Responsible Parties Research Articles

Challenges of variant reinterpretation: Opinions of stakeholders and need for guidelines

PurposeThe knowledge used to classify genetic variants is continually evolving, and the classification can change on the basis of newly available data. Although up-to-date variant classification is essential for clinical management, reproductive planning, and identifying at-risk family members, there is no consistent practice across laboratories or clinicians on how or under what circumstances to perform variant reinterpretation. MethodsWe conducted exploratory focus groups (N = 142) and surveys (N = 1753) with stakeholders involved in the process of variant reinterpretation (laboratory directors, clinical geneticists, genetic counselors, nongenetic providers, and patients/parents) to assess opinions on key issues, including initiation of reinterpretation, variants to report, termination of the responsibility to reinterpret, and concerns about consent, cost, and liability. ResultsStakeholders widely agreed that there should be no fixed termination point to the responsibility to reinterpret a previously reported genetic variant. There were significant concerns about liability and lack of agreement about many logistical aspects of variant reinterpretation. ConclusionOur findings suggest a need to (1) develop consensus and (2) create transparency and awareness about the roles and responsibilities of parties involved in variant reinterpretation. These data provide a foundation for developing guidelines on variant reinterpretation that can aid in the development of a low-cost, scalable, and accessible approach.

The Influence of Business Ethics and Accountant Ethics on Fraud: Empirical Study of Scrap Companies in Cikarang

This tax avoidance effort is a form of fraud. Fraud is an action that is intentionally carried out with the aim of personal or group interests so that certain parties will lose. By the translation of the Indonesian Institute of Certified Public Accountants, Fraud is an act carried out by individuals or intentionally by a responsible party or management of a third party, employee, or governance deceptive to obtain an advantage by violating the law or unfairly. Several factors encourage fraud, including economic, emotional, or value pressures. Then, there are opportunities due to weak control or abuse of authority. Then Rationalization or looking for justification for the occurrence of fraud. There are also individual factors related to a person's morale, namely Need (Need) and greed (greed) which are related to the needs and views of officials/employees related to company assets. Also, honest people can cheat with the pressure they face at work.

JURIDICAL OVERVIEW OF MEDICAL TELECONSULTATION PRACTICE DURING THE COVID-19 PANDEMIC: A NARRATIVE REVIEW

The mandate of the 1945 Constitution, that everyone has the right to live in physical and spiritual prosperity, to live and to have a good and healthy living environment, and the right to obtain health services while the ratio or comparison of health workers in this case doctors and the population in Indonesia is not balanced or not at the ideal number. In order to equalize the rights of citizens to obtain adequate and standard health services, the government issued a regulation on telemedicine in this case more often referred to as teleconsultation. Especially in this era of the Covid-19 pandemic, these services are very helpful for the community, so that their health conditions are monitored. It is hoped that services using information and communication technology facilities will have a good impact as well as conventional medical services and still pay attention to the rights and responsibilities of both parties and do not cause losses in their implementation, the preparation of this research uses the type of normative research. The materials for this research come from laws and regulations, regulations issued by the Minister of Health, the Civil Code, as well as other relevant sources.

Impact of coastal development on coastal morphology of Taiwan: Case studies and proposed countermeasures

When economic expansion started in the late 1970s, Taiwan was in desperate need of better infrastructure. In response, the government began construction along the coasts around the island. Many of these structures were constructed under time constraints, and their possible effects on the environment were not considered. Years later, some of the structures were found to have disrupted littoral sediment transport, resulting in the retreat of shorelines downstream. The Integrated Coastal Zone Management Plan demands the implementation of remedial measures for erosion by the responsible party in the near future. However, as morphological changes are complicated processes involving both natural and human-induced drivers, the liabilities of the parties involved are typically difficult to determine. In this study, bathymetric analysis and numerical simulation were used to assess the effects of coastal structures on coastal erosion. With the former, the rate of change of the bathymetric volume along the shore was used to identify the extent of the structural effect. The latter one is then used to clarify the respective effect of adjacent structures on coastal bathymetry. Three cases with different surroundings were considered to verify the scheme. It is suggested that range of influence of the structure should be determined in terms of coastal cells. In the case of multiple structures existing within a cell, the cost of remedial measures should be proportional to the length of the structure vertical to the coastline. Remedies to restore the continuity of longshore drift are then proposed. These results can be used to promote effective coastal zone management and prevent further deterioration.

