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Kaptain, George J., Christopher I. Shaffrey, Tord D. Alden, Jacob N. Young i Richard Whitehill. "The influence of secondary gain on surgical outcome: a comparison between cervical and lumbar discectomy". Neurosurgical Focus 5, nr 2 (sierpień 1998): E8. http://dx.doi.org/10.3171/foc.1998.5.2.9.
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Although the expectation of monetary compensation has been associated with failures in lumbar discectomy, the issue has not been investigated in patients undergoing cervical disc surgery. The authors analyzed the relationship between economic forms of secondary gain and surgical outcome in a group of patients with a common pay scale, retirement plan, and disability program. All procedures were performed at the Portsmouth Naval Medical Center between 1993 and 1995; active-duty military servicepersons treated for cervical radiculopathy were prospectively included. Clinical, demographic, and financial factors were analyzed to determine which were predictive of outcome. Financial data were used to create a compensation incentive, which is proportional to the patient's rank, years of service, potential disability, retirement eligibility, and base pay and reflects the monetary incentive of disability. The results of cervical surgery were compared to a previously reported companion population of patients treated for lumbar disc disease. A good outcome was defined as a return to active duty, whereas a referral for disability was considered a poor surgical result. A 100% follow-up rate was obtained for 269 patients who underwent 307 cervical operations. Only 16% (43 of 269) of patients who underwent cervical operation received disability, whereas 24.7% (86 of 348) of patients who underwent lumbar discectomy obtained a poor result (p = 0.0082). Although economic forms of secondary gain were not associated with a poor outcome in cervical disease, both the rank (p = 0.002) and duration (p = 0.03) of an individual's military career were significant factors (p = 0.02). Of the medical variables tested, multilevel surgery (p = 0.03) and revision operations at the same level (p = 0.03) were associated with referral for medical discharge. Secondary gain in the form of economic compensation influences outcome in lumbar but not cervical disc surgery patients; the increased rate of disability referral in patients who underwent lumbar discectomy may reflect an expectation of economic compensation. Social factors that are independent of the anticipation of economic compensation seem to influence the outcome in cervical disc surgery patients.
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Newbold, Stephanie. "Thomas Jefferson’s Role in Transforming Higher Education Curriculum in the United States". Public Voices 11, nr 2 (19.04.2017): 15. http://dx.doi.org/10.22140/pv.488.
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For decades, public administrative scholars and historians have maintained that while Thomas Jefferson had an extraordinary substantive mind, he was not a formative figure within the intellectual, institutional, and constitutional development of public administration theory and practice. Thoroughly investigating Jefferson’s early political career does reveal that he was not interested in the daily operations of government, but as time progressed his lengthy career in public service began to transform his opinions on the relationship between good government and good administration and how sound administrative practice complemented many of the republican values espoused in The Federalist. Upon a careful examination of Jefferson’s retirement years, when he dedicated the remainder of his life to establishing the University of Virginia, the administrative genius of his mind takes center stage. In this role, Jefferson not only created Virginia’s first public institution for higher education but also dramatically reformed liberal arts curriculum standards for colleges and universities across the nation. Twenty-first century public administration scholars and practitioners should welcome this exceptional contribution to the intellectual history of American public administration with openness and with a renewed commitment to the institutional legitimacy of our field.
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Nathakorn Thammapilan, Jintanee Ru-Zhue i Somnuk Aujirapongpan. "Service needs of elderly members in Bangkok Youth Center (Thai-Japan)". GSC Advanced Research and Reviews 19, nr 2 (30.05.2024): 156–62. http://dx.doi.org/10.30574/gscarr.2024.19.2.0178.
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The objective of this research is to study the service needs and factors related to elderly members who use the services of the Bangkok Youth Center (Thai-Japan). The study used a questionnaire survey as a data collection tool for 200 samples. The statistics used in the data analysis were frequency, percentage, mean, and standard deviation, t-test (Independent Sample t-test, F-test (Independent Sample F-test)One-way ANOVA, and the Pearson’s correlation coefficient to test the relationship between variables. According to the study, the majority of the samples were men, between 60 – 65 years old, marital status, had a bachelor’s degree, owned business as a career before retirement, did not work after retirement and had a monthly income of 20,001-50,000 baht. The results of testing the demographic factors on service needs, by using t-test and F-test statistics, showed that the different of gender, age, status, career before retirement and career after retirement were not different, whereas educational and monthly income were. The result of testing the motivation factors on service needs, by using the Pearson’s correlation coefficient statistic, showed that both intrinsic motives and extrinsic motives were related in medium level in the same way. Therefore, the study’s results could be useful for involved organization for operation planning.
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Obisesan, Dorcas Olajoju. "MANAGEMENT OF DAY CARE CENTER BY RETIRED WOMEN: A PANACEA FOR SUSTAINABLE RETIREMENT". Nigeria Journal of Home Economics (ISSN: 2782-8131) 10, nr 7 (30.06.2022): 102–7. http://dx.doi.org/10.61868/njhe.v10i7.140.
