Expenditure Of Money Research Articles

Effectiveness of multifaceted and tailored strategies to implement a fall-prevention guideline into acute care nursing practice: a before-and-after, mixed-method study using a participatory action research approach.

BackgroundResearch- and/or evidence-based knowledge are not routinely adopted in healthcare and nursing practice. It is also unclear which implementation strategies are effective in nursing practice and what expenditures of time and money are required for the successful implementation of clinical practice guidelines (CPGs). The aim in this study was to assess the effectiveness and required time investment of multifaceted and tailored strategies for implementing an evidence-based fall-prevention guideline (Falls CPG) into nursing practice in an acute care hospital setting.MethodsA before-and-after, mixed-method design was used within a participatory action research approach (PAR). The study was carried out in two departments of an Austrian university teaching hospital and included all graduate and assistant nurses. Data were collected through a questionnaire, group discussions and semi-structured interviews. Qualitative data were content-analysed using a template based on the Consolidated Framework for Implementation Research (CFIR), which also served as a theoretical framework for the study. Quantitative data were descriptively analysed using appropriate tests for independent groups.ResultsBy applying multifaceted and tailored implementation strategies, the graduate and assistant nurses’ knowledge on fall prevention, how to access the Falls CPG and the guideline itself increased significantly between baseline and final assessment (p ≤ .001). Qualitative data also revealed an increase in participant awareness of fall prevention. A baseline positive attitude towards guidelines improved significantly towards the end of the project (p = .001). Required fall prevention equipment like baby monitors or one-way glide sheets were available for use and any required environmental adaptations, e.g. a handrail in the corridor, were made. Hospital nursing personnel (approximately 150) invested a total of 1192 hours of working time over the course of the project.ConclusionsMultifaceted strategies tailored to the specific setting within a PAR approach and guided by the CFIR enabled the effective implementation of a CPG into acute care nursing practice. Nursing managers now have sound knowledge of the time resources required for CPG implementation.Electronic supplementary materialThe online version of this article (doi:10.1186/s12912-015-0064-z) contains supplementary material, which is available to authorized users.

Role and Impact of Budget as an Instrument of Financial and Developmental Policy in Kosovo

In this research paper will be presented a detailed description of the methodology for analysis the budget and the improving connections, and budget planning for the provision of financial and developmental policies in Kosovo. This paper has been written intelligibly, so that could be read and easily understood by non-specialists of field of economics and finance. State budget is one of the most important economic instruments, to have Government of Kosovo in available. Drafting and spending the budget Kosovo has been the competence of local institutions since the establishment of the Provisional Institutions. However, even after more than a decade from the time when local institutions have enjoyed the right to drafting the costs of the state budget, there are major problems in drafting procedures, expenditure and budget reporting. Kosovo budget in some cases is approved hastily and without debate in the Assembly of Kosovo. The current form of appropriations and budget reports is not at that level of detail as to enable the members of the Assembly and citizens understand clearly the way of divisions and expenditure of public money. DOI: 10.5901/mjss.2015.v4n1s1p61

Bidder Selection in Public Procurement using a Fuzzy Decision Support System

Bidder selection in public procurement is a decision making problem whose primary purpose is to achieve the cost effectiveness and efficiency in the expenditure of public money. This principle is also known as the principle of “value for money”. This selection is based on many alternatives and many quantitative and qualitative criteria where qualitative criteria are often expressed as linguistic uncertain variables. The theory of fuzzy sets is a tool suitable to model uncertainty when applied to a variety of problems in real life. However, many fuzzy methods require complex calculation and they are not appropriate for using in public procurement because they slow down this process. In this paper, in order to make a quick decision in public procurement, a Decision Support System based on the fuzzy extent analysis method is developed. In order to demonstrate the usefulness of this system, a real-life case scenario of public procurement is presented.

A Sectoral Framework for Analyzing Money, Credit and Unconventional Monetary Policy

This paper sets out an empirical framework for examining the dynamics of money and credit at a sectoral level. Our purpose is to understand and monitor the transmission mechanisms of different policies that affect the financial sector, with an eye to practical policy analysis. We use the banking system’s balance sheet as an organising framework and model the stocks of broad money and credit held by different sectors. Each sector is modelled as a separate block with money, credit, and sectoral expenditure modelled jointly together with the relevant financial yields. The sectors are then knitted together using aggregate relationships and identities. Overall the model can be thought of as an estimated disaggregated version of the IS-LM-CC model which additionally incorporates the principle that ‘loans create deposits’. We illustrate, by example, how this framework can be used in practice: first by examining the sectoral transmission of quantitative easing and second, the effect of disturbances to credit markets. We also discuss how other policy tools, such as the Funding for Lending Scheme and macroprudential policies, could be examined in our framework.

