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PubMedDate not supplied

Teaching emergency preparedness to restricted-budget families.

OBJECTIVE: To fulfill the health teaching and promotion responsibilities of public health nurses, a teaching intervention was devised to prepare low-income, low-resource families to survive a worst-case disaster scenario. The purpose of this study is to introduce that plan. DESIGN: Teaching sessions were held to increase awareness about disaster preparedness and to provide the resources necessary for preparing disaster kits on a restricted budget. SAMPLE: This project focused on families enrolled at the Children's Relief Nursery in Portland, Oregon's St. Johns District. MEASUREMENTS: Posttest assessments and client follow-up at 3, 6, and 12 months were used to assess the effectiveness of the curriculum and follow-through on kit preparation. RESULTS: A replicable teaching tool was successfully developed, and the interest and commitment of community partners dedicated to assisting restricted-budget families was secured. CONCLUSIONS: States' disaster plans hinge on individuals' implementation of their own survival plans, and it is vital that these individuals be made aware of their responsibility. It is truly a matter of life and death that families possess the skills, knowledge, and resources to carry out a disaster survival plan successfully, and it is the ethical responsibility of the public health nurse to intervene.

Disaster Planning↗
PubMed2005

Unexpected changes to the global methane budget over the past 2000 years.

We report a 2000-year Antarctic ice-core record of stable carbon isotope measurements in atmospheric methane (delta13CH4). Large delta13CH4 variations indicate that the methane budget varied unexpectedly during the late preindustrial Holocene (circa 0 to 1700 A.D.). During the first thousand years (0 to 1000 A.D.), delta13CH4 was at least 2 per mil enriched compared to expected values, and during the following 700 years, an about 2 per mil depletion occurred. Our modeled methane source partitioning implies that biomass burning emissions were high from 0 to 1000 A.D. but reduced by almost approximately 40% over the next 700 years. We suggest that both human activities and natural climate change influenced preindustrial biomass burning emissions and that these emissions have been previously understated in late preindustrial Holocene methane budget research.

Journal Article↗
PubMed1974

Budget and the National Cancer Program.

The budget picture for the NCI is presented for your information and evaluation-evaluation in the sense that I need and would appreciate your comments. A major issue of course is balance, in terms of clinic versus laboratory; short-term versus long-term; academic versus commercial; targeted versus nontargeted; grants versus contracts versus intramural; national versus international, and the like. It must be recognized that within a program of this emotion, visibility, and importance scientific findings and other considerations will dictate changes on at least a monthly basis. Things other than science contribute to this balance. On any given day we live within the impact of at least three budget years (what we received and did last year, what we will receive and do this year, and what this will allow us to receive and do next year). The federal budgetary process as well as the priority-setting processes of science are such that new directions cannot be taken as qulickly as woLld be optimal. Priorities muLst be set in cancer at least in their broad sense; for in addition to other areas of biomedical research, there are other compelling demands for the limited federal dollar. There will never be enouLgh resources to do all that can be done or needs to be done in cancer research. That probably is as it should be. In this regard it is heartening that operating funds for the institutes at NIH other than NCI will increase by $264 million in 1974. It is as true that information from research in other disciplines and categorical diseases will provide leads to cancer, as well as the reverse. And certainly, virtually no one wants to see resources for cancer increased at the expense of other important tasks and opportunities. This article is not an attempt to justify or to defend the spending plan of the National Cancer Program. It is to let youL know what's going on and to seek further advice on how to do it better. Articles on other aspects of the program will be published in journals including Science, Cancer Research, and the Journal of the National Cancer Institute.

National Institutes of Health (U.S.)↗
PubMed1980

The planner as public health resource allocator: post-Proposition 13 county health services in California and the role of the HSAs in budget review and public hearings.

