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The purpose of this study was two-fold: to identify role functions and characteristics perceived as important to Advanced Nurse Practitioners (ANPs) in Texas, and to identify differences in perceived importance of role functions and characteristics of ANPs according to gender, educational preparation, practice setting, and whether the practitioner entered practice before or after the current rules and regulations for ANP practice were adopted. Two questionnaires and a demographic data form were mailed to 300 ANPs in primary health care in Texas, with 152 responding. Data from the questionnaire, "Characteristics of the Advanced Nurse Practitioner," were analyzed using independent group t-tests. The findings indicated that the characteristics "person-oriented," "perceptive," and "skilled in problem-solving" were the most valued by the practitioners, while aggressive" was the least valued. Independent group t-tests were used to analyze data from the instrument, "Advanced Nurse Practitioner Functions." The results of this analysis were not significant. The Chi square test was used to further examine data from this questionnaire to determine if the responses differed from chance. With the exception of four items, all of the responses differed significantly from chance. The responses "extremely important or important" were selected significantly more frequently that any of the other options. Not appropriate," was selected significantly more often than could be expected by chance for two functions: suturing minor lacerations and performing incision and drainage of wounds. Fourteen functions were examined further using frequency, percentage of responses, and the Chi square test to determine if there were differences in responses between groups. There were significant differences in responses between ANPs in nurse-managed settings and those in physician-managed settings on four functions: ordering diagnostic tests, prescribing medications in consultation with a physician, suturing minor lacerations, and performing incision and drainage of wounds. Practice setting and educational preparation were the variables which had the greatest impact on perceived importance of the characteristics and functions to ANP practice.

No presente trabalho é proposto um modelo de simulação de uma cadeia de suprimentos integrada com adoção da estratégia de VMI (Vendor Managed Inventory) entre uma empresa do setor de minério de ferro e alguns de seus fornecedores estratégicos. O modelo baseia-se em uma estrutura de avaliação de sistemas VMI adaptada de Sarpola et al. (2007) em conjunto com as configurações de cadeias de suprimentos propostas por Holmström et al (2003), o que permite medir o desempenho da cadeia de suprimentos segundo 3 níveis de integração. É feita uma revisão bibliográfica dos conceitos da estratégia de VMI, políticas de estoque em sistemas integrados, compartilhamento e grau de visibilidade de informações ao longo da cadeia de suprimentos. Os resultados obtidos possibilitam realizar uma análise quantitativa dos benefícios do VMI, onde são considerados demanda estocástica, lead time aleatório, produtos com características diferentes, compartilhamento de informações, visibilidade parcial da cadeia de suprimentos, lotes variáveis, cálculo dos estoques de segurança considerando informações dos pedidos, demanda real do cliente e erros de previsão. / In this paper we proposed a simulation model of an integrated supply chain with the adoption of VMI (Vendor Managed Inventory) strategy between a company of the iron ore and some of its strategic suppliers. The model is based on a framework for evaluating VMI systems adapted from Sarpola et al. (2007) together with the configurations of supply chains proposed by Holmström et al (2003), which measures the performance of the supply chain using 3 levels of integration. It is a literature review of the concepts of the strategy of VMI, inventory policies in integrated systems, sharing and degree of visibility of information throughout the supply chain. The results allowed to perform a quantitative analysis of the benefits of VMI, which are considered as stochastic demand, random lead time, products with different characteristics, information sharing, partial visibility of the supply chain, lots of variables, calculation of safety stocks based on information from client orders, actual customer demand and forecasting errors.

