International Radiographers in Danger: A Letter to the Editor

I have published a case study about how British universities −who offer radiographic reporting programs for radiographers− put admission conditions and tuitions on radiographers in three categories which are; British citizens, European citizens, and internationals [1]. I compared the three categories by collecting the data from the universities’ websites directly. The case study has a simple methodology which is clearly explained in the paper [1]. The case study showed that there is no English language requirements for Europeans due to the Bologna Agreement in June 19, 1999 and the Copenhagen Declaration in November 2002. The English language is not the mother tongue of any European country besides the UK. The tuitions for international students are very high compared to the UK/European citizens where they (UK/European) have the same low tuition. In addition, the international students can’t join approved programs from the HCPC, while UK/European citizens can join HCPC approved programs. The interpretation modules are not allowed for international students and they are allowed for UK/ European students. Training, ability to have the HCPC registration, and the ability to work all are allowed for UK/European citizens, while international students are not allowed to do so. After I published this case study which shows the facts in solid data that there is segregation on all levels and discrimination against international Radiographers, the Society and College of Radiographers and the Head of Radiography Education sent two letters threatening the journals Editors and I [2,3]. They said they are so perfect and they do not have any discrimination whatsoever [2,3]. They demanded to remove the paper from the online source and publish an apology [2,3]. They threaten and bullied me and the journal editors that they will legally be suing us for defamation. Therefore, I publish this letter challenging them to sue me. What I have published is accurate 100% and I did not make the numbers from my head. I collected the data from the universities’ websites directly. All that they claimed in their letters are wrong and emotionally driven. They did not stop here, no they continued by sending their trolls to report my researchgate account to suspend my account for more than one month. Is well known that the HCPC and the British media when someone is not British get suspended or not allowed to do any medical practice in the UK for any issue, the British media and HCPC publish their names, age, gender, ethnicity, nationality, and what mistake they did, but when the person is a white British citizen, the HCPC and the media tend to hide their identity and usually they get suspended for a short period of time. The HCPC, Society of Radiographers, and Heads of Radiography Education are discriminating on all levels against us as international radiographers and this is supported by numbers and solid data. They claim that they are so perfect and do not have any issue. This level of denial indicates that there is a massive issue and this is only the tip of the iceberg. The Society of Radiographers did not help the UK or international Radiographers in any way, shape, or form. Instead of denying their discriminatory behaviors against us, they should help the international Radiographers to rebuild their health care sector which collapsed after the pandemic (i.e. SARS II CoV a.k.a Covid-19). They have already a large shortage of Radiographers in the UK and with these behaviors, they will never solve the problems which the British citizens face every day in UK hospitals. No one should forget the number of international health care workers who sacrificed their lives during the pandemic to help the patients in the UK.

Effects of the CMS’ Public Reporting Program for Inpatient Psychiatric Facilities on Targeted and Nontargeted Safety: Differences Between For-Profits and Nonprofits

The Centers for Medicare and Medicaid Services implemented the Inpatient Psychiatric Facility Quality Reporting Program in 2012, which publicly reports facilities’ performance on restraint and seclusion (R-S) measures. Using data from Massachusetts, we examined whether nonprofits and for-profits responded differently to the program on targeted indicators, and if the program had a differential spillover effect on nontargeted indicators of quality by ownership. Episodes of R-S (targeted), complaints (nontargeted), and discharges were obtained for 2008-2017 through public records requests to the Commonwealth of Massachusetts. Using difference-in-differences estimators, we found no differential changes in R-S between for-profits and nonprofits. However, for-profits had larger increases in overall complaints, safety-related complaints, abuse-related complaints, and R-S-related complaints compared with nonprofits. This is the first study to examine the effects of a national public reporting program among psychiatric facilities on nontargeted measures. Researchers and policymakers should further scrutinize intended and unintended consequences of performance-reporting programs.

