the customer satisfaction feedback; C was the customer satisfaction feedback, the wait time feedback, and the goal setting for wait time reduction; and A' was a follow-up condition that was similar to the original baseline condition. Wait times were reduced by approximately 20%, and there was concomitant increased shift in levels of customer satisfaction, as indicated by the correlation between these variables (r = -0.57 and P < .05). Given the current prescription-filling process, we do not expect that major, additional reductions in wait times could be produced. Many variables may account for the variability in any individual customer's wait time. Data from this study may provide useful preliminary benchmarking data for standard pharmacy wait times.

Minimizing patient waiting time in emergency department of public hospital using simulation optimization approach

NASA Astrophysics Data System (ADS)

Ibrahim, Ireen Munira; Liong, Choong-Yeun; Bakar, Sakhinah Abu; Ahmad, Norazura; Najmuddin, Ahmad Farid

2017-04-01

Emergency department (ED) is the main unit of a hospital that provides emergency treatment. Operating 24 hours a day with limited number of resources invites more problems to the current chaotic situation in some hospitals in Malaysia. Delays in getting treatments that caused patients to wait for a long period of time are among the frequent complaints against government hospitals. Therefore, the ED management needs a model that can be used to examine and understand resource capacity which can assist the hospital managers to reduce patients waiting time. Simulation model was developed based on 24 hours data collection. The model developed using Arena simulation replicates the actual ED's operations of a public hospital in Selangor, Malaysia. The OptQuest optimization in Arena is used to find the possible combinations of a number of resources that can minimize patients waiting time while increasing the number of patients served. The simulation model was modified for improvement based on results from OptQuest. The improvement model significantly improves ED's efficiency with an average of 32% reduction in average patients waiting times and 25% increase in the total number of patients served.

An empirical application of transaction-costs theory to organizational design characteristics.

PubMed

Williams, S

2000-01-01

The environmental uncertainty component of transaction-costs theory was used to predict the organizational structural characteristics of size (number of employees) and horizontal differentiation (number of vice presidents) using financial and management information from the COMPACT DISCLOSURE data base (which contains the most recent annual and periodic reports for more than 12,000 public companies). Organizations were categorized as low- or high-uncertainty industries according to Dess and Beard's (1984) Dynamism Scale, and net sales volume was controlled. As predicted, high-uncertainty companies had significantly higher horizontal differentiation than low-uncertainty firms, a finding that supports the transaction-costs expectation that organizations may require more departments or personnel to cope with increasing uncertainty. Surprisingly, low-uncertainty firms were found to have significantly more employees than high-uncertainty organizations, which is the opposite of what transaction-costs theory predicts. Possible explanations for this unexpected finding and further potential limitations are discussed.

Improving Patient Satisfaction with Waiting Time

ERIC Educational Resources Information Center

Eilers, Gayleen M.

2004-01-01

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

Influence of positive distractions on children in two clinic waiting areas.

PubMed

Pati, Debajyoti; Nanda, Upali

2011-01-01

To examine the influence of positive distraction on the behavior and activity of children in two clinic waiting areas. People spend a considerable proportion of time waiting in hospitals. Studies show that the quality of waiting environments influences the perception of quality of care and caregivers, that perception of waiting time is a better indicator of patient satisfaction than actual waiting time, and that the waiting environment contributes to the perception of wait time. In fact, the attractiveness of the physical environment in waiting areas has been shown to be significantly associated with higher perceived quality of care, less anxiety, and higher reported positive interaction with staff. Can positive distractions in waiting areas improve the waiting experience, as indicated by the behavior and activities of children waiting for treatment? Five distraction conditions were randomly introduced in the waiting area of the dental and cardiac clinics of a major pediatric tertiary care center through a single plasma screen intervention. The attention, behavior, and activities of waiting children were recorded. Data on 158 pediatric patients were collected over 12 days during December 2008 and January 2009. Data analysis shows that the introduction of distraction conditions was associated with more calm behavior and less fine and gross movement, suggesting significant calming effects associated with the distraction conditions. Data also suggest that positive distraction conditions are significant attention grabbers and could be an important contributor to improving the waiting experience for children in hospitals by improving environmental attractiveness.

31 CFR 598.407 - Offshore transactions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Offshore transactions. 598.407 Section 598.407 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE... Interpretations § 598.407 Offshore transactions. The prohibitions contained in § 598.203 apply to transactions by...

Are seismic waiting time distributions universal?

NASA Astrophysics Data System (ADS)

Davidsen, Jörn; Goltz, Christian

2004-11-01

We show that seismic waiting time distributions in California and Iceland have many features in common as, for example, a power-law decay with exponent α ~ 1.1 for intermediate and with exponent γ ~ 0.6 for short waiting times. While the transition point between these two regimes scales proportionally with the size of the considered area, the full distribution is not universal and depends in a non-trivial way on the geological area under consideration and its size. This is due to the spatial distribution of epicenters which does not form a simple mono-fractal. Yet, the dependence of the waiting time distributions on the threshold magnitude seems to be universal.

78 FR 10639 - Proposed Amendment to Prohibited Transaction Exemption 2006-06 (PTE 2006-06) for Services...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-14

...The Department of Labor (the Department) is extending the comment period for a proposed amendment to PTE 2006-06, a prohibited transaction class exemption issued under the Employee Retirement Income Security Act of 1974 (ERISA). PTE 2006-06 provides an exemption for certain transactions entered into on behalf of individual account pension plans that have been abandoned by their sponsors.

31 CFR 598.407 - Offshore transactions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Offshore transactions. 598.407 Section 598.407 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Interpretations § 598.407 Offshore transactions. The prohibitions contained in § 598.203 apply to transactions by...

31 CFR 598.407 - Offshore transactions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Offshore transactions. 598.407 Section 598.407 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Interpretations § 598.407 Offshore transactions. The prohibitions contained in § 598.203 apply to transactions by...

31 CFR 598.407 - Offshore transactions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Offshore transactions. 598.407 Section 598.407 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Interpretations § 598.407 Offshore transactions. The prohibitions contained in § 598.203 apply to transactions by...

31 CFR 598.407 - Offshore transactions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Offshore transactions. 598.407 Section 598.407 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Interpretations § 598.407 Offshore transactions. The prohibitions contained in § 598.203 apply to transactions by...

Interior effects on comfort in healthcare waiting areas.

PubMed

Bazley, C; Vink, P; Montgomery, J; Hedge, A

2016-07-21

This study compared the effects of pre-experience and expectations on participant comfort upon waking, arrival to, and after an appointment, as well as the assessment of properly placed Feng Shui elements in three healthcare waiting rooms. Participants assessed comfort levels using self-report surveys. The researcher conducted 'intention interviews' with each doctor to assess the goals of each waiting area design, and conducted a Feng Shui assessment of each waiting area for properly placed Feng Shui elements. The waiting area designed by the Feng Shui expert rated 'most comfortable', followed by the waiting area design by a doctor, and the lowest comfort rating for the conventional waiting room design. Results show a sufficiently strong effect to warrant further research. Awareness of the external environment, paired with pre-experience and expectation, influences comfort for people over time. Fostering and encouraging a holistic approach to comfort utilizing eastern and western concepts and ergonomic principles creates a sense of "placeness" and balance in the design for comfort in built environments. This is new research information on the influences of the comfort experience over time, to include pre-experience, expectations and the placement of elements in the external environment.

17 CFR 5.2 - Prohibited transactions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... applicable to any retail forex transaction. (b) Fraudulent conduct prohibited. It shall be unlawful for any... indirectly, in or in connection with any retail forex transaction: (1) To cheat or defraud or attempt to... prohibited. (1) No person who acts as the counterparty for any retail forex transaction may do so for an...

17 CFR 5.2 - Prohibited transactions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... applicable to any retail forex transaction. (b) Fraudulent conduct prohibited. It shall be unlawful for any... indirectly, in or in connection with any retail forex transaction: (1) To cheat or defraud or attempt to... prohibited. (1) No person who acts as the counterparty for any retail forex transaction may do so for an...

17 CFR 5.2 - Prohibited transactions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... applicable to any retail forex transaction. (b) Fraudulent conduct prohibited. It shall be unlawful for any... indirectly, in or in connection with any retail forex transaction: (1) To cheat or defraud or attempt to... prohibited. (1) No person who acts as the counterparty for any retail forex transaction may do so for an...

How to report and monitor the performance of waiting list management.

PubMed

Torkki, Markus; Linna, Miika; Seitsalo, Seppo; Paavolainen, Pekka

2002-01-01

Potential problems concerning waiting list management are often monitored using mean waiting times based on empirical samples. However, the appropriateness of mean waiting time as an indicator of access can be questioned if a waiting list is not managed well, e.g., if the queue discipline is violated. This study was performed to find out about the queue discipline in waiting lists for elective surgery to reveal potential discrepancies in waiting list management. There were 1,774 waiting list patients for hallux valgus or varicose vein surgery or sterilization. The waiting time distributions of patients receiving surgery and of patients still waiting for an operation are presented in column charts. The charts are compared with two model charts. One model chart presents a high queue discipline (first in-first out) and another a poor queue discipline (random) queue. There were significant differences in waiting list management across hospitals and patient categories. Examples of a poor queue discipline were found in queues for hallux valgus and varicose vein operations. A routine waiting list reporting should be used to guarantee the quality of waiting list management and to pinpoint potential problems in access. It is important to monitor not only the number of patients in the waiting list but also the queue discipline and the balance between demand and supply of surgical services. The purpose for this type of reporting is to ensure that the priority setting made at health policy level also works in practise.

Waiting Points in Nova and X-ray Burst Nucleosynthesis

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

Sunayama, Tomomi; Smith, Michael Scott; Lingerfelt, Eric J

2008-01-01

In nova and X-ray burst nucleosynthesis, waiting points are nuclei in the reaction path which interrupt the nuclear flow towards heavier nuclei, typically because of a weak proton capture reaction and a long beta+ lifetime. Waiting points can influence the energy generation and final abundances synthesized in these explosions. We have constructed a systematic, quantitative set of criteria to identify rp-process waiting points, and use them to search for waiting points in post-processing simulations of novae and X-ray bursts. These criteria have been incorporated into the Computational Infrastructure for Nuclear Astrophysics, online at nucastrodata.org, to enable anyone to run customizedmore » searches for waiting points.« less

Waiting Points in Nova and X-ray burst Nucleosynthesis

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

Sunayama, Tomomi; Oak Ridge Institute for Science Education, Oak Ridge, Tennessee 37831-0117; Smith, Michael S.

2008-05-21

In nova and X-ray burst nucleosynthesis, waiting points are nuclei in the reaction path which delay the nuclear flow towards heavier nuclei, typically because of a weak proton capture reaction and a long {beta}{sup +} lifetime. Waiting points can influence the energy generation and final abundances synthesized in these explosions. We have constructed a systematic, quantitative set of criteria to identify rp-process waiting points, and use them to search for waiting points in post-processing simulations of novae and X-ray bursts. These criteria have been incorporated into the Computational Infrastructure for Nuclear Astrophysics, online at nucastrodata.org, to enable anyone to runmore » customized searches for waiting points.« less

31 CFR 596.304 - Financial transaction.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Financial transaction. 596.304... REGULATIONS General Definitions § 596.304 Financial transaction. The term financial transaction shall have the meaning set forth in 18 U.S.C. 1956(c)(4), as from time to time amended. As of the effective date, this...

[Has the time arrived for the management of waiting lists?].

PubMed

Bernal, E

2002-01-01

Individuals on the waiting list frequently suffer an additional risk caused by the mean time until they receive treatment; however, other individuals do not need the treatment for which they are waiting.Both arguments, which can be contrasted with empirical evidence, would be sufficient to affirm that waiting list management should be implemented, leaving aside policies that are more of less opportunistic. Opportunistic policies are understood as those providing misinformation on waiting lists or their "manipulation", and using programs of auto-coordination with the sole aim of reaching the end of the year without a waiting list of not more than six months, etc. The panorama is not completely bleak. Some management initiatives (and even Politics with a capital P) are opening the way forward and may enter the Agenda in the next few years. In this context, the application of guaranteed times of medical care or the prioritization of waiting lists according to explicit criteria should be highlighted. It is worth remembering that, except for the queues in the waiting rooms of health centers and emergency departments, waiting lists are mediated by the decision of the physician. Therefore, an essential strategy for managing waiting lists consists of attenuating the problems caused by uncertainty (or ignorance) of the patient's diagnosis or prognosis.

Anonymous Transactions in Computer Networks

NASA Astrophysics Data System (ADS)

Dolev, Shlomi; Kopeetsky, Marina

We present schemes for providing anonymous transactions while privacy and anonymity are preserved, providing user anonymous authentication in distributed networks such as the Internet. We first present a practical scheme for anonymous transactions while the transaction resolution is assisted by a Trusted Authority. This practical scheme is extended to a theoretical scheme where a Trusted Authority is not involved in the transaction resolution. Given an authority that generates for each player hard to produce evidence EVID (e. g., problem instance with or without a solution) to each player, the identity of a user U is defined by the ability to prove possession of said evidence. We use Zero-Knowledge proof techniques to repeatedly identify U by providing a proof that U has evidence EVID, without revealing EVID, therefore avoiding identity theft.

Colour Consideration for Waiting areas in hospitals

NASA Astrophysics Data System (ADS)

Zraati, Parisa

2012-08-01

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

31 CFR 561.404 - Significant transaction or transactions; significant financial services; significant financial...

Code of Federal Regulations, 2014 CFR

2014-07-01

... conducting or facilitating the financial transaction described in paragraph (b) of § 561.204 and the National Iranian Oil Company (“NIOC”), the Naftiran Intertrade Company (“NICO”), any entity owned or controlled by... Human Rights Act of 2012 (“TRA”), or of the financial transaction on the objectives of the National...

Ultrasound waiting lists: rational queue or extended capacity?

PubMed

Brasted, Christopher

2008-06-01

The features and issues regarding clinical waiting lists in general and general ultrasound waiting lists in particular are reviewed, and operational aspects of providing a general ultrasound service are also discussed. A case study is presented describing a service improvement intervention in a UK NHS hospital's ultrasound department, from which arises requirements for a predictive planning model for an ultrasound waiting list. In the course of this, it becomes apparent that a booking system is a more appropriate way of describing the waiting list than a conventional queue. Distinctive features are identified from the literature and the case study as the basis for a predictive model, and a discrete event simulation model is presented which incorporates the distinctive features.

Why wait so long for child care? An analysis of waits, queues and work in a South African urban health centre.

PubMed

Bachmann, M O; Barron, P

1997-01-01

Long waits at large urban clinics obstruct primary care delivery, imposing time costs on patients, deterring appropriate utilization and causing patient dissatisfaction. This paper reports on an innovative attempt by staff in a large South African urban health centre to analyse a system of queues and preventive and curative services for pre-school children, and thereafter to evaluate changes. The study had a cross-sectional work study design, with repeated measurement of waiting times after 13 months. At baseline the preventive clinic was found to have several inessential processes and waits; these were eliminated or overlapped, and clinic sessions per week were increased. A year later median waiting times had decreased substantially in the preventive clinic, but had increased in the curative clinic. Simple research can explain long waits, inform and measure changes, and provide evidence to justify primary care integration and would be useful in health centres and hospital outpatient departments in developing countries.

Waiting time care guarantees: necessity or nemesis?

PubMed

Joshi, N P; Noseworthy, F T; Noseworthy, T W

2006-01-01

One of the priorities of governments in Canada is to reduce long waiting times for health services. This has raised the prospect of introducing waiting time care guarantees. Such guarantees affirm the healthcare system's social contract with the public and provide an entitlement to Canadians to receive timely care. There are clinical, legal and political implications, which must be considered and well managed before introduction. Other countries have ventured down this path. They teach us that waiting time care guarantees are good policy and make good sense. Correspondingly, they remind us not to make a promise we are not ready to keep.

Community Currency Trading Method through Partial Transaction Intermediary Process

NASA Astrophysics Data System (ADS)

Kido, Kunihiko; Hasegawa, Seiichi; Komoda, Norihisa

A community currency is local money that is issued by local governments or Non-Profit Organization (NPO) to support social services. The purpose of introducing community currencies is to regenerate communities by fostering mutual aids among community members. In this paper, we propose a community currency trading method through partial intermediary process, under operational environments without introducing coordinators all the time. In this method, coordinators perform coordination between service users and service providers during several months from the start point of transactions. After the period of coordination, participants spontaneously make transactions based on their trust area and a trust evaluation method based on the number of provided services and complaint information. This method is especially effective to communities with close social networks and low trustworthiness. The proposed method is evaluated through multi-agent simulation.

Parental satisfaction with paediatric care, triage and waiting times.

PubMed

Fitzpatrick, Nicholas; Breen, Daniel T; Taylor, James; Paul, Eldho; Grosvenor, Robert; Heggie, Katrina; Mahar, Patrick D

2014-04-01

The present study aims to determine parental and guardian's perceptions of paediatric emergency care and satisfaction with care, waiting times and triage category in a community ED. A structured questionnaire was provided to parents or guardians of paediatric patients presenting to emergency. The survey evaluated parent perceptions of waiting time, environment/facilities, professionalism and communication skills of staff and overall satisfaction of care. One hundred and thirty-three completed questionnaires were received from parents of paediatric patients. Responses were overall positive with respect to the multiple domains assessed. Parents generally considered waiting times to be appropriate and consistent with triage categories. Overall satisfaction was not significantly different for varying treatment or waiting times. Patients triaged as semi-urgent were of the opinion that waiting times were less appropriate than urgent, less-urgent or non-urgent patients. On the basis of the present study, patient perceptions and overall satisfaction of care does not appear to be primarily influenced by time spent waiting or receiving treatment. Attempts made at the triage process to ensure that semi-urgent patients have reasonable expectations of waiting times might provide an opportunity to improve these patients' expectations and perceptions. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

22 CFR 208.205 - Why is it important to know if a particular transaction is a covered transaction?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Why is it important to know if a particular transaction is a covered transaction? 208.205 Section 208.205 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Covered Transactions § 208.205 Why is it...

Identifying demand for health resources using waiting times information.

PubMed

Blundell, R; Windmeijer, F

2000-09-01

In this paper the differences in average waiting times are utilized to identify the determinants of demand for health services. The equilibrium waiting time framework is used, but the full equilibrium assumption is relaxed by selecting areas with low waiting times and by estimating a (semi-)parametric selection model. Determinants of supply are used as instruments for the endogeneity of waiting times. A model for the demand for acute services at the ward level in the UK is estimated. The model estimates, and their implications for health service allocations in the UK, are contrasted against more standard allocation models. The present results show that it is critically important to account for rationing by waiting times when identifying needs from care utilization data. Copyright 2000 John Wiley & Sons, Ltd.

The Religious Meaning in "Waiting for Godot"

ERIC Educational Resources Information Center

Wang, Jing

2011-01-01

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

Transactive System: Part II: Analysis of Two Pilot Transactive Systems using Foundational Theory and Metrics

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

Lian, Jianming; Sun, Y.; Kalsi, Karanjit

This document is the second of a two-part report. Part 1 reviewed several demonstrations of transactive control and compared them in terms of their payoff functions, control decisions, information privacy, and mathematical solution concepts. It was suggested in Part 1 that these four listed components should be adopted for meaningful comparison and design of future transactive systems. Part 2 proposes qualitative and quantitative metrics that will be needed to compare alternative transactive systems. It then uses the analysis and design principles from Part 1 while conducting more in-depth analysis of two transactive demonstrations: the American Electric Power (AEP) gridSMART Demonstration,more » which used a double –auction market mechanism, and a consensus method like that used in the Pacific Northwest Smart Grid Demonstration. Ultimately, metrics must be devised and used to meaningfully compare alternative transactive systems. One significant contribution of this report is an observation that the decision function used for thermostat control in the AEP gridSMART Demonstration has superior performance if its decision function is recast to more accurately reflect the power that will be used under for thermostatic control under alternative market outcomes.« less

Outcomes of videotape instruction in clinic waiting area.

PubMed

Oermann, Marilyn H; Webb, Sue A; Ashare, Jo Ann

2003-01-01

The purpose of our study was to examine the effectiveness of general health-promotion teaching for patients in the waiting room of a clinic, using focused videotape instruction. An experimental design was used. Subjects were patients (N = 215) in the waiting rooms of clinics in a university medical center in the Midwest. Patients were randomly assigned to two groups: focused videotape instruction in the clinic (n = 106) and control (no instruction in the clinic waiting area) (n = 109). The outcome measures included patient learning about a health education topic and patient satisfaction with overall care, explanations by the provider, and education received during the clinic visit. There was a significant gain in knowledge for patients who viewed the videotape in the waiting room (t = 5.43, df = 213, p < .0001), and they were more satisfied with their education compared with the control group (t = 4.73, df = 213, p < .0001). This study supports focused video instruction as an effective and efficient teaching intervention for disseminating health information in the waiting area.

Outpatient Office Wait Times and Quality of Care for Medicaid Patients

PubMed Central

Oostrom, Tamar; Einav, Liran; Finkelstein, Amy

2018-01-01

Time spent in the doctor’s waiting room captures an important aspect of the healthcare experience. We analyzed data on 21 million outpatient visits obtained from electronic health record systems, allowing us to measure time spent in the waiting room beyond the scheduled appointment time. Median wait time was just over 4 minutes. Almost one-fifth of visits had waits longer than 20 minutes, and 10% were over 30 minutes. Waits were shorter for early morning appointments, younger patients, and at larger practices. Median wait time was 4.1 minutes for privately-insured and 4.6 minutes for Medicaid patients; adjusting for patient and appointment characteristics, Medicaid patients were 20% more likely than the privately-insured to wait longer than 20 minutes (P<0.001), with most of this disparity explained by differences in practices and providers they saw. Wait time for Medicaid patients relative to the privately-insured was longer in states with relatively lower Medicaid reimbursement rates. PMID:28461348

24 CFR 982.204 - Waiting list: Administration of waiting list.

Code of Federal Regulations, 2010 CFR

2010-04-01

... size (number of bedrooms for which family qualifies under PHA occupancy standards); (3) Date and time... list. (d) Family size. (1) The order of admission from the waiting list may not be based on family size, or on the family unit size for which the family qualifies under the PHA occupancy policy. (2) If the...

[Dealing with Waiting Times in Health Systems - An International Comparative Overview].

PubMed

Finkenstädt, V

2015-10-01

Waiting times in the health system are a form of rationing that exists in many countries. Previous studies on this topic are mainly related to the problem of international comparability of waiting times or on the presentation of national strategies as to how they should be reduced. This review adds to this analysis and examines how the OECD countries deal with waiting times in the health-care system and investigates which information is published about waiting for what purpose. Furthermore, waiting times and the type of health system financing are compared. A systematic internet research on waiting times in the health-care system was conducted on the websites of the competent authorities (Ministry of Health or other authorities and institutions). The identified publications were then examined for the purpose of their deployment. Finally, the OECD Health Data were analysed to determine the relationship between tax and contribution financing of public health care expenditure. The primary form of financing was compared with the results of the waiting time analysis. 16 OECD countries are identified which officially collect and publish administrative data on waiting times on the Internet. The data are processed differently depending on the country. By providing this information, two main objectives are pursued: a public monitoring of waiting times in the health system (14 countries) and information for patients on waiting times (9 countries). Official statistics on waiting times exist mainly in countries with tax-financed health systems, whereas this is not the case in the majority of OECD countries with health systems that are funded through contributions. The publication of administrative waiting times data is primarily intended to inform the patient and as a performance indicator in terms of access to health care. Even if data on waiting times are published, the publication of indicators and the management of waiting lists alone will not solve the problem. Rather

17 CFR 30.9 - Fraudulent transactions prohibited.

Code of Federal Regulations, 2010 CFR

2010-04-01

... prohibited. 30.9 Section 30.9 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION FOREIGN FUTURES AND FOREIGN OPTIONS TRANSACTIONS § 30.9 Fraudulent transactions prohibited. It shall be unlawful... foreign futures contract or foreign options transaction: (a) To cheat or defraud or attempt to cheat or...

The association between waiting for psychological therapy and therapy outcomes as measured by the CORE-OM.

PubMed

Beck, Alison; Burdett, Mark; Lewis, Helen

2015-06-01

To investigate the impact of waiting for psychological therapy on client well-being as measured by the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) global distress (GD) score. Global distress scores were retrieved for all clients referred for psychological therapy in a secondary care mental health service between November 2006 and May 2013 and who had completed a CORE-OM at assessment and first session. GD scores for a subgroup of 103 clients who had completed a CORE-OM during the last therapy session were also reviewed. The study sample experienced a median wait of 41.14 weeks between assessment and first session. The relationship between wait time from referral acceptance to assessment, and assessment GD score was not significant. During the period between assessment and first session no significant difference in GD score was observed. Nevertheless 29.1% of the sample experienced reliable change; 16.0% of clients reliably improved and 13.1% reliably deteriorated whilst waiting for therapy. Demographic factors were not found to have a significant effect on the change in GD score between assessment and first session. Waiting time was associated with post-therapy outcomes but not to a degree which was meaningful. The majority of individuals (54.4%), regardless of whether they improved or deteriorated whilst waiting for therapy, showed reliable improvement at end of therapy as measured by the CORE-OM. The majority of GD scores remained stable while waiting for therapy; however, 29.1% of secondary care clients experienced either reliable improvement or deterioration. Irrespective of whether they improved, deteriorated or remained unchanged whilst waiting for therapy, most individuals who had a complete end of therapy assessment showed reliable improvements following therapy. There was no significant difference in GD score between assessment and first session recordings. A proportion of clients (29.1%) showed reliable change, either improvement or

The British Columbia Nephrologists' Access Study (BCNAS) - a prospective, health services interventional study to develop waiting time benchmarks and reduce wait times for out-patient nephrology consultations.

PubMed

Schachter, Michael E; Romann, Alexandra; Djurdev, Ognjenka; Levin, Adeera; Beaulieu, Monica

2013-08-29

Early referral and management of high-risk chronic kidney disease may prevent or delay the need for dialysis. Automatic eGFR reporting has increased demand for out-patient nephrology consultations and in some cases, prolonged queues. In Canada, a national task force suggested the development of waiting time targets, which has not been done for nephrology. We sought to describe waiting time for outpatient nephrology consultations in British Columbia (BC). Data collection occurred in 2 phases: 1) Baseline Description (Jan 18-28, 2010) and 2) Post Waiting Time Benchmark-Introduction (Jan 16-27, 2012). Waiting time was defined as the interval from receipt of referral letters to assessment. Using a modified Delphi process, Nephrologists and Family Physicians (FP) developed waiting time targets for commonly referred conditions through meetings and surveys. Rules were developed to weigh-in nephrologists', FPs', and patients' perspectives in order to generate waiting time benchmarks. Targets consider comorbidities, eGFR, BP and albuminuria. Referred conditions were assigned a priority score between 1-4. BC nephrologists were encouraged to centrally triage referrals to see the first available nephrologist. Waiting time benchmarks were simultaneously introduced to guide patient scheduling. A post-intervention waiting time evaluation was then repeated. In 2010 and 2012, 43/52 (83%) and 46/57 (81%) of BC nephrologists participated. Waiting time decreased from 98(IQR44,157) to 64(IQR21,120) days from 2010 to 2012 (p = <.001), despite no change in referral eGFR, demographics, nor number of office hrs/wk. Waiting time improved most for high priority patients. An integrated, Provincial initiative to measure wait times, develop waiting benchmarks, and engage physicians in active waiting time management associated with improved access to nephrologists in BC. Improvements in waiting time was most marked for the highest priority patients, which suggests that benchmarks had an

Waiting Online: A Review and Research Agenda.

ERIC Educational Resources Information Center

Ryan, Gerard; Valverde, Mireia

2003-01-01

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

The surgical waiting time initiative: A review of the Nigerian situation

PubMed Central

Abdulkareem, Imran Haruna

2014-01-01

SUMMARY The concept of surgical waiting time initiative (SWAT) was introduced in developed countries to reduce elective surgery waiting lists and increase efficiency of care. It was supplemented by increasing popularity of day surgery, which shortens elective waiting lists and minimises cancellations. It is established in Western countries, but not in developing countries like Nigeria where it is still evolving. A search was carried out in Pub Med, Google, African journals online (AJOL), Athens and Ovid for relevant publications on elective surgery waiting list in Nigeria, published in English language. Words include waiting/wait time, waiting time initiative, time to surgery, waiting for operations, waiting for intervention, waiting for procedures and time before surgery in Nigeria. A total of 37 articles published from Nigeria in relation to various waiting times were found from the search and fulfilled the inclusion criteria. Among them, 11 publications (29.7%) were related to emergency surgery waiting times, 10 (27%) were related to clinic waiting times, 9 (24.3%) were related to day case surgery, 2 (5.5%) were related to investigation waiting times and only 5 (13.5%) articles were specifically published on elective surgery waiting times. A total of 9 articles (24.5%) were published from obstetrics and gynaecology (OG), 7 (19%) from general surgery, 5 (13.5%) from public health, 3 (8%) from orthopaedics, 3 (8%) from general practice (GP), 3 (8%) from paediatrics/paediatric surgery, 2 (5.5%) from ophthalmology, 1 (2.7%) from ear, nose and throat (ENT), 1 (2.7%) from plastic surgery, 1 (2.7%) from urology and only 1 (2.7%) article was published from dental/maxillofacial surgery. Waiting times mean different things to different health practitioners in Nigeria. There were only 5/37 articles (13.5%) specifically related to elective surgery waiting times in Nigerian hospitals, which show that the concept of the SWAT is still evolving in Nigeria. Of the 37, 11 (24

The surgical waiting time initiative: A review of the Nigerian situation.

