298 research outputs found

    Методы оценки налогооблагаемой прибыли в Германии

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    Оценка налогооблагаемой прибыли имеет важнейшее значение для налоговой нагрузки в сфере бизнеса и поэтому является предметом политических дискуссий и претерпевает постоянные изменения. С учетом актуальности проблемы, сформулирована цель исследования: анализ законодательно установленных методов оценки налогооблагаемой прибыли в Германии, их достоинств и недостатков, а также особенностей их практического применения. Данный анализ может быть использован для изучения перспектив совершенствования налоговой системы и развития бизнеса в России. В статье рассматриваются сферы применения различных методов оценки прибыли. Выявлено, что важнейшими из них являются метод полного сравнения операционных активов компании (налоговый баланс) и метод основанный на оценке чистой прибыли. Главное отличие этих методов в том, что первый построен на основе сопоставления балансов на начало и конец года, что и позволяет сравнивать операционные активы, а второй базируется на принципе денежного потока (поступления и расходования денежных средств). В работе подробно описывается применение указанных методов. Проведенный анализ показал, что сравнение операционных активов компании является более точным методом, хотя и гораздо более дорогостоящим, чем отчетность, основанная на методе чистой прибыли. Анализ подтверждается практическими примерами.The assessment of taxable earnings is of fundamental importance for the corporate tax burden. Therefore it is often subject of political discussions and is either witnessing a constant process of change. Against this background, the aim of this paper is to analyse the structure of the assessment of taxable earnings in Germany. This can be used to obtain information on the possibilities for future national developments in Russia. We start with an overview of the areas of application of the different methods for the assessment of earnings. It shows that the complete comparison of a company’s operating assets (so-called tax balance sheet) and the statement based on the net income method are the most important methods. The fundamental difference between this two methods: the statement based on the net income method is controlled by the inflow and outflow principle (flow value statement), the stock value statement, which makes it necessary to draw up two balance sheets (one at the start of the year and one at the end of the year, underlies the comparison of the company’s operating assets. Therefore the analysis focuses on these two methods. It shows, that the complete comparison of a company’s operating assets is more accurate but although much more costly than the statement based on the net income method. The analysis is supported by practical examples, which are also used to illustrate the differences between the two main methods

    Kleinere biologische bedrijven

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    Er zijn in Nederland en Vlaanderen veel kleinere biologische bedrijven. Zij houden zich vaak bezig met groenteteelt op kleine schaal en verkopen rechtstreeks aan de consument. Kenmerk van deze bedrijven is dat ze veel gewassen op een kleine oppervlakte telen. Veel bedrijven verkopen via groenteabonnementen, webwinkel, biologische markt of winkel aan huis. Deze bedrijven bepalen voor een belangrijk deel het gezicht van de biologische landbouw

    Niet kerende grondbewerking (NKG)

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    Een goede bodemstructuur en een gezonde bodem zijn belangrijk in de biologische landbouw. Bodemverdichting is vaak direct te zien aan een biologisch gewas. Daarom maken biologische ondernemers gebruik van vaste mest, groenbemesters, rijpaden, GPS besturing en mechanisatie die niet zwaarder is dan noodzakelijk. Ook niet kerende grondbewerking (NKG) kan een positieve invloed op de bodemstructuur hebben

    The influence of context on the effectiveness of hospital quality improvement strategies: a review of systematic reviews.

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    BACKGROUND: It is now widely accepted that the mixed effect and success rates of strategies to improve quality and safety in health care are in part due to the different contexts in which the interventions are planned and implemented. The objectives of this study were to (i) describe the reporting of contextual factors in the literature on the effectiveness of quality improvement strategies, (ii) assess the relationship between effectiveness and contextual factors, and (iii) analyse the importance of contextual factors. METHODS: We conducted an umbrella review of systematic reviews searching the following databases: PubMed, Cochrane Database of Systematic Reviews, Embase and CINAHL. The search focused on quality improvement strategies included in the Cochrane Effective Practice and Organisation of Care Group taxonomy. We extracted data on quality improvement effectiveness and context factors. The latter were categorized according to the Model for Understanding Success in Quality tool. RESULTS: We included 56 systematic reviews in this study of which only 35 described contextual factors related with the effectiveness of quality improvement interventions. The most frequently reported contextual factors were: quality improvement team (n = 12), quality improvement support and capacity (n = 11), organization (n = 9), micro-system (n = 8), and external environment (n = 4). Overall, context factors were poorly reported. Where they were reported, they seem to explain differences in quality improvement effectiveness; however, publication bias may contribute to the observed differences. CONCLUSIONS: Contextual factors may influence the effectiveness of quality improvement interventions, in particular at the level of the clinical micro-system. Future research on the implementation and effectiveness of quality improvement interventions should emphasize formative evaluation to elicit information on context factors and report on them in a more systematic way in order to better appreciate their relative importance

