Administration's Request Research Articles

Pilot to scale: Implementing a digital triage solution across a large comprehensive cancer centre.

225 Background: Princess Margaret Cancer Centre (PM) sees over 80,000 patients annually and primarily operates using an outpatient model. Historically patients use a phone/voicemail triage service to communicate with their care team between scheduled visits. Many patient queries lack critical information necessary for effective screening, assessment, and processing. In turn leading to delays or missed calls that negatively impact patient experience, system efficiency, and safety. To address these challenges, we piloted a digital triage service and subsequently implemented in sixteen clinics. This project evaluated initial adoption, usage, care patterns and satisfaction in the first 5 months post-implementation. Methods: We used human-centred service design to develop the digital triage service within the EMR (Epic). Implementation strategies to scale across all outpatient clinics included leadership buy-in, co-design with key stakeholders, a phased implementation approach, and improvement cycles. To evaluate initial adoption, usage and care patterns, we used EMR system data. To assess patient satisfaction, we surveyed patients who used the service during the first three months. We conducted semi-structured interviews with staff to understand their experience integrating digital triage into their workflow. Results: Following the go-live period, patients sent an average of 1096 digital requests per month, representing 16% of all triage requests (phone + digital). The most common requests were symptom management (36% of nursing requests) and appointment change requests (40% of administrative requests). The algorithm automatically routed 93% of requests to the most appropriate care team member, compared to 74% pre-implementation. When asked if they were satisfied with their experience, most patients agreed or were neutral (69% and 10%, respectively), while 21% disagreed. In semi-structured interviews, nurses and administrative staff described improved efficiency by having triage requests integrated within the EMR, while have challenges related to prioritizing requests across multiple channels (e.g. digital, phone, others). Conclusions: Digital triage is foundational for better cataloguing and understanding our patients' unmet needs at home and between visits, enabling a continuous learning process to understand when and why people struggle throughout their care journey. Ongoing analyses will explore disease site-specific trends, compare phone to digital triage, and identify differences between users of each method. The data will inform further improvement cycles on the build and workflows, while enabling appropriate resourcing of this critical service and shifts towards proactive care.

A EXIGÊNCIA DE REQUERIMENTO ADMINISTRATIVO PRÉVIO JUNTO AO INSS PARA FINS DE CARACTERIZAÇÃO DO INTERESSE DE AGIR A LUZ DA JURISPRUDÊNCIA

This article aims to briefly discuss the requirement by Brazilian Courts of prior administrative request with the INSS for the purpose of characterizing the requirement of standing in judicial actions seeking the granting of social security benefits. To achieve this goal, research was conducted on the jurisprudence of the Supreme Federal Court, the Superior Court of Justice, and the Regional Federal Courts.

Phone triage in primary care practices

In primary care medicine for adult or pediatric populations, phone calls from patients or parents are common. The variety of questions is broad, going from simple administrative requests to life-threatening emergencies. The safety of the patient is the main priority when answering these calls. In opposition to emergency departments in hospitals where numerous well-defined triage systems (for example, Swiss Emergency Triage Scale), including clinical exam with vital signs, have been used, it is difficult to find practical guidelines for a safe and efficient phone triage in medical practices. Swiss pediatricians already use a triage book to help them assess the need for emergency care for their young patients. A similar type of resource would be helpful for a safe management of calls in adult medicine.

Phone triage in primary care practices

In primary care medicine for adult or pediatric populations, phone calls from patients or parents are common. The variety of questions is broad, going from simple administrative requests to life-threatening emergencies. The safety of the patient is the main priority when answering these calls. In opposition to emergency departments in hospitals where numerous well-defined triage systems (for example, Swiss Emergency Triage Scale), including clinical exam with vital signs, have been used, it is difficult to find practical guidelines for a safe and efficient phone triage in medical practices. Swiss pediatricians already use a triage book to help them assess the need for emergency care for their young patients. A similar type of resource would be helpful for a safe management of calls in adult medicine.

Failure of the dual orexin receptor antagonist suvorexant to engender drug discrimination in rats.

For abuse potential assessment, U.S. Food and Drug Administration (FDA) requests that new, brain-penetrating drugs are ideally compared with approved drugs that share the mechanism of action and are judged to have abuse liability by the Drug Enforcement Agency. For development of the dual orexin receptor antagonist (DORA) daridorexant, the FDA recommended conducting a rat drug discrimination paradigm against the approved, schedule IV, DORA suvorexant. Surprisingly, at suvorexant plasma levels up to three-fold the maximum concentration at the highest approved human dose, rats did not learn to discriminate the suvorexant stimulus from vehicle.