Between cabinet membership and opposition: Commitment and responsibility of support parties

Existing research suggests that government participation is crucial for how voters evaluate party performance and how they cast their votes. However, in real life the distinction between government and opposition is not as straight-forward as one would think. Minority governments often enjoy the legislative support of external support parties, which play an ambiguous role in politics: while they are formally part of the opposition, they are simultaneously committed to keeping the government in office and passing its bills. How do voters evaluate parties that support a minority government? Will they respond to different frames about the significance of the commitment that support parties have made to government policy and survival? In a survey experiment, I test whether framing a written agreement as effective will cause voters to attribute more or less responsibility to the support parties and find that they respond to different frames by altering their perceptions of the importance of the agreement, but not their responsibility attribution.

Nagari Government Cooperation with Nomads Monitors in the Development of Nagari Sulit Air District of Solok

Nomads in West Sumatra have a very big share in the development of the village, one of which is Sulit Air, which has quite a several Nomads and has a nomadic organization called Sulit Air Sepakat (SAS) so that it becomes one of the overseas assisted villages that must collaborate with nomads in the social, cultural and economic fields. It turns out that the implementation of cooperation has not yet been realized. There are problems such as coordination between parties collaborating with local governments and commitments from collaborating parties the purpose of this research is to describe the implementation of cooperation between the Nagari government and migrants in the development of Nagari Sulit Air in Solok Regency. This research uses the descriptive qualitative method. Data collection techniques using interviews and documentation. The result shows that the implementation of the cooperation has not been implemented as a whole. In the initiation process, the collaboration has been carried out well, starting from the beginning of the collaboration to the actors involved and the relationships between actors. Areas of cooperation are also carried out well with the submission of work plans but the areas that are cooperated have not been developed. There is nobody for organizing cooperation that is authorized to carry out this cooperation. The responsibility of the cooperation parties is still high but the commitment between the parties is reduced, one of which is due to the difficulty in resolving land acquisition problems.

Implications of Covid-19 Pandemic on School-age children with Autism Spectrum Disorders

IntroductionThe Covid-19 pandemic has caused multilevel changes worldwide. Everyday life of all people has been altered drastically. Children with ASD seem to face difficulties due to their heightened sensitivity to unpredictable and complex changes in their lifestyle. Our presentation aims to reveal the effects of Covid-19 on school-age children with Autism Spectrum Disorders.ObjectivesThe main thematic areas of this research, concerning the social workers’ questionnaire, focused on the routine, psycho-emotional field, school performance, sociability and school environment of children with ASD.MethodsBetween June 22nd and August 16th, 2021, social workers (n=38) and parents (n=25) administrated a questionnaire -through google form platform- which investigated issues around routine, psycho-emotional field, school performance, sociability, school, and family. Descriptive statistics were used for statistical analysis of the data.ResultsThe routine and psycho-emotional conditions of children with ASD were found to have a negative shift. Moreover, the degree of change on school performance was moderate, while sociability change was minimal. The significance of the school’s contribution and the impact of the Covid-19 pandemic on the family functionality was highly observed. Another interesting finding was that children with ASD did not display discomfort for the mandatory social limitations or fear for the virus transmission.ConclusionsLastly, it is important to implement appropriate practices for the protection of children with ASD, through the mobilization of the responsible parties and thus, social policy transformations are vital for this vulnerable population.DisclosureNo significant relationships.

State Building in Crisis Governance: Donald Trump and COVID-19.

State Building in Crisis Governance: Donald Trump and COVID-19.