International Radiographers in British Universities: A Case Study

Many British universities offer radiographic reporting programs, but these programs are designed to allow British citizens only to join those programs. Usually, these programs are a part-time and those programs use the “spoon-feeding education” approach which is not the same approach that used with international students. Usually, internationals allowed to join self−learning programs that make unqualified radiographers who will not be able to pass any examination from any medical registry organization worldwide. Usually, these post−graduate programs use distance learning, self-learning, no exams, no GPA, no score, and continues assessment approach. All the programs that international students can join, are non-Health and Care Professions Council (HCPC) accredited programs. If these programs had an accreditation, the graduates will be able to work in the United Kingdom to fill the shortage of Reporting Radiographers. Due to the discriminatory regulations by British university against international applicants, they could not join any good accredited program. Keywords: Discrimination; International Students; Radiographic Reporting; Admission, Education

An Analysis of the Current State of the Consumer Credit Reporting System in China

The Chinese Social Credit System (SCS), known as the first national digitally-implemented credit rating system, consists of two parallel arms: a government-run and a commercial one. The government-run arm of the SCS, especially efforts to blacklist and redlist individuals and organizations, has attracted significant attention worldwide. In contrast, the commercial part has been less often in the public spotlight except for discussions about Zhima Credit.The commercial arm of the SCS, also referred to as the Consumer Credit Reporting System (CCRS), has been under development for about two decades and took a major step forward in 2015 when 8 companies were granted permission to implement pilot consumer credit reporting programs. This development fundamentally increased the reach and impact of the SCS due to these companies’ sizable customer base and access to vast troves of consumer-related information.In this paper, we first map the Chinese CCRS to understand the actors in the credit reporting ecosystem. Then, we study 13 consumer credit reporting companies to examine how they collect and use personal information. Based on the findings, we discuss the relationship between the CCRS and the SCS including the changes in the power relationships between the government, consumer credit reporting companies and Chinese citizens.

Implementasi Peraturan Menteri Agama Tentang Pendidikan Agama Islam Pada Sekolah Dalam Kinerja Pengawas Pendidikan Agama Islam

This study aims to analyze the Implementation of the Minister of Religion Regulation of the Republic of Indonesia No 02 of 2012 concerning Madrasah Supervisors and Islamic Religious Education Supervisors at Subulussalam City Junior High School, and to analyze the performance of Islamic Religious Education supervisors in Subulussalam Municipality Middle School. Research informants were selected by purposive sampling. Data collection techniques used through interviews and observation. Data Analysis Techniques used in this study are qualitative data analysis techniques. The results showed that the implementation of RI Minister of Religion Regulation No. 02 of 2012 in terms of communication and bureaucratic structure has been successfully implemented at the Subulussalam Ministry of Religion, but has not been fully successful in terms of resources and disposition. Implementation of RI Minister of Religion Regulation No. 02 of 2012 often experiences obstacles in the field because the conditions faced are less supportive in its implementation so that further policies can become less in line with the regulations implemented. Availability of funds for the implementation of supervision of Islamic Education is still relatively low. Islamic Education Supervisors are also less active in organization, especially supervisory professional organizations, and are less committed to carrying out supervisory duties. The performance of Islamic Education supervisors has increased in terms of the preparation of supervision and reporting programs for the implementation of supervision, but the supervisory performance of Islamic Education has not succeeded in increasing in terms of implementing supervision.

FRI0524 THE ACR’S RHEUMATOLOGY INFORMATICS SYSTEM FOR EFFECTIVENESS (RISE) REGISTRY SUPPORTS SMALL RHEUMATOLOGY PRACTICES FOR FEDERAL QUALITY REPORTING PROGRAM

