Search

Child pornography possession/receipt offenders are a controversial offender group due to mixed and occasionally divergent evidence about their risk profile, offending history and psychopathology. Using a population of male offenders who ever perpetrated a sexual offense from a federal jurisdiction in the central United States, the current study developed an exploratory post hoc empirical profile of these offenders. The profile has some success in the validation component of our study and showed significant associations with self-reported sexual abuse of child victims ages 3–12 years, but non-significant associations to adolescent and adult victims. It significantly linked to the conceptually expected victim group and the significant statistical effect withstood controls for generally robust indicators of antisocial conduct including antisocial personality disorder, arrest onset, total adverse childhood experiences, age and race. We view the findings as exploratory and encourage additional empirical study of this important offender group.

Today, a lot of us have a lot of digital wallet services that we use. Because of that tracking our spending has become significantly harder because most people use more than one digital wallet. This study aims to find out how can we utilize QR code in the payment receipt at out digital transaction, to keep track on our transaction on various digital wallet. To help keep track of the expenses from the various digital wallet, we use QR code that is generated from the receipt of the transaction that contain the encrypted data of the transaction that occurs. This data can be scanned so it can be added to a personal budget tracker app so the user can manage their digital expenses in one view.

In the conditions of competition and instability production companies forced continuously improve the production process and develop new innovative technologies and equipment in order to maintain their positions in the market. An important role in this play by improving the methods of planning and managing the process of production development, development of innovative products and forecasting measures to adapt to changing requirements of the external and internal market. This paper consider a multiphase sequential technological process (STP) with a branched structure at each phase of the production process. For the Poisson flow of receipt and processing of parts, a mathematical model proposed in the form of multi–channel QS with waiting and queue restriction. On this model, the criteria for evaluating the work of the STP formed and cost models synthesized for solving the problems of innovation and optimization of the STP. For each phase of the production process, the problem of evaluating the effectiveness of innovative equipment upgrades and the problem of selecting the optimal amount of equipment has solved. If there is a discrepancy between the flow of receipt and processing of parts of this mathematical model, the values of the initial criteria determined by the results of a certain number of repeated simulation of the STP operation. Ref.11, pic. 2

The study of theoretical and methodological approaches to assessing the risk and efficiency of innovation and investment activities of agricultural enterprises. By studying the scientific developments of scientists and their understanding, a generalization of indicators used in foreign and domestic practice for assessing the effectiveness of innovative activities of agricultural enterprises has been carried out. Criteria for making a decision on investing in a specific innovative project for each of the indicators are determined, the need for their use in combination with indicators of the financial condition of the enterprise, namely: indicators of liquidity, solvency, as well as coefficients of financial stability, business activity, etc., is substantiated. When analyzing the effectiveness of innovation and investment activities, the method of discounting is used - a method of comparing costs and revenues, as well as incoming and outgoing cash flows, which are carried out at different times and / or at regular intervals. By bringing the value of revenues and expenditures to a specific point in time, their comparability is achieved, and therefore the assessment of risks and effectiveness of innovation and investment will be more reliable. At the moment, Ukrainian-language terminology in the evaluation of innovative projects is not yet stable. For these reasons, it is better to use the English name of these indicators, which is common in world scientific practice. As a result of the analysis of scientific achievements on the evaluation of the effectiveness of investment projects, five main indicators were selected, on which the further selection of the most promising projects is based. Most of these criteria use the amount of net present cash flows from sales. It is possible to build an estimate of such flows on the basis of the analysis of volumes of sale of production and receipt of means on accounts of the enterprise. The proposed indicators can be used to build a portfolio of innovative projects of agricultural enterprises. Substantiated further research in the direction of assessing the effectiveness of several innovative projects and their comparison when choosing objects for investment.

The article analyses the production and technological readiness of bachelors of vocational education in food technology, reveals the essence and outlines the main characteristics of the criteria, indicators and levels of production and technological readiness of bachelors of food technology. The purpose of the article is to substantiate the criteria, indicators and characteristics of the levels for diagnosing the initial level of production and technological readiness and further research and experimental work. The content of education embodies the desired result, a list of requirements for a graduate of an educational institution and provides for the receipt of educational information that, in aggregate, provides the potential for assimilating the knowledge system, mastering the system of skills and abilities, and forming worldview, civic and professionally significant personal qualities. Deep socio-economic, industrial and technological transformations taking place in Ukraine require new approaches to the system of training specialists in various industries and the search for new effective forms of organizing the educational process. To analyze the state of production and technological training of bachelors in the field of food technologies in pedagogical institutions of higher education, the general theoretical provisions of vocational education are considered, which form the basis for the selection of the content and organization of production and technological training. Achieving the goal involved the use of the following methods: analysis, comparison, systematization and generalization of normative documents, philosophical, psychological, pedagogical and methodological sources on the research topic, analysis of the structure of students in specialty 015.21 Vocational education (Food Technology) criteria, indicators and levels of production and technological readiness of bachelors of professional education in food technology. The use of a set of methods allowed to characterize the production and technological readiness of bachelors of food technology by the formation of indicators of relevant criteria (motivational-value, cognitive, activity, reflexive) at the following levels: high, medium, low. Substantiated criteria, indicators and characterized levels were used for research and experimental work, in particular, diagnosing the initial level of production and technological readiness.

Tax deferred assets (TDAs) such as 401(k)s cannot be directly valued with other assets such as homes and stocks because TDAs carry a substantial deferred tax liability on withdrawal. I also net out implicit taxes on accrued capital gains and compare pre-tax and post-tax wealth. The empirical analysis covers 1983-2016 based on the Survey of Consumer Finances for conventional net worth, NW, and augmented wealth, AW, the sum of NW, pension wealth PW, and Social Security wealth SSW. Like TDAs, defined benefit pension and Social Security benefits are taxed on receipt. Netting out implicit taxes lowered PW by 24% in 2016. It also devalued SSW by 14%, NW by 5%, and AW by 8% but the reduction was lower in the 1980s. Subtracting implicit taxes lowered PW and SSW inequality but had no appreciable impact on NW or AW inequality. I also consider the bequest value BV of wealth, including death benefits. While TDAs are still subject to income tax at withdrawal, other assets are valued on a step-up in basis. BV was considerably greater than NW but BV inequality notably lower. When estimated estate taxes due on death are subtracted, BV was substantially lowered and its inequality sharply reduced.

Purpose When the Centers for Medicare and Medicaid Services (CMS) changed policies about medical student documentation, students with proper supervision may now document their history, physical exam, and medical decision-making in the electronic health record (EHR) for billable encounters. Since documentation is a core entrustable professional activity for medical students, the authors sought to evaluate student opportunities for documentation and feedback across and between clerkships. Method In February 2018, a multidisciplinary workgroup was formed to implement student documentation at Duke University Health System, including educating trainees and supervisors, tracking EHR usage, and enforcing CMS compliance. From August 2017 to August 2018, locations and types of student-involved services (student-faculty, or student-resident-faculty) were tracked using billing data from attestation statements. Student end-of-clerkship evaluations included opportunity for documentation and receipt of feedback. Since documentation was not allowed prior to August 2018 it was not possible to compare to prior student experiences. Results In the first half of the academic year, 6,972 patient encounters were billed as student-involved services, 52% (n = 3,612) in the inpatient setting and 47% (n = 3,257) in the outpatient setting. Most (74%) of the inpatient encounters also involved residents and most (92%) of outpatient encounters were student-teaching physician only.Approximately 90% of students indicated having had opportunity to document in the EHR across clerkships, except for procedure-based clerkships such as surgery and obstetrics. Receipt of feedback was present along with opportunity for documentation more than 85% of the time on services using evaluation and management coding. Most students (>90%) viewed their documentation as having a moderate or high impact on patient care. Conclusions Changes to student documentation were successfully implemented and adopted; changes met both compliance and education needs within the health system without resulting in potential abuses of student work for service.

