Arbitration Agreements In Health Care: Myths and Reality

It is asserted that alternative dispute resolution methods, particularly mandatory binding arbitration agreements, have become the rule in health care delivery. A study was conducted to ascertain how widespread mandatory arbitration agreements between health plans and providers and their enrollees and patients really are, to assess how decisions regarding their use are made and to evaluate the prospects of their future use

Ministry and stress : listening to Anglican clergy in Wales

This study set out to examine the experiences of stress in ministry among a sample of Anglican clergy serving in Wales. Building on recent quantitative studies of work-related psychological health among Anglican clergy in England, the study employed mainly qualitative methods to illustrate eight issues: the clergy's overall assessment of their present health, their understanding of the characteristics of stress, their assessment of the levels of symptoms of stress within their own lives, their identification of the causes of stress within their experience of ministry, the people on whom they call for support in times of stress, their strategy for and styles of recreation, their assessment of the pastoral care provision available to clergy, and their views on enhancing initial clergy training to equip clergy to cope with stress. Data provided by 73 clergy (10 female and 63 male) portray a group of professionally engaged men and women who are well aware of the stress-related dynamics of their vocation, who are displaying classic signs of work-overload, and who are critical of and resistant to strategies that may confuse the pastoral care of stressed clergy with the accepted management role of the Church's hierarchy of bishops and archdeacons

Merit Rating for Physicians’ Malpractice Premiums: Only a Modest Deterrent

Results of a study showed that the targeting of malpractice-prone physicians from past paid-claims histories is only moderately accurate. It is possible, however, to gather more detailed information about physicians in addition to claims history and premium class that might lead to a more accurate prospective identification of those who will incur future paid claims

Clergy work-related psychological health : listening to the Ministers of Word and Sacrament within the United Reformed Church in England

Drawing on the classic model of balanced affect proposed by Bradburn (The structure of psychological well-being, Aldine, Chicago, IL, 1969), this study conceptualised poor work-related psychological health in terms of high levels of negative affect in the absence of acceptable levels of positive affect. In order to illuminate self-perceptions of work-related psychological health among a well-defined group of clergy, a random sample of 58 ministers of word and sacrament serving within the west midlands synod of the United Reformed Church in England completed an open-ended questionnaire concerned with the following six guiding questions. Do you enjoy your work? How would you define stress? How would you define burnout? What stresses are there in your ministry? What do you do to keep healthy? What can the church do to enhance the work-related psychological health of ministers? Content analysis highlighted the main themes recurring through these open-ended responses. The conclusion is drawn that ministers of word and sacrament within the United Reformed Church in England are exposed to a number of recurrent recognisable sources of stress. Suggestions are advanced regarding the need for future more detailed research and for the development of more effective pastoral strategies

The relationship between recalled self-esteem as a child and current levels of professional burnout among Anglican clergy in England

This study links and tests three strands of theory concerned with explaining individual differences in levels of professional burnout in general and among religious professionals in particular. These three strands concern the significance of current self-esteem, recalled self-esteem as a child, and personality. Data were provided by a sample of 1,278 male stipendiary parochial clergy working in the Church of England who completed the modified Maslach Burnout Inventory (specially designed for use among clergy), and the short-form Revised Eysenck Personality Questionnaire (designed to measure the personality dimensions of extraversion, neuroticism and psychoticism), together with a semantic differential index of recalled self-esteem as a child. The bivariate correlation coefficients demonstrated significant associations between more positive self-esteem as a child and lower levels of professional burnout (higher personal accomplishment, lower emotional exhaustion and lower depersonalisation). The bivariate correlation coefficients also demonstrated significant associations between personality and professional burnout. Multiple regression analyses, however, demonstrated that the association between recalled self-esteem as a child and professional burnout largely disappeared after controlling for the personality variables. The conclusion is drawn that knowledge about the personality profile of clergy functions as a more secure predictor of susceptibility to professional burnout than knowledge about recalled self-esteem as a child