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Retirement is the period of time when a person decides to leave the labour permanently. It is simply the end of employment, which denotes a period of significant change in every employee's life. Typically, these changes are upsetting and traumatic for the retiree. Taking care of a child is like tending to a garden's plants. Children need proper care and nurturing to develop into strong adults, just as plants need water, sunlight, and fertilizer to grow up healthily. The upbringing of the children is crucial to everyone's life. The operation of a high-quality day care center business, the varieties that are available, tips for choosing good ones, its traits, dangers, and difficulties, as well as its implications for retiree sustainability, are all examined in this study. The study came to the conclusion that daycare facilities offer working-class parents a solution to their dilemma by relieving their tension and exhaustion. Among other things, it was advised that the government support the provision of infrastructure for all daycare facilities, schools, and levels of education to ensure their efficient operation.
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Dermer, Philip J. "Trip Notes on a Return to Israel and The West Bank: Reflections on U.S. Peacemaking, the Security Mission, and What Should be Done". Journal of Palestine Studies 39, nr 3 (2010): 66–81. http://dx.doi.org/10.1525/jps.2010.xxxix.3.66.
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The following document, previously unpublished, was written in March 2010 by a recently retired ( June 2009) U.S. Army colonel with thirty years experience in the Middle East, including tours of duty and advisory roles (in both military/security and civilian domains) from North Africa to the Persian Gulf. The subject of the informal report is the author's first two trips as a "civilian" to Israel and the West Bank, where he had served two tours of duty, most recently as U.S. military attachéé in Tel Aviv during Israel's 2005 unilateral disengagement from Gaza and the formation of the U.S. Security Coordinator's (USSC) mission to reform Palestinian Authority (PA) security forces. Written as an internal document for military colleagues and government circles, the report has been circulating widely——as did the author's earlier briefings on travel or missions in Syria, Lebanon, Jordan, Egypt, and especially Iraq——among White House senior staff, the Joint Chiefs of Staff, the Defense Intelligence Agency, CENTCOM (U.S. Central Command), EUCOM (U.S. European Command), and the USSC team. The document's focus is the state of the "peace process" and the current situation in the West Bank, with particular attention to the PA security forces and the changes on the ground since the author's last tour there ended in mid-2007. But the real interest of the paper lies in the message directed at its intended audience of military and government policy officials——that is, its frank assessment of the deficiencies of the U.S. peace effort and the wider U.S. policy-making system in the Israel-Palestine arena, with particular emphasis on the disconnect between the situation on the ground and the process led by Washington. The critique has special resonance in light of the emerging new thinking in the administration fueled by the military high command's unhappiness (expressed by CENTCOM commander General David Petraeus and Joint Chiefs of Staff chairman Admiral Michael Mullen) with the State Department's handling of Middle East diplomacy, especially with regard to the Israeli-Palestinian conflict, on the grounds that diplomatic failures are having a negative impact on U.S. operations elsewhere in the region. For most JPS readers, the report has additional interest as an insider's view of the U.S. security presence in the Israel-Palestine arena. It also reflects a military approach that is often referenced but largely absent in public discourse and academic writings. The author, in addition to his tours of duty and peacekeeping missions in various Middle Eastern countries, has served as advisor to two U.S. special Middle East envoys, the U.S. negotiating team with Syria, General Petraeus, Lieutenant General Keith Dayton, Vice President Dick Cheney, and, more generally, to CENTCOM, the Department of Defense, and the Joint Chiefs of Staff, among others. In retirement, he has worked with CENTCOM as a key primary subject matter expert in the development of analyses and solutions for its area of responsibility, leads predeployment briefings for army units heading to Iraq, and travels frequently to Iraq and elsewhere in the region as an independent consultant. He is currently in Afghanistan with the CENTCOM commander's Afghanistan-Pakistan Center of Excellence. The report, made available to JPS, is being published with the author's permission.
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Smith, Bradley L., Monica G. Griffin, Alexander Heyliger i Brianne M. Ritchie. "Assessment of hospital emergency medication kit use at a large academic medical center with automated dispensing machine technology". American Journal of Health-System Pharmacy 77, Supplement_1 (21.01.2020): S8—S12. http://dx.doi.org/10.1093/ajhp/zxz294.
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Abstract Purpose Hospital emergency medication kits (HEMKs) are used to provide certain critical medications in emergent situations, despite many technological advancements for patient safety and medication distribution. We sought to evaluate HEMK usage and analyze associated costs to identify and recommend process improvements. Methods Mayo Clinic in Rochester, MN, is a large multisite academic medical center with 2 hospital campuses and many ambulatory clinics. All documentation of the approximately 250 HEMKs in circulation was analyzed from January to November 2017. The primary outcome was HEMK use. Secondary outcomes included individual medication usage and associated costs. These data were then used to recommend process improvements. Results Of 880 HEMKs evaluated, 675 (76.7%) were used, resulting in expiration 23.3% of the time. A total of 1,024 emergency medications were used, most commonly for hypoglycemia. Many of these medications are also available in automated dispensing machines for patient care use. Cost analysis revealed an average annual cost of nearly $200,000 associated with HEMKs. The results of our analysis indicated little added benefit of HEMKs in the setting of automated dispensing machine optimization. Steps for HEMK retirement are described. Conclusion HEMKs offered little added benefit considering technological advancements that have been made in patient safety and medication distribution since their inception. Retirement of HEMKs is anticipated to increase pharmacy operational efficiency by using automated dispensing machine technology and appropriate emergency response protocols to ensure optimal patient care.
