WorldWideScience

Sample records for beneficiary designation form

  1. 5 CFR 1651.4 - How to change or cancel a designation of beneficiary.

    Science.gov (United States)

    2010-01-01

    ... of beneficiary, the participant must submit to the TSP record keeper a new TSP designation of beneficiary form meeting the requirements of § 1651.3 to the TSP record keeper. If the TSP receives more than... the participant. A participant may change a TSP beneficiary at any time, without the knowledge or...

  2. 78 FR 53507 - Agency Information Collection (Beneficiary Travel Mileage Reimbursement Application Form...

    Science.gov (United States)

    2013-08-29

    ... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-NEW] Agency Information Collection (Beneficiary Travel Mileage Reimbursement Application Form) Activity Under OMB Review AGENCY: Veterans Health... Control No. 2900- NEW (Beneficiary Travel Mileage Reimbursement Application Form)'' in any correspondence...

  3. Study and Redefining Beneficiary Participation in Process Of House Design

    Directory of Open Access Journals (Sweden)

    Monshizadeh Morteza

    2016-01-01

    Full Text Available Since housing has a special place in human life and his physical, psychological and interactions, so in addition the unity of humans, multiplicity and diversity of them must be considered. This possible only by beneficiary participation in the design process, but because society has different economic and social texture and classes; and settling suit because of the time and place of special indexes are entitled, so prepare a comprehensive model includes the testimony and circumstances; identify factors influencing participation optimum need to selection population and certain species of private construction. Standard tool to study topic does not exist, so in order to produce tools using qualitative research methods; interpretation - historical correlation to extract components and variables and their effects on each other and enjoyed target table Content consisting of four domains of general knowledge - specialized knowledge of participation - participation mechanisms and factors influencing participation achieved. Extracted factors are: the initial formation of partnership - partnership executive process - the role of participant - optimal participation; by study and analyze the theoretical model. Due to history and social aspects; cultural participation in Shiraz; promote scientific and participatory approach designed to make operating housing; bed and new horizons of development of facilities and areas in the design of residential environment created and due consultation and decision making in addition to beneficiary participation to promote optimum utility of space; mutual flexibility and utilization of space; increase fixation and motivation will lead beneficiary reside” and the main question: “how is the model of scientific position optimal participation planning instrument in private housing in the city of Shiraz, in the process of design, implementation and use”.

  4. 48 CFR 853.215-70 - VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA.

    Science.gov (United States)

    2010-10-01

    ..., Application for Furnishing Nursing Home Care to Beneficiaries of VA. 853.215-70 Section 853.215-70 Federal... 853.215-70 VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA. VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA, will be used for...

  5. 78 FR 66972 - Submission for Review: Designation of Beneficiary: Civil Service Retirement System (CSRS), SF 2808

    Science.gov (United States)

    2013-11-07

    ... OFFICE OF PERSONNEL MANAGEMENT Submission for Review: Designation of Beneficiary: Civil Service Retirement System (CSRS), SF 2808 AGENCY: U.S. Office of Personnel Management. ACTION: 60-Day notice and... Retirement System, SF 2808. As required by the Paperwork Reduction Act of 1995 (Pub. L. 104-13, 44 U.S.C...

  6. Cold-formed steel design

    CERN Document Server

    Yu, Wei-Wen

    2010-01-01

    The definitive text in the field, thoroughly updated and expanded Hailed by professionals around the world as the definitive text on the subject, Cold-Formed Steel Design is an indispensable resource for all who design for and work with cold-formed steel. No other book provides such exhaustive coverage of both the theory and practice of cold-formed steel construction. Updated and expanded to reflect all the important developments that have occurred in the field over the past decade, this Fourth Edition of the classic text provides you with more of the detailed, up-to-the-minute techni

  7. Temporal form in interaction design

    DEFF Research Database (Denmark)

    Vallgårda, Anna; Winther, Morten Trøstrup; Mørch, Nina

    2015-01-01

    temporal forms by letting a series of expert designers reflect upon them. We borrow a framework from Boorstin’s film theory in which he distinguishes between the voyeuristic, the vicarious, and the visceral experience. We show how to use rhythms, complexity, gentle or forceful behavior, etc., to create...

  8. 5 CFR 1651.10 - Deceased and non-existent beneficiaries.

    Science.gov (United States)

    2010-01-01

    ... beneficiary form dies before the participant, the beneficiary's share will be paid equally to other living beneficiaries bearing the same relationship to the participant as the deceased beneficiary. However, if the... descendants, if any. If there are no other beneficiaries bearing the same relationship or, in the case of...

  9. 38 CFR 9.4 - Beneficiaries and options.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Beneficiaries and options... SERVICEMEMBERS' GROUP LIFE INSURANCE AND VETERANS' GROUP LIFE INSURANCE § 9.4 Beneficiaries and options. Any designation of beneficiary or election of settlement options is subject to the provisions of 38 U.S.C. 1970...

  10. Reconciling Form and Function through Generative Design

    OpenAIRE

    Nordin, Axel

    2015-01-01

    The current form-giving activity in industrial design is characterized by explorations that depend on the individual capability to mentally manipulate a solution space from which to select and express the intended result. Industrial designers frequently rely on artistic experimentation, aesthetic inspiration, or design briefs. These points of departure often result in satisfactory results, but they could be augmented by algorithmic form generation, optimization, and complex morphologies. By a...

  11. Medicare Current Beneficiary Survey

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Characteristics and Perceptions of the Medicare Population Data from the 2010 Medicare Current Beneficiary Survey is a series of source books based on the...

  12. Design, Form, and Function in Art Education

    Science.gov (United States)

    Vande Zande, Robin

    2007-01-01

    Human beings are influenced by design every day through continuous contact with functional form in and through visual culture. They encounter a continuous current of such new styles as clothing fashions, architecture, furniture and advertisements. The American pursuit of happiness has become related to an increasing flow of products and…

  13. Forming Artistic-Design Competency of Vocational Design Teacher

    Science.gov (United States)

    Falco, Vera P.; Fedorov, Vladimir A.; Dorozhkin, Evgenij M.; Merkushova, Nina I.; Bakanach, Olga V.

    2016-01-01

    The relevance of the problem under study is based on the necessity to achieve effectiveness of the learning process aimed at forming a competent specialist and ensuring the quality of training of vocational teacher of a certain subject (design). The aim of the article is to provide theoretical substantiation, to elaborate and to test the…

  14. Recent Health Care Use and Medicaid Entry of Medicare Beneficiaries.

    Science.gov (United States)

    Keohane, Laura M; Trivedi, Amal N; Mor, Vincent

    2017-10-01

    To examine the relationship between Medicaid entry and recent health care use among Medicare beneficiaries. We identified Medicare beneficiaries without full Medicaid or use of hospital or nursing home services in 2008 (N = 2,163,387). A discrete survival analysis estimated beneficiaries' monthly likelihood of entry into the full Medicaid program between January 2009 and June 2010. During the 18-month study period, Medicaid entry occurred for 1.1% and 3.7% of beneficiaries who aged into Medicare or originally qualified for Medicare due to disability, respectively. Among beneficiaries who aged into Medicare, 49% of new Medicaid participants had no use of inpatient, skilled nursing facility, or nursing home services during the study period. Individuals who recently used inpatient, skilled nursing facility or nursing home services had monthly rates of 1.9, 14.0, and 38.1 new Medicaid participants per 1,000 beneficiaries, respectively, compared with 0.4 new Medicaid participants per 1,000 beneficiaries with no recent use of these services. Although recent health care use predicted greater likelihood of Medicaid entry, half of new Medicaid participants used no hospital or nursing home care during the study period. These patterns should be considered when designing and evaluating interventions to reform health care delivery for dual-eligible beneficiaries. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. Who are the beneficiaries?

    Science.gov (United States)

    Tännsjö, Torbjörn

    1992-10-01

    Is it defensible that society spends money on medical or research projects intended to help people solve their fertility problems? Suppose that we want to answer this question from the point of view of a utilitarian cost-benefit analysis. The answer to the question then depends, of course, on how expensive these projects turn out to be, relative to the costs of other possible projects. But it depends also on how we assess the benefits of these projects. To whom do they accrue? Who are the beneficiaries of these projects?

  16. Forming Core Elements for Strategic Design Management

    DEFF Research Database (Denmark)

    Beim, Anne; Vibæk, Kasper Sánchez

    2007-01-01

    . This evolution also leads to a demand for precise definitions of the values and qualities that can be used as managing tools in common building practice and it puts the traditional architectural design process under pressure. This paper outlines an approach to architectural quality as dealt with in the design...... and how the architectural potentials are realized when dealing with modern industrial processes are examined. To analyse and structure the empirical data, a model was developed consisting of four approaches for action. The approaches are categorized along different dichotomies in order to point out...... the model was tested in the architectural education at the Royal Danish Academy of Fine Arts - School of Architecture. The overall research project has two aims - to help offices identify the characteristics and specific methods of working with architectural quality in an industrialized context...

  17. Rational design of fiber forming supramolecular structures

    Science.gov (United States)

    Wang, Benjamin K; Kanahara, Satoko M

    2016-01-01

    Recent strides in the development of multifunctional synthetic biomimetic materials through the self-assembly of multi-domain peptides and proteins over the past decade have been realized. Such engineered systems have wide-ranging application in bioengineering and medicine. This review focuses on fundamental fiber forming α-helical coiled-coil peptides, peptide amphiphiles, and amyloid-based self-assembling peptides; followed by higher order collagen- and elastin-mimetic peptides with an emphasis on chemical / biological characterization and biomimicry. PMID:27022140

  18. Beneficiary contact moderates relationship between authentic leadership and engagement

    Directory of Open Access Journals (Sweden)

    Caren B. Scheepers

    2016-07-01

    Full Text Available Orientation: Beneficiary contact moderates the relationship between authentic leadership and work engagement. Research purpose: The objective of this study was to examine the moderating effect of the breadth, depth and frequency of employee interaction with the beneficiaries of their work on the positive impact of authentic leadership on work engagement. Motivation for the study: Investigating the boundary conditions of the relationship between leaders and followers is vital to enhance the positive effect of leadership. Authentic leadership has not previously been examined with respect to beneficiary contact as a specific situational factor. The researchers therefore set out to ascertain whether beneficiary contact has a strengthening or weakening effect on the impact of authentic leadership on work engagement. Research design, approach and method: The researchers administered the Authentic Leadership Questionnaire (ALQ, the Utrecht Work Engagement Scale (UWES-9 and Grant’s scale on Beneficiary Contact. Main findings: The findings showed that beneficiary contact had a weakening effect on the positive relationship between authentic leadership and work engagement. Practical/managerial implications: Ideally, organisations create environments conducive to work engagement in which leadership plays an important role. This study found that one factor in the work environment, namely beneficiary contact, might have an adverse effect on the positive relationship that authentic leadership has on work engagement. Leaders should therefore take organisational contextual realities into account, such as regular, intense interaction of employees with the beneficiaries of their work. This situation could create strain for individual employees, requiring additional organisational support. Contribution/value-add: Organisations need to recognise the impact of beneficiary contact on the relationship between authentic leadership and work engagement. The researchers

  19. Chronic Conditions among Medicare Beneficiaries

    Data.gov (United States)

    U.S. Department of Health & Human Services — The data used in the chronic condition reports are based upon CMS administrative enrollment and claims data for Medicare beneficiaries enrolled in the...

  20. Designing usable web forms- Empirical evaluation of web form improvement guidelines

    DEFF Research Database (Denmark)

    Seckler, Mirjam; Heinz, Silvia; Bargas-Avila, Javier A.

    2014-01-01

    This study reports a controlled eye tracking experiment (N = 65) that shows the combined effectiveness of 20 guidelines to improve interactive online forms when applied to forms found on real company websites. Results indicate that improved web forms lead to faster completion times, fewer form...... submission trials, and fewer eye movements. Data from subjective questionnaires and interviews further show increased user satisfaction. Overall, our findings highlight the importance for web designers to improve their web forms using UX guidelines....

  1. Visual Communication Design as a Form of Public Pedagogy

    Science.gov (United States)

    Kelly, Meghan

    2015-01-01

    This paper identifies visual communication design as a form of public pedagogy. Communication design practices aim to achieve the successful transmission of a message to a recipient in a visual mode. Understanding the theories and practices of visual communication design can assist in enhancing the reception of the communication, as these…

  2. A regression-based Kansei engineering system based on form feature lines for product form design

    Directory of Open Access Journals (Sweden)

    Yan Xiong

    2016-06-01

    Full Text Available When developing new products, it is important for a designer to understand users’ perceptions and develop product form with the corresponding perceptions. In order to establish the mapping between users’ perceptions and product design features effectively, in this study, we presented a regression-based Kansei engineering system based on form feature lines for product form design. First according to the characteristics of design concept representation, product form features–product form feature lines were defined. Second, Kansei words were chosen to describe image perceptions toward product samples. Then, multiple linear regression and support vector regression were used to construct the models, respectively, that predicted users’ image perceptions. Using mobile phones as experimental samples, Kansei prediction models were established based on the front view form feature lines of the samples. From the experimental results, these two predict models were of good adaptability. But in contrast to multiple linear regression, the predict performance of support vector regression model was better, and support vector regression is more suitable for form regression prediction. The results of the case showed that the proposed method provided an effective means for designers to manipulate product features as a whole, and it can optimize Kansei model and improve practical values.

  3. Designing Effective Web Forms for Older Web Users

    Science.gov (United States)

    Li, Hui; Rau, Pei-Luen Patrick; Fujimura, Kaori; Gao, Qin; Wang, Lin

    2012-01-01

    This research aims to provide insight for web form design for older users. The effects of task complexity and information structure of web forms on older users' performance were examined. Forty-eight older participants with abundant computer and web experience were recruited. The results showed significant differences in task time and error rate…

  4. Influence of system considerations on waste form design

    International Nuclear Information System (INIS)

    Bauer, A.A.; Matthews, S.C.; Peterson, R.W.

    1979-01-01

    The design of waste forms is constrained by waste management system considerations imposed during generation, treatment, packaging, transportation, storage, and isolation. In the isolation phase, the waste form provides one of the barriers to release in a multibarrier system that includes the natural geologic and hydrologic barriers as well as other engineered barriers

  5. Determinants of Medicare plan choices: are beneficiaries more influenced by premiums or benefits?

    Science.gov (United States)

    Jacobs, Paul D; Buntin, Melinda B

    2015-07-01

    To evaluate the sensitivity of Medicare beneficiaries to premiums and benefits when selecting healthcare plans after the introduction of Part D. We matched respondents in the 2008 Medicare Current Beneficiary Survey to the Medicare Advantage (MA) plans available to them using the Bid Pricing Tool and previously unavailable data on beneficiaries' plan choices. We estimated a 2-stage nested logit model of Medicare plan choice decision making, including the decision to choose traditional fee-for-service (FFS) Medicare or an MA plan, and for those choosing MA, which specific plan they chose. Beneficiaries living in areas with higher average monthly rebates available from MA plans were more likely to choose MA rather than FFS. When choosing MA plans, beneficiaries are roughly 2 to 3 times more responsive to dollars spent to reduce cost sharing than reductions in their premium. We calculated an elasticity of plan choice with respect to the monthly MA premium of -0.20. Beneficiaries with lower incomes are more sensitive to plan premiums and cost sharing than higher-income beneficiaries. MA plans appear to have a limited incentive to aggressively price their products, and seem to compete primarily over reduced beneficiary cost sharing. Given the limitations of the current plan choice environment, policies designed to encourage the selection of lower-cost plans may require increasing premium differences between plans and providing the tools to enable beneficiaries to easily assess those differences.

  6. Measuring the Complexity of Urban Form and Design

    OpenAIRE

    Boeing, Geoff

    2017-01-01

    Complex systems have become a popular lens for conceptualizing cities, and complexity has substantial implications for urban performance and resilience. This paper develops a typology of methods and measures for assessing the complexity of the built form at the scale of urban design. It extends quantitative methods from urban planning, network science, ecosystems studies, fractal geometry, and information theory to the physical urban form and the analysis of qualitative human experience. Metr...

  7. Design and Implementation of Direct Form FIR Filter

    OpenAIRE

    Kumar, Hanny; Kumar, Kamal

    2016-01-01

    The research article presents the design of the direct form of the Finite Impulse Response (FIR) filter using VHDL programming language. Multimedia technology and broadband communication demand the low power and high performance design applications in Digital Signal Processing (DSP). The digital filters are most important element of the communication system and DSP. In the paper, 7 tap FIR filter is implemented in Xilinx 14.2 software and functionally simulated in Modelsim 10.1 b software. Th...

  8. A Marketing Assessment of Beneficiaries at Kimbrough Army Community Hospital

    Science.gov (United States)

    1993-05-01

    environment, organizational goal formulation, strategy formulation, Marketing Assessment 10 organization and systems design ( Kotler , 1987). Second...environmental analysis itself is concerned with identifying marketing opportunities, threats, environmental trends and their implications ( Kotler , 1987...decision to develop beneficiary subgroups was based on the marketing principle of market segmentation which assumes that no one strategy will work for

  9. Designing Mobile Interactions: The continual convergence of form and context

    DEFF Research Database (Denmark)

    Kjeldskov, Jesper

    2013-01-01

    fremmes en design-orienteret måde at opnå konvergens mellem form og kontekst gennem en kontekstuelt forankret, helhedsorienteret, og kontinuerligt udfoldende designproces. “Fantasi er vigtigere end viden. For viden er begrænset, mens fantasien favner hele verden” sagde Albert Einstein i 1931. Inden...

  10. Function and Form: Shifts in Modernist Architects’ Design Thinking

    Directory of Open Access Journals (Sweden)

    Atli Magnus Seelow

    2017-01-01

    Full Text Available Since the so-called “type-debate” at the 1914 Werkbund Exhibition in Cologne—on individual versus standardized types—the discussion about turning Function into Form has been an important topic in Architectural Theory. The aim of this article is to trace the historic shifts in the relationship between Function and Form: First, how Functional Thinking was turned into an Art Form; this orginates in the Werkbund concept of artistic refinement of industrial production. Second, how Functional Analysis was applied to design and production processes, focused on certain aspects, such as economic management or floor plan design. Third, how Architectural Function was used as a social or political argument; this is of particular interest during the interwar years. A comparison of theses different aspects of the relationship between Function and Form reveals that it has undergone fundamental shifts—from Art to Science and Politics—that are tied to historic developments. It is interesting to note that this happens in a short period of time in the first half of the 20th Century. Looking at these historic shifts not only sheds new light on the creative process in Modern Architecture, this may also serve as a stepstone towards a new rethinking of Function and Form.

  11. Assessing Medicare beneficiaries' willingness-to-pay for medication therapy management services.

    Science.gov (United States)

    Woelfel, Joseph A; Carr-Lopez, Sian M; Delos Santos, Melanie; Bui, Ann; Patel, Rajul A; Walberg, Mark P; Galal, Suzanne M

    2014-02-01

    To assess Medicare beneficiaries' willingness-to-pay (WTP) for medication therapy management (MTM) services and determine sociodemographic and clinical characteristics influencing this payment amount. A cross-sectional, descriptive study design was adopted to elicit Medicare beneficiaries' WTP for MTM. Nine outreach events in cities across Central/Northern California during Medicare's 2011 open-enrollment period. A total of 277 Medicare beneficiaries participated in the study. Comprehensive MTM was offered to each beneficiary. Pharmacy students conducted the MTM session under the supervision of licensed pharmacists. At the end of each MTM session, beneficiaries were asked to indicate their WTP for the service. Medication, self-reported chronic conditions, and beneficiary demographic data were collected and recorded via a survey during the session. The mean WTP for MTM was $33.15 for the 277 beneficiaries receiving the service and answering the WTP question. WTP by low-income subsidy recipients (mean ± standard deviation; $12.80 ± $24.10) was significantly lower than for nonsubsidy recipients ($41.13 ± $88.79). WTP was significantly (positively) correlated with number of medications regularly taken and annual out-of-pocket drug costs. The mean WTP for MTM was $33.15. WTP for MTM significantly varied by race, subsidy status, and number of prescription medications taken. WTP was significantly higher for nonsubsidy recipients than subsidy recipients, and significantly positively correlated with the number of medications regularly taken and the beneficiary rating of the delivered services.

  12. OASDI Beneficiaries by State and County, 2011

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  13. OASDI Beneficiaries by State and County, 2010

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  14. OASDI Beneficiaries by State and County, 2014

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  15. OASDI Beneficiaries by State and County, 2003

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population people receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the...

  16. OASDI Beneficiaries by State and County, 2002

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  17. OASDI Beneficiaries by State and County, 2009

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  18. OASDI Beneficiaries by State and County, 1999

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population - people receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the...

  19. OASDI Beneficiaries by State and County, 2013

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  20. OASDI Beneficiaries by State and County, 2000

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  1. OASDI Beneficiaries by State and County, 2008

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  2. OASDI Beneficiaries by State and County, 2015

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  3. OASDI Beneficiaries by State and County, 2007

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  4. OASDI Beneficiaries by State and County, 2016

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  5. OASDI Beneficiaries by State and County, 2006

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  6. OASDI Beneficiaries by State and County, 2005

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  7. OASDI Beneficiaries by State and County, 2001

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the local...

  8. OASDI Beneficiaries by State and County, 2004

    Data.gov (United States)

    Social Security Administration — This annual publication focuses on the Social Security beneficiary population people receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the...

  9. Cataract surgery among Medicare beneficiaries.

    Science.gov (United States)

    Schein, Oliver D; Cassard, Sandra D; Tielsch, James M; Gower, Emily W

    2012-10-01

    To present descriptive epidemiology of cataract surgery among Medicare recipients in the United States. Cataract surgery performed on Medicare beneficiaries in 2003 and 2004. Medicare claims data were used to identify all cataract surgery claims for procedures performed in the United States in 2003-2004. Standard assumptions were used to limit the claims to actual cataract surgery procedures performed. Summary statistics were created to determine the number of procedures performed for each outcome of interest: cataract surgery rates by age, sex, race and state; surgical volume by facility type and surgeon characteristics; time interval between first- and second-eye cataract surgery. The national cataract surgery rate for 2003-2004 was 61.8 per 1000 Medicare beneficiary person-years. The rate was significantly higher for females and for those aged 75-84 years. After adjustment for age and sex, blacks had approximately a 30% lower rate of surgery than whites. While only 5% of cataract surgeons performed more than 500 cataract surgeries annually, these surgeons performed 26% of the total cataract surgeries. Increasing surgical volume was found to be highly correlated with use of ambulatory surgical centers and reduced time interval between first- and second-eye surgery in the same patient. The epidemiology of cataract surgery in the United States Medicare population documents substantial variation in surgical rates by race, sex, age, and by certain provider characteristics.

  10. Methodology Series Module 8: Designing Questionnaires and Clinical Record Forms.

    Science.gov (United States)

    Setia, Maninder Singh

    2017-01-01

    As researchers, we often collect data on a clinical record form or a questionnaire. It is an important part of study design. If the questionnaire is not well designed, the data collected will not be useful. In this section of the module, we have discussed some practical aspects of designing a questionnaire. It is useful to make a list of all the variables that will be assessed in the study before preparing the questionnaire. The researcher should review all the existing questionnaires. It may be efficient to use an existing standardized questionnaire or scale. Many of these scales are freely available and may be used with an appropriate reference. However, some may be under copyright protection and permissions may be required to use the same questionnaire. While designing their own questionnaire, researchers may use open- or close-ended questions. It is important to design the responses appropriately as the format of responses will influence the analysis. Sometimes, one can collect the same information in multiple ways - continuous or categorical response. Besides these, the researcher can also use visual analog scales or Likert's scale in the questionnaire. Some practical take-home points are: (1) Use specific language while framing the questions; (2) write detailed instructions in the questionnaire; (3) use mutually exclusive response categories; (4) use skip patterns; (5) avoid double-barreled questions; and (6) anchor the time period if required.

  11. Utilizing Nested Normal Form to Design Redundancy Free JSON Schemas

    Directory of Open Access Journals (Sweden)

    Wai Yin Mok

    2016-12-01

    Full Text Available JSON (JavaScript Object Notation is a lightweight data-interchange format for the Internet. JSON is built on two structures: (1 a collection of name/value pairs and (2 an ordered list of values (http://www.json.org/. Because of this simple approach, JSON is easy to use and it has the potential to be the data interchange format of choice for the Internet. Similar to XML, JSON schemas allow nested structures to model hierarchical data. As data interchange over the Internet increases exponentially due to cloud computing or otherwise, redundancy free JSON data are an attractive form of communication because they improve the quality of data communication through eliminating update anomaly. Nested Normal Form, a normal form for hierarchical data, is a precise characterization of redundancy. A nested table, or a hierarchical schema, is in Nested Normal Form if and only if it is free of redundancy caused by multivalued and functional dependencies. Using Nested Normal Form as a guide, this paper introduces a JSON schema design methodology that begins with UML use case diagrams, communication diagrams and class diagrams that model a system under study. Based on the use cases’ execution frequencies and the data passed between involved parties in the communication diagrams, the proposed methodology selects classes from the class diagrams to be the roots of JSON scheme trees and repeatedly adds classes from the class diagram to the scheme trees as long as the schemas satisfy Nested Normal Form. This process continues until all of the classes in the class diagram have been added to some JSON scheme trees.

  12. Common micronutrient deficiencies among food aid beneficiaries ...

    African Journals Online (AJOL)

    admin

    Abstract. Background: Ethiopia is amongst the African countries that have received significant food aid. Nonetheless, the common micronutrient deficiencies among food aid beneficiaries are not well documented. Objective: To find out the common micronutrient deficiencies among food aid beneficiaries in the country based ...

  13. ARCHITECTURAL FORM CREATION IN THE DESIGN STUDIO: PHYSICAL MODELING AS AN EFFECTIVE DESIGN TOOL

    Directory of Open Access Journals (Sweden)

    Wael Abdelhameed

    2011-11-01

    Full Text Available This research paper attempts to shed more light on an area of the design studio, which concerns with the use of physical modeling as a design medium in architectural form creation. An experiment has been carried out during an architectural design studio in order to not only investigate physical modeling as a tool of form creation but also improve visual design thinking that students employ while using this manual tool. To achieve the research objective, a method was proposed and applied to track form creation processes, based upon three types of operation, namely: sketching transformations, divergent physical-modeling transformations, and convergent physical-modeling transformations. The method helps record the innovative transitions of form during conceptual designing in a simple way. Investigating form creation processes and activities associated with visual design thinking enables the research to conclude to general results of the role of physical modeling in the conceptual phase of designing, and to specific results of the methods used in this architectural design studio experiment.

  14. Parametric design of a part with free-form surfaces

    Institute of Scientific and Technical Information of China (English)

    KIM Yeoung-il; KIM Li-ra; JUN Cha-soo

    2006-01-01

    3D solid models for parts with regular-form surfaces (PRFSs) are effectively generated using traditional parametric design techniques. A new model is obtained by changing some parameters defining the model. The parts with free-form surfaces(PFFSs), however, cannot be defined by several parameters. Usually they are defined by some geometric elements like profile curves. The traditional parametric design approaches have not easily dealt with the PFFSs. A method for generating a solid model and an engineering drawing for PFFSs is proposed in this paper: First, the new profiles are generated from input point data. Second,the profile information is extracted from the existing model. Last, the old profiles are replaced with the new profiles. This method can preserve the associative information of the existing model and automatically generate the drawing including views, dimensions, and annotations. The proposed method has been implemented using a commercial CAD/CAM system, Unigraphics, and API functions written in C-language, and were applied to the blades of a turbine generator. Some illustrative examples are provided in order to show the effectiveness of the proposed method.

  15. The Expanded Public Works Programme: Perspectives of direct beneficiaries

    OpenAIRE

    Mondli S. Hlatshwayo

    2017-01-01

    Scholarship on the Expanded Public Works Programme (EPWP) in South Africa tends to focus on quantitative evaluation to measure the progress made in the implementation of EPWP projects. The number of employment opportunities created by EPWP, demographic profiling, skills acquired by beneficiaries and training opportunities related to the Programme form the basis of typical statistical evaluations of it, but exclude comment by the workers who participate in its projects. Based on primary source...

  16. Basics of case report form designing in clinical research

    Directory of Open Access Journals (Sweden)

    Shantala Bellary

    2014-01-01

    Full Text Available Case report form (CRF is a specialized document in clinical research. It should be study protocol driven, robust in content and have material to collect the study specific data. Though paper CRFs are still used largely, use of electronic CRFs (eCRFS are gaining popularity due to the advantages they offer such as improved data quality, online discrepancy management and faster database lock etc. Main objectives behind CRF development are preserving and maintaining quality and integrity of data. CRF design should be standardized to address the needs of all users such as investigator, site coordinator, study monitor, data entry personnel, medical coder and statistician. Data should be organized in a format that facilitates and simplifies data analysis. Collection of large amount of data will result in wasted resources in collecting and processing it and in many circumstances, will not be utilized for analysis. Apart from that, standard guidelines should be followed while designing the CRF. CRF completion manual should be provided to the site personnel to promote accurate data entry by them. These measures will result in reduced query generations and improved data integrity. It is recommended to establish and maintain a library of templates of standard CRF modules as they are time saving and cost-effective. This article is an attempt to describe the methods of CRF designing in clinical research and discusses the challenges encountered in this process.

  17. Basics of case report form designing in clinical research.

    Science.gov (United States)

    Bellary, Shantala; Krishnankutty, Binny; Latha, M S

    2014-10-01

    Case report form (CRF) is a specialized document in clinical research. It should be study protocol driven, robust in content and have material to collect the study specific data. Though paper CRFs are still used largely, use of electronic CRFs (eCRFS) are gaining popularity due to the advantages they offer such as improved data quality, online discrepancy management and faster database lock etc. Main objectives behind CRF development are preserving and maintaining quality and integrity of data. CRF design should be standardized to address the needs of all users such as investigator, site coordinator, study monitor, data entry personnel, medical coder and statistician. Data should be organized in a format that facilitates and simplifies data analysis. Collection of large amount of data will result in wasted resources in collecting and processing it and in many circumstances, will not be utilized for analysis. Apart from that, standard guidelines should be followed while designing the CRF. CRF completion manual should be provided to the site personnel to promote accurate data entry by them. These measures will result in reduced query generations and improved data integrity. It is recommended to establish and maintain a library of templates of standard CRF modules as they are time saving and cost-effective. This article is an attempt to describe the methods of CRF designing in clinical research and discusses the challenges encountered in this process.

  18. Characteristics and healthcare utilisation patterns of high-cost beneficiaries in the Netherlands: a cross-sectional claims database study

    NARCIS (Netherlands)

    Wammes, J.J.G.; Tanke, M.A.C.; Jonkers, W.; Westert, G.P.; Wees, P.J. van der; Jeurissen, P.P.T.

    2017-01-01

    OBJECTIVE: To determine medical needs, demographic characteristics and healthcare utilisation patterns of the top 1% and top 2%-5% high-cost beneficiaries in the Netherlands. DESIGN: Cross-sectional study using 1 year claims data. We broke down high-cost beneficiaries by demographics, the most

  19. Designing Advanced Ceramic Waste Forms for Electrochemical Processing Salt Waste

    International Nuclear Information System (INIS)

    Ebert, W. L.; Snyder, C. T.; Frank, Steven; Riley, Brian

    2016-01-01

    This report describes the scientific basis underlying the approach being followed to design and develop ''advanced'' glass-bonded sodalite ceramic waste form (ACWF) materials that can (1) accommodate higher salt waste loadings than the waste form developed in the 1990s for EBR-II waste salt and (2) provide greater flexibility for immobilizing extreme waste salt compositions. This is accomplished by using a binder glass having a much higher Na_2O content than glass compositions used previously to provide enough Na+ to react with all of the Cl- in the waste salt and generate the maximum amount of sodalite. The phase compositions and degradation behaviors of prototype ACWF products that were made using five new binder glass formulations and with 11-14 mass% representative LiCl/KCl-based salt waste were evaluated and compared with results of similar tests run with CWF products made using the original binder glass with 8 mass% of the same salt to demonstrate the approach and select a composition for further studies. About twice the amount of sodalite was generated in all ACWF materials and the microstructures and degradation behaviors confirmed our understanding of the reactions occurring during waste form production and the efficacy of the approach. However, the porosities of the resulting ACWF materials were higher than is desired. These results indicate the capacity of these ACWF waste forms to accommodate LiCl/KCl-based salt wastes becomes limited by porosity due to the low glass-to-sodalite volume ratio. Three of the new binder glass compositions were acceptable and there is no benefit to further increasing the Na content as initially planned. Instead, further studies are needed to develop and evaluate alternative production methods to decrease the porosity, such as by increasing the amount of binder glass in the formulation or by processing waste forms in a hot isostatic press. Increasing the amount of binder glass to eliminate porosity will decrease the waste

  20. Designing Advanced Ceramic Waste Forms for Electrochemical Processing Salt Waste

    Energy Technology Data Exchange (ETDEWEB)

    Ebert, W. L. [Argonne National Lab. (ANL), Argonne, IL (United States); Snyder, C. T. [Argonne National Lab. (ANL), Argonne, IL (United States); Frank, Steven [Argonne National Lab. (ANL), Argonne, IL (United States); Riley, Brian [Argonne National Lab. (ANL), Argonne, IL (United States)

    2016-03-01

    This report describes the scientific basis underlying the approach being followed to design and develop “advanced” glass-bonded sodalite ceramic waste form (ACWF) materials that can (1) accommodate higher salt waste loadings than the waste form developed in the 1990s for EBR-II waste salt and (2) provide greater flexibility for immobilizing extreme waste salt compositions. This is accomplished by using a binder glass having a much higher Na2O content than glass compositions used previously to provide enough Na+ to react with all of the Cl– in the waste salt and generate the maximum amount of sodalite. The phase compositions and degradation behaviors of prototype ACWF products that were made using five new binder glass formulations and with 11-14 mass% representative LiCl/KCl-based salt waste were evaluated and compared with results of similar tests run with CWF products made using the original binder glass with 8 mass% of the same salt to demonstrate the approach and select a composition for further studies. About twice the amount of sodalite was generated in all ACWF materials and the microstructures and degradation behaviors confirmed our understanding of the reactions occurring during waste form production and the efficacy of the approach. However, the porosities of the resulting ACWF materials were higher than is desired. These results indicate the capacity of these ACWF waste forms to accommodate LiCl/KCl-based salt wastes becomes limited by porosity due to the low glass-to-sodalite volume ratio. Three of the new binder glass compositions were acceptable and there is no benefit to further increasing the Na content as initially planned. Instead, further studies are needed to develop and evaluate alternative production methods to decrease the porosity, such as by increasing the amount of binder glass in the formulation or by processing waste forms in a hot isostatic press. Increasing the amount of binder glass to eliminate porosity will decrease

  1. National Beneficiary Survey (NBS) Round 3

    Data.gov (United States)

    Social Security Administration — A cross-sectional survey of a nationally representative sample of social security beneficiaries age 18-64 receiving disability benefits in active pay status as of...

  2. National Beneficiary Survey (NBS) Round 2

    Data.gov (United States)

    Social Security Administration — A cross-sectional survey of a nationally representative sample of 4,864 social security beneficiaries age 18-64 receiving disability benefits in active pay status as...

  3. National Beneficiary Survey (NBS) Round 4

    Data.gov (United States)

    Social Security Administration — A cross-sectional survey of a nationally representative sample of social security beneficiaries age 18-64 receiving disability benefits in active pay status as of...

  4. OASDI Beneficiaries and Benefits by State, 2014

    Data.gov (United States)

    Social Security Administration — This annual map focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the state level in...

  5. Medicare Current Beneficiary Survey - Limited Data Set

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Medicare Current Beneficiary Survey (MCBS) is a continuous, multipurpose survey of a representative national sample of the Medicare population. There are two...

  6. Beneficiary Activation in the Medicare Population

    Data.gov (United States)

    U.S. Department of Health & Human Services — According to findings reported in Beneficiary Activation in the Medicare Population, published in Volume 4, Issue 4 of the Medicare and Medicaid Research Review,...

  7. National Beneficiary Survey (NBS) Round 1

    Data.gov (United States)

    Social Security Administration — A cross-sectional survey of a nationally representative sample of 6,520 social security beneficiaries age 18-64 receiving disability benefits in active pay status as...

  8. Costs and Clinical Quality Among Medicare Beneficiaries..

    Data.gov (United States)

    U.S. Department of Health & Human Services — Authors of Costs and Clinical Quality Among Medicare Beneficiaries - Associations with Health Center Penetration of Low-Income Residents, published in Volume 4,...

  9. Assessment of Factors Influencing Beneficiary Participation in ...

    African Journals Online (AJOL)

    ISSN 0794-5698. Assessment of Factors Influencing Beneficiary Participation in Fadama II Project ... project implementation (80%) in the stages of project development. Women .... the project as they appeared to have more family burden to ...

  10. OASDI Beneficiaries and Benefits by State- 2015

    Data.gov (United States)

    Social Security Administration — This annual map focuses on the Social Security beneficiary population receiving Old-Age, Survivors, and Disability Insurance (OASDI) benefits at the state level in...

  11. The affordable care ACT on loyalty programs for federal beneficiaries.

    Science.gov (United States)

    Piacentino, Justin J; Williams, Karl G

    2014-02-01

    To discuss changes in the law that allow community pharmacy loyalty programs to include and offer incentives to Medicare and Medicaid beneficiaries. The retailer rewards exception of the Patient Protection and Affordable Care Act of 2010 and its change to the definition of remuneration in the civil monetary penalties of the Anti-Kickback Statute now allow incentives to be earned on federal benefit tied prescription out-of-pocket costs. The criteria required to design a compliant loyalty program are discussed. Community pharmacies can now include Medicare and Medicaid beneficiaries in compliant customer loyalty programs, where allowed by state law. There is a need for research directly on the influence of loyalty programs and nominal incentives on adherence.

  12. Knowledge of Precision Farming Beneficiaries

    Directory of Open Access Journals (Sweden)

    A.V. Greena

    2016-05-01

    Full Text Available Precision Farming is one of the many advanced farming practices that make production more efficient by better resource management and reducing wastage. TN-IAMWARM is a world bank funded project aims to improve the farm productivity and income through better water management. The present study was carried out in Kambainallur sub basin of Dharmapuri district with 120 TN-IAMWARM beneficiaries as respondents. The result indicated that more than three fourth (76.67 % of the respondents had high level of knowledge on precision farming technologies which was made possible by the implementation of TN-IAMWARM project. The study further revealed that educational status, occupational status and exposure to agricultural messages had a positive and significant contribution to the knowledge level of the respondents at 0.01 level of probability whereas experience in precision farming and social participation had a positive and significant contribution at 0.05 level of probability.

  13. How Medicare Could Provide Dental, Vision, and Hearing Care for Beneficiaries.

    Science.gov (United States)

    Willink, Amber; Shoen, Cathy; Davis, Karen

    2018-01-01

    The Medicare program specifically excludes coverage of dental, vision, and hearing services. As a result, many beneficiaries do not receive necessary care. Those that do are subject to high out-of-pocket costs. Examine gaps in access to dental, vision, and hearing services for Medicare beneficiaries and design a voluntary dental, vision, and hearing benefit plan with cost estimates. Uses the Medicare Current Beneficiary Survey, Cost and Use File, 2012, with population and costs projected to 2016 values. Among Medicare beneficiaries, 75 percent of people who needed a hearing aid did not have one; 70 percent of people who had trouble eating because of their teeth did not go to the dentist in the past year; and 43 percent of people who had trouble seeing did not have an eye exam in the past year. Lack of access was particularly acute for poor beneficiaries. Because few people have supplemental insurance covering these additional services, among people who received care, three-fourths of their costs of dental and hearing services and 60 percent of their costs of vision services were paid out of pocket. We propose a basic benefit package for dental, vision, and hearing services offered as a premium-financed voluntary insurance option under Medicare. Assuming the benefit package could be offered for $25 per month, we estimate the total coverage costs would be $1.924 billion per year, paid for by premiums. Subsidies to reach low-income beneficiaries would follow the same design as the Part D subsidy.

  14. Collaborative design as a form of professional development

    NARCIS (Netherlands)

    Voogt, Joke; Laferriere, Therese; Breuleux, Alain; Itow, Rebecca C.; McKenney, Susan; Hickey, Daniel T.

    2014-01-01

    Design of (technology-enhanced) learning activities and materials is one fruitful process through which teachers learn and become professionals. To facilitate this process, research is needed to understand how teachers learn through design, how this process may be supported, and how teacher

  15. Design and Fabrication of a Free-Form Reciprocal Roof

    DEFF Research Database (Denmark)

    Parigi, Dario

    2015-01-01

    The paper presents the framework and the design and construction process of a freeform reciprocal pavilion realized during a one-week long workshop with the students of the 1st semester of the Master of Science in Architecture and Design, fall 2014, at Aalborg University. The workshop didactic...... of relations between design parameters and a wide array of measurable performances. Due to the reciprocal structures geometric complexity, the shape generation process is handled using the Reciprocalizer, a software tool developed by the author that embeds in a computational environment the constructional...... logic of reciprocal structures. It enables to engage in real time in iterative processes that allows unfolding the geometric complexity and turn it into a source of inspiration for expanding the design space and triggering the development of unique, adapted and integrated design solutions. Reciprocal...

  16. Research on the Bionics Design of Automobile Styling Based on the Form Gene

    Science.gov (United States)

    Aili, Zhao; Long, Jiang

    2017-09-01

    From the heritage of form gene point of view, this thesis has analyzed the gene make-up, cultural inheritance and aesthetic features in the evolution and development of forms of brand automobiles and proposed the bionic design concept and methods in the automobile styling design. And this innovative method must be based on the form gene, and the consistency and combination of form element must be maintained during the design. Taking the design of Maserati as an example, the thesis will show you the design method and philosophy in the aspects of form gene expression and bionic design innovation for the future automobile styling.

  17. Architectural design of an advanced naturally ventilated building form

    Energy Technology Data Exchange (ETDEWEB)

    Lomas, K.J. [De Montfort University, Leicester (United Kingdom). Institute of Energy and Sustainable Development

    2007-02-15

    Advanced stack-ventilated buildings have the potential to consume much less energy for space conditioning than typical mechanically ventilated or air-conditioned buildings. This paper describes how environmental design considerations in general, and ventilation considerations in particular, shape the architecture of advanced naturally ventilated (ANV) buildings. The attributes of simple and advanced naturally ventilated buildings are described and a taxonomy of ANV buildings presented. Simple equations for use at the preliminary design stage are presented. These produce target structural cross section areas for the key components of ANV systems. The equations have been developed through practice-based research to design three large educational buildings: the Frederick Lanchester Library, Coventry, UK; the School of Slavonic and East European Studies, London, UK; the Harm A. Weber Library, Elgin, near Chicago, USA. These buildings are briefly described and the sizes of the as-built ANV features compared with the target values for use in preliminary design. The three buildings represent successive evolutionary stages: from advanced natural ventilation, to ANV with passive downdraught cooling, and finally ANV with HVAC support. Hopefully the guidance, simple calculation tools and case study examples will give architects and environmental design consultants confidence to embark on the design of ANV buildings. (author)

  18. Medicare Beneficiary Knowledge of the Part D Program

    Data.gov (United States)

    U.S. Department of Health & Human Services — Medicare Beneficiary Knowledge of the Part D Program and Its Relationship with Voluntary Enrollment According to findings appearing in Medicare Beneficiary Knowledge...

  19. Orthogonal designs Hadamard matrices, quadratic forms and algebras

    CERN Document Server

    Seberry, Jennifer

    2017-01-01

    Orthogonal designs have proved fundamental to constructing code division multiple antenna systems for more efficient mobile communications. Starting with basic theory, this book develops the algebra and combinatorics to create new communications modes. Intended primarily for researchers, it is also useful for graduate students wanting to understand some of the current communications coding theories.

  20. Common micronutrient deficiencies among food aid beneficiaries ...

    African Journals Online (AJOL)

    Results: Vitamin A and iron deficiencies were the most prevalent micronutrient deficiencies among food aid beneficiaries. Other probable deficiencies prevailing were zinc, vitamins thiamine, riboflavin, niacin folate, cyano-cobalamine, ascorbic acid vitamin D and calcium because of the low intake of dairy products and meat.

  1. Tax system competition – instruments and beneficiaries

    OpenAIRE

    Krzysztof Biernacki

    2014-01-01

    Tax competition among states and jurisdictions has already been examined many times in the economic literature. However, the main scope of the research was focused on a tax rates competition in income taxes and its consequences in bringing direct investments. This scripture/commentary tries to analyze various instruments and beneficiaries of the tax system competition and provide a general overview on this subject.

  2. 32 CFR 728.58 - Federal Aviation Agency (FAA) beneficiaries.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Federal Aviation Agency (FAA) beneficiaries. 728... Federal Agencies § 728.58 Federal Aviation Agency (FAA) beneficiaries. (a) Beneficiaries. Air Traffic Control Specialists (ATCS) of the FAA when appropriate authorization has been furnished by the FAA...

  3. Design and monitoring of photostability systems for amlodipine dosage forms.

    Science.gov (United States)

    Ragno, G; Cione, E; Garofalo, A; Genchi, G; Ioele, G; Risoli, A; Spagnoletta, A

    2003-10-20

    Photostability of amlodipine (AML) has been monitored in several pharmaceutical inclusion systems characterized by plurimolecular aggregation of the drug and excipients with high molecular weight. Several formulations including cyclodextrins, liposomes and microspheres have been prepared and characterized. The photodegradation process has been monitored according to the conditions suggested by the ICH Guideline for photostability testing, by using a light cabinet equipped with a Xenon lamp and monitored by spectrophotometry. The formulations herein tested have been found to be able to considerably increase drug stability, when compared with usual pharmaceutical forms. The residual concentration detected in the inclusion complexes with cyclodextrins and liposomes was 90 and 77%, respectively, while a very good value of 97% was found for microspheres, after a radiant exposure of 11,340 kJm(-2).

  4. Giving form to computational things: developing a practice of interaction design

    DEFF Research Database (Denmark)

    Vallgårda, Anna K. A.

    2014-01-01

    between states. Thus, an interaction design practice needs to encompass this temporal form giving in combination with physical form giving and performances of the interaction gestalt. In this paper, I propose this trinity of forms as a framework to unfold the practice of interaction design. I further...

  5. Understanding the glass-forming ability of active pharmaceutical ingredients for designing supersaturating dosage forms.

    Science.gov (United States)

    Kawakami, Kohsaku; Usui, Toshinori; Hattori, Mitsunari

    2012-09-01

    Amorphous solid dispersions have great potential for enhancing oral absorption of poorly soluble drugs. Crystallization behavior during storage and after exposure to aqueous media must be examined in detail for designing stable and effective amorphous formulations, and it is significantly affected by the intrinsic properties of an amorphous drug. Many attempts have been made to correlate various thermodynamic parameters of pharmaceutical glasses with their crystallization behavior; however, variations in model drugs that could be used for such investigation has been limited because the amorphous characteristics of drugs possessing a high crystallization tendency are difficult to evaluate. In this study, high-speed differential scanning calorimetry, which could inhibit their crystallization using high cooling rates up to 2000°C/s, was employed for assessing such drugs. The thermodynamic parameters of the glasses, including glass transition temperature (T(g)) and fragility, were obtained to show that their crystallization tendency cannot be explained simply by the parameters, although there have been general thought that fragility may be correlated with crystallization tendency. Also investigated was correlation between the thermodynamic parameters and crystallization tendency upon contact with water, which influences in vivo efficacy of amorphous formulations. T(g) was correlated well with the crystallization tendency upon contact with water. Copyright © 2012 Wiley Periodicals, Inc.

  6. How Do Pharmacists Assist Medicare Beneficiaries with Limited Income? A Cross-Sectional Study of Community Pharmacies in Alabama.

    Science.gov (United States)

    Westrick, Salisa C; Hastings, Tessa J; McFarland, Stuart J; Hohmann, Lindsey A; Hohmann, Natalie S

    2016-09-01

    Many Medicare beneficiaries have limited income and report problems paying for their medications. Programs are available to assist these low-income individuals. However, these programs are underused because of lack of general awareness and perceived complexity of program applications. To (a) determine the frequency of encounters by pharmacists with Medicare beneficiaries who cannot afford prescription drugs; (b) identify strategies that pharmacists use to assist Medicare beneficiaries who cannot afford prescription drugs; and (c) explore what pharmacists know about programs for Medicare beneficiaries with limited income. This study used a mixed-mode survey of 350 randomly sampled community pharmacies located in 32 counties in Alabama with a high proportion of Medicare beneficiaries who were potentially eligible for low-income subsidy programs. Measures included frequency of encounters by pharmacists with Medicare beneficiaries who could not afford their medications, strategies used to assist Medicare beneficiaries, and pharmacists' knowledge of programs for Medicare beneficiaries with limited income. Of 350 surveys sent, 12 were nondeliverable, and 151 were completed (response rate=44.6%). About 50% of respondents reported encountering Medicare beneficiaries who could not afford their medications at least weekly. Various strategies were reported, including refiling claims that were previously denied every day (40.7%), contacting insurance companies at least once per week (43.2%), and loaning medications at least 2-3 times per month (29.1%). Only 12.6% reported referring beneficiaries to the Aging and Disability Resource Centers (ADRCs) to assess eligibility for limited-income programs. When asked about programs for beneficiaries with limited income, the answers were predominantly "don't know for sure." Several strategies were used by pharmacists in an attempt to help limited-income Medicare beneficiaries obtain their medications. Lack of knowledge about financial

  7. 78 FR 36035 - Proposed Information Collection Activity: [Beneficiary Travel Mileage Reimbursement Application...

    Science.gov (United States)

    2013-06-14

    ... provided for their convenience. This collection of information is necessary to enable the VHA to provide... online through FDMS. FOR FURTHER INFORMATION CONTACT: Cynthia Harvey-Pryor at (202) 461-5870 or Fax (202... use of other forms of information technology. Titles: Beneficiary Travel Mileage Reimbursement...

  8. New strategies and developments in transparent free-form design: From facetted to nearly smooth envelopes

    KAUST Repository

    Baldassini, Niccolo; Pottmann, Helmut; Raynaud, Jacques; Schiftner, Alexander

    2009-01-01

    -form transparent design today is mainly based on triangularly facetted forms or quadrilateral meshes supported by a structure composed of rectilinear bars, with strong shape restrictions. After a brief review of the history, we report on some very recent progress

  9. The Expanded Public Works Programme: Perspectives of direct beneficiaries

    Directory of Open Access Journals (Sweden)

    Mondli S. Hlatshwayo

    2017-09-01

    Full Text Available Scholarship on the Expanded Public Works Programme (EPWP in South Africa tends to focus on quantitative evaluation to measure the progress made in the implementation of EPWP projects. The number of employment opportunities created by EPWP, demographic profiling, skills acquired by beneficiaries and training opportunities related to the Programme form the basis of typical statistical evaluations of it, but exclude comment by the workers who participate in its projects. Based on primary sources, including in-depth interviews, newspaper reports and internet sources, this article seeks to provide a qualitative review of the EPWP from the perspective of the beneficiaries of municipal EPWP projects. Various South African government sectors hire EPWP workers to provide local services such as cleaning and maintaining infrastructure, but the employment of these workers can still be regarded as precarious, in the sense that they have no job security, earn low wages and have no benefits such as medical aid or pension fund. The interviewees indicated that, although they appreciate the temporary employment opportunities provided by the EPWP, they also experience health and safety risks and lack the advantages of organised labour groupings. Their main disadvantage, however, is that they cannot access permanent employment, which offers better wages and concomitant benefits.

  10. Investigation of the Electrohydraulic Forming Process with respect to the Design of Sharp Edged Contours

    OpenAIRE

    Beerwald, C.; Homberg, W.; Pröbsting, A.

    2010-01-01

    The overcoming of design constraints with respect to forming of sharply contoured sheet metal workpieces made of high strength steel or other materials which are difficult to form is an important aspect in sheet metal part production. One interesting solution to extend existing forming limits can be the use of electrohydraulic forming as single forming operation or in combination with quasi-static hydroforming. Apart from promising results regarding the feasible part geometries this process a...

  11. Medication adherence and Medicare expenditure among beneficiaries with heart failure.

    Science.gov (United States)

    Lopert, Ruth; Shoemaker, J Samantha; Davidoff, Amy; Shaffer, Thomas; Abdulhalim, Abdulla M; Lloyd, Jennifer; Stuart, Bruce

    2012-09-01

    To (1) measure utilization of and adherence to heart failure medications and (2) assess whether better adherence is associated with lower Medicare spending. Pooled cross-sectional design using six 3-year cohorts of Medicare beneficiaries with congestive heart failure (CHF) from 1997 through 2005 (N = 2204). Adherence to treatment was measured using average daily pill counts. Bivariate and multivariate methods were used to examine the relationship between medication adherence and Medicare spending. Multivariate analyses included extensive variables to control for confounding, including healthy adherer bias. Approximately 58% of the cohort were taking an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB), 72% a diuretic, 37% a beta-blocker, and 34% a cardiac glycoside. Unadjusted results showed that a 10% increase in average daily pill count for ACE inhibitors or ARBs, beta-blockers, diuretics, or cardiac glycosides was associated with reductions in Medicare spending of $508 (not significant [NS]), $608 (NS), $250 (NS), and $1244 (P <.05), respectively. Estimated adjusted marginal effects of a 10% increase in daily pill counts for beta-blockers and cardiac glycosides were reductions in cumulative 3-year Medicare spending of $510 to $561 and $750 to $923, respectively (P <.05). Higher levels of medication adherence among Medicare beneficiaries with CHF were associated with lower cumulative Medicare spending over 3 years, with savings generally exceeding the costs of the drugs in question.

  12. The Effect of Length in Employment Sites’ Web Form Design on User Preferences

    Directory of Open Access Journals (Sweden)

    Yu-Ching Wang

    2014-06-01

    Full Text Available Web form has become a critical component for many Web applications and services. Previous research has investigated into the general design of web form layout without examining the impact of variations in format, length and structure on user experience. This study explores users’ preference and performance over Web forms of different lengths deployed on an employment site. Three types of design of Web forms were developed as the experiment instruments for 48 participants to test and evaluate. Results show that participants’ preferences and satisfaction varied by the length of Web forms. Participants’ preferences were also affected by their previous Internet experiences with job websites. In the end, recommendations for design principles for Web forms used for job sites were presented. [Article content in Chinese

  13. Prediction of the surface roughness of AA6082 flow-formed tubes by design of experiments

    International Nuclear Information System (INIS)

    Srinivasulu, M.; Komaraiah, M.; Rao, C. S. Krishna Prasada

    2013-01-01

    Flow forming is a modern, chipless metal forming process that is employed for the production of thin-walled seamless tubes. Experiments are conducted on AA6082 alloy pre-forms to flow form into thin-walled tubes on a CNC flow-forming machine with a single roller. Design of experiments is used to predict the surface roughness of flow-formed tubes. The process parameters selected for this study are the roller axial feed, mandrel speed, and roller radius. A standard response surface methodology (RSM) called the Box Behnken design is used to perform the experimental runs. The regression model developed by RSM successfully predicts the surface roughness of AA6082 flow-formed tubes within the range of the selected process parameters.

  14. Prediction of the surface roughness of AA6082 flow-formed tubes by design of experiments

    Energy Technology Data Exchange (ETDEWEB)

    Srinivasulu, M. [Government Polytechnic for Women Badangpet, Hyderabad (India); Komaraiah, M. [Sreenidhi Institute of Science and Technology, Hyderabad (India); Rao, C. S. Krishna Prasada [Bharat Dynamics Limited, Hyderabad (India)

    2013-06-15

    Flow forming is a modern, chipless metal forming process that is employed for the production of thin-walled seamless tubes. Experiments are conducted on AA6082 alloy pre-forms to flow form into thin-walled tubes on a CNC flow-forming machine with a single roller. Design of experiments is used to predict the surface roughness of flow-formed tubes. The process parameters selected for this study are the roller axial feed, mandrel speed, and roller radius. A standard response surface methodology (RSM) called the Box Behnken design is used to perform the experimental runs. The regression model developed by RSM successfully predicts the surface roughness of AA6082 flow-formed tubes within the range of the selected process parameters.

  15. A Framework for Mapping User-Designed Forms to Relational Databases

    Science.gov (United States)

    Khare, Ritu

    2011-01-01

    In the quest for database usability, several applications enable users to design custom forms using a graphical interface, and forward engineer the forms into new databases. The path-breaking aspect of such applications is that users are completely shielded from the technicalities of database creation. Despite this innovation, the process of…

  16. Optimal assignment methods in three-form planned missing data designs for longitudinal panel studies

    NARCIS (Netherlands)

    Jorgensen, T.D.; Rhemtulla, M.; Schoemann, A.; McPherson, B.; Wu, W.; Little, T.D.

    2014-01-01

    Planned missing designs are becoming increasingly popular, but because there is no consensus on how to implement them in longitudinal research, we simulated longitudinal data to distinguish between strategies of assigning items to forms and of assigning forms to participants across measurement

  17. Insect form vision as one potential shaping force of spider web decoration design.

    Science.gov (United States)

    Cheng, R-C; Yang, E-C; Lin, C-P; Herberstein, M E; Tso, I-M

    2010-03-01

    Properties of prey sensory systems are important factors shaping the design of signals generated by organisms exploiting them. In this study we assessed how prey sensory preference affected the exploiter signal design by investigating the evolutionary relationship and relative attractiveness of linear and cruciate form web decorations built by Argiope spiders. Because insects have an innate preference for bilaterally symmetrical patterns, we hypothesized that cruciate form decorations were evolved from linear form due to their higher visual attractiveness to insects. We first reconstructed a molecular phylogeny of the Asian members of the genus Argiope using mitochondrial markers to infer the evolutionary relationship of two decoration forms. Results of ancestral character state reconstruction showed that the linear form was ancestral and the cruciate form derived. To evaluate the luring effectiveness of two decoration forms, we performed field experiments in which the number and orientation of decoration bands were manipulated. Decoration bands arranged in a cruciate form were significantly more attractive to insects than those arranged in a linear form, no matter whether they were composed of silks or dummies. Moreover, dummy decoration bands arranged in a cruciate form attracted significantly more insects than those arranged in a vertical/horizontal form. Such results suggest that pollinator insects' innate preference for certain bilateral or radial symmetrical patterns might be one of the driving forces shaping the arrangement pattern of spider web decorations.

  18. Changes in agri-business outcomes among the dairy beneficiaries ...

    African Journals Online (AJOL)

    This study compared changes in uptake of agri-business practices, productivity and wealth creation between dairy beneficiaries and non-beneficiaries of Contracted Extension Service Delivery Model (CESDM) implemented by Kenya Agricultural Productivity and Agribusiness Project (KAPAP) in selected counties of Kenya ...

  19. Fadama III Beneficiaries' Adherence to Project Guidelines in Ogun ...

    African Journals Online (AJOL)

    It was recommended that the implementers should keep up their efforts at sensitising beneficiaries on the implementation guidelines of the project, re-work their strategies at addressing procurement and FUEF inadequacies among the beneficiaries and fast-track the delivery of project benefits in the communities. Key words: ...

  20. Design of New-Generation Usable Forms of Topical Haemostatic Agents Containing Chitosan

    Directory of Open Access Journals (Sweden)

    Dorota Zielińska

    2017-12-01

    Full Text Available Designing usable forms of topical haemostatic agents is the most important activity during the design process, resulting in strengthened functional properties of the final medical devices. This study aimed to propose indications for a research programme based on risk management supporting the development of two usable forms of a topical haemostatic agent: chitosan/alginate lyophilized foam and chitosan/alginate impregnated gauze. Both of the usable forms of the topical haemostatic agent, being the main part of the modified combat gauze, were fabricated using the chitosan/alginate complex. Risk analysis is helpful in developing an appropriate research programme, significantly reducing the risk to an acceptable level.