Immediately following adoption of Proposition 13 in California in June of 1978, the state legislature adopted a Bail-Out program which included procedures for monitoring the detrimental effects of disproportionate reductions in public health, inpatient and outpatient county budgets. For a variety of reasons, the methodology and procedures employed failed to reveal the adverse effects of Proposition 13 on health services. This paper deals with the actual and potential role of health systems agencies (HSAs) in monitoring such effects, commenting in public hearings on budget review and, in general, playing a policy analysis role that links local government with the citizenry on the one hand and the state government on the other. In addition to identifying the weakness of the State's monitoring effort in identifying negative effects in program analysis and staffing reductions, the findings point out the limited role of HSAs. Specific recommendations are offered for improvement of HSA involvement in future resource allocation planning in California and the United States as a whole.

California↗
PubMed2003

Unconventional ventral attachment of time-depth recorders as a new method for investigating time budget and diving behaviour of seabirds.

We tested the use of commercially available electronic time-depth recorders (TDRs) to quantify activities and thus total time budgets of seabirds. This new method involved first fitting TDRs onto the birds' bellies (not on their backs), and, secondly, analysing continuous recordings of temperature, light and pressure to differentiate activities on land and at sea. The birds studied were 12 common guillemots (Uria aalge) rearing chicks at Hornøya, in northern Norway. The method successfully recorded five different activities: at the colony, flying, diving, and resting or active at the sea surface. Overall, common guillemots spent 68% of their time at the colony and 32% at sea. While at sea, the birds spent the majority (77%) of their time at the surface, during which they were active 64% of the time, and rested only 13%. Birds engaged in the costly behaviours of flying and diving for shorter times (11% and 12% of their time at sea, respectively). The method allowed us to differentiate between two types of trips to sea based on the presence (foraging trips: 77% of the total number of trips) or absence (non-foraging trips: 23%) of dives. On average, foraging trips lasted 3.2 h, but most trips were shorter (<1 h), during which the mean estimated travel distance from the colony was 11 km. Diving occurred in bouts of 7.7+/-6.6 dives (mean +/- S.D.). The mean maximum dive depth was 10.2+/-7.6 m (deepest dive: 37 m), and the mean dive duration and post-dive intervals were 38.7+/-21.3 s (longest dive: 119 s) and 20+/-12 s, respectively. Direct and indirect evidence suggests that common guillemots had no difficulty in finding food during the study period, and that the TDRs had minimal effects on the birds' behaviour and physiology. The method is easy to use in the field and is applicable to many other flying seabird species; it is therefore an efficient way of collecting information on time budgets and diving behaviour in the context of various ecological and monitoring studies.

Animals↗
PubMed1998

The effects of acquisition cost and budget-based compensation on the attitudes of pharmacy directors toward the adoption of a cost-effective new drug.

To test the effect of differences in acquisition cost and budget-based monetary compensation systems on the intent to support the adoption of a cost-effective new drug, over 350 hospital pharmacy directors were asked to indicate their intentions as to the adoption of a cost-effective new thrombolytic agent, presented at 3 different prices. Although the economic savings for the hypothetical product were constant across all price points tested, respondents exposed to the highest price were more likely to resist the adoption of the new agent than those exposed to lower prices (p < 0.001). Respondents whose compensation was contingent on their control of the drug budget indicated a higher likelihood to resist the adoption of the new agent than did those whose salary was not so determined. These findings indicate that significant hurdles, psychological and organisational, still exist for the acceptance and use of pharmacoeconomic information in the hospital setting.

Decision Making↗
PubMed2005

The case of tumour necrosis factor-alpha inhibitors in the treatment of rheumatoid arthritis: a budget impact analysis.