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Kim, Se Yul, Yu Na Jung i Seon Jong Yoo. "A Study on the Operating Factors of Continuing Care Retirement Community(CCRC) in Korea". Korea Real Estate Institute 32, nr 4 (31.12.2022): 21–32. http://dx.doi.org/10.35136/krer.32.4.2.
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Korea is rapidly entering a super-aged society, creating housing issues for the elderly. Determining the necessity to understand the continuing care retirement community (CCRC), a model that enables the realization of the value of “aging in place” (AIP), was the starting point of this study. This study aims to identify the types of facilities that most closely resemble the “Korean style of CCRC” and to analyze the factors affecting its operation because there is currently no complete CCRC type in Korea. The subjects of this study were 31 senior welfare housing and 3 paid elderly care facilities among the residential welfare facilities for the elderly registered with the Ministry of Health and Welfare as of 2020. The “Korean style of CCRC” was defined as facilities with four or more of the independent living, assisted living, nursing home, daycare center, and community center . Subsequently, logistic regression analysis was conducted. The results indicated that the probability of operating as a “Korean-style CCRC” increases when the following factors are greater: land area, total number of households, efficiency rate, number of community facilities, number of workers, and monthly living expenses. Meanwhile, the number of years elapsed and the move-in price per 3.3㎡ were analyzed to have no effect. This study is expected to identify the current status of residential welfare facilities for the elderly and suggest implications for potential consumers who wish to move into CCRCs in order to facilitate their facility selection.
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Mara, Cynthia M., i James T. Ziegenfuss. "Creating the Strategic Future of Long-Term-Care Organizations". Care Management Journals 2, nr 2 (styczeń 2000): 116–24. http://dx.doi.org/10.1891/1521-0987.2.2.116.
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The operating environment in the health care industry is turbulent—organizations are expected to adapt or die. This paper addresses the structure of a strategic planning process for long-term-care organizations. Nursing homes, assisted living (personal care) facilities, continuing care retirement communities, adult day services centers, hospice programs and home-and community-based agencies face both opportunities and threats. The authors recommend an eight-step process for strategy making: plan to plan; external analysis; internal analysis; vision; matching current and future strategies; strategy choice; action and linkage to operations and budget. A case example illustrates the concepts. Long-term-care leaders are encouraged to plan for their future or face a future planned by competitors and regulators.
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Tan, Kangye, Yihui Tian, Fang Xu i Chunsheng Li. "Research on Multi-Objective Optimal Scheduling for Power Battery Reverse Supply Chain". Mathematics 11, nr 4 (10.02.2023): 901. http://dx.doi.org/10.3390/math11040901.
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In the context of carbon neutralization, the electric vehicle and energy storage market is growing rapidly. As a result, battery recycling is an important work with the consideration of the advent of battery retirement and resource constraints, environmental factors, resource regional constraints, and price factors. Based on the theoretical research of intelligent algorithm and mathematical models, an integer programming model of urban power battery reverse supply chain scheduling was established with the goal of the highest customer satisfaction and the least total cost of logistics and distribution, to study the influence of the resources and operation status of a built city recycling center and dismantling center on the power battery reverse supply chain. The model includes vehicle load, customer demand point satisfaction range, and service capacity constraints. This study collected regional image data, conducted image analysis, and further designed an improved Non-dominated Sorting Genetic Algorithm-II (NSGA-II) optimization algorithm suitable to solve the global optimization problem by introducing the improvement strategy of convergence rate, particle search, and the traditional elite individual retention. The results verified the practicability of the model, the global optimization ability of the algorithm to solve the problem, and the operation speed through comparing the results obtained from the basic algorithm. A reasonable comprehensive solution for the location and path optimization of the urban recycling center was also obtained. Multi-objective optimization was carried out in vehicle scheduling, facility construction, and customer satisfaction construction. The basic algorithm and integrated optimization software were compared. We found that the model and the scheme provided by the algorithm can significantly reduce the operation cost of the enterprise. This research provided new insights for enterprises to effectively utilize resources and optimize the reverse supply chain scheduling of an urban power battery.
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Tamura, S., S. Kurihara, M. Ichikawa, F. Souna, K. Hoshina, S. Osanai, Y. Tsutsumi i M. Itoh. "Development of a knowledge transfer support system for water treatment technology". Water Practice and Technology 14, nr 4 (27.08.2019): 764–71. http://dx.doi.org/10.2166/wpt.2019.060.
