scholarly journals The introduction of new medical devices in the public health service of a small region of Spain

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
B Arana Aragón ◽  
D Gavrila ◽  
V Fernández Gomez ◽  
M J Ferrandez Cámara ◽  
J A Floris Martín ◽  
...  
Keyword(s):  
Health Service ◽  
Medical Devices ◽  
Positive Impact ◽  
Small Region ◽  
The Public ◽  
Health Technologies ◽  
Use Of Resources ◽  
Part Time ◽  
The Mean ◽  
Mean Time

Abstract Issue The introduction of health technologies could have a positive impact on the population's health. However, it also plays a significant role on the evolution of the sanitary budget. These circumstances have promoted the development of specific groups of experts in health technologies assessment under the criteria of effectiveness, safety and efficiency. Description of the Problem The main goal of Murcia Health Service is to guarantee the health of its population through an optimal use of resources. New medical devices(MD)need to be evaluated prior to their use in medical practice. HTA reports published by international and national agencies are not covering the growing and accelerated offer and demand of new MD Results A technical group in charge of the evaluation of new MD requests (GTESIDS)was created in 2014. The group consists of 12 part-time collaborators of different health professions. During 2019, GTESIDS received 69 requests of evaluation, two thirds of which from surgical specialties, mainly general(11),orthopedic(10)and ophthalmic(7)surgery. GTESIDS advised to incorporate 23 and not to incorporate 26 MD, while 20 were still being evaluated as of February 29, 2020. The mean time GTESIDS needed to reach a conclusion and emit a recommendation was 151 days. We have found a published HTA report for only one of the MD evaluated. Lessons HTA reports published by international and national agencies are rarely available and need to be adapted to the local framework. The GTESIDS scope would improve with a better resource allocation that will allow a more thorough and rapid evaluation. Key messages HTA reports are not covering the growing offer of new medical device. The experience in Murcia has taught us the need to strengthen an actual collaboration between agencies.

scholarly journals Time required to move cash through slot machines

2018 ◽  
Vol 21 (3) ◽  
pp. 376-384 ◽  
Author(s):  
Karen Kelly ◽  
Carl James Schwarz ◽  
Ricardo Gomez ◽  
Kim Marsh
Keyword(s):  
British Columbia ◽  
Slot Machines ◽  
Content Type ◽  
The Public ◽  
Average Value ◽  
The Mean ◽  
Time Required ◽  
Rest Breaks ◽  
Mean Time ◽  
Practical Implications

Purpose The purpose of this paper is to present an empirical study on the time needed to load and disburse cash using bill validators on slot machines and stand-alone cash dispensers in casinos in British Columbia under a Ticket In Ticket Out (TITO) system. Design/methodology/approach Testing took place over two days, using 18 machines. The results were extrapolated to estimate the approximate time required to process $1,000,000 with different average bill amounts in the cash mix and three different bill validator machines in common use. The average value per bill using the cash mix used by the public in the casino was $33.11 [standard error (SE) $2.11]. Findings The mean time/accepted note ranged from 4.12 to 9.65 s, depending on bill validator type. This implies that the time needed to load $1,000,000 onto credit slips using bill validators on slot machines ranges from 35 to 81 h, excluding rest breaks and other breaks. The time needed to redeem $1,000,000 is estimated to be 3 h. Practical/implications The implications of these finding for illicit actors to successfully launder large amounts of cash are discussed. Given the time needed to physically handle the cash, and other control systems currently in use in casinos in British Columbia, processing large amounts of cash using bill validators on slot machines would require a highly organized team that would find it difficult to elude detection. Originality/value The trial results provide a baseline estimate to be used going forward when investigating or proposing money laundering methodologies that include slot machines.

scholarly journals Judicial demand of medications through the Federal Justice of the State of Paraná

2017 ◽  
Vol 15 (1) ◽  
pp. 85-91 ◽  
Author(s):  
Renato Mitsunori Nisihara ◽  
Ana Carolina Possebom ◽  
Luiza de Martino Cruvinel Borges ◽  
Ana Claudia Athanasio Shwetz ◽  
Fernanda Francis Benevides Bettes
Keyword(s):  
Cross Sectional Study ◽  
The State ◽  
Brand Name ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Public ◽  
Online System ◽  
Broad Variety ◽  
The Mean ◽  
Mean Time

ABSTRACT Objective To describe the profile of lawsuits related to drug requests filled at the Federal Justice of the State of Paraná. Methods A cross-sectional study, and the data were obtained through consulting the lawsuits at the online system of the Federal Justice of Paraná. Results Out of 347 lawsuits included in the study, 55% of plaintiffs were women, with a median age of 56 years. Oncology was the field with more requests (23.6%), and the highest mean costs. A wide variety of diseases and broad variety of requested drugs were found in the lawsuits. Approximately two-thirds of them were requested by the brand name, and the most often requested drugs were palivizumab and tiotropium bromide. Only 14.5% of the requested medicines were registered in the National Medication Register. The Public Defender’s Office filled actions in 89.6% of cases and all lawsuits had an interim relief. The mean time for approval was 35 days and 70% of requests were granted. Conclusion Oncology was the field with the highest demand for medicines at the Federal Justice of Paraná in 2014. A great variety of medications was requested. The Public Defender´s Office represented most lawsuits. All demands had an interim relief, and the majority of requests were granted, within an average of 35 days.