The aim of this study is to conduct research and analysis on Indonesia's progress toward the Sustainable Development Goals (SDGs) Quality Education over the last three years (2015-2018). The aim of this study is to assess and comprehend Indonesia's progress toward achieving the Sustainable Development Goals (SDGs) for Quality Education since they were announced in 2015. In Indonesia, the Sustainable Development Goals (SDGs) and Education Quality thesis utilizes a qualitative research design. We conducted this research using a case study analysis based on the procedure, the data, and the triangulation of sources. We draw certain conclusions as a result of the study. To begin, in comparison to four years ago, at the time of the SDGs' initial ratification, Indonesia experienced better progress in terms of timeliness and participatory processes. But even so, the challenges faced by implementing the SDGs are not just about those two things. In terms of substance, the ambition of SDGs to eliminate the negation component of the development is a work that is almost close to utopia. Second, in terms of the process, the implementation of SDGs Quality Education at the national level still leaves homework such as accountability mechanisms, receipt of data from non-government parties, and the participation process itself. This should not be seen as a burden but rather a challenge that must be faced to improve performance for the acceleration of Indonesia's quality education national development until 2030. Third, the active role of the government is certainly the main capital for the implementation and achievement of SDGs quality education in Indonesia. Initiatives that come from various parties, including universities, bring optimism that the SDGs quality education will be implemented on inclusive and participatory principles. Fourth, a coalition of civil society organizations is needed to ensure that the SDGs' quality education is implemented in the context of Indonesia's growth, both at the national and regional levels. These social systems have the potential to pressure the Indonesian government to prepare for a variety of things, both procedurally and substantively.

Among colorectal cancer (CRC) survivors, treatment for metastatic recurrence is most effective when malignancies are detected early through surveillance with carcinoembryonic antigen (CEA) level test and computer tomography (CT) imaging. However, utilization of these tests is low, and many survivors fail to meet the recommended guidelines. This population-based study assesses individual- and neighborhood-level factors associated with receipt of CEA and CT surveillance testing. We used the Surveillance, Epidemiology and End Results (SEER)–Medicare data to identify Medicare beneficiaries diagnosed with CRC stages II–III between 2010 and 2013. We conducted multivariate logistic regression to estimate the effect of individual and neighborhood factors on receipt of CEA and CT tests within 18 months post-surgery. Overall, 78% and 58% of CRC survivors received CEA and CT testing, respectively. We found significant within racial/ethnic differences in receipt of these surveillance tests. Medicare-Medicaid dual coverage was associated with 39% lower odds of receipt of CEA tests among non-Hispanic Whites, and Blacks with dual coverage had almost two times the odds of receiving CEA tests compared to Blacks without dual coverage. Although this study did not find significant differences in receipt of initial CEA and CT surveillance testing across racial/ethnic groups, the assessment of the factors that measure access to care suggests differences in access to these procedures within racial/ethnic groups. Our findings have implications for developing targeted interventions focused on promoting surveillance for the early detection of metastatic recurrence among colorectal cancer survivors and improve their health outcomes.

We study outcomes to ADR (American Depositary Receipt) investments between August 1954 and September 2020, with particular attention to ADRs associated with Chinese firms. Overall, ADRs improved in...

Sexual assault and intimate partner violence (IPV) are common experiences in women, but few studies have examined correlates of social reactions experienced by victims telling others about assault. This systematic review identified 30 studies through searches of research databases on correlates of social reactions to disclosure of sexual assault or IPV in samples of adult victims or disclosure recipients. Studies showed evidence of greater negative social reactions for Black and Hispanic victims, less educated, and bisexual victims. More extensive trauma histories in victims were related to receipt of greater negative social reactions, whereas assault characteristics (e.g., victim–offender relationship, alcohol use, perpetrator violence during assault) were sometimes associated with negative reactions. In terms of postassault factors, more psychological symptoms, self-blame, avoidance coping, less perceived control, and less posttraumatic growth were related to more negative social reactions. Disclosure characteristics, telling informal sources, and telling more sources were related to more positive reactions, whereas telling both formal and informal sources was related to negative reactions. Demographic, attitudinal, and relational factors were related to disclosure recipients’ intended social reactions. Future research needs to examine how various factors relate to social reactions in the context of theory, and clinical treatment and interventions should use this information to identify and intervene with victims to reduce negative social reactions and their psychological impacts and to increase positive social reactions particularly from informal support sources.

In this article, we study the association between mental health problems in adolescence and early adulthood and later receipt of social assistance in the capital region of Finland. Using register d...

PURPOSE Antibiotic resistance is a major public health threat. Antibiotic use is the main driver of resistance, with children and the state of Kentucky having particularly high rates of outpatient antibiotic prescribing. The purpose of this study was to describe patient and provider characteristics associated with pediatric antibiotic use in Kentucky Medicaid children. METHODS We used Medicaid prescription claims data from 2012 to 2017 to describe patterns of pediatric antibiotic receipt in Kentucky. Patient and provider variables were analyzed to identify variations in prescribing. FINDINGS Children who were female, less than 2 years old, White, and living in a rural area had consistently higher rates of antibiotic prescriptions. There was significant geographic variability in prescribing, with children in Eastern Kentucky receiving more than 3 courses of antibiotics a year. Most antibiotic prescriptions for children were written by general practitioners and nurse practitioners rather than pediatricians. CONCLUSION These findings support the need for extensive antibiotic stewardship efforts inclusive of rural outpatient practices.

Across the European Union, the receipt of agricultural subsidisation is increasingly being predicated on the delivery of public goods. In the English context, in particular, these changes can be seen in the redirection of money to the new Environmental Land Management scheme. Such shifts reflect the changed expectations that society is placing on agriculture—from something that provides one good (food) to something that supplies many (food, access to green spaces, healthy rural environment, flood resilience, reduced greenhouse gas emissions). Whilst the reasons behind the changes are well documented, understanding how these shifts are being experienced by the managers expected to deliver on these new expectations is less well understood. Bourdieu’s social theory and the good farmer concept are used to attend to this blind spot, and to provide timely insight as the country progresses along its public goods subsidy transition. Evidence from 65 interviews with 40 different interviewees (25 of whom gave a repeat interview) show a general willingness towards the transition to a public goods model of subsidisation. The optimisation and efficiency that has historically characterised the productivist identity is colouring the way managers are approaching the delivery of public goods. Ideas of land sparing and land sharing (and the farming preference for the former over the latter) are used to help understand these new social and attitudinal realities. The policy implications of these findings are discussed, with reference to the new scheme’s ‘priority themes’.