Implementasi E-Kios Dalam Mempercepat Pelayanan Publik Sebagai Inovasi Pemerintah Di Kelurahan Pradah Kalikendal Kota Surabaya

The application of E-Kios as a form of population administration service innovation which aims to make it easier for the public to carry out population administration requests is still not optimal due to problems with internal and external factors, for internal factors this service is carried out directly on the service destination website, not through the E-Kios website and in the environment. External E-Kios communication is still not running well because it only relies on poster stand displays in sub-districts, sub-district health centers and RW halls. The implementation of E-Kiosks uses Edward III's Implementation theory, namely: communication, resources, disposition and bureaucratic structure so that services using E-kiosks can be easily noticed and used effectively.

Expansion of Interpretation of Phrase of Preliminary Investigation Stages Through Systematic Interpretation as a Solution to Prejudicial Dispute

This study examined two things; the first is related to the relationship between judicial disputes, legal protection, and the role of the preliminary investigator; the second is related to the expansion of the phrase of preliminary investigation stages in the Criminal Procedure Code through systematic interpretation. This study applied normative legal research methods specified on the type of legal research for in-concreto cases. To strengthen the study, a statutory approach, a case approach, and a theoretical approach were used. The results of the study found that the actions of preliminary investigator who were limited to carrying out preliminary investigation without paying attention to cases that had a direct relationship with the cases being investigated could not yet provide legal protection, because they opened up opportunities for judicial disputes to occur. Speaking of which, judicial disputes need to be avoided through the use of systematic interpretation carried out by preliminary investigator in the preliminary investigation stages to expand the interpretation of the phrase of preliminary investigation stages in the Criminal Procedure Code and its derivative regulations. The systematic interpretation referred to is carried out in a limited manner, by simply reading opportunities for civil lawsuits and state administrative requests from parties involved in the case being investigated. In addition, it ensured the similarity of the parties involved in criminal cases as well as civil cases or state administrative cases in question.

Pelaksanaan Kegiatan Pelayanan Administrasi Kependudukan Melalui Aplikasi Klampid New Generation Di Kelurahan Genting Kalianak Kota Surabaya

The Surabaya City Population and Civil Registry Office partners with the Ministry of Education, Culture, Research and Technology in the MSIB Batch 4 program. This activity is designed for students who want to assist the Surabaya City Government in providing Population Administration services at the Population and Civil Registration Service, by going directly as a form of service to public. In MSIB activities with the Surabaya City Population and Civil Registration Service, students participate in the population administration service process through the Klampid New Generation Application. During the internship, students get 1 KNG account to help sub-district staff process population administration requests for residents of Genting Kalianak. Through this MSIB program, the author as an apprentice student hopes to be able to show a real contribution to his work in socializing the Kalimasada program to the Genting Kalianak sub-district community to create an orderly population administration society.

MÜKELLEFİN ÖZEL ESASLARA ALINMASININ MÜLKİYET HAKKI ÇERÇEVESİNDE DEĞERLENDİRİLMESİ

Katma Değer Vergisi Uygulama Tebliği ile getirilen özel esaslar, idarenin vergi alacağını güvence altına almak amacıyla uygulamaya koyduğu bir sistemdir. Bu düzenlemenin temel hedefi hazineye gelir kaydedilen vergiler içinde KDV’nin büyük bir paya sahip olması nedeniyle iade edilecek KDV tutarının hukuka aykırı olarak iadesini engellemektir. Özel esaslar uygulamasının sonuçları ilgili mükellefler kadar o mükelleflerden alış ve satışları olan mükellefleri de etkilemektedir. Bu durumdaki mükelleflerden vergi idaresi, düzeltme beyannamesi ile sahte fatura düzenleyicisi olduğu belirlenen mükelleflerden yapılan alımlara ilişkin KDV’nin indirim hesabından çıkartılmasını istemektedir. Mükelleflerin fişlenmesi olarak değerlendirilen özel esaslara alınma uygulaması birçok açıdan mülkiyet hakkının ihlali olarak değerlendirilmektedir. Mülkiyet hakkının korunması hukuk devleti açısından elzemdir. Mülkiyet hakkı, vergilendirme yetkisi ile doğrudan bağlantı kurabileceğimiz bir haktır. Çünkü ilgili kişiyi mülkiyetten, yani ödenmesi gereken para miktarından mahrum eder. Çalışmada öncelikle mülkiyet hakkının vergilendirme yetkisi ile bağlantısı değerlendirilecektir. Çalışmanın devamında ise özel esaslar uygulamasının hukuki sonuçlarının mülkiyet hakkını ihlal edip etmediği hususu AİHM kararları çerçevesinde değerlendirilecektir.

