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...

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

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.

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. ...

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.

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 ...

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.

Chronic Conditions among Medicare Beneficiaries

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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...

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

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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.

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...

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: ...

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

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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.

Flu shots and the characteristics of unvaccinated elderly Medicare beneficiaries.

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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

National Beneficiary Survey (NBS) Round 3

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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...

National Beneficiary Survey (NBS) Round 4

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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...

National Beneficiary Survey (NBS) Round 2

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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...

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...

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...

The Expanded Public Works Programme: Perspectives of direct beneficiaries

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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.

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,...

Analysis of Satisfaction Degree of the Public Insurance System Beneficiaries

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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.

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.

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...

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

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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.

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

OASDI Beneficiaries by State and County, 2011

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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...

OASDI Beneficiaries by State and County, 2010

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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...

OASDI Beneficiaries by State and County, 2014

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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...

OASDI Beneficiaries by State and County, 2003

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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...

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...

OASDI Beneficiaries by State and County, 2009

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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...

OASDI Beneficiaries by State and County, 1999

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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...

OASDI Beneficiaries by State and County, 2013

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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...

OASDI Beneficiaries by State and County, 2000

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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...

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...

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...

OASDI Beneficiaries by State and County, 2007

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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...

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...

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...

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...

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...

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...

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

OASDI Beneficiaries and Benefits by State, 2014

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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...

OASDI Beneficiaries and Benefits by State- 2015

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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...

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

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.

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...

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

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,...

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...

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

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...

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

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.

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 ...

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

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

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.

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.

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.

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?

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.

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...

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...

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...

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.

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.

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.

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.

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.

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).

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

[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.

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.

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...

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.

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.

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...

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...

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...

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....

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…

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...

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%)...

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

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.

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

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...

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.

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.

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

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.

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...

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…

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.

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

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

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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.

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...

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...

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...

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.

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”.

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.

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...

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...

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...

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...

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…

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] ...

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.

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

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.

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

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.

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...

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.

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...

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

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.

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.

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...

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...

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.

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...

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

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.

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.

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

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.

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.

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...

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...

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…

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

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.

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.

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.

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…

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.

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...

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...

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...

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.

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…

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...

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...

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...

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...

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

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

"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.

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...

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...

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...

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...

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.

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...

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)

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.

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...

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.

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...

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

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.

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.

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

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 ...

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.

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

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…

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.

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...

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...

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...

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...

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...

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

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...

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....

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

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

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...

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.

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.

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...

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.

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...

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...

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…

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

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.

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.

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.

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.

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.

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

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

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

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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

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

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

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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.

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

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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

A Mirage or a Rural Life Line? Analysing the impact of Mahatma Gandhi Rural Employment Guarantee Act on Women Beneficiaries of Assam

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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.

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

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.

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.

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.

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...

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....

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.

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.

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 ...

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.

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.

[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.

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

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.

Comparative Evaluation of Cash Benefit Scheme of Janani Suraksha Yojana for Beneficiary Mothers from Different Health Care Settings of Rewa District, Madhya Pradesh, India.

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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

Self-reported colorectal cancer screening of Medicare beneficiaries in family medicine vs. internal medicine practices in the United States: a cross-sectional study

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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.

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.

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.

[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. 
.

Group life insurance

CERN Multimedia

2013-01-01

The CERN Administration wishes to inform staff members and fellows having taken out optional life insurance under the group contract signed by CERN that the following changes to the rules and regulations entered into force on 1 January 2013:   The maximum age for an active member has been extended from 65 to 67 years. The beneficiary clause now allows insured persons to designate one or more persons of their choice to be their beneficiary(-ies), either at the time of taking out the insurance or at a later date, in which case the membership/modification form must be updated accordingly. Beneficiaries must be clearly identified (name, first name, date of birth, address).   The membership/modification form is available on the FP website: http://fp.web.cern.ch/helvetia-life-insurance For further information, please contact: Valentina Clavel (Tel. 73904) Peggy Pithioud (Tel. 72736)

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.

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

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.

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...

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.

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.

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

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.

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...

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

Customers, clients or co-designers

DEFF Research Database (Denmark)

Plant, Peter

2007-01-01

The primary beneficiaries of career guidance are the direct users. At which level should they be involved? This article points to levels of involvement that go beyond satisfaction surveys and into democratisation.......The primary beneficiaries of career guidance are the direct users. At which level should they be involved? This article points to levels of involvement that go beyond satisfaction surveys and into democratisation....

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...

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.

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.

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...

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

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.

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.

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...

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

Implementation of Structural Health Monitoring for the USMC CH-53E

Science.gov (United States)

2010-01-01

assembly, main rotor hub upper plate assembly, main rotor blade extender, main gear box housing, main gearbox shaft , and the main rotor spindle ...spectrum. The objective is to determine if an aircraft is flown more or less severely than designed , and to provide benefit in the form of either...aircraft is flown more or less severely than designed , and to provide benefit in the form of either safety or economy. Although most of the beneficiaries

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.

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...

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

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.

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.

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.

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.

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.

78 FR 22935 - Agency Information Collection Activities; Proposed Request and Comment Request

Science.gov (United States)

2013-04-17

...: (1) An initial intake interview (documented on a demonstration enrollment form), and (2) a consent... only fill this form out 1 time. Consent Form 8,000 Subjects will 8,000 2 266 only fill this form out 1... Form SSA-322, the Beneficiary Interview and Auditor's Observation form, to interview beneficiaries or...

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

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.

31 CFR 346.2 - Registration.

Science.gov (United States)

2010-07-01

..., DEPARTMENT OF THE TREASURY BUREAU OF THE PUBLIC DEBT REGULATIONS GOVERNING UNITED STATES INDIVIDUAL... ownership or beneficiary form. A bond registered in the beneficiary form will be inscribed substantially as...

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.

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

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.

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.

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.

Variación del estado nutricional durante el tratamiento antituberculoso en beneficiarios del programa PANTBC Change in nutritional status over the course of antituberculosis treatment in current and past beneficiaries of the program PANTBC

Directory of Open Access Journals (Sweden)

Juan Pablo Aparco

2012-09-01

Full Text Available Objetivos. Analizar la variación nutricional de los beneficiarios actuales y pasados del Programa de Alimentación y Nutrición al Paciente Ambulatorio con Tuberculosis y Familia (PANTBC. Materiales y métodos. Se realizó un análi-sis secundario a partir de la valoración antropométrica por medio del índice de masa corporal (IMC en beneficiarios actuales y pasados del programa PANTBC. Las mediciones se realizaron al inicio, segundo y quinto o sexto mes y se comparó la distribución del estado nutricional al inicio respecto al final (prueba de McNemar-Bowker. Resultados. Se incluyó información de 409 beneficiarios actuales y 110 beneficiarios pasados. Tanto en beneficiarios actuales como pasados se observó disminución progresiva de la condición de bajo peso (IMCObjectives. Analyze the nutritional changes among current and old beneficiaries of the Food and Nutrition Program for Outpatients with Tuberculosis and their Family (PANTBC, Spanish acronym. Materials and methods. A secondary analysis was conducted based on the anthropometric measurements with the body mass index (BMI in current and old beneficiaries of the PANTBC program. The measurements were taken at the baseline, second and fifth or sixth month, and the distribution of the nutritional status was analyzed at baseline as compared to the endpoint (McNemar-Bowker test. Results. Information about 409 current beneficiaries and 110 old beneficiaries were included. A progressive decline in low weight as well as an increase in overweight were observed in both current and old beneficiaries (IMC<18.5. The results of the third measurement showed that 57.7% of current beneficiaries who started with low weight ended up with normal weight, while 20.7% of those who started with normal weight ended up with overweight. The analysis of the nutritional status at baseline compared to the endpoint showed changes in distribution (p<0.05. Conclusions. Across the PANTBC program, there is a variation

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.