Fake data? The need for Theory of Sampling concepts in environmental research and investigations

The sampling intensive mining and environmental industries share a common need for representative data but differ in the motivations to accomplish this objective. The desire to obtain representative sample data for “commodities” in the mining industry is driven by anticipated economic gain and the exploitation of natural resources. The desire to obtain representative sample data for “contaminants” in the environmental industry is driven by anticipated social gain and the protection of natural resources. In terms of obtaining reliably representative data, motivation driven by economic gain has thus far been the clear winner. Theory of Sampling concepts are well established and tested in the mining industry. The environmental industry, in contrast, has traditionally been plagued by scientifically unsound sampling practices and data that are not reliably representative of conditions in the field. This has significant implications for topics ranging from the efficient identification and remediation of contaminated industrial lands to the accurate assessment of risk to human health and the environment. This paper explores the nature and cause of this dichotomy and presents a methodical approach for application of Theory of Sampling concepts to environmental testing of soil, water and air. Much of the problem is tied to a general recognition of compositional and distributional heterogeneity in contaminated media but unawareness of a method to control it or an understanding of the magnitude of potential error. As a result, published regulatory guidance focused on classical sampling and statistical methods appropriate for testing of“finite element” media. A lone exception is testing of indoor air, where concepts of “Decision Units” and sampling methods more appropriate for testing of “infinite element” media have long been employed to control and represent heterogeneity. The solutions are, in hindsight, relatively simple. Pushback from affected parties and even scientists and environmental agencies can be significant, however. This is primarily due to a lack of training of environmental professionals in the Theory of Sampling and the common absence of clear evidence of erroneous or misleading sample data in the field. Reluctance to change is also tied in some cases to implications regarding liability for past and ongoing projects. The need for more reliable, efficient and science-based methods to assess and address risk posed by environmental contamination is clear, however. Progress will be made by countries like China that are beginning to tackle legacies of early development and are able to learn from the successes as well as the mistakes of countries that have been addressing environmental contamination for several decades. Training of environmental workers as well as pressure from liability-savvy responsible parties, attorneys and financial institutions will continue to force the industry to evolve, to the benefit of the environment as well as stakeholders on all sides.

Legal reflections on the doctor-patient relationship in preparation for South Africa’s National Health Insurance


 The doctor-patient relationship is the foundation of any medical intervention. Over time, the relationship has changed, from the era of paternalism to the era of self-determination or patient autonomy, following changes resulting from consumerism and lately, in South Africa, socialised medicine as a result of the proposed National Health Insurance (NHI). The premise of this article is that patient autonomy is invariably limited by a determination of who will carry the cost of a medical intervention. In recent years, legislative developments have affected the understanding of a patient and doctor through the introduction of new references, such as ‘user’, ‘data subject’ and ‘consumer’ for a patient, and ‘service provider’ and ‘responsible party’ for a doctor, each giving different meanings to the doctor-patient relationship. Recent statutory additions also include new remedies available to aggrieved patients as parties in the doctor-patient relationship. The article concludes with brief observations on how the NHI will alter the essence and nature of the doctor-patient relationship in future.
 

Key Factors Analysis of Severity of Automobile to Two-Wheeler Traffic Accidents Based on Bayesian Network

The purpose of this paper is to analyze the complex coupling relationships among accident factors contributing to the automobile and two-wheeler traffic accidents by establishing the Bayesian network (BN) model of the severity of traffic accidents, so as to minimize the negative impact of automobile to two-wheeler traffic accidents. According to the attribution of primary responsibility, traffic accidents were divided to two categories: the automobile and two-wheeler traffic as the primary responsible party. Two BN accident severity analysis models for different primary responsible parties were proposed by innovatively combining the Kendall correlation analysis method with the BN model. A database of 1560 accidents involving an automobile and two-wheeler in Guilin, Guangxi province, were applied to calibrate the model parameters and validate the effectiveness of the models. The result shows that the BN models could reflect the real relationships among the influential factors of the two types of traffic accidents. For traffic accidents of automobiles and two-wheelers as the primary responsible party, respectively, the biggest influential factors leading to fatality were weather and visibility, and the corresponding fluctuations in the probability of occurrence were 32.20% and 27.23%, respectively. Moreover, based on multi-factor cross-over analysis, the most influential factors leading to fatality were: {Off-Peak Period → Driver of Two-Wheeler: The elderly → Driving Behavior of Two-Wheeler: Parking} and {Drunk Driving Two-Wheeler → Having a License of Automobiles → Visibility: 50 m~100 m}, respectively. The results provide a theoretical basis for reducing the severity of automobile to two-wheeler traffic accidents.