  1. Advances in Design and Fabrication of Free-Form Reciprocal Structures

    DEFF Research Database (Denmark)

    Parigi, Dario

    2016-01-01

    The paper presents the advances in design and fabrication of free-form Reciprocal Structures, and their application a during a one-week long workshop with the students of the 1st semester of the Master of Science in Architecture and Design, fall 2015, at Aalborg University. Two new factors were...... introduced and tested: a new version of the software Reciprocalizer, and an evolution of the Reciprocalizer Robot. The workshop didactic framework Performance Aided/Assisted Design (PAD) is presented....

  2. New strategies and developments in transparent free-form design: From facetted to nearly smooth envelopes

    KAUST Repository

    Baldassini, Niccolo

    2009-09-01

    Free-form geometries in architecture pose new challenges to designers and engineers. Form, structure and fabrication processes are closely linked, which makes the realization of complex architectural free-form structures even harder. Free-form transparent design today is mainly based on triangularly facetted forms or quadrilateral meshes supported by a structure composed of rectilinear bars, with strong shape restrictions. After a brief review of the history, we report on some very recent progress in this area. Beginning with a presentation of improved methods for triangle mesh design, we also discuss experiences in coupling triangular glass panels with continuous curved structures, seeking an optimised structural behaviour and simplified connections. Furthermore, we present how the results of research on planar quadrilateral (PQ) meshes lead the way to optimized beam layouts and the breakdown of free-form shapes using planar quadrilateral panels. PQ meshes are rooted in discrete differential geometry, an active area of mathematical research. Using recent projects as examples, we discuss how transparent free-form envelopes with a smooth visual appearance are achievable if the structure is designed to adhere to the limits of current glazing technology and the surfaces are reasonably simple (e.g. rotational, overall developable, or of a small scale). In section 6 we show how the latter restriction can be relaxed: the theoretical and computational methodology for PQ meshes can easily be extended to create nearly smooth approximations of free-form surfaces by single-curved panels. This has a strong impact on glass panelling design, since it avoids expensive double-curvature glass and exploits cold-bending technology. We elaborate on how this discretisation technique goes hand in hand with the technology for construction of the structure, glazing system and structural joints. Our approach has been tested in three case studies, each one validating a particular aspect of

  3. Pre-Rationalized Parametric Designing of Roof Shells Formed by Repetitive Modules of Catalan Surfaces

    Directory of Open Access Journals (Sweden)

    Jolanta Dzwierzynska

    2018-04-01

    Full Text Available The aim of the study is to develop an original, methodical, and practical approach to the early stages of parametric design of roof shells formed by repetitive modules of Catalan surfaces. It is presented on the example of designing the roof shells compound of four concrete elements. The designing process proposed by us consists in linking geometric shaping of roofs’ models with their structural analysis and optimization. Contrary to other methods, which use optimization process in order to find free roof forms, we apply it in order to explore and improve design alternatives. It is realized with the application of designing tools working in Rhinoceros 3D software. The flexible scripts elaborated by us, in order to achieve roofs’ models of regular and symmetrical shapes, are converted into simulation models to perform structural analysis. It is mainly focused on how the roof shells perform dependently on their geometric characteristics. The simulation enables one to evaluate various roof shells’ shapes, as well as to select an optimal design solution. The proposed approach to the conceptual design process may drive the designing to achieve geometric and structural forms which not only follow the design intentions but also target better results.

  4. Enhancing and diluting the legal status of subsidiary protection beneficiaries under Union law

    DEFF Research Database (Denmark)

    Storgaard, Louise Halleskov

    2016-01-01

    Is it in accordance with the Qualification Directive (QD) to restrict the freedom of movement within the host country of beneficiaries of subsidiary protection (a form of protection parallel to refugee status) in receipt of social security benefits? This question was addressed by the CJEU in its...... and the substantive content of subsidiary protection while it, on the other hand, creates uncertainty about the applicable non-discrimination standard in such cases...

  5. High-throughput spectrometer designs in a compact form-factor: principles and applications

    Science.gov (United States)

    Norton, S. M.

    2013-05-01

    Many compact, portable Raman spectrometers have entered the market in the past few years with applications in narcotics and hazardous material identification, as well as verification applications in pharmaceuticals and security screening. Often, the required compact form-factor has forced designers to sacrifice throughput and sensitivity for portability and low-cost. We will show that a volume phase holographic (VPH)-based spectrometer design can achieve superior throughput and thus sensitivity over conventional Czerny-Turner reflective designs. We will look in depth at the factors influencing throughput and sensitivity and illustrate specific VPH-based spectrometer examples that highlight these design principles.

  6. CAD system of design and engineering provision of die forming of compressor blades for aircraft engines

    Science.gov (United States)

    Khaimovich, I. N.

    2017-10-01

    The articles provides the calculation algorithms for blank design and die forming fitting to produce the compressor blades for aircraft engines. The design system proposed in the article allows generating drafts of trimming and reducing dies automatically, leading to significant reduction of work preparation time. The detailed analysis of the blade structural elements features was carried out, the taken limitations and technological solutions allowed forming generalized algorithms of forming parting stamp face over the entire circuit of the engraving for different configurations of die forgings. The author worked out the algorithms and programs to calculate three dimensional point locations describing the configuration of die cavity. As a result the author obtained the generic mathematical model of final die block in the form of three-dimensional array of base points. This model is the base for creation of engineering documentation of technological equipment and means of its control.

  7. Relationship between Process, form and Representation in the Design Environment of 21st Century

    Directory of Open Access Journals (Sweden)

    Bülent Onur TURAN

    2011-10-01

    Full Text Available Research in design and design methodologies began to appear in industrialized societies in the 1950s and 1960s and design, as an act been described in various ways. After this period, examination of, and debates over the contents and components of design, as well as such topics as the thinking process of the designer, gradually increased and in this context new theories and methods emerged. Today, these examinations and debates have gained a new dimension in terms of developments in science and technology, particularly with the involvement of computer environment and computational technologies in the design process. This work is focused on the interactive transformations between the process, form and representation which determine contemporary architectural discourse.

  8. A numerical method for the design of free-form reflectors for lighting applications

    NARCIS (Netherlands)

    Prins, C.R.; Thije Boonkkamp, ten J.H.M.; Roosmalen, van J.; IJzerman, W.L.; Tukker, T.W.

    2013-01-01

    In this article we present a method for the design of fully free-form reflectors for illumination systems. We derive an elliptic partial differential equation of the Monge-Ampère type for the surface of a reflector that converts an arbitrary parallel beam of light into a desired intensity output

  9. Direct Closed-Form Design of Finite Alphabet Constant Envelope Waveforms for Planar Array Beampatterns

    KAUST Repository

    Bouchoucha, Taha

    2015-01-01

    them hard to use in practice especially for real time radar applications. In this paper, we provide a closed-form solution to design the covariance matrix for a given beampattern in the three dimensional space using planar arrays, which is then used

  10. Design of a ring resonator-based optical beam forming network for phased array receive antennas

    NARCIS (Netherlands)

    van 't Klooster, J.W.J.R.; Roeloffzen, C.G.H.; Meijerink, Arjan; Zhuang, L.; Marpaung, D.A.I.; van Etten, Wim; Heideman, Rene; Leinse, Arne; Schippers, H.; Verpoorte, J.; Wintels, M.

    2008-01-01

    A novel squint-free ring resonator-based optical beam forming network (OBFN) for phased array antennas (PAA) is proposed. It is intended to provide broadband connectivity to airborne platforms via geostationary satellites. In this paper, we present the design of the OBFN and its control system. Our

  11. 42 CFR 424.54 - Payment to the beneficiary's legal guardian or representative payee.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Payment to the beneficiary's legal guardian or... Ordinarily Made § 424.54 Payment to the beneficiary's legal guardian or representative payee. Medicare may pay amounts due a beneficiary to the beneficiary's legal guardian or representative payee. ...

  12. Environment as a basis for the design of advertising structures by forming

    Science.gov (United States)

    Khmelevsky, Y. P.; Seryakov, V. A.; Mamontov, G. Y.; Tsarenko, D. T.

    2017-01-01

    A few different neighbouring styles of architectural forms are quite frequent in the cities of great historical past. As a result, a designer or architect has to solve the complex problem while designing the objects within such environment, i.e. one has to fit them naturally into the existing site development. Often, form making is found to be hard, due to the fact that the existing architectural forms of totally different stylistic execution coexist in the visual proximity. Presently, placement of the advertising bills in urban environment is both an urgent and debatable issue. On the one hand, advertising providers are keen to present their product bigger and brighter, on the other hand, the overall and eye-catching exhibition stands can be disharmonious with the surrounding architectural ensemble of the city. This situation is relevant for every cultural city.

  13. Evaluating Urban Forms for Comparison Studies in the Massing Design Stage

    Directory of Open Access Journals (Sweden)

    Kian Wee Chen

    2017-06-01

    Full Text Available We introduce five performance indicators to facilitate the comparison of urban massing design in the early design stages. The five simple indicators are based on existing studies and cover three main performance areas that are sensitive to urban form changes: solar, ventilation, and connectivity potentials. The first three indicators—the non-solar heated façade to floor area index, daylight façade to floor area index, and photovoltaics envelope to floor area index—measure the solar potential. The frontal area index measures the ventilation potential and the route-directness index measures the connectivity potential. The indicators are simple to use, as they only require urban geometry data for their calculation. We demonstrate the indicators in two case studies; variations in the values of these indicators show that they are sensitive to urban form changes and can be used in comparative studies to identify better performing urban forms among massing designs. We implement the indicators as an open-source Python library, Pyliburo, that designers and researchers can readily access and integrate into their existing design workflows.

  14. Beneficiary price sensitivity in the Medicare prescription drug plan market.

    Science.gov (United States)

    Frakt, Austin B; Pizer, Steven D

    2010-01-01

    The Medicare stand-alone prescription drug plan (PDP) came into existence in 2006 as part of the Medicare prescription drug benefit. It is the most popular plan type among Medicare drug plans and large numbers of plans are available to all beneficiaries. In this article we present the first analysis of beneficiary price sensitivity in the PDP market. Our estimate of elasticity of enrollment with respect to premium, -1.45, is larger in magnitude than has been found in the Medicare HMO market. This high degree of beneficiary price sensitivity for PDPs is consistent with relatively low product differentiation, low fixed costs of entry in the PDP market, and the fact that, in contrast to changing HMOs, beneficiaries can select a PDP without disrupting doctor-patient relationships.

  15. Basic Stand Alone Skilled Nursing Facility Beneficiary PUF

    Data.gov (United States)

    U.S. Department of Health & Human Services — This release contains the Basic Stand Alone (BSA) Skilled Nursing Facility (SNF) Beneficiary Public Use Files (PUF) with information from Medicare SNF claims. The...

  16. U.S. Outpatient Beneficiary Satisfaction at Korean Hospitals

    National Research Council Canada - National Science Library

    Hayman, Alex L

    2008-01-01

    .... The analysis measured overall patient satisfaction as it relates to beneficiary category, gender and command sponsorship. The project data was utilized to verify and/or identify potential target areas of patient satisfaction.

  17. Principles for designing proteins with cavities formed by curved β sheets

    Energy Technology Data Exchange (ETDEWEB)

    Marcos, Enrique; Basanta, Benjamin; Chidyausiku, Tamuka M.; Tang, Yuefeng; Oberdorfer, Gustav; Liu, Gaohua; Swapna, G. V. T.; Guan, Rongjin; Silva, Daniel-Adriano; Dou, Jiayi; Pereira, Jose Henrique; Xiao, Rong; Sankaran, Banumathi; Zwart, Peter H.; Montelione, Gaetano T.; Baker, David

    2017-01-12

    Active sites and ligand-binding cavities in native proteins are often formed by curved β sheets, and the ability to control β-sheet curvature would allow design of binding proteins with cavities customized to specific ligands. Toward this end, we investigated the mechanisms controlling β-sheet curvature by studying the geometry of β sheets in naturally occurring protein structures and folding simulations. The principles emerging from this analysis were used to design, de novo, a series of proteins with curved β sheets topped with α helices. Nuclear magnetic resonance and crystal structures of the designs closely match the computational models, showing that β-sheet curvature can be controlled with atomic-level accuracy. Our approach enables the design of proteins with cavities and provides a route to custom design ligand-binding and catalytic sites.

  18. Closed-form Solution to Directly Design FACE Waveforms for Beampatterns Using Planar Array

    KAUST Repository

    Bouchoucha, Taha; Ahmed, Sajid; Al-Naffouri, Tareq Y.; Alouini, Mohamed-Slim

    2015-01-01

    In multiple-input multiple-output radar systems, it is usually desirable to steer transmitted power in the region-of-interest. To do this, conventional methods optimize the waveform covariance matrix, R, for the desired beampattern, which is then used to generate actual transmitted waveforms. Both steps require constrained optimization, therefore, use iterative algorithms. The main challenges encountered in the existing approaches are the computational complexity and the design of waveforms to use in practice. In this paper, we provide a closed-form solution to design covariance matrix for the given beampattern using the planar array, which is then used to derive a novel closed-form algorithm to directly design the finite-alphabet constant-envelope (FACE) waveforms. The proposed algorithm exploits the two-dimensional fast-Fourier-transform. The performance of our proposed algorithm is compared with existing methods that are based on semi-definite quadratic programming with the advantage of a considerably reduced complexity.

  19. Closed-form Solution to Directly Design FACE Waveforms for Beampatterns Using Planar Array

    KAUST Repository

    Bouchoucha, Taha

    2015-04-19

    In multiple-input multiple-output radar systems, it is usually desirable to steer transmitted power in the region-of-interest. To do this, conventional methods optimize the waveform covariance matrix, R, for the desired beampattern, which is then used to generate actual transmitted waveforms. Both steps require constrained optimization, therefore, use iterative algorithms. The main challenges encountered in the existing approaches are the computational complexity and the design of waveforms to use in practice. In this paper, we provide a closed-form solution to design covariance matrix for the given beampattern using the planar array, which is then used to derive a novel closed-form algorithm to directly design the finite-alphabet constant-envelope (FACE) waveforms. The proposed algorithm exploits the two-dimensional fast-Fourier-transform. The performance of our proposed algorithm is compared with existing methods that are based on semi-definite quadratic programming with the advantage of a considerably reduced complexity.

  20. Observation Status, Poverty, and High Financial Liability Among Medicare Beneficiaries.

    Science.gov (United States)

    Goldstein, Jennifer N; Zhang, Zugui; Schwartz, J Sanford; Hicks, LeRoi S

    2018-01-01

    Medicare beneficiaries hospitalized under observation status are subject to cost-sharing with no spending limit under Medicare Part B. Because low-income status is associated with increased hospital use, there is concern that such beneficiaries may be at increased risk for high use and out-of-pocket costs related to observation care. Our objective was to determine whether low-income Medicare beneficiaries are at risk for high use and high financial liability for observation care compared with higher-income beneficiaries. We performed a retrospective, observational analysis of Medicare Part B claims and US Census Bureau data from 2013. Medicare beneficiaries with Part A and B coverage for the full calendar year, with 1 or more observation stay(s), were included in the study. Beneficiaries were divided into quartiles representing poverty level. The associations between poverty quartile and high use of observation care and between poverty quartile and high financial liability for observation care were evaluated. After multivariate adjustment, the risk of high use was higher for beneficiaries in the poor (Quartile 3) and poorest (Quartile 4) quartiles compared with those in the wealthiest quartile (Quartile 1) (adjusted odds ratio [AOR], 1.21; 95% confidence interval [CI], 1.13-1.31; AOR, 1.24; 95% CI, 1.16-1.33). The risk of high financial liability was higher in every poverty quartile compared with the wealthiest and peaked in Quartile 3, which represented the poor but not the poorest beneficiaries (AOR, 1.17; 95% CI, 1.10-1.24). Poverty predicts high use of observation care. The poor or near poor may be at highest risk for high liability. Copyright © 2018 Elsevier Inc. All rights reserved.

  1. Designing products as an integral part of choreography of interaction : the product's form as an integral part of movement

    NARCIS (Netherlands)

    Klooster, S.; Overbeeke, C.J.; Feijs, L.; Kyffin, S.; Young, B.

    2005-01-01

    Recent developments in design research concentrate on two themes (1) the unity of form, function and interaction and (2) the semantics of movement. The Design Movement approach incorporates unity of form, function and interaction through movement. Design Movement introduces the design of products as

  2. Pre-Enrollment Reimbursement Patterns of Medicare Beneficiaries Enrolled in “At-Risk” HMOs

    Science.gov (United States)

    Eggers, Paul W.; Prihoda, Ronald

    1982-01-01

    The Health Care Financing Administration (HCFA) has initiated several demonstration projects to encourage HMOs to participate in the Medicare program under a risk mechanism. These demonstrations are designed to test innovative marketing techniques, benefit packages, and reimbursement levels. HCFA's current method for prospective payments to HMOs is based on the Adjusted Average Per Capita Cost (AAPCC). An important issue in prospective reimbursement is the extent to which the AAPCC adequately reflects the risk factors which arise out of the selection process of Medicare beneficiaries into HMOs. This study examines the pre-enrollment reimbursement experience of Medicare beneficiaries who enrolled in the demonstration HMOs to determine whether or not a non-random selection process took place. The three demonstration HMOs included in the study are the Fallon Community Health Plan, the Greater Marshfield Community Health Plan, and the Kaiser-Permanente medical program of Portland, Oregon. The study includes 18,085 aged Medicare beneficiaries who had enrolled in the three plans as of April, 1981. We included comparison groups consisting of a 5 percent random sample of aged Medicare beneficiaries (N = 11,240) living in the same geographic areas as the control groups. The study compares the groups by total Medicare reimbursements for the years 1976 through 1979. Adjustments were made for AAPCC factor differences in the groups (age, sex, institutional status, and welfare status). In two of the HMO areas there was evidence of a selection process among the HMOs enrollees. Enrollees in the Fallon and Kaiser health plans were found to have had 20 percent lower Medicare reimbursements than their respective comparison groups in the four years prior to enrollment. This effect was strongest for inpatient services, but a significant difference also existed for use of physician and outpatient services. In the Marshfield HMO there was no statistically significant difference in pre

  3. Closed-form solutions for linear regulator design of mechanical systems including optimal weighting matrix selection

    Science.gov (United States)

    Hanks, Brantley R.; Skelton, Robert E.

    1991-01-01

    Vibration in modern structural and mechanical systems can be reduced in amplitude by increasing stiffness, redistributing stiffness and mass, and/or adding damping if design techniques are available to do so. Linear Quadratic Regulator (LQR) theory in modern multivariable control design, attacks the general dissipative elastic system design problem in a global formulation. The optimal design, however, allows electronic connections and phase relations which are not physically practical or possible in passive structural-mechanical devices. The restriction of LQR solutions (to the Algebraic Riccati Equation) to design spaces which can be implemented as passive structural members and/or dampers is addressed. A general closed-form solution to the optimal free-decay control problem is presented which is tailored for structural-mechanical system. The solution includes, as subsets, special cases such as the Rayleigh Dissipation Function and total energy. Weighting matrix selection is a constrained choice among several parameters to obtain desired physical relationships. The closed-form solution is also applicable to active control design for systems where perfect, collocated actuator-sensor pairs exist.

  4. Integrated Analysis of Flow, Form, and Function for River Management and Design Testing

    Science.gov (United States)

    Lane, B. A. A.; Pasternack, G. B.; Sandoval Solis, S.

    2017-12-01

    Rivers are highly complex, dynamic systems that support numerous ecosystem functions including transporting sediment, modulating biogeochemical processes, and regulating habitat availability for native species. The extent and timing of these functions is largely controlled by the interplay of hydrologic dynamics (i.e. flow) and the shape and composition of the river corridor (i.e. form). This study applies synthetic channel design to the evaluation of river flow-form-function linkages, with the aim of evaluating these interactions across a range of flows and forms to inform process-driven management efforts with limited data and financial requirements. In an application to California's Mediterranean-montane streams, the interacting roles of channel form, water year type, and hydrologic impairment were evaluated across a suite of ecosystem functions related to hydrogeomorphic processes, aquatic habitat, and riparian habitat. Channel form acted as the dominant control on hydrogeomorphic processes considered, while water year type controlled salmonid habitat functions. Streamflow alteration for hydropower increased redd dewatering risk and altered aquatic habitat availability and riparian recruitment dynamics. Study results highlight critical tradeoffs in ecosystem function performance and emphasize the significance of spatiotemporal diversity of flow and form at multiple scales for maintaining river ecosystem integrity. The approach is broadly applicable and extensible to other systems and ecosystem functions, where findings can be used to characterize complex controls on river ecosystems, assess impacts of proposed flow and form alterations, and inform river restoration strategies.

  5. Grand-design Spiral Arms in a Young Forming Circumstellar Disk

    Energy Technology Data Exchange (ETDEWEB)

    Tomida, Kengo; Lin, Chia Hui [Department of Earth and Space Science, Osaka University, Toyonaka, Osaka 560-0043 (Japan); Machida, Masahiro N. [Department of Earth and Planetary Sciences, Faculty of Sciences, Kyushu University, Nishi-ku, Fukuoka 819-0395 (Japan); Hosokawa, Takashi [Department of Physics, Kyoto University, Sakyo-ku, Kyoto 606-8502 (Japan); Sakurai, Yuya, E-mail: tomida@vega.ess.sci.osaka-u.ac.jp [Department of Physics, The University of Tokyo, Tokyo 113-0033 (Japan)

    2017-01-20

    We study formation and long-term evolution of a circumstellar disk in a collapsing molecular cloud core using a resistive magnetohydrodynamic simulation. While the formed circumstellar disk is initially small, it grows as accretion continues, and its radius becomes as large as 200 au toward the end of the Class-I phase. A pair of grand-design spiral arms form due to gravitational instability in the disk, and they transfer angular momentum in the highly resistive disk. Although the spiral arms disappear in a few rotations as expected in a classical theory, new spiral arms form recurrently as the disk, soon becoming unstable again by gas accretion. Such recurrent spiral arms persist throughout the Class-0 and I phases. We then perform synthetic observations and compare our model with a recent high-resolution observation of a young stellar object Elias 2–27, whose circumstellar disk has grand-design spiral arms. We find good agreement between our theoretical model and the observation. Our model suggests that the grand-design spiral arms around Elias 2–27 are consistent with material arms formed by gravitational instability. If such spiral arms commonly exist in young circumstellar disks, it implies that young circumstellar disks are considerably massive and gravitational instability is the key process of angular momentum transport.

  6. Grand-design Spiral Arms in a Young Forming Circumstellar Disk

    International Nuclear Information System (INIS)

    Tomida, Kengo; Lin, Chia Hui; Machida, Masahiro N.; Hosokawa, Takashi; Sakurai, Yuya

    2017-01-01

    We study formation and long-term evolution of a circumstellar disk in a collapsing molecular cloud core using a resistive magnetohydrodynamic simulation. While the formed circumstellar disk is initially small, it grows as accretion continues, and its radius becomes as large as 200 au toward the end of the Class-I phase. A pair of grand-design spiral arms form due to gravitational instability in the disk, and they transfer angular momentum in the highly resistive disk. Although the spiral arms disappear in a few rotations as expected in a classical theory, new spiral arms form recurrently as the disk, soon becoming unstable again by gas accretion. Such recurrent spiral arms persist throughout the Class-0 and I phases. We then perform synthetic observations and compare our model with a recent high-resolution observation of a young stellar object Elias 2–27, whose circumstellar disk has grand-design spiral arms. We find good agreement between our theoretical model and the observation. Our model suggests that the grand-design spiral arms around Elias 2–27 are consistent with material arms formed by gravitational instability. If such spiral arms commonly exist in young circumstellar disks, it implies that young circumstellar disks are considerably massive and gravitational instability is the key process of angular momentum transport.

  7. Safety regulation for the design approval of special form radioactive sources

    International Nuclear Information System (INIS)

    Cho, Woon-Kap

    2009-01-01

    Several kinds of special form radioactive sources for industrial, medical applications are being produced in Korea. Special form radioactive sources should meet strict safety requirements specified in the domestic safety regulations and the design of the sources should be certified by the regulatory authority, the Ministry of Education, Science and Technology (MEST). Several safety tests such as impact, percussion, heating, and leak tests are performed on the sources according to the domestic regulations and the international safety standards such as ANSI N542-1977 and ISO 2919-1999(E). As a regulatory expert body, Korea Institute of Nuclear Safety (KINS) assesses various types of application documents, such as safety analysis report, quality assurance program, and other documents evidencing fulfillment of requirements for design approval of the special form radioactive sources, submitted by a legal person who intends to produce special form radioactive sources and then reports the assessment result to MEST. A design approval certificate is issued to the applicant by MEST on the basis of a technical evaluation report presented by KINS.

  8. Using event related potentials to identify a user's behavioural intention aroused by product form design.

    Science.gov (United States)

    Ding, Yi; Guo, Fu; Zhang, Xuefeng; Qu, Qingxing; Liu, Weilin

    2016-07-01

    The capacity of product form to arouse user's behavioural intention plays a decisive role in further user experience, even in purchase decision, while traditional methods rarely give a fully understanding of user experience evoked by product form, especially the feeling of anticipated use of product. Behavioural intention aroused by product form designs has not yet been investigated electrophysiologically. Hence event related potentials (ERPs) were applied to explore the process of behavioural intention when users browsed different smart phone form designs with brand and price not taken into account for mainly studying the brain activity evoked by variety of product forms. Smart phone pictures with different anticipated user experience were displayed with equiprobability randomly. Participants were asked to click the left mouse button when certain picture gave them a feeling of behavioural intention to interact with. The brain signal of each participant was recorded by Curry 7.0. The results show that pictures with an ability to arouse participants' behavioural intention for further experience can evoke enhanced N300 and LPPs (late positive potentials) in central-parietal, parietal and occipital regions. The scalp topography shows that central-parietal, parietal and occipital regions are more activated. The results indicate that the discrepancy of ERPs can reflect the neural activities of behavioural intention formed or not. Moreover, amplitude of ERPs occurred in corresponding brain areas can be used to measure user experience. The exploring of neural correlated with behavioural intention provide an accurate measurement method of user's perception and help marketers to know which product can arouse users' behavioural intention, maybe taken as an evaluating indicator of product design. Copyright © 2016 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  9. Analytic free-form lens design for imaging applications with high aspect ratio

    Science.gov (United States)

    Duerr, Fabian; Benítez, Pablo; Miñano, Juan Carlos; Meuret, Youri; Thienpont, Hugo

    2012-10-01

    A new three-dimensional analytic optics design method is presented that enables the coupling of three ray sets with only two free-form lens surfaces. Closely related to the Simultaneous Multiple Surface method in three dimensions (SMS3D), it is derived directly from Fermat's principle, leading to multiple sets of functional differential equations. The general solution of these equations makes it possible to calculate more than 80 coefficients for each implicit surface function. Ray tracing simulations of these free-form lenses demonstrate superior imaging performance for applications with high aspect ratio, compared to conventional rotational symmetric systems.

  10. The Open Form Inducer Approach for Structure-Based Drug Design.

    Directory of Open Access Journals (Sweden)

    Daniel Ken Inaoka

    Full Text Available Many open form (OF structures of drug targets were obtained a posteriori by analysis of co-crystals with inhibitors. Therefore, obtaining the OF structure of a drug target a priori will accelerate development of potent inhibitors. In addition to its small active site, Trypanosoma cruzi dihydroorotate dehydrogenase (TcDHODH is fully functional in its monomeric form, making drug design approaches targeting the active site and protein-protein interactions unrealistic. Therefore, a novel a priori approach was developed to determination the TcDHODH active site in OF. This approach consists of generating an "OF inducer" (predicted in silico to bind the target and cause steric repulsion with flexible regions proximal to the active site that force it open. We provide the first proof-of-concept of this approach by predicting and crystallizing TcDHODH in complex with an OF inducer, thereby obtaining the OF a priori with its subsequent use in designing potent and selective inhibitors. Fourteen co-crystal structures of TcDHODH with the designed inhibitors are presented herein. This approach has potential to encourage drug design against diseases where the molecular targets are such difficult proteins possessing small AS volume. This approach can be extended to study open/close conformation of proteins in general, the identification of allosteric pockets and inhibitors for other drug targets where conventional drug design approaches are not applicable, as well as the effective exploitation of the increasing number of protein structures deposited in Protein Data Bank.

  11. Teaching Form as Form

    DEFF Research Database (Denmark)

    Keiding, Tina Bering

    2012-01-01

    understanding of form per se, or, to use an expression from this text, of form as form. This challenge can be reduced to one question: how can design teaching support students in achieving not only the ability to recognize and describe different form-related concepts in existing design (i.e. analytical...

  12. Writing participatory design: a workshop on interpreting, accounting and novel forms of reporting

    DEFF Research Database (Denmark)

    Light, Ann; Malmborg, Lone; Messeter, Jörn

    2016-01-01

    This workshop asks participatory designers and researchers to consider how they write about their work and what role there is for novel approaches to expression, forms drawn from other disciplines, and open and playful texts. As we bring social science and humanities sensibilities to bear...... reflections on designing? How far are we making our practice even as we write? Is the page a contemplative or collaborative space? Does the tyranny of the conference paper overwrite everything? Join us for this day of reading, writing and discussion about how we tell the stories that matter most to us....

  13. Writing Participatory Design – A Workshop on Interpreting, Accounting and Novel Forms of Reporting

    DEFF Research Database (Denmark)

    Light, Ann; Malmborg, Lone; Messeter, Jörn

    2016-01-01

    This workshop asks participatory designers and researchers to consider how they write about their work and what role there is for novel approaches to expression, forms drawn from other disciplines, and open and playful texts. As we bring social science and humanities sensibilities to bear...... reflections on designing? How far are we making our practice even as we write? Is the page a contemplative or collaborative space? Does the tyranny of the conference paper overwrite everything? Join us for this day of reading, writing and discussion about how we tell the stories that matter most to us....

  14. Design of the Nonlinear Pin Rubber Forming Equipment Integrating the Functions of Extruding, Dewatering, Drying & Expanding

    Directory of Open Access Journals (Sweden)

    Yuefeng Yuan

    2014-12-01

    Full Text Available The top priority of car-tire suppliers is to improve wetland grip force of the using tires, reduce the rolling resistance and the rolling noise of tires. It is urgent for the tire industry to research and develop high-performance tires to solve the above problems. They must use the high- performance synthetic rubber and auxiliary rubber to develop the most advanced manufacturing technologies and equipment. Silica, a kind of important tire auxiliary rubber, can significantly reduce the rolling resistance of tires, improve the grip force and properties resistant to ice, wetness or slippery of tires. In this paper, based on the conventional tire rubber forming technologies of extrusion, dewatering, drying and expanding, a study is made on the conical screw, the dewatering barrel, the drying barrel, the pin layout scheme, the expanding die head, cutter and the control system. The nonlinear pin rubber forming equipment integrating the functions of extrusion, dewatering, drying and expanding is designed and applied to tire auxiliary rubber forming. The experiment shows that the forming device can realize the one-step forming, with high forming efficiency, low cost and less labor.

  15. Particle Engineering Via Mechanical Dry Coating in the Design of Pharmaceutical Solid Dosage Forms.

    Science.gov (United States)

    Qu, Li; Morton, David A V; Zhou, Qi Tony

    2015-01-01

    Cohesive powders are problematic in the manufacturing of pharmaceutical solid dosage forms because they exhibit poor flowability, fluidization and aerosolization. These undesirable bulk properties of cohesive powders represent a fundamental challenge in the design of efficient pharmaceutical manufacturing processes. Recently, mechanical dry coating has attracted increasing attention as it can improve the bulk properties of cohesive powders in a cheaper, simpler, safer and more environment-friendly way than the existing solvent-based counterparts. In this review, mechanical dry coating techniques are outlined and their potential applications in formulation and manufacturing of pharmaceutical solid dosage forms are discussed. Reported data from the literature have shown that mechanical dry coating holds promise for the design of superior pharmaceutical solid formulations or manufacturing processes by engineering the interfaces of cohesive powders in an efficient and economical way.

  16. An efficient genetic algorithm for the design optimization of cold-formed steel portal frame buildings

    OpenAIRE

    Phan, Thanh Duoc; Lim, James; Tanyimboh, Tiku T.; Sha, Wei

    2013-01-01

    The design optimization of a cold-formed steel portal frame building is considered in this paper. The proposed genetic algorithm (GA) optimizer considers both topology (i.e., frame spacing and pitch) and cross-sectional sizes of the main structural members as the decision variables. Previous GAs in the literature were characterized by poor convergence, including slow progress, that usually results in excessive computation times and/or frequent failure to achieve an optimal or near-optimal sol...

  17. The Swedish Utilities joint approach to form common basis for design requirements for the future

    International Nuclear Information System (INIS)

    Hansson, B.

    1998-01-01

    The Owners of the Swedish Nuclear Power Plants have decided to form a document that should state the design principals and requirement for cost-effective and continuous development of the reactor safety in the future. The development of this document will be a part of the modernization and development of the Swedish Nuclear Power Plants. The basis for this document is an evaluation of Swedish and International standards and regulations as IAEA/INSAG, US-regulations, EUR etc. (author)

  18. Design of a cam-form tool in precision reuse of a digital paper display

    International Nuclear Information System (INIS)

    Pa, Pai-Shan

    2010-01-01

    A reuse fabrication module that uses micro electroremoving as a precision machining process with a new design of the cam-form tool to remove defective indium-tin-oxide (ITO) thin film from the optical PET surfaces of a digital paper display is presented. A small diameter of the cathode of the cam-form tool corresponds to a higher removal rate for the ITO nanostructure. A small edge radius of the anode and a small gap width between the cathode and the ITO surface takes less time for the same amount of ITO removal. A higher feed rate of the optical PET diaphragm combines with enough electric power to drive fast micro-electroremoving. The high rotational speed of the cam-form tool can improve the effect of dreg discharge and is advantageous to associate with the fast feed rate of the optical PET diaphragm.

  19. Parkinson’s Disease and Home Healthcare Use and Expenditures among Elderly Medicare Beneficiaries

    Directory of Open Access Journals (Sweden)

    Sandipan Bhattacharjee

    2015-01-01

    Full Text Available This study estimated excess home healthcare use and expenditures among elderly Medicare beneficiaries (age ≥ 65 years with Parkinson’s disease (PD compared to those without PD and analyzed the extent to which predisposing, enabling, need factors, personal health choice, and external environment contribute to the excess home healthcare use and expenditures among individuals with PD. A retrospective, observational, cohort study design using Medicare 5% sample claims for years 2006-2007 was used for this study. Logistic regressions and Ordinary Least Squares regressions were used to assess the association of PD with home health use and expenditures, respectively. Postregression nonlinear and linear decomposition techniques were used to understand the extent to which differences in home healthcare use and expenditures among elderly Medicare beneficiaries with and without PD can be explained by individual-level factors. Elderly Medicare beneficiaries with PD had higher home health use and expenditures compared to those without PD. 27.5% and 18% of the gap in home health use and expenditures, respectively, were explained by differences in characteristics between the PD and no PD groups. A large portion of the differences in home healthcare use and expenditures remained unexplained.

  20. Constitutive modeling for analysis and design of aluminum sheet forming processes

    International Nuclear Information System (INIS)

    Barlat, F.; Chung, K.; Yoon, J-W.; Choi, S-H.

    2000-01-01

    Finite element modeling (FEM) technology is one of the most powerful tools used to design new products, i.e. appliances, automotive, rigid packaging and aerospace parts, etc., and processes. However, FEM users need data and models to characterize the materials used to fabricate the new products. In fact, they need more information than the traditional and standard yield strength, ultimate strength, elongation, etc. Constitutive models and their associated coefficients represent a new way to describe material properties, a way that can be used by FEM users. In order to help manufacturers use more aluminum alloy sheet in their products, appropriate material models are needed to analyze and design specifically for these materials. This work describes a methodology that provides phenomenological constitutive equations based on three main microstructure components of aluminum alloys: dislocation density, second-phase particles and crystallographic texture. Examples of constitutive equations and their applications to numerical sheet forming process analysis and design are provided in this work. (author)

  1. The Topographic Design of River Channels for Form-Process Linkages.

    Science.gov (United States)

    Brown, Rocko A; Pasternack, Gregory B; Lin, Tin

    2016-04-01

    Scientists and engineers design river topography for a wide variety of uses, such as experimentation, site remediation, dam mitigation, flood management, and river restoration. A recent advancement has been the notion of topographical design to yield specific fluvial mechanisms in conjunction with natural or environmental flow releases. For example, the flow convergence routing mechanism, whereby shear stress and spatially convergent flow migrate or jump from the topographic high (riffle) to the low point (pool) from low to high discharge, is thought to be a key process able to maintain undular relief in gravel bedded rivers. This paper develops an approach to creating riffle-pool topography with a form-process linkage to the flow convergence routing mechanism using an adjustable, quasi equilibrium synthetic channel model. The link from form to process is made through conceptualizing form-process relationships for riffle-pool couplets into geomorphic covariance structures (GCSs) that are then quantitatively embedded in a synthetic channel model. Herein, GCSs were used to parameterize a geometric model to create five straight, synthetic river channels with varying combinations of bed and width undulations. Shear stress and flow direction predictions from 2D hydrodynamic modeling were used to determine if scenarios recreated aspects of the flow convergence routing mechanism. Results show that the creation of riffle-pool couplets that experience flow convergence in straight channels requires GCSs with covarying bed and width undulations in their topography as supported in the literature. This shows that GCSs are a useful way to translate conceptualizations of form-process linkages into quantitative models of channel form.

  2. Flu shots and the characteristics of unvaccinated elderly Medicare beneficiaries.

    Science.gov (United States)

    Lochner, Kimberly A; Wynne, Marc

    2011-12-21

    Data from the Medicare Current Beneficiary Survey, 2009. • Overall, 73% of Medicare beneficiaries aged 65 years and older reported receiving a flu shot for the 2008 flu season, but vaccination rates varied by socio-demographic characteristics. Flu vaccination was lowest for beneficiaries aged 65-74 years old, who were non-Hispanic Blacks and Hispanics, were not married, had less than a high school education, or who were eligible for Medicaid (i.e., dual eligibles). • Healthcare utilization and personal health behavior were also related to vaccination rates, with current smokers and those with no hospitalizations or physician visits being less likely to be vaccinated. • Among those beneficiaries who reported receiving a flu shot, 59% received it in a physician's office or clinic, with the next most common setting being in the community (21%); e.g., grocery store, shopping mall, library, or church. • Among those beneficiaries who did not receive a flu shot, the most common reasons were beliefs that the shot could cause side effects or disease (20%), that they didn't think the shot could prevent the flu (17%), or that the shot wasn't needed (16%). Less than 1% reported that they didn't get the flu shot because of cost. Elderly persons (aged 65 years and older) are at increased risk of complications from influenza, with the majority of influenza-related hospitalizations and deaths occurring among the elderly (Fiore et al., 2010). Most physicians recommend their elderly patients get a flu shot each year, and many hospitals inquire about elderly patient's immunization status upon admission, providing a vaccination if requested. The importance of getting a flu shot is underscored by the Department of Health and Human Services' Healthy People initiative, which has set a vaccination goal of 90% for the Nation's elderly by the year 2020 (Department of Health and Human Services [DHHS], 2011). Although all costs related to flu shots are covered by Medicare, requiring

  3. Direct Closed-Form Design of Finite Alphabet Constant Envelope Waveforms for Planar Array Beampatterns

    KAUST Repository

    Bouchoucha, Taha

    2015-05-01

    Multiple Input Multiple Output (MIMO) radar systems has attracted lately a lot of attention thanks to its advantage over the classical phased array radar systems. We site among these advantages the improvement of parametric identifiability, achievement of higher spatial resolution and design of complex beampatterns. In colocated multiple-input multiple-output radar systems, it is usually desirable to steer transmitted power in the region-of-interest in order to increase the Signal to Noise Ratio (SNR) and reduce any undesired signal and thus improve the detection process. This problem is also known as transmit beampattern design. To achieve this goal, conventional methods optimize the waveform covariance matrix, R, for the desired beampattern, which is then used to generate the actual transmitted waveforms. Both steps require constrained optimization. Most of the existing methods use iterative algorithms to solve these problems, therefore their computational complexity is very high which makes them hard to use in practice especially for real time radar applications. In this paper, we provide a closed-form solution to design the covariance matrix for a given beampattern in the three dimensional space using planar arrays, which is then used to derive a novel closed-form algorithm to directly design the finite-alphabet constant-envelope waveforms. The proposed algorithm exploits the two-dimensional discrete Fourier transform which is implemented using fast Fourier transform algorithm. Consequently, the computational complexity of the proposed beampattern solution is very low allowing it to be used for large arrays to change the beampattern in real time. We also show that the number of required snapshots in each waveform depends on the beampattern and that it is less than the total number of transmit antennas. In addition, we show that the proposed waveform design method can be used with non symmetric beampatterns. The performance of our proposed algorithm compares

  4. Methodology Series Module 9: Designing Questionnaires and Clinical Record Forms - Part II.

    Science.gov (United States)

    Setia, Maninder Singh

    2017-01-01

    This article is a continuation of the previous module on designing questionnaires and clinical record form in which we have discussed some basic points about designing the questionnaire and clinical record forms. In this section, we will discuss the reliability and validity of questionnaires. The different types of validity are face validity, content validity, criterion validity, and construct validity. The different types of reliability are test-retest reliability, inter-rater reliability, and intra-rater reliability. Some of these parameters are assessed by subject area experts. However, statistical tests should be used for evaluation of other parameters. Once the questionnaire has been designed, the researcher should pilot test the questionnaire. The items in the questionnaire should be changed based on the feedback from the pilot study participants and the researcher's experience. After the basic structure of the questionnaire has been finalized, the researcher should assess the validity and reliability of the questionnaire or the scale. If an existing standard questionnaire is translated in the local language, the researcher should assess the reliability and validity of the translated questionnaire, and these values should be presented in the manuscript. The decision to use a self- or interviewer-administered, paper- or computer-based questionnaire depends on the nature of the questions, literacy levels of the target population, and resources.

  5. Methodology Series Module 9: Designing Questionnaires and Clinical Record Forms – Part II

    Science.gov (United States)

    Setia, Maninder Singh

    2017-01-01

    This article is a continuation of the previous module on designing questionnaires and clinical record form in which we have discussed some basic points about designing the questionnaire and clinical record forms. In this section, we will discuss the reliability and validity of questionnaires. The different types of validity are face validity, content validity, criterion validity, and construct validity. The different types of reliability are test-retest reliability, inter-rater reliability, and intra-rater reliability. Some of these parameters are assessed by subject area experts. However, statistical tests should be used for evaluation of other parameters. Once the questionnaire has been designed, the researcher should pilot test the questionnaire. The items in the questionnaire should be changed based on the feedback from the pilot study participants and the researcher's experience. After the basic structure of the questionnaire has been finalized, the researcher should assess the validity and reliability of the questionnaire or the scale. If an existing standard questionnaire is translated in the local language, the researcher should assess the reliability and validity of the translated questionnaire, and these values should be presented in the manuscript. The decision to use a self- or interviewer-administered, paper- or computer-based questionnaire depends on the nature of the questions, literacy levels of the target population, and resources. PMID:28584367

  6. A simple design rule for 1st order form-closure of underactuated hands

    Directory of Open Access Journals (Sweden)

    S. Krut

    2011-02-01

    Full Text Available The property of form-closure of a grasp, as generally defined in the literature, is based on the assumption that contact points between the hand and the object are fixed in space. However, this assumption is false when considering a grasp exerted by an underactuated hand, since in this case, it is not possible to control the position of each phalanx independently. In spite of researchers' interest in studying form-closure, none of the available published work on this subject takes into consideration the particular kinematics of underactuated hands. Actually, there are few available tools to qualify or quantify the stability of a grasp exerted by an underactuated hand, thus the design of underactuated hands mostly results from an intuitive approach. This paper aims to reduce this gap.

    A classification of underactuated hands is proposed, based on the expression of contact forces. This highlights the influence of non-backdrivable mechanisms introduced in the transmission of the closing motion of the hand on the stability of the grasp. The way to extend the original definition of form-closure to underactuated grasps is illustrated. A more general definition is formulated, which checks the stability of the set "object + hand". Using this new definition, a simple rule is proposed for designing a hand capable of achieving 1st order form-closed grasps.

    This paper was presented at the IFToMM/ASME International Workshop on Underactuated Grasping (UG2010, 19 August 2010, Montréal, Canada.

  7. Analysis of Satisfaction Degree of the Public Insurance System Beneficiaries

    Directory of Open Access Journals (Sweden)

    Manuela PANAITESCU

    2013-08-01

    Full Text Available The public insurance system provides financial benefits to individuals that are obtained by collecting the due contributions. The analysis of satisfaction degree of the beneficiaries of the system was carried out to determine the challenges the system is facing and for determining the needs of the beneficiaries. In order to reduce the financial constraints the public insurance system is facing, it is necessary to create an appropriate insurance system that meets the needs of the beneficiaries. The research took into account that the public insurance system determines the quality of life of the population and has a strong influence on the economy, particularly on the labour market and the capital market.

  8. Closed-form solution to directly design frequency modulated waveforms for beampatterns

    KAUST Repository

    Ahmed, Sajid

    2018-03-12

    The targets image performance depends on the transmit beampattern and power-spectral-density of the probing signal. To design such probing signals for multiple-input multiple output (MIMO) radar, conventional algorithms are iterative in nature, therefore high computational complexity restricts their use in real time applications. In this paper, to achieve the desired beampattern, a novel closed-form algorithm to design frequency-modulated (FM) waveforms for MIMO radar is proposed. The proposed algorithm has negligible computational complexity and yields unity peak-to-average power ratio constant envelope waveforms. Moreover, in contrast to the narrow band algorithms, it has almost flat main and side lobes. In the proposed algorithm, a relationship between the width of symmetric beampattern and the product of initial frequency and duration of the baseband FM waveforms is developed.

  9. 7 CFR 1710.104 - Service to non-RE Act beneficiaries.

    Science.gov (United States)

    2010-01-01

    ... GUARANTEES Loan Purposes and Basic Policies § 1710.104 Service to non-RE Act beneficiaries. (a) To the... made to finance electric facilities to serve consumers that are not RE Act beneficiaries. (b) Loan...

  10. Is the Linear Modeling Technique Good Enough for Optimal Form Design? A Comparison of Quantitative Analysis Models

    Science.gov (United States)

    Lin, Yang-Cheng; Yeh, Chung-Hsing; Wang, Chen-Cheng; Wei, Chun-Chun

    2012-01-01

    How to design highly reputable and hot-selling products is an essential issue in product design. Whether consumers choose a product depends largely on their perception of the product image. A consumer-oriented design approach presented in this paper helps product designers incorporate consumers' perceptions of product forms in the design process. The consumer-oriented design approach uses quantification theory type I, grey prediction (the linear modeling technique), and neural networks (the nonlinear modeling technique) to determine the optimal form combination of product design for matching a given product image. An experimental study based on the concept of Kansei Engineering is conducted to collect numerical data for examining the relationship between consumers' perception of product image and product form elements of personal digital assistants (PDAs). The result of performance comparison shows that the QTTI model is good enough to help product designers determine the optimal form combination of product design. Although the PDA form design is used as a case study, the approach is applicable to other consumer products with various design elements and product images. The approach provides an effective mechanism for facilitating the consumer-oriented product design process. PMID:23258961

  11. Process description and plant design for preparing ceramic high-level waste forms

    International Nuclear Information System (INIS)

    Grantham, L.F.; McKisson, R.L.; Guon, J.; Flintoff, J.F.; McKenzie, D.E.

    1983-01-01

    The ceramics process flow diagram has been simplified and upgraded to utilize only two major processing steps - fluid-bed calcination and hot isostatic press consolidating. Full-scale fluid-bed calcination has been used at INEL to calcine high-level waste for 18 y; and a second-generation calciner, a fully remotely operated and maintained calciner that meets ALARA guidelines, started calcining high-level waste in 1982. Full-scale hot isostatic consolidation has been used by DOE and commercial enterprises to consolidate radioactive components and to encapsulate spent fuel elements for several years. With further development aimed at process integration and parametric optimization, the operating knowledge of full-scale demonstration of the key process steps should be rapidly adaptable to scale-up of the ceramic process to full plant size. Process flowsheets used to prepare ceramic and glass waste forms from defense and commercial high-level liquid waste are described. Preliminary layouts of process flow diagrams in a high-level processing canyon were prepared and used to estimate the preliminary cost of the plant to fabricate both waste forms. The estimated costs for using both options were compared for total waste management costs of SRP high-level liquid waste. Using our design, for both the ceramic and glass plant, capital and operating costs are essentially the same for both defense and commercial wastes, but total waste management costs are calculated to be significantly less for defense wastes using the ceramic option. It is concluded from this and other studies that the ceramic form may offer important advantages over glass in leach resistance, waste loading, density, and process flexibility. Preliminary economic calculations indicate that ceramics must be considered a leading candidate for the form to immobilize high-level wastes

  12. Spectrophotometric Quantification of Vilazodone Hydrochloride in Pharmaceutical Dosage Form Using Quality by Design Approach

    International Nuclear Information System (INIS)

    Panda, S.S.; Kumar, B.V.V.R.K.; Beg, S.; Behera, S.

    2015-01-01

    The present work deals with development and validation of a novel, robust, precise and accurate spectrophotometric method, for the estimation of vilazodone hydrochloride in tablets using the principle of Quality by Design (QbD). A fractional factorial design (FFD) was employed for initial parameter screening. Further the screened parameters were subjected to central composite design (CCD) for evaluating method robustness and method optimization. Different statistical parameters were evaluated to decide appropriateness of experimental data. Vilazodone shows absorption maximum at 285 nm using methanol. Factor screening slit width and sampling interval were identified as critical method variables, which were further evaluated by a CCD. Good linearity was obtained for vilazodone in the range of 5-60 μg/ mL with R"2 > 0.999. The method was found to be accurate with good average % recovery (more than 100 %). Developed method was validated as per ICH guidelines. Based on QbD development of spectrophotometric method ensured that quality is built into the method. The method was robust and can be applied for determination of the vilazodone in pharmaceutical dosage form. (author)

  13. 32 CFR 728.59 - Peace Corps beneficiaries.

    Science.gov (United States)

    2010-07-01

    ... beneficiaries seeking dental care will be requested, whenever possible, to furnish advanced authorization. (5... National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE... sponsor. (4) Dental care. Limit dental care to emergencies. Render only that care essential to relieve...

  14. 29 CFR 4.133 - Beneficiary of contract services.

    Science.gov (United States)

    2010-07-01

    ... service and laundry and dry cleaning service for personnel at military installations. Furthermore, there... 29 Labor 1 2010-07-01 2010-07-01 true Beneficiary of contract services. 4.133 Section 4.133 Labor Office of the Secretary of Labor LABOR STANDARDS FOR FEDERAL SERVICE CONTRACTS Application of the...

  15. Wellbeing of Beneficiaries of the University Based Agricultural ...

    African Journals Online (AJOL)

    E M IGBOKWE

    The possibility of doing this won't be without the efforts of ... Nigeria in different higher institutions of learning have been adopted in different ... of UBAES and ADP are to engage in programmes that will see to the ... 6 months span) and weighted mean was used to rate beneficiaries access to these ... cars, farm size etc.

  16. Micronutrient deficiencies in food aid beneficiaries: A review of ...

    African Journals Online (AJOL)

    African Journal of Food, Agriculture, Nutrition and Development ... in food aid beneficiary populations and to guide the formulation of food aid products, this ... In some cases, food aid rations provide insufficient quantity and quality of ... studies found documenting the nutritional status of non-emergency food aid recipients.

  17. Differences between paid and unpaid social services for beneficiaries

    NARCIS (Netherlands)

    Metz, Judith; Roza, Lonneke; Meijs, Lucas; van Baren, Eva; Hoogervorst, Niek

    2017-01-01

    In many Western welfare states, social work services that have traditionally been provided by paid employees are being replaced by family support, community support, informal networks and volunteering. For the field of social work, it is relevant to know what it matters to beneficiaries whether

  18. 42 CFR 478.40 - Beneficiary's right to a hearing.

    Science.gov (United States)

    2010-10-01

    ... (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS RECONSIDERATIONS AND APPEALS Utilization and Quality Control Quality Improvement Organization (QIO) Reconsiderations and Appeals § 478.40 Beneficiary's right to a... under the Hospital Insurance Program, of part 405 of this chapter apply to hearings and appeals under...

  19. 42 CFR 412.507 - Limitation on charges to beneficiaries.

    Science.gov (United States)

    2010-10-01

    ... prospective payment system. If Medicare has paid the full LTC-DRG payment, that payment applies to the... SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Long-Term Care Hospitals § 412.507 Limitation on charges to beneficiaries. (a) Prohibited...

  20. Body Pain Reporting in Tricare Eligible Beneficiaries with Orofacial Pain

    Science.gov (United States)

    2015-06-01

    provider performed a standard orofacial pain clinical examination. This included at a minimum a cranial nerve exam, shoulder and cervical range of...Attachment 2 Date The author hereby certifies that the use of any copyrighted material in the thesis manuscript entitled: Body pain reporting in...Tricare eligible beneficiaries with orofacial pain

  1. Patient Satisfaction and Prognosis for Functional Improvement and Deterioration, Institutionalization, and Death Among Medicare Beneficiaries Over 2 Years.

    Science.gov (United States)

    Bogner, Hillary R; de Vries McClintock, Heather F; Kurichi, Jibby E; Kwong, Pui L; Xie, Dawei; Hennessy, Sean; Streim, Joel E; Stineman, Margaret G

    2017-01-01

    To examine how patient satisfaction with care coordination and quality and access to medical care influence functional improvement or deterioration (activity limitation stage transitions), institutionalization, or death among older adults. National representative sample with 2-year follow-up. Medicare Current Beneficiary Survey from calendar years 2001 to 2008. Community-dwelling adults (N=23,470) aged ≥65 years followed for 2 years. Not applicable. A multinomial logistic regression model taking into account the complex survey design was used to examine the association between patient satisfaction with care coordination and quality and patient satisfaction with access to medical care and activities of daily living (ADL) stage transitions, institutionalization, or death after 2 years, adjusting for baseline socioeconomics and health-related characteristics. Out of 23,470 Medicare beneficiaries, 14,979 (63.8% weighted) remained stable in ADL stage, 2508 (10.7% weighted) improved, 3210 (13.3% weighted) deteriorated, 582 (2.5% weighted) were institutionalized, and 2281 (9.7% weighted) died. Beneficiaries who were in the top quartile of satisfaction with care coordination and quality were less likely to be institutionalized (adjusted relative risk ratio [RRR], .68; 95% confidence interval [CI], .54-.86). Beneficiaries who were in the top quartile of satisfaction with access to medical care were less likely to functionally deteriorate (adjusted RRR, .87; 95% CI, .79-.97), be institutionalized (adjusted RRR, .72; 95% CI, .56-.92), or die (adjusted RRR, .86; 95% CI, .75-.98). Knowledge of patient satisfaction with medical care and risk of functional deterioration may be helpful for monitoring and addressing disability-related health care disparities and the effect of ongoing policy changes among Medicare beneficiaries. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  2. Minerals and design of new waste forms for conditioning nuclear waste

    Science.gov (United States)

    Montel, Jean-Marc

    2011-02-01

    Safe storage of radioactive waste is a major challenge for the nuclear industry. Mineralogy is a good basis for designing ceramics, which could eventually replace nuclear glasses. This requires a new storage concept: separation-conditioning. Basic rules of crystal chemistry allow one to select the most suitable structures and natural occurrences allow assessing the long-term performance of ceramics in a geological environment. Three criteria are of special interest: compatibility with geological environment, resistance to natural fluids, and effects of self-irradiation. If mineralogical information is efficient for predicting the behaviour of common, well-known minerals, such as zircon, monazite or apatite, more research is needed to rationalize the long-term behaviour of uncommon waste form analogs.

  3. Design and performance assessment of radioactive waste forms: what can we learn from natural analogues

    International Nuclear Information System (INIS)

    Petit, J.C.

    1991-01-01

    In this review, we specify the role of natural analogues for the development of solid radioactive waste-forms. Numerous works have been carried out on the major matrices proposed or actually in use for both high-level (glasses, spent fuel, ceramics) and low- or intermediate-level wastes (cement-based materials, bitumens, resins) as well as for metallic containers. We show that some natural, historical or archaeological materials can be considered as good analogues. We suggest that their use has been quite limited in the past for the design of matrices but that both qualitative and quantitative information of great interest (and in some cases unique) have been already inferred for assessing their long-term performance. 14 figs., 1 tab., 72 refs

  4. [Study on dosage form design for improving oral bioavailability of traditional Chinese medicines].

    Science.gov (United States)

    Xia, Hai-Jian; Zhang, Zhen-Hai; Yao, Dong-Dong; Jia, Xiao-Bin

    2013-09-01

    Both chemical drugs and traditional Chinese medicines have the problem of low bioavailability. However, as traditional Chinese medicines are a multi-component complex, their dosage forms are required to be designed in line with their characteristics, in order to improve the bioavailability of traditional Chinese medicines. Traditional Chinese medicines are mostly prepared into pill, powder, paste, elixir and decoction, but with such drawbacks as high administration dose and poor efficacy. With the process of modernization of traditional Chinese medicines, new-type preparations have be developed and made outstanding achievements. However, they fail to make an organic integration between traditional Chinese medicine theories and modern preparation theories. Characteristics of traditional Chinese medicines are required to be taken into account during the development of traditional Chinese medicines. In the article, multi-component preparation technology was adopted to establish a multi-component drug release system of traditional Chinese medicines on the basis of multiple components of traditional Chinese medicines.

  5. The design and fabrication of supramolecular semiconductor nanowires formed by benzothienobenzothiophene (BTBT)-conjugated peptides.

    Science.gov (United States)

    Khalily, Mohammad Aref; Usta, Hakan; Ozdemir, Mehmet; Bakan, Gokhan; Dikecoglu, F Begum; Edwards-Gayle, Charlotte; Hutchinson, Jessica A; Hamley, Ian W; Dana, Aykutlu; Guler, Mustafa O

    2018-05-18

    π-Conjugated small molecules based on a [1]benzothieno[3,2-b]benzothiophene (BTBT) unit are of great research interest in the development of solution-processable semiconducting materials owing to their excellent charge-transport characteristics. However, the BTBT π-core has yet to be demonstrated in the form of electro-active one-dimensional (1D) nanowires that are self-assembled in aqueous media for potential use in bioelectronics and tissue engineering. Here we report the design, synthesis, and self-assembly of benzothienobenzothiophene (BTBT)-peptide conjugates, the BTBT-peptide (BTBT-C3-COHN-Ahx-VVAGKK-Am) and the C8-BTBT-peptide (C8-BTBT-C3-COHN-Ahx-VVAGKK-Am), as β-sheet forming amphiphilic molecules, which self-assemble into highly uniform nanofibers in water with diameters of 11-13(±1) nm and micron-size lengths. Spectroscopic characterization studies demonstrate the J-type π-π interactions among the BTBT molecules within the hydrophobic core of the self-assembled nanofibers yielding an electrical conductivity as high as 6.0 × 10-6 S cm-1. The BTBT π-core is demonstrated, for the first time, in the formation of self-assembled peptide 1D nanostructures in aqueous media for potential use in tissue engineering, bioelectronics and (opto)electronics. The conductivity achieved here is one of the highest reported to date in a non-doped state.