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.

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.

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...

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)

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.

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.

Do beneficiaries' views matter in healthcare purchasing decisions? Experiences from the Nigerian tax-funded health system and the formal sector social health insurance program of the National Health Insurance Scheme.

Science.gov (United States)

Ibe, Ogochukwu; Honda, Ayako; Etiaba, Enyi; Ezumah, Nkoli; Hanson, Kara; Onwujekwe, Obinna

2017-12-28

Purchasing is a health financing function that involves the transfer of pooled resources to providers on behalf of a covered population. Little attention has been paid to the extent to which the views of that population  are reflected in purchasing decisions. This article explores how purchasers in two financing mechanisms: the Formal Sector Social Health Insurance Programme (FSSHIP) operating under the Nigerian National Health Insurance Scheme (NHIS), and the tax-funded health system perform their roles in light of their responsibilities to the populations. A case study approach was adopted in which each financing mechanism is a case. Sixteen (16) in-depth interviews with purchasers and eight (8) focus group discussions with beneficiaries were held. Agency and organizational behavioural theories were used to characterise the purchaser-citizen relationships. A deductive framework approach was used to assess whether actions identified in a model of 'ideal' strategic purchasing actions were undertaken in each case. For both cases, mechanisms exist to reflect people's health needs in purchasing decisions, including quantitative and qualitative needs assessment, mechanisms to raise awareness of benefit entitlements and allow choice. However, purchasers do not use the mechanisms to effectively engage with and hold themselves accountable to the people. In the tax-funded system, weak information systems and unclear communication channels between the purchaser and citizens constrain assessment of needs; while timeliness of health information and poor engagement practices of Health Maintenance Organisations (HMOs) are the main constraints in FSSHIP. Inadequate information sharing in both mechanisms limits beneficiaries' awareness of entitlements. Although beneficiaries of FSSHIP can choose providers, lack of information on the quality of services offered by providers constrains rational decision-making and the inability to change HMOs reduces HMO responsiveness to

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.

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...

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.

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.

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.

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.

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.

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

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.

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.

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.

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....

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

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

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.

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.

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)

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.

5 CFR 1604.8 - Death benefits.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Death benefits. 1604.8 Section 1604.8... benefits. The account balance of a deceased service member will be paid as described at 5 CFR part 1651... benefit, a service member must file a valid beneficiary designation form. If the TSP maintains a service...

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...

78 FR 17777 - Proposed Information Collection (Application for Furnishing Long-Term Care Service to...

Science.gov (United States)

2013-03-22

... (Application for Furnishing Long- Term Care Service to Beneficiaries of Veterans Affairs, and Residential Care.... Application for Furnishing Long-Term Care Services to Beneficiaries of Veterans Affairs, VA Form 10-1170. b. Residential Care Home Program--Sponsor Application, VA Form 2407. OMB Control Number: 2900-0616. Type of...

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.

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

Designing the Cash and Counseling Demonstration and Evaluation.

Science.gov (United States)

Doty, Pamela; Mahoney, Kevin J; Simon-Rusinowitz, Lori

2007-02-01

The Cash and Counseling Demonstration and Evaluation (CCDE) was designed as an experiment in shifting the paradigm in home and community-based long-term care from a professional/bureaucratic model of service delivery to one emphasizing consumer choice and control. The experimental intervention was an individualized budget offered in lieu of traditional Medicaid-covered services, such as agency-delivered aide services or a plan of care developed and coordinated by a professional case-manager, which typically involves authorization for several different providers to deliver a range of services. Within the spending limits established by their budgets, program participants were largely free to choose the types and amounts of paid services and supports they judged best able to meet their disability-related personal assistance needs. Medicaid beneficiaries in selected states who volunteered to participate. In all of the participating state Medicaid programs, beneficiaries eligible to participate included elders and younger adults with chronic disabilities and, in one state, adults and children with mental retardation/developmental disabilities could also participate. Minor children and adults with cognitive impairment could participate via representatives (family or friends who agreed to assist them in managing their services or to act as their surrogate decision-makers). Members of the CCDE management team describe the rationale for and implications of key design decisions. Key design decisions included the choice of research methodology (random assignment of CCDE participants in each state to treatment and control groups), selection of the state sites (AR, FL, NJ, NY), and the need for the CCDE to comply with federal waiver requirements for Medicaid research and demonstration projects. Principle Findings. The CCDE design was successfully implemented in three of the four state Medicaid programs selected for participation. The successful implementation of the CCDE

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.

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

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....

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.

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

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

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

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.

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.

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.

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

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.

Health Disparities in the Relationship of Neighborhood Greenness to Mental Health Outcomes in 249,405 U.S. Medicare Beneficiaries

Directory of Open Access Journals (Sweden)

Scott C. Brown

2018-03-01

Full Text Available Prior studies suggest that exposure to the natural environment may be important for optimal mental health. The present study examines the association between block-level greenness (vegetative presence and mental health outcomes, in a population-based sample of 249,405 U.S. Medicare beneficiaries aged ≥65 years living in Miami-Dade County, Florida, USA, whose location did not change from 2010 to 2011. Multilevel analyses examined relationships between greenness, as measured by mean Normalized Difference Vegetation Index from satellite imagery at the Census block level, and each of two mental health outcomes; Alzheimer’s disease and depression, respectively, after statistically adjusting for age, gender, race/ethnicity, and neighborhood income level of the individuals. Higher block-level greenness was linked to better mental health outcomes: There was a reduced risk of Alzheimer’s disease (by 18% and depression (by 28% for beneficiaries living in blocks that were 1 SD above the mean for greenness, as compared to blocks that were 1 SD below the mean. Planned post-hoc analyses revealed that higher levels of greenness were associated with even greater mental health benefits in low-income neighborhoods: An increase in greenness from 1 SD below to 1 SD above the mean was associated with 37% lower odds of depression in low-income neighborhoods, compared to 27% and 21% lower odds of depression in medium- and high-income neighborhoods, respectively. Greenness may be effective in promoting mental health in older adults, particularly in low-income neighborhoods, possibly as a result of the increased opportunities for physical activity, social interaction, or stress mitigation.