scholarly journals Art. V.—Topography of Nineveh, illustrative of the Maps of the chief cities of Assyria; and the general Geography of the country intermediate between the Tigris and the Upper Zab

1854 ◽  
Vol 15 ◽  
pp. 297-396 ◽  
Author(s):  
Felix Jones
Keyword(s):  
The Public ◽  
The Subject ◽  
The Mean ◽  
Mean Time ◽  
Insight Into ◽  
Of Greece

Within the last decade of years, the museums of France and England have been enriched by numerous monuments of Assyrian art, that clearly show the soil from which they were obtained was peopled by a race who, to its warlike habits, added many of the refinements of civilized life. The researches of Botta and Layard—so far as lapidary tablets are capable of conveying the economy of a nation—hare familiarised us in some measure with the public rites and ceremonies of the Assyrians, as well as given an insight into their more domestic concerns; and the pens of these travellers have further elucidated the subject in a manner of which the praise of the public is guarantee to the ability displayed, while the monuments themselves, as patents of their energy, remain in the capitals of Europe, until, in the course of time, they share in the fate of their Assyrian predecessors. Profoundly indifferent, however, to such an event, our savans are in the mean time labouring to unravel the mystic characters engraved on the records so lately revealed to ua; and such is the progress made, that we may shortly expect to be as cognizant of the deeds of the “stouthearted king and the glory of his high looks,” as we are conversant with the celebrities of Greece or Rome. The only desideratum wanting, it appears, to complete the picture of Assyria, is a faithful sketch of her aspect in desolation, when she is “empty, and void, and waste; when flocks lie down in the midst of her; and when her rivers are opened, and her palace is dissolved.” This we have endeavoured to supply in the three maps of the vestiges of Assyria, made from actual survey of the spot. Topography, however, is a dry subject, and we enter upon it with diffidence and reluctance.

scholarly journals A simple approach to the management of service risk in a local mental health service

1999 ◽  
Vol 23 (11) ◽  
pp. 649-651 ◽  
Author(s):  
Mark Davies
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Service ◽  
Health Service ◽  
Clinical Governance ◽  
Simple Approach ◽  
Mentally Disordered ◽  
The Public ◽  
Local Mental Health ◽  
Use Of Resources

Risk, and how to manage risk, have become dominant themes of this decade. Risk is essentially any feature of an organisation which is likely to prevent that organisation from achieving its primary aims (Rosen, 1995). In general, the lower the risk in an organisation, the higher the performance of that organisation is likely to be. In turn this can lead to more efficient use of resources. In the area of mental health, the consequences of risk can be serious, this being amply demonstrated by the public inquiries into homicides by mentally disordered people. Such inquiries consistently reveal inadequacies in local services providing mental health care (Appleby, 1997). The identification and management of risk within local mental health services has therefore become a priority. Clinicians as managers have a key role in such a development, particularly with the introduction of clinical governance (Oyebode et al, 1999). This paper outlines a simple approach to risk management in a local mental health service.

scholarly journals Art. II.—Letters to the Secretary of the Royal Asiatic Society

1841 ◽  
Vol 6 (11) ◽  
pp. 11-41
Author(s):  
W. Morley ◽  
Duncan Forbes
Keyword(s):  
The Public ◽  
French Government ◽  
Asiatic Society ◽  
The Press ◽  
The Subject ◽  
The Mean ◽  
Mean Time ◽  
Royal Asiatic Society

Whilst I was engaged last year in making a catalogue of the Oriental MSS. comprised in the libraries of the Society and the Oriental Translation Committee, I met with the historical MS. which is the subject of the following letter. I, at that time, applied to the Council of the Society for permission to forward a description of the MS. to M. Quatremere, who is employed in editing the only portion of the work hitherto known, in the hope that he would represent the matter to the French Government, and cause our MS. to be published in the “Collection Orientale,” as a sequel to his “Histoire des Mongols.” The council acceded to my request, and I accordingly wrote to M. Quatremère on the subject, but whether on account of my letter not having reached its destination or from the press of business, he has not as yet returned any answer to my communication. In the mean time, I think it desirable that the existence of this important volume should be made known to the public, and I have accordingly drawn up the following account of the MS. for insertion in the Journal of the Society.

scholarly journals Analysis of institutional factors that cause gender pay gaps in Ukraine

2021 ◽  
Vol 11 (1) ◽  
pp. 1-13
Author(s):  
Svitlana Tsymbaliuk ◽  
Anna Volkovska
Keyword(s):  
Positive Impact ◽  
Correlation Factor ◽  
Organizational Level ◽  
Equal Opportunities ◽  
Economic Activities ◽  
Wage Differences ◽  
The Public ◽  
Part Time ◽  
The Impact ◽  
Sector Part

