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Previous research have considered presupposed knowledge as a communicational difficulty in conceiving the meaning of the articles of the legal cods by the reader / addressee. The main question is this: to which extent is the scope of the presumed knowledge? The hypothesis in this research, based on the functional grammar approach, is that the scope of presumed knowledge extends to the extent that in -text and out -of-text references expand the scope of text and meaning. We, in implementation, based on some selective and incidental articles from the Code of Criminal Procedure (CCP), have followed the scope of their references in order to discover its in -text and out -of-text network. The research results show that the domain of presumed knowledge, networked, includes all law codes, legal texts, legal theories, judicial structure, and related knowledge. The following types of references continuously delay the meaning of the clause and article to the last frontiers of presupposed knowledge: explicit references (in -text and out -of-text), implicit references (in -text and out -of-text) including: heterogeneous references, concurrent references, iterative references, and negative reference. Heterogeneous references show that criminal laws (Code of Criminal Procedure, Penal Code, and other criminal codes) focus on the "crime" as the core signifier reflecting the network of knowledge which is presupposed. The results show that any reference, even explicit reference, creates a level of communication complexity and becomes more difficult when the articles, rules, and texts refer to each other back and forth. [ABSTRACT FROM AUTHOR]

We introduce the groupwise-pivotal referral (GPR) mechanism for auctions where buyers can participate through referrals. Each buyer's type consists of a valuation and referable buyers. Unlike the second-price auction (SPA), the Vickrey-Clarke-Groves (VCG) mechanism provides referral incentives. However, VCG is not budget-feasible. In contrast, under complete information, GPR is core-selecting, implying efficiency and budget feasibility. Under incomplete information, bidders refer truthfully and have no incentive to underbid in GPR. Furthermore, GPR's ex-post revenue outperforms both VCG and SPA, not just in equilibrium but also when bidders do not use weakly dominated strategies. [ABSTRACT FROM AUTHOR]

Background/Purpose: There is a distinct lack of published studies evaluating the reasons for delay in definitive treatment of open fractures. This study aimed to determine the specific factors causing delay in the timely treatment of open fractures from the time of injury and to analyse the quality of treatment performed at the pre-hospital level. Methods: In total, 250 consecutive patients with open fractures were assessed for time to surgery from injury and admission. The referred patients were analysed for distance of travel, level of referring hospital and appropriateness of care. The reasons for delay in terms of infrastructural- and patient-related factors were analysed individually and in combination. Results: There were 37 direct patients (Group A) and 213 referred patients (Group B). Inappropriate care was present in 172 out of 213 (80.8%) referred patients. In total, 84% patients travelled more than 50 kms. The definitive surgery in referred patients was likely to be significantly delayed with regard to time from injury (29.84 vs 44.84 h, p ≤ 0.02). After admission, the time to surgery was greater than 24 h in 102 patients. Multivariate regression analysis determined that associated injuries and lack of fitness for surgery caused greater delay than non-availability of operation theatre or intensive care unit bed. Conclusion: Delayed referral, inadequate pre-hospital care and delay in surgery due to patient- and infrastructural-related issues at tertiary centre were identified as critical gaps in open fracture care in India. The importance of appropriate basic knowledge about management of open fractures should be emphasized at all structural level of care. [ABSTRACT FROM AUTHOR]

BackgroundUnder new bundled payment models, hospitals are financially responsible for post-acute care delivered by providers such as skilled nursing facilities (SNFs) and home health agencies (HHAs). The hope is that hospitals will use post-acute care more prudently and better coordinate care with post-acute providers. However, little is known about existing patterns in hospitals׳ referrals to post-acute providers.MethodsPost-acute provider referrals were identified using SNF and HHA claims within 14 days following hospital discharge. Hospital post-acute care network size and concentration were estimated across hospital types and regions. The 2008 Medicare Provider Analysis and Review claims for acute hospitals and SNFs, and the 100% HHA Standard Analytic Files were used.ResultsThe mean post-acute care network size for U.S. hospitals included 57.9 providers with 37.5 SNFs and 23.4 HHAs. The majority of these providers (65.7% of SNFs, 60.9% of HHAs) accounted for 1 percent or less of a hospital׳s referrals and classified as “low-volume”. Other post-acute providers we classified as routine. The mean network size for routine providers was greater for larger hospitals, teaching hospitals and in regions with higher per capita post-acute care spending.ConclusionsThe average hospital works with over 50 different post-acute providers. Moreover, the size of post-acute care networks varies considerably geographically and by hospital characteristics. These results provide context on the complex task hospitals will face in coordinating care with post-acute providers and cutting costs under new bundled payment models.

