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Truche, Paul, Rachel E. NeMoyer, Sara Patiño-Franco, Juan P. Herrera-Escobar, Myerlandi Torres, Luis F. Pino, and Gregory L. Peck. "Publicly funded interfacility ambulance transfers for surgical and obstetrical conditions: A cross sectional analysis in an urban middle-income country setting." PLOS ONE 15, no. 11 (November 6, 2020): e0241553. http://dx.doi.org/10.1371/journal.pone.0241553.
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Introduction Interfacility transfers may reflect a time delay of definitive surgical care, but few studies have examined the prevalence of interfacility transfers in the urban low- and middle-income (LMIC) setting. The aim of this study was to determine the number of interfacility transfers required for surgical and obstetric conditions in an urban MIC setting to better understand access to definitive surgical care among LMIC patients. Methods A retrospective analysis of public interfacility transfer records was conducted from April 2015 to April 2016 in Cali, Colombia. Data were obtained from the single municipal ambulance agency providing publicly funded ambulance transfers in the city. Interfacility transfers were defined as any patient transfer between two healthcare facilities. We identified the number of transfers for patients with surgical conditions and categorized transfers based on patient ICD-9-CM codes. We compared surgical transfers from public vs. private healthcare facilities by condition type (surgical, obstetric, nonsurgical), transferring physician specialty, and transfer acuity (code blue, emergent, urgent and nonurgent) using logistic regression. Results 31,659 patient transports occurred over the 13-month study period. 22250 (70.2%) of all transfers were interfacility transfers and 7777 (35%) of transfers were for patients with surgical conditions with an additional 2,244 (10.3%) for obstetric conditions. 49% (8660/17675) of interfacility transfers from public hospitals were for surgical and obstetric conditions vs 32% (1466/4580) for private facilities (P<0.001). The most common surgical conditions requiring interfacility transfer were fractures (1,227, 5.4%), appendicitis (913, 4.1%), wounds (871, 3.9%), abdominal pain (818, 3.6%), trauma (652, 2.9%), and acute abdomen (271, 1.2%). Conclusion Surgical and obstetric conditions account for nearly half of all urban interfacility ambulance transfers. The most common reasons for transfer are basic surgical conditions with public healthcare facilities transferring a greater proportion of patient with surgical conditions than private facilities. Timely access to an initial healthcare facility may not be a reliable surrogate of definitive surgical care given the substantial need for interfacility transfers.
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Wulandari, Corry, and Nadezhda Baryshnikova. "DID PUBLIC CASH TRANSFER CROWD OUT INTER-HOUSEHOLD TRANSFERS IN INDONESIA? EVIDENCE FROM "BANTUAN LANGSUNG TUNAI /BLT"." INFO ARTHA 3, no. 2 (November 5, 2019): 67–84. http://dx.doi.org/10.31092/jia.v3i2.571.
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In 2005 the Government of Indonesia introduced an unconditional cash transfer program called the ‘Bantuan Langsung Tunai’ (BLT), aimed at assisting poor people who were suffering from the removal of a fuel subsidy. There are concerns, however, that the introduction of a public transfer system can negatively affect inter-household transfers through the crowding-out effect, which exists when donor households reduce the amount of their transfers in line with public transfers received from the government. The poor may not therefore have received any meaningful impact from the public cash transfer, as they potentially receive fewer transfers from inter-household private donors. For the government to design a public transfer system, it is necessary to properly understand the dynamics of private transfer behaviour. Hence, this study evaluates whether there exists a crowding-out effect of public transfers on inter-household transfers in Indonesia.Using data from the Indonesia Family Life Survey (IFLS) and by applying Coarsened Exact Matching (CEM) and Difference-in-differences (DID) approaches, this study found that the likelihood to receive transfers from other family members (non-co-resident) reduces when the household receives BLT. However, there is no significant impact of BLT on transfers from parents and friends.
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Sun, Licheng, and Sui Fang. "Irrational Carbon Emission Transfers in Supply Chains under Environmental Regulation: Identification and Optimization." Sustainability 14, no. 3 (January 18, 2022): 1099. http://dx.doi.org/10.3390/su14031099.
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Irrational transfer of carbon emissions in the supply chain refers to the phenomenon that after the transfer of carbon emissions occurs, the profits of any party in the supply chain are reduced compared to before the transfer. Identifying and optimizing irrational transfers of carbon emissions in supply chains under environmental regulation are the bases for establishing green supply chains. By constructing a manufacturer-led Steinberg model, we obtained identification intervals for such transfers, then analyzed the influences of the changes in various coefficients. Finally, we designed a carbon emission transfer cost-sharing contract to obtain optimized intervals for shifts from irrational to rational transfers and used a Nash bargaining model to obtain the optimal share rates within the intervals. The results indicated irrational transfer intervals existed in supply chains. When a supplier has a low ability to receive transfers, the range of the irrational transfer intervals increases as the supplier’s capacity coefficient for receiving carbon emission transfers, the transfer investment cost coefficient, the emission reduction investment cost coefficient, and the consumer’s low-carbon awareness intensity increase. Otherwise, the range decreases as these coefficients increase when the supplier’s ability to receive transfers has a large coefficient. In this range, a cost-sharing contract can effectively shift the transfers from irrational to rational and an optimal cost-sharing ratio can help the transfers reach the optimal level, which is beneficial in terms of constructing a green supply chain.
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Haushofer, Johannes, and Jeremy Shapiro. "The Short-term Impact of Unconditional Cash Transfers to the Poor: Experimental Evidence from Kenya*." Quarterly Journal of Economics 131, no. 4 (July 19, 2016): 1973–2042. http://dx.doi.org/10.1093/qje/qjw025.
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Abstract We use a randomized controlled trial to study the response of poor households in rural Kenya to unconditional cash transfers from the NGO GiveDirectly. The transfers differ from other programs in that they are explicitly unconditional, large, and concentrated in time. We randomized at both the village and household levels; furthermore, within the treatment group, we randomized recipient gender (wife versus husband), transfer timing (lump-sum transfer versus monthly installments), and transfer magnitude (US$404 PPP versus US$1,525 PPP). We find a strong consumption response to transfers, with an increase in household monthly consumption from $158 PPP to $193 PPP nine months after the transfer began. Transfer recipients experience large increases in psychological well-being. We find no overall effect on levels of the stress hormone cortisol, although there are differences across some subgroups. Monthly transfers are more likely than lump-sum transfers to improve food security, whereas lump-sum transfers are more likely to be spent on durables, suggesting that households face savings and credit constraints. Together, these results suggest that unconditional cash transfers have significant impacts on economic outcomes and psychological well-being.
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Nair, Dilip, Mary Gibbs, Todd Gress, and Shawndra Barker. "Potentially Avoidable Acute Care Patient Transfers to a Rural Academic Medical Center." West Virginia Medical Journal 116, no. 2 (July 2020): 36–41. http://dx.doi.org/10.21885/wvmj.2020.3.
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Though inter-facility acute care patient transfers from resource-limited rural hospitals are necessary, it is desirable to minimize them for several reasons. Some transfers might be potentially avoidable with appropriate pre-transfer teleconsultation. We conducted a retrospective record review of adult patient transfers to our rural academic medical center for medical-surgical services or critical care to estimate the frequency of potentially avoidable patient transfers and to identify any re-quested specialty that was more often associated withpotentially avoidable patient transfers. Excluded were patients transferred via trauma network or for obstetrics care. Transfers were judged potentially avoidable if resulting in live discharge within 48 hours without procedures or intensive care. We studied patient demographics and transferring facility characteristics.We examined 1,180 transfers between June 2016 and January 2017 and judged 21.6% (N=255) potentially avoidable. Transfers for Neurology consultation were 2.5 times (95% CI 1.2 -5.0) more likely to be avoidable relative to transfers for General Surgery. Neurology was the only specialty associated with a greater likelihood of potentially avoidable transfers than the comparator specialty.A significant proportion of inter-facility patient transfers to our facility are potentially avoidable. Neurology-related transfers might warrant pre-transfer teleconsultation.
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Chuang, David. "Distal Nerve Transfers: A Perspective on the Future of Reconstructive Microsurgery." Journal of Reconstructive Microsurgery 34, no. 09 (May 16, 2018): 669–71. http://dx.doi.org/10.1055/s-0038-1656719.
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Abstract Background Nerve transfer can be broadly separated into two categories: proximal nerve graft and/or transfer and distal nerve transfer. The superiority of proximal nerve graft/transfer over distal nerve transfer strategy has been debated extensively, but which strategy is the best has not yet been defined. Each technique has its own advantages and disadvantages. However, proximal nerve graft/transfer is still the main reconstructive procedure based on the principle of “no diagnosis, then no treatment.” Proximal nerve transfer can avoid iatrogenic injury where the lesion is still in continuity and neurolysis is the only procedure without further cutting the nerve. Results Our clinical and experimental study show that proximal nerve grafts/transfers yield at least equal or better results compared to distal nerve transfers. Proximal nerve grafts/transfers remain the mainstay of my reconstructive strategy. Proximal nerve graft/transfer offers more accurate diagnosis and proper treatment to restore shoulder and elbow functions simultaneously. Distal nerve transfers can offer more efficient elbow flexion. Conclusion Combined, both strategies in primary nerve reconstruction are especially recommended when there is no healthy or not enough donor nerve available Distal nerve transfers should be considered as a complementary option for proximal nerve grafts/ transfers.
