Using Ontario health administrative data, we identified 12,143 adults with chronic kidney disease (CKD) who received outpatient nephrology care prior to start of renal replacement therapy (RRT) in order to study the effect of care-related factors in predicting late start of predialysis care (PDC, defined as first outpatient nephrology visit <6 months prior to RRT start) and to explore covariates which further quantify the PDC received. Lack of an usual provider of primary care (OR 0.76; 95%CI 0.66, 0.87) predicted late start of PDC. In addition to late start of PDC, number of nephrology visits (OR 0.97 per visit; 95% CI 0.96, 0.98), and having seen a nephrologist in only 1 or 2 of the 6 months prior to RRT start (OR 1.33; 95%CI 1.18, 1.51), were also independent predictors of one-year mortality, suggesting that other measures of PDC are needed to better characterize the care received.

Using Ontario health administrative data, we identified 12,143 adults with chronic kidney disease (CKD) who received outpatient nephrology care prior to start of renal replacement therapy (RRT) in order to study the effect of care-related factors in predicting late start of predialysis care (PDC, defined as first outpatient nephrology visit <6 months prior to RRT start) and to explore covariates which further quantify the PDC received. Lack of an usual provider of primary care (OR 0.76; 95%CI 0.66, 0.87) predicted late start of PDC. In addition to late start of PDC, number of nephrology visits (OR 0.97 per visit; 95% CI 0.96, 0.98), and having seen a nephrologist in only 1 or 2 of the 6 months prior to RRT start (OR 1.33; 95%CI 1.18, 1.51), were also independent predictors of one-year mortality, suggesting that other measures of PDC are needed to better characterize the care received.

The purpose of this study is mainly to discuss the relationship between employer brand, perceived external prestige and word-of-mouth referral. Most of the previous studies about employer brand focus on its recruitment function and also word-of-mouth are mostly applied on the product decision-making. Therefore, this study is seeking to discover the influence of employer brand on triggering employees¡¦ perceived external prestige. By the process of identifying the organization, employees will further have word-of-mouth referral toward public and find the proper potential employees who will be the human capital and further be the competitive advantages for organization. This study uses two questionnaires to collect data from two levels. One of the objects of this study is human resource managers or human resource staffs who have recruitment experiences. Another one is the employee in the firm. There are 34 valid questionnaires of organizational- level and 311 valid questionnaires of individual-level. By adapting the hierarchical linear model to analyze the data and get the result: the employer brand has partially positively influence on word-of-mouth referral, the employer brand has positively influence on the perceived external prestige, the perceived external prestige has positively influence on word-of-mouth referral and the perceived external prestige has partially mediate the positively influence on the relationship between employer brand and word-of-mouth referral.

We consider a hierarchical maximal covering location problem to locate p health centers and q hospitals in such a way that maximum demand is covered, where health centers and hospitals have successively inclusive hierarchy. Demands are 3 types: demand requiring low-level service only, demand requiring high-level service only, and demand requiring both levels of service at the same time. All types of requirements of a demand point should be either covered by hospital providing both levels of service or referred to hospital via health center since a demand point is not covered unless all levels of requirements are satisfied. Thus, a health center cannot be opened unless it is suitable to refer its covered demand to a hospital. Referral is defined as coverage of health centers by hospitals. We also added partial coverage to this complex hierarchic structure, that is, a demand point is fully covered up to the minimum critical distance, non-covered after the maximum critical distance and covered with a decreasing quality while increasing distance to the facility between minimum and maximum critical distances. We developed an MIP formulation to solve the Hierarchical Maximal Covering Location Problem with referral in the presence of partial coverage. We solved small-size problems optimally using GAMS. For large-size problems we developed a Genetic Algorithm that gives near-optimal results quickly. We tested our Genetic Algorithm on randomly generated problems of sizes up to 1000 nodes.

Professional research project (Au.D.)--University of South Florida, 2000. / Title from PDF of title page. / Document formatted into pages; contains 48 pages. / Includes bibliographical references. / Text (Electronic thesis) in PDF format. / ABSTRACT: The primary objective of the project was to survey recognized "experts" in the field of neurodiagnostic audiology and practicing audiologists regarding their referral criteria and referral patterns for administering an auditory brainstem response test (ABR). For purposes of this study, "expert" was defined as any recognized audiologist with at least two or more publications and/or seminarsin the field of auditory evoked potentials. / Responses of experts and practicing audiologists were compared and contrasted to establish: a) if there was a standard referral pattern; b) what, if any, were the apparent critical components of referral patterns; and, c) whether or not current practice reflected the utilization of such critical components. The survey was designed to establish whether the respondent was practicing, in what type of practice setting, and how often ABRs were performed. Specificity and sensitivity of ABR outcomes was also requested. / The survey was administered verbally, via telephone, to 3 experts and was sent via e-mail to 178 randomly selected audiologists in the United States. Of the latter 53 returned, 38 reported conducting ABRs. Thus, data analysis was reported on 38 respondents. The survey results did not reveal a consistent standard referral pattern. Critical components for referral were hypothesized based on the "expert" majority response. These include ABR referral based on the presence of: (1) asymmetric sensorineural hearing loss; (2) unilateral tinnitus; (3) positive reflex decay; and, (4) word recognition rollover. The majority of "non-expert" practitioners surveyed reported that these symptoms warranted consideration for referral, thus reflecting utilization of apparent critical components. / System requirements: World Wide Web browser and PDF reader. / Mode of access: World Wide Web.

