Association of the Comprehensive ESRD Care (CEC) Model with Treatment Adherence

Background: Poor adherence to scheduled dialysis treatments is common and can cause adverse clinical and economic outcomes. In 2015, the Center for Medicare and Medicaid Innovation launched the Comprehensive End-Stage Renal Disease Care (CEC) Model, a novel modification of the Accountable Care Organization framework. Many Model participants reported efforts to increase dialysis adherence and promptly reschedule missed treatments. Methods: With Medicare databases covering 2014-2019, we used difference-in-differences models to compare treatment adherence among patients aligned to 1,037 CEC facilities relative to those aligned to matched comparison facilities, while accounting for their differences at baseline. Using dates of service, we identified patients who typically received three weekly treatments and the days when treatments typically occurred. Skipped treatments were defined as days when the patient was not hospitalized but did not receive an expected treatment, and rescheduled treatments as days when a patient who had skipped their previous treatment received an additional treatment before their next expected treatment date. Results: Patients in the CEC Model had higher odds of attending as-scheduled sessions relative to the comparison group, though the effect was only marginally significant (OR=1.018, p=0.076). Effects were stronger among females (OR=1.028, p=0.062) than males (OR=1.010, p=0.485), and among those under 70 years (OR=1.024, p=0.040) than those 70+ (OR=0.999, p=0.963). The CEC was associated with higher odds of rescheduled sessions (OR=1.092, p<0.001). Effects were significant for both sexes, but were larger among males (OR=1.109, p<0.0001) than females (OR=1.070, p=0.012), and effects were significant among those under 70 years (OR=1.121, p<0.0001), but not those 70+ years (OR=0.990, p=0.796). Conclusions: The CEC Model is intended to incentivize strategies to prevent costly interventions. Because poor dialysis adherence may precipitate hospitalizations or other adverse events, many CEC Model participants encouraged adherence and promptly rescheduled missed treatments as strategic priorities. This study suggests the success of these efforts, though the absolute magnitudes of the effects were modest.

Framing and control for sustainability of industries

PurposeThe paper attempts to frame the challenge of managing the transition to a sustainable economy by way of a conceptual model consisting of a zero-footprint regulatory regime and a sustainability fund.Design/methodology/approachA conceptual model of the sustainable industrial revolution has been developed based on the learnings from industries such as originators (mining), farming, pharmaceuticals, pesticides and chemicals and long-lasting artefacts against an overall perspective.FindingsIt is suggested to have an institutional structural mechanism in place to ensure that footprint is minimized through recycling including refurbishing, resale or transformation. This includes management of recycling businesses through execution of a zero-waste regulatory regime that will build and use a sustainability fund.Research limitations/implicationsThe limitations of the paper are arising out of the topic being an issue of gigantic proportions with immense complexity. An attempt has been made to bring out the inescapability and the imperative of a sustainable industrial revolution.Practical implicationsThis paper presents practical aspects such as collusion between trash and recycling businesses, land use and social aspects of criticality of public support. If implemented, the suggested model can make a paradigm shift in the way firms, industry and governments can handle the challenge of sustainability.Originality/valueThe value of this conceptual paper lies in an attempt to extend the learning organization framework to the concept of a regulatory model for sustainability that is not limited to the definition of a firm but stands extended to industries and to the economics, land use and demographics of the planet.

The Planarian Anatomy Ontology: A resource to connect data within and across experimental platforms

As the planarian research community expands, the need for an interoperable data organization framework for tool building has become increasingly apparent. Such software would streamline data annotation and enhance cross-platform and cross-species searchability. We created the Planarian Anatomy Ontology (PLANA), an extendable relational framework of defined Schmidtea mediterranea (Smed) anatomical terms used in the field. At publication, PLANA contains over 850 terms describing Smed anatomy from subcellular to system-level across all life cycle stages, in intact animals, and regenerating body fragments. Terms from other anatomy ontologies were imported into PLANA to promote interoperability and comparative anatomy studies. To demonstrate the utility of PLANA as a tool for data curation, we created resources for planarian embryogenesis, including a staging series and molecular fate mapping atlas, and the Planarian Anatomy Gene Expression database, which allows retrieval of a variety of published transcript/gene expression data associated with PLANA terms. As an open-source tool built using FAIR (findable, accessible, interoperable, reproducible) principles, our strategy for continued curation and versioning of PLANA also provides a platform for community-led growth and evolution of this resource.