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Mehta, Mitali S., and Amruta G. Ekbote. "Awareness of safe transfers in ambulance drivers after road traffic accidents." International Journal Of Community Medicine And Public Health 10, no. 11 (October 31, 2023): 4350–54. http://dx.doi.org/10.18203/2394-6040.ijcmph20233476.
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Background: Today accidents are among the leading causes of death. Deaths due to road traffic accidents are increasing at an alarming rate throughout the world. Hence, safe transfers become an important aspect to deal with. Ambulance drivers being the providers for this transfer should know about safe transfers and how is it performed. Methods: A validated self-structured questionnaire consisting of 14 questions related to knowledge about safe transfers was prepared and circulated to ambulance drivers via Google forms. Ethical approval and informed consent were taken. A total of 102 participants were included in the study and descriptive data analysis was done. Results: Out of 102 participants, 10.8% of drivers had attended a road trauma first aid course, 41.2% of participants had heard about safe transfers, 98% had transferred an RTA victim, 3.9% of participants knew the right way to transfer a patient with spinal injury, 37.3% of subjects knew how to transfer fracture cases, 96% of the participants knew safest way used for transferring a patient, 47.1% drivers knew about “golden hour”, 80.3% participants knew the correct way to transfer a traumatic patient, 22.5% of subjects knew the importance of safe transfers and 99% of drivers felt the need to learn about safe transfers. Conclusions: The study concludes that there is overall less awareness about safe transfers among ambulance workers. Although the willingness to learn about safe transfers is comparatively high. There is a need to increase awareness about safe transfers in ambulance drivers
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Matalamäki, Marko, Elina Varamäki, Anmari Viljamaa, Juha Tall, and Anna-Maria Mäkelä. "Unsuccessful SME Business Transfers." Journal of Enterprising Culture 28, no. 02 (June 2020): 121–46. http://dx.doi.org/10.1142/s0218495820500065.
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Business transfers are linked to both the beginning and the end of entrepreneurial processes. A person can become an entrepreneur by acquiring an existing business instead of starting one, and exit from entrepreneurship can occur through selling the business. Business transfers are gradually becoming more common among small businesses, largely due to entrepreneurs’ aging, and thus deserve attention from entrepreneurship scholars. In particular, the issue of why and how business transfer negotiations fail without achieving a transfer has received little research attention. The purpose of this paper is to explore this phenomenon from potential buyers’ and sellers’ perspectives. The findings are based on a sample of 156 responses. The results suggest that the problems occurring in unfinished business transfers are quite numerous and the gaps between the views of the two negotiating parties are wider than in cases where business transfer negotiations are concluded successfully, indicating that the initial negotiation positions can be crucial. This research proposes some key elements to consider when planning an exit by business transfer and highlight the importance of unfinished small business transfers as an essential element of a dynamic business transfer market; a substantial proportion of the potential buyers and sellers are satisfied with the outcome even though the transfer did not occur.
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Giang, Wayne C. W., Birsen Donmez, Mahvareh Ahghari, and Russell D. MacDonald. "The Impact of Precipitation on Land Interfacility Transport Times." Prehospital and Disaster Medicine 29, no. 6 (November 4, 2014): 593–99. http://dx.doi.org/10.1017/s1049023x14001149.
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AbstractIntroductionTimely transfer of patients among facilities within a regionalized critical-care system remains a large obstacle to effective patient care. For medical transport systems where dispatchers are responsible for planning these interfacility transfers, accurate estimates of interfacility transfer times play a large role in planning and resource-allocation decisions. However, the impact of adverse weather conditions on transfer times is not well understood.Hypothesis/ProblemPrecipitation negatively impacts driving conditions and can decrease free-flow speeds and increase travel times. The objective of this research was to quantify and model the effects of different precipitation types on land travel times for interfacility patient transfers. It was hypothesized that the effects of precipitation would accumulate as the distance of the transfer increased, and they would differ based on the type of precipitation.MethodsUrgent and emergent interfacility transfers carried out by the medical transport system in Ontario from 2005 through 2011 were linked to Environment Canada's (Gatineau, Quebec, Canada) climate data. Two linear models were built to estimate travel times based on precipitation type and driving distance: one for transfers between cities (intercity) and another for transfers within a city (intracity).ResultsPrecipitation affected both transfer types. For intercity transfers, the magnitude of the delays increased as driving distance increased. For median-distance intercity transfers (48 km), snow produced delays of approximately 9.1% (3.1 minutes), while rain produced delays of 8.4% (2.9 minutes). For intracity transfers, the magnitude of delays attributed to precipitation did not depend on distance driven. Transfers in rain were 8.6% longer (1.7 minutes) compared to no precipitation, whereas only statistically marginal effects were observed for snow.ConclusionPrecipitation increases the duration of interfacility land ambulance travel times by eight percent to ten percent. For transfers between cities, snow is associated with the longest delays (versus rain), but for transfers within a single city, rain is associated with the longest delays.GiangWCW, DonmezB, AhghariM, MacDonaldRD. The impact of precipitation on land interfacility transport times. Prehosp Disaster Med. 2014;29(6):1-7.
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Sethia, Deepak. "Vertical Sharing and Horizontal Distribution of Federal-Provincial Transfers in Canada, 1983-2018." Canadian Tax Journal/Revue fiscale canadienne 69, no. 1 (April 2021): 35–82. http://dx.doi.org/10.32721/ctj.2021.69.1.sethia.
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The Canada health transfer (CHT), the Canada social transfer (CST), and the equalization program are the main pillars of intergovernmental transfers in Canada. These transfers aim to address the vertical and horizontal fiscal imbalances that arise within the Canadian federation. This article provides a framework for the decomposition of federal transfers into their vertical and horizontal components. The empirical analysis is carried out for the period 1983-2018, which is divided into seven subperiods for analytical purposes. The results for the most recent subperiod, 2015-2018, show that (1) vertical, horizontal, and surplus transfers account for 74.85, 24.27, and 0.88 percent, respectively, of the total federal transfers; (2) the federal transfers addressed nearly 77 percent of the initial horizontal fiscal inequalities; (3) the equalization program is the primary channel for reducing horizontal fiscal inequalities, accounting for 85 percent of the total horizontal transfers; and (4) the CHT and CST have effectively become a channel for vertical transfers, contributing little toward horizontal equalization. In this context, there is potential for reform in the federal transfer system. The author suggests that vertical fiscal imbalances could be reduced by transferring tax points to provinces instead of providing specific-purpose transfers. The author also argues that immediate reforms are required in the fiscal stabilization program to address the concerns of oil-producing provinces that face a revenue shortfall because of the decline in oil prices.
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Ferriere, Axelle, Philipp Grübener, Gaston Navarro, and Oliko Vardishvili. "On the optimal design of transfers and income-tax progressivity." International Finance Discussion Paper, no. 1350 (August 2022): 1–52. http://dx.doi.org/10.17016/ifdp.2022.1350.
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We study the optimal design of means-tested transfers and progressive income taxes. In a simple analytical model, we demonstrate an optimally negative relation between transfers and income-tax progressivity due to efficiency and redistribution concerns. In a rich dynamic model, we quantify the optimal plan with flexible tax-and-transfer functions. Transfers should be larger than currently in the U.S. and financed with moderate income-tax progressivity. Transfers are key to implement higher progressivity in average than in marginal tax-and-transfer rates, achieving redistribution while preserving efficiency. Quantitatively, the left tail of the income distribution determines optimal transfers, whereas the right tail determines income-tax progressivity.
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Petkovic, Djuro, Montri D. Wongworawat, and Scott Richard Anderson. "Factors Affecting Appropriateness of Interfacility Transfer for Hand Injuries." HAND 13, no. 1 (October 28, 2016): 108–13. http://dx.doi.org/10.1177/1558944716675147.
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Background: Transfers of patients with higher acuity injuries to trauma centers have helped improve care since the enactment of Emergency Medical Treatment and Active Labor Act. However, an unintended consequence is the inappropriate transfer of patients who do not truly require handover of care. Methods: We retrospectively reviewed the records of all patients transferred to our level I trauma center for injuries distal to the ulnohumeral joint between April 1, 2013, and March 31, 2014; 213 patients were included. We examined the records for appropriateness of transfer based on whether the patient required the care of the receiving hospital’s attending surgeon (appropriate transfer) or whether junior-level residents treated the patient alone (inappropriate transfer) and calculated odds ratios. We performed logistic regression to identify factors associated with appropriateness of transfer; these factors included specialist evaluation prior to transfer, age, insurance status, race, injury type, sex, shift time, distance traveled, and median income. Results: The risk of inappropriate transfers was 68.5% (146/213). Specialist evaluation at the referring hospital was not associated with a lower risk of inappropriate transfers (odds ratio 1.62 [95% CI: 0.48-5.34], P = .383). Only evening shift (15:01 to 23:00) was associated with inappropriate transfers. Amputations and open fractures were associated with appropriate transfers. Conclusion: Second shift and type of injury (namely, amputations and open fractures) were significant factors to appropriateness of transfer. No significant association was found between specialist evaluation and appropriate transfers. Future studies may focus on finding reasons and aligning incentives to minimize inappropriate transfers and associated systems costs.