PubMed

Abdulkareem, Imran Haruna

2014-11-01

The concept of surgical waiting time initiative (SWAT) was introduced in developed countries to reduce elective surgery waiting lists and increase efficiency of care. It was supplemented by increasing popularity of day surgery, which shortens elective waiting lists and minimises cancellations. It is established in Western countries, but not in developing countries like Nigeria where it is still evolving. A search was carried out in Pub Med, Google, African journals online (AJOL), Athens and Ovid for relevant publications on elective surgery waiting list in Nigeria, published in English language. Words include waiting/wait time, waiting time initiative, time to surgery, waiting for operations, waiting for intervention, waiting for procedures and time before surgery in Nigeria. A total of 37 articles published from Nigeria in relation to various waiting times were found from the search and fulfilled the inclusion criteria. Among them, 11 publications (29.7%) were related to emergency surgery waiting times, 10 (27%) were related to clinic waiting times, 9 (24.3%) were related to day case surgery, 2 (5.5%) were related to investigation waiting times and only 5 (13.5%) articles were specifically published on elective surgery waiting times. A total of 9 articles (24.5%) were published from obstetrics and gynaecology (OG), 7 (19%) from general surgery, 5 (13.5%) from public health, 3 (8%) from orthopaedics, 3 (8%) from general practice (GP), 3 (8%) from paediatrics/paediatric surgery, 2 (5.5%) from ophthalmology, 1 (2.7%) from ear, nose and throat (ENT), 1 (2.7%) from plastic surgery, 1 (2.7%) from urology and only 1 (2.7%) article was published from dental/maxillofacial surgery. Waiting times mean different things to different health practitioners in Nigeria. There were only 5/37 articles (13.5%) specifically related to elective surgery waiting times in Nigerian hospitals, which show that the concept of the SWAT is still evolving in Nigeria. Of the 37, 11 (24

The topology of card transaction money flows

NASA Astrophysics Data System (ADS)

Zanin, Massimiliano; Papo, David; Romance, Miguel; Criado, Regino; Moral, Santiago

2016-11-01

Money flow models are essential tools to understand different economical phenomena, like saving propensities and wealth distributions. In spite of their importance, most of them are based on synthetic transaction networks with simple topologies, e.g. random or scale-free ones, as the characterisation of real networks is made difficult by the confidentiality and sensitivity of money transaction data. Here, we present an analysis of the topology created by real credit card transactions from one of the biggest world banks, and show how different distributions, e.g. number of transactions per card or amount, have nontrivial characteristics. We further describe a stochastic model to create transactions data sets, feeding from the obtained distributions, which will allow researchers to create more realistic money flow models.

Transactions and Answer Judging in Multimedia Instruction: A Way to Transact with Features Appearing in Video and Graphic Images.

ERIC Educational Resources Information Center

Casey, Carl

1992-01-01

Discussion of transactions in computer-based instruction for ill-structured and visual domains focuses on two transactions developed for meteorology training that provide the capability to interact with video and graphic images at a very detailed level. Potential applications for the transactions are suggested, and early evaluation reports are…

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

NASA Astrophysics Data System (ADS)

Wang, Jianfeng

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

What's in a wait? Contrasting management science and economic perspectives on waiting for emergency care.

PubMed

Morton, Alec; Bevan, Gwyn

2008-02-01

The current paper reviews and contrasts a management science view of waiting for healthcare, which centres on queues as devices for buffering demand, with an economic view, which stresses the role of the incentive structure, in the context of English Accident and Emergency Departments. We demonstrate that the management science view provides insight into waiting time performance within a single facility but is limited in its ability to shed light on variations in performance across facilities. We argue, with reference to supporting data, that such variations may be explainable by a proper understanding of the incentive structure in A&E Departments.

Do waiting times affect health outcomes? Evidence from coronary bypass.

PubMed

Moscelli, Giuseppe; Siciliani, Luigi; Tonei, Valentina

2016-07-01

Long waiting times for non-emergency services are a feature of several publicly-funded health systems. A key policy concern is that long waiting times may worsen health outcomes: when patients receive treatment, their health condition may have deteriorated and health gains reduced. This study investigates whether patients in need of coronary bypass with longer waiting times are associated with poorer health outcomes in the English National Health Service over 2000-2010. Exploiting information from the Hospital Episode Statistics (HES), we measure health outcomes with in-hospital mortality and 28-day emergency readmission following discharge. Our results, obtained combining hospital fixed effects and instrumental variable methods, find no evidence of waiting times being associated with higher in-hospital mortality and weak association between waiting times and emergency readmission following a surgery. The results inform the debate on the relative merits of different types of rationing in healthcare systems. They are to some extent supportive of waiting times as an acceptable rationing mechanism, although further research is required to explore whether long waiting times affect other aspects of individuals' life. Copyright © 2016 Elsevier Ltd. All rights reserved.

Electron Waiting Times in Mesoscopic Conductors

NASA Astrophysics Data System (ADS)

Albert, Mathias; Haack, Géraldine; Flindt, Christian; Büttiker, Markus

2012-05-01

Electron transport in mesoscopic conductors has traditionally involved investigations of the mean current and the fluctuations of the current. A complementary view on charge transport is provided by the distribution of waiting times between charge carriers, but a proper theoretical framework for coherent electronic systems has so far been lacking. Here we develop a quantum theory of electron waiting times in mesoscopic conductors expressed by a compact determinant formula. We illustrate our methodology by calculating the waiting time distribution for a quantum point contact and find a crossover from Wigner-Dyson statistics at full transmission to Poisson statistics close to pinch-off. Even when the low-frequency transport is noiseless, the electrons are not equally spaced in time due to their inherent wave nature. We discuss the implications for renewal theory in mesoscopic systems and point out several analogies with level spacing statistics and random matrix theory.

Maternity waiting homes in Ethiopia--three decades experience.

PubMed

Gaym, Asheber; Pearson, Luwei; Soe, Khynn Win Win

2012-07-01

Access to comprehensive emergency obstetric care is limited in Ethiopia. Maternity waiting homes are part of the strategies utilized to improve access to hard to reach rural populations. Despite long years of existence of this service in Ethiopia, the practice has not been adequately assessed so far. Describe the current status of maternity waiting home services in Ethiopia All facilities in Ethiopia that have a maternity waiting home were identified from FMOH data as well as personal contacts with focal persons at Regional Health Bureaus in the nine regions and UNICEF regional offices. A standardized data collection tool for facility assessment was developed by the quality referral team, Health Section, UNICEF. Data collection included site visits and documentation of infrastructural related issues through a facility checklist. Service related issues were also collected from log books and other documents as well as through interview with relevant staff Focus group discussions were held with all MWHs attendants who were found admitted at the time of the review at Attat, Wolisso and Gidole hospital maternity waiting homes on major thematic areas identified by the review team regarding MWH care The practice of maternity waiting homes in Ethiopia spans more than three decades. Nine facilities located in five Regional States had maternity waiting home services. All except one were located in hospitals. Admission capacity ranged from 4 up to 44 mothers at a time. Seven of the maternity waiting homes required the clients to cater for their own food, firewood and clothing supply providing only kitchen space and few kitchen utensils. Clients came from as far as 400 kms away to obtain services. Medical care and documentation of services were not standardized Duration of stay varied from 3-90 days. Monthly admission rates varied from 0-84 mothers at different institutions. Major indications for admission were previous caesarean section 34%; previous fistula repair 12

[Patients' satisfaction and waiting time in oncology day care centers in Champagne-Ardenne].

PubMed

Debreuve-Theresette, A; Jovenin, N; Stona, A C; Kraïem-Leleu, M; Burde, F; Parent, D; Hettler, D; Rey, J B

2015-12-01

Quality of life of patients suffering from cancer may be influenced by the way healthcare is organized and by patient experiences. Nowadays, chemotherapy is often provided in day care centers. This study aimed to assess patient waiting time and satisfaction in oncology day care centers in Champagne-Ardenne, France. This cross-sectional survey involved all patients receiving ambulatory chemotherapy during a one-week period in day care centers of Champagne-Ardenne public and private healthcare institutions participating in the study. Sociodemographic, medical and outpatient data were collected. Patient satisfaction was measured using the Out-Patsat35 questionnaire. Eleven (out of 16) oncology day care centers and 441 patients participated in the study. Most of the patients were women (n=252, 57.1%) and the mean age was 61±12 years. The mean satisfaction score was 82±14 (out of 100) and the mean waiting time between the assigned appointment time and administration of chemotherapy was 97±60 min. This study has shown that waiting times are important. However, patients are satisfied with the healthcare organization, especially regarding nursing support. Early preparation of chemotherapy could improve these parameters. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

The British Columbia Nephrologists’ Access Study (BCNAS) – a prospective, health services interventional study to develop waiting time benchmarks and reduce wait times for out-patient nephrology consultations

PubMed Central

2013-01-01

Background Early referral and management of high-risk chronic kidney disease may prevent or delay the need for dialysis. Automatic eGFR reporting has increased demand for out-patient nephrology consultations and in some cases, prolonged queues. In Canada, a national task force suggested the development of waiting time targets, which has not been done for nephrology. Methods We sought to describe waiting time for outpatient nephrology consultations in British Columbia (BC). Data collection occurred in 2 phases: 1) Baseline Description (Jan 18-28, 2010) and 2) Post Waiting Time Benchmark-Introduction (Jan 16-27, 2012). Waiting time was defined as the interval from receipt of referral letters to assessment. Using a modified Delphi process, Nephrologists and Family Physicians (FP) developed waiting time targets for commonly referred conditions through meetings and surveys. Rules were developed to weigh-in nephrologists’, FPs’, and patients’ perspectives in order to generate waiting time benchmarks. Targets consider comorbidities, eGFR, BP and albuminuria. Referred conditions were assigned a priority score between 1-4. BC nephrologists were encouraged to centrally triage referrals to see the first available nephrologist. Waiting time benchmarks were simultaneously introduced to guide patient scheduling. A post-intervention waiting time evaluation was then repeated. Results In 2010 and 2012, 43/52 (83%) and 46/57 (81%) of BC nephrologists participated. Waiting time decreased from 98(IQR44,157) to 64(IQR21,120) days from 2010 to 2012 (p = <.001), despite no change in referral eGFR, demographics, nor number of office hrs/wk. Waiting time improved most for high priority patients. Conclusions An integrated, Provincial initiative to measure wait times, develop waiting benchmarks, and engage physicians in active waiting time management associated with improved access to nephrologists in BC. Improvements in waiting time was most marked for the highest priority

Children's preferences concerning ambiance of dental waiting rooms.

PubMed

Panda, A; Garg, I; Shah, M

2015-02-01

Despite many advances in paediatric dentistry, the greatest challenge for any paediatric dentist is to remove the anxiety related to a dental visit and have a child patient to accept dental treatment readily. Minor changes made in the waiting room design can have a major effect on the way any child perceives the upcoming dental experience. This study was carried out to determine children's preferences regarding the dental waiting area so as to improve their waiting experience and reduce their preoperative anxiety before a dental appointment. This was a cross-sectional descriptive study using survey methodology. A questionnaire designed to evaluate children's preferences regarding the waiting room was distributed to new paediatric patients, aged between 6 and 11 years of age, attending an outpatient dental facility and was completed by 212 children (127 males, 85 females). The analyses were carried out on cross-tables using Phi (for 2×2 tables) or Cramer's V (for larger than 2×2 tables) to assess responses to the questionnaire items across age groups and gender. A majority of children preferred music and the ability to play in a waiting room. They also preferred natural light and walls with pictures. They preferred looking at an aquarium or a television and sitting on beanbags and chairs and also preferred plants and oral hygiene posters Repetious. The results obtained from this study may help the dental team decide on an appropriate design of their paediatric waiting room so as to make children comfortable in the dental environment and improve delivery of health care.

45 CFR 162.1901 - Medicaid pharmacy subrogation transaction.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Medicaid pharmacy subrogation transaction. 162... STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Medicaid Pharmacy Subrogation § 162.1901 Medicaid pharmacy subrogation transaction. The Medicaid pharmacy subrogation transaction is the...

45 CFR 162.1901 - Medicaid pharmacy subrogation transaction.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Medicaid pharmacy subrogation transaction. 162... STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Medicaid Pharmacy Subrogation § 162.1901 Medicaid pharmacy subrogation transaction. The Medicaid pharmacy subrogation transaction is the...

45 CFR 162.1901 - Medicaid pharmacy subrogation transaction.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Medicaid pharmacy subrogation transaction. 162... STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Medicaid Pharmacy Subrogation § 162.1901 Medicaid pharmacy subrogation transaction. The Medicaid pharmacy subrogation transaction is the...

45 CFR 162.1901 - Medicaid pharmacy subrogation transaction.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Medicaid pharmacy subrogation transaction. 162... STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Medicaid Pharmacy Subrogation § 162.1901 Medicaid pharmacy subrogation transaction. The Medicaid pharmacy subrogation transaction is the...

45 CFR 162.1901 - Medicaid pharmacy subrogation transaction.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Medicaid pharmacy subrogation transaction. 162... STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Medicaid Pharmacy Subrogation § 162.1901 Medicaid pharmacy subrogation transaction. The Medicaid pharmacy subrogation transaction is the...

The influence of parametric and external noise in act-and-wait control with delayed feedback.

PubMed

Wang, Jiaxing; Kuske, Rachel

2017-11-01

We apply several novel semi-analytic approaches for characterizing and calculating the effects of noise in a system with act-and-wait control. For concrete illustration, we apply these to a canonical balance model for an inverted pendulum to study the combined effect of delay and noise within the act-and-wait setting. While the act-and-wait control facilitates strong stabilization through deadbeat control, a comparison of different models with continuous vs. discrete updating of the control strategy in the active period illustrates how delays combined with the imprecise application of the control can seriously degrade the performance. We give several novel analyses of a generalized act-and-wait control strategy, allowing flexibility in the updating of the control strategy, in order to understand the sensitivities to delays and random fluctuations. In both the deterministic and stochastic settings, we give analytical and semi-analytical results that characterize and quantify the dynamics of the system. These results include the size and shape of stability regions, densities for the critical eigenvalues that capture the rate of reaching the desired stable equilibrium, and amplification factors for sustained fluctuations in the context of external noise. They also provide the dependence of these quantities on the length of the delay and the active period. In particular, we see that the combined influence of delay, parametric error, or external noise and on-off control can qualitatively change the dynamics, thus reducing the robustness of the control strategy. We also capture the dependence on how frequently the control is updated, allowing an interpolation between continuous and frequent updating. In addition to providing insights for these specific models, the methods we propose are generalizable to other settings with noise, delay, and on-off control, where analytical techniques are otherwise severely scarce.

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

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

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

Wait times for gastroenterology consultation in Canada: The patients’ perspective

PubMed Central

Paterson, WG; Barkun, AN; Hopman, WM; Leddin, DJ; Paré, P; Petrunia, DM; Sewitch, MJ; Switzer, C; van Zanten, S Veldhuyzen

2010-01-01

Long wait times for health care have become a significant issue in Canada. As part of the Canadian Association of Gastroenterology’s Human Resource initiative, a questionnaire was developed to survey patients regarding wait times for initial gastroenterology consultation and its impact. A total of 916 patients in six cities from across Canada completed the questionnaire at the time of initial consultation. Self-reported wait times varied widely, with 26.8% of respondents reporting waiting less than two weeks, 52.4% less than one month, 77.1% less than three months, 12.5% reported waiting longer than six months and 3.6% longer than one year. One-third of patients believed their wait time was too long, with 9% rating their wait time as ‘far too long’; 96.4% believed that maximal wait time should be less than three months, 78.9% believed it should be less than one month and 40.3% believed it should be less than two weeks. Of those working or attending school, 22.6% reported missing at least one day of work or school because of their symptoms in the month before their appointment, and 9.0% reported missing five or more days in the preceding month. A total of 20.2% of respondents reported being very worried about having a serious disease (ie, scored 6 or higher on 7-point Likert scale), and 17.6% and 14.8%, respectively, reported that their symptoms caused major impairment of social functioning and with the activities of daily living. These data suggest that a significant proportion of Canadians with digestive problems are not satisfied with their wait time for gastroenterology consultation. Furthermore, while awaiting consultation, many patients experience an impaired quality of life because of their gastrointestinal symptoms. PMID:20186353

Towards decision support for waiting lists: an operations management view.

PubMed

Vissers, J M; Van Der Bij, J D; Kusters, R J

2001-06-01

This paper considers the phenomenon of waiting lists in a healthcare setting, which is characterised by limitations on the national expenditure, to explore the potentials of an operations management perspective. A reference framework for waiting list management is described, distinguishing different levels of planning in healthcare--national, regional, hospital and process--that each contributes to the existence of waiting lists through managerial decision making. In addition, different underlying mechanisms in demand and supply are distinguished, which together explain the development of waiting lists. It is our contention that within this framework a series of situation specific models should be designed to support communication and decision making. This is illustrated by the modelling of the demand for cataract treatment in a regional setting in the south-eastern part of the Netherlands. An input-output model was developed to support decisions regarding waiting lists. The model projects the demand for treatment at a regional level and makes it possible to evaluate waiting list impacts for different scenarios to meet this demand.

Reducing pharmacy wait time to promote customer service: a follow-up study.

PubMed

Slowiak, Julie M; Huitema, Bradley E

2015-01-01

The present study had 3 objectives: (1) to evaluate the effects of 2 different interventions (feedback regarding customer satisfaction with wait time and combined feedback and goal setting) on wait time in a hospital outpatient pharmacy; (2) to assess the extent to which the previously applied interventions maintained their effects; and (3) to evaluate the differences between the effects of the original study and those of the present follow-up study. Participants were 10 employees (4 pharmacists and 6 technicians) of an outpatient pharmacy. Wait times and customer satisfaction ratings were collected for "waiting customers." An ABCB within-subjects design was used to assess the effects of the interventions on both wait time and customer satisfaction, where A was the baseline (no feedback and no goal setting); B was the customer satisfaction feedback; and C was the customer satisfaction feedback, the wait time feedback, and the goal setting for wait time reduction. Wait time decreased after baseline when the combined intervention was introduced, and wait time increased with the reintroduction of satisfaction feedback (alone). The results of the replication study confirm the pattern of the results of the original study and demonstrate high sensitivity of levels of customer satisfaction with wait time. The most impressive result of the replication is the nearly 2-year maintenance of lower wait time between the end of the original study and the beginning (baseline) of the replication.

17 CFR 155.6 - Trading standards for the transaction of business on registered derivatives transaction execution...

Code of Federal Regulations, 2011 CFR

2011-04-01

... 17 Commodity and Securities Exchanges 1 2011-04-01 2011-04-01 false Trading standards for the transaction of business on registered derivatives transaction execution facilities. 155.6 Section 155.6 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION TRADING STANDARDS § 155.6 Trading...

17 CFR 155.6 - Trading standards for the transaction of business on registered derivatives transaction execution...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Trading standards for the transaction of business on registered derivatives transaction execution facilities. 155.6 Section 155.6 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION TRADING STANDARDS § 155.6 Trading...

17 CFR 155.6 - Trading standards for the transaction of business on registered derivatives transaction execution...

Code of Federal Regulations, 2012 CFR

2012-04-01

... 17 Commodity and Securities Exchanges 1 2012-04-01 2012-04-01 false Trading standards for the transaction of business on registered derivatives transaction execution facilities. 155.6 Section 155.6 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION TRADING STANDARDS § 155.6 Trading...

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

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

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

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

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

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

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

ERIC Educational Resources Information Center

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

2015-01-01

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

Real waiting times for surgery. Proposal for an improved system for their management.

PubMed

Abásolo, Ignacio; Barber, Patricia; González López-Valcárcel, Beatriz; Jiménez, Octavio

2014-01-01

In Spain, official information on waiting times for surgery is based on the interval between the indication for surgery and its performance. We aimed to estimate total waiting times for surgical procedures, including outpatient visits and diagnostic tests prior to surgery. In addition, we propose an alternative system to manage total waiting times that reduces variability and maximum waiting times without increasing the use of health care resources. This system is illustrated by three surgical procedures: cholecystectomy, carpal tunnel release and inguinal/femoral hernia repair. Using data from two Autonomous Communities, we adjusted, through simulation, a theoretical distribution of the total waiting time assuming independence of the waiting times of each stage of the clinical procedure. We show an alternative system in which the waiting time for the second consultation is established according to the time previously waited for the first consultation. Average total waiting times for cholecystectomy, carpal tunnel release and inguinal/femoral hernia repair were 331, 355 and 137 days, respectively (official data are 83, 68 and 73 days, respectively). Using different negative correlations between waiting times for subsequent consultations would reduce maximum waiting times by between 2% and 15% and substantially reduce heterogeneity among patients, without generating higher resource use. Total waiting times are between two and five times higher than those officially published. The relationship between the waiting times at each stage of the medical procedure may be used to decrease variability and maximum waiting times. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

Space, place and (waiting) time: reflections on health policy and politics.

PubMed

Sheard, Sally

2018-02-19

Health systems have repeatedly addressed concerns about efficiency and equity by employing trans-national comparisons to draw out the strengths and weaknesses of specific policy initiatives. This paper demonstrates the potential for explicit historical analysis of waiting times for hospital treatment to add value to spatial comparative methodologies. Waiting times and the size of the lists of waiting patients have become key operational indicators. In the United Kingdom, as National Health Service (NHS) financial pressures intensified from the 1970s, waiting times have become a topic for regular public and political debate. Various explanations for waiting times include the following: hospital consultants manipulate NHS waiting lists to maintain their private practice; there is under-investment in the NHS; and available (and adequate) resources are being used inefficiently. Other countries have also experienced ongoing tensions between the public and private delivery of universal health care in which national and trans-national comparisons of waiting times have been regularly used. The paper discusses the development of key UK policies, and provides a limited Canadian comparative perspective, to explore wider issues, including whether 'waiting crises' were consciously used by policymakers, especially those brought into government to implement new economic and managerial strategies, to diminish the autonomy and authority of the medical professional in the hospital environment.

Outpatient Office Wait Times And Quality Of Care For Medicaid Patients.

PubMed

Oostrom, Tamar; Einav, Liran; Finkelstein, Amy

2017-05-01

The time patients spend in a doctor's waiting room prior to a scheduled appointment is an important component of the quality of the overall health care experience. We analyzed data on twenty-one million outpatient visits obtained from electronic health record systems, which allowed us to measure time spent in the waiting room beyond the scheduled appointment time. Median wait time was a little more than four minutes. Almost one-fifth of visits had waits longer than twenty minutes, and 10 percent were more than thirty minutes. Waits were shorter for early-morning appointments, for younger patients, and at larger practices. Median wait time was 4.1 minutes for privately insured patients and 4.6 minutes for Medicaid patients. After adjustment for patient and appointment characteristics, Medicaid patients were 20 percent more likely than the privately insured patients to wait longer than twenty minutes, with most of this disparity explained by differences in practices and providers they saw. Wait times for Medicaid patients relative to privately insured patients were longer in states with relatively lower Medicaid reimbursement rates. The study complements other work that suggests that Medicaid patients face some additional barriers in the receipt of care. Project HOPE—The People-to-People Health Foundation, Inc.

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

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

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

Transactive Systems Simulation and Valuation Platform Trial Analysis

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

Widergren, Steven E.; Hammerstrom, Donald J.; Huang, Qiuhua

Transactive energy systems use principles of value to coordinate responsive supply and demand in energy systems. Work continues within the Transactive Systems Program, which is funded by the U.S. Department of Energy at Pacific Northwest National Laboratory, to understand the value of, understand the theory behind, and simulate the behaviors of transactive energy systems. This report summarizes recent advances made by this program. The main capability advances include a more comprehensive valuation model, including recommended documentation that should make valuation studies of all sorts more transparent, definition of economic metrics with which transactive mechanisms can be evaluated, and multiple improvementsmore » to the time-simulation environment that is being used to evaluate transactive scenarios.« less

Effect of self-triage on waiting times at a walk-in sexual health clinic.

PubMed

Hitchings, Samantha; Barter, Janet

2009-10-01

Lengthy waiting times can be a major problem in walk-in sexual health clinics. They are stressful for both patients and staff and may lead to clients with significant health issues leaving the department before being seen by a clinician. A self-triage system may help reduce waiting times and duplication of work, improve patient pathways and decrease wasted visits. This paper describes implementation of a self-triage system in two busy sexual and reproductive health clinics. Patients were asked to complete a self-assessment form on registration to determine the reason for attendance. This then enabled patients to be directed to the most appropriate specialist or clinical service. The benefits of this approach were determined by measuring patient waiting times, reduction in unnecessary specialist review together with patient acceptability as tested by a patient satisfaction survey. The ease of comprehension of the triage form was also assessed by an independent readers' panel. A total of 193 patients were recruited over a 4-month period from November 2004 to February 2005. Patients from the November and December clinics were assigned to the 'traditional treatment' arm, with patients at subsequent clinics being assigned to the 'self-triage' system. Waiting times were collected by the receptionist and clinic staff. Ninety six patients followed the traditional route, 97 the new self-triage system. Sixty-nine (35.8%) patients completed the satisfaction survey. The self-triage system significantly reduced waiting time from 40 (22, 60) to 23 (10, 40) minutes [results expressed as median (interquartile range)]. There was a non-significant reduction in the proportion of patients seeing two clinicians from 21% to 13% (p = 0.17). Satisfaction levels were not significantly altered (95% compared to 97% satisfied, p = 0.64). The readers' panel found the triage form both easy to understand and to complete. Self-triage can effectively reduce clinic waiting times and allow better

45 CFR 162.1801 - Coordination of benefits transaction.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Coordination of benefits transaction. 162.1801... RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Coordination of Benefits § 162.1801 Coordination of benefits transaction. The coordination of benefits transaction is the transmission from any entity to a...

22 CFR 513.220 - Continuation of covered transactions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... and participants shall not renew or extend covered transactions (other than no-cost time extensions... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Continuation of covered transactions. 513.220... Continuation of covered transactions. (a) Notwithstanding the debarment, suspension, proposed debarment under...

31 CFR 800.214 - Foreign government-controlled transaction.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Foreign government-controlled..., ACQUISITIONS, AND TAKEOVERS BY FOREIGN PERSONS Definitions § 800.214 Foreign government-controlled transaction. The term foreign government-controlled transaction means any covered transaction that could result in...

31 CFR 800.214 - Foreign government-controlled transaction.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Foreign government-controlled..., ACQUISITIONS, AND TAKEOVERS BY FOREIGN PERSONS Definitions § 800.214 Foreign government-controlled transaction. The term foreign government-controlled transaction means any covered transaction that could result in...

31 CFR 800.214 - Foreign government-controlled transaction.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Foreign government-controlled..., ACQUISITIONS, AND TAKEOVERS BY FOREIGN PERSONS Definitions § 800.214 Foreign government-controlled transaction. The term foreign government-controlled transaction means any covered transaction that could result in...

17 CFR 31.17 - Records of leverage transactions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Records of leverage... LEVERAGE TRANSACTIONS § 31.17 Records of leverage transactions. (a) Each leverage transaction merchant receiving a leverage customer's order shall immediately upon receipt thereof prepare a written record of...

76 FR 18255 - Amendment to Prohibited Transaction Exemption (PTE) 96-23 for Plan Asset Transactions Determined...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-01

... Determined by In-House Asset Managers Agency: Employee Benefits Security Administration, Labor. Action... various transactions involving employee benefit plans whose assets are managed by in-house asset managers... Asset Transactions Determined by In-House Asset Managers to OMB for review and clearance at the time the...

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

PubMed

Munichor, Nira; Rafaeli, Anat

2007-03-01

The authors examined the effect of time perception and sense of progress in telephone queues on caller reactions to 3 telephone waiting time fillers: music, apologies, and information about location in the queue. In Study 1, conducted on 123 real calls, call abandonment was lowest, and call evaluations were most positive with information about location in the queue as the time filler. In Study 2, conducted with 83 participants who experienced a simulated telephone wait experience, sense of progress in the queue rather than perceived waiting time mediated the relationship between telephone waiting time filler and caller reactions. The findings provide insight for the management and design of telephone queues, as well as theoretical insight into critical cognitive processes that underlie telephone waiting, opening up an important new research agenda. (c) 2007 APA, all rights reserved.

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.