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Abstract The water supply must be safe and sustainable. This requires a regulatory compliance, selection of an optimal water treatment process, timely response to water quality incidents as well as maintaining internal skills and knowledge among utility personnel to keep appropriate operational standards in the long run. Water supply services in Japan face various challenges, including a shrinking revenue base due to a declining population as well as a mass retirement of the baby-boomer generation. The Japan Water Research Center conducted questionnaire surveys and based on our findings developed the ‘knowledge transfer support system for water treatment technology’ for utilities to maintain internal skills and knowledge in the face of shrinking labour forces in the water sector. The system consists of three components: the database on water treatment technology, learning program on water treatment technology, and the assessment tool for knowledge transfer on water treatment technology.
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Mauricaite, R., i M. Williams. "OS07.9.A Gliocova: Impact of surgeon and centre volume on 30-day mortality, readmission and risk of complication after first surgical intervention in brain tumour patients in England diagnosed between 2013-2018". Neuro-Oncology 24, Supplement_2 (1.09.2022): ii17—ii18. http://dx.doi.org/10.1093/neuonc/noac174.054.
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Abstract Background The Gliocova dataset uses linked English national cancer data on all 51,775 adult primary brain tumour patients diagnosed between 2013-2018. Here we are investigating the effect of surgeon and centre volume on post-surgical outcomes such as 30-day mortality, readmission and risk of complication. Material and Methods We selected patients from our dataset that have undergone surgical debulking or biopsy for the first time. We calculated surgeon and centre volume per 6 year period. To exclude non-tumour surgeons who might do occasional tumour cases as an emergency, we removed those that performed less than 12 operations over the 6 year period and to remove newly qualified/ near retirement surgeons we removed those that did not perform at least 1 operation within the 6 first months of 2013 and last 6 months of 2018. We developed univariate regression models to link surgeon and centre volume with 30-day mortality, readmission and risk of complication and are currently working on multivariate models including other predictors such as age, sex, Elixhauer comorbidity index, deprivation status, type of intervention (biopsy vs surgical debulking), and tumour type (i.e., Glioblastoma versus other types of brain tumours). Results We identified 29,258 patients (out of 51,775) that have undergone a surgical intervention (28,173 surgical debulking; and 1,207 biopsy). In-hospital mortality was 0.99% (N = 289), 30-day mortality was 2.3% (N = 677) and 30-day readmission was 12.7% (N = 3,725). No surgeons performed less than 1 operation during the first 6 months of 2013 or last 6 months of 2018. In univariate analyses, centre volume predicted the risk of 30-day mortality (p-value<0.01) and risk of complication (p-value<0.001), whereas surgeon volume only significantly predicted risk of complication (p-value<0.001). Neither surgeon volume nor centre volume were statistically significant predictors of 30-day readmission in univariate analysis. Conclusion As most surgeon and centre volume studies in brain tumour patients come from the United States, our study is one of a few in Europe to investigate this in a large adult brain tumour population. In our future work we will refine the model to account for patient factors, and assess the cost of complications and variation of these across centres, tumour types and other patient and hospital level characteristics. More information about the Gliocova project can be accessed here: https://blogs.imperial.ac.uk/gliocova/about-gliocova/. GlioCova is supported by the Imperial/NIHR BRC, and the members of the GlioCova EAG. This work uses data provided by patients and collected by the NHS as part of their care and support
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Bustos, Richard, Stephen Andrew Gadsden, Pawel Malysz, Mohammad Al-Shabi i Shohel Mahmud. "Health Monitoring of Lithium-Ion Batteries Using Dual Filters". Energies 15, nr 6 (18.03.2022): 2230. http://dx.doi.org/10.3390/en15062230.
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Accurate estimation of a battery’s capacity is critical for determining its state of health (SOH) and retirement, as well as to ensure its reliable operation. In this paper, a dual filter architecture using the Kalman filter (KF) and the novel sliding innovation filter (SIF) was implemented to estimate the capacity and state of charge (SOC) of a lithium-ion battery. NASA’s Prognostic Center of Excellence (PCOE) B005 battery data set was selected for this experiment based on its wide use in academia and industry. This dataset contains cycling data of a 2 Ah lithium-ion battery until its capacity was measured at 1.3 Ah or less. The dual polarity equivalent circuit model (DP-ECM) was selected for modeling. The model parameter values were estimated using the least squares (LS) algorithm. Under normal operating conditions, both the dual-KF and dual-SIF performed similarly in terms of estimation accuracy. However, an uncertainty case was considered where the filters were subjected to rapid changing dynamics by cutting the data by 300 cycles. In this case, the battery capacity root-mean-square error (RMSE) for the dual-KF and the proposed dual-SIF were 0.1233 and 0.0675, respectively. Under rapidly changing dynamics and faulty conditions, the dual-SIF shows better convergence and robustness to disturbances.
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Sanfilippo, Fred, Priscilla Markwood i David N. Bailey. "Retaining the Value of Former Department Chairs: The Association of Pathology Chairs Experience". Academic Pathology 7 (1.01.2020): 237428952098168. http://dx.doi.org/10.1177/2374289520981685.