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Mackinnon, Susan. "Future Perspectives in the Management of Nerve Injuries." Journal of Reconstructive Microsurgery 34, no. 09 (April 1, 2018): 672–74. http://dx.doi.org/10.1055/s-0038-1639353.
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Aim The author presents a solicited “white paper” outlining her perspective on the role of nerve transfers in the management of nerve injuries. Methods PubMed/MEDLINE and EMBASE databases were evaluated to compare nerve graft and nerve transfer. An evaluation of the scientific literature by review of index articles was also performed to compare the number of overall clinical publications of nerve repair, nerve graft, and nerve transfer. Finally, a survey regarding the prevalence of nerve transfer surgery was administrated to the World Society of Reconstructive Microsurgery (WSRM) results. Results Both nerve graft and transfer can generate functional results and the relative success of graft versus transfer depended on the function to be restored and the specific transfers used. Beginning in the early 1990s, there has been a rapid increase from baseline of nerve transfer publications such that clinical nerve transfer publication now exceeds those of nerve repair or nerve graft. Sixty-two responses were received from WSRM membership. These surgeons reported their frequency of “usually or always using nerve transfers for repairing brachial plexus injuries as 68%, radial nerves as 27%, median as 25%, and ulnar as 33%. They reported using nerve transfers” sometimes for brachial plexus 18%, radial nerve 30%, median nerve 34%, ulnar nerve 35%. Conclusion Taken together this evidence suggests that nerve transfers do offer an alternative technique along with tendon transfers, nerve repair, and nerve grafts.
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Forget, Evelyn L., Alexander D. Peden, and Stephenson B. Strobel. "Cash Transfers, Basic Income and Community Building." Social Inclusion 1, no. 2 (September 6, 2013): 84–91. http://dx.doi.org/10.17645/si.v1i2.113.
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The austerity movement in high-income countries of Europe and North America has renewed calls for a guaranteed Basic Income. At the same time, conditional and unconditional cash transfers accompanied by rigorous impact evaluations have been conducted in low- and middle-income countries with the explicit support of the World Bank. Both Basic Income and cash transfer programs are more confidently designed when based on empirical evidence and social theory that explain how and why cash transfers to citizens are effective ways of encouraging investment in human capital through health and education spending. Are conditional cash transfers more effective and/or more efficient than unconditional transfers? Are means-tested transfers effective? This essay draws explicit parallels between Basic Income and unconditional cash transfers, and demonstrates that cash transfers to citizens work in remarkably similar ways in low-, middle- and high-income countries. It addresses the theoretical foundation of cash transfers. Of the four theories discussed, three explicitly acknowledge the interdependence of society and are based, in increasingly complex ways, on ideas of social inclusion. Only if we have an understanding of how cash transfers affect decision-making can we address questions of how best to design cash transfer schemes.
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Kristina, Anita, Mohtar Rasyid, and Putu Ayu Pramitha Purwanti. "The impact of social assistance on households’ transfer behavior: A micro data analysis." Jurnal Ekonomi dan Bisnis 26, no. 1 (February 7, 2023): 1–20. http://dx.doi.org/10.24914/jeb.v26i1.4354.
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This paper investigates whether public transfers crowd-out inter-household transfers in Indonesia. Using household data from Indonesia Family Life Survey (IFLS-3 & IFLS-4), this study evaluates the impact of direct cash transfer programs (Bantuan Langsung Tunai, BLT) on inter-family transfer (i.e., monetary transfer from parents, siblings, child, and other family members who do not live co-residently). The results indicate that, in general, the crowding-out effect is relatively small. This effect is statistically significant only in urban households but not rural ones. This finding suggests that expanding public transfer under formal social security programs to cover poor households does not significantly reduce the existence of informal transfers. Further, public transfers potentially improve the distribution of household income.
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Zhang, Chi, Torsten Eken, Silje Bakken Jørgensen, Magne Thoresen, and Signe Søvik. "Effects of patient-level risk factors, departmental allocation and seasonality on intrahospital patient transfer patterns: network analysis applied on a Norwegian single-centre data set." BMJ Open 12, no. 3 (March 2022): e054545. http://dx.doi.org/10.1136/bmjopen-2021-054545.
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ObjectivesDescribe patient transfer patterns within a large Norwegian hospital. Identify risk factors associated with a high number of transfers. Develop methods to monitor intrahospital patient flows to support capacity management and infection control.DesignRetrospective observational study of linked clinical data from electronic health records.SettingTertiary care university hospital in the Greater Oslo Region, Norway.ParticipantsAll adult (≥18 years old) admissions to the gastroenterology, gastrointestinal surgery, neurology and orthopaedics departments at Akershus University Hospital, June 2018 to May 2019.MethodsNetwork analysis and graph theory. Poisson regression analysis.Outcome measuresPrimary outcome was network characteristics at the departmental level. We describe location-to-location transfers using unweighted, undirected networks for a full-year study period. Weekly networks reveal changes in network size, density and key categories of transfers over time. Secondary outcome was transfer trajectories at the individual patient level. We describe the distribution of transfer trajectories in the cohort and associate number of transfers with patient clinical characteristics.ResultsThe cohort comprised 17 198 hospital stays. Network analysis demonstrated marked heterogeneity across departments and throughout the year. The orthopaedics department had the largest transfer network size and density and greatest temporal variation. More transfers occurred during weekdays than weekends. Summer holiday affected transfers of different types (Emergency department-Any location/Bed ward-Bed ward/To-From Technical wards) differently. Over 75% of transferred patients followed one of 20 common intrahospital trajectories, involving one to three transfers. Higher number of intrahospital transfers was associated with emergency admission (transfer rate ratio (RR)=1.827), non-prophylactic antibiotics (RR=1.108), surgical procedure (RR=2.939) and stay in intensive care unit or high-dependency unit (RR=2.098). Additionally, gastrosurgical (RR=1.211), orthopaedic (RR=1.295) and neurological (RR=1.114) patients had higher risk of many transfers than gastroenterology patients (all effects: p<0.001).ConclusionsNetwork and transfer chain analysis applied on patient location data revealed logistic and clinical associations highly relevant for hospital capacity management and infection control.
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Dowling, MJ, Una Molloy, Cathy Payne, Sarah McLean, Regina McQuillan, Claire Noonan, and DJ Ryan. "318 Does a Teleconference-Delivered Educational Programme (ECHO) Provided to Nursing Homes Reduce Emergency Hospital Transfers?" Age and Ageing 48, Supplement_3 (September 2019): iii1—iii16. http://dx.doi.org/10.1093/ageing/afz102.67.
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Abstract Background Nursing home staff manage increasingly complex patients yet struggle to access education programmes due to geographical logistical barriers. The aim of this study is to measure the impact on emergency hospital transfers a novel teleconference-delivered palliative care education programme (ECHO) has on patient transfers from nursing homes to emergency departments. Methods Ten interactive sessions were provided to staff from 20 nursing homes, using teleconferencing technology through the “Project ECHO” model. “Transfer forms” were completed by participating staff 6 months before echo, and 6 months from commencement of echo outlining details of emergency hospital transfers. Participating sites must attend 4 or more of 10 sessions for study inclusion. Results Of 20 nursing homes, 15 attended sufficient sessions, and they submitted data regarding 260 emergency transfers over a 12-month period. There was no significant difference in the number of transfers pre vs post ECHO (137 of 260 vs 123 of 260, p=0.62). There was no significant difference in likelihood of hospital admission, length of stay, or number of weekend transfers to hospital (p=0.26, 0.68 and 0.6 respectively). Post-echo, patients were less likely to have pain documented as the primary symptom (11 of 137 vs 1 of 123, p=0.006), and it was more likely that transfer wishes were documented in advance (62 of 137 (45%) vs 82 of 123 (67%), p<0.001). Increase in transfer wishes documentation was explained primarily by an increase in a “for transfer” decision (27 of 62 vs 67 of 82) p=<0.001). Conclusion This teleconference, ECHO-delivered palliative education programme did not affect overall rates of emergency hospital transfers from nursing homes. However, it did significantly lower rates of transfers reporting pain as the primary symptom, tentatively suggesting a possible impact on “reversible” hospital transfers. ECHO significantly increased likelihood of transfer status discussion, while most “extra” discussions resulted in a “for transfer” decision.
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Broman, Kristy Kummerow, Sharon E. Phillips, Jesse M. Ehrenfeld, Mayur B. Patel, Oscar M. Guillamondegui, Kenneth W. Sharp, Richard A. Pierce, Benjamin K. Poulose, and Michael D. Holzman. "Identifying Futile Interfacility Surgical Transfers." American Surgeon 83, no. 8 (August 2017): 866–70. http://dx.doi.org/10.1177/000313481708300838.