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...

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.

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.

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.

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.''

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.

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

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

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.

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)

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...

78 FR 79723 - Agency Information Collection Activities: Proposed Request and Comment Request

Science.gov (United States)

2013-12-31

... collection techniques or other forms of information technology. Mail, email, or fax your comments and... beneficiaries must be in full-time attendance status at an educational institution. In addition, SSA requires... the changes or events the student beneficiaries report will affect their continuing entitlement to SSA...

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.

75 FR 15495 - Agency Information Collection (Application for Furnishing Long-Term Care Services to...

Science.gov (United States)

2010-03-29

... (Application for Furnishing Long- Term Care Services to Beneficiaries of Veterans Affairs, and Residential Care... Furnishing Long-Term Care Services to Beneficiaries of Veterans Affairs, VA Form 10-1170. b. Residential Care... application used by a residential care facility or home that wishes to provide residential home care to...

5 CFR 2634.401 - General considerations.

Science.gov (United States)

2010-01-01

... or control of the trust, such as investment counsel, investment advisers, accountants, or tax... and beneficiary taxes. For tax purposes, because a trust is a separate entity distinct from its beneficiaries, a trustee must file an annual fiduciary tax return for the trust (IRS Form 1041). In addition...

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...

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.

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.

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....

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...

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)

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

International Recognition of FormAkademisk

Directory of Open Access Journals (Sweden)

Janne Beate Reitan

2017-12-01

Full Text Available FormAkademisk was invited to the Design Journal Editors' Meeting at the College of Design, Architecture, Art, and Planning (DAAP, University of Cincinnati in late October, as the only design research journal from the Nordic region. The meeting was organized in advance of the International Association of Societies of Design Research (IASDR 2017 conference.Liv Merete Nielsen, who initiated the creation of  FormAkademisk and has been a Section Editor since the start-up and I, who have been the Editor-in-Chief for the entire period, travelled to the meeting.FormAkademisk   was in good company - among the others invited, we can mention the American Design Issues and the British Design Studies, both of which are at Level 2 of the Norwegian Science Index - NVI. Other reputable journals invited were the International Journal of Design from Taiwan, She Ji - The Journal of Design, Economics, and Innovation from Tongji University in Shanghai, China, Design and Culture from the United States, Co-Design from the United Kingdom, Information Design Journal published in the Netherlands with an international editorial board, Journal of Design, Business & Society with an international editorial board, the French Sciences du Design and Visible Language published at the University of Cincinnati, USA who hosted the meeting.First, we warmed up by describing each journal's editorial profile. For FormAkademisk we emphasized that we have two equal focuses – research in design, but also research in design education for the general public. This combination seems to be unique internationally.Common issues we discussed further were challenges with the quality of submitted articles and obtaining qualified peer reviewers. We also discussed whether we would agree on a common understanding of what it means to be included as an author of an article. Based on the discussions, FormAkademisk comes well prepared compared to the other internationally leading design research

Usability of Public Administration Electronic Forms

Directory of Open Access Journals (Sweden)

Miloslav Hub

2015-06-01

Full Text Available This paper is focused on the testing and evaluating of public administration electronic forms from the usability point of view. Its objective is to design a suitable methodology for usability testing of electronic forms and their description and distribution to public administration information systems professionals. Firstly, methods of usability engineering are summarized and a suitable method for usability testing and evaluation of electronic forms is selected. Farther, the methodology of electronic forms usability testing that uses the selected method is suggested. In the last part of the paper the case study that uses the proposed methodology is suggested and performed. The main benefit of the work is the design of testing methodology and proposition of the set of recommendations for new public administration electronic forms design.

31 CFR 360.26 - Application for relief; after receipt of bond.

Science.gov (United States)

2010-07-01

... coowners, if living) authorized under the regulations in this part to request payment of the bond. In addition: (1) If the bond is in beneficiary form and the owner and beneficiary are both living, the... the application is approved, relief will be granted either by the issuance of a bond bearing the same...

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...

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

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...

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...

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.

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.

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...

19 CFR 10.232 - Definitions.

Science.gov (United States)

2010-04-01

... the CBERA which the President also has designated as a beneficiary country for purposes of... by the President or his designee, published in the Federal Register, that the beneficiary country has... entered into by the United States, Canada, and Mexico on December 17, 1992. Preferential tariff treatment...

APPLICATION OF THE GAP TECHNIQUE IN MEASURING SERVICE QUALITY IN EGYPTIAN FEDERATION KARATE

Directory of Open Access Journals (Sweden)

Khalil Samira

2010-08-01

Full Text Available This study aims to measure the gap between the administration and the beneficiaries of the quality of the service in the federation and sport regions of Karate. The sample of this study was chosen randomly between the members of the board of directors of the Federation and regions, the coaches , referees and players registered in theEgyptian Federation of Karate whose numbers are (149. The sample of the study was classified into two beneficiary classes. The first beneficiary class is coaches and referees whose number are (70 persons and their administration is the members of the board of directors of the Federation and its regions whose number are (14persons. The second class is the players whose number are (65 players and their administration is the members ofthe board of directors of the Federation and its regions the referees and coaches' number are (84 persons. This study used a questionnaire (SERVQUAL to measure the quality of the service. Results pointed to a negative gap between the expectations of the beneficiaries of the excellent service level and the perceptions of the administrations of these expectations.These results refer to the weakness of administration ability in the Egyptian Federation of Karate to know the needs and desires of beneficiaries from (coaches-referees- players of the quality level in the service provided to them. The existence of a relative gap between the perceptions of the beneficiaries of the service actually provided and the administration of the qualities of the service actually provided, therefore itrefers to the decline the motive level of the administration of Egyptian Federation of Karate to provide the service to the beneficiaries in a form that conforms with what the administration already decided for the specifications. The existence of a negative gap between the expectations of the beneficiaries of the level of theexcellent service and its perception of the actual performance of this service refers to

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

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

Analyses of Military Healthcare Benefit Design and Delivery: Study in Support of the Military Compensation and Retirement Modernization Commission

Science.gov (United States)

2015-01-01

Health Sciences , and other specialized skill training and professional development education programs; • Base Operations/Communications – DoD medical and... Actuary lowered its estimate of future per capita medical spending for dual-eligible beneficiaries (i.e., beneficiaries eligible for both TRICARE and...of the covered population into account. While advanced actuarial modeling would be required to determine each plan’s actual premiums, here we

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)

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

19 CFR 10.223 - Articles eligible for preferential treatment.

Science.gov (United States)

2010-04-01

... President or his designee has designated in the Federal Register as not available in commercial quantities... beneficiary country that the President or his designee and representatives of the CBTPA beneficiary country....61.00 of the HTSUS duty-free from Canada, Mexico or Israel. (3) Dyed, printed, or finished thread. An...

