Accounting for groups: the dynamics of intragroup deliberation

In a highly influential work, List and Pettit (Group Agency: The Possibility, Design, and Status of Corporate Agents, Oxford University Press, 2011) draw upon the theory of judgement aggregation to offer an argument for the existence of nonreductive group agents; they also suggest that nonreductive group agency is a widespread phenomenon. In this paper, we argue for the following two claims. First, that the axioms they consider cannot naturally be interpreted as either descriptive characterisations or normative constraints upon group judgements, in general. This makes it unclear how the List and Pettit argument is to apply to real world group behaviour. Second, by examining empirical data about how group judgements are made by a powerful international regulatory board, we show how each of the List and Pettit axioms can be violated in ways which are straightforwardly explicable at the level of the individual. This suggests that group agency may best be understood as a pluralistic phenomenon, where close inspection of the dynamics of intragroup deliberation can reveal that what prima facie appears to be a nonreductive group agent is, in fact, reducible.

LABORATORY DIAGNOSTICS OF MALE INFERTILITY. BIOMARKERS AND METHODS. Part II

The new paradigm have been arise concerning to samples, markers and methods for assessment of male infertility. Nowadays, a sample “semen” and “sperm sediment” take a key role in examination and management of the subfertile couple. The advantages of sample “semen” such as non-invasive painless procedure as well as the wider range of diagnostic findings by number of methods (cytology, molecular and cultural) highlight the increasly importance of this diagnostic approach in comparison with conventional ones – prostate secretion and urethral scraping which obtained by invasive procedures – by massage and damaging a mucus membrane, respectively. According to the Russian register this review also presents the current situation with the work list of kits and devices for assessment of male infertility and inflammatory of male accessory glands.

The Burden of Add-On Orders in a Laboratory With Manual Processing

In order to avoid additional blood draws for their patients, clinicians frequently order add-on tests on existing specimens in the laboratory. Manually processing these add-ons is problematic, utilizes tremendous resources, and raises concerns regarding specimen integrity. The objective of this study was to analyze add-on ordering patterns and assess the time and resources required to complete these orders. In this retrospective study conducted at a large, multisite, academic medical center, a report was generated from the laboratory information system (LIS) to identify all the add-on orders that were placed with details about the type of add-on test, which specimen it was added to, and location from where an add-on order was placed for a 2-month period (August 5 to October 4, 2018). The workflow was observed and financial cost was calculated. The laboratory received 5,658 add-on orders during the study period. By laboratory protocol, 859 tests were cancelled, leaving 4,799 tests to be processed. Add-on orders were most common for liver tests (7.48%), creatine kinase (6.35%), troponin (6.31%), vancomycin level (5.93%), thyroid-stimulating hormone (4.91%), magnesium (4.81%), and vitamin B12 (4.33%). The add-on orders were mainly generated for inpatient (74.07%) followed by emergency (17.79%) and outpatient departments (8.12%). The add-on request is placed by the clinical provider in the hospital information system (HIS) as a generic “Add-on Order” test, with free text to specify the test and specimen. A clerk in the laboratory uses the LIS-generated work list to electronically order the requested tests to the original specimen. Subsequently, a clerk must manually locate the original specimen and deliver it to the performing lab to run the add-on test. The median turnaround time from the provider placing the generic add-on order in the HIS to the lab placing the add-on in the LIS is 119 minutes. The median time for the provider to place an add-on after the initial order is 462 minutes. The average time needed to monitor the add-on work list, electronically place the add-on to the original order, and retrieve the sample for one test for a skilled senior statistical clerk is 7 minutes. The average number of add-on requests received daily is 71. Therefore, the daily time to process add-ons is 497 minutes (8.2 hours). Based on the hourly cost and fringe in the laboratory ($28.92/hour), these add-on tests cost $237/day in labor ($86,000/year). Our study demonstrates the significant cost and labor burden of add-on tests in a laboratory with manual processing. The laboratory is considering transitioning to direct provider ordering of add-ons to existing specimens using laboratory-defined rules in the HIS and moving to total laboratory automation with robotic specimen archival and retrieval to reduce the manual efforts, which would streamline the add-on workflow.