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Surgeons perceive that some surgical transfers are futile, but the incidence and risk factors of futile transfer are not quantified. Identifying futile interfacility transfers could save cost and undue burdens to patients and families. We sought to describe the incidence and factors associated with futile transfers. We conducted a retrospective cohort study from 2009 to 2013 including patients transferred to a tertiary referral center for general or vascular surgical care. Futile transfers were defined as resulting in death or hospice discharge within 72 hours of transfer without operative, endoscopic, or radiologic intervention. One per cent of patient transfers were futile (27/ 1696). Characteristics of futile transfers included older age, higher comorbidity burden and illness severity, vascular surgery admission, Medicare insurance, and surgeon documentation of end-stage disease as a factor in initial decision-making. Among futile transfers, 82 per cent were designated as do not resuscitate (vs 9% of nonfutile, P < 0.01), and 59 per cent received a palliative care consult (vs 7%, P < 0.01). A small but salient proportion of transferred patients undergo deliberate care de-escalation and early death or hospice discharge without intervention. Efforts to identify such patients before transfer through improved communication between referring and accepting surgeons may mitigate burdens of transfer and facilitate more comfortable deaths in patients’ local communities.
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Ledgard, James P., and Claudia R. Gschwind. "Evidence for efficacy of new developments in reconstructive upper limb surgery for tetraplegia." Journal of Hand Surgery (European Volume) 45, no. 1 (November 17, 2019): 43–50. http://dx.doi.org/10.1177/1753193419886443.
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Nerve transfers are increasingly utilized for upper limb reconstruction in tetraplegia. We reviewed the literature for results achieved by nerve transfers for elbow extension, wrist control and finger and thumb flexion and extension. Muscle strength grading was the only outcome measure consistently reported. The results confirm that nerve transfers can effectively reanimate muscles in selected cases, with comparable strength with those achieved with tendon transfer for elbow extension but inferior strength for finger and thumb flexion. Transfer of supinator nerve branches to the posterior interosseous nerve appears to be reliable and offers increased span and better hand opening than is observed after tendon transfers. Only one publication demonstrated how reinnervation of muscles with nerve transfers translated into improved function, activity and participation for patients. More prospective studies, using standardized outcome measures, are needed to define the precise role of nerve transfers.
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Jappelli, Tullio, Mario Padula, and Giovanni Pica. "DO TRANSFER TAXES REDUCE INTERGENERATIONAL TRANSFERS?" Journal of the European Economic Association 12, no. 1 (January 15, 2014): 248–75. http://dx.doi.org/10.1111/jeea.12044.
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Castro, Rita, and António Carrizo Moreira. "Mapping Internal Knowledge Transfers in Multinational Corporations." Administrative Sciences 13, no. 1 (January 6, 2023): 16. http://dx.doi.org/10.3390/admsci13010016.
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Managing multiple knowledge transfers between headquarters and subsidiaries, among subsidiaries, and also within each of these units is crucial for multinational corporations’ (MNCs) survival. Therefore, this article aims to uncover the main factors influencing internal knowledge transfers in MNCs—including intra-unit knowledge transfers and transfers between units, namely, conventional, horizontal, and reverse knowledge transfers. To achieve this goal, a systematic literature review (SLR) was conducted to synthesize the content of 85 articles. From a set of 1439 papers, only 85 related to knowledge transfer and knowledge sharing were considered. Based on an inductive thematic approach, eight different research categories and 97 topics were identified. Four different internal knowledge transfers (intra knowledge transfer (IKT), horizontal knowledge transfer (HKT), conventional knowledge transfer (CKT), and reverse knowledge transfer (RKT)) are compared across eight thematic categories and 97 topics. According to the results obtained, the depth of the topics analyzed varies, as does the variety of categories, with RKT being more deeply analyzed than IKT. There is a clear dominance of vertical knowledge transfer (CKT + RHT) over HKT. The exercise of power (e.g., size, knowledge base) still dominates CKT and RKT in most of the studies analyzed, which are traditionally affected by the characteristics of MNCs, HQs and subsidiaries. The debate on HKT is affected by the classical perspectives of power-based relations (e.g., expatriates, size, knowledge base) among subsidiaries. Although important, intra-unit knowledge transfer is greatly influenced by characteristics.
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Espinosa Dice, Ana Lucia, Angela M. Bengtson, Kevin M. Mwenda, Christopher J. Colvin, and Mark N. Lurie. "Quantifying clinic transfers among people living with HIV in the Western Cape, South Africa: a retrospective spatial analysis." BMJ Open 11, no. 12 (December 2021): e055712. http://dx.doi.org/10.1136/bmjopen-2021-055712.
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ObjectivesFor persons living with HIV (PLWH) in long-term care, clinic transfers are common and influence sustained engagement in HIV care, as they are associated with significant time out-of-care, low CD4 count, and unsuppressed viral load on re-entry. Despite the geospatial nature of clinic transfers, there exist limited data on the geospatial trends of clinic transfers to guide intervention development. In this study, we investigate the geospatial characteristics and trends of clinic transfers among PLWH on antiretroviral therapy (ART) in the Western Cape Province of South Africa.DesignRetrospective spatial analysis.SettingPLWH who initiated ART treatment between 2012 and 2016 in South Africa’s Western Cape Province were followed from ART initiation to their last visit prior to 2017. Deidentified electronic medical records from all public clinical, pharmacy, and laboratory visits in the Western Cape were linked across space and time using a unique patient identifier number.Participants4176 ART initiators in South Africa (68% women).MethodsWe defined a clinic transfer as any switch between health facilities that occurred on different days and measured the distance between facilities using geodesic distance. We constructed network flow maps to evaluate geospatial trends in clinic transfers over time, both for individuals’ first transfer and overall.ResultsTwo-thirds of ART initiators transferred health facilities at least once during follow-up. Median distance between all clinic transfer origins and destinations among participants was 8.6 km. Participant transfers were heavily clustered around Cape Town. There was a positive association between time on ART and clinic transfer distance, both among participants’ first transfers and overall.ConclusionThis study is among the first to examine geospatial trends in clinic transfers over time among PLWH. Our results make clear that clinic transfers are common and can cluster in urban areas, necessitating better integrated health information systems and HIV care.
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Fürész, Diána Ivett. "Correlation between profitability and transfer activity in European football." Croatian Review of Economic, Business and Social Statistics 4, no. 2 (November 1, 2018): 15–22. http://dx.doi.org/10.2478/crebss-2018-0009.
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AbstractThe transfer market of European football can be classified as a system. In this system, the effectiveness of participant teams can depend on the activity in players’ transfers. This article assesses the utility of network analysis in analysing connections between the mentioned concepts. The hypothesis is that there is causality between a club’s activity in the transfer market and its profit from transfers. This research is based on empirical transfer data of major soccer teams, which have had a significant role in the last 12 years in Europe. It is assumed that the most active clubs in the transfer system have more financial power in the transfer market, while teams which are not active in transfers have less profit from transfers. In the network analysis, the teams can be defined as a set of nodes and connected by edges (interactions). The thickness of the edges and the size of the nodes depend on the volume of transfers among clubs. The number of interactions and the amount of the transfer price can measure this volume also. Considering the results of network indices, the relationships between the two phenomena were reviewed. In order to explore these relationships, the correlations among all of the relevant variables in the transfer market were also measured.
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Perera, Sumudu, Ananda Rathnayake, Janaka Fernando, Thilani Navaratne, and Dilan Rajapakshe. "The Impact of Policy Shift from In-kind Transfers to Direct Cash Transfers on Paddy Production: Evidence from Mahaweli H System in Sri Lanka." South Asia Economic Journal 22, no. 1 (March 2021): 88–109. http://dx.doi.org/10.1177/13915614211004821.
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In 2016, the Sri Lankan government introduced a policy change related to fertilizer subsidy by converting the in-kind transfer into a direct cash transfer. This research article analyses the consequences of this policy change on the paddy production from economics perspective. The analysis uses national-level data from 1961 to 2013 and farm-level data collected in 2016. Macro-level findings manifest that the use of fertilizer significantly increases the paddy production in Sri Lanka. It was also identified that the cash amount granted under the direct cash transfer policy is not equivalent to the in-kind transfer programme. As a result, paddy production is expected to decline under the direct cash transfer programme when compared to the material subsidy scheme. However, this is against the preference of economists on direct cash transfers over in-kind transfers. The findings reveal that direct cash transfers increase the paddy production under two conditions: (a) when rational farmers effectively utilize the cash grants to optimize their production inputs; and (b) an equivalent amount of in-kind transfer is provided as direct cash transfer. Hence, direct cash transfers are not always better than in-kind transfers; it is better when in-kind transfer is compensated with an equivalent amount of cash transfer. JEL: A1, B1, B2, C1, C5, D6, N5
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Sammer, Douglas M., and Kevin C. Chung. "Tendon Transfers: Part I. Principles of Transfer and Transfers for Radial Nerve Palsy." Plastic and Reconstructive Surgery 123, no. 5 (May 2009): 169e—177e. http://dx.doi.org/10.1097/prs.0b013e3181a20526.