31 CFR 1024.314 - Structured transactions.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) FINANCIAL CRIMES ENFORCEMENT NETWORK, DEPARTMENT OF THE TREASURY RULES FOR MUTUAL FUNDS Reports Required To Be Made By Mutual Funds § 1024.314 Structured transactions. Refer to § 1010.314 of this chapter for rules regarding structured transactions for mutual funds. ...

Optimal Investment Under Transaction Costs: A Threshold Rebalanced Portfolio Approach

NASA Astrophysics Data System (ADS)

Tunc, Sait; Donmez, Mehmet Ali; Kozat, Suleyman Serdar

2013-06-01

We study optimal investment in a financial market having a finite number of assets from a signal processing perspective. We investigate how an investor should distribute capital over these assets and when he should reallocate the distribution of the funds over these assets to maximize the cumulative wealth over any investment period. In particular, we introduce a portfolio selection algorithm that maximizes the expected cumulative wealth in i.i.d. two-asset discrete-time markets where the market levies proportional transaction costs in buying and selling stocks. We achieve this using "threshold rebalanced portfolios", where trading occurs only if the portfolio breaches certain thresholds. Under the assumption that the relative price sequences have log-normal distribution from the Black-Scholes model, we evaluate the expected wealth under proportional transaction costs and find the threshold rebalanced portfolio that achieves the maximal expected cumulative wealth over any investment period. Our derivations can be readily extended to markets having more than two stocks, where these extensions are pointed out in the paper. As predicted from our derivations, we significantly improve the achieved wealth over portfolio selection algorithms from the literature on historical data sets.

Optimal Server Scheduling to Maintain Constant Customer Waiting Times

DTIC Science & Technology

1988-12-01

I I• I I I I I LCn CN OPTIMAL SERVER SCHEDUUNG TO MAINTAIN CONSTANT CUSTOMER WAITING TIMES THESIS Thomas J. Frey Captain UISAF AFIT/GOR/ENS/88D-7...hw bees appsewlf in ple rtan. cd = , ’ S 087 AFIT/GORMENS/8D-7 OPTIMAL SERVER SCHEDUUNG TO MAINTAIN~ CONSTANT CUSTOMER WAITING TIMES THESIS Thomas j...CONSTANT CUSTOMER WAITING TIMES THESIS Presented to the Faculty of the School of Engineering of the Air Force Institute of Technology Air University In

A process to establish and use base period prices for national forest system transaction evidence timber appraisal

Treesearch

Richard W. Haynes; Kenneth E. Skog; Richard Aubuchon

2016-01-01

The USDA Forest Service is required to appraise timber prior to it being offered for sale. Currently the Forest Service uses a transaction evidence based approach, but concerns have been raised about availability—both in number and applicability—of timber sales used as the basis of this approach. In addition to the problem of few sales, in certain situations a notable...

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

PubMed

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

2014-04-01

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

A transaction assessment method for allocation of transmission services

NASA Astrophysics Data System (ADS)

Banunarayanan, Venkatasubramaniam

The purpose of this research is to develop transaction assessment methods for allocating transmission services that are provided by an area/utility to power transactions. Transmission services are the services needed to deliver, or provide the capacity to deliver, real and reactive power from one or more supply points to one or more delivery points. As the number of transactions increase rapidly in the emerging deregulated environment, accurate quantification of the transmission services an area/utility provides to accommodate a transaction is becoming important, because then appropriate pricing schemes can be developed to compensate for the parties that provide these services. The Allocation methods developed are based on the "Fair Resource Allocation Principle" and they determine for each transaction the following: the flowpath of the transaction (both real and reactive power components), generator reactive power support from each area/utility, real power loss support from each area/utility. Further, allocation methods for distributing the cost of relieving congestion on transmission lines caused by transactions are also developed. The main feature of the proposed methods is representation of actual usage of the transmission services by the transactions. The proposed method is tested extensively on a variety of systems. The allocation methods developed in this thesis for allocation of transmission services to transactions is not only useful in studying the impact of transactions on a transmission system in a multi-transaction case, but they are indeed necessary to meet the criteria set forth by FERC with regard to pricing based on actual usage. The "consistency" of the proposed allocation methods has also been investigated and tested.

Longer wait times affect future use of VHA primary care.

PubMed

Wong, Edwin S; Liu, Chuan-Fen; Hernandez, Susan E; Augustine, Matthew R; Nelson, Karin; Fihn, Stephan D; Hebert, Paul L

2017-07-29

Improving access to the Veterans Health Administration (VHA) is a high priority, particularly given statutory mandates of the Veterans Access, Choice and Accountability Act. This study examined whether patient-reported wait times for VHA appointments were associated with future reliance on VHA primary care services. This observational study examined 13,595 VHA patients dually enrolled in fee-for-service Medicare. Data sources included VHA administrative data, Medicare claims and the Survey of Healthcare Experiences of Patients (SHEP). Primary care use was defined as the number of face-to-face visits from VHA and Medicare in the 12 months following SHEP completion. VHA reliance was defined as the number of VHA visits divided by total visits (VHA+Medicare). Wait times were derived from SHEP responses measuring the usual number of days to a VHA appointment with patients' primary care provider for those seeking immediate care. We defined appointment wait times categorically: 0 days, 1day, 2-3 days, 4-7 days and >7 days. We used fractional logistic regression to examine the relationship between wait times and reliance. Mean VHA reliance was 88.1% (95% CI = 86.7% to 89.5%) for patients reporting 0day waits. Compared with these patients, reliance over the subsequent year was 1.4 (p = 0.041), 2.8 (p = 0.001) and 1.6 (p = 0.014) percentage points lower for patients waiting 2-3 days, 4-7 days and >7 days, respectively. Patients reporting longer usual wait times for immediate VHA care exhibited lower future reliance on VHA primary care. Longer wait times may reduce care continuity and impact cost shifting across two federal health programs. Copyright © 2017. Published by Elsevier Inc.

The Impact of One-Dose Package of Medicines on Patient Waiting Time in Dispensing Pharmacy: Application of a Discrete Event Simulation Model.

PubMed

Furushima, Daisuke; Yamada, Hiroshi; Kido, Michiko; Ohno, Yuko

2018-01-01

Improvement in patient waiting time in dispensing pharmacies is an important element for patient and pharmacists. The One-Dose Package (ODP) of medicines was implemented in Japan to support medicine adherence among elderly patients; however, it also contributed to increase in patient waiting times. Given the projected increase in ODP patients in the near future owing to rapid population aging, development of improved strategies is a key imperative. We conducted a cross-sectional survey at a single dispensing pharmacy to clarify the impact of ODP on patient waiting time. Further, we propose an improvement strategy developed with use of a discrete event simulation (DES) model. A total of 673 patients received pharmacy services during the study period. A two-fold difference in mean waiting time was observed between ODP and non-ODP patients (22.6 and 11.2 min, respectively). The DES model was constructed with input parameters estimated from observed data. Introduction of fully automated ODP (A-ODP) system was projected to reduce the waiting time for ODP patient by 0.5 times (from 23.1 to 11.5 min). Furthermore, assuming that 40% of non-ODP patients would transfer to ODP, the waiting time was predicted to increase to 56.8 min; however, introduction of the A-ODP system decreased the waiting time to 20.4 min. Our findings indicate that ODP is one of the elements that increases the waiting time and that it might become longer in the future. Introduction of the A-ODP system may be an effective strategy to improve waiting time.

5 CFR 919.405 - May I enter into a covered transaction with a participant if a principal of the transaction is...

Code of Federal Regulations, 2010 CFR

2010-01-01

... with a participant if a principal of the transaction is excluded? 919.405 Section 919.405 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED... § 919.405 May I enter into a covered transaction with a participant if a principal of the transaction is...

Waiting endurance time estimation of electric two-wheelers at signalized intersections.

PubMed

Huan, Mei; Yang, Xiao-bao

2014-01-01

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

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

PubMed Central

Huan, Mei; Yang, Xiao-bao

2014-01-01

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

31 CFR 357.28 - Transaction requests.

Code of Federal Regulations, 2010 CFR

2010-07-01

... BONDS, NOTES AND BILLS HELD IN LEGACY TREASURY DIRECT Legacy Treasury Direct Book-Entry Securities System (Legacy Treasury Direct) § 357.28 Transaction requests. (a) General. Unless otherwise authorized... owner of the security. In addition to any required certification, a transaction request form executed by...

Object Management Group object transaction service based on an X/Open and International Organization for Standardization open systems interconnection transaction processing kernel

NASA Astrophysics Data System (ADS)

Liang, J.; Sédillot, S.; Traverson, B.

1997-09-01

This paper addresses federation of a transactional object standard - Object Management Group (OMG) object transaction service (OTS) - with the X/Open distributed transaction processing (DTP) model and International Organization for Standardization (ISO) open systems interconnection (OSI) transaction processing (TP) communication protocol. The two-phase commit propagation rules within a distributed transaction tree are similar in the X/Open, ISO and OMG models. Building an OTS on an OSI TP protocol machine is possible because the two specifications are somewhat complementary. OTS defines a set of external interfaces without specific internal protocol machine, while OSI TP specifies an internal protocol machine without any application programming interface. Given these observations, and having already implemented an X/Open two-phase commit transaction toolkit based on an OSI TP protocol machine, we analyse the feasibility of using this implementation as a transaction service provider for OMG interfaces. Based on the favourable result of this feasibility study, we are implementing an OTS compliant system, which, by initiating the extensibility and openness strengths of OSI TP, is able to provide interoperability between X/Open DTP and OMG OTS models.

Interventions to reduce waiting times for elective procedures.

PubMed

Ballini, Luciana; Negro, Antonella; Maltoni, Susanna; Vignatelli, Luca; Flodgren, Gerd; Simera, Iveta; Holmes, Jane; Grilli, Roberto

2015-02-23

Long waiting times for elective healthcare procedures may cause distress among patients, may have adverse health consequences and may be perceived as inappropriate delivery and planning of health care. To assess the effectiveness of interventions aimed at reducing waiting times for elective care, both diagnostic and therapeutic. We searched the following electronic databases: Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (1946-), EMBASE (1947-), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), ABI Inform, the Canadian Research Index, the Science, Social Sciences and Humanities Citation Indexes, a series of databases via Proquest: Dissertations & Theses (including UK & Ireland), EconLit, PAIS (Public Affairs International), Political Science Collection, Nursing Collection, Sociological Abstracts, Social Services Abstracts and Worldwide Political Science Abstracts. We sought related reviews by searching the Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effectiveness (DARE). We searched trial registries, as well as grey literature sites and reference lists of relevant articles. We considered randomised controlled trials (RCTs), controlled before-after studies (CBAs) and interrupted time series (ITS) designs that met EPOC minimum criteria and evaluated the effectiveness of any intervention aimed at reducing waiting times for any type of elective procedure. We considered studies reporting one or more of the following outcomes: number or proportion of participants whose waiting times were above or below a specific time threshold, or participants' mean or median waiting times. Comparators could include any type of active intervention or standard practice. Two review authors independently extracted data from, and assessed risk of bias of, each included study, using a standardised form and the EPOC 'Risk

Enhancing outpatient clinics management software by reducing patients' waiting time.

PubMed

Almomani, Iman; AlSarheed, Ahlam

The Kingdom of Saudi Arabia (KSA) gives great attention to improving the quality of services provided by health care sectors including outpatient clinics. One of the main drawbacks in outpatient clinics is long waiting time for patients-which affects the level of patient satisfaction and the quality of services. This article addresses this problem by studying the Outpatient Management Software (OMS) and proposing solutions to reduce waiting times. Many hospitals around the world apply solutions to overcome the problem of long waiting times in outpatient clinics such as hospitals in the USA, China, Sri Lanka, and Taiwan. These clinics have succeeded in reducing wait times by 15%, 78%, 60% and 50%, respectively. Such solutions depend mainly on adding more human resources or changing some business or management policies. The solutions presented in this article reduce waiting times by enhancing the software used to manage outpatient clinics services. Both quantitative and qualitative methods have been used to understand current OMS and examine level of patient's satisfaction. Five main problems that may cause high or unmeasured waiting time have been identified: appointment type, ticket numbering, doctor late arrival, early arriving patient and patients' distribution list. These problems have been mapped to the corresponding OMS components. Solutions to the above problems have been introduced and evaluated analytically or by simulation experiments. Evaluation of the results shows a reduction in patient waiting time. When late doctor arrival issues are solved, this can reduce the clinic service time by up to 20%. However, solutions for early arriving patients reduces 53.3% of vital time, 20% of the clinic time and overall 30.3% of the total waiting time. Finally, well patient-distribution lists make improvements by 54.2%. Improvements introduced to the patients' waiting time will consequently affect patients' satisfaction and improve the quality of health care services

46 CFR 9.8 - Broken periods.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC EXTRA COMPENSATION FOR OVERTIME SERVICES § 9.8 Broken periods. In computing extra compensation where the services rendered are in broken... with the waiting time and computed as continuous service. ...

Family experience of waiting for living donor liver transplantation: from parental donor perspective.

PubMed

Chou, Chu-Yi; Chen, Yu-Chih; Chen, Chao-Long; Chen, Jo-Lin; Mu, Pei-Fan

2009-06-01

The aim of this study was to investigate from the perspectives of the donor parents of children with biliary atresia, the essence of family experiences during the period when waiting for a living donor liver transplant. Living donor liver transplantation is a new hope for children and families when the child suffers from biliary atresia. It is obvious, during the waiting period, for a family with a child undergoing living donor liver transplantation, that the process has a serious impact and there is a need for them to be well-prepared. A descriptive phenomenological design was used in this study. Nine donor parents from a medical centre in Taiwan participated in this study. The inclusion criteria were that the parent had a child with biliary atresia, that the child had received living donor liver transplantation over the last year and a half and that the parent was the living donor for child's liver transplantation. An open in-depth interview technique encouraged the parents to reflect on their experiences as the process raised their feelings to a conscious level. The data were analysed using the Colaizzi's approach. This study explores the essence of families undergoing the waiting period for living donor liver transplantation surgery from the point of view of the donating parents. Five themes emerged: (1) surgery as hope of rebirth, (2) negotiating the decision to have surgery, (3) the selection of the donor to achieve family welfare, (4) preparing and planning for the surgery and (5) worry over the impact of the surgery. The results demonstrate that the parents' experiences included a variety of domains: hope of rebirth, mental negotiation while deciding on surgery and choice of donor, coping with the preparation for surgery and the possible impact on the family of the surgery. The findings indicated that nursing professionals should provide family-centred care to assist the family with the steps needed to move toward surgery.

Where does the waiting list begin? A short review of the dynamics and organization of modern waiting lists.

PubMed

Rotstein, Dalia L; Alter, David A

2006-06-01

Waiting for medical care is the by-product of system rationing, where demand exceeds supply. In this short report we expand on the conventional concept of the queue, by focusing on the regulation of demand and by incorporating a funnel and spout analogy. Real-world examples are used to illustrate the infancy of funnel or demand-side reform initiatives targeting the queue, and the suggestion is made that policy needs to address the concept of 'waiting' much earlier in the treatment cycle.

17 CFR 5.9 - Security deposits for retail forex transactions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... forex transactions. 5.9 Section 5.9 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION OFF-EXCHANGE FOREIGN CURRENCY TRANSACTIONS § 5.9 Security deposits for retail forex transactions. (a) Each futures commission merchant engaging, or offering to engage, in retail forex transactions...

17 CFR 5.9 - Security deposits for retail forex transactions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... forex transactions. 5.9 Section 5.9 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION OFF-EXCHANGE FOREIGN CURRENCY TRANSACTIONS § 5.9 Security deposits for retail forex transactions. (a) Each futures commission merchant engaging, or offering to engage, in retail forex transactions...

17 CFR 5.9 - Security deposits for retail forex transactions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... forex transactions. 5.9 Section 5.9 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION OFF-EXCHANGE FOREIGN CURRENCY TRANSACTIONS § 5.9 Security deposits for retail forex transactions. (a) Each futures commission merchant engaging, or offering to engage, in retail forex transactions...

Intention-based therapy for autism spectrum disorder: promising results of a wait-list control study in children.

PubMed

Weiner, Robert H; Greene, Roger L

2014-01-01

Autism is a complex neurodevelopmental disability that usually manifests during the first three years of life and typically lasts throughout a person's lifetime. The purpose of this study is to investigate the efficacy of NeuroModulation Technique (NMT), a form of intention-based therapy, in improving functioning in children diagnosed with autism. A total of 18 children who met the study criteria were selected to participate. All children completed baseline measures. The children in the experimental group (n = 9) received two sessions a week of NMT for six weeks. Then, children in the wait-list control group (n = 9) received two sessions a week of NMT for six weeks. Primary efficacy outcome measures included the Pervasive Developmental Disorder Behavioral Inventory Autism Composite Index, the Aberrant Behavior Checklist-Community Total Score, and the Autism Treatment Evaluation Checklist Total Score. Our hypotheses were that children in both groups would show significant improvement over their respective baseline scores following NMT treatment, which would reflect an improvement in adaptive behaviors as well as a decrease in maladaptive behaviors. Statistical analysis indicates a significant improvement in both the experimental and wait-list control group on all primary outcome measures following NMT treatment. The wait-list control group demonstrated no significant improvement on test measures over baseline scores during the wait period. No adverse reactions were reported. These findings suggest that NMT is a promising intervention for autism that has the potential to produce a significant reduction in maladaptive behaviors and a significant increase in adaptive behaviors within a relatively short period of time. © 2013 The Authors. Published by Elsevier Inc. All rights reserved.

12 CFR 349.3 - Prohibited transactions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... connection with any retail forex transaction: (1) Cheat or defraud or attempt to cheat or defraud any person... insured depository institution can cause retail forex transactions to be effected for a retail forex customer without the retail forex customer's specific authorization, then neither the FDIC-supervised...

12 CFR 349.3 - Prohibited transactions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... connection with any retail forex transaction: (1) Cheat or defraud or attempt to cheat or defraud any person... insured depository institution can cause retail forex transactions to be effected for a retail forex customer without the retail forex customer's specific authorization, then neither the FDIC-supervised...

12 CFR 48.3 - Prohibited transactions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... may, directly or indirectly, in or in connection with any retail forex transaction: (1) Cheat or... exercising discretion prohibited. If a national bank can cause retail forex transactions to be effected for a retail forex customer without the retail forex customer's specific authorization, then neither the...

12 CFR 48.3 - Prohibited transactions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... may, directly or indirectly, in or in connection with any retail forex transaction: (1) Cheat or... exercising discretion prohibited. If a national bank can cause retail forex transactions to be effected for a retail forex customer without the retail forex customer's specific authorization, then neither the...

12 CFR 349.3 - Prohibited transactions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... connection with any retail forex transaction: (1) Cheat or defraud or attempt to cheat or defraud any person... insured depository institution can cause retail forex transactions to be effected for a retail forex customer without the retail forex customer's specific authorization, then neither the FDIC-supervised...

12 CFR 48.3 - Prohibited transactions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... may, directly or indirectly, in or in connection with any retail forex transaction: (1) Cheat or... exercising discretion prohibited. If a national bank can cause retail forex transactions to be effected for a retail forex customer without the retail forex customer's specific authorization, then neither the...

Transaction-Based Building Controls Framework, Volume 1: Reference Guide

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

Somasundaram, Sriram; Pratt, Robert G.; Akyol, Bora A.

This document proposes a framework concept to achieve the objectives of raising buildings’ efficiency and energy savings potential benefitting building owners and operators. We call it a transaction-based framework, wherein mutually-beneficial and cost-effective market-based transactions can be enabled between multiple players across different domains. Transaction-based building controls are one part of the transactional energy framework. While these controls realize benefits by enabling automatic, market-based intra-building efficiency optimizations, the transactional energy framework provides similar benefits using the same market -based structure, yet on a larger scale and beyond just buildings, to the society at large.

Advertising emergency department wait times.

PubMed

Weiner, Scott G

2013-03-01

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

Advertising Emergency Department Wait Times

PubMed Central

Weiner, Scott G.

2013-01-01

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

The transactional interpretation of quantum mechanics

NASA Astrophysics Data System (ADS)

Cramer, John G.

2001-06-01

The transactional interpretation of quantum mechanics [1] was originally published in 1986 and is now about 14 years old. It is an explicitly nonlocal and Lorentz invariant alternative to the Copenhagen interpretation. It interprets the formalism for a quantum interaction as describing a "handshake" between retarded waves (ψ) and advanced waves (ψ*) for each quantum event or "transaction" in which energy, momentum, angular momentum, and other conserved quantities are transferred. The transactional interpretation offers the advantages that (1) it is actually "visible" in the formalism of quantum mechanics, (2) it is economical, involving fewer independent assumptions than its rivals, (3) it is paradox-free, resolving all of the paradoxes of standard quantum theory including nonlocality and wave function collapse, (4) it does not give a privileged role to observers or measurements, and (5) it permits the visualization of quantum events. We will review the transactional interpretation and some of its applications to "quantum paradoxes."

Waiting for Merlot: anticipatory consumption of experiential and material purchases.

PubMed

Kumar, Amit; Killingsworth, Matthew A; Gilovich, Thomas

2014-10-01

Experiential purchases (money spent on doing) tend to provide more enduring happiness than material purchases (money spent on having). Although most research comparing these two types of purchases has focused on their downstream hedonic consequences, the present research investigated hedonic differences that occur before consumption. We argue that waiting for experiences tends to be more positive than waiting for possessions. Four studies demonstrate that people derive more happiness from the anticipation of experiential purchases and that waiting for an experience tends to be more pleasurable and exciting than waiting to receive a material good. We found these effects in studies using questionnaires involving a variety of actual planned purchases, in a large-scale experience-sampling study, and in an archival analysis of news stories about people waiting in line to make a purchase. Consumers derive value from anticipation, and that value tends to be greater for experiential than for material purchases. © The Author(s) 2014.

Waiting for Water

ERIC Educational Resources Information Center

Lamson-Nussbaum, Jorie

2013-01-01

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

Organ Type and Waiting Time

MedlinePlus

... but each organ type has its own individual distribution policy reflects reflect factors that are unique to each organ type: Kidney Waiting time Donor/recipient immune system compatibility Prior living donor ...

2 CFR 180.205 - Why is it important if a particular transaction is a covered transaction?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 2 Grants and Agreements 1 2010-01-01 2010-01-01 false Why is it important if a particular transaction is a covered transaction? 180.205 Section 180.205 Grants and Agreements OFFICE OF MANAGEMENT AND... § 180.415; or (2) A Federal agency official obtains an exception from the agency head or designee to...

Absorbers in the Transactional Interpretation of Quantum Mechanics

NASA Astrophysics Data System (ADS)

Boisvert, Jean-Sébastien; Marchildon, Louis

2013-03-01

The transactional interpretation of quantum mechanics, following the time-symmetric formulation of electrodynamics, uses retarded and advanced solutions of the Schrödinger equation and its complex conjugate to understand quantum phenomena by means of transactions. A transaction occurs between an emitter and a specific absorber when the emitter has received advanced waves from all possible absorbers. Advanced causation always raises the specter of paradoxes, and it must be addressed carefully. In particular, different devices involving contingent absorbers or various types of interaction-free measurements have been proposed as threatening the original version of the transactional interpretation. These proposals will be analyzed by examining in each case the configuration of absorbers and, in the special case of the so-called quantum liar experiment, by carefully following the development of retarded and advanced waves through the Mach-Zehnder interferometer. We will show that there is no need to resort to the hierarchy of transactions that some have proposed, and will argue that the transactional interpretation is consistent with the block-universe picture of time.

Non-Poissonian Distribution of Tsunami Waiting Times

NASA Astrophysics Data System (ADS)

Geist, E. L.; Parsons, T.

2007-12-01

Analysis of the global tsunami catalog indicates that tsunami waiting times deviate from an exponential distribution one would expect from a Poisson process. Empirical density distributions of tsunami waiting times were determined using both global tsunami origin times and tsunami arrival times at a particular site with a sufficient catalog: Hilo, Hawai'i. Most sources for the tsunamis in the catalog are earthquakes; other sources include landslides and volcanogenic processes. Both datasets indicate an over-abundance of short waiting times in comparison to an exponential distribution. Two types of probability models are investigated to explain this observation. Model (1) is a universal scaling law that describes long-term clustering of sources with a gamma distribution. The shape parameter (γ) for the global tsunami distribution is similar to that of the global earthquake catalog γ=0.63-0.67 [Corral, 2004]. For the Hilo catalog, γ is slightly greater (0.75-0.82) and closer to an exponential distribution. This is explained by the fact that tsunamis from smaller triggered earthquakes or landslides are less likely to be recorded at a far-field station such as Hilo in comparison to the global catalog, which includes a greater proportion of local tsunamis. Model (2) is based on two distributions derived from Omori's law for the temporal decay of triggered sources (aftershocks). The first is the ETAS distribution derived by Saichev and Sornette [2007], which is shown to fit the distribution of observed tsunami waiting times. The second is a simpler two-parameter distribution that is the exponential distribution augmented by a linear decay in aftershocks multiplied by a time constant Ta. Examination of the sources associated with short tsunami waiting times indicate that triggered events include both earthquake and landslide tsunamis that begin in the vicinity of the primary source. Triggered seismogenic tsunamis do not necessarily originate from the same fault zone

12 CFR 240.3 - Prohibited transactions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... or in connection with any retail forex transaction: (1) Cheat or defraud or attempt to cheat or... banking institution that has authority to cause retail forex transactions to be effected for a retail forex customer without the retail forex customer's specific authorization may not (and an affiliate of...

31 CFR 595.206 - Exempt transactions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Exempt transactions. 595.206 Section 595.206 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Exempt transactions. (a) Personal communications. The prohibitions contained in this part do not apply to...

31 CFR 595.206 - Exempt transactions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Exempt transactions. 595.206 Section 595.206 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Exempt transactions. (a) Personal communications. The prohibitions contained in this part do not apply to...

31 CFR 595.206 - Exempt transactions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Exempt transactions. 595.206 Section 595.206 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Exempt transactions. (a) Personal communications. The prohibitions contained in this part do not apply to...

31 CFR 595.206 - Exempt transactions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Exempt transactions. 595.206 Section 595.206 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF... Exempt transactions. (a) Personal communications. The prohibitions contained in this part do not apply to...

Transaction fees and optimal rebalancing in the growth-optimal portfolio

NASA Astrophysics Data System (ADS)

Feng, Yu; Medo, Matúš; Zhang, Liang; Zhang, Yi-Cheng

2011-05-01

The growth-optimal portfolio optimization strategy pioneered by Kelly is based on constant portfolio rebalancing which makes it sensitive to transaction fees. We examine the effect of fees on an example of a risky asset with a binary return distribution and show that the fees may give rise to an optimal period of portfolio rebalancing. The optimal period is found analytically in the case of lognormal returns. This result is consequently generalized and numerically verified for broad return distributions and returns generated by a GARCH process. Finally we study the case when investment is rebalanced only partially and show that this strategy can improve the investment long-term growth rate more than optimization of the rebalancing period.

Waiting Lists for Radiation Therapy: A Case Study

PubMed Central

2001-01-01

Background Why waiting lists arise and how to address them remains unclear, and an improved understanding of these waiting list "dynamics" could lead to better management. The purpose of this study is to understand how the current shortage in radiation therapy in Ontario developed; the implications of prolonged waits; who is held accountable for managing such delays; and short, intermediate, and long-term solutions. Methods A case study of the radiation therapy shortage in 1998-99 at Princess Margaret Hospital, Toronto, Ontario, Canada. Relevant documents were collected; semi-structured, face-to-face interviews with ten administrators, health care workers, and patients were conducted, audio-taped and transcribed; and relevant meetings were observed. Results The radiation therapy shortage arose from a complex interplay of factors including: rising cancer incidence rates; broadening indications for radiation therapy; human resources management issues; government funding decisions; and responsiveness to previous planning recommendations. Implications of delays include poorer cancer control rates; patient suffering; and strained doctor-patient relationships. An incompatible relationship exists between moral responsibility, borne by government, and legal liability, borne by physicians. Short-term solutions include re-referral to centers with available resources; long-term solutions include training and recruiting health care workers, improving workload standards, increasing compensation, and making changes to the funding formula. Conclusion Human resource planning plays a critical role in the causes and solutions of waiting lists. Waiting lists have harsh implications for patients. Accountability relationships require realignment. PMID:11319944

Wait watchers: the application of a waiting list active management program in ambulatory care.

PubMed

de Belvis, Antonio Giulio; Marino, Marta; Avolio, Maria; Pelone, Ferruccio; Basso, Danila; Dei Tos, Gian Antonio; Cinquetti, Sandro; Ricciardi, Walter

2013-04-01

This study describes and evaluates the application of a waiting list management program in ambulatory care. Waiting list active management survey (telephone call and further contact); before and after controlled trial. Local Health Trust in Veneto Region (North-East of Italy) in 2008-09. Five hundred and one people on a 554 waiting list for C Class ambulatory care diagnostic and/or clinical investigations (electrocardiography plus cardiology ambulatory consultation, eye ambulatory consultation, carotid vessels Eco-color-Doppler, legs Eco-color-Doppler or colonoscopy, respectively). Active list management program consisting of a telephonic interview on 21 items to evaluate socioeconomic features, self-perceived health status, social support, referral physician, accessibility and patients' satisfaction. A controlled before-and-after study was performed to evaluate anonymously the overall impact on patients' self-perceived quality of care. The rate of patients with deteriorating healthcare conditions; rate of dropout; interviewed degree of satisfaction about the initiative; overall impact on citizens' perceived quality of care. 95.4% patients evaluated the initiative as useful. After the intervention, patients more likely to have been targeted with the program showed a statistically significant increase in self-reported quality of care. Positive impact of the program on some dimensions of ambulatory care quality (health status, satisfaction, willingness to remain in the queue), thus confirming the outstanding value of 'not to leave people alone' and 'not to leave them feeling themselves alone' in healthcare delivery.