  6. Promoting pneumococcal immunizations among rural Medicare beneficiaries using multiple strategies.

    Science.gov (United States)

    Johnson, Elizabeth A; Harwell, Todd S; Donahue, Peg M; Weisner, M'liss A; McInerney, Michael J; Holzman, Greg S; Helgerson, Steven D

    2003-01-01

    Vaccine-preventable diseases among adults are major contributing causes of morbidity and mortality in the United States. However, adult immunizations continue to be underutilized in both urban and rural areas. To evaluate the effectiveness of a community-wide education campaign and mailed reminders promoting pneumococcal immunizations to rural Medicare beneficiaries. We implemented a community-wide education campaign, and mailed reminders were sent to Medicare beneficiaries in 1 media market in Montana to increase pneumococcal immunizations. In a second distinct media market, mailed reminders only were sent to beneficiaries. The proportion of respondents aged 65 years and older aware of pneumococcal immunizations increased significantly from baseline to follow-up among respondents both in the education-plus-reminder (63% to 78%, P = 0.04) and the reminder-only (64% to 74%, P = 0.05) markets. Overall from 1998 to 1999, there was a 3.7-percentage-point increase in pneumococcal immunization claims for Medicare beneficiaries in the education-plus-reminder market and a 1.5-percentage-point increase in the reminder-only market. Medicare beneficiaries sent reminders in the education-plus-reminder market compared to those in the reminder-only market were more likely to have a claim for pneumococcal immunization in 1999 (odds ratio 1.18, 95% confidence interval 1.08 to 1.28). The results suggest that these quality improvement strategies (community education plus reminders and reminders alone) modestly increased pneumococcal immunization awareness and pneumococcal immunization among rural adults. Mailed reminder exposure was associated with an increased prevalence of pneumococcal immunizations between 1998 and 1999 and was augmented somewhat by the education campaign.

  7. Design of a system to measure thermal diffusivity of metals in the form of miniature disks

    International Nuclear Information System (INIS)

    Zimmerschied, M.K.

    1986-03-01

    This report describes the design of a system to measure the thermal diffusivity of stainless steel alloy specimens in the form of 3-mm-diameter, 0.3-mm-thick disks. To measure these tiny specimens, the flash method devised by Parker et al. is employed; in this method, one surface of the specimen is exposed to a pulse of energy and the temperature response of the opposite surface is recorded. Derivations of the governing equations are included; these derivations differ from the work of Parker et al. bcause the heat pulse irradiating the specimen in this system is a square wave (in intensity vs time) rather than triangular, and the equation for estimating the maximum temperature of the irradiated surface of the specimen was simplified by the elimination of several variables. The design, selection, or modification of each of the components of the system to meet the criteria of the flash method is described. The capability of this system to perform in accordance with the assumptions of the flash method is discussed, and recommendations for improvement of the present system and extension of its capabilities are included

  8. Design of an oval-form cathode for the precision etching process of e-paper surface

    International Nuclear Information System (INIS)

    Pa, P.S.

    2009-01-01

    A newly designed oval-form cathode using electroetching for indium-tin-oxide (ITO) microstructure removal from the surface of e-paper polymer PET films is presented. Through ultra-precise microstructural etching, the semiconductor industry can effectively reclaim defective products, thereby reducing production costs. The design features for the ITO removal process and the tool design of oval-form cathodes are of significant interest. A smaller oval-form cathode minor axis, a higher cathode rotational speed, a higher concentration, or a higher electrolyte temperature corresponds to a higher ITO etching rate.

  9. Design of Cold-Formed Steel Screw Connections with Gypsum Sheathing at Ambient and Elevated Temperatures

    Directory of Open Access Journals (Sweden)

    Wei Chen

    2016-09-01

    Full Text Available Load-bearing cold-formed steel (CFS walls sheathed with double layers of gypsum plasterboard on both sides have demonstrated good fire resistance and attracted increasing interest for use in mid-rise CFS structures. As the main connection method, screw connections between CFS and gypsum sheathing play an important role in both the structural design and fire resistance of this wall system. However, studies on the mechanical behavior of screw connections with double-layer gypsum sheathing are still limited. In this study, 200 monotonic tests of screw connections with single- or double-layer gypsum sheathing at both ambient and elevated temperatures were conducted. The failure of screw connections with double-layer gypsum sheathing in shear was different from that of single-layer gypsum sheathing connections at ambient temperature, and it could be described as the breaking of the loaded sheathing edge combined with significant screw tilting and the loaded sheathing edge flexing fracture. However, the screw tilting and flexing fracture of the loaded sheathing edge gradually disappear at elevated temperatures. In addition, the influence of the loaded edge distance, double-layer sheathing and elevated temperatures is discussed in detail with clear conclusions. A unified design formula for the shear strength of screw connections with gypsum sheathing is proposed for ambient and elevated temperatures with adequate accuracy. A simplified load–displacement model with the post-peak branch is developed to evaluate the load–displacement response of screw connections with gypsum sheathing at ambient and elevated temperatures.

  10. National Law Restrictions on Family Reunification Rights of International Protection Beneficiaries from a ECHR/EU Perspective

    DEFF Research Database (Denmark)

    Storgaard, Louise Halleskov

    n light of the refugee crisis, European countries are exploring new ways to restrict access of migrants to their territory. One such restriction relates to family reunification rights of international protection beneficiaries. Proposals in this area have already been adopted or are currently being...... considered in countries such as Norway, Denmark, Sweden, Austria and Germany most commonly in the form of waiting periods before applications for family reunification can be submitted and/or age requirements. The personal scope of these proposals differs. In some countries the restrictions apply/are intended...... to apply to international beneficiaries in general while they in other countries are applicable/envisaged applicable only to persons with subsidiary protection status or persons fleeing from generalised violence. The intention of the paper is to examine whether this legislative trend is in conformity...

  11. Form Follows Feeling : The Acquisition of Design Expertise and the function of Aesthesis in the Design Process

    NARCIS (Netherlands)

    Curry, T.M.

    2017-01-01

    While the consideration of functional and technical criteria, as well as a sense of coherence are basic requirements for solving a design problem; it is the ability to induce an intended quality of aesthetic experience that is the hallmark of design expertise. Expert designers possess a highly

  12. Design and strength evaluation of structural joint made by electro-magnetic forming (EMF)

    International Nuclear Information System (INIS)

    Park, Young-Bae; Oh, Soo-Ik; Kim, Heon-Young

    2004-01-01

    Recently, weight reduction of vehicles has been of great interest, and consequently, the use of low-density materials in the automotive industry is increasing every year. Materials should not be substituted such a way that material of component parts is simply changed because there is a problem in achieving stiffness and strength. To achieve these requirements, the automobile should be redesigned totally. Aluminum spaceframe is rapidly being adopted as a body structure for accommodating lightness, stiffness and strength requirement. In aluminum spaceframe manufacturing, it is often required to join aluminum tube. But there are few suitable methods for joining aluminum tube, so that much interest has been focused on testing suitable joining methods. Joining by electromagnetic forming(EMF) can be useful method in joining aluminum tube, which offers some advantages compared with the conventional joining method. In this paper, joining by EMF was investigated as a pre-study for applying an automotive spaceframe. Finite element simulations and strength tests were performed to analyze the influence of geometric parameters on joint strength. Based on these results, configurations of axial joint and torque joint were suggested and guidelines for designing EMF joint were established

  13. Ideal flow theory for the double - shearing model as a basis for metal forming design

    Science.gov (United States)

    Alexandrov, S.; Trung, N. T.

    2018-02-01

    In the case of Tresca’ solids (i.e. solids obeying the Tresca yield criterion and its associated flow rule) ideal flows have been defined elsewhere as solenoidal smooth deformations in which an eigenvector field associated everywhere with the greatest principal stress (and strain rate) is fixed in the material. Under such conditions all material elements undergo paths of minimum plastic work, a condition which is often advantageous for metal forming processes. Therefore, the ideal flow theory is used as the basis of a procedure for the preliminary design of such processes. The present paper extends the theory of stationary planar ideal flow to pressure dependent materials obeying the double shearing model and the double slip and rotation model. It is shown that the original problem of plasticity reduces to a purely geometric problem. The corresponding system of equations is hyperbolic. The characteristic relations are integrated in elementary functions. In regions where one family of characteristics is straight, mapping between the principal lines and Cartesian coordinates is determined by linear ordinary differential equations. An illustrative example is provided.

  14. Pharmacokinetics of RK-28 (a new radiosensitizer) and pharmaceutical design of a suppository form using rats

    International Nuclear Information System (INIS)

    Kim, Nak-Seo; Umejima, Hiroyuki; Miyata, Kaori; Okubo, Mayumi; Goto, Shigeru; Kato, Tetsuo; Mikami, Yukio; Sagitani, Hiromichi; Inoue, Haruyuki.

    1994-01-01

    The pharmacokinetics of RK-28, a new hypoxic cell radiosensitizer, was studied in rats following its intravenous, intraportal, oral and rectal administration. The pharmaceutical design of an RK-28 suppository form was also examined. After intravenous injection, RK-28 was rapidly removed from the plasma (biological half-life of 17 min) and its area under the curve (AUC) was proportional to the amount of RK-28 administered. The absolute bioavailability of RK-28 was 59.7% for intraportal administration and 36.9% for oral administration. Following oral administration of RK-28, it seems likely that specific acid-catalyzed decomposition of RK-28 takes place in the stomach and then the absorbed RK-28 undergoes first-pass metabolism in the liver. When 'solidified RK-28 suppository,' made by solidifying molten RK-28, was inserted into the rectum, hepatic first-pass metabolism could be avoided substantially. The resulting absolute bioavailability of RK-28 increased to 75%. Furthermore, 'RK-28 emulsion suppository,' prepared by emulsifying RK-28 with 1-hexadecanol and hydrogenated castor oil (HCO 60) at 80degC, showed a plasma concentration-time curve very suitable for radiation therapy; the maximum plasma concentration was attained 30 min after rectal administration and then decreased within a short period. Administration of 'RK-28 emulsion suppository,' resulted in an absolute bioavailability of 76%. (author)

  15. Empirical versus Random Item Selection in the Design of Intelligence Test Short Forms--The WISC-R Example.

    Science.gov (United States)

    Goh, David S.

    1979-01-01

    The advantages of using psychometric thoery to design short forms of intelligence tests are demonstrated by comparing such usage to a systematic random procedure that has previously been used. The Wechsler Intelligence Scale for Children Revised (WISC-R) Short Form is presented as an example. (JKS)

  16. Transformer design principles with applications to core-form power transformers

    CERN Document Server

    Del Vecchio, Robert M; Feeney, Mary-Ellen F

    2001-01-01

    Transformer Design Principles presents the theory of transformer operation and the methods and techniques of designing them. It emphasizes the physical principles and mathematical tools for simulating transformer behavior, including modern computer techniques. The scope of the book includes types of construction, circuit analysis, mechanical aspects of design, high voltage insulation requirements, and cooling design. The authors also address test procedures and reliability methods to assure successful design and discuss the economic analysis of designs. Summarizing material currently scattered

  17. The phenomenon of factoring, benefits for beneficiary and national economy

    Directory of Open Access Journals (Sweden)

    Kasavica Petar

    2015-01-01

    Full Text Available The essay encompasses three thematic units focused on the phenomenon of factoring and its benefits for beneficiaries and national economies. In the first part the essay analyses background, concept and participants, types of factoring products, and how factoring functions from the perspective of involved risks. In the second part the essay analyses benefits of factoring for beneficiaries, especially their financial performances and how factoring decreases collection risk and costs of working capital financing. In the third part the essay analyses benefits of factoring for national economies tackling its capabilities to support declining companies and how factoring upgrades macroeconomic figures and features of financial sector. This part explains the way how national economies are organized through international factoring based on two factor systems. The goal of the essay is to pinpoint micro benefits and their impact on macro environment, i.e. national economy.

  18. Design of a Bahasa Melayu Grammar Online Learning Portal for Form Two Students Using Delphi Technique

    Science.gov (United States)

    Leng, Chin Hai; Siraj, Saedah; Asmawi, Adelina; Dewitt, Dorothy; Ranee, Alina

    2013-01-01

    This study was aimed at developing a Bahasa Melayu grammar learning portal for Form Two students (BMGLP). A developmental approach was used in this study. Needs analysis was carried out on the Bahasa Melayu teachers and Form Two students. The results of needs analysis on Form Two students showed that they preferred topics such as question…

  19. Design Optimization of Long-Span Cold-Formed Steel Portal Frames Accounting for Effect of Knee Brace Joint Configuration

    OpenAIRE

    Thanh Duoc Phan; James B. P. Lim; Meheron Selowara Joo; Hieng-Ho Lau

    2017-01-01

    The application of cold-formed steel channel sections for portal frames becomes more popular for industrial and residential purposes. Experimental tests showed that such structures with long-span up to 20 m can be achieved when knee brace joints are included. In this paper, the influence of knee brace configuration on the optimum design of long-span cold-formed steel portal frames is investigated. The cold-formed steel portal frames are designed using Eurocode 3 under ultimate limit states. A...

  20. Use of gonioscopy in medicare beneficiaries before glaucoma surgery.

    Science.gov (United States)

    Coleman, Anne L; Yu, Fei; Evans, Stacy J

    2006-12-01

    The American Academy of Ophthalmology Preferred Practice Patterns for angle closure and open-angle glaucoma (OAG) patients recommends performing bilateral gonioscopy upon initial presentation to evaluate the possibility of narrow angle or angle-closure glaucoma (ACG) and then repeating the examination at least every 5 years. This study aims to assess how commonly eye care providers perform gonioscopy before planned glaucoma surgery in OAG, anatomic narrow angle, and ACG in the Medicare population. Data obtained from a 5% random sample of Medicare beneficiaries undergoing glaucoma surgery in the United States in 1999 were retrospectively reviewed. The proportion of patients with evidence of at least one gonioscopic examination before glaucoma surgery was determined for the period of 1995 to 1999. Demographic and clinical factors potentially influencing the decision to perform gonioscopy were also examined. Overall, gonioscopy is apparently performed in 49% of Medicare beneficiaries during the 4 to 5 years preceding glaucoma surgery. This rate was significantly lower (P gonioscopy rates (P Gonioscopy examination before glaucoma surgery in Medicare beneficiaries is underused, undercoded, and/or miscoded, given current recommendations. Underuse is of particular concern in patients undergoing laser iridotomy as it is the diagnostic test of choice in ACG.

  1. Patient Satisfaction, Empowerment, and Health and Disability Status Effects of a Disease Management-Health Promotion Nurse Intervention among Medicare Beneficiaries with Disabilities

    Science.gov (United States)

    Friedman, Bruce; Wamsley, Brenda R.; Liebel, Dianne V.; Saad, Zabedah B.; Eggert, Gerald M.

    2009-01-01

    Purpose: To report the impact on patient and informal caregiver satisfaction, patient empowerment, and health and disability status of a primary care-affiliated disease self-management-health promotion nurse intervention for Medicare beneficiaries with disabilities and recent significant health services use. Design and Methods: The Medicare…

  2. Design and synthesis of an amphiphilic graft hydrogel having a hydrophobic domain formed by multiple interactions

    Energy Technology Data Exchange (ETDEWEB)

    Nitta, Kyohei [Department of Life and Functional Material Science, Graduate School of Natural Science, Konan University, 8-9-1 Okamoto, Higashinada, Kobe 658-8501 (Japan); Japan Society for the Promotion of Science (DC1), Ichibancho, Chiyoda, Tokyo 102-8471 (Japan); Kimoto, Atsushi [Department of Chemistry of Functional Molecules, Faculty of Science and Engineering, Konan University, 8-9-1 Okamoto, Higashinada, Kobe 658-8501 (Japan); Watanabe, Junji, E-mail: junjiknd@konan-u.ac.jp [Department of Chemistry of Functional Molecules, Faculty of Science and Engineering, Konan University, 8-9-1 Okamoto, Higashinada, Kobe 658-8501 (Japan)

    2016-11-01

    A novel hydrogel having hydrophobic oligo segments and hydrophilic poly(acrylamidoglycolic acid) (PAGA) as pH responsive polymer segments was designed and synthesized to be used as a soft biomaterial. Poly(trimethylene carbonate) (PTMC) as the side chain, for which the degrees of polymerization were 9, 19, and 49, and the composition ratios were 1, 5, and 10 mol%, was used as the oligo segment in the hydrogel. The swelling ratio of the hydrogel was investigated under various changes in conditions such as pH, temperature, and hydrogen bonding upon urea addition. Under pH 2–11 conditions, the graft gel reversibly swelled and shrank due to the effect of PAGA main chain. The interior morphology and skin layer of the hydrogel was observed by a scanning electron microscope. The hydrogel composed of PAGA as the hydrophilic polymer backbone had a sponge-like structure, with a pore size of approximately 100 μm. On the other hand, upon increasing the ratio of trimethylene carbonate (TMC) units in the hydrogel, the pores became smaller or disappeared. Moreover, thickness of the skin layer significantly increased with the swelling ratio depended on the incorporation ratios of the PTMC macromonomer. Molecular incorporation in the hydrogel was evaluated using a dye as a model drug molecule. These features would play an important role in drug loading. Increasing the ratio of TMC units favored the adsorption of the dye and activation of the incorporation behavior. - Highlights: • Hydrogen bonding and hydrophobic interaction are dominant factor for forming hydrogels. • Hydrogel properties were tuned by changing in graft length and macromonomer content in feed. • The resulting graft gel could encapsulate and retain organic dye in the hydrogel. • Poly(trimethylene carbonate) segment in the hydrogel was dominant unit for hydrogel.

  3. Design of Solid Form Xenon-124 Target for Producing I-123 Radioisotope Using Computer Simulation Techniques

    International Nuclear Information System (INIS)

    Kamali Moghaddam, K.; Sadeghi, M.; Kakavand, T.; Shokri Bonab, S.

    2006-01-01

    Recently in Cyclotron and Nuclear Medicine Department of NRCAM, at Atomic Energy organization of Iran (AEOI), a system for producing 1-123 via Xe-124 gas target technology, has been constructed and installed. One of the major problems in this system is the highly expensive cost of the enriched Xenon-124 gas. Therefore, saving this gas inside the system is very important. Unfortunately, by accidental rupture of the window foil or bad function of O-rings, the whole Xenon gas will escape from the system immediately. In this paper, by using computer codes; ALICE91, SRIM and doing some calculations we are going to demonstrate our latest effort for feasibility study of producing I-123 with the above mentioned reactions, but using Xe-124 solid target instead. According to our suggested design, a conical shaped irradiation vessel made of copper with 1 mm thickness, 1 cm outlet diameter, 5 cm length and 12 deg. angle at summit can be fixed inside a liquid nitrogen housing chamber. The Xenon-124 gas will be sent to the inside of this very cold conical trap and eventually deposited on its surface in solid form. Our calculation shows that during bombardment with 17-28 MeV proton energy, the thickness of solidified Xenon layer will remain around .28 mm. Likewise; thermo-dynamical calculation shows that in order to prevent the evaporation of solidified Xenon, the maximum permissible proton beam current for this system should be less than 1.4 μA. According to these working conditions, the production yield of I-123 can be predicted to be around 150 mCi/μAh. (authors)

  4. Design and synthesis of an amphiphilic graft hydrogel having a hydrophobic domain formed by multiple interactions

    International Nuclear Information System (INIS)

    Nitta, Kyohei; Kimoto, Atsushi; Watanabe, Junji

    2016-01-01

    A novel hydrogel having hydrophobic oligo segments and hydrophilic poly(acrylamidoglycolic acid) (PAGA) as pH responsive polymer segments was designed and synthesized to be used as a soft biomaterial. Poly(trimethylene carbonate) (PTMC) as the side chain, for which the degrees of polymerization were 9, 19, and 49, and the composition ratios were 1, 5, and 10 mol%, was used as the oligo segment in the hydrogel. The swelling ratio of the hydrogel was investigated under various changes in conditions such as pH, temperature, and hydrogen bonding upon urea addition. Under pH 2–11 conditions, the graft gel reversibly swelled and shrank due to the effect of PAGA main chain. The interior morphology and skin layer of the hydrogel was observed by a scanning electron microscope. The hydrogel composed of PAGA as the hydrophilic polymer backbone had a sponge-like structure, with a pore size of approximately 100 μm. On the other hand, upon increasing the ratio of trimethylene carbonate (TMC) units in the hydrogel, the pores became smaller or disappeared. Moreover, thickness of the skin layer significantly increased with the swelling ratio depended on the incorporation ratios of the PTMC macromonomer. Molecular incorporation in the hydrogel was evaluated using a dye as a model drug molecule. These features would play an important role in drug loading. Increasing the ratio of TMC units favored the adsorption of the dye and activation of the incorporation behavior. - Highlights: • Hydrogen bonding and hydrophobic interaction are dominant factor for forming hydrogels. • Hydrogel properties were tuned by changing in graft length and macromonomer content in feed. • The resulting graft gel could encapsulate and retain organic dye in the hydrogel. • Poly(trimethylene carbonate) segment in the hydrogel was dominant unit for hydrogel.

  5. Design of an off-axis visual display based on a free-form projection screen to realize stereo vision

    Science.gov (United States)

    Zhao, Yuanming; Cui, Qingfeng; Piao, Mingxu; Zhao, Lidong

    2017-10-01

    A free-form projection screen is designed for an off-axis visual display, which shows great potential in applications such as flight training for providing both accommodation and convergence cues for pilots. The method based on point cloud is proposed for the design of the free-form surface, and the design of the point cloud is controlled by a program written in the macro-language. In the visual display based on the free-form projection screen, when the error of the screen along Z-axis is 1 mm, the error of visual distance at each filed is less than 1%. And the resolution of the design for full field is better than 1‧, which meet the requirement of resolution for human eyes.

  6. Form Follows Feeling – The Acquisition of Design Expertise and the Function of Aesthesis in the Design Process

    Directory of Open Access Journals (Sweden)

    Terrence Michael Curry

    2017-07-01

    The research provides evidence that more than technical rationality, expert designers rely heavily on a highly developed embodied way of knowing (tacit knowledge througout the design process that allows them to know more than they can say. Indeed, this is the hallmark of expert performers in many fields. However, this ability is not to be understood as natural talent, but as a result of an intense developmental process that includes years of deliberate practice necessary to restructure the brain and adapt the body in a manner that facilitates exceptional performance. For expert designers it is aesthesis (a kind of body knowledge, functioning as a meta-heuristic, that allows them to solve a complex problem situation in a manner that appears effortless. Aesthesis is an ability that everyone possesses, but that expert designers have highly developed and adapted to allow them to produce buildings and built environments that induce an intended quality of aesthetic experience in the user. It is a cognitive ability that functions to both (restructure the design problem and evaluate the solution; and allows the designer to inhabit the design world feelingly while seeking aesthetic resonance that anticipates the quality of atmosphere another is likely to experience. This ability is critical to the acquisition of design expertise.

  7. [Dietary diversity in women who live in food insecurity settings in Mexico, beneficiaries of a food support program].

    Science.gov (United States)

    Morales Ruán, María Del Carmen; Valenzuela Bravo, Danae Gabriela; Jiménez Aguilar, Alejandra; Cuevas Nasu, Lucía; Méndez Gómez Humarán, Ignacio; Shamah Levy, Teresa

    2018-02-16

    food diversity is an approximation of diet quality. In Mexico, the Food Support Program (PAL, by its acronym in Spanish) grants support to families facing food poverty, in form of cash (PAL EFECTIVO) or through monetary transfers on a card intended exclusively for the purchase of food (PAL SIN-HAMBRE), seeking to improve their food diversity. to compare the dietary diversity in women beneficiaries of both schemes and their association with the level of food insecurity (FI) at household level. a cross-sectional study was carried out in a national random sample of 243 women beneficiaries from PAL EFECTIVO and 277 from PAL SIN-HAMBRE in 14 states. A multinomial logistic regression model was constructed to measure the association between the FI perception index and its relationship with the PAL and the dietary diversity index. the PAL SIN-HAMBRE scheme is associated with a lower probability of mild and severe FI with respect to the PAL EFECTIVO. The interaction between the type of scheme and the dietary diversity index showed that the PAL EFECTIVO had a lower probability of severe FI when the dietary diversity index was greater with respect to the PAL SIN-HAMBRE. the FI in the household and the low dietary diversity seem to be strongly associated in women of childbearing age and this relationship is higher in those beneficiaries of the PAL SIN-HAMBRE scheme.

  8. Designing adverse event forms for real-world reporting: participatory research in Uganda.

    Science.gov (United States)

    Davies, Emma C; Chandler, Clare I R; Innocent, Simeon H S; Kalumuna, Charles; Terlouw, Dianne J; Lalloo, David G; Staedke, Sarah G; Haaland, Ane

    2012-01-01

    The wide-scale roll-out of artemisinin combination therapies (ACTs) for the treatment of malaria should be accompanied by continued surveillance of their safety. Post-marketing pharmacovigilance (PV) relies on adverse event (AE) reporting by clinicians, but as a large proportion of treatments are provided by non-clinicians in low-resource settings, the effectiveness of such PV systems is limited. To facilitate reporting, AE forms should be easily completed; however, most are challenging for lower-level health workers and non-clinicians to complete. Through participatory research, we sought to develop user-friendly AE report forms to capture information on events associated with ACTs.Following situation analysis, we undertook workshops with community medicine distributors and health workers in Jinja, Uganda, to develop a reporting form based on experiences and needs of users, and communication and visual perception principles. Participants gave feedback for revisions of subsequent versions. We then conducted 8 pretesting sessions with 77 potential end users to test and refine passive and active versions of the form.The development process resulted in a form that included a pictorial storyboard to communicate the rationale for the information needed and facilitate rapport between the reporter and the respondent, and a diary format to record the drug administration and event details in chronological relation to each other. Successive rounds of pretesting used qualitative and quantitative feedback to refine the form, with the final round showing over 80% of the form completed correctly by potential end users.We developed novel AE report forms that can be used by non-clinicians to capture pharmacovigilance data for anti-malarial drugs. The participatory approach was effective for developing forms that are intuitive for reporters, and motivating for respondents. The forms, or their key components, could be adapted for use in other low-literacy settings to improve quality

  9. Designing adverse event forms for real-world reporting: participatory research in Uganda.

    Directory of Open Access Journals (Sweden)

    Emma C Davies

    Full Text Available The wide-scale roll-out of artemisinin combination therapies (ACTs for the treatment of malaria should be accompanied by continued surveillance of their safety. Post-marketing pharmacovigilance (PV relies on adverse event (AE reporting by clinicians, but as a large proportion of treatments are provided by non-clinicians in low-resource settings, the effectiveness of such PV systems is limited. To facilitate reporting, AE forms should be easily completed; however, most are challenging for lower-level health workers and non-clinicians to complete. Through participatory research, we sought to develop user-friendly AE report forms to capture information on events associated with ACTs.Following situation analysis, we undertook workshops with community medicine distributors and health workers in Jinja, Uganda, to develop a reporting form based on experiences and needs of users, and communication and visual perception principles. Participants gave feedback for revisions of subsequent versions. We then conducted 8 pretesting sessions with 77 potential end users to test and refine passive and active versions of the form.The development process resulted in a form that included a pictorial storyboard to communicate the rationale for the information needed and facilitate rapport between the reporter and the respondent, and a diary format to record the drug administration and event details in chronological relation to each other. Successive rounds of pretesting used qualitative and quantitative feedback to refine the form, with the final round showing over 80% of the form completed correctly by potential end users.We developed novel AE report forms that can be used by non-clinicians to capture pharmacovigilance data for anti-malarial drugs. The participatory approach was effective for developing forms that are intuitive for reporters, and motivating for respondents. The forms, or their key components, could be adapted for use in other low-literacy settings

  10. The Components of Smile Design: New York University Smile Evaluation Form Revisited, Update 2015.

    Science.gov (United States)

    Calamia, John R; Wolff, Mark S

    2015-07-01

    This article updates a simple checklist of foundational knowledge in aesthetic dental concepts that allows clinicians to organize their thoughts, to record the concerns of the patient, and to map out those improvements that must be addressed. This adjunct is called a Smile Evaluation Form. Along with other adjuncts such as radiographs, study casts, and diagnostic wax-ups, the Smile Evaluation Form allows clinicians to form a conceptual visualization of the expected end point. It provides a checklist for discussions with other disciplines in the team, to provide a logical sequence of treatment with a mutually agreed-on end point. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Design Optimization of Long-Span Cold-Formed Steel Portal Frames Accounting for Effect of Knee Brace Joint Configuration

    Directory of Open Access Journals (Sweden)

    Thanh Duoc Phan

    2017-12-01

    Full Text Available The application of cold-formed steel channel sections for portal frames becomes more popular for industrial and residential purposes. Experimental tests showed that such structures with long-span up to 20 m can be achieved when knee brace joints are included. In this paper, the influence of knee brace configuration on the optimum design of long-span cold-formed steel portal frames is investigated. The cold-formed steel portal frames are designed using Eurocode 3 under ultimate limit states. A novel method in handling design constraints integrated with genetic algorithm is proposed for searching the optimum design of cold-formed steel portal frames. The result showed that the proposed routine for design optimization effectively searched the near global optimum solution with the computational time is approximate 50% faster than methods being popularly used in literature. The optimum configuration for knee brace joint can reduce the section size of rafter and so the lighter frame could be obtained especially for long-span portal frame. The minimum weight of main frame obtained from optimization process is approximate 19.72% lighter than a Benchmark Frame used in the full-scale experimental test.

  12. Out of Pocket expenditure among beneficiaries of Janani Shishu Suraksha Karyakaram

    Directory of Open Access Journals (Sweden)

    Jyoti Tyagi

    2016-12-01

    Full Text Available Background: About 67,000 women in India die every year (MoHFW, 2011, due to pregnancy related complications. Similarly, every year more than 13 lacs infants die, within 1 year of the birth and out of these approximately 9 lacs i.e. 2/3rd of the infant deaths take place within the first four weeks of life (1.Out of these, approximately 7 lacs i.e. 75% of the deaths take place within a week of the birth and a majority of these occur in the first two days after birth (1. In view of the difficulty being faced by the pregnant women and parents of sick new-born (MoHFW,2011, along with high out-of-pocket expenses incurred by them on delivery and treatment of sick new-born, Ministry of Health and Family Welfare has taken a major initiative, to provide completely free and cashless services to pregnant women including normal deliveries and caesarean operations and sick new born (up to 30 days after birth in Government health institutions in both rural & urban areas. Material & Methods: In this community based descriptive cross-sectional study, data was collected from 100 mothers, who had delivered in last one year at District Hospital Maternal Wing situated at Morar Block of Gwalior District M.P and MO, ANM’s, ASHA’s, using Semi structured close ended Interview schedule and an open ended questionnaire respectively. Data were compared by using SPSS (ver. 22.0 Result: Expenses were divided under two heads, medical and non-medical. 15% of the total beneficiaries incurred the medical expenses in the form of medicines, diagnostics etc. and almost 99% of all the respondents incurred the non-medical expenses in the form of transport, food etc. Conclusion: Based on the outcome of the study the overall impression was that 59% of the beneficiaries were not aware of the JSSK scheme. Only during pregnancies through the initiatives of the ASHAs the beneficiaries came to know about the free entitlements of the scheme. There was unavailability of ambulance when

  13. Developing Automatic Form and Design System Using Integrated Grey Relational Analysis and Affective Engineering

    Directory of Open Access Journals (Sweden)

    Chen-Yuan Liu

    2018-01-01

    Full Text Available In the modern highly competitive marketplace and global market environment, product quality improvements that abridge development time and reduce the production costs are effective methods for promoting the business competitiveness of a product in shorter lifecycles. Since the design process is the best time to control such parameters, systematically designing the processes to develop a product that more closely fits the demand requirements for the market is a key factor for developing a successful product. In this paper, a combined affective engineering method and grey relational analysis are used to develop a product design process. First, design image scale technology is used to acquire the best the design criteria factors, and then affective engineering methods are used to set the relationships between customer needs and production factors. Finally, grey relational analysis is used to select the optimal design strategy. Using this systematic design method, a higher quality product can be expanded upon in a shorter lead-time for improving business competition.

  14. Economic burden of hospitalizations of Medicare beneficiaries with heart failure

    Directory of Open Access Journals (Sweden)

    Kilgore M

    2017-05-01

    Full Text Available Meredith Kilgore,1 Harshali K Patel,2 Adrian Kielhorn,2 Juan F Maya,2 Pradeep Sharma1 1Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, 2Amgen, Inc., Thousand Oaks, CA, USA Objective: The objective of this study was to assess the costs associated with the hospitalization and the cumulative 30-, 60-, and 90-day readmission rates in a cohort of Medicare beneficiaries with heart failure (HF.Methods: This was a retrospective, observational study based on data from the national 5% sample of Medicare beneficiaries. Inpatient data were gathered for Medicare beneficiaries with at least one HF-related hospitalization between July 1, 2005, and December 31, 2011. The primary end point was the average per-patient cost of hospitalization for individuals with HF. Secondary end points included the cumulative rate of hospitalization, the average length of hospital stay, and the cumulative 30-, 60-, and 90-day readmission rates.Results: Data from 63,678 patients with a mean age of 81.8 years were included in the analysis. All costs were inflated to $2,015 based on the medical care component of the Consumer Price Index. The mean per-patient cost of an HF-related hospitalization was $14,631. The mean per-patient cost of a cardiovascular (CV-related or all-cause hospitalization was $16,000 and $15,924, respectively. The cumulative rate of all-cause hospitalization was 218.8 admissions per 100 person-years, and the median length of stay for HF-related, CV-related, and all-cause hospitalizations was 5 days. Also, 22.3% of patients were readmitted within 30 days, 33.3% were readmitted within 60 days, and 40.2% were readmitted within 90 days.Conclusion: The costs associated with hospitalization for Medicare beneficiaries with HF are substantial and are compounded by a high rate of readmission. Keywords: heart failure, Medicare, health economics, hospitalization, costs

  15. 29 CFR Appendix E to Part 825 - Designation Notice to Employee of FMLA Leave (Form WH-382)

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Designation Notice to Employee of FMLA Leave (Form WH-382) E Appendix E to Part 825 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR OTHER LAWS THE FAMILY AND MEDICAL LEAVE ACT OF 1993 Pt. 825, App. E Appendix E to Part...

  16. Design optimization of cold-formed steel portal frames taking into account the effect of building topology

    Science.gov (United States)

    Phan, Duoc T.; Lim, James B. P.; Sha, Wei; Siew, Calvin Y. M.; Tanyimboh, Tiku T.; Issa, Honar K.; Mohammad, Fouad A.

    2013-04-01

    Cold-formed steel portal frames are a popular form of construction for low-rise commercial, light industrial and agricultural buildings with spans of up to 20 m. In this article, a real-coded genetic algorithm is described that is used to minimize the cost of the main frame of such buildings. The key decision variables considered in this proposed algorithm consist of both the spacing and pitch of the frame as continuous variables, as well as the discrete section sizes. A routine taking the structural analysis and frame design for cold-formed steel sections is embedded into a genetic algorithm. The results show that the real-coded genetic algorithm handles effectively the mixture of design variables, with high robustness and consistency in achieving the optimum solution. All wind load combinations according to Australian code are considered in this research. Results for frames with knee braces are also included, for which the optimization achieved even larger savings in cost.

  17. DFT-Based Closed-form Covariance Matrix and Direct Waveforms Design for MIMO Radar to Achieve Desired Beampatterns

    KAUST Repository

    Bouchoucha, Taha

    2017-01-23

    In multiple-input multiple-out (MIMO) radar, for desired transmit beampatterns, appropriate correlated waveforms are designed. To design such waveforms, conventional MIMO radar methods use two steps. In the first step, the waveforms covariance matrix, R, is synthesized to achieve the desired beampattern. While in the second step, to realize the synthesized covariance matrix, actual waveforms are designed. Most of the existing methods use iterative algorithms to solve these constrained optimization problems. The computational complexity of these algorithms is very high, which makes them difficult to use in practice. In this paper, to achieve the desired beampattern, a low complexity discrete-Fourier-transform based closed-form covariance matrix design technique is introduced for a MIMO radar. The designed covariance matrix is then exploited to derive a novel closed-form algorithm to directly design the finite-alphabet constant-envelope waveforms for the desired beampattern. The proposed technique can be used to design waveforms for large antenna array to change the beampattern in real time. It is also shown that the number of transmitted symbols from each antenna depends on the beampattern and is less than the total number of transmit antenna elements.

  18. Design stresses in probabilistic form for ellipsoidal and toroidal pressure vessels

    International Nuclear Information System (INIS)

    Smith, C.O.

    1979-01-01

    Design has customarily been based on applied loading, geometry, and handbook values for strength to give a deterministic solution. The engineering profession, however, has become increasingly concerned with the adequacy of design calculations. This concern indicates a need for critical evaluation of designs based on arbitrary multipliers, such as factors of safety or worst-case treatment. Ellipsoids are frequently used for end closure of cylindrical pressure shells. Toroids of elliptic or circular cross-section, are widely used, e.g., for connecting two parallel legs in a U-shape. This paper gives equations for means and standard deviations of stresses developed in ellipsoids and toroids with internal pressure. Inherent are: (1) design variables are generally characterized by spectra of values (assumed to be normally distributed), rather than by unique values, and (2) a small, but finite, probability of failure must be recognized in any design. By coupling stresses due to applied loading as calculated by the given equations with strength available in a material, reliability (or the alternative probability of failure) can be calculated. Conversely, for a given reliability the appropriate size can be determined. (orig.)

  19. Work participation and health-related characteristics of sickness absence beneficiaries with multiple somatic symptoms

    DEFF Research Database (Denmark)

    Momsen, A H; Nielsen, Claus Vinther; Nielsen, M B D

    2016-01-01

    unemployed was higher for this group than for those with a low score. Adjusting for general health reduced the association between symptoms and unemployment, whereas problems with social relations only affected it marginally. Conclusions: Sick-listed individuals reporting high levels of symptoms were more......Objectives: The primary aim was to study whether high levels of multiple symptoms influenced sick-listed individuals' employment status or desire to return to work (RTW) and whether this was associated with social relations at work. Study design: A cross-sectional study nested in a clinical trial......-listing, and use of health care were register-data. Multivariate logistic regression analyses with adjustments were performed. Results: Beneficiaries with high SCL-SOM score (n = 218, 33%) reported poorer health, job satisfaction, a lower desire to RTW and more problems with supervisors. The risk of being...

  20. An unusual pattern of tattooing in the form of body designing: A case report

    Directory of Open Access Journals (Sweden)

    Laxman Gangadhar Phad

    2016-12-01

    In the present case the patient was brought to our hospital for eliciting consumption of alcohol and any other injuries over the body. The person examined had decorated his left arm and forearm by fine designs by a blue ball point pen. He also had multiple fresh incised cuts on the forearms and wrist. Such a presentation with a somewhat risk taking, masochistic behavior and the chronic nature of drawing designs over the body by a ball point pen was very rare and not noted as per best of our knowledge.

  1. Physical barriers formed from gelling liquids: 1. numerical design of laboratory and field experiments

    International Nuclear Information System (INIS)

    Finsterle, S.; Moridis, G.J.; Pruess, K.; Persoff, P.

    1994-01-01

    The emplacement of liquids under controlled viscosity conditions is investigated by means of numerical simulations. Design calculations are performed for a laboratory experiment on a decimeter scale, and a field experiment on a meter scale. The purpose of the laboratory experiment is to study the behavior of multiple gout plumes when injected in a porous medium. The calculations for the field trial aim at designing a grout injection test from a vertical well in order to create a grout plume of a significant extent in the subsurface

  2. Impact of HIV Infection on Medicare Beneficiaries with Lung Cancer

    International Nuclear Information System (INIS)

    Lee, J. Y.; Moore, P. C.; Lensing, S. Y.

    2012-01-01

    The incidence of lung cancer among individuals infected with the human immunodeficiency virus (HIV) is elevated compared to that among the general population. This study examines the prevalence of HIV and its impact on outcomes among Medicare beneficiaries who are 65 years of age or older and were diagnosed with non small cell lung cancer (NSCLC) between 1997 and 2008. Prevalence of HIV was estimated using the Poisson point estimate and its 95% confidence interval. Relative risks for potential risk factors were estimated using the log-binomial model. A total of 111,219 Medicare beneficiaries met the study criteria. The prevalence of HIV was 156.4 per 100,000 (95% CI: 140.8 to 173.8) and has increased with time. Stage at NSCLC diagnosis did not vary by HIV status. Mortality rates due to all causes were 44%, 76%, and 88% for patients with stage I/II, III, and IV NSCLC, respectively. Across stages of disease, there was no difference between those who were HIV-infected and those who were not with respect to overall mortality. HIV patients, however, were more likely to die of causes other than lung cancer than their immunocompetent counterparts.

  3. A new method for designing dual foil electron beam forming systems. I. Introduction, concept of the method

    International Nuclear Information System (INIS)

    Adrich, Przemysław

    2016-01-01

    In Part I of this work existing methods and problems in dual foil electron beam forming system design are presented. On this basis, a new method of designing these systems is introduced. The motivation behind this work is to eliminate the shortcomings of the existing design methods and improve overall efficiency of the dual foil design process. The existing methods are based on approximate analytical models applied in an unrealistically simplified geometry. Designing a dual foil system with these methods is a rather labor intensive task as corrections to account for the effects not included in the analytical models have to be calculated separately and accounted for in an iterative procedure. To eliminate these drawbacks, the new design method is based entirely on Monte Carlo modeling in a realistic geometry and using physics models that include all relevant processes. In our approach, an optimal configuration of the dual foil system is found by means of a systematic, automatized scan of the system performance in function of parameters of the foils. The new method, while being computationally intensive, minimizes the involvement of the designer and considerably shortens the overall design time. The results are of high quality as all the relevant physics and geometry details are naturally accounted for. To demonstrate the feasibility of practical implementation of the new method, specialized software tools were developed and applied to solve a real life design problem, as described in Part II of this work.

  4. A new method for designing dual foil electron beam forming systems. I. Introduction, concept of the method

    Energy Technology Data Exchange (ETDEWEB)

    Adrich, Przemysław, E-mail: Przemyslaw.Adrich@ncbj.gov.pl

    2016-05-01

    In Part I of this work existing methods and problems in dual foil electron beam forming system design are presented. On this basis, a new method of designing these systems is introduced. The motivation behind this work is to eliminate the shortcomings of the existing design methods and improve overall efficiency of the dual foil design process. The existing methods are based on approximate analytical models applied in an unrealistically simplified geometry. Designing a dual foil system with these methods is a rather labor intensive task as corrections to account for the effects not included in the analytical models have to be calculated separately and accounted for in an iterative procedure. To eliminate these drawbacks, the new design method is based entirely on Monte Carlo modeling in a realistic geometry and using physics models that include all relevant processes. In our approach, an optimal configuration of the dual foil system is found by means of a systematic, automatized scan of the system performance in function of parameters of the foils. The new method, while being computationally intensive, minimizes the involvement of the designer and considerably shortens the overall design time. The results are of high quality as all the relevant physics and geometry details are naturally accounted for. To demonstrate the feasibility of practical implementation of the new method, specialized software tools were developed and applied to solve a real life design problem, as described in Part II of this work.

  5. The Design of Case Products’ Shape Form Information Database Based on NURBS Surface

    Science.gov (United States)

    Liu, Xing; Liu, Guo-zhong; Xu, Nuo-qi; Zhang, Wei-she

    2017-07-01

    In order to improve the computer design of product shape design,applying the Non-uniform Rational B-splines(NURBS) of curves and surfaces surface to the representation of the product shape helps designers to design the product effectively.On the basis of the typical product image contour extraction and using Pro/Engineer(Pro/E) to extract the geometric feature of scanning mold,in order to structure the information data base system of value point,control point and node vector parameter information,this paper put forward a unified expression method of using NURBS curves and surfaces to describe products’ geometric shape and using matrix laboratory(MATLAB) to simulate when products have the same or similar function.A case study of electric vehicle’s front cover illustrates the access process of geometric shape information of case product in this paper.This method can not only greatly reduce the capacity of information debate,but also improve the effectiveness of computer aided geometric innovation modeling.

  6. Visual Form, Ethics, and a Typology of Purpose: Teaching Effective Information Design

    Science.gov (United States)

    Rosenquist, Christina

    2012-01-01

    Stallworth Williams introduces concepts of visual rhetoric and ethics for a classroom exercise in the analysis and revision of a sales letter. This article revisits Stallworth Williams's proposed teaching strategies, suggesting that not only do students need to be instructed in elements of visual design, but they must also be taught to link those…

  7. Forming the face of green products : Mood boards and early consumer involvement in ship interior design

    NARCIS (Netherlands)

    Murto, P.; Ahola, M.; Person, F.E.O.K.

    2013-01-01

    In this paper, we study mood boards and the process by which they can be used to understand consumer inferences about environmental sustainability in the early stages of green product development. As a component of a research project on sustainable ship design, we created mood boards showcasing

  8. Form Follows Function: Designer Chemistry at the 52nd Bürgenstock Conference.

    Science.gov (United States)

    Heretsch, Philipp

    2017-07-24

    The 52nd Bürgenstock Conference on Stereochemistry took place from April 30-May 4, 2017, and showed how chemistry and design go hand-in-hand (as reflected in the image of the Bauhausarchiv in Berlin). In this Conference Report, Philipp Heretsch outlines the program. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  9. Achieving process intensification form the application of a phenomena based synthesis, Design and intensification methodology

    DEFF Research Database (Denmark)

    Babi, Deenesh Kavi; Lutze, Philip; Woodley, John

    of PI still faces challenges [2] because the identification and design of intensified processes is not simple [3]. Lutze et al [3] has developed a systematic PI synthesis/design method at the unit operations (Unit-Ops) level, where the search space is based on a knowledge-base of existing PI equipment...... for the manufacture of methyl acetate by replacing with one single reactive distillation column the multi-step process which consisted of one reactor, extractive distillation, liquid-liquid separation and azeotropic distillation. However, except for reactive distillation and dividing wall columns, the implementation......, the starting point is knowledge of existing Unit-Ops and therefore a limitation arising from their application is that they are able to generate new integrations/combinations of intensified equipment but are unable to generate novel PI solutions employing new Unit-Ops. Therefore, incentives exist for a more...

  10. Die design optimization on sheet metal forming with considering the phenomenon of springback to improve product quality

    Directory of Open Access Journals (Sweden)

    Darmawan Agung Setyo

    2018-01-01

    Full Text Available The process of sheet metal forming is one of the very important processes in manufacture of products mainly in the automotive field. In sheet metal forming, it is added a certain size at the die to tolerate a result of the elasticity restoration of material. Therefore, when the product is removed from the die then the process elastic recovery will end within the allowable tolerance size. Extra size of the die is one method to compensate for springback. The aim of this research is to optimize the die by entering a springback value in die design to improve product quality that is associated with accuracy the final size of the product. Simulation processes using AutoForm software are conducted to determine the optimal parameters to be used in the forming process. Variations the Blank Holder Force of 77 N, 97 N, and 117 N are applied to the plate material. The Blank Holder Force application higher than 97 N cannot be conducted because the Forming Limit Diagram indicates the risk of tearing. Then the Blank Holder Force of 37 N, 57 N and 77 N are selected and applied in cup drawing process. Even though a few of wrinkling are appear, however there is no significant deviation of dimension between the product and the design of cup.

  11. 42 CFR 423.6 - Cost-sharing in beneficiary education and enrollment-related costs.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Cost-sharing in beneficiary education and enrollment-related costs. 423.6 Section 423.6 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... BENEFIT General Provisions § 423.6 Cost-sharing in beneficiary education and enrollment-related costs. The...

  12. 26 CFR 1.501(c)(8)-1 - Fraternal beneficiary societies.

    Science.gov (United States)

    2010-04-01

    ... beneficiary societies. (a) A fraternal beneficiary society is exempt from tax only if operated under the lodge system or for the exclusive benefit of the members so operating. Operating under the lodge system means... parent organization and largely self-governing, called lodges, chapters, or the like. In order to be...

  13. 42 CFR 411.51 - Beneficiary's responsibility with respect to no-fault insurance.

    Science.gov (United States)

    2010-10-01

    ...-fault insurance. 411.51 Section 411.51 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... PAYMENT Limitations on Medicare Payment for Services Covered Under Liability or No-Fault Insurance § 411.51 Beneficiary's responsibility with respect to no-fault insurance. (a) The beneficiary is...

  14. [Characteristics of beneficiaries of a GP-centred health care contract in Germany].

    Science.gov (United States)

    Freund, Tobias; Szecsenyi, Joachim; Ose, Dominik

    2010-11-01

    Since 2004, primary care in Germany has increasingly been provided in special general practitioner (GP)-centred health care contracts (HZV). To date there is limited evidence about the characteristics of their beneficiaries regarding morbidity burden and health care utilization. We analysed insurance claims data from all beneficiaries of the "Allgemeine Ortskrankenkasse (AOK) Baden-Württemberg" listed in 10 general practices that contracted in a special GP-centred health care contract (HZV). We compared beneficiaries enrolled in the HZV with those who were not enrolled in the contract. Comparisons included the number of hospital admissions in 2007-2008 and the Charlson comorbidity index. Insurance claims data of 6,026 beneficiaries were available for analysis. In the third quarter of 2009, 51% (3,066) of the beneficiaries were enrolled in the HZV. They were significantly older (mean 61 years [SD 18 years] vs. 49 years [SD 22 years]; p contract tended to be older and suffered from a higher morbidity burden when compared with beneficiaries of the same health care fund who were not enrolled in the contract. Besides, beneficiaries of the contract had higher numbers of hospital admissions during the two year period before enrolment. These findings have substantial implications for individualized care management approaches that may be offered to beneficiaries of GP-centred health care contracts.

  15. Design of a gastroretentive mucoadhesive dosage form of furosemide for controlled release

    Directory of Open Access Journals (Sweden)

    Sharad S. Darandale

    2012-10-01

    Full Text Available The aim of the present study was to develop and characterize a gastroretentive dosage form suitable for controlled drug release. It consists of a drug loaded polymeric film made up of a bilayer of immediate (IR and controlled release (CR layers folded into a hard gelatin capsule. Gastroretention results from unfolding and swelling of the film and its bioadhesion to the gastric mucosa. Furosemide, a drug with a narrow absorption window, was selected as the model drug. Inclusion of hydroxypropyl β-cyclodextrin in both layers and Carbopol® 971P NF in the CR layer of the bilayer film resulted in optimum drug release, bioadhesion and mechanical properties. The film with zig-zag folding in the capsule was shown to unfold and swell under acidic conditions and provide IR of drug over 1 h and CR for up to 12 h in acidic medium. X-ray diffraction, differential scanning calorimetry and scanning electron microscopy revealed uniform dispersion of furosemide in the polymeric matrices. The results indicate the dosage form is gastroretentive and can provide controlled release of drugs with narrow therapeutic windows.

  16. Method for Forming Pulp Fibre Yarns Developed by a Design-driven Process

    Directory of Open Access Journals (Sweden)

    Tiia-Maria Tenhunen

    2016-01-01

    Full Text Available A simple and inexpensive method for producing water-stable pulp fibre yarns using a deep eutectic mixture composed of choline chloride and urea (ChCl/urea was developed in this work. Deep eutectic solvents (DESs are eutectic mixtures consisting of two or more components that together have a lower melting point than the individual components. DESs have been previously studied with respect to cellulose dissolution, functionalisation, and pre-treatment. This new method uses a mixture of choline chloride and urea, which is used as a swelling and dispersing agent for the pulp fibres in the yarn-forming process. Although the pulp seemed to form a gel when dispersed in ChCl/urea, the ultrastructure of the pulp was not affected. To enable water stability, pulp fibres were crosslinked by esterification using polyacrylic acid. ChCl/urea could be easily recycled and reused by distillation. The novel process described in this study enables utilisation of pulp fibres in textile production without modification or dissolution and shortening of the textile value chain. An interdisciplinary approach was used, where potential applications were explored simultaneously with material development from process development to the early phase prototyping.

  17. Design of process parameters for the incremental tube forming (ITF) by FEM to control product properties

    Science.gov (United States)

    Nazari, Esmaeil; Löbbe, Christian; Gallus, Stefan; Izadyar, S. Ahmad; Tekkaya, A. Erman

    2018-05-01

    The incremental tube forming (ITF) is a process combination of the kinematic tube bending and spinning to shape high strength and tailored tubes with variable diameters and thicknesses. In contrast to conventional bending methods, the compressive stress superposition by the spinning process facilitates low bending stresses, so that geometrical errors are avoided and the shape accuracy is improved. The study reveals the interaction of plastic strains of the rolling and bending process through an explicit FEM investigation. For this purpose, the three-dimensional machine set-up is discretized and modeled in terms of the fully disclosed spinning process during the gradual deflection of the tube end for bending. The analysis shows that, depending on the forming tool shape, the stress superposition is accompanied by high plastic strains. Furthermore, this phenomenon is explained by the three dimensional normal and shear strains during the incremental spinning. Analyzing the strains history also shows a nonlinearity between the strains by bending and spinning. It is also shown that process parameters like rotational velocity of the spinning rolls have a huge influence on the deformation pattern. Finally, the method is used for the manufacturing of an example product, which reveals the high process flexibility. In one clamp a component with a graded wall thickness and outside diameter along the longitudinal axis is produced.

  18. A comparative study of mid-day meal beneficiaries and private school attendees

    Directory of Open Access Journals (Sweden)

    Madhavi Bhargava

    2014-12-01

    Full Text Available Background: India is undergoing a rapid demographic transition accompanied by an epidemiologic and nutritional transition. The nutritional status of school-going children who form a major section of the population, can give an indication of the changing trends in nutritional profile of the population. According to Planning Commission report, 2010, Mid Day Meal (MDM Program has been successful in addressing classroom hunger and the objective of social equity in government school attendees. Aims & Objectives: To study the pattern of school lunch intake and nutritional status in private and government school-going children of district Dehradun. Material & Methods: This was an observational cross-sectional study in district Dehradun in government and private schools, with participants from class 1 to 12. A 24-hour dietary recall was done to measure caloric intake. Height and weight were measured using Microtoise (accuracy 0.1cm and digital weighing machine (Omron Model: HN286, accuracy 100 gm. Statistical analysis was done using SPSS, version 22. Nutritional status was classified using WHO cut-offs and analyzed using AnthroPlus Software. Student t-test was used to compare caloric intake of subgroups. Association between nutritional status and other variables was assessed using Chi-squared test. Results: Using WHO cut-offs, the proportion of thin children was 5.4% in private school and 21.5% in MDM beneficiaries of government schools. The proportion of children who were overweight was 27.7% in private schools and 3.6% in government schools (p<.0.05. The caloric content of school lunch was 271 Kcal in private school attendees and 375 Kcal in MDM beneficiaries. Proportion of children who skipped school lunch increased as they progressed in higher classes, and this proportion was greater in students of government schools beyond class VIII. Conclusion: The study highlights the need for more large scale nutritional surveys with school lunch in focus.

  19. Certain aspects of the accounting of the bank guarantee at the principal and the beneficiary

    Directory of Open Access Journals (Sweden)

    L. A. Zimakova

    2016-01-01

    Full Text Available For any kind of business such category as risks is peculiar. The research of this category was conducted by scientists from the different sides, certain approaches of protection against risks were developed and instruments of decrease in financial risks are offered. The bank guarantee is one of the most demanded instruments of additional financial protection today. Its active using of the commercial organizations courses questions of the organization of the detailed accounting of guarantees at the principal and the beneficiary. A little concerning the historical aspect of the bank guarantee, authors provided the overview of the determinations of "bank guarantee" characterizing it as the banking service providing distribution of responsibility between the guarantor and the principal under certain conditions. Having considered the essence of the legal nature and features of the bank guarantee recommendations about the organization of the disaggregated financial accounting on off-balance accounts were developed. In particular, need of allocation of a currency type as the directions of conducting the analytics providing correctness of reflection of cost criterion is proved. For the purpose of control of timeliness of carrying out calculations it is recommended to allocate guarantees: coincident and in coincident with primary obligation; short-term and long-term. From the point of view of nature of guarantees payment guarantees and guarantees of obligation fulfilment were allocated. These recommendations concern the beneficiary, and lack of accounting entries at a principal generates need of creation of additional registers and analytical reports which forms were offered by authors. The provided recommendations will allow obtaining transparent information on bank guarantees for the purpose of its full disclosure in the financial reporting.

  20. Closed-form solutions for linear regulator-design of mechanical systems including optimal weighting matrix selection

    Science.gov (United States)

    Hanks, Brantley R.; Skelton, Robert E.

    1991-01-01

    This paper addresses the restriction of Linear Quadratic Regulator (LQR) solutions to the algebraic Riccati Equation to design spaces which can be implemented as passive structural members and/or dampers. A general closed-form solution to the optimal free-decay control problem is presented which is tailored for structural-mechanical systems. The solution includes, as subsets, special cases such as the Rayleigh Dissipation Function and total energy. Weighting matrix selection is a constrained choice among several parameters to obtain desired physical relationships. The closed-form solution is also applicable to active control design for systems where perfect, collocated actuator-sensor pairs exist. Some examples of simple spring mass systems are shown to illustrate key points.

  1. The Legal Structure of Commercial Banks and Financial Regulation : does organizational form matter for the design of bank regulation?

    OpenAIRE

    Cedeno-Brea, Enmanuel

    2017-01-01

    markdownabstractDo the different ways that commercial banks are legally organized matter for the design of financial regulation? It is often assumed that most commercial banks are setup as investor owned business corporations. However, this is not always the case In many jurisdictions, banks are legally organized using a plethora of organizational forms, which include: co-operatives, mutual associations and even nonprofit entities. Thus, some of the distinctive legal attributes and features o...

  2. Integration Strategy for Free-form Lithium Ion Battery: Material, Design to System level Applications

    KAUST Repository

    Kutbee, Arwa T.

    2017-10-31

    Power supply in any electronic system is a crucial necessity. Especially so in fully compliant personalized advanced healthcare electronic self-powered systems where we envision seamless integration of sensors and actuators with data management components in a single freeform platform to augment the quality of our healthcare, smart living and sustainable future. However, the status-quo energy storage (battery) options require packaging to protect the indwelling toxic materials against harsh physiological environment and vice versa, compromising its mechanical flexibility, conformability and wearability at the highest electrochemical performance. Therefore, clean and safe energy storage solutions for wearable and implantable electronics are needed to replace the commercially used unsafe lithium-ion batteries. This dissertation discusses a highly manufacturable integration strategy for a free-form lithium-ion battery towards a genuine mechanically compliant wearable system. We sequentially start with the optimization process for the preparation of all solid-state material comprising a ‘’Lithium-free’’ lithium-ion microbattery with a focus on thin film texture optimization of the cathode material. State of the art complementary metal oxide semiconductor technology was used for the thin film based battery. Additionally, this thesis reports successful development of a transfer-less scheme for a flexible battery with small footprint and free form factor in a high yield production process. The reliable process for the flexible lithium-ion battery achieves an enhanced energy density by three orders of magnitude compared to the available rigid ones. Interconnection and bonding procedures of the developed batteries are discussed for a reliable back end of line process flexible, stretchable and stackable modules. Special attention is paid to the advanced bonding, handling and packaging strategies of flexible batteries towards system-level applications. Finally, this

  3. Structural aspects of cold-formed steel section designed as U-shape composite beam

    Science.gov (United States)

    Saggaff, Anis; Tahir, Mahmood Md.; Azimi, Mohammadamin; Alhajri, T. M.

    2017-11-01

    Composite beam construction usually associated with old-style Hot-Rolled Steel Section (HRSS) has proven to act much better in compare with Cold-Formed Steel Section (CFSS) sections due to thicker section. Due, it's getting popular to replace HRSS with CFSS in some aspects as a composite beam. The advantages such as lightweight, cost effective and easy to install have contributed to the apply CFSS as a preferred construction material for composite beam. There is a few technical data available regarding the application of the usage of CFSS as a composite system, despite the potentials use for residential and light-weight industrial constructions. This paper presents an experimental tests results which have been conducted using CFSS as composite beam. Composite action of CFSS arranged as double beam with Self-Compacting Concrete (SCC) slab are integrated together with bolted shear connectors were used. A full-scale test comprised of 3 proposed composite beam specimens with bolted shear connector spaced at 300 mm interval of grade 8.8 was using single nut with washer on flange of CFS, cast to the slab and loaded until failed. The test show that the bolted shear connector yielded better capacity of ultimate strength and ultimate moment for the proposed composite beam. It can be concluded that, bolted shear connectors of 16 mm in diameter performed better than the other diameter size of bolted shear connectors.