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Livadariu, Ioana, Ahmed Elmokashfi, and Amogh Dhamdhere. "On IPv4 transfer markets: Analyzing reported transfers and inferring transfers in the wild." Computer Communications 111 (October 2017): 105–19. http://dx.doi.org/10.1016/j.comcom.2017.07.012.
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Castleberry, Brad B., and Ashleigh Acevedo. "Water barons for the water barren? A survey of interbasin water transfer laws in western states." Texas Water Journal 8, no. 1 (May 15, 2017): 29–41. http://dx.doi.org/10.21423/twj.v8i1.7060.
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Interbasin transfers of water have become an increasingly popular water management tool—especially among the western states—to address vulnerability to water shortages in those regions susceptible to widely fluctuating drought conditions and population growth. Such transfers offer a practical resolution to the geographic limitations and disparate distribution of water availability. The regulatory frameworks for interbasin transfers adopted across western states, however, vary rather drastically in balancing the practicality of interbasin transfers with equity to the basin of origin. Like its counterparts, Texas has adopted an interbasin transfer statute—Texas Water Code § 11.085—that includes common elements of interbasin transfer regulations aimed at maintaining this balance, including protecting the basin of origin, requiring a distinct demonstration of purpose and need, maintaining existing water rights, and promoting the public interest. However, in comparison to other western states, Texas has a relatively strict framework for interbasin transfers that does not always facilitate the use of such transfers when it is otherwise pragmatic to do so. Policymakers and stakeholders in Texas should thus consider whether and to what extent the balance struck by interbasin transfer laws of other western states is appropriate for Texas and more conducive to using interbasin transfers as a water management strategy across the state. Citation: Castleberry B, Acevedo A. 2017. Water barons for the water barren? A survey of interbasin water transfer laws in western states. Texas Water Journal. 8(1):29-41. Available from: https://doi.org/10.21423/twj.v8i1.7060.
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Ku, Yee-Shan, Zhili Wang, Shaowei Duan, and Hon-Ming Lam. "Rhizospheric Communication through Mobile Genetic Element Transfers for the Regulation of Microbe–Plant Interactions." Biology 10, no. 6 (May 28, 2021): 477. http://dx.doi.org/10.3390/biology10060477.
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The transfer of mobile genetic elements (MGEs) has been known as a strategy adopted by organisms for survival and adaptation to the environment. The rhizosphere, where microbes and plants coexist, is a hotspot of MGE transfers. In this review, we discuss the classic mechanisms as well as novel mechanisms of MGE transfers in the rhizosphere. Both intra-kingdom and cross-kingdom MGE transfers will be addressed. MGE transfers could be ancient events which drove evolution or recurrent events which regulate adaptations. Recent findings on MGE transfers between plant and its interacting microbes suggest gene regulations brought forth by such transfers for symbiosis or defense mechanisms. In the natural environment, factors such as temperature and soil composition constantly influence the interactions among different parties in the rhizosphere. In this review, we will also address the effects of various environmental factors on MGE transfers in the rhizosphere. Besides environmental factors, plant root exudates also play a role in the regulation of MGE transfer among microbes in the rhizosphere. The potential use of microbes and plants for bioremediation will be discussed.
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George, Benjamin P., Sara J. Doyle, George P. Albert, Ania Busza, Robert G. Holloway, Kevin N. Sheth, and Adam G. Kelly. "Interfacility transfers for US ischemic stroke and TIA, 2006–2014." Neurology 90, no. 18 (April 4, 2018): e1561-e1569. http://dx.doi.org/10.1212/wnl.0000000000005419.
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ObjectiveTo investigate changes in emergency department (ED) transfers for ischemic stroke (IS) and TIA.MethodsWe performed a retrospective observational study using the US Nationwide Emergency Department Sample to identify changes in interfacility ED transfers for IS and TIA from the perspective of the transferring ED (2006–2014). We calculated nationwide transfer rates and individual ED transfer rates for IS/TIA by diagnosis and hospital characteristics. Hospital-level fractional logistic regression examined changes in transfer rates over time.ResultsThe population-estimated number of transfers for IS/TIA increased from 22,576 patient visits in 2006 to 54,485 patient visits in 2014 (p trend < 0.001). The rate of IS/TIA transfer increased from 3.4 (95% confidence interval [CI] 3.0–3.8) in 2006 to 7.6 (95% CI 7.2–7.9) in 2014 per 100 ED visits. Among individual EDs, mean transfer rates for IS/TIA increased from 8.2 per 100 ED visits (median 2.0, interquartile range [IQR] 0–10.2) to 19.4 per 100 ED visits (median 8.1, IQR 1.1–33.3) (2006–2014) (p trend < 0.001). Transfers were more common among IS. Transfer rates were greatest among rural (adjusted odds ratio [AOR] 3.05, 95% CI 2.56–3.64) vs urban/teaching and low-volume EDs (AOR 7.49, 95% CI 6.58–8.53, 1st vs 4th quartile). The adjusted odds of transfer for IS/TIA increased threefold (2006–2014).ConclusionsInterfacility ED transfers for IS/TIA more than doubled from 2006 to 2014. Further work should determine the necessity of IS/TIA transfers and seek to optimize the US stroke care system.
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Douglas-Ntagha, Pamela Bernice. "Redesigning the transfer center process to adapt to increasing demands for services." Journal of Clinical Oncology 30, no. 34_suppl (December 1, 2012): 156. http://dx.doi.org/10.1200/jco.2012.30.34_suppl.156.
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156 Background: Hospitals are faced with limited resources and a need to provide care to patients with the greatest needs. Methods: Develop a systematic approach for accepting external transfers to the appropriate setting of care based on clinical criteria Initiate communication between external physicians and accepting MDA (MD Anderson) physicians and ICU physicians as appropriate Identify a process for documenting clinical information to ensure appropriate and timely transfers to MDA Ensure policies and procedures align with EMTALA regulation. Results: MDA ICU physicians involved in the initial decision, as appropriate External transfer acceptance based on bed availability MDA physician must be physically present to manage transfer, conduct evaluation and develop treatment plan Incorporate into procedure telephone communication with external physician, TC Medical Director, MDA accepting physician (ICU and Pedi physician as appropriate) Operational definitions for routine and urgent have been established Non-emergent transfers occur weekdays between the hours of 8AM and 5PM Transfer Acceptance Form to capture clinical information was developed. Conclusions: Problem 1: Suboptimal Communication Developed a TC form. During first eight months of operation we achieved 85% compliance with regards to documentation of transfer. Compliance continues to trend upward. Problem 2: Placement of Patients in Appropriate Care Settings Decreased utilization of MDA Emergency Center beds noted as external transfer to inpatient beds increased. Problem 3: Sporadic Arrival of Non-emergent Transfers The majority of after-hours (between 5PM and 8AM) transfers were routine and urgent prior to project. After the intervention, the number of routine and urgent after-hours transfer trended downwards. After-hour emergent transfers increased indicating appropriate utilization of beds for patients with the greatest needs. Problem 4: Lack of Systematic Screening and Documentation Retrospective medical record audits of 100% of emergent transfers were conducted by the TCMedical Directors in collaboration with the Director of Patient Resources. 97% of emergent transfers were confirmed as emergent on retrospective review.
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Betekhtina, V. A. "Classification of Transfers in Sports." Actual Problems of Russian Law 19, no. 1 (February 17, 2024): 110–18. http://dx.doi.org/10.17803/1994-1471.2024.158.1.110-118.
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The increase in the number of conflict situations that arise when athletes and coaches are transfered to other employers is due, among other things, to the lack of a unified theoretical approach to the definition of this concept and, therefore, the delimitation of sports transfers from related phenomena. At present, a relatively small number of scientific works are devoted to the classification of sports transfer, which seems to be a significant gap in the theoretical understanding of sports transfers that needs to be filled. The paper proposes a classification of sports transfers depending on the type of jurisdiction to which the subjects of the sports transfer belong (national and international); the period of its implementation (permanent and temporary; its subjects (transfers of athletes and coaches). Some types can be distinguished between from the point of view of forms of labor regulation sports transfer: a) transitions (transfers) based on termination of the employment contract concluded with the previous employer in the manner established by paragraphs 3, 4 of Art. 77 of the Labor Code of the Russian Federation, Article 80 of the Labor Code of the Russian Federation, and on concluding a new employment contract with a new employer; b) transitions (transfers) involving the termination of an employment contract by agreement of the parties (clause 1 of Article 77 of the Labor Code of the Russian Federation) with the subsequent conclusion of an employment contract with another employer; c) transitions (transfers) in the order of transferring an employee to work for another employer (clause 5 of Article 77 of the Labor Code of the Russian Federation); d) transitions (transfers) in the order of temporary transfer of an athlete to another employer in the manner established by Article 348.4 of the Labor Code of the Russian Federation. The absence of reasons for identifying a sports transfer with a change of sports citizenship is substantiated.
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LEUNG, P. C. "Double Toe Transfers." Journal of Hand Surgery 12, no. 2 (April 1987): 162–65. http://dx.doi.org/10.1016/0266-7681_87_90004-0.