Impacto del mapa de riesgos como estrategia de monitorización y mejora de seguridad del paciente en urgencias

ObjectiveTo design a risk map (RM) as a tool for identifying and managing risks in the paediatric emergency department and to assess the impact of the improvement actions developed based on the identified risks in terms of the level of risk to patient safety. MethodologyA multidisciplinary working group reviewed the entire care process by applying the Failure Mode and Effects Analysis (FMEA) tool. Project phases: 1) RM 2017 and planning of improvement actions; 2) Development and implementation of improvement actions; 3) RM 2019; 4) Analysis: evolution of the RM and impact of improvement actions. ResultsA total of 106 failure modes (FMs) were identified in the 2017 RM (54.7% high- or very high risk). We applied prioritization criteria to select the improvement actions to plan. Nineteen improvement actions were planned, with assigned responsible parties and deadlines, to address 46 priority FMs. One hundred percent were implemented. In the 2019 RM, we identified 110 FMs (48.2% high risk) and found an overall reduction of the risk level of 20%. Analysing the 46 priority FMs that had been addressed by the 19 planned improvement actions, we found that 60% had changed from high to medium risk level and that the risk level had decreased, both overall (–27.8%) and by process. ConclusiónThe FMEA is a useful tool to identify risks, analyse the impact of improvement strategies and monitor the risk level of a complex clinical care department. The improvement actions developed succeeded in reducing the level of risk in the processes in our unit, improving patient safety.

Legal Supervision of Audit Practice in Corporate Takeovers

Auditing services are active throughout corporate takeover process. Audit issues not only affect the nature, efficiency and consequences of takeovers, but also matter the quality and social effects of corporate development after the successful reorganization. This paper aims to enhance the audit quality in the takeover process, and further improve the structure, productivity and social responsibility of takeover parties. Qualitative analysis method and case study are adopted in this paper to investigate the legal issues on audit involved in the takeover process, and explores their fundamental reasons and negative effects on the development of companies and society. This paper finds that since the acquiring companies need to master the comprehensive information of target companies, they incline to choose the audit firms associated with the target companies. Those firms have the opportunity to collude with the target companies and may damage the takeover performance by hiding decision-making power or even falsifying financial data1. In addition, in order to defeat other potential competitors, acquiring companies need to review the financial records and assess the key personnel of target companies within a limited time. They may miss out some technical issues of corporate governance at the stage of pre-takeover due diligence.2 Therefore, this paper suggests that takeover parties adopt shared audit. As the information intermediary, shared audit could effectively eliminate the illegal acts caused by the collusion among auditors and auditees, convey accurate information and promote higher-quality takeovers.

The California GeoTracker Database: A Unique Public Resource for Understanding Contaminated Sites

AbstractData mining as a research tool requires access to high quality datasets. Investigation and cleanup of contaminated sites yield large amounts of monitoring data; however, historically, these data have not been available in large, consolidated datasets. The California GeoTracker web site and database is a public repository for a wide variety of information related to investigation and remediation of cleanup sites in California. Under California regulations, responsible parties must submit laboratory analytical results for environmental samples in electronic form along with reports and other information. The GeoTracker website also supports public access to the entire database of laboratory analytical results, which, for some sites, date back to 2001. This database includes approximately 285,000,000 analytical records for more than 50,000 contaminated and formerly contaminated sites in California. Because of the large volume of publicly‐available data, GeoTracker has been used as the primary data source for a number of data mining studies in the last 10 years. This article describes the GeoTracker origin story and how it has evolved to account for changes in regulatory priorities such as understanding vapor intrusion mechanisms and distribution of per‐ and polyfluoroalkyl substances (PFAS) in the environment, while maintaining database continuity. Finally, we review data mining projects that have utilized GeoTracker to better understand various aspects of contaminated site management. This review illustrates how long‐term commitment to collection and sharing of environmental data can support the general public and the regulatory and research communities.