The therapeutic potential of medical cannabis to treat a variety of conditions is becoming increasingly recognised. Globally, a large number of countries have now legalised cannabis for medical uses and a substantial number of patients are able to access their medications. Yet in the UK, where medical cannabis was legalised in November 2018, only a handful of NHS prescriptions have been written, meaning that most patients are unable to access the medicine. Reasons for this are manyfold and include the perceived lack of clinical evidence due to the challenges of studying medical cannabis through randomised controlled trials. In order to develop the current evidence base, the importance of incorporating real-world data (RWD) to assess the effectiveness and efficacy of medical cannabis has gradually become recognised. The current paper provides a detailed outline of Project Twenty21 (T21), the UK’s first medical cannabis registry, launched in August 2020. We provide the rationale for T21 and describe the methodology before reporting the characteristics of the ‘first patients’ enrolled in the registry. We describe the health status of all patients enrolled into the project during its first 7 months of operation and the sociodemographic characteristics and primary presenting conditions for these patients, as well as details of the medical cannabis prescribed to these individuals. By 12th March 2021, 678 people had been enrolled into T21; the majority (64%) were male and their average age was 38.7 years (range = 18–80). The most commonly reported primary conditions were chronic pain (55.6%) and anxiety disorders (32.0%) and they reported high levels of multi-morbidity, including high rates of insomnia and depression. We also present preliminary evidence from 75 patients followed up after 3 months indicating that receipt of legal, prescribed cannabis was associated with a significant increase in self-reported health, assessed using the visual analogue scale of the EQ-5D-5L (Cohen’s d = .77, 95% CI = .51–1.03). Our initial findings complement reports from other large-scale databases globally, indicating that the current RWD is building up a pattern of evidence. With many clinicians demanding better and faster evidence to inform their decisions around prescribing medical cannabis, the current and future results of T21 will expand the existing evidence base on the effectiveness of cannabis-based medical products (CBMPs).

Bisphenol A (BPA) has been widely used in thermal receipt papers as a color developer; however, it has been substituted with alternative chemicals such as bisphenol S (BPS) due to the global restriction and regulations about the BPA in thermal receipt papers as a result of negative effects on human and environmental health. Little is known about the current changes of BPA or BPS in thermal receipt papers and its implication to human exposure. This study investigated the concentrations of BPA and BPS in thermal receipt papers collected from 14 business sites (n = 18); juice bar, bakery store, wholesale marts, bank, theater, clothe store, fast-food restaurant, coffee shop, cosmetic shop, bookstore, post office, and convenience store. Among 18 samples, BPA concentrations in 13 receipt samples from 9 public facilities were in range of 1.4 µg/g in a bookstore to 10,353.3 µg/g in a theater. In case of BPS, it was detected in 8 receipt samples from 8 public facilities in range of 4182.4 µg/g in a theater (before printing) to 11,946.3 µg/g in a post office (before printing). The estimated daily intake (EDI) of BPA and BPS by dermal absorption was evaluated on the basis of average concentrations in terms of contact frequencies between general individual and occupational individual. For the general individual, the EDI of BPA and BPS ranged from 0.08 ng/d in a bookstore to 602 ng/d in a theater (after printing) and ranged from 243 ng/d in a box office (before printing) and 694 ng/d in a post office, respectively. For the occupational individual, the EDI of BPA and BPS ranged from 6.1 ng/d in a bookstore to 45,123 ng/d in a theater (after printing) and ranged from 18,228 ng/d in a box office (before printing) to 52,065 ng/d in a post office, respectively. This study shows the current changes of BPA and BPS in thermal receipt papers and emerging concerns by BPS as much as concerns by BPA that needs further investigation about adverse effects on human health.

Translating evidence-based diabetes prevention programs into the community is needed to make promising interventions accessible to individuals at-risk of type 2 diabetes. To increase the likelihood of successful translation, implementation evaluations should be conducted to understand program outcomes and provide feedback for future scale-up sites. The purpose of this research was to examine the delivery of, and engagement with, an evidence-based diet and exercise diabetes prevention program when delivered by fitness facility staff within a community organization. Ten staff from a community organization were trained to deliver the diabetes prevention program. Between August 2019–March 2020, 26 clients enrolled in the program and were assigned to one of the ten staff. Three fidelity components were accessed. First, staff completed session-specific fidelity checklists (n = 156). Second, two audio-recorded counseling sessions from all clients underwent an independent coder fidelity check (n = 49). Third, staff recorded client goals on session-specific fidelity checklists and all goals were independently assessed for (a) staff goal-setting fidelity, (b) client intervention receipt, and (c) client goal enactment by two coders (n = 285). Average self-reported fidelity was 90% for all six sessions. Independent coder scores for both counseling sessions were 83% and 81%. Overall staff helped clients create goals in line with program content and had a goal achievement of 78%. The program was implemented with high fidelity by staff at a community organization and clients engaged with the program. Findings increase confidence that program effects are due to the intervention itself and provide feedback to refine implementation strategies to support future scale-up efforts.

La presente investigación evalúa el impacto de la Alimentación Complementaria Escolar (comúnmente conocida como desayuno/merienda escolar) sobre los gastos en alimentación por parte de los hogares, salud y seguridad alimentaria. La investigación toma importancia debido a la crisis mundial ocasionada por el Nuevo Coronavirus (SARS-CoV-2) que obliga a la mayoría de los países latinoamericanos, incluido Bolivia, a permanecer en cuarentena, deteniendo las actividades escolares y, en consecuencia, privando a los niños(as)/adolescentes de colegios públicos y de convenio de la Alimentación Complementaria Escolar. Dado que algunos estudiantes reciben el desayuno/merienda escolar y otros no, se propone un método de emparejamiento por puntaje de propensión (propensity score matching) para recrear un contexto experimental y, de esa forma, poder estimar de mejor manera el efecto del tratamiento. Los resultados de la estimación con los diferentes métodos de inferencia empleados muestran que la recepción de la Alimentación Complementaria Escolar representa un alivio por parte de los hogares en el gasto en alimentación y, resultados a nivel seguridad alimentaria, muestranque la ausencia del desayuno/merienda escolar incrementa la probabilidad de que el hogar perciba cierto grado inseguridad alimentaria.

Children in lower income households are less likely to be diagnosed with autism spectrum disorder (ASD) and diagnosis is often delayed. Lack of or delayed identification of ASD minimizes a child’s ability to receive effective early intervention services that support development of functional independence skills. Research has yet to identify relationships between functional independence and household income for children with ASD. A cross-sectional national survey with 231 caregivers of children with autism aged 2–12 years was conducted. Caregivers completed a 90-min survey examining family demographics, intervention services, autism symptom severity, and children’s functional behavioral outcomes. Significant differences in functional independence behavior scores were identified for children from the highest and lowest income categories when controlling for autism symptom severity, age of diagnosis, and receipt of intervention services. This study provides preliminary evidence to support the association between income and functional independent behavior for children with ASD.

Social distancing restrictions and health- and economic-driven demand shifts from COVID-19 shut down many small businesses with especially negative impacts on minority owners. Is there evidence that the unprecedented federal government response to help small businesses—the Paycheck Protection Program (PPP) and the related COVID-19 Economic Injury Disaster Loans (EIDL)—which had a stated goal of helping disadvantaged groups, was disbursed evenly to minority communities? In this descriptive research note, we provide the first detailed analysis of how the 2020 PPP and EIDL funds were disbursed across minority communities in the country. From our analysis of data on the universe of loans from these programs and administrative data on employer firms, we generally find a slightly positive relationship between PPP loan receipt per business and the minority share of the population or businesses, although funds flowed to minority communities later than to communities with lower minority shares. PPP loan amounts per employee, however, are negatively related to the minority share of the population. The EIDL program, in contrast, both in numbers per business and amounts per employee, was distributed positively to minority communities.

The present research develops a two-warehouse economic order quantity (EOQ) model with imperfect products under fuzzy environment. Usually, the acquiring cost for an inventory model should be paid while receiving its receipt. Sometimes the supplier may offer to pay the purchasing amount in advance. Also, the capacity of warehouse plays a vital role in the inventory models. In lockdown situation, there is no supply to the customer throughout the lockdown period and so the inventory level remains stable during that period. This paper scrutinizes the Fuzzy EOQ model with substandard products which incorporates the notion of advance payment, repair option and lockdown situation. The proportion of defective product is considered as triangular fuzzy number. Fuzzy EOQ model is formulated to obtain the optimal order quantity which maximizes the expected annual profit and endorsed with numerical illustration. The sensitivity analysis for the proposed model is performed to show the impact of fuzziness on the proportion of defective rate along with the changes in parameters.