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Ten double toe transfers for mutilating hand injuries have been studied. In two patients with total loss of all digits, pincer pinch was restored by the transfer of two separate toes, one to each side of the stump. Seven patients had survival of the thumb and a three-point chuck pinch was provided by transfer of a second toe plus a wrap-around flap over a bone graft to create a third, but stiff digit. One patient required three fingers and was treated by one single toe transfer and one double toe transfer.
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Orenstein, Evan W., Daria F. Ferro, Christopher P. Bonafide, Christopher P. Landrigan, Scott Gillespie, and Naveen Muthu. "Hidden health IT hazards: a qualitative analysis of clinically meaningful documentation discrepancies at transfer out of the pediatric intensive care unit." JAMIA Open 2, no. 3 (August 7, 2019): 392–98. http://dx.doi.org/10.1093/jamiaopen/ooz026.
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Abstract Objective The risk of medical errors increases upon transfer out of the intensive care unit (ICU). Discrepancies in the documented care plan between notes at the time of transfer may contribute to communication errors. We sought to determine the frequency of clinically meaningful discrepancies in the documented care plan for patients transferred from the pediatric ICU to the medical wards and identified risk factors. Materials and Methods Two physician reviewers independently compared the transfer note and handoff document of 50 randomly selected transfers. Clinically meaningful discrepancies in the care plan between these two documents were identified using a coding procedure adapted from healthcare failure mode and effects analysis. We assessed the influence of risk factors via multivariable regression. Results We identified 34 clinically meaningful discrepancies in 50 patient transfers. Fourteen transfers (28%) had ≥1 discrepancy, and ≥2 were present in 7 transfers (14%). The most common discrepancy categories were differences in situational awareness notifications and documented current therapy. Transfers with handoff document length in the top quartile had 10.6 (95% CI: 1.2–90.2) times more predicted discrepancies than transfers with handoff length in the bottom quartile. Patients receiving more medications in the 24 hours prior to transfer had higher discrepancy counts, with each additional medication increasing the predicted number of discrepancies by 17% (95% CI: 6%–29%). Conclusion Clinically meaningful discrepancies in the documented care plan pose legitimate safety concerns and are common at the time of transfer out of the ICU among complex patients.
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Martinez EJ, Salmeron. "Current Status of Nerve Transfers: “Supercharge End-to-Side Transfer in Severe Cubital Syndrome”." Journal of Orthopaedics & Bone Disorders 4, no. 2 (2020): 1–11. http://dx.doi.org/10.23880/jobd-16000200.
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Supercharge end-to-side (SETS) technique has been increasingly implemented in the treatment of nerve pathologies. It was known for its use in ulnar injury, and although it seemed that its usefulness was more directed to injuries due to ulnar nerve section, with this work and based on all the literature available to date, the aim is to assess the possibilities of implementation based on the results of the articles published in compression-type injuries, especially those classified as severe that have little treatment available to improve their evolutionary course, and where their use to date was doubtful. A compilation is made of all the evidence to date of cubital tunnel syndrome, focused on treatments, and on the emergence of the SETS technique as a therapeutic option. The purpose of the study was to collect and review the indications, results, and complications of end-to-side axonal super feeding transfer of the interosseous nerve anterior to the ulnar nerve. Twenty-one articles that met the inclusion and exclusion criteria were finally reviewed, most of them retrospective (level of evidence IV) and some review or case series (level of evidence II/ III). The data has been pooled and analyzed focusing on the primary outcomes: intrinsic muscle recovery and complications. SETS is a successful procedure with low morbidity, which can restore the function of the intrinsic musculature in patients with severe proximal ulnar nerve compression injuries thanks to the anterior interosseous nerve (median branch) that serves as a donor. Although the technique has already begun to be introduced in the sketch of the treatment of the lesion, to implement it with assured success, prospective studies should be carried out that corroborate it with greater certainty than the articles published on the subject to date. Even so, it has been possible to verify as previous indications for performing supercharge: a normal donor nerve electromyogram (it will be performed in a pronator square), a preoperative electromyogram of the injured nerve that must have a reduced amplitude of compound muscle action potential (demonstrating axonal loss) and an electromyogram to know if the denervated motor endplates remain receptive to reinnervation (check they have spontaneous activity and this is shown by fibrillation potentials and / or acute positive waves).
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Wagner, Emilio, Pablo Wagner, Diego Zanolli de Solminihac, Cristian Ortiz, Andres Keller Díaz, Ruben Radkievich, Gunther Redenz Gallardo, and Rodrigo Guzman-Venegas. "Posterior tibial tendon transfer." Foot & Ankle Orthopaedics 2, no. 3 (September 1, 2017): 2473011417S0004. http://dx.doi.org/10.1177/2473011417s000400.
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Category: Ankle, Basic Sciences/Biologics, Tendon Transfer, Dropfoot Introduction/Purpose: Posterior tibial tendon transfer (PTTT) is performed for a variety of pathologies where loss of dorsiflexion is compensated by the transfer, e.g. cavus foot, neurologic foot (dropfoot), etc. Transfers can be performed subcutaneously through a circumtibial way or deeply through the interosseous membrane (transmembranous). The latter is classically routed above the extensor retinaculum. We evaluated the circumtibial (CT), above-retinaculum transmembranous (ART) and below-retinaculum transmembranous (BRT) transfers gliding resistance and kinematics in a cadaveric model during ankle range of motion (ROM). Our first hypothesis was that the CT would be the transfer with more gliding resistance and with more kinematic alteration. Our second hypothesis was that the ART would not show significant differences against the BRT transfer. Methods: 8 cadaveric foot- ankle – distal tibia were prepared, identifying all extensor and flexor tendons proximally. The skin and subcutaneous tissue were kept intact. Each specimen was mounted on a special frame, and luminous markers were attached to the skin to adapt it to the Oxford Foot Model. A dead weight equal to 50% of the stance phase force was applied to each tendon, except for the Achilles tendon. Each specimen served as its own control, testing dorsiflexion when pulling the tibialis anterior (TA), recording the kinematics and gliding resistance. Then, dorsiflexion was tested with the transfers already described (CT, ART and BRT PTTT). A 10-repetition cycle of dorsiflexion and plantarflexion was performed for each condition. The movement of the foot was recorded using high speed cameras, and the force needed to achieve dorsiflexion was registered in every cycle. Statistical analysis was performed using the SPSS software. Results: The circumtibial transfer showed the highest gliding resistance (p<0.05). The ART and BRT transfers increased the least the gliding resistance over the control, with no difference between them (p>0.05). Regarding kinematics, all transfers decreased ankle ROM, being the CT transfer the condition with less range of motion (-9 degrees, p<0.05). ART and BRT transfers did not show differences relative to ankle ROM among them. The CT transfer significantly produced more supination of the forefoot over the hindfoot (p<0.05). The ART and BRT transfers did not differ from the control group relative to supination/pronation. Finally all the transfers produced a significant abduction motion of the forefoot compared to the control, with no difference between them. Conclusion: The circumtibial transfer had the highest tendon gliding resistance and the worst kinematics of all transfers. It achieves less dorsiflexion and in an inverted position. Interestingly, there was minimal difference in gliding resistance between the above and below retinaculum transmembranous transfers. Per our results, we suggest that when performing a PTTT the transmembranous route should be the transfer of choice. The potential bowstringing effect which may be painful and not cosmetic for patients when performing a PTTT subcutaneously (ART) could be avoided if the transfer is routed under the retinaculum, without significant compromise of the final function.
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Chia, Dawn Sinn Yii, Kazuteru Doi, Yasunori Hattori, and Sotetsu Sakamoto. "Elbow flexion strength and contractile activity after partial ulnar nerve or intercostal nerve transfers for brachial plexus injuries." Journal of Hand Surgery (European Volume) 45, no. 8 (May 7, 2020): 818–26. http://dx.doi.org/10.1177/1753193420922184.
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We compared the outcomes of 23 partial ulnar nerve and 15 intercostal nerve transfers for elbow flexion reconstruction in patients with C56 or C567 brachial plexus injuries using manual muscle power, dynamometric measurements of elbow flexion strength and electromyography. The range of elbow flexion and muscle strength recovery to Grade 3 or 4 were comparable between the two groups. The patients with C567 injuries had significantly stronger eccentric contraction after the partial ulnar nerve transfer than after the intercostal nerve transfer ( p < 0.05). Electromyography of individual muscles demonstrated that the patients with partial ulnar nerve transfers were unable to voluntarily isolate biceps contraction and recruited forearm flexors and extensors. The patients after partial ulnar nerve transfer had significantly more activity of the forearm muscles during concentric elbow flexion than after intercostal nerve transfers ( p < 0.05). We conclude that partial ulnar nerve transfers were superior to intercostal nerve transfers when assessed quantitatively with the dynamometer to evaluate elbow flexion, although simultaneous recruitment of forearm muscles may have contributed to the increased elbow flexion strength in the patients with the partial ulnar nerve transfer. Level of evidence: III
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Etoori, David, Chodziwadziwa Whiteson Kabudula, Alison Wringe, Brian Rice, Jenny Renju, Francesc Xavier Gomez-Olive, and Georges Reniers. "Investigating clinic transfers among HIV patients considered lost to follow-up to improve understanding of the HIV care cascade: Findings from a cohort study in rural north-eastern South Africa." PLOS Global Public Health 2, no. 5 (May 24, 2022): e0000296. http://dx.doi.org/10.1371/journal.pgph.0000296.