Analysis of the functioning of the educational and research laboratory “Pharmadar” in the context of the preparation of a Ph.D. on the example of the pedagogical load of the cycle of choice “Preclinical experimental research”

The cycle of choice “Preclinical experimental research” is an integral component of the compulsory discipline “Pharmacology”. Successful pedagogical training of scientific personnel (graduate students) became possible thanks to the development of the curriculum, which, first of all, became possible thanks to the efforts of the scientific personnel of the Pharmadar Educational and Research Laboratory. They provide not only the functioning of the cycle, but also carry out the scientific and practical burden of fulfilling the tasks of scientific research and economic calculation programs. The composition of the mandatory documentation of pedagogical (educational) work, on which the training of graduate students studying the cycle “Preclinical Experimental Research” is carried out, includes: a practical training program for applicants for the degree of candidate of medical sciences in the specialty 14.03.05 – “pharmacology”; the provision on attaching to the Department of Pharmacology approved by the Academic Council in order to master the mandatory program “222 – medicine, pharmacology”; thematic and calendar plans; independent work; list of additional literature; guidelines The laboratory staff, with the help of graduate students and doctoral students, have developed, improved and patented a number of methods for providing preclinical studies. Thus, the functioning of an educational research laboratory creates an optimal and rational scientific and practical basis for the preparation of a Ph.D. by mastering a post-graduate cycle of choice “Preclinical experimental research”, which was shown by the example of the functioning of the laboratory. In the future, it is appropriate and promising to develop a curriculum for English-speaking students, given the constant increase in their number among university entrants, and as a result — increase in the proportion of foreign citizens, among graduates and entering postgraduate study.

Comparison of Russian, Chinese and European seismic design on pseudo-static seismic coefficient in slope analysis

Most design codes and specifications recommend a simple pseudo-static approach for the analysis of slope stability under seismic conditions. The codes in different countries appoint different pseudo-static seismic coefficient. The present work list different seismic coefficients in Russian, Chinese and European codes. A sensitivity analysis of a case slope was carried out using GeoStudio, then determined that the stability of the slope is more sensitive to material cohesion and seismic coefficient than material density and friction angle. It’s shown that the chosen of the seismic coefficient has a big effect on slope stability.