Prevalence, phenotype and medication for the pediatric inflammatory bowel disease population of a state in Southeastern Brazil.

BACKGROUNDInflammatory bowel disease (IBD) can lead to social and economic impacts worldwide. In Brazil, where its adult prevalence is increasing, the epidemiology of the pediatric population is not well known, although there is a documented increase in pediatric IBD incidence worldwide. Brazil has continental dimensions, and Espírito Santo is a state of southeastern Brazil, the region with the highest demographic densities and is the economically most important in the country.AIMTo assess the prevalence, incidence, phenotype and medications in a Southeastern Brazilian pediatric population.METHODSData were retrieved from the Public Medication-Dispensing System of the Department of Health in Espírito Santo state from documentation required to have access to highly expensive medication from August 1, 2012 to July 31, 2014. There were 1048 registered patients with IBD of all ages, and of these patients, the cases ≤ 17 years were selected. The data were obtained through the analysis of administrative requests for these medications and included medical reports, endoscopy exams, histopathology and imaging tests, which followed the Clinical Protocols and Therapeutic Guidelines of the Brazilian Government. Only confirmed cases of IBD were included in the study.RESULTSThere were 55 pediatric patients/1048 registered patients (5.34%), with Crohn's disease (CD) representing 30/55 (55%), ulcerative colitis (UC) 24/55 (43.6%) and 1 unclassified IBD, a significant difference from adult patients (P = 0.004). The prevalence of IBD in pediatric patients was 5.02 cases/100.000 inhabitants; the incidence in 2014 was 1.36 cases/100.000 inhabitants. The mean age at diagnosis was 12.2 years (± 4.2). There were 7 children diagnosed up to 6 years old, 7 between 7 to 10 years old and 41 between 11 and ≤ 17 years old. There was no difference in the distribution of UC and CD between these age categories (P = 0.743). There was no difference in gender distribution in relation to adults. Children and adolescents with UC had a predominance of pancolitis, unlike adults (P = 0.001), and used aminosalicylates and immunomodulators for their treatment. Pediatric patients with CD did not present a difference in disease location but had a higher frequency of fistulizing behavior (P = 0.03) and perianal disease phenotype (P = 0.007) than adult patients. Patients with CD used more immunomodulators and biological therapy. Treatment with biological therapy was more frequently used in pediatric patients than in adults (P < 0.001).CONCLUSIONAlthough the data from this study demonstrate that incidence and prevalence rates are low in southeastern Brazil, these data demonstrate the severity of IBD in pediatric patients, with the need for early diagnosis and therapy, avoiding serious damage.

Necessidade de prévio requerimento administrativo para propositura de ação judicial

The Supreme Court, in a recent decision, recognized the need for prior administrative request to set the interest of acting in which to propose a lawsuit. This article lists the main arguments that the rapporteur of the case, Minister Luís Roberto Barroso, used to render its decision.

Risk characterisation of milk protein contamination in milk-alternative ice cream products sold as frozen desserts in the United States

ABSTRACT Milk protein is recognised as one of the eight most common food allergens in the United States, and one of the most common causes of fatal or near-fatal food-induced anaphylactic reactions globally. Undeclared allergens in food products are the leading cause of the U.S. Food and Drug Administration (FDA) requests for food recalls, with undeclared milk protein as the most frequently cited allergen. The purpose of this study was to evaluate the prevalence of milk protein contamination in milk-alternative ice cream products sold as frozen dessert in the U.S. and labelled as ‘non-dairy’, ‘dairy-free’, and/or ‘vegan’, and to characterise the potential risk for allergic individuals consuming these products. Thirty-two unique milk-alternative frozen dessert products, including flavours with and without inclusions, from 16 different brands, were tested for the presence of milk proteins using enzyme-linked immunosorbent assay. Milk protein was detected in three of the tested products: two contained solid inclusions, and one did not have inclusions. One of the three products with detectable milk protein had an advisory statement indicating the product was made in a facility that processed milk. Although no consensus exists as to the minimal dose of milk protein necessary to elicit an adverse effect in a milk-sensitised individual, the milk protein quantities in one serving of each of the three products exceeded some of the published thresholds. These results suggest that one serving of certain milk-alternative frozen dessert products could potentially elicit an allergic response in highly sensitive individuals.

