3,487 research outputs found

    Socialized Medicine: An Analysis of Bureaucratic Inefficiency

    Get PDF
    In analyzing the health care systems of Great Britain and Canada, this Comment examines the policies and reasons behind the passing of legislation which led to the advent of socialized medicine in these two nations. In addition, a discussion of the operation of these socialized health systems illustrates the turmoil and complexity associated with government medicine, and the need for subsequent legislative reforms. As this Comment reveals, these socialized systems, where overriding political objectives create further misallocation of resources and decreased quality of care, fail to provide a viable solution to American health concerns. Instead, reforms should be undertaken within the present market system, a structure that remains flexible to change and promotes innovation

    A Simulation Study Of Economic Production Quantity Lot Size To Kanban For A Single Line Production System Under Various Setup Times With Average Work In Process (WIP) Inventory Cost As Performance Metric

    Get PDF
    The Setup time variable was evaluated for the two systems (Kanban and EPQ) against the performance measure of average WIP inventory cost.  EPQ outperforms Kanban on average WIP inventory cost at setup times less than 8 minutes.  The research helped clarify for practitioners whether EPQ might be more suitable than Kanban for their given situations

    Metabolic balance studies and dietary protein requirements in patients undergoing continuous ambulatory peritoneal dialysis

    Get PDF
    Metabolic balance studies and dietary protein requirements in patients undergoing continuous ambulatory peritoneal dialysis. Balance studies for nitrogen, potassium, magnesium, phosphorus, and calcium were carried out in eight men undergoing continuous ambulatory peritoneal dialysis (CAPD) to determine dietary protein requirements and mineral balances. Patients were fed high energy diets for 14 to 33 days which provided either 0.98 (seven studies) or 1.44g (six studies) of primarily high biological value protein/kg body wt/day. Mean nitrogen balance was neutral with the lower protein diet (+0.35 ± 0.83SEMg/day) and strongly positive with the higher protein diet (+2.94 ± 0.54g/day). With the higher protein diet the balances for potassium, magnesium, and phosphorus were strikingly positive, there was an increase in body weight in all patients, and a rise in mid-arm muscle circumference in five of the six patients. The relation between protein intake and nitrogen balance suggests that the daily protein requirement for clinically stable CAPD patients should be at least 1.1g/kg/day; to account for variability among subjects 1.2 to 1.3g protein/kg/day is probably preferable. Potassium balance correlated directly with nitrogen balance (r = 0.81). High fecal potassium losses (19 ± 1.2 mEq/day) in all patients probably helped maintain normal serum potassium concentrations. Mean serum magnesium was increased (3.1 ± 0.1 mg/dl), and magnesium balances were positive suggesting that the dialysate magnesium of 1.85 mg/dl is excessive. The netgain of calcium from dialysate was 84 ± 18 mg/day; this correlated inversely with serum calcium levels (r = -0.90).Bilans mĂ©taboliques et besoins protĂ©iques alimentaires de malades en dialyse pĂ©ritonĂ©ale continue ambulatoire. Des Ă©tudes de bilan de l'azote, du potassium, du magnĂ©sium, du phosphore et du calcium, Ă©taient fait en sept hommes en dialyse pĂ©ritonĂ©ale continue ambulatoire (CAPD), pour dĂ©terminer leurs besoins protĂ©iques alimentaires et leur bilan minĂ©ral. Les malades ont reçu pendant 14 Ă  33 jours des rĂ©gimes hautement Ă©nergĂ©tiques, apportant soit 0,98 (sept Ă©tudes), soit 1,44g (six Ă©tudes) de protĂ©ines de haute valeur biologique par kg de poids et par jour. Le bilan azotĂ© moyen etait nul avec le rĂ©gime comportant la plus faibie teneur protĂ©ique (+ 0,35 ± 0,88g/jSEM) et Ă©tait fortement positive avec le rĂ©gime Ă  plus forte teneur protĂ©ique (+2,94 ± 0,54g/j). Avec le rĂ©gime Ă  haute teneur en protĂ©ine, les bilans potassique, magnĂ©sien et phosphorĂ© Ă©taient fortement positifs; le poids corporel s'est Ă©levĂ© chez tous les malades; la circonfĂ©rence musculaire mesurĂ©e du milieu du bras a augmentĂ© chez cinq sur six malades. La relation existant entre l'apport protĂ©ique et le bilan azotĂ© suggĂšre que les besoins journaliers en protĂ©ines pour des malades cliniquement stables en CAPD devraient ĂȘtre au moins de 1,1g/kg/j; 1,2 Ă  1,3g de protĂ©ines/kg/j sont sans doute prĂ©fĂ©rables pour tenir compte de la variabilitĂ© entre les sujets. Le bilan potassique Ă©tait directement corrĂ©lĂ© avec la balance azotĂ©e (r = 0,81). De fortes pertes potassiques fĂ©cales (19 ± 1,2 mEq/j) chez tous les malades ont probablement contribuĂ© Ă  maintenir normales les concentrations sĂ©riques du potassium. La magnĂ©sĂ©mie moyenne Ă©tait Ă©levĂ©e (3,1 ± 0,1 mg/dl), et les bilans magnĂ©siens aient positifs suggĂ©rant que le magnĂ©sium du dialysat (1,85 18 mg/dl) Ă©tait trop Ă©levĂ©. Le gain net en calcium Ă  partir du dialysat Ă©tait de 84 ± 18 mg/j; ce gain Ă©tait inversement corrĂ©lĂ© avec la calcĂ©mie (r = 0,90)

