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Tuesday, November 30, 2010

10 Tips for Reducing Sugar Intake

The average American eats more sugar in one day than our ancestors did during an entire lifetime. They prized sugary foods for their abundant calories and quick energy spike. Thus, now we are wired to reach for the cookie jar over and over and over – even though we have no lions to outrun.

Sugar has a very high caloric content and virtually no nutritional value. Besides causing weight gain, it also encourages inflammation and infection, compromises the immune system and raises insulin levels. Insulin encourages the storage of fat, elevates triglyceride levels and promotes cardiovascular disease, asthma, mood swings, diabetes, gallstones, hypertension and arthritis. Still want that piece of cake?

We all know that sugar can cause health problems, however our eating culture revolves around sugary, salty, fatty, unhealthy foods. Even those without a raging sweet tooth will find that it's almost impossible to avoid eating refined sugar these days, as grocery manufacturers routinely add it to everything from bread and pizza dough to spaghetti sauce and salad dressing.

Eating less sugar is one of the best actions you can take to improve your current and future health, but saying "no" to sweets isn't as easy as it seems. If you can't cut out sugar completely (who can?), then try the following tips to quickly and painlessly reduce your sugar intake. It seems this becomes increasingly handy during the holiday season...

1. Cut down on processed and packaged foods. Salad dressings, spaghetti sauces, soups and even pizza crusts contain sugar. If you make your own soup, you will unlikely be adding a cup of sugar to the stew pot, however this is exactly what manufacturers do. Try to purchase groceries with the least amount of packaging as possible.

2. Indulge in the highest-quality sweets that you can afford. You will get more satisfaction from enjoying one divine chocolate truffle than you will from six crappy little sandwich cookies. Resolve to only eat sweets that you really, really like. Forget the rest, and then don't beat up on yourself when you have a sugary treat that you really enjoy.

3. Free sweets aren't free. Many work sites, businesses or offices always have on hand candy, doughnuts or other sweets to snack on. It is human nature to grab these cheap calories and ingest them, however you will pay for the free treats later with poor health and a belly roll.

4. Banish the candy jar. Do you have a candy jar on your desk at work, school, or some other handy and convenient place? Remove it, and you will reduce your sugar intake. Even just moving a candy dish from your desk to a table across the room will drastically decrease the amount that you eat.

5. Know your sugars. Fructose, glucose, lactose, maltodextrin and dextrose are all types of sugar masquerading under their scientific names. Read grocery labels so that you know what you are putting into your body.

6. Don't drink liquid candy. Soda is basically that – liquid candy. Most Americans think of soda as a beverage, and most Americans are overweight. Think of soda as a special treat rather than a daily occurrence, and you will enjoy it even more and avoid all those empty calories. Besides, we've got the Top 10 Reason to Banish Soda. 

7. Watch your breakfast. Deep-fried dough topped with icing and candy sprinkles isn't anywhere near healthy, but doughnuts are a tried-and-true American breakfast. Just say no. Also passing as breakfast: giant muffins (muffins = cake), frappuccinos and smoothies – these are basically milkshakes. Starting your morning off with a sugar overload like this will offset your energy and unbalance your system for the rest of the day.
8. Indulge your sweet tooth naturally. Fruits, honey, maple syrup and molasses all contain natural sugars. Although these foods are no health superstars, they are a better option when the sweet tooth strikes and you are craving some sugary action. An apple will give you a sweet burst of flavor along with beneficial vitamins and fiber. Check out our Guide to 10 Natural Sweeteners. 

9. Go black and never go back. Resolve to drink your coffee and tea without sugar and milk; this small change of mind can save you several sweet teaspoons every single day, and you will most likely find that you do not miss it. And besides, ordering a straight-up black coffee or espresso is infinitely cooler (and cheaper!) than ordering the triple-no-fat half-caramel grande Flufficino with whip and chocolate drizzle. Don't let your daily caffeine requirements become an excuse to load up on sugar.

10. If you just have to have something sweet at the end of every meal, keep a pile of your favorite gum on hand and enjoy a piece for dessert. This will give your brain the sweet sensation it desires and will keep your mouth occupied from chewing other more high-calorie dessert options. Of course, conventional gum isn't healthy either, but you can find natural and even organic gums at your local health food store.

Medical transcription outsourcing: Acting as a catalyst for change

Medical transcription is a vital component of the healthcare process; creating patient records which can be used as a point of reference as required. Patient records are invaluable as a decision making tool in planning care for patients, as the basis for coding and billing, as evidence in case of litigation. Documenting the healthcare service provided to patients also prevents duplication of efforts and helps saving on resources.


The process of medical transcription requires inputs in the form of personnel, infrastructure and technology to be able to create accurate and speedy patient records. Having an in-house medical transcription department can lead to dilution of focus of time, attention and other resources from the core business of providing quality healthcare. Outsourcing medical transcription on a turnkey basis to a professional service provider helps the healthcare facility focus on the core business.

Availing professional transcription services from the outsourced medical transcription service provider can act as catalyst for change in focus and provides strategic advantages.

How does outsourcing medical transcription act as a catalyst for change?
Outsourcing medical transcription to a professional service provider helps increase focus on core business, by providing services with the following benefits:

  • Savings on cost of transcription: One of the main and obvious benefits of outsourcing medical transcription is that of savings on direct and indirect cost of transcription. Not only that quality medical transcription services also help speed up the reimbursement process.
  • Renewed focus on improving services: Outsourcing medical transcription frees up a lot of resources including key personnel, information technology infrastructure, real estate etc. This helps the healthcare facility renew their focus on improving the quality of services in their core business utilizing these resources.
  • Helps cope with expansion plans without diluting quality: Outsourcing medical transcription ensures that the quality of transcription, that is; accuracy, turnaround time and security are not compromised irrespective of the quantity of services required. Healthcare facilities can add on additional specialties and services without fear of dilution of quality in patient records
  • Access to a talent pool and the right technology: Outsourcing medical transcription basically provides access to a trained pool of transcriptionists without adding on to the payroll of the healthcare facility. Another benefit of outsourced medical transcription services is that of access to technology used by the service provider for the transcription process. Technology is a major part of the medical transcription process requiring huge amount of investment, maintenance and up gradation costs.
Outsourcing provides access to technology without any of these hassles. The benefits of technology used by the medical transcription service provider helps in improving speed, security and ease of use by providing:

  1. A system that enables automatic upload of audio files for transcription at predetermined intervals
  2. Different modes of document delivery like automatic printing, faxing, delivery to specified folders, access of transcripts to multiple users etc
  3. Facility for electronic signature
  4. Secure technology like data encryption, multi tiered application architecture, firewalls etc.
  5. HL7 interface for EMR adoption
  6. System for keeping track of dictation, transcripts etc
Outsourcing medical transcription to the right provider enables healthcare facilities to leverage on the experience, expertise, manpower and technology of the service provider. Outsourcing medical transcription to the right service provider can help act as a catalyst for positive change.