Background:The Rheumatology Informatics System for Effectiveness (RISE) Registry was developed by the ACR to help rheumatologists improve quality of care and meet federal reporting requirements. In the current quality program administered by the U.S. Centers for Medicare and Medicaid services, rheumatologists are scored on quality measures, and performance is tied to financial incentives or penalties. Rheumatoid arthritis (RA)-specific quality measures can only be submitted through RISE to federal programs.Objectives:This study used data from the RISE registry to investigate rheumatologists’ federal reporting patterns on five RA-specific quality measures in 2018 and investigated the effect of practice characteristics on federal reporting of these measures.Methods:We analyzed data on all rheumatologists who continuously participated in RISE between Jan 2017 to Dec 2018 and who had patients eligible for at least one RA-specific measure. Five measures were examined: tuberculosis screening before biologic use, disease activity assessment, functional status assessment, assessment and classification of disease prognosis, and glucocorticoid management. We assessed whether or not rheumatologists reported specific quality measures via RISE. We investigated the effect of practice characteristics (practice structure; number of providers; geographic region) on the likelihood of reporting using adjusted analyses that controlled for measure performance (performance in 2018; change in performance from 2017; and performance relative to national average performance). Analyses accounted for clustering by practice.Results:Data from 799 providers from 207 practices managing 213,757 RA patients was examined. The most common practice structure was a single-specialty group practice (53%), followed by solo (28%) and multi-specialty group practice (12%). Most providers (73%) had patients eligible for all five RA quality measures. Federal reporting of quality measures through RISE varied significantly by provider, ranging from no reporting (60%) to reporting all eligible RA measures (12.2%). Reporting through RISE also varied significantly by quality measure and was highest for functional status assessment (36%) and lowest for assessment and classification of disease prognosis (20%). Small practices (1-4 providers) were more likely to report all eligible RA quality measures compared to larger practices (21%, 6%; p<0.001). In adjusted analyses, solo practices were more likely than single-specialty group practices to report RA measures (42%, 31%; p<0.027) while multispecialty group practices were less likely (18%, 31%; p<0.001). Additionally, higher performance in 2018 and performance ≥ the national average performance was associated with federal reporting of the measures through RISE (p≤0.004).Conclusion:Forty percent of U.S. rheumatologists participating in RISE used the registry for federal quality reporting. Physicians using RISE for reporting were disproportionately in small and solo practices, suggesting that the registry is fulfilling an important role in helping these practices participate in national quality reporting programs. Supporting small practices is especially important given the workforce shortages in rheumatology. We observed that practices reporting through RISE had higher measure performance than other participating practices, which suggests that the registry is facilitating quality improvement. Studies are ongoing to further investigate the impact of federal quality reporting programs and RISE participation on the quality of rheumatologic care in the United States.Disclaimer: This data was supported by the ACR’s RISE Registry. However, the views expressed represent those of the authors, not necessarily those of the ACR.Disclosure of Interests:Zara Izadi: None declared, Tracy Johansson: None declared, Jing Li: None declared, Gabriela Schmajuk Grant/research support from: Pfizer, Jinoos Yazdany Grant/research support from: Pfizer

Tinjauan Pelaksanaan Evaluasi Pelaporan Program P2 Demam Berdarah Dengue (DBD) Puskesmas di Dinas Kesehatan Kabupaten Indragiri Hulu Tahun 2019

The monthly reporting of Dengue Hemorrhagic Fever (DHF) at the Puskesmas must be sent to the Indragiri Hulu District Health Office so that it can be evaluated to reduce the number of cases of Dengue Hemorrhagic Fever (DHF). The purpose of this study was to find out whether the evaluation of monthly reporting of Dengue Hemorrhagic Fever (DHF) was carried out at the Indragiri Hulu District Health Office. This type of research is descriptive with a qualitative approach, namely by describing and explaining the implementation of the Puskesmas Dengue Hemorrhagic Fever P2 (DBD) Evaluation Program at the Indragiri Hulu District Health Office in 2019.The results of the study on the implementation of the P2 DBD Evaluation report, namely, there are still a number of Puskesmas whose content of P2 DBD reports is still incomplete, there are still a number of Puskesmas that deliver reports past the specified period, evaluation of DHF P2 reporting programs in Puskesmas conducted by the District Health Office Indragiri Hulu in the form of meetings in the quarterly period at the Health Office discusses all programs, but special evaluations on the P2 DBD program have not run efficiently, and written policies have not been available for the Indragiri Hulu District Health Office or the Puskesmas. The policy is still under construction.The conclusion is the evaluation of the P2 DBD program reporting at the Indragiri Hulu District Health Office has been carried out, but it has not been maximized. Evaluation carried out by the Health Office is an evaluation of all programs in the Puskesmas, for special evaluation on the P2 DBD reporting not yet available. It is said to be not maximal because the evaluations carried out have not been consistent, because sometimes evaluations are carried out within three months, or within four months, and there is no policy to carry out the evaluation activities. So it is advisable to make a policy and carry out a socialization about evaluating the Puskesmas DHF monthly report.