PROGRAM JAMINAN KESEHATAN NASIONAL DARI ASPEK SUMBER DAYA MANUSIA PELAKSANA PELAYANAN KESEHATAN

<p>Jaminan kesehatan nasional (JKN) mulai beroperasi sejak 1 Januari 2014. Pelaksanaan jaminan kesehatan di Kabupaten Tabalong, masih mengalami beberapa permasalahan seperti SDM pelaksana pelayanan kesehatan yang masih belum mencukupi baik dari segi kuantitas, distribusi dan kualitas. Penelitian ini bertujuan untuk melakukan evaluasi program JKN dari aspek SDM pelaksana pelayanan kesehatan di Kabupaten Tabalong periode Januari-Juni 2014. Penelitian ini menggunakan <em>mix method </em>dengan desain urutan pembuktian <em>sequential explanatory</em>. Subjek penelitian berasal dari Dinas Kesehatan Kabupaten Tabalong, RSUD H. Badaruddin, Puskesmas Kelua dan BPJS Kesehatan. Hasil evaluasi konteks, informan memahami mengenai batasan JKN, <em>roadmap</em> dan hambatan program. Hasil evaluasi input SDM pelaksana pelayanan kesehatan, kuantitas masih mengalami kekurangan 136 orang. Distribusi di Puskesmas Kelua sudah sesuai dengan standar ketenagaan di puskesmas tetapi kuantitasnya masih belum sesuai standar rasio per 100.000 jumlah penduduk. Distribusi di RSUD H. Badaruddin berdasarkan standar ketenagaan kesehatan di rumah sakit sudah sesuai, kecuali untuk dokter spesialis. Penilaian kualitas SDM di Puskesmas Kelua belum menggunakan standar Kepmenkes Nomor 857 Tahun 2009. Sedangkan di RSUD H. Badaruddin masih menggunakan penilaian Daftar Penilaian Pelaksanaan Pekerjaan (DP3). Hasil evaluasi proses, kuantitas sudah meningkat tetapi masih mengalami kekurangan 82 orang. Distribusi di Puskesmas Kelua tidak ada perubahan. Distribusi di RSUD H. Badaruddin mengalami penambahan tenaga keperawatan. Penilaian kualitas SDM di Puskesmas Kelua tidak ada perubahan. Penilaian SDM di RSUD H. Badaruddin menggunakan Penilaian Prestasi Kerja Pegawai (PKP). Evaluasi output menunjukkan belum ada perubahan kuantitas, distribusi dan kualitas dari hasil evaluasi proses. Pelaksanaan JKN di Kabupaten Tabalong sudah berjalan, baik dari aspek peraturan perundangan, kepesertaan, pelayanan kesehatan, keuangan dan tata kelola organisasi. Ada beberapa hambatan seperti peraturan daerah masih kurang dan kurangnya jumlah SDM pelaksana pelayanan kesehatan. Oleh karena itu, perlu adanya upaya penambahan kuantitas dan pemerataan distribusi SDM pelaksana pelayanan kesehatan oleh Pemerintah Daerah dan upaya memaksimalkan jumlah dan kualitas SDM pelaksana pelayanan kesehatan yang tersedia.<strong><em></em></strong><strong></strong></p><p align="center"> </p><p><em>National health insurance (JKN) started operating on January 1, 2014. The implementation of health insurance in Tabalong, still have some problems such as health services workforce are still not enough in terms of quantity, distribution and quality. This study aims to evaluate the JKN program of </em><em>health services </em><em>workforce aspects in Tabalong period January to June 2014. This study used a mixed method design </em><em>with</em><em> sequential explanatory. Study subjects were from the Department of Health Tabalong, H. Badaruddin Hospital, </em><em>Kelua </em><em>Health Center and BPJS Health. The results of the evaluation context, informants understand the JKN restrictions, roadmap and program obstacle</em><em>s</em><em>. The results of the evaluation of</em><em> health services</em><em> workforce inputs, the quantity is still deficient 136 people. Distribution in Kelua Health Center is appropriate with the standard for personnel in health centers but the quantity is still not appropriate </em><em>with the </em><em>ratio per 100,000 of population standard. Distribution in H. Badaruddin hospital</em><em> </em><em>based health workforce standards in hospitals is appropriate, except to specialists. Assessment of the quality of human resources in </em><em>Kelua </em><em>Health Center </em><em>not </em><em>using Kepmenkes No. 857 of 2009</em><em> </em><em>standard. While in H. Badaruddin</em><em> </em><em>hospital still use assessment Implementation Assessment Work List (DP3). The results of the evaluation process, the quantity has increased but is still deficient 82 people. Distribution in Kelua Health Center no change. Distribution in H. Badaruddin hospital</em><em> </em><em>have additional </em><em>for </em><em>nursing staff. Assessment of the quality of human resources in the </em><em>Kelua </em><em>Health Center no change. Assessment of human resources in H. Badaruddin hospital</em><em> </em><em>using Employee Job Performance Assessment (PKP). Evaluation of the output shows no change in the quantity, distribution and quality of the results of the evaluation process. Implementation JKN in Tabalong already running, both from the aspect of legislation, participation, health care, financial and organizational governance. There are several obstacles such as local regulation are still lacking and the lack of </em><em>workforce</em><em> for the services of health.</em><em> </em><em>Therefore, efforts are needed to increase the quantity and distribution of health workforce by local government and maximizing the amount and quality of available health workforce.</em></p>