  4. Design and evaluation of buccal films as paediatric dosage form for transmucosal delivery of ondansetron.

    Science.gov (United States)

    Trastullo, Ramona; Abruzzo, Angela; Saladini, Bruno; Gallucci, Maria Caterina; Cerchiara, Teresa; Luppi, Barbara; Bigucci, Federica

    2016-08-01

    In the process of implementation and innovation of paediatric dosage forms, buccal films for transmucosal administration of drug represent one of the most interesting approach. In fact, films are able to provide an extended duration of activity allowing minimal dosage and frequency and offer an exact and flexible dose, associated with ease of handling. The objective of the present study was to develop polymeric films for the sustained release of ondansetron hydrochloride, a selective inhibitor of 5-HT3 receptors indicated in paediatrics for the prevention and treatment of nausea and vomiting caused by cytotoxic chemotherapy or radiotherapy and postoperatively. Films were prepared by casting and drying of aqueous solutions containing different weight ratios of hydroxypropylmethylcellulose (HPMC) with chitosan (CH) or sodium hyaluronate (HA) or gelatin (GEL) and characterized for their physico-chemical and functional properties. The presence of HA, GEL and CH did not improve the mucoadhesive properties of HPMC film. The inclusion of GEL and CH in HPMC film increased in vitro drug release with respect to the inclusion of HA, although films containing HA showed the highest water uptake. Moreover in agreement with the release behaviour, the inclusion of CH and GEL provided higher drug permeation through porcine buccal mucosa with respect to HPMC film and ensured linear permeation profiles of drug. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. ORGANIZATIONAL DESIGN AND CHANGE. THE EVOLUTION OF TRADE UNIONS ORGANIZATION FORMS IN ROMANIA AFTER 1989

    Directory of Open Access Journals (Sweden)

    LUMINIŢA CRISTINA CIOCAN

    2012-05-01

    Full Text Available The study: „Management and organizational change. Evolution of union organization forms in Romania after 1989” propose as subject of analyze a type of organization which, through its affiliation to the civil society and through its role conferred by low, becomes the key for the proper functioning of the labor market. Along with the change of political regime from December 1989, the trade union organizations were put in a position to cope with a triple: reorganization, learning a new social role and public image reconfiguration, including cancellation of the association (inevitable with the “ancient” trade union. The study proposes three major subjects: defining the term union organization accompanied by possible interpretations of the role of this type of organization at the society level – „collective voice”, counter pole , political actor, collective negotiator, transnational and promoter of the class struggle, the last role not being characteristic to a democratic society; the description of the syndicate organizations evolution in Romania, after 1990; the argue of the necessity of an organizational change felt by the unions, under the impact of some factors depending on socio-economic and politic changes.

  6. The specification and testing of radioactive sources designated as ''special form'' under the IAEA transport regulations

    International Nuclear Information System (INIS)

    Aston, D.; Bodimeade, A.H.; Hall, E.G.; Taylor, C.B.G.

    1982-01-01

    The object of this study is to remove some of the uncertainties associated with the application of the IAEA Regulations insofar as they apply to Special Form materials. The first part of this project involved a comparison of the ISO and IAEA Regulations. An analysis of the physical tests has been carried out. The second and most important part of the project involved an assessment of the leakage tests used to evaluate the capsules after each of the physical tests. The work has defined and confirmed by experiment the relationship between the IAEA and ISO impact and percussion tests. The practical application of the tests particularly with regard to specimen orientation will be aided by the data now available. The work has established the sensitivities of the primary volumetric leak test methods and practical procedures are outlined. Volumetric leak test methods, with sentivities approximately 10 - 5 mbar l/s, are considered to be more reliable in detecting leakage paths in capsules than methods using solid leachable or non-leachable radioactive contents. The work reported should assist in the updating and clarification and harmonisation of IAEA Safety Series Nos 6 and 37 and ISO 4919 and ISO TR 4826

  7. Disease management for chronically ill beneficiaries in traditional Medicare.

    Science.gov (United States)

    Bott, David M; Kapp, Mary C; Johnson, Lorraine B; Magno, Linda M

    2009-01-01

    We summarize the Centers for Medicare and Medicaid Services' (CMS's) experience with disease management (DM) in fee-for-service Medicare. Since 1999, the CMS has conducted seven DM demonstrations involving some 300,000 beneficiaries in thirty-five programs. Programs include provider-based, third-party, and hybrid models. Reducing costs sufficient to cover program fees has proved particularly challenging. Final evaluations on twenty programs found three with evidence of quality improvement at or near budget-neutrality, net of fees. Interim monitoring covering at least twenty-one months on the remaining fifteen programs suggests that four are close to covering their fees. Characteristics of the traditional Medicare program present a challenge to these DM models.

  8. DESIGNING EDUCATIONAL PROCESS OF FORMING SOCIAL AND PEDAGOGICAL COMPETENCE OF FUTURE PRIMARY SCHOOL TEACHERS IN INCLUSIVE SECONDARY SCHOOL

    Directory of Open Access Journals (Sweden)

    Zoia Shevtsiv

    2017-04-01

    Full Text Available The article is devoted to the issue of social and pedagogical competence of future primary school teacher in inclusive secondary schools. The aim of the article is to define the concept “design” and “pedagogical design”; to disclose methodological approaches and main features of pedagogical design of forming of social and pedagogical competence of future primary school teacher in inclusive secondary schools; to identify structural elements of social and pedagogical competence. The article analyzes the essence of the concept “design”. The process of designing educational system of social and pedagogical competence of future primary school teacher in inclusive secondary school is based on several interrelated methodological approaches, including systematic, axiological, active, person-centered, contextual acmeological, and competential ones. Important factors and theoretical starting positions are designing general principles of education: humanism and democracy; principles of teaching, scientific, professional orientation, integrity, communication theory and practice, consistency and systematic, variability, pedagogical creativity. The special principles are the following: problematic, technologizing, dialogization, and competence ones. Social and pedagogical competence of future primary school teachers in inclusive secondary school is structured by the cognitive, active, professional and personal components. Structure components are defined as a synthesis of social and pedagogical competences, educational and developmental, communicative, diagnostic, organizational, predictive, preventive, security and defense, correctional and rehabilitation, adaptation items. Established continuity of the educational process of forming social and pedagogical competence of future primary school teacher in inclusive secondary school takes place during the period of study in higher education establishments. The following conclusions are drawn that

  9. Market characteristics and awareness of managed care options among elderly beneficiaries enrolled in traditional Medicare.

    Science.gov (United States)

    Mittler, Jessica N; Landon, Bruce E; Zaslavsky, Alan M; Cleary, Paul D

    2011-10-14

    Medicare beneficiaries' awareness of Medicare managed care plans is critical for realizing the potential benefits of coverage choices. To assess the relationships of the number of Medicare risk plans, managed care penetration, and stability of plans in an area with traditional Medicare beneficiaries' awareness of the program. Cross-sectional analysis of Medicare Current Beneficiary Survey data about beneficiaries' awareness and knowledge of Medicare managed care plan availability. Logistic regression models used to assess the relationships between awareness and market characteristics. Traditional Medicare beneficiaries (n = 3,597) who had never been enrolled in Medicare managed care, but had at least one plan available in their area in 2002, and excluding beneficiaries under 65, receiving Medicaid, or with end stage renal disease. Traditional Medicare beneficiaries' knowledge of Medicare managed care plans in general and in their area. Having more Medicare risk plans available was significantly associated with greater awareness, and having an intermediate number of plans (2-4) was significantly associated with more accurate knowledge of Medicare risk plan availability than was having fewer or more plans. Medicare may have more success engaging consumers in choice and capturing the benefits of plan competition by more actively selecting and managing the plan choice set. Public Domain.

  10. CFORM- LINEAR CONTROL SYSTEM DESIGN AND ANALYSIS: CLOSED FORM SOLUTION AND TRANSIENT RESPONSE OF THE LINEAR DIFFERENTIAL EQUATION

    Science.gov (United States)

    Jamison, J. W.

    1994-01-01

    CFORM was developed by the Kennedy Space Center Robotics Lab to assist in linear control system design and analysis using closed form and transient response mechanisms. The program computes the closed form solution and transient response of a linear (constant coefficient) differential equation. CFORM allows a choice of three input functions: the Unit Step (a unit change in displacement); the Ramp function (step velocity); and the Parabolic function (step acceleration). It is only accurate in cases where the differential equation has distinct roots, and does not handle the case for roots at the origin (s=0). Initial conditions must be zero. Differential equations may be input to CFORM in two forms - polynomial and product of factors. In some linear control analyses, it may be more appropriate to use a related program, Linear Control System Design and Analysis (KSC-11376), which uses root locus and frequency response methods. CFORM was written in VAX FORTRAN for a VAX 11/780 under VAX VMS 4.7. It has a central memory requirement of 30K. CFORM was developed in 1987.

  11. A new method for designing dual foil electron beam forming systems. II. Feasibility of practical implementation of the method

    International Nuclear Information System (INIS)

    Adrich, Przemysław

    2016-01-01

    In Part I of this work a new method for designing dual foil electron beam forming systems was introduced. In this method, an optimal configuration of the dual foil system is found by means of a systematic, automatized scan of system performance in function of its parameters. At each point of the scan, Monte Carlo method is used to calculate the off-axis dose profile in water taking into account detailed and complete geometry of the system. The new method, while being computationally intensive, minimizes the involvement of the designer. In this Part II paper, feasibility of practical implementation of the new method is demonstrated. For this, a prototype software tools were developed and applied to solve a real life design problem. It is demonstrated that system optimization can be completed within few hours time using rather moderate computing resources. It is also demonstrated that, perhaps for the first time, the designer can gain deep insight into system behavior, such that the construction can be simultaneously optimized in respect to a number of functional characteristics besides the flatness of the off-axis dose profile. In the presented example, the system is optimized in respect to both, flatness of the off-axis dose profile and the beam transmission. A number of practical issues related to application of the new method as well as its possible extensions are discussed.

  12. Design and realization on function of pre-forming and continuous winding for HT-7U special winding machine

    International Nuclear Information System (INIS)

    Yu Jie; Gao Daming; Wen Jun; Zhu Wenhua; Cheng Leping; Tao Yuming

    2000-05-01

    The winding machine is one of the critical facilities for R and D of HT-7U construction. The machine mainly consists of five parts, CICC pay-off spool, a four-rollers straightening assembly, a four-roller forming/bending assembly, continuous winding structure and CNC control system with three-axis CNC control. The facility is needed for CICC magnet fabrication of HT-7U. The main requirements of the winding machine are: continuous winding to reduce number of joints inside the coils; pre-forming CICC conductor to avoid winding with tension; suitable for all TF and PF coils within the scope of various coil shape and dimension limit; improving the configuration tolerance, specially flatness of the CICC conductor. The author emphasizes on the design and realization on function of Pre-forming and Continuous Winding for HT-7U special winding machine. The winding machine with high accuracy has just been developed and applied to the construction of HT-7U model coils

  13. Medicare hospital spending per patient (Medicare Spending per Beneficiary) – Additional Decimal Places

    Data.gov (United States)

    U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...

  14. 78 FR 78342 - Extension of Autism Services Demonstration Project for TRICARE Beneficiaries Under the Extended...

    Science.gov (United States)

    2013-12-26

    ... DEPARTMENT OF DEFENSE Office of the Secretary Extension of Autism Services Demonstration Project... (the Department) Enhanced Access to Autism Services Demonstration Project (Autism Demonstration) under the Extended Care Health Option (ECHO) for beneficiaries diagnosed with an Autism Spectrum Disorder...

  15. 76 FR 80903 - Extension of Autism Services Demonstration Project for TRICARE Beneficiaries Under the Extended...

    Science.gov (United States)

    2011-12-27

    ... DEPARTMENT OF DEFENSE Office of the Secretary Extension of Autism Services Demonstration Project... Enhanced Access to Autism Services Demonstration Project under the Extended Care Health Option for beneficiaries diagnosed with an Autism Spectrum Disorder (ASD). Under the demonstration, the Department...

  16. 20 CFR 10.301 - May the physician designated on Form CA-16 refer the employee to another medical specialist or...

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false May the physician designated on Form CA-16 refer the employee to another medical specialist or medical facility? 10.301 Section 10.301 Employees... another medical specialist or medical facility? The physician designated on Form CA-16 may refer the...

  17. Artificial Neural Networks as an Architectural Design Tool-Generating New Detail Forms Based On the Roman Corinthian Order Capital

    Science.gov (United States)

    Radziszewski, Kacper

    2017-10-01

    The following paper presents the results of the research in the field of the machine learning, investigating the scope of application of the artificial neural networks algorithms as a tool in architectural design. The computational experiment was held using the backward propagation of errors method of training the artificial neural network, which was trained based on the geometry of the details of the Roman Corinthian order capital. During the experiment, as an input training data set, five local geometry parameters combined has given the best results: Theta, Pi, Rho in spherical coordinate system based on the capital volume centroid, followed by Z value of the Cartesian coordinate system and a distance from vertical planes created based on the capital symmetry. Additionally during the experiment, artificial neural network hidden layers optimal count and structure was found, giving results of the error below 0.2% for the mentioned before input parameters. Once successfully trained artificial network, was able to mimic the details composition on any other geometry type given. Despite of calculating the transformed geometry locally and separately for each of the thousands of surface points, system could create visually attractive and diverse, complex patterns. Designed tool, based on the supervised learning method of machine learning, gives possibility of generating new architectural forms- free of the designer’s imagination bounds. Implementing the infinitely broad computational methods of machine learning, or Artificial Intelligence in general, not only could accelerate and simplify the design process, but give an opportunity to explore never seen before, unpredictable forms or everyday architectural practice solutions.

  18. Directory of national competent authorities' approval certificates for package design, special form material and shipment of radioactive material. 1992 ed

    International Nuclear Information System (INIS)

    1992-08-01

    Being in a unique position to facilitate information exchange, the Secretariat of the International Atomic Energy Agency was requested by its Standing Advisory Group on the Safe Transport of Radioactive Material (SAGSTRAM) to collate package approval data and publish periodical reports thereon. A database was implemented on the mainframe computer in the mid-1980s but this was soon adapted for use on a personal computer. A fully menu-driven system programme was designed that allows both contributing Member States and the Secretariat more flexibility in data processing and reporting. Complete documentation is available in the form of a user guide. The cut-off date used for this report is 31 August 1992. This report supersedes IAEA-TECDOC-617 ''Directory of National Competent Authorities' Approval Certificates for Package Design, Special Form Material and Shipment of Radioactive Material, 1991 Edition''. The information contained in this report is given in six tables. In each of these, information is presented in alphabetical order based on the certificate number. The certificate number is identical with the competent authority identification mark. It is composed of the issuing Member State's international vehicle registration identification (VRI) code, followed by a slash, then a unique number specific to a particular design or shipment that is assigned by the competent authority, another slash and finally a code identifying the type of package involved. ''-85'' is appended to those certificates that were approved on the basis of the 1985 Edition of Safety Series No. 6. Tables 1 to 4 present administrative data including issue and expiry dates, package identification, package serial numbers, modes for which the package/shipment is approved and the edition of Safety Series No. 6 on which the approval has been based. The technical information on package mass, authorized contents, and detailed and general description of the package are contained in Table 5. Table 6

  19. Directory of national competent authorities' approval certificates for package design, special form material and shipment of radioactive material. 2002 ed

    International Nuclear Information System (INIS)

    2002-08-01

    The current edition of the transport Regulations was published in 1996 and is more commonly referred to as 'ST-1'. Earlier Editions were known as Safety Series No. 6. The latest English reprint (2000) is now identified as TS-R-1 (ST-1, Revised). The transport Regulations elaborate requirements for the design, fabrication and maintenance of packaging as well as those for preparation, consigning, handling, carriage, storage in transit and receipt of the packages at final destination. Approval issued in the form of certificates is required for the design or shipment of packages. This report supersedes IAEA-TECDOC-1237 Directory of National Competent Authorities' Approval Certificates for Package Design, Special Form Material and Shipment of Radioactive Material, 2001 Edition. It is distributed worldwide to the IAEA Member States' competent authorities for transport, and other entities who have requested copies. Electronic copies of the main data file are provided to registered users of the PACKTRAM database. The information contained in this report is given in six tables. In each of these, information is presented in alphabetical order based on the certificate number. Tables 1 to 4 present administrative data including issue and expiry dates, package identification, package serial numbers, modes for which the package/shipment is approved and the edition of the IAEA Transport Safety Regulations on which the approval has been based. The technical information on package mass, authorized contents, and detailed and general description of the package are contained in Table 5. Table 6 shows the certificates reported to the Secretariat by each participating Member State

  20. Directory of national competent authorities' approval certificates for package design, special form material and shipment of radioactive material. 2001 edition

    International Nuclear Information System (INIS)

    2001-08-01

    The current edition of the transport Regulations was published in 1996 and is more commonly referred to as 'ST-1'. Earlier Editions were known as Safety Series No. 6. The latest English reprint (2000) is now identified as TS-R-1 (ST-1, Revised). The transport Regulations elaborate requirements for the design, fabrication and maintenance of packaging as well as those for preparation, consigning, handling, carriage, storage in transit and receipt of the packages at final destination. Approval issued in the form of certificates is required for the design or shipment of packages. This report supersedes IAEA-TECDOC-1171 D irectory of National Competent Authorities' Approval Certificates for Package Design, Special Form Material and Shipment of Radioactive Material, 2000 Edition . It is distributed worldwide to the IAEA Member States' competent authorities for transport, and other entities who have requested copies. Electronic copies of the main data file are provided to registered users of the PACKTRAM database. The information contained in this report is given in six tables. In each of these, information is presented in alphabetical order based on the certificate number. Tables 1 to 4 present administrative data including issue and expiry dates, package identification, package serial numbers, modes for which the package/shipment is approved and the edition of the IAEA Transport Safety Regulations on which the approval has been based. The technical information on package mass, authorized contents, and detailed and general description of the package are contained in Table 5. Table 6 shows the certificates reported to the Secretariat by each participating Member State

  1. The price sensitivity of Medicare beneficiaries: a regression discontinuity approach.

    Science.gov (United States)

    Buchmueller, Thomas C; Grazier, Kyle; Hirth, Richard A; Okeke, Edward N

    2013-01-01

    We use 4 years of data from the retiree health benefits program of the University of Michigan to estimate the effect of price on the health plan choices of Medicare beneficiaries. During the period of our analysis, changes in the University's premium contribution rules led to substantial price changes. A key feature of this 'natural experiment' is that individuals who had retired before a certain date were exempted from having to pay any premium contributions. This 'grandfathering' creates quasi-experimental variation that is ideal for estimating the effect of price. Using regression discontinuity methods, we compare the plan choices of individuals who retired just after the grandfathering cutoff date and were therefore exposed to significant price changes to the choices of a 'control group' of individuals who retired just before that date and therefore did not experience the price changes. The results indicate a statistically significant effect of price, with a $10 increase in monthly premium contributions leading to a 2 to 3 percentage point decrease in a plan's market share. Copyright © 2012 John Wiley & Sons, Ltd.

  2. 31 CFR 360.6 - Authorized forms of registration.

    Science.gov (United States)

    2010-07-01

    ... coowners. The form of registration “A and B” is not authorized. Examples: David R. Johnson 123-45-6789 or Anna B. Johnson. Maria S. Gonzalez 987-65-4321 or Juan C. Gonzalez. (3) Beneficiary form. A bond may be... Pension Fund of Safety Manufacturing Company, U/A with the company, dated March 31, 1996, 12-3456789...

  3. Design of a PROTAC that antagonizes and destroys the cancer-forming X-protein of the hepatitis B virus

    International Nuclear Information System (INIS)

    Montrose, Kristopher; Krissansen, Geoffrey W.

    2014-01-01

    Highlights: • A novel proteolysis targeting chimeric molecule (PROTAC) to treat hepatitis B. • The PROTAC antagonizes and destroys the X-protein of the hepatitis B virus. • The PROTAC is a fusion of the X-protein oligomerization and instability domains. • The oligomerization domain is a dominant-negative inhibitor of X-protein function. • X-protein-targeting PROTACs have potential to prevent hepatocellular carcinoma. - Abstract: The X-protein of the hepatitis B virus (HBV) is essential for virus infection and contributes to the development of HBV-induced hepatocellular carcinoma (HCC), a disease which causes more than one million deaths each year. Here we describe the design of a novel PROTAC (proteolysis targeting chimeric molecule) capable of simultaneously inducing the degradation of the X-protein, and antagonizing its function. The PROTAC was constructed by fusing the N-terminal oligomerization and C-terminal instability domains of the X-protein to each other, and rendering them cell-permeable by the inclusion of a polyarginine cell-penetrating peptide (CPP). It was predicted that the oligomerization domain would bind the X-protein, and that the instability domain would cause the X-protein to be targeted for proteasomal degradation. Addition of the PROTAC to HepG2 liver cancer cells, engineered to express full-length and C-terminally truncated forms of the X-protein, resulted in the degradation of both forms of the X-protein. A cell-permeable stand-alone form of the oligomerization domain was taken up by HepG2 cells, and acted as a dominant-negative inhibitor, causing inhibition of X-protein-induced apoptosis. In summary, the PROTAC described here induces the degradation of the X-protein, and antagonizes its function, and warrants investigation in a preclinical study for its ability to prevent or treat HBV infection and/or the development of HCC

  4. Design of a PROTAC that antagonizes and destroys the cancer-forming X-protein of the hepatitis B virus

    Energy Technology Data Exchange (ETDEWEB)

    Montrose, Kristopher; Krissansen, Geoffrey W., E-mail: gw.krissansen@auckland.ac.nz

    2014-10-31

    Highlights: • A novel proteolysis targeting chimeric molecule (PROTAC) to treat hepatitis B. • The PROTAC antagonizes and destroys the X-protein of the hepatitis B virus. • The PROTAC is a fusion of the X-protein oligomerization and instability domains. • The oligomerization domain is a dominant-negative inhibitor of X-protein function. • X-protein-targeting PROTACs have potential to prevent hepatocellular carcinoma. - Abstract: The X-protein of the hepatitis B virus (HBV) is essential for virus infection and contributes to the development of HBV-induced hepatocellular carcinoma (HCC), a disease which causes more than one million deaths each year. Here we describe the design of a novel PROTAC (proteolysis targeting chimeric molecule) capable of simultaneously inducing the degradation of the X-protein, and antagonizing its function. The PROTAC was constructed by fusing the N-terminal oligomerization and C-terminal instability domains of the X-protein to each other, and rendering them cell-permeable by the inclusion of a polyarginine cell-penetrating peptide (CPP). It was predicted that the oligomerization domain would bind the X-protein, and that the instability domain would cause the X-protein to be targeted for proteasomal degradation. Addition of the PROTAC to HepG2 liver cancer cells, engineered to express full-length and C-terminally truncated forms of the X-protein, resulted in the degradation of both forms of the X-protein. A cell-permeable stand-alone form of the oligomerization domain was taken up by HepG2 cells, and acted as a dominant-negative inhibitor, causing inhibition of X-protein-induced apoptosis. In summary, the PROTAC described here induces the degradation of the X-protein, and antagonizes its function, and warrants investigation in a preclinical study for its ability to prevent or treat HBV infection and/or the development of HCC.

  5. Are Press Depictions of Affordable Care Act Beneficiaries Favorable to Policy Durability?

    Science.gov (United States)

    Chattopadhyay, Jacqueline

    2015-01-01

    If successfully implemented and enduring, the Affordable Care Act (ACA) stands to expand health insurance access in absolute terms, reduce inter-group disparities in that access, and reduce exposure to the financial vulnerabilities illness entails. Its durability--meaning both avoidance of outright retrenchment and fidelity to its policy aims--is thus of scholarly interest. Past literature suggests that social constructions of a policy's beneficiaries may impact durability. This paper first describes media portrayals of ACA beneficiaries with an eye toward answering three descriptive questions: (1) Do portrayals depict beneficiaries as economically heterogeneous? (2) Do portrayals focus attention on groups that have acquired new political relevance due to the ACA, such as young adults? (3) What themes that have served as messages about beneficiary "deservingness" in past social policy are most frequent in ACA beneficiary portrayals? The paper then assesses how the portrayal patterns that these questions uncover may work both for and against the ACA's durability, finding reasons for confidence as well as caution. Using manual and automated methods, this paper analyzes newspaper text from August 2013 through January 2014 to trace portrayals of two ACA "target populations" before and during the new law's first open-enrollment period: those newly eligible for Medicaid, and those eligible for subsidies to assist in the purchase of private health insurance under the ACA. This paper also studies newspaper text portrayals of two groups informally crafted by the ACA in this timeframe: those gaining health insurance and those losing it. The text data uncover the following answers to the three descriptive questions for the timeframe studied: (1) Portrayals may underplay beneficiaries' economic heterogeneity. (2) Portrayals pay little attention to young adults. (3) Portrayals emphasize themes of workforce participation, economic self-sufficiency, and insider status. Health

  6. Factors influencing Poverty Alleviation among Women Credit Beneficiaries in Tanzania: A Case Study of FINCA’s Women Credit beneficiaries in Mwanza

    Directory of Open Access Journals (Sweden)

    Samuel Nyambega Nyang’au

    2014-04-01

    Full Text Available Many credit schemes in Tanzania channel their funds to womenwith the objective of alleviating poverty among them. Despite this, majority ofwomen in the country continue to wallow in poverty. The present research wascarried out among the Foundation for International Community Assistance’s womencredit beneficiaries in Mwanza. The study set out to address the followingobjectives: to analyze the influence of the husband’s cooperation, relevanttraining and interest rate on poverty alleviation among women creditbeneficiaries in Tanzania taking Foundation for International CommunityAssistance in Mwanza as a case study. Using simple regression model, resultsshowed that cooperation from the husband as well as relevant training influencespoverty alleviation among women credit beneficiaries in Tanzania by 56 and 36percent respectively. But interest rate was found to have no significantinfluence at all. The paper recommends that seminars be conducted so thathusbands can be taught the importance of cooperating with their wives. Aboveall giving training to women credit beneficiaries will go a long way insharpening their business skills. Future researchers should research onlaziness and complacency among women credit beneficiaries and the influence onpoverty.

  7. Application of mixture experimental design to simvastatin apparent solubility predictions in the microemulsifion formed by self-microemulsifying.

    Science.gov (United States)

    Meng, Jian; Zheng, Liangyuan

    2007-09-01

    Self-microemulsifying drug delivery systems (SMEDDS) are useful to improve the bioavailability of poorly water-soluble drugs by increasing their apparent solubility through solubilization. However, very few studies, to date, have systematically examined the level of drug apparent solubility in o/w microemulsion formed by self-microemulsifying. In this study, a mixture experimental design was used to simulate the influence of the compositions on simvastatin apparent solubility quantitatively through an empirical model. The reduced cubic polynomial equation successfully modeled the evolution of simvastatin apparent solubility. The results were presented using an analysis of response surface showing a scale of possible simvastatin apparent solubility between 0.0024 ~ 29.0 mg/mL. Moreover, this technique showed that simvastatin apparent solubility was mainly influenced by microemulsion concentration and, suggested that the drug would precipitate in the gastrointestinal tract due to dilution by gastrointestinal fluids. Furthermore, the model would help us design the formulation to maximize the drug apparent solubility and avoid precipitation of the drug.

  8. Hospice utilization of Medicare beneficiaries in Hawai‘i compared to other states

    Directory of Open Access Journals (Sweden)

    Deborah Taira

    2017-11-01

    Full Text Available The objective is to examine hospice utilization among Medicare beneficiaries in Hawai‘i compared to other states. Data were from the 2014 Medicare Hospice Utilization and Payment Public Use File, which included information on 4,025 hospice providers, more than 1.3 million hospice beneficiaries, and over $15 billion in Medicare payments. Multivariable linear regression models were estimated to compare hospice utilization in Hawai‘i to that of other states. Control variables included age, gender, and type of Medicare coverage. Medicare beneficiaries using hospice in Hawai‘i differed significantly from beneficiaries in other states in several ways. Hawai‘i beneficiaries were more likely to be Asian (57% vs. 1%, p < .001 and “other race” (10% vs. 0.1%, p < .001, and less likely to be White (28% vs. 84%, p < .001. Hawai‘i beneficiaries were also more likely to have Medicare Advantage (55% vs. 30%, p = .05. Regarding primary diagnoses, hospice users in Hawai‘i were significantly more likely to have a primary diagnosis of stroke (11% vs. 8%, p = .03 and less likely to have respiratory disease (5% vs. 11%, p = .003. In addition, hospice users in Hawai‘i were more likely to use services in their homes (74% vs. 52%, p = .03. Hawai‘i hospice users were also less likely to die while in hospice (42% vs. 47%, p = .002. Characteristics of Medicare beneficiaries in Hawai‘i differ from those in other states, regarding demographic characteristics, type of coverage, primary diagnoses, likelihood of using services in their homes, and death rates. Further research is needed to better understand factors affecting these differences and whether these differences warrant changes in policy or practice.

  9. Racial disparities in poverty account for mortality differences in US medicare beneficiaries

    Directory of Open Access Journals (Sweden)

    Paul L. Kimmel

    2016-12-01

    Full Text Available Higher mortality in Blacks than Whites has been consistently reported in the US, but previous investigations have not accounted for poverty at the individual level. The health of its population is an important part of the capital of a nation. We examined the association between individual level poverty and disability and racial mortality differences in a 5% Medicare beneficiary random sample from 2004 to 2010. Cox regression models examined associations of race with all-cause mortality, adjusted for demographics, comorbidities, disability, neighborhood income, and Medicare “Buy-in” status (a proxy for individual level poverty in 1,190,510 Black and White beneficiaries between 65 and 99 years old as of January 1, 2014, who had full and primary Medicare Part A and B coverage in 2004, and lived in one of the 50 states or Washington, DC.Overall, black beneficiaries had higher sex-and-age adjusted mortality than Whites (hazard ratio [HR] 1.18. Controlling for health-related measures and disability reduced the HR for Black beneficiaries to 1.03. Adding “Buy-in” as an individual level covariate lowered the HR for Black beneficiaries to 0.92. Neither of the residential measures added to the predictive model. We conclude that poorer health status, excess disability, and most importantly, greater poverty among Black beneficiaries accounts for racial mortality differences in the aged US Medicare population. Poverty fosters social and health inequalities, including mortality disparities, notwithstanding national health insurance for the US elderly. Controlling for individual level poverty, in contrast to the common use of area level poverty in previous analyses, accounts for the White survival advantage in Medicare beneficiaries, and should be a covariate in analyses of administrative databases. Keywords: USA, Poverty, Socioeconomic status, Mortality, Race, Neighborhood, Disability, Disparities, Buy-in, Dual-eligible, Medicare, Medicaid, USRDS

  10. Out-of-pocket health spending by poor and near-poor elderly Medicare beneficiaries.

    Science.gov (United States)

    Gross, D J; Alecxih, L; Gibson, M J; Corea, J; Caplan, C; Brangan, N

    1999-04-01

    To estimate out-of-pocket health care spending by lower-income Medicare beneficiaries, and to examine spending variations between those who receive Medicaid assistance and those who do not receive such aid. DATA SOURCES AND COLLECTION: 1993 Medicare Current Beneficiary Survey (MCBS) Cost and Use files, supplemented with data from the Bureau of the Census (Current Population Survey); the Congressional Budget Office; the Health Care Financing Administration, Office of the Actuary (National Health Accounts); and the Social Security Administration. We analyzed out-of-pocket spending through a Medicare Benefits Simulation model, which projects out-of-pocket health care spending from the 1993 MCBS to 1997. Out-of-pocket health care spending is defined to include Medicare deductibles and coinsurance; premiums for private insurance, Medicare Part B, and Medicare HMOs; payments for non-covered goods and services; and balance billing by physicians. It excludes the costs of home care and nursing facility services, as well as indirect tax payments toward health care financing. Almost 60 percent of beneficiaries with incomes below the poverty level did not receive Medicaid assistance in 1997. We estimate that these beneficiaries spent, on average, about half their income out-of-pocket for health care, whether they were enrolled in a Medicare HMO or in the traditional fee-for-service program. The 75 percent of beneficiaries with incomes between 100 and 125 percent of the poverty level who were not enrolled in Medicaid spent an estimated 30 percent of their income out-of-pocket on health care if they were in the traditional program and about 23 percent of their income if they were enrolled in a Medicare HMO. Average out-of-pocket spending among fee-for-service beneficiaries varied depending on whether beneficiaries had Medigap policies, employer-provided supplemental insurance, or no supplemental coverage. Those without supplemental coverage spent more on health care goods and

  11. The Use of Ambulatory Blood Pressure Monitoring Among Medicare Beneficiaries in 2007-2010

    Science.gov (United States)

    Shimbo, Daichi; Kent, Shia T; Diaz, Keith M; Huang, Lei; Viera, Anthony J; Kilgore, Meredith; Oparil, Suzanne; Muntner, Paul

    2014-01-01

    The US Centers for Medicaid and Medicare Services reimburses ambulatory blood pressure monitoring (ABPM) for suspected white coat hypertension. We estimated ABPM use between 2007 and 2010 among a 5% random sample of Medicare beneficiaries (≥ 65 years). In 2007, 2008, 2009 and 2010, the percentage of beneficiaries with ABPM claims was 0.10%, 0.11%, 0.10%, and 0.09% respectively. A prior diagnosis of hypertension was more common among those with versus without an ABPM claim (77.7% versus 47.0%). Among hypertensive beneficiaries, 95.2% of those with an ABPM claim were taking antihypertensive medication. Age 75-84 versus 65-74 years, having coronary heart disease, chronic kidney disease, multiple prior hypertension diagnoses, and having filled multiple classes of antihypertensive medication were associated with an increased odds for an ABPM claim among hypertensive beneficiaries. ABPM use was very low among Medicare beneficiaries and was not primarily used for diagnosing white coat hypertension in untreated individuals. PMID:25492832

  12. Classification of the financial sustainability of health insurance beneficiaries through data mining techniques

    Directory of Open Access Journals (Sweden)

    Sílvia Maria Dias Pedro Rebouças

    2016-09-01

    Full Text Available Advances in information technologies have led to the storage of large amounts of data by organizations. An analysis of this data through data mining techniques is important support for decision-making. This article aims to apply techniques for the classification of the beneficiaries of an operator of health insurance in Brazil, according to their financial sustainability, via their sociodemographic characteristics and their healthcare cost history. Beneficiaries with a loss ratio greater than 0.75 are considered unsustainable. The sample consists of 38875 beneficiaries, active between the years 2011 and 2013. The techniques used were logistic regression and classification trees. The performance of the models was compared to accuracy rates and receiver operating Characteristic curves (ROC curves, by determining the area under the curves (AUC. The results showed that most of the sample is composed of sustainable beneficiaries. The logistic regression model had a 68.43% accuracy rate with AUC of 0.7501, and the classification tree obtained 67.76% accuracy and an AUC of 0.6855. Age and the type of plan were the most important variables related to the profile of the beneficiaries in the classification. The highlights with regard to healthcare costs were annual spending on consultation and on dental insurance.

  13. Reforming Access: Trends in Medicaid Enrollment for New Medicare Beneficiaries, 2008-2011.

    Science.gov (United States)

    Keohane, Laura M; Rahman, Momotazur; Mor, Vincent

    2016-04-01

    To evaluate whether aligning the Part D low-income subsidy and Medicaid program enrollment pathways in 2010 increased Medicaid participation among new Medicare beneficiaries. Medicare enrollment records for years 2007-2011. We used a multinomial logistic model with state fixed effects to examine the annual change in limited and full Medicaid enrollment among new Medicare beneficiaries for 2 years before and after the reforms (2008-2011). We identified new Medicare beneficiaries in the years 2008-2011 and their participation in Medicaid based on Medicare enrollment records. The percentage of beneficiaries enrolling in limited Medicaid at the start of Medicare coverage increased in 2010 by 0.3 percentage points for individuals aging into Medicare and by 1.3 percentage points for those qualifying due to disability (p < .001). There was no significant difference in the size of enrollment increases between states with and without concurrent limited Medicaid eligibility expansions. Our findings suggest that streamlining financial assistance programs may improve Medicare beneficiaries' access to benefits. © Health Research and Educational Trust.

  14. Comparability and Usability: Key issues in the design of internet forms for New Zealand’s 2006 Census of Populations and Dwellings

    Directory of Open Access Journals (Sweden)

    Lyn Potaka

    2008-03-01

    Full Text Available Designing internet questionnaires to collect data that will ultimately be comparable with the data collected from paper questionnaires can present a number of challenges for developers. This paper discusses the design and development of internet forms for use in a mixed-mode Census in New Zealand in 2006. Using experiences from the design and testing of prototype forms, it describes design features intended to take full advantage of the capabilities of the internet mode, while preserving the qualities of paper based responding to help prevent mode effects. The discussion also highlights the role of usability testing as a key tool in evaluating the success of those design strategies and ensuring that the forms would be simple and easy to use.

  15. Directory of national competent authorities' approval certificates for package design, special form material and shipment of radioactive material. 2003 ed

    International Nuclear Information System (INIS)

    2003-10-01

    This is the fourteenth annual report being published by the Secretariat of the International Atomic Energy Agency since implementing its database on package approval certificates (PACKTRAM) at the recommendation of the Transport Safety Standards Committee (TRANSSC). It supersedes IAEA-TECDOC-1302 'Directory of National Competent Authorities' Approval Certificates for Package Design, Special Form Material and Shipment of Radioactive Material, 2002 Edition'. Through the database, the Secretariat collects administrative and technical information provided by the issuing competent authority about package approval certificates. Such data are used mainly by national competent authorities and port and customs officials to assist in regulating radioactive material movements in their country, and also by manufacturers and shippers of radioactive material. The database carries information on extant certificates and those that expired within the last complete calendar year. The PACKTRAM database only contains information that has been provided to the IAEA. The data are not complete nor guaranteed to be accurate. If detailed information is required, the original package approval certificates must be consulted. If information is required about package approval certificates that are not contained in the database, the issuing competent authority must be consulted

  16. Directory of national competent authorities' approval certificates for package design, special form material and shipment of radioactive material. 2003 ed

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2003-10-01

    This is the fourteenth annual report being published by the Secretariat of the International Atomic Energy Agency since implementing its database on package approval certificates (PACKTRAM) at the recommendation of the Transport Safety Standards Committee (TRANSSC). It supersedes IAEA-TECDOC-1302 'Directory of National Competent Authorities' Approval Certificates for Package Design, Special Form Material and Shipment of Radioactive Material, 2002 Edition'. Through the database, the Secretariat collects administrative and technical information provided by the issuing competent authority about package approval certificates. Such data are used mainly by national competent authorities and port and customs officials to assist in regulating radioactive material movements in their country, and also by manufacturers and shippers of radioactive material. The database carries information on extant certificates and those that expired within the last complete calendar year. The PACKTRAM database only contains information that has been provided to the IAEA. The data are not complete nor guaranteed to be accurate. If detailed information is required, the original package approval certificates must be consulted. If information is required about package approval certificates that are not contained in the database, the issuing competent authority must be consulted.

  17. Study of the liquid-film-forming apparatus as an alternative aeration system: design criteria and operating condition.

    Science.gov (United States)

    Hongprasith, Narapong; Imai, Tsuyoshi; Painmanakul, Pisut

    2017-06-01

    Aeration is an important factor in aquaculture systems because it is a vital condition for all organisms that live in water and respire aerobically. Generally, mechanical surface aerators are widely used in Thailand due to their advantage for increasing dissolved oxygen (DO) and for their horizontal mixing of aquaculture ponds with large surface areas. However, these systems still have some drawbacks, primarily the low oxygen transfer efficiency (OTE) and energy. Regarding this issue, alternative aeration systems should be studied and applied. Therefore, this research aims to study the aeration mechanism obtained by the diffused-air aeration combined with a liquid-film-forming apparatus (LFFA). The effect of gas flow rates, types, and patterns of aerator installation were investigated in an aquaculture pond of 10 m × 10 m × 1.5 m. The analytical parameters were volumetric mass transfer coefficient (k L a), OTE, and aeration efficiency (AE). From the results, the '4-D' with partitions was proposed as the suitable pattern for the LFFA installation. The advantage could be obtained from high energy performance with 1.2 kg/kW h of AE. Then, the operation conditions can be applied as a design guideline for this alternative aeration system in the aquaculture ponds.

  18. Barriers to Employment Among Social Security Disability Insurance Beneficiaries in the Mental Health Treatment Study.

    Science.gov (United States)

    Milfort, Roline; Bond, Gary R; McGurk, Susan R; Drake, Robert E

    2015-12-01

    This study examined barriers to employment among Social Security Disability Insurance (SSDI) beneficiaries who received comprehensive vocational and mental health services but were not successful in returning to work. This study examined barriers to employment among 430 SSDI beneficiaries with mental disorders who received evidence-based vocational and mental health services for two years but worked less than one month or not at all. Comprehensive care teams, which included employment specialists, made consensus judgments for each participant, identifying the top three barriers to employment from a checklist of 14 common barriers. Teams most frequently identified three barriers to employment: poorly controlled symptoms of mental illness (55%), nonengagement in supported employment (44%), and poorly controlled general medical problems (33%). Other factors were identified much less frequently. Some SSDI beneficiaries, despite having access to comprehensive services, continued to experience psychiatric impairments, difficulty engaging in vocational services, and general medical problems that limited their success in employment.

  19. A profile of social security child beneficiaries and their families: sociodemographic and economic characteristics.

    Science.gov (United States)

    Tamborini, Christopher R; Cupito, Emily; Shoffner, Dave

    2011-01-01

    Using a rich dataset that links the Census Bureau's Survey of Income and Program Participation calendar-year 2004 file with Social Security benefit records, this article provides a portrait of the sociodemographic and economic characteristics of Social Security child beneficiaries. We find that the incidence ofbenefit receipt in the child population differs substantially across individual and family-level characteristics. Average benefit amounts also vary across subgroups and benefit types. The findings provide a better understanding of the importance of Social Security to families with beneficiary children. Social Security is a major source of family income for many child beneficiaries, particularly among those with low income or family heads with lower education and labor earnings.

  20. Favorable Risk Selection in Medicare Advantage: Trends in Mortality and Plan Exits Among Nursing Home Beneficiaries

    Science.gov (United States)

    Goldberg, Elizabeth M.; Trivedi, Amal N.; Mor, Vincent; Jung, Hye-Young; Rahman, Momotazur

    2016-01-01

    The 2003 Medicare Modernization Act (MMA) increased payments to Medicare Advantage plans and instituted a new risk-adjustment payment model to reduce plans' incentives to enroll healthier Medicare beneficiaries and avoid those with higher costs. Whether the MMA reduced risk selection remains debatable. This study uses mortality differences, nursing home utilization, and switch rates to assess whether the MMA successfully decreased risk selection from 2000 to 2012. We found no decrease in the mortality difference or adjusted difference in nursing home use between plan beneficiaries pre- and post the MMA. Among beneficiaries with nursing home use, disenrollment from Medicare Advantage plans declined from 20% to 12%, but it remained 6 times higher than the switch rate from traditional Medicare to Medicare Advantage. These findings suggest that the MMA was not associated with reductions in favorable risk selection, as measured by mortality, nursing home use, and switch rates. PMID:27516452

  1. The Use of Ambulatory Blood Pressure Monitoring Among Medicare Beneficiaries in 2007-2010

    OpenAIRE

    Shimbo, Daichi; Kent, Shia T; Diaz, Keith M; Huang, Lei; Viera, Anthony J; Kilgore, Meredith; Oparil, Suzanne; Muntner, Paul

    2014-01-01

    The US Centers for Medicaid and Medicare Services reimburses ambulatory blood pressure monitoring (ABPM) for suspected white coat hypertension. We estimated ABPM use between 2007 and 2010 among a 5% random sample of Medicare beneficiaries (≥ 65 years). In 2007, 2008, 2009 and 2010, the percentage of beneficiaries with ABPM claims was 0.10%, 0.11%, 0.10%, and 0.09% respectively. A prior diagnosis of hypertension was more common among those with versus without an ABPM claim (77.7% versus 47.0%)...

  2. Nonemergency medical transportation and health care visits among chronically ill urban and rural medicaid beneficiaries.

    Science.gov (United States)

    Thomas, Leela V; Wedel, Kenneth R

    2014-01-01

    Inaccessibility to health care services due to lack of transportation affects the most vulnerable segments of the society. The effect of Medicaid-provided nonemergency medical transportation (NEMT) in Oklahoma on health care visits for the management of chronic illnesses is examined. Analyses of claims data show that African Americans are the highest users of NEMT. Medicaid beneficiaries who use NEMT services are significantly more likely to make the recommended number of annual visits for the management of chronic conditions than those who do not use NEMT. Increased use of NEMT by making the services more accommodating and convenient for beneficiaries is proposed.

  3. The Final Beneficiaries are Actors Active Little and Influential in Decisions on Public Policy in Brazil

    Directory of Open Access Journals (Sweden)

    Diolina Rodrigues Santiago Silva

    2016-10-01

    Full Text Available Public policies are government programs that directly influence the citizens' lives. In the formulation and implementation of these policies, there is the presence of political and private actors. The final beneficiaries are between different types of private actors. Some laws require the government listen to society at the time of decision-making in public policy and in national conferences and public consultations. The final beneficiaries, actual users of these public policies have to reach some mechanisms of direct participation in the formulation of these policies, but the number of participants is smaller and doesn't influence in making government decisions.

  4. Home Health Agency Characteristics and Quality Outcomes for Medicare Beneficiaries With Rehabilitation-Sensitive Conditions.

    Science.gov (United States)

    Mroz, Tracy M; Meadow, Ann; Colantuoni, Elizabeth; Leff, Bruce; Wolff, Jennifer L

    2018-06-01

    To examine associations between organizational characteristics of home health agencies (eg, profit status, rehabilitation therapy staffing model, size, and rurality) and quality outcomes in Medicare beneficiaries with rehabilitation-sensitive conditions, conditions for which occupational, physical, and/or speech therapy have the potential to improve functioning, prevent or slow substantial decline in functioning, or increase ability to remain at home safely. Retrospective analysis. Home health agencies. Fee-for-service beneficiaries (N=1,006,562) admitted to 9250 Medicare-certified home health agencies in 2009. Not applicable. Institutional admission during home health care, community discharge, and institutional admission within 30 days of discharge. Nonprofit (vs for-profit) home health agencies were more likely to discharge beneficiaries to the community (odds ratio [OR], 1.23; 95% confidence interval [CI], 1.13-1.33) and less likely to have beneficiaries incur institutional admissions within 30 days of discharge (OR, .93; 95% CI, .88-.97). Agencies in rural (vs urban) counties were less likely to discharge patients to the community (OR, .83; 95% CI, .77-.90) and more likely to have beneficiaries incur institutional admissions during home health (OR, 1.24; 95% CI, 1.18-1.30) and within 30 days of discharge (OR, 1.15; 95% CI, 1.10-1.22). Agencies with contract (vs in-house) therapy staff were less likely to discharge beneficiaries to the community (OR, .79, 95% CI, .70-.91) and more likely to have beneficiaries incur institutional admissions during home health (OR, 1.09; 95% CI, 1.03-1.15) and within 30 days of discharge (OR, 1.17; 95% CI, 1.07-1.28). As payers continue to test and implement reimbursement mechanisms that seek to reward value over volume of services, greater attention should be paid to organizational factors that facilitate better coordinated, higher quality home health care for beneficiaries who may benefit from rehabilitation. Copyright © 2017

  5. Cross-Linguistic Variation in the Treatment of Beneficiaries and the Argument vs. Adjunct Distinction

    Directory of Open Access Journals (Sweden)

    Denis Creissels

    2014-01-01

    Full Text Available This paper compares the expression of beneficiaries with that of typical arguments and typical adjuncts in a sample of languages illustrating the variation in the extent to which NPs encoding beneficiaries show a syntactic behavior more or less similar to that of typical arguments or typical adjuncts. The observations support the position according to which semantic argumenthood as a comparative concept must be distinguished from its possible syntactic correlates, and must be defined as a scalar rather than categorical concept reflecting the interaction between the various factors that may contribute to defining the degree of involvement of participants in an event.

  6. The effect of tooling design parameters on web-warping in the flexible roll forming of UHSS

    International Nuclear Information System (INIS)

    Jiao, Jingsi; Weiss, Matthias; Rolfe, Bernard; Mendiguren, Joseba; Galdos, Lander

    2013-01-01

    To reduce weight and improve passenger safety there is an increased need in the automotive industry to use Ultra High Strength Steels (UHSS) for structural and crash components. However, the application of UHSS is restricted by their limited formability and the difficulty of forming them in conventional processes. An alternative method of manufacturing structural auto body parts from UHSS is the flexible roll forming process which can accommodate materials with high strength and limited ductility in the production of complex and weight-optimised components. However, one major concern in the flexible roll forming is web-warping, which is the height deviation of the profile web area. This paper investigates, using a numerical model, the effect on web-warping with respect to various forming methods. The results demonstrate that different forming methods lead to different amount of web-warping in terms of forming the product with identical geometry

  7. The effect of tooling design parameters on web-warping in the flexible roll forming of UHSS

    Science.gov (United States)

    Jiao, Jingsi; Rolfe, Bernard; Mendiguren, Joseba; Galdos, Lander; Weiss, Matthias

    2013-12-01

    To reduce weight and improve passenger safety there is an increased need in the automotive industry to use Ultra High Strength Steels (UHSS) for structural and crash components. However, the application of UHSS is restricted by their limited formability and the difficulty of forming them in conventional processes. An alternative method of manufacturing structural auto body parts from UHSS is the flexible roll forming process which can accommodate materials with high strength and limited ductility in the production of complex and weight-optimised components. However, one major concern in the flexible roll forming is web-warping, which is the height deviation of the profile web area. This paper investigates, using a numerical model, the effect on web-warping with respect to various forming methods. The results demonstrate that different forming methods lead to different amount of web-warping in terms of forming the product with identical geometry.

  8. 45 CFR 205.25 - Eligibility of supplemental security income beneficiaries for food stamps or surplus commodities.

    Science.gov (United States)

    2010-10-01

    ... beneficiaries for food stamps or surplus commodities. 205.25 Section 205.25 Public Welfare Regulations Relating....25 Eligibility of supplemental security income beneficiaries for food stamps or surplus commodities... XVI of the Social Security Act, the State agency shall make the following determinations: (1) The...

  9. Choice of Personal Assistance Services Providers by Medicare Beneficiaries Using a Consumer-Directed Benefit: Rural-Urban Differences

    Science.gov (United States)

    Meng, Hongdao; Friedman, Bruce; Wamsley, Brenda R.; Van Nostrand, Joan F.; Eggert, Gerald M.

    2010-01-01

    Purpose: To examine the impact of an experimental consumer-choice voucher benefit on the selection of independent and agency personal assistance services (PAS) providers among rural and urban Medicare beneficiaries with disabilities. Methods: The Medicare Primary and Consumer-Directed Care Demonstration enrolled 1,605 Medicare beneficiaries in 19…

  10. 20 CFR 10.17 - Is a beneficiary who defrauds the Government in connection with a claim for benefits still...

    Science.gov (United States)

    2010-04-01

    ... connection with a claim for benefits, the beneficiary's entitlement to any further compensation benefits will... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Is a beneficiary who defrauds the Government in connection with a claim for benefits still entitled to those benefits? 10.17 Section 10.17...

  11. 76 FR 59663 - Limitations of Duty- and Quota-Free Imports of Apparel Articles Assembled in Beneficiary Sub...

    Science.gov (United States)

    2011-09-27

    ... of Apparel Articles Assembled in Beneficiary Sub-Saharan African Countries From Regional and Third... Acceleration Act of 2004, Pub. L. 108-274; Division D, Title VI, section 6002 of the Tax Relief and Health Care... beneficiary sub-Saharan African countries. Section 112(b)(3) of TDA 2000 provides duty- and quota-free...

  12. 78 FR 59917 - Limitations of Duty- and Quota-Free Imports of Apparel Articles Assembled in Beneficiary Sub...

    Science.gov (United States)

    2013-09-30

    ... of Apparel Articles Assembled in Beneficiary Sub-Saharan African Countries From Regional and Third... 6002 of the Tax Relief and Health Care Act of 2006 (TRHCA 2006), Public Law 109-432, and section 1... apparel articles wholly assembled in one or more beneficiary sub-Saharan African countries from fabric...

  13. 20 CFR 411.566 - May an EN use outcome or milestone payments to make payments to the beneficiary?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false May an EN use outcome or milestone payments... an EN use outcome or milestone payments to make payments to the beneficiary? Yes, an EN may use milestone or outcome payments to make payments to a beneficiary. [73 FR 29350, May 20, 2008] ...

  14. 26 CFR 1.1312-5 - Correlative deductions and inclusions for trusts or estates and legatees, beneficiaries, or heirs.

    Science.gov (United States)

    2010-04-01

    ..., heirs, or legatees; or (4) The exclusion of such amounts from the income of the beneficiaries, heirs, or... invalid the clause directing accumulation and determines that the income is required to be currently... beneficiary's tax for the year 1954, based on the exclusion from 1954 gross income of the capital gains...

  15. Factors affecting perception of beneficiaries of National Programme on Improved Cookstoves regarding cost-benefit of adoption of Mamta Stove

    Energy Technology Data Exchange (ETDEWEB)

    George, R.; Yadla, V.L. [M.S. Univ. of Baroda, Vadodara (India). Home Management Dept.

    1995-10-01

    Perceived levels of cost-benefit of adoption of Mamta Stove (MS) was investigated on a sample of 390 beneficiaries of National Programme on Improved Cookstoves (NPIC) drawn through multistage random sampling technique from 3 villages in Gujarat State, viz., Kanjari, Vadadla, and Sindhrot. A standardized cost-benefit scale that exhibited a reliability coefficient of 0.92 was used in the study. The main cooks revealed a mean age of 36 years. Regarding perception on available sources of cooking fuel and accessibility to those, a wide disparity was observed, not only with reference to commercial sources and fuel forms but also with reference to free fuels gathered from forest land and waste land. MSs were installed in rural kitchens with the active involvement of about 50% of the main cooks. Majority of the cooks in Sindhrot village attended user education camps. The mean perceived cost-benefit ratio (PCBR) was computed to be 0.14. However, PCBR of the cooks from Sindhrot village was 0.51 while those of Vadadla and Kanjari were 0.09 and {minus}0.19 respectively. The correlation coefficient computed between PCBR and selected variables revealed that there existed a significant positive correlation between PCBR of the cook and their participation in NPIC and quality of installation of MS. The observation of the highest PCBR in Sindhrot village, a model smokeless village developed by TBU Baroda, could be attributed to the implementation of NPIC in a systematic manner adopting participatory model. The paper discusses at length the implications of the study and outlines the strategies for achieving widespread adoption of MS by beneficiaries of NPIC.

  16. Forming a method mindset : The role of knowledge and preference in facilitating heuristic method usage in design

    NARCIS (Netherlands)

    Daalhuizen, J.J.; Person, F.E.O.K.; Gattol, V.

    2013-01-01

    Both systematic and heuristic methods are common practice when designing. Yet, in teaching students how to design, heuristic methods are typically only granted a secondary role. So, how do designers and students develop a mindset for using heuristic methods? In this paper, we study how prior

  17. Forming a method mindset: The role of knowledge and preference in facilitating heuristic method usage in design

    DEFF Research Database (Denmark)

    Daalhuizen, Jaap; Person, Oscar; Gattol, Valentin

    2013-01-01

    Both systematic and heuristic methods are common practice when designing. Yet, in teaching students how to design, heuristic methods are typically only granted a secondary role. So, how do designers and students develop a mindset for using heuristic methods? In this paper, we study how prior...... knowledge (about heuristic methods and their usage) and preference (for using heuristic methods) relate to the reported use of heuristic methods when designing. Drawing on a survey among 304 students enrolled in a master-level course on design theory and methodology, we investigated method usage for five...... indirectly influenced method usage through a 'complementary' mediation of method preference....

  18. Inflammatory bowel disease and risk of Parkinson's disease in Medicare beneficiaries.

    Science.gov (United States)

    Camacho-Soto, Alejandra; Gross, Anat; Searles Nielsen, Susan; Dey, Neelendu; Racette, Brad A

    2018-05-01

    Gastrointestinal (GI) dysfunction precedes the motor symptoms of Parkinson's disease (PD) by several years. PD patients have abnormal aggregation of intestinal α-synuclein, the accumulation of which may be promoted by inflammation. The relationship between intestinal α-synuclein aggregates and central nervous system neuropathology is unknown. Recently, we observed a possible inverse association between inflammatory bowel disease (IBD) and PD as part of a predictive model of PD. Therefore, the objective of this study was to examine the relationship between PD risk and IBD and IBD-associated conditions and treatment. Using a case-control design, we identified 89,790 newly diagnosed PD cases and 118,095 population-based controls >65 years of age using comprehensive Medicare data from 2004-2009 including detailed claims data. We classified IBD using International Classification of Diseases version 9 (ICD-9) diagnosis codes. We used logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs) to evaluate the association between PD and IBD. Covariates included age, sex, race/ethnicity, smoking, Elixhauser comorbidities, and health care use. PD was inversely associated with IBD overall (OR = 0.85, 95% CI 0.80-0.91) and with both Crohn's disease (OR = 0.83, 95% CI 0.74-0.93) and ulcerative colitis (OR = 0.88, 95% CI 0.82-0.96). Among beneficiaries with ≥2 ICD-9 codes for IBD, there was an inverse dose-response association between number of IBD ICD-9 codes, as a potential proxy for IBD severity, and PD (p-for-trend = 0.006). IBD is associated with a lower risk of developing PD. Copyright © 2018 Elsevier Ltd. All rights reserved.

  19. The National Heart Failure Project: a health care financing administration initiative to improve the care of Medicare beneficiaries with heart failure.

    Science.gov (United States)

    Masoudi, F A; Ordin, D L; Delaney, R J; Krumholz, H M; Havranek, E P

    2000-01-01

    This is the second in a series describing Health Care Financing Administration (HCFA) initiatives to improve care for Medicare beneficiaries with heart failure. The first article outlined the history of HCFA quality-improvement projects and current initiatives to improve care in six priority areas: heart failure, acute myocardial infarction, stroke, pneumonia, diabetes, and breast cancer. This article details the objectives and design of the Medicare National Heart Failure Quality Improvement Project (NHF), which has as its goal the improvement of inpatient heart failure care. (c)2000 by CHF, Inc.

  20. Methodology for a computer-aided design of shrink fits that considers the roughness and form defects of the manufacturing process

    Energy Technology Data Exchange (ETDEWEB)

    Boutoutaou, H. [Universit M' hamed Bougara, Boumerdes (Algeria); Fontaine, J. F. [Universit de Bourgogne, Auxerre (France)

    2015-05-15

    The use of the interference fit (Shrink fit) assembly technique is increasing nowadays. However, design methodologies for such assemblies employ older models based on restrictive assumptions regarding the shape and surface quality of assembled parts. A finite element method software is frequently used to overcome this drawback. Such software allows an approach that is close to the physical reality of the parts (Complex form) of an assembly. However, surfaces are generally considered to be perfect cylinders with a constant tightening. The proposed approach allows both form defects and roughness to be introduced into the design, and thus, the manufacturing process is considered. Form defect is integrated directly into the mesh, whereas roughness is considered by a homogenized finite element of the interface. An application of the approach is presented to determine the specifications that consider the manufacturing process (Honing, grinding, and turning). This simple method can be easily applied in industrial design offices.

  1. Methodology for a computer-aided design of shrink fits that considers the roughness and form defects of the manufacturing process

    International Nuclear Information System (INIS)

    Boutoutaou, H.; Fontaine, J. F.

