Allocation Criteria Research Articles

Allocation of Scattered Teeth From a Batavia 1629 Communal Grave

ABSTRACTWhen the Dutch ship Batavia wrecked in 1629 on Morning Reef in the Houtman Abrolhos Islands off the coast of Western Australia, most of the passengers and crew survived the wreck, but about 200 of the survivors later perished on and around Beacon Island where they had landed after the wreck. As many as 81 bodies may be buried on Beacon Island and 21 bodies have been excavated to date. During the 2017–2018 excavations, seven of the buried individuals were excavated from a communal grave. During the excavation, 18 teeth were found scattered in the soil around the bodies. A systematic method is presented to allocate isolated teeth to their appropriate skeleton using tooth morphology and tooth wear as the primary criteria for allocation. Tooth wear must be similar to the adjacent and opposing dentition before the tooth is considered for allocation. If the wear is similar, the tooth is gently fitted into the proposed tooth socket. The fit of the tooth in the tooth socket is visually assessed, and if close, the tooth is radiographed in situ to confirm the allocation. Each separated tooth must be tested in all the sites to which it is appropriate. If a tooth fits more than one site, it cannot be allocated. Use of this method allowed allocation of 10 separated teeth in 28 possible sites. The possible cause of the separation of teeth from the skeleton is discussed.

The relative importance of severity and rarity criteria in health resource allocation: an umbrella review.

The primary objectives of this umbrella review were to (a) quantify the relative importance, of "severity" and "rarity" criteria in health resource allocation; and (b) analyze the contextual factors influencing the relative importance. The secondary objective was to examine how "severity" and "rarity" criteria are defined. Searches were carried out in PubMed and Embase to identify eligible systematic reviews. Quality appraisal of systematic reviews was undertaken. From identified systematic reviews, primary studies were extracted and further screened for eligibility. The inclusion of severity and rarity criteria and their respective weights in primary studies were examined. Descriptive and regression analyses were performed. Twenty-nine systematic reviews were screened, of which nine met the inclusion criteria. Primary studies included in these systematic reviews were retrieved and screened, resulting in forty articles included in the final analysis. Disease severity was more frequently considered (n=29/40) than disease rarity (n=23/40) as an evaluation criterion. Out of all cases where both were included as evaluation criteria, disease severity was assigned higher weights 84 percent of the time (n=21/25). Our review found consistent evidence that disease severity is more relevant and preferred to rarity as a priority-setting criterion albeit constraints in statistical analysis imposed by limited sample size and data availability. Where funding for rare diseases is concerned, we advocate that decision-makers be explicit in clarifying the significance of disease severity and/or rarity as a value driver behind decisions. Our findings also reinforce the relevance of disease severity as a criterion in priority setting.

Task Allocation and Sequence Planning for Human-Robot Collaborative Disassembly of End-of-Life Products Using the Bees Algorithm.

Remanufacturing, which benefits the environment and saves resources, is attracting increasing attention. Disassembly is arguably the most critical step in the remanufacturing of end-of-life (EoL) products. Human-robot collaborative disassembly as a flexible semi-automated approach can increase productivity and relieve people of tedious, laborious, and sometimes hazardous jobs. Task allocation in human-robot collaborative disassembly involves methodically assigning disassembly tasks to human operators or robots. However, the schemes for task allocation in recent studies have not been sufficiently refined and the issue of component placement after disassembly has not been fully addressed in recent studies. This paper presents a method of task allocation and sequence planning for human-robot collaborative disassembly of EoL products. The adopted criteria for human-robot disassembly task allocation are introduced. The disassembly of each component includes dismantling and placing. The performance of a disassembly plan is evaluated according to the time, cost, and utility value. A discrete Bees Algorithm using genetic operators is employed to optimise the generated human-robot collaborative disassembly solutions. The proposed task allocation and sequence planning method is validated in two case studies involving an electric motor and a power battery from an EoL vehicle. The results demonstrate the feasibility of the proposed method for planning and optimising human-robot collaborative disassembly solutions.