TransDyne, a leader in the outsourced medical transcription industry has utilized their extensive background in information technology and their experience in providing medical transcription services to come up with medical transcription solutions that help healthcare facilities save on time, money and effort. TransDyne offers quality medical transcription at reasonable prices, executed by experienced and qualified medical transcriptionists with a very quick turnaround time executed through secure HIPAA and HITECH compliant channels, with very high levels of accuracy and all this with technology that is advanced but easy to use!

To avail complete outsourced medical transcription services from TransDyne, click here.

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A Confidentiality Clause or an Oath of Fealty?

The advancement of modern scientific medicine depends on the search for and dissemination of truth. Academic medicine, like the rest of academia, ought to be based on openness, transparency, and academic freedom. The 1940 American Association of University Professors (AAUP) Statement of Principles on Academic Freedom and Tenure opened with:
The common good depends upon the free search for truth and its free exposition.
Yet we have written about dark clouds of secrecy spreading over medicine and health care. The increasingly powerful leaders of health care increasingly use opacity and secrecy to keep what they are doing out of the public eye. We have frequently discussed the anechoic effect, how it is just not done to discuss certain topics, particularly those related to the adverse effects of bad (ill-informed, incompetent, self-interested, conflicted, or corrupt) leadership and bad (opaque, unaccountable, mission-hostile, unethical) governance of health care organizations.  People may feel it is unseemly to speak badly of renowned institutions such as hospitals and universities.  People with conflicts of interest may not be inclined to criticize those who pay them.  Now people employed by contemporary health care organizations may have to pledge theri silence to keep their jobs.

The latest story in this regard comes from Virginia Commonwealth University (VCU), which includes VCU Health Systems, and MCV Hospital and Physicians.  (Full disclosure: I was a VCU full-time faculty member from 1987-1994, and still am on the adjunct faculty.)  In 2008, the VCU President resigned after the university's secret research contract with a tobacco company, and the President's own position on the board of directors of another tobacco company were revealed (see blog post here and others here).

Michael Rao, the President since 2008, is now under outside review after it was revealed that he required his staff to sign a secrecy pledge.  The story appeared in the Richmond Times-Dispatch:
Virginia Commonwealth University President Michael Rao asks employees who work in his office to sign an unusual confidentiality agreement that bars them from talking about what they observe about him or his family.

The prohibition goes beyond the standard agreement that university employees sign acknowledging that they can't disclose personal or proprietary information.

The agreement, a copy of which was obtained by the Richmond Times-Dispatch, covers interactions at Rao's office and at his residence. It bars disclosure not just to the news media, family or friends, but also to colleagues, 'clergy and attorneys, or to any other person not otherwise identified.'

'I agree that any such disclosure in violation of this nondisclosure agreement could result in irreparable damage and harm to VCU, President Rao, and/or his family'" the agreement states. 'Any such violation or anticipated violation' would entitle Rao to seek 'injunctive relief' in Richmond or Henrico County circuit courts.

VCU spokeswoman Pam Lepley said she could not comment immediately yesterday.

Several current or former employees of the president's office confirmed that they had been asked to sign the agreement, including Kimberley Busch, Rao's former scheduler.

She described it as a 'what happens in the president's office stays in the president's office' agreement.

The newly uncovered confidentiality clause provoked strong criticism:
Raymond D. Cotton, a Washington attorney who specializes in higher-education governance, said such a confidentiality agreement is highly unusual and goes against the culture of openness and transparency in higher education.

'There is this concept of academic freedom that is broader than the First Amendment,' he said.

In fact, since Virginia Commonwealth University is a state-supported institution, the confidentiality clause may be unconstitutional, as reported by WTVR:
Kent Willis with the Virginia American Civil Liberties Union said the agreement doesn't pass constitutional muster.

'A public employee, no matter where they are in the government, has a right to speak out on matters of public concern,' Willis said. 'That's a U.S. Supreme Court case, it's guaranteed to every public employee by the First Amendment to the Constitution.'

Willis said there are numerous legal issues raised by the contract. But, he said, the bottom line problem with the contract 'is the attitude. This is a contract that says 'I'm not transparent. I don't want you to know what is going on. I'm running a closed shop.''

Times-Dispatch columnist Michael Paul Williams wrote:
VCU, we have a problem. This confidentiality agreement does not inspire confidence. The lack of transparency only gives the appearance that someone's hiding something.

He also further quoted Kent Willis:
Rao's contract 'fails to address this whistle-blower right and could create conflicts for employees, who are silenced by the employment contract,' yet have a constitutional right to speak out on some matters, Willis said.

And as Willis points out, even if a person's constitutional right trumps the contract, how many employees are willing to take that risk?

'Particularly disturbing is the prohibition against talking to an attorney,' he said. 'If an employee believes something illegal is going on at work, an attorney is precisely the person he or she should be talking with.'

We just posted about how a pharmaceutical company included a confidentiality clause in a consulting contract, suggesting the deliberate creation of a conflict of interest in order to prevent criticism of the company's products or practices. 

However, in several ways, the present example is more insidious.  First, it involves a university, whose mission is to discover and disseminate the truth.  Thus, as noted above, the confidentiality agreement subverts the university's core mission.  Second, it was required of full-time employees who wanted to keep  their jobs, making choose between secrecy and unemployment.  Third, it was particularly harsh, addressing incipient as well as actual disclosure, and including injunctive relief as well as the threat of  termination.  Fourth, it protected not just the organization and its products, but personally protected the organization's leader and his family.  It was not just a contract, but an oath of fealty, as if the CEO were nobility, or even royalty.