Iodine waste form summary report (FY 2007)

International Nuclear Information System (INIS)

Krumhansl, James Lee; Nenoff, Tina Maria; McMahon, Kevin A.; Gao, Huizhen; Rajan, Ashwath Natech

2007-01-01

This new program at Sandia is focused on Iodine waste form development for GNEP cycle needs. Our research has a general theme of 'Waste Forms by Design' in which we are focused on silver loaded zeolite waste forms and related metal loaded zeolites that can be validated for chosen GNEP cycle designs. With that theme, we are interested in materials flexibility for iodine feed stream and sequestration material (in a sense, the ability to develop a universal material independent on the waste stream composition). We also are designing the flexibility to work in a variety of repository or storage scenarios. This is possible by studying the structure/property relationship of existing waste forms and optimizing them to our current needs. Furthermore, by understanding the properties of the waste and the storage forms we may be able to predict their long-term behavior and stability. Finally, we are working collaboratively with the Waste Form Development Campaign to ensure materials durability and stability testing

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.

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.

Medicare capitation model, functional status, and multiple comorbidities: model accuracy

Science.gov (United States)

Noyes, Katia; Liu, Hangsheng; Temkin-Greener, Helena

2012-01-01

Objective This study examined financial implications of CMS-Hierarchical Condition Categories (HCC) risk-adjustment model on Medicare payments for individuals with comorbid chronic conditions. Study Design The study used 1992-2000 data from the Medicare Current Beneficiary Survey and corresponding Medicare claims. The pairs of comorbidities were formed based on the prior evidence about possible synergy between these conditions and activities of daily living (ADL) deficiencies and included heart disease and cancer, lung disease and cancer, stroke and hypertension, stroke and arthritis, congestive heart failure (CHF) and osteoporosis, diabetes and coronary artery disease, CHF and dementia. Methods For each beneficiary, we calculated the actual Medicare cost ratio as the ratio of the individual’s annualized costs to the mean annual Medicare cost of all people in the study. The actual Medicare cost ratios, by ADLs, were compared to the HCC ratios under the CMS-HCC payment model. Using multivariate regression models, we tested whether having the identified pairs of comorbidities affects the accuracy of CMS-HCC model predictions. Results The CMS-HCC model underpredicted Medicare capitation payments for patients with hypertension, lung disease, congestive heart failure and dementia. The difference between the actual costs and predicted payments was partially explained by beneficiary functional status and less than optimal adjustment for these chronic conditions. Conclusions Information about beneficiary functional status should be incorporated in reimbursement models since underpaying providers for caring for population with multiple comorbidities may provide severe disincentives for managed care plans to enroll such individuals and to appropriately manage their complex and costly conditions. PMID:18837646

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.

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

Design and validation of a questionnaire to examine the quality of public sport service employees of Association of Municipalities in Extremadura

Directory of Open Access Journals (Sweden)

Alberto Blázquez Manzano

2011-11-01

Full Text Available Abstract This article describes the design and validation of a specific questionnaire to know the views of managers and sports facilitators on the elements and purposes should focus quality activities of associations of municipalities in Extremadura in the area of ​ ​dynamic sports and the degree of usefulness, and difficulty beneficiaries in the development and implementation of service charters in place. The results showed an adaptation of the content and wording of questions and items as appropriate in both the average (> .81 and the value of V Aiken (> .88.

Design and analysis of ultrasonic monaural audio guiding device for the visually impaired.

Science.gov (United States)

Kim, Keonwook; Kim, Hyunjai; Yun, Gihun; Kim, Myungsoo

2009-01-01

The novel Audio Guiding Device (AGD) based on the ultrasonic, which is named as SonicID, has been developed in order to localize point of interest for the visually impaired. The SonicID requires the infrastructure of the transmitters for broadcasting the location information over the ultrasonic carrier. The user with ultrasonic headset receives the information with variable amplitude upon the location and direction of the user due to the ultrasonic characteristic and modulation method. This paper proposes the monaural headset form factor of the SonicID which improves the daily life of the beneficiary compare to the previous version which uses the both ears. Experimental results from SonicID, Bluetooth, and audible sound show that the SonicID demonstrates comparable localization performance to the audible sound with silence to others.

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.

26 CFR 1.665(a)-0 - Excess distributions by trusts; scope of subpart D.

Science.gov (United States)

2010-04-01

.... person, the resulting tax is computed under the provisions of section 669. To prevent double taxation... Internal Revenue Code, in the case of trusts other than foreign trusts created by U.S. persons, is designed generally to prevent a shift of tax burden to a trust from a beneficiary or beneficiaries. In the case of a...

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...

[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.

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.

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

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.

A benefit/risk approach towards selecting appropriate pharmaceutical dosage forms - an application for paediatric dosage form selection.

Science.gov (United States)

Sam, Tom; Ernest, Terry B; Walsh, Jennifer; Williams, Julie L

2012-10-05

The design and selection of new pharmaceutical dosage forms involves the careful consideration and balancing of a quality target product profile against technical challenges and development feasibility. Paediatric dosage forms present particular complexity due to the diverse patient population, patient compliance challenges and safety considerations of this vulnerable population. This paper presents a structured framework for assessing the comparative benefits and risks of different pharmaceutical design options against pre-determined criteria relating to (1) efficacy, (2) safety and (3) patient access. This benefit/risk framework has then been applied to three hypothetical, but realistic, scenarios for paediatric dosage forms in order to explore its utility in guiding dosage form design and formulation selection. The approach allows a rigorous, systematic and qualitative assessment of the merits and disadvantages of each dosage form option and helps identify mitigating strategies to modify risk. The application of a weighting and scoring system to the criteria depending on the specific case could further refine the analysis and aid decision-making. In this paper, one case study is scored for illustrative purposes. However, it is acknowledged that in real development scenarios, the generation of actual data considering the very specific situation for the patient/product/developer would come into play to drive decisions on the most appropriate dosage form strategy. Copyright © 2012 Elsevier B.V. All rights reserved.

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

Directory of energy data collection forms. Forms in use as of October 1995

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-01-01

This is an authoritative listing of selected public use forms currently used as basic energy information gathering tools by the Department of Energy (DOE). This directory provides an overview of DOE`s energy information collection programs for decisionmakers in Government and industry. Forms designed to collect energy information and used by the Energy Information Administration (EIA) as of October 1995 are included in this directory. For each form listed in this directory, an abstract is included that describes the form`s uses, its respondents, and the data collected. For the reader`s convenience in finding specific types of collections, several indices have been provided in this directory. A listing of the forms grouped by energy source and function begins on page 26. Beginning on page 38 are the publications derived from the collections, and on page 50, are the forms linked to general respondent categories.

Protonated form: the potent form of potassium-competitive acid blockers.