Towards a Standardized LCOE Calculation for Informed Decision-Making in Energy Policy and Investment: Application to the Colombian Context

The Levelized cost of electricity - LCOE represents a constant cost per unit of generated electrical energy, resulting from the analysis of the total costs throughout the life cycle of a generation plant. Its widespread use, thanks to its simplicity of calculation and potential of standardization, has made it one of the primary criteria for comparing electricity generation technologies. However, in the pursuit of simplification and generalization, certain aspects associated with the socioeconomic context of the region, as well as accounting and financial concepts, are excluded due to externalities or incentives related to regulatory and fiscal policies. These exclusions affect the accuracy of LCOE and introduce uncertainty when using it as a criterion for investment decision-making or allocation of public resources for the development of renewable sources. This article proposes a clear and standardized methodology for calculating LCOE, which allows for a fair and precise comparison of renewable energy generation options in rural areas. It contributes to informed and transparent decision-making in the fields of energy policy and public investment for expanding electricity service coverage. The proposed methodology is based on the financial cash flow matrix to address variability sources in the calculation, considering the local context of the generation project.

The Financial Model for Water and Sanitation Services in Portugal: Lessons from Decades of Subsidies and Questionable Public Policies

Despite the billions of euros used as subsidies over recent decades, Portugal’s water sector continues to struggle, being characterized by significant inefficiencies and differences between high- and low-performing water and sanitation services (WSSs). Current subsidy policies lack transparency and are not linked to performance results, undermining efforts to promote efficiency and sustainability in both environmental and financial dimensions. To address these issues, this article highlights relevant aspects to be taken into account in the redefinition of funding allocation in the Portuguese WSS sector. By implementing performance-based criteria for subsidy allocation and prioritization, regardless of the identity of beneficiaries or providers, we aim to instigate accountability and efficiency in this process. The analysis draws on empirical data to highlight the shortcomings of existing practices and demonstrates the potential benefits of adopting the “user-pays” principle. This principle is able to improve the definition of tariffs aiming for full cost recovery, while still providing for disadvantaged and vulnerable customers through social tariffs or assistance programs. Key findings indicate that coordinated efforts among government agencies, regulators, public and private utilities, and municipalities are essential to develop and promote effective financing strategies. This stakeholder’s cooperation is essential for managing the urban water cycle sustainably and addressing the sector’s long-term challenges. This research implies that a strategic shift in subsidy allocation is required, to develop accountability, efficiency, and equity in the WSS sector. The allocation of financial resources must be better justified to enhance overall performance in the sector.

Personal responsibility for health in Bulgarian public health law and social legislation

BackgroundIn the last decades all health systems have experienced a lack of resources. Against this background, the idea of ​​applying personal responsibility of the patient as a criterion for allocation of resources (PRCAR) is gaining increasing attention. Bulgarian healthcare reform has been marked by the implementation of many new strategies, that grounded our scientific interest towards investigating PRCAR in Bulgarian public health law and social legislation.MethodsThrough a search of national legal databases 7 documents were selected and subjected to content analysis.ResultsProspective responsibility was found in two and retrospective responsibility - in three documents, two of which imposed explicit penalties on the patient. Two documents did not distinguish between the types of patient responsibility. PRCAR was found to be controversial through the prism of the social justice principle. The discussion was conducted through the perspectives of evidence translation of research to law, particularities of social cohesion in Bulgaria, and the interpretation of principles of public health ethics.ConclusionAlthough PRCAR was traceable in Bulgarian legislation, no supporting arguments for its introduction were deduced. The applicability of PRCAR should be further studied and wider public debate should be initiated.

Factor analysis of risk allocation criteria (RAC) in public-private partnership (PPP) projects: A case of New Zealand

The utilization of Public Private Partnerships (PPPs) has become widely prevalent as an innovative approach for procuring public infrastructure projects. Risk transfer/allocation is one of the main reasons for this widespread adoption and considered a critical success factor for a PPP. Given the importance of equitable risk allocation, this study identified and analysed 10 key risk allocation criteria. Experts with experience in PPP projects in New Zealand were surveyed through an empirical questionnaire to obtain industry-wide data. Mean score analysis and factor analysis were then used to analyse the collected data. In order to ensure the validity of the analysis results, appropriate statistical tests such as Cronbach’s Alpha, Kaiser-Meyer-Olkin (KMO) statistic and Bartlett’s test of Sphericity were conducted. Result indicate that the most important criteria for risk allocation are “risk foresight”, “minimize risk loss” and “response to risk”. Furthermore, factor analysis showed that the identified RAC can be classified into three component groups namely “risk management expertise”, “core risk management capability” and “risk management strategy”. This study aims to provide PPP stakeholders with useful insights into the most effective measures for achieving equitable risk allocation. To achieve this, the study recommends to consider the risk management capabilities of both the public and private sectors in light of the identified RACs/groupings. The results of the study are expected to assist PPP stakeholders in developing strategies that can enhance risk management and achieve a fair distribution of risks.