The wavelength dependence of polarization in NGC 2023

NGC 2023 is a bright reflection nebula illuminated by the central star HD37903. At 2 microns the nebula is seen solely by reflected light from the central star but in the NIR there is excess radiation that is supposed to arise from thermal emission from a population of small grains (Sellgren, 1984). The unexpectedly high surface brightness at R and I wavelengths has led to the suggestion that even at these wavelengths there is a significant contribution from this thermal emission process (Witt, Schild, and Kraiman, 1984). If the nebula is seen by reflected starlight then this radiation will be linearly polarized. The level of polarization depends on the scattering geometry, grain size distribution, etc., and is typically 20 to 40 percent for nebulae such as NGC 1999 which is morphologically similar to NGC 2023. If, in any waveband, there is a contribution of radiation from emission processes this radiation will be unpolarized and will serve to dilute the scattered radiation to give a lower level of observed polarization. A study of the wavelength dependence of polarization in nebulae in which there may be thermal emission from grains will indicate the contribution from this process to the total luminosity. Polarization maps were produced in BVRI wavebands for the NGC 2023 nebulosity which confirm that at all wavelengths it is a reflection nebula illuminated by a central star. The wavelength dependence of polarization at representative points in the nebula and in a scatter plot of polarization in V and I wavebands at all points at which measurements are given. Results indicate that throughout the nebula there is a general trend for the level of polarization to increase with wavelength and that maximum levels of polarization occur at the longest wavelengths. No evidence is seen in the data for any significant contribution from the thermal emission from grains in the BVRI luminosity of NGC 2023

Metaldehyde removal from drinking water by adsorption onto filtration media: mechanisms and optimisation

Trace micropollutants should be removed during drinking water production without increasing the disinfection-by-product formation potential or energy demand of the treatment process. We demonstrate the efficacy of different filtration media to remove metaldehyde through controlled batch experiments on water augmented with metaldehyde. Equilibrium concentrations of metaldehyde and surrogate organics were successfully described by the Freundlich isotherm. Metaldehyde can be attenuated to varying degrees with activated carbon and sand with an active and inactive biofilm with kf values ranging from 0.006–0.3 (mg g−1)(L mg−1)1/n. The presence of the active biofilm improved metaldehyde adsorption by sand media, due to additional biosorption mechanisms, a greater surface area or biodegradation. Baseline levels of competing natural organic matter surrogates (NOM) reduced overall adsorption efficacy but increasing concentrations of NOM did not impact metaldehyde removal efficacy in a significant way. Biological activated carbon was identified as the most suitable adsorbent of metaldehyde (94% removal) but sand with an acclimated biofilm was capable of acting as a bio-adsorbent of metaldehyde even under environmentally relevant concentrations (41% adsorption from 0.002.5 mg L−1). Moreover, we observed that thermal hydrolysis of metaldehyde occurred at 60 °C, suggesting that thermal regeneration of GAC for this pesticide was possible at relatively low temperatures. Biological adsorption and thermal hydrolysis approaches presented herein offered a way forward to increase efficiency and cost effectiveness of existing treatments for metaldehyde

SOME FORENSIC ASPECTS OF BALLISTIC IMAGING

Analysis of ballistics evidence (spent cartridge casings and bullets) has been a staple of forensic criminal investigation for almost a century. Computer-assisted databases of images of ballistics evidence have been used since the mid-1980s to help search for potential matches between pieces of evidence. In this article, we draw on the 2008 National Research Council Report Ballistic Imaging to assess the state of ballistic imaging technology. In particular, we discuss the feasibility of creating a national reference ballistic imaging database (RBID) from test-fires of all newly manufactured or imported firearms. A national RBID might aid in using crime scene ballistic evidence to generate investigative leads to a crime gun’s point of sale. We conclude that a national RBID is not feasible at this time, primarily because existing imaging methodologies have insufficient discriminatory power. We also examine the emerging technology of micro- stamping for forensic identification purposes: etching a known identifier on firearm or ammunition parts so that they can be directly read and recovered from crime scene evidence. Microstamping could provide a stronger basis for identification based on ballistic evidence than the status quo, but substantial further research is needed to thoroughly assess its practical viability