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Investigating clinical transfers of HIV patients is important for accurate estimates of retention and informing interventions to support patients. We investigate transfers for adults reported as lost to follow-up (LTFU) from eight HIV care facilities in the Agincourt health and demographic surveillance system (HDSS), South Africa. Using linked clinic and HDSS records, outcomes of adults more than 90 days late for their last scheduled clinic visit were determined through clinic and routine tracing record reviews, HDSS data, and supplementary tracing. Factors associated with transferring to another clinic were determined through Cox regression models. Transfers were graphically and geospatially visualised. Transfers were more common for women, patients living further from the clinic, and patients with higher baseline CD4 cell counts. Transfers to clinics within the HDSS were more likely to be undocumented and were significantly more likely for women pregnant at ART initiation. Transfers outside the HDSS clustered around economic hubs. Patients transferring to health facilities within the HDSS may be shopping for better care, whereas those who transfer out of the HDSS may be migrating for work. Treatment programmes should facilitate transfer processes for patients, ensure continuity of care among those migrating, and improve tracking of undocumented transfers.
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Chen, Yu “April”, Ran Li, and Linda Serra Hagedorn. "International Reverse Transfer Students: A Critical Analysis Based on Field, Habitus, and Social and Cultural Capital." Community College Review 48, no. 4 (June 15, 2020): 376–99. http://dx.doi.org/10.1177/0091552120932223.
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Objective: International reverse transfer students are international students who begin their postsecondary journey at a four-year institution but subsequently transfer to a community college. In this qualitative study, we examine the lived experiences of international reverse transfers to understand the reasons for reverse-transfer and to understand the students’ learning experiences. Methods: Using a phenomenological approach, we recruited 10 international reverse transfer students attending one four-year university or one of the two community colleges. We conducted individual interviews with all participants and analyzed transcript data through Bourdieu’s sociological theory of field, habitus, and social and cultural capital. Results: We identified three types of international reverse transfer students: undergraduate reverse transfers, temporary reverse transfers, and postbaccalaureate reverse transfers. Each type reported different reasons for reverse transfer but shared similar influential factors of the reverse transfer process as well as the learning experiences while enrolled at the community colleges. Contributions: This study helps to fill an information and research gap regarding international reverse transfer students. We present the academic, social, and cultural challenges faced by international students and offer practical implications for higher education practitioners for improved understandings and better processes to serve international students from diverse cultural backgrounds.
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Malmberg, Jonas. "The Legal Position of Employees’ in Cross-Border Transfers of Undertakings in the EU: A Question of Jurisdiction and Choice of Law." International Journal of Comparative Labour Law and Industrial Relations 22, Issue 3 (September 1, 2006): 385–406. http://dx.doi.org/10.54648/ijcl2006020.
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Abstract: The EC Transfer of Undertakings Directive (2001/23/EC) aims to protect the position of employees in the case of a transfer of undertaking. This paper discusses the way in which the Directive is to be applied to cross-border transfers of undertakings. The analysis indicates that, in principle, the Directive is applicable to such transfers. Since the Directive must be implemented under national law, this involves different national rules for transfers of undertakings, even if they are harmonised to some extent. As a result, one key issue concerns which country?s law is to apply and which country?s courts have jurisdiction to hear disputes arising from cross-border transfers.
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CHANG, J., and N. F. JONES. "Simultaneous Toe-to-Hand Transfer and Lower Extremity Amputations for Severe Upper and Lower Limb Defects: The Use of Spare Parts." Journal of Hand Surgery 27, no. 3 (June 2002): 219–23. http://dx.doi.org/10.1054/jhsb.2001.0735.
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From 1995 to 2000, five microvascular toe-to-hand transfers were performed in three children who were simultaneously undergoing lower extremity amputations. Their ages at time of transfer ranged from 4 to 10 years and the types of lower extremity amputation included toe amputation, foot amputation and through-knee amputation. The resulting toe-to-hand transfers included three great toe-to-thumb transfers and one combined great and second toe-to-hand transfer. The toe-to-hand transfers were all successful and all the lower extremity amputations healed without complications. In all cases, improved hand function and lower extremity function was noted by the families. These unique cases represent the ultimate use of spare parts in congenital hand surgery.
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Iacob, Stanca, Yanzhi Wang, Susan C. Peterson, Sven Ivankovic, Salil Bhole, Patrick T. Tracy, and Patrick W. Elwood. "Evaluation of factors associated with interhospital transfers to pediatric and adult tertiary level of care: A study of acute neurological disease cases." PLOS ONE 17, no. 12 (December 14, 2022): e0279031. http://dx.doi.org/10.1371/journal.pone.0279031.
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Introduction Patient referrals to tertiary level of care neurological services are often potentially avoidable and result in inferior clinical outcomes. To decrease transfer burden, stakeholders should acquire a comprehensive perception of specialty referral process dynamics. We identified associations between patient sociodemographic data, disease category and hospital characteristics and avoidable transfers, and differentiated factors underscoring informed decision making as essential care management aspects. Materials and methods We completed a retrospective observational study. The inclusion criteria were pediatric and adult patients with neurological diagnosis referred to our tertiary care hospital. The primary outcome was potentially avoidable transfers, which included patients discharged after 24 hours from admission without requiring neurosurgery, neuro-intervention, or specialized diagnostic methodologies and consult in non-neurologic specialties during their hospital stay. Variables included demographics, disease category, health insurance and referring hospital characteristics. Results Patient referrals resulted in 1615 potentially avoidable transfers. A direct correlation between increasing referral trends and unwarranted transfers was observed for dementia, spondylosis and trauma conversely, migraine, neuro-ophthalmic disease and seizure disorders showed an increase in unwarranted transfers with decreasing referral trends. The age group over 90 years (OR, 3.71), seizure disorders (OR, 4.16), migraine (OR, 12.50) and neuro-ophthalmic disease (OR, 25.31) significantly associated with higher probability of avoidable transfers. Disparities between pediatric and adult transfer cases were identified for discrete diagnoses. Hospital teaching status but not hospital size showed significant associations with potentially avoidable transfers. Conclusions Neurological dysfunctions with overlapping clinical symptomatology in ageing patients have higher probability of unwarranted transfers. In pediatric patients, disease categories with complex symptomatology requiring sophisticated workup show greater likelihood of unwarranted transfers. Future transfer avoidance recommendations include implementation of measures that assist astute disorder assessment at the referring hospital such as specialized diagnostic modalities and teleconsultation. Additional moderators include after-hours specialty expertise provision and advanced directives education.
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Senjaya, Ferry. "Nerve Transfers for an Upper Brachial Plexus Injury: A Case Report." Indonesian Journal of Physical Medicine & Rehabilitation 3, no. 01 (June 1, 2014): 15–24. http://dx.doi.org/10.36803/ijpmr.v3i01.237.
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Objective: To demonstrate multiple nerve transfers as primary surgical management for an upperplexus injury.Methods: A 6-year-old boy who suffered a preganglionic upper brachial plexus injury following a motor vehicle accident, exhibited complete biceps, deltoids, suprapinatus, and infraspinatus palsies.Multiple nerve transfers, which consist of spinal accessory nerves to suprascapular nerve transfer, median and ulnar motor fascicles to biceps and brachialis motor branches transfers, and long head oftriceps motor branch to axillary nerve transfer were performed 6 months after injury.Results: 13 months post multiple nerve transfer, the patient has regained M4+/5 elbow flexion, M4/5 external rotation, and M4/5 shoulder abduction.Conclusion: Nerve transfer is a viable option for upper plexus palsy management. With a sound surgical technique and good case selection, the results can be very rewarding. This case showedquite robust re-innervation with significant functional recovery at a one-year follow-up following multiple nerve transfers.Keywords: Brachial Plexus Injury, Upper Plexus Injury, Nerve Root Avulsion, Nerve Transfers, Functional Recovery.
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Wang, Sarah, and David B. Seifer. "Age-Related Increase in Live-Birth Rates of First Frozen Thaw Embryo Compared With First Fresh Transfer in Initial Assisted Reproductive Technology Cycles Without Preimplantation Genetic Testing [ID 2683417]." Obstetrics & Gynecology 143, no. 5S (May 2024): 27S—28S. http://dx.doi.org/10.1097/01.aog.0001013224.80825.7b.