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Serving as a clinical department chair in an academic health center is an increasingly complex and difficult position. In 2014, the Association of Pathology Chairs engaged former chairs to assist its members by establishing an ad hoc committee of “Senior Fellows,” which then became a permanent Senior Fellows Group. The Senior Fellows Group currently includes more than 50 former chairs, many of whom subsequently served as deans, medical center executives, and in other leadership roles. The primary mission of the Senior Fellows Group has been to provide advice, consultation, and mentoring to members of the Association of Pathology Chairs, especially new chairs and faculty interested in leadership roles. All new chairs are asked if they wish to select or be assigned a Senior Fellow advisor. Each Senior Fellow is listed on the Association of Pathology Chairs website with the areas of advice they are willing to provide, which include: “on-boarding” issues and opportunities facing a new chair; strategy (eg, departmental priorities, mission balance); administration (eg, financial, operational); institutional reviews of chairs/departments; interaction with institutional leaders (eg, other chairs, deans, hospital leadership); fundraising; faculty management (eg, recruitment, retention, annual evaluations, productivity, dismissal); and personal issues (eg, work–life balance, stepping down, retirement). The Senior Fellows Group also has participated actively in essentially all Association of Pathology Chairs programs, committees, fundraising, and projects. The organized structure and function of the Senior Fellows Group has been of significant value to the membership of the Association of Pathology Chairs, as well as to the participating former chairs, and may provide a model for other academic organizations to utilize this important resource.
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Burpee, Robert W. "The Sanders Barotropic Tropical Cyclone Track Prediction Model (SANBAR)". Meteorological Monographs 55 (1.11.2008): 233–40. http://dx.doi.org/10.1175/0065-9401-33.55.233.
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Abstract Sanders designed a barotropic tropical cyclone (TC) track prediction model for the North Atlantic TC basin that became known as the Sanders barotropic (SANBAR) model. It predicted the streamfunction of the deeplayer mean winds (tropical circulation vertically averaged from 1000 to 100 hPa) that represents the vertically averaged tropical circulations. Originally, the wind input for the operational objective analysis (OA) consisted of winds measured by radiosondes and 44 bogus winds provided by analysis at the National Hurricane Center (NHC), which corresponded to the vertically averaged flow over sparsely observed tropical, subtropical, and midlatitude oceanic regions. The model covered a fixed regional area and had a grid size of ~ 154 km. It estimated the initial storm motion solely on the basis of the large-scale flow from the OA, not taking into account the observed storm motion. During 1970, the SANBAR model became the first dynamical TC track model to be run operationally at NHC. Track forecasts of SANBAR were verified from the 1971 TC season when track model verifications began at NHC until its retirement after the 1989 Atlantic TC season. The average annual SANBAR forecast track errors were verified relative to Climatology and Persistence (CLIPER), the standard no-skill track forecast. Comparison with CLIPER determines the skill of track forecast methods. Verifications are presented for two different versions of the SANBAR model system used operationally during 1973–84 and 1985–89. In homogeneous comparisons (i.e., includes only forecasts for the same initial times) for the former period, SANBAR's track forecasts were slightly better than CLIPER at 24–48-h forecast intervals; however, from 1985 to 1989 the average SANBAR track forecast errors from 24–72 h were ~10% more skillful than homogeneous CLIPER track forecasts.
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Wang, Guangyu, i Nopporn Tasnaina. "Guideline of Service Managerial Strategies Development Based on Marketing Mixes Concepts for Promoting Exercise Activities in Sport Park". International Journal of Sociologies and Anthropologies Science Reviews 3, nr 6 (17.11.2023): 281–94. http://dx.doi.org/10.60027/ijsasr.2023.3516.
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Background and Aim: In 2014, the Chinese government issued Several Opinions on Accelerating the Development of the Sports Industry and Promoting Sports Consumption Six tasks including enriching market supply, building several small and medium-sized sports facilities for the convenience and benefit of the people, developing fitness and leisure programs and enriching sports events; We should also create a fitness atmosphere, advocate a healthy life, and actively promote the opening of public sports facilities. This research objective was to create a guided servicing managerial strategies development based on marketing mixes concepts to develop service operation in public sports parks. Materials and Methods: This research was conducted by the integrative approach of Serve Quality and Marketing Mixes. Data was collected by interviewing experts and a questionnaire which constructed by the researcher to collect data from samples who participated in the sport park activities total of 20 experts’ interviews and 384 people for the questionnaire. Develop questionnaires to survey the problems, obstacles, needs, and suggestions on physical fitness, sports, and exercise activities in the park of the people and officers in those parks by applying POLC 4 m’s, SERVQUAL, and marketing mixes concept questionnaires. Use a software package to analyze the data. Result: The Sport Center Park is funded by the Zhanjiang government and it is managed by the Zhanjiang Sports Bureau. It is necessary to define the vision, and goal to notify the expected status of the park in the future and motivate the staff to meet them. Should assignment and organization of the resources and distribution of functions into groups to establish working relationships and coordination to accomplish tasks with efficiency and effectiveness. Select the right persons, train those needy persons, promote of best persons, retirement of old persons, performance appraisal of all the personnel, and adequate remuneration of personnel. The direction deals with making the workers learn techniques to perform the jobs assigned to them. Direction includes guidance, supervision, and motivation of employees. And Co-ordinating helps an organization accomplish objectives. The difficulty of coordination depends upon the size of the organization. The difficulty of co-ordination is increased with the increasing of the size of the organization. Motivation includes increasing the speed of performance of a work and developing a willingness on the part of workers. This is done by a resourceful leader. The workers expect favorable climate conditions to work and fair treatment. The park should pay attention to having more standardized management and consider the marketing mix components to create the management and service. Conclusion: Customers’ observed response is commonly lower than their expected response, especially on the aspects of promotion, people, and physical evidence, which means the sport park management can be improved on these aspects. The limitations of this research are the small sample size of the investigation, which may constrain the evaluation results; what is measured in this paper is only the current service quality of the sports park, not a long-term result of service quality, so it lacks a certain dynamic. Based on this study, the author put forward management strategies for the Zhanjiang Sports Center Park.
