Mandatory Participation Research Articles

Canadian Registry of Implantable Electronic Device Outcomes: Surveillance of High-Voltage Leads

BackgroundCardiac implantable electrical devices (CIEDs) are subject to advisories and complications that can result in morbidity and mortality for patients; there is currently no system in Canada to track these. MethodsThis was a multicenter, prospective cohort study conducted at 5 centers to determine feasibility. Patients with a de novo high-voltage (HV) lead implantation were included and followed for a minimum of 1 year. ResultsThere were 611 leads enrolled into the registry over 18 months. The mean age was 62.4 ± 12.8 years; 144 (23.6%) women were enrolled. The indication for lead implantation was for primary prevention in 65.5%. There were 497 (82.1%) de novo devices (single chamber: 54.5%, dual chamber: 20.5%, cardiac resynchronization therapy [CRT] 25.0%); the remainder of the procedures was a system revision for either upgrade (8.1%) or lead revision (9.8%). The lead revision rate at 1 year was 3.4%, with the primary reason being lead dislodgements. Mortality rate was 3.8% at 1 year. The rate of any device-related complication was 2.0% at 30 days, with the highest rate in CRT implants (4.9%, P = 0.0105). At 1 year, the complication rate was 4.5%, with no significant difference among device types. ConclusionsThis study demonstrates that device surveillance is feasible and highlights (1) the need for CIED surveillance to track device-related complications, (2) the scope of this should be larger, and (3) mandatory participation should be considered. This system could predict CIEDs that may be susceptible to higher than usual rates of failure, mitigating adverse outcomes in patients.

The Legal Differences between CIDC and CDC

Both Collective Defined Contribution (CDC) and Collective Individual Defined Contribution (CIDC) schemes place any risks on pension scheme members instead of an external risk-bearer. In CDC schemes, assets are pooled collectively, allowing for risks to be shared between pension scheme members. In Individual DC schemes (IDC), the scheme members bear such risks individually. But CDC’s collective nature leaves little room for individual risk management and the pension assets are allocated to scheme members via rules that are often complex and ambiguous. CIDC schemes strive to retain the desirable aspects of CDC and IDC schemes, while improving on some of the drawbacks. The drawbacks of a CDC scheme are mitigated by the introduction of 1) individually quantifiable pension pots through individual accounts, 2) individual risk management and 3) a simplified scheme. The drawbacks of an IDC scheme are mitigated by 1) mandatory participation, 2) collective management of assets, and 3) sharing of risks. It therefore seems that CIDC schemes have a number of important advantages over CDC schemes. CIDC scheme members should be clearly informed of their legal position vis-a-vis their employer and pension provider, and the contract should clearly define the risks. Scheme members appear to benefit from individual risk management and individually identifiable pension pots, while employers and/or pension providers seem relieved from risks and enjoy the security of fixed pension contributions. The possibility to take out a lump sum seems contrary to the collective sharing of risks in both CIDC and CDC schemes.

Contractual health services performance agreements for responsive health systems: from conception to implementation in the case of Qatar.

Despite their use worldwide, strategy-based performance management is limited in the Eastern Mediterranean Region. This article explores Qatar's experience, the first from the Region, in implementing contractual agreements between healthcare providers and the regulator-Ministry of Public Health-to align strategy, performance and accountabilities. mixed-methods including tools development and pilot-testing, guided by performance management cycle with a focus on knowledge translation and key principles: feasibility; mandatory participation; participatory approach through Steering Committee. All public, private and semi-governmental hospitals and primary healthcare centers. (i) semi-structured interviews; (ii) review of 4982 indicators; (iii) Delphi technique for selecting indicators with > 80% agreement on importance and > 60% agreement on feasibility; (iv) capacity-building of providers and Ministry staff and 2-month pilot assessed by questionnaire with indicators scoring > 3 considered valid, reliable and feasible; and (v) 1-year grace period assessed by questionnaire. Approach strengths and challenges; Data collection and healthcare quality improvements. Contracts mandate reporting 25 hospital and 15 primary healthcare indicators to the regulator, which delivers confidential benchmarking reports to providers. Scorecards were discussed with the regulator for evidence-informed policymaking. The approach uncovered system-related challenges and learning for public and private sectors: providers commended the participatory approach (82%) and indicated that contracts enabled collecting valid and timely data (64%) and improved healthcare quality (55%). This experience provides insights for countries implementing performance management, responsive regulation and public-private partnerships. It suggests that contractual agreements can be useful, despite their mandatory nature, if clear principles are applied early on.