On the Different Fair Allocations of Economic Benefits for Energy Communities

Energy Communities (ECs) are aggregations of users that cooperate to achieve economic benefits by sharing energy instead of operating individually in the so-called “disagreement” case. As there is no unique notion of fairness for the cost/profit allocation of ECs, this paper aims to identify an allocation method that allows for an appropriate weighting of both the interests of an EC as a whole and those of all its members. The novelty is in comparing different optimization approaches and cooperative allocation criteria, satisfying different notions of fairness, to assess which one may be best suited for an EC. Thus, a cooperative model is used to optimize the operation of an EC that includes two consumers and two solar PV prosumers. The model is solved by the “Social Welfare” approach to maximizing the total “incremental” economic benefit (i.e., cost saving and/or profit increase) and by the “Nash Bargaining” approach to simultaneously maximize the total and individual incremental economic benefits, with respect to the “disagreement” case. Since the “Social Welfare” approach could lead to an unbalanced benefit distribution, the Shapley value and Nucleolus criteria are applied to re-distribute the total incremental economic benefit, leading to higher annual cost savings for consumers with lower electricity demand. Compared to “Social Welfare” without re-distribution, the Nash Bargaining distributes 39–49% and 9–17% higher annual cost savings to consumers with lower demand and to prosumers promoting the energy sharing within the EC, respectively. However, total annual cost savings drop by a maximum of 5.5%, which is the “Price of Fairness”.

A study on the introduction of mixed payment compensation system through top-down cost information analysis in Korea

This study aims to identify the problems of the Korean health insurance fee system and to suggest a reasonable insurance fee construction alternative using the cost analysis data of hospitals. To this end, the characteristics of the medical fee payment system and hospital cost analysis were examined, and the cost data of one national public general hospital were used for the analysis. The cost allocation criteria were divided into labor costs, material costs, pharmaceutical costs, equipment costs, and overhead costs, and a top-down cost analysis was conducted. The analysis results showed that the cost was greater than the income in the case of outpatient and inpatient treatment performance, and the analysis results on the amount of physician workload showed that the relative value of physician workload calculated based on the cost was analyzed to require an increase of 1.52 times for hospitalization fees and 1.72 times for examination fees. The main factor affecting the cost compensation rate was that when the proportion of examination fees was high, the cost compensation level increased, while on the other hand, the cost compensation rate decreased as the proportion of physician labor costs increased or the length of stay increased. In order to resolve the ongoing complaints of medical service providers under the current fee-for-service system and secure the appropriateness of health insurance compensation rates, compensation for physician fees should be induced to realize the level of cost compensation through cost-based, per-service fee calculations, and the rationality of the payment compensation system can be secured by securing autonomy of providers through bundled fees for hospital costs and changing the payment method.

Factors Associated with Waitlist Time on Liver Transplantation

Objectives: Liver transplantation (LT) is the main therapy for patients with cirrhosis or fulminant liver failure. However, there is a disproportion between the demand and availability of organs, such that the waitlist mortality ranged from 20 to 38% when the only allocation criterion was the time of inclusion on the waitlist. Brazil then adopted the Model for End-stage Liver Disease (MELD) score, aiming to prioritize patients with a higher risk of death for LT. !erefore, this study aimed to determine factors associated with waitlist time for LT. Methods: Retrospective cohort study of adult patients listed for LT from October 2012 to December 2019 in a single state in Brazil. Results: !e study analyzes 1,262 patients (869 males, 68.91%; median age, 53.33 ± 11.48 years; median waitlist time, 103.88 ± 162.05 days; median MELD Sodium [MELD-Na] score of 22.41 ± 6.09). Alcoholic liver cirrhosis (n = 369; 29.24%) and chronic viral hepatitis (n = 295; 23.38%) were the most prevalent reasons for LT. Blood groups O (n = 534; 42.31%) and A (n = 474; 37.56%) prevailed among the recipients. !e state capital and its metropolitan region accounted for 91.20% (n = 1,151) of all liver transplants performed. Most donors were deceased (n = 1,258; 99.68%). Patients with MELD-Na scores > 21 (p < 0.001), non-O blood group (p = 0.002), age < 53 years (p = 0.003), and those listed ≥ 2017 spent ≤ 30 days on the waitlist (p < 0.001). Conclusion: A waitlist period of ≤ 30 days was associated with higher MELD-Na scores, younger ages, non-O blood groups, and LT listings before 2017.