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Quock, Tiffany P., Zheng-Yi Zhou, Byran Dai, Wenxi Tang i Kathleen F. Villa. "A Model Estimating Indirect Costs of Premature Death Associated with Severe Hepatic Veno-Occlusive Disease (sVOD) Among Hematopoietic Stem Cell Transplant (HSCT) Patients in the United States (U.S.)". Blood 126, nr 23 (3.12.2015): 3273. http://dx.doi.org/10.1182/blood.v126.23.3273.3273.
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Abstract Introduction Hepatic veno-occlusive disease (VOD), also known as sinusoidal obstruction syndrome (SOS) is a potentially fatal complication of HSCT and is characterized by hepatomegaly, right upper quadrant pain, jaundice, and ascites (Gratwohl A et al JAMA 2010). Severe VOD (sVOD) is clinically characterized by multi-organ dysfunction and is estimated to have a mortality rate of over 80% (Coppell JA et al BBMT 2010). VOD and particularly sVOD pose a significant economic burden in direct medical costs by adding an estimated $53,000 to HSCT (2004 U.S. dollars; Saito et al BBMT 2008), or $78,000 in 2015 dollars. However, little research has been conducted in ascertaining the indirect costs associated with premature death due to VOD. In our study, we developed an economic model to evaluate the indirect cost associated with premature death due to sVOD among HSCT patients in the U.S. Methods An Excel-based model was developed to estimate the indirect cost associated with premature death due to sVOD among HSCT patients. Model inputs included prevalence of sVOD as well as mortality, age, salary, employment rate, and life expectancy. Inputs were obtained from the published literature, Center for International Blood & Marrow Transplant Research (CIBMTR), Centers for Disease Control and Prevention (CDC), U.S. Census Bureau, and Organisation for Economic Co-operation and Development (OECD). The model considered lost productivity as the result of premature death by calculating the number of years between the age of sVOD-related death and the assumed age of retirement (65 years old); it was assumed that the lifetime salary reflected underlying productivity of HSCT survivors who did not develop sVOD. Annual salary and life expectancy among HSCT survivors were adjusted from the general population to reflect decreased productivity in the first 2 years immediately following HSCT. Annual average salary inputs by age categories were assumed to be the same as the general population. Age of the working population was assumed to be between 18 and 65 years old. Excess mortality from sVOD was calculated as number of deaths among sVOD patients minus the number of deaths among HSCT patients who did not develop sVOD. Indirect cost was expressed as the cumulative salary for all productive years contributed by a patient and included a 3% discount for each additional year. Total lost productivity years and indirect costs by age category were obtained by multiplying each respective per patient value by the number of excess deaths in each age category. A sensitivity analysis was performed to examine the impact of changes in key model parameters on model results. Results The model estimated 361 excess deaths per year due to sVOD in the HSCT population. The excess deaths due to sVOD were associated with indirect costs of over $68 million due to reduced life expectancy and consequent productivity loss. AlloSCT patients were younger on average, resulting in greater indirect costs ($39 million) compared to AutoSCT ($29 million). AlloSCT patients lost 3,637 productive years on average compared to 2,353 lost productive years for AutoSCT patients despite fewer patients receiving AlloSCT than AutoSCT. A sensitivity analysis showed that the total indirect costs due to overall VOD (non-severe and severe) were as high as $73.3 million. Conclusion sVOD imposes a substantial economic burden on patients in terms of excess deaths, lost productivity, and indirect costs. The model underestimates indirect costs largely due to not accounting for productivity loss among children and their caregivers or those older than 65. It also does not calculate productivity loss among HSCT survivors. Future research is warranted to elicit the additional indirect costs associated with non-severe VOD. Figure 3. Deterministic Sensitivity Analysis: Total Indirect Costs due to Excess Deaths due to sVOD Compared with HSCT Survivors without VOD. Figure 3. Deterministic Sensitivity Analysis: Total Indirect Costs due to Excess Deaths due to sVOD Compared with HSCT Survivors without VOD. Disclosures Quock: Jazz Pharmaceuticals: Employment, Equity Ownership. Zhou:Jazz Pharmaceuticals: Other: Analysis Group received funding for this analysis from Jazz Pharmaceuticals, Inc.; Analysis Group: Employment. Dai:Jazz Pharmaceuticals: Other: Analysis Group received funding for this analysis from Jazz Pharmaceuticals, Inc.; Analysis Group: Employment. Tang:Jazz Pharmaceuticals: Other: Analysis Group received funding for this analysis from Jazz Pharmaceuticals, Inc.; Analysis Group: Employment. Villa:Jazz Pharmaceuticals: Employment, Equity Ownership.