Learning organization as a framework for networks’ learning and collaboration

Purpose The purpose of this study was to use Watkins and Marsick model of a learning organization (1993, 1996), the dimensions of the learning organization questionnaire as a framework for interdisciplinary network collaboration and knowledge sharing. Design/methodology/approach The research team used a mixed-methods approach for data collection. Survey data was collected from 181 networks. In addition, data was collected from two focus groups with six participants each. Findings Results, in general, showed that the learning organization culture could be used as a framework for interdisciplinary network collaboration. In particular, results showed that shared vision, imbedded systems and knowledge sharing were key driving forces required for successful collaboration. Research limitations/implications Theoretical and practical implications were discussed, and conditions for learning organization culture for networks were established. Originality/value People in a network era need more than training; they need ongoing, interdisciplinary, collaborative support to solve complex problems. Organizations can only work effectively if barriers to organizational learning were removed. This originality of this paper lies in applying learning organization framework at the network level.

Toward a transitional care from childhood and adolescence to adulthood in surgical neurooncology? A lesson from the Necker-Enfants Malades and the Sainte-Anne Hospitals collaboration

OBJECTIVE Transitional care in surgical neurooncology is poorly studied. However, this period is pivotal, since it allows the patient to be empowered in his or her disease management. Here, the authors describe the experience of the Necker-Enfants Malades and the Sainte-Anne Hospital collaboration. METHODS The mixed transitional consultations started in September 2019 in a dedicated space for transitional care, named the “La Suite” department, located in the Necker-Enfants Malades Hospital, Paris, France. The authors organized planned consultations to schedule the clinical and radiological follow-up in the adult neurosurgical department but also emergency consultations to manage tumor recurrence in young adult patients. Transitional care was performed jointly by pediatric and adult neurosurgeons who have developed clinical and research skills in the field of surgical neurooncology. Neuropathological analysis was performed by a neuropathologist who is specialized in pediatric and adult neurooncology. RESULTS Fourteen patients benefited from a mixed transitional consultation. All of them accepted to start their management in an adult neurosurgical environment. Eleven patients (78.6%) for whom the disease was controlled benefited from a planned consultation. Three patients (21.4%) required rapid neurosurgical management for a tumor recurrence (n = 2) or for a new primary CNS tumor (n = 1) and benefited from an emergency consultation. CONCLUSIONS For adult patients harboring a brain tumor during childhood or adolescence, the authors suggest that neurosurgeons specialized in adult surgical neurooncology with a full knowledge in pediatric neurooncology will combine the required skills to optimize care management for these patients within a dedicated multidisciplinary organization framework.

Analisis Keputusan Indonesia terhadap WHO FCTC pada Masa Kepemimpinan Presiden Joko Widodo Tahun 2014-2019

This article aims to analyze Indonesia’s decision on World Health Organization Framework Convention on Tobacco Control (WHO FCTC) in the leadership period of President Joko Widodo from 2014-2019. As one out of nine states which have not to sign and ratify WHO FCTC, historically Indonesia is one of the full drafting member states which actively involved in the convention’s making and negotiations since 1996. However, from 2003 until 2019, Indonesia still refuses to sign or ratify WHO FCTC. From past years, studies about Indonesia’s non-compliance decision on WHO FCTC limited by the analysis focused on domestic factors to explain state’s behavior, non-state actors’ interest, or discourse about tobacco control issues. This article provides an analysis of the state’s (Indonesia) behavior from the systemic level by using the theory of international regime’s functions. By using secondary data obtained from official documents of state or international organizations, books, journals, and other online sources linked to Indonesia’s decision on WHO FCTC, this article shows that Indonesia’s non-compliance decision to WHO FCTC in the leadership of President Joko Widodo from 2014-2019, caused by Indonesian government’s negative interpretations to the legal liability, reducing cost, and information facilitation functions of WHO FCTC.