    Gait Analysis of Teenagers and Young Adults Diagnosed with Autism & Severe Verbal Communication Disorders

    Get PDF
    Both movement differences and disorders are common within autism spectrum disorders (ASD). These differences have wide and heterogeneous variability among different ages and sub-groups all diagnosed with ASD. Gait was studied in a more homogeneously identified group of nine teenagers and young adults who scored as “severe” in both measures of verbal communication and overall rating of Autism on the Childhood Autism Rating Scales (CARS). The ASD individuals were compared to a group of typically developing university undergraduates of similar ages. All participants walked a distance of 6-meters across a GAITRite (GR) electronic walkway for six trials. The ASD and comparison groups differed widely on many spatiotemporal aspects of gait including: step and stride length, foot positioning, cadence, velocity, step time, gait cycle time, swing time, stance time, and single and double support time. Moreover, the two groups differed in the percentage of the total gait cycle in each of these phases. The qualitative rating of “Body Use” on the CARS also indicated severe levels of unusual body movement for all of the ASD participants. These findings demonstrate that older teens and young adults with “severe” forms of Verbal Communication Impairments and Autism differ widely in their gait from typically developing individuals. The differences found in the current investigation are far more pronounced compared to previous findings with younger and/or less severely involved individuals diagnosed with ASD as compared to typically developing controls. As such, these data may be a useful anchor-point in understanding the trajectory of development of gait specifically and motor functions generally.

    Two-Legged Hopping in Autism Spectrum Disorders

    Get PDF
    Sensory processing deficits are common within autism spectrum disorders (ASD). Deficits have a heterogeneous dispersion across the spectrum and multimodal processing tasks are thought to magnify integration difficulties. Two-legged hopping in place in sync with an auditory cue (2.3, 3.0 Hz) was studied in a group of six individuals with expressive language impaired ASD (ELI-ASD) and an age-matched control group. Vertical ground reaction force data were collected and discrete Fourier transforms were utilized to determine dominant hopping cadence. Effective leg stiffness was computed through a mass-spring model representation. The ELI-ASD group were unsuccessful in matching their hopping cadence (2.21 ± 0.30 hops·s−1, 2.35 ± 0.41 hops·s−1) to either auditory cue with greater deviations at the 3.0 Hz cue. In contrast, the control group was able to match hopping cadence (2.35 ± 0.06 hops·s−1, 3.02 ± 0.10 hops·s−1) to either cue via an adjustment of effective leg stiffness. The ELI-ASD group demonstrated a varied response with an interquartile range (IQR) in excess of 0.5 hops·s−1 as compared to the control group with an IQR \u3c 0.03 hops·s−1. Several sensorimotor mechanisms could explain the inability of participants with ELI-ASD to modulate motor output to match an external auditory cue. These results suggest that a multimodal gross motor task can (1) discriminate performance among a group of individuals with severe autism, and (2) could be a useful quantitative tool for evaluating motor performance in individuals with ASD individuals

    Contracting with Limited Commitment: Evidence from Employment-Based Health Insurance Contracts

    Get PDF
    When an individual\u27s health status is observable, but evolving over time, the key to maintaining a successful health insurance arrangement is to have the healthier members of the group cross-subsidize those who experience adverse health outcomes. We argue that impediments to worker mobility may serve to mitigate the attrition of healthy individuals from employer-sponsored insurance pools, thereby creating a de facto commitment mechanism that allows for more complete insurance of health risks than would be possible in the absence of such frictions. Using data on health insurance contracts obtained from the 1987 National Medical Expenditure Survey, we find that the quantity of insurance provided, as measured by lifetime limits on benefits and annual stop-loss amounts, is positively related to the degree of worker commitment. These results illustrate the importance of commitment in the design of long-term contracts, and provide an additional rationale for the practice of bundling health insurance with employment