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Nolten, Donna, i Katherine Clarkson. "Abstract 3635: Mentoring a Stroke Program Coordinator: A Planned, Staged Approach". Stroke 43, suppl_1 (luty 2012). http://dx.doi.org/10.1161/str.43.suppl_1.a3635.
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Background and Issues: Transitions between stroke coordinators can have a deleterious effect upon stroke program development and operations. Typically, a one-month notice of resignation is given. This allows insufficient time to advertise, interview, hire and train or orient new staff. Complicating the issue, the number of experienced stroke coordinators has not kept pace with demand. Hence, extensive training may be required for the replacement if one with experience is not available. Purpose: The purpose of our project was to prepare for a seamless transition between a retiring stroke coordinator and her replacement while maintaining quality and adding neurovascular intervention to the program. Methods: Our facility provides a phased-retirement program that allows gradual transition between full time employment and retirement. In July 2009, a eighty percent stroke coordinator position was split between a coordinator mentee and the experienced coordinator mentor. Over an eighteen-month period, responsibilities were gradually shifted to the replacement with ongoing education, guidance and support from the previous coordinator. For the first six months, orientation and coaching took place on an almost daily basis. Over the following year, progressive periods were planned for independent program management with available backup and support Results: A cerebrovascular intervention program was successfully implemented during the period. Primary Stroke Center Certification was maintained. Compliance with stroke performance measures did not decrease. The Get with the Guidelines Gold Plus Award was received for 2009, 2010 and 2011. Acute stroke treatment rates increased due to program enhancements and improvements during the period. Conclusions: This planned, progressive approach to program leadership transition allowed sufficient training for the replacement coordinator. At the conclusion of the process, the mentee stepped into the full-time position. This seamless transition provided for successful program operations and development.
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Viglianti, Elizabeth M., Kaitlyn Hanisko, Rachel Bucy, Lee Ewing, Bradley Youles, Kyle Kepreos, Jessica Lehrich i in. "Abstract 112: One Year Later: Patient-reported Outcomes Among Survivors of In-hospital Cardiac Arrest in Veterans Administration Hospitals". Circulation: Cardiovascular Quality and Outcomes 8, suppl_2 (maj 2015). http://dx.doi.org/10.1161/circoutcomes.8.suppl_2.112.
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Background: Short term mortality following in-hospital cardiac arrests (IHCA) is well understood. However, little is known about long term patient-reported outcomes - such as activities of daily living, cognitive function, and depression among survivors of IHCA. Objective: To assess the patient-reported outcomes in IHCA survivors 12-months after cardiac arrest. Methods: Veteran survivors of IHCA (ICD-9-CM codes 99.60, 99.63 or 427.5) who were discharged alive from a U.S. Veterans Administration Medical Center from September 1, 2013 to October 31, 2013 were identified. After confirmation of eligibility by medical record review, they were mailed a research information packet. Those who did not opt-out were contacted by phone two weeks later. Veterans who consented were surveyed by phone or mail. The survey encompassed Katz Activities of Daily Living (ADL), Lawton Instrumental Activities of Daily Living (IADLs), self-reported depressive symptoms (via the PHQ-9) and an assessment of cognition (via the modified Telephone Interview for Cognitive Status (mTICS) as used by the Health and Retirement Study). Results: Among 50 IHCA survivors, 37 (74%) completed surveys; survey operations are detailed in another abstract. Among those 37 who completed the survey, answers to all patient-reported outcomes items were obtained from 29 (78%). Respondents’ median age was 66 years old (range 38 to 87) and 95% were male. The survivors self-reported health assessment of their health was poor, with 8% and 40% describing their health as “poor” or fair” respectively, but only 5% saying “very good” and none reporting “excellent”. Similarly, 27% reported having 4 or more health-related difficulties in their basic and instrumental activities of daily living, 24% reported 1-3, and 46% none. On the PHQ-9, 19% had scores consistent with severe depression. Of those tested for cognitive impairment, 32% were at risk for at least some cognitive impairment. Conclusion: Among survivors of IHCA, we found that few patients at 12-months reported an overall sense of good health, and a significant number of patients had high-levels of disability, cognitive impairment and depression. There is an urgent need to understand the epidemiology and trajectory of this poor health, and develop interventions to improve the long term outcomes of IHCA.
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Xu, Guoquan, Fang-Chun Liu, Hsiao-Tang Hsu i Jerry Lin. "The association between public pension fund characteristics and pension accounting choices". Asian Review of Accounting, 12.07.2022. http://dx.doi.org/10.1108/ara-10-2021-0195.