Abstract Objective The aim of this study was to assess the magnitude, trend and reasons of rejection among referred specimens through referral network to the Amhara Public Health Institute (APHI) for laboratory testing. Results A total of 42,923 specimens were received at APHI reference laboratories. Of which, 221 (0.5%) specimens were rejected. CD4, HIV viral load, genexpert and EID specimens’ rejection rates were 0.7%, 0.6%, 0.3% and 0.2%, respectively. CD4 specimens were rejected due to wrong package (84.2%) and presence of clots (15.8%). Un-centrifuge (46.9%), hemolysis (19.8%) and use of wrong tube (17.7%) were the main rejection reasons for HIV viral load specimens. Although viral load specimen rejection was improved from 1.8 to 0% up to February/2018, the problem was reoccurred and continued to the end of May (1.3%) and June (0.3%) 2018. Moreover, CD4 specimen rejection (4.3%) was out of the established target in May, and exposed infant diagnosis (EID) specimen rejection became increased since March 2018. Hence, appropriate corrective and preventive actions and close follow up could reduce the problem of specimen referral network.

From the viewpoint of a monopolist who is selling a product in a market where peer communication matters, a social network of consumers is a valuable resource that can elevate a company's revenue if used effectively. In order to understand and realize the potential value within a social network, this paper focuses on measuring the link value in marketing-oriented scenarios and further adopting the measured value to propose profitable referral strategies. We measure the link value by considering how much a company's revenue changes when a new link is added. Moreover, different market scenarios are considered, including different degrees of price discrimination and different levels of information. More interestingly, we identify the relationship between the measured link value and the (weighted) Bonacich centrality in various market scenarios. Then, we design and propose profitable referral networks based on measured link value, which serves as a new perspective for designing a profitable referral mechanism. From numerical examples, several properties are summarized in order to determine how the measured link value is influenced by the interaction between market scenarios and network structures. Furthermore, a series of simulations have also been conducted to validate the effectiveness of the proposed referral networks as well as to provide insight into managerial practices. [ABSTRACT FROM AUTHOR]

Background: Evidence-based falls prevention programs are available in many communities, but participation in such programs remains low. This study aimed to develop community-based referral networks of organizations to facilitate the uptake of evidence-based falls prevention programs through engaging older adults at risk for falls with the RememberingWhen™ program and connecting them to evidence-based programs in Midwestern communities. Methods: Guided by the Practical, Robust Implementation and Sustainability Model (PRISM), referral networks were developed in two Midwestern communities (urban and micropolitan) through a seven-step community engagement plan: establishing and operationalizing the State-level Advisory Board (SAB), identifying falls prevention resources, conducting community assessments, developing Local Advisory Groups (LAG), operationalizing the LAG, developing referral network and protocols, and implementing the network. Semistructured interviews guided by the RE-AIM framework were conducted with members of the SAB, LAG, administrators and staff from organizations that participated in networks, and older adult participants. Results: After participating in the development of referral networks, participants felt they learned important skills that they can use to develop additional collaborations and networks in the future, emphasized the benefits of building community capacity among organizations with common missions. Interview data yielded strategies on enhancing the referral network’s reach, impact, adoption, implementation efficiency, and maintenance. Conclusion: Future sustainability studies of such networks should explore identified challenges and strategies to sustain efforts. Results highlight the importance of ongoing funds to support the efforts of organizational networks in communities. [ABSTRACT FROM AUTHOR]