Court-Ordered Campaign Finance Deregulation and Stock Value of Contributors

The Bipartisan Campaign Reform Act of 2002 addressed two issues, soft money and independent expenditures on issue ads for electoral advocacy. The Supreme Court initially upheld most provisions in 2003 but subsequently weakened and struck down provisions on independent expenditures. I examine the stock value of firms with a long history of campaign contributions around the key developments of three Supreme Court cases. Stock prices of contributing firms react positively to Court events associated with campaign finance deregulation. It implies that the average rates of return to these rights of political spending are between 1 and 2% of stock values.

Pattern of Mechanical Injuries of Fatal Interpersonal Violence Cases in a Tertiary Care Centre

For every person who dies as a result of violence, many more are injured and suffer from a range of physical, sexual, reproductive and mental health problems. Violence places a massive burden on national economies, costing countries billions of money expenditure each year in health care, law enforcement and lost productivity. In India the share of violent crimes in total crimes was 10.9% during 2009–2010, 11.0% in 2011, 11.5% in 2012 and 11.3% (total 3, 00, 357) in 2013 respectively. The present prospective study on Interpersonal Violence cases was conducted in the Department of Forensic Medicine and Toxicology, Patna Medical College and Hospital Patna from September, 2008–2010 on 80 cases. The primary aim of present study is to find out Pattern of fatalities after death in the region due to violence affecting human body. Our study showed that maximum number of injury was seen on upper limb 86.25%, but maximum number of death was due to injury to head and neck 75%. Abrasion 92.5% was the most common type of external injury followed by contusion 56.25%, skull fractures 51.25% and firearm injuries 8.75%.

Mempermudah Pengawasan Operasional dan Keuangan di Biro Perjalanan dengan Menggunakan Aplikasi Gtass

Some travel agencies have difficulty in monitoring the operational control and generating financial report. This is due to the operation of the data storage for business transactions conducted separately , and the reporting of the financial statements company are still found not in accordance with the bank reconciliation . In this study, the methodology the system development life cycle (SDLC) is used ranging from data collection through interview, observation and study of the literature up to the stage of application development, namely the analysis phase in the travel agency using the method of direct observation of the flow through the reporting process. After that, go into the design stages of database design methods and user interface. Global Travel Agency System Solutions (GTASS) product is the integration system designed specifically for the corporate travel agency that exists to facilitate control operations, such as creating a bill (invoice), Letter of Gurantee (LG) and financial oversight as receipts and expenditure of money. With the ease of processing, then the presentation of the financial statements can be done automatically. Important early financial supervision carried out by the travel agency due to an increase in sales without adequate consideration of financial supervision, will lead to the emergence of new problems, which in turn will hamper efforts to increase the sales.

Unintended consequences of expensive cancer therapeutics—the pursuit of marginal indications and a me-too mentality that stifles innovation and creativity: the John Conley Lecture.

Cancer is expected to continue as a major health and economic problem worldwide. Several factors are contributing to the increasing economic burden imposed by cancer, with the cost of cancer drugs an undeniably important variable. The use of expensive therapies with marginal benefits for their approved indications and for unproven indications is contributing to the rising cost of cancer care. We believe that expensive therapies are stifling progress by (1) encouraging enormous expenditures of time, money, and resources on marginal therapeutic indications and (2) promoting a me-too mentality that is stifling innovation and creativity. The modest gains of Food and Drug Administration-approved therapies and the limited progress against major cancers is evidence of a lowering of the efficacy bar that, together with high drug prices, has inadvertently incentivized the pursuit of marginal outcomes and a me-too mentality evidenced by the duplication of effort and redundant pharmaceutical pipelines. We discuss the economic realities that are driving this process and provide suggestions for radical changes to reengineer our collective cancer ecosystem to achieve better outcomes for society.

The Intelligence Gap: What the Multinational Enterprise Can Learn From Government and Military Intelligence Organizations

Over the past several decades, companies have spent literally trillions of dollars acquiring the latest technologies and building their internal information processing and analysis capabilities. And yet with all this expenditure of time, money, and effort, large enterprises are still caught off-guard on an almost daily basis because they fail to anticipate critical developments in their competitive environment. This shortcoming can be mitigated by adopting an intelligence mind-set. This article provides an overview of seven specific problems concerning the use of business intelligence in the multinational enterprise (MNE) and discusses the corresponding best practices found in professional intelligence organizations. It closes with some suggestions on implementing those best practices in the MNE. © 2014 Wiley Periodicals, Inc.

