84 research outputs found
Electronic Healthcare Data Collection and Pay-for-Performance: Translating Theory into Practice
No full textWith insight grounded in his work for a national data collection consortium and as Vice President of Quality and Outcomes at the Children\u27s Hospital of Wisconsin, the author connects the theory of pay-for-performance to the realities of its implementation. The author expands the Diagnosing the Data conversation by describing the challenges of collecting meaningful data and by addressing the potential legal issues that data use raises. Drawing on his national and local experience, the author concludes with suggestions for adopting data collection programs that are both clinically relevant and scientifically reliable
Results on a Strong Multiplicity One Theorem
No full textWe prove an analogue of the strong multiplicity one theorem in the context of -spherical representations of the group appearing in for uniform torsion-free lattices in . This is a generalisation of a previous result by the first author and C. S. Rajan in \cite{B-R-2011} for the case of .11 pages, accepted for publication in New York Journal of Mathematic
Agricultural trade liberalization in the Uruguay Round : one step forward, one step back?
No full textAfter evaluating the Uruguay Round's impact on agriculture and border protection in the next decade, the author concludes that while there was significant reform of the rules - particularly the conversion of nontariff barriers into tariffs and the reduction and binding of all tariffs - in practice, trade will probably be liberalized less than expected. The objective of the Round was to reverse protectionism and remove trade distortions. This may not be achieved in practice, at least not until further reductions are carried out in future rounds of negotiations. The major exception to this conclusion is in high-income Asian countries, where protection for major commodities will be significantly reduced. The tariffication and binding of all tariffs on agricultural products represents a significant step forward. Liberalization is implicit because countries are prohhibited from arbitrarily raising tariffs to new higher levels. But many of the newly established tariffs are so high in many countries as to effectively prohibit trade. Patterns of liberalization vary considerably by commodity and by country. Generally, the extent of liberalization was diminished by binding tariffs to the base period of 1986-88, when border protection was at a high point. In most OECD countries, this was worsened by"dirty tariffication:"the new base tariffs offered even greater protection than the nontariff barriers they replaced. Even after the commitments to tariff reductions in the Round, the ad valorem measure of the final binding tariffs will remain higher than the average rate of protection in 1982-93. A number of developing countries in East Asia, Latin America, and the Middle East chose to lock in prior liberalization efforts on some products. But for most commodities, there will be little actual liberalization, since most developing countries chose to bind their tariffs at a maximum level. Even when countries reduced already-bound rates, bound tariffs remained significantly higher than current applied rates, giving countries the flexibility to raise tariffs later. The high level of bound tariffs may allow countries to apply variable tariffs below the bound level, thus failing to stabilize tariffs and improve market access. Moreover, the Round did not touch many of the worst distortions in developing countries, such as import subsidies, export taxes, state-trading monopolies, and domestic policies that implicitly tax agriculture.Trade Policy,Environmental Economics&Policies,Economic Theory&Research,Export Competitiveness,Rules of Origin,Trade Policy,Rules of Origin,TF054105-DONOR FUNDED OPERATION ADMINISTRATION FEE INCOME AND EXPENSE ACCOUNT,Environmental Economics&Policies,Economic Theory&Research
Hungary's bankruptcy experience, 1992-93
No full textHungary adopted a tough new bankruptcy law in late 1991 that took effect on January 1, 1992. It required managers of firms with arrears over 90 days to any creditor to file for either reorganization or liquidation within eight days (the so-called"automatic trigger") and provided a rather sympathetic framework in which to do so. The result: since January 1992, more than 25,000 cases have been filed - far beyond lawmakers'expectations. Both positive and negative views about the law have been expressed, but details about how the process has actually worked have been scarce. The authors help fill this information gap by providing detailed data on a randomly selected stratified sample of actual cases filed in 1992-93, supplemented by information gained through interviews with judges, liquidations, and firms involved in bankruptcy. Their conclusions are as follows. First, the bankruptcy process appears to have had some degree of economic logic in 1992 and 1993. Better firms were more likely to enter and emerge"successfully"from reorganization, while worse firms were more likely either to fail in reorganization or to file directly for liquidation. Second, judicial reorganization need not be slow and costly. The first wave of reorganizations was handled surprisingly quickly, especially considering the sheer number of cases, the novelty of the process, and the shortage of trained judges. This quickness was possible largely because of the decentralized design of the process. Once the court approved a case, the court had little role. (Amendments added in 1993 may have made the process more bureaucratic and expensive). Third, in this sample, major delays occurred not in reorganization but in liquidation. Creditors will do almost anything to avoid filing for liquidation, and once firms enter liquidation they are still likely to be kept alive indefinitely. In the end, this lack of a viable creditor-led"exit"and debt collection mechanism harms firms by increasing the cost and reducing the flow of credit. Fourth, although the bankruptcy process displays some degree of economic logic, one should not assume that it operates as a similar law would in a market economy. In particular, a likely source of private gain in Hungary appears to be asset or other value diversion (or"value-stripping) before bankruptcy. Fifth, the main need is to strengthen the incentives of creditors to monitor the process closely and to improve their ability to do so.Banks&Banking Reform,International Terrorism&Counterterrorism,Strategic Debt Management,Small Scale Enterprise,Small and Medium Size Enterprises,Banks&Banking Reform,Strategic Debt Management,Legal Products,International Terrorism&Counterterrorism,Economic Theory&Research
Small and medium-size enterprises in economic development : possiblities for research and policy