BACKGROUND: Treatment with tumour necrosis factor (TNF)-alpha inhibitors offers promising new opportunities to improve the health-related QOL of patients with rheumatoid arthritis (RA) in Denmark. As of September 2003, two such compounds -- infliximab and etanercept -- were registered for use by patients with RA. These drugs have shown the ability to reduce disease activity and to slow down or halt the development of new joint damage in otherwise treatment-resistant patients with RA. The acquisition cost of the drugs is high, with 1 year of treatment costing euros 9000-12,000 per patient. OBJECTIVE: The aim of this study was to assess the potential impact on the Danish healthcare budget of prescribing infliximab or etanercept to patients with RA. METHOD: Two treatment implementation scenarios were investigated. In the progressive scenario, all patients newly diagnosed with RA were offered TNFalpha inhibitors as the drug of first choice. In the modest scenario, only patients with insufficient disease suppression by conventional therapy with disease-modifying anti-rheumatic drugs (DMARDs) were offered TNFalpha inhibitor therapy. The budget impact analysis, which was part of a Danish health technology assessment of TNFalpha inhibitors, focused on the number of patients offered treatment during a 5-year period and resource use related to drug and staff costs. Simple sensitivity analyses assessed the consequences of changing the drug dosage, the number of patients offered treatment and the rate of treatment cessation. RESULTS: The results suggested that both implementation strategies would impose additional costs per year on the Danish healthcare service, in the range of euros 67-188 million for the progressive scenario and euros 17-49 million for the modest scenario (price level August 2002). These costs represent between half and up to five times the amount currently used on treating patients with RA. CONCLUSION: This analysis suggests that the introduction of TNFalpha inhibitors into the treatment regimen of patients with RA could pose a considerable financial burden on the Danish healthcare system.

Antibodies, Monoclonal↗
PubMed1976

The 1977 U.S. budget: a time for choice?

This paper continues to spin the thread of previous analyses of the bleakness of the budgetary outlook in the United States and the difficulty of change. The budget remains mortgaged by actions in previous years, and the economic outlook is uncertain. "The politics of frugality" has come to dominate the American political scene, but the President's choices to reduce spending on human resource programs by $18 billion are more apparent than real. The new Congressional review procedures, a reaction to the Watergate years, interrelate budget with health policy and highlight the necessity for action to control medical care prices if any new federal initiatives, e.g. national health insurances, are to be budgetarily feasible.

Economics, Medical↗
PubMedDate not supplied

New equipment for 1989 capital budgets. A checklist of new technologies that may improve your hospital's competitive position.

With growing constraints on all categories of inpatient revenue, many hospitals face their tightest-ever capital budgets in 1989. Yet pressures continue for hospitals to acquire new technologies in order to remain competitive and attract patients and physicians. This summary of new technologies that many hospitals should be considering will aid in prioritizing capital budget requests.

Capital Expenditures↗
PubMed2000

Medicare program; provisions of the Balanced Budget Refinement Act of 1999; hospital inpatient payments and rates and costs of graduate medical education. Health Care Financing Administration (HCFA), HHS. Interim final rule with comment period.

This interim final rule with comment period implements, or conforms the regulations to, certain statutory provisions relating to Medicare payments to hospitals for inpatient services that are contained in the Medicare, Medicaid, and State Children's Health Insurance Program Balanced Budget Refinement Act of 1999 (Public Law 106-113). These provisions relate to reclassification of hospitals from urban to rural status, reclassification of certain hospitals for purposes of payment during Federal fiscal year 2000, critical access hospitals, payments to hospitals excluded from the hospital inpatient prospective payment system, and payments for indirect and direct graduate medical education costs. Many of the provisions of Public Law 106-113 modify changes to the Social Security Act made by the Balanced Budget Act of 1997 (P.L. 105-33). These provisions are already in effect in accordance with Public Law 106-113.

Economics, Hospital↗
PubMed2001

Medicare program; changes to the hospital inpatient prospective payment systems and rates and costs of graduate medical education: fiscal year 2002 rates; provisions of the Balanced Budget Refinement Act of 1999; and provisions of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000. Final rules.