Evaluating the role of a humanoid robot to support learning in children with profound and multiple disabilities

Purpose – The purpose of this paper is to identify ways teachers might employ a robot to achieve learning objectives with pupils with intellectual disabilities and potential outcome measures. Design/methodology/approach – A series of five case studies where teacher-pupil dyads were observed during five planned video-recorded sessions with a humanoid robot. Engagement was rated in a classroom setting and during the last session with the robot. Video recordings were analysed for duration of engagement, teacher assistance and number of goals achieved. Findings – Teachers identified a wide range of learning objectives ranging from an appreciation of cause and effect to improving the pupil's sense of direction. The robot's role could be to reward behaviour, provide cues or provide an active element to learning. Rated engagement was significantly higher with the robot than in the classroom. Research limitations/implications – A robot with a range of functions that allowed it to be engaging and motivating for the wide range of pupils in special education would be expensive and require teachers to learn how to use it. The findings identify ways to provide evidence that this expenditure of time and money is worthwhile. Originality/value – There is almost no research teachers can refer to on using robots to support learning in children with intellectual disabilities. This paper is therefore of value for researchers who wish to investigate using robots to educate children with intellectual disabilities, as it can provide vital information to aid study design.

The Method of Finding the Center of Steam Turbine Shaft Coupling Based on Multiple Practice

It is magnificent to find the center of the coupling after many calculations, test and optimization. It presents a check based on looking methods and determine the centering of this calculation method after repeatedly overhaul of a 200mw extraction condensing steam turbine adjusting center practice. The effectiveness of its application in practice can duration, and the average time and its consumption of money could be reduced to 1/3, 1/3 and 1/5of its original, illustrates the adjustment process issues which should pay attention to,and provides technical reference for the safe operation of the same type of rotating machinery .

Analysis of income inequality factors

This paper is a report of the analysis of the basic factors, which form the income differentiation of Russia’s population in the 2000s. This describes the methods and results of calculating differentiated balances of money income and expenditures of the population in 2007–2012.

Personalizing HIV Therapeutics in Resource-Limited Rural Communities: Lessons Learned From the Use of New Tools in Africa

With growing information on antiretroviral drug pharmacogenetics, several studies have been conducted in African countries. One unique strand of knowledge that is currently emerging is the use of dried plasma spot devices in rural communities in Africa with a view to individualizying drugs employed against HIV infection. The results are encouraging as a relatively inexpensive test could inform on the probability of adverse reactions or treatment failure, thus helping to select the best regimen for a given patient in different African populations. This could have an important impact in African countries where anti-viral therapy failures (whether related to low adherence/intolerance or to resistance/insufficient drugs exposure) have huge associated costs, both in terms of disease progression and money expenditure. Data on the available information on pharmacogenetics in African patients as well as patients of African descendant are reviewed. Nevertheless no randomized controlled study evaluating the impact of pharmacogenetics in Africa has so far been conducted, particularly with a view to employing novel diagnostic platforms such as dried plasma/blood spot devices in rural communities. Following the discussed data a few candidate genes are suggested as potential candidates for prospective studies taking into account two pitfalls in the path towards individualized antiretroviral regimens in Africa: the reliance on non-African based laboratories that signal the need for local capacity building as well as international collaborations, and finally the need to better understand genetic diversity of different ethnic groups in the African continent. Keywords: Antiretrovirals, Africa, HIV, limited resource countries, personalized medicine, pharmacogenetics, single nucleotide polymorphisms, therapeutic drug monitoring.

The Price Sensitivity of Health Plan Choice among Retirees: Evidence from the German Social Health Institute

We investigate two determinants of the price sensitivity of health plan demand: the size of the choice set and the salience of premium differences. Using variation in both features in the German Social Health Insurance (SHI) and information on health plan switches of retirees in the German Socio Economic Panel, augmented with information on individuals’ choice sets we find that retirees react less to potential savings from switching when they have more plans to choose from and when differences between premiums are less salient. Simplifying choices could save consumers money and improve the functioning of the health insurance market.

Back to the Future: Assessing the Fuel Displacement Potential Using Electricity in Vermont for Residential Space and Water Heating

Over several decades in Vermont, a concerted effort was made to shift home heating away from electricity to fuels including oil, propane, and to a lesser degree natural gas. Highly efficient heat pump technology offers an opportunity today to transition back to electricity as an energy source for home heating, and could save consumers money and reduce greenhouse gas emissions.