Objective To replicate findings from a prior study which identified prospective associations between use of products for weight control and subsequent receipt of a first-time eating disorder (ED) diagnosis among female adolescents and young adults. Method Data from a prospective cohort study, Project EAT (Eating and Activity in Teens and Young Adults), were used to examine prospective associations between self-reported past-year diet pill and laxative use for weight control and self-reported receipt of an ED diagnosis among females without prior receipt of an ED diagnosis (N = 1,015). Participants were followed from early/middle adolescence (EAT-I; Mage = 14.9 years) into late adolescence/emerging adulthood (EAT-II; Mage = 19.5 years) and young adulthood (EAT-III; Mage = 24.8 years). Results First-time receipt of an ED diagnosis was reported by 2.4% of participants at EAT-II and 4.0% at EAT-III. After adjusting for demographics and weight status, participants using diet pills (risk ratio [RR] = 3.58, 95% confidence interval [CI]: 1.96-6.54) and laxatives (RR = 2.77, 95% CI: 1.01-7.64) had greater risk of receiving a first-time ED diagnosis within 5 years than those not using these products. Discussion The present study replicated prior findings, providing further evidence for a prospective link between use of products for weight control and subsequent receipt of an ED diagnosis.

The recent judgment of Fancourt J in Byers v Samba Financial Group considers whether a transferee of trust assets who has taken free of the beneficiary’s proprietary interest under the applicable foreign law of property can nevertheless be exposed to personal liability under the English law of knowing receipt. The issue, as the Judge observed, may be of considerable importance to equity lawyers.

PURPOSE: We sought to investigate the association between Medicaid expansion under the Affordable Care Act and access to stage-appropriate definitive treatment for breast, colon, non–small-cell lung, and prostate cancer for underserved racial and ethnic minorities and at minority-serving hospitals (MSHs). METHODS: We conducted a retrospective, difference-in-differences study including minority patients with nonmetastatic breast, colon, non–small-cell lung, and prostate cancer and patients treated at MSHs between the age of 40 and 64, with tumors at stages eligible for definitive treatment from the National Cancer Database. We not only defined non-Hispanic Black and Hispanic cancer patients as racial and ethnic minorities but also report findings for non-Hispanic Black cancer patients separately. We examined the effect of Medicaid expansion on receipt of stage-appropriate definitive therapy, time to treatment initiation (TTI) within 30 days of diagnosis, and TTI within 90 days of diagnosis. RESULTS: Receipt of definitive treatment for minorities in expansion states did not change compared with minority patients in nonexpansion states. The proportion of racial and ethnic minorities in expansion states receiving treatment within 30 days increased (difference-in-differences: +3.62%; 95% CI, 1.63 to 5.61; P < .001) compared with minority patients in nonexpansion states; there was no change for TTI within 90 days. Analysis focused on Black cancer patients yielded similar results. In analyses stratified by MSH status, there was no change in receipt of definitive therapy, TTI within 30 days, and TTI within 90 days when comparing MSHs in expansion states with MSHs in nonexpansion states. CONCLUSION: In our cohort of cancer patients with treatment-eligible disease, we found no significant association between Medicaid expansion and changes in receipt of definitive treatment for breast, prostate, lung, and colon cancer for racial and ethnic minorities and at MSHs. Medicaid expansion was associated with improved TTI at the patient level for racial and ethnic minorities, but not at the facility level for MSHs. Targeted interventions addressing the needs of MSHs are still needed to continue mitigating national facility–level disparities in cancer outcomes.

Background Many cancer survivors face financial difficulties that prevent them from receiving appropriate health care. Racial/ethnic disparities in receipt of health care have been reported among cancer survivors, but recent data for important racial/ethnic subgroups of the US population are lacking. Methods To learn more about barriers to healthcare access faced by cancer survivors, we analyzed data from the NIH “All of Us” Research Program. Data were analyzed about demographic factors and other personal characteristics, personal medical history of cancer, healthcare utilization, and access to care. Results As of November 2020, a total of 5426 participants had a history of cancer (excluding skin cancer). About 88.2% were non‐Hispanic White; 3.9% were Black, African American, or African; 1.3% were Asian; 4.1% were Hispanic, Latino, or Spanish; and 1.2% reported more than one race. Just over one‐half had an annual income of $75,000 or greater. The majority of the participants (71.7%) were college graduates or had an advanced degree. About 47.0%% had private health insurance, 41.0% had Medicare, 6.0% had Medicaid, and the remainder had military, Veterans Affairs, other insurance, or no health insurance. Frequently cited reasons for delayed care in the past 12 months were “had to pay out of pocket for some or all of the procedures,” “deductible was too high/or could not afford the deductible,” “couldn't afford the copay,” “couldn't get time off work,” and “were nervous about seeing a health care provider.” Discussion A minority of cancer survivors who participated in the NIH “All of Us” Program had difficulty paying for health care in the past 12 months. Of particular concern are minorities such as African American and Hispanic cancer survivors along with those who are low income., Many cancer survivors face financial problems that prevent them from receiving timely and recommended health care. A minority of cancer survivors who participated in the NIH “All of Us” Research Program had difficulty paying for health care in the past 12 months. Of particular concern are minorities such as African American and Hispanic cancer survivors along with those who are low income.

Male and female patients often receive different medical evaluations and treatment even when they have the same symptoms, and relative to men, women are less likely to receive benefits within social insurance programs that rely on medical evaluations. This article reviews evidence from prior research that documents the existence of these gender gaps in health care and disability benefit receipt. The article then describes potential mechanisms underlying these gender gaps. The article concludes by discussing new work on the role of health-care providers in contributing to gender gaps.

Evaluate the impact of the Food Insecurity Nutrition Incentive (FINI) grant program on self-reported fruit and vegetable (FV) expenditures.Pre-post quasi-experimental study design.Farmers markets and grocery stores in states with FINI projects.A total of 2,471 Supplemental Nutrition Assistance Program (SNAP) households in 4 intervention groups who lived near a FINI retailer (farmers market or grocery store) and 4 matched comparison groups who did not live near a FINI retailer.Awareness and use of point-of-sale incentives and changes in self-reported monthly household FV expenditures.Ordinary least squares intent-to-treat regression model using lagged dependent variable model framework.Awareness of FINI was higher among households who were near a FINI retailer and had shopped there before FINI than those who lived near a FINI retailer but had not shopped there before FINI; the number of information sources from which SNAP participants heard about FINI was positively associated with incentive receipt (P0.05). Among those who received incentives, the average amount of incentives received at the last shopping trip ranged from $15 to $23. The FINI program had a positive impact on the average monthly FV expenditures for those in the farmers market shopper, grocery store shopper, and grocery store general intervention groups-increases ranged from $9 to $15 (P0.05).Point-of-sale incentives were associated with an increase in FV expenditures among SNAP households. Further research is needed to examine (1) effective messaging strategies to increase incentive awareness and (2) the long-term impact of incentives on FV expenditures.