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

PubMed

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

2000-03-18

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

12 CFR 217.133 - Cleared transactions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 12 Banks and Banking 2 2014-01-01 2014-01-01 false Cleared transactions. 217.133 Section 217.133... Measurement Approaches Risk-Weighted Assets for General Credit Risk § 217.133 Cleared transactions. (a... section 133(c)(2); (B) DF = the funded portion of the Board-regulated institution's default fund...

31 CFR 515.206 - Exempt transactions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... credit issued by a Cuban bank and confirmed by an American bank. These are permissible transactions under... enhancements. (b) Donation of food. The prohibitions contained in this part do not apply to transactions incident to the donation of food to nongovernmental organizations or individuals in Cuba. [54 FR 5233, Feb...

77 FR 54862 - Integrated Hedging Transactions of Qualifying Debt

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-06

... Integrated Hedging Transactions of Qualifying Debt AGENCY: Internal Revenue Service (IRS), Treasury. ACTION... certain integrated transactions that involve a foreign currency denominated debt instrument and multiple... foreign currency denominated debt instrument and multiple associated hedging transactions. The text of...

Specific timely appointments for triage reduced waiting lists in an outpatient physiotherapy service.

PubMed

Harding, K E; Bottrell, J

2016-12-01

Waiting lists with triage systems are commonly used in outpatient physiotherapy but may not be effective. Could an alternative model of access and triage reduce waiting times over a sustained period with no additional resources? Observational study comparing retrospective data for 11 months prior to the introduction of a new model of access compared with data for the equivalent 11 months afterwards. Patients referred to a physiotherapy outpatient department at an outer metropolitan hospital before (n=721) and after (n=707) the introduction of the new model. A model of access and triage known as 'specific timely appointments for triage' (STAT), in which appointment slots are preserved in advance specifically for new patients based on calculation of average demand. Time from referral to first assessment, number of appointments per patient, occasions of non-attendance and total length of stay in the service. Median time from referral to first appointment was 18 days [interquartile range (IQR) 11 to 33 days] in the pre-intervention group, compared with 14 days (IQR 9 to 21 days) in the post-intervention group (P<0.01). The number of physiotherapy appointments also reduced (IQR 2 to 6 vs IQR 1 to 4; P<0.01). There were no changes in non-attendance rates or total time in the service. Waiting time for outpatient physiotherapy was 22% lower in the year following the introduction of the STAT model. While acknowledging the limitations of a pre- and post-measurement design, this model may have potential for reducing waiting times for outpatient physiotherapy without additional resources. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Built spaces and features associated with user satisfaction in maternity waiting homes in Malawi.

PubMed

McIntosh, Nathalie; Gruits, Patricia; Oppel, Eva; Shao, Amie

2018-07-01

To assess satisfaction with maternity waiting home built spaces and features in women who are at risk for underutilizing maternity waiting homes (i.e. residential facilities that temporarily house near-term pregnant mothers close to healthcare facilities that provide obstetrical care). Specifically we wanted to answer the questions: (1) Are built spaces and features associated with maternity waiting home user satisfaction? (2) Can built spaces and features designed to improve hygiene, comfort, privacy and function improve maternity waiting home user satisfaction? And (3) Which built spaces and features are most important for maternity waiting home user satisfaction? A cross-sectional study comparing satisfaction with standard and non-standard maternity waiting home designs. Between December 2016 and February 2017 we surveyed expectant mothers at two maternity waiting homes that differed in their design of built spaces and features. We used bivariate analyses to assess if built spaces and features were associated with satisfaction. We compared ratings of built spaces and features between the two maternity waiting homes using chi-squares and t-tests to assess if design features to improve hygiene, comfort, privacy and function were associated with higher satisfaction. We used exploratory robust regression analysis to examine the relationship between built spaces and features and maternity waiting home satisfaction. Two maternity waiting homes in Malawi, one that incorporated non-standardized design features to improve hygiene, comfort, privacy, and function (Kasungu maternity waiting home) and the other that had a standard maternity waiting home design (Dowa maternity waiting home). 322 expectant mothers at risk for underutilizing maternity waiting homes (i.e. first-time mothers and those with no pregnancy risk factors) who had stayed at the Kasungu or Dowa maternity waiting homes. There were significant differences in ratings of built spaces and features between the

Waiting in the surgery.

PubMed

Fry, F

1994-07-01

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

Waiting Narratives of Lung Transplant Candidates

PubMed Central

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

2013-01-01

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

Waiting narratives of lung transplant candidates.

PubMed

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

2013-01-01

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

Transaction Logging.

ERIC Educational Resources Information Center

Jones, S.; And Others

1997-01-01

Discusses the use of transaction logging in Okapi-related projects to allow search algorithms and user interfaces to be investigated, evaluated, and compared. A series of examples is presented, illustrating logging software for character-based and graphical user interface systems, and demonstrating the usefulness of relational database management…

Protocol to Exploit Waiting Resources for UASNs.

PubMed

Hung, Li-Ling; Luo, Yung-Jeng

2016-03-08

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

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

PubMed

Glenn, Nicole M

2013-03-01

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

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

PubMed

Sundmacher, Leonie; Kopetsch, Thomas

2013-09-10

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

How to Use EMTS to Report Transactions for Fuel Programs

EPA Pesticide Factsheets

Reporting instructions for parties who transact Renewable Identification Numbers (RINs) and must enter transaction information in the EPA Moderated Transaction System (EMTS) within five (5) business days.

A Randomized, Wait-List Controlled Effectiveness Trial Assessing School-Wide Positive Behavior Support in Elementary Schools

ERIC Educational Resources Information Center

Horner, Robert H.; Sugai, George; Smolkowski, Keith; Eber, Lucille; Nakasato, Jean; Todd, Anne W.; Esperanza, Jody

2009-01-01

We report a randomized, wait-list controlled trial assessing the effects of school-wide positive behavior support (SWPBS). An effectiveness analysis was conducted with elementary schools in Hawaii and Illinois where training and technical assistance in SWPBS was provided by regular state personnel over a 3-year period. Results document that the…

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

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

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

8 CFR 207.5 - Waiting lists and priority handling.

Code of Federal Regulations, 2010 CFR

2010-01-01

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

24 CFR 100.115 - Residential real estate-related transactions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 1 2011-04-01 2011-04-01 false Residential real estate-related... Estate-Related Transactions § 100.115 Residential real estate-related transactions. The term residential real estate-related transactions means: (a) The making or purchasing of loans or providing other...

24 CFR 100.115 - Residential real estate-related transactions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 24 Housing and Urban Development 1 2012-04-01 2012-04-01 false Residential real estate-related... Estate-Related Transactions § 100.115 Residential real estate-related transactions. The term residential real estate-related transactions means: (a) The making or purchasing of loans or providing other...

24 CFR 100.115 - Residential real estate-related transactions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 1 2014-04-01 2014-04-01 false Residential real estate-related... Estate-Related Transactions § 100.115 Residential real estate-related transactions. The term residential real estate-related transactions means: (a) The making or purchasing of loans or providing other...

24 CFR 100.115 - Residential real estate-related transactions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Residential real estate-related... Estate-Related Transactions § 100.115 Residential real estate-related transactions. The term residential real estate-related transactions means: (a) The making or purchasing of loans or providing other...

24 CFR 100.115 - Residential real estate-related transactions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 1 2013-04-01 2013-04-01 false Residential real estate-related... Estate-Related Transactions § 100.115 Residential real estate-related transactions. The term residential real estate-related transactions means: (a) The making or purchasing of loans or providing other...

31 CFR 1026.310 - Reports of transactions in currency.

Code of Federal Regulations, 2011 CFR

2011-07-01

... and Introducing Brokers in Commodities § 1026.310 Reports of transactions in currency. The reports of transactions in currency requirements for futures commission merchants and introducing brokers in commodities... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Reports of transactions in currency...

Deficient neural activity subserving decision-making during reward waiting time in intertemporal choice in adult attention-deficit hyperactivity disorder.

PubMed

Todokoro, Ayako; Tanaka, Saori C; Kawakubo, Yuki; Yahata, Noriaki; Ishii-Takahashi, Ayaka; Nishimura, Yukika; Kano, Yukiko; Ohtake, Fumio; Kasai, Kiyoto

2018-04-24

Impulsivity, which significantly affects social adaptation, is an important target behavioral characteristic in interventions for attention-deficit hyperactivity disorder (ADHD). Typically, people are willing to wait longer to acquire greater rewards. Impulsivity in ADHD may be associated with brain dysfunction in decision-making involving waiting behavior under such situations. We tested the hypothesis that brain circuitry during a period of waiting (i.e., prior to the acquisition of reward) is altered in adults with ADHD. The participants included 14 medication-free adults with ADHD and 16 healthy controls matched for age, sex, IQ, and handedness. The behavioral task had participants choose between a delayed, larger monetary reward and an immediate, smaller monetary reward, where the reward waiting time actually occurred during functional magnetic resonance imaging measurement. We tested for group differences in the contrast values of blood-oxygen-level dependent signals associated with the length of waiting time, calculated using the parametric modulation method. While the two groups did not differ in the time discounting rate, the delay-sensitive contrast values were significantly lower in the caudate and visual cortex in individuals with ADHD. The higher impulsivity scores were significantly associated with lower delay-sensitive contrast values in the caudate and visual cortex. These results suggest that deficient neural activity affects decision-making involving reward waiting time during intertemporal choice tasks, and provide an explanation for the basis of impulsivity in adult ADHD. © 2018 The Author. Psychiatry and Clinical Neurosciences © 2018 Japanese Society of Psychiatry and Neurology.

47 CFR 32.27 - Transactions with affiliates.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 2 2014-10-01 2014-10-01 false Transactions with affiliates. 32.27 Section 32.27 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES UNIFORM SYSTEM OF ACCOUNTS FOR TELECOMMUNICATIONS COMPANIES General Instructions § 32.27 Transactions with...

47 CFR 32.27 - Transactions with affiliates.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 2 2013-10-01 2013-10-01 false Transactions with affiliates. 32.27 Section 32.27 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES UNIFORM SYSTEM OF ACCOUNTS FOR TELECOMMUNICATIONS COMPANIES General Instructions § 32.27 Transactions with...

47 CFR 32.27 - Transactions with affiliates.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 2 2011-10-01 2011-10-01 false Transactions with affiliates. 32.27 Section 32.27 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES UNIFORM SYSTEM OF ACCOUNTS FOR TELECOMMUNICATIONS COMPANIES General Instructions § 32.27 Transactions with...

Mortality on the Waiting List for Lung Transplantation in Patients with Idiopathic Pulmonary Fibrosis: A Single-Centre Experience.

PubMed

Bennett, David; Fossi, Antonella; Bargagli, Elena; Refini, Rosa Metella; Pieroni, Maria; Luzzi, Luca; Ghiribelli, Claudia; Paladini, Piero; Voltolini, Luca; Rottoli, Paola

2015-10-01

Lung transplantation (LTX) is nowadays accepted as a treatment option for selected patients with end-stage pulmonary disease. Idiopathic pulmonary fibrosis (IPF) is characterized by the radiological and histologic appearance of usual interstitial pneumonia. It is associated with a poor prognosis, and LTX is considered an effective treatment to significantly modify the natural history of this disease. The aim of the present study was to analyse mortality during the waiting list in IPF patients at a single institution. A retrospective analysis on IPF patients (n = 90) referred to our Lung Transplant Program in the period 2001-2014 was performed focusing on patients' characteristics and associated risk factors. Diagnosis of IPF was associated with high mortality on the waiting list with respect to other diagnosis (p < 0.05). No differences in demographic, clinical, radiological data and time spent on the waiting list were observed between IPF patients who underwent to LTX or lost on the waiting list. Patients who died showed significant higher levels of pCO2 and needed higher flows of O2-therapy on effort (p < 0.05). Pulmonary function tests failed to predict mortality and no other medical conditions were associated with survival. Patients newly diagnosed with IPF, especially in small to medium lung transplant volume centres and in Countries where a long waiting list is expected, should be immediately referred to transplantation, delay results in increased mortality. Early identification of IPF patients with a rapid progressive phenotype is strongly needed.

Systems and methods for performing wireless financial transactions

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

McCown, Steven Harvey

2012-07-03

A secure computing module (SCM) is configured for connection with a host device. The SCM includes a processor for performing secure processing operations, a host interface for coupling the processor to the host device, and a memory connected to the processor wherein the processor logically isolates at least some of the memory from access by the host device. The SCM also includes a proximate-field wireless communicator connected to the processor to communicate with another SCM associated with another host device. The SCM generates a secure digital signature for a financial transaction package and communicates the package and the signature tomore » the other SCM using the proximate-field wireless communicator. Financial transactions are performed from person to person using the secure digital signature of each person's SCM and possibly message encryption. The digital signatures and transaction details are communicated to appropriate financial organizations to authenticate the transaction parties and complete the transaction.« less

Pathways to Male Transactional Sex in Mumbai, India.

PubMed

Srivastava, Ankur; Goldbach, Jeremy T

2017-10-27

The article explores pathways to male transactional sex, focusing on entering, soliciting practices, role of pimps, client characteristics, and negotiations. Little scientific literature exists regarding male transactional sex in India, who represent a high-risk group for HIV infection. Case studies with 10 men who engage in transactional sex were conducted, who were recruited using purposive snowball sampling and interviewed at a social service organization. Participants differed in their sexual identity, sex roles, soliciting practices, and clients. Most of them listed economic crisis as their reason for entering transactional sex. Strategies to find clients included self-solicitation and referrals, while pimps played a major role in solicitation, negotiations, and events of crisis. The relationship among men who engage in transactional sex, pimps, and clients involves points of negotiation, opportunities, and limitations. HIV prevention should focus on identifying and addressing the groups' unique needs and working with pimps on risk-reduction strategies and crisis interventions.

Challenging "Waiting for Superman"

ERIC Educational Resources Information Center

Bruhn, Molle

2014-01-01

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

The uncertainty room: strategies for managing uncertainty in a surgical waiting room.

PubMed

Stone, Anne M; Lammers, John C

2012-01-01

To describe experiences of uncertainty and management strategies for staff working with families in a hospital waiting room. A 288-bed, nonprofit community hospital in a Midwestern city. Data were collected during individual, semistructured interviews with 3 volunteers, 3 technical staff members, and 1 circulating nurse (n = 7), and during 40 hours of observation in a surgical waiting room. Interview transcripts were analyzed using constant comparative techniques. The surgical waiting room represents the intersection of several sources of uncertainty that families experience. Findings also illustrate the ways in which staff manage the uncertainty of families in the waiting room by communicating support. Staff in surgical waiting rooms are responsible for managing family members' uncertainty related to insufficient information. Practically, this study provided some evidence that staff are expected to help manage the uncertainty that is typical in a surgical waiting room, further highlighting the important role of communication in improving family members' experiences.

ED adds business center to wait area.

PubMed

2007-10-01

Providing your patients with Internet access in the waiting area can do wonders for their attitudes and make them much more understanding of long wait times. What's more, it doesn't take a fortune to create a business center. The ED at Florida Hospital Celebration (FL) Health made a world of difference with just a couple of computers and a printer. Have your information technology staff set the computers up to preserve the privacy of your internal computer system, and block out offensive sites. Access to medical sites can help reinforce your patient education efforts.

41 CFR 302-11.23 - When must I request to have my initial time period extended?

Code of Federal Regulations, 2010 CFR

2010-07-01

... have my initial time period extended? 302-11.23 Section 302-11.23 Public Contracts and Property Management Federal Travel Regulation System RELOCATION ALLOWANCES RESIDENCE TRANSACTION ALLOWANCES 11-ALLOWANCES FOR EXPENSES INCURRED IN CONNECTION WITH RESIDENCE TRANSACTIONS General Rules Time Limitations...

41 CFR 302-11.23 - When must I request to have my initial time period extended?

Code of Federal Regulations, 2014 CFR

2014-07-01

... have my initial time period extended? 302-11.23 Section 302-11.23 Public Contracts and Property Management Federal Travel Regulation System RELOCATION ALLOWANCES RESIDENCE TRANSACTION ALLOWANCES 11-ALLOWANCES FOR EXPENSES INCURRED IN CONNECTION WITH RESIDENCE TRANSACTIONS General Rules Time Limitations...

41 CFR 302-11.23 - When must I request to have my initial time period extended?

Code of Federal Regulations, 2013 CFR

2013-07-01

... have my initial time period extended? 302-11.23 Section 302-11.23 Public Contracts and Property Management Federal Travel Regulation System RELOCATION ALLOWANCES RESIDENCE TRANSACTION ALLOWANCES 11-ALLOWANCES FOR EXPENSES INCURRED IN CONNECTION WITH RESIDENCE TRANSACTIONS General Rules Time Limitations...

41 CFR 302-11.23 - When must I request to have my initial time period extended?

Code of Federal Regulations, 2011 CFR

2011-07-01

... have my initial time period extended? 302-11.23 Section 302-11.23 Public Contracts and Property Management Federal Travel Regulation System RELOCATION ALLOWANCES RESIDENCE TRANSACTION ALLOWANCES 11-ALLOWANCES FOR EXPENSES INCURRED IN CONNECTION WITH RESIDENCE TRANSACTIONS General Rules Time Limitations...

41 CFR 302-11.23 - When must I request to have my initial time period extended?

Code of Federal Regulations, 2012 CFR

2012-07-01

... have my initial time period extended? 302-11.23 Section 302-11.23 Public Contracts and Property Management Federal Travel Regulation System RELOCATION ALLOWANCES RESIDENCE TRANSACTION ALLOWANCES 11-ALLOWANCES FOR EXPENSES INCURRED IN CONNECTION WITH RESIDENCE TRANSACTIONS General Rules Time Limitations...

Shorter Perceived Outpatient MRI Wait Times Associated With Higher Patient Satisfaction.

PubMed

Holbrook, Anna; Glenn, Harold; Mahmood, Rabia; Cai, Qingpo; Kang, Jian; Duszak, Richard

2016-05-01

The aim of this study was to assess differences in perceived versus actual wait times among patients undergoing outpatient MRI examinations and to correlate those times with patient satisfaction. Over 15 weeks, 190 patients presenting for outpatient MR in a radiology department in which "patient experience" is one of the stated strategic priorities were asked to (1) estimate their wait times for various stages in the imaging process and (2) state their satisfaction with their imaging experience. Perceived times were compared with actual electronic time stamps. Perceived and actual times were compared and correlated with standardized satisfaction scores using Kendall τ correlation. The mean actual wait time between patient arrival and examination start was 53.4 ± 33.8 min, whereas patients perceived a mean wait time of 27.8 ± 23.1 min, a statistically significant underestimation of 25.6 min (P < .001). Both shorter actual and perceived wait times at all points during patient encounters were correlated with higher satisfaction scores (P < .001). Patients undergoing outpatient MR examinations in an environment designed to optimize patient experience underestimated wait times at all points during their encounters. Shorter perceived and actual wait times were both correlated with higher satisfaction scores. As satisfaction surveys play a larger role in an environment of metric transparency and value-based payments, better understanding of such factors will be increasingly important. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Decreasing Wait Times and Increasing Patient Satisfaction: A Lean Six Sigma Approach.

PubMed

Godley, Mary; Jenkins, Jeanne B

2018-06-08

Patient satisfaction scores in the vascular interventional radiology department were low, especially related to wait times in registration and for tests/treatments, with low scores for intentions to recommend. The purpose of our quality improvement project was to decrease wait times and improve patient satisfaction using Lean Six Sigma's define, measure, analyze, improve, and control (DMAIC) framework with a pre-/postintervention design. There was a statistically significant decrease in wait times (P < .0019) and an increase in patient satisfaction scores in 3 areas: registration wait times (from 17 to 99 percentiles), test/treatment (from 19 to 60 percentiles), and likelihood to recommend (from 6 to 97 percentiles). Lean Six Sigma was an effective framework for use in decreasing wait times and improving patient satisfaction.

17 CFR 5.20 - Special calls for account and transaction information.

Code of Federal Regulations, 2013 CFR

2013-04-01

...'s account in retail forex transactions. (c) Special calls for information on open transactions in... introducing brokers. Upon special call by the Commission for information relating to retail forex transactions... concerning accounts of traders owning or controlling such retail forex transaction positions, as may be...

17 CFR 5.20 - Special calls for account and transaction information.

Code of Federal Regulations, 2012 CFR

2012-04-01

...'s account in retail forex transactions. (c) Special calls for information on open transactions in... introducing brokers. Upon special call by the Commission for information relating to retail forex transactions... concerning accounts of traders owning or controlling such retail forex transaction positions, as may be...

17 CFR 5.20 - Special calls for account and transaction information.

Code of Federal Regulations, 2014 CFR

2014-04-01

...'s account in retail forex transactions. (c) Special calls for information on open transactions in... introducing brokers. Upon special call by the Commission for information relating to retail forex transactions... concerning accounts of traders owning or controlling such retail forex transaction positions, as may be...

75 FR 76139 - Real-Time Public Reporting of Swap Transaction Data

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-07

... Transaction Data; Proposed Rule #0;#0;Federal Register / Vol. 75 , No. 234 / Tuesday, December 7, 2010...-Time Public Reporting of Swap Transaction Data AGENCY: Commodity Futures Trading Commission. ACTION...-time public reporting of swap transaction and pricing data for all swap transactions. Additionally, the...

Respiratory viral RNA on toys in pediatric office waiting rooms.

PubMed

Pappas, Diane E; Hendley, J Owen; Schwartz, Richard H

2010-02-01

Toys in pediatric office waiting rooms may be fomites for transmission of viruses. Eighteen samples were taken from office objects on 3 occasions. Samples were tested for presence of picornavirus (either rhinovirus or enterovirus) on all 3 sample days; in addition, January samples were tested for respiratory syncytial virus and March samples were tested for influenza A and B. In addition, 15 samples were obtained from the sick waiting room before and after cleaning. Polymerase chain reaction was used to detect picornavirus, respiratory syncytial virus, and influenza A or B virus. Finally, 20 samples were obtained from the fingers of a researcher after handling different toys in the sick waiting room, and samples were then obtained from all the same toys; all samples were tested for picornavirus by polymerase chain reaction. Viral RNA was detected on 11 of 52 (21%) of toys sampled. Ten of the positives were picornavirus; 1 was influenza B virus. Three (30%) of 10 toys from the new toy bag, 6 of 30 (20%) in the sick child waiting room, and 2 of 12 (17%) in the well child waiting room were positive. Six (40%) of 15 toys in the sick waiting room were positive for picornaviral RNA before cleaning; after cleaning, 4 (27%) of 15 were positive in spite of the fact that RNA was removed from 4 of 6 of the original positives. Three (15%) of 20 toys in the sick waiting room were positive for picornaviral RNA, but RNA was not transferred to the fingers of the investigator who handled these toys. About 20% of the objects in a pediatric office may be contaminated with respiratory viral RNA, most commonly picornavirus RNA. Cleaning with a disinfectant cloth was only modestly effective in removing the viral RNA from the surfaces of toys, but transfer of picornaviral RNA from toys to fingers was inefficient.

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

PubMed

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

2015-08-01

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

77 FR 54808 - Integrated Hedging Transactions of Qualifying Debt

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-06

... integrated transactions that involve a foreign currency denominated debt instrument and multiple associated... currency). See Sec. 1.988-5(a)(9). A qualified hedging transaction is an integrated economic transaction...) regardless of its denominated currency. See Sec. 1.988-5(a)(3). A Sec. 1.988-5(a) hedge is a spot contract...

26 CFR 31.3406(b)(2)-3 - Window transactions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 15 2010-04-01 2010-04-01 false Window transactions. 31.3406(b)(2)-3 Section 31... SOURCE Collection of Income Tax at Source § 31.3406(b)(2)-3 Window transactions. (a) Requirement to backup withhold. Withholding under section 3406 applies to a window transaction (as defined in paragraph...

Acceptability of an open-label wait-listed trial design: Experiences from the PROUD PrEP study.

PubMed

Gafos, Mitzy; Brodnicki, Elizabeth; Desai, Monica; McCormack, Sheena; Nutland, Will; Wayal, Sonali; White, Ellen; Wood, Gemma; Barber, Tristan; Bell, Gill; Clarke, Amanda; Dolling, David; Dunn, David; Fox, Julie; Haddow, Lewis; Lacey, Charles; Nardone, Anthony; Quinn, Killian; Rae, Caroline; Reeves, Iain; Rayment, Michael; White, David; Apea, Vanessa; Ayap, Wilbert; Dewsnap, Claire; Collaco-Moraes, Yolanda; Schembri, Gabriel; Sowunmi, Yinka; Horne, Rob

2017-01-01

PROUD participants were randomly assigned to receive pre-exposure prophylaxis (PrEP) immediately or after a deferred period of one-year. We report on the acceptability of this open-label wait-listed trial design. Participants completed an acceptability questionnaire, which included categorical study acceptability data and free-text data on most and least liked aspects of the study. We also conducted in-depth interviews (IDI) with a purposely selected sub-sample of participants. Acceptability questionnaires were completed by 76% (415/544) of participants. After controlling for age, immediate-group participants were almost twice as likely as deferred-group participants to complete the questionnaire (AOR:1.86;95%CI:1.24,2.81). In quantitative data, the majority of participants in both groups found the wait-listed design acceptable when measured by satisfaction of joining the study, intention to remain in the study, and interest in joining a subsequent study. However, three-quarters thought that the chance of being in the deferred-group might put other volunteers off joining the study. In free-text responses, data collection tools were the most frequently reported least liked aspect of the study. A fifth of deferred participants reported 'being deferred' as the thing they least liked about the study. However, more deferred participants disliked the data collection tools than the fact that they had to wait a year to access PrEP. Participants in the IDIs had a good understanding of the rationale for the open-label wait-listed study design. Most accepted the design but acknowledged they were, or would have been, disappointed to be randomised to the deferred group. Five of the 25 participants interviewed reported some objection to the wait-listed design. The quantitative and qualitative findings suggest that in an environment where PrEP was not available, the rationale for the wait-listed trial design was well understood and generally acceptable to most participants in

49 CFR 534.6 - Reporting corporate transactions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... CONTEXT OF CHANGES IN CORPORATE RELATIONSHIPS § 534.6 Reporting corporate transactions. Manufacturers who... 49 Transportation 6 2013-10-01 2013-10-01 false Reporting corporate transactions. 534.6 Section... heavy-duty vehicles to which Corporate Average Fuel Economy or Fuel Consumption standards apply shall...

49 CFR 534.6 - Reporting corporate transactions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... CONTEXT OF CHANGES IN CORPORATE RELATIONSHIPS § 534.6 Reporting corporate transactions. Manufacturers who... 49 Transportation 6 2014-10-01 2014-10-01 false Reporting corporate transactions. 534.6 Section... heavy-duty vehicles to which Corporate Average Fuel Economy or Fuel Consumption standards apply shall...

49 CFR 534.6 - Reporting corporate transactions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... CONTEXT OF CHANGES IN CORPORATE RELATIONSHIPS § 534.6 Reporting corporate transactions. Manufacturers who... 49 Transportation 6 2012-10-01 2012-10-01 false Reporting corporate transactions. 534.6 Section... heavy-duty vehicles to which Corporate Average Fuel Economy or Fuel Consumption standards apply shall...

Visualizing Dynamic Bitcoin Transaction Patterns.

PubMed

McGinn, Dan; Birch, David; Akroyd, David; Molina-Solana, Miguel; Guo, Yike; Knottenbelt, William J

2016-06-01

This work presents a systemic top-down visualization of Bitcoin transaction activity to explore dynamically generated patterns of algorithmic behavior. Bitcoin dominates the cryptocurrency markets and presents researchers with a rich source of real-time transactional data. The pseudonymous yet public nature of the data presents opportunities for the discovery of human and algorithmic behavioral patterns of interest to many parties such as financial regulators, protocol designers, and security analysts. However, retaining visual fidelity to the underlying data to retain a fuller understanding of activity within the network remains challenging, particularly in real time. We expose an effective force-directed graph visualization employed in our large-scale data observation facility to accelerate this data exploration and derive useful insight among domain experts and the general public alike. The high-fidelity visualizations demonstrated in this article allowed for collaborative discovery of unexpected high frequency transaction patterns, including automated laundering operations, and the evolution of multiple distinct algorithmic denial of service attacks on the Bitcoin network.