The good news is that this confidentiality agreement now sits in the glare of sunlight.  One does wonder, however, how many other such agreements are already in force so that the would be nobility who now run too much of health care to avoid any embarassing revelations about what their leadership really is about.

We are a long way from the transparency that true health care reform requires. 

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The November HIT Standards Committee meeting

The November HIT Standards Committee meeting focused on existing implementations of point to point transport standards as a foundation for its evaluation of the Direct project.

We began the meeting with a report from the Implementation Workgroup, which will gather testimony on January 10-11, 2011 about the experience of implementing standards in certified systems and achieving meaningful use goals.

We discussed the work of the other HIT Standards Committee workgroups including the upcoming effort by the Vocabulary Task Force to take testimony on device content and vocabulary standards.   Given the evolving importance of home care devices, implantable devices, and mHealth, ensuring robust standards in this area is important.

We started the day's testimony noting that we will be discussing just point to point "push" use cases this month.   Typical components of such an approach are a routing method, a provider directory, certificate management, auditing, and acknowledgement of delivery.   Use cases covered by the "push" approach include PCP to specialist referrals, routing to registries, e-prescribing data exchanges between providers/pharmacies, and sending summaries to patients.

Here are links to the testimony:

Peter Tippett, Verizon

John Feikema, Visionshare

Joseph Carlson, Covisint

Anand Shroff, Axolotl

Cris Ross, Surescripts 

Eric Dishman & Gary Binder, Intel

After the testimony we summarized the major themes.

Directories -  Proposed directory options ranged from a nationally centralized yellow pages of organizations to a federated white pages of persons/departments/machines to undiscoverable local directories.  Email is an example of a directory which is generally undiscoverable outside an organization.   Once you know the email address of a person, email gateways route from organization to organization.   Once email arrives at the organization, it is routed to the recipient using a local directory.   Whatever directory and addressing scheme is chosen, it is very important that all vendors support it to achieve a network of networks that enables any provider to connect to any other provider.

Identity/Trust - Each of the vendors is using X.509 certificate-based approaches to secure organization to organization transport plus a formal certificate management approach (based on policy) to verifying identity and achieving a trust fabric.   Creating a chain of trust among vendors is very important to supporting network to network transport.

Transport - SMTP/SMIME, REST, and SOAP have all been used successfully in the real world as transport standards for health information exchange.  Achieving common directories and a trust fabric are more important than settling on a single transport protocol.  However, in the interest of keeping the architecture simple, there should be few, not many standards options for transport.  Having at least one common transport approach to enable universal addressing is desirable.

The internet itself is based on a small number of standards specifying directories such as the Domain Naming System (DNS) system, which is implemented in a federated architecture.   The internet has a small set of standards enabling certificate authorities to act as "electronic notaries", establishing identity and trust.   On top of this foundation of directories and trust, there are multiple transport protocols that used to support specific use cases such as HTTPS, FTP, SMTP, etc.    Push-based healthcare information exchange should use an analogous approach - get the directory/addressing and identify/trust right, then use the transport standards that best support workflow and are easy to implement.

Our next steps are to get policy guidance from the HIT Policy Committee Provider Directory Workgroup, review the Implementation guides from the testifying vendors who have successfully implemented a trust fabric, and assemble a multi-stakeholder team of interested participants from the HIT Standards Committee to evaluate NHIN Direct.   We'll use objective criteria, informed by today's testimony to consider NHIN Direct on its own merits, evaluating its implementation specifications against the project goals to be simple, direct, scalable, and secure transport for the little guy.

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APSCSC ASSISTANTS GRADE I and II EXAM QUESTIONS

LEGAL QUESTIONS:

Q.1. �Acquisition of res nullius� is:
(a) original acquisition of ownership
(b) derivative acquisition of ownership
(c) mere custody of the thing
(d) accessory acquisition of ownership
Ans. (a)
Q.2. The cancellation of the driving license of a person is an example of:
(a) expiratory theory
(b) preventive theory
(c) reformative theory
(d) deterrent theory
Ans. (b)
Directions The following questions consist of two statements, one labelled the Assertion (A) and the other labelled the Reason (R). You are to examine these two statement carefully and decide if the Assertion (A) and the Reason (R) are individually true and if so, whether the reason is correct explanation of the Assertion. Select you answers to these questions using the codes given below and mark our answer sheet accordingly.
(a) Both A and Rare true and R is the correct explanation of A.
(b) Both A and R are true but R is not a correct explanation of A.
(c) A is true but R is false,
(d) A is false but R is true.
Q.3. Assertion (A): For legal duty, sanction is an essential element attached for its breach.
Reason (R): Presence of sanction is the test of legal duty.
Ans. (a)
Q.4. Which one of the following statements is related to Salmond ?
(a) Jurisprudence is lawyer�s perspective
(b) Jurisprudence is formal science of positive law
(c) Jurisprudence is science of the first principle of civil law
(d) Jurisprudence is the scientific synthesis of� all principles of law
Ans. (c)
Q.5. According to Austin, sanction is:
(a) the permission to do an act
(b) the evil consequence of disobeying the command of the sovereign
(c) a right granted by law
(d) a power to inflict punishment
Ans. (b)
Q.6. Match List-I (Jurists) with List-II (Definitions) and select the correct answer using the codes given below the Lists:
List-I                                                                List-II
(Jurists) (Definitions)
A. Ulpian                                              1.Lawyer�s    extra version
B. Julius Stone                                      2. Science of just and unjust.
C. Patterson                                           3.Philosophy of positive law
D. Austin                                               4. Social Science
Codes:
A B C D
(a) 4 3 2 1
(b) 2 1 4 3
(c) 4 1 2 3
(d) 2 3 4 1
Ans. (b)
Q.7. Consider the following statements:
(a) Laws are commands.
(b) The analysis of legal concept is distinct from sociological and historical inquiries.
(c) Decisions can be deducted logically with recourse to morality
(d) The law as it is has to be kept separate from the law and ought to be.
Which of the statements given above are related to positivism?
(a) 1, 2 and 4
(b) 1, 2 and 3
(c) 2, 3 and 4
(d) 1 and 4
Ans. (a)
Q.8. Which one of the following statements is not related is the Natural Law School?
(a) Evaluation of any part of the law must be done in terms of its effects
(b) There is a connection between means and ends
(c) Justice originates in pure practical reason
(d) Law consists of means of achieving ends
Ans. (a)
Q.9. Ratio decidendi of a case is which one of the following?
(a) The order of the court in the case
(b) The final decree passed by the Court
(c) The underlying principle or legal reasons on which the result of the case depends
(d) The part of the judgment which has persuasive effect
Ans. (c)
Q.10. Match List-I with List-II and select the correct answer using the codes given below the Lists:
List-I                                                       List-II
A. Savigny                                   1.Evolutionary concept of history
B. Hegel                                       2.Evolution . with laissez-fair
C. Herbert Spenser                       3.Status to contract
D. Henry Maine                           4.Reflection of spirit of people in legal system
Codes:
A B C D
(a) 3 2 1 4
(b) 4 1 2 3
(c) 3 1 2 4
(d) 4 2 1 3
Ans. (d)
Q.11. Consider the following statements:
1. Law is not made, but is already available in the soul of human beings
2. The nature of legal system is a reflection of spirit of the people
3. Law grows with the growth and strength with the strength of the people
4. Customary law dies when law is codified
Which of the statements given above are related to the �Volksgeist� theory propagated by Savigny?
(a) l, 2 and 3
(b) 2, 3 and 4
(c) l, 3 and 4
(d) l and 4
Ans. (b)
Q.12. Match List (Statement) with List-II (Author) and select the correct answer using the codes given below the Lists:
List-I                                                                                     List-II
(Statement)                                                                              (Author)
A. Sociological School is �metajuristic�                                1.Julius Stone
B. Formal analysis of the structure of English law                2.Bentham
C. Jurisprudence is lawyer�s   extra version                           3.Austin
D. Distinguishes between expositional and censorial law     4.Kelsen
Code:
A B C D
(a) 4 2 1 3
(b) 1 3  4 2
(c) 4 3  1 2
(d) 1 2 4 3
Ans.(c)
Q.13. Consider the following statements:
1. The outstanding fact of the society is the interdependence of men
2. The doctrine of sovereignty has become meaningless
3. Laws should be treated from the angle of purpose
4; The only right which any man can possess is the right always to do his duty
Which of the statements given above can be subscribed to Duguit?
(a) 2 and 3
(b) 1 and 4
(c) 1, 2 and 3
(d) 1, 2 and 4
Ans. (d)
Q.14. Which one of the following rights is a right in re-propia.?
(a) Easement
(b) License
(c) Lessee�s right
(d) Ownership
Ans.(d)
Q.15. Legislation grows out of theory but customary law grows of practice. The existence of legislation is essential which one of the following?
(a) de facto
(b) de jure
(c) Both de facto and de jure
(d) Dependent on recognition
Ans. (b)
Q.16. Match List-I (Jurists) with List-Il (Theory) and select the correct answer using the codes given below the Lists:
List-I                                                                List-II
(Jurists)                                                          (Theory)
A. Ihering                                                      1. Social solidarity
B. Bentham                                                   2. Social engineering
C. Roscoe Pound                                           3. Social control
D. Duguit                                                      4. Pleasure pain
Codes:
A B C D
(a) 3 1 2 4
(b) 2 4 3 1
(c) 3 4 2 1
(d) 2 1 3 4
Ans. (c)
Ans. (c)
Q.17. For a valid custom, there are certain prerequisites.
Which one out of the following conditions of a valid custom is not correct?
(a) Custom must be continuous
(b) Custom must be reasonable
(c) Custom might be contrary to statutory law
(d) Custom must not be immoral
Ans. (c)
Q.18. Consider the following statements:
1. Human being alone can be subjects of jural relations.
2. The members of a corporation and the beneficiaries of a foundation are the only �person�.
3. Juristic persons are treated as if they are human beings.
4. The dignity of being a juristic person has to be conceded by the state.
Which of the statements given above is/are related to
the purpose theory?
(a) 4 only
(b) 2 and 3
(c) 1 and 4
(d) 1 only
Ans. (d)
Q.19. A tenant went to jail for two years leaving his mistress in occupation. The mistress also left after sometime. The tenant claimed that he remained in possession.
Consider the following statements:
1. The tenant remained in possession as he had left his mistress in occupation.
2. The tenant did not remain in possession as he has gone to jail for two years.
3. The tenant was being unfair and as such he did not remain in possession.
4. The tenant remained in possession as he has been fair
Which one of statements given above is/are correct?
(a) 2 and 3
(b) 1 and 3
(c) 1 only
(d) 4 only
Ans. (c)
Q.20. X allows Y to put his goods in a room of X�s house. Y sends his agent Z to put the goods in the room. Z puts the goods in the room, locks it up and keeps the key with him. Who is in possession of the room?
(a) X
(b) Y
(c)  Z
(d) Both X and Z
Ans. (b)
Q.21. Which of the following is an element of  Ihering theory of possession?
(a) Overemphasis on the element of animus
(b) Equal emphasis on the elements of animus and corpus
(c) Owner like appearance in relation to a thing
(d) Immediate physical power to exclude any foreign agency.
Ans. (c)
Q.22. Ownership without possession can be termed as which
one of the following?
(a) No ownership
(b) Quasi ownership
(c) Incomplete ownership
(d) No-corporeal ownership
Ans. (d)
Q.23. Which one out of the following statements is not correct with reference to Savigny�s theory of Volksgeist?
(a) Law cannot be universal or general in character
(b) Law is found and not made
(c) Law grows with the growth and strengthens with the strength of people
(d) Law is an instrument of social change and social reform
Ans. (d)
Q.24. Who among the following propounded the theory of possession which lays stress not on animus, but on de facto control?
(a) Salmond
(b) Pollock
(b) Pollock
(c) Holmes
(d) Jhering
Ans. (b)
Q.25. �A� borrowed a sum of Rs. 5,000/- from �B�, which he did not repay for a period of three years. Now which
one of the following rights does �B� have against �A�?
(a) Perfect right
(b) Imperfect right
(c) Proprietary right
(d) None of the above
Ans. (b)
Q.26. What do Rights in re-aliena mean ?
(a) Rights in the things of others
(b) Rights in one�s own things
(c) Rights relating to property
(d) Rights to receive damages
Ans. (a)
Q.27. Match List-I with List-II and select the correct answer from the codes given below the List:
List-I                                                       List-Il
A. Supreme Legislation                 1.Law based on discretion of the authority
B. Executive Legislation                2. Law enacted by authority other than legislature
C. Debated Legislation                  3. Law enacted by the legislation
D. Conditional Legislation            4. Ordinance issued by the resident/Governor Law
made by judges with the case
Codes:
A B C D
(a) 3 4 2 1
(b) 2 1 5 4
(c) 3 1 2 4
(d) 2 4 5 1
Ans. (a)
Q.28. Who among the following divided the sources of law into formal sources and material sources?
(a) Allen
(b) Keeton
(c) Salmond
(d) Gray
Ans. (c)
Q.29. Why is the expiatory theory of punishment obsolete now?
(a) It does not empower the State to impose punish
(b) It is incapable to reform the wrong doer
(c) It is based on moral doctrines
(d) It enlarges the limits of jurisprudence
Ans. (c)
Q.30. Eugen Ehrlich is a well known Jurist of sociological school of jurisprudence. Which one of the following statements may not be attributed to the theory propounded by him?
(a) Law is derived from social facts
(b) Law depends on social compulsion
(c) There is a �living law� underlying the formal rule of the legal system
(d) State law has significant influence on shaping and development of living law
Ans. (d)
Q.31. Balancing of social interests and the doctrines of social engineering is the greatest contribution to sociological school. This is attributed to whom?
(a) Duguit
(b) Roscoe Pound
(c) Savigny
(d) Jhering.
Ans. (b)
Q.32. Which of the following factors are responsible for the resurgence in favour of natural law thinking in the twentieth century ?
1. The decline in social and economic stability in the twentieth century
2. The expansion in government activity
3. Growth of weapons of destruction and policies of. genocide
4. Growing inclination of people towards religion
Select the correct answer using the codes given below:
(a) 2, 3 and 4
(b) 3 and 4
(c) 1, 2 and 6
(d) 1 and 4
Ans. (c)
Q.33.Match List-I (Jurists) with List-II (View About Law/Jurisprudence) and select the correct answer using the codes given below the Lists:
List-I                                                                List-II
(Jurists)                                            (View About Law/Jurisprudence)
A. Bentham                                               1. Concept of law
B. Austin                                                   2. Pure theory of law
C. Kelsen                                                  3. Limits of jurisprudence defined
D. Hart                                                      4. Province of jurisprudence determined
5. Concept of living law
Codes:
A B C D
(a) 1 2 5 3
(b) 3 4 2 1
(c) 1 4 2 3
(d) 3 2 5 1
Ans. (b)
Q.34. There is a clear cut division between the spheres of the legislature and the judiciary. The former makes the laws and the latter applies them. Which one of the following propounds this doctrine ?
(a) Analytical jurisprudence
(b) Historical jurisprudence
(c) Sociological jurisprudence
(d) Philosophical jurisprudence
Ans.(a)
Q.35. It is said that the next step forward in the long path of man�s progress must be from jurisprudence to jurimetrics. In this context, what does jurimetrics signify?
1. Speculation about law
2. Scientific investigation of legal problems
3. Increasing awareness of the fruits of interdisciplinary co-operation
4. Relationship between law, economy and society
Select the correct answer using the codes given
below:
(a) 1, 2 and 3
(b) 2, 3 and 4
(c) 1,3and4
(d) 1, 2and 4
Ans.(b)
Directions The following questions consist of two statements, one labelled the Assertion (A) and the other labelled the Reason (R). You are to examine these two statement carefully and decide if the Assertion (A) and the Reason (R) are individually true and if so, whether the reason is correct explanation of the Assertion. Select you answers to these questions using the codes given below and mark our answer sheet accordingly.
(a) Both A and Rare true and R is the correct explanation of A.
(b) Both A and R are true but R is not a correct explanation of A.
(c) A is true but R is false,
(d) A is false but R is true.
Q.36. Assertion (A) : Austin does speak of the science of law
Reason (R) : Science of law and philosophy of positive law are synonymous to him.
Ans. (c)
Q.37. The Constitution of India is federal in character because
(a) the Head of the State (the President) is elected by an electoral college cOnsisting of the elected members of both the Houses of Parliament and the elected members of the Legislative Assemblies of the States
(b) the Governors of States are appointed by the President and they hold office during the pleasure of the President
(c) there is distribution of power between the Union and the States
(d) the amendment of the Constitution can be made only by following the procedure laid down in the Constitution and in some cases the amendment requires ratification by Legislatures of the States
Ans. (c)
Q.38. Consider the following judgments delivered by the Supreme Court of India in:
1. Keshvananda Bharati v. State of Kerala
2. Re Berubari
3. Excel Weary. Union of India
The correct chronological sequence of the above judgments is:
(a) 1, 3, 2
(b) l, 2, 3
(c) 3, 1, 2
(d) 2, 1, 3
Ans. (d)
Q.39. After which one of the following Supreme Court decisions was the special provision for socially and educationally backward classes introduced by an amendment of the Constitution?
(a) Balaji v. State of Mysore
(b) State of Madras v. Champakam Dorairajan
(c) Devadasan v. Union of India
(d) Periakaruppan v.State of Tamil Nadu.
Ans. (b)
Q.40. An Electricity Board terminated the Services of certain employees arbitrarily without giving notice. Which one of the following alternative remedies can be best adopted by the concerned employees?
(a) The employees can move the High Court by a writ as Electricity Board is included within the definition of State.
(b) The employees can make an appeal to the State Government.
(c) The employees can move the High Court after getting the permission of Electricity Board only.
(d) The employees can directly approach the Supreme Court for violation of a fundamental right
Ans. (a)
Q.41. Which one of the following is NOT �State� for the purpose of Article 1.2 of the Constitution?
(a) National Council of Educational Research and Training (NCERT)
(b) A nationalized bank
(c) Institute of Medical Education and Research Chandigarh
(d) Grih Katyan Kendra
Ans. (a)
Q.42. Under the Indian Constitution, which one of the following is NOT a specific ground on which the State can place restrictions on freedom of religion?
(a) Public order
(b) Morality
(c) Social Justice
(d) Health
Ans. (c)
Q.43 .Which of the following statements are true with regard to the Fundamental Right of the minorities in educational matters?
1. The minority has only the right to administer the educational institutions.
2. The . minority has the right to. establish and administer educational institutions.
3. The right is absolute and not subject to any restriction.
4. Reasonable restrictions may be imposed to promote efficiency and prevent maladministration.
Select the correct answer using the codes given below:
Codes:
(a) 1, 2 and 3
(b) 2 and 4
(c) 2, 3 and 4
(d) 1 and 3
Ans. (b)
Q.44. Arrange the following decision of the Supreme Court on Fundamental Right relating to personal liberty in the correct chronological sequence:
1. Menaka Gandhi v. Union of India
2. A.D.M. Jabalpur v. Shiva Kant Shukla
3. A.K.Gopalan v. State of Madras
Select the correct answer using the codes given below:
Codes:
(a) 3, 2, 1
(b) 2, 1, 3
(c) 2,3, l
(d) 1, 2, 3
Ans. (a)
Q.45. Fundamental duties have been add in the Constitution by 42nd Amendment Act, 1976 in accordance with the recommendations of:
(a) Santhannam Committee
(b) Sarkaria Committee
(c) Swaran Singh Committee
(d) Indira Gandhi-Nehru Committee
Ans. (c)
Q.46. �Provisions relating to fundamental duties cannot be enforced by writs. They can be only promoted by constitutional methods. But they can be used for interpreting ambiguous statutes.�
In which one of the following cases was the aforesaid principle enunciated?
(a) Moti Lal v. State of U.P.
(b) Civil Rights Committee v. Union of India
(c) Head Masters v. Union of India
(d) Magan Bhai v. Union of India
Ans. (c)
Q.47. Who among the following holds his/her office at the pleasure of the President?
(a) Chairman of the Union Public Service Commission
(b) Attorney General of India
(c) Speaker of the Lok Sabha
(d) Comptroller and Auditor General of India
Ans. (b)
Q.48. In the event of occurrence of vacancies in the offices of both, the President and the Vice-President of India, who among the following shall discharge the functions of the President till a new President is elected?
(a) Speaker of the Lok Sabha
(b) Leader of the majority party in the Lok Sabha
(c) Chief Justice of India
(d) Senior-most Governor.
Ans. (c)
Q.49. The executive power of the Union is vested in the:
(a) Union Cabinet
(b) President of India
(c) Prime Minister
(d) Union Council of Ministers
Ans. (b)
Q.50. Who among the following can establish additional courts for better administration of any existing law with respect to a matter concerned in the Union List?
(a) Chief Justice of India
(b) High Court of the concerned State
(c) Parliament
(d) Concerned State Legislature
Ans. (c)

APSCSC EXAM SCHEDULE

ANDHRA PRADESH STATE CIVIL SUPPLIES CORPORATION GRADE-I & GRADE-II ALL POSTS RECRUITMENT EXAM WILL HELD ON 12-12-2010 AT HYDERABAD CENTER ONLY.

For Details see http://www.civilsuppliesrecruitment.in

"All men of action are dreamers." ~ James G. Huneker

The Benefits of Fruits and Vegetables

Nutritionists have long advised us to add color to our diet. In fact, they say the more colors we eat, the better balanced the meal. A new study in the Archives of Internal Medicine supports this belief.

Carotenoids are yellow, orange and red pigments made by plants that come into our body through fruits and vegetables. They're found in yellow-orange vegetables such as carrots and sweet potatoes, and dark green vegetables, like green beans.

There are two types of carotenoids, alpha- and beta-carotene, which both produce vitamin A in our bodies. More is known about beta-carotene because of its possible role in preventing chronic disease.

Now, in a new study of over 15-thousand adults, researchers measured the concentration of alpha-carotene in the blood. Over a 14 year period they found that the risk of death was lower for people with elevated levels of alpha-carotene.

The investigators think that the benefits of high alpha-carotene eventually flattens out - it's not an elixir of eternal life. But they conclude that increasing fruit and vegetable consumption may prevent premature death.

The science is still out on just how this works. But it further supports previous findings - and conventional wisdom - that fruit and vegetable consumption is beneficial to people's overall health.
For tips on how to boost fruits and vegetables in your diet...and to see the benefits each one provides, click on the American Heart Association website.

Source  http://www.wdio.com/article/stories/S1857838.shtml?cat=11803

Monday, November 29, 2010

Medical transcription outsourcing: Helping the documentation process

The importance of maintaining patient medical records is undeniable in both the operational and commercial aspects of healthcare. Healthcare facilities have various options available to them to document the patient- healthcare professional encounter. The options available for documenting are:
 
  • Dictation to transcription: The healthcare professional has the option of dictating notes of his/her encounter with the patient. These audio files can be converted into text reports using the following options:
  1. In-house transcriptionists
  2. Independent contractors
  3. Outsourcing to a professional medical transcription service provider
  4. A combination of any of these above sources
  • Speech recognition software: This enables the dictation of the healthcare professional into text format using the recognition software instantly. In theory this sounds like the best solution. But this method has many shortcomings, some of which are:
  1. The software needs to be trained
  2. The healthcare professional has to change his method of dictation
  3. The document produced by speech recognition software is only 60%- 80% accurate, needing extensive editing and quality checking
  • Direct entry into EMR/EHR: This enables the healthcare professional to capture data at the point of care using point and click templates. Though this method allows for instant documentation, this method has some shortcomings:
  1. Lack of narrative details
  2. Decreases the productivity of the healthcare professional
  3. Focuses the attention of the healthcare professional on the computer instead of the patient
    Though there are many options available to healthcare professionals and healthcare facilities for creating patient medical records, all the methods need the support of experienced and skilled medical transcription services to meet all the criteria of healthcare documentation. Outsourcing medical transcription to a professional service provider can help healthcare facilities and healthcare professionals meet all the criteria of healthcare documentation.
     
    How can outsourced medical transcription services help meet the criteria for healthcare documentation?
    Outsourcing medical transcription to a professional service provider provides healthcare facilities access to all the resources required for healthcare documentation, namely:
    • Trained and skilled medical transcriptionists to ensure accuracy and speed
    • The right processes to ensure quality and security
    • The right technology to ensure speed, security and ease of use.
    The principles of healthcare documentation are:
    • Accuracy: The process of medical transcription ensures that the information provided by the healthcare professional and the support staff in the audio record is captured with maximum accuracy possible
    • Completeness: The medical transcription process ensures that the information provided by the healthcare professional is capture completely to the extent possible
    • Timeliness: The process of medical transcription ensures that the patient medical records are created on a timely basis by using the right team, the right process and the right technology
    • Interoperability: Interoperability of the data in the patient records can be ensured by the medical transcription service provider using HL7 interface. HL7 functions as a standard to ensure that critical healthcare information is made available to various sources without the meaning getting lost.
    • Retrievability: Most outsourced medical transcription service providers keep the audio records and the transcribed documents on their systems for a period of time as specified by the healthcare facility, after which they are archived. The staff at the healthcare facility can retrieve this data by using various criteria like patient name, MRN no, the provider, the date of treatment or a combination of any of these criteria
    • Authentication: Outsourced medical transcription service providers have the provision of the healthcare professionals being able to electronically sign off on transcribed reports to authenticate them
    • Auditability: In case of any missing words or data, these would be highlighted by the medical transcriptionists so that the healthcare professionals can audit these records and correct the missing/ wrong entries
    • Confidentiality and security: Outsourcing to the right medical transcription service provider ensures that the service provider would have HIPAA / HITECH compliant measures in place to secure confidential patient information covering technology, processes, infrastructure and teams.
      TransDyne, leader in the outsourced medical transcription industry has used their background in information technology to develop software and tools for medical transcription that save on efforts and money and adhere to the principles of healthcare documentation.
       
      TransDyne offers quality medical transcription at reasonable prices, executed by experienced and qualified medical transcriptionists with a very quick turnaround time executed through secure HIPAA and HITECH compliant channels, with very high levels of accuracy and all this with technology that is advanced but easy to use!
       
       
      To avail outsourced medical transcription services from TransDyne, click here.
    Unique identification of the patient: The process of medical transcription ensures that the identity of the patient is captured in the manner narrated by the healthcare professional to ensure unique identification
    What are the principles of healthcare documentation and how do outsourced medical transcription services help healthcare facilities adhere to these principles?
     

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TTD HELPER (WATER WORKS) RECRUITMENT

TTD HELPER (ELECTRICAL) RECRUITMENT

TTD SUB EDITORS RECRUITMENT

TIRUMALA TIRUPATI DEVASTHANAMS: TIRUPATI
MATTER FOR NOTIFICATION NO. 10/ 20102011
Roc.No: E10/16537/2010 dated: 24112010

Applications are invited from the eligible and interested candidates for the posts of
SUB EDITORS, TTD with the following qualifications and should reach to the Executive
Officer, T.T.D., K.T. Road, Tirupati on or before 13122010
with complete bio data particulars such as proof of age, educational qualifications, Technical Qualifications,
Marks Statements, Experience, caste etc. (Photocopies with attestation from the
Gazetted Officer) along with recent three passport size photos. The cover should be
superscribed as �Application for the post of SUB EDITOR, TTD�. The Management
is not responsible for postal delay or any other delays. Incomplete and applications
received after last date will not be entertained. The TTD Management is having right to
cancel notification / postpone the selections / Interviews / written tests if any without
any intimation to the candidates on administrative reasons and also subject to receipt of
approval from the Government of Andhra Pradesh.
PERSONS PROFESSING HINDU RELIGION
SHOULD ONLY APPLY

DETAILS OF THE POSTS
S.NO. NAME OF THE POST        NO. OF POSTS        
1         KANNADA                                    2                                   
2         ENGLISH                                       1
3         TELUGU (PUBLICATION
           WING & SAPTAGIRI)                  3
4         TAMIL                                          1
5          HINDI                                          1

6 Qualifications : (i) Must be a postgraduate or its
equivalent in the concerned language.
(ii) Must have Diploma in Journalism or
three years experience in a reputed
newspapers of concerned language will
be considered as additional qualification.
(iii) Must not have completed thirty five years of age.
7. Age : (i) Must have completed 18 years and must not have completed
35 (thirty five) years of age as on 01-07-2010.
(ii) Upper age relaxable by 5(five)
years in respect of B.C., S.C. and S.T.
Categories of candidates.
(iii) Upper age relaxable by 10 (ten)
years in respect of Physically
Handicapped candidates.
8. Scale of Pay : Rs. 1615042590
(IN RPS 2010)

TTD EDITOR IN CHIEF RECRUITMENT

TIRUMALA TIRUPATI DEVASTHANAMS: TIRUPATI
MATTER FOR NOTIFICATION NO. 09/ 20102011
Roc.No: E10/16536/2010 dated 27112010

Applications are invited from the eligible and interested candidates for the tenure
post of EDITOR IN CHIEF, TTD on tenure basis for a period of 03 (three) years with the
following qualifications and should reach to the Executive Officer, T.T.D., K.T. Road,
Tirupati on or before 10122010
with complete bio data particulars such as proof of
age, educational qualifications, Technical Qualifications, Marks Statements,
Experience, caste etc. ( Photocopies with attestation from the Gazetted Officer ) along
with recent three passport size photos. The cover should be superscribed as
�Application for the post of EDITOR IN CHIEF, TTD. The Management is not
responsible for postal delay or any other delays. Incomplete applications and
applications received after last date will not be entertained. The TTD Management is
having right to cancel notification / postpone the selections / Interviews / written tests if
any without any intimation to the candidates on administrative reasons and also subject
to receipt of approval from the Government of Andhra Pradesh.
PERSONS PROFESSING HINDU RELIGION SHOULD ONLY APPLY
DETAILS OF THE POST
TENURE POST FOR A PEROID OF THREE YEARS
1. Name of the Post : EDITOR IN CHIEF
2. No. of Posts : 01 (one)
3. Reservation Category : Open Category
4. Qualifications : Masters Degree in Telugu and Sanskrit with
Ph.D and should have knowledge in applied
linguistics with a fair number of valid and
reputed publications (minimum of 20 in
recognized Journals or books).
5. Age : Below 65 years and is relaxable in
deserving cases.
6. Pay : Commensurate with the qualifications
and experience & negotiable
7. Last date : 10-12-2010
PERSONS POSSSESSING HINDU RELIGION SHALL ONLY APPLY
For further details, other terms and conditions, please visit
TTD Website www.tirumala.org./ www.tirupati.org

What Are You Doing To Live Your Dreams Today? http://ping.fm/FK9gU

CRS to put on a great educational opportunity for Non-Profit Organizations

Commercial Risk Service will be offering a Workshop/Seminar on Thursday, January 27th geared toward educating the Non-Profits in Northwest Arkansas. All Non-Profit Organizations are welcome to attend. The Workshop/Seminar will be held at the DoubleTree Hotel in Bentonville and will begin at 8:00 that morning and last until 10:00. A free breakfast will be served starting at 7:30 for all workshop attendees.

Key areas of information include:

1) How to make your non-profit more competitive Information on how the non-profit world is changing, and how you need to respond to those changes. Key operational changes that need to be made within the organization.

2) Sarbanes-Oxley Best Practices Helpful information from a CPA firm about how to correctly and legally respond to this relatively new process, and how it affects your operation.

3) Blending resources for the community Information from a key player in the NW Arkansas Non-Profit community that shows Non-Profits how to work with people of limited resources and abilities and make it as easy for them as possible to help themself.

If you would like to sign up for this particular workshop, please click on the link below.

As we have stated many times, one of CRS� commitments to our customers is to give them the most educational information we can in order to help them learn how to improve their operations and reduce their risks in the process. This Workshop/Seminar for our non-profit friends in NW Arkansas is just another example of that commitment. If any of you have suggestions for future workshops or seminars, please respond and let us know what would be important for you.

Afformations – A Powerful Tool to Reprogram the Mind http://ping.fm/X4EAt

Social Media Marketing Rule #1 and the Google Model http://ping.fm/Qefqk

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Citizen Journalism: Why I Blog on Healthcare Informatics

I am teaching my current students about alternate media, a.k.a. citizen journalism, also known as "blogging", in a course on organizational and social aspects of healthcare informatics.

I am using a (de-identified) personal experience as an example of why alternate media is valuable in getting "inconvenient" memes into circulation.

In addition to recent articles such as "The Problems with Peer Review" (in the British Medical Journal by Mark Henderson, Science Editor, the Times, London. BMJ 2010;340:c1409), "Ghostwriting at Elite Academic Medical Centers in the United States" (LaCasse & Leo, PLoS Medicine, February 2010, Volume 7, Issue 2) and others about ghostwriting and other ills affecting the conventional biomedical literature, I provided my students the personal example below.

I thought the example might be interesting to blog readers as well.

Here is the example I used with my students:

Regarding a paper I wrote a few years ago and that I ultimately simply posted on Scribd, "Remediating an Unintended Consequence of Healthcare IT: A Dearth of Data on Unintended Consequences of Healthcare IT" (link), an anonymous peer reviewer had this to say when I submitted it to "journal XYZ":

Comments to the Author

This paper addresses a potentially important issue but adds little that is new or that goes beyond what a reader might find in a major city newspaper. Proposing a classification of sources of UC and analysis of reasons for undereporting of each type in the resulting classification could be a useful addition to the field.

This was certainly an ironic if not bizarre comment. A paper on a scarcity of data on unintended consequences of health IT due to a "closed culture" in the HIT industry does not add anything new "beyond what one might find in a major city newspaper?"

Unfortunately, the anonymous peer review process does not allow me to ask what newspaper this reviewer reads, but it was clear to me this reviewer was 1) attempting to prevent the paper's publication and 2) "moving the goalposts" to delay it or have the focus on scarcity removed by seeking for me to "propose a classification of sources of UC" (tangential or even irrelevant to the paper's topic).

I felt it likely the review of a revised paper by this reviewer would have led to negative comments on any proposed classification schema.

Worse, was this, in a dialog via several emails I've condensed for readability. It is very likely it came from the same reviewer above:

EDITOR OF JOURNAL XYZ: I suggest Scot that you modify this into an editorial. One reviewer recognized the writing and asked me if this may have been pre-published on a blog. Any possibility for that?

In other words, I was being accused by the anonymous reviewer of possibly violating the ethics of journal publication and the contract I signed to not pre-publish (the journal has exclusive rights).

My response:

SS: No, this work was entirely original, written from a clean slate, and was not pre-published on a blog. I would think the reviewers would know me better than that in terms of integrity.

The editor shot back:

EDITOR: My response as well. Good - looking forward to the edits. Happy snow day

I reminded the editor:

SS: Not to mention the extensive footnotes showing where I sourced my material. In an age of search engines, I have to ask the following:

- was the person who raised this concern so technologically limited they were unable to search themselves to answer their own question?
- did this person have such a lack of trust they felt compelled to make such a statement?
- did this person raise this due to bias against the fundamental thesis of the paper?

I think it's fair to say there is very, very strong pushback against articles such as this being published. I have to consider whether it's worth my while to continue, or to withdraw the paper.

At which point I received the following revealing comment from the editor:

EDITOR: I think, Scot, that you have a talent for sniffing out problems, dangers, risk, failures and by addressing them in your head on ways, you are likely to make enemies. You are doing a valuable job, but you have to realize that people are threatened by you. That's why the respond in this manner. Not that it is excusable, but it is understandable.

I decided it was not worth revising the paper due to that reviewer's comments and the editor's observations, and therefore disseminated the paper via the Healthcare Renewal blog and Scribd.

(I note that "making enemies" by directly confronting possible risks of a new technology in healthcare suggests skewed priorities among those so affected.)

While I believe the current Wikileaks web exposures have gone insanely too far, as those incidents involved exposure of sensitive material held illegally that could people to be harmed, damage international relations, and cause other unforeseen ill effects, the web has proven valuable for dissemination of one's ideas that have not been able to escape the gravity of the sometimes "peer review Black Hole."

-- SS

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