Introduction We investigated changes in tobacco product use and receipt of cessation counseling among smokers within 50 US states and the District of Columbia between 2010/2011 and 2014/2015 among adults aged ≥18 years. Methods Data were from the Tobacco Use Supplement to the Current Population Survey, a household-based survey designed to yield representative estimates at the state and national levels (n=153725 for 2010/2011 and n=163920 for 2014/2015). Tobacco product use was estimated for all adults. We calculated receipt of cessation counseling among current cigarette smokers who visited a dentist (data available for 2010/2011 only) or a medical doctor (data available for both 2010/2011 and 2014/2015). Betweenyear changes were assessed with chi-squared tests. Results Between 2010/2011 and 2014/2015, declines occurred in 22 states for combustible tobacco smoking, and in 13 states for any tobacco use. Among current cigarette smokers who visited a medical doctor, 13 states had an increase in the receipt of advice or assistance to quit between 2010/2011 and 2014/2015. State-specific estimates of receipt of advice during 2014/2015 ranged from 58.7% (Arkansas) to 80.7% (Wisconsin). During 2010/2011, 31.2% of current cigarette smokers who visited a dentist were advised to quit smoking, and only 7.6% were assisted to quit. By state, the proportion receiving dentist advice to quit ranged from 21.4% (Montana) to 38.9% (Alaska). These estimates were lower than those from physicians in each state. Conclusions Wide variability in delivery of cessation counseling existed across states, and dentists were less likely to deliver cessation counseling than physicians.

Background: Supported Employment has been advocated for by successive governments and policymakers alike as the best approach to employment inclusion for people with an intellectual disability who are in receipt of social care. Yet only 5.2% of this demographic are in any form of work and these numbers have been persistently stagnant for many years. Aims: This study aimed to explore the employment landscape and grapple with the intersecting layers of policy consequence for people who have an intellectual disability, and are in receipt of social care, who wish to engage with work preparation employment support. Methods: As an active participant in the field, this study was ethnographic and conducted at a new job club that had been established in England. In addition, three further sites of complementary data were explored in Wales, through interviews and focus groups. Findings: This study demonstrates that there is a mismatch between how evidence informs policy, and how funding is allocated to support with work preparation. Those unable to secure Supported Employment services are, instead, navigating extreme employment disadvantage and scant opportunities, in the open labour market. Further, bound up in this analysis is evidence of a non-universal understanding of waged work where any form of financial remuneration is welcome. Discussion and conclusion: Overall, with a mismatch between evidence that informs policy, policy rhetoric, realistic employment prospects, and available work, without a fundamental employment policy shift, the very low employment rates within this demographic will not increase.

This research aims to find out how much the contribution and how effective the sources of Local Revenues are to the Local revenues of Blitar City. With the type of data used is secondary data obtained from the Office of Financial Management Revenue and Regional Assets of Blitar City and quantitative analysis tools in the form of calculation of the contribution of local revenue sources, the ratio of effectivenes from local revenues sources to local revenues to know the financial independence of the region. The result is that the sources of Local Indigenous Income that contribute the most to local revenues receipts are local taxes, while the lowest are the results of segregated management. When viewed from the effectiveness of local revenues based on the calculation results obtained that the effectiveness of The Original Income of Blitar City Area is very effective with a value of 109.49%. As for the receipt of pad resources to know the financial independence of Blitar City area is still lacking with the average yield value – averaged over the last five years of 17.54%.

To identify the prevalence of women Veterans reporting receipt of counseling about health optimization prior to pregnancy, topics most frequently discussed, and factors associated with receipt of this care. We analyzed data from a nationally representative, cross-sectional telephone survey of women Veterans (n = 2302) ages 18–45 who used VA for primary care in the previous year. Our sample included women who were (1) currently pregnant or trying to become pregnant, (2) not currently trying but planning for pregnancy in the future, or (3) unsure of pregnancy intention. Multivariable logistic regression was used to examine adjusted associations of patient- and provider-level factors with receipt of any counseling about health optimization prior to pregnancy (prepregnancy counseling) and with counseling on specific topics. Among 512 women who were considering or unsure about pregnancy, fewer than half (49%) reported receiving any prepregnancy counseling from a VA provider in the past year. For those who did, the most frequently discussed topics included healthy weight (29%), medication safety (27%), smoking (27%), and folic acid use before pregnancy (27%). Factors positively associated with receipt of prepregnancy counseling include history of mental health conditions (aOR = 1.96, 95% CI: 1.28, 3.00) and receipt of primary care within a dedicated women’s health clinic (aOR = 2.07, 95% CI: 1.35, 3.18), whereas factors negatively associated include far-future and unsure pregnancy intentions (aOR = 0.35, 95% CI: 0.17, 0.71 and aOR = 0.33, 95% CI: 0.16, 0.70, respectively). Routine assessment of pregnancy preferences in primary care could identify individuals to whom counseling about health optimization prior to pregnancy can be offered to promote patient-centered family planning care.

This study aims to assess risks and carry out risk mapping in reallocating and refocusing the East Nusa Tenggara Provincial regional revenue and expenditure budgeting during the Covid-19 Pandemic. Qualitative research methods are carried out through literature studies, normative studies and prospective studies. Assessment of the scale of likelihood and impact risk for government management was carried out by 32 government internal supervisory in Provincial and District Inspectors in East Nusa Tenggara. Respondents assess, prospectively, the likelihood and impact scales of the identified risks. The results showed 25 risks of reallocating and refocusing the regional revenue and expenditure when Pademi Covid-19 was identified and analyzed. At the high-risk level, when reallocating and refocusing the budget during the Covid 19 pandemic, the PPK Region Unit Works has the task of preparing Region Unit Works financial reports. The risk of such activities is being late in preparing Region Unit Works financial reports; risk of being late in compiling budget implementation documents from the activities of Budget user officials; and the risk of an orderly general cash book made by the treasurer of receipt/expenditure. There is one risk involved at the very low level, namely inappropriate cash due to incorrectly inputting the transaction nominal; there are transactions that have not been inputted so that there is a difference; there is an advance payment which is not recorded; money used for non-operational needs.

O envelhecimento humano é um fenômeno mundial que pode ser analisado como um processo natural, contínuo, progressivo e irreversível, onde há alterações orgânicas, psicológicas e morfofuncionais. O processo de envelhecer é visto de forma diferenciada em cada cultura, podendo ser marcado por aspectos positivos e negativos, e a representação sobre envelhecimento na sociedade influencia na relação que se estabelece com o trabalho. Participaram da pesquisa, 28 produtores rurais do município de Diamantino – MT, do sexo masculino e idade entre 65 e 87 anos; 64,3% têm Ensino Fundamental Incompleto; 67,9% é casado e moram com suas esposas, e/ou filhos e/ou netos. A respeito do recebimento sócioassistencial, 50% recebem aposentadoria, 17,9% recebem algum Benefício de Prestação Continuada (BPC) e 17,9% não recebe aposentadoria e nem benefício. Os entrevistados foram divididos em dois grupos: o primeiro composto por produtores rurais cuja posse de propriedade(s) não ultrapassa 100 hectares classificado como pequeno produtor, e o segundo por produtores com propriedade(s) que totalizam mais de 100 hectares. Para a análise, utilizou-se a Teoria das Representações Sociais e o método de análise de conteúdo do discurso. A respeito do significado atribuído ao envelhecimento, foram classificadas as seguintes categorias emergentes do construto trabalho: Necessidades, Otimismo, Dignidade, Dignidade/Realização e Autodeterminação. Foi possível perceber, por meio dos relatos apresentados pelas entrevistadas, elementos significativos que possibilitaram a aproximação com a realidade de vida de cada um dos participantes, onde houveram relados sobre as dificuldades e superações relacionadas ao trabalho e vinculações com a permanência no trabalho rural.