Directory of Open Access Journals (Sweden)

Hua-Jun Luo

Full Text Available Potassium-competitive acid blockers (P-CABs are highly safe and active drugs targeting H+,K+-ATPase to cure acid-related gastric diseases. In this study, we for the first time investigate the interaction mechanism between the protonated form of P-CABs and human H+,K+-ATPase using homology modeling, molecular docking, molecular dynamics and binding free energy calculation methods. The results explain why P-CABs have higher activities with higher pKa values or at lower pH. With positive charge, the protonated forms of P-CABs have more competitive advantage to block potassium ion into luminal channel and to bind with H+,K+-ATPase via electrostatic interactions. The binding affinity of the protonated form is more favorable than that of the neutral P-CABs. In particular, Asp139 should be a very important binding site for the protonated form of P-CABs through hydrogen bonds and electrostatic interactions. These findings could promote the rational design of novel P-CABs.

Protonated form: the potent form of potassium-competitive acid blockers.

Science.gov (United States)

Luo, Hua-Jun; Deng, Wei-Qiao; Zou, Kun

2014-01-01

Potassium-competitive acid blockers (P-CABs) are highly safe and active drugs targeting H+,K+-ATPase to cure acid-related gastric diseases. In this study, we for the first time investigate the interaction mechanism between the protonated form of P-CABs and human H+,K+-ATPase using homology modeling, molecular docking, molecular dynamics and binding free energy calculation methods. The results explain why P-CABs have higher activities with higher pKa values or at lower pH. With positive charge, the protonated forms of P-CABs have more competitive advantage to block potassium ion into luminal channel and to bind with H+,K+-ATPase via electrostatic interactions. The binding affinity of the protonated form is more favorable than that of the neutral P-CABs. In particular, Asp139 should be a very important binding site for the protonated form of P-CABs through hydrogen bonds and electrostatic interactions. These findings could promote the rational design of novel P-CABs.

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.

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

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

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.

Development of a Prototype Model-Form Uncertainty Knowledge Base

Science.gov (United States)

Green, Lawrence L.

2016-01-01

Uncertainties are generally classified as either aleatory or epistemic. Aleatory uncertainties are those attributed to random variation, either naturally or through manufacturing processes. Epistemic uncertainties are generally attributed to a lack of knowledge. One type of epistemic uncertainty is called model-form uncertainty. The term model-form means that among the choices to be made during a design process within an analysis, there are different forms of the analysis process, which each give different results for the same configuration at the same flight conditions. Examples of model-form uncertainties include the grid density, grid type, and solver type used within a computational fluid dynamics code, or the choice of the number and type of model elements within a structures analysis. The objectives of this work are to identify and quantify a representative set of model-form uncertainties and to make this information available to designers through an interactive knowledge base (KB). The KB can then be used during probabilistic design sessions, so as to enable the possible reduction of uncertainties in the design process through resource investment. An extensive literature search has been conducted to identify and quantify typical model-form uncertainties present within aerospace design. An initial attempt has been made to assemble the results of this literature search into a searchable KB, usable in real time during probabilistic design sessions. A concept of operations and the basic structure of a model-form uncertainty KB are described. Key operations within the KB are illustrated. Current limitations in the KB, and possible workarounds are explained.

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

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...

Stability of return to work after a coordinated and tailored intervention for sickness absence compensation beneficiaries with mental health problems: results of a two-year follow-up study.

Science.gov (United States)

Martin, Marie H T; Nielsen, Maj Britt D; Pedersen, Jacob; Rugulies, Reiner

2015-01-01

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, coordinated and tailored RTW-intervention in terms of stability of RTW, cumulative sickness absence and labour market status after 2 years among sickness absence compensation beneficiaries with MHPs. In a quasi-randomised, controlled trial, we followed recipients of the intervention (n = 88) and of conventional case management (n = 80) for 2 years to compare their risk of recurrent sickness absence and unemployment after RTW, their cumulative sickness absence and their labour market status after 2 years. We found no statistically significant intervention effect in terms of the risk of recurrent sickness absence or unemployment. Intervention recipients had more cumulated sickness absence in year one (mean difference = 58 days; p sickness absence or improved labour market status after 2 years when compared to conventional case management. Evidence for effective return-to-work (RTW) interventions for people with mental health problems is limited, as most research to date has been done in the context of musculoskeletal disorders. A complex, multidisciplinary intervention, detached from the workplace, does not appear to improve the stability of RTW and may actually lead to more sickness absence days and less self-support when 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.

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.

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.

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.

Designing with precedents

NARCIS (Netherlands)

Pasman, G.

2003-01-01

Every year designers are challenged to generate new and unique product forms. Often, the design and form of previous products constitutes a basis for the generation of new ones. What role then do existing products play in the generation and development of new product forms? How can this role be

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...

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.

Rural-Urban Differences in Alzheimer's Disease and Related Disorders Diagnostic Prevalence in Kentucky and West Virginia.

Science.gov (United States)

Abner, Erin L; Jicha, Gregory A; Christian, W Jay; Schreurs, Bernard G

2016-06-01

Older adults living in rural areas may face barriers to obtaining a diagnosis of Alzheimer's disease and related disorders (ADRD). We sought to examine rural-urban differences in prevalence of ADRD among Medicare beneficiaries in Kentucky and West Virginia, 2 contiguous, geographically similar states with large rural areas and aged populations. We used Centers for Medicare and Medicaid Services Public Use Files data from 2007 to 2013 to assess prevalence of ADRD at the county level among all Medicare beneficiaries in each state. Rural-Urban Continuum Codes were used to classify counties as rural or urban. We used Poisson regression to estimate unadjusted and adjusted prevalence ratios. Primary analyses focused on 2013 data and were repeated for 2007 to 2012. This study was completely ecologic. After adjusting for state, average beneficiary age, percent of female beneficiaries, percent of beneficiaries eligible for Medicaid in each county, Central Appalachian county, percent of age-eligible residents enrolled in Medicare, and percent of residents under age 65 enrolled in Medicare in our adjusted models, we found that 2013 ADRD diagnostic prevalence was 11% lower in rural counties (95% CI: 9%-13%). Medicare beneficiaries in rural counties in Kentucky and West Virginia may be underdiagnosed with respect to ADRD. However, due to the ecologic design, and evidence of a younger, more heavily male beneficiary population in some rural areas, further studies using individual-level data are needed to confirm the results. © 2015 National Rural Health Association.

A basic form-language for shape-changing interfaces

DEFF Research Database (Denmark)

Winther, Morten Trøstrup; Vallgårda, Anna

2016-01-01

In this paper we propose a basic form language for shape- changing forms that work independently of materials and contexts of use. This form language is meant to inform design practice and therefore it is essential that it is easily graspable and available. Instead of relying on post analyses and...... of the language in three ways: through using it in practice both as generative for our designs, as means to communicate with external collaborators, and finally we demonstrate its analytical power through analyzing three shape-changing interfaces made by others....

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...

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

Specialty Payment Model Opportunities and Assessment: Gastroenterology and Cardiology Model Design Report.