Nearly 700,000 prisoners return to communities annually, and approximately two-thirds are rearrested within 3 years of release. The cyclic pattern of recidivism presents risks to both returning offenders and the communities that accept them. Reentry research tends to include the voice and experiences of juveniles, community members, and service providers, and narrowly focuses on the socioeconomic conditions of adult ex-offender populations pre- and post-release. Few researchers have explored the attitudes of those returning citizens or the perceived impact on treatment success, as related to employment-based, post-release reintegration programs. This study investigated the attitudes of 32 participants of Project Empowerment, the District of Columbia's post-release program. The ecology of public administration theory and empowerment theory provided the theoretical frameworks for understanding offender reentry within employment-based programming. Interview data were coded and analyzed consistent with a modified van Kaam method. A key finding indicates job-readiness training completion is largely contingent upon development of positive attitudes from both public administrators and participants. Additionally, participants were cognizant of the attitudes of community members regarding reentry and employment, and were more likely to see program participation as beneficial if perceived community support was high. The implications for positive social change include recommendations for reentry programs, such as Project Empowerment, to create an empowerment environment conducive to attitude development concerning self and society. Such an environment creates trust and opportunities for successful engagement in employment programs and decreases the risk of recidivism among communities that support individuals returning from incarceration.

Professional research project (Au.D.)--University of South Florida, 2001. / Title from PDF of title page. / Document formatted into pages; contains 29 pages. / Includes bibliographical references. / Text (Electronic thesis) in PDF format. / ABSTRACT: The primary objective of the project was to survey audiologists in clinical practice setting to determine the amount of time taken to perform various audiologic tests using Current Procedural Terminology, (CPT) codes to define these tests and if these CPT codes were felt to be adequate. Audiologists were also asked to respond regarding possible impact and reimbursement changes in their clinical practices related to managed care. Responses of audiologists were analyzed to determine: a) adequacy of CPT codes; b)average time to perform various audiologic tests; c) impact managed care onclinical practice; and d) changes in reimbursement as a result of managed care. / The survey was designed to determine the type of work setting, typical job duty, average monthly caseload and hours per day spent on patient care for each respondent. The survey with a cover letter explaining the purpose was mailed to 93 audiologists in clinical setting in the state of Florida. Five were returned undeliverable, and 39 of the remaining 88 were returned either completed or partially completed. The survey results revealed over 71% of the audiologists felt the current CPT codes were adequate. Time spent performing traditional audiologic tests, such as comprehensive audiometric evaluations and impedance testing, was fairly consistent. / Greater time variability occurred in tests used to determine vestibular function. Over three-quarters of the respondents believed managed care has had a negative impact on their clinical practices, while 11% believe they have been positively impacted. Approximately 82% of the audiologists have had reductions in reimbursement as a result of managed care, while 10% have seen no change and 5% have enjoyed slightly greater reimbursement. / System requirements: World Wide Web browser and PDF reader. / Mode of access: World Wide Web.

Introduction: Nowadays beverage companies must focus on maintaining healthy finishedgoods inventory stocks in order to be able to decrease inventory costs, meet customerrequirements and to obtain competitive advantage. However many beverage SMEdon’t have an accurate planning and forecasting to manufacturing inventories. Thereforethey often face the problem of optimization in inventory management due to several differentreasons. As a result, company loses its competitiveness. Thus, there is a need tocoordinate Inventory activities of beverage SMEs to improve inventories’ planning. The purpose of this study is to analyze how inventory management is organized in a small Chinese beverage company. Frame of reference: This research is based on the theoretical framework relates with InventoryManagement (IM) and Retailer-managed inventory (RMI), vendor-managed inventory(VMI) and Collaborative Planning, Forecasting and Replenishment (CPFR).Empirical Data were collected through personal interviews and organization documents. Methodology: The research strategy for this paper is a single case study. This strategy allows investigating topic in its real life context. The inductive approach is used for this research based on qualitative data. The major source of data collection was semi-structured interviews and the company's documents. For analyzing data categorization approach was applied. Conclusion: The study found that inventory management theories presented in scientificliteratures are used in practice. To achieve better inventory management for beverageSMEs, the authors summarize four importance parameters based on literatures and findings.The authors also provide some suggestions based on the importance parameters inthe conclusion to optimize the case company’s inventory management.