Culture change and mandating quality improvement.

A mandatory programme of quality improvement (QI) education was developed for newly qualified Foundation Year1 (FY1) doctors to complete their curriculum requirements. Their perceptions were evaluated to refine the programme. The programme delivered theoretical and experiential learning. Participants were asked to form groups and to come up with their own projects addressing the areas of need that they had identified. The 9-month group project included formal teaching and a formal presentation to the hospital. There was access to facilitation and teaching throughout. Self-rating questionnaires were used to measure the effects of the programme on knowledge and motivation. In a quasi-experimental design, data were compared before and after the programme, and comparison data were collected from the FY1 of the previous year. Across the domains of knowledge, attitudes and motivations, there were no significant differences between the pre-intervention group and the comparison group. Pre- and post-intervention [mean(SD)median] there was a significant increase in overall QI knowledge [2.1(0.76)2.0 versus 3.2(0.62)3.0; p=0.000]; however, by the end the FY1s were less motivated to complete the projects [3.9(0.54)4.0 versus 3.4(0.91)4.0; p=0.02] and were less positive about them [2.3(0.69)2.0 versus 3.0(0.77)3.0; p=0.005]. They felt that the projects were less important for their professional development [3.89(0.66)4.0 versus 3.1(0.73)3.0; p=0.000] and were less likely to generate positive change in the long term [2.72(0.61)3.0 versus 3.4(0.92)3.5; p=0.007]. Doctors perceptions [of QI] were evaluated to refine a mandatory programme DISCUSSION: Despite delivering a successful theoretical and experiential QI teaching programme with more trainee involvement, the results suggest that mandatory participation for the completion of training risks losing the innovative and creative force of junior doctors and, for some, reducing it to a tick-box exercise.

Pension Privatisation: Benefits and Costs

During the last 10 years, many OECD countries introduced reforms which included automatic enrolment or mandatory participation in privately managed pension schemes. The current article aims to reveal the benefits and costs of privately managed pension schemes. The article uses a study of pension schemes’ bylaws in Israel to study the degree to which the shift to privately operated DC schemes results in the transfer of risk from capital to labour and in the entrenchment of gender and income inequalities. The article shows that the shift of pension provision from defined benefit (DB) to defined contribution (DC) entails a significant shift of risk from capital to labour. Moreover, separately from the DB to DC shift, moving from public management to private management increases employees’ pension risks. Lastly, the paper shows that the combination of the shifts from DB to DC and from public to private management involves a shift in governance, which exposes pension scheme members to a high likelihood of lower returns as well as to gender and income inequalities.

The Calculation of the Remaining Results of Operations of Statements Financial and Cooperative Performance on KSP Usaha Jakarta Branch Office

KSP Usaha Mandiri is a cooperative engaged in lending service. The purpose of this research is to know the results of the remaining results in the division of and the performance of KSP Usaha Mandiri, Jakarta Branch Office. Of the remaining result is an income earned on cooperative. The results are derived based on revenue total minus costs total and liabilities within one year of the book concerned. Data collection methods in the preparation of the final project is a method of observation, interviews, and methods library study where the method of discussion used is qualitative descriptive, the method of data without using statistical method. In the division of the remaining results there are principles of division of the remaining results of sourced from members, the remaining results are services from capital and transactions own members, the division of the remaining results operations carried out transparently, the remaining results of the proceeds paid in cash. The role of the remaining results in the statements financial is very important to know the calculation in the division of the remaining results to members. In the period 2014-2016 there has been an increase of the remaining results obtained by KSP Usaha Mandiri. There are several factors that can influence the increase of the remaining results in the cooperative in the capital which consist of principal savings and mandatory savings and participation of members.

Правовые аспекты участия специалиста-психолога в исполнительном производстве, связанном с воспитанием детей (Часть II)

The article reveals the questions about the order of the choice and involvement of a specialist psychologist to participate in the enforcement proceedings related to the upbringing of children, by bailiff-contractor or on the initiative of the party of enforcement proceedings. At the moment in the execution of court decisions on the transfer and the confiscation of the child bailiffs do not attract the psychologist at the preparatory stage for working separately with the child, however, such possibility is provided in paragraph 17 of part 1 of article 64 of the Federal law “On enforcement proceedings”. Proposals are made on the legislative consolidation of the mandatory participation of a specialist psychologist in the execution of Executive documents related to the upbringing of children. The authors identify the requirements for professional competence, which should be owned by a specialist psychologist, and raise the question of the need to develop a training program for psychologists involved in the execution of court decisions related to the upbringing of children. On the basis of the analysis of practice and letters of Federal Bailiffs Service of Russia authors identify tasks which should be solved by the psychologist in enforcement proceedings.

