Routine Patient Care in Clinical Trials: Whose Cost Is It Anyway?

This article examines the issue of coverage for routine medical expenses for clinical trial patients by third party payers from both a medical and political policy perspective. It is critical for patients, investigators, and sponsors to know who is responsible for paying these costs. This issue affects the willingness of patients to enter clinical trials and has the potential to affect which diseases will be the subjects of clinical trials. This presentation first summarizes the basics of clinical trials and then explores the definition of routine care in clinical trials. Medicare reimbursement, an issue that has been the subject of recent decisive action, is the starting point. The article provides explanation and discussion of the possible models, federal and state, for mandated coverage by other third party payers of routine patient care in clinical trials. A policy discussion and analysis follow, which includes information on the potential effects of this change on third party payers as well as researchers and patients. The placement of the cost liability for these expenses is related to other issues of patient protection; there is a brief discussion of the dangers of research on human subjects past and present to place this issue within the larger context of patient protection. In general, this mandated coverage is sensible and would create good public policy. However, it is important that patient protection remain the top priority in what could be an increased number of trials. The wording of the mandate should be careful not to shift costs that are rightfully borne by the trial sponsor to others

Routine Patient Care in Clinical Trials: Whose Cost Is It Anyway?

This article examines the issue of coverage for routine medical expenses for clinical trial patients by third party payers from both a medical and political policy perspective. It is critical for patients, investigators, and sponsors to know who is responsible for paying these costs. This issue affects the willingness of patients to enter clinical trials and has the potential to affect which diseases will be the subjects of clinical trials. This presentation first summarizes the basics of clinical trials and then explores the definition of routine care in clinical trials. Medicare reimbursement, an issue that has been the subject of recent decisive action, is the starting point. The article provides explanation and discussion of the possible models, federal and state, for mandated coverage by other third party payers of routine patient care in clinical trials. A policy discussion and analysis follow, which includes information on the potential effects of this change on third party payers as well as researchers and patients. The placement of the cost liability for these expenses is related to other issues of patient protection; there is a brief discussion of the dangers of research on human subjects past and present to place this issue within the larger context of patient protection. In general, this mandated coverage is sensible and would create good public policy. However, it is important that patient protection remain the top priority in what could be an increased number of trials. The wording of the mandate should be careful not to shift costs that are rightfully borne by the trial sponsor to others

Physiological Control of Differentiation of Xylem Elements

The physiological control of xylem differentiation is considered from holistic and reductionist perspectives. Cell type determination is identified as a central problem, but cell quality is also noted as being especially important from a utilization standpoint. The review focuses on biochemical and genetic controls and on cytological events during differentiation. The concluding section deals with the molecular assembly of xylem cells and suggests that a systems theory approach might be a powerful tool in understanding the physiology of xylem cell differentiation

A Biometric Technique for Reaction Tissue Research

Images of sections of tissue taken from the upper side of leaning stems of Populus deltoides were projected on a paper grid system. Specimens were oriented so that the cambium and the last three annual increments were included in cross section. Counts of stimulated and non-stimulated cells in randomly selected grids were recorded. This procedure provides a means of subjecting the incidence of tension wood and other cytohistological phenomena to statistical analysis

Ecologically Inspired Metrics for Rare Earth Element Critical Material Systems

Greenhouse gas emission reduction targets have increased demand for clean energy technologies, and the growth required for these technologies has led to concern over material availability and criticality. Critical materials are defined as having risks associated with them such as supply gaps or price volatility. Existing metrics for criticality determination are narrowly focused on physical scarcity of single materials, whereas many critical materials are byproducts of large, complex, interconnected material systems. Industrial ecology borrows methods from ecology to study complex material and energy flows, which can be used for a systems-perspective analysis. In this work, critical rare earth material systems are likened to food webs and analyzed using ecological network metrics and metrics borrowed from network analysis. This study considers food web metrics—partner diversity, connectance, specialization asymmetry, vulnerability, extinction slope, niche overlap, weighted betweenness, normalized degree, interaction push-pull, cluster coefficient, Shannon’s diversity, interaction evenness, and d’—best suited for describing systemic criticality in metal or mineral use systems. These metrics were applied to 10 rare earth elements and their end uses for China, Japan, and the United States from 1995-2007 as a case study to determine if ecologically inspired metrics could provide improved criticality assessment. Metrics address three system levels: 1) network, 2) group, and 3) individual elements/products. It was determined that some metrics highlight instances where rare earth systems are becoming more specialized making them vulnerable to supply risks. Application of ecological network metrics to material systems has advantages for criticality assessments, and future work should consider additional systems and the interactions between the various metrics to better understand these systems and lessons available from a systems-perspective

PENGARUH MEKANISME GOOD CORPORATE GOVERNANCE TERHADAP FINANCIAL REPORTING LAG (Studi Empiris Perusahaan Manufaktur yang Terdaftar di BEI Tahun 2014-2016)

Penelitian ini dibuat dengan tujuan untuk memberikan bukti empiris mengenai pengaruh penerapan mekanisme good corporate governance terhadap financial reporting lag. Good corporate governance dalam penelitian ini diukur dengan komisaris independen, komite audit, kepemilikan institusinal, kepemilikan manajerial dan kualitas audit. Sampel penelitian yang digunakan dalam penelitian ini adalah perusahaan manufaktur yang terdaftar di Bursa Efek Indonesia tahun 2014-2016. Purposive sampling digunakan sebagai metode pengambilan sampel. Teknik analisis yang digunakan adalah metode analisis regresi berganda dengan SPSS Versi 20. Hasil penelitian ini menunjukkan bahwa komite audit, kepemilikan institusinal, kepemilikan manajerial berpengaruh terhadap financial reporting lag sedangankan komisaris independen dan kualitas audit tidak berpengaruh terhadap financial reporting lag

Attract-Motivate-Retain Millennials: A Job Design Perspective from Thern, Inc.

The process of defining the way work will be performed, called job design, is one of the most important aspects of a running an efficient and effective business. Not only is job design imperative to the success of a business, but also to the overall satisfaction of employees. We will be focusing our research of job design on Thern Inc. To specify the aspect of the company’s job design, we will be analyzing the company’s employee retention, the balance between work and life, college recruiting the company does, and how the company appeals to the younger generation. We will be using theories such as the Job Characteristics Model to analyze the performance of Thern’s job design methods. This performance will be determined by interviewing employees, communicating with the company’s head of HR, and comparing this information we find to current industry trends.https://openriver.winona.edu/urc2019/1014/thumbnail.jp