Science.gov (United States)

Mulcahy, Andrew W; Chan, Chris; Hirshman, Samuel; Huckfeldt, Peter J; Kofner, Aaron; Liu, Jodi L; Lovejoy, Susan L; Popescu, Ioana; Timbie, Justin W; Hussey, Peter S

2015-07-15

Gastroenterology and cardiology services are common and costly among Medicare beneficiaries. Episode-based payment, which aims to create incentives for high-quality, low-cost care, has been identified as a promising alternative payment model. This article describes research related to the design of episode-based payment models for ambulatory gastroenterology and cardiology services for possible testing by the Center for Medicare and Medicaid Innovation at the Centers for Medicare and Medicaid Services (CMS). The authors analyzed Medicare claims data to describe the frequency and characteristics of gastroenterology and cardiology index procedures, the practices that delivered index procedures, and the patients that received index procedures. The results of these analyses can help inform CMS decisions about the definition of episodes in an episode-based payment model; payment adjustments for service setting, multiple procedures, or other factors; and eligibility for the payment model.

Design Theory Projectability

DEFF Research Database (Denmark)

Baskerville, Richard; Pries-Heje, Jan

2014-01-01

design science research is materially prescriptive, it requires a different perspective in developing the breadth of applications of design theories. In this paper we propose different concepts that embody forms of general technological knowledge The concept of projectability, developed originally......Technological knowledge has been characterized as having a scope that is specific to a particular problem. However, the information systems community is exploring forms of design science research that provide a promising avenue to technological knowledge with broader scope: design theories. Because...... as a means of distinguishing realized generalizations from unrealized generalizations, helps explain how design theories, being prescriptive, possess a different form of applicability. The concept of entrenchment describes the use of a theory in many projections. Together these concepts provide a means...

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

Exploratory Topology Modelling of Form-Active Hybrid Structures

DEFF Research Database (Denmark)

Holden Deleuran, Anders; Pauly, Mark; Tamke, Martin

2016-01-01

The development of novel form-active hybrid structures (FAHS) is impeded by a lack of modelling tools that allow for exploratory topology modelling of shaped assemblies. We present a flexible and real-time computational design modelling pipeline developed for the exploratory modelling of FAHS...... that enables designers and engineers to iteratively construct and manipulate form-active hybrid assembly topology on the fly. The pipeline implements Kangaroo2's projection-based methods for modelling hybrid structures consisting of slender beams and cable networks. A selection of design modelling sketches...

Engineering Design vs. Artistic Design: Some Educational Consequences

Science.gov (United States)

Eder, Wolfgang Ernst

2013-01-01

"Design" can be a noun, or a verb. Six paths for research into engineering design (as verb) are identified, they must be coordinated for internal consistency and plausibility. Design research tries to clarify design processes and their underlying theories--for designing in general, and for particular forms, e.g., design engineering. Theories are a…

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

The Need for Design Cases: Disseminating Design Knowledge

Directory of Open Access Journals (Sweden)

Elizabeth Boling

2010-01-01

Full Text Available This article covers the definition of a design case as a specialized and critical form of design knowledge, including discussion of similar types of scholarship that are not design cases and the characteristic ways in which design cases are used. Arguments for developing rigorous design cases are presented.

Medicare Part D-a roundtable discussion of current issues and trends.

Science.gov (United States)

Balfour, Donald C; Evans, Steven; Januska, Jeff; Lee, Helen Y; Lewis, Sonya J; Nolan, Steve R; Noga, Mark; Stemple, Charles; Thapar, Kishan

2009-01-01

Medicare Part D was introduced with a goal of providing access to prescription drug coverage for all Medicare beneficiaries. Regulatory mandates and the changing landscape of health care require continued evaluation of the state of the Part D benefit. To review the current state of plan offerings and highlight key issues regarding the administration of the Part D benefit. The Part D drug benefit continues to evolve. The benefit value appears to be diluted compared to the benefit value of large employer plans. Regulatory restrictions mandated by the Centers for Medicare and Medicaid Services (CMS) are reported to inhibit the ability of plans to create an effective, competitive drug benefit for Medicare beneficiaries. Management in this restrictive environment impedes competitive price negotiations and formulary coverage issues continue to create confusion especially for patients with chronic diseases. The doughnut hole coverage gap represents a significant cost-shifting issue for beneficiaries that may impact medication adherence and persistence. To address these and other challenges, CMS is working to improve the quality of care for Part D beneficiaries by designing and supporting demonstration projects. Although these projects are in different stages, all stakeholders are hopeful that they will lead to the development of best practices by plans to help manage their beneficiaries more efficiently. A significant number of Medicare beneficiaries are currently receiving prescription drug benefits through Part D. The true value of this benefit has been called into question as a result of plan design parameters that lead to cost-shifting, an increasing burden for enrollees. Concerns regarding the ability to provide a competitive plan given the stringent rules and regulations have been voiced by plan administrators. In an effort to drive toward evidence-based solutions, CMS is working to improve the overall quality of care through numerous demonstration projects.

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

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

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;…

Preliminary Design and Computational Fluid Dynamics Analysis of Supercritical Carbon Dioxide Turbine Blade

International Nuclear Information System (INIS)

Jeong, Wi S.; Kim, Tae W.; Suh, Kune Y.

2007-01-01

The supercritical gas turbine Brayton cycle has been adopted in the secondary loop of the Generation IV Nuclear Energy Systems, and planned to be installed in power conversion cycles of the nuclear fusion reactors as well. The supercritical carbon dioxide (SCO 2 ) is one of widely considered fluids for this concept. The potential beneficiaries include the Secure Transportable Autonomous Reactor- Liquid Metal (STAR-LM), the Korea Advanced Liquid Metal Reactor (KALIMER) and Battery Omnibus Reactor Integral System (BORIS) which is being developed at the Seoul National University. The reason for these welcomed applications is that the SCO 2 Brayton cycle can achieve higher overall energy conversion efficiency than the steam turbine Rankine cycle. Seoul National University has recently been working on the SCO 2 based Modular Optimized Brayton Integral System (MOBIS). The MOBIS design power conversion efficiency is about 45%. Gas turbine design is crucial part in achieving this high efficiency. In this paper, the preliminary analysis on first stage of gas turbine was performed using CFX as a solver

Machining and metrology systems for free-form laser printer mirrors

Indian Academy of Sciences (India)

R. Narasimhan (Krishtel eMaging) 1461 1996 Oct 15 13:05:22

optical systems were designed and manufactured for the individual laser wavelength to be ... The design objective in utilizing a free-form mirror has resulted in a corresponding ... Since mass production of these free-form mirrors is required, the ...

Transfer cask system design activities: status and plan

International Nuclear Information System (INIS)

Locke, D.; Gutierrez, C. Gonzalez; Damiani, C.; Gracia, V.; Friconneau, J.-P.; Martins, J.-P.; Blight, J.