PD33-12 EVALUATION OF THE CHARACTERISTICS AND URGENCY OF HOME-CALL PAGER COMMUNICATIONS AND UROLOGY TRAINEE-PERCEPTION OF THE HOME-CALL EXPERIENCE

You have accessJournal of UrologyEducation Research V (PD33)1 Sep 2021PD33-12 EVALUATION OF THE CHARACTERISTICS AND URGENCY OF HOME-CALL PAGER COMMUNICATIONS AND UROLOGY TRAINEE-PERCEPTION OF THE HOME-CALL EXPERIENCE Katherine Fero, Thomas Gaither, Cindy Gu, Arielle Radparvar, Delaney Basile, Mostyn Fero, Karim Chamie, Steven Lerman, and Jonathan Bergman Katherine FeroKatherine Fero More articles by this author , Thomas GaitherThomas Gaither More articles by this author , Cindy GuCindy Gu More articles by this author , Arielle RadparvarArielle Radparvar More articles by this author , Delaney BasileDelaney Basile More articles by this author , Mostyn FeroMostyn Fero More articles by this author , Karim ChamieKarim Chamie More articles by this author , Steven LermanSteven Lerman More articles by this author , and Jonathan BergmanJonathan Bergman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002037.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There is a dearth of research on the subject of pager communications after-hours in the setting of home call. Without a “post-call day”, trainees who take home-call learn and work the day after being on-call. We aimed to characterize the volume and type of pages received overnight, evaluate the urgency of each communication, and report trainee perceptions of their home call experience. METHODS: Pager data was obtained for residents on home call overnight at a single academic hospital from 8/2019- 1/2020. Overnight coverage was defined as 17:00-05:00. The on-call resident is the first responder for consults and urology inpatients. The date, time, type/origin of the page was abstracted. For pages from 23:00-04:00 we prioritized the page subject. All consults were high priority, as were pages about abnormal vital signs, critical lab results and new symptoms. Low priority pages included ‘FYI’ pages about stable patients, administrative requests and questions about future orders. Residents who have rotated at this site were surveyed for their perceptions of the home-call experience. RESULTS: Over 6 months, 979 pages were received by the on-call resident overnight, corresponding to 5 pages per night. Most were regarding patients admitted to urology (56.3%), followed by patient phone calls (15.5%), inpatient consultations (14.8%), ED consultations (11.1%) and other sources (2.3%). Over half of the nights studied (57%) trainees were paged at least once between 23:00-04:00; during those hours 37.9% of pages were low priority, 18.7% medium, and 35.9% high; 7.6% were unable to be characterized. 63% of residents surveyed reported feeling overwhelmed by the volume of overnight pages at least “sometimes”. Most residents (88.9%) underestimated the number of pages received per night. CONCLUSIONS: Residents on home call are frequently paged overnight, though they underestimate the frequency likely representing normalization of receipt of pages. Most pages relate to inpatient needs, but more than a third are low priority and non-urgent. These data should be used to inform quality improvement projects and policy aimed to improve efficiency and quality of healthcare provider communication and patient care, while minimizing disruption and reducing work-related fatigue and stress. Source of Funding: KEF is supported by H&H Lee UCLA Surgical Scholars © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e581-e581 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Katherine Fero More articles by this author Thomas Gaither More articles by this author Cindy Gu More articles by this author Arielle Radparvar More articles by this author Delaney Basile More articles by this author Mostyn Fero More articles by this author Karim Chamie More articles by this author Steven Lerman More articles by this author Jonathan Bergman More articles by this author Expand All Advertisement Loading ...