Acute Kidney Injury after Liver Transplantation

Abstract Liver transplantation is the only curative treatment for terminal liver failure. Advances in immunosuppressive therapy and improvements in surgical techniques have improved patient survival in the post-transplant period. At the same time, however, the incidence of late complications is increasing, which has been contributed to by the broadening of the indication criteria in liver allocation. The most common complications include chronic kidney disease, the aetiology of which is multifactorial with a predominance of calcineurin inhibitor toxicity in the post-transplant period. The prevalence ranges from 30% to 90% depending on the definition used and the methodology used to measure renal function. Early detection of risk factors and early intervention lead to a significant improvement in the quality of life of recipients in the post-transplant period.

Determination of Accommodation Tax Spending Areas Using the SWARA Method

The allocation of revenue generated from the accommodation tax, which has recently been introduced in Türkiye, has not been specified within the framework of the law. In this context, the aim of the research is to determine the spending areas and establish priority ranking for the tax collected from tourists. In this regard, data was collected using a survey form consisting of 20 criteria and analyzed using the SWARA method. Upon examining the research findings, the highest average criteria for allocation are financing activities, improving infrastructure and superstructure services, preserving and restoring natural and cultural heritage sites, investing in destination marketing efforts, maintaining museums, and creating recreation activity areas. The lowest average criteria, on the other hand, include supporting projects for refugee integration, providing holiday support to disadvantaged groups, and offering campaigns for public transportation services. As a result of the research, participants indicated that the tax revenue should be allocated to creating permanent structures, restoration and maintenance efforts, and areas related to destination marketing rather than campaigns, projects, or aids that would directly benefit tourists, local residents, or refugees.

Contemporary Bridge to Heart Transplantation With Venoarterial Extracorporeal Membrane Oxygenation.

Objective: In October 2018, the United Network for Organ Sharing changed their heart allocation criteria to prioritize patients on temporary mechanical circulatory support. This study assesses outcomes of patients bridged to orthotopic heart transplantation (OHT) with venoarterial extracorporeal membrane oxygenation (VA ECMO) since this change. Methods: We conducted a retrospective single-center study of adults (≥18 years) supported with VA ECMO at the time of OHT (October 1, 2018, to December 31, 2021). The primary outcome was midterm survival. Results: During the study period, 117 patients underwent OHT including 52 adults ≥18 years (44%) and 65 children <18 years (56%). Among adults, 8 (15%) were supported with VA ECMO at the time of OHT and are included in this study; 75% were male (n = 6), and the median age was 52.5 (interquartile range [IQR] = 23.5 to 57.25) years. Most patients were peripherally cannulated (75%, n = 6) and supported with an intra-aortic balloon pump during the pretransplant period (87.5%, n = 7). The median ECMO duration was 7 (IQR = 4.5 to 25.25) days. Three patients experienced complications on ECMO (37.5%), including thromboembolic bowel infarction (12.5%, n = 1) and bleeding requiring reintervention (25%, n = 2). All patients survived to discharge without posttransplantation complications and were alive at the latest follow-up. The median follow-up time was 24.8 (IQR = 19.5 to 28.2) months. Conclusions: Patients can be successfully bridged with VA ECMO directly to OHT with excellent midterm results. Key contributors to our outcomes include early extubation, use of bivalirudin over heparin, ambulation, and rehabilitation while on ECMO.