Visualizing Dynamic Bitcoin Transaction Patterns

PubMed Central

McGinn, Dan; Birch, David; Akroyd, David; Molina-Solana, Miguel; Guo, Yike; Knottenbelt, William J.

2016-01-01

Abstract This work presents a systemic top-down visualization of Bitcoin transaction activity to explore dynamically generated patterns of algorithmic behavior. Bitcoin dominates the cryptocurrency markets and presents researchers with a rich source of real-time transactional data. The pseudonymous yet public nature of the data presents opportunities for the discovery of human and algorithmic behavioral patterns of interest to many parties such as financial regulators, protocol designers, and security analysts. However, retaining visual fidelity to the underlying data to retain a fuller understanding of activity within the network remains challenging, particularly in real time. We expose an effective force-directed graph visualization employed in our large-scale data observation facility to accelerate this data exploration and derive useful insight among domain experts and the general public alike. The high-fidelity visualizations demonstrated in this article allowed for collaborative discovery of unexpected high frequency transaction patterns, including automated laundering operations, and the evolution of multiple distinct algorithmic denial of service attacks on the Bitcoin network. PMID:27441715

No-waiting dentine self-etch concept-Merit or hype.

PubMed

Huang, Xue-Qing; Pucci, César R; Luo, Tao; Breschi, Lorenzo; Pashley, David H; Niu, Li-Na; Tay, Franklin R

2017-07-01

A recently-launched universal adhesive, G-Premio Bond, provides clinicians with the alternative to use the self-etch technique for bonding to dentine without waiting for the adhesive to interact with the bonding substrate (no-waiting self-etch; Japanese brochure), or after leaving the adhesive undisturbed for 10s (10-s self-etch; international brochure). The present study was performed to examine in vitro performance of this new universal adhesive bonded to human coronal dentine using the two alternative self-etch modes. One hundred and ten specimens were bonded using two self-etch application modes and examined with or without thermomechanical cycling (10,000 thermal cycles and 240,000 mechanical cycles) to simulate one year of intraoral functioning. The bonded specimens were sectioned for microtensile bond testing, ultrastructural and nanoleakage examination using transmission electron microscopy. Changes in the composition of mineralised dentine after adhesive application were examined using Fourier transform infrared spectroscopy. Both reduced application time and thermomechanical cycling resulted in significantly lower bond strengths, thinner hybrid layers, and significantly more extensive nanoleakage after thermomechanical cycling. Using the conventional 10-s application time improved bonding performance when compared with the no-waiting self-etch technique. Nevertheless, nanoleakage was generally extensive under all testing parameters employed for examining the adhesive. Although sufficient bond strength to dentine may be achieved using the present universal adhesive in the no-waiting self-etch mode that does not require clinicians to wait prior to polymerisation of the adhesive, this self-etch concept requires further technological refinement before it can be recommended as a clinical technique. Although the surge for cutting application time to increase user friendliness remains the most frequently sought conduit for advancement of dentine bonding

31 CFR 510.404 - Transactions ordinarily incident to a licensed transaction authorized.

Code of Federal Regulations, 2012 CFR

2012-07-01

... to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY NORTH KOREA SANCTIONS REGULATIONS Interpretations § 510.404 Transactions ordinarily incident to a licensed...

Appointment Wait Time, Primary Care Provider Status, and Patient Demographics are Associated With Nonattendance at Outpatient Gastroenterology Clinic.

PubMed

Shrestha, Manish P; Hu, Chengcheng; Taleban, Sasha

2016-09-22

We intended to identify the factors associated with missed appointments at a gastroenterology (GI) clinic in an academic setting. Missed clinic appointments reduce clinic efficiency, waste resources, and increase costs. Limited data exist on subspecialty clinic attendance. We performed a case-control study using data from the electronic health record of patients scheduled for an appointment at the adult GI clinic at the Banner University Medical Center between March and October of 2014. Patients who missed their appointment during the study period served as cases. Controls were randomly selected from patients who completed their appointment during the study period. Analysis included univariate and multivariate logistic regression analysis. Of 2331 scheduled clinic appointments, 195 (8.4%) were missed appointments. Longer waiting time from referral to scheduled appointment was significantly associated with missed appointment (AOR=1.014; 95% CI, 1.01-1.02; P<0.001). Patients with primary care providers (PCPs) were less likely to miss their appointment than those without PCPs (AOR=0.35; 95% CI, 0.18-0.66; P=0.001). Among patient demographic characteristics, ethnicity and marital status were associated with missed appointment. Wait time, ethnicity, marital status, and PCP status were associated with missed GI clinic appointments. Further investigations are needed to assess the effects of intervention strategies directed at reducing appointment wait time and increasing PCP-based care.

Wait-Time and Multiple Representation Levels in Chemistry Lessons

ERIC Educational Resources Information Center

Li, Winnie Sim Siew; Arshad, Mohammad Yusof

2014-01-01

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

Emergency department waiting times: Do the raw data tell the whole story?

PubMed

Green, Janette; Dawber, James; Masso, Malcolm; Eagar, Kathy

2014-02-01

To determine whether there are real differences in emergency department (ED) performance between Australian states and territories. Cross-sectional analysis of 2009-10 attendances at an ED contributing to the Australian non-admitted patient ED care database. The main outcome measure was difference in waiting time across triage categories. There were more than 5.8 million ED attendances. Raw ED waiting times varied by a range of factors including jurisdiction, triage category, geographic location and hospital peer group. All variables were significant in a model designed to test the effect of jurisdiction on ED waiting times, including triage category, hospital peer group, patient socioeconomic status and patient remoteness. When the interaction between triage category and jurisdiction entered the model, it was found to have a significant effect on ED waiting times (P<0.001) and triage was also significant (P<0.001). Jurisdiction was no longer statistically significant (P=0.248 using all triage categories and 0.063 using only Australian Triage Scale 2 and 3). Although the Council of Australian Governments has adopted raw measures for its key ED performance indicators, raw waiting time statistics are misleading. There are no consistent differences in ED waiting times between states and territories after other factors are accounted for. WHAT IS KNOWN ABOUT THE TOPIC? The length of time patients wait to be treated after presenting at an ED is routinely used to measure ED performance. In national health agreements with the federal government, each state and territory in Australia is expected to meet waiting time performance targets for the five ED triage categories. The raw data indicate differences in performance between states and territories. WHAT DOES THIS PAPER ADD? Measuring ED performance using raw data gives misleading results. There are no consistent differences in ED waiting times between the states and territories after other factors are taken into account

Developing Transactional Distance Scale and Examining Transactional Distance Perception of Blended Learning Students in Terms of Different Variables

ERIC Educational Resources Information Center

Horzum, Mehmet Baris

2011-01-01

The first purpose of this study was to develop valid and reliable a scale which measure the transactional distance. Besides, the second purpose of the study was to investigate whether the transactional distance perception differed according to gender, utilized component and number of logins to system, and also blended learning was useful. The…

Assessing the performance of centralized waiting lists for patients without a regular family physician using clinical-administrative data.

PubMed

Breton, Mylaine; Smithman, Mélanie Ann; Brousselle, Astrid; Loignon, Christine; Touati, Nassera; Dubois, Carl-Ardy; Nour, Kareen; Boivin, Antoine; Berbiche, Djamal; Roberge, Danièle

2017-01-05

With 4.6 million patients who do not have a regular family physician, Canada performs poorly compared to other OECD countries in terms of attachment to a family physician. To address this issue, several provinces have implemented centralized waiting lists to coordinate supply and demand for attachment to a family physician. Although significant resources are invested in these centralized waiting lists, no studies have measured their performance. In this article, we present a performance assessment of centralized waiting lists for unattached patients implemented in Quebec, Canada. We based our approach on the Balanced Scorecard method. A committee of decision-makers, managers, healthcare professionals, and researchers selected five indicators for the performance assessment of centralized waiting lists, including both process and outcome indicators. We analyzed and compared clinical-administrative data from 86 centralized waiting lists (GACOs) located in 14 regions in Quebec, from April 1, 2013, to March 31, 2014. During the study period, although over 150,000 patients were attached to a family physician, new requests resulted in a 30% median increase in patients on waiting lists. An inverse correlation of average strength was found between the rates of patients attached to a family physician and the proportion of vulnerable patients attached to a family physician meaning that as more patients became attached to an FP through GACOs, the proportion of vulnerable patients became smaller (r = -0.31, p < 0.005). The results showed very large performance variations both among GACOs of different regions and among those of a same region for all performance indicators. Centralized waiting lists for unattached patients in Quebec seem to be achieving their twofold objective of attaching patients to a family physician and giving priority to vulnerable patients. However, the demand for attachment seems to exceed the supply and there appears to be a tension between giving

47 CFR 64.902 - Transactions with affiliates.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) MISCELLANEOUS RULES RELATING TO COMMON CARRIERS Allocation of Costs § 64.902 Transactions with affiliates. Except for carriers which employ average schedules in lieu of determining their costs, all carriers... 47 Telecommunication 3 2010-10-01 2010-10-01 false Transactions with affiliates. 64.902 Section 64...

17 CFR 200.735-5 - Securities transactions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 17 Commodity and Securities Exchanges 2 2012-04-01 2012-04-01 false Securities transactions. 200.735-5 Section 200.735-5 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION... Employees and Former Members and Employees of the Commission § 200.735-5 Securities transactions. Securities...

17 CFR 200.735-5 - Securities transactions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 17 Commodity and Securities Exchanges 2 2011-04-01 2011-04-01 false Securities transactions. 200.735-5 Section 200.735-5 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION... Employees and Former Members and Employees of the Commission § 200.735-5 Securities transactions. Securities...

17 CFR 200.735-5 - Securities transactions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 17 Commodity and Securities Exchanges 2 2013-04-01 2013-04-01 false Securities transactions. 200.735-5 Section 200.735-5 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION... Employees and Former Members and Employees of the Commission § 200.735-5 Securities transactions. Securities...

49 CFR 534.6 - Reporting corporate transactions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... CONTEXT OF CHANGES IN CORPORATE RELATIONSHIPS § 534.6 Reporting corporate transactions. Link to an... 49 Transportation 6 2011-10-01 2011-10-01 false Reporting corporate transactions. 534.6 Section... exerts control over the design, production or sale of automobiles to which a Corporate Average Fuel...

Simulating water markets with transaction costs

PubMed Central

Erfani, Tohid; Binions, Olga; Harou, Julien J

2014-01-01

This paper presents an optimization model to simulate short-term pair-wise spot-market trading of surface water abstraction licenses (water rights). The approach uses a node-arc multicommodity formulation that tracks individual supplier-receiver transactions in a water resource network. This enables accounting for transaction costs between individual buyer-seller pairs and abstractor-specific rules and behaviors using constraints. Trades are driven by economic demand curves that represent each abstractor's time-varying water demand. The purpose of the proposed model is to assess potential hydrologic and economic outcomes of water markets and aid policy makers in designing water market regulations. The model is applied to the Great Ouse River basin in Eastern England. The model assesses the potential weekly water trades and abstractions that could occur in a normal and a dry year. Four sectors (public water supply, energy, agriculture, and industrial) are included in the 94 active licensed water diversions. Each license's unique environmental restrictions are represented and weekly economic water demand curves are estimated. Rules encoded as constraints represent current water management realities and plausible stakeholder-informed water market behaviors. Results show buyers favor sellers who can supply large volumes to minimize transactions. The energy plant cooling and agricultural licenses, often restricted from obtaining water at times when it generates benefits, benefit most from trades. Assumptions and model limitations are discussed. Key Points Transaction tracking hydro-economic optimization models simulate water markets Proposed model formulation incorporates transaction costs and trading behavior Water markets benefit users with the most restricted water access PMID:25598558

Simulating water markets with transaction costs.

PubMed

Erfani, Tohid; Binions, Olga; Harou, Julien J

2014-06-01

This paper presents an optimization model to simulate short-term pair-wise spot-market trading of surface water abstraction licenses (water rights). The approach uses a node-arc multicommodity formulation that tracks individual supplier-receiver transactions in a water resource network. This enables accounting for transaction costs between individual buyer-seller pairs and abstractor-specific rules and behaviors using constraints. Trades are driven by economic demand curves that represent each abstractor's time-varying water demand. The purpose of the proposed model is to assess potential hydrologic and economic outcomes of water markets and aid policy makers in designing water market regulations. The model is applied to the Great Ouse River basin in Eastern England. The model assesses the potential weekly water trades and abstractions that could occur in a normal and a dry year. Four sectors (public water supply, energy, agriculture, and industrial) are included in the 94 active licensed water diversions. Each license's unique environmental restrictions are represented and weekly economic water demand curves are estimated. Rules encoded as constraints represent current water management realities and plausible stakeholder-informed water market behaviors. Results show buyers favor sellers who can supply large volumes to minimize transactions. The energy plant cooling and agricultural licenses, often restricted from obtaining water at times when it generates benefits, benefit most from trades. Assumptions and model limitations are discussed. Transaction tracking hydro-economic optimization models simulate water marketsProposed model formulation incorporates transaction costs and trading behaviorWater markets benefit users with the most restricted water access.

Transactive Campus Energy Systems: Final Report

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

Katipamula, Srinivas; Corbin, Charles D.; Haack, Jereme N.

Transactive energy refers to the combination of economic and control techniques to improve grid reliability and efficiency. The fundamental purpose of transactive energy management is to seamlessly coordinate the operation of large numbers of new intelligent assets—such as distributed solar, energy storage and responsive building loads—to provide the flexibility needed to operate the power grid reliably and at minimum cost, particularly one filled with intermittent renewable generation such as the Pacific Northwest. It addresses the key challenge of providing smooth, stable, and predictable “control” of these assets, despite the fact that most are neither owned nor directly controlled by themore » power grid. The Clean Energy and Transactive Campus (CETC) work described in this report was done as part of a Cooperative Research and Development Agreement (CRADA) between the U.S. Department of Energy’s Pacific Northwest National Laboratory (PNNL) and the Washington State Department of Commerce (Commerce) through the Clean Energy Fund (CEF). The project team consisted of PNNL, the University of Washington (UW) and Washington State University (WSU), to connect the PNNL, UW, and WSU campuses to form a multi-campus testbed for transaction-based energy management—transactive—solutions. Building on the foundational transactive system established by the Pacific Northwest Smart Grid Demonstration (PNWSGD), the purpose of the project was to construct the testbed as both a regional flexibility resource and as a platform for research and development (R&D) on buildings/grid integration and information-based energy efficiency. This report provides a summary of the various tasks performed under the CRADA.« less

12 CFR 551.130 - When must I settle a securities transaction?

Code of Federal Regulations, 2010 CFR

2010-01-01

... RECORDKEEPING AND CONFIRMATION REQUIREMENTS FOR SECURITIES TRANSACTIONS Settlement of Securities Transactions § 551.130 When must I settle a securities transaction? (a) You may not effect or enter into a contract... 12 Banks and Banking 5 2010-01-01 2010-01-01 false When must I settle a securities transaction...

Transactional sex and risk for HIV infection in sub-Saharan Africa: a systematic review and meta-analysis.

PubMed

Wamoyi, Joyce; Stobeanau, Kirsten; Bobrova, Natalia; Abramsky, Tanya; Watts, Charlotte

2016-01-01

Young women aged 15 to 24 years in sub-Saharan Africa continue to be disproportionately affected by HIV. A growing number of studies have suggested that the practice of transactional sex may in part explain women's heightened risk, but evidence on the association between transactional sex and HIV has not yet been synthesized. We set out to systematically review studies that assess the relationship between transactional sex and HIV among men and women in sub-Saharan Africa and to summarize the findings through a meta-analysis. The search strategy included 8 databases, hand searches in 10 journals, and searches across 17 websites and portals for organizations as informed by expert colleagues. A systematic review of cross-sectional and longitudinal studies was carried out for studies on women and men who engage in transactional sex published up through 2014. Random effects meta-analysis was used to further examine the relationship between transactional sex and prevalent HIV infection across a subset of studies with the same exposure period. Analyses were conducted separately for men and women. Nineteen papers from 16 studies met our inclusion criteria. Of these 16 studies, 14 provided data on women and 10 on men. We find a significant, positive, unadjusted or adjusted association between transactional sex and HIV in 10 of 14 studies for women, one of which used a longitudinal design (relative risk (RR)=2.06, 95% confidence interval (CI): 1.22 -3.48). Out of 10 studies involving men, only 2 indicate a positive association between HIV and transactional sex in unadjusted or adjusted models. The meta-analysis confirmed general findings from the systematic review (unadjusted meta-analysis findings are significant for women ( n= 4; pooled odds ratio (OR)=1.54, 95% CI: 1.04-2.28; I 2 =42.5%, p= 0.156), but not for men ( n= 4; pooled OR=1.47, 95% CI: 0.85-2.56; I 2 =50.8%, p= 0.107). Transactional sex is associated with HIV among women, whereas findings for men were

Activity in children with ADHD during waiting situations in the classroom: a pilot study.

PubMed

Antrop, Inge; Buysse, Ann; Roeyers, Herbert; Van Oost, Paulette

2005-03-01

According to the optimal stimulation theory and the delay aversion hypothesis, children with attention deficit hyperactivity disorder (ADHD) experience difficulties when they are confronted with low levels of stimulation and delay, respectively. This study investigated the activity level of children with ADHD during waiting situations in the classroom. Three series of hypothesis were made: (1) with respect to the comparison between waiting and non-waiting intervals, (2) with respect to the effects of non-temporal stimulation, and (3) with respect to the effects of temporal stimulation on behaviour during waiting. The activity level of 14 children with ADHD and 14 control children between the ages of 6 and 11 years was observed during two non-waiting class situations and three waiting situations: without any stimulation, in the presence of nontemporal stimulation and in the presence of temporal stimulation. Both groups of children obtained higher activity scores for all behavioural dimensions during waiting compared with non-waiting situations. The results further revealed additive effects of waiting and diagnostic group on behaviour. Additional nontemporal stimulation during waiting affected the behaviour of all children for most behavioural characteristics. For noisiness, additive effects were also found for diagnostic group and either non-temporal stimulation or temporal stimulation. For restlessness, a trend for an interaction effect between diagnostic group and nontemporal stimulation was found. The findings have clear implications for school observations within an assessment protocol.

Poster - 26: Electronic Waiting Room Management for a busy Cancer Centre

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

Kildea, John; Hijal, Tarek

We describe an electronic waiting room management system that we have developed and deployed in our cancer centre. Our system connects with our electronic medical records systems, gathers data for a machine learning algorithm to predict future patient waiting times, and is integrated with a mobile phone app. The system has been in operation for over nine months and has led to reduced lines, calmer waiting rooms and overwhelming patient and staff satisfaction.

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

PubMed

Carlsen, Fredrik; Kaarboe, Oddvar Martin

2015-11-01

We investigate whether educational attainment affects waiting time of elderly patients in somatic hospitals. We consider three distinct pathways; that patients with different educational attainment have different disease patterns, that patients with different levels of education receive treatments at different hospitals, and that patient choice and supply of local health services within hospital catchment areas explain unequal waiting time of different educational groups. We find evidence of an educational gradient in waiting time for male patients, but not for female patients. Conditional on age, male patients with tertiary education wait 45% shorter than male patients with secondary or primary education. The first pathway is not quantitatively important as controlling for disease patters has little effect on relative waiting times. The second pathway is important. Relative to patients with primary education, variation in waiting time and education level across local hospitals contributes to higher waiting time for male patients with secondary education and female patients with secondary or tertiary education and lower waiting time for male patients with tertiary education. These effects are in the order of 15-20%. The third pathway is also quantitatively important. The educational gradients within catchment areas disappear when we control for travel distance and supply of private specialists. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Socioeconomic status and waiting times for health services: An international literature review and evidence from the Italian National Health System.

PubMed

Landi, Stefano; Ivaldi, Enrico; Testi, Angela

2018-04-01

In the absence of priority criteria, waiting times are an implicit rationing instrument where the absence or limited use of prices creates an excess of demand. Even in the presence of priority criteria, waiting times may be unfair because they reduce health care demand of patients in lower socio-economic conditions due to high opportunity costs of time or a decay in their health level. Significant evidence has shown a relationship between socioeconomic status and the length of waiting time. The first phase of the study involved an extensive review of the existent literature for the period of 2002-2016 in the main databases (Scopus, PubMed and Science Direct). Twenty-eight met the eligibility criteria. The 27 papers were described and classified. The e mpirical objective of this study was to determine whether socioeconomic characteristics affect waiting time for different health services in the Italian national health system. The services studied were specialist visits, diagnostics tests and elective surgeries. A classification tree and logistic regression models were implemented. Data from the 2013 Italian Health National Survey were used. The analysis found heterogeneous results for different types of service. Individuals with lower education and economic resources have a higher risk of experiencing excessive waiting times for diagnostic and specialist visits. For elective surgery, socioeconomic inequalities are present but appear to be lower. Copyright © 2018 Elsevier B.V. All rights reserved.

What happened to the no-wait hospital? A case study of implementation of operational plans for reduced waits.

PubMed

Hansson, Johan; Tolf, Sara; Øvretveit, John; Carlsson, Jan; Brommels, Mats

2012-01-01

Both research and practice show that waiting lists are hard to reduce. Implementing complex interventions for reduced waits is an intricate and challenging process that requires special attention for surrounding factors helping and hindering the implementation. This article reports a case study of a hospital implementation of operational plans for reduced waits, with an emphasis on the process of change. A case study research design, theoretically informed by the Pettigrew and Whipp model of strategic change, was applied. Data were gathered from individual and focus group interviews with informants from different organizational levels at different times and from documents and plans. The findings revealed arrangements both helping and hindering the implementation work. Helping factors were the hospital's contemporary savings requirements and experiences from similar change initiatives. Those hindering the actions to plan and agree the changes were unclear support functions and unclear task prioritization. One contribution of this study is to demonstrate the advantages, disadvantages, and challenges of a contextualized case study for increased understanding of factors influencing organizational change implementation. One lesson for current policy is to regard context factors that are critical for successful implementation.

Parenting Stress and Child Behavior Problems within Families of Children with Developmental Disabilities: Transactional Relations across 15 Years

PubMed Central

Woodman, Ashley C.; Mawdsley, Helena P.; Hauser-Cram, Penny

2014-01-01

Parents of children with developmental disabilities (DD) are at increased risk of experiencing psychological stress compared to other parents. Children’s high levels of internalizing and externalizing problems have been found to contribute to this elevated level of stress. Few studies have considered the reverse direction of effects, however, in families where a child has a DD. The present study investigated transactional relations between child behavior problems and maternal stress within 176 families raising a child with early diagnosed DD. There was evidence of both child-driven and parent-driven effects over the 15-year study period, spanning from early childhood (age 3) to adolescence (age 18), consistent with transactional models of development. Parent-child transactions were found to vary across different life phases and with different domains of behavior problems. PMID:25462487

An Efficient Wait-Free Vector

DOE PAGES

Feldman, Steven; Valera-Leon, Carlos; Dechev, Damian

2016-03-01

The vector is a fundamental data structure, which provides constant-time access to a dynamically-resizable range of elements. Currently, there exist no wait-free vectors. The only non-blocking version supports only a subset of the sequential vector API and exhibits significant synchronization overhead caused by supporting opposing operations. Since many applications operate in phases of execution, wherein each phase only a subset of operations are used, this overhead is unnecessary for the majority of the application. To address the limitations of the non-blocking version, we present a new design that is wait-free, supports more of the operations provided by the sequential vector,more » and provides alternative implementations of key operations. These alternatives allow the developer to balance the performance and functionality of the vector as requirements change throughout execution. Compared to the known non-blocking version and the concurrent vector found in Intel’s TBB library, our design outperforms or provides comparable performance in the majority of tested scenarios. Over all tested scenarios, the presented design performs an average of 4.97 times more operations per second than the non-blocking vector and 1.54 more than the TBB vector. In a scenario designed to simulate the filling of a vector, performance improvement increases to 13.38 and 1.16 times. This work presents the first ABA-free non-blocking vector. Finally, unlike the other non-blocking approach, all operations are wait-free and bounds-checked and elements are stored contiguously in memory.« less

17 CFR 242.601 - Dissemination of transaction reports and last sale data with respect to transactions in NMS stocks.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Dissemination of transaction reports and last sale data with respect to transactions in NMS stocks. 242.601 Section 242.601 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION (CONTINUED) REGULATIONS M, SHO, ATS, AC...

31 CFR 800.302 - Transactions that are not covered transactions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (Continued) OFFICE OF INVESTMENT SECURITY, DEPARTMENT OF THE TREASURY REGULATIONS PERTAINING TO MERGERS... percent of the voting securities of Corporation X, which is a U.S. business. Assuming no other relevant facts, the acquisition of the securities is not a covered transaction. Example 2. Corporation A, a...

Access to specialist gastroenterology care in Canada: The Practice Audit in Gastroenterology (PAGE) Wait Times Program

PubMed Central

Armstrong, David; Barkun, Alan NG; Chen, Ying; Daniels, Sandra; Hollingworth, Roger; Hunt, Richard H; Leddin, Desmond

2008-01-01

BACKGROUND: Canadian wait time data are available for the treatment of cancer and heart disease, as well as for joint replacement, cataract surgery and diagnostic imaging procedures. Wait times for gastroenterology consultation and procedures have not been studied, although digestive diseases pose a greater economic burden in Canada than cancer or heart disease. METHODS: Specialist physicians completed the practice audit if they provided digestive health care, accepted new patients and recorded referral dates. For patients seen for consultation or investigation over a one-week period, preprogrammed personal digital assistants were used to collect data including the main reason for referral, initial referral and consultation dates, procedure dates (if performed), personal and family history, and patient symptoms, signs and test results. Patient triaging, appropriateness of the referral and timeliness of care were noted. RESULTS: Over 10 months, 199 physicians recorded details of 5559 referrals, including 1903 visits for procedures. The distribution of total wait times (from referral to procedure) nationally was highly skewed at 91/203 days (median/75th percentile), with substantial interprovincial variation: British Columbia, 66/185 days; Alberta, 134/284 days; Ontario, 110/208 days; Quebec, 71/149 days; New Brunswick, 104/234 days; and Nova Scotia, 42/84 days. The percentage of physicians by province offering average-risk screening colonoscopy varied from 29% to 100%. DISCUSSION: Access to specialist gastroenterology care in Canada is limited by long wait times, which exceed clinically reasonable waits for specialist treatment. Although exhibiting some methodological limitations, this large practice audit sampling offers broadly generalized results, as well as a means to identify barriers to health care delivery and evaluate strategies to address these barriers, with the goals of expediting appropriate care for patients with digestive health disorders and

Waiting lists and elective surgery: ordering the queue.

PubMed

Curtis, Andrea J; Russell, Colin O H; Stoelwinder, Johannes U; McNeil, John J

2010-02-15

In the Australian public health system, access to elective surgery is rationed through the use of waiting lists in which patients are assigned to broad urgency categories. Surgeons are principally responsible for referring patients to waiting lists, deciding on the appropriate urgency category, and selecting patients from the waiting list to receive surgery. There are few agreed-upon criteria to help surgeons make these decisions, leading to striking differences between institutions in proportions of patients allocated to urgency categories. In other countries with publicly funded health systems, programs have been developed that aim to make prioritisation more consistent and access to surgery more equitable. As demand for health care increases, similar programs should be established in Australia using relevant clinical and psychosocial factors. Prioritisation methodology adapted for elective surgery may have a role in prioritising high-demand procedures in other areas of health care.

31 CFR 537.404 - Transactions incidental to a licensed transaction authorized.

Code of Federal Regulations, 2010 CFR

2010-07-01

... provided in paragraph (b) of this section. (b) Transactions licensed pursuant to subpart E of this part and... in property are blocked pursuant to § 537.201(a), provided that the account is not on the books of a...

Public views on a wait time management initiative: a matter of communication.

PubMed

Bruni, Rebecca A; Laupacis, Andreas; Levinson, Wendy; Martin, Douglas K

2010-08-05

Many countries have tried to reduce waiting times for health care through formal wait time reduction strategies. Our paper describes views of members of the public about a wait time management initiative--the Ontario Wait Time Strategy (OWTS) (Canada). Scholars and governmental reports have advocated for increased public involvement in wait time management. We provide empirically derived recommendations for public engagement in a wait time management initiative. Two qualitative studies: 1) an analysis of all emails sent by the public to the (OWTS) email address; and 2) in-depth interviews with members of the Ontario public. Email correspondents and interview participants supported the intent of the OWTS. However they wanted more information about the Strategy and its actions. Interview participants did not feel they were sufficiently made aware of the Strategy and email correspondents requested additional information beyond what was offered on the Strategy's website. Moreover, the email correspondents believed that some of the information that was provided on the Strategy's website and through the media was inaccurate, misleading, and even dishonest. Interview participants strongly supported public involvement in the OWTS priority setting. Findings suggest the public wanted increased communication from and with the OWTS. Effective communication can facilitate successful public engagement, and in turn fair and legitimate priority setting. Based on the study's findings we developed concrete recommendations for improving public involvement in wait time management.