2011-01-01

The ITER Cask and Plug Remote Handling System (CPRHS), a.k.a. Transfer Cask System, is a critical element of the ITER Remote Maintenance System (IRMS) devoted to transportation of components between the Tokamak building and Hot Cell. Due to the necessary confinement of contaminated components the CPRHS is defined as Safety Importance Class 1 (SIC-1) plus the mobile nature of the CPRHS brings with it a significant number of complex interfaces with other ITER sub-systems. With a total CPRHS fleet in excess of 20 units, including seven typologies, the management of design and procurement needs to be carefully planned and implemented to ensure compliance with ITER's requirements. Fusion for Energy (F4E) and its beneficiaries/contractors are currently working under ITER Task Agreements (ITAs) on the conceptual design of the CPRHS and, following the signing of the Procurement Arrangement (PA) in mid 2012, will take responsibility for the entire CPRHS fleet. F4E must, therefore, develop a robust strategy to meet the needs of both ITER machine assembly (for which a number of CPRHS units will be utilised) and the remote maintenance of ITER. Within this context this paper will present the status of the current CPRHS design activities, highlight some of the significant issues which will be faced during procurement and present the overall strategy which is being implemented by F4E in order to meet these challenging objectives.

Design in the planning arena : how regional designing influences strategic spatial planning

NARCIS (Netherlands)

Kempenaar, Annet

2017-01-01

Regional designing is a form of spatial design that engages with the future physical form and arrangement of regions, including its aesthetic appearances and how it can come about. As such it is closely entangled with spatial planning. This thesis studies the influence of regional designing on

Design and impact of bundled payment for detox and follow-up care.

Science.gov (United States)

Quinn, Amity E; Hodgkin, Dominic; Perloff, Jennifer N; Stewart, Maureen T; Brolin, Mary; Lane, Nancy; Horgan, Constance M

2017-11-01

Recent payment reforms promote movement from fee-for-service to alternative payment models that shift financial risk from payers to providers, incentivizing providers to manage patients' utilization. Bundled payment, an episode-based fixed payment that includes the prices of a group of services that would typically treat an episode of care, is expanding in the United States. Bundled payment has been recommended as a way to pay for comprehensive SUD treatment and has the potential to improve treatment engagement after detox, which could reduce detox readmissions, improve health outcomes, and reduce medical care costs. However, if moving to bundled payment creates large losses for some providers, it may not be sustainable. The objective of this study was to design the first bundled payment for detox and follow-up care and to estimate its impact on provider revenues. Massachusetts Medicaid beneficiaries' behavioral health, medical, and pharmacy claims from July 2010-April 2013 were used to build and test a detox bundled payment for continuously enrolled adults (N=5521). A risk adjustment model was developed using general linear modeling to predict beneficiaries' episode costs. The projected payments to each provider from the risk adjustment analysis were compared to the observed baseline costs to determine the potential impact of a detox bundled payment reform on organizational revenues. This was modeled in two ways: first assuming no change in behavior and then assuming a supply-side cost sharing behavioral response of a 10% reduction in detox readmissions and an increase of one individual counseling and one group counseling session. The mean total 90-day detox episode cost was $3743. Nearly 70% of the total mean cost consists of the index detox, psychiatric inpatient care, and short-term residential care. Risk mitigation, including risk adjustment, substantially reduced the variation of the mean episode cost. There are opportunities for organizations to gain revenue

Implementing a Generative Urban Design Model : Grammar-based design patterns for urban design

NARCIS (Netherlands)

Beirao, J.N.; Mendes, G.; Duarte, J.; Stouffs, R.M.F.

2010-01-01

This paper shows the first results of a prototype implementation of a generative urban design tool. This implementation will form part of a design support tool for a GIS based platform defined to formulate, generate and evaluate urban designs. These three goals, formulation, generation and

Adapforms: A framework for creating and validating adaptive forms

DEFF Research Database (Denmark)

Bohøj, Morten; Bouvin, Niels Olof; Gammelmark, Henrik

2011-01-01

AdapForms is a framework for adaptive forms, consisting of a form de nition 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 enables...

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.

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.

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.)

Review on Cold-Formed Steel Connections

Science.gov (United States)

Tan, Cher Siang; Mohammad, Shahrin; Md Tahir, Mahmood; Shek, Poi Ngian

2014-01-01

The concept of cold-formed light steel framing construction has been widespread after understanding its structural characteristics with massive research works over the years. Connection serves as one of the important elements for light steel framing in order to achieve its structural stability. Compared to hot-rolled steel sections, cold-formed steel connections perform dissimilarity due to the thin-walled behaviour. This paper aims to review current researches on cold-formed steel connections, particularly for screw connections, storage rack connections, welded connections, and bolted connections. The performance of these connections in the design of cold-formed steel structures is discussed. PMID:24688448

Clinical and epidemiologic characteristics of an outbreak of novel H1N1 (swine origin) influenza A virus among United States military beneficiaries.

Science.gov (United States)

Crum-Cianflone, Nancy F; Blair, Patrick J; Faix, Dennis; Arnold, John; Echols, Sara; Sherman, Sterling S; Tueller, John E; Warkentien, Tyler; Sanguineti, Gabriela; Bavaro, Mary; Hale, Braden R

2009-12-15

A novel swine-origin influenza A (H1N1) virus was identified in March 2009 and subsequently caused worldwide outbreaks. The San Diego region was an early focal point of the emerging pandemic. We describe the clinical and epidemiologic characteristics of this novel strain in a military population to assist in future outbreak prevention and control efforts. We performed an epidemiologic evaluation of novel H1N1 virus infections diagnosed in San Diego County among 96,258 local US military beneficiaries. The structured military medical system afforded the ability to obtain precise epidemiologic information on the impact on H1N1 virus infection in a population. The novel H1N1 virus was confirmed using real-time reverse transcriptase polymerase chain reaction (rRT-PCR). From 21 April through 8 May 2009, 761 patients presented with influenza-like illness and underwent rRT-PCR testing. Of these patients, 97 had confirmed novel H1N1 virus infection, with an incidence rate of 101 cases per 100,000 persons. The median age of H1N1 patients with H1N1 virus infection was 21 years (interquartile range, 15-25 years). Fever was a universal symptom in patients with H1N1 virus infection; other symptoms included cough (present in 96% of patients), myalgia or arthralgia (57%), and sore throat (51%). Sixty-eight (70%) of our patients had an identifiable epidemiologic link to another confirmed patient. The largest cluster of cases of H1N1 virus infection occurred on a Navy ship and involved 32 (8%) of 402 crew members; the secondary attack rate was 6%-14%. The rapid influenza testing that was used during this outbreak had a sensitivity of 51% and specificity of 98%, compared with rRT-PCR. Only 1 patient was hospitalized, and there were no deaths. A novel H1N1 influenza A virus caused a significant outbreak among military beneficiaries in San Diego County, including a significant cluster of cases onboard a Navy ship. The outbreak described here primarily affected adolescents and young

What Is This Thing Called "Design" in Design Research and Instructional Design

Science.gov (United States)

Cronje, Johannes

2013-01-01

This paper will consider the phenomenon of design research. It will then consider four research positions in social science research. The paper will show how the design perspectives map onto the research paradigms and how by rotating through these paradigms, a design research cycle is formed. Finally, the paper will discuss four research questions…

75 FR 30062 - Submission for OMB Review: Comment Request

Science.gov (United States)

2010-05-28

... collection techniques or other forms of information technology, e.g., permitting electronic submission of...-0017. Agency Form Numbers: CA-40; CA-41; and CA-42. Affected Public: Individuals or Households and... eligible beneficiaries of federal employees and Non-Appropriated Fund Instrumentality employees who die...