The thesis has been performed at Volvo Car Customer Service in Gothenburg, Sweden. The output from the study will support Volvo to secure the Just-In-Time delivery of referrals for the after-market. The scope was limited to referrals from pre-planned orders, which occurs when there is no availability in the distribution centre where the orders were placed. Volvo's main warehouse in Europe is the Central Distribution Centre, which process referrals. The warehouse had an ongoing organisational change during this study. The concern was that the change would not lead to optimal conditions for processing referrals for different markets. It was therefore important to preserve the market knowledge in order to maintain a reliable referral service. A qualitative study was used and the information was gathered primarily through semi-structured interviews. Literature was studied both initially and continuously through the study. Analyse of the literature, current situation and data collection generated ideas for possible ways of securing the referral process and improvements. Benchmarking and Workshop was also performed in order to obtain further ideas. The result of this study was an information material containing information about all concerned markets, overview of referral flow and information regarding how the Central Distribution Centre needs to print referrals. The proposals suggested for future work were explained in long- and short-term. The short-term suggestions include use of the developed material in order to preserve the knowledge along with providing correct working conditions. For long-term suggestions focus has been on how to reduce or remove the printing problem. For future work Volvo Car Customer Service should consider these proposals in order to secure and improve the referral service.

Thesis (M.Tech.: Chiropratic)- Dept.of Chiropractic, Durban Institute of Technology, 2006 xvii, 148 leaves / Chiropractors and homeopaths belong to the same paradigm i.e. the biopsychosocial. Due to this fact, there has been a perception that there will automatically be a good referral relationship between these two. This was therefore assumed to be true in the South African context; however until now there has never been any quantifiable evidence as to what the interprofessional ties are between these two professions in this context. This study looked into the current status quo of the factors affecting referrals between chiropractors and homeopaths practicing in the greater Durban Metro area and looks towards future studies which may enhance the interprofessional relationship.

The accurate and timely referral and identification of twice-exceptional students remains a challenge. In a statewide study, the referral decisions for both special education and gifted programming evaluations made by four participant groups (i.e., general education teachers, special education teachers, gifted education teachers, and school psychologists) were compared. Participants were randomly assigned to read one of three identically described students in a vignette that differed only in the presence of a diagnostic label—autism spectrum disorder (ASD), specific learning disability (SLD), or no diagnostic label. In all, special education teachers made the most special education referrals, while gifted education teachers made the most gifted programming referrals, both regardless of the diagnostic label present. The students with diagnostic labels were recommended for special education referrals significantly more than for gifted programming, while this difference was not evident in the no diagnostic label condition. Moreover, the student with the ASD label was the most likely to be referred for evaluations for both special education and gifted programming out of all three vignette conditions. Overall findings indicated the importance of considering the referral source as well as how the presence of a diagnostic label might influence educational referral decisions, particularly in how this might influence overall multidisciplinary team decisions for these unique learners.

Epidemiological studies have shown that disparities in mental health service utilization still exist among ethnic minority groups in the United States. This study looks specifically at the lay referral system and what factors influence the likelihood of an individual referring a friend to mental health services. Since college student populations have fewer barriers than most to seeking treatment, 60 Asian American and 49 White American college students were sampled for the purposes of this study. They evaluated one of four vignettes in which cultural competency of the potential therapist and type of symptoms being presented were manipulated. Though there was no significant interaction found, implications of the current findings and corrections to the methodology for future research are discussed.

Research indicates that large numbers of young people are underachieving in UK schools, and that school exclusion levels are unacceptably high. In addition, there are increased numbers of students unable to secure a place in mainstream schools. These unplaced and excluded young people are described by New Labour as `vulnerable', `disaffected' or at risk of disaffection (Social_Exclusion_Unit 1998b). The numbers of young people considered `disaffected' indicates a national problem and so, in response to this, there is a government led drive to `socially include' `excluded' young people and young people considered `at risk' of `exclusion'. This UK study examines the principles and practices of practitioners working with identified `at-risk' and `hard to reach' populations. This thesis seeks to unpack this complex situation of social `exclusion' and `inclusion' as it relates to education by asking; who are the `actors' in this expanding world of `social inclusion'? How can some practitioners `reach' and `include' so called `hard to reach' `disaffected' young people? This research explores socially inclusive practice. It aims to investigate whether a model of socially inclusive practice exists or can be established that could be used by educators, parents, human resource (HR) professionals and others concerned with client services in the helping professions. Social exclusion is one of the key concerns of the New Labour agenda. Inclusive education is perceived as central to promoting social inclusion (Social_Exclusion_Unit 1998b) and as a result there are a number of social inclusion projects operating throughout the UK. These projects generally offer provision for young people who, in the judgement of excluding mainstream practitioners, should be placed outside of their responsibility. These excluding practices reflect the values and ideal of the institution and how they perceive their own ability to respond to the total needs of the learner in their care. Excluded young people are typically referred to pupil referral units (PRU's), study centres or other education provision established to meet the statutory requirement of the education authority to maintain education provision. The practitioner is the focus of this investigation and preliminary issues associated with an investigation into social inclusion practice will be considered in an attempt to identify `what works' in opening up educational opportunities to an inclusive culture. This study then, examines the practice and rationale employed by staff at a project providing education otherwise than at school (EOTAS) to young people unplaced, excluded or at risk of exclusion from mainstream school by analysing empirical data collected over a 3-year period using qualitative instruments. Grounded Theory is the methodological approach used to elicit data and the findings provide valuable insights into inclusive education practices. In addition, a number of relevant and important issues are identified. The theoretical model that emerges is informed by the insights and issues that emerge in this, the first major UK study, into inclusive practice in education where the practitioner is the main focus of the study. This research puts forward a model of professional understanding for inclusive education and makes a contribution to the development of new approaches. The results offer clear indicators for a transferable framework of socially inclusive practice.