The 47th Annual Meeting of the European Society for Blood and Marrow Transplantation: Physicians - Oral Sessions (O010 – O169)

Background: Axicabtagen Ciloleucel (axi-cel) is approved in Europe for the treatment of adults with R/R large B-cell lymphoma (LBCL), primary mediastinal B-cell lymphoma (PMBCL) and transformed follicular lymphoma (tFL). In Spain, nationwide CAR-T administration requests are reviewed centrally within the Ministry of Health. We analyzed the real-world outcomes of patients treated with axicel under the commercial label in Spanish centers. Methods: Six designated centers for commercial CAR-T administration collected data on behalf of GETH-GELTAMO. Data were collected retrospectively from consecutive patients in whom apheresis was performed for axi-cel treatment from Febrruary-2019 to November-2020. CRS and ICANS were graded with the ASTCT consensus criteria. Response was assessed according to the Lugano criteria. Results: 106 patients with R/R lymphoma underwent apheresis for axi-cel. At data cutoff, 92 (87%) received infusion. The reasons for not undergoing infusion were progression-related death in 12 (86%), tumor lysis syndrome in 1 (7%) and complete response after bridging therapy in 1 (7%). Of note, 14 patients were conditioned and infused during the peak of COVID-19 epidemic in Spain (March-April 2020). Median time from Ministry approval to infusion was 54 days. Histology consisted of 74% DLBCL with 11% tFL, and 15% PMBCL. Disease status at lymphodepletion was PD in 69%, SD in 22% and PR in 9%. All patients received lymphodepletion. Median time from leukapheresis to start of lymphodepletion was 34 days. Median time from leukapheresis to infusion was 39 days. Median hospitalization period was 21 days. Any grade of CRS occurred in 86% of pts (18% grade 2, 6.5% grades 3-4). Tocilizumab was used in 58% of patients who developed CRS, corticosteroids in 19%. ICANS was diagnosed in 42.5% of pts (10% grade 2, 15% grade 3-4). Treatment for ICANS included corticosteroids in 78%, tocilizumab in 31%, siltuximab in 15%, and anakinra in 21%. ICU admission was needed in 20 patients (22%). 4 patients died in the context of ICANS, 1 due to CRS, and 1 due to infection. Of 80 patients evaluable and restaged at day 30, ORR was 78% with 40% CR, 38% PR, 11% PD and 11% SD or indeterminate. Of 58 patients evaluable at day 100, 66% had ongoing response (CR 48%, PR 18%). Of 23 patients evaluable at day 180, 65% presented CR. Of 39 patients who showed PR/SD at day 30, 9 (23%) converted to CR. After a median follow-up of 6.3 months, EFS and OS were 55.5% and 78%, respectively in the infused population, with an estimated median EFS and OS of 13.1 and 7.3 months. In the intention-to-treat analysis for all patients who underwent apheresis, median estimated OS and EFS were 12.3 (95%CI 8.9-15.7) and 6.6 months (95%CI 4.6-8.5), respectively (Figure 1). Conclusions: This Spanish multicenter retrospective analysis shows encouraging results of axi-cell treatment in patients with R/R aggressive B-cell lymphoma in the real-world setting. Significant toxicity events were less frequent than those reported in the pivotal trial, however events of mortality associated to toxicity occurred. With a limited follow-up time, response outcomes are favorable.

Peningkatan Pemahaman Masyarakat Terhadap Penegakan Hukum Lingkungan di Kelurahan Lembah Sari Kecamatan Rumbai PesisirKota Pekanbaru

Enforcement of Environmental Law consists of Enforcement of Environmental Administrative Law, Enforcement of Civil Environmental Law, and Enforcement of Criminal Environmental Law in accordance with Law No. 32 of 2009 concerning Environmental Protection and Management. Law Enforcement Environmental Administration requests that those who reject the law or not meet the requirements, stop or approve the original situation (before there is a conflict). Enforcement of Civil Environmental Law is the second law enforcement effort after administrative law because it only focuses on efforts to compensate victims for environmental pollution or damage. Criminal Law Enforcement receives an ultimum remedium or final legal remedy because law enforcement here is intended to cancel a security court or a fine for those who try to pollute and / or destroy the environment. Introductory discussion with dialogue, with work procedures to support the methods offered are lectures / discussions and dialogues conducted according to the schedule requested in accordance with partner requests for improvement in the discussion of program time. In this service program, it will produce scientific articles in accordance with the proposed activity plan, while for partners is knowledge about partners is knowledge about environmental law enforcement for the community of Lembah Sari.