We are revising the Medicare hospital inpatient prospective payment systems for operating and capital costs to: implement applicable statutory requirements, including a number of provisions of the Medicare, Medicaid, and SCHIP [State Children's Health Insurance Program] Benefits Improvement and Protection Act of 2000 (Public Law 106-554); and implement changes arising from our continuing experience with these systems. In addition, in the Addendum to this final rule, we describe changes to the amounts and factors used to determine the rates for Medicare hospital inpatient services for operating costs and capital-related costs. These changes apply to discharges occurring on or after October 1, 2001. We also set forth the rate-of-increase limits as well as policy changes for hospitals and hospital units excluded from the prospective payment systems. We are making changes to the policies governing payments to hospitals for the direct costs of graduate medical education and critical access hospitals. Lastly, we are responding to public comments received on the following two related interim final rules that we published in the Federal Register and finalizing those interim rules: An August 1, 2000 interim final rule with comment period (65 FR 47026, HCFA-1131-IFC) that implemented, or conformed the regulations to, certain statutory provisions relating to Medicare payments to hospitals for inpatient services that were contained in the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 (Public Law 106-113), and that were effective during FY 2000. These provisions related to reclassification of hospitals from urban to rural status, reclassification of certain hospitals for purposes of payment during fiscal year 2000, critical access hospitals, payments to hospitals excluded from the prospective payment system, and payments for indirect and direct graduate medical education costs. A June 13, 2001 interim final rule with comment period (66 FR 32172, HCFA-1178-IFC) that implemented, or conformed the regulations to, certain statutory provisions relating to Medicare payments to hospitals for inpatient services that were contained in Public Law 106- 554, and that were effective prior to passage of Public Law 106-554 on December 21, 2000; on April 1, 2001; or on July 1, 2001. Many of the provisions of Public Law 106-554 modified changes to the Social Security Act made by Public Law 106-113 or the Balanced Budget Act of 1997 (Public Law 105-33), or both.

Education, Medical, Graduate↗
PubMed2000

[Effect of temperature on energy budget of Taiwanese red tilapia hybrid (Oreochromis niloticus x O. mossambicus)].

The energy budget of Taiwanese red tilapia hybrid (Oreochromis niloticus x O. massambicus) with a body weight of 25.33-26.23 g was measured at salinity 14 and at water temperature 22, 28 and 34 degrees C in July-August 1996. The results showed that its specific growth rate, conversion efficiency and maximum food consumption were significantly affected by temperature, and reached peaks of 1.79, 60.01% and 2.59% B.W.d-1 at 28 degrees C. The effect of temperature on the absorption efficiency was not significant, with an average absorption efficiency 64.58%. The effect of temperature on the proportions of food energy allocated to each component of the energy budget was significant. The ratio of growth energy was the highest(26.4%) at temperature 28 degrees C, and that of metabolism energy was 37.23%.

Absorption↗
PubMed1997

Neo-isolationism, balanced-budget conservatism, and the fiscal impacts of immigrants.

"A rise in neo-isolationism in the United States has given encouragement to a new fiscal politics of immigration. Growing anti-immigrant sentiment has coalesced with forces of fiscal conservatism to make immigrants an easy target of budget cuts. Limits on legal alien access to social welfare programs that are contained in the 1996 welfare and immigration reform acts seem motivated not so much by a guiding philosophy of what it means to be a member of American society as by a desire to shrink the size of the federal government and to produce a balanced budget. Even more than in the past, the consequence of a shrinking welfare state is to metamorphose legal immigrants from public charges to windfall gains for the federal treasury."

Americas↗
PubMed2002

[Effect of different fertilization system on soil nutrient budget].

A long-term experiment was carried out on a damp palm soil about ten years under the condition of nutrient recycling and reutilization. The quantity of crop nutrients transferred from the system, and the nutrient budget of N, P and K in soil were studied. The results of a ten-year field experiment indicated that the use of nutrients recycled in the farming systems with appropriate amount of fertilizers applied according to the soil nutrient supplying ability could not only produce high crop yield, but also balance the soil nutrient budget, so that, there were no significant surplus of nutrients (mainly inorganic nitrogen) which might emit or leach out of soil into environment.

Agriculture↗
PubMed2003

[Carbon budget of ecosystem in Changbai Mountain Natural Reserve].