[Waiting time for the first colposcopic examination in women with abnormal Papanicolaou test].

PubMed

Nascimento, Maria Isabel do; Rabelo, Irene Machado Moraes Alvarenga; Cardoso, Fabrício Seabra Polidoro; Musse, Ricardo Neif Vieira

2015-08-01

To evaluate the waiting times before obtaining the first colposcopic examination for women with abnormal Papanicolaou smears. Retrospective cohort study conducted on patients who required a colposcopic examination to clarify an abnormal pap test, between 2002 January and 2008 August, in a metropolitan region of Brazil. The waiting times were defined as: Total Waiting Time (interval between the date of the pap test result and the date of the first colposcopic examination); Partial A Waiting Time (interval between the date of the pap test result and the date of referral); Partial B Waiting Time (interval between the date of referral and the date of the first colposcopic examination). Means, medians, relative and absolute frequencies were calculated. The Kruskal-Wallis test and Pearson's chi-square test were used to determine statistical significance. A total of 1,544 women with mean of age of 34 years (SD=12.6 years) were analyzed. Most of them had access to colposcopic examination within 30 days (65.8%) or 60 days (92.8%) from referral. Mean Total Waiting Time, Partial A Waiting Time, and Partial B Waiting Time were 94.5 days (SD=96.8 days), 67.8 days (SD=95.3 days) and 29.2 days (SD=35.1 days), respectively. A large part of the women studied had access to colposcopic examination within 60 days after referral, but Total waiting time was long. Measures to reduce the waiting time for obtaining the first colposcopic examination can help to improve the quality of care in the context of cervical cancer control in the region, and ought to be addressed at the phase between the date of the pap test results and the date of referral to the teaching hospital.

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

PubMed

Mehra, Payal

2016-08-08

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

75 FR 33642 - Proposed Amendment to Prohibited Transaction Exemption (PTE) 96-23 for Plan Asset Transactions...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-14

...This document contains a notice of pendency before the Department of Labor (the Department) of a proposed amendment to PTE 96- 23. The exemption permits various transactions involving employee benefit plans whose assets are managed by in-house asset managers (INHAMs), provided the conditions of the exemption are met. The proposed amendment would affect participants and beneficiaries of employee benefit plans, the sponsoring employers of such plans, INHAMs, and other persons engaging in the described transactions.

Transaction costs and community-based natural resource management in Nepal.

PubMed

Adhikari, Bhim; Lovett, Jon C

2006-01-01

Transaction costs in community-based resource management are incurred by households attempting to enforce property right rules over common resources similar to those inherent in private property rights. Despite their importance, transaction costs of community-based management of common pool resources (CPRs) are often not incorporated into the economic analysis of participatory resource management. This paper examines the transaction costs incurred by forest users in community forestry (CF) based on a survey of 309 households belonging to eight different forest user groups (FUGs) in the mid hills of Nepal. The analysis reveals that the average 'poor' household incurred Nepalese rupees (NRS) 1265 in transaction costs annually, while wealthier 'rich' households incurred an average of NRS 2312 per year. Although richer households bear higher proportions of such costs, transaction costs for CF management as a percentage of resource appropriation costs are higher for poorer households (26%) than those of middle-wealth (24%) or rich households (14%). There are also village differences in the level of transaction costs. The results show that transaction costs are a major component of resource management costs and vary according to socio-economic status of resource users and characteristics of the community.

17 CFR 5.9 - Security deposits for retail forex transactions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 17 Commodity and Securities Exchanges 1 2011-04-01 2011-04-01 false Security deposits for retail forex transactions. 5.9 Section 5.9 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION OFF-EXCHANGE FOREIGN CURRENCY TRANSACTIONS § 5.9 Security deposits for retail forex transactions...

SouthWest view, Street Car Waiting House, north and east elevations ...

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

South-West view, Street Car Waiting House, north and east elevations - North Philadelphia Station, Street Car Waiting House, 2900 North Broad Street, on northwest corner of Broad Street & Glenwood Avenue, Philadelphia, Philadelphia County, PA

12 CFR 223.33 - What rules apply to derivative transactions?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 3 2011-01-01 2011-01-01 false What rules apply to derivative transactions... Requirements Under Section 23A § 223.33 What rules apply to derivative transactions? (a) Market terms requirement. Derivative transactions between a member bank and its affiliates (other than depository...

15 CFR 908.14 - Business to be transacted in writing.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Business to be transacted in writing... MAINTAINING RECORDS AND SUBMITTING REPORTS ON WEATHER MODIFICATION ACTIVITIES § 908.14 Business to be transacted in writing. All business transacted with the National Oceanic and Atmospheric Administration with...

Electronic Business Transaction Infrastructure Analysis Using Petri Nets and Simulation

ERIC Educational Resources Information Center

Feller, Andrew Lee

2010-01-01

Rapid growth in eBusiness has made industry and commerce increasingly dependent on the hardware and software infrastructure that enables high-volume transaction processing across the Internet. Large transaction volumes at major industrial-firm data centers rely on robust transaction protocols and adequately provisioned hardware capacity to ensure…

Strategic R&D transactions in personalized drug development.

PubMed

Makino, Tomohiro; Lim, Yeongjoo; Kodama, Kota

2018-03-21

Although external collaboration capability influences the development of personalized medicine, key transactions in the pharmaceutical industry have not been addressed. To explore specific trends in interorganizational transactions and key players, we longitudinally surveyed strategic transactions, comparing them with other advanced medical developments, such as antibody therapy, as controls. We found that the financing deals of start-ups have surged over the past decade, accelerating intellectual property (IP) creation. Our correlation and regression analyses identified determinants of financing deals among alliance deals, acquisition deals, patents, research and development (R&D) licenses, market licenses, and scientific papers. They showed that patents positively correlated with transactions, and that the number of R&D licenses significantly predicted financing deals. This indicates, for the first time, that start-ups and investors lead progress in personalized medicine. Copyright © 2018 Elsevier Ltd. All rights reserved.

NorthEast view; Street Car Waiting House, south (front) and west ...

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

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

Transaction costs, externalities and information technology in health care.

PubMed

Ferguson, B; Keen, J

1996-01-01

This paper discusses some of the economic issues which underpin the rationale for investment in information and communications technologies (ICTs). Information imperfections lead to significant transaction costs (search, negotiating and monitoring) which in turn confer a negative externality on parties involved in exchange. This divergence in private and social costs leads to a degree of resource misallocation (efficiency loss) which, uncorrected, results in a sub-optimal outcome. Traditional solutions to this problem are to rely upon direct government action to reduce the costs of transacting between market agents, or to employ tax/subsidy measures and other legislative action to achieve the desired market outcome. Three key policy questions are raised in the context of the NHS purchaser/provider relationship. Firstly, what is the optimum level of transaction costs; secondly, can ICTs assist in lowering the level of transaction costs to the optimum level; thirdly, who should bear the investment cost in reducing the level of transaction costs? The issue of property rights in different information systems is discussed and raises interesting policy questions about how much investment should be undertaken centrally rather than devolved to a more local level. In some ways this economic framework offers a post hoc justification of why different ICT systems have been introduced at various levels of the NHS. Essentially this reduces to the problem of externalities: providing good information confers a positive externality: not providing relevant, timely and accurate information confers a negative externality, by increasing further the level of transaction costs. The crucial role which ICT systems can play lies in attempting to reduce the level of transaction costs and driving the market towards what Dahlman has described as the transaction-cost-constrained equilibrium.

Department of Defense Transactions Entering the International Balance of Payments

DTIC Science & Technology

1963-07-01

divisions of funds under the provisions of Section 3679, Revised Statutes. D. Accounting and ,eport.tn6 1. -he accout !. C rEporting of transactIons enterina...management and control of transactions entering the international balance of payments will ino’.ude a programming, budgEting, 5 accouting , and reporting s

31 CFR 800.220 - Party or parties to a transaction.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (Continued) OFFICE OF INVESTMENT SECURITY, DEPARTMENT OF THE TREASURY REGULATIONS PERTAINING TO MERGERS, ACQUISITIONS, AND TAKEOVERS BY FOREIGN PERSONS Definitions § 800.220 Party or parties to a transaction. The terms party to a transaction and parties to a transaction mean: (a) In the case of an acquisition of an...

Aid Effectiveness, Transaction Costs and Conditionality in the Education Sector

ERIC Educational Resources Information Center

Ashford, Richard; Biswas, Shampa

2010-01-01

The reduction of transaction costs is a commonly mentioned yet rarely elaborated goal for aid effectiveness in educational development. The casual use of the concept of transaction costs conceals which costs may be reduced, which costs are required and, indeed, what transaction costs actually are. Examining issues related to harmonizing the…

Public views on a wait time management initiative: a matter of communication

PubMed Central

2010-01-01

Background Many countries have tried to reduce waiting times for health care through formal wait time reduction strategies. Our paper describes views of members of the public about a wait time management initiative - the Ontario Wait Time Strategy (OWTS) (Canada). Scholars and governmental reports have advocated for increased public involvement in wait time management. We provide empirically derived recommendations for public engagement in a wait time management initiative. Methods Two qualitative studies: 1) an analysis of all emails sent by the public to the (OWTS) email address; and 2) in-depth interviews with members of the Ontario public. Results Email correspondents and interview participants supported the intent of the OWTS. However they wanted more information about the Strategy and its actions. Interview participants did not feel they were sufficiently made aware of the Strategy and email correspondents requested additional information beyond what was offered on the Strategy's website. Moreover, the email correspondents believed that some of the information that was provided on the Strategy's website and through the media was inaccurate, misleading, and even dishonest. Interview participants strongly supported public involvement in the OWTS priority setting. Conclusions Findings suggest the public wanted increased communication from and with the OWTS. Effective communication can facilitate successful public engagement, and in turn fair and legitimate priority setting. Based on the study's findings we developed concrete recommendations for improving public involvement in wait time management. PMID:20687952

Informing Healthcare Waiting Area Design Using Transparency Attributes: A Comparative Preference Study.

PubMed

Jiang, Shan; Powers, Matthew; Allison, David; Vincent, Ellen

2017-07-01

This study aimed to explore people's visual preference for waiting areas in general hospital environments designed with transparency attributes that fully integrate nature. Waiting can be a tedious and frustrating experience among people seeking healthcare treatments and negatively affect their perception of the quality of care. Positive distractions and supportive designs have gained increasing attraction to improve people's waiting experience. Nature, which has shown therapeutic effects according to a growing amount of evidence, could be a distinguished positive distraction in waiting areas. Additionally, the theory of transparency was operationalized to indicate a spatial continuity between the external nature and the built interiors in general healthcare waiting area design. A survey method was adopted in the study. Twenty-one images of general healthcare waiting areas depicting three design typologies were preselected following a strict procedure, including designs with (a) no window views, (b) limited window views to nature, and (c) transparent spaces with maximum natural views. Ninety-five student participants rated the images based on their visual preference using a Likert-type scale. The results showed that transparent waiting areas were significantly preferred. A significant positive relationship existed between the level of transparency and people's preference scores. The factor analysis indicated additional supportive features that may affect people's preferences, including daylight, perceived warmth, noninstitutional furniture arrangement, visual orientation, and the use of natural materials for interior design. However, these tentative results need to be furthered tested with the real patient population as the next step of this study.

Value-cell bar charts for visualizing large transaction data sets.

PubMed

Keim, Daniel A; Hao, Ming C; Dayal, Umeshwar; Lyons, Martha

2007-01-01

One of the common problems businesses need to solve is how to use large volumes of sales histories, Web transactions, and other data to understand the behavior of their customers and increase their revenues. Bar charts are widely used for daily analysis, but only show highly aggregated data. Users often need to visualize detailed multidimensional information reflecting the health of their businesses. In this paper, we propose an innovative visualization solution based on the use of value cells within bar charts to represent business metrics. The value of a transaction can be discretized into one or multiple cells: high-value transactions are mapped to multiple value cells, whereas many small-value transactions are combined into one cell. With value-cell bar charts, users can 1) visualize transaction value distributions and correlations, 2) identify high-value transactions and outliers at a glance, and 3) instantly display values at the transaction record level. Value-Cell Bar Charts have been applied with success to different sales and IT service usage applications, demonstrating the benefits of the technique over traditional charting techniques. A comparison with two variants of the well-known Treemap technique and our earlier work on Pixel Bar Charts is also included.

Delays in Prior Living Kidney Donors Receiving Priority on the Transplant Waiting List

PubMed Central

Klassen, David K.; Kucheryavaya, Anna Y.; Stewart, Darren E.

2016-01-01

Background and objectives Prior living donors (PLDs) receive very high priority on the Organ Procurement and Transplantation Network (OPTN) kidney waiting list. Program delays in adding PLDs to the waiting list, setting their status to active, and submitting requests for PLD priority can affect timely access to transplantation. Design, setting, participants, & measurements We used the OPTN and the Centers for Medicare and Medicaid Services data to examine timing of (1) listing relative to start of dialysis, (2) activation on the waiting list, and (3) requests for PLD priority relative to listing date. There were 210 PLDs (221 registrations) added to the OPTN kidney waiting list between January 1, 2010 and July 31, 2015. Results As of September 4, 2015, 167 of the 210 PLDs received deceased donor transplants, six received living donor transplants, two died, five were too sick to transplant, and 29 were still waiting. Median waiting time to deceased donor transplant for PLDs was 98 days. Only 40.7% of 221 PLD registrations (n=90) were listed before they began dialysis; 68.3% were in inactive status for <90 days, 17.6% were in inactive status for 90–365 days, 8.6% were in inactive status for 1–2 years, and 5.4% were in inactive status for >2 years. Median time of PLDs waiting in active status before receiving PLD priority was 2 days (range =0–1450); 67.4% of PLDs received PLD priority within 7 days after activation, but 15.4% waited 8–30 days, 8.1% waited 1–3 months, 4.1% waited 3–12 months, and 5.0% waited >1 year in active status for PLD priority. After receiving priority, most were transplanted quickly. Median time in active status with PLD priority before deceased donor transplant was 23 days. Conclusions Fewer than one half of listed PLDs were listed before starting dialysis. Most listed PLDs are immediately set to active status and receive PLD priority quickly, but a substantial number spends time in active status without PLD priority or a large

A state of limbo: the politics of waiting in neo-liberal Latvia.

PubMed

Ozoliņa-Fitzgerald, Liene

2016-09-01

This article presents an ethnographic study of politics of waiting in a post-Soviet context. While activation has been explored in sociological and anthropological literature as a neo-liberal governmental technology and its application in post-socialist context has also been compellingly documented, waiting as a political artefact has only recently been receiving increased scholarly attention. Drawing on ethnographic fieldwork at a state-run unemployment office in Riga, this article shows how, alongside activation, state welfare policies also produce passivity and waiting. Engaging with the small but developing field of sociological literature on the politics of waiting, I argue that, rather than interpreting it as a clash between 'neo-liberal' and 'Soviet' regimes, we should understand the double-move of activation and imposition of waiting as a key mechanism of neo-liberal biopolitics. This article thus extends the existing theorizations of the temporal politics of neo-liberalism. © London School of Economics and Political Science 2016.

Improved estimation of commuter waiting times using headway and commuter boarding information

NASA Astrophysics Data System (ADS)

Ramli, Muhamad Azfar; Jayaraman, Vasundhara; Kwek, Hyen Chee; Tan, Kian Heong; Lee Kee Khoon, Gary; Monterola, Christopher

2018-07-01

The average amount of waiting time spent by commuters is one of the key indicators of service quality for public bus operations. While actual measurements of actual waiting time is difficult to be done en masse, models of waiting time can be derived from bus headways and these models have been adopted by transport planners in monitoring and regulating service reliability of operators. However, these models are founded on several assumptions on the patterns of commuter arrival which may not be applicable for bus services that experience high demand and heavily fluctuating commuter patterns. Given the availability of granular data on commuter boarding from automated fare collection systems, we propose a new methodology to better estimate the average waiting time of commuters. The formulation is anchored and validated using a three-month dataset from ten selected bus routes in Singapore. Finally, we discuss how our new measure allows for minimization of commuter waiting time through schedule optimization.

Transaction based approach

NASA Astrophysics Data System (ADS)

Hunka, Frantisek; Matula, Jiri

2017-07-01

Transaction based approach is utilized in some methodologies in business process modeling. Essential parts of these transactions are human beings. The notion of agent or actor role is usually used for them. The paper on a particular example describes possibilities of Design Engineering Methodology for Organizations (DEMO) and Resource-Event-Agent (REA) methodology. Whereas the DEMO methodology can be regarded as a generic methodology having its foundation in the theory of Enterprise Ontology the REA methodology is regarded as the domain specific methodology and has its origin in accountancy systems. The results of these approaches is that the DEMO methodology captures everything that happens in the reality with a good empirical evidence whereas the REA methodology captures only changes connected with economic events. Economic events represent either change of the property rights to economic resource or consumption or production of economic resources. This results from the essence of economic events and their connection to economic resources.

Wait Time and Effective Social Studies Instruction: What Can Research in Science Education Tell Us?

ERIC Educational Resources Information Center

Atwood, Virgina A.; Wilen, William W.

1991-01-01

Defines wait time as the length of time teachers wait for answers from students after asking a question. Maintains that increasing wait time can stimulate reflective thinking and student involvement. Reviews the research literature on wait time studies in science education. Finds that student responses improve and participation expands with…

12 CFR Appendix E to Part 226 - Rules For Card Issuers That Bill on a Transaction-By-Transaction Basis

Code of Federal Regulations, 2010 CFR

2010-01-01

... provisions of Subpart B apply if credit cards are issued and (1) the card issuer and the seller are the same... 226.10. Section 226.11. This section applies when a card issuer receives a payment or other credit... Bill on a Transaction-by-Transaction Basis The following provisions of Subpart B apply if credit cards...

Commercial agencies and surrogate motherhood: a transaction cost approach.

PubMed

Galbraith, Mhairi; McLachlan, Hugh V; Swales, J Kim

2005-03-01

In this paper we investigate the legal arrangements involved in UK surrogate motherhood from a transaction-cost perspective. We outline the specific forms the transaction costs take and critically comment on the way in which the UK institutional and organisational arrangements at present adversely influence transaction costs. We then focus specifically on the potential role of surrogacy agencies and look at UK and US evidence on commercial and voluntary agencies. Policy implications follow.

Transactive Control of Commercial Buildings for Demand Response

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

Hao, He; Corbin, Charles D.; Kalsi, Karanjit

Transactive control is a type of distributed control strategy that uses market mechanism to engage self-interested responsive loads to achieve power balance in the electrical power grid. In this paper, we propose a transactive control approach of commercial building Heating, Ventilation, and Air- Conditioning (HVAC) systems for demand response. We first describe the system models, and identify their model parameters using data collected from Systems Engineering Building (SEB) located on our Pacific Northwest National Laboratory (PNNL) campus. We next present a transactive control market structure for commercial building HVAC system, and describe its agent bidding and market clearing strategies. Severalmore » case studies are performed in a simulation environment using Building Control Virtual Test Bed (BCVTB) and calibrated SEB EnergyPlus model. We show that the proposed transactive control approach is very effective at peak clipping, load shifting, and strategic conservation for commercial building HVAC systems.« less

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

PubMed

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

2016-01-01

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

Transactional sex and risk for HIV infection in sub-Saharan Africa: a systematic review and meta-analysis

PubMed Central

Wamoyi, Joyce; Stobeanau, Kirsten; Bobrova, Natalia; Abramsky, Tanya; Watts, Charlotte

2016-01-01

Introduction Young women aged 15 to 24 years in sub-Saharan Africa continue to be disproportionately affected by HIV. A growing number of studies have suggested that the practice of transactional sex may in part explain women's heightened risk, but evidence on the association between transactional sex and HIV has not yet been synthesized. We set out to systematically review studies that assess the relationship between transactional sex and HIV among men and women in sub-Saharan Africa and to summarize the findings through a meta-analysis. Methods The search strategy included 8 databases, hand searches in 10 journals, and searches across 17 websites and portals for organizations as informed by expert colleagues. A systematic review of cross-sectional and longitudinal studies was carried out for studies on women and men who engage in transactional sex published up through 2014. Random effects meta-analysis was used to further examine the relationship between transactional sex and prevalent HIV infection across a subset of studies with the same exposure period. Analyses were conducted separately for men and women. Results Nineteen papers from 16 studies met our inclusion criteria. Of these 16 studies, 14 provided data on women and 10 on men. We find a significant, positive, unadjusted or adjusted association between transactional sex and HIV in 10 of 14 studies for women, one of which used a longitudinal design (relative risk (RR)=2.06, 95% confidence interval (CI): 1.22 –3.48). Out of 10 studies involving men, only 2 indicate a positive association between HIV and transactional sex in unadjusted or adjusted models. The meta-analysis confirmed general findings from the systematic review (unadjusted meta-analysis findings are significant for women (n=4; pooled odds ratio (OR)=1.54, 95% CI: 1.04–2.28; I2=42.5%, p=0.156), but not for men (n=4; pooled OR=1.47, 95% CI: 0.85–2.56; I2=50.8%, p=0.107). Conclusions Transactional sex is associated with HIV among women

The ethics of waiting and anticipating life beyond.

PubMed

Milton, Constance L

2014-01-01

Waiting is a common everyday experience. It is particularly important to person(s) and families living with changing complex health patterns and may be especially vital to those who are anticipating the end-of-life and beyond. The author in this column offers a discussion of potential definitions, meanings, and straight thinking responsibilities for healthcare professionals, as they provide professional services with persons and families who may be arduously experiencing the phenomenon of waiting with ever-changing health situations. Implications for professional nurse practice are offered from a humanbecoming perspective.

Development of an Information Model for Kidney Transplant Wait List.

PubMed

Bircan, Hüseyin Yüce; Özçelik, Ümit; Uysal, Nida; Demirağ, Alp; Haberal, Mehmet

2015-11-01

Deceased-donor kidney transplant is unique among surgical procedures that are an urgent procedure performed in an elective population. It has not been possible to accurately determine when a given patient will be called for transplant. Patients on the active transplant list can be called for a transplant at any time. As a result, every effort must be made to optimize their health according to best practices and published clinical practice guidelines. Once the patient is placed on the transplant wait list after undergoing an initial extensive evaluation, continued surveillance is required. Therefore, we developed a kidney transplant wait list surveillance software program that alerts organ transplant coordinator on time regarding which patients need a work-up. The new designed software has a database of our waiting patients with their completed and pending controls. The software also has built-in functions to warn the responsible staff with an E-mail. If one of the controls of a recipient delayed, the software sends an automated E-mail to the staff regarding the patients delayed controls. The software is a Web application that works on any platform with a Web browser and Internet connection and allows access by multiple users. The software has been developed with NET platform. The database is SQL server. The software has the following functions: patient communication info, search, alert list, alert E-mail, control entry, and system management. As of January 2014, a total of 21 000 patients were registered on the National Kidney Transplant wait list in Turkey and the kidney transplant wait list had been expanding by 2000 to 3000 patients each year. Therefore computerized wait list programs are crucial to help to transplant centers to keep their patients up-to-date on time.

Transactional Sex among Noninjecting Illicit Drug Users: Implications for HIV Transmission.

PubMed

Guimarães, Rafael Alves; Rodovalho, Aurélio Goulart; Fernandes, Inaina Lara; Silva, Graciele Cristina; de Felipe, Rodrigo Lopes; Vera, Ivânia; Gregório, Valéria Duarte; Lucchese, Roselma

2016-01-01

Noninjecting illicit drug users (NIDUs) present high risk for HIV infection, due especially to transactional sex. This study aimed to estimate the prevalence and risk factors for transactional sex among NIDUs in the Southwest region of Goiás State, Central Brazil. The prevalence of self-reported transactional sex was 22.8%. Prevalence in women and men was 52.7% and 16.8%, respectively, a significant difference (p < 0.001). Crack use and history of sexually transmitted infections (STI) were risk factors for transactional sex in men. Homelessness, crack use, sex under the influence of drugs, and history of sexual violence were risk factors for transactional sex in women. A high prevalence of transactional sex was observed among NIDUs. This risk behavior may contribute to the high rates of HIV among this population and their social networks and in the general population.

General practice cooperatives: long waiting times for home visits due to long distances?

PubMed Central

Giesen, Paul; van Lin, Nieke; Mokkink, Henk; van den Bosch, Wil; Grol, Richard

2007-01-01

Background The introduction of large-scale out-of-hours GP cooperatives has led to questions about increased distances between the GP cooperatives and the homes of patients and the increasing waiting times for home visits in urgent cases. We studied the relationship between the patient's waiting time for a home visit and the distance to the GP cooperative. Further, we investigated if other factors (traffic intensity, home visit intensity, time of day, and degree of urgency) influenced waiting times. Methods Cross-sectional study at four GP cooperatives. We used variance analysis to calculate waiting times for various categories of traffic intensity, home visit intensity, time of day, and degree of urgency. We used multiple logistic regression analysis to calculate to what degree these factors affected the ability to meet targets in urgent cases. Results The average waiting time for 5827 consultations was 30.5 min. Traffic intensity, home visit intensity, time of day and urgency of the complaint all seemed to affect waiting times significantly. A total of 88.7% of all patients were seen within 1 hour. In the case of life-threatening complaints (U1), 68.8% of the patients were seen within 15 min, and 95.6% of those with acute complaints (U2) were seen within 1 hour. For patients with life-threatening complaints (U1) the percentage of visits that met the time target of 15 minuts decreased from 86.5% (less than 2.5 km) to 16.7% (equals or more than 20 km). Discussion and conclusion Although home visits waiting times increase with increasing distance from the GP cooperative, it appears that traffic intensity, home visit intensity, and urgency also influence waiting times. For patients with life-threatening complaints waiting times increase sharply with the distance. PMID:17295925

General practice cooperatives: long waiting times for home visits due to long distances?

PubMed

Giesen, Paul; van Lin, Nieke; Mokkink, Henk; van den Bosch, Wil; Grol, Richard

2007-02-12

The introduction of large-scale out-of-hours GP cooperatives has led to questions about increased distances between the GP cooperatives and the homes of patients and the increasing waiting times for home visits in urgent cases. We studied the relationship between the patient's waiting time for a home visit and the distance to the GP cooperative. Further, we investigated if other factors (traffic intensity, home visit intensity, time of day, and degree of urgency) influenced waiting times. Cross-sectional study at four GP cooperatives. We used variance analysis to calculate waiting times for various categories of traffic intensity, home visit intensity, time of day, and degree of urgency. We used multiple logistic regression analysis to calculate to what degree these factors affected the ability to meet targets in urgent cases. The average waiting time for 5827 consultations was 30.5 min. Traffic intensity, home visit intensity, time of day and urgency of the complaint all seemed to affect waiting times significantly. A total of 88.7% of all patients were seen within 1 hour. In the case of life-threatening complaints (U1), 68.8% of the patients were seen within 15 min, and 95.6% of those with acute complaints (U2) were seen within 1 hour. For patients with life-threatening complaints (U1) the percentage of visits that met the time target of 15 minutes decreased from 86.5% (less than 2.5 km) to 16.7% (equals or more than 20 km). Although home visits waiting times increase with increasing distance from the GP cooperative, it appears that traffic intensity, home visit intensity, and urgency also influence waiting times. For patients with life-threatening complaints waiting times increase sharply with the distance.

31 CFR 19.215 - Which nonprocurement transactions are not covered transactions?

Code of Federal Regulations, 2010 CFR

2010-07-01

... governmental entity; (2) A public international organization; (3) An entity owned (in whole or in part) or... foreign governments or foreign governmental entities. (b) A benefit to an individual as a personal... results from ordinary governmental operations. (g) Any other transaction if the application of an...

29 CFR 1471.215 - Which nonprocurement transactions are not covered transactions?

Code of Federal Regulations, 2010 CFR

2010-07-01

... governmental entity; (2) A public international organization; (3) An entity owned (in whole or in part) or... foreign governments or foreign governmental entities. (b) A benefit to an individual as a personal... transaction. (f) An incidental benefit that results from ordinary governmental operations. (g) Any other...

Review of "Waiting for Superman"

ERIC Educational Resources Information Center

Dutro, Elizabeth

2011-01-01

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

10 CFR 74.15 - Nuclear material transaction reports.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 2 2014-01-01 2014-01-01 false Nuclear material transaction reports. 74.15 Section 74.15 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) MATERIAL CONTROL AND ACCOUNTING OF SPECIAL NUCLEAR MATERIAL General Reporting and Recordkeeping Requirements § 74.15 Nuclear material transaction reports. (a...

10 CFR 74.15 - Nuclear material transaction reports.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 2 2013-01-01 2013-01-01 false Nuclear material transaction reports. 74.15 Section 74.15 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) MATERIAL CONTROL AND ACCOUNTING OF SPECIAL NUCLEAR MATERIAL General Reporting and Recordkeeping Requirements § 74.15 Nuclear material transaction reports. (a...

10 CFR 74.15 - Nuclear material transaction reports.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 2 2011-01-01 2011-01-01 false Nuclear material transaction reports. 74.15 Section 74.15 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) MATERIAL CONTROL AND ACCOUNTING OF SPECIAL NUCLEAR MATERIAL General Reporting and Recordkeeping Requirements § 74.15 Nuclear material transaction reports. (a...