Background: According to the Council of Medical Schemes of South Africa (CMS, 2007:52), nearly seventeen percent of the total benefits paid during 2006 were for medicine. Medicine is thus a cost-driving contributor to total healthcare financing. There are various factors influencing and driving medicine usage and cost patterns, including inter alia provider preference, therapeutic committees, marketing and cost. Objectives: The purpose of this study was to identify the top twenty trade name products according to total cost and prevalence in a section of the private health care sector of South Africa, and to identify cost driving products. Methodology: A quantitative, retrospective drug utilisation review (DUR) study was performed on computerised medication records (medicine claims data) for two consecutive years (i.e. 2005 and 2006) that were obtained from a South African pharmaceutical benefit management company (PBM). The study population consisted of 1 218358 and 1 259 099 patients for 2005 and 2006 respectively. A total of 19 860 679 and 21 473017 medicine items that were claimed during 2005 and 2006 were included in the review. Descriptive statistics were used to describe the data, and were analysed using the Statistical Analysis System® SAS 9.1® programme. The cost prevalence index (CPI), developed by Serfontein (1989:180), was used as an indicator of the relative expensiveness of medicine. Resource- and activity driver products (cost driving products) were identified on the database by calculating the total cost of the product, the CPI of the product as well as the prevalence of the product. Variables for analysis included age, gender, prescriber and provider types. Resurts and discussion: A total number of 8 522 574 and 9 046 138 prescriptions were analysed, with an average of 2.33 ± 1.56 and 2.37 ± 1.58 items per prescription during 2005 and 2006 respectively. The average cost per prescription for the total database was R222.16 ± R463.13 for 2005 and R226.25 ± R557.49 for 2006. Members had to co-pay an average of R26.33 ± R102.70 per prescription in 2005 compared to R29.74 ± R103.96 per prescription in 2006. Children under the age of nine accounted for approximately 13% of the total study population, the adolescent age group < 9 and ≥ 19 years) represented 12%, age group three < 19 and ≥ 45 years) represented 38%, age group four < 45 and ≥ 59 years) represented 21% and the geriatric age group (patients older than 59 years) represented 16% of the total study population on the database. About 44% of the study population were male compared to 56% female patients. The top twenty trade name products ranked according to total cost represented about 13% (N=R1 893376 921.00 and N=R2 046 944382.50 in 2005 and 2006 respectively) of the overall medicine cost. The top five trade name products according to total cost for 2005 in descending order were Upitor 1 Omg and 20mg, Fosamax 70mg, Celebrex 200mg and Prexum 4mg. During 2006 the top five trade name products were similar except for Cipralex 10mg in the place of Celebrex 200mg. The CPls for all these products were above one; these products were also all activity drivers. The top twenty trade name products ranked according to prevalence represented about 11% (N=19 860679 and N=21 473074) of the total medicine prevalence for both study periods. The top five trade name products according to prevalence for both years contained Eltroxin 100mcg, Ecotrin 81 mg, Upitor 10mg and Alcophyllex syrup, with Myprodol capsules in 2005 and Mybulen tablets in 2006. Upitor 1 Omg was the only cost driver product in this list. General medical practitioners prescribed the largest quantity of medicine items and represented about 73% of all the medicine items on the database. The medicine prescribed by general medical prescribers accounted for 65% of the overall medicine expenditure on the database. Pharmacies can be seen as the main providers of medicine items. Pharmacies provided approximately 80% of the medicine items and represented over 91% of the total medicine expenditure. Cardiovascular agents were the main pharmacological group that represented the greatest percentage of the total medicine cost, about 19% in both study years. Cardiovascular agents were also positioned 1st according to prevalence and represented about 14% of the overall medicine prevalence in both the study periods. Conclusions and recommendations: Cost driver products can be seen as the products that drives medicine expenditure in the managed health care environment, thus driving the total cost of medicine treatment in the private health care sector of South Africa. Through the implementation of managed health care information- and management instruments medicine expenditure can be reduced. Recommendations for future research have been made. / Thesis (M. Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2009.