The study used EPPML, a biological geochemistry cycle model that was built, to simulate the carbon budget for ecosystems in Changbai Mountain Natural Reserve. The results indicated that the annual net primary productivity [NPP (carbon)] of the natural reserve was 1.332 x 10(6) t.a-1. The annual NPP of mixed broad-leaved and Korean pine forest and spruce-fir forest were maximal, 0.540 x 10(6) t.a-1 and 0.428 x 10(6) t.a-1 respectively. The area and productivity of the two stands were maximal in Changbai Mountain, therefore, the simulating productivity of the two stands most greatly affect carbon cycle and carbon budget of the natural reserve, and the veracity of the former decides the security of the latter. To sum up, not only did the simulations accord with routines in the relative comparisons between different vegetation belts and climate belts in the whole natural reserve, but also was exact in the absolute comparisons with very disperse data from field survey. Vegetations in the natural reserve had evident carbon sink functions, mainly exhibiting in the increasing of carbon, about 1.058 x 10(6) t.a-1. The annual carbon of mixed broad-leaved and Korean pine forest increased greatest (0.452 x 10(6) t.a-1), secondly spruce-fir forest (0.339 x 10(6) t.a-1). The two stands played crucial roles in the carbon sink for Changbai Mountain, others being Changbai larch forest, broad-leaved forest, meadow, shrub, alpine tundra, subalpine Betula ermanii forest and alpine grass. In 1995, the decomposing carbon of soil organic matter was 0.169 x 10(6) t.a-1 higher than the littering carbon in the natural reserve. There was accumulation of organic matter in the meadow soil and shrub soil. The decomposition and accumulation of soil organic matter was in the nearly balancing condition in the alpine tundra soil and alpine grass soil. The decomposition of organic matter was as one and a half time or double as litterfall in the arbor forest soil.

Carbon↗
PubMed2004

[Effects of different temperatures on the growth and energy budget of Chinese shrimp, Fenneropenaeus chinensis].

The effect of temperature on the growth and energy budget of Chinese shrimp Fenneropenaeus chinensis was studied at 18, 22, 25, 28, 31 and 34 degrees C. The results showed that its specific growth rate in terms of body weight and energy accumulation increased with temperature between 18 degrees C and 31 degrees C, and then decreased significantly at 34 degrees C. The similar trend was observed in food consumption and apparent digestion rate. The food conversion efficiency in weight and energy were 28.99%-53.09% and 15.70%-7.24%, respectively, which decreased with increasing temperature. The optimum temperature for the growth of shrimp was calculated from the relationship of SGR, which was 29.7 degrees C in this study. The energy budget of shrimp showed that the energy assimilated from food decreased with increasing temperature, while that spent in metabolism increased with increasing temperature. The results indicated that the high growth rate of Chinese shrimp at suitable temperature mainly resulted from the significant increase of food consumption and apparent digestion rate at corresponding temperature regimes.

Algorithms↗
PubMed2005

A software tool to aid budget planning for long-term care at local authority level.

In this paper, we present a software tool that implements a novel modelling framework developed by the authors to provide useful information to budget planners for long-term care at local authority level. By combining unit costs of care with an underlying survival model for publicly funded residents in long-term care, the software tool is able to provide forecasts on the cost of maintaining the group of elderly who are currently in long-term care (referred to as known commitments) for a period of time. User interacts with the tool via a friendly graphical interface that guides them through a set of screens of options in a familiar wizard fashion. This tool was created and tested in collaboration with an English borough. Feedbacks from the care planner and manager show that the tool helps them gain better understanding on the behaviour of length-of-stay of residents under their care, and provides quantitative inputs into their decision making on budget planning for long-term care.

Humans↗
PubMed1991

Global budgeting and the control of hospital costs.

This paper attempts to answer the question: Would global budgeting control hospital costs in the United States? It reviews the development of health insurance and the growth of specialization in the United States, as well as the experience of Canada in attempting to control costs in a fee-for-service national medical care program. It concludes that the main causes of cost escalation in the U.S. are fee-for-service and overspecialization, and urges adoption of the NAPHP proposal for payment of physicians in a national program, i.e. global budgeting for the entire package of ambulatory and institutional services. It also presents a nine-point program for immediate State action to lower costs.

Canada↗