10 CFR 74.15 - Nuclear material transaction reports.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 2 2012-01-01 2012-01-01 false Nuclear material transaction reports. 74.15 Section 74.15 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) MATERIAL CONTROL AND ACCOUNTING OF SPECIAL NUCLEAR MATERIAL General Reporting and Recordkeeping Requirements § 74.15 Nuclear material transaction reports. (a...

Enabling narrative pedagogy: inviting, waiting, and letting be.

PubMed

Ironside, Pamela M

2014-01-01

This article describes how teachers enable Narrative Pedagogy in their courses by explicating the Concernful Practice Inviting: Waiting and Letting Be. Narrative Pedagogy, a research-based, phenomenological approach to teaching and learning, extends conventional pedagogies and offers nursing faculty an alternative way of transforming their schools and courses. Using hermeneutic phenomenology, interview data collected over a 10-year period were analyzed by coding practical examples of teachers' efforts to enact Narrative Pedagogy. When Narrative Pedagogy is enacted, teachers and students focus on thinking and learning together about nursing phenomena and seek new understandings about how they may provide care in the myriad situations they encounter. Although the Concernful Practices co-occur, explicating inviting experiences can assist new teachers, and those seeking to extend their pedagogical literacy, by providing new understandings of how Narrative Pedagogy can be enacted.

RECONCILIATION OF WAITING TIME STATISTICS OF SOLAR FLARES OBSERVED IN HARD X-RAYS

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

Aschwanden, Markus J.; McTiernan, James M., E-mail: aschwanden@lmsal.co, E-mail: jimm@ssl.berkeley.ed

2010-07-10

We study the waiting time distributions of solar flares observed in hard X-rays with ISEE-3/ICE, HXRBS/SMM, WATCH/GRANAT, BATSE/CGRO, and RHESSI. Although discordant results and interpretations have been published earlier, based on relatively small ranges (<2 decades) of waiting times, we find that all observed distributions, spanning over 6 decades of waiting times ({Delta}t {approx} 10{sup -3}-10{sup 3} hr), can be reconciled with a single distribution function, N({Delta}t) {proportional_to} {lambda}{sub 0}(1 + {lambda}{sub 0{Delta}}t){sup -2}, which has a power-law slope of p {approx} 2.0 at large waiting times ({Delta}t {approx} 1-1000 hr) and flattens out at short waiting times {Delta}t {approx}waiting times is invariant for sampling with different flux thresholds, while the mean waiting time scales reciprocically with the number of detected events, {Delta}t {sub 0} {proportional_to} 1/n {sub det}. This waiting time distribution can be modeled with a nonstationary Poisson process with a flare rate {lambda} = 1/{Delta}t that varies as f({lambda}) {proportional_to} {lambda}{sup -1}exp - ({lambda}/{lambda}{sub 0}). This flare rate distribution requires a highly intermittent flare productivity in short clusters with high rates, separated by relatively long quiescent intervals with very low flare rates.« less

Survey of Access to GastroEnterology in Canada: The SAGE wait times program

PubMed Central

Leddin, Desmond; Bridges, Ronald J; Morgan, David G; Fallone, Carlo; Render, Craig; Plourde, Victor; Gray, Jim; Switzer, Connie; McHattie, Jim; Singh, Harminder; Walli, Eric; Murray, Iain; Nestel, Anthony; Sinclair, Paul; Chen, Ying; Irvine, E Jan

2010-01-01

BACKGROUND: Assessment of current wait times for specialist health services in Canada is a key method that can assist government and health care providers to plan wisely for future health needs. These data are not readily available. A method to capture wait time data at the time of consultation or procedure has been developed, which should be applicable to other specialist groups and also allows for assessment of wait time trends over intervals of years. METHODS: In November 2008, gastroenterologists across Canada were asked to complete a questionnaire (online or by fax) that included personal demographics and data from one week on at least five consecutive new consultations and five consecutive procedure patients who had not previously undergone a procedure for the same indication. Wait times were collected for 18 primary indications and results were then compared with similar survey data collected in 2005. RESULTS: The longest wait times observed were for screening colonoscopy (201 days) and surveillance of previous colon cancer or polyps (272 days). The shortest wait times were for cancer-likely based on imaging or physical examination (82 days), severe or rapidly progressing dysphagia or odynophagia (83 days), documented iron-deficiency anemia (90 days) and dyspepsia with alarm symptoms (99 days). Compared with 2005 data, total wait times in 2008 were lengthened overall (127 days versus 155 days; P<0.05) and for most of the seven individual indications that permitted data comparison. CONCLUSION: Median wait times for gastroenterology services continue to exceed consensus conference recommended targets and have significantly worsened since 2005. PMID:20186352

17 CFR 33.3 - Unlawful commodity option transactions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Unlawful commodity option... REGULATION OF DOMESTIC EXCHANGE-TRADED COMMODITY OPTION TRANSACTIONS § 33.3 Unlawful commodity option... of, or maintain a position in, any commodity option transaction subject to the provisions of this...

12 CFR 370.4 - Transaction Account Guarantee Program.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Transaction Account Guarantee Program. 370.4 Section 370.4 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION REGULATIONS AND STATEMENTS OF GENERAL POLICY TEMPORARY LIQUIDITY GUARANTEE PROGRAM § 370.4 Transaction Account Guarantee Program. (a) In...

Allocation and management issues in multiple-transaction open access transmission networks

NASA Astrophysics Data System (ADS)

Tao, Shu

This thesis focuses on some key issues related to allocation and management by the independent grid operator (IGO) of unbundled services in multiple-transaction open access transmission networks. The three unbundled services addressed in the thesis are transmission real power losses, reactive power support requirements from generation sources, and transmission congestion management. We develop the general framework that explicitly represents multiple transactions undertaken simultaneously in the transmission grid. This framework serves as the basis for formulating various problems treated in the thesis. We use this comprehensive framework to develop a physical-flow-based mechanism to allocate the total transmission losses to each transaction using the system. An important property of the allocation scheme is its capability to effectively deal with counter flows that result in the presence of specific transactions. Using the loss allocation results as the basis, we construct the equivalent loss compensation concept and apply it to develop flexible and effective procedures for compensating losses in multiple-transaction networks. We present a new physical-flow-based mechanism for allocating the reactive power support requirements provided by generators in multiple-transaction networks. The allocatable reactive support requirements are formulated as the sum of two specific components---the voltage magnitude variation component and the voltage angle variation component. The formulation utilizes the multiple-transaction framework and makes use of certain simplifying approximations. The formulation leads to a natural allocation as a function of the amount of each transaction. The physical interpretation of each allocation as a sensitivity of the reactive output of a generator is discussed. We propose a congestion management allocation scheme for multiple-transaction networks. The proposed scheme determines the allocation of congestion among the transactions on a physical

2 CFR 180.225 - How do I know if a transaction in which I may participate is a covered transaction?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 2 Grants and Agreements 1 2010-01-01 2010-01-01 false How do I know if a transaction in which I may participate is a covered transaction? 180.225 Section 180.225 Grants and Agreements OFFICE OF MANAGEMENT AND BUDGET GOVERNMENTWIDE GUIDANCE FOR GRANTS AND AGREEMENTS Reserved OMB GUIDELINES TO AGENCIES...

The efficacy of direct anti-HCV drugs improves early post-liver transplant survival and induces significant changes in waiting list composition.

PubMed

Crespo, Gonzalo; Trota, Núria; Londoño, Maria-Carlota; Mauro, Ezequiel; Baliellas, Carme; Castells, Lluís; Castellote, Jose; Tort, Jaume; Forns, Xavier; Navasa, Miquel

2018-07-01

The efficacy of direct-acting antivirals (DAAs) has dramatically changed the prognosis of patients with chronic hepatitis C. We aimed to evaluate the impact of DAA therapy on the composition of the liver transplant (LT) waiting list and the early post-transplant survival. We evaluated all patients admitted to the waiting list for a primary LT between 1st January 2008 and 31st of December 2016 in Catalonia, Spain. Time span was divided into two periods according to the availability of different antiviral therapies: 2008-2013 (interferon-based therapies) and 2014-2016 (DAA). Changes in the indications of LT and the aetiology of liver disease, as well as post-LT patient survival, were evaluated according to the year of inclusion and transplantation, respectively. We included 1,483 patients. Admissions in the waiting list for hepatitis C virus (HCV)-related liver disease decreased significantly, from 47% in 2008-2013 to 35% in 2014-2016 (p <0.001), particularly because of a reduction in patients with decompensated cirrhosis. In contrast, NASH-related inclusions increased from 4% to 7% (p = 0.003). Three-year post-LT patient survival increased significantly in the second period in the whole cohort (82% vs. 91%, p = 0.002), because of better survival in anti-HCV positive patients (76% vs. 91%, p = 0.001), but not in anti-HCV negative patients (88% vs. 91% p = 0.359). Anti-HCV positive serology, the time period of 2008-2013 and higher donor age were independently associated with post-LT mortality in the whole cohort; while time period and donor age were independently associated with post-LT mortality in anti-HCV positive recipients. The high efficacy of DAAs is associated with significant changes in the composition of the LT waiting list and, more importantly, results in improved post-transplant survival. The efficacy of the new direct-acting antivirals is associated with a significant improvement in survival of patients undergoing liver transplantation

7 CFR 3017.215 - Which nonprocurement transactions are not covered transactions?

Code of Federal Regulations, 2010 CFR

2010-01-01

... defined in part 1485 of this title. (j) Any transaction under the Department of Agriculture's conservation... export or substitution of Federal timber governed by the Forest Resources Conservation and Shortage... programs conducted in the interest of public health and safety, and animal and plant health and safety. (m...

An investigation of the impact of prolonged waiting times on blood donors in Ireland.

PubMed

McKeever, T; Sweeney, M R; Staines, A

2006-02-01

The aim of this study was to investigate the impact of prolonged queuing times on blood donors, by measuring their satisfaction levels, and positive and negative affects. As donation times have increased over the past number of years within the Irish Blood Transfusion Service, this is an important issue to examine in a climate where voluntary donors are becoming scarce and demands on people's time are increasing. Eighty-five blood donors were sampled from one urban and one rural blood donor clinic. The respondents conducted a questionnaire by means of face-to-face interview, while waiting in the clinic. The questionnaire contained the Positive and Negative Affect Scale (PANAS), and a waiting satisfaction scale. Both actual and perceived waiting times of the donors were noted. Waiting time was found to be negatively related to satisfaction. Inexperienced donors expressed higher levels of negative affect than experienced donors. Urban donors were significantly more satisfied than rural donors. There was a significant difference in perceived waiting time between lone donors and those queuing in a group, with those waiting alone perceiving their wait as shorter. While all respondents stated that they intended to donate again, over one-third stated that prolonged waiting times would be their most likely deterrent. However, only 15% stated that long queuing times might actually prevent them from donating in the future, and almost all respondents said that they would recommend donation to a friend, despite long queuing times. Although our results show that the respondents were not satisfied with current waiting times, it did not seem to affect their future intentions to donate. These findings provide some optimism for the future of blood donation in Ireland, as they suggest a strong sense of commitment to donation within the population sampled. Future research could explore the application of 'the service industry' approach to waiting times to blood donation clinics.

Transactional Sex among Noninjecting Illicit Drug Users: Implications for HIV Transmission

PubMed Central

Rodovalho, Aurélio Goulart; Fernandes, Inaina Lara; Silva, Graciele Cristina; de Felipe, Rodrigo Lopes; Vera, Ivânia; Gregório, Valéria Duarte; Lucchese, Roselma

2016-01-01

Noninjecting illicit drug users (NIDUs) present high risk for HIV infection, due especially to transactional sex. This study aimed to estimate the prevalence and risk factors for transactional sex among NIDUs in the Southwest region of Goiás State, Central Brazil. The prevalence of self-reported transactional sex was 22.8%. Prevalence in women and men was 52.7% and 16.8%, respectively, a significant difference (p < 0.001). Crack use and history of sexually transmitted infections (STI) were risk factors for transactional sex in men. Homelessness, crack use, sex under the influence of drugs, and history of sexual violence were risk factors for transactional sex in women. A high prevalence of transactional sex was observed among NIDUs. This risk behavior may contribute to the high rates of HIV among this population and their social networks and in the general population. PMID:27648467

Waiting time distribution in public health care: empirics and theory.

PubMed

Dimakou, Sofia; Dimakou, Ourania; Basso, Henrique S

2015-12-01

Excessive waiting times for elective surgery have been a long-standing concern in many national healthcare systems in the OECD. How do the hospital admission patterns that generate waiting lists affect different patients? What are the hospitals characteristics that determine waiting times? By developing a model of healthcare provision and analysing empirically the entire waiting time distribution we attempt to shed some light on those issues. We first build a theoretical model that describes the optimal waiting time distribution for capacity constraint hospitals. Secondly, employing duration analysis, we obtain empirical representations of that distribution across hospitals in the UK from 1997-2005. We observe important differences on the 'scale' and on the 'shape' of admission rates. Scale refers to how quickly patients are treated and shape represents trade-offs across duration-treatment profiles. By fitting the theoretical to the empirical distributions we estimate the main structural parameters of the model and are able to closely identify the main drivers of these empirical differences. We find that the level of resources allocated to elective surgery (budget and physical capacity), which determines how constrained the hospital is, explains differences in scale. Changes in benefits and costs structures of healthcare provision, which relate, respectively, to the desire to prioritise patients by duration and the reduction in costs due to delayed treatment, determine the shape, affecting short and long duration patients differently. JEL Classification I11; I18; H51.

Sustainability: orthopaedic surgery wait time management strategies.

PubMed

Amar, Claudia; Pomey, Marie-Pascale; SanMartin, Claudia; De Coster, Carolyn; Noseworthy, Tom

2015-01-01

The purpose of this paper is to examine Canadian organizational and systemic factors that made it possible to keep wait times within federally established limits for at least 18 months. The research design is a multiple cases study. The paper selected three cases: Case 1 - staff were able to maintain compliance with requirements for more than 18 months; Case 2 - staff were able to meet requirements for 18 months, but unable to sustain this level; Case 3 - staff were never able to meet the requirements. For each case the authors interviewed persons involved in the strategies and collected documents. The paper analysed systemic and organizational-level factors; including governance and leadership, culture, resources, methods and tools. Findings indicate that the hospital that was able to maintain compliance with the wait time requirements had specific characteristics: an exclusive mandate to do only hip and knee replacement surgery; motivated staff who were not distracted by other concerns; and a strong team spirit. The authors' research highlights an important gradient between three cases regarding the factors that sustain waiting times. The paper show that the hospital factory model seems attractive in a super-specialized surgery context. However, patients are selected for simple surgeries, without complications, and so this cannot be considered a unique model.

Reward Sensitivity and Waiting Impulsivity: Shift towards Reward Valuation away from Action Control

PubMed Central

Mechelmans, Daisy J; Strelchuk, Daniela; Doñamayor, Nuria; Banca, Paula; Robbins, Trevor W; Baek, Kwangyeol

2017-01-01

Abstract Background Impulsivity and reward expectancy are commonly interrelated. Waiting impulsivity, measured using the rodent 5-Choice Serial Reaction Time task, predicts compulsive cocaine seeking and sign (or cue) tracking. Here, we assess human waiting impulsivity using a novel translational task, the 4-Choice Serial Reaction Time task, and the relationship with reward cues. Methods Healthy volunteers (n=29) performed the monetary incentive delay task as a functional MRI study where subjects observe a cue predicting reward (cue) and wait to respond for high (£5), low (£1), or no reward. Waiting impulsivity was tested with the 4-Choice Serial Reaction Time task. Results For high reward prospects (£5, no reward), greater waiting impulsivity on the 4-CSRT correlated with greater medial orbitofrontal cortex and lower supplementary motor area activity to cues. In response to high reward cues, greater waiting impulsivity was associated with greater subthalamic nucleus connectivity with orbitofrontal cortex and greater subgenual cingulate connectivity with anterior insula, but decreased connectivity with regions implicated in action selection and preparation. Conclusion These findings highlight a shift towards regions implicated in reward valuation and a shift towards compulsivity away from higher level motor preparation and action selection and response. We highlight the role of reward sensitivity and impulsivity, mechanisms potentially linking human waiting impulsivity with incentive approach and compulsivity, theories highly relevant to disorders of addiction. PMID:29020291

Does Wait-List Size at Registration Influence Time to Surgery? Analysis of a Population-Based Cardiac Surgery Registry

PubMed Central

Sobolev, Boris; Levy, Adrian; Hayden, Robert; Kuramoto, Lisa

2006-01-01

Objective To determine whether the probability of undergoing coronary bypass surgery within a certain time was related to the number of patients on the wait list at registration for the operation in a publicly funded health system. Methods A prospective cohort study comparing waiting times among patients registered on wait lists at the hospitals delivering adult cardiac surgery. For each calendar week, the list size, the number of new registrations, and the number of direct admissions immediately after angiography characterized the demand for surgery. Results The length of delay in undergoing treatment was associated with list size at registration, with shorter times for shorter lists (log-rank test 1,198.3, p<.0001). When the list size at registration required clearance time over 1 week patients had 42 percent lower odds of undergoing surgery compared with lists with clearance time less than 1 week (odds ratio [OR] 0.58 percent, 95 percent, confidence interval [CI] 0.53–0.63), after adjustment for age, sex, comorbidity, period, and hospital. The weekly number of new registrations exceeding weekly service capacity had an independent effect toward longer service delays when the list size at registration required clearance time less than 1 week (OR 0.56 percent, 95 percent CI 0.45–0.71), but not for longer lists. Every time the operation was performed for a patient requiring surgery without registration on wait lists, the odds of surgery for listed patients were reduced by 6 percent (OR 0.94, CI 0.93–0.95). Conclusion For wait-listed patients, time to surgery depends on the list size at registration, the number of new registrations, as well as on the weekly number of patients who move immediately from angiography to coronary bypass surgery without being registered on a wait list. Hospital managers may use these findings to improve resource planning and to reduce uncertainty when providing advice on expected treatment delays. PMID:16430599

Transactions at a Northeastern Supermarket Chain: Differences by Supplemental Nutrition Assistance Program Use.

PubMed

Franckle, Rebecca L; Moran, Alyssa; Hou, Tao; Blue, Dan; Greene, Julie; Thorndike, Anne N; Polacsek, Michele; Rimm, Eric B

2017-10-01

Although one in seven Americans receives Supplemental Nutrition Assistance Program (SNAP) benefits, little is known about how these benefits for food are spent because individual-level sales data are not publicly available. The purpose of this study is to compare transactions made with and without SNAP benefits at a large regional supermarket chain. Sales data were obtained from a large supermarket chain in the Northeastern U.S. for a period of 2 years (April 2012-April 2014). Multivariate multiple regression models were used to quantify relative differences in dollars spent on 31 predefined SNAP-eligible food categories. Analyses were completed in 2016. Transactions with SNAP benefit use included higher spending on less healthful food categories, including sugar-sweetened beverages ($1.08), red meat ($1.55), and convenience foods ($1.34), and lower spending on more healthful food categories, such as fruits (-$1.51), vegetables (-$1.35), and poultry (-$1.25) compared to transactions without SNAP benefit use. These findings provide objective data to compare purchases made with and without SNAP benefits. Next steps should be to test proposed SNAP modifications to determine whether they would have the intended effect of promoting healthier purchasing patterns among SNAP beneficiaries. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

31 CFR 515.573 - Transactions by news organizations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Transactions by news organizations... Licenses, Authorizations, and Statements of Licensing Policy § 515.573 Transactions by news organizations... operation of news bureaus in Cuba whose primary purpose is the gathering and dissemination of news to the...

31 CFR 515.573 - Transactions by news organizations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Transactions by news organizations... Licenses, Authorizations, and Statements of Licensing Policy § 515.573 Transactions by news organizations... operation of news bureaus in Cuba whose primary purpose is the gathering and dissemination of news to the...

31 CFR 515.573 - Transactions by news organizations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Transactions by news organizations... Licenses, Authorizations, and Statements of Licensing Policy § 515.573 Transactions by news organizations... operation of news bureaus in Cuba whose primary purpose is the gathering and dissemination of news to the...

31 CFR 515.573 - Transactions by news organizations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Transactions by news organizations... Licenses, Authorizations, and Statements of Licensing Policy § 515.573 Transactions by news organizations... operation of news bureaus in Cuba whose primary purpose is the gathering and dissemination of news to the...

31 CFR 515.573 - Transactions by news organizations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Transactions by news organizations... Licenses, Authorizations, and Statements of Licensing Policy § 515.573 Transactions by news organizations... operation of news bureaus in Cuba whose primary purpose is the gathering and dissemination of news to the...

17 CFR 32.3 - Unlawful commodity option transactions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Unlawful commodity option... REGULATION OF COMMODITY OPTION TRANSACTIONS § 32.3 Unlawful commodity option transactions. (a) On and after... extend credit in lieu thereof) from an option customer as payment of the purchase price in connection...

21 CFR 1314.25 - Requirements for retail transactions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Requirements for retail transactions. 1314.25 Section 1314.25 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE RETAIL SALE OF SCHEDULED LISTED CHEMICAL PRODUCTS Sales by Regulated Sellers § 1314.25 Requirements for retail transactions...

21 CFR 1314.25 - Requirements for retail transactions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 9 2013-04-01 2013-04-01 false Requirements for retail transactions. 1314.25 Section 1314.25 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE RETAIL SALE OF SCHEDULED LISTED CHEMICAL PRODUCTS Sales by Regulated Sellers § 1314.25 Requirements for retail transactions...

21 CFR 1314.25 - Requirements for retail transactions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 9 2014-04-01 2014-04-01 false Requirements for retail transactions. 1314.25 Section 1314.25 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE RETAIL SALE OF SCHEDULED LISTED CHEMICAL PRODUCTS Sales by Regulated Sellers § 1314.25 Requirements for retail transactions...

21 CFR 1314.25 - Requirements for retail transactions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 9 2012-04-01 2012-04-01 false Requirements for retail transactions. 1314.25 Section 1314.25 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE RETAIL SALE OF SCHEDULED LISTED CHEMICAL PRODUCTS Sales by Regulated Sellers § 1314.25 Requirements for retail transactions...

21 CFR 1314.25 - Requirements for retail transactions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 9 2011-04-01 2011-04-01 false Requirements for retail transactions. 1314.25 Section 1314.25 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE RETAIL SALE OF SCHEDULED LISTED CHEMICAL PRODUCTS Sales by Regulated Sellers § 1314.25 Requirements for retail transactions...

31 CFR 340.11 - Failure to complete transaction.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance:Treasury 2 2012-07-01 2012-07-01 false Failure to complete transaction. 340.11 Section 340.11 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued... TREASURY BONDS THROUGH COMPETITIVE BIDDING § 340.11 Failure to complete transaction. If any successful...

31 CFR 340.11 - Failure to complete transaction.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Failure to complete transaction. 340.11 Section 340.11 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued... TREASURY BONDS THROUGH COMPETITIVE BIDDING § 340.11 Failure to complete transaction. If any successful...

31 CFR 340.11 - Failure to complete transaction.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance:Treasury 2 2013-07-01 2013-07-01 false Failure to complete transaction. 340.11 Section 340.11 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued... TREASURY BONDS THROUGH COMPETITIVE BIDDING § 340.11 Failure to complete transaction. If any successful...

31 CFR 340.11 - Failure to complete transaction.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 2 2011-07-01 2011-07-01 false Failure to complete transaction. 340.11 Section 340.11 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued... TREASURY BONDS THROUGH COMPETITIVE BIDDING § 340.11 Failure to complete transaction. If any successful...

31 CFR 340.11 - Failure to complete transaction.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance: Treasury 2 2014-07-01 2014-07-01 false Failure to complete transaction. 340.11 Section 340.11 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued... TREASURY BONDS THROUGH COMPETITIVE BIDDING § 340.11 Failure to complete transaction. If any successful...

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

PubMed

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

2013-01-01

One of the core goals of a universal health care system is to eliminate discrimination on the basis of socioeconomic status. We test for discrimination using patient waiting times for non-emergency treatment in public hospitals. Waiting time should reflect patients' clinical need with priority given to more urgent cases. Using data from Australia, we find evidence of prioritisation of the most socioeconomically advantaged patients at all quantiles of the waiting time distribution. These patients also benefit from variation in supply endowments. These results challenge the universal health system's core principle of equitable treatment. Copyright © 2012 Elsevier B.V. All rights reserved.

Waiting times for cancer patients in Sweden: A nationwide population-based study.

PubMed

Robertson, Stephanie; Adolfsson, Jan; Stattin, Pär; Sjövall, Annika; Winnersjö, Rocio; Hanning, Marianne; Sandelin, Kerstin

2017-05-01

The reported long waiting times for cancer patients have mostly been related to prognostic outcome and less to patient-related experience to outcome. We assessed waiting times for patients with cancer of the breast, prostate, colon or rectum in Sweden. The median time from referral to start of treatment was assessed using data from clinical cancer registers for patients who received curative treatment during 2011, 2012 and 2013. The median overall waiting time in different counties ranged from 7 to 28 days for breast cancer, from 117 to 280 days for prostate cancer, from 27 to 64 days for colon cancer and from 48 to 80 days for rectal cancer. For the entire nation, the median time from referral to start of treatment remained unchanged from 2011 to 2013 for each cancer diagnosis. Large variations were found in waiting times between different counties in Sweden and between different types of cancer. The long waiting times identified in this study emphasize the need to improve national programmes for more rapid diagnosis and treatment.

The waiting time problem in a model hominin population.

PubMed

Sanford, John; Brewer, Wesley; Smith, Franzine; Baumgardner, John

2015-09-17

Functional information is normally communicated using specific, context-dependent strings of symbolic characters. This is true within the human realm (texts and computer programs), and also within the biological realm (nucleic acids and proteins). In biology, strings of nucleotides encode much of the information within living cells. How do such information-bearing nucleotide strings arise and become established? This paper uses comprehensive numerical simulation to understand what types of nucleotide strings can realistically be established via the mutation/selection process, given a reasonable timeframe. The program Mendel's Accountant realistically simulates the mutation/selection process, and was modified so that a starting string of nucleotides could be specified, and a corresponding target string of nucleotides could be specified. We simulated a classic pre-human hominin population of at least 10,000 individuals, with a generation time of 20 years, and with very strong selection (50% selective elimination). Random point mutations were generated within the starting string. Whenever an instance of the target string arose, all individuals carrying the target string were assigned a specified reproductive advantage. When natural selection had successfully amplified an instance of the target string to the point of fixation, the experiment was halted, and the waiting time statistics were tabulated. Using this methodology we tested the effect of mutation rate, string length, fitness benefit, and population size on waiting time to fixation. Biologically realistic numerical simulations revealed that a population of this type required inordinately long waiting times to establish even the shortest nucleotide strings. To establish a string of two nucleotides required on average 84 million years. To establish a string of five nucleotides required on average 2 billion years. We found that waiting times were reduced by higher mutation rates, stronger fitness benefits, and

Spontaneous activity in the waiting brain: a marker of impulsive choice in attention-deficit/hyperactivity disorder?

PubMed

Hsu, Chia-Fen; Benikos, Nicholas; Sonuga-Barke, Edmund J S

2015-04-01

Spontaneous very low frequency oscillations (VLFO), seen in the resting brain, are attenuated when individuals are working on attention demanding tasks or waiting for rewards (Hsu et al., 2013). Individuals with attention-deficit/hyperactivity disorder (ADHD) display excess VLFO when working on attention tasks. They also have difficulty waiting for rewards. Here we examined the waiting brain signature in ADHD and its association with impulsive choice. DC-EEG from 21 children with ADHD and 21 controls (9-15 years) were collected under four conditions: (i) resting; (ii) choosing to wait; (iii) being "forced" to wait; and (iv) working on a reaction time task. A questionnaire measured two components of impulsive choice. Significant VLFO reductions were observed in controls within anterior brain regions in both working and waiting conditions. Individuals with ADHD showed VLFO attenuation while working but to a reduced level and none at all when waiting. A closer inspection revealed an increase of VLFO activity in temporal regions during waiting. Excess VLFO activity during waiting was associated with parents' ratings of temporal discounting and delay aversion. The results highlight the potential role for waiting-related spontaneous neural activity in the pathophysiology of impulsive decision-making of ADHD. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Is Waiting the Hardest Part? Comparing the Emotional Experiences of Awaiting and Receiving Bad News.

PubMed

Sweeny, Kate; Falkenstein, Angelica

2015-11-01

Awaiting uncertain news is stressful, but is it more stressful than receiving bad news? We compared these emotional experiences in two studies. Participants in Study 1 reflected on a personal experience awaiting news that ultimately turned out badly, and participants in Study 2 were law graduates awaiting their results on the bar exam who ultimately failed the exam. In Study 1, participants were ambivalent as to whether awaiting or receiving bad news was more difficult, and emotion ratings in both studies confirmed this ambivalence. Anxiety was higher in anticipation of bad news (at least at the moment of truth) than in the face of it, whereas other negative emotions were more intense following the news than during the waiting period. Thus, whether waiting is "the hardest part" depends on whether one prefers to be racked with anxiety or afflicted with other negative emotions such as anger, disappointment, depression, and regret. © 2015 by the Society for Personality and Social Psychology, Inc.