Background: According to the Council of Medical Schemes of South Africa (CMS, 2007:52), nearly seventeen percent of the total benefits paid during 2006 were for medicine. Medicine is thus a cost-driving contributor to total healthcare financing. There are various factors influencing and driving medicine usage and cost patterns, including inter alia provider preference, therapeutic committees, marketing and cost. Objectives: The purpose of this study was to identify the top twenty trade name products according to total cost and prevalence in a section of the private health care sector of South Africa, and to identify cost driving products. Methodology: A quantitative, retrospective drug utilisation review (DUR) study was performed on computerised medication records (medicine claims data) for two consecutive years (i.e. 2005 and 2006) that were obtained from a South African pharmaceutical benefit management company (PBM). The study population consisted of 1 218358 and 1 259 099 patients for 2005 and 2006 respectively. A total of 19 860 679 and 21 473017 medicine items that were claimed during 2005 and 2006 were included in the review. Descriptive statistics were used to describe the data, and were analysed using the Statistical Analysis System® SAS 9.1® programme. The cost prevalence index (CPI), developed by Serfontein (1989:180), was used as an indicator of the relative expensiveness of medicine. Resource- and activity driver products (cost driving products) were identified on the database by calculating the total cost of the product, the CPI of the product as well as the prevalence of the product. Variables for analysis included age, gender, prescriber and provider types. Resurts and discussion: A total number of 8 522 574 and 9 046 138 prescriptions were analysed, with an average of 2.33 ± 1.56 and 2.37 ± 1.58 items per prescription during 2005 and 2006 respectively. The average cost per prescription for the total database was R222.16 ± R463.13 for 2005 and R226.25 ± R557.49 for 2006. Members had to co-pay an average of R26.33 ± R102.70 per prescription in 2005 compared to R29.74 ± R103.96 per prescription in 2006. Children under the age of nine accounted for approximately 13% of the total study population, the adolescent age group < 9 and ≥ 19 years) represented 12%, age group three < 19 and ≥ 45 years) represented 38%, age group four < 45 and ≥ 59 years) represented 21% and the geriatric age group (patients older than 59 years) represented 16% of the total study population on the database. About 44% of the study population were male compared to 56% female patients. The top twenty trade name products ranked according to total cost represented about 13% (N=R1 893376 921.00 and N=R2 046 944382.50 in 2005 and 2006 respectively) of the overall medicine cost. The top five trade name products according to total cost for 2005 in descending order were Upitor 1 Omg and 20mg, Fosamax 70mg, Celebrex 200mg and Prexum 4mg. During 2006 the top five trade name products were similar except for Cipralex 10mg in the place of Celebrex 200mg. The CPls for all these products were above one; these products were also all activity drivers. The top twenty trade name products ranked according to prevalence represented about 11% (N=19 860679 and N=21 473074) of the total medicine prevalence for both study periods. The top five trade name products according to prevalence for both years contained Eltroxin 100mcg, Ecotrin 81 mg, Upitor 10mg and Alcophyllex syrup, with Myprodol capsules in 2005 and Mybulen tablets in 2006. Upitor 1 Omg was the only cost driver product in this list. General medical practitioners prescribed the largest quantity of medicine items and represented about 73% of all the medicine items on the database. The medicine prescribed by general medical prescribers accounted for 65% of the overall medicine expenditure on the database. Pharmacies can be seen as the main providers of medicine items. Pharmacies provided approximately 80% of the medicine items and represented over 91% of the total medicine expenditure. Cardiovascular agents were the main pharmacological group that represented the greatest percentage of the total medicine cost, about 19% in both study years. Cardiovascular agents were also positioned 1st according to prevalence and represented about 14% of the overall medicine prevalence in both the study periods. Conclusions and recommendations: Cost driver products can be seen as the products that drives medicine expenditure in the managed health care environment, thus driving the total cost of medicine treatment in the private health care sector of South Africa. Through the implementation of managed health care information- and management instruments medicine expenditure can be reduced. Recommendations for future research have been made. / Thesis (M. Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2009.

Thesis (D.P.H.)--University of Michigan.

Thesis (M.S.)--University of Michigan, 1999. / Includes bibliographical references.