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PurposeThe choice of accounting methods is critical in measuring the performance and sustainability of a public defined benefit pension (DBP) plan, and such measurement has an impact on the effectiveness of the entire pension system. Prior literature rarely discusses the choice and rationale of the accounting assumptions for public DBP plans. This study fills the gap by investigating whether crucial plan characteristics, including operational performance, financial health, sponsor fiscal stress, and audit quality, are associated with the accounting assumptions of public DBP plans.Design/methodology/approachThe sample includes 1,170 plan-years from the intersection of the Center for Retirement Research and public DBPs' annual financial reports for the years 2001–2013. This study develops regression models to examine the relationship between the characteristics of public DBP practices and DBP accounting choices.FindingsThe empirical results show that the public DBPs that have better investment performance, higher funding status, less fiscal stress, and that are audited by Big 4 accounting firms are more likely to adopt conservative accounting choices.Originality/valueThe study documents the impact of crucial pension plan characteristics on public DBP managers' accounting choices, which were not extensively discussed in pension literature. The findings help us understand the rationale for employing different accounting treatments in the context of public pension fund practices. In addition, the study sheds light on policy implications for the future reform of public pension regulations.
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EVSEN AYDIN, Esra. "An Islamic Seminary in the XVI. Century in Jerusalem: The Tâziyya Madrasa". Hitit İlahiyat Dergisi, 30.06.2022. http://dx.doi.org/10.14395/hid.1052227.
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Bearing sanctity for all of the three monotheistic religions, Jerusalem is known to have witnessed interreligious conflicts throughout the history, and the city has evidently retained its importance for Muslims for ages. In due course, reconstruction and urbanization activities continued in every corner of the city in order to create a Muslim identity, especially within the Haram al-Sharif district, which was accepted as the third “haram”, namely the place of consecration, succeeding Mecca and Medina during every period under Islamic rule. Due to its geographical location, Jerusalem, which hasn’t portrayed the characteristics of a commercial center and did not have a military and political central location except for the period of the Crusaders, was not only a sacred religious center but also an important Islamic seminary center during the times when Muslims used to hold predomination. In addition to the independent religious institutes and seminaries such as madrasas, Sufi lodges and zâwiyas, ribâts and hankahs built in the city, the Masjid al-Aqsa itself was not only a structure for performing prayers, but always hosted mosque lessons, dhikr assemblies, and disciplerings called “mastaba” inaugurated in its courtyard. Thus, it performed the function of a lively Islamic seminary center. It must be noted that the establishment of Islamic seminaries in the city started in the Ayyubids period and reached its peak with the Mamluks, and as for the Ottoman period; a policy that ensured the preservation of the existing system, and of the cornerstone institutions together with the other foundations was followed. It is fair to say that, further studies on Jerusalem’s madrasas are indispensable in order to reveal various issues such as madrasas’ way of functioning in the post-Ottoman process and the parameters related to the control of the religious foundations available in the district. To this end, this article focuses on the functioning of the Tâziyya Madrasa, which is probably medium-sized one, and built by the Mamluk Emir, Emir Tâz, who served in important military and administrative services and lived in Jerusalem after his retirement, notwithstanding the political problems he faced in the last days of his tenure. Tâziyya, one of the more than fifty madrasas established around the Masjid al-Aqsa, was founded in the XVIth century. As a witness of the vibrant Islamic training life in the city, whose population was recorded to be only around 5 thousand in the 16th century, it continued its activities during the rule of the Ottoman state. Existing studies in the literature dealing with the structure and functioning of the madrasas in the Arab territories during the Ottoman period mostly focus on the larger scaled and visible structures whose foundations have survived till the present day, or whose foundation holders and students can be traced through the strata books, making it relatively easy to attain data. With the aim of contributing the scholarly-interest and related literature, this study aims to present sound evaluations with regard to medium-sized madrasas’ that used to be abundant in the XVIth century Jerusalem. The available literature regarding the issue the Sharia court records and “mühimme” records dating back to different times in the century are reviewed. Since the Jerusalem Sharia court records are in Arabic, there are difficulties in reading them due to the physical conditions and writing characters of the notebooks, and there are few studies in Turkish literature that examine the subject directly by taking these local sources to the center. This article aims to contribute to the field with this aspect. The article consists of five sub-headings. In the first part, biographical information about the Mamluk Emir, Emir Tâz, who was the founder of the madrasa, and in the second part, the spatial characteristics of the madrasa are introduced. In the third chapter, which deals with the monetary resource of the waqf, which was the most important element for the continuity of the madrasa, and the people in charge of its operation, both the size of the financial support of the madrasa and some problems encountered therein, are revealed. Under the fourth title, focusing on the elements of the pedagogical activity of the madrasa, issues such as the selection of the rank and file in Jerusalem madrasas, the competition to obtain a rank, the teaching capacity of the madrasa and the opportunities it offers are given special attention, in particular to the Tâziyya madrasa. Finally, the other religious services in the madrasa are critically examined.