Despite Ukraine’s commitments regarding non-discrimination and ensuring gender equality, the issue of gender pay gaps remains relevant. The aim of the study is to identify factors that cause gender pay gaps and assess their impact on wage differences at the institutional level in Ukraine. Based on the generalization of the research results, macroeconomic and microeconomic approaches to the grouping of factors that cause gender pay gaps have been identified. Based on the analysis of statistical data, it has been determined that gender occupational segregation exists in Ukraine, as most women work in low-wage economic activities; women are more likely to lead businesses with a lower level of wages. As the result of the assessment of the impact of various factors on wage differences, it has been found that gender pay gaps are the smallest in the public sector. Part-time employment in 2018 affected gender pay gaps by 3.8%. Based on the correlation factor analysis, the positive impact of increasing the minimum wage and innovative development on reducing gender pay gaps has been substantiated. The hypothesis regarding the impact of collective bargaining on gender pay gaps at the organizational level has been refuted. Promising measures have been identified that would help to create equal opportunities and reduce gender pay gaps, and thus to fulfill Ukraine’s commitments in the context of European integration.

The Use of the International Caries Detection and Assessment System (ICDAS) in a National Health Service General Dental Practice as Part of an Oral Health Assessment

2010 ◽  
Vol os17 (4) ◽  
pp. 153-160 ◽  
Author(s):  
Charles Ormond ◽  
Gail Douglas ◽  
Nigel Pitts
Keyword(s):  
Oral Health ◽  
National Health Service ◽  
Health Service ◽  
Health Assessment ◽  
Assessment System ◽  
Caries Detection ◽  
Dental Practice ◽  
General Dental Practice ◽  
The Mean ◽  
Mean Time

Introduction The Scottish Dental Clinical Effectiveness Programme (SDCEP) is developing guidance for oral health assessment and review that is intended for use in National Health Service (NHS) general dental practice. One section of this guidance is assessment of the teeth, including their caries status. The detailed caries assessment method identified by the guidance group is the International Caries Detection and Assessment System (ICDAS). Aim The aim of this study was to investigate the implications of using the ICDAS in an NHS general practice and, in particular, the time taken to use the system. Method After online and in-practice training and calibration, 50 adult and 50 child patients were randomly allocated for assessment using the ICDAS detection codes. The ICDAS protocol states that the teeth should be clean and dry. For this study, all patients had their teeth brushed by the dentist before the assessment and the results were recorded on draft ICDAS clinical pro forma sheets. The time taken for the assessment was assessed with a stopwatch and recorded in a spreadsheet program. Results The results showed that the mean time for the assessment of an adult was 3.80 minutes, or 4.99 minutes if the time for pre-examination cleaning and drying was included. For a child, the mean time was 2.53 minutes, or 3.99 minutes if pre-examination brushing time was included. Conclusions These results indicate that with training and experience, it is possible to carry out an ICDAS assessment in a time that is practical in general dental practice.

Predicting Daily Maintenance Dose of Fluindione, an Oral Anticoagulant Drug

1996 ◽  
Vol 75 (05) ◽  
pp. 731-733 ◽  
Author(s):  
V Cazaux ◽  
B Gauthier ◽  
A Elias ◽  
D Lefebvre ◽  
J Tredez ◽  
...  
Keyword(s):  
Effective Dose ◽  
Maintenance Dose ◽  
Successive Approximations ◽  
Hemorrhagic Complication ◽  
Simple Method ◽  
Individual Variations ◽  
Anticoagulant Drug ◽  
The Mean ◽  
Mean Time ◽  
Daily Maintenance Dose

SummaryDue to large inter-individual variations, the dose of vitamin K antagonist required to target the desired hypocoagulability is hardly predictible for a given patient, and the time needed to reach therapeutic equilibrium may be excessively long. This work reports on a simple method for predicting the daily maintenance dose of fluindione after the third intake. In a first step, 37 patients were delivered 20 mg of fluindione once a day, at 6 p.m. for 3 consecutive days. On the morning of the 4th day an INR was performed. During the following days the dose was adjusted to target an INR between 2 and 3. There was a good correlation (r = 0.83, p<0.001) between the INR performed on the morning of day 4 and the daily maintenance dose determined later by successive approximations. This allowed us to write a decisional algorithm to predict the effective maintenance dose of fluindione from the INR performed on day 4. The usefulness and the safety of this approach was tested in a second prospective study on 46 patients receiving fluindione according to the same initial scheme. The predicted dose was compared to the effective dose soon after having reached the equilibrium, then 30 and 90 days after. To within 5 mg (one quarter of a tablet), the predicted dose was the effective dose in 98%, 86% and 81% of the patients at the 3 times respectively. The mean time needed to reach the therapeutic equilibrium was reduced from 13 days in the first study to 6 days in the second study. No hemorrhagic complication occurred. Thus the strategy formerly developed to predict the daily maintenance dose of warfarin from the prothrombin time ratio or the thrombotest performed 3 days after starting the treatment may also be applied to fluindione and the INR measurement.

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