    2015-01-01

    The use of the interference fit (Shrink fit) assembly technique is increasing nowadays. However, design methodologies for such assemblies employ older models based on restrictive assumptions regarding the shape and surface quality of assembled parts. A finite element method software is frequently used to overcome this drawback. Such software allows an approach that is close to the physical reality of the parts (Complex form) of an assembly. However, surfaces are generally considered to be perfect cylinders with a constant tightening. The proposed approach allows both form defects and roughness to be introduced into the design, and thus, the manufacturing process is considered. Form defect is integrated directly into the mesh, whereas roughness is considered by a homogenized finite element of the interface. An application of the approach is presented to determine the specifications that consider the manufacturing process (Honing, grinding, and turning). This simple method can be easily applied in industrial design offices.

  2. 42 CFR 415.162 - Determining payment for physician services furnished to beneficiaries in teaching hospitals.

    Science.gov (United States)

    2010-10-01

    ... furnished to beneficiaries in teaching hospitals. 415.162 Section 415.162 Public Health CENTERS FOR MEDICARE... BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings § 415.162 Determining payment for physician services...

  3. 28 CFR 104.52 - Distribution of award to decedent's beneficiaries.

    Science.gov (United States)

    2010-07-01

    ... VICTIM COMPENSATION FUND OF 2001 Payment of Claims § 104.52 Distribution of award to decedent's beneficiaries. The Personal Representative shall distribute the award in a manner consistent with the law of the decedent's domicile or any applicable rulings made by a court of competent jurisdiction. The Personal...

  4. Substantial Physician Turnover And Beneficiary 'Churn' In A Large Medicare Pioneer ACO.

    Science.gov (United States)

    Hsu, John; Vogeli, Christine; Price, Mary; Brand, Richard; Chernew, Michael E; Mohta, Namita; Chaguturu, Sreekanth K; Weil, Eric; Ferris, Timothy G

    2017-04-01

    Alternative payment models, such as accountable care organizations (ACOs), attempt to stimulate improvements in care delivery by better alignment of payer and provider incentives. However, limited attention has been paid to the physicians who actually deliver the care. In a large Medicare Pioneer ACO, we found that the number of beneficiaries per physician was low (median of seventy beneficiaries per physician, or less than 5 percent of a typical panel). We also found substantial physician turnover: More than half of physicians either joined (41 percent) or left (18 percent) the ACO during the 2012-14 contract period studied. When physicians left the ACO, most of their attributed beneficiaries also left the ACO. Conversely, about half of the growth in the beneficiary population was because of new physicians affiliating with the ACO; the remainder joined after switching physicians. These findings may help explain the muted financial impact ACOs have had overall, and they raise the possibility of future gaming on the part of ACOs to artificially control spending. Policy refinements include coordinated and standardized risk-sharing parameters across payers to prevent any dilution of the payment incentives or confusion from a cacophony of incentives across payers. Project HOPE—The People-to-People Health Foundation, Inc.

  5. 75 FR 32480 - Funding Opportunity: Affordable Care Act Medicare Beneficiary Outreach and Assistance Program...

    Science.gov (United States)

    2010-06-08

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration on Aging Funding Opportunity: Affordable Care Act Medicare Beneficiary Outreach and Assistance Program Funding for Title VI Native American Programs Purpose of Notice: Availability of funding opportunity announcement. Funding Opportunity Title/Program Name: Affordable Care Act Medicare...

  6. 32 CFR 728.53 - Department of Labor, Office of Workers' Compensation Programs (OWCP) beneficiaries.

    Science.gov (United States)

    2010-07-01

    ... DEPARTMENT FACILITIES Beneficiaries of Other Federal Agencies § 728.53 Department of Labor, Office of Workers... injury) incurred while engaged in: (i) Training. (ii) Flight instructions. (iii) Travel to or from... injury.) This category includes but is not limited to: (i) Civilian student employees in training at Navy...

  7. 42 CFR 409.42 - Beneficiary qualifications for coverage of services.

    Science.gov (United States)

    2010-10-01

    ... HUMAN SERVICES MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Home Health Services Under Hospital... home health services, a beneficiary must meet each of the following requirements: (a) Confined to the..., management and evaluation of a patient care plan is considered a reasonable and necessary skilled service...

  8. 75 FR 8927 - Autism Services Demonstration Project for TRICARE Beneficiaries Under the Extended Care Health...

    Science.gov (United States)

    2010-02-26

    ... DEPARTMENT OF DEFENSE Office of the Secretary Autism Services Demonstration Project for TRICARE... Access to Autism Services Demonstration Project under the Extended Care Health Option for beneficiaries diagnosed with an Autism Spectrum Disorder (ASD). Under the demonstration, the Department implemented a...

  9. 26 CFR 1.167(h)-1 - Life tenants and beneficiaries of trusts and estates.

    Science.gov (United States)

    2010-04-01

    ... reserve) allocable to each. For example: (1) If under the trust instrument or local law the income of a... local law the income of a trust is to be distributed to a named beneficiary, but the trustee is directed... otherwise provided in this paragraph when the trust instrument or local law requires or permits the trustee...

  10. 26 CFR 1.679-2 - Trusts treated as having a U.S. beneficiary.

    Science.gov (United States)

    2010-04-01

    ... beneficiaries generally does not include heirs who will benefit from the trust under the laws of intestate... of the trust instrument do not allow the trust to be amended to benefit a U.S. person, but the law... law. A creates and funds FT for the benefit of C. The terms of FT (which, according to the trust...

  11. U.S. Preventive Services Task Force recommendations and cancer screening among female Medicare beneficiaries.

    Science.gov (United States)

    Salloum, Ramzi G; Kohler, Racquel E; Jensen, Gail A; Sheridan, Stacey L; Carpenter, William R; Biddle, Andrea K

    2014-03-01

    Medicare covers several cancer screening tests not currently recommended by the U.S. Preventive Services Task Force (Task Force). In September 2002, the Task Force relaxed the upper age limit of 70 years for breast cancer screening recommendations, and in March 2003 an upper age limit of 65 years was introduced for cervical cancer screening recommendations. We assessed whether mammogram and Pap test utilization among women with Medicare coverage is influenced by changes in the Task Force's recommendations for screening. We identified female Medicare beneficiaries aged 66-80 years and used bivariate probit regression to examine the receipt of breast (mammogram) and cervical (Pap test) cancer screening reflecting changes in the Task Force recommendations. We analyzed 9,760 Medicare Current Beneficiary Survey responses from 2001 to 2007. More than two-thirds reported receiving a mammogram and more than one-third a Pap test in the previous 2 years. Lack of recommendation was given as a reason for not getting screened among the majority (51% for mammogram and 75% for Pap). After controlling for beneficiary-level socioeconomic characteristics and access to care factors, we did not observe a significant change in breast and cervical cancer screening patterns following the changes in Task Force recommendations. Although there is evidence that many Medicare beneficiaries adhere to screening guidelines, some women may be receiving non-recommended screening services covered by Medicare.

  12. 38 CFR 3.666 - Incarcerated beneficiaries and fugitive felons-pension.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Incarcerated beneficiaries and fugitive felons-pension. 3.666 Section 3.666 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS ADJUDICATION Pension, Compensation, and Dependency and Indemnity Compensation...

  13. 38 CFR 3.714 - Improved pension elections-public assistance beneficiaries.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Improved pension elections-public assistance beneficiaries. 3.714 Section 3.714 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS ADJUDICATION Pension, Compensation, and Dependency and Indemnity Compensation...

  14. 42 CFR 405.1205 - Notifying beneficiaries of hospital discharge appeal rights.

    Science.gov (United States)

    2010-10-01

    ...” is defined as any facility providing care at the inpatient hospital level, whether that care is short... basis, limited to specialty care or providing a broader spectrum of services. This definition includes... beneficiary refuses to sign the notice. The hospital may annotate its notice to indicate the refusal, and the...

  15. 26 CFR 1.673(c)-1 - Reversionary interest after income beneficiary's death.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 8 2010-04-01 2010-04-01 false Reversionary interest after income beneficiary's death. 1.673(c)-1 Section 1.673(c)-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Grantors and Others Treated As Substantial Owners § 1.673(c)-1 Reversionary interest after...

  16. 19 CFR 10.178 - Direct costs of processing operations performed in the beneficiary developing country.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Direct costs of processing operations performed in... processing operations performed in the beneficiary developing country. (a) Items included in the direct costs of processing operations. As used in § 10.176, the words “direct costs of processing operations...

  17. Habitat and Recreational Fishing Opportunity in Tampa Bay: Linking Ecological and Ecosystem Services to Human Beneficiaries

    Science.gov (United States)

    Estimating value of estuarine habitat to human beneficiaries requires that we understand how habitat alteration impacts function through both production and delivery of ecosystem goods and services (EGS). Here we expand on the habitat valuation technique of Bell (1997) with an es...

  18. Preventable hospitalizations among adult Medicaid beneficiaries with concurrent substance use disorders

    Directory of Open Access Journals (Sweden)

    Kit Sang Leung

    2015-01-01

    Conclusions: Substance use disorder is statistically associated with hospitalizations for most Ambulatory Care Sensitive Conditions but not with length of hospital stay for Ambulatory Care Sensitive Conditions, after adjusting for covariates. The significant associations between substance use disorder and Ambulatory Care Sensitive Condition admissions suggest unmet primary health care needs for substance use disorder beneficiaries and a need for integrated primary/behavioral healthcare.

  19. Technical support for GEIS: radioactive waste isolation in geologic formations. Volume 16. Repository preconceptual design studies: BPNL waste forms in salt

    International Nuclear Information System (INIS)

    1978-04-01

    This volume, Volume 16, ''Repository Preconceptual Design Studies: BPNL Waste Forms in Salt,'' is one of a 23 volume series, ''Technical Support for GEIS: Radioactive Waste Isolation in Geologic Formations,'' Y/OWI/TM-36, which supplements the ''Contribution to Draft Generic Environmental Impact Statement on Commercial Waste Management: Radioactive Waste Isolation in Geologic Formations,'' Y/OWI/TM-44. The series provide a more complete technical basis for the preconceptual designs, resource requirements, and environmental source terms associated with isolating commercial LWR wastes in underground repositories in salt, granite, shale and basalt. Wastes are considered from three fuel cycles: uranium and plutonium recycling, no recycling of spent fuel and uranium-only recycling. This document describes a preconceptual design for a nuclear waste storage facility in salt. The waste forms assumed to arrive at the repository were supplied by Battelle Pacific Northwest Laboratories (BPNL). The facility design consists of several chambers excavated deep within a geologic formation together with access shafts and supportive surface structures. The facility design provides for: receiving and unloading waste containers; lowering them down shafts to the mine level; transporting them to the proper storage area and emplacing them in mined storage rooms. Drawings of the facility design are contained in TM-36/17, ''Drawings for Repository Preconceptual Design Studies: BPNL Waste Forms in Salt.''

  20. DFT-Based Closed-form Covariance Matrix and Direct Waveforms Design for MIMO Radar to Achieve Desired Beampatterns

    KAUST Repository

    Bouchoucha, Taha; Ahmed, Sajid; Al-Naffouri, Tareq Y.; Alouini, Mohamed-Slim

    2017-01-01

    optimization problems. The computational complexity of these algorithms is very high, which makes them difficult to use in practice. In this paper, to achieve the desired beampattern, a low complexity discrete-Fourier-transform based closed-form covariance

  1. Die-cavity Design for High-Precision Nett-Forming of Engineering Component (PRECI4M)

    DEFF Research Database (Denmark)

    Ravn, Bjarne Gottlieb

    This report covers the 6-months period from month 37 to month 42 of the project. The following tasks are reported: • Task 14: Auto-interface between Data Retrieval and FE Analysis Software • Task 21: Tool Design Principles • Task 23: Specification of Tool Design System • Task 54: Development of S...... of Software Codes • Task 61: Design of Experiments for Validation • Task 62: Validation Experiments......This report covers the 6-months period from month 37 to month 42 of the project. The following tasks are reported: • Task 14: Auto-interface between Data Retrieval and FE Analysis Software • Task 21: Tool Design Principles • Task 23: Specification of Tool Design System • Task 54: Development...

  2. Activity Limitation Stages Are Associated With Risk of Hospitalization Among Medicare Beneficiaries.

    Science.gov (United States)

    Na, Ling; Pan, Qiang; Xie, Dawei; Kurichi, Jibby E; Streim, Joel E; Bogner, Hillary R; Saliba, Debra; Hennessy, Sean

    2017-05-01

    Activity limitation stages based on activities of daily living (ADLs) and instrumental activities of daily living (IADLs) are associated with 3-year mortality in elderly Medicare beneficiaries, yet their associations with hospitalization risk in this population have not been studied. To examine the independent association of activity limitation stages with risk of hospitalization within a year among Medicare beneficiaries aged 65 years and older. Cohort study. Community. A total of 9447 community-dwelling elderly Medicare beneficiaries from the Medicare Current Beneficiary Survey for years 2005-2009. Stages were derived for ADLs and IADLs separately. Associations of stages with time to first hospitalization and time to recurrent hospitalizations within a year were assessed with Cox proportional hazards models, with which we accounted for baseline sociodemographics, smoking status, comorbidities, and the year of survey entry. Time to first hospitalization and time to recurrent hospitalizations within 1 year. The adjusted risk of first hospitalization increased with greater activity limitation stages (except stage III). The hazard ratios (95% confidence intervals) for ADL stages I-IV compared with stage 0 (no limitations) were 1.49 (1.36-1.63), 1.61 (1.44-1.80), 1.54 (1.35-1.76), and 2.06 (1.61-2.63), respectively. The pattern for IADL stages was similar. For recurrent hospitalizations, activity limitation stages were associated with the risk of the first hospitalization but not with subsequent hospitalizations. Activity limitation stages are associated with the risk of first hospitalization in the subsequent year among elderly Medicare beneficiaries. Stages capture clinically interpretable profiles of ADL and IADL functionality and describe preserved functions and activity limitation in an aggregated measure. Stage can inform interventions to ameliorate disability and thus reduce the risk of a subsequent hospitalization in this population. IV. Copyright © 2017

  3. Direct observation of Medicaid beneficiary attempts to fill prescriptions for nicotine replacement medications.

    Science.gov (United States)

    Richter, Kimber P; Shergina, Elena; Grodie, Amanda; Massey, Justin K; Ellerbeck, Edward F; Applegate, Amanda; Faseru, Babalola

    2018-04-21

    Although many states have expanded Medicaid coverage of cessation medications, utilization remains low. Anecdotal reports suggest that beneficiaries are at times denied coverage of cessation medications at the pharmacy counter. We conducted an observational community-wide case study of Medicaid beneficiary attempts to fill over-the-counter nicotine replacement therapy at pharmacies. We recruited tobacco-using beneficiaries from a Federally Qualified Health Center, whose providers wrote paper prescriptions for nicotine patches. Study staff escorted beneficiaries to all eligible pharmacies (n = 18) in a Midwestern community to observe fill attempts. Study staff recorded encounters via smartphone into a secure database on a university server. Seven of 18 pharmacies (39%) did not fill the prescription on the day of the attempt. Of these, 6 offered to order the patch for pick-up at a later date. All (4/4) chain pharmacies filled the prescription; 2/3 mass merchant pharmacies failed to fill. Combining successful same-day fills with offers to order for pick-up, 17/18 (94%) would ultimately have been able to obtain patches. This pilot study found that many beneficiaries left pharmacies without a prescription in hand. Successful same-day fills varied markedly by store type. For people with low incomes, transportation presents a major barrier for delayed pick-up. In addition, delays can fuel ambivalence toward quitting. Future research based on this pilot study might address whether patients who fail to secure a same-day prescription ever fill the prescription and, if not, the degree to which this barrier contributes to success or failure in quitting. Copyright © 2018 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  4. Variations in Influenza and Pneumonia Immunizations for Medicare Beneficiaries Served by Rural Health Clinics.

    Science.gov (United States)

    Wan, Thomas T H; Lin, Yi-Ling; Ortiz, Judith

    2017-08-01

    The availability of a rural health clinic (RHC) database over the period of 6 years (2008-2013) offers a unique opportunity to examine the trends and patterns of disparities in immunization for influenza and pneumonia among Medicare beneficiaries in the southeastern states. The purpose of this exploratory study was twofold. First, it examined the rural trends and patterns of immunization rates before (2008-2009) and after (2010-2013) the Affordable Care Act (ACA) enactment by state and year. Second, it investigated how contextual, organizational, and aggregate patient characteristics may influence the variations in immunization for influenza and pneumonia of Medicare beneficiaries served by RHCs. Four data sources from federal agencies were merged to perform a longitudinal analysis of the influences of contextual, organizational, and aggregate patient characteristics on the disparities in immunization rates of rural Medicare beneficiaries for influenza and pneumonia. We included both time-varying and time-constant predictors in a multivariate analysis using Generalized Estimating Equation. This study revealed the increased immunization rates for both influenza and pneumonia over a period of 6 years. The ACA had a positive effect on increased immunization rates for pneumonia, but not for influenza, in rural Medicare beneficiaries in the eight states. The RHCs that served more dually-eligible patients had higher immunization rates. For influenza immunization, provider-based RHCs had a higher rate than the independent RHCs. For pneumonia immunization, no organizational variables were relevant in the explanation of the variability. The results also showed that no single dominant factor influenced health care disparities. This investigation suggested further improvements in preventive care are needed to target poor and isolated rural beneficiaries. Furthermore, the integration of immunization data from multiple sources is critically needed for understanding health

  5. DESIGN ASPECTS REGARDING THE RELATIONSHIPS BETWEEN THE FUNCTION, THE FORM AND THE USE OF HIGH SPEED TRAINS

    Directory of Open Access Journals (Sweden)

    CARP Bogdan

    2013-06-01

    Full Text Available This paper proposes to present a comparative study between three Electric-Diesel High Speed Train Power car bodies; the study is oriented on design issues and is concentrated especially on the aesthetical elements and the functional role. This comparison also involves the aero dynamical properties of the shapes used in the design of the Power cars. The 3D modeling of the three car bodies is made in CATIA V5, one of the powerful tools for computer aided design.

  6. Collaborative form(s)

    DEFF Research Database (Denmark)

    Gunn, Wendy

    anthropology engages groups of people within collaborative, interdisciplinary, inter-organizational design processes and co-analytic activities vs. the individual anthropologist conducting studies of people. In doing anthropology by means of design as Gatt and Ingold (2013) have shown, design is considered...... the process of research rather than its object. In its temporal orientation, anthropology by means of design moves, ‘…forward with people in tandem with their desires and aspirations rather than going back over times passed’ (ibid 2013: 141). Doing design by means of anthropology takes as its most fundamental...

  7. Utility of the MMPI-2-RF (Restructured Form) Validity Scales in Detecting Malingering in a Criminal Forensic Setting: A Known-Groups Design

    Science.gov (United States)

    Sellbom, Martin; Toomey, Joseph A.; Wygant, Dustin B.; Kucharski, L. Thomas; Duncan, Scott

    2010-01-01

    The current study examined the utility of the recently released Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008) validity scales to detect feigned psychopathology in a criminal forensic setting. We used a known-groups design with the Structured Interview of Reported Symptoms (SIRS;…

  8. In situ forming hydrogels for intra-articular delivery of celecoxib: from polymer design to in vivo studies

    NARCIS (Netherlands)

    Petit, A.

    2014-01-01

    The main topic of this thesis was the development and evaluation of an injectable in situ forming gel made of acylated PCLA-PEG-PLCA copolymers for the local and sustained release of celecoxib, which is to date the drug of choice for the treatment of OA (Chapter 1). As shown in this thesis, the

  9. Designer bFGF-incorporated D-form self-assembly peptide nanofiber scaffolds to promote bone repair

    Energy Technology Data Exchange (ETDEWEB)

    He, Bin, E-mail: binheing@163.com [Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016 (China); Ou, Yunsheng; Chen, Shuo; Zhao, Weikang; Zhou, Ao [Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016 (China); Zhao, Jinqiu [Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016 (China); Li, Hong [School of Physical Science and Technology, Sichuan University, Chengdu 610000 (China); Jiang, Dianming [Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016 (China); Zhu, Yong, E-mail: 568731668@qq.com [Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016 (China)

    2017-05-01

    D-Form and L-form peptide nanofiber scaffolds can spontaneously form stable β-sheet secondary structures and nanofiber hydrogel scaffolds, and hold some promise in hemostasis and wound healing. We report here on the synthetic self-assembling peptide D-RADA16 and L-RADA16 are both found to produce stable β-sheet secondary structure and nanofiber hydrogel scaffolds based on circular dichroism (CD) spectroscopy, transmission electron microscopy (TEM) and rheology analysis etc. D-RADA16 hydrogel and L-RADA16 hydrogel can enhance obvious bone repair in femoral condyle defects of the Sprague-Dawley (SD) rat model compared to PBS treatment. Based on micro-computed tomography (CT), it was revealed that D-RADA16 hydrogel and L-RADA16 hydrogel were capable to obtain the extensive bone healing. Histological evaluation also found that these two hydrogels facilitate the presence of more mature bone tissue within the femoral condyle defects. Additionally, D-RADA16 hydrogel showed some potential in storing and releasing basic-fibroblast growth factor (bFGF) which was able to further promote bone regeneration based on micro-CT analysis. These results indicate that D-form peptide nanofiber hydrogel have some special capacity for bone repair. - Highlights: • Peptide D-RADA16 and L-RADA16 can form stable hydrogels. • D-RADA16 hydrogel can obtain the comparable and extensive promotion to bone healing compared to L-RADA16 hydrogel. • L-RADA16 hydrogel allows for slow release of bFGF.

  10. Changes in health care spending and quality for Medicare beneficiaries associated with a commercial ACO contract.

    Science.gov (United States)

    McWilliams, J Michael; Landon, Bruce E; Chernew, Michael E

    2013-08-28

    In a multipayer system, new payment incentives implemented by one insurer for an accountable care organization (ACO) may also affect spending and quality of care for another insurer's enrollees served by the ACO. Such spillover effects reflect the extent of organizational efforts to reform care delivery and can contribute to the net impact of ACOs. We examined whether the Blue Cross Blue Shield (BCBS) of Massachusetts' Alternative Quality Contract (AQC), an early commercial ACO initiative associated with reduced spending and improved quality for BCBS enrollees, was also associated with changes in spending and quality for Medicare beneficiaries, who were not covered by the AQC. Quasi-experimental comparisons from 2007-2010 of elderly fee-for-service Medicare beneficiaries in Massachusetts (1,761,325 person-years) served by 11 provider organizations entering the AQC in 2009 or 2010 (intervention group) vs beneficiaries served by other providers (control group). Using a difference-in-differences approach, we estimated changes in spending and quality for the intervention group in the first and second years of exposure to the AQC relative to concurrent changes for the control group. Regression and propensity score methods were used to adjust for differences in sociodemographic and clinical characteristics. The primary outcome was total quarterly medical spending per beneficiary. Secondary outcomes included spending by setting and type of service, 5 process measures of quality, potentially avoidable hospitalizations, and 30-day readmissions. Before entering the AQC, total quarterly spending per beneficiary for the intervention group was $150 (95% CI, $25-$274) higher than for the control group and increased at a similar rate. In year 2 of the intervention group's exposure to the AQC, this difference was reduced to $51 (95% CI, -$109 to $210; P = .53), constituting a significant differential change of -$99 (95% CI, -$183 to -$16; P = .02) or a 3.4% savings

  11. Design studies of Laminar Flow Control (LFC) wing concepts using superplastics forming and diffusion bonding (SPF/DB)

    Science.gov (United States)

    Wilson, V. E.

    1980-01-01

    Alternate concepts and design approaches were developed for suction panels and techniques were defined for integrating these panel designs into a complete LFC 200R wing. The design concepts and approaches were analyzed to assure that they would meet the strength, stability, and internal volume requirements. Cost and weight comparisions of the concepts were also made. Problems of integrating the concepts into a complete aircraft system were addressed. Methods for making splices both chordwise and spanwise, fuel light joints, and internal duct installations were developed. Manufacturing problems such as slot aligment, tapered slot spacing, production methods, and repair techniques were addressed. An assessment of the program was used to developed recommendations for additional research in the development of SPF/DB for LFC structure.

  12. Design of nonimaging concentrators as second stages in tandem with image-forming first-stage concentrators

    Science.gov (United States)

    Winston, R.; Welford, W. T.

    1980-01-01

    The paper discusses the paraboloidal mirror as a tracking solar concentrator, fitting a nonimaging second stage to the paraboloidal mirror, other image-forming systems as first stages, and tracking systems in two-dimensional geometry. Because of inherent aberrations, the paraboloidal mirror cannot achieve the thermodynamic limit. It is shown how paraboloidal mirrors of short focal ratio and similar systems can have their flux concentration enhanced to near the thermodynamic limit by the addition of nonimaging compound elliptical concentrators.

  13. Design of nonimaging concentrators as second stages in tandem with image-forming first-stage concentrators

    Science.gov (United States)

    Winston, R.; Welford, W. T.

    1980-02-01

    The paper discusses the paraboloidal mirror as a tracking solar concentrator, fitting a nonimaging second stage to the paraboloidal mirror, other image-forming systems as first stages, and tracking systems in two-dimensional geometry. Because of inherent aberrations, the paraboloidal mirror cannot achieve the thermodynamic limit. It is shown how paraboloidal mirrors of short focal ratio and similar systems can have their flux concentration enhanced to near the thermodynamic limit by the addition of nonimaging compound elliptical concentrators.

  14. New insight on glass-forming ability and designing Cu-based bulk metallic glasses: The solidification range perspective

    International Nuclear Information System (INIS)

    Wu, Jili; Pan, Ye; Li, Xingzhou; Wang, Xianfei

    2014-01-01

    Highlights: • The equation, T rg = T g /T l , was rotationally modified to T rg = κ(T m /T l ) + C/T l . • The newly generalized equation suggests a way for describing glass-forming ability. • Several new Cu-based bulk metallic glasses were discovered by solidification range. - Abstract: In this paper, a new equation was rationally generalized from the reduced glass transition temperature. This equation indicates that solidification range can be used for describing glass-forming ability, which can be calculated with the aid of computational thermodynamic approach. Based on this scenario, several new Cu-based bulk metallic glasses in the ternary Cu–Zr–Ti alloy system were discovered. The as-cast samples were characterized by X-ray diffraction and transmission electronic microscopy. The results indicate that as-cast samples have monolithic amorphous nature. Thermal analysis validates that the smaller solidification range is closely related to the higher glass-forming ability, which is contributed to the effect of solidification time on the formation of bulk metallic glasses. This work also suggests that solidus can influence glass formation

  15. The Legal Structure of Commercial Banks and Financial Regulation : does organizational form matter for the design of bank regulation?

    NARCIS (Netherlands)

    V.L.E. Cedeno-Brea (Enmanuel)

    2017-01-01

    markdownabstractDo the different ways that commercial banks are legally organized matter for the design of financial regulation? It is often assumed that most commercial banks are setup as investor owned business corporations. However, this is not always the case In many jurisdictions, banks are

  16. On the design of a (H)EV steerable warning device using acoustic beam forming and advanced numerical acoustic simulation

    NARCIS (Netherlands)

    Van Genechten, B.; Vansant, K.; Berkhoff, Arthur P.

    2014-01-01

    This paper describes the simulation-based design methodology used in the eVADER project for the development of targeted acoustic warning devices for increased detectability of Hybrid and Electric Vehicles (HEVs) while, at the same time, reducing urban noise pollution. A key component of this system

  17. Study on the design and manufacturing requirements of container for low level radioactive solid waste form KRR decommissioning

    International Nuclear Information System (INIS)

    Lee, D. K.; Kim, H. R.; Park, S. K.; Jung, K. H.; Jung, W. S.; Jung, K. J.

    2000-01-01

    The design requirement and manufacturing criteria have been proposed on the container for the storage and transportation of low level radioactive solid waste from decommissioning of KRR 1 and 2. The structure analysis was carried out based on the design criteria, and the safety of the container was assessed. The ISO container with its capacity of 4m 3 was selected for the radioactive solid waste storage. The proposed container was satisfied the criteria of ISO 1496/1 and the packaging standard of atomic energy act. manufacturing and test standards of IAEA were also applied to the container. Stress distribution and deformation were analyzed under given condition using ANSYS code, and the maximum stress was verified to be within yield stress without any structural deformation. From the results of lifting tests, it was verified that the container was safe

  18. Theory and practice as cultural forms and the research design on The open school program in the Danish school reform

    DEFF Research Database (Denmark)

    Knudsen, Lars Emmerik Damgaard; Haastrup, Lisbeth

    2015-01-01

    and not necessarily bridgeable but always embedded in the cultural setting or topos that surrounds them. This gave us inspiration to view the theory and practice theme in a pedagogical perspective where the knowledge forms and variable relations are not evaluated as optimal or coherent but as different ways......) Teori og praksisdidaktik. København. Unge Pædagoger Jorgensen, E. R. (2005). "Four Philosophical Models of the Relationship Between Theory and Practice." Philosophy of Music Education Review 13(no. 1). Knudsen, L. E. D. Knudsen (2012). Teori og praksis i læreruddannelsen. Kundskabsformer, kultur og...

  19. Technical support for GEIS: radioactive waste isolation in geologic formations. Volume 2. Commercial waste forms, packaging and projections for preconceptual repository design studies

    International Nuclear Information System (INIS)

    1978-04-01

    This volume, Y/OWI/TM-36/2, ''Commercial Waste Forms, Packaging and Projections for Preconceptual Repository Design Studies,'' is one of a 23-volume series, ''Technical Support for GEIS: Radioactive Waste Isolation in Geologic Formations,'' Y/OWI/TM-36, which supplements the ''Contribution to Draft Generic Environmental Impact Statement on Commercial Waste Management: Radioactive Waste Isolation in Geologic Formations,'' Y/OWI/TM-44. The series provides a more complete technical basis for the preconceptual designs, resource requirements, and environmental source terms associated with isolating commercial LWR wastes in underground repositories in salt, granite, shale and basalt. Wastes are considered from three fuel cycles: uranium and plutonium recycling, no recycling of spent fuel and uranium-only recycling. This volume contains the data base for waste forms, packages, and projections from the commercial waste defined by the Office of Waste Isolation in ''Nuclear Waste Projections and Source Term Data for FY 1977,'' Y/OWI/TM-34. Also, as an alternative data base for repository design and analysis, waste forms, packages, and projections for commercial waste defined by Battelle Pacific Northwest Laboratory (BPNL) have been included. This data base consists of a reference case for use in the alternative design study and a definition of combustible wastes for use in mine fire and hydrogen generation analyses

  20. Technical support for GEIS: radioactive waste isolation in geologic formations. Volume 2. Commercial waste forms, packaging and projections for preconceptual repository design studies

    Energy Technology Data Exchange (ETDEWEB)

    1978-04-01

    This volume, Y/OWI/TM-36/2, ''Commercial Waste Forms, Packaging and Projections for Preconceptual Repository Design Studies,'' is one of a 23-volume series, ''Technical Support for GEIS: Radioactive Waste Isolation in Geologic Formations,'' Y/OWI/TM-36, which supplements the ''Contribution to Draft Generic Environmental Impact Statement on Commercial Waste Management: Radioactive Waste Isolation in Geologic Formations,'' Y/OWI/TM-44. The series provides a more complete technical basis for the preconceptual designs, resource requirements, and environmental source terms associated with isolating commercial LWR wastes in underground repositories in salt, granite, shale and basalt. Wastes are considered from three fuel cycles: uranium and plutonium recycling, no recycling of spent fuel and uranium-only recycling. This volume contains the data base for waste forms, packages, and projections from the commercial waste defined by the Office of Waste Isolation in ''Nuclear Waste Projections and Source Term Data for FY 1977,'' Y/OWI/TM-34. Also, as an alternative data base for repository design and analysis, waste forms, packages, and projections for commercial waste defined by Battelle Pacific Northwest Laboratory (BPNL) have been included. This data base consists of a reference case for use in the alternative design study and a definition of combustible wastes for use in mine fire and hydrogen generation analyses.

  1. Explaining the increased health care expenditures associated with gastroesophageal reflux disease among elderly Medicare beneficiaries with chronic obstructive pulmonary disease: a cost-decomposition analysis

    Directory of Open Access Journals (Sweden)

    Ajmera M

    2014-04-01

    Full Text Available Mayank Ajmera,1 Amit D Raval,1 Chan Shen,2 Usha Sambamoorthi1 1Department of Pharmaceutical Systems and Policy, School of Pharmacy, School of Medicine, West Virginia University, Morgantown, WV, USA; 2Department of Biostatistics and Health Services Research, University of Texas MD Anderson Cancer Center, Houston, TX, USA Objective: To estimate excess health care expenditures associated with gastroesophageal reflux disease (GERD among elderly individuals with chronic obstructive pulmonary disease (COPD and examine the contribution of predisposing characteristics, enabling resources, need variables, personal health care practices, and external environment factors to the excess expenditures, using the Blinder-Oaxaca linear decomposition technique. Methods: This study utilized a cross-sectional, retrospective study design, using data from multiple years (2006-2009 of the Medicare Current Beneficiary Survey linked with fee-for-service Medicare claims. Presence of COPD and GERD was identified using diagnoses codes. Health care expenditures consisted of inpatient, outpatient, prescription drugs, dental, medical provider, and other services. For the analysis, t-tests were used to examine unadjusted subgroup differences in average health care expenditures by the presence of GERD. Ordinary least squares regressions on log-transformed health care expenditures were conducted to estimate the excess health care expenditures associated with GERD. The Blinder-Oaxaca linear decomposition technique was used to determine the contribution of predisposing characteristics, enabling resources, need variables, personal health care practices, and external environment factors, to excess health care expenditures associated with GERD. Results: Among elderly Medicare beneficiaries with COPD, 29.3% had co-occurring GERD. Elderly Medicare beneficiaries with COPD/GERD had 1.5 times higher ($36,793 vs $24,722 [P<0.001] expenditures than did those with COPD/no GERD. Ordinary

  2. A multisite randomized controlled trial on time to self-support among sickness absence beneficiaries

    DEFF Research Database (Denmark)

    Nielsen, Maj Britt D.; Vinsløv Hansen, Jørgen; Aust, Birgit

    2015-01-01

    BACKGROUND: In 2010, the Danish Government launched the Danish national return-to-work (RTW) programme to reduce sickness absence and promote labour market attainment. Multidisciplinary teams delivered the RTW programme, which comprised a coordinated, tailored and multidisciplinary effort (CTM......) for sickness absence beneficiaries at high risk for exclusion from the labour market. The aim of this article was to evaluate the effectiveness of the RTW programme on self-support. METHODS: Beneficiaries from three municipalities (denoted M1, M2 and M3) participated in a randomized controlled trial. We.......54-0.95). In M1, we found no difference between the two groups (HR = 0.99, 95% CI: 0.84-1.17). CONCLUSION: The effect of the CTM programme on return to self-support differed substantially across the three participating municipalities. Thus, generalizing the study results to other Danish municipalities...

  3. THE AUDIT OF FINANCIAL STATEMENTS PREPARED BY THE BENEFICIARIES OF EU GRANT

    Directory of Open Access Journals (Sweden)

    Danut Rada

    2013-12-01

    Full Text Available The patrimonial economic entities - public institutions or economic agents, beneficiaries of EU grants, are required to maintain separate accounts situations of the use of these financial resources and also to prepare financial statements in which to be reflected the fees occurred by implementing of projects. The audit of these financial statements is specific and is based on the provisions of international audit standards ISRS 4400 “international standard for related services” and ISAE 3000 “international standard for certification measures”. In some cases, considering the request of the audit beneficiary, can be applied the provisions of ISA 800, International Audit Standard “Special Considerations-Audit of financial statements prepared in accordance with special purpose frameworks”.

  4. Early Hospital Readmission is a Predictor of One-Year Mortality in Community-Dwelling Older Medicare Beneficiaries

    NARCIS (Netherlands)

    Lum, H.D.; Studenski, S.A.; Degenholtz, H.B.; Hardy, S.E.

    2012-01-01

    BACKGROUND: Hospital readmission within thirty days is common among Medicare beneficiaries, but the relationship between rehospitalization and subsequent mortality in older adults is not known. OBJECTIVE: To compare one-year mortality rates among community-dwelling elderly hospitalized Medicare

  5. Risk factors for dementia after critical illness in elderly medicare beneficiaries

    OpenAIRE

    Guerra, Carmen; Linde-Zwirble, Walter T; Wunsch, Hannah

    2012-01-01

    Introduction Hospitalization increases the risk of a subsequent diagnosis of dementia. We aimed to identify diagnoses or events during a hospitalization requiring critical care that are associated with a subsequent dementia diagnosis in the elderly. Methods A cohort study of a random 5% sample of Medicare beneficiaries who received intensive care in 2005 and survived to hospital discharge, with three years of follow-up (through 2008) was conducted using Medicare claims files. We defined demen...

  6. Sample Loss and Survey Bias in Estimates of Social Security Beneficiaries: A Tale of Two Surveys.

    OpenAIRE

    John L. Czajka; James Mabli; Scott Cody

    2008-01-01

    Data from the Census Bureau’s Survey of Income and Program Participation (SIPP) and the Current Population Survey (CPS) provide information on current and potential beneficiaries served by Social Security Administration (SSA) programs. SSA also links administrative records to the records of survey respondents who provide Social Security numbers. These matched data expand the content of the SIPP and CPS files to fields available only through SSA and Internal Revenue Service records—such as l...

  7. THE AUDIT OF FINANCIAL STATEMENTS PREPARED BY THE BENEFICIARIES OF EU GRANT

    OpenAIRE

    Danut Rada; Doina Rada

    2013-01-01

    The patrimonial economic entities - public institutions or economic agents, beneficiaries of EU grants, are required to maintain separate accounts situations of the use of these financial resources and also to prepare financial statements in which to be reflected the fees occurred by implementing of projects. The audit of these financial statements is specific and is based on the provisions of international audit standards ISRS 4400 “international standard for related services” and ISAE 3000 ...

  8. Session 1 theme: Various forms of design basis knowledge and effects of its loss on Safety. Views from EDF

    International Nuclear Information System (INIS)

    Servière, Georges

    2013-01-01

    Design basis knowledge - What happens or may happen and corresponding required knowledge: • Unexpected events or failures of equipment; • Spare part issues (no longer availaible,…); • Change in applicable regulations / requirements; • Change of operating conditions; • Change of plant performances; • Evolution of external environment and conditions; • Events and accidents on other plants, worldwide; • New knowledge availaible; • Periodic safety reviews and upgrades; • Extension of plant operation life; • Decommissioning and dismantling; • Some of those you may choose not to do, but most of them have to be faced and need appropriate knowledge

  9. Inhaled anticholinergic use and all-cause mortality among elderly Medicare beneficiaries with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Ajmera M

    2013-06-01

    Full Text Available Mayank Ajmera,1 Chan Shen,2 Xiaoyun Pan,1 Patricia A Findley,3 George Rust,4 Usha Sambamoorthi1 1Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA; 2Department of Biostatistics, MD Anderson Cancer Center, University of Texas, Houston, TX, USA; 3School of Social Work, Rutgers University, New Brunswick, NJ, USA; 4Department of Family Medicine, Morehouse School of Medicine, Atlanta, GA, USA Background: The purpose of this study was to examine the association between use of inhaled anticholinergics and all-cause mortality among elderly individuals with chronic obstructive pulmonary disease (COPD, after controlling for demographic, socioeconomic, health, functional status, smoking, and obesity. Methods: We used a retrospective longitudinal panel data design. Data were extracted for multiple years (2002–2009 of the Medicare Current Beneficiary Survey (MCBS linked with fee-for-service Medicare claims. Generic and brand names of inhaled anticholinergics were used to identify inhaled anticholinergic utilization from the self-reported prescription medication files. All-cause mortality was assessed using the vital status variable. Unadjusted group differences in mortality rates were tested using the chi-square statistic. Multivariable logistic regressions with independent variables entered in separate blocks were used to analyze the association between inhaled anticholinergic use and all-cause mortality. All analyses accounted for the complex design of the MCBS. Results: Overall, 19.4% of the elderly Medicare beneficiaries used inhaled anticholinergics. Inhaled anticholinergic use was significantly higher (28.5% among those who reported poor health compared with those reporting excellent or very good health (12.7%. Bivariate analyses indicated that inhaled anticholinergic use was associated with significantly higher rates of all-cause mortality (18.7% compared with nonusers (13.6%. However

  10. Low-Cost Generic Program Use by Medicare Beneficiaries: Implications for Medication Exposure Misclassification in Administrative Claims Data.

    Science.gov (United States)

    Pauly, Nathan J; Talbert, Jeffery C; Brown, Joshua

    2016-06-01

    proportion of LCGP users and the proportion of LCGP fills out of all medications available through LCGPs increased from 2007 to 2012. There is a high rate of LCGP use among Medicare beneficiaries aged 65 years or greater. Claims-based research and quality assurance programs focusing on the benefits and harms of medications available through these programs are at risk of underestimating the true medication exposure in this population and should account for this possibility in sensitivity analyses. Managed care organizations should incentivize the reporting of LCGP medication use or make adjustments to generic medication benefit structures to more effectively capture true medication exposure. No direct sources of funding were used to conduct this study. Data acquisition was supported by the University of Kentucky Center for Clinical and Translational Science through funding from NIH NCATS grant #UL1TR000117. Brown is the Humana-Pfizer Research Fellow at the Institute for Pharmaceutical Outcomes & Policy at the University of Kentucky College of Pharmacy and is provided salary from these corporations. However, neither company provided any direct funding for the current study nor provided any input or guidance for the design, methods, or drafting of the manuscript. Pauly has no financial disclosures or conflicts of interest. Portions of these results were presented at the 20th International Society for Pharmacoeconomics and Outcomes Research International Meeting; May 16-20, 2015; Philadelphia, Pennsylvania. Study concept and design were primarily contributed by Brown, along with the other authors. Brown took the lead in data collection and interpretation, along with Pauly and Talbert. All authors participated in the writing and revision of the manuscript.

  11. Comparing Hospital Processes and Outcomes in California Medicare Beneficiaries: Simulation Prompts Reconsideration.

    Science.gov (United States)

    Escobar, Gabriel J; Baker, Jennifer M; Turk, Benjamin J; Draper, David; Liu, Vincent; Kipnis, Patricia

    2017-01-01

    This article is not a traditional research report. It describes how conducting a specific set of benchmarking analyses led us to broader reflections on hospital benchmarking. We reexamined an issue that has received far less attention from researchers than in the past: How variations in the hospital admission threshold might affect hospital rankings. Considering this threshold made us reconsider what benchmarking is and what future benchmarking studies might be like. Although we recognize that some of our assertions are speculative, they are based on our reading of the literature and previous and ongoing data analyses being conducted in our research unit. We describe the benchmarking analyses that led to these reflections. The Centers for Medicare and Medicaid Services' Hospital Compare Web site includes data on fee-for-service Medicare beneficiaries but does not control for severity of illness, which requires physiologic data now available in most electronic medical records.To address this limitation, we compared hospital processes and outcomes among Kaiser Permanente Northern California's (KPNC) Medicare Advantage beneficiaries and non-KPNC California Medicare beneficiaries between 2009 and 2010. We assigned a simulated severity of illness measure to each record and explored the effect of having the additional information on outcomes. We found that if the admission severity of illness in non-KPNC hospitals increased, KPNC hospitals' mortality performance would appear worse; conversely, if admission severity at non-KPNC hospitals' decreased, KPNC hospitals' performance would appear better. Future hospital benchmarking should consider the impact of variation in admission thresholds.

  12. Access to Care for Medicare-Medicaid Dually Eligible Beneficiaries: The Role of State Medicaid Payment Policies.

    Science.gov (United States)

    Zheng, Nan Tracy; Haber, Susan; Hoover, Sonja; Feng, Zhanlian

    2017-12-01

    Medicaid programs are not required to pay the full Medicare coinsurance and deductibles for Medicare-Medicaid dually eligible beneficiaries. We examined the association between the percentage of Medicare cost sharing paid by Medicaid and the likelihood that a dually eligible beneficiary used evaluation and management (E&M) services and safety net provider services. Medicare and Medicaid Analytic eXtract enrollment and claims data for 2009. Multivariate analyses used fee-for-service dually eligible and Medicare-only beneficiaries in 20 states. A comparison group of Medicare-only beneficiaries controlled for state factors that might influence utilization. Paying 100 percent of the Medicare cost sharing compared to 20 percent increased the likelihood (relative to Medicare-only) that a dually eligible beneficiary had any E&M visit by 6.4 percent. This difference in the percentage of cost sharing paid decreased the likelihood of using safety net providers, by 37.7 percent for federally qualified health centers and rural health centers, and by 19.8 percent for hospital outpatient departments. Reimbursing the full Medicare cost-sharing amount would improve access for dually eligible beneficiaries, although the magnitude of the effect will vary by state and type of service. © Health Research and Educational Trust.

  13. The final TimeWarp: using form and content to support player experience and presence when designing location-aware mobile augmented reality games

    OpenAIRE

    Blum, Lisa; Wetzel, Richard; McCall, Roderick; Oppermann, Leif; Broll, Wolfgang

    2012-01-01

    Designing Augmented Reality location aware games requires an understanding of how form and content issues impact on presence. A study of 60 players was conducted using questionnaires, video analysis and interviews. The results indicate that content including: moral dilemmas, strong narratives, using real locations effectively and applying simple physical behavior within virtual characters to improve embodiment have a positive impact on player experience. The results are presented in ...

  14. A Simple Snap Oscillator with Coexisting Attractors, Its Time-Delayed Form, Physical Realization, and Communication Designs

    Science.gov (United States)

    Rajagopal, Karthikeyan; Jafari, Sajad; Akgul, Akif; Karthikeyan, Anitha; Çiçek, Serdar; Shekofteh, Yasser

    2018-05-01

    In this paper, we report a novel chaotic snap oscillator with one nonlinear function. Dynamic analysis of the system shows the existence of bistability. To study the time delay effects on the proposed snap oscillator, we introduce multiple time delay in the fourth state equation. Investigation of dynamical properties of the time-delayed system shows that the snap oscillator exhibits the same multistable properties as the nondelayed system. The new multistable hyperjerk chaotic system has been tested in chaos shift keying and symmetric choc shift keying modulated communication designs for engineering applications. It has been determined that the symmetric chaos shift keying modulated communication system implemented with the new chaotic system is more successful than the chaos shift keying modulation for secure communication. Also, circuit implementation of the chaotic snap oscillator with tangent function is carried out showing its feasibility.

  15. Directory of national competent authorities' approval certificates for package design, special form material and shipment of radioactive material. 2004 ed

    International Nuclear Information System (INIS)

    2004-10-01

    The PACKTRAM database contains administrative and technical information provided annually by the issuing competent authority about package approval certificates. Such data are used mainly by national competent authorities and port and customs officials to assist in regulating radioactive material movements in their country, and also by manufacturers and shippers of radioactive material. The database carries information on extant certificates and those that expired within the last complete calendar year. This is the fifteenth PACKTRAM annual report to being published by the IAEA. It is distributed worldwide mainly to designated competent authorities, as well as to registered interested parties. The database itself is maintained at www.packtram.org and can be accessed by the general public

  16. Design of a long-term antipsychotic in situ forming implant and its release control method and mechanism.

    Science.gov (United States)

    Wang, Lexi; Wang, Aiping; Zhao, Xiaolei; Liu, Ximing; Wang, Dan; Sun, Fengying; Li, Youxin

    2012-05-10

    Two kinds of in situ forming implants (ISFIs) of atypical antipsychotics, risperidone and its 9-hydroxy active metabolite, paliperidone, using poly(lactide-co-glycolide)(PLGA) as carrier, were investigated. Significant difference was observed in the solution-gel transition mechanism of the two systems: homogeneous system of N-methyl-2-pyrrolidone (NMP) ISFI, in which drug was dissolved, and heterogeneous system of dimethyl sulfoxide (DMSO) ISFI, in which drug was dispersed. Fast solvent extractions were found in both systems, but in comparison with the high drug release rate from homogeneous system of drug/polymer/NMP, a fast solvent extraction from the heterogeneous system of drug/polymer/DMSO was not accompanied by a high drug release rate but a rapid solidification of the implant, which resulted in a high drug retention, well-controlled initial burst and slow release of the drug. In vivo study on beagle dogs showed a more than 3-week sustained release with limited initial burst. Pharmacologic evaluation on optimized paliperidone ISFIs presented a sustained-suppressing effect from 1 day to 38 day on the MK-801 induced schizophrenic behavior mice model. A long sustained-release antipsychotic ISFI of 50% drug loading and controlled burst release was achieved, which indicated a good potential in clinic application. Copyright © 2012 Elsevier B.V. All rights reserved.

  17. Optimization of the 3-Point Bending Failure of Anodized Aluminum Formed in Tartaric/Sulphuric Acid Using Doehlert Design

    Science.gov (United States)

    Bensalah, W.; Feki, M.; De-Petris Wery, M.; Ayedi, H. F.

    2015-02-01

    The bending failure of anodized aluminum in tartaric/sulphuric acid bath was modeled using Doehlert design. Bath temperature, anodic current density, sulphuric acid, and tartaric acid concentrations were retained as variables. Thickness measurements and 3-point bending experiments were conducted. The deflection at failure ( D f) and the maximum load ( F m) of each sample were, then, deducted from the corresponding flexural responses. The treatment of experimental results has established mathematical models of second degree reflecting the relation of cause and effect between the factors and the studied properties. The optimum path study of thickness, deflection at failure, and maximum load, showed that the three optima were opposite. Multicriteria optimization using the desirability function was achieved in order to maximize simultaneously the three responses. The optimum conditions were: C tar = 18.2 g L-1, T = 17.3 °C, J = 2.37 A dm-2, C sul = 191 g L-1, while the estimated response values were e = 57.7 µm, D f = 5.6 mm, and F m = 835 N. Using the established models, a mathematical correlation was found between deflection at failure and thickness of the anodic oxide layer. Before bending tests, aluminum oxide layer was examined by scanning electron microscopy (SEM) and atomic force microscopy. After tests, the morphology and the composition of the anodic oxide layer were inspected by SEM, optical microscopy, and glow-discharge optical emission spectroscopy.

  18. Directory of national competent authorities' approval certificates for package design, special form material and shipment of radioactive material. 1991 edition

    International Nuclear Information System (INIS)

    1991-08-01

    The format of this report is a result of recommendations made by the Standing Advisory Group on the Safe Transport of Radioactive Material (SAGSTRAM) at its 6th meeting in November 1987. The database was at that time maintained on the main frame and it was felt that adapting it for use on a personal computer would allow more flexibility in data processing and reporting. This document supersedes TECDOC-552 ''Directory of National Competent Authorities' Approval Certificates for Package Design and Shipment of Radioactive Material 1990 Edition''. Since publication of TECDOC-552, some modifications affecting the structure of the database and reporting formats were undertaken. These are fully described in ''Working Material: The PACKTRAM Database National Competent Authority Package Approval Certificates, User Guide Rev. 1'', which was released in early 1991. The present report is contained in five tables. In each of these, information is presented in alphabetical order based on the certificate number. This is composed of the issuing Member State's VRI code, followed by a slash, then a three- or four-digit number, another slash and finally a code identifying the type of package involved. ''-85'' is appended to those certificates that were approved on the basis of the 1985 Edition of Safety Series No. 6. Tables 1 to 4 present administrative data including issue and expire, dates, package identification, package serial numbers, modes for which the package/shipment is approved and the edition of Safety Series No. 6 on which the approval has been based. The technical information on package mass, authorized contents, and detailed and general description of the package are contained in Table. 5

  19. [Population-based study of child developmental screening in Mexican PROSPERA beneficiaries younger than 5 years old].

    Science.gov (United States)

    Rizzoli-Córdoba, Antonio; Martell-Valdez, Liliana; Delgado-Ginebra, Ismael; Villasís-Keever, Miguel Ángel; Reyes-Morales, Hortensia; O'Shea-Cuevas, Gabriel; Aceves-Villagrán, Daniel; Carrasco-Mendoza, Joaquín; Villagrán-Muñoz, Víctor Manuel; Halley-Castillo, Elizabeth; Vargas-López, Guillermo; Muñoz-Hernández, Onofre

    Evaluación del Desarrollo Infantil or Child Development Evaluation (CDE) test, a screening tool designed and validated in Mexico, classifies child development as normal (green) or abnormal (developmental lag or yellow and risk of delay or red). Population-based results of child development level with this tool are not known. The objective of this work was to evaluate the developmental level of children aged 1-59 months living in poverty (PROSPERA program beneficiaries) through application of the CDE test. CDE tests were applied by specifically trained and standardized personnel to children rural areas; fine motor skills, language and knowledge were more affected in males. The proportion of children with abnormal results is similar to other population-based studies. The highest rate in older children reinforces the need for an early-based intervention. The different pattern of areas affected between urban and rural areas suggests the need for a differentiated intervention. Copyright © 2015 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

  20. Total cost of care lower among Medicare fee-for-service beneficiaries receiving care from patient-centered medical homes.

    Science.gov (United States)

    van Hasselt, Martijn; McCall, Nancy; Keyes, Vince; Wensky, Suzanne G; Smith, Kevin W

    2015-02-01

    To compare health care utilization and payments between NCQA-recognized patient-centered medical home (PCMH) practices and practices without such recognition. Medicare Part A and B claims files from July 1, 2007 to June 30, 2010, 2009 Census, 2007 Health Resources and Services Administration and CMS Utilization file, Medicare's Enrollment Data Base, and the 2005 American Medical Association Physician Workforce file. This study used a longitudinal, nonexperimental design. Three annual observations (July 1, 2008-June 30, 2010) were available for each practice. We compared selected outcomes between practices with and those without NCQA PCMH recognition. Individual Medicare fee-for-service (FFS) beneficiaries and their claims and utilization data were assigned to PCMH or comparison practices based on where they received the plurality of evaluation and management services between July 1, 2007 and June 30, 2008. Relative to the comparison group, total Medicare payments, acute care payments, and the number of emergency room visits declined after practices received NCQA PCMH recognition. The decline was larger for practices with sicker than average patients, primary care practices, and solo practices. This study provides additional evidence about the potential of the PCMH model for reducing health care utilization and the cost of care. © Health Research and Educational Trust.

  1. Patient-Centered Medical Home Features and Health Care Expenditures of Medicare Beneficiaries with Chronic Disease Dyads.

    Science.gov (United States)

    Philpot, Lindsey M; Stockbridge, Erica L; Padrón, Norma A; Pagán, José A

    2016-06-01

    Three out of 4 Medicare beneficiaries have multiple chronic conditions, and managing the care of this growing population can be complex and costly because of care coordination challenges. This study assesses how different elements of the patient-centered medical home (PCMH) model may impact the health care expenditures of Medicare beneficiaries with the most prevalent chronic disease dyads (ie, co-occurring high cholesterol and high blood pressure, high cholesterol and heart disease, high cholesterol and diabetes, high cholesterol and arthritis, heart disease and high blood pressure). Data from the 2007-2011 Medical Expenditure Panel Survey suggest that increased access to PCMH features may differentially impact the distribution of health care expenditures across health care service categories depending on the combination of chronic conditions experienced by each beneficiary. For example, having no difficulty contacting a provider after regular hours was associated with significantly lower outpatient expenditures for beneficiaries with high cholesterol and diabetes (n = 635; P = 0.038), but it was associated with significantly higher inpatient expenditures for beneficiaries with high blood pressure and high cholesterol (n = 1599; P = 0.015), and no significant differences in expenditures in any category for beneficiaries with high blood pressure and heart disease (n = 1018; P > 0.05 for all categories). However, average total health care expenditures are largely unaffected by implementing the PCMH features considered. Understanding how the needs of Medicare beneficiaries with multiple chronic conditions can be met through the adoption of the PCMH model is important not only to be able to provide high-quality care but also to control costs. (Population Health Management 2016;19:206-211).

  2. The effectiveness of formative assessment with understanding by design (UbD) stages in forming habits of mind in prospective teachers

    Science.gov (United States)

    Gloria, R. Y.; Sudarmin, S.; Wiyanto; Indriyanti, D. R.

    2018-03-01

    Habits of mind are intelligent thinking dispositions that every individual needs to have, and it needs an effort to form them as expected. A behavior can be formed by continuous practice; therefore the student's habits of mind can also be formed and trained. One effort that can be used to encourage the formation of habits of mind is a formative assessment strategy with the stages of UbD (Understanding by Design), and a study needs to be done to prove it. This study aims to determine the contribution of formative assessment to the value of habits of mind owned by prospective teachers. The method used is a quantitative method with a quasi-experimental design. To determine the effectiveness of formative assessment with Ubd stages on the formation of habits of mind, correlation test and regression analysis were conducted in the formative assessment questionnaire consisting of three components, i.e. feed back, peer assessment and self assessment, and habits of mind. The result of the research shows that from the three components of Formative Assessment, only Feedback component does not show correlation to students’ habits of mind (r = 0.323). While peer assessment component (r = 0. 732) and self assessment component (r = 0.625), both indicate correlation. From the regression test the overall component of the formative assessment contributed to the habits of mind at 57.1%. From the result of the research, it can be concluded that the formative assessment with Ubd stages is effective and contributes in forming the student's habits of mind; the formative assessment components that contributed the most are the peer assessment and self assessment. The greatest contribution goes to the Thinking interdependently category.

  3. Understanding the increase in the number of childbirth-related leave beneficiaries in Serbia

    Directory of Open Access Journals (Sweden)

    Stanić Katarina

    2017-01-01

    Full Text Available Over the past number of years, the public expenditures for childbirth-related leave benefits have more than doubled – in 2015 amounted to 0.7% GDP in relation to 0.3% GDP in 2002. This increase can mainly be attributed to the increased number of beneficiaries that grew consistently from 24 thousand in 2002 up to 40 thousand in 2015, despite the fact that the annual number of live births has been almost continually decreasing and the registered employment has dropped by almost 20 per cent in the observed period. One of the clear reasons explaining part of this increase is the extension of 3+ order of birth leaves in 2006, from one to two years, which can explain the increase of around 3.5 thousand of beneficiaries. Another reason is high number of beneficiaries using special child-care leave meant for parents with children with disabilities, but which, in reality, is very often used simply as the extension of parental leave. The average number of special child-care leave beneficiaries in the second half of 2015 amounted to 2.8 thousand. When these two effects are taken into account, we still notice significant increase of beneficiaries of around 10 thousand in the observed period. Fictitious employment during the pregnancy can explain this increase to some extent. Available data unambiguously show that a number of women formally employing during the second and third trimester of pregnancy has increased from 800 in 2002 to almost 3.5 thousand monthly average in the second half of 2015. There are two flaws of the childbirth-related leave programme in Serbia, which together lead to the constant increase of the number of beneficiaries. First is the lack of flexibility of the programme, both in terms of eligibility for acquiring the right as well as in terms of flexibility in use. Maternity/parental leave benefit may acquire only those in „standard employment” i.e. employed under employment contract (and entrepreneurs while other type of

  4. The PACKTRAM database on national competent authorities' approval certificates for package design, special form material and shipment of radioactive material. User's guide for compiled system program

    International Nuclear Information System (INIS)

    1995-01-01

    The PACKTRAM system program enables Member States to prepare data diskettes on national competent authorities' approval certificates for package design, special form material and shipment of radioactive material, for submission to the IAEA, and facilitates data manipulation and report preparation for the IAEA. The system program is provided as a 424 kbyte executable file, for which this document is the User Guide. The system is fully menu-driven and requires an IBM-compatible personal computer with a minimum of 640 kbyte random access memory, a hard drive and one 3-1/2 inch diskette drive. 3 refs, 6 tabs

  5. Prevalence and Geographic Variations of Polypharmacy Among West Virginia Medicaid Beneficiaries.

    Science.gov (United States)

    Feng, Xue; Tan, Xi; Riley, Brittany; Zheng, Tianyu; Bias, Thomas K; Becker, James B; Sambamoorthi, Usha

    2017-11-01

    West Virginia (WV) residents are at high risk for polypharmacy given its considerable chronic disease burdens. To evaluate the prevalence, correlates, outcomes, and geographic variations of polypharmacy among WV Medicaid beneficiaries. In this cross-sectional study, we analyzed 2009-2010 WV Medicaid fee-for-service (FFS) claims data for adults aged 18-64 (N=37,570). We defined polypharmacy as simultaneous use of drugs from five or more different drug classes on a daily basis for at least 60 consecutive days in one year. Multilevel logistic regression was used to explore the individual- and county-level factors associated with polypharmacy. Its relationship with healthcare utilization was assessed using negative binomial regression and logistic regression. The univariate local indicators of spatial association method was applied to explore spatial patterns of polypharmacy in WV. The prevalence of polypharmacy among WV Medicaid beneficiaries was 44.6%. High-high clusters of polypharmacy were identified in southern WV, indicating counties with above-average prevalence surrounded by counties with above-average prevalence. Polypharmacy was associated with being older, female, eligible for Medicaid due to cash assistance or medical eligibility, having any chronic conditions or more chronic conditions, and living in a county with lower levels of education. Polypharmacy was associated with more hospitalizations, emergency department visits, and outpatient visits, as well as higher non-drug medical expenditures. Polypharmacy was prevalent among WV Medicaid beneficiaries and was associated with substantial healthcare utilization and expenditures. The clustering of high prevalence of polypharmacy in southern WV may suggest targeted strategies to reduce polypharmacy burden in these areas.