A medical home is a model of patient-centered, comprehensive care recommended by the American Academy of Pediatrics for all children. The aims of this study were (1) to determine if the presence of a medical home is associated with improved health service outcomes of children with autism, and (2) to determine if the presence of a medical home is associated with improved key functional outcomes in children with autism. This study used data from the 2016–2017 National Survey of Children’s Health. We used a medical home construct of 14 survey questions as the main independent variable in logistic regression models estimating cross-sectional association, and also evaluated the interaction between medical home and demographic and household characteristics, including race, income, household composition, and autism severity in regression for outcomes. Overall, the presence of a medical home was associated with increased parent reporting of shared health care decision-making, receipt of preventive pediatric care, and reduced frustration in accessing services. Some functional outcomes were also positively associated with the presences of a medical home in children with parent-reported mild autism symptoms; children who had a medical home visited the ED less often than children without a medical home. This did not persist for children with moderate or severe parent-rated autism. Based on parent-reported, cross-sectional data from a large, nationally representative sample of families with a child with autism, the presence of a medical home was positively associated with some improved health services and functional outcomes.

Depression is a common problem for adults on the autism spectrum, but little is known about depression-related service receipt in this group. To understand depression diagnostic and treatment status better, we collected information on current depressive symptoms, depression diagnosis, and treatment status of 315 young adults with a childhood diagnosis of autism from the Simons Foundation Powering Autism Research for Knowledge registry. About two-thirds (65.4%) of the adults had been diagnosed with depression, and 46.7% currently met clinical cut-offs for depression on depressive symptoms measures. Among the currently depressed, the majority (83.0%) had a formal depression diagnosis. Despite being no more likely than males to be currently depressed, females (biological sex) were more likely to have received a depression diagnosis. As for depression treatment, 58.5% of currently depressed adults were currently being treated, and 68% had previously received treatment. Medication was the most common form of treatment, followed by individual therapy. Likelihood of receiving depression treatment was higher among those with a formal depression diagnosis and with higher levels of education. Adults reported several barriers to accessing treatment for depression, including financial and insurance issues, accessibility to appropriate care, and professionals’ lack of understanding about depression in autism. Lay abstract Depression is common among adults on the autism spectrum, but little is known about the extent to which these adults living in the community access diagnostic and treatment services for depression. To address this gap, we surveyed 315 adults on the autism spectrum on depression symptoms, diagnosis, and services. About half of the sample had scores on standard depression measures that suggested they were currently depressed ( n = 147, 46.7%). Among the currently depressed, most of them had received a depression diagnosis from a professional. Depressed females were about 3.5 times more likely than depressed males to have a depression diagnosis. More than half of the currently depressed adults on the autism spectrum reported receiving depression treatment at the time of the study, while about two-thirds had previously received treatment. Those with a depression diagnosis were more likely to have received treatment, and those who had some education beyond high school were more likely to be currently receiving treatment. Financial and insurance issues were the most common barriers that adults reported in accessing treatment for depression.

The article attempts to find out in the Polish archives copies of the Patriarchal and Synodal-Canonical Tomos of the Ecumenical Patriarchate dated November 13, 1924. The peculiarities of the perception of the status of this document by Polish officials (de facto – as an international agreement) are analyzed. It is determined that the term «authentic Tomos» was used both for the official public copy in Greek and for a copy of the French translation certified by the Chancellery of the Holy Synod of the Patriarchate of Constantinople. The dates of receipt of copies of the document in Poland, as well as their transfer to the Ministry of Religious Affairs and Public Education and Warsaw Metropolitan Dionizy (Valedynskiy) of have been set. The information about the place of preservation of the authentic copy in French has been checked and clarified. Evidence is given in favor of the version that the Greek copy of Tomos was kept in the Polish state archives during 1926-1939, and not in the archives of the Warsaw Orthodox Metropolis. The validity of assumptions about the fate of this copy after 1939 was assessed, in particular, the possibility of finding it in archives outside Poland. A verification of the widespread notion that a key copy of the 1924 Tomos was sent to Moscow in 1948 has been verified. The author concluded that the uncertainty as to whether the authentic copy of the Tomos 1924 has been preserved «reflects» both the vicissitudes of the struggle for autocephaly of the Polish Orthodox Church and the specifics of state-church relations in different periods.

Objetivo: analisar de que forma o contexto econômico afeta a relação entre a governança corporativa e a volatilidade das ações das companhias abertas brasileiras listadas na Brasil, Bolsa, Balcão (B3), no período de 2010 a 2018. Método: partindo-se de uma pesquisa quantitativa, descritiva e documental, utilizou-se a volatilidade das ações em base anual como métrica para volatilidade (variável dependente), mecanismos internos (estrutura de propriedade e de controle, número de membros do conselho administrativo e fiscal) e mecanismos externos (níveis de governança da B3, American Depositary Receipt e free float) como proxies de governança corporativa (variável independente de interesse) e variáveis de controle (Produto Interno Bruto - PIB e outras). Originalidade/Relevância: não há consenso em relação a como as práticas de governança corporativa afetam a volatilidade das ações, ao se considerar o contexto econômico em que se encontra o país, visto que diferentes proxies podem causar efeitos diversos perante o mercado (Li et al., 2013; Litov et al., 2006). Resultados: verificou-se que, em geral, os mecanismos internos apresentam influência significativa com relação à volatilidade das ações apenas quando analisados em conjunto com a variação do PIB, ao passo que os mecanismos externos não apresentaram influência significativa em relação à volatilidade das ações. Contribuições Teóricas/Metodológicas: amplia-se a discussão acerca da interação das práticas de governança corporativa com a volatilidade dos preços das ações das companhias abertas brasileiras, assim como dos diferentes enfoques da tomada de decisão ao se analisar os mecanismos internos e externos de governança corporativa no contexto econômico brasileiro. Objective: to analyze how the economic context affects the relationship between corporate governance and stock market volatility of Brazilian public companies listed on B3 S.A. - Brasil, Bolsa, Balcão (B3), from 2010 to 2018. Method: based on quantitative, descriptive, and documentary research, the stock market volatility on an annual basis was used as a metric for volatility (dependent variable); internal mechanisms (ownership and control structure, number of members of the administrative and fiscal council) and external mechanisms (B3 governance levels, American Depositary Receipt, and free float) such as corporate governance proxies (independent variable of interest); and control variables (Gross Domestic Product - GDP and others). Originality/Relevance: there is no consensus regarding the way that corporate governance practices affect stock market volatility, when considering the economic context in which the country finds itself, given that different proxies can cause different effects before the market (Li et al., 2013; Litov et al., 2006). Results: it was found that, in general, internal mechanisms have a significant influence in relation to stock market volatility only when analyzed together with the variation in GDP. The external mechanisms, on the other hand, did not show significant influence in relation to the stock market volatility. Theoretical / Methodological Contributions: the discussion about the interaction of corporate governance practices with the volatility in the stock market prices of Brazilian companies is broadened, as well as the different approaches to decision-making when analyzing the internal and external mechanisms of corporate governance in the Brazilian economic context.