ЕВОЛЮЦІЯ ПАРТІЙНОЇ СИСТЕМИ РЕСПУБЛІКИ КІПР: ВІД ЗАРОДЖЕННЯ ДО СТАБІЛІЗАЦІЇ

The process of the formation of the party system of Cyprus was considered. The period from colonial to 1981 is covered. The factors that influenced the evolution of the parties of Cyprus, in particular the internal conflict, were underlined. Emphasizes the importance of the ethnic component of the population of Cyprus. The attention was paid to the role of the Orthodox Church in shaping the political system of Cyprus. The article analyzes the norms of the Constitution of the Republic of Cyprus (1960) concerning political parties, in which the focus was on the parliamentary aspect of party activity. The role of Archbishop Makarios III, the first president of Cyprus, for the further evolution of the party system in the 1960–70s was revealed. Presented chronology of the appearance of the main parties of Cyprus and their participation in elections and coalitions. The article emphasizes that after the accession of Cyprus to the EU in 2004, the party system of the state is experiencing the trend of the newest European tendencies on the national party palette: the level of people’s confidence in the parties is decreasing, the party identity is blurred, the voter turnout is gradually decreasing, new types of parties are emerging, Radicalization is notable and so on. The party system of Cyprus is special, even if only within the EU there is a pro-communist party (Progressive Party of the Labor People of Cyprus), represented in the European Parliament, among the leading political forces. It was emphasized that the political parties of Cyprus until 1974 were purely electoral mechanisms. The new stage of development began with the stabilization of the post-colonial political system of Cyprus. At this time, the church lost its past influence, and the majoritarian electoral system alienated itself. This led to a new stage in the development of the party system in the late 1970s. It is noted that the determining factor was the transition to a proportional electoral system and the introduction of mandatory participation of voters in the vote. It was emphasized that these legislative innovations became important factors in the development of the modern party system of Cyprus. Since that time, the Cypriot parties have become more independent and united in the coalition.

Health Management System Knowledge Base for Formation and Support of a Preventive Measures Plan

This paper describes the creation of a knowledge base for an intelligent healthcare management system dealing with cases of stroke, myocardial infarction and depression. The main purpose of the knowledge base is to discover and evaluate risk factors and situations which can lead to such diseases, and to enable the formation and support of a preventative measures plan. The present version of the knowledge base is implemented using a heterogeneous semantic network approach and utilizes expert opinions about risk factors and events influencing an individual’s health. Data includes genetic predisposition, lifestyle, and external environment. Data is compiled with the aid of questionnaires, mobile devices, case histories and information from social media. Information from social media is analyzed using data and text mining methods with the goal of evaluating the user’s condition. All of the data obtained is accumulated in a single database. The knowledge base establishes risk factors, including changes in those factors over the course of time, and circumstances or events which might precipitate the emergence of pathology. Hypotheses are generated about the current state of the user’s health, the active risk factors which created conditions for the onset of disease, and circumstances which might produce an increase or decrease in risk factors. Prophylactic measures to reduce those risks are suggested through analysis of the hypotheses generated. Recommendations regarding prophylactic measures are formed with the aid of the knowledge base, the user case-library, and collaborative filtering methods. Recommendations are based on 4P medicine, which re-quires mandatory participation of system users in maintaining their health.

Опыт, проблемы и перспективы практической реализации концепции «Открытого Правительства» в Российской Федерации

The author’s hypothesis investigated in this article is connected with the statement about the imbalance in the practical implementation of the principles and priorities of the concept of open government in Russia and the need to study the institutional causes of this imbalance. The purpose of the study is to develop conceptual proposals, the implementation of which will help to smooth out and eliminate the imbalances noted above in development. The article on the one hand, notes the clear achievements in solving many technical and technological problems that have recently hampered the formation of e — government, edemocracy, open government. These include only a partial solution at the state level of the problem of functioning of a convenient and legally signifcant system of identifcation of citizens in the electronic environment, the rating of the functioning of the elements of the electronic democracy and the lack of real interest of citizens to participate in decision-making by public authorities, often narrowing in practice the principles of the concept of “Open Government” to the task of ensuring the openness of data. The identified successes and problems in the formation and development of open government elements allow the authors to offer and justify their vision of promising directions for the practical implementation of the concept of “Open Government” in the Russian Federation. Among them: the need of developing and implementing mechanisms to ensure the mandatory participation of a significant number of the country’s citizens in the public discussion of issues directly affecting their interests, their mandatory direct impact on the adoption of socially significant decisions; the expansion of the use of crowdsourcing as an effective, economic and socially effective tool for involving citizens in socially aware decision-making.