No full textThe World Bank's most important long-term advantage in promoting development, says the author, may lie in opportunities to address related obstacles simultaneously. It could mount concurrent efforts to address the problems of small and medium-size enterprises in a particular sector, region, or economy, for example. It could address the conditions of founding new firms, providing finance or technical assistance, developing mutual support institutions, resolving disputes, and perhaps reducing counterproductive government interventions. Were the Bank to follow such a coordinated approach, programs could be designed to generate data to illuminate the impacts and interactions of various elements of policy. These data could be exploited, then, in research designs, or even the design of management information systems, shaped by program evaluation. The author proposes four general issues for research (plus a series of topics for each issue). (1) Can Bank initiatives involving small and medium-size enterprises in developing countries facilitate the entry of these enterprises into similar learning relationships with other firms - foreign firms, larger firms in their own countries, or each other? (2) The economic significance of high"turbulence"(entry and exit rates) in small-firm populations is poorly understood. The fact of high turbulence is well-documented in industrial countries; it is not for developing countries, but available data suggest a broadly similar pattern. Are high failure rates for small businesses symptomatic of an important shortcoming in the system of economic organization itself? Or should the unit of analysis be the enterprise, the entrepreneur, or the entrepreneur's family? (3) Is the apparent trend favoring a larger economic role for smaller production units autonomous rather than induced by other changes? Does it depend on general operating factors such as the declining costs of communication and computation? (4) The rate of learning by a small firm may depend on the nature of its transacting partner. Certain multinational enterprises make good teachers, for example, but certain local labor markets or markets for consumer goods and services may not be well-positioned for relevant learning. They may learn well how to adjust to local circumstances but not to the international diffusion of technology and ways of organizing (the main source of hope for developing countries). Perhaps Bank policy should be more concerned with transaction patterns.General Technology,Environmental Economics&Policies,Decentralization,ICT Policy and Strategies,Small and Medium Size Enterprises,Environmental Economics&Policies,General Technology,Small and Medium Size Enterprises,ICT Policy and Strategies,Small Scale Enterprise
Environmental regulation and development : a cross-country empirical analysis
No full textThe authors develop comparative indices of environmental policy and performance for 31 countries using a quantified analysis of reports prepared for the United Nations Conference on Environmental and Development. In cross-country regressions, they find a very strong, continuous association between their indicators and national income per capita, particularly when adjusted for purchasing power parity. Their results suggest a characteristic progression in development. Poor agrarian economies focus first on natural resource protection. With increased urbanization and industrialization, countries move from initial regulation of water pollution to air pollution control. The authors highlight the importance of institutional development. Environmental regulation is more advanced in developing countries with relatively secure property rights, effective legal and judicial systems, and efficient public administration.Public Health Promotion,Environmental Economics&Policies,Health Economics&Finance,Agricultural Research,Economic Theory&Research,Environmental Economics&Policies,Health Economics&Finance,Agricultural Research,Economic Theory&Research,Environmental Governance
National Sleep Foundation’s sleep time duration recommendations:methodology and results summary
No full textObjective: The objective was to conduct a scientifically rigorous update to the National Sleep Foundation’s
sleep duration recommendations.
Methods: The National Sleep Foundation convened an 18-member multidisciplinary expert panel,
representing 12 stakeholder organizations, to evaluate scientific literature concerning sleep duration recommendations.
We determined expert recommendations for sufficient sleep durations across the lifespan
using the RAND/UCLA Appropriateness Method.
Results: The panel agreed that, for healthy individuals with normal sleep, the appropriate sleep duration for
newborns is between 14 and 17 hours, infants between 12 and 15 hours, toddlers between 11 and 14 hours,
preschoolers between 10 and 13 hours, and school-aged children between 9 and 11 hours. For teenagers, 8
to 10 hours was considered appropriate, 7 to 9 hours for young adults and adults, and 7 to 8 hours of sleep
for older adults.
Conclusions: Sufficient sleep duration requirements vary across the lifespan and fromperson to person. The recommendations
reported here represent guidelines for healthy individuals and those not suffering froma sleep
disorder. Sleep durations outside the recommended range may be appropriate, but deviating far from thenormal range is rare. Individuals who habitually sleep outside the normal range may be exhibiting signs or
symptoms of serious health problems or, if done volitionally,may be compromising their health and well-being
Role of Physical Therapy and Rehabilitation in SAPHO Syndrome- A Rare Condition
No full textSAPHO syndrome (synovitis, acne, pustulosis, hyperostosis and osteitis) is heterogenous, rare entity with manifestations of
Pustulo-Psoriatic Hyperostotic Spondyloarthritis (PPHS) and Chronic Recurrent Multifocal Osteomyelitis (CRMO). It can occur in
all the age groups with unknown etiology. Hereby, author presents a case of 37-year-old female who reported with the complaint
of bilateral knee pain and lower back pain. Laboratory investigations revealed elevated Erythrocyte Sedimentation Rate (ESR) and
C-Reactive Protein (CRP) levels. Bone scintigraphy and Magnetic Resonance Imaging (MRI) showed bone lesions, The diagnosis
of SAPHO syndrome was made. The present article highlights the role of physical therapy as a non-pharmacological treatment
modality to reduce pain, the intensity of which was measured by Numeric Pain Rating Scale (NPRS). The Range Of Motion (ROM)
was measured by digital inclinometer and her Quality of Life (QoL) was measured by the 36-item short form health survey (SF-36)
scale. Eight weeks postprotocol showed significant improvement in pain, ROM and QOL. This suggests a positive outcome of
rehabilitation in SAPHO syndrome
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