  6. From theoretical to actual ecosystem services: mapping beneficiaries and spatial flows in ecosystem service assessments

    Directory of Open Access Journals (Sweden)

    Kenneth J. Bagstad

    2014-06-01

    Full Text Available Ecosystem services mapping and modeling has focused more on supply than demand, until recently. Whereas the potential provision of economic benefits from ecosystems to people is often quantified through ecological production functions, the use of and demand for ecosystem services has received less attention, as have the spatial flows of services from ecosystems to people. However, new modeling approaches that map and quantify service-specific sources (ecosystem capacity to provide a service, sinks (biophysical or anthropogenic features that deplete or alter service flows, users (user locations and level of demand, and spatial flows can provide a more complete understanding of ecosystem services. Through a case study in Puget Sound, Washington State, USA, we quantify and differentiate between the theoretical or in situ provision of services, i.e., ecosystems' capacity to supply services, and their actual provision when accounting for the location of beneficiaries and the spatial connections that mediate service flows between people and ecosystems. Our analysis includes five ecosystem services: carbon sequestration and storage, riverine flood regulation, sediment regulation for reservoirs, open space proximity, and scenic viewsheds. Each ecosystem service is characterized by different beneficiary groups and means of service flow. Using the ARtificial Intelligence for Ecosystem Services (ARIES methodology we map service supply, demand, and flow, extending on simpler approaches used by past studies to map service provision and use. With the exception of the carbon sequestration service, regions that actually provided services to people, i.e., connected to beneficiaries via flow paths, amounted to 16-66% of those theoretically capable of supplying services, i.e., all ecosystems across the landscape. These results offer a more complete understanding of the spatial dynamics of ecosystem services and their effects, and may provide a sounder basis for

  7. Outcomes associated with comorbid atrial fibrillation and heart failure in Medicare beneficiaries with acute coronary syndrome.

    Science.gov (United States)

    Chen, Shih-Yin; Crivera, Concetta; Stokes, Michael; Boulanger, Luke; Schein, Jeff

    2014-02-20

    Atrial fibrillation (AF) and heart failure (HF) are both common comorbid conditions of elderly patients with acute coronary syndrome (ACS), but published data on their associated clinical and economic outcomes are limited. Our study included patients from the Medicare Current Beneficiary Survey with an incident hospitalization for ACS between 03/01/2002 and 12/31/2006. Applying population weights, we identified 795 incident ACS patients, representing more than 2.5 million Medicare beneficiaries. Of this population, 13.1% had comorbid AF, and 22.9% had HF, which were identified from Medicare claims during the 6 months prior to the first ACS event (index date) Subsequent cardiovascular (CV) hospitalizations and mortality were compared using Kaplan-Meier curves. Cox proportional hazards regressions were used to estimate the relative risk of AF and HF on CV events and mortality. Healthcare costs were summarized for the calendar year in which the incident ACS event occurred. HF was associated with a 41% higher risk of mortality (HR = 1.41; 95% confidence interval [CI] 1.05-1.89). Both AF (HR = 1.46; 95% CI 1.14-1.87) and HF (HR = 1.61; 95% CI 1.26-2.06) were associated with higher risks of subsequent CV events. During the year of the incident ACS event, ACS patients with comorbid AF or HF had approximately $18,000 higher total healthcare costs than those without these comorbidities. Using a nationally representative sample of Medicare beneficiaries, we observed a significantly higher clinical and economic burden of patients hospitalized for ACS with comorbid AF and HF compared with those without these conditions.

  8. From theoretical to actual ecosystem services: mapping beneficiaries and spatial flows in ecosystem service assessments

    Science.gov (United States)

    Bagstad, Kenneth J.; Villa, Ferdinando; Batker, David; Harrison-Cox, Jennifer; Voigt, Brian; Johnson, Gary W.

    2014-01-01

    Ecosystem services mapping and modeling has focused more on supply than demand, until recently. Whereas the potential provision of economic benefits from ecosystems to people is often quantified through ecological production functions, the use of and demand for ecosystem services has received less attention, as have the spatial flows of services from ecosystems to people. However, new modeling approaches that map and quantify service-specific sources (ecosystem capacity to provide a service), sinks (biophysical or anthropogenic features that deplete or alter service flows), users (user locations and level of demand), and spatial flows can provide a more complete understanding of ecosystem services. Through a case study in Puget Sound, Washington State, USA, we quantify and differentiate between the theoretical or in situ provision of services, i.e., ecosystems’ capacity to supply services, and their actual provision when accounting for the location of beneficiaries and the spatial connections that mediate service flows between people and ecosystems. Our analysis includes five ecosystem services: carbon sequestration and storage, riverine flood regulation, sediment regulation for reservoirs, open space proximity, and scenic viewsheds. Each ecosystem service is characterized by different beneficiary groups and means of service flow. Using the ARtificial Intelligence for Ecosystem Services (ARIES) methodology we map service supply, demand, and flow, extending on simpler approaches used by past studies to map service provision and use. With the exception of the carbon sequestration service, regions that actually provided services to people, i.e., connected to beneficiaries via flow paths, amounted to 16-66% of those theoretically capable of supplying services, i.e., all ecosystems across the landscape. These results offer a more complete understanding of the spatial dynamics of ecosystem services and their effects, and may provide a sounder basis for economic

  9. 75 FR 15754 - Agency Forms Submitted for OMB Review, Request for Comments

    Science.gov (United States)

    2010-03-30

    ...'s marital history, work history, military service, benefits from other governmental agencies and.... The application and related forms obtain information about the applicant's family work history... beneficiaries, claimants, employers and members of the public want and expect, as well as their satisfaction...

  10. Patient satisfaction and loyalty among military healthcare beneficiaries enrolled in a managed care program.

    Science.gov (United States)

    Jennings, B M; Loan, L A

    1999-11-01

    A study was performed to evaluate military beneficiaries' motivation for choosing to change from a civilian managed care system to the military managed care system. Concerns about healthcare cost, quality, and access underpin major reform in military healthcare. The military health system (MHS) is implementing managed care through an initiative known as TRICARE. Patient choice and satisfaction are highly relevant to all healthcare delivery systems; they are being explored aggressively in the MHS as TRICARE evolves. This descriptive study was conducted using a telephone survey consisting of 63 items derived from four pre-existing instruments as well as five facility-specific questions and demographics. The population of interest targeted military beneficiaries on a TRICARE waiting list who, at the time of enrollment, indicated a desire to receive care at the military facility. Consumers were inclined to return to the military system because of loyalty. Also, this study provided evidence that staff courtesy is important to those who seek healthcare. Good quality and accessibility were verified as essential elements in sustaining a consumer's positive view of and attraction to a particular healthcare system. Cost was proven to be a less substantial factor of consumer decision making. Surveys such as this give healthcare providers more information about aspects of care, such as patient loyalty and interpersonal dynamics, that attract people to their healthcare delivery systems. For healthcare systems to thrive, consumer influence and the power of patient dissatisfaction must be understood.

  11. Affiliation of the beneficiaries of a deferred pension to the CERN Health Insurance Scheme

    CERN Multimedia

    2003-01-01

    Subsequent to the modifications to the Rules and Regulations of the Pension Fund allowing members of the personnel having five years of affiliation to the Fund to opt for a deferred retirement pension, the Organization wishes to recall the rules relating to the affiliation of those beneficiaries to the CERN Health Insurance Scheme (CHIS). In accordance with Articles III 2.02 and VIII 4.02 of the CHIS Rules, beneficiaries of a deferred retirement pension can only be Members of the CHIS as CERN pensioners if they applied to remain Members of the Scheme upon termination of their compulsory membership as a member of the personnel and if their membership has been uninterrupted up to the moment they become CERN pensioners. The applicable contribution for this intermediate period is indicated in Articles III 5.03 and X 1.02 of the CHIS Rules. The amount is revised annually, and is set at 936 CHF/ month for 2003. Human Resources Division Tel. 73635

  12. Knowledge, awareness, and utilization pattern of services under Janani Suraksha Yojana among beneficiaries in rural area of Himachal Pradesh

    Directory of Open Access Journals (Sweden)

    Prem Lal Chauhan

    2015-01-01

    Full Text Available Introduction: Safe motherhood is perceived as a human right, and the health sector is always encouraged to provide quality services to ensure the same. Government of India launched a scheme called Janani Suraksha Yojana (JSY on April 11, 2005, under the flagship of National Rural Health Mission to reduce maternal and neonatal mortality, by promoting institutional deliveries for which financial incentives are provided to mothers delivering in the health facilities. Objective: To study the knowledge, awareness, and utilization pattern of services under JSY among the beneficiaries in rural area of Shimla, Himachal Pradesh, India. Materials and Methods: This cross-sectional study was conducted among the 78 JSY beneficiaries residing in the rural field practice area of Indira Gandhi Medical College Shimla, Himachal Pradesh, India. These beneficiaries were interviewed with pretested, predesigned, semi-structured close ended questionnaire by house-to-house visits, after obtaining informed consent. Results: Majority of the JSY beneficiaries (50; 64% were in the age group of 20–25 years and 43 (55.1% of them heard about the JSY scheme before the present pregnancy. Anganwadi workers 78 (100% and female health workers (62; 79.5% were the main sources of information. More than half of the study participants (44; 56% had good knowledge about the scheme and 42 (53.85% registered their name in health institution during thefirst trimester of last pregnancy. Forty-four (56.4% beneficiaries had undergone three antenatal checkups and only 11 (14.1% of them received three postnatal (PN visits. All the beneficiaries received the JSY incentives 1-week the following delivery. Conclusions: Awareness regarding the JSY scheme, early antenatal registration, minimum three antenatal care visits, and three PN visits is still low among rural women which needs strengthening through intensification of IEC activities.

  13. 20 CFR 411.555 - Can the EN keep the milestone and outcome payments even if the beneficiary does not achieve all...

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Can the EN keep the milestone and outcome payments even if the beneficiary does not achieve all outcome months? 411.555 Section 411.555 Employees... Payment Systems § 411.555 Can the EN keep the milestone and outcome payments even if the beneficiary does...

  14. 19 CFR 10.26 - Articles assembled or processed in a beneficiary country in whole of U.S. components or...

    Science.gov (United States)

    2010-04-01

    ..., material, ingredient, or article remained under the control of the customs authority of the non-beneficiary... 19 Customs Duties 1 2010-04-01 2010-04-01 false Articles assembled or processed in a beneficiary... textile components cut to shape in the United States. 10.26 Section 10.26 Customs Duties U.S. CUSTOMS AND...

  15. Design

    DEFF Research Database (Denmark)

    Volf, Mette

    This publication is unique in its demystification and operationalization of the complex and elusive nature of the design process. The publication portrays the designer’s daily work and the creative process, which the designer is a part of. Apart from displaying the designer’s work methods...... and design parameters, the publication shows examples from renowned Danish design firms. Through these examples the reader gets an insight into the designer’s reality....

  16. Minerals and design of new waste forms for conditioning nuclear waste; Les mineraux et la formulation de nouvelles matrices de stockage pour les dechets radioactifs

    Energy Technology Data Exchange (ETDEWEB)

    Montel, J.M. [G2R, CNRS, Ecole nationale superieure de geologie, Nancy-universite, BP 70239, 54056 Vandoeuvre-les-Nancy (France)

    2011-02-15

    Safe storage of radioactive waste is a major challenge for the nuclear industry. Mineralogy is a good basis for designing ceramics, which could eventually replace nuclear glasses. This requires a new storage concept: separation-conditioning. Basic rules of crystal chemistry allow one to select the most suitable structures and natural occurrences allow assessing the long-term performance of ceramics in a geological environment. Three criteria are of special interest: compatibility with geological environment, resistance to natural fluids, and effects of self-irradiation. If mineralogical information is efficient for predicting the behaviour of common, well-known minerals, such as zircon, monazite or apatite, more research is needed to rationalize the long-term behaviour of uncommon waste form analogs. (author)

  17. Development of a data acquisition system in form of an apparatus which is specially designed for the study of the cerebral metabolism employing radioactive tracers

    International Nuclear Information System (INIS)

    Ponchon, J.

    1988-03-01

    The subject of this thesis is the development of a data acquisition system in form of an apparatus which is specially designed for the study of cerebral metabolism employing radioactive tracers. Currently, the test is based on the continuous inhalation of gas identified with oxygen 15. After an inhalation period of 6 to 8 minutes the local brain radioactivity attains an equilibrium which corresponds to the parameters of brain metabolism. The constant measurement of the radioactivity facilitates the monitoring of the evolution of these parameters. The apparatus consists of an assemby of lead collimators in which are lodged 26 gamma ray detectors (INa probes), each one of which scans a particular brain region. For ease of use and the provision of numerous possibilities, each detector has been assigned a multichannel pulse height analyser which has been developed by ourselves in order to correspond to and to comply with the demands of our tests. They are equipped with a device which automatically corrects for dead time thereby permitting the analysis of random impulses of a rate greater than 50.000 per second with a loss of less than 1%. The multichannel analysers are connected to a central computer which by means of suitably adapted software allows the calibration of different channel of measurement, controls, the choice of the zone of interest to be integrated and the presentation of integrated results in form of graphs [fr

  18. Optimization of Forced Degradation Using Experimental Design and Development of a Stability-Indicating Liquid Chromatographic Assay Method for Rebamipide in Bulk and Tablet Dosage Form

    Directory of Open Access Journals (Sweden)

    Sandeep SONAWANE

    2016-09-01

    Full Text Available A novel stability-indicating RP-HPLC assay method was developed and validated for quantitative determination of rebamipide in bulk and tablet dosage form. Rebamipide (drug and drug product solutions were exposed to acid and alkali hydrolysis, thermal stress, oxidation by hydrogen peroxide and photodegradation. Experimental design has been used during forced degradation to determine significant factors responsible for degradation and to obtain optimal degradation conditions. In addition, acid and alkali hydrolysis was performed using a microwave oven. The chromatographic method employed the HiQ sil C-18HS (250 × 4.6 mm; 5 μm column with mobile phase consisting of 0.02 M potassium phosphate (pH adjusted to 6.8 and methanol (40:60, v/v and the detection was performed at 230 nm. The procedure was validated for specificity, linearity, accuracy, precision and robustness. There was no interference observed of excipients and degradation products in the determination of the active pharmaceutical ingredient. The method showed good accuracy and precision (intra and inter day and the response was linear in a range from 0.5 to 5 μg mL−1. The method was found to be simple and fast with less trial and error experimentation by making use of experimental design. Also, it proved that microwave energy can be used to expedite hydrolysis of rebamipide.

  19. Cross-Sectional Analysis of Per Capita Supply of Doctors of Chiropractic and Opioid Use in Younger Medicare Beneficiaries.

    Science.gov (United States)

    Weeks, William B; Goertz, Christine M

    2016-05-01

    The purpose of this study was to determine whether the per-capita supply of doctors of chiropractic (DCs) or Medicare spending on chiropractic care was associated with opioid use among younger, disabled Medicare beneficiaries. Using 2011 data, at the hospital referral region level, we correlated the per-capita supply of DCs and spending on chiropractic manipulative therapy (CMT) with several measures of per-capita opioid use by younger, disabled Medicare beneficiaries. Per-capita supply of DCs and spending on CMT were strongly inversely correlated with the percentage of younger Medicare beneficiaries who had at least 1, as well as with 6 or more, opioid prescription fills. Neither measure was correlated with mean daily morphine equivalents per opioid user or per chronic opioid user. A higher per-capita supply of DCs and Medicare spending on CMT were inversely associated with younger, disabled Medicare beneficiaries obtaining an opioid prescription. However, neither measure was associated with opioid dosage among patients who obtained opioid prescriptions. Copyright © 2016. Published by Elsevier Inc.

  20. 19 CFR 10.196 - Cost or value of materials produced in a beneficiary country or countries.

    Science.gov (United States)

    2010-04-01

    ... country where it is tanned to create nonperishable “crust leather”. The tanned product is then imported... tanned to create nonperishable “crust leather”. The tanned skin is then imported directly into the U.S... composed is not wholly the growth, product, or manufacture of a beneficiary country and (2) the tanning...

  1. 20 CFR 30.17 - Is a beneficiary who defrauds the government in connection with a claim for EEOICPA benefits...

    Science.gov (United States)

    2010-04-01

    ... OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED General Provisions Rights and Penalties § 30... for benefits under the Act or any other federal or state workers' compensation law, the beneficiary... trial) any entitlement to any further benefits for any injury, illness or death covered by this part for...

  2. 42 CFR 411.12 - Charges imposed by an immediate relative or member of the beneficiary's household.

    Science.gov (United States)

    2010-10-01

    ...) Natural or adoptive parent, child, or sibling. (3) Stepparent, stepchild, stepbrother, or stepsister. (4... if the physician who ordered or supervised the services has an excluded relationship to the... provider or supplier if the owner has an excluded relationship to the beneficiary; and (ii) Charges imposed...

  3. Disability and Hospital Care Expenses among National Health Insurance Beneficiaries: Analyses of Population-Based Data in Taiwan

    Science.gov (United States)

    Lin, Lan-Ping; Lee, Jiunn-Tay; Lin, Fu-Gong; Lin, Pei-Ying; Tang, Chi-Chieh; Chu, Cordia M.; Wu, Chia-Ling; Lin, Jin-Ding

    2011-01-01

    Nationwide data were collected concerning inpatient care use and medical expenditure of people with disabilities (N = 937,944) among national health insurance beneficiaries in Taiwan. Data included gender, age, hospitalization frequency and expenditure, healthcare setting and service department, discharge diagnose disease according to the ICD-9-CM…

  4. Medicare Part D is associated with reducing the financial burden of health care services in Medicare beneficiaries with diagnosed diabetes.

    Science.gov (United States)

    Li, Rui; Gregg, Edward W; Barker, Lawrence E; Zhang, Ping; Zhang, Fang; Zhuo, Xiaohui; Williams, Desmond E; Soumerai, Steven B

    2013-10-01

    Medicare Part D, implemented in 2006, provided coverage for prescription drugs to all Medicare beneficiaries. To examine the effect of Part D on the financial burden of persons with diagnosed diabetes. We conducted an interrupted time-series analysis using data from the 1996 to 2008 Medical Expenditure Panel Survey (11,178 persons with diabetes who were covered by Medicare, and 8953 persons aged 45-64 y with diabetes who were not eligible for Medicare coverage). We then compared changes in 4 outcomes: (1) annual individual out-of-pocket expenditure (OOPE) for prescription drugs; (2) annual individual total OOPE for all health care services; (3) annual total family OOPE for all health care services; and (4) percentage of persons with high family financial burden (OOPE ≥10% of income). For Medicare beneficiaries with diabetes, Part D was associated with a 28% ($530) decrease in individual annual OOPE for prescription drugs, a 23% ($560) reduction in individual OOPE for all health care, a 23% ($863) reduction in family OOPE for all health care, and a 24% reduction in the percentage of families with high financial burden in 2006. There were similar reductions in 2007 and 2008. By 2008, the percentage of Medicare beneficiaries with diabetes living in high financial burden families was 37% lower than it would have been had Part D not been in place. Introduction of Part D coverage was associated with a substantial reduction in the financial burden of Medicare beneficiaries with diabetes and their families.

  5. 75 FR 60066 - Limitations of Duty- and Quota-Free Imports of Apparel Articles Assembled in Beneficiary ATPDEA...

    Science.gov (United States)

    2010-09-29

    ... set of Harmonized System lines listed in the Annex to the World Trade Organization Agreement on... COMMITTEE FOR THE IMPLEMENTATION OF TEXTILE AGREEMENTS Limitations of Duty- and Quota-Free Imports of Apparel Articles Assembled in Beneficiary ATPDEA Countries From Regional Country Fabric AGENCY...

  6. Potential Beneficiaries of the Obama Administration’s Executive Action Programs Deeply Embedded in US Society

    Directory of Open Access Journals (Sweden)

    Donald Kerwin

    2016-03-01

    Full Text Available The Obama administration has developed two broad programs to defer immigration enforcement actions against undocumented persons living in the United States: (1 Deferred Action for Parents of Americans and Lawful Permanent Residents (DAPA; and (2 Deferred Action for Childhood Arrivals (DACA. The DACA program, which began in August 2012, was expanded on November 20, 2014. DAPA and the DACA expansion (hereinafter referred to as “DACA-plus” are currently under review by the US Supreme Court and subject to an active injunction.This paper offers a statistical portrait of the intended direct beneficiaries of DAPA, DACA, and DACA-plus. It finds that potential DAPA, DACA, and DACA-plus recipients are deeply embedded in US society, with high employment rates, extensive US family ties, long tenure, and substantial rates of English-language proficiency. The paper also notes various groups that would benefit indirectly from the full implementation of DAPA and DACA or, conversely, would suffer from the removal of potential beneficiaries of these programs. For example, all those who would rely on the retirement programs of the US government will benefit from the high employment rates and relative youth of the DACA population, while many US citizens who rely on the income of a DAPA-eligible parent would fall into poverty or extreme poverty should that parent be removed from the United States.This paper offers an analysis of potential DAPA and DACA beneficiaries. In an earlier study, the authors made the case for immigration reform based on long-term trends related to the US undocumented population, including potential DAPA and DACA beneficiaries (Warren and Kerwin 2015. By contrast, this paper details the degree to which these populations have become embedded in US society. It also compares persons eligible for the original DACA program with those eligible for DACA-plus.As stated, the great majority of potential DAPA and DACA recipients enjoy strong family

  7. When is a lie acceptable? Work and private life lying acceptance depends on its beneficiary.

    Science.gov (United States)

    Cantarero, Katarzyna; Szarota, Piotr; Stamkou, Eftychia; Navas, Marisol; Dominguez Espinosa, Alejandra Del Carmen

    2018-01-01

    In this article we show that when analyzing attitude towards lying in a cross-cultural setting, both the beneficiary of the lie (self vs other) and the context (private life vs. professional domain) should be considered. In a study conducted in Estonia, Ireland, Mexico, The Netherlands, Poland, Spain, and Sweden (N = 1345), in which participants evaluated stories presenting various types of lies, we found usefulness of relying on the dimensions. Results showed that in the joint sample the most acceptable were other-oriented lies concerning private life, then other-oriented lies in the professional domain, followed by egoistic lies in the professional domain; and the least acceptance was shown for egoistic lies regarding one's private life. We found a negative correlation between acceptance of a behavior and the evaluation of its deceitfulness.

  8. Cruise Tourism in Dominica: Benefits and Beneficiaries Bruno Marques, Romain Cruse

    Directory of Open Access Journals (Sweden)

    Bruno Marques

    2015-09-01

    Full Text Available The impressive growth of cruise tourism in Dominica, inside highly competitive area of the Caribbean basin, gives the island an astonishing flavor of success. By adopting a systemic approach the article demonstrates that three agents concentrate more than 70% of the financial impact of the cruise activity in Dominica: the local travel agencies, souvenir shops and the cruise lines. The low dispersion of the beneficiaries is concomitant with a spatial concentration and a minimal macroeconomic benefit. This case study, devoted to Dominica, suggests a highly concentrated model of cruise tourism in the Caribbean underpinned by organized tours as the main mode of experiencing the stopovers and a source of revenue for cruise lines, whose subcontractor: the local travel agencies are the primary distribution channel of cruise tourism revenue, high level of economic and spatial concentration generating low trickle down macroeconomic effect.

  9. Recessions and seniors' health, health behaviors, and healthcare use: analysis of the Medicare Current Beneficiary Survey.

    Science.gov (United States)

    McInerney, Melissa; Mellor, Jennifer M

    2012-09-01

    A number of studies report that U.S. state mortality rates, particularly for the elderly, decline during economic downturns. Further, several prior studies use microdata to show that as state unemployment rates rise, physical health improves, unhealthy behaviors decrease, and medical care use declines. We use data on elderly mortality rates and data from the Medicare Current Beneficiary Survey from a time period that encompasses the start of the Great Recession. We find that elderly mortality is countercyclical during most of the 1994-2008 period. Further, as unemployment rates rise, seniors report worse mental health and are no more likely to engage in healthier behaviors. We find suggestive evidence that inpatient utilization increases perhaps because of an increased physician willingness to accept Medicare patients. Our findings suggest that either elderly individuals respond differently to recessions than do working age adults, or that the relationship between unemployment and health has changed. Copyright © 2012 Elsevier B.V. All rights reserved.

  10. Composite hollow core vaults: An analysis of the Fusée Céramic System and the design of form-active environmental friendly roofs

    Directory of Open Access Journals (Sweden)

    Wim Kamerling

    2016-03-01

    Full Text Available Just after World-War II building materials were scarce, architects and engineers had to design buildings using not much cement and steel. In French an architect, Jacques Couëlle, had invented a system with céramique infill elements to reduce for structures of concrete the self-weight and need of cement and steel. In the fifties and sixties of the twentieth century these céramique elements, known as Fusée Céramique elements, were used widely in France, North Africa and the Netherlands, mostly for barrel vaults and shells. Nowadays most of these structures are pulled down and the remaining buildings do not meet the demands of the present concerning climate comfort, insulation and safety. This thesis analyses the structural design of cylindrical Fusée Céramique roofs in the context of those days. The effect of the céramique infill elements for the time dependent deformations, stiffness and load bearing capacity, including second order, is studied. To save the few remaining buildings for the coming generations the possibilities to strengthen these structures with slender light elements of steel are explored. The effect of the strengthening is described for a Fusée Céramique vault, designed and constructed in the past. Reinforced concrete is a widely used building material with many advantages. Unfortunately the production of both reinforcement and cement is quite energy intensive and causes the emission of greenhouse gasses as NO2, NO and CO2. Reducing the need of cement is a relative simple way to reduce the emission of these greenhouse gasses. In practice roofs are seldom really flat but curved or at least slightly inclined, to drain rainwater and snow. Structurally curved structures, transferring loads as a surface-active or form-active structural system, are very efficient. The need of material and the self-weight is pretty low. This can be very useful if in the future the potentials of roofs for producing food and energy are used more

  11. Depression Following Thrombotic Cardiovascular Events in Elderly Medicare Beneficiaries: Risk of Morbidity and Mortality

    Directory of Open Access Journals (Sweden)

    Christopher M. Blanchette

    2009-01-01

    Full Text Available Purpose. Depression and antidepressant use may independently increase the risk of acute myocardial infarction and mortality in adults. However, no studies have looked at the effect of depression on a broader thrombotic event outcome, assessed antidepressant use, or evaluated elderly adults. Methods. A cohort of 7,051 community-dwelling elderly beneficiaries who experienced a thrombotic cardiovascular event (TCE were pooled from the 1997 to 2002 Medicare Current Beneficiary Survey and followed for 12 months. Baseline characteristics, antidepressant utilization, and death were ascertained from the survey, while indexed TCE, recurrent TCE, and depression (within 6 months of indexed TCE were taken from ICD-9 codes on Medicare claims. Time to death and first recurrent TCE were assessed using descriptive and multivariate statistics. Results. Of the elders with a depression claim, 71.6% had a recurrent TCE and 4.7% died within 12 months of their indexed TCE, compared to 67.6% and 3.9% of those elders without a depression claim. Of the antidepressant users, 72.6% experienced a recurrent TCE and 3.9% died, compared to 73.7% and 4.6% in the subset of selective serotonin reuptake inhibitor (SSRI users. Depression was associated with a shorter time to death (P=.008 in the unadjusted analysis. However, all adjusted comparisons revealed no effect by depression, antidepressant use, or SSRI use. Conclusions. Depression was not associated with time to death or recurrent TCEs in this study. Antidepressant use, including measures of any antidepressant use and SSRI use, was not associated with shorter time to death or recurrent TCE.

  12. Benefits and costs of intensive lifestyle modification programs for symptomatic coronary disease in Medicare beneficiaries.

    Science.gov (United States)

    Zeng, Wu; Stason, William B; Fournier, Stephen; Razavi, Moaven; Ritter, Grant; Strickler, Gail K; Bhalotra, Sarita M; Shepard, Donald S

    2013-05-01

    This study reports outcomes of a Medicare-sponsored demonstration of two intensive lifestyle modification programs (LMPs) in patients with symptomatic coronary heart disease: the Cardiac Wellness Program of the Benson-Henry Mind Body Institute (MBMI) and the Dr Dean Ornish Program for Reversing Heart Disease® (Ornish). This multisite demonstration, conducted between 2000 and 2008, enrolled Medicare beneficiaries who had had an acute myocardial infarction or a cardiac procedure within the preceding 12 months or had stable angina pectoris. Health and economic outcomes are compared with matched controls who had received either traditional or no cardiac rehabilitation following similar cardiac events. Each program included a 1-year active intervention of exercise, diet, small-group support, and stress reduction. Medicare claims were used to examine 3-year outcomes. The analysis includes 461 elderly, fee-for-service, Medicare participants and 1,795 controls. Cardiac and non-cardiac hospitalization rates were lower in participants than controls in each program and were statistically significant in MBMI (P costs of $3,801 and $4,441 per participant for the MBMI and Ornish Programs, respectively, were offset by reduced health care costs yielding non-significant three-year net savings per participant of about $3,500 in MBMI and $1,000 in Ornish. A trend towards lower mortality compared with controls was observed in MBMI participants (P = .07). Intensive, year-long LMPs reduced hospitalization rates and suggest reduced Medicare costs in elderly beneficiaries with symptomatic coronary heart disease. Copyright © 2013 Mosby, Inc. All rights reserved.

  13. Variation in Postsepsis Readmission Patterns: A Cohort Study of Veterans Affairs Beneficiaries

    Science.gov (United States)

    2017-01-01

    Rationale: Rehospitalization is common after sepsis, but little is known about the variation in readmission patterns across patient groups and care locations. Objectives: To examine the variation in postsepsis readmission rates and diagnoses by patient age, nursing facility use, admission year, and hospital among U.S. Veterans Affairs (VA) beneficiaries. Methods: Observational cohort study of VA beneficiaries who survived a sepsis hospitalization (2009–2011) at 114 VA hospitals, stratified by age (readmission after sepsis hospitalization and proportion of readmissions resulting from specific diagnoses, including the proportion of “potentially preventable” readmissions. Readmission diagnoses were similar from 2009 to 2011, with little variation in readmission rates across hospitals. The top six readmission diagnoses (heart failure, pneumonia, sepsis, urinary tract infection, acute renal failure, and chronic obstructive pulmonary disease) accounted for 30% of all readmissions. Although about one in five readmissions had a principal diagnosis for infection, 58% of all readmissions received early systemic antibiotics. Infection accounted for a greater proportion of readmissions among patients discharged to nursing facilities compared with patients discharged to home (25.0–27.1% vs. 16.8%) and among older vs. younger patients (22.2% vs. 15.8%). Potentially preventable readmissions accounted for a quarter of readmissions overall and were more common among older patients and patients discharged to nursing facilities. Conclusions: Hospital readmission rates after sepsis were similar by site and admission year. Heart failure, pneumonia, sepsis, and urinary tract infection were common readmission diagnoses across all patient groups. Readmission for infection and potentially preventable diagnoses were more common in older patients and patients discharged to nursing facilities. PMID:27854510

  14. Discontinuity of Medicaid Coverage: Impact on Cost and Utilization Among Adult Medicaid Beneficiaries With Major Depression.

    Science.gov (United States)

    Ji, Xu; Wilk, Adam S; Druss, Benjamin G; Lally, Cathy; Cummings, Janet R

    2017-08-01

    Gaps in Medicaid coverage may disrupt access to and continuity of care. This can be detrimental for beneficiaries with chronic conditions, such as major depression, for whom disruptions in access to outpatient care may lead to increased use of acute care. However, little is known about how Medicaid coverage discontinuities impact acute care utilization among adults with depression. Examine the relationship between Medicaid discontinuities and service utilization among adults with major depression. A total of 139,164 adults (18-64) with major depression was identified using the 2003-2004 Medicaid Analytic eXtract Files. We used generalized linear and two-part models to examine the effect of Medicaid discontinuity on service utilization. To establish causality in this relationship, we used instrumental variables analysis, relying on exogenous variation in a state-level policy for identification. Emergency department (ED) visits, inpatient episodes, inpatient days, and Medicaid-reimbursed costs. Approximately 29.4% of beneficiaries experienced coverage disruptions. In instrumental variables models, those with coverage disruptions incurred an increase of $650 in acute care costs per-person per Medicaid-covered month compared with those with continuous coverage, evidenced by an increase in ED use (0.1 more ED visits per-person-month) and inpatient days (0.6 more days per-person-month). The increase in acute costs contributed to an overall increase in all-cause costs by $310 per-person-month (all P-valuesMedicaid coverage may help prevent acute episodes requiring high-cost interventions.

  15. Utilization of Integrated Child Development Services (ICDS Scheme by child beneficiaries in Coastal Karnataka, India

    Directory of Open Access Journals (Sweden)

    Saranya Sivanesan

    2016-06-01

    Full Text Available Background: India’s main early childhood development intervention the ICDS Scheme has been sustained for 40 years and has been successful in some ways. However, nearly half of the children under six years are still under nourished. The program in reducing the proportion of undernourished children over the past decade has been modest and slower in India than what has been achieved in other countries with comparable socio-economic indicators. Aims & Objectives: 1. To study the utilization of services offered to children under ICDS, 2. To assess the perception about the services. Materials & Methods: A community based cross sectional study was done among mothers of 271 children in the age group three to six years registered in anganwadis. Results: Median duration of absenteeism to anganwadi was five months during the last six months enquired. About 95.9% of registered child beneficiaries utilized supplementary nutrition services and only 48.7% mothers of child beneficiaries were attending nutrition and health education sessions. Among mothers who were aware of growth monitoring, only 73.6% of their children’s weight was checked regularly.  About 60% of mothers were not happy with the quality of food served to their children in the anganwadi. Among children adherent to anganwadi, 72.5% children’s weight remained normal. Conclusion: Only 75% children were regularly attending. Median duration of adherence to anganwadi services was only 12 months and the most common reason for not adhering to the services is due to their simultaneous enrollment in other private nursery school.

  16. Transgender Medicare Beneficiaries and Chronic Conditions: Exploring Fee-for-Service Claims Data

    Science.gov (United States)

    Guerino, Paul; Ewald, Erin; Laffan, Alison M.

    2017-01-01

    Abstract Purpose: Data on the health and well-being of the transgender population are limited. However, using claims data we can identify transgender Medicare beneficiaries (TMBs) with high confidence. We seek to describe the TMB population and provide comparisons of chronic disease burden between TMBs and cisgender Medicare beneficiaries (CMBs), thus laying a foundation for national level TMB health disparity research. Methods: Using a previously validated claims algorithm based on ICD-9-CM codes relating to transsexualism and gender identity disorder, we identified a cohort of TMBs using Medicare Fee-for-Service (FFS) claims data. We then describe the demographic characteristics and chronic disease burden of TMBs (N = 7454) and CMBs (N = 39,136,229). Results: Compared to CMBs, a greater observed proportion of TMBs are young (under age 65) and Black, although these differences vary by entitlement. Regardless of entitlement, TMBs have more chronic conditions than CMBs, and more TMBs have been diagnosed with asthma, autism spectrum disorder, chronic obstructive pulmonary disease, depression, hepatitis, HIV, schizophrenia, and substance use disorders. TMBs also have higher observed rates of potentially disabling mental health and neurological/chronic pain conditions, as well as obesity and other liver conditions (nonhepatitis), compared to CMBs. Conclusion: This is the first systematic look at chronic disease burden in the transgender population using Medicare FFS claims data. We found that TMBs experience multiple chronic conditions at higher rates than CMBs, regardless of Medicare entitlement. TMBs under age 65 show an already heavy chronic disease burden which will only be exacerbated with age. PMID:29125908

  17. Trends in Hospitalization Rates and Outcomes of Endocarditis among Medicare Beneficiaries

    Science.gov (United States)

    Bikdeli, Behnood; Wang, Yun; Kim, Nancy; Desai, Mayur M.; Quagliarello, Vincent; Krumholz, Harlan M.

    2015-01-01

    Objectives To determine the hospitalization rates and outcomes of endocarditis among older adults. Background Endocarditis is the most serious cardiovascular infection and is especially common among older adults. Little is known about recent trends for endocarditis hospitalizations and outcomes. Methods Using Medicare inpatient Standard Analytic Files, we identified all Fee-For-Service beneficiaries aged ≥65 years with a principal or secondary diagnosis of endocarditis from 1999-2010. We used Medicare Denominator Files to report hospitalizations per 100,000 person-years. Rates of 30-day and 1-year mortality were calculated using Vital Status Files. We used mixed-effects models to calculate adjusted rates of hospitalization and mortality and to compare the results before and after 2007, when the American Heart Association revised recommendations for endocarditis prophylaxis. Results Overall, 262,658 beneficiaries were hospitalized with endocarditis. The adjusted hospitalization rate increased from 1999-2005, reaching 83.5 per 100,000 person-years in 2005, and declined during 2006-2007. After 2007, the decline continued, reaching 70.6 per 100,000 person-years in 2010. Adjusted 30-day and 1-year mortality rates ranged from 14.2% to 16.5% and from 32.6% to 36.2%, respectively. There were no consistent changes in adjusted rates of 30-day and 1-year mortality after 2007. Trends in rates of hospitalization and outcomes were consistent across demographic subgroups. Adjusted rates of hospitalization and mortality declined consistently in the subgroup with principal diagnosis of endocarditis. Conclusions Our study highlights the high burden of endocarditis among older adults. We did not observe an increase in adjusted rates of hospitalization or mortality associated with endocarditis after publication of the 2007 guidelines. PMID:23994421

  18. Antihypertensive medication classes used among medicare beneficiaries initiating treatment in 2007-2010.

    Science.gov (United States)

    Kent, Shia T; Shimbo, Daichi; Huang, Lei; Diaz, Keith M; Kilgore, Meredith L; Oparil, Suzanne; Muntner, Paul

    2014-01-01

    After the 2003 publication of the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) guidelines, there was a 5-10% increase in patients initiating antihypertensive medication with a thiazide-type diuretic, but most patients still did not initiate treatment with this class. There are few contemporary published data on antihypertensive medication classes filled by patients initiating treatment. We used the 5% random Medicare sample to study the initiation of antihypertensive medication between 2007 and 2010. Initiation was defined by the first antihypertensive medication fill preceded by 365 days with no antihypertensive medication fills. We restricted our analysis to beneficiaries ≥ 65 years who had two or more outpatient visits with a hypertension diagnosis and full Medicare fee-for-service coverage for the 365 days prior to initiation of antihypertensive medication. Between 2007 and 2010, 32,142 beneficiaries in the 5% Medicare sample initiated antihypertensive medication. Initiation with a thiazide-type diuretic decreased from 19.2% in 2007 to 17.9% in 2010. No other changes in medication classes initiated occurred over this period. Among those initiating antihypertensive medication in 2010, 31.3% filled angiotensin-converting enzyme inhibitors (ACE-Is), 26.9% filled beta blockers, 17.2% filled calcium channel blockers, and 14.4% filled angiotensin receptor blockers (ARBs). Initiation with >1 antihypertensive medication class decreased from 25.6% in 2007 to 24.1% in 2010. Patients initiated >1 antihypertensive medication class most commonly with a thiazide-type diuretic and either an ACE-I or ARB. These results suggest that JNC 7 had a limited long-term impact on the choice of antihypertensive medication class and provide baseline data prior to the publication of the 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults from the Panel Members Appointed to

  19. The Influence of Co-Morbidity and Other Health Measures on Dental and Medical Care Use among Medicare beneficiaries 2002

    Science.gov (United States)

    Chen, Haiyan; Moeller, John; Manski, Richard J.

    2011-01-01

    Objective To assess the impact of co-morbidity and other health measures on the use of dental and medical care services among the community-based Medicare population with data from the 2002 Medicare Current Beneficiary Survey. Methods A co-morbidity index is the main independent variable of our study. It includes oral cancer as a co-morbidity condition and was developed from Medicare claims data. The two outcome variables indicate whether a beneficiary had a dental visit during the year and whether the beneficiary had an inpatient hospital stay during the year. Logistic regressions estimated the relationship between the outcome variables and co-morbidity after controlling for other explanatory variables. Results High scores on the co-morbidity index, high numbers of self-reported physical limitations, and fair or poor self-reported health status were correlated with higher hospital use and lower dental care utilization. Similar results were found for other types of medical care including medical provider visits, outpatient care, and prescription drugs. A multiple imputation technique was used for the approximate 20% of the sample with missing claims, but the resulting co-morbidity index performed no differently than the index constructed without imputation. Conclusions Co-morbidities and other health status measures are theorized to play either a predisposing or need role in determining health care utilization. The study’s findings confirm the dominant role of these measures as predisposing factors limiting access to dental care for Medicare beneficiaries and as need factors producing higher levels of inpatient hospital and other medical care for Medicare beneficiaries. PMID:21972460

  20. Self-reported Function, Health Resource Use, and Total Health Care Costs Among Medicare Beneficiaries With Glaucoma.

    Science.gov (United States)

    Prager, Alisa J; Liebmann, Jeffrey M; Cioffi, George A; Blumberg, Dana M

    2016-04-01

    The effect of glaucoma on nonglaucomatous medical conditions and resultant secondary health care costs is not well understood. To assess self-reported medical conditions, the use of medical services, and total health care costs among Medicare beneficiaries with glaucoma. Longitudinal observational study of 72,587 Medicare beneficiaries in the general community using the Medicare Current Beneficiary Survey (2004-2009). Coding to extract data started in January 2015, and analyses were performed between May and July 2015. Self-reported health, the use of health care services, adjusted mean annual total health care costs per person, and adjusted mean annual nonoutpatient costs per person. Participants were 72,587 Medicare beneficiaries 65 years or older with (n = 4441) and without (n = 68,146) a glaucoma diagnosis in the year before collection of survey data. Their mean age was 76.9 years, and 43.2% were male. Patients with glaucoma who responded to survey questions on visual disability were stratified into those with (n = 1748) and without (n = 2639) self-reported visual disability. Medicare beneficiaries with glaucoma had higher adjusted odds of inpatient hospitalizations (odds ratio [OR], 1.27; 95% CI, 1.17-1.39; P total health care costs and $2599 (95% CI, $1985-$3212; P total and nonoutpatient medical costs. Perception of vision loss among patients with glaucoma may be associated with depression, falls, and difficulty walking. Reducing the prevalence and severity of glaucoma may result in improvements in associated nonglaucomatous medical conditions and resultant reduction in health care costs.

  1. Proposing transportation designs and concepts to make Houston METRO's southeast line at the Palm Center area more walkable, bikeable, and livable.

    Science.gov (United States)

    2015-12-01

    Over the years, the Palm Center (PC) in Houston, Texas, has been the beneficiary of several economic : development endeavors designed to ignite economic and community growth and revitalization. While : these endeavors brought forth initial success, t...

  2. Limited take-up of health coverage tax credits: a challenge to future tax credit design.

    Science.gov (United States)

    Dorn, Stan; Varon, Janet; Pervez, Fouad

    2005-10-01

    The Trade Act of 2002 created federal tax credits to subsidize health coverage for certain early retirees and workers displaced by international trade. Though small, this program offers the opportunity to learn how to design future tax credits for larger groups of uninsured. During September 2004, the most recent month for which there are data about all forms of Trade Act credits, roughly 22 percent of eligible individuals received credits. The authors find that health insurance tax credits are more likely to reach their target populations if such credits: 1) limit premium costs for the low-income uninsured and do not require full premium payments while applications are pending; 2) provide access to coverage that beneficiaries value, including care for preexisting conditions; 3) are combined with outreach that uses easily understandable, multilingual materials and proactive enrollment efforts; and 4) feature a simple application process involving one form filed with one agency.

  3. (EOI) Form

    International Development Research Centre (IDRC) Digital Library (Canada)

    Dorine Odongo

    COLLABORATING TECHNICAL AGENCIES: EXPRESSION OF INTEREST FORM. • Please read the information provided about the initiative and the eligibility requirements in the Prospectus before completing this application form. • Ensure all the sections of the form are accurately completed and saved in PDF format.

  4. Modular forms

    NARCIS (Netherlands)

    Edixhoven, B.; van der Geer, G.; Moonen, B.; Edixhoven, B.; van der Geer, G.; Moonen, B.

    2008-01-01

    Modular forms are functions with an enormous amount of symmetry that play a central role in number theory, connecting it with analysis and geometry. They have played a prominent role in mathematics since the 19th century and their study continues to flourish today. Modular forms formed the

  5. Comparing the Health Care Experiences of Medicare Beneficiaries with and without Depressive Symptoms in Medicare Managed Care versus Fee-for-Service.

    Science.gov (United States)

    Martino, Steven C; Elliott, Marc N; Haviland, Amelia M; Saliba, Debra; Burkhart, Q; Kanouse, David E

    2016-06-01

    To compare patient experiences and disparities for older adults with depressive symptoms in managed care (Medicare Advantage [MA]) versus Medicare Fee-for-Service (FFS). Data came from the 2010 Medicare CAHPS survey, to which 220,040 MA and 135,874 FFS enrollees aged 65 and older responded. Multivariate linear regression was used to test whether case-mix-adjusted associations between depressive symptoms and patient experience differed for beneficiaries in MA versus FFS. Dependent measures included four measures of beneficiaries' experiences with doctors (e.g., reports of doctor communication) and seven measures of beneficiaries' experiences with plans (e.g., customer service). Beneficiaries with depressive symptoms reported worse experiences than those without depressive symptoms regardless of coverage type. For measures assessing interactions with the plan (but not for measures assessing interactions with doctors), the disadvantage for beneficiaries with versus without depressive symptoms was larger in MA than in FFS. Disparities in care experienced by older Medicare beneficiaries with depressive symptoms tend to be more negative in managed care than in FFS. Efforts are needed to identify and address the barriers these beneficiaries encounter to help them better traverse the managed care environment. © Health Research and Educational Trust.

  6. Development and Validation of a Rapid RP-HPLC Method for the Determination of Venlafaxine Hydrochloride in Pharmaceutical Dosage forms using Experimental Design

    Directory of Open Access Journals (Sweden)

    Vanita Somasekhar

    2009-01-01

    Full Text Available The objective of the current study was to develop a simple, accurate, precise and rapid reversed-phase HPLC method and subsequent validation as per ICH guidelines for the determination of venlafaxine hydrochloride in pharmaceutical dosage forms. The proposed RP-HPLC method utilizes a 5 μm Varian® Microsorb-MV 100 C18 column (250 mmx4.6 mm at ambient temperature. A 23 factorial design consisting of 3 factors at 2 levels was set up to standardize the chromatographic conditions. A numerical optimization technique employing the desirability approach was used to locate the optimum chromatographic conditions. The optimum mobile phase consisted of acetonitrile, 0.04 M potassium dihydrogen phosphate buffer and methanol (45:25:30, v/v, with pH adjusted to 5.5 using 10% phosphoric acid solution. The mobile phase was delivered isocratically at a flow rate of 1 mL/min with UV detection at 224 nm. The calibration plots constructed using the optimized chromatographic conditions displayed good linear relationship in the concentration range of 1-50 μg/mL with r=0.9992. The method was validated for precision, accuracy, robustness and recovery. The minimum detectable and minimum quantifiable amounts were found to be 0.568 and 1.72 μg/mL, respectively and the method was found to be reproducible from the statistical data generated. Venlafaxine hydrochloride was eluted at 3.43 min

  7. Oil royalties payment impact on socio-economic beneficiary countries development; O impacto do pagamento de royalties do petroleo no desenvolvimento socio-economico dos municipios beneficiarios

    Energy Technology Data Exchange (ETDEWEB)

    Lucchesi, Cesar Augusto M.; Anuatti Neto, Francisco [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Faculdade de Economia, Administracao e Contabilidade

    2004-07-01

    This research proposes to evaluate oil royalties payment impact on socio-economic beneficiary counties indicators. In the first step, it has been made royalties payments distribution among beneficiary counties (942), what showed a meaningful paid resources concentration between 1993 and 1999, when 20% of the beneficiaries apportioned of 98,5% from this period paid royalties. For these 188 greatest exaction counties the royalties impact analyses on County Human Development Index (IDH-M) evolution showed the received royalties amount positively influenced the 2000 IDH-M additional comparing to 1991. It indicates the petroleum industry contribution to municipal development of those counties which receive these resources. (author)

  8. 75 FR 10018 - Proposed Collection; Comment Request for Form 1041 and Related Schedules D, J, and K-1

    Science.gov (United States)

    2010-03-04

    ... 1041 and Related Schedules D, J, and K-1 AGENCY: Internal Revenue Service (IRS), Treasury. ACTION..., the IRS is soliciting comments concerning Form 1041 and related Schedules D, J, and K-1, U.S. Income...), Accumulation Distribution for Certain Complex Trusts (Schedule J), and Beneficiary's Share of Income...

  9. 78 FR 23981 - Proposed Collection; Comment Request for Form 1041 and Related Schedules D, J, and K-1

    Science.gov (United States)

    2013-04-23

    ... 1041 and Related Schedules D, J, and K-1 AGENCY: Internal Revenue Service (IRS), Treasury. ACTION..., the IRS is soliciting comments concerning Form 1041 and related Schedules D, J, and K-1, U.S. Income... Losses (Schedule D), Accumulation Distribution for Certain Complex Trusts (Schedule J), and Beneficiary's...

  10. Design

    DEFF Research Database (Denmark)

    Volf, Mette

    Design - proces & metode iBog®  er enestående i sit fokus på afmystificering og operationalisering af designprocessens flygtige og komplekse karakter. Udgivelsen går bag om designerens daglige arbejde og giver et indblik i den kreative skabelsesproces, som designeren er en del af. Udover et bredt...... indblik i designerens arbejdsmetoder og designparametre giver Design - proces & metode en række eksempler fra anerkendte designvirksomheder, der gør det muligt at komme helt tæt på designerens virkelighed....

  11. Design

    Science.gov (United States)

    Buchanan, Richard; Cross, Nigel; Durling, David; Nelson, Harold; Owen, Charles; Valtonen, Anna; Boling, Elizabeth; Gibbons, Andrew; Visscher-Voerman, Irene

    2013-01-01

    Scholars representing the field of design were asked to identify what they considered to be the most exciting and imaginative work currently being done in their field, as well as how that work might change our understanding. The scholars included Richard Buchanan, Nigel Cross, David Durling, Harold Nelson, Charles Owen, and Anna Valtonen. Scholars…

  12. The South African traditional health practitioner as a beneficiary of and provider to medical funds and schemes through the traditional health practitioners Act (Act No 22, 2007: A present-day perspective

    Directory of Open Access Journals (Sweden)

    Gabriel Louw

    2017-01-01

    Full Text Available Background Payments to traditional health practitioners for services rendered from medical funds and schemes, as envisaged by the Traditional Health Practitioners Act (Act No 22, 2007, is controversial and a point of contention. Such policy was followed before in South Africa in the 1990s when some funds and schemes offered limited alternative healthcare benefits for members consulting traditional healers. Aims The study aimed to offer a contemporary view of the South African traditional health practitioner as a provider to and beneficiary of the medical funds and schemes through the Traditional Health Practitioners Act (No 22, 2007. Methods This is an exploratory and descriptive study that makes use of an historical approach by means of investigation and a literature review. The emphasis is on using current documentation like articles, books and newspapers as primary sources to reflect on the South African traditional health practitioner as a provider to and beneficiary of the medical schemes and funds through the Traditional Health Practitioners Act (No 22, 2007. The findings are offered in narrative form. Results It seems as if the South African authorities completely misunderstand the future implications of the Traditional Health Practitioners Act (No 22, 2007 on healthcare. This is specifically true when it comes to the right to claim from medical funds and schemes for services rendered by traditional health practitioners and the possible extra costs for these medical schemes and funds. Conclusion The implications of Section 42(2 of the Traditional Health Practitioners Act (No 22, 2007 which aims to set up a claiming process for traditional health practitioners, seems to be very problematic. The fact that Act No 22 (2007 has not been enacted properly nine years after its promulgation has put a halt on the professionalization of traditional healers until 2015. This also affected their status as a beneficiary of and service provider to the

  13. THE FMOS-COSMOS SURVEY OF STAR-FORMING GALAXIES AT z ∼ 1.6. III. SURVEY DESIGN, PERFORMANCE, AND SAMPLE CHARACTERISTICS

    Energy Technology Data Exchange (ETDEWEB)

    Silverman, J. D.; Sugiyama, N. [Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Kashiwa, 277-8583 (Japan); Kashino, D. [Division of Particle and Astrophysical Science, Graduate School of Science, Nagoya University, Nagoya, 464-8602 (Japan); Sanders, D.; Zahid, J.; Kewley, L. J.; Chu, J.; Hasinger, G. [Institute for Astronomy, University of Hawaii, 2680 Woodlawn Drive, Honolulu, HI, 96822 (United States); Kartaltepe, J. S. [National Optical Astronomy Observatory, 950 N. Cherry Ave., Tucson, AZ, 85719 (United States); Arimoto, N. [Subaru Telescope, 650 North A’ohoku Place, Hilo, Hawaii, 96720 (United States); Renzini, A. [Instituto Nazionale de Astrofisica, Osservatorio Astronomico di Padova, vicolo dell’Osservatorio 5, I-35122, Padova, Italy, EU (Italy); Rodighiero, G.; Baronchelli, I. [Dipartimento di Fisica e Astronomia, Universita di Padova, vicolo Osservatorio, 3, I-35122, Padova (Italy); Daddi, E.; Juneau, S. [Laboratoire AIM, CEA/DSM-CNRS-Universite Paris Diderot, Irfu/Service d’Astrophysique, CEA Saclay (France); Nagao, T. [Graduate School of Science and Engineering, Ehime University, 2-5 Bunkyo-cho, Matsuyama 790-8577 (Japan); Lilly, S. J.; Carollo, C. M. [Institute of Astronomy, ETH Zürich, CH-8093, Zürich (Switzerland); Capak, P. [Spitzer Science Center, California Institute of Technology, Pasadena, CA 91125 (United States); Ilbert, O., E-mail: john.silverman@ipmu.jp [Aix Marseille Université, CNRS, LAM (Laboratoire d’Astrophysique de Marseille) UMR 7326, F-13388, Marseille (France); and others

    2015-09-15

    We present a spectroscopic survey of galaxies in the COSMOS field using the Fiber Multi-object Spectrograph (FMOS), a near-infrared instrument on the Subaru Telescope. Our survey is specifically designed to detect the Hα emission line that falls within the H-band (1.6–1.8 μm) spectroscopic window from star-forming galaxies with 1.4 < z < 1.7 and M{sub stellar} ≳ 10{sup 10} M{sub ⊙}. With the high multiplex capability of FMOS, it is now feasible to construct samples of over 1000 galaxies having spectroscopic redshifts at epochs that were previously challenging. The high-resolution mode (R ∼ 2600) effectively separates Hα and [N ii]λ6585, thus enabling studies of the gas-phase metallicity and photoionization state of the interstellar medium. The primary aim of our program is to establish how star formation depends on stellar mass and environment, both recognized as drivers of galaxy evolution at lower redshifts. In addition to the main galaxy sample, our target selection places priority on those detected in the far-infrared by Herschel/PACS to assess the level of obscured star formation and investigate, in detail, outliers from the star formation rate (SFR)—stellar mass relation. Galaxies with Hα detections are followed up with FMOS observations at shorter wavelengths using the J-long (1.11–1.35 μm) grating to detect Hβ and [O iii]λ5008 which provides an assessment of the extinction required to measure SFRs not hampered by dust, and an indication of embedded active galactic nuclei. With 460 redshifts measured from 1153 spectra, we assess the performance of the instrument with respect to achieving our goals, discuss inherent biases in the sample, and detail the emission-line properties. Our higher-level data products, including catalogs and spectra, are available to the community.

  14. Health care utilization and expenditures among Medicaid beneficiaries with neuropathic pain following spinal cord injury

    Directory of Open Access Journals (Sweden)

    Margolis JM

    2014-07-01

    Full Text Available Jay M Margolis,1 Paul Juneau,1 Alesia Sadosky,2 Joseph C Cappelleri,3 Thomas N Bryce,4 Edward C Nieshoff5 1Truven Health Analytics, Bethesda, MD, USA; 2Pfizer Inc., New York, NY, USA; 3Pfizer Inc., Groton, CT, USA; 4Department of Rehabilitation Medicine, The Icahn School of Medicine at Mount Sinai, New York, NY, USA; 5Department of Physical Medicine and Rehabilitation, Wayne State University School of Medicine, Detroit, MI, USA Background: The study aimed to evaluate health care resource utilization (HRU and costs for neuropathic pain (NeP secondary to spinal cord injury (SCI among Medicaid beneficiaries. Methods: The retrospective longitudinal cohort study used Medicaid beneficiary claims with SCI and evidence of NeP (SCI-NeP cohort matched with a cohort without NeP (SCI-only cohort. Patients had continuous Medicaid eligibility 6 months pre- and 12 months postindex, defined by either a diagnosis of central NeP (ICD-9-CM code 338.0x or a pharmacy claim for an NeP-related antiepileptic or antidepressant drug within 12 months following first SCI diagnosis. Demographics, clinical characteristics, HRU, and expenditures were compared between cohorts. Results: Propensity score-matched cohorts each consisted of 546 patients. Postindex percentages of patients with physician office visits, emergency department visits, SCI- and pain-related procedures, and outpatient prescription utilization were all significantly higher for SCI-NeP (P<0.001. Using regression models to account for covariates, adjusted mean expenditures were US$47,518 for SCI-NeP and US$30,150 for SCI only, yielding incremental costs of US$17,369 (95% confidence interval US$9,753 to US$26,555 for SCI-NeP. Factors significantly associated with increased cost included SCI type, trauma-related SCI, and comorbidity burden. Conclusion: Significantly higher HRU and total costs were incurred by Medicaid patients with NeP secondary to SCI compared with matched SCI-only patients. Keywords: spinal

  15. Antihypertensive medication classes used among medicare beneficiaries initiating treatment in 2007-2010.

    Directory of Open Access Journals (Sweden)

    Shia T Kent

    Full Text Available After the 2003 publication of the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7 guidelines, there was a 5-10% increase in patients initiating antihypertensive medication with a thiazide-type diuretic, but most patients still did not initiate treatment with this class. There are few contemporary published data on antihypertensive medication classes filled by patients initiating treatment.We used the 5% random Medicare sample to study the initiation of antihypertensive medication between 2007 and 2010. Initiation was defined by the first antihypertensive medication fill preceded by 365 days with no antihypertensive medication fills. We restricted our analysis to beneficiaries ≥ 65 years who had two or more outpatient visits with a hypertension diagnosis and full Medicare fee-for-service coverage for the 365 days prior to initiation of antihypertensive medication. Between 2007 and 2010, 32,142 beneficiaries in the 5% Medicare sample initiated antihypertensive medication. Initiation with a thiazide-type diuretic decreased from 19.2% in 2007 to 17.9% in 2010. No other changes in medication classes initiated occurred over this period. Among those initiating antihypertensive medication in 2010, 31.3% filled angiotensin-converting enzyme inhibitors (ACE-Is, 26.9% filled beta blockers, 17.2% filled calcium channel blockers, and 14.4% filled angiotensin receptor blockers (ARBs. Initiation with >1 antihypertensive medication class decreased from 25.6% in 2007 to 24.1% in 2010. Patients initiated >1 antihypertensive medication class most commonly with a thiazide-type diuretic and either an ACE-I or ARB.These results suggest that JNC 7 had a limited long-term impact on the choice of antihypertensive medication class and provide baseline data prior to the publication of the 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults from the Panel

  16. ALL MEMBERS AND BENEFICIARIES OF THE PENSION FUND ARE INVITED TO ATTEND THE ANNUAL GENERAL ASSEMBLY

    CERN Multimedia

    2000-01-01

    Annual General Assembly to be held in the CERN Auditorium on Wednesday 4 October 2000 at 14.30 hrs The Agenda comprises: 1. Opening Remarks: - P. Levaux 2. The Swiss provident system: - C. Cuénoud recent trends 3. Annual Report 1999: - C. Cuénoud Presentation and results Copies of the Report are available from divisional secretariats. 4. Pension Fund’s investment policy and performance: - G. Maurin 5. Questions from members and beneficiaries Persons wishing to ask questions are encouraged to submit them, where possible, in writing in advance, addressed to Mr C. Cuénoud, Administrator of the Fund. 5. Conclusions P. Levaux As usual, participants are invited to drinks after the assembly. NB The minutes of the 1999 General Assembly are available from the Administration of the Fund (tel.(+4122)767 9194; e-mail Graziella.Praire@cern.ch) SOME ASPECTS OF THE FUND’S ACTIVITIES IN 1999 The Governing Board (at 31 December 1999) Members Appointed by C. Bovet (Alternate: E. Chiaveri...

