Medical Technology Investment Decision-Making at U.S. Hospitals: A Comparative Case Study of Four Organizations

Investments in expensive medical technologies, ranging from computed tomography (CT) scanners to proton beam accelerators, consume a major share of hospitals’ capital budgets. The demand by physicians, patients and other stakeholders for medical technologies often exceeds a hospital’s financial resources. When allocating their tight budgets, hospitals also need to account for multiple organizational objectives. The objective of this paper is to analyze current practices in medical technology investment decision-making at U.S. hospitals. Through semi-structured interviews of administrators at four hospital organizations, we obtained information on their medical technology investment decision approach. Findings from our interviews confirm that a systematic decision process that considers all organizational objectives, analyzes and integrates comprehensive data, and is objective and consistent is rarely applied. We propose that hospital organizations develop and implement such systematic processes and do so by building upon decision analysis principles and approaches, such as the Simple Multi-Attribute Rating Technique (SMART)

The maximal discrete extension of the Hermitian modular group

Let Gamma(n)(O-K) denote the Hermitian modular group of degree n over an imaginary-quadratic number field K. In this paper we determine its maximal discrete extension in SU(n, n; C), which co-incides with the normalizer of Gamma(n)(O-K). The description involves the n-torsion subgroup of the ideal class group of K. This group is defined (K) over cap (n) and we can describe the ramified over a particular number field primes in it. In the case n = 2 we give an explicit description, which involves generalized Atkin-Lehner involutions. Moreover we find a natural characterization of this group in SO(2, 4)

A study of acculturation : ORMU57, Portland's Old Chinatown, ca. 1870-1920

This archaeological based research uses ceramics in the study of acculturation from a site excavated by an urban archaeology contract firm, and utilizes the theories of consumer choice, ethnicity and acculturation. Artifact analysis took place in the form of minimum vessel counts, artifact relative frequencies, and Chinese artifact values, as well as various mapping strategies in attempts to indicate and evaluate counts and distribution patterns for the assessment of levels of acculturation within a portion of the Chinese community of Old Chinatown in Portland, Oregon. Field methodology inconsistencies only allowed for minimal conclusions, however achaeological and historical evidence indicated that very low levels of acculturation did occur among those living within the study area. This research also allowed for investigations into urban contract archaeology field methods. It was found that if future researchers wish to study the area of acculturation based on archaeological evidence, consistency and thoroughness will have to be a priority within field methods of sites excavated

O abuso do direito de voto na recuperação judicial

Busca o presente trabalho analisar os parâmetros que são adotados para que se reconheça o abuso do direito de voto pelos credores no processo de recuperação judicial. Para tanto, buscouse analisar os casos mais recorrentes em que a jurisprudência brasileira reconheceu um voto como sendo abusivo, sistematizando-os em grupos conforme os fundamentos que foram utilizados para formar a decisão. Assim, foi possível reconhecer as hipóteses de abuso do direito de voto por inobservância ao princípio da preservação da empresa, de abuso do direito de voto por inobservância da boa-fé perante o devedor e de abuso do direito de voto por inobservância do dever de lealdade perante os demais credores. Por fim, também foi feita uma análise das disposições presentes no Projeto de Lei nº 10.220/2018 sobre o tema, apontando a eventual influência destas disposições nas hipóteses de abuso do direito de voto que já se encontram consolidadas pela jurisprudência pátria.This paper seeks to analyze the parameters that are adopted in order to recognize the creditors abuse of right to vote in the reorganization process. For this purpose, it was analyzed the most recurrent cases in which the Brazilian jurisprudence recognized a vote as being abusive, systemizing them in groups according to the reasons that were used to justify the decision. Therefore, it was possible to recognize the hypotheses of abuse of the right to vote for the failure to comply with principle of preservation of the company, for the failure to observe good faith before the debtor and for the failure to comply with the duty of loyalty to the other creditors. Finally, an analysis of the provisions present in the Bill No. 10.220/2018 on the subject was also made, pointing to the possible influence of these provisions on the hypotheses of abuse of the right to vote that are already consolidated by the Brazilian jurisprudence

Pre-hatching stages of the tailed frog, (Ascaphus truei) (Stejnegar)

Description of anuran larvae with the use of staging tables is a common practice in the study of frog life-histories, but there has been no previous description or table of Ascaphus larvae. In comparing Ascaphus larvae to a simplified staging table for anurans it was found that these larvae vary considerably from those of other anurans. Five stages had to be eliminated (Fertilization, Grey Crescent, Neural Plate, Gill Circulation, and Cornea Transparent) and five new ones created (Deposition, Neural Groove, Eye Pigmentation, Body Pigmentation, and Hatching). The final result was a series of twenty-one stages, from Deposition through Hatching, through which the growth and development of the larvae could be traced and which will, it is hoped, facilitate discussion of larval Ascaphus in any further studies. Determination of tadpole food habits through stomach and intestinal content samples was largely unsuccessful