Minimizing Misconceptions: Designing an Electrical and Magnetic Syllabus for Prospective Elementary School Teachers Using Predict Observe Explain-Conceptual Change Text (POE-CCT)

This study aims to 1) Obtain empirical data on the needs analysis for developing electrical and magnetic learning devices using the Predict-Observe-Explain (POE) approach assisted by Conceptual Change Text (CCT), and 2) Gather comprehensive information on designing a syllabus for electricity and magnetism using POE assisted by CCT. This qualitative research focuses on the define and design stages of the 4D model and involves 30 second-semester students from the Elementary School Teacher Education Study Program, including 6 men and 24 women, enrolled in the Basic Science Concepts course. Data collection methods included interviews to develop and validate a product based on needs analysis, such as graduate learning outcomes related to the course, relevant study materials, learning methods, time allocation, learning resources, references, learning media, and assessment criteria. The data was analyzed using content analysis techniques. The findings of this study confirm that 1) A learning tool using the POE-CCT approach is necessary to reduce misconceptions among prospective elementary school teachers, particularly in understanding the domains of electricity and magnetism, which are conceptually complex. The designed syllabus aims to address these misconceptions by incorporating POE learning tools assisted by CCT. This includes stages where students predict outcomes and reasons, observe and record their findings, and explain their observations followed by class discussions. 2) The syllabus development stage, based on needs analysis, results in POE learning tools with CCT assistance that promote independent prediction, observation, and explanation. This structured approach enhances active engagement, deeper understanding, and conceptual refinement through collaborative discourse, promising improved comprehension and retention of complex scientific concepts in the classroom.

How to control China's total amount of carbon emissions? An analysis of provincial allowance demands

Establishing a total amount control system for carbon emissions is crucial for China to achieve its carbon peak and neutrality targets. Given the heterogeneity among provinces, it is essential to consider provincial demands for carbon emission allowances (CEA) when allocating China's total amount target of carbon emissions. By identifying provincial preferences for different allocation criteria (equality, responsibility, capability, and efficiency), this study proposed a CEA allocation scheme that contributes to achieving China's 2030 carbon emission target with the least compromise among provinces. The results show that emission reduction efforts vary widely across provinces under any single-criterion scheme. Preferences for allocation criteria diverge among provinces, with a notable preference towards responsibility and equality. However, adhering to provincial expectations for CEA could jeopardize the attainment of national emission reduction target. The least-compromise allocation scheme integrates various criteria while weighting them differently: equality (0.42), responsibility (0.28), efficiency (0.16), and capability (0.14). Considering the varying pressure for emission reduction among provinces, it is vital to formulate differentiated policies and measures.

Ethical prioritization of critical care resources during COVID-19: perspectives from Italy and the United States.

This article examines some of the ethical challenges of prioritizing intensive care resources during the Covid-19 pandemic by comparing the Italian and United States contexts. After presenting an overview to the clinical, ethical, and public debates in Italy, the article will discuss the development of triage allocation protocols in United States hospitals. Resource allocation criteria underwent increased scrutiny and critique in both countries, which resulted in modified professional and expert guidance regarding healthcare ethics during times of emergency and resource scarcity.

Listening to Stakeholders' Voices on Funding Social Inclusion in Sport for People with Disabilities-Proposal for Criteria.

The value of sport is extensively documented; however, there are still groups who do not have the opportunity to enjoy the benefits of sport due to lack of investment, particularly important for people with disabilities. A gap persists in understanding the effectiveness of inclusive sport programs in addressing equity-related targets, particularly on the effective methods of financing inclusion in sport for individuals with disabilities. Therefore, providing a platform for stakeholders to express their perspectives becomes crucial. Through focus groups and the World Café approach, the aim of this study was to gather insights from athletes, parents, professionals, and sport club managers regarding the funding of inclusive sport for people with disabilities. A total of 72 participants took part in nine focus groups in Portugal, Slovenia, and Hungary: 27 athletes with disabilities, 22 coaches, other technicians and parents, and 23 club managers/directors. Findings were divided into five topics: (1) perspectives on current funding satisfaction; (2) perspectives on sources and criteria for funding; (3) perspectives on ideal funding; (4) perspectives on ideas to reach decision-makers; and (5) proposals on ideal criteria for funding. Based on these findings, six measurable criteria for fair funding allocation were suggested that could develop a properly weighted system of criteria for decision-makers to assess the allocation of funding among inclusive sport organizations with the potential to catalyze broader policy and societal changes. Additionally, there is a pressing need to develop a funding model for inclusive sport for individuals with disabilities.