BACKGROUND: Financial relationships between physicians and the pharmaceutical and medical device industries are common, but the factors associated with physicians receiving payments are unknown. OBJECTIVE: The objective of this study is to evaluate the influence of physicians’ professional networks’ characteristics on the receipt of payments among physicians. DESIGN: Network analysis of cross-sectional data PARTICIPANTS: US physicians who shared Medicare patients with other physicians in 2015 (N=357,813). EXPOSURE (INTERVENTION): Proportion of a physician’s professional network that received industry payments and other network characteristics including number of physician connections, how central the physician is within the network, and the tightness of the referral network in which a physician is located. MAIN OUTCOME MEASURES: Relative risk of receiving industry payments. We used modified Poisson regression to control for confounding by gender, time since graduation, practice size, and practice setting (teaching hospital vs. not). We included dummy variables for specialty and hospital referral region level. KEY RESULTS: The proportion of a physician’s peers in their professional network that received payments was strongly associated with receipt of pharmaceutical or device industry payments by the physician (top vs bottom quartile aRR=1.28, 95%CI=1.25–1.31). Physician’s centrality within a network had a small positive effect on receiving payment (top vs bottom quartile aRR=1.02, 95%CI=1.01–1.04). Network density also had a small negative association with receipt of payment (top vs bottom quartile aRR=0.97, 95%CI=0.96–0.98). CONCLUSIONS: Network characteristics, particularly the receipt of payments among physicians one shares patients with, are associated with whether a physician receives payments. This finding has implications for institutional regulation of industry payments to physicians and demonstrates how institutional policy may impact not only the physicians within the institution but also physicians outside of the institution. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11606-021-06802-9.

Transgender (trans) persons are sexually assaulted at high rates and often encounter barriers to equitable services and supports. The receipt of timely and appropriate postassault care, provided increasingly by specialized forensic nurses around the world, is critical in ameliorating the harms that accompany sexual assault. In order to adequately respond to the acute health care needs of trans clients and attend to longer term psychosocial difficulties that some experience, forensic nurses not only require specialized training but must also cultivate collaborative relationships with trans-positive health and social services in their communities. To meet this need, we describe our strategy to advance trans-affirming practice in the sexual assault context. We outline the design and evaluation of a trans-affirming care curriculum for forensic nurses. We also discuss the planning, formation, and maturation of an intersectoral network through which to disseminate our curriculum, foster collaboration, and promote trans-affirming practice across health care and social services in Ontario, Canada. Our approach to advancing trans-affirming practice holds the potential to address systemic barriers experienced by trans survivors and transform the response to sexual assault across other sectors and jurisdictions.

The purpose of this study was to determine the Acceptance and Management of Customer Funds at Bank Jateng, Magelang Coordinator Branch. This type of research is qualitative, because it puts more emphasis on the process that is taken from actual events, after which it concluded. The data in this research is the process of managing customer funds at Bank Jateng, Magelang Coordinator Branch. The data source of this research comes from an informant who was interviewed structurally. Based on the data analysis, it can be concluded that: (1) Receipt of customer funds at the Magelang Coordinator Branch Bank Jateng uses the accrual-based method. Funds received by the Magelang Coordinator Branch of the Central Java Bank can be in the form of demand deposits, savings deposits, and time deposits. These funds are collected from the community. (2) The management of customer funds at the Magelang Coordinating Bank Central Java shall use the cash-based method. Management of customer funds at Bank Jateng, the Coordinator of Magelang Branch in the form of loans, such as: Personal Loan (PLO), Small Business Credit (KUK), Multipurpose Credit, People's Business Credit (KUR), Kreditasalt Fur Wiederaufbau Credit (KFW), and additional business capital for family business activities. Keywords: qualitative; cash; personal loan; credibility alt fur wiederaufbau.

OBJECTIVE To characterize national trends and characteristics of adults with diabetes receiving American Diabetes Association (ADA) guideline-recommended care. RESEARCH DESIGN AND METHODS We performed serial cross-sectional analyses of 4,069 adults aged ≥20 years with diabetes who participated in the 2005–2018 National Health and Nutrition Examination Survey (NHANES). RESULTS Overall, the proportion of U.S. adults with diabetes receiving ADA guideline-recommended care meeting all five criteria by self-report in the past year (having a primary doctor for diabetes and one or more visits for this doctor, HbA1c testing, an eye examination, a foot examination, and cholesterol testing) increased from 25.0% in 2005–2006 to 34.1% in 2017–2018 (P-trend = 0.004). For participants with age ≥65 years, it increased from 29.3% in 2005–2006 to 44.2% in 2017–2018 (P-trend = 0.001), whereas for participants with age 40–64 and 20–39 years, it did not change significantly during the same time period: 25.2% to 25.8% (P-trend = 0.457) and 9.9% to 26.0% (P-trend = 0.401), respectively. Those who were not receiving ADA guideline-recommended care were more likely to be younger, of lower socioeconomic status, uninsured, newly diagnosed with diabetes, not on diabetes medication, and free of hypercholesterolemia. CONCLUSIONS Receipt of ADA guideline-recommended care increased only among adults with diabetes aged ≥65 years in the past decade. In 2017–2018, only one of three U.S. adults with diabetes reported receiving ADA guideline-recommended care, with even a lower receipt of care among those

High levels of coverage with safe and effective immunizations are critical to the successful control and prevention of vaccine-preventable diseases worldwide. In addition to stringent standards to regulate the safety of vaccines, robust postlicensure monitoring systems help ensure that the benefits of vaccines continue to outweigh the risks for the populations who receive them. National Expanded Programmes on Immunization (EPI) are typically responsible for identifying and investigating adverse events following immunization (AEFI), including assessment of causality. National regulatory authorities (NRAs) are mandated to perform postlicensure surveillance of adverse drug reactions, including those associated with receipt of vaccines. This report describes global progress toward meeting World Health Organization (WHO) indicators on minimal country capacity for vaccine safety surveillance and coordination of AEFI reporting between countries' EPI and NRAs. In 2019, among 194 countries, 129 (66.5%) reported having an operational national AEFI causality review committee, compared with 94 (48.5%) in 2010. During 2010-2019, the proportion of countries reporting ≥10 AEFI per 100,000 surviving infants per year (an indicator of country capacity to monitor immunization safety) increased, from 41.2% to 56.2%. In 2019, however, only 46 (23.7%) countries reported AEFI data from both EPI and NRAs. Although global progress has been made toward strengthening systems for vaccine safety monitoring over the past decade, new indicators for monitoring global immunization safety performance are needed to better reflect program functionality. Continued global efforts will be vital to address barriers to routine reporting of AEFI, build national capacity for AEFI investigation and data management, and improve sharing of AEFI data at national, regional, and global levels.

Purpose The purpose of this study was to investigate the rates of referral to and receipt of acute and long-term services and identify factors that could impact these rates for children who experienced an acquired brain injury (ABI) during early childhood who are now in elementary and middle school. Method This was a retrospective chart review and prospective phone survey of 29 caregivers of children with ABIs. Results Acutely, two thirds of this sample received hospital-based rehabilitation services, but only 44.8% of families reported receiving ABI-specific education or a referral to educational or rehabilitation services at the time of discharge. At an average of 8.5 years postinjury, children in this sample were largely reported to be performing positively in school. While special education rates did not change significantly over time, 20.7% of the sample reported having unmet educational needs. Additionally, service receipt decreased over time. Various injury and educational factors influenced rates of long-term special education and service receipt. Conclusions This study contributes to the emerging literature focusing on long-term outcomes of children with ABI. The results reinforce that children who experience an ABI in early childhood are unlikely to receive ABI-specific education or referrals to educational and rehabilitation services during their acute-care stay and, in the chronic stages of recovery, present with educational and therapy needs that can go unmet. To improve long-term service access for children who experience an early ABI, pathways need to be established within the acute-care setting for education and referrals that connect the child and family to treatment within early intervention and educational systems. Maintaining these pathways long term, particularly for potential social-behavioral and cognitive-communication concerns, could increase access to appropriate services and, thus, decrease unmet needs for children with ABI.