Democratic Norms, Empirical Realities and Approaches to Improving Voter Turnout

Though falling turnout in recent decades has been recognised as a problem for democracy, the solutions that have been proposed have mostly been drawn from the realms of the marketplace and society, rather than that of democracy. The inadequate empirical theory that subtends many policy initiatives designed to improve turnout accounts for why these initiatives have largely failed to achieve their stated aims. I argue that electoral participation should be seen through the conceptual lens of collective action, and that this approach suggests mandatory electoral participation as an equitable and effective coordination device. I further argue that compulsory turnout offers a good fit with democratic norms of equality, rights and political obligation.

Professional formation through personal involvement and value integration.

Formation is an important part of nursing education, and it is the responsibility of nurse educators to facilitate learning situations that provide students with opportunities for personal discovery. Studies have shown that awareness of one's own vulnerability can be a source of professional maturation and courageous action. The study setting is a Christian university that emphasises its value base through the perspective of diakonia in the nursing programme. Diakonia is understood as the provision of caring. Two hundred and forty-five pages of reflective journals from 124 third-year students were analysed with qualitative content analysis. The main theme of the study was Professional formation through personal involvement and value integration. Four categories emerged: 1) Diakonia as a guide to professional compassion; 2) Consciousness of one's own values; 3) The urge to act courageously; and 4) Choosing to spend the time available. The article discusses how students can integrate values in their professional lives by using all senses when learning in real-life situations and by using systematic reflection alone and together with others. Professional formation is an ongoing process, and we have found that mandatory participation, reiteration and progression are important conditions for such formation to occur.

Lights, Camera, Empathy: A Request to Slow the Emergency Medicine Standardized Video Interview Project Study.

We believe that the strongest residencies feature trainees of diverse personalities and backgrounds. We believe that true understanding and excellence in patient care are nurtured by these differences, and we firmly disagree with any actions that, intentionally or not, diminish our field's diversity. Attempting to predict future potential from a psychometric present may be shade to growth for the diverse physicians that EM hopes to attract. If applicant metrics are not adequate or valid, we must reevaluate their utility and inclusion. However, we recommend that a more thorough explanation of the need for the SVI pilot study be shared, with consideration to the possibility that other markers of an applicant's portfolio may already satisfy this need. We question the utility of an additional measure that increases burden and potential bias on medical students who have no ability to decline participation or participate in design. Until the validity of the SVI's ability to predict future performance is determined, mandatory participation and reporting to residency programs should not be implemented.

Pension Privatisation: Benefits and Costs

Abstract During the last 10 years, many OECD countries introduced reforms which included automatic enrolment or mandatory participation in privately managed pension schemes. The current article aims to reveal the benefits and costs of privately managed pension schemes. The article uses a study of pension schemes’ bylaws in Israel to study the degree to which the shift to privately operated DC schemes results in the transfer of risk from capital to labour and in the entrenchment of gender and income inequalities. The article shows that the shift of pension provision from defined benefit (DB) to defined contribution (DC) entails a significant shift of risk from capital to labour. Moreover, separately from the DB to DC shift, moving from public management to private management increases employees’ pension risks. Lastly, the paper shows that the combination of the shifts from DB to DC and from public to private management involves a shift in governance, which exposes pension scheme members to a high likelihood of lower returns as well as to gender and income inequalities.

Mandatory Participation in a Wellness Program: The General Surgery Resident’s Perspective

Mandatory Participation in a Wellness Program: The General Surgery Resident’s Perspective

Pathways to Education: An Integrated Approach to Helping At-Risk High School Students

Pathways to Education is a comprehensive youth support program developed to improve academic outcomes among those entering high school from very poor social-economic backgrounds. The program includes proactive mentoring to each student, daily tutoring, group activities, career counseling, and college transition assistance, combined with immediate and long-term incentives to reinforce a minimum degree of mandatory participation. The program began in 2001 for entering Grade 9 students living in Regent Park, the largest public housing project in Toronto, and expanded in 2007 to include two additional Toronto projects. In all three locations, participation rates quickly rose, to more than 85 percent, even though parents and students were required to commit in writing to conditions and high expectations of the program. Comparing students from other housing projects before and after the introduction of the program, high school graduation and post secondary enrollment rates rose dramatically for Pathways eligible students, in some cases by more than 50 percent.