[Reducing patient waiting time for the outpatient phlebotomy service using six sigma].

PubMed

Kim, Yu Kyung; Song, Kyung Eun; Lee, Won Kil

2009-04-01

One of the challenging issues of the outpatient phlebotomy services at most hospitals is that patients have a long wait. The outpatient phlebotomy team of Kyungpook National University Hospital applied six sigma breakthrough methodologies to reduce the patient waiting time. The DMAIC (Define, Measure, Analyze, Improve, and Control) model was employed to approach the project. Two hundred patients visiting the outpatient phlebotomy section were asked to answer the questionnaires at inception of the study to ascertain root causes. After correction, we surveyed 285 patients for same questionnaires again to follow-up the effects. A defect was defined as extending patient waiting time so long and at the beginning of the project, the performance level was 2.61 sigma. Using fishbone diagram, all the possible reasons for extending patient waiting time were captured, and among them, 16 causes were proven to be statistically significant. Improvement plans including a new receptionist, automatic specimen transport system, and adding one phlebotomist were put into practice. As a result, the number of patients waited more than 5 min significantly decreased, and the performance level reached 3.0 sigma in December 2007 and finally 3.35 sigma in July 2008. Applying the six sigma, the performance level of waiting times for blood drawing exceeding five minutes were improved from 2.61 sigma to 3.35 sigma.

34 CFR 85.215 - Which nonprocurement transactions are not covered transactions?

Code of Federal Regulations, 2010 CFR

2010-07-01

... transactions: (a) A direct award to— (1) A foreign government or foreign governmental entity; (2) A public international organization; (3) An entity owned (in whole or in part) or controlled by a foreign government; or... governmental entities. (b) A benefit to an individual as a personal entitlement without regard to the...

21 CFR 1404.215 - Which nonprocurement transactions are not covered transactions?

Code of Federal Regulations, 2010 CFR

2010-04-01

... transactions: (a) A direct award to— (1) A foreign government or foreign governmental entity; (2) A public international organization; (3) An entity owned (in whole or in part) or controlled by a foreign government; or... governmental entities. (b) A benefit to an individual as a personal entitlement without regard to the...

22 CFR 1006.215 - Which nonprocurement transactions are not covered transactions?

Code of Federal Regulations, 2010 CFR

2010-04-01

... transactions: (a) A direct award to— (1) A foreign government or foreign governmental entity; (2) A public international organization; (3) An entity owned (in whole or in part) or controlled by a foreign government; or... governmental entities. (b) A benefit to an individual as a personal entitlement without regard to the...

2 CFR 180.215 - Which nonprocurement transactions are not covered transactions?

Code of Federal Regulations, 2010 CFR

2010-01-01

... transactions: (a) A direct award to— (1) A foreign government or foreign governmental entity; (2) A public international organization; (3) An entity owned (in whole or in part) or controlled by a foreign government; or... governmental entities. (b) A benefit to an individual as a personal entitlement without regard to the...

22 CFR 1508.215 - Which nonprocurement transactions are not covered transactions?

Code of Federal Regulations, 2010 CFR

2010-04-01

... transactions: (a) A direct award to— (1) A foreign government or foreign governmental entity; (2) A public international organization; (3) An entity owned (in whole or in part) or controlled by a foreign government; or... governmental entities. (b) A benefit to an individual as a personal entitlement without regard to the...

17 CFR 5.20 - Special calls for account and transaction information.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 17 Commodity and Securities Exchanges 1 2011-04-01 2011-04-01 false Special calls for account and transaction information. 5.20 Section 5.20 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION OFF-EXCHANGE FOREIGN CURRENCY TRANSACTIONS § 5.20 Special calls for account and transaction...

Not all waits are equal: an exploratory investigation of emergency care patient pathways.

PubMed

Swancutt, Dawn; Joel-Edgar, Sian; Allen, Michael; Thomas, Daniel; Brant, Heather; Benger, Jonathan; Byng, Richard; Pinkney, Jonathan

2017-06-24

Increasing pressure in the United Kingdom (UK) urgent care system has led to Emergency Departments (EDs) failing to meet the national requirement that 95% of patients are admitted, discharged or transferred within 4-h of arrival. Despite the target being the same for all acute hospitals, individual Trusts organise their services in different ways. The impact of this variation on patient journey time and waiting is unknown. Our study aimed to apply the Lean technique of Value Stream Mapping (VSM) to investigate care processes and delays in patient journeys at four contrasting hospitals. VSM timing data were collected for patients accessing acute care at four hospitals in South West England. Data were categorised according to waits and activities, which were compared across sites to identify variations in practice from the patient viewpoint. We included Public and Patient Involvement (PPI) to fully interpret our findings; observations and initial findings were considered in a PPI workshop. One hundred eight patients were recruited, comprising 25,432 min of patient time containing 4098 episodes of care or waiting. The median patient journey was 223 min (3 h, 43 min); just within the 4-h target. Although total patient journey times were similar between sites, the stage where the greatest proportion of waiting occurred varied. Reasons for waiting were dominated by waits for beds, investigations or results to be available. From our sample we observed that EDs without a discharge/clinical decision area exhibited a greater proportion of waiting time following an admission or discharge decision. PPI interpretation indicated that patients who experience waits at the beginning of their journey feel more anxious because they are 'not in the system yet'. The novel application of VSM analysis across different hospitals, coupled with PPI interpretation, provides important insight into the impact of care provision on patient experience. Measures that could reduce patient

2 CFR 180.405 - May I enter into a covered transaction with a participant if a principal of the transaction is...

Code of Federal Regulations, 2010 CFR

2010-01-01

... a participant if a principal of the transaction is excluded? 180.405 Section 180.405 Grants and Agreements OFFICE OF MANAGEMENT AND BUDGET GOVERNMENTWIDE GUIDANCE FOR GRANTS AND AGREEMENTS Reserved OMB... participant if a principal of the transaction is excluded? As a Federal agency official, you may not enter...

"Making Do": Adapting Transaction Systems to Organizational Needs.

ERIC Educational Resources Information Center

Barreau, Deborah K.

2001-01-01

Discusses transaction systems that are designed for rapid data entry and task completion, and describes a study of three organizations that use commercial off-the-shelf software (COTS) products for providing customer service as well as for processing transactions. Concludes that organizations made do with systems designed for one application to…

Transaction-Level Learning Analytics in Online Authentic Assessments

ERIC Educational Resources Information Center

Nyland, Rob; Davies, Randall S.; Chapman, John; Allen, Gove

2017-01-01

This paper presents a case for the use of transaction-level data when analyzing automated online assessment results to identify knowledge gaps and misconceptions for individual students. Transaction-level data, which records all of the steps a student uses to complete an assessment item, are preferred over traditional assessment formats that…

Waiting time distribution revealing the internal spin dynamics in a double quantum dot

NASA Astrophysics Data System (ADS)

Ptaszyński, Krzysztof

2017-07-01

Waiting time distribution and the zero-frequency full counting statistics of unidirectional electron transport through a double quantum dot molecule attached to spin-polarized leads are analyzed using the quantum master equation. The waiting time distribution exhibits a nontrivial dependence on the value of the exchange coupling between the dots and the gradient of the applied magnetic field, which reveals the oscillations between the spin states of the molecule. The zero-frequency full counting statistics, on the other hand, is independent of the aforementioned quantities, thus giving no insight into the internal dynamics. The fact that the waiting time distribution and the zero-frequency full counting statistics give a nonequivalent information is associated with two factors. Firstly, it can be explained by the sensitivity to different timescales of the dynamics of the system. Secondly, it is associated with the presence of the correlation between subsequent waiting times, which makes the renewal theory, relating the full counting statistics and the waiting time distribution, no longer applicable. The study highlights the particular usefulness of the waiting time distribution for the analysis of the internal dynamics of mesoscopic systems.

Transactions of the Chinese Solar Energy Society (Selected Articles),

DTIC Science & Technology

1983-08-04

iDAld- 870 TRANSACTIONS OF THE CHINESE SOLAR ENERGY SOCIETY i/i ’A1 (SELECTED ARTICLES)<U) FOREIGN TECHNOLOGY DIV I WRIGHT-PRTTERSON RF8 OH 7 SUN ET...34 . -.-. - - - - , " ’ ’-. . .. .. ...- " . ’ " FTD-ID(RS)T-1067-83 10 00 FOREIGN TECHNOLOGY DIVISION TRANSACTIONS OF THE CHINESE SOLAR ENERGY SOCIETY (Selected Articles...l067-83 4 August 1983 MICROFICHE NR: FTD-83-C-000960 TRANSACTIONS OF THE CHINESE SOLAR ENERGY SOCIETYI(Selected Articles) English pages: 16 Source: Acta

5 CFR 531.405 - Waiting periods for within-grade increase.

Code of Federal Regulations, 2010 CFR

2010-01-01

... step 4-52 calendar weeks of creditable service; (ii) Rate of basic pay equal to or greater than the... creditable service; and (iii) Rate of basic pay equal to or greater than the rate of basic pay at step 7-156... step 4-260 days of creditable service in a pay status over a period of not less than 52 calendar weeks...

5 CFR 531.405 - Waiting periods for within-grade increase.

Code of Federal Regulations, 2011 CFR

2011-01-01

... step 4-260 days of creditable service in a pay status over a period of not less than 52 calendar weeks... step 4-52 calendar weeks of creditable service; (ii) Rate of basic pay equal to or greater than the rate of basic pay at step 4 and less than the rate of basic pay at step 7-104 calendar weeks of...

Transactional Sex and Preferences for Pre-Exposure Prophylaxis (PrEP) Administration Modalities Among Men Who Have Sex With Men (MSM).

PubMed

Mgbako, Ofole; Park, Su Hyun; Mayer, Kenneth H; Schneider, John A; Goedel, William C; Hambrick, H Rhodes; Duncan, Dustin T

2018-04-10

Pre-exposure prophylaxis (PrEP) is an important biomedical human immunodeficiency virus (HIV) prevention tool gaining more popularity among Parisian men who have sex with men (MSM) who engage in transactional sex. This study examines the knowledge of, and willingness to use, different modalities of PrEP among this subgroup. Broadcast advertisements were placed on a geosocial-networking smartphone application with a link to a Web-based survey during three 24-hour periods in October 2016. Modified Poisson regression models were used to assess the association between engagement in transactional sex and preferences for each of these PrEP modalities. A total of 444 respondents were included. About 14% reported engagement in transactional sex. In all, 90% of MSM who engaged in transactional sex were knowledgeable of daily oral PrEP, while 13.3% were knowledgeable about long-acting injectable PrEP or penile or rectal microbicides. They were more likely to be aware of long-acting injectable PrEP (aRR = 2.52, 95% CI = 1.16 to 5.47) and willing to use daily oral PrEP (aRR = 1.48; 95% CI = 1.11 to 1.98) or long-acting injectable PrEP (aRR = 1.40; 95% CI = 1.09 to 1.81) than MSM who had not engaged in transactional sex. Long-acting injectable PrEP may be an important HIV-prevention option for MSM who engage in transactional sex if this modality is proven effective.

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

ERIC Educational Resources Information Center

Vitus, Kathrine

2010-01-01

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

41 CFR 105-68.215 - Which nonprocurement transactions are not covered transactions?

Code of Federal Regulations, 2010 CFR

2010-07-01

... foreign government or foreign governmental entity; (2) A public international organization; (3) An entity... wholly or partially of one or more foreign governments or foreign governmental entities. (b) A benefit to... incidental benefit that results from ordinary governmental operations. (g) Any other transaction if the...

31 CFR 575.419 - Transactions in Iraqi debt.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Transactions in Iraqi debt. 575.419 Section 575.419 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE... § 575.419 Transactions in Iraqi debt. Section 575.533 authorizes U.S. persons to trade in Iraqi...

Impact of Appointment Waiting Time on Attendance Rates at a Clinical Cancer Genetics Service.

PubMed

Shaw, Tarryn; Metras, Julie; Ting, Zoe Ang Li; Courtney, Eliza; Li, Shao-Tzu; Ngeow, Joanne

2018-05-24

The increase in demand for clinical cancer genetics services has impacted the ability to provide services timeously. Given limited resources, this often results in extended appointment waiting times. Over the last 3 years, the Cancer Genetics Service at the National Cancer Centre Singapore has continued to experience a steady increase in demand for its service. Nevertheless, significant no-show rates have been reported. This study sought to determine whether an association exists between appointment waiting times and attendance rates. Data was gathered for all participants meeting inclusion criteria. Attendance rates and appointment waiting times were calculated. The relationship between mean waiting times for those who did and did not attend their scheduled appointments was evaluated using Welch's t test and linear regression model. The results showed a significant difference in mean appointment waiting times between patients who did and did not attend (32.66 versus 43.50 days respectively; p < 0.0001). Furthermore, patients who waited for longer than 37 days were significantly less likely to attend. No-show rates increased as the waiting time increased, at a rate of 19.60% per 20 days and 21.40% per 30 days. In conclusion, appointment waiting time is a significant predictor for patient attendance. Strategies to ensure patients receive an appointment within the necessary timeframe at the desired setting are important to ensure that individuals at increased cancer risk attend their appointments in order to manage their cancer risks effectively.

Waiting time of inpatients before elective surgical procedures at a State Government Teaching Hospital in India.

PubMed

Ray, Shreyasi; Kirtania, Jyotirmay

2017-01-01

Abundant published literature exists addressing the issues of outpatient waiting lists before surgery. However, there is no published literature on inpatient waiting time before elective surgical procedures. This study aims to measure the inpatient waiting time, identify the factors that affect the inpatient waiting time, and recommend the ways of reducing the waiting time of inpatients before elective surgical procedures, at a state government teaching hospital in India. Descriptive research methods and quality control tools were used for this prospective observational study. Descriptive statistics, Shapiro-Wilk test of normality, Wilcoxon-Mann-Whitney Test, and Kruskal-Wallis test were used. Pareto charts were used to highlight the most important modifiable factors among the set of factors causing increased waiting time. We also applied the M/M/c model (Erlang - A model) of queue theory to analyze the traffic intensity and system congestion. The median waiting time of inpatients before elective surgery was 12 days (interquartile range = 11.5 days). The waiting time was influenced significantly (P < 0.05) by the patient's age, physical status, and the financial status. The surgical specialty, blood product booking and procurement, cross-specialty consultation before surgery, and Intensive Care Unit booking were the other important factors. Modifiable and nonmodifiable factors affecting the inpatient waiting time of surgical patients were identified. Control measures that can reduce the waiting time of inpatients before elective surgery were identified.

A transactional framework for pediatric rehabilitation: shifting the focus to situated contexts, transactional processes, and adaptive developmental outcomes.

PubMed

King, Gillian; Imms, Christine; Stewart, Debra; Freeman, Matt; Nguyen, Tram

2018-07-01

A paradigm shift is taking place in pediatric rehabilitation research, practice, and policy - a shift towards the real-life contexts of clients rather than requiring clients to navigate the world of pediatric rehabilitation. This article proposes a conceptual framework to bring about a broader awareness of clients' lives and transactional processes of change over the life course. The framework draws attention to transactional processes by which individuals, situated in life contexts, change and adapt over the life course and, in turn, influence their contextual settings and broader environments. This framework is based on (a) basic tenets derived from foundational theories taking a life course perspective to change, and (b) transactional processes identified from relevant pediatric rehabilitation models that bring these foundational theories into the pediatric rehabilitation sphere. The framework identifies three types of transactional processes relevant to pediatric rehabilitation: facilitative, resiliency, and socialization processes. These processes describe how contexts and people mutually influence each other via opportunities and situated experiences, thus facilitating capacity, adaptation to adversity, and socialization to new roles and life transitions. The utility of the framework is considered for research, practice, service organizations, and policy. Implications for Rehabilitation The framework supports practitioners going beyond person and environment as separate entities, to provide services to the "situated person" in real-life contexts The framework shifts the focus from "body structures/functions" and "person in activity" to "person in changing and challenging life contexts" Working from a transactional perspective, practitioner-client conversations will change; practitioners will view client situations through a lens of opportunities and experiences, assess client experiences in real-life contexts, and strive to create context-based therapy

Bottlenecks and Waiting Points in Nucleosynthesis in X-ray bursts and Novae

NASA Astrophysics Data System (ADS)

Smith, Michael S.; Sunayama, Tomomi; Hix, W. Raphael; Lingerfelt, Eric J.; Nesaraja, Caroline D.

2010-08-01

To better understand the energy generation and element synthesis occurring in novae and X-ray bursts, we give quantitative definitions to the concepts of ``bottlenecks'' and ``waiting points'' in the thermonuclear reaction flow. We use these criteria to search for bottlenecks and waiting points in post-processing element synthesis explosion simulations. We have incorporated these into the Computational Infrastructure for Nuclear Astrophysics, a suite of nuclear astrophysics codes available online at nucastrodata.org, so that anyone may perform custom searches for bottlenecks and waiting points.

Bottlenecks and Waiting Points in Nucleosynthesis in X-ray bursts and Novae

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

Smith, Michael S.; Hix, W. Raphael; Nesaraja, Caroline D.

2010-08-12

To better understand the energy generation and element synthesis occurring in novae and X-ray bursts, we give quantitative definitions to the concepts of ''bottlenecks'' and ''waiting points'' in the thermonuclear reaction flow. We use these criteria to search for bottlenecks and waiting points in post-processing element synthesis explosion simulations. We have incorporated these into the Computational Infrastructure for Nuclear Astrophysics, a suite of nuclear astrophysics codes available online at nucastrodata.org, so that anyone may perform custom searches for bottlenecks and waiting points.

Patient Satisfaction Is Associated With Time With Provider But Not Clinic Wait Time Among Orthopedic Patients.

PubMed

Patterson, Brendan M; Eskildsen, Scott M; Clement, R Carter; Lin, Feng-Chang; Olcott, Christopher W; Del Gaizo, Daniel J; Tennant, Joshua N

2017-01-01

Clinic wait time is considered an important predictor of patient satisfaction. The goal of this study was to determine whether patient satisfaction among orthopedic patients is associated with clinic wait time and time with the provider. The authors prospectively enrolled 182 patients at their outpatient orthopedic clinic. Clinic wait time was defined as the time between patient check-in and being seen by the surgeon. Time spent with the provider was defined as the total time the patient spent in the examination room with the surgeon. The Consumer Assessment of Healthcare Providers and Systems survey was used to measure patient satisfaction. Factors associated with increased patient satisfaction included patient age and increased time with the surgeon (P=.024 and P=.037, respectively), but not clinic wait time (P=.625). Perceived wait time was subject to a high level of error, and most patients did not accurately report whether they had been waiting longer than 15 minutes to see a provider until they had waited at least 60 minutes (P=.007). If the results of the current study are generalizable, time with the surgeon is associated with patient satisfaction in orthopedic clinics, but wait time is not. Further, the study findings showed that patients in this setting did not have an accurate perception of actual wait time, with many patients underestimating the time they waited to see a provider. Thus, a potential strategy for improving patient satisfaction is to spend more time with each patient, even at the expense of increased wait time. [Orthopedics. 2017; 40(1):43-48.]. Copyright 2016, SLACK Incorporated.

Toys are a potential source of cross-infection in general practitioners' waiting rooms.

PubMed Central

Merriman, Eileen; Corwin, Paul; Ikram, Rosemary

2002-01-01

The waiting rooms of general practitioners' surgeries usually have toys provided for children. The level of contamination of these toys and the effectiveness of toy decontamination was investigated in this study. Hard toys from general practitioners' waiting rooms had relatively low levels of contamination, with only 13.5% of toys showing any coliform counts. There were no hard toys with heavy contamination by coliforms or other bacteria. Soft toys were far more likely to be contaminated, with 20% of toys showing moderate to heavy coliform contamination and 90% showing moderate to heavy bacterial contamination. Many waiting-room toys are not cleaned routinely. Soft toys are hard to disinfect and tend to rapidly become recontaminated after cleaning. Conversely, hard toys can be cleaned and disinfected easily. Soft toys in general practitioners' waiting rooms pose an infectious risk and it is therefore recommended that soft toys are unsuitable for doctors' waiting rooms. PMID:11885823

31 CFR 560.555 - Winding-down of transactions prohibited by § 560.215.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Winding-down of transactions... Winding-down of transactions prohibited by § 560.215. (a) Except as set forth in paragraphs (b) and (c) of this section, all transactions ordinarily incident and necessary to the winding-down of transactions...

31 CFR 560.555 - Winding-down of transactions prohibited by § 560.215.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Winding-down of transactions... Winding-down of transactions prohibited by § 560.215. (a) Except as set forth in paragraphs (b) and (c) of this section, all transactions ordinarily incident and necessary to the winding-down of transactions...

The effect of waiting times on demand and supply for elective surgery: Evidence from Italy.

PubMed

Riganti, Andrea; Siciliani, Luigi; Fiorio, Carlo V

2017-09-01

Waiting times are a major policy concern in publicly funded health systems across OECD countries. Economists have argued that, in the presence of excess demand, waiting times act as nonmonetary prices to bring demand for and supply of health care in equilibrium. Using administrative data disaggregated by region and surgical procedure over 2010-2014 in Italy, we estimate demand and supply elasticities with respect to waiting times. We employ linear regression models with first differences and instrumental variables to deal with endogeneity of waiting times. We find that demand is inelastic to waiting times while supply is more elastic. Estimates of demand elasticity are between -0.15 to -0.24. Our results have implications on the effectiveness of policies aimed at increasing supply and their ability to reduce waiting times. Copyright © 2017 John Wiley & Sons, Ltd.

20 CFR 404.1592 - The trial work period.

Code of Federal Regulations, 2014 CFR

2014-04-01

... which you may test your ability to work and still be considered disabled. It begins and ends as...); (ii) If you perform work demonstrating the ability to engage in substantial gainful activity during any required waiting period for benefits; (iii) If you perform work demonstrating the ability to...

20 CFR 404.1592 - The trial work period.

Code of Federal Regulations, 2012 CFR

2012-04-01

... which you may test your ability to work and still be considered disabled. It begins and ends as...); (ii) If you perform work demonstrating the ability to engage in substantial gainful activity during any required waiting period for benefits; (iii) If you perform work demonstrating the ability to...

20 CFR 404.1592 - The trial work period.

Code of Federal Regulations, 2013 CFR

2013-04-01

... which you may test your ability to work and still be considered disabled. It begins and ends as...); (ii) If you perform work demonstrating the ability to engage in substantial gainful activity during any required waiting period for benefits; (iii) If you perform work demonstrating the ability to...

24 CFR 100.110 - Discriminatory practices in residential real estate-related transactions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... residential real estate-related transactions. 100.110 Section 100.110 Housing and Urban Development... Discrimination in Residential Real Estate-Related Transactions § 100.110 Discriminatory practices in residential real estate-related transactions. (a) This subpart provides the Department's interpretation of the...

24 CFR 100.110 - Discriminatory practices in residential real estate-related transactions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... residential real estate-related transactions. 100.110 Section 100.110 Housing and Urban Development... Discrimination in Residential Real Estate-Related Transactions § 100.110 Discriminatory practices in residential real estate-related transactions. (a) This subpart provides the Department's interpretation of the...

24 CFR 100.110 - Discriminatory practices in residential real estate-related transactions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... residential real estate-related transactions. 100.110 Section 100.110 Housing and Urban Development... Discrimination in Residential Real Estate-Related Transactions § 100.110 Discriminatory practices in residential real estate-related transactions. (a) This subpart provides the Department's interpretation of the...

24 CFR 100.110 - Discriminatory practices in residential real estate-related transactions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... residential real estate-related transactions. 100.110 Section 100.110 Housing and Urban Development... Discrimination in Residential Real Estate-Related Transactions § 100.110 Discriminatory practices in residential real estate-related transactions. (a) This subpart provides the Department's interpretation of the...

24 CFR 100.110 - Discriminatory practices in residential real estate-related transactions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... residential real estate-related transactions. 100.110 Section 100.110 Housing and Urban Development... Discrimination in Residential Real Estate-Related Transactions § 100.110 Discriminatory practices in residential real estate-related transactions. (a) This subpart provides the Department's interpretation of the...

The effectiveness of interventions aimed at reducing anxiety in health care waiting spaces: a systematic review of randomized and nonrandomized trials.

PubMed

Biddiss, Elaine; Knibbe, Tara Joy; McPherson, Amy

2014-08-01

Reducing waiting anxiety is an important objective of patient-centered care. Anxiety is linked to negative health outcomes, including longer recovery periods, lowered pain thresholds, and for children in particular, resistance to treatment, nightmares, and separation anxiety. The goals of this study were (1) to systematically review published research aimed at reducing preprocedural waiting anxiety, and (2) to provide directions for future research and development of strategies to manage preprocedural waiting anxiety in health care environments. We performed a systematic review of the literature via ISI Web of Knowledge, PubMed, PsycINFO, EMBASE, CINAHL, and Medline. Included in this review were studies describing measurable outcomes in response to interventions specifically intended to improve the waiting experience of patients in health care settings. Primary outcomes of interest were stress and anxiety. Exclusion criteria included (a) studies aimed at reducing wait times and management of waiting lists only, (b) waiting in non-health care settings, (c) design of health care facilities with nonspecific strategies pertaining to waiting spaces, (d) strategies to reduce pain or anxiety during the course of medical procedures, and (e) interventions such as massage, acupuncture, or hypnosis that require dedicated staff and/or private waiting environments to administer. We identified 8690 studies. Forty-one articles met the inclusion criteria. In adult populations, 33 studies were identified, wherein the effects of music (n = 25), aromatherapy (n = 6), and interior design features (n = 2) were examined. Eight pediatric studies were identified investigating play opportunities (n = 2), media distractions (n = 2), combined play opportunities and media distractions (n = 3), and music (n = 1). Based on results from 1129 adult participants in the 14 studies that evaluated music and permitted meta-analysis, patients who listened to music before a medical procedure exhibited a

Transactive discourse during assessment conversations on science learning

NASA Astrophysics Data System (ADS)

Russell, H. A., III

2005-11-01

It has been argued that development of science knowledge is the result of social interaction and adoption of shared understandings between teachers and students. A part of understanding that process is determining how student reasoning develops in groups. Transactive discussion is a form of negotiation between group members as they interpret the meaning of their logical statements about a topic. More importantly, it is a form of discourse that often leads to cognitive change as a result of the interaction between group participants as they wrestle with their different perspectives in order to achieve a common understanding. The research reported here was a correlational study designed to investigate the relationship between the various forms of transactive discussion and learning outcome performance seen in an investigation involving 24 students in a middle-SES high school located in southwest Atlanta, Georgia. Pretest and posttest measures of genetics reasoning, as well as curriculum content test data, were used in this study. Group discussion was captured on videotape and analyzed to determine whether transactional discussion was present and whether or not it had an effect on learning outcome measures. Results of this study showed that participant use of transactive discussion played a role in development of reasoning abilities in the area of genetics. It is suggested that teachers should monitor classroom discourse for the presence of transactive discussion as such discourse plays a role in fostering performance outcomes.

41 CFR 105-68.405 - May I enter into a covered transaction with a participant if a principal of the transaction is...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false May I enter into a covered transaction with a participant if a principal of the transaction is excluded? 105-68.405 Section 105-68.405 Public Contracts and Property Management Federal Property Management Regulations System...

31 CFR 357.29 - Time required for processing transaction request.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Book-Entry Securities System (Legacy Treasury Direct) § 357.29 Time required for processing transaction request. For purposes of a transaction request affecting payment instructions with respect to a security...

Waiting is the hardest part: anticipating medical test results affects processing and recall of important information.

PubMed

Portnoy, David B

2010-07-01

Waiting for medical test results that signal physical harm can be a stressful and potentially psychologically harmful experience. Despite this, interventionists and physicians often use this wait time to deliver behavior change messages and other important information about the test, possible results and its implications. This study examined how "bracing" for a medical test result impacts cognitive processing, as well as recall of information delivered during this period. Healthy U.S. university students (N = 150) were tested for a deficiency of a fictitious saliva biomarker that was said to be predictive of long-term health problems using a 2 (Test Result) x 2 (Expected immediacy of result: 10 min, 1 month) factorial design. Participants expecting to get the test result shortly should have been bracing for the result. While waiting for the test results participants completed measures of cognitive processing. After participants received the test result, recall of information about the biomarker was tested in addition to cognitive measures. One week later, participants who were originally told they did not have the deficiency had their recall assessed again. Results showed that anticipating an imminent test result increased cognitive distraction in the processing of information and lowered recall of information about the test and the biomarker. These results suggest that delivering critical information to patients after administering a test and immediately before giving the results may not be optimal.

17 CFR 229.1005 - (Item 1005) Past contacts, transactions, negotiations and agreements.