  17. Reductions in mortality among Medicare beneficiaries following the implementation of Medicare Part D.

    Science.gov (United States)

    Semilla, April P; Chen, Fang; Dall, Timothy M

    2015-07-01

    Medicare Part D is a prescription drug program that provides seniors and disabled individuals enrolled in Medicare with outpatient drug coverage benefits. Part D has been shown to increase access to medicines and improve medication adherence; however, the effect of Part D on health outcomes has not yet been extensively studied. In this study, we used a published and validated Markov-based microsimulation model to quantify the relationships among medication use, disease incidence and severity, and mortality. Based on the simulation results, we estimate that since the implementation of Part D in 2006, nearly 200,000 Medicare beneficiaries have lived at least 1 year longer. Reductions in mortality have occurred because of fewer deaths associated with medication-sensitive conditions such as diabetes, congestive heart failure, stroke, and myocardial infarction. Improved access to medication through Medicare Part D helps patients improve blood pressure, cholesterol, and blood glucose levels, which in turn can prevent or delay the onset of disease and the incidence of adverse health events, thus reducing mortality.

  18. Rates, Amounts, and Determinants of Ambulatory Blood Pressure Monitoring Claim Reimbursements Among Medicare Beneficiaries

    Science.gov (United States)

    Kent, Shia T.; Shimbo, Daichi; Huang, Lei; Diaz, Keith M.; Viera, Anthony J.; Kilgore, Meredith; Oparil, Suzanne; Muntner, Paul

    2014-01-01

    Ambulatory blood pressure monitoring (ABPM) can be used to identify white coat hypertension and guide hypertensive treatment. We determined the percentage of ABPM claims submitted between 2007–2010 that were reimbursed. Among 1,970 Medicare beneficiaries with submitted claims, ABPM was reimbursed for 93.8% of claims that had an ICD-9 diagnosis code of 796.2 (“elevated blood pressure reading without diagnosis of hypertension”) versus 28.5% of claims without this code. Among claims without an ICD-9 diagnosis code of 796.2 listed, those for the component (e.g., recording, scanning analysis, physician review, reporting) versus full ABPM procedures and performed by institutional versus non-institutional providers were each more than two times as likely to be successfully reimbursed. Of the claims reimbursed, the median payment was $52.01 (25–75th percentiles: $32.95–$64.98). In conclusion, educating providers on the ABPM claims reimbursement process and evaluation of Medicare reimbursement may increase the appropriate use of ABPM and improve patient care. PMID:25492833

  19. ESTIMATING MORAL DEVELOPMENT IN A SAMPLE OF ALTERNATIVE FORMULAS OF PRISON SENTENCED BENEFICIARIES FROM WEST VENEZUELA

    Directory of Open Access Journals (Sweden)

    CARLOS ENRIQUE ZERPA

    2006-05-01

    Full Text Available The level of moral development in a sampled of convicts from West Venezuela is presented. The studywas carried out by means of Defining Issues Test (DIT evaluation. The sample includes 50 persons between19 and 55 years old (M = 34,33 y DT = 8,76, out of them 39 were males (average age 33,74,DT=8,24 an 11 were females (average age 35,91, DT=10,67. All of them were beneficiaries of alternativesformulas of their respective sentences such as social work, parole or conditional suspension ofsentences and following the corresponding process or rehabilitation out of prisons. This sample registereda moral principles index of 19,67 and a non-relevant answers index of 12,07 as well as fourthmoral developmental stage of 41,3 which are unusually high. The results suggest that there is not astatistically significant difference in the pattern of moral development depending on sex, age, or institutionfor sentenced fulfillment. However, the unusual high pattern of answers and the inverse correspondence between the duration of sentences and the resulting level of moral principles suggest that thesample behaves in a way, which is different from what is expected in no-out-law samples. Findings andimplications are discused.

  20. Possible causes of poverty within a group of land reform beneficiaries in the midlands of KwaZulu-Natal: Analysis and policy recommendations

    OpenAIRE

    Shinns, L.H.; Lyne, Michael C.

    2005-01-01

    This study investigates possible causes of poverty afflicting a community of land reform beneficiaries in the Midlands of KwaZulu-Natal. The 38 beneficiary households had previously been clustered into four groups displaying different symptoms of poverty. Linear Discriminant Analysis was used first to distinguish households that were relatively income and asset "rich" from those that were relatively income and asset "poor", and second to distinguish households that were relatively income poor...

  1. States With Medically Needy Pathways: Differences in Long-Term and Temporary Medicaid Entry for Low-Income Medicare Beneficiaries.

    Science.gov (United States)

    Keohane, Laura M; Trivedi, Amal; Mor, Vincent

    2017-10-01

    Medically needy pathways may provide temporary catastrophic coverage for low-income Medicare beneficiaries who do not otherwise qualify for full Medicaid benefits. Between January 2009 and June 2010, states with medically needy pathways had a higher percentage of low-income beneficiaries join Medicaid than states without such programs (7.5% vs. 4.1%, p < .01). However, among new full Medicaid participants, living in a state with a medically needy pathway was associated with a 3.8 percentage point (adjusted 95% confidence interval [1.8, 5.8]) increase in the probability of switching to partial Medicaid and a 4.5 percentage point (adjusted 95% confidence interval [2.9, 6.2]) increase in the probability of exiting Medicaid within 12 months. The predicted risk of leaving Medicaid was greatest when new Medicaid participants used only hospital services, rather than nursing home services, in their first month of Medicaid benefits. Alternative strategies for protecting low-income Medicare beneficiaries' access to care could provide more stable coverage.

  2. "I don't want to go back to the farm": A case study of Working for Water beneficiaries

    Directory of Open Access Journals (Sweden)

    Jan A. Hough

    2013-09-01

    Full Text Available In addition to clearing invasive alien plants, the Working for Water (WfW Programme, as a South African government public works programme, provides short-term employment and training to empower the poor in finding alternative employment within the labour market. Several studies indicate that its beneficiaries become financially dependent on WfW projects and tend to be reluctant to leave the programme. The sociological reasons for this reluctance, however, remain largely unstudied. We therefore address this gap by reporting on a case study of four WfW projects in the Western Cape Province. Face-to-face interviews with beneficiaries suggest that a number of push and pull factors contribute to their dependency on WfW. Chief among these factors is a fear among previous farmworkers of returning to farm work. It was found that the latter can be linked to a historical power-relations legacy between landowners and farmworkers, mainly created by institutional racism still prevailing on many Western Cape farms. These findings bear important implications for the implementation of a new draft WfW policy aimed at encouraging private landowners to employ WfW beneficiaries on their land as clearers of invasive alien plants.

  3. Design

    DEFF Research Database (Denmark)

    Jensen, Ole B.; Pettiway, Keon

    2017-01-01

    In this chapter, Ole B. Jensen takes a situational approach to mobilities to examine how ordinary life activities are structured by technology and design. Using “staging mobilities” as a theoretical approach, Jensen considers mobilities as overlapping, actions, interactions and decisions by desig...... by providing ideas about future research for investigating mobilities in situ as a kind of “staging,” which he notes is influenced by the “material turn” in social sciences....... with a brief description of how movement is studied within social sciences after the “mobilities turn” versus the idea of physical movement in transport geography and engineering. He then explains how “mobilities design” was derived from connections between traffic and architecture. Jensen concludes...

  4. Offering lung cancer screening to high-risk medicare beneficiaries saves lives and is cost-effective: an actuarial analysis.

    Science.gov (United States)

    Pyenson, Bruce S; Henschke, Claudia I; Yankelevitz, David F; Yip, Rowena; Dec, Ellynne

    2014-08-01

    By a wide margin, lung cancer is the most significant cause of cancer death in the United States and worldwide. The incidence of lung cancer increases with age, and Medicare beneficiaries are often at increased risk. Because of its demonstrated effectiveness in reducing mortality, lung cancer screening with low-dose computed tomography (LDCT) imaging will be covered without cost-sharing starting January 1, 2015, by nongrandfathered commercial plans. Medicare is considering coverage for lung cancer screening. To estimate the cost and cost-effectiveness (ie, cost per life-year saved) of LDCT lung cancer screening of the Medicare population at high risk for lung cancer. Medicare costs, enrollment, and demographics were used for this study; they were derived from the 2012 Centers for Medicare & Medicaid Services (CMS) beneficiary files and were forecast to 2014 based on CMS and US Census Bureau projections. Standard life and health actuarial techniques were used to calculate the cost and cost-effectiveness of lung cancer screening. The cost, incidence rates, mortality rates, and other parameters chosen by the authors were taken from actual Medicare data, and the modeled screenings are consistent with Medicare processes and procedures. Approximately 4.9 million high-risk Medicare beneficiaries would meet criteria for lung cancer screening in 2014. Without screening, Medicare patients newly diagnosed with lung cancer have an average life expectancy of approximately 3 years. Based on our analysis, the average annual cost of LDCT lung cancer screening in Medicare is estimated to be $241 per person screened. LDCT screening for lung cancer in Medicare beneficiaries aged 55 to 80 years with a history of ≥30 pack-years of smoking and who had smoked within 15 years is low cost, at approximately $1 per member per month. This assumes that 50% of these patients were screened. Such screening is also highly cost-effective, at <$19,000 per life-year saved. If all eligible Medicare

  5. Innovative care models for high-cost Medicare beneficiaries: delivery system and payment reform to accelerate adoption.

    Science.gov (United States)

    Davis, Karen; Buttorff, Christine; Leff, Bruce; Samus, Quincy M; Szanton, Sarah; Wolff, Jennifer L; Bandeali, Farhan

    2015-05-01

    About a third of Medicare beneficiaries are covered by Medicare Advantage (MA) plans or accountable care organizations (ACOs). As a result of assuming financial risk for Medicare services and/or being eligible for shared savings, these organizations have an incentive to adopt models of delivering care that contribute to better care, improved health outcomes, and lower cost. This paper identifies innovative care models across the care continuum for high-cost Medicare beneficiaries that MA plans and ACOs could adopt to improve care while potentially achieving savings. It suggests policy changes that would accelerate testing and spread of promising care delivery model innovations. Targeted review of the literature to identify care delivery models focused on high-cost or high-risk Medicare beneficiaries. This paper presents select delivery models for high-risk Medicare beneficiaries across the care continuum that show promise of yielding better care at lower cost that could be considered for adoption by MA plans and ACOs. Common to these models are elements of the Wagner Chronic Care Model, including practice redesign to incorporate a team approach to care, the inclusion of nonmedical personnel, efforts to promote patient engagement, supporting provider education on innovations,and information systems allowing feedback of information to providers. The goal of these models is to slow the progression to long-term care, reduce health risks, and minimize adverse health impacts, all while achieving savings.These models attempt to maintain the ability of high-risk individuals to live in the home or a community-based setting, thereby avoiding costly institutional care. Identifying and implementing promising care delivery models will become increasingly important in launching successful population health initiatives. MA plans and ACOs stand to benefit financially from adopting care delivery models for high-risk Medicare beneficiaries that reduce hospitalization. Spreading

  6. Contributor Form

    Directory of Open Access Journals (Sweden)

    Chief Editor

    2014-09-01

    to produce preprints or reprints and translate into languages other than English for sale or free distribution; and 4 the right to republish the work in a collection of articles in any other mechanical or electronic format. We give the rights to the corresponding author to make necessary changes as per the request of the journal, do the rest of the correspondence on our behalf and he/she will act as the guarantor for the manuscript on our behalf. All persons who have made substantial contributions to the work reported in the manuscript, but who are not contributors, are named in the Acknowledgment and have given me/us their written permission to be named. If I/we do not include an Acknowledgment that means I/we have not received substantial contributions from non-contributors and no contributor has been omitted.S NoAuthors' NamesContribution (IJCME Guidelines{1 substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; 2 drafting the article or revising it critically for important intellectual content; and 3 final approval of the version to be published. Authors should meet conditions 1, 2, and 3}.SignatureDate                              Note: All the authors are required to sign independently in this form in the sequence given above. In case an author has left the institution/country and whose whereabouts are not known, the senior author may sign on his/her behalf taking the responsibility.No addition/deletion/ or any change in the sequence of the authorship will be permissible at a later stage, without valid reasons and permission of the Editor.If the authorship is contested at any stage, the article will be either returned or will not be processed for publication till the issue is solved.Maximum up to 4 authors for short communication and up to 6 authors for original article.

  7. Contributors Form

    Directory of Open Access Journals (Sweden)

    Chief Editor

    2016-06-01

    to produce preprints or reprints and translate into languages other than English for sale or free distribution; and 4 the right to republish the work in a collection of articles in any other mechanical or electronic format. We give the rights to the corresponding author to make necessary changes as per the request of the journal, do the rest of the correspondence on our behalf and he/she will act as the guarantor for the manuscript on our behalf. All persons who have made substantial contributions to the work reported in the manuscript, but who are not contributors, are named in the Acknowledgment and have given me/us their written permission to be named. If I/we do not include an Acknowledgment that means I/we have not received substantial contributions from non-contributors and no contributor has been omitted.S NoAuthors' NamesContribution (IJCME Guidelines{1 substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; 2 drafting the article or revising it critically for important intellectual content; and 3 final approval of the version to be published. Authors should meet conditions 1, 2, and 3}.SignatureDate                              Note: All the authors are required to sign independently in this form in the sequence given above. In case an author has left the institution/country and whose whereabouts are not known, the senior author may sign on his/her behalf taking the responsibility.No addition/deletion/ or any change in the sequence of the authorship will be permissible at a later stage, without valid reasons and permission of the Editor.If the authorship is contested at any stage, the article will be either returned or will not be processed for publication till the issue is solved.Maximum up to 4 authors for short communication and up to 6 authors for original article.

  8. SUCCESS KEY IN DESIGNING A NEW PRODUCT

    OpenAIRE

    Liliana LUCA; Constanţa RĂDULESCU

    2017-01-01

    In this paper we use a quality management instrument called a tree diagram, based on undigital data, in order to show what the solutions are in order to solve an analyzed problem. The problem proposed to be analyzed is: identifying specific objects and corresponding measures to successfully design a new product. The proposed solutions are grouped into three specific objectives: Top management commitment; Beneficiary need analysis; Designing process quality. The tree diagram for th...

  9. Design of the environment of care for safety of patients and personnel: does form follow function or vice versa in the intensive care unit?

    Science.gov (United States)

    Bartley, Judene; Streifel, Andrew J

    2010-08-01

    We review the context of the environment of care in the intensive care unit setting in relation to patient safety and quality, specifically addressing healthcare-associated infection issues and solutions involving interdisciplinary teams. Issues addressed include current and future architectural design and layout trends, construction trends affecting intensive care units, and prevention of construction-associated healthcare-associated infections related to airborne and waterborne risks and design solutions. Specific elements include single-occupancy, acuity-scalable intensive care unit rooms; environmental aspects of hand hygiene, such as water risks, sink design/location, human waste management, surface selection (floor covering, countertops, furniture, and equipment) and cleaning, antimicrobial-treated or similar materials, ultraviolet germicidal irradiation, specialized rooms (airborne infection isolation and protective environments), and water system design and strategies for safe use of potable water and mitigation of water intrusion. Effective design and operational use of the intensive care unit environment of care must engage critical care personnel from initial planning and design through occupancy of the new/renovated intensive care unit as part of the infection control risk assessment team. The interdisciplinary infection control risk assessment team can address key environment of care design features to enhance the safety of intensive care unit patients, personnel, and visitors. This perspective will ensure the environment of care supports human factors and behavioral aspects of the interaction between the environment of care and its occupants.

  10. Changes in Initial Treatment for Prostate Cancer Among Medicare Beneficiaries, 1999–2007

    International Nuclear Information System (INIS)

    Dinan, Michaela A.; Robinson, Timothy J.; Zagar, Timothy M.; Scales, Charles D.; Curtis, Lesley H.; Reed, Shelby D.; Lee, W. Robert; Schulman, Kevin A.

    2012-01-01

    Purpose: In the absence of evidence from large clinical trials, optimal therapy for localized prostate cancer remains unclear; however, treatment patterns continue to change. We examined changes in the management of patients with prostate cancer in the Medicare population. Methods and Materials: We conducted a retrospective claims-based analysis of the use of radiation therapy, surgery, and androgen deprivation therapy in the 12 months after diagnosis of prostate cancer in a nationally representative 5% sample of Medicare claims. Patients were Medicare beneficiaries 67 years or older with incident prostate cancer diagnosed between 1999 and 2007. Results: There were 20,918 incident cases of prostate cancer between 1999 and 2007. The proportion of patients receiving androgen deprivation therapy decreased from 55% to 36%, and the proportion of patients receiving no active therapy increased from 16% to 23%. Intensity-modulated radiation therapy replaced three-dimensional conformal radiation therapy as the most common method of radiation therapy, accounting for 77% of external beam radiotherapy by 2007. Minimally invasive radical prostatectomy began to replace open surgical approaches, being used in 49% of radical prostatectomies by 2007. Conclusions: Between 2002 and 2007, the use of androgen deprivation therapy decreased, open surgical approaches were largely replaced by minimally invasive radical prostatectomy, and intensity-modulated radiation therapy replaced three-dimensional conformal radiation therapy as the predominant method of radiation therapy in the Medicare population. The aging of the population and the increasing use of newer, higher-cost technologies in the treatment of patients with prostate cancer may have important implications for nationwide health care costs.

  11. Breast reconstruction after mastectomy among Department of Defense beneficiaries by race.

    Science.gov (United States)

    Enewold, Lindsey R; McGlynn, Katherine A; Zahm, Shelia H; Poudrier, Jill; Anderson, William F; Shriver, Craig D; Zhu, Kangmin

    2014-10-01

    Postmastectomy breast reconstruction increased approximately 20% between 1998 and 2008 in the United States and has been found to improve body image, self-esteem, and quality of life. These procedures, however, tend to be less common among minority women, which may be due to variations in health care access. The Department of Defense provides equal health care access, thereby affording an exceptional environment in which to assess whether racial variations persist when access to care is equal. Linked Department of Defense cancer registry and medical claims data were used. The receipt of reconstruction was compared between white women (n = 2974) and black women (n = 708) who underwent mastectomies to treat incident histologically confirmed breast cancer diagnosed from 1998 through 2007. During the study period, postmastectomy reconstruction increased among both black (27.3% to 40.0%) and white (21.8% to 40.6%) female patients with breast cancer. Receipt of reconstruction did not vary significantly by race (odds ratio, 0.93; 95% confidence interval, 0.76-1.15). Reconstruction decreased significantly with increasing age, tumor stage, and receipt of radiotherapy and was significantly more common in more recent years and among active service women, TRICARE Prime (health maintenance organization) beneficiaries, and women whose sponsor was an officer. The receipt of breast reconstruction did not vary by race within this equal-access health system, indicating that the racial disparities reported in previous studies may have been due in part to variations in access to health care. Additional research to determine why a large percentage of patients with breast cancer do not undergo reconstruction might be beneficial, particularly because these procedures have been associated with noncosmetic benefits. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.

  12. Rising Prices of Targeted Oral Anticancer Medications and Associated Financial Burden on Medicare Beneficiaries.

    Science.gov (United States)

    Shih, Ya-Chen Tina; Xu, Ying; Liu, Lei; Smieliauskas, Fabrice

    2017-08-01

    Purpose The high cost of oncology drugs threatens the affordability of cancer care. Previous research identified drivers of price growth of targeted oral anticancer medications (TOAMs) in private insurance plans and projected the impact of closing the coverage gap in Medicare Part D in 2020. This study examined trends in TOAM prices and patient out-of-pocket (OOP) payments in Medicare Part D and estimated the actual effects on patient OOP payments of partial filling of the coverage gap by 2012. Methods Using SEER linked to Medicare Part D, 2007 to 2012, we identified patients who take TOAMs via National Drug Codes in Part D claims. We calculated total drug costs (prices) and OOP payments per patient per month and compared their rates of inflation with general health care prices. Results The study cohort included 42,111 patients who received TOAMs between 2007 and 2012. Although the general prescription drug consumer price index grew at 3% per year over 2007 to 2012, mean TOAM prices increased by nearly 12% per year, reaching $7,719 per patient per month in 2012. Prices increased over time for newly and previously launched TOAMs. Mean patient OOP payments dropped by 4% per year over the study period, with a 40% drop among patients with a high financial burden in 2011, when the coverage gap began to close. Conclusion Rising TOAM prices threaten the financial relief patients have begun to experience under closure of the coverage gap in Medicare Part D. Policymakers should explore methods of harnessing the surge of novel TOAMs to increase price competition for Medicare beneficiaries.

  13. Comparison of postarthroplasty functional outcomes in skilled nursing facilities among Medicare and Managed Care beneficiaries

    Directory of Open Access Journals (Sweden)

    Brandon A. Haghverdian, BSc

    2017-12-01

    Full Text Available Background: After home health care, the skilled nursing facility (SNF is the most commonly used postacute care modality, among Medicare beneficiaries, after total joint arthroplasty. Prior studies demonstrated that a loss in postsurgical ambulatory gains is incurred in the interval between hospital discharge and arrival at the SNF. The aim of this present study is to determine the consequences of that loss in function, as well as compare SNF-related outcomes in patients with Medicare vs Managed Care (MC insurance. Methods: We conducted a retrospective analysis of 80 patients (54 Medicare and 26 MC who attended an SNF after hospitalization for total joint arthroplasty. Outcomes from physical therapy records were abstracted from each patient's SNF file. Results: There was an approximately 40% drop-off in gait achievements between hospital discharge and SNF admission. This decline in ambulation was significantly greater in Medicare patients (Medicare: 94.6 ± 123.2 ft, MC: 40.0 ± 48.9 ft, P = .034. Larger reductions in gait achievements between hospital discharge and SNF admission were significantly correlated with longer SNF lengths of stay and poorer gait achievements by SNF discharge. Patients with MC insurance made significant improvements in gait training at the SNF beyond that which was acquired at the hospital, whereas Medicare patients did not (PMedicare = .28, PMC = .003. Conclusions: Large losses in motor function between hospital discharge and SNF admission were associated with poor functional outcomes and longer stays at the SNF. These effects were more pronounced in Medicare patients than those with MC insurance. Keywords: Total joint arthroplasty, Skilled nursing facility, Medicare, Managed Care, Physical therapy

  14. Supplemental technical information in support of Y/OWI/TM--44. Volume 17. Drawings for repository preconceptual design studies: BPNL waste forms in salt

    International Nuclear Information System (INIS)

    1978-04-01

    Volume 17 contains drawings of a preconceptual design for a nuclear waste storage facility in salt. Three full cycles are considered: full recycle, throwaway cycle, and uranium recycle with plutonium in high-level waste

  15. Purchased Behavioral Health Care Received by Military Health System Beneficiaries in Civilian Medical Facilities, 2000-2014.

    Science.gov (United States)

    Wooten, Nikki R; Brittingham, Jordan A; Pitner, Ronald O; Tavakoli, Abbas S; Jeffery, Diana D; Haddock, K Sue

    2018-02-06

    Behavioral health conditions are a significant concern for the U.S. military and the Military Health System (MHS) because of decreased military readiness and increased health care utilization. Although MHS beneficiaries receive direct care in military treatment facilities, a disproportionate majority of behavioral health treatment is purchased care received in civilian facilities. Yet, limited evidence exists about purchased behavioral health care received by MHS beneficiaries. This longitudinal study (1) estimated the prevalence of purchased behavioral health care and (2) identified patient and visit characteristics predicting receipt of purchased behavioral health care in acute care facilities from 2000 to 2014. Medical claims with Major Diagnostic Code 19 (mental disorders/diseases) or 20 (alcohol/drug disorders) as primary diagnoses and TRICARE as the primary/secondary payer were analyzed for MHS beneficiaries (n = 17,943) receiving behavioral health care in civilian acute care facilities from January 1, 2000, to December 31, 2014. The primary dependent variable, receipt of purchased behavioral health care, was modeled for select mental health and substance use disorders from 2000 to 2014 using generalized estimating equations. Patient characteristics included time, age, sex, and race/ethnicity. Visit types included inpatient hospitalization and emergency department (ED). Time was measured in days and visits were assumed to be correlated over time. Behavioral health care was described by both frequency of patients and visit type. The University of South Carolina Institutional Review Board approved this study. From 2000 to 2014, purchased care visits increased significantly for post-traumatic stress disorder, adjustment, anxiety, mood, bipolar, tobacco use, opioid/combination opioid dependence, nondependent cocaine abuse, psychosocial problems, and suicidal ideation among MHS beneficiaries. The majority of care was received for mental health disorders (78

  16. Anti-tuberculosis drug combination for controlled oral delivery using 3D printed compartmental dosage forms: From drug product design to in vivo testing

    DEFF Research Database (Denmark)

    Genina, Natalja; Boetker, Johan Peter; Colombo, Stefano

    2017-01-01

    for treatment of tuberculosis (TB) that negatively interact with each other upon simultaneous release in acidic environment. The dcDUs were designed in silico by computer aided design (CAD) and fabricated in two steps; first three-dimensional (3D) printing of the outer structure, followed by hot-melt extrusion...... (HME) of the drug-containing filaments. The structure of the fabricated dcDUs was visualized by scanning electron microscopy (SEM). The 3D printed compartmentalized shells were loaded with filaments containing active pharmaceutical ingredient (API) and selectively sealed to modulate drug dissolution...

  17. Structure-based design of a disulfide-linked oligomeric form of the simian virus 40 (SV40) large T antigen DNA-binding domain

    International Nuclear Information System (INIS)

    Meinke, Gretchen; Phelan, Paul; Fradet-Turcotte, Amélie; Archambault, Jacques; Bullock, Peter A.

    2011-01-01

    With the aim of forming the ‘lock-washer’ conformation of the origin-binding domain of SV40 large T antigen in solution, using structure-based analysis an intermolecular disulfide bridge was engineered into the origin-binding domain to generate higher order oligomers in solution. The 1.7 Å resolution structure shows that the mutant forms a spiral in the crystal and has the de novo disulfide bond at the protein interface, although structural rearrangements at the interface are observed relative to the wild type. The modular multifunctional protein large T antigen (T-ag) from simian virus 40 orchestrates many of the events needed for replication of the viral double-stranded DNA genome. This protein assembles into single and double hexamers on specific DNA sequences located at the origin of replication. This complicated process begins when the origin-binding domain of large T antigen (T-ag ODB) binds the GAGGC sequences in the central region (site II) of the viral origin of replication. While many of the functions of purified T-ag OBD can be studied in isolation, it is primarily monomeric in solution and cannot assemble into hexamers. To overcome this limitation, the possibility of engineering intermolecular disulfide bonds in the origin-binding domain which could oligomerize in solution was investigated. A recent crystal structure of the wild-type T-ag OBD showed that this domain forms a left-handed spiral in the crystal with six subunits per turn. Therefore, we analyzed the protein interface of this structure and identified two residues that could potentially support an intermolecular disulfide bond if changed to cysteines. SDS–PAGE analysis established that the mutant T-ag OBD formed higher oligomeric products in a redox-dependent manner. In addition, the 1.7 Å resolution crystal structure of the engineered disulfide-linked T-ag OBD is reported, which establishes that oligomerization took place in the expected manner

  18. Clinical Analysis of Icotinib on Beneficiary of 
Advanced Non-small Cell Lung Cancer with EGFR Common Mutation

    Directory of Open Access Journals (Sweden)

    Xiaowen JIANG

    2016-04-01

    Full Text Available Background and objective Targeted therapy has become an indispensable therapy method in advanced non-small cell lung cancer (NSCLC treatment. Epithelial growth factor receptor (EGFR tyrosine kinase inhibitor (TKI can significantly prolong the survival of patients harboring EGFR gene mutation. Icotinb is China's first EGFR-TKI with independent intellectual property rights. The aim of this study is to investigate the clinical characteristics about the beneficiary of advanced NSCLC patients with EGFR Common mutation who were treated with Icotinib. Retrospectively collect the data about beneficiary [progression-free survival (PFS≥6 months] and analysis of the related risk factors for prognosis. Methods From September 1, 2011 to September 30, 2015, 231 cases of advanced NSCLC beneficiary with EGFR common mutation were enrolled for treatment with icotinib in Zhejiang Cancer Hospital. Results The one year benefit rate was 67.9% in the group treated with Icotinib as first line, and in the groupas second line or above was 53.6%, which is statisticallysignificant. The two years benefit rate was 18.7% and 9.3%, respectively. The median PFS of first line group and the second line or above was 16.7 and 12.4 months, respectively. The presence of brain metastasis (P=0.010, Prior chemotherapy (P=0.001, Eastern Cooperative Oncology Group (ECOG score (P=0.001 were the main factors influencing the prognosis. The most common adverse were skin rashes (51 cases, 22.1% and diarrhea (27 cases, 11.7%. Conclusion Icotinib offers long-term clinical benefit and good tolerance for advanced NSCLC harboring EGFR gene mutation. Its advantage groups in addition to the patients with brain metastases and better ECOG score, the curative effect of patients with the first-line treatment is superior to second or further line.

  19. [Clinical Analysis of Icotinib on Beneficiary of 
Advanced Non-small Cell Lung Cancer with EGFR Common Mutation].

    Science.gov (United States)

    Jiang, Xiaowen; Wang, Wenxian; Zhang, Yiping

    2016-04-20

    Targeted therapy has become an indispensable therapy method in advanced non-small cell lung cancer (NSCLC) treatment. Epithelial growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) can significantly prolong the survival of patients harboring EGFR gene mutation. Icotinb is China's first EGFR-TKI with independent intellectual property rights. The aim of this study is to investigate the clinical characteristics about the beneficiary of advanced NSCLC patients with EGFR Common mutation who were treated with Icotinib. Retrospectively collect the data about beneficiary [progression-free survival (PFS)≥6 months] and analysis of the related risk factors for prognosis. From September 1, 2011 to September 30, 2015, 231 cases of advanced NSCLC beneficiary with EGFR common mutation were enrolled for treatment with icotinib in Zhejiang Cancer Hospital. The one year benefit rate was 67.9% in the group treated with Icotinib as first line, and in the groupas second line or above was 53.6%, which is statisticallysignificant. The two years benefit rate was 18.7% and 9.3%, respectively. The median PFS of first line group and the second line or above was 16.7 and 12.4 months, respectively. The presence of brain metastasis (P=0.010), Prior chemotherapy (P=0.001), Eastern Cooperative Oncology Group (ECOG) score (P=0.001) were the main factors influencing the prognosis. The most common adverse were skin rashes (51 cases, 22.1%) and diarrhea (27 cases, 11.7%). Icotinib offers long-term clinical benefit and good tolerance for advanced NSCLC harboring EGFR gene mutation. Its advantage groups in addition to the patients with brain metastases and better ECOG score, the curative effect of patients with the first-line treatment is superior to second or further line. 
.

  20. Storage, preparation, and usage of fortified food aid among Guatemalan, Ugandan, and Malawian beneficiaries: a field study report.

    Science.gov (United States)

    Rowe, Jonathan P; Brodegard, William C; Pike, Oscar A; Steele, Frost M; Dunn, Michael L

    2008-09-01

    An important consideration in determining the ability of fortified food-aid commodities to meet the nutritional needs of beneficiaries is the manner in which commodities are utilized and prepared and the degree to which micronutrient losses occur during handling and cooking by the beneficiaries. A field study was conducted in Uganda, Malawi, and Guatemala to obtain data on storage, preparation, and usage of fortified blended foods provided by the US Agency for International Development. Interview and observational data on the use of corn-soy blend, cornmeal, soy-fortified cornmeal, soy-fortified bulgur, and fortified vegetable oil were collected from more than 100 households and two wet-feeding sites (where food is prepared and served by staff on-site) in 32 villages. Storage practices by beneficiaries appeared to be appropriate, and all commodities observed were free from off-flavors and odors. Cooking water was typically obtained from boreholes or open wells with a pH range of 4.7 to 7.7 Food preparation usually took place in covered areas with the use of an aluminum or clay pot over a wood-fueled fire. Thin or thick porridges were the most common dishes prepared from cereal-based products, with concentration ranges of 10% to 31% (wt/ wt) in water. Cooking times for porridges ranged from 5 to 53 minutes, with a mean of 26 minutes. Tortillas and beverages were other preparations commonly observed in Guatemala. Vegetable oil was typically used for pan frying. Cooking fuel could be saved and nutritional quality probably improved if relief agencies emphasized shorter cooking times. These data can be used to simulate preparation methods in the laboratory for assessment of the nutritional impact of cooking.

  1. Upscaling the Number of Learners, Fragmenting the Role of Teachers: How Do Massive Open Online Courses (MOOCs) Form New Conditions for Learning Design?

    Science.gov (United States)

    Buhl, Mie; Andreasen, Lars Birch; Pushpanadham, Karanam

    2018-01-01

    The proliferation and expansion of massive open online courses (MOOCs) prompts a need to revisit classical pedagogical questions. In what ways will MOOCs facilitate and promote new e-learning pedagogies? Is current learning design adequate for the "massiveness" and "openness" of MOOCs? This article discusses the ways in which…

  2. The Co-Evolution between Product Form Design and Product CategoriesThe Renaissance of the Behind-the-ear Hearing Aid

    DEFF Research Database (Denmark)

    Krabbe, Anders Dahl

    in the hearing aid industry in the period 2003-2010. Data for the study include interviews, archival material, industry statistics, and hearing care trade journals. The study contributes to theory with the following results: Co-evolutionary dynamics found in the case of technological designs were also observed...

  3. Access Customized Forms

    OpenAIRE

    Cosma Emil; Jeflea Victor

    2010-01-01

    By using Word, Excel or PowerPoint one can automate routine operations using the VBA language (Visual Basic for Applications). This language is also used in Access, allowing access to data stored in tables or queries. Thus, Access and VBA resources can be used together. Access is designed for programming forms and reports (among other things), so there won’t be found any of the VBA editor’s specific forms.

  4. Upscaling the number of learners, fragmenting the role of teachers: How do massive open online courses (MOOCs) form new conditions for learning design?

    Science.gov (United States)

    Buhl, Mie; Andreasen, Lars Birch; Pushpanadham, Karanam

    2018-03-01

    The proliferation and expansion of massive open online courses (MOOCs) prompts a need to revisit classical pedagogical questions. In what ways will MOOCs facilitate and promote new e-learning pedagogies? Is current learning design adequate for the "massiveness" and "openness" of MOOCs? This article discusses the ways in which MOOCs create new conditions for designing learning processes. The authors present various theoretical approaches to learning design and discuss a combination of theoretical perspectives. They discern a fragmentation of the teacher role; where the teacher was once the main person responsible for planning, practice and reflection, those activities may now be performed by different actors with different areas of responsibility. The theoretical discussion is complemented by a review of recent studies of new practices and design formats aiming to overcome the upscaling issues of MOOCs. The authors present a multifaceted picture of MOOC methodologies, including a typology of hybrid approaches to MOOC design. Through the example of MOOC implementation in India, they address the integration of MOOCs into formal higher education systems. They conclude their article with the contention that, through upscaling, important facets of students' intellectual development and critical thinking might be left to the students themselves. This may cause problems. Adequate scaffolding from a teacher, such as adapting activities to the specific situation, might be needed to develop the skills required to be a self-directed learner. Furthermore, upscaling seems to promote a separation of the formerly unified teacher functions of planning, teaching and assessing, which necessitates increased collaboration among the many new actors in the field of pedagogy.

  5. Association Between Treatment by Locum Tenens Internal Medicine Physicians and 30-Day Mortality Among Hospitalized Medicare Beneficiaries.

    Science.gov (United States)

    Blumenthal, Daniel M; Olenski, Andrew R; Tsugawa, Yusuke; Jena, Anupam B

    2017-12-05

    Use of locum tenens physicians has increased in the United States, but information about their quality and costs of care is lacking. To evaluate quality and costs of care among hospitalized Medicare beneficiaries treated by locum tenens vs non-locum tenens physicians. A random sample of Medicare fee-for-service beneficiaries hospitalized during 2009-2014 was used to compare quality and costs of hospital care delivered by locum tenens and non-locum tenens internal medicine physicians. Treatment by locum tenens general internal medicine physicians. The primary outcome was 30-day mortality. Secondary outcomes included inpatient Medicare Part B spending, length of stay, and 30-day readmissions. Differences between locum tenens and non-locum tenens physicians were estimated using multivariable logistic regression models adjusted for beneficiary clinical and demographic characteristics and hospital fixed effects, which enabled comparisons of clinical outcomes between physicians practicing within the same hospital. In prespecified subgroup analyses, outcomes were reevaluated among hospitals with different levels of intensity of locum tenens physician use. Of 1 818 873 Medicare admissions treated by general internists, 38 475 (2.1%) received care from a locum tenens physician; 9.3% (4123/44 520) of general internists were temporarily covered by a locum tenens physician at some point. Differences in patient characteristics, demographics, comorbidities, and reason for admission between locum tenens and non-locum tenens physicians were not clinically relevant. Treatment by locum tenens physicians, compared with treatment by non-locum tenens physicians (n = 44 520 physicians), was not associated with a significant difference in 30-day mortality (8.83% vs 8.70%; adjusted difference, 0.14%; 95% CI, -0.18% to 0.45%). Patients treated by locum tenens physicians had significantly higher Part B spending ($1836 vs $1712; adjusted difference, $124; 95% CI, $93 to $154

  6. Long-term declines in ADLs, IADLs, and mobility among older Medicare beneficiaries

    Directory of Open Access Journals (Sweden)

    Wolinsky Fredric D

    2011-08-01

    Full Text Available Abstract Background Most prior studies have focused on short-term (≤ 2 years functional declines. But those studies cannot address aging effects inasmuch as all participants have aged the same amount. Therefore, the authors studied the extent of long-term functional decline in older Medicare beneficiaries who were followed for varying time lengths, and the authors also identified the risk factors associated with those declines. Methods The analytic sample included 5,871 self- or proxy-respondents who had complete baseline and follow-up survey data that could be linked to their Medicare claims for 1993-2007. Functional status was assessed using activities of daily living (ADLs, instrumental ADLs (IADLs, and mobility limitations, with declines defined as the development of two of more new difficulties. Multiple logistic regression analysis was used to focus on the associations involving respondent status, health lifestyle, continuity of care, managed care status, health shocks, and terminal drop. Results The average amount of time between the first and final interviews was 8.0 years. Declines were observed for 36.6% on ADL abilities, 32.3% on IADL abilities, and 30.9% on mobility abilities. Functional decline was more likely to occur when proxy-reports were used, and the effects of baseline function on decline were reduced when proxy-reports were used. Engaging in vigorous physical activity consistently and substantially protected against functional decline, whereas obesity, cigarette smoking, and alcohol consumption were only associated with mobility declines. Post-baseline hospitalizations were the most robust predictors of functional decline, exhibiting a dose-response effect such that the greater the average annual number of hospital episodes, the greater the likelihood of functional status decline. Participants whose final interview preceded their death by one year or less had substantially greater odds of functional status decline

  7. A prospective cohort study of long-term cognitive changes in older Medicare beneficiaries.

    Science.gov (United States)

    Wolinsky, Fredric D; Bentler, Suzanne E; Hockenberry, Jason; Jones, Michael P; Weigel, Paula A; Kaskie, Brian; Wallace, Robert B

    2011-09-20

    Promoting cognitive health and preventing its decline are longstanding public health goals, but long-term changes in cognitive function are not well-documented. Therefore, we first examined long-term changes in cognitive function among older Medicare beneficiaries in the Survey on Assets and Health Dynamics among the Oldest Old (AHEAD), and then we identified the risk factors associated with those changes in cognitive function. We conducted a secondary analysis of a prospective, population-based cohort using baseline (1993-1994) interview data linked to 1993-2007 Medicare claims to examine cognitive function at the final follow-up interview which occurred between 1995-1996 and 2006-2007. Besides traditional risk factors (i.e., aging, age, race, and education) and adjustment for baseline cognitive function, we considered the reason for censoring (entrance into managed care or death), and post-baseline continuity of care and major health shocks (hospital episodes). Residual change score multiple linear regression analysis was used to predict cognitive function at the final follow-up using data from telephone interviews among 3,021 to 4,251 (sample size varied by cognitive outcome) baseline community-dwelling self-respondents that were ≥ 70 years old, not in managed Medicare, and had at least one follow-up interview as self-respondents. Cognitive function was assessed using the 7-item Telephone Interview for Cognitive Status (TICS-7; general mental status), and the 10-item immediate and delayed (episodic memory) word recall tests. Mean changes in the number of correct responses on the TICS-7, and 10-item immediate and delayed word recall tests were -0.33, -0.75, and -0.78, with 43.6%, 54.9%, and 52.3% declining and 25.4%, 20.8%, and 22.9% unchanged. The main and most consistent risks for declining cognitive function were the baseline values of cognitive function (reflecting substantial regression to the mean), aging (a strong linear pattern of increased decline

  8. Designing new biocompatible glass-forming Ti75-x Zr10 Nbx Si15 (x = 0, 15) alloys: corrosion, passivity, and apatite formation.

    Science.gov (United States)

    Abdi, Somayeh; Oswald, Steffen; Gostin, Petre Flaviu; Helth, Arne; Sort, Jordi; Baró, Maria Dolors; Calin, Mariana; Schultz, Ludwig; Eckert, Jürgen; Gebert, Annett

    2016-01-01

    Glass-forming Ti-based alloys are considered as potential new materials for implant applications. Ti75 Zr10 Si15 and Ti60 Zr10 Nb15 Si15 alloys (free of cytotoxic elements) can be produced as melt-spun ribbons with glassy matrix and embedded single β-type nanocrystals. The corrosion and passivation behavior of these alloys in their homogenized melt-spun states have been investigated in Ringer solution at 37°C in comparison to their cast multiphase crystalline counterparts and to cp-Ti and β-type Ti-40Nb. All tested materials showed very low corrosion rates as expressed in corrosion current densities icorr  alloys passive states in a wide potential range. This corresponds to low passive current densities ipass  = 2 ± 1 µA/cm(2) based on the growth of oxide films with thickness d alloys is beneficial for stable surface passivity. The addition of Nb does not only improve the glass-forming ability and the mechanical properties but also supports a high pitting resistance even at extreme anodic polarization up to 4V versus SCE were oxide thickness values of d ∼35 nm are reached. With regard to the corrosion properties, the Nb-containing nearly single-phase glassy alloy can compete with the β-type Ti-40Nb alloy. SBF tests confirmed the ability for formation of hydroxyapatite on the melt-spun alloy surfaces. All these properties recommend the new glass-forming alloys for application as wear- and corrosion-resistant coating materials for implants. © 2015 Wiley Periodicals, Inc.

  9. Designing of an artificial light energy converter in the form of short-chain dyad when combined with core-shell gold/silver nanocomposites.

    Science.gov (United States)

    Dutta Pal, Gopa; Paul, Somnath; Bardhan, Munmun; De, Asish; Ganguly, Tapan

    2017-06-05

    UV-vis absorption, steady state and time resolved fluorescence and absorption spectroscopic investigations demonstrate that the short chain dyad MNTMA when combined with gold-silver core-shell (Au@Ag) nanocomposite , forms elongated conformers in the excited state whereas for the dyad - Ag (spherical) system the majority of dyads remains in a folded conformation. In the dyad-core-shell nanocomposite system, energy wasting charge recombination rate slows down primarily due to elongated conformation and thus it may be anticipated that this hybrid nanocomposite system may serve as a better light energy conversion device. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Isoreticular metal-organic frameworks, process for forming the same, and systematic design of pore size and functionality therein, with application for gas storage

    Science.gov (United States)

    Yaghi, Omar M.; Eddaoudi, Mohamed; Li, Hailian; Kim, Jaheon; Rosi, Nathaniel

    2007-03-27

    The ability to design and construct solid-state materials with pre-determined structures is a grand challenge in chemistry. An inventive strategy based on reticulating metal ions and organic carboxylate links into extended networks has been advanced to a point that has allowed the design of porous structures in which pore size and functionality can be varied systematically. MOF-5, a prototype of a new class of porous materials and one that is constructed from octahedral Zn--O--C clusters and benzene links, was used to demonstrate that its 3-D porous system can be functionalized with the organic groups, --Br, --NH2, --OC3H7, --OC5H11, --H4C2, and --H4C4, and its pore size expanded with the long molecular struts biphenyl, tetrahydropyrene, pyrene, and terphenyl. The ability to direct the formation of the octahedral clusters in the presence of a desired carboxylate link is an essential feature of this strategy, which resulted in the design of an isoreticular (having the same framework topology) series of sixteen well-defined materials whose crystals have open space representing up to 91.1% of the crystal volume, and homogeneous periodic pores that can be incrementally varied from 3.8 to 28.8 angstroms. Unlike the unpredictable nature of zeolite and other molecular sieve syntheses, the deliberate control exercised at the molecular level in the design of these crystals is expected to have tremendous implications on materials properties and future technologies. Indeed, data indicate that members of this series represent the first monocrystalline mesoporous organic/inorganic frameworks, and exhibit the highest capacity for methane storage (155 cm3/cm3 at 36 atm) and the lowest densities (0.41 to 0.21 g/cm3) attained to date for any crystalline material at room temperature.

  11. High Frequency Design Considerations for the Large Detector Number and Small Form Factor Dual Electron Spectrometer of the Fast Plasma Investigation on NASA's Magnetospheric Multiscale Mission

    Science.gov (United States)

    Kujawski, Joseph T.; Gliese, Ulrik B.; Cao, N. T.; Zeuch, M. A.; White, D.; Chornay, D. J; Lobell, J. V.; Avanov, L. A.; Barrie, A. C.; Mariano, A. J.; hide

    2015-01-01

    Each half of the Dual Electron Spectrometer (DES) of the Fast Plasma Investigation (FPI) on NASA's Magnetospheric MultiScale (MMS) mission utilizes a microchannel plate Chevron stack feeding 16 separate detection channels each with a dedicated anode and amplifier/discriminator chip. The desire to detect events on a single channel with a temporal spacing of 100 ns and a fixed dead-time drove our decision to use an amplifier/discriminator with a very fast (GHz class) front end. Since the inherent frequency response of each pulse in the output of the DES microchannel plate system also has frequency components above a GHz, this produced a number of design constraints not normally expected in electronic systems operating at peak speeds of 10 MHz. Additional constraints are imposed by the geometry of the instrument requiring all 16 channels along with each anode and amplifier/discriminator to be packaged in a relatively small space. We developed an electrical model for board level interactions between the detector channels to allow us to design a board topology which gave us the best detection sensitivity and lowest channel to channel crosstalk. The amplifier/discriminator output was designed to prevent the outputs from one channel from producing triggers on the inputs of other channels. A number of Radio Frequency design techniques were then applied to prevent signals from other subsystems (e.g. the high voltage power supply, command and data handling board, and Ultraviolet stimulation for the MCP) from generating false events. These techniques enabled us to operate the board at its highest sensitivity when operated in isolation and at very high sensitivity when placed into the overall system.

  12. Influenza vaccination coverage estimates in the fee-for service Medicare beneficiary population 2006 - 2016: Using population-based administrative data to support a geographic based near real-time tool.

    Science.gov (United States)

    Shen, Angela K; Warnock, Rob; Brereton, Stephaeno; McKean, Stephen; Wernecke, Michael; Chu, Steve; Kelman, Jeffrey A

    2018-04-11

    Older adults are at great risk of developing serious complications from seasonal influenza. We explore vaccination coverage estimates in the Medicare population through the use of administrative claims data and describe a tool designed to help shape outreach efforts and inform strategies to help raise influenza vaccination rates. This interactive mapping tool uses claims data to compare vaccination levels between geographic (i.e., state, county, zip code) and demographic (i.e., race, age) groups at different points in a season. Trends can also be compared across seasons. Utilization of this tool can assist key actors interested in prevention - medical groups, health plans, hospitals, and state and local public health authorities - in supporting strategies for reaching pools of unvaccinated beneficiaries where general national population estimates of coverage are less informative. Implementing evidence-based tools can be used to address persistent racial and ethnic disparities and prevent a substantial number of influenza cases and hospitalizations.

  13. Track 1 - fuel fabrication: design, manufacture and automation stress field of blister forming in a metallic fuel and its interaction with clad

    International Nuclear Information System (INIS)

    Singh, A.K.; Hussain, M.M.; Singh, R.P.; Singh, R.N.; Chakravartty, J.K.; Shah, B.K.; Ståhle, P.

    2009-01-01

    One of the most critical components for the nuclear reactor is nuclear fuel. The fuel is subjected to severe environment of temperature, thermal stress, irradiation and corrosion in a reactor and its behaviour is governed by complex interaction of physical, chemical, mechanical and metallurgical processes which become operative in the reactor environment. A good fuel element should perform reliably in a reactor without experiencing any type of failure during its lifetime. Hence, the fabrication of nuclear fuel elements to the stringent quality requirements as demanded by the designers is a highly specialized and sophisticated technology

  14. How Social Care Beneficiaries in Poland Rate Relative Harmfulness of Various Tobacco and Nicotine-Containing Products.

    Science.gov (United States)

    Milcarz, Marek; Polańska, Kinga; Bak-Romaniszyn, Leokadia; Kaleta, Dorota

    2017-09-07

    The aim of the study was to examine how social care beneficiaries rate the relative harmfulness of tobacco/nicotine-containing products compared to traditional cigarettes. This information is crucial for the development of effective tobacco control strategies targeting disadvantaged populations. The cross-sectional study covered 1817 respondents who were taking advantage of social aid services offered by the local social care institutions in the Piotrkowski district, via face-to-face interviews. The linear regression analysis indicated that relative to women, men consider slim cigarettes, smokeless tobacco and e-cigarettes to be more harmful than traditional cigarettes ( p traditional cigarettes reported menthol cigarettes to be less harmful than traditional cigarettes, relative to the non-smokers ( p = 0.05). The current results demonstrate that social care beneficiaries are not aware of the fact that some products are less harmful than others. Education concerning tobacco/nicotine products should include advice on how to reduce the adverse health effects of smoking (e.g., avoiding inhalation of combusted products), while driving the awareness that no nicotine-containing products are safe.

  15. Costs and clinical quality among Medicare beneficiaries: associations with health center penetration of low-income residents.

    Science.gov (United States)

    Sharma, Ravi; Lebrun-Harris, Lydie A; Ngo-Metzger, Quyen

    2014-01-01

    Determine the association between access to primary care by the underserved and Medicare spending and clinical quality across hospital referral regions (HRRs). Data on elderly fee-for-service beneficiaries across 306 HRRs came from CMS' Geographic Variation in Medicare Spending and Utilization database (2010). We merged data on number of health center patients (HRSA's Uniform Data System) and number of low-income residents (American Community Survey). We estimated access to primary care in each HRR by "health center penetration" (health center patients as a proportion of low-income residents). We calculated total Medicare spending (adjusted for population size, local input prices, and health risk). We assessed clinical quality by preventable hospital admissions, hospital readmissions, and emergency department visits. We sorted HRRs by health center penetration rate and compared spending and quality measures between the high- and low-penetration deciles. We also employed linear regressions to estimate spending and quality measures as a function of health center penetration. The high-penetration decile had 9.7% lower Medicare spending ($926 per capita, p=0.01) than the low-penetration decile, and no different clinical quality outcomes. Compared with elderly fee-for-service beneficiaries residing in areas with low-penetration of health center patients among low-income residents, those residing in high-penetration areas may accrue Medicare cost savings. Limited evidence suggests that these savings do not compromise clinical quality.

  16. Smoking Patterns and Smoking Cessation Willingness—A Study among Beneficiaries of Government Welfare Assistance in Poland

    Directory of Open Access Journals (Sweden)

    Katarzyna Milcarz

    2017-01-01

    Full Text Available This study examines the prevalence and tobacco use patterns among adult social assistance beneficiaries and their interest in quitting. The results are based on data collected in a cross-sectional survey conducted among adults in the Piotrkowski district. A sample of 3636 social assistance beneficiaries produced a total of 1817 respondents who completed face-to-face questionnaires. Overall, 37.1% of the respondents, including 52.8% men and 29.6% women, were current smokers. Over one third of the smokers reported their willingness to quit. In the study population, several characteristics were significantly associated with the current daily smoking: male gender, low educational attainment, unemployment or temporary employment, lack of awareness of smoking-associated health risks, use of e-cigarettes, and exposure to environmental tobacco smoke (ETS. The intention to quit smoking among the daily smokers was positively correlated with their awareness of smoking-associated health risks, lack of previous quit attempts, and low exposure to ETS. Smoking prevalence among social assistance recipients tends to be higher than in the general population, but more than half of the smokers are willing to quit. There is an urgency to develop policies tailored to the needs of these disadvantaged population groups.

  17. The Effect of Clinical Care Location on Clinical Outcomes After Peripheral Vascular Intervention in Medicare Beneficiaries.

    Science.gov (United States)

    Turley, Ryan S; Mi, Xiaojuan; Qualls, Laura G; Vemulapalli, Sreekanth; Peterson, Eric D; Patel, Manesh R; Curtis, Lesley H; Jones, W Schuyler

    2017-06-12

    Modifications in reimbursement rates by Medicare in 2008 have led to peripheral vascular interventions (PVI) being performed more commonly in outpatient and office-based clinics. The objective of this study was to determine the effects of this shift in clinical care setting on clinical outcomes after PVI. Modifications in reimbursement have led to peripheral vascular intervention (PVI) being more commonly performed in outpatient hospital settings and office-based clinics. Using a 100% national sample of Medicare beneficiaries from 2010 to 2012, we examined 30-day and 1-year rates of all-cause mortality, major lower extremity amputation, repeat revascularization, and all-cause hospitalization by clinical care location of index PVI. A total of 218,858 Medicare beneficiaries underwent an index PVI between 2010 and 2012. Index PVIs performed in inpatient settings were associated with higher 1-year rates of all-cause mortality (23.6% vs. 10.4% and 11.7%; p index revascularization and geographic region on the occurrence of all-cause hospitalization, repeat revascularization, and lower extremity amputation. Index PVI performed in office-based settings was associated with a higher hazard of repeat revascularization when compared with other settings. Differences in clinical outcomes across treatment settings and geographic regions suggest that inconsistent application of PVI may exist and highlights the need for studies to determine optimal delivery of PVI in clinical practice. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  18. A randomized controlled trial of intensive care management for disabled Medicaid beneficiaries with high health care costs.

    Science.gov (United States)

    Bell, Janice F; Krupski, Antoinette; Joesch, Jutta M; West, Imara I; Atkins, David C; Court, Beverly; Mancuso, David; Roy-Byrne, Peter

    2015-06-01

    To evaluate outcomes of a registered nurse-led care management intervention for disabled Medicaid beneficiaries with high health care costs. Washington State Department of Social and Health Services Client Outcomes Database, 2008-2011. In a randomized controlled trial with intent-to-treat analysis, outcomes were compared for the intervention (n = 557) and control groups (n = 563). A quasi-experimental subanalysis compared outcomes for program participants (n = 251) and propensity score-matched controls (n = 251). Administrative data were linked to describe costs and use of health services, criminal activity, homelessness, and death. In the intent-to-treat analysis, the intervention group had higher odds of outpatient mental health service use and higher prescription drug costs than controls in the postperiod. In the subanalysis, participants had fewer unplanned hospital admissions and lower associated costs; higher prescription drug costs; higher odds of long-term care service use; higher drug/alcohol treatment costs; and lower odds of homelessness. We found no health care cost savings for disabled Medicaid beneficiaries randomized to intensive care management. Among participants, care management may have the potential to increase access to needed care, slow growth in the number and therefore cost of unplanned hospitalizations, and prevent homelessness. These findings apply to start-up care management programs targeted at high-cost, high-risk Medicaid populations. © Health Research and Educational Trust.

  19. Decontamination systems information and research program -- Literature review in support of development of standard test protocols and barrier design models for in situ formed barriers project

    International Nuclear Information System (INIS)

    1994-12-01

    The US Department of Energy is responsible for approximately 3,000 sites in which contaminants such as carbon tetrachloride, trichlorethylene, perchlorethylene, non-volatile and soluble organic and insoluble organics (PCBs and pesticides) are encountered. In specific areas of these sites radioactive contaminants are stored in underground storage tanks which were originally designed and constructed with a 30-year projected life. Many of these tanks are now 10 years beyond the design life and failures have occurred allowing the basic liquids (ph of 8 to 9) to leak into the unconsolidated soils below. Nearly one half of the storage tanks located at the Hanford Washington Reservation are suspected of leaking and contaminating the soils beneath them. The Hanford site is located in a semi-arid climate region with rainfall of less than 6 inches annually, and studies have indicated that very little of this water finds its way to the groundwater to move the water down gradient toward the Columbia River. This provides the government with time to develop a barrier system to prevent further contamination of the groundwater, and to develop and test remediation systems to stabilize or remove the contaminant materials. In parallel to remediation efforts, confinement and containment technologies are needed to retard or prevent the advancement of contamination plumes through the environment until the implementation of remediation technology efforts are completed. This project examines the various confinement and containment technologies and protocols for testing the materials in relation to their function in-situ

  20. Identification of three new phase II metabolites of a designer drug methylone formed in rats by N-demethylation followed by conjugation with dicarboxylic acids.