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INTRODUCTION: Compare live-birth outcomes stratified by age between primary frozen (FET) and fresh transfers in initial autologous assisted reproductive technology (ART) cycles without preimplantation genetic testing (PGT). METHODS: This was a retrospective cohort study of autologous first ART cycles without PGT comparing success rates of primary embryo transfer (frozen thaw versus fresh) from the 2014–2020 SARTCORS database. We compared live-birth rate (LBR) stratified by age and cumulative live-birth rate (CLBR) for first FET versus first fresh cycles in first ART cycle. Primary transfer (FET or fresh) was the first transfer for an index retrieval. LBR was number of live births from first embryo transfer associated with first retrieval. CLBR was defined as at least one live birth from all linked embryo transfers within 1 year from initial retrieval. Multivariate logistic regression (MLR) determined association between live-birth outcomes and method of transfer. RESULTS: 228,171 first ART cycles resulted in primary embryo transfer. 62,100 initial FETs and 166,071 fresh transfers were compared. LBR was 48.3% for initial FETs versus 39.8% for initial fresh transfers (P<.001). CLBR was 71.8% for initial FETs versus 59.2% for initial fresh transfers (P<.001). MLR demonstrated that initial FETs had a greater chance of live birth across all age groups, with adjusted odds ratio of live birth incrementally increasing with advancing age groups. CONCLUSION: Overall, LBR and CLBR were greater for first FET than fresh transfers with incremental increases in odds of live birth with advancing age, suggesting the presence of a more favorable age-related change in endometrial receptivity present in frozen–thawed cycles.
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Ray, Wilson Z., Jason Chang, Ammar Hawasli, Thomas J. Wilson, and Lynda Yang. "Motor Nerve Transfers." Neurosurgery 78, no. 1 (September 22, 2015): 1–26. http://dx.doi.org/10.1227/neu.0000000000001029.
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Abstract Brachial plexus and peripheral nerve injuries are exceedingly common. Traditional nerve grafting reconstruction strategies and techniques have not changed significantly over the last 3 decades. Increased experience and wider adoption of nerve transfers as part of the reconstructive strategy have resulted in a marked improvement in clinical outcomes. We review the options, outcomes, and indications for nerve transfers to treat brachial plexus and upper- and lower-extremity peripheral nerve injuries, and we explore the increasing use of nerve transfers for facial nerve and spinal cord injuries. Each section provides an overview of donor and recipient options for nerve transfer and of the relevant anatomy specific to the desired function.
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Scollan, Joseph P., Jared M. Newman, Neil V. Shah, Erika Kuehn, and Steven M. Koehler. "Free Gracilis Muscle Transfers Compared with Nonfree Muscle Flaps for Reanimation of Elbow Flexion: A Meta-Analysis." Journal of Hand and Microsurgery 12, no. 01 (November 22, 2019): 37–42. http://dx.doi.org/10.1055/s-0039-1697064.
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Abstract Objectives Elbow flexion loss is a debilitating upper extremity injury. Surgical treatment options include nonfree muscle transfers (tendon transfers, nerve transfers, Steindler procedure, Oberlin transfers, and pedicled muscle transfers) or free muscle transfers. We sought to determine if free muscle transfers and nonfree muscle transfers have similar outcomes for elbow flexion reanimation. Materials and Methods A literature search for studies evaluating free and nonfree muscle transfers for elbow flexion reanimation was performed. Included studies reported on transfer failure (strength <M3, unable to flex arm against gravity), strength, range of motion (ROM), or Disabilities of the Arm, Shoulder, and Hand (DASH) score. Pooled odds ratios were used to calculate failure rate, and pooled mean differences were used to calculate differences in strength, ROM, and DASH scores. Results Six studies were included (n = 331 patients). Free muscle patients experienced lower failure rates than nonfree muscle patients. There was no significant difference in ROM. A nonsignificant trend toward better mean strength and DASH scores among free muscle patients was observed. Conclusion Free muscle transfers may be superior to nonfree muscle transfers for elbow flexion reanimation, given their lower failure rates. Well-powered future studies may reveal differences in strength and DASH scores between free and nonfree muscle transfers.
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Droege, Cordula. "Transfers of detainees: legal framework, non-refoulement and contemporary challenges." International Review of the Red Cross 90, no. 871 (September 2008): 669–701. http://dx.doi.org/10.1017/s1560775508000102.
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AbstractThe article outlines the legal framework that governs transfers of individuals, and in particular the international law principle of non-refoulement and other obstacles to transfers. The author addresses some of the new legal and practical challenges arising in detention and transfers in the context of multinational operations abroad and analyses the contemporary practice of transfer agreements.
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Wong, Eliza Lai-Yi, Jennifer Mengwei Liao, Christopher Etherton-Beer, Loretta Baldassar, Gary Cheung, Claire Margaret Dale, Elisabeth Flo, et al. "Scoping Review: Intergenerational Resource Transfer and Possible Enabling Factors." International Journal of Environmental Research and Public Health 17, no. 21 (October 27, 2020): 7868. http://dx.doi.org/10.3390/ijerph17217868.
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We explore the intergenerational pattern of resource transfer and possible associated factors. A scoping review was conducted of quantitative, peer-reviewed, English-language studies related to intergenerational transfer or interaction. We searched AgeLine, PsycINFO, Social Work Abstracts, and Sociological Abstracts for articles published between Jane 2008 and December 2018. Seventy-five studies from 25 countries met the inclusion criteria. The scoping review categorised resource transfers into three types: financial, instrumental, and emotional support. Using an intergenerational solidarity framework, factors associated with intergenerational transfer were placed in four categories: (1) demographic factors (e.g., age, gender, marital status, education, and ethno-cultural background); (2) needs and opportunities factors, including health, financial resources, and employment status; (3) family structures, namely, family composition, family relationship, and earlier family events; and (4) cultural-contextual structures, including state policies and social norms. Those factors were connected to the direction of resource transfer between generations. Downward transfers from senior to junior generations occur more frequently than upward transfers in many developed countries. Women dominate instrumental transfers, perhaps influenced by traditional gender roles. Overall, the pattern of resource transfer between generations is shown, and the impact of social norms and social policy on intergenerational transfers is highlighted. Policymakers should recognise the complicated interplay of each factor with different cultural contexts. The findings could inform policies that strengthen intergenerational solidarity and support.
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Brinkley-Rubinstein, Lauren, Katherine LeMasters, Phuc Nguyen, Kathryn Nowotny, David Cloud, and Alexander Volfovsky. "The association between intersystem prison transfers and COVID-19 incidence in a state prison system." PLOS ONE 16, no. 8 (August 12, 2021): e0256185. http://dx.doi.org/10.1371/journal.pone.0256185.
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Prisons are the epicenter of the COVID-19 pandemic. Media reports have focused on whether transfers of incarcerated people between prisons have been the source of outbreaks. Our objective was to examine the relationship between intersystem prison transfers and COVID-19 incidence in a state prison system. We assessed the change in the means of the time-series of prison transfers and their cross-correlation with the time-series of COVID-19 tests and cases. Regression with automatic detection of multiple change-points was used to identify important changes to transfers. There were over 20,000 transfers between the state’s prisons from January through October 2020. Most who were transferred (82%), experienced a single transfer. Transfers between prisons are positively related to future COVID-19 case rates but transfers are not reactive to current case rates. To mitigate the spread of COVID-19 in carceral settings, it is crucial for transfers of individuals between facilities to be limited.
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Ponce Rodríguez, Raúl Alberto, and Benito Alan Ponce Rodríguez. "An Analysis of Optimal Tax Revenue Sharing for Mexico." Revista Mexicana de Economía y Finanzas 17, no. 2 (November 26, 2021): 1–20. http://dx.doi.org/10.21919/remef.v17i2.523.
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We develop an analysis that identifies the characteristics of an optimal system of shared tax collection and intergovernmental transfers. Mathematical optimization is used to find the level of taxes and intergovernmental transfers. Formulas for the optimal level of taxes and transfers to subnational governments are characterized. We suggest reforms to intergovernmental transfers to include the costs of tax inefficiency, some tax equalization transfer rules, and the marginal social benefits of local public spending. Future research could include local public spending with regional externalities, migration, and consider a dynamic model. This article proposes an original theoretical model of optimal tax coordination and transfers. The optimal level of taxes and transfers are identified. This paper proposes reforms to the participation formula for subnational governments.
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HUTKOVÁ, KAROLINA. "Technology Transfers and Organization: The English East India Company and the Transfer of Piedmontese Silk Reeling Technology to Bengal, 1750s–1790s." Enterprise & Society 18, no. 4 (August 14, 2017): 921–51. http://dx.doi.org/10.1017/eso.2017.4.
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This article addresses two questions: Why do firms centralize, and what determines the success and failure of technology transfers? First, it argues that centralization decreases the costs of technology transfers, especially if knowledge is tacit, by reducing transaction costs. Second, it argues that an important factor for the success of a technology transfer is the capacity of a firm to mitigate agency problems. The English East India Company (EEIC) is mostly studied as a trading body. This article analyzes the company’s attempt to become a producer of raw silk in Bengal. In order to improve the quality of Bengal raw silk and thus increase the silk’s trading potential, it decided to apply Piedmontese reeling technologies that relied on a centralized system of production, which significantly decreased the transmission costs of the technology transfer and was thus the key for its success. However, because the EEIC’s management system involved in silk manufacturing was not innovated, the transfer’s effectiveness was diminished.