Cemiplimab monotherapy for first-line treatment of advanced non-small-cell lung cancer with PD-L1 of at least 50%: a multicentre, open-label, global, phase 3, randomised, controlled trial

We aimed to examine cemiplimab, a programmed cell death 1 inhibitor, in the first-line treatment of advanced non-small-cell lung cancer with programmed cell death ligand 1 (PD-L1) of at least 50%. In EMPOWER-Lung 1, a multicentre, open-label, global, phase 3 study, eligible patients recruited in 138 clinics from 24 countries (aged ≥18 years with histologically or cytologically confirmed advanced non-small-cell lung cancer, an Eastern Cooperative Oncology Group performance status of 0-1; never-smokers were ineligible) were randomly assigned (1:1) to cemiplimab 350 mg every 3 weeks or platinum-doublet chemotherapy. Crossover from chemotherapy to cemiplimab was allowed following disease progression. Primary endpoints were overall survival and progression-free survival per masked independent review committee. Primary endpoints were assessed in the intention-to-treat population and in a prespecified PD-L1 of at least 50% population (per US Food and Drug Administration request to the sponsor), which consisted of patients with PD-L1 of at least 50% per 22C3 assay done according to instructions for use. Adverse events were assessed in all patients who received at least one dose of the assigned treatment. This study is registered with ClinicalTrials.gov, NCT03088540 and is ongoing. Between June 27, 2017 and Feb 27, 2020, 710 patients were randomly assigned (intention-to-treat population). In the PD-L1 of at least 50% population, which consisted of 563 patients, median overall survival was not reached (95% CI 17·9-not evaluable) with cemiplimab (n=283) versus 14·2 months (11·2-17·5) with chemotherapy (n=280; hazard ratio [HR] 0·57 [0·42-0·77]; p=0·0002). Median progression-free survival was 8·2 months (6·1-8·8) with cemiplimab versus 5·7 months (4·5-6·2) with chemotherapy (HR 0·54 [0·43-0·68]; p<0·0001). Significant improvements in overall survival and progression-free survival were also observed with cemiplimab in the intention-to-treat population despite a high crossover rate (74%). Grade 3-4 treatment-emergent adverse events occurred in 98 (28%) of 355 patients treated with cemiplimab and 135 (39%) of 342 patients treated with chemotherapy. Cemiplimab monotherapy significantly improved overall survival and progression-free survival compared with chemotherapy in patients with advanced non-small-cell lung cancer with PD-L1 of at least 50%, providing a potential new treatment option for this patient population. Regeneron Pharmaceuticals and Sanofi.

ANALISIS EFEKTIVITAS SISTEM INFORMASI MANAJEMEN PENERIMAAN PENGELOLAAN PERMOHONAN ADMINISTRASI KEPENDUDUKAN (SIMP3AK) PADA DINAS PENCATATAN SIPIL KOTA MAGELANG

Penelitian ini bertujuan untuk mengetahui efektivitas Sistem Informasi Manajemen Penerimaan Pengelolaan Permohonan Administrasi Kependudukan (SIMP3AK) Pada Dinas Pencatatan Sipil Kota Magelang. Pengumpulan data menggunakan metode wawancara, observasi dan dokumentasi. Keakuratan data dari Sistem Informasi Manajemen Penerimaan Pengelolaan Permohonan Administrasi Kependudukan (SIMP3AK) dinilai sudah lebih akurat jika dibandingkan dengan sistem manual, karena semua data penduduk disimpan dalam data base, sehingga pada saat data penduduk dibutuhkan operator tinggal mengakses data yang telah ada. Namun masih terdapat kelemahan dari program SIMP3AK yaitu terdapat kesalahan data penduduk, kesalahan foto dengan data yang tercantum. Pelaksanaan implementasi Sistem Informasi Manajemen Penerimaan Pengelolaan Permohonan Administrasi Kependudukan (SIMP3AK) pada Dinas Pencatatan Sipil Kota Magelang sudah berjalan dengan baik, walau masih terdapat beberapa kekurangan. Diharapkan pelayanan kepada masyarakat khususnya administrasi kependudukan dapat lebih baik dan maksimal.