    Science.gov (United States)

    Židková, Monika; Linhart, Igor; Balíková, Marie; Himl, Michal; Dvořáčková, Veronika; Lhotková, Eva; Páleníček, Tomáš

    2018-06-01

    1. Methylone (3,4-methylenedioxy-N-methylcathinone, MDMC), which appeared on the illicit drug market in 2004, is a frequently abused synthetic cathinone derivative. Known metabolic pathways of MDMC include N-demethylation to normethylone (3,4-methylenedioxycathinone, MDC), aliphatic chain hydroxylation and oxidative demethylenation followed by monomethylation and conjugation with glucuronic acid and/or sulphate. 2. Three new phase II metabolites, amidic conjugates of MDC with succinic, glutaric and adipic acid, were identified in the urine of rats dosed subcutaneously with MDMC.HCl (20 mg/kg body weight) by LC-ESI-HRMS using synthetic reference standards to support identification. 3. The main portion of administered MDMC was excreted unchanged. Normethylone, was a major urinary metabolite, of which a minor part was conjugated with dicarboxylic acids. 4. Previously identified ring-opened metabolites 4-hydroxy-3-methoxymethcathinone (4-OH-3-MeO-MC), 3-hydroxy-4-methoxymeth-cathinone (3-OH-4-MeO-MC) and 3,4-dihydroxymethcathinone (3,4-di-OH-MC) mostly in conjugated form with glucuronic and/or sulphuric acids were also detected. 5. Also, ring-opened metabolites derived from MDC, namely, 4-hydroxy-3-methoxycathinone (4-OH-3-MeO-C), 3-hydroxy-4-methoxycathinone (3-OH-4-MeO-C) and 3,4-dihydroxycathinone (3,4-di-OH-C) were identified for the first time in vivo.

  1. Out-of-pocket medical expenses for inpatient care among beneficiaries of the National Health Insurance Program in the Philippines.

    Science.gov (United States)

    Tobe, Makoto; Stickley, Andrew; del Rosario, Rodolfo B; Shibuya, Kenji

    2013-08-01

    OBJECTIVE The National Health Insurance Program (NHIP) in the Philippines is a social health insurance system partially subsidized by tax-based financing which offers benefits on a fee-for-service basis up to a fixed ceiling. This paper quantifies the extent to which beneficiaries of the NHIP incur out-of-pocket expenses for inpatient care, and examines the characteristics of beneficiaries making these payments and the hospitals in which these payments are typically made. METHODS Probit and ordinary least squares regression analyses were carried out on 94 531 insurance claims from Benguet province and Baguio city during the period 2007 to 2009. RESULTS Eighty-six per cent of claims involved an out-of-pocket payment. The median figure for out-of-pocket payments was Philippine Pesos (PHP) 3016 (US$67), with this figure varying widely [inter-quartile range (IQR): PHP 9393 (US$209)]. Thirteen per cent of claims involved very large out-of-pocket payments exceeding PHP 19 213 (US$428)-the equivalent of 10% of the average annual household income in the region. Membership type, disease severity, age and residential location of the patient, length of hospitalization, and ownership and level of the hospital were all significantly associated with making out-of-pocket payments and/or the size of these payments. CONCLUSION Although the current NHIP reduces the size of out-of-pocket payments, NHIP beneficiaries are not completely free from the risk of large out-of-pocket payments (as the size of these payments varies widely and can be extremely large), despite NHIP's attempts to mitigate this by setting different benefit ceilings based on the level of the hospital and the severity of the disease. To reduce these large out-of-pocket payments and to increase financial risk protection further, it is essential to ensure more investment for health from social health insurance and/or tax-based government funding as well as shifting the provider payment mechanism from a fee

  2. 38 CFR 3.1000 - Entitlement under 38 U.S.C. 5121 to benefits due and unpaid upon death of a beneficiary.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Entitlement under 38 U.S.C. 5121 to benefits due and unpaid upon death of a beneficiary. 3.1000 Section 3.1000 Pensions... Dependency and Indemnity Compensation Accrued § 3.1000 Entitlement under 38 U.S.C. 5121 to benefits due and...

  3. 26 CFR 1.642(h)-3 - Meaning of “beneficiaries succeeding to the property of the estate or trust”.

    Science.gov (United States)

    2010-04-01

    ... property of the estate or trustâ. 1.642(h)-3 Section 1.642(h)-3 Internal Revenue INTERNAL REVENUE SERVICE... § 1.642(h)-3 Meaning of “beneficiaries succeeding to the property of the estate or trust”. (a) The... excess of deductions over gross income for which a deduction is allowed, under section 642(h). (b) With...

  4. Will the beneficiaries of the “Minha Casa, Minha Vida” program be satisfied? Empirical evidence in the state of Minas Gerais [doi: 10.21529/RECADM.2017008

    Directory of Open Access Journals (Sweden)

    Vinicius Souza Moreira

    2017-10-01

    Full Text Available The “Minha Casa, Minha Vida” Program (PMCMV is the main Brazilian government initiative to remedy the country's housing deficit, which, due to its reality, requires adequate management, avoiding detours that could make it unfeasible. In this sense, the objective was to evaluate the PMCMV results based on the perception of the beneficiary families. The theoretical framework was based on the concepts of evaluation of social programs and their application to the housing context. The investigation occurred in Minas Gerais, considering a sample of 110 families distributed in eight municipalities. We adopted three categories: housing unit, housing complex and environment. In relation to the housing unit, beneficiaries of horizontal housing were more satisfied; large families showed lower satisfaction and the second phase of the Program was better evaluated. On the housing set, beneficiaries of the vertical groups, with less members and of enterprises of the second phase were more satisfied. As for the environment, there was a decrease in satisfaction with infrastructure and access to the city as family size increased. From the contact with the beneficiaries was clear the social importance of the PMCMV and the modification promoted in their lives. It is considered necessary, based on the critical points raised, to continue making corrections in the Program so that the promoted improvements can solve the social inequalities.   Keywords Housing; Evaluation; Public policy; Satisfaction.

  5. 26 CFR 1.662(a)-1 - Inclusion of amounts in gross income of beneficiaries of estates and complex trusts; general.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 8 2010-04-01 2010-04-01 false Inclusion of amounts in gross income of beneficiaries of estates and complex trusts; general. 1.662(a)-1 Section 1.662(a)-1 Internal Revenue INTERNAL... Trusts Which May Accumulate Income Or Which Distribute Corpus § 1.662(a)-1 Inclusion of amounts in gross...

  6. Geographic variation in fee-for-service medicare beneficiaries' medical costs is largely explained by disease burden.

    Science.gov (United States)

    Reschovsky, James D; Hadley, Jack; Romano, Patrick S

    2013-10-01

    Control for area differences in population health (casemix adjustment) is necessary to measure geographic variations in medical spending. Studies use various casemix adjustment methods, resulting in very different geographic variation estimates. We study casemix adjustment methodological issues and evaluate alternative approaches using claims from 1.6 million Medicare beneficiaries in 60 representative communities. Two key casemix adjustment methods-controlling for patient conditions obtained from diagnoses on claims and expenditures of those at the end of life-were evaluated. We failed to find evidence of bias in the former approach attributable to area differences in physician diagnostic patterns, as others have found, and found that the assumption underpinning the latter approach-that persons close to death are equally sick across areas-cannot be supported. Diagnosis-based approaches are more appropriate when current rather than prior year diagnoses are used. Population health likely explains more than 75% to 85% of cost variations across fixed sets of areas.

  7. Stability of return to work after a coordinated and tailored intervention for sickness absence compensation beneficiaries with mental health problems

    DEFF Research Database (Denmark)

    Martin, Marie H. T.; D. Nielsen, Maj Britt; Pedersen, Jacob

    2015-01-01

    PURPOSE: Mental health problems (MHPs) are increasingly common as reasons for long-term sickness absence. However, the knowledge of how to promote a stable return to work (RTW) after sickness absence due to MHPs is limited. The purpose of this study was to assess the effects of a multidisciplinary...... showed no benefits in terms of improved stability of RTW, reduced sickness absence or improved labour market status after 2 years when compared to conventional case management. IMPLICATIONS FOR REHABILITATION: Evidence for effective return-to-work (RTW) interventions for people with mental health...... compared to conventional case management of sickness absence beneficiaries in Denmark. A stronger focus on cooperation with social insurance officers and employers may produce better results....

  8. Are trends in billing for high-intensity emergency care explained by changes in services provided in the emergency department? An observational study among US Medicare beneficiaries

    Science.gov (United States)

    Burke, Laura G; Wild, Robert C; Orav, E John; Hsia, Renee Y

    2018-01-01

    Objective There has been concern that an increase in billing for high-intensity emergency care is due to changes in coding practices facilitated by electronic health records. We sought to characterise the trends in billing for high-intensity emergency care among Medicare beneficiaries and to examine the degree to which trends in high-intensity billing are explained by changes in patient characteristics and services provided in the emergency department (ED). Design, setting and participants Observational study using traditional Medicare claims to identify ED visits at non-federal acute care hospitals for elderly beneficiaries in 2006, 2009 and 2012. Outcomes measures Billing intensity was defined by emergency physician evaluation and management (E&M) codes. We tested for overall trends in high-intensity billing (E&M codes 99285, 99291 and 99292) and in services provided over time using linear regression models, adjusting for patient characteristics. Additionally, we tested for time trends in rates of admission to the hospital and to the intensive care unit (ICU). Next, we classified outpatient visits into 39 diagnosis categories and analysed the change in proportion of high-intensity visits versus the change in number of services. Finally, we quantified the extent to which trends in high-intensity billing are explained by changes in patient demographics and services provided in the ED using multivariable modelling. Results High-intensity visits grew from 45.8% of 671 103 visits in 2006 to 57.8% of 629 010 visits in 2012 (2.0% absolute increase per year; 95% CI 1.97% to 2.03%) as did the mean number of services provided for admitted (1.28 to 1.41; +0.02 increase in procedures per year; 95% CI 0.018 to 0.021) and discharged ED patients (7.1 to 8.6; +0.25 increase in services per year; 95% CI 0.245 to 0.255). There was a reduction in hospital admission rate from 40.1% to 35.9% (−0.68% per year; 95% CI −0.71% to −0.65%; Pbilled as high intensity

  9. Oral health service utilization by elderly beneficiaries of the Mexican Institute of Social Security in México city

    Directory of Open Access Journals (Sweden)

    Solórzano-Santos Fortino

    2007-12-01

    Full Text Available Abstract Background The aging population poses a challenge to Mexican health services. The aim of this study is to describe recent oral health services utilization and its association with socio-demographic characteristics and co-morbidity in Mexican Social Security beneficiaries 60 years and older. Methods A sample of 700 individuals aged 60+ years was randomly chosen from the databases of the Mexican Institute of Social Security (IMSS. These participants resided in the southwest of Mexico City and made up the final sample of a cohort study for identifying risk factors for root caries in elderly patients. Sociodemographic variables, presence of cognitive decline, depression, morbidity, medication consumption, and utilization of as well as reasons for seeking oral health services within the past 12 months were collected through a questionnaire. Clinical oral assessments were carried out to determine coronal and root caries experience. Results The sample consisted of 698 individuals aged 71.6 years on average, of whom 68.3% were women. 374 participants (53.6% had made use of oral health services within the past 12 months. 81% of those who used oral health services sought private medical care, 12.8% sought social security services, and 6.2% public health services. 99.7% had experienced coronal caries and 44.0% root caries. Female sex (OR = 2.0, 6 years' schooling or less (OR = 1.4, and caries experience in more than 22 teeth (OR = 0.6 are factors associated with the utilization of these services. Conclusion About half the elderly beneficiaries of social security have made use of oral health services within the past 12 months, and many of them have to use private services. Being a woman, having little schooling, and low caries experience are factors associated with the use of these services.

  10. Memory design

    DEFF Research Database (Denmark)

    Tanderup, Sisse

    by cultural forms, often specifically by the concept of memory in philosophy, sociology and psychology, while Danish design traditionally has been focusing on form and function with frequent references to the forms of nature. Alessi's motivation for investigating the concept of memory is that it adds......Mind and Matter - Nordik 2009 Conference for Art Historians Design Matters Contributed Memory design BACKGROUND My research concerns the use of memory categories in the designs by the companies Alessi and Georg Jensen. When Alessi's designers create their products, they are usually inspired...... a cultural dimension to the design objects, enabling the objects to make an identity-forming impact. Whether or not the concept of memory plays a significant role in Danish design has not yet been elucidated fully. TERMINOLOGY The concept of "memory design" refers to the idea that design carries...

  11. Densified waste form and method for forming

    Science.gov (United States)

    Garino, Terry J.; Nenoff, Tina M.; Sava Gallis, Dorina Florentina

    2015-08-25

    Materials and methods of making densified waste forms for temperature sensitive waste material, such as nuclear waste, formed with low temperature processing using metallic powder that forms the matrix that encapsulates the temperature sensitive waste material. The densified waste form includes a temperature sensitive waste material in a physically densified matrix, the matrix is a compacted metallic powder. The method for forming the densified waste form includes mixing a metallic powder and a temperature sensitive waste material to form a waste form precursor. The waste form precursor is compacted with sufficient pressure to densify the waste precursor and encapsulate the temperature sensitive waste material in a physically densified matrix.

  12. Project beneficiary participation and behavioural intentions promoting project sustainability: : The mediating role of psychological ownership

    NARCIS (Netherlands)

    Aga, Deribe Assefa; Noorderhaven, Niels; Vallejo, B.

    It is of great importance that development projects (especially those projects that target improving the livelihood of rural communities) continue to deliver their intended benefits over their intended economic life – we call this ‘project sustainability’. Applying an experimental design, our study

  13. Fra tanke til form

    DEFF Research Database (Denmark)

    Der er gået 20 år siden Aalborg og Nordjylland i 1997 fik sin egen, unikke civilingeniøruddannelse i form af Arkitektur & Design-uddannelsen ved Aalborg Universitet. Hele forløbet er nu dokumenteret i en jubilæumsbog, der fortæller om hvordan uddannelsen i sin tid blev etableret; hvordan undervis...... størrelse på over 500 studerende, de fleste med daglig gang i den store CREATE-bygning på havnefronten i Aalborg....

  14. Self-reported colorectal cancer screening of Medicare beneficiaries in family medicine vs. internal medicine practices in the United States: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Higgins Angela Y

    2012-03-01

    Full Text Available Abstract Background The benefit of screening for decreasing the risk of death from colorectal cancer (CRC has been shown, yet many patients in primary care are still not undergoing screening according to guidelines. There are known variations in delivery of preventive health care services among primary care physicians. This study compared self-reported CRC screening rates and patient awareness of the need for CRC screening of patients receiving care from family medicine (FPs vs. internal medicine (internists physicians. Methods Nationally representative sample of non-institutionalized beneficiaries who received medical care from FPs or internists in 2006 (using Medicare Current Beneficiary Survey. The main outcome was the percentage of patients screened in 2007. We also examined the percentage of patients offered screening. Results Patients of FPs, compared to those of internists, were less likely to have received an FOBT kit or undergone home FOBT, even after accounting for patients' characteristics. Compared to internists, FPs' patients were more likely to have heard of colonoscopy, but were less likely to receive a screening colonoscopy recommendation (18% vs. 27%, or undergo a colonoscopy (43% vs. 46%, adjusted odds ratios [AOR], 95% confidence interval [CI]-- 0.65, 0.51-0.81 or any CRC screening (52% vs. 60%, AOR, CI--0.80, 0.68-0.94. Among subgroups examined, higher income beneficiaries receiving care from internists had the highest screening rate (68%, while disabled beneficiaries receiving care from FPs had the lowest screening rate (34%. Conclusion Patients cared for by FPs had a lower rate of screening compared to those cared for by internists, despite equal or higher levels of awareness; a difference that remained statistically significant after accounting for socioeconomic status and access to healthcare. Both groups of patients remained below the national goal of 70 percent.

  15. A Mirage or a Rural Life Line? Analysing the impact of Mahatma Gandhi Rural Employment Guarantee Act on Women Beneficiaries of Assam

    Directory of Open Access Journals (Sweden)

    Rituparna Bhattacharyya

    2013-05-01

    Full Text Available The National Rural Employment Guarantee Act (NREGA, launched in February 2006 was renamed in October 02, 2009 as the Mahatma Gandhi National Rural Employment Guarantee Act (henceforth, MGNREGA. It is an anti-poverty flagship programme of the Government of India. The key purpose of MGNREGA is to enhance wage employment in the rural areas by providing at least 100 days of guaranteed employment to every household in a financial year.  The MGNREGA implementation status report for the financial year 2012-2013 unfolds that the programme has already provided employment to 44.9 million households across 28 districts and five union territories. Hence, it is becoming increasingly difficult to ignore the impact of MGNREGA on women beneficiaries. A plethora of research argues that MGNREGA, which promotes inclusive growth, is a vehicle of change, a lifeline for rural women. So far, however, there has been very little discussion about the impact of MGNREGA on women beneficiaries of Assam. This research is an attempt to examine the participation of women in MGNREGA, Assam. It critically looks at the issues, problems and challenges confronted by the women while working at MGNREGA. Written from a feminist perspective on gender, poverty and women’s empowerment, the research seeks to address the problems of the women beneficiaries through their lived experiences. For this, we conducted in-depth interviews with the women beneficiaries in the months of August and September, 2009 in four remote areas namely, Burka, Chandrapur, Barbhang and Muguriya, the first two situated in Kamrup, while the third and the fourth in Barpeta districts of Assam, where the programme of MGNREGA is on-going. The findings of the research suggest measures so that the programme can be made more effective in the long run.

  16. Comparison of Clinical Features in a Population of Basic Military Trainees Versus the General Department of Defense Beneficiary Population Presenting With Influenza.

    Science.gov (United States)

    Scheuller, H Samuel; Park, Jisuk; Lott, Lisa; Tavish, Michele; Danaher, Patrick

    2017-09-01

    Upper respiratory tract infection (URI) is a well-documented cause of morbidity, extra expense, and lost training time among basic military trainees (BMTs). The goal of this study was to characterize the clinical presentation of influenza in the BMT population and to better understand how this presentation differs from that of the general Department of Defense (DoD) beneficiary population (non-BMTs). Clinical and demographic data were collected in a prospective study that enrolled DoD beneficiaries presenting to medical treatment facilities in San Antonio, Texas, with URI symptoms between January 2005 and March 2011. Vital signs and symptom duration were collected at the time of enrollment along with basic demographic information. Among 4,448 participants enrolled, 466 (10.5%) tested positive for influenza: 198 of 3,103 BMTs (6.4%) vs. 268 of 1,345 non-BMTs (20%) (p 0.5°F, p 0.5, 95% CI = 0.3-0.8, p 0.5, 95% CI = 0.3-0.8, p standard deviation = 1.4) symptoms, whereas non-BMTs presented with a mean of 6.9 (standard deviation = 1.3) symptoms (p < 0.01). The pretest probability of a BMT presenting with URI symptoms having influenza is significantly lower than that for the general DoD beneficiary population. BMTs with influenza presented sooner, with higher fever, and with fewer overall symptoms than the general DoD beneficiary population. These differences are likely attributable to early reporting and response bias and less likely attributed to age. Military efforts to identify BMTs with suspected influenza infection early and to refer them for treatment promptly are efficacious. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

  17. Prevalence and Correlates of Physical Inactivity during Leisure-Time and Commuting among Beneficiaries of Government Welfare Assistance in Poland

    Directory of Open Access Journals (Sweden)

    Dorota Kaleta

    2017-09-01

    Full Text Available Physical activity (PA has well-documented health benefits helping to prevent development of non-communicable diseases. The aim of the study was to examine the prevalence and factors associated with physical inactivity during leisure-time (LTPA and commuting (CPA among adult social assistance beneficiaries in Piotrkowski district. The studied sample consisted of 1817 respondents. Over 73% of the study population did not meet the recommended levels of LTPA. Fifty two % of the respondents had none leisure-time physical activity and 21.5% exercised occasionally. Main reasons for not taking up LTPA included: high general physical activity (36.4%, lack of time (28.1%, no willingness to exercise (25.4%. Close to 82% of the surveyed population did not practice commuting physical activity (CPA. The men had higher risk for inactivity during LTPA compared to the women (OR = 1.35; 95% CI: 1.11–1.65; p ≤ 0.05. Higher odds of CPA inactivity were associated with unemployment, moderate and heavy drinking and having a number of health problems. The prevalence of physical inactivity among the social assistance recipients is much higher than it is in the general population. Promotion of an active lifestyle should take into consideration substantial differences between the general population and disadvantaged individuals and their various needs.

  18. Neighborhood Environment and Disparities in Health Care Access Among Urban Medicare Beneficiaries With Diabetes: A Retrospective Cohort Study.

    Science.gov (United States)

    Ryvicker, Miriam; Sridharan, Sridevi

    2018-01-01

    Older adults' health is sensitive to variations in neighborhood environment, yet few studies have examined how neighborhood factors influence their health care access. This study examined whether neighborhood environmental factors help to explain racial and socioeconomic disparities in health care access and outcomes among urban older adults with diabetes. Data from 123 233 diabetic Medicare beneficiaries aged 65 years and older in New York City were geocoded to measures of neighborhood walkability, public transit access, and primary care supply. In 2008, 6.4% had no office-based "evaluation and management" (E&M) visits. Multilevel logistic regression indicated that this group had greater odds of preventable hospitalization in 2009 (odds ratio = 1.31; 95% confidence interval: 1.22-1.40). Nonwhites and low-income individuals had greater odds of a lapse in E&M visits and of preventable hospitalization. Neighborhood factors did not help to explain these disparities. Further research is needed on the mechanisms underlying these disparities and older adults' ability to navigate health care. Even in an insured population living in a provider-dense city, targeted interventions may be needed to overcome barriers to chronic illness care for older adults in the community.

  19. Prevalence and Correlates of Physical Inactivity during Leisure-Time and Commuting among Beneficiaries of Government Welfare Assistance in Poland.

    Science.gov (United States)

    Kaleta, Dorota; Kalucka, Sylwia; Szatko, Franciszek; Makowiec-Dąbrowska, Teresa

    2017-09-26

    Physical activity (PA) has well-documented health benefits helping to prevent development of non-communicable diseases. The aim of the study was to examine the prevalence and factors associated with physical inactivity during leisure-time (LTPA) and commuting (CPA) among adult social assistance beneficiaries in Piotrkowski district. The studied sample consisted of 1817 respondents. Over 73% of the study population did not meet the recommended levels of LTPA. Fifty two % of the respondents had none leisure-time physical activity and 21.5% exercised occasionally. Main reasons for not taking up LTPA included: high general physical activity (36.4%), lack of time (28.1%), no willingness to exercise (25.4%). Close to 82% of the surveyed population did not practice commuting physical activity (CPA). The men had higher risk for inactivity during LTPA compared to the women (OR = 1.35; 95% CI: 1.11-1.65; p ≤ 0.05). Higher odds of CPA inactivity were associated with unemployment, moderate and heavy drinking and having a number of health problems. The prevalence of physical inactivity among the social assistance recipients is much higher than it is in the general population. Promotion of an active lifestyle should take into consideration substantial differences between the general population and disadvantaged individuals and their various needs.

  20. Assessment of Intervention Being Provided at AWCs Related to Nutrition and Care during Pregnancy and Lactation in District Budgam of Kashmir Region J&K (Based on Beneficiary Responses)

    OpenAIRE

    Iffat Ghani; Rajini Dhingra

    2017-01-01

    This research was planned to study the intervention being provided by AWCs (Anganwadi Centers) to improve the knowledge level of women beneficiaries regarding health care and nutrition during pregnancy and lactation. Inthis context, four blocks were purposively selected from district Budgam of Kashmir region. From these four blocks 60 AWCs were randomly selected through lottery method with 15 AWCs from each block. A total number of 240 women beneficiaries were purposively selected from these ...

  1. Comparative Evaluation of Cash Benefit Scheme of Janani Suraksha Yojana for Beneficiary Mothers from Different Health Care Settings of Rewa District, Madhya Pradesh, India.

    Directory of Open Access Journals (Sweden)

    Trivedi R

    2014-05-01

    Full Text Available Introduction: For better outcomes in mother and child health, Government of India launched the National Rural Health Mission (NRHM in 2005 with a major objective of providing accessible, affordable and quality health care to the rural population; especially the vulnerable. Reduction in MMR to 100/100,000 is one of its goals and the Janani Suraksha Yojana (JSY is the key strategy of NRHM to achieve this reduction. The JSY, as a safe motherhood intervention and modified alternative of the National Maternity Benefit Scheme (NMBS, has been implemented in all states and Union territories with special focus on low performing states. The main objective and vision of JSY is to reduce maternal, neo-natal mortality and promote institutional delivery among the poor pregnant women of rural and urban areas. This scheme is 100% centrally sponsored and has an integrated delivery and post delivery care with the help of a key person i.e. ASHA (Accredited Social Health Activist, followed by cash monetary help to the women. Objectives: 1To evaluate cash benefit service provided under JSY at different health care settings. 2 To know the perception and elicit suggestions of beneficiaries on quality of cash benefit scheme of JSY. Methodology: This is a health care institute based observational cross sectional study including randomly selected 200 JSY beneficiary mothers from the different health care settings i.e., Primary Health Centres, Community Health Centres, District Hospital and Medical College Hospital of Rewa District of Madhya Pradesh state. Data was collected with the help of set pro forma and then analysed with Epi Info 2000. Chi square test was applied appropriately. Results: 60% and 80% beneficiaries from PHC and CHC received cash within 1 week after discharge whereas 100% beneficiaries of District Hospital and Medical College Hospital received cash at the time of discharge; the overall distribution of time of cash disbursement among beneficiaries of

  2. Harmonic Maass forms and mock modular forms

    CERN Document Server

    Bringmann, Kathrin; Ono, Ken

    2017-01-01

    Modular forms and Jacobi forms play a central role in many areas of mathematics. Over the last 10-15 years, this theory has been extended to certain non-holomorphic functions, the so-called "harmonic Maass forms". The first glimpses of this theory appeared in Ramanujan's enigmatic last letter to G. H. Hardy written from his deathbed. Ramanujan discovered functions he called "mock theta functions" which over eighty years later were recognized as pieces of harmonic Maass forms. This book contains the essential features of the theory of harmonic Maass forms and mock modular forms, together with a wide variety of applications to algebraic number theory, combinatorics, elliptic curves, mathematical physics, quantum modular forms, and representation theory.

  3. A Framework for Interactively Helpful Web Forms

    DEFF Research Database (Denmark)

    Bohøj, Morten; Bouvin, Niels Olof; Gammelmark, Henrik

    2012-01-01

    AdapForms is a framework for adaptive forms, consisting of a form definition language designating structure and constraints upon acceptable input, and a software architecture that continuously validates and adapts the form presented to the user. The validation is performed server-side, which enab...

  4. On good ETOL forms

    DEFF Research Database (Denmark)

    Skyum, Sven

    1978-01-01

    This paper continues the study of ETOL forms and good EOL forms done by Maurer, Salomaa and Wood. It is proven that binary very complete ETOL forms exist, good synchronized ETOL forms exist and that no propagating or synchronized ETOL form can be very complete.......This paper continues the study of ETOL forms and good EOL forms done by Maurer, Salomaa and Wood. It is proven that binary very complete ETOL forms exist, good synchronized ETOL forms exist and that no propagating or synchronized ETOL form can be very complete....

  5. What are the economic and social effects from the electric power beneficiary price of the largest consumers

    International Nuclear Information System (INIS)

    Bogov, Dimitar

    2003-01-01

    In the last few years the two largest consumers of electricity 'Feni' and 'Jugohrom', were sold to the foreign strategic investor. The key issue in the negotiations with the investor was the price of electricity for these companies. The final outcome is known, they got beneficiary price. Now two questions emerge: (1) what is the exact size of the under pricing? (2) what are the economic and social effects of their activity and whether the social gain for the country is higher than the loss for the country from the under pricing of electricity. The paper is trying to give an answer on the second question. Therewith, the analyze is focused on two issues: (1) how much is the contribution of these two companies on production, export and economic growth of the Republic of Macedonia; (2) what is their impact on the living standard and social costs. Macedonian industry has very unfavorable structure with only a few export products. Restructuring of industry and widening of the array of products is a slow process. Until new products and new industries are developed, the only generator of larger export and higher economic growth is the increase of the export of existing products. 'Feni industry' and 'Silmak' are some of rare Macedonian companies that have foreign strategic investor who provide stable and unlimited market (having in mind that Macedonian production is relatively small compared to the world demand for nickel and ferro silicium). Thus, the growth of export of metals produced by 'Feni industry' and 'Silmak' could be the principal generators of the growth of Macedonian economy in the period of restructuring of the industry and development of new competitive products. (Original)

  6. Variables Associated With Inpatient and Outpatient Resource Utilization Among Medicare Beneficiaries With Nonalcoholic Fatty Liver Disease With or Without Cirrhosis.

    Science.gov (United States)

    Sayiner, Mehmet; Otgonsuren, Munkhzul; Cable, Rebecca; Younossi, Issah; Afendy, Mariam; Golabi, Pegah; Henry, Linda; Younossi, Zobair M

    2017-03-01

    Nonalcoholic fatty liver disease (NAFLD) is one of the leading causes of chronic liver disease worldwide with tremendous clinical burden. The economic burden of NAFLD is not well studied. To assess the economic burden of NAFLD. Medicare beneficiaries (January 1, 2010 to December 31, 2010) with NAFLD diagnosis by International Classification of Diseases, Ninth Revision codes in the absence of other liver diseases were selected. Inpatient and outpatient resource utilization parameters were total charges and total provider payments. NAFLD patients with compensated cirrhosis (CC) were compared with decompensated cirrhosis (DC). A total of 976 inpatients and 4742 outpatients with NAFLD were included-87% were white, 36% male, 30% had cardiovascular disease (CVD) or metabolic syndrome conditions, and 12% had cirrhosis. For inpatients, median total hospital charge was $36,289. NAFLD patients with cirrhosis had higher charges and payments than noncirrhotic NAFLD patients ($61,151 vs. $33,863 and $18,804 vs. $10,146, P<0.001). Compared with CC, NAFLD patients with DC had higher charges and payments (P<0.02). For outpatients, median total charge was $9,011. NAFLD patients with cirrhosis had higher charges and payments than noncirrhotic NAFLD patients ($12,049 vs. $8,830 and $2,586 vs. $1,734, P<0.001). Compared with CC, DC patients had higher total charges ($15,187 vs. $10,379, P=0.04). In multivariate analysis, variables associated with increased inpatient resource utilization were inpatient mortality, DC, and CVD; for outpatients, having CVD, obesity, and hypertension (all P<0.001). NAFLD is associated with significant economic burden to Medicare. Presence of cirrhosis and CVD are associated with increased resource utilization.

  7. Forms of Approximate Radiation Transport

    CERN Document Server

    Brunner, G

    2002-01-01

    Photon radiation transport is described by the Boltzmann equation. Because this equation is difficult to solve, many different approximate forms have been implemented in computer codes. Several of the most common approximations are reviewed, and test problems illustrate the characteristics of each of the approximations. This document is designed as a tutorial so that code users can make an educated choice about which form of approximate radiation transport to use for their particular simulation.

  8. STUDI KOMPARASI KINERJA HULL FORM METODE SCHELTEMA DENGAN HULL FORM KAPAL IKAN TRADISIONAL TIPE DAERAH BATANG

    OpenAIRE

    A.F. Zakki; Parlindungan Manik

    2012-01-01

    This study comparation of hull form performance was analysed becaused there was suggestion that a ship was built by hull form scheming this time (Scheltema, Formdata, NPL Series) is better than a ship that was built traditionally because there is no basic erudite calculation in hull form design. So hull form design was result of natural adaptation. Such performance are ship’s resistance, stability, and ship’s navigation.This research about hull form performance is expected can giv...

  9. Electroweak form factors

    International Nuclear Information System (INIS)

    Singh, S.K.

    2002-01-01

    The present status of electroweak nucleon form factors and the N - Δ transition form factors is reviewed. Particularly the determination of dipole mass M A in the axial vector form factor is discussed

  10. SuperFormLab: showing SuperFormLab

    DEFF Research Database (Denmark)

    2013-01-01

    bachelor program, followed by two years of master studies. The courses are offered equally to students from other design disciplines, e.g. industrial design. Teaching is mainly in English as the program is attended by a relatively large group of non-Danish students, who seek exactly this combination......3D-printing in clay and ceramic objects shaped by your own sounds and movements! Digital form transferred via CNC-milling to ornamental ceramic wall-cladding. Brave New World… Students and their teacher at SuperFormLab, the new ceramic workshop of the School of Design at the Royal Danish Academy...... of Fine Arts in Copenhagen, will be showing results of their investigations into the potential of combining digital technologies with ceramic materials. It is now possible to shape the most complex mathematical, virtual 3D objects through the use of advanced software-programs. And more than that – you can...

  11. Fabrication Aware Form-finding

    DEFF Research Database (Denmark)

    Egholm Pedersen, Ole; Larsen, Niels Martin; Pigram, Dave

    2014-01-01

    This paper describes a design and construction method that combines two distinct material systems with fabrication aware form-finding and file-to-factory workflows. The method enables the fluent creation of complex materially efficient structures comprising high populations of geometrically uniqu...

  12. Making It Safe to Grow Old: A Financial Simulation Model for Launching MediCaring Communities for Frail Elderly Medicare Beneficiaries.

    Science.gov (United States)

    Bernhardt, Antonia K; Lynn, Joanne; Berger, Gregory; Lee, James A; Reuter, Kevin; Davanzo, Joan; Montgomery, Anne; Dobson, Allen

    2016-09-01

    At age 65, the average man and woman can respectively expect 1.5 years and 2.5 years of requiring daily help with "activities of daily living." Available services fail to match frail elders' needs, thereby routinely generating errors, unreliability, unwanted services, unmet needs, and high costs. The number of elderly Medicare beneficiaries likely to be frail will triple between 2000 and 2050. Low retirement savings, rising medical and long-term care costs, and declining family caregiver availability portend gaps in badly needed services. The financial simulation reported here for 4 diverse MediCaring Communities shows lower per capita costs. Program savings are substantial and can improve coverage and function of local supportive services within current overall Medicare spending levels. The Altarum Institute Center for Elder Care and Advanced Illness has developed a reform model, MediCaring Communities, to improve services for frail elderly Medicare beneficiaries through longitudinal care planning, better-coordinated and more desirable medical and social services, and local monitoring and management of a community's quality and supply of services. This study uses financial simulation to determine whether communities could implement the model within current Medicare and Medicaid spending levels, an important consideration to enable development and broad implementation. The financial simulation for MediCaring Communities uses 4 diverse communities chosen for adequate size, varying health care delivery systems, and ability to implement reforms and generate data rapidly: Akron, Ohio; Milwaukie, Oregon; northeastern Queens, New York; and Williamsburg, Virginia. For each community, leaders contributed baseline population and program effect estimates that reflected projections from reported research to build the model. The simulation projected third-year savings between $269 and $537 per beneficiary per month and cumulative returns on investment between 75% and 165%. The

  13. Toroidal helical quartz forming machine

    International Nuclear Information System (INIS)

    Hanks, K.W.; Cole, T.R.

    1977-01-01

    The Scyllac fusion experimental machine used 10 cm diameter smooth bore discharge tubes formed into a simple toroidal shape prior to 1974. At about that time, it was discovered that a discharge tube was required to follow the convoluted shape of the load coil. A machine was designed and built to form a fused quartz tube with a toroidal shape. The machine will accommodate quartz tubes from 5 cm to 20 cm diameter forming it into a 4 m toroidal radius with a 1 to 5 cm helical displacement. The machine will also generate a helical shape on a linear tube. Two sets of tubes with different helical radii and wavelengths have been successfully fabricated. The problems encountered with the design and fabrication of this machine are discussed

  14. Epidemiology and Self-Treatment of Travelers’ Diarrhea in a Large, Prospective Cohort of Department of Defense Beneficiaries

    Science.gov (United States)

    Lalani, Tahaniyat; Maguire, Jason D.; Grant, Edward M.; Fraser, Jamie; Ganesan, Anuradha; Johnson, Mark D.; Deiss, Robert G.; Riddle, Mark S.; Burgess, Timothy; Tribble, David R.

    2014-01-01

    Background Infectious diarrhea is a common problem among travelers. Expert guidelines recommend the prompt use of antibiotics for self-treatment of moderate or severe traveler’s diarrhea (TD). There is limited data on whether travelers follow these self-treatment guidelines. We evaluated the risk factors associated with TD, use of TD self-treatment, and risk of irritable bowel syndrome (IBS) during travel. Methods Department of Defense beneficiaries traveling outside the US for ≤ 6.5 months were enrolled in a prospective cohort study. Participants received pre- and post-travel surveys, and could opt into a travel illness diary and follow-up surveys for symptoms of IBS. Standard definitions were used to assess for TD and IBS. Sub-optimal self-treatment was defined as use of antibiotics (with or without antidiarrheal agents) for mild TD, or use of antidiarrheals alone or no self-treatment in cases of moderate or severe TD. Results Twenty-four percent of participants (270/1120) met criteria for TD. The highest incidence was recorded in Africa (8.6 cases/100 person-weeks, 95% CI: 6.7–10.5). Two hundred and twelve TD cases provided information regarding severity and self-treatment: 89 (42%) had mild TD and 123 (58%) had moderate or severe TD. Moderate or severe TD was independently associated with suboptimal self-treatment (OR 10.4 [95% CI: 4.92–22.0]). Time to last unformed stool did not differ between optimal and suboptimal self-treatment. IBS occurred in 4.5% (7/154) of TD cases and 3.1% (16/516) of patients without TD (p=0.39). Among TD cases, a lower incidence of IBS was noted in participants who took antibiotics (4.8% (5/105) vs. 2.2% (1/46)), but the difference did not reach statistical significance (p=0.60). Conclusions Our results suggest the underutilization of antibiotics in travelers with moderate or severe TD. Further studies are needed to systematically evaluate pre-travel instruction and traveler adherence to self-treatment guidelines, and the

  15. Spironolactone use and higher hospital readmission for Medicare beneficiaries with heart failure, left ventricular ejection fraction 73 m(2.).

    Science.gov (United States)

    Inampudi, Chakradhari; Parvataneni, Sridivya; Morgan, Charity J; Deedwania, Prakash; Fonarow, Gregg C; Sanders, Paul W; Prabhu, Sumanth D; Butler, Javed; Forman, Daniel E; Aronow, Wilbert S; Allman, Richard M; Ahmed, Ali

    2014-07-01

    Although randomized controlled trials have demonstrated benefits of aldosterone antagonists for patients with heart failure and reduced ejection fraction (HFrEF), they excluded patients with serum creatinine >2.5 mg/dl, and their use is contraindicated in those with advanced chronic kidney disease (CKD). In the present analysis, we examined the association of spironolactone use with readmission in hospitalized Medicare beneficiaries with HFrEF and advanced CKD. Of the 1,140 patients with HFrEF (EF 73 m(2)), 207 received discharge prescriptions for spironolactone. Using propensity scores (PSs) for the receipt of discharge prescriptions for spironolactone, we estimated PS-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for spironolactone-associated outcomes. Patients (mean age 76 years, 49% women, 25% African-American) had mean EF 28%, mean eGFR 31 ml/min/1.73 m(2), and mean potassium 4.5 mEq/L. Spironolactone use had significant PS-adjusted association with higher risk of 30-day (HR 1.41, 95% CI 1.04 to 1.90) and 1-year (HR 1.36, 95% CI 1.13 to 1.63) all-cause readmissions. The risk of 1-year all-cause readmission was higher among 106 patients with eGFR 73 m(2) (HR 4.75, 95% CI 1.84 to 12.28) than among those with eGFR 15 to 45 ml/min/1.73 m(2) (HR 1.34, 95% CI 1.11 to 1.61, p for interaction 0.003). Spironolactone use had no association with HF readmission and all-cause mortality. In conclusion, among hospitalized patients with HFrEF and advanced CKD, spironolactone use was associated with higher all-cause readmission but had no association with all-cause mortality or HF readmission. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. The Form of HWID Theory

    DEFF Research Database (Denmark)

    Clemmensen, Torkil

    2015-01-01

    The aim of activities within the Human-Computer Interaction (HCI) area named Human Work Interaction Design (HWID) is to establish relationships between empirical work-domain studies and recent developments in interaction design. Recent areas of research within HWID include design sketches for work......, usability in context, work analysis for HCI, and integration of work analysis and interaction design methods for pervasive and smart workplaces. Across these areas, the question emerges what form of theory may HWID research produce? The aim with this paper is to investigate the requirements of different...... research purposes to a common framework. We take the position that we should approach HWID with a lightweight, medium-level framework that is useful to guide the application of other theories to study the relation between work analysis and interaction design. We analyse the requirements to theory found...

  17. Adaptive municipal electronic forms

    NARCIS (Netherlands)

    Kuiper, Pieternel; van Dijk, Elisabeth M.A.G.; Bondarouk, Tatiana; Ruel, Hubertus Johannes Maria; Guiderdoni-Jourdain, Karine; Oiry, Ewan

    Adaptation of electronic forms (e-forms) seems to be a step forward to reduce the burden for people who fill in forms. Municipalities more and more offer e-forms online that can be used by citizens to request a municipal product or service or by municipal employees to place a request on behalf of a

  18. Designing friends

    NARCIS (Netherlands)

    Heylen, Dirk K.J.; Nijholt, Antinus; Stronks, B.; van der Vet, P.E.; Rosenberg, D.

    2003-01-01

    Embodied Conversational Agents are virtual humans that can interact with humans using verbal and non-verbal forms of communication. In most cases, they have been designed for short interactions. This paper asks the question how one would start to design synthetic characters that can become your

  19. Performance Design

    DEFF Research Database (Denmark)

    Svabo, Connie

    Contribution to conference: Art and Presence The emerging field of Performance Design is unfolded as a bastard form of research/art/design/practice, with shapeshifting, monstruous, hybrid and transformational qualities. The potential for presencing, which emerges out of momentarily transgressing...

  20. Spray-formed tooling

    Science.gov (United States)

    McHugh, K. M.; Key, J. F.

    The United States Council for Automotive Research (USCAR) has formed a partnership with the Idaho National Engineering Laboratory (INEL) to develop a process for the rapid production of low-cost tooling based on spray forming technology developed at the INEL. Phase 1 of the program will involve bench-scale system development, materials characterization, and process optimization. In Phase 2, prototype systems will be designed, constructed, evaluated, and optimized. Process control and other issues that influence commercialization will be addressed during this phase of the project. Technology transfer to USCAR, or a tooling vendor selected by USCAR, will be accomplished during Phase 3. The approach INEL is using to produce tooling, such as plastic injection molds and stamping dies, combines rapid solidification processing and net-shape materials processing into a single step. A bulk liquid metal is pressure-fed into a de Laval spray nozzle transporting a high velocity, high temperature inert gas. The gas jet disintegrates the metal into fine droplets and deposits them onto a tool pattern made from materials such as plastic, wax, clay, ceramics, and metals. The approach is compatible with solid freeform fabrication techniques such as stereolithography, selective laser sintering, and laminated object manufacturing. Heat is extracted rapidly, in-flight, by convection as the spray jet entrains cool inert gas to produce undercooled and semi-solid droplets. At the pattern, the droplets weld together while replicating the shape and surface features of the pattern. Tool formation is rapid; deposition rates in excess of 1 ton/h have been demonstrated for bench-scale nozzles.

  1. Birth preparedness and complication readiness among the women beneficiaries of selected rural primary health centers of Dakshina Kannada district, Karnataka, India.

    Directory of Open Access Journals (Sweden)

    Kibballi Madhukeshwar Akshaya

    Full Text Available Birth preparedness and complication readiness (BPCR is a strategy to promote timely use of skilled maternal and neonatal care during childbirth. According to World Health Organization, BPCR should be a key component of focused antenatal care. Dakshina Kannada, a coastal district of Karnataka state, is categorized as a high-performing district (institutional delivery rate >25% under the National Rural Health Mission. However, a substantial proportion of women in the district experience complications during pregnancy (58.3%, childbirth (45.7%, and postnatal (17.4% period. There is a paucity of data on BPCR practice and the factors associated with it in the district. Exploring this would be of great use in the evidence-based fine-tuning of ongoing maternal and child health interventions.To assess BPCR practice and the factors associated with it among the beneficiaries of two rural Primary Health Centers (PHCs of Dakshina Kannada district, Karnataka, India.A facility-based cross-sectional study was conducted among 217 pregnant (>28 weeks of gestation and recently delivered (in the last 6 months women in two randomly selected PHCs from June -September 2013. Exit interviews were conducted using a pre-designed semi-structured interview schedule. Information regarding socio-demographic profile, obstetric variables, and knowledge of key danger signs was collected. BPCR included information on five key components: identified the place of delivery, saved money to pay for expenses, mode of transport identified, identified a birth companion, and arranged a blood donor if the need arises. In this study, a woman who recalled at least two key danger signs in each of the three phases, i.e., pregnancy, childbirth, and postpartum (total six was considered as knowledgeable on key danger signs. Optimal BPCR practice was defined as following at least three out of five key components of BPCR.Proportion, Odds ratio, and adjusted Odds ratio (adj OR for optimal BPCR

  2. Birth preparedness and complication readiness among the women beneficiaries of selected rural primary health centers of Dakshina Kannada district, Karnataka, India.

    Science.gov (United States)

    Akshaya, Kibballi Madhukeshwar; Shivalli, Siddharudha

    2017-01-01

    Birth preparedness and complication readiness (BPCR) is a strategy to promote timely use of skilled maternal and neonatal care during childbirth. According to World Health Organization, BPCR should be a key component of focused antenatal care. Dakshina Kannada, a coastal district of Karnataka state, is categorized as a high-performing district (institutional delivery rate >25%) under the National Rural Health Mission. However, a substantial proportion of women in the district experience complications during pregnancy (58.3%), childbirth (45.7%), and postnatal (17.4%) period. There is a paucity of data on BPCR practice and the factors associated with it in the district. Exploring this would be of great use in the evidence-based fine-tuning of ongoing maternal and child health interventions. To assess BPCR practice and the factors associated with it among the beneficiaries of two rural Primary Health Centers (PHCs) of Dakshina Kannada district, Karnataka, India. A facility-based cross-sectional study was conducted among 217 pregnant (>28 weeks of gestation) and recently delivered (in the last 6 months) women in two randomly selected PHCs from June -September 2013. Exit interviews were conducted using a pre-designed semi-structured interview schedule. Information regarding socio-demographic profile, obstetric variables, and knowledge of key danger signs was collected. BPCR included information on five key components: identified the place of delivery, saved money to pay for expenses, mode of transport identified, identified a birth companion, and arranged a blood donor if the need arises. In this study, a woman who recalled at least two key danger signs in each of the three phases, i.e., pregnancy, childbirth, and postpartum (total six) was considered as knowledgeable on key danger signs. Optimal BPCR practice was defined as following at least three out of five key components of BPCR. Proportion, Odds ratio, and adjusted Odds ratio (adj OR) for optimal BPCR practice. A

  3. Adapting participatory design to design information system with rural Ethiopian community

    DEFF Research Database (Denmark)

    Zewge, Amanuel; Dittrich, Yvonne; Bekele, Rahel

    2015-01-01

    Most of the Information and Communication Technology for Development initiatives introduced to communities in developing countries fails to deliver its promises due to the lack of intended beneficiary involvement. Participatory Design assumes to be effective as long as its nature of participations...... and methods are contextualized to a given settings. To this end, we discuss the implication of considering local (rural community) culture of participation practices, and propose a procedure to be followed in the early phases of information system development process. Finally we argue that, such adaption...... could advance the Participatory Action Research methodology....

  4. Helping Hand: The Salin Kaalaman Tungo sa Kaunlaran Extension Program of Polytechnic University of the Philippines Among the Beneficiaries of the Pilot Centers in Sta. Mesa, Manila, Philippines

    Directory of Open Access Journals (Sweden)

    Junnette B. Hasco

    2016-11-01

    Full Text Available One of the four-fold functions of State Universities and Colleges in accordance by their mandates was to provide assistance to communities; this was achieved thru conducting different skills and development trainings in partnership with Local Government Units (LGU’s. This study was conducted to assess the current Extension program of the Polytechnic University of the Philippines (PUP. Some 74 beneficiaries from the 23 centers of Sta. Mesa, Manila were identified through the use of purposive sampling. The data gathering made use of aided surveys. Weighted Mean and Pearson Product Moment of Correlation was used to treat and process statistical data. Findings revealed that the Extension Services conducted by the PUP Salin Kaalaman Tungo sa Kaunlaran Extension Program (SALIN were highly effective regarding Information Dissemination, Staff and Officials, Trainings and Programs, Trainers and Speakers, Programs, Accommodation and Venue and the personal impact of the Extension Program to the Beneficiaries. Satisfaction rating on the extension program was also high. Further, this study found out that as respondents are satisfied with the implementation of SALIN, the greater the chance of positive assessment on the effectiveness of the project. The study also disclosed problems and recommendations identified by the respondents. In addressing the research gaps, this study further identified recommendations to enhance capabilities of program implementers such as better execution in the delivery of extension services, fund sourcing and forging linkages or networking.

  5. Transurethral resection of the prostate among Medicare beneficiaries in the United States: time trends and outcomes. Prostate Patient Outcomes Research Team (PORT).

    Science.gov (United States)

    Lu-Yao, G L; Barry, M J; Chang, C H; Wasson, J H; Wennberg, J E

    1994-11-01

    The purpose of this study was to examine the epidemiology of transurethral resection of the prostate (TURP) and associated risks among Medicare beneficiaries during the period of 1984 to 1990. Medicare hospital claims for a 20% national sample of Medicare beneficiaries were used to identify TURPs performed during the study period. All reported rates were adjusted to the composition of the 1990 Medicare population. Risks of mortality and reoperation were evaluated using life-table methods. The age-adjusted rate of TURP reached a peak in 1987 and declined thereafter. Similar trends were observed for all age groups. In 1990, the rates of TURP (including all indications) were approximately 25, 19, and 13 per 1000 for men over the age of 75, 70 to 74, and 65 to 69, respectively. The 30-day mortality following TURP for the treatment of benign prostatic hyperplasia (BPH) decreased from 1.20% in 1984 to 0.77% in 1990 (linear trend, p = 0.0001). The cumulative incidence of a second TURP among men with BPH has likewise decreased steadily over time; in this study, the average was 7.2% over 7 years (5.5% when the indication for the second TURP was restricted to BPH only). The rate of TURP has been declining since 1987, conceivably due to increasing availability of alternative treatments or changes in treatment preferences of patients and physicians. Over the same period, the outcomes following TURPs have improved, perhaps due to improved surgical care and changes in patient selection.

  6. Repository design

    Energy Technology Data Exchange (ETDEWEB)

    John, C M

    1982-01-01

    Various technical issues of radioactive waste design are addressed in this paper. Two approaches to repository design considered herein are: (1) design to minimize the disturbance of the hot rock; and (2) designs that intentionally modify the hot rock to insure better containment of the wastes. The latter designs range from construction of a highly impermeable barrier around a spherical cavern to creating a matrix of tunnels and boreholes to form a cage within which the hydraulic pressure is nearly constant. Examples of these design alternatives are described in some detail. It is concluded that proposed designs for repositories illustrate that performance criteria considered acceptable for such facilities can be met by appropriate site selection and repository engineering. With these technically feasible design concepts, it is also felt that socioeconomic and institutional issues can be better resolved. (BLM)

  7. The Textile Form of Sound

    DEFF Research Database (Denmark)

    Bendixen, Cecilie

    Sound is a part of architecture, and sound is complex. Upon this, sound is invisible. How is it then possible to design visual objects that interact with the sound? This paper addresses the problem of how to get access to the complexity of sound and how to make textile material revealing the form...... goemetry by analysing the sound pattern at a specific spot. This analysis is done theoretically with algorithmic systems and practical with waves in water. The paper describes the experiments and the findings, and explains how an analysis of sound can be catched in a textile form....

  8. Against Logical Form

    Directory of Open Access Journals (Sweden)

    P N Johnson-Laird

    2010-10-01

    Full Text Available An old view in logic going back to Aristotle is that an inference is valid in virtue of its logical form. Many psychologists have adopted the same point of view about human reasoning: the first step is to recover the logical form of an inference, and the second step is to apply rules of inference that match these forms in order to prove that the conclusion follows from the premises. The present paper argues against this idea. The logical form of an inference transcends the grammatical forms of the sentences used to express it, because logical form also depends on context. Context is not readily expressed in additional premises. And the recovery of logical form leads ineluctably to the need for infinitely many axioms to capture the logical properties of relations. An alternative theory is that reasoning depends on mental models, and this theory obviates the need to recover logical form.

  9. Forms of Arthritis

    Science.gov (United States)

    ... this page please turn Javascript on. Forms of Arthritis Past Issues / Fall 2006 Table of Contents Today, ... of Linda Saisselin Osteoarthritis (OA) — the form of arthritis typically occurring during middle or old age, this ...

  10. Forms Management Policy

    Science.gov (United States)

    To establish EPA’s Forms Management Program; to describe the requisite roles, responsibilities, and procedures necessary for the successful management of EPA forms; and to more clearly fulfill EPA’s obligations in this regard.

  11. FORMS OF YOUTH TRAVEL

    OpenAIRE

    Moisã Claudia Olimpia; Moisã Claudia Olimpia

    2011-01-01

    Taking into account the suite of motivation that youth has when practicing tourism, it can be said that the youth travel takes highly diverse forms. These forms are educational tourism, volunteer programs and “work and travel”, cultural exchanges or sports tourism and adventure travel. In this article, we identified and analyzed in detail the main forms of youth travel both internationally and in Romania. We also illustrated for each form of tourism the specific tourism products targeting you...

  12. Design Research as Conceptual Designing

    DEFF Research Database (Denmark)

    Ylirisku, Salu; Jacucci, Giulio; Sellen, Abigail

    2015-01-01

    define conceptual designing as a constructive framing and re-framing activity, which is mediated by and targeted at the creation of new design concepts. Conceptual designing as an approach is valuable for addressing the fuzziness and ambiguity typical of research that explores novel areas with new...... partners, methods and resources. It is by no means a new phenomenon, and the main contribution of the article is the clarification of conceptual designing as a particular approach to designing and researching. The approach embraces openness, resource-construction and collaboration. We conclude...... that conceptual designing can be especially useful in research and design projects that bring different kinds of people, organizations, technologies and domains together into the forming of new well-founded proposals for development. The presentation of conceptual designing in this paper is written...

  13. Unified form language

    DEFF Research Database (Denmark)

    Alnæs, Martin S.; Logg, Anders; Ølgaard, Kristian Breum

    2014-01-01

    We present the Unied Form Language (UFL), which is a domain-specic language for representing weak formulations of partial dierential equations with a view to numerical approximation. Features of UFL include support for variational forms and functionals, automatic dierentiation of forms and expres...... libraries to generate concrete low-level implementations. Some application examples are presented and libraries that support UFL are highlighted....

  14. Method for forming ammonia

    Science.gov (United States)

    Kong, Peter C.; Pink, Robert J.; Zuck, Larry D.

    2008-08-19

    A method for forming ammonia is disclosed and which includes the steps of forming a plasma; providing a source of metal particles, and supplying the metal particles to the plasma to form metal nitride particles; and providing a substance, and reacting the metal nitride particles with the substance to produce ammonia, and an oxide byproduct.

  15. Mesonic Form Factors

    Energy Technology Data Exchange (ETDEWEB)

    Frederic D. R. Bonnet; Robert G. Edwards; George T. Fleming; Randal Lewis; David Richards

    2003-07-22

    We have started a program to compute the electromagnetic form factors of mesons. We discuss the techniques used to compute the pion form factor and present preliminary results computed with domain wall valence fermions on MILC asqtad lattices, as well as Wilson fermions on quenched lattices. These methods can easily be extended to rho-to-gamma-pi transition form factors.

  16. Conditions of contract for construction for building and engineering works designed by the employer : general conditions : guidance for the preparation of particular conditions forms of letter of tender, contract agreement and dispute adjudication agreement

    CERN Document Server

    1999-01-01

    Conditions of Contract for Construction, which are recommended for building or engineering works designed by the Employer or by his representative, the Engineer. Under the usual arrangements for this type of contract, the Contractor constructs the works in accordance with a design provided by the Employer. However, the works may include some elements of Contractor-designed civil, mechanical, electrical and/or construction works.

  17. 13 CFR 120.194 - Use of computer forms.

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Use of computer forms. 120.194... Applying to All Business Loans Computerized Sba Forms § 120.194 Use of computer forms. Any Applicant or Participant may use computer generated SBA application forms, closing forms, and other forms designated by SBA...

  18. Academic Medical Centers Forming Accountable Care Organizations and Partnering With Community Providers: The Experience of the Johns Hopkins Medicine Alliance for Patients.

    Science.gov (United States)

    Berkowitz, Scott A; Ishii, Lisa; Schulz, John; Poffenroth, Matt

    2016-03-01

    Academic medical centers (AMCs)--which include teaching hospital(s) and additional care delivery entities--that form accountable care organizations (ACOs) must decide whether to partner with other provider entities, such as community practices. Indeed, 67% (33/49) of AMC ACOs through the Medicare Shared Savings Program through 2014 are believed to include an outside community practice. There are opportunities for both the AMC and the community partners in pursuing such relationships, including possible alignment around shared goals and adding ACO beneficiaries. To create the Johns Hopkins Medicine Alliance for Patients (JMAP), in January 2014, Johns Hopkins Medicine chose to partner with two community primary care groups and one cardiology practice to support clinical integration while adding approximately 60 providers and 5,000 Medicare beneficiaries. The principal initial interventions within JMAP included care coordination for high-risk beneficiaries and later, in 2014, generating dashboards of ACO quality measures to facilitate quality improvement and early efforts at incorporating clinical pathways and Choosing Wisely recommendations. Additional interventions began in 2015.The principal initial challenges JMAP faced were data integration, generation of quality measure reports among disparate electronic medical records, receiving and then analyzing claims data, and seeking to achieve provider engagement; all these affected timely deployment of the early interventions. JMAP also created three regional advisory councils as a forum promoting engagement of local leadership. Network strategies among AMCs, including adding community practices in a nonemployment model, will continue to require thoughtful strategic planning and a keen understanding of local context.

  19. Bridging the Gap: Collaboration between a School of Pharmacy, Public Health, and Governmental Organizations to provide Clinical and Economic Services to Medicare Beneficiaries

    Directory of Open Access Journals (Sweden)

    Rajul Patel

    2018-01-01

    Full Text Available Objective: Promoting healthy communities through the provision of accessible quality healthcare services is a common mission shared by schools of pharmacy, public health departments, and governmental agencies. The following study seeks to identify and detail the benefits of collaboration between these different groups. Methods: In total, 112 mobile clinics targeting Medicare beneficiaries were held in 20 cities across Northern/Central California from 2007 to 2016. Under the supervision of licensed pharmacists, trained student pharmacists provided vaccinations, health screenings, Medicare Part D plan optimization services, and Medication Therapy Management (MTM to patients at each clinic site. Clinic support was extended by public health departments, governmental agency partners, and a health professional program. Results: Since clinic inception, 8,996 patients were provided services. In total, 19,441 health screenings and 3,643 vaccinations were collectively provided to clinic patients. We assisted 5,549 beneficiaries with their Part D benefit, resulting in an estimated aggregate out-of-pocket drug cost savings of $5.7 million. Comprehensive MTM services were provided to 4,717 patients during which 8,184 medication-related problem (MRP were identified. In 15.3% of patients, the MRP was determined severe enough to warrant prescriber follow-up. In total, 42.9% of clinic patients were from racial/ethnic minority groups and 25.5% had incomes ≤150% of the Federal Poverty Level. Conclusion: Collaboration between a school of pharmacy, public health departments, and governmental organizations can effectively serve Medicare beneficiary populations and result in: 1 lower out-of-pocket drug costs, 2 minimization of medication-related problems, 3 increased vaccination uptake, and 4 increased utilization of health screenings. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate

  20. Forms of Life, Forms of Reality

    Directory of Open Access Journals (Sweden)

    Piergiorgio Donatelli

    2015-10-01

    Full Text Available The article explores aspects of the notion of forms of life in the Wittgensteinian tradition especially following Iris Murdoch’s lead. On the one hand, the notion signals the hardness and inexhaustible character of reality, as the background needed in order to make sense of our lives in various ways. On the other, the hardness of reality is the object of a moral work of apprehension and deepening to the point at which its distinctive character dissolves into the family of connections we have gained for ourselves. The two movements of thought are connected and necessary.