From Social Network to Data Envelopment Analysis: Identifying Benchmarks at the Site Management Level

AbstractIt is widely accepted in the construction industry that contract documents, specifying the responsibility and risk of each participant, are the basis for project managers’ and superintendents’ decision making (DM). However, in practice strict adherence to the formal procedures and chains of command would not always be possible without an unacceptable expenditure of time and money. Although much attention is given to the decisions at the project manager and superintendent level, the underlying rules and mechanisms for the moment-to-moment DM at the site management level has not been documented. In this paper, a social network (SN)–based data envelopment analysis (DEA) benchmarking procedure (SDBP), which combines DEA (assessing the relative efficiency of DM units) and SN (concentrating on the relationships amongst DM units) to identify the benchmarks for the inefficient specialty trades (STs). This paper also uses a case study to illustrate how to implement the SDBP. This research contributes to th...

Federal-State Financial Relations and the Constitutional Limits on Spending Public Money

This paper surveys and explains the history of how the Australian Constitution was intended to deal with Federal-State financial relations and what has happened in practice. It discusses how the original intention that the federal surplus be returned to the States was thwarted and how the federal Government took over areas of State tax revenue and reduced the tax-bases of the States, making them financially dependent on federal largesse. It discusses how the federal Government took the view that it could spend money on any subject whatsoever, regardless of whether it fell within federal legislative power and how two recent High Court decisions have imposed significant limitations on federal expenditure of public money. It concludes by discussing the federal Government's response and the other options that the federal Government might explore.

Déplacements de consommation et transferts de richesses en Île-de-France

L'importance des transferts de richesses dans la construction economique des territoires ne cesse d'etre soulignee. Si un premier mouvement est observable des lieux d'emploi aux lieux de residence, un second tient a la dissociation entre espaces de consommation et espaces residentiels. Cet article propose une mesure inedite des transferts interdepartementaux de richesses en Ile-de-France par le prisme des depenses de consommation. Il s'appuie sur le croisement d'une enquete de la mobilite quotidienne des Franciliens et d'une autre relative a leurs depenses. L'objectif est ici d'ameliorer la comprehension de la performance economique des territoires, de mesurer l'attractivite commerciale et ses effets sur la redistribution geographique des richesses. Les resultats obtenus soulignent des desequilibres structurels et l'eclatement des lieux de consommation, entre ancrage parisien des activites de spectacles et de loisirs, ainsi que la restauration, et une specialisation de la peripherie autour des achats courants et exceptionnels. L'analyse des transferts de richesses interdepartementaux expose par ailleurs la force des interdependances qui participent de la structuration de la metropole.

Reduction of streamflow monitoring networks by a reference point approach

Adoption of an integrated approach to water management strongly forces policy and decision-makers to focus on hydrometric monitoring systems as well. Existing hydrometric networks need to be assessed and revised against the requirements on water quantity data to support integrated management. One of the questions that a network assessment study should resolve is whether a current monitoring system can be consolidated in view of the increased expenditures in time, money and effort imposed on the monitoring activity. Within the last decade, governmental monitoring agencies in Turkey have foreseen an audit on all their basin networks in view of prevailing economic pressures. In particular, they question how they can decide whether monitoring should be continued or terminated at a particular site in a network. The presented study is initiated to address this question by examining the applicability of a method called “reference point approach” (RPA) for network assessment and reduction purposes. The main objective of the study is to develop an easily applicable and flexible network reduction methodology, focusing mainly on the assessment of the “performance” of existing streamflow monitoring networks in view of variable operational purposes. The methodology is applied to 13 hydrometric stations in the Gediz Basin, along the Aegean coast of Turkey. The results have shown that the simplicity of the method, in contrast to more complicated computational techniques, is an asset that facilitates the involvement of decision makers in application of the methodology for a more interactive assessment procedure between the monitoring agency and the network designer. The method permits ranking of hydrometric stations with regard to multiple objectives of monitoring and the desired attributes of the basin network. Another distinctive feature of the approach is that it also assists decision making in cases with limited data and metadata. These features of the RPA approach highlight its advantages over the existing network assessment and reduction methods.

California’s ZEV Action Plan

Accelerating the market for zero-emission vehicles (ZEVs) is a cornerstone of California’s long-term transportation strategy to reduce localized pollution and greenhouse gas emissions, save consumers money, and enable continued economic growth. In addition to promoting these vehicle technologies, the state supports the development and use of low carbon fuels, as well as planning more environmentally sustainable communities that reduce unnecessary vehicle travel and congestion. In March 2012 Governor Brown signed an Executive Order calling for 1.5 million ZEVs by 2025. To identify specific actions that the State can take to reach this goal, the Governor’s Office with the input from a Governor’s Office Interagency Working Group developed the 2013 ZEV Action Plan.