FACTORS AFFECTING RESEARCH COMPETENCIES OF ACADEMICS IN THE DISCIPLINE OF HUMANITIES AND SOCIAL SCIENCES (HSS) IN THE CONTEXT OF OPEN AND DISTANCE LEARNING (ODL)

Abstract: The main purpose of the study is to examine the factors affecting research competencies of academics in the discipline of HSS in the context of ODL using the Motivational System Theory (MST). The interviews were conducted with twenty academics in the Faculty of Humanities and Social Sciences at the Open university of Sri Lanka (purposive sampling). The qualitative data were thematically analyzed. The results showed that the personal and institutional factors affecting research competencies of academics in the discipline of HSS. Moreover, at the institutional level, the resources, training, supportive mechanism and research culture are not properly established to achieve the research competencies of the academics. On the other hand, the personal factors such as family commitments and biological reasons are negatively affecting research competencies of academics. Therefore, the responsible parties should facilitate the academics to achieve the research competencies by providing the required resources, facilities, opportunities, guidance, training and creating a staff and student friendly working environment within the institution.
 Keywords: Academics; Humanities and Social Sciences; Motivational System Theory; Open and Distance Learning; Research competencies

Evaluation of Interventions Targeting Follow-up Appointment Scheduling After Emergency Department Referral to Ophthalmology Clinics Using A3 Problem Solving

Many patients seen for eye-related issues in the emergency department do not receive recommended follow-up care. Prior evidence supports that scheduling appointments is a barrier to accomplishing the transition to outpatient ophthalmology care. To evaluate time until appointment scheduling following emergency department discharge with urgent outpatient ophthalmology referral. The A3 problem solving process was implemented by a multidisciplinary team as part of a structured quality improvement program with the goal of reducing the mean time between urgent referral placement in the emergency department and outpatient ophthalmology appointment scheduling. The study was conducted at Stanford Health Care, an academic medical center in Palo Alto, California, affiliated with Stanford University School of Medicine. Using medical center administrative records, all patients discharged from the adult emergency department with an urgent outpatient referral to the Stanford Department of Ophthalmology from August 9 to September 19, 2020 (baseline; n = 43), and from October 26 to November 29, 2020 (after implementation of all interventions; n = 21), were included. Interventions developed to target the workflow of the ophthalmology resident, emergency department, ophthalmology clinic, and health system schedulers to address key drivers of the referral-scheduling process included medical record documentation guidelines, identification of responsible parties, preidentified appointment slots, patient education materials, and education of stakeholders, and were implemented by October 25, 2020. Mean time between urgent referral placement (ie, emergency department discharge) and appointment scheduling with outpatient ophthalmology at baseline vs postintervention. At baseline, appointments were scheduled a mean (range) 2.8 (0-7) days after referral placement. In the 5 weeks following implementation of interventions, the mean (range) decreased to 1.3 (0-4) days, a difference of 1.5 days (95% CI, 0.20-2.74; P = .02). This corresponds to 642 (95% CI, 86-1173) days of reduced patient wait time annually. In addition, there was less variability in the number of days between referral and appointment scheduling after intervention compared with baseline. The results suggest improvement in efficiency of outpatient ophthalmology appointment scheduling of urgent emergency department referrals could be achieved through application of a quality improvement methodology by a multidisciplinary team representing key stakeholders in the process.

Audits for Accountability: Evidence from Municipal By-Elections in South Africa

Theories of retrospective accountability assume that voters punish poor governance and reward improvements, yet empirical evidence remains mixed. We extend this research to a new context, assessing the impact of audits on electoral outcomes in South African municipalities. Our novel identification strategy focuses on by-elections triggered by deaths in office of local councilors and compares those taking place before and after audit results are announced each year. We find that timely audit information affects the vote share of the responsible party, with voters rewarding improvements and punishing poor audits by about 5 percentage points. Additional individual-level survey evidence confirms the underpinning behavioral response more generally. Our study is the first to demonstrate electoral accountability effects of audit information at full scale, involving universal spatial and temporal coverage as well as public and organic dissemination.