    Involvement of patients or their representatives in quality management functions in EU hospitals:implementation and impact on patient-centred care strategies

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    OBJECTIVE: The objective of this study was to describe the involvement of patients or their representatives in quality management (QM) functions and to assess associations between levels of involvement and the implementation of patient-centred care strategies. DESIGN: A cross-sectional, multilevel STUDY DESIGN: that surveyed quality managers and department heads and data from an organizational audit. SETTING: Randomly selected hospitals (n = 74) from seven European countries (The Czech Republic, France, Germany, Poland, Portugal, Spain and Turkey). PARTICIPANTS: Hospital quality managers (n = 74) and heads of clinical departments (n = 262) in charge of four patient pathways (acute myocardial infarction, stroke, hip fracture and deliveries) participated in the data collection between May 2011 and February 2012. MAIN OUTCOME MEASURES: Four items reflecting essential patient-centred care strategies based on an on-site hospital visit: (1) formal survey seeking views of patients and carers, (2) written policies on patients' rights, (3) patient information literature including guidelines and (4) fact sheets for post-discharge care. The main predictors were patient involvement in QM at the (i) hospital level and (ii) pathway level. RESULTS: Current levels of involving patients and their representatives in QM functions in European hospitals are low at hospital level (mean score 1.6 on a scale of 0 to 5, SD 0.7), but even lower at departmental level (mean 0.6, SD 0.7). We did not detect associations between levels of involving patients and their representatives in QM functions and the implementation of patient-centred care strategies; however, the smallest hospitals were more likely to have implemented patient-centred care strategies. CONCLUSIONS: There is insufficient evidence that involving patients and their representatives in QM leads to establishing or implementing strategies and procedures that facilitate patient-centred care; however, lack of evidence should not be interpreted as evidence of no effect

    A possible influence of the Great White Spot on Saturn kilometric radiation periodicity

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    The periodicity of Saturn kilometric radiation (SKR) varies with time, and its two periods during the first 5 years of the Cassini mission have been attributed to SKR from the northern and southern hemisphere. After Saturn equinox in August 2009, there were long intervals of time (March 2010 to February 2011 and September 2011 to June 2012) with similar northern and southern SKR periods and locked SKR phases. However, from March to August 2011 the SKR periods were split up again, and the phases were unlocked. In this time interval, the southern SKR period slowed down by ~ 0.5% on average, and there was a large jump back to a faster period in August 2011. The northern SKR period speeded up and coalesced again with the southern period in September 2011. We argue that this unusual behavior could be related to the so-called Great White Spot (GWS), a giant thunderstorm that raged in Saturn's atmosphere around that time. For several months in 2011, the visible head of the GWS had the same period of ~ 10.69 h as the main southern SKR modulation signal. The GWS was most likely a source of intense gravity waves that may have caused a global change in Saturn's thermospheric winds via energy and momentum deposition. This would support the theory that Saturn's magnetospheric periodicities are driven by the upper atmosphere. Since the GWS with simultaneous SKR periodicity measurements have only been made once, it is difficult to prove a physical connection between these two phenomena, but we provide plausible mechanisms by which the GWS might modify the SKR periods

    The tRNA methyltransferase Dnmt2 is required for accurate polypeptide synthesis during haematopoiesis

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    The Dnmt2 enzyme utilizes the catalytic mechanism of eukaryotic DNA methyltransferases to methylate several tRNAs at cytosine 38. Dnmt2 mutant mice, flies, and plants were reported to be viable and fertile, and the biological function of Dnmt2 has remained elusive. Here, we show that endochondral ossification is delayed in newborn Dnmt2-deficient mice, which is accompanied by a reduction of the haematopoietic stem and progenitor cell population and a cell-autonomous defect in their differentiation. RNA bisulfite sequencing revealed that Dnmt2 methylates C38 of tRNA Asp(GTC), Gly(GCC), and Val(AAC), thus preventing tRNA fragmentation. Proteomic analyses from primary bone marrow cells uncovered systematic differences in protein expression that are due to specific codon mistranslation by tRNAs lacking Dnmt2-dependent methylation. Our observations demonstrate that Dnmt2 plays an important role in haematopoiesis and define a novel function of C38 tRNA methylation in the discrimination of near-cognate codons, thereby ensuring accurate polypeptide synthesis

    Changes in volume, clinical practice and outcome after reorganisation of oesophago-gastric cancer care in England: A longitudinal observational study.