Evidence Base for Optimal Preoperative Preparation for Bariatric Surgery: Does Mandatory Weight Loss Make a Difference?

Preoperative weight loss regimens prior to bariatric surgery have been a routine and common practice for many centers, in the US and around the world. The mandated participation in such programs has largely been influenced by loco-regional payer requirements. The relationship between adherence to a mandatory weight loss regimen and achieved preoperative weight loss as well as the clinical impact of preoperative weight loss on bariatric outcomes remains uncertain. This review examines the available current literature, in the context of previous findings, regarding the impact of mandated preoperative weight loss regimens and mandatory weight loss on bariatric outcomes. The reviewed studies do not provide sufficient evidence that mandatory participation in a preoperative weight loss regimen prior to bariatric surgery is associated with achieved weight loss or durable bariatric outcome benefit. Preoperative weight loss, when achieved, may confer a positive benefit on postoperative complications; however, this is not a consistent finding in the literature and requires further validation. The practice of mandating participation in a preoperative weight loss regimen or requiring mandatory weight loss prior to bariatric surgery is not supported by current literature and may serve as an obstacle to medically necessary and potentially life-saving treatment.

Compulsory Membership of Pension Schemes and the Free Movement of Services in the EU

Mandatory pension participation in the Netherlands is currently under review. This article examines the manner in which the system of mandatory participation in sectoral pension funds is presently organised as well as future proposals from the perspective of the freedom to provide services. It also briefly reviews mandatory participation in Belgium, Denmark, Germany, France and Sweden and asks whether it constitutes a barrier to the freedom enshrined in Article 56 TFEU. Restrictions of this freedom in the field of mandatory participation are too easily excused in the Netherlands by pointing to decisions by the European Court of Justice (ECJ) in which it judged the system to be permissible. These decisions, however, were made from the perspective of competition law, and not on the basis of Article 56 TFEU. Grounds for justifying restrictions to this freedom exist, although different justifications are available for direct and indirect discrimination. The article questions how mandatory participation in the Member States considered in this article fare from this perspective?

Compulsory membership of pension schemes and the free movement of services in the EU

Mandatory pension participation in the Netherlands is currently under review. This article examines the manner in which the system of mandatory participation in sectoral pension funds is presently organised as well as future proposals from the perspective of the freedom to provide services. It also briefly reviews mandatory participation in Belgium, Denmark, Germany, France and Sweden and asks whether it constitutes a barrier to the freedom enshrined in Article 56 TFEU. Restrictions of this freedom in the field of mandatory participation are too easily excused in the Netherlands by pointing to decisions by the European Court of Justice (ECJ) in which it judged the system to be permissible. These decisions, however, were made from the perspective of competition law, and not on the basis of Article 56 TFEU. Grounds for justifying restrictions to this freedom exist, although different justifications are available for direct and indirect discrimination. The article questions how mandatory participation in the Member States considered in this article fare from this perspective?

Local environmental NGO roles in biodiversity governance: a Czech-German comparison

Abstract Recently, the role of nongovernmental organizations (NGOs)s in environmental governance has been widely investigated, especially regarding the issue of mandatory public participation in policy-making within a European context. This paper aims to redirect scientific attention from their pure participation to their field actions, i.e., to the role they play in actual natural resource management, especially at the local level, and reframe local environmental NGO roles and positions based on the criteria for scale and influence. More specifically, this paper seeks to identify factors that promote NGOs as effective complements in the protection of state biodiversity and stresses local impacts of different governance schemes. Determining factors were investigated through a series of in-depth case studies undertaken in the Czech-German border region of the eastern Krušné hory Mts. (Erzgebirge, Ore Mts.). Rather than a quantitatively oriented survey among NGOs, this study focused primarily on a specific territory and, subsequently, on the identification of relevant actor performance (including NGO representatives) within this territory. The method applied for comparison was the Institutional Analysis and Development Framework (IAD Framework). This design enabled a comparison of different social practices in the homogeneous ecosystem present on both sides of the border and captured the influence of specific social and historical cross-border features on environmental NGO performance.