The dissemination and impacts of deceptive eWOM: a dynamic process perspective

ABSTRACT To minimise risk, consumers seek out eWOM, recommendations, and reviews from others before making purchasing decisions. However, it is not uncommon to see companies masterminding deceptive eWOM, disguising promotional messages as user-generated product reviews to attract and retain consumers. The extant literature is extremely limited regarding deceptive eWOM and its long-term effects. Ours is the first longitudinal study to examine consumers’ belief and attitude changes in the context of deceptive eWOM. This study found that, in a herding situation, deceptive eWOM can strongly influence changes in consumers’ beliefs and attitudes, whether in the early phase or mainstream phase, at the pre-adoption stage. If deceptive eWOM emerges earlier, it has a more powerful influence later. At the post-adoption stage, once they have used it, consumers may change their evaluations of a new product. However, this new evaluation is still subject to the initial anchoring effect brought by deceptive eWOM. If consumers sense deceptive eWOM and attribute it to a certain responsible party, the anchoring effect will be weakened. These findings provide further knowledge and understanding of the effects of deceptive eWOM, with implications for firms seeking to develop more effective eWOM marketing strategies.

A strategic monitoring approach for learning to improve natural infrastructure

Natural infrastructure (NI) development, including ecosystem restoration, is an increasingly popular approach to leverage ecosystem services for sustainable development, climate resilience, and biodiversity conservation goals. Although implementation and planning for these tools is accelerating, there is a critical need for effective post-implementation monitoring to accumulate performance data and evidence for best practices. The complexity and longer time scales associated with NI, compounded by differing disciplinary definitions and concepts of monitoring necessitate a deliberate and strategic approach to monitoring that encompasses different timeframes and objectives. This paper outlines a typology of monitoring classes differentiated by temporal scale, purpose of data collection, the information benefits of monitoring, and the responsible party. Next, we provide a framework and practical guidelines for designing monitoring plans for NI around learning objectives. In particular, we emphasize conducting research and development monitoring, which provides scientifically rigorous evidence for methodological improvement beyond the project scale. Wherever feasible, and where NI tools are relatively new and untested, such monitoring should avoid wasted effort and ensure progress and refinement of methodology and practice over time. Finally, we propose institutional changes that would promote greater adoption of research and development monitoring to increase the evidence base for NI implementation at larger scales.

Regulatory intelligence of health technologies in Greece

Greece has a public universal health system, the National Health System (ESY) – with mandatory insurance coverage (IKA) for all working people (either employees or self-employed). On top of that, people can voluntarily have private insurance. EOPYY (National Organisation for Healthcare Provision) is the only responsible party for purchasing health services funded by public resources based on the National Social Security Fund (EFKA) contributions and state budget. There is only a limited number of drugs being exclusively provided by the public health care system, for free (EOPYY pharmacies) like the high-cost medications. Other than these, patients can buy any drug they want. National Organization for Medicines (EOF) is the regulatory authority and also responsible for pharmacovigilance of medicines, medical products, of beauty and veterinary drugs. In 2011, the pricing and reimbursement processes were separated, with pricing taking place after marketing authorization; subsequently, analysis for reimbursement by the social health insurance is allowed with inclusion in a positive list. New pharmaceutical products follow an external reference pricing system, in which the maximum ex-factory price for medicines under patent is defined by the mean of the three lowest prices for the same drug in European Union (EU) countries, this same rule being applied to biological and biosimilar medicines. Generic drugs are priced either by the mean of the three lowest prices charged in the EU or by a 50% price reduction in relation to the period in which the medication was under patent; thus, the maximum prices of the generic drugs are set at 65% of the price of the respective reference product. In 2018, the Health Technology Assessment (HTA) was introduced in the country to evaluate medications and to issue recommendations to the Ministry of Health on the inclusion or removal of products from the Positive List. As the HTA process is still being reformed in Greece, it is believed that, in the coming years, the country will have the opportunity to improve the implementation, having the linking of the HTA results with the clinical guidelines as one of the major challenges.