Post marketing surveillance of suspected adverse drug reactions through spontaneous reporting: current status, challenges and the future

Background: To highlight the importance of spontaneous reporting programs in post marketing surveillance of medicines. Authors also aimed at providing various dimensions of spontaneous programs, including the strengths and weakness, and providing an insight on the future prospects of pharmacovigilance systems. Methods: Various literature related to post marketing surveillance and spontaneous reporting programs were reviewed and the relevant ones highlighting the strengths and weaknesses are summarized. A balance of information on strengths and weaknesses is listed. The health professionals’ awareness regarding existing spontaneous reporting programs is highlighted. Future prospects of pharmacovigilance are discussed. Results: Though beneficial, spontaneous reporting programs encounter several limitations and difficulties in diagnosing adverse drug reaction. Under-reporting and bias are major challenges. Online signal detection tools and innovative methods are needed to strengthen the spontaneous reporting programs. We provide the various issues to be considered while depending on spontaneous reporting programs as a method of post marketing surveillance. Conclusion: To strengthen the spontaneous reporting programs as an effective post marketing surveillance method, more awareness among health professionals and innovative strategies is needed. Integrating pharmacogenetic data can be a potential aspect of future pharmacovigilance. Plain language summary Monitoring adverse effects of marketed medicines through reporting by healthcare professionals and its challenges and way forward Introduction: This article highlights the importance of safety monitoring of medicines after they are launched in the market, mainly through reporting by healthcare professionals. We also highlight the strengths and weaknesses, and provide an insight on the future prospects of pharmacovigilance systems. Methods: Various literature related to the topic were reviewed and the relevant ones highlighting the strengths and weaknesses are summarized. A balance of information on strengths and weaknesses is listed. Health professionals’ awareness regarding existing programs on reporting safety of medicines is highlighted. Results: Though beneficial, reporting of adverse effects by healthcare professionals who deal with patient lacks clarity in diagnosing the adverse effects. Under-reporting and bias are the major challenges. Online software is needed to strengthen reporting by healthcare professionals. We list the various issues to be considered while depending on healthcare professionals’ reporting of adverse effects as a method of post marketing surveillance. Conclusion: To strengthen medicine safety monitoring and reporting by healthcare professionals, more awareness among health professionals and innovative strategies are needed. Integrating the genetic data of patients can be beneficial in predicting adverse effects, therefore avoiding them and enhancing safe prescribing and dispensing by healthcare professionals.

A Population Dynamic Model to Assess the Diabetes Screening and Reporting Programs and Project the Burden of Undiagnosed Diabetes in Thailand

Diabetes mellitus (DM) is rising worldwide, exacerbated by aging populations. We estimated and predicted the diabetes burden and mortality due to undiagnosed diabetes together with screening program efficacy and reporting completeness in Thailand, in the context of demographic changes. An age and sex structured dynamic model including demographic and diagnostic processes was constructed. The model was validated using a Bayesian Markov Chain Monte Carlo (MCMC) approach. The prevalence of DM was predicted to increase from 6.5% (95% credible interval: 6.3–6.7%) in 2015 to 10.69% (10.4–11.0%) in 2035, with the largest increase (72%) among 60 years or older. Out of the total DM cases in 2015, the percentage of undiagnosed DM cases was 18.2% (17.4–18.9%), with males higher than females (p-value < 0.01). The highest group with undiagnosed DM was those aged less than 39 years old, 74.2% (73.7–74.7%). The mortality of undiagnosed DM was ten-fold greater than the mortality of those with diagnosed DM. The estimated coverage of diabetes positive screening programs was ten-fold greater for elderly compared to young. The positive screening rate among females was estimated to be significantly higher than those in males. Of the diagnoses, 87.4% (87.0–87.8%) were reported. Targeting screening programs and good reporting systems will be essential to reduce the burden of disease.

Company Cooperation and U.S. Sentencing Guidelines

The U.S. Sentencing Commission has changed how the U.S. Sentencing Guidelines calculate fines for certain defendant companies. The amendments, effective November 1, 2010, make more readily available a long-standing three-level offense-level reduction. This change shifts the inquiry away from (1) the (mis)conduct of the company’s high-level personnel and toward (2) the effectiveness of the company’s compliance and ethics program. This move will surely benefit corporate defendants. Therefore, it is something for which compliance professionals and in-house legal counsel need to both understand and prepare. As the benefits of incentivizing companies to adopt proactive compliance, ethics, and self-reporting programs gain wider recognition, other countries eager to beef up their anti-bribery efforts can be expected to follow suit.