Future product design

DEFF Research Database (Denmark)

Andreasen, Mogens Myrup

1997-01-01

This paper (in form of overheads) formulate new challenges and possibilities for engineering design, utilizing rationalization effect from modularisation, re-use and transparaency.......This paper (in form of overheads) formulate new challenges and possibilities for engineering design, utilizing rationalization effect from modularisation, re-use and transparaency....

Impact of National Ambient Air Quality Standards Nonattainment Designations on Particulate Pollution and Health.

Science.gov (United States)

Zigler, Corwin M; Choirat, Christine; Dominici, Francesca

2018-03-01

Despite dramatic air quality improvement in the United States over the past decades, recent years have brought renewed scrutiny and uncertainty surrounding the effectiveness of specific regulatory programs for continuing to improve air quality and public health outcomes. We employ causal inference methods and a spatial hierarchical regression model to characterize the extent to which a designation of "nonattainment" with the 1997 National Ambient Air Quality Standard for ambient fine particulate matter (PM2.5) in 2005 causally affected ambient PM2.5 and health outcomes among over 10 million Medicare beneficiaries in the Eastern United States in 2009-2012. We found that, on average across all retained study locations, reductions in ambient PM2.5 and Medicare health outcomes could not be conclusively attributed to the nonattainment designations against the backdrop of other regional strategies that impacted the entire Eastern United States. A more targeted principal stratification analysis indicates substantial health impacts of the nonattainment designations among the subset of areas where the designations are estimated to have actually reduced ambient PM2.5 beyond levels achieved by regional measures, with noteworthy reductions in all-cause mortality, chronic obstructive pulmonary disorder, heart failure, ischemic heart disease, and respiratory tract infections. These findings provide targeted evidence of the effectiveness of local control measures after nonattainment designations for the 1997 PM2.5 air quality standard.

Combined Waste Form Cost Trade Study

International Nuclear Information System (INIS)

Gombert, Dirk; Piet, Steve; Trickel, Timothy; Carter, Joe; Vienna, John; Ebert, Bill; Matthern, Gretchen

2008-01-01

A new generation of aqueous nuclear fuel reprocessing, now in development under the auspices of the DOE Office of Nuclear Energy (NE), separates fuel into several fractions, thereby partitioning the wastes into groups of common chemistry. This technology advance enables development of waste management strategies that were not conceivable with simple PUREX reprocessing. Conventional wisdom suggests minimizing high level waste (HLW) volume is desirable, but logical extrapolation of this concept suggests that at some point the cost of reducing volume further will reach a point of diminishing return and may cease to be cost-effective. This report summarizes an evaluation considering three groupings of wastes in terms of cost-benefit for the reprocessing system. Internationally, the typical waste form for HLW from the PUREX process is borosilicate glass containing waste elements as oxides. Unfortunately several fission products (primarily Mo and the noble metals Ru, Rh, Pd) have limited solubility in glass, yielding relatively low waste loading, producing more glass, and greater disposal costs. Advanced separations allow matching the waste form to waste stream chemistry, allowing the disposal system to achieve more optimum waste loading with improved performance. Metals can be segregated from oxides and each can be stabilized in forms to minimize the HLW volume for repository disposal. Thus, a more efficient waste management system making the most effective use of advanced waste forms and disposal design for each waste is enabled by advanced separations and how the waste streams are combined. This trade-study was designed to juxtapose a combined waste form baseline waste treatment scheme with two options and to evaluate the cost-benefit using available data from the conceptual design studies supported by DOE-NE

Drug plan design incentives among Medicare prescription drug plans.

Science.gov (United States)

Huskamp, Haiden A; Keating, Nancy L; Dalton, Jesse B; Chernew, Michael E; Newhouse, Joseph P

2014-07-01

Medicare Advantage prescription drug plans (MA-PDs) and standalone prescription drug plans (PDPs) face different incentives for plan design resulting from the scope of covered benefits (only outpatient drugs for PDPs versus all drug and nondrug services for Medicare Advantage [MA]/MA-PDs). The objective is to begin to explore how MA-PDs and PDPs may be responding to their different incentives related to benefit design. We compared 2012 PDP and MA-PD average formulary coverage, prior authorization (PA) or step therapy use, and copayment requirements for drugs in 6 classes used commonly among Medicare beneficiaries. We primarily used 2012 Prescription Drug Plan Formulary and Pharmacy Network Files and MA enrollment data. 2011 Truven Health MarketScan claims were used to estimate drug prices and to compute drug market share. Average coverage and PA/step rates, and average copayment requirements, were weighted by plan enrollment and drug market share. MA-PDs are generally more likely to cover and less likely to require PA/step for brand name drugs with generic alternatives than PDPs, and MA-PDs often have lower copayment requirements for these drugs. For brands without generics, we generally found no differences in average rates of coverage or PA/step, but MA-PDs were more likely to cover all brands without generics in a class. We found modest, confirmatory evidence suggesting that PDPs and MA-PDs respond to different incentives for plan design. Future research is needed to understand the factors that influence Medicare drug plan design decisions.

Imulation of polymer forming processes - addressing industrial needs

International Nuclear Information System (INIS)

Thibault, F.; DiRaddo, R.

2011-01-01

The objective of this paper is to present the development of simulation and design optimization capabilities, for polymer forming processes, in the context of addressing industrial needs. Accomplishments generated from close to twenty years of research in this field, at the National Research Council (NRC), are presented. Polymer forming processes such as extrusion blow moulding, stretch blow moulding and thermoforming have been the focus of the work, yet the research is extendable to similar polymer forming operations such as micro-blow moulding, sheet blow moulding and composites stamping. The research considers material models, process sequence integration and design optimization, derivative processes and 3D finite elements with multi-body contact.

Visual Design Principles: An Empirical Study of Design Lore

Science.gov (United States)

Kimball, Miles A.

2013-01-01

Many books, designers, and design educators talk about visual design principles such as balance, contrast, and alignment, but with little consistency. This study uses empirical methods to explore the lore surrounding design principles. The study took the form of two stages: a quantitative literature review to determine what design principles are…

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.

Application of Six Sigma Robust Optimization in Sheet Metal Forming

International Nuclear Information System (INIS)

Li, Y.Q.; Cui, Z.S.; Ruan, X.Y.; Zhang, D.J.

2005-01-01

Numerical simulation technology and optimization method have been applied in sheet metal forming process to improve