Alleinerziehende in der Betreuungsplatzvergabe: Status quo und Handlungsempfehlungen

Abstract Single parents and their children benefit particularly from early childhood education and childcare programmes. Nevertheless, almost a third of single parents in Germany who need childcare for their children under the age of three are unable to find it. Although around 70 % of day care providers claim to take the single-parent criterion into account when allocating slots, the prevailing allocation procedures cannot guarantee that this is implemented. This article shows how transparent allocation criteria can be designed nationwide and how their implementation can be realised through suitable, centralised, municipal allocation systems. Particularly in (western) German regions with a high unmet demand for institutional childcare, single-parent status should be considered as an independent criterion in addition to other factors such as employment and child age.

Needs assessment in long-term care: expression of national principles for priority setting in service allocation

BackgroundLong-term care services for older adults are characterised by increasing needs and scarce resources. Political strategies have led to the reorganisation of long-term care services, with an increased focus on “ageing in place” and efficient use of resources. There is currently limited research on the processes by which resource allocation decisions are made by service allocators of long-term care services for older adults. The aim of this study is to explore how three political principles for priority setting in long-term care, resource, severity and benefit, are expressed in service allocation to older adults.MethodsThis qualitative study uses data from semi-structured individual interviews, focus groups and observations of service allocators who assess needs and assign long-term care services to older adults in Norway. The data were supplemented with individual decision letters from the allocation office, granting or denying long-term care services. The data were analysed using reflexive thematic analysis.ResultsThe allocators drew on all three principles for priority setting when assessing older adults’ long-term care needs and allocating services. We found that the three principles pushed in different directions in the allocation process. We identified six themes related to service allocators’ expression of the principles: (1) lowest effective level of care as a criterion for service allocation (resource), (2) blanket allocation of low-cost care services (resource), (3) severity of medical and rehabilitation needs (severity), (4) severity of care needs (severity), (5) benefit of generous service allocation (benefit) and (6) benefit of avoiding services (benefit).ConclusionsThe expressions of the three political principles for priority setting in long-term care allocation are in accordance with broader political trends and discourses regarding “ageing in place”, active ageing, an investment ideology, and prioritising those who are “worse off”. Increasing attention to the rehabilitation potential of older adults and expectations that they will take care of themselves increase the risk of not meeting frail older adults’ care needs. Additionally, difficulties in defining the severity of older adults’ complex needs lead to debates regarding “worse off” versus potentiality in future long-term care services allocation.Trial registrationNot applicable.

ECMO as a bridge to heart transplantation: Insights into stratification by heart failure etiology

PurposeRevisions to the heart allocation criteria in 2018 motivated an increased use of extracorporeal membrane oxygenation (ECMO) as a bridge to transplantation. Studies have demonstrated inferior post-transplant outcomes in patients bridged with ECMO but do not account for underlying diagnosis. Our objective was to elucidate the differential impact of ECMO on outcomes by heart failure (HF) etiology. MethodsThe United Network of Organ Sharing (UNOS) database was queried for adults who underwent isolated heart transplantation after October 2018. Patients were stratified by ECMO utilization at time of transplantation, and then by HF etiology. After baseline statistical comparisons, survival analysis relied on Kaplan-Meier estimates and Cox proportional models. Results13,203 patients were included, of whom 761 (5.8%) were supported with ECMO. ECMO patients were younger (48 vs. 54 years, p<0.001), less likely to have diabetes (24% vs 30%, p<0.001), smoke cigarettes (31% vs 41%, p<0.001) or have prior cardiac surgery (29% vs. 36%, p<0.001), more likely to require dialysis (20% vs. 5%, p<0.001), and spent fewer days on the waitlist (59 vs. 190, p<0.001). After adjustment, ECMO was associated with increased mortality (HR 1.85, p<0.001) in the full cohort. After incorporating HF etiology, this increased mortality risk persisted in all subgroups except restrictive cardiomyopathy and congenital heart disease (CHD). ConclusionsOur findings illustrate that HF etiology is associated with differing outcomes when bridging with ECMO. ECMO patients with restrictive cardiomyopathy or CHD did not have increased mortality risk. With ECMO utilization increasing, these data are hypothesis-generating and serve as a basis for further studies.