The article is devoted to the partnership of social workers and ombudsmen as an influential tool for the citizens' rights protection. The common aspects of professional activity of social workers and ombudsmen in the citizens' rights protection of Ukraine and European countries are analyzed. Analyzed the annual reports of the National Ombudsman, clarified the dynamics of the receipt of citizens' reports about violations of their rights. There is a growing number of human rights violations in the field of social protection. The ombudsman has the right to make recommendations to the central executive bodies, which are ripe after the monitoring visits. Through the activities of social workers and the ombudsman, the state assumes the main functions of ensuring human rights in the social sphere. Foreign experience on the significant role of «natural allies» (social workers and ombudsmen) in drafting a formal protocol of strategic and tactical cooperation to optimize the residents' interests based on a friendly advisory approach have been highlighted. Most often, social workers and ombudsmen are forced to act as intermediaries between people and the state or other bodies to uphold justice and provide protection in cases where measures taken by the state in the interests of society as a whole threaten the rights and freedoms of individuals or groups. There is a need to intensify cooperation between the ombudsman's offices, social protection departments and social service providers (for example, through the joint Commissions on the quality of social services establishment, joint investigations into unsatisfactory social or medical care complaints). It seems relevant to expand the positions of specialized ombudsmen (for social protection (security), military ombudsman) as independent officials in communities (municipalities) for Ukraine.

Purpose Colorectal cancer (CRC) is increasing in South Korea due to westernized eating habits and regular health check-ups. The Korean Health Insurance Review and Assessment Service (HIRA) has conducted a national quality assessment of the treatment of CRC. This study examined the quality assessment report of the Korean HIRA and analyzed the status of practice pattern and the epidemiology of CRC in South Korea.Materials and Methods The number of subjects was determined based on the number of surgical procedures in each institution during 2012-2017. The institution types were classified according to the number of beds and the composition of oncologic specialists. Twenty-one indicators for diagnosis, chemotherapy, radiotherapy, surgery, pathology, and mortality were analyzed and the interinstitutional variation for each indicator was calculated.Results Among 21 evaluation indices, indicators related to medical records, receipt of chemotherapy with a high coefficient of variation of ≥ 0.1% were improved over 6 years until the survey in 2017. In the analysis of indices affecting surgical mortality, the regional lymph node resection and examination rate (p=0.022) showed a negative correlation with surgical mortality. Hospitalization stay (p < 0.001) and hospitalization cost (p=0.002) were positively correlated with surgical mortality.Conclusion This study showed that the treatment quality and examination status for CRC in South Korea were appropriate for improving relevant medical records, receipt of chemotherapy, maintaining the quality of treatment, and mortality. These analyses could be the basis for developing an improved quality assessment program worldwide.

Tourism receipt through visitors' spending is one of the contributors that stimulate the local economy. Therefore, it is crucial to determine the factors influencing these spending preferences. This study determines factors and average spending on accommodations using segmentation techniques for Perhentian Island's visitors. Determinant factors include demographic, trip-related, and psychographic characteristics. Data were collected through a survey and run for 929 visitors using two-step Chi-Square Automatic Interaction Detection (CHAID) analysis. The analysis produces a three-level regression tree and later a classification tree. The findings documented that, level 1 consisted of four segments and were segmented according to the country of origin (COO). Overall, the Italian is a segment that has the highest average spending. The fourth segment of level 1, namely Malaysia, branched out further to level 2 and level 3. These levels were segmented based on the number of dependents during the trip and length of stay, respectively. For domestic visitors, Malaysian with dependents on the trip spend the highest. Based on the results, recommendations for the Perhentian Islands accommodation operator were to provide infrastructure to accommodate families for domestic market and marketing strategy that target Italians for the international market. The results could also assist local authorities outlining tourism planning.

The research method used in this study is explanatory research. The population in this study was all employees at PT. X Home and Brach Office. Data collection techniques used in this study was using questionnaires with a total sample of 60 respondents. The program used in analyzing data uses SPSS Version 24. Based on the result of the study, it shows that Account Receivable Internal Control and Accounts Receivable Receipt Effectiveness is included in the good category. The result of the study also showed that account Receivable Internal Control in contributing to Accounts Receivable Receipt Effectiveness’s 30.1%. So the higher the Account Receivable Internal Control was, the Higher the Accounts Receivable Receipt Effectiveness.

We aimed at assessing the health-related quality-of-life (HRQoL) of refugees and asylum seekers in Northern Greece. The SF-36 Health Survey was used to assess participants’ HRQoL. Participants were contacted in person. Correlation and dependence tests were employed to examine the association of participants’ demographic, residence-related and medical-related characteristics with the two SF-36 component (physical-PCS/mental-MCS) scales. Regressions were conducted to investigate the effect of these characteristics on component scales. Refugees and asylum seekers (n = 161) living in urban apartments and camps in Northern Greece participated in the study reporting poor HRQoL (PCS = 43.9, MCS = 39.5). Age, gender, duration of stay, benefits offered by Non-Governmental Organisations (NGOs), type of accommodation, suffering from a serious health problem and receipt of medication were associated with HRQoL. This study constitutes the first research assessing HRQoL of refugees and asylum seekers in Northern Greece.

The study aims to analyze impact of Lady Health Worker program on use of maternal health services in community with a lady health worker. The main focus was the rural districts of Sindh for this case study. The maternal health service is determined by at least four Antenatal care (ANC) visits provided to mother and receipt of at least two Tetanus Toxoid (TT) injections to mother during pregnancy. These have direct impact on maternal mortality rate and infant mortality rate. Secondary data pertaining to all districts of Sind for three years (2017-2019) was collected from the Sindh Lady Health Worker program office Hyderabad for analysis purpose. Further secondary data of Pakistan Demographic and Health Survey (2017-18) was also used to see the impact of intervention of LHW program implemented by Ministry of Health Pakistan in 1994 and then devolved to provinces after the implementation of 18th Constitutional Amendment in 2010. The study found that the services provided by the lady health workers in communities in these districts has positively influenced the uptake of maternal health services as determined by the variables like antenatal visits by pregnant mothers to nearest health facilities and receipt of Tetanus Toxoid injection during pregnancy.

Background Polypharmacy raises the risk of drug-drug interactions and adverse events among patients with cancer. Most polypharmacy research has focused on adults age 65 or older enrolled in Medicare insurance. To better inform pharmacy practice and cancer care delivery, data are needed on polypharmacy among commercially insured patients with cancer and those younger than 65. Methods We performed a retrospective analysis of insurance enrollment and claims files linked to the Puget Sound Cancer Surveillance System for adults age 18 and older who were commercially insured, diagnosed with stage IV cancer, survived 30+ days after diagnosis, and did not enroll in hospice. We describe the prevalence of polypharmacy, chemotherapy use, and medication-related out-of-pocket (OOP) costs in the last month of life. Results Of 606 patients, 390 (64%) experienced polypharmacy (i.e. 5+ medications) in the last 30 days of life. Almost half (n = 297, 49%) received chemotherapy or targeted agents; chemotherapy was associated with significantly higher odds of polypharmacy (odds ratio (OR) 2.93, 95% confidence interval (CI) 2.04–4.20). The most commonly prescribed medications at end of life were opioids, benzodiazepines and anti-emetics. Among 484 patients (80%) incurring medication-related costs in the last month of life, median total OOP cost was $82 (interquartile range $30–$200). Seven patients (1%) had total costs above $5,000. The median chemotherapy-related OOP cost was $446 (IQR $150–$1896); 32 patients (7%) had chemotherapy-related OOP costs between $1,000 and $5,000. Conclusion Most patients with advanced cancer experienced polypharmacy at end of life, although most medications observed herein are commonly used for supportive care. Patients receiving chemotherapy had higher medication-related OOP costs, and chemotherapy was significantly associated with polypharmacy at end of life. Evaluation of polypharmacy at end of life may represent an important opportunity to improve quality of life and reduce costs for patients and families.