Senator Byrd Shepherds a Bill

Senator Byrd Shepherds a Bill Katherine A. Scott In 1974 the fifty-six-year-old senior senator from West Virginia prepared to shepherd through the Senate a bill to overhaul the congressional budget process—a project that would have long-term consequences, both for the nation and for his political future. It was a massive undertaking, and one that would require careful attention to detail and much patience. It was a challenge—that is to say, it was custom-made for Senator Robert C. Byrd. Through the late winter and early spring of 1974, as the battle among the three branches of government reached a climax in the Watergate scandal, Byrd quietly tended to the less dramatic but equally consequential work of reforming the federal budget process. He devoted months of time and energy to crafting a bipartisan solution to a problem that had plagued the legislative branch for six decades—the federal budget. Throughout the twentieth century, Congress had struggled to develop a mechanism to fund—effectively and efficiently—the exponential growth of the federal government. "I would venture to say there is no more complex, no more important legislation before this session of the Congress than [this] subject matter," Byrd remarked at a Senate hearing on January 15, 1974.1 Byrd's bill, the Budget and Impoundment Control Act of 1974, signed into law by President Richard Nixon on July 12, 1974, would help Congress to regain its position as a coequal branch of government. When Byrd embarked on this journey in late 1973, he may not have been confident that his efforts would succeed. The Senate had lost two recent battles with the executive branch over national budgets and federal spending. The first confrontation with the president came with Congress's growing opposition to America's continued involvement in the war in Vietnam. Then, as senators reluctantly acquiesced to the administration's request to raise the debt ceiling—the third such request in a calendar year—they also battled the president over his impoundment of funds. By 1974 Senator Byrd and a growing number of his colleagues had become increasingly alarmed by [End Page 37] Congress's inability to shape and implement policy through its constitutional power of the purse. Ending the War in Vietnam The first battle in this war of the budget erupted shortly after Richard Nixon became president. Though Nixon had campaigned on a pledge to end the war in Vietnam, it wasn't long before senators on the Senate Foreign Relations Committee received disturbing news. A classified Senate investigation found that while the administration was drawing down troops in Vietnam, it was expanding the war into neighboring countries—without consulting members of Congress. These developments forced some senators to take a fateful step to confront the administration. On September 16, 1969, Senator John Sherman Cooper, a moderate Kentucky Republican, offered an amendment to a military procurement authorization bill to restrict military funding the following year. "I want it clearly understood," Cooper explained when introducing his proposal, that my purpose "is to prohibit . . . the use of any funds appropriated by the Congress . . . to the Armed Forces . . . for sending our [military] into war, armed conflict, combat . . . in Laos and Thailand."2 Cooper aimed to prohibit the war's expansion by halting the flow of congressionally approved funds. He hoped his plan would force the administration to withdraw troops from the region.3 The Senate unanimously approved Cooper's amendment, 86–0, on September 17, 1969, but in conference House negotiators stripped that language from the bill. Undeterred, Cooper tried to amend another defense authorization bill a few weeks later. Joined by colleague Frank Church, a liberal Democrat from Idaho, the Cooper-Church amendment sought to limit the use of congressionally approved funds to "finance the introduction of American ground troops into Laos or Thailand."4 This amendment became law on December 29, 1969. Four months later, President Nixon announced that he had sent US ground troops into neighboring Cambodia without advising Congress. Frustrated and irate, senators denounced the action. The chairman of the Senate Foreign Relations Committee, William Fulbright, a Democrat from Arkansas, was characteristically blunt: "The Executive is conducting a constitutionally unauthorized Presidential war...

The tension between managerial and critical professional discourses in social work

Summary While managerialism is widely criticized for its deskilling effect on professional discourses, the evaluation of the power relations between managerialism and the critical professionalism that opposes it has not yet been sufficiently developed. To enable the assessment of fluctuations in these power relations, this study used in-depth interviews with 14 street-level social workers to examine the encounter between these discursive standpoints in the context of a specific case of an administrative request for critical professional programs to be implemented in the field. Findings The findings highlight the operation of recognition as a salient parameter of discursive power positions. We address three aspects of recognition—discursive, interpersonal, and institutional—and demonstrate the existence of a struggle over the acceptable professional standpoint in the institutionalized public field of social work. Applications Attention should be given to the different dimensions of recognition in order to enable the implementation of critical practice in the public field of social work. These dimensions can be addressed through broad training of various players in the field and the institutional backing of critical practice requirements.

Robotic Bureaucracy and Administrative Burden: What Are the Effects of Universities’ Computer Automated Research Grants Management Systems?

Our paper seeks to understand effects of computerized approaches to university research grants and contracts management, especially impacts on administrative burden. Ours is a multi-method paper, including interviews with academic researchers but focuses chiefly on participant-observer research, using hundreds of our own emails from two projects located at two different universities. We find that robotic emails have complex effects and that their utility pertains to researchers' familiarity with the systems and compliance requirements, the clarity of administrative requests, the extent and location of staff support, and the interaction of personal work habits with system requirements. We provide suggestions for improving automated research administration.