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    AIM: The centralisation of oesophago-gastric (O-G) cancer services in England was recommended in 2001, partly because of evidence for a volume-outcome effect for patients having surgery. This study investigated the changes in surgical services for O-G cancer and postoperative mortality since centralisation. METHODS: Patients with O-G cancer who had an oesophageal or gastric resection between April 2003 and March 2014 were identified in the national Hospital Episodes Statistics database. We derived information on the number of NHS trusts performing surgery, their surgical volume, and the number of consultants operating. Postoperative mortality was measured at 30 days, 90 days and 1 year. Logistic regression was used to examine how surgical outcomes were related to patient characteristics and organisational variables. RESULTS: During this period, 29 205 patients underwent an oesophagectomy or gastrectomy. The number of NHS trusts performing surgery decreased from 113 in 2003-04 to 43 in 2013-14, and the median annual surgical volume in NHS trusts rose from 21 to 55 patients. The annual 30 day, 90 day and 1 year mortality decreased from 7.4%, 11.3% and 29.7% in 2003-04 to 2.5%, 4.6% and 19.8% in 2013-14, respectively. There was no evidence that high-risk patients were not undergoing surgery. Changes in NHS trust volume explained only a small proportion of the observed fall in mortality. CONCLUSION: Centralisation of surgical services for O-G cancer in England has resulted in lower postoperative mortality. This cannot be explained by increased volume alone

    Achtergronddocument Midterm meting Monitor Effectindicatoren Agenda Vitaal Platteland

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    De Monitor AVP is een systeem waarin eenduidige gegevens worden opgenomen voor monitoring van effecten, resultaten en prestaties van de beleidsdoelstellingen opgenomen in de Agenda Vitaal Platteland (AVP) van het ministerie van Economische Zaken, Landbouw & Innovatie (EL&I). Dit document geeft de resultaten en achtergrondinformatie van de midterm meting en de methoden van de metingen van de afzonderlijke effectindicatoren van de Monitor AVP. De effectindicatoren zijn bedoeld om de maatschappelijke effecten van de Agenda Vitaal Platteland inzichtelijk te maken. Dit achtergronddocument is opgesteld om de continuïteit voor toekomstige herhalingsmetingen te waarborgen

    Patient Experience Shows Little Relationship with Hospital Quality Management Strategies.

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    OBJECTIVES: Patient-reported experience measures are increasingly being used to routinely monitor the quality of care. With the increasing attention on such measures, hospital managers seek ways to systematically improve patient experience across hospital departments, in particular where outcomes are used for public reporting or reimbursement. However, it is currently unclear whether hospitals with more mature quality management systems or stronger focus on patient involvement and patient-centered care strategies perform better on patient-reported experience. We assessed the effect of such strategies on a range of patient-reported experience measures. MATERIALS AND METHODS: We employed a cross-sectional, multi-level study design randomly recruiting hospitals from the Czech Republic, France, Germany, Poland, Portugal, Spain, and Turkey between May 2011 and January 2012. Each hospital contributed patient level data for four conditions/pathways: acute myocardial infarction, stroke, hip fracture and deliveries. The outcome variables in this study were a set of patient-reported experience measures including a generic 6-item measure of patient experience (NORPEQ), a 3-item measure of patient-perceived discharge preparation (Health Care Transition Measure) and two single item measures of perceived involvement in care and hospital recommendation. Predictor variables included three hospital management strategies: maturity of the hospital quality management system, patient involvement in quality management functions and patient-centered care strategies. We used directed acyclic graphs to detail and guide the modeling of the complex relationships between predictor variables and outcome variables, and fitted multivariable linear mixed models with random intercept by hospital, and adjusted for fixed effects at the country level, hospital level and patient level. RESULTS: Overall, 74 hospitals and 276 hospital departments contributed data on 6,536 patients to this study (acute myocardial infarction n = 1,379, hip fracture n = 1,503, deliveries n = 2,088, stroke n = 1,566). Patients admitted for hip fracture and stroke had the lowest scores across the four patient-reported experience measures throughout. Patients admitted after acute myocardial infarction reported highest scores on patient experience and hospital recommendation; women after delivery reported highest scores for patient involvement and health care transition. We found no substantial associations between hospital-wide quality management strategies, patient involvement in quality management, or patient-centered care strategies with any of the patient-reported experience measures. CONCLUSION: This is the largest study so far to assess the complex relationship between quality management strategies and patient experience with care. Our findings suggest absence of and wide variations in the institutionalization of strategies to engage patients in quality management, or implement strategies to improve patient-centeredness of care. Seemingly counterintuitive inverse associations could be capturing a scenario where hospitals with poorer quality management were beginning to improve their patient experience. The former suggests that patient-centered care is not yet sufficiently integrated in quality management, while the latter warrants a nuanced assessment of the motivation and impact of involving patients in the design and assessment of services
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