897 resultados para administrative burden


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Benefit News, brought to you by the DAS Benefits Team, providing you with the most up-to-date information about the state of Iowa’s employee benefits.

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Benefit News, brought to you by the DAS Benefits Team, providing you with the most up-to-date information about the state of Iowa’s employee benefits.

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Benefit News, brought to you by the DAS Benefits Team, providing you with the most up-to-date information about the state of Iowa’s employee benefits.

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Report on a review of the Central Procurement Enterprise (CPE) of the Iowa Department of Administrative Services for the period July 1, 2009 through March 31, 2013

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Benefit News, brought to you by the DAS Benefits Team, providing you with the most up-to-date information about the state of Iowa’s employee benefits.

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Atrial arrhythmias (AAs) are a common complication in adult patients with congenital heart disease. We sought to compare the lifetime prevalence of AAs in patients with right- versus left-sided congenital cardiac lesions and their effect on the prognosis. A congenital heart disease diagnosis was assigned using the International Disease Classification, Ninth Revision, diagnostic codes in the administrative databases of Quebec, from 1983 to 2005. Patients with AAs were those diagnosed with an International Disease Classification, Ninth Revision, code for atrial fibrillation or intra-atrial reentry tachycardia. To ensure that the diagnosis of AA was new, a washout period of 5 years after entry into the database was used, a period during which the patient could not have received an International Disease Classification, Ninth Revision, code for AA. The cumulative lifetime risk of AA was estimated using the Practical Incidence Estimators method. The hazard ratios (HRs) for mortality, morbidity, and cardiac interventions were compared between those with right- and left-sided lesions after adjustment for age, gender, disease severity, and cardiac risk factors. In a population of 71,467 patients, 7,756 adults developed AAs (isolated right-sided, 2,229; isolated left-sided, 1,725). The lifetime risk of developing AAs was significantly greater in patients with right- sided than in patients with left-sided lesions (61.0% vs 55.4%, p <0.001). The HR for mortality and the development of stroke or heart failure was similar in both groups (HR 0.96, 95% confidence interval [CI] 0.86 to 1.09; HR 0.94, 95% CI 0.80 to 1.09; and HR 1.10, 95% CI 0.98 to 1.23, respectively). However, the rates of cardiac catheterization (HR 0.63, 95% CI 0.55 to 0.72), cardiac surgery (HR 0.40, 95% CI 0.36 to 0.45), and arrhythmia surgery (HR 0.77, 95% CI 0.6 to 0.98) were significantly less for patients with right-sided lesions. In conclusion, patients with right-sided lesions had a greater lifetime burden of AAs. However, their morbidity and mortality were no less than those with left-sided lesions, although the rate of intervention was substantially different.

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Benefit News, brought to you by the DAS Benefits Team, providing you with the most up-to-date information about the state of Iowa’s employee benefits.

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This article sets out to study the profile of Swiss administrative elites at federal level by showing how their profile has evolved in the light of what has come to be known as the wave of New Public Management (NPM), which has benefited from a very fertile ground in Switzerland. These elites correspond to a specific institutional order, in relation to specific organizational structures and workings, and have specific characteristics in terms of career paths and academic background. However, the administrative reforms that have been rolled out since the 1980s have transformed the institutional order within which executives of the federal administration evolve. This article analyses the extent to which these transformations have had an impact on the characteristics of these elites, through indicators such as academic capital, social capital, and career path within and outside the administration. The results show a slow but significant transformation in the profiles of these elites towards an increasing managerialization, reflecting that of the context in which they evolve.Points for practitioners The relationship between politics and the administration is naturally shaped by individuals but is closely dependent on the profiles of the players. They are currently undergoing a transformation in the wake of administrative reforms, and also of the changing profiles of both the political and administrative players. Gaining an insight into the slow transformation of the profiles of administrative elites therefore sheds light on the political-administrative nexus. The gradual managerialization of the administrative elite highlighted in this article also allows for a better understanding of which professional experiences, qualifications and skills are valued today within the senior civil service in Switzerland.

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The Iowa Diabetes Prevention and Control Program provides educational opportunities for health care providers via the Iowa Communications Network interactive fiber optic system. The program also certifies diabetes outpatient education programs in Iowa based on minimum criteria for quality programs. In Iowa during the past 20 years, the prevalence rate of diagnosed diabetes increased dramatically among adults: Between 1991 and 2009 the crude diabetes prevalence rate rose by 84%, from 3.8% to 7.0%. Between these years, the age‐adjusted adult diagnosed diabetes prevalence rate increased by 64%, rising from 3.7% to 6.4%. During the 18 years 1991‐93 through 2006‐08, the number of Iowa adults with diagnosed diabetes more than doubled, increasing from 78,000 to 162,000. While the Iowa Behavioral Risk Factor Surveillance System (BRFSS), upon which the numbers cited above are based, provides reliable state‐level self‐reported data on adults with diagnosed diabetes, it is unable to provide estimates of undiagnosed diabetes. National estimates put the prevalence of undiagnosed adult diabetes at about 5%, raising the estimated adult diabetes prevalence rate in Iowa to 12% (280,000 adults) (Cowie,2009). Another 5% of all Iowa adults are estimated to have diagnosed pre‐diabetes, while 25% of all Iowa adults, based on national estimates from the 2005‐06 National Health and Nutrition and Examination Survey (NHANES), likely have undiagnosed pre‐diabetes. (Cowie, 2009)

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The Iowa Diabetes Prevention and Control Program provides educational opportunities for health care providers via the Iowa Communications Network interactive fiber optic system. The program also certifies diabetes outpatient education programs in Iowa.