Perception of Internal Controls Helps Explain Whistleblowing

The nonprofit sector may suffer financially from inconsistency in regulations and polices surrounding internal control implementation. To address this issue, our study explores how perceived internal control strength differs between nonprofit and for-profit organizations. Furthermore, we examine three components of the Committee of Sponsoring Organization framework to determine which components might significantly influence whistleblowing for nonprofit organizations. As expected, all three components appear to significantly influence whistleblowing for those in for-profit organizations. For those in nonprofit organizations, the perception of control activities and monitoring activities significantly mediates the relationship between organization type and whistleblowing intentions. Finally, the data indicate that the use of an anonymous website for whistleblowing at a nonprofit organization may require added attention and resources if employees at nonprofits are to use this outlet to the same extent as it is used at a for-profit organization.

Machine learning Algorithm of Intrusion Detection System

Web of thing (WoT) is a gifted answer for interface and access each gadget through the web. Consistently the gadget includes increments with huge variety fit as a fiddle, size, use and intricacy. In this paper Since WoT drives the world and changes individuals' lives with its wide scope of administrations and applications. In any case, WoT offers various types of assistance through applications, it faces serious security issues and powerless against assaults, for example, sinkhole assault, overhang dropping, forswearing of administration assaults. So on, the Interruption recognition framework is utilized to recognize such assaults when the organization's security is penetrated. Given a scale extension of Web of Things for a practical asset the executives in brilliant urban communities, a legitimate plan of an interruption recognition framework IDS is basic to protect the future organization framework from interlopers. With the development of associated things, the most broadly utilized brought together cloud-based IDS regularly suers from high inertness and organization overhead, subsequently coming about in lethargy to assaults and moderate recognition of pernicious clients.

InterGlobe Aviation Ltd.: need for strategy

Learning outcomes Discussion of the case will enable the students to: ● use “Strengths, Weaknesses, Opportunities, and Threats” analysis. ● Use “pros and cons” analysis. ● Explain what constitutes an effective strategy. ● Analyze the quality of the strategy for IndiGo Airlines (IA). ● Explain sustained competitive advantage through value, rareness, imitability and organization framework. Case overview/synopsis This case describes a situation in which InterGlobe Aviation Ltd. (IGAL) has been experiencing multiple engine snags because of the faulty Pratt and Whitney engines. In a span of two years between June 2018 and January 2020, IGAL faced around 22 snags. IGAL is known to be one of the safest airlines in the world, the engine issue has tainted its reputation. In October 2019, in just one week IA faced four-engine snags, forcing the Directorate General of Civil Aviation (DGCA) to come out with a guideline in November 2019. The faulty engines were to be replaced by January 31, 2020. If IA failed to complete the task by the given deadline then IA would have to ground around 70–80 aircraft. IA was way behind the deadline when on January 13, 2020, they received an email from DGCA mentioning an extension of the deadline to May 31, 2020. The purpose of this case is to provide an opportunity for the participants to take into consideration the data given for IA and make assumptions and resolve the dilemma through which Ronojoy Dutta (Dutta), the Chief executive officer if IA is going through. Complexity academic level The case engages the participants in deciding a suitable course of action for IA to develop a strategy and is ideal to teach elements of strategy. The case can be used in the following courses/programs: ● A strategy formulation module in strategic management program or post-graduate program in management. Supplementary materials Teaching Notes are available for educators only. Subject code CSS 11: Strategy. Supplementary materials Teaching Notes are available for educators only.