Introduction: This study aims to examine the association between provider attributes, including network (patient panel size, degree-number of peer connections, and community size- number of a closely connected group of peers) and individual attributes (travel distance, specialties, and rural practice), and a predominant (most visited) provider., Methods: This study utilized South Carolina's Medicaid claims data during 2014 to 2018, focusing on live births in hospitals. Samples were limited to pregnant women continuously enrolled in Medicaid throughout pregnancy. Predominant providers (total = 2153) were identified for 29 569 pregnancies. Network analyses involved 5520 providers, comprising 3667 antenatal care (ANC) providers and 1853 non-ANC providers. A Cartesian product (n = 45 929 845) combined five annual provider lists with all included pregnancies. Logistic regressions with repeated measures were applied to this retrospective case-control study., Results: The results demonstrated that a medium or large degree were associated with being a predominant provider if the community size was medium or large. A predominant provider was more likely to be located near, rather than far from, the served woman, and in rural areas rather than urban ones. They were also more likely to be specialists, midwives, and nurse practitioners than primary care physicians., Conclusion: The results suggest that both individual and network attributes were significantly associated with being a predominant provider. Policies aimed at addressing access issues for antenatal care should consider both the individual and network attributes of providers, as providers may not be able to alter their individual attributes but can always optimize their social network., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

It is still unclear what the optimal structure of mental health care networks should be. We examine whether certain types of network structure have been associated with improved continuity of care and greater social integration. A social network survey was carried out, covering 954 patients across 19 mental health networks in Belgium in 2014. We found continuity of care to be associated with large, centralized, and homophilous networks, whereas social integration was associated with smaller, centralized, and heterophilous networks. Two important goals of mental health service provision, continuity of care and social integration, are associated with different types of network. Further research is needed to ascertain the direction of this association. [ABSTRACT FROM AUTHOR]

Background/purpose: There is a distinct lack of published studies evaluating the reasons for delay in definitive treatment of open fractures. This study aimed to determine the specific factors causing delay in the timely treatment of open fractures from the time of injury and to analyse the quality of treatment performed at the pre-hospital level., Methods: In total, 250 consecutive patients with open fractures were assessed for time to surgery from injury and admission. The referred patients were analysed for distance of travel, level of referring hospital and appropriateness of care. The reasons for delay in terms of infrastructural- and patient-related factors were analysed individually and in combination., Results: There were 37 direct patients (Group A) and 213 referred patients (Group B). Inappropriate care was present in 172 out of 213 (80.8%) referred patients. In total, 84% patients travelled more than 50 kms. The definitive surgery in referred patients was likely to be significantly delayed with regard to time from injury (29.84 vs 44.84 h, p  ≤ 0.02). After admission, the time to surgery was greater than 24 h in 102 patients. Multivariate regression analysis determined that associated injuries and lack of fitness for surgery caused greater delay than non-availability of operation theatre or intensive care unit bed., Conclusion: Delayed referral, inadequate pre-hospital care and delay in surgery due to patient- and infrastructural-related issues at tertiary centre were identified as critical gaps in open fracture care in India. The importance of appropriate basic knowledge about management of open fractures should be emphasized at all structural level of care., Competing Interests: Conflict of interestThe authors declare that they have no conflict of interest., (© Indian Orthopaedics Association 2021.)

• Early identification of complication facilitated early referral • Emergency obstetric services are available 24hour a day and 7 days a week • Poor client perception about reception at the hospital is found to be one of the barriers • Weak supportive supervision and poor staff motivation posed a problem on emergency referral In developing countries including Ethiopia, maternal mortality ratio remains unacceptably high. During pregnancy and childbirth, a woman may acquire one or more of obstetric complications including hemorrhage, sepsis, hypertension and obstructed labor. Early diagnosed and referral of women who experienced obstetric complications to a specialty center can save the life of women and babies. However, several factors might affect the referral procedures of these women. Therefore, this study was aimed at assessing the facilitators and barriers of obstetric referral in selected public health facilities of Addis Ababa city administration, Ethiopia. A qualitative study design was employed to obtain the narratives of 12 healthcare workers and three recently referred mothers. The study included a regional health bureau, a lead hospital and a health center. Thematic analysis was employed to present to present the findings of the study and open code software was used to code and generate the themes. This study revealed several barriers and some facilitators of obstetric referral. Early identification of complications, exercising teamwork, availability of referral protocol, availability of ambulance and effective communication system were the major reported factors which enhanced obstetric referral. Several themes including poor perception of clients, poor supportive supervision, lack of staff motivation and shortage of beds and medical equipment, lack of competence among the staffs and shortage of ambulance at health center were emerged as barriers of obstetric referral. This study revealed several barriers of obstetric referral in the Addis Ababa city administration although a number of facilitators of obstetric referral exist. All of the reported barriers are related to the existing health system that need a collective action of all the actors to eliminate the barriers while enhancing the facilitators of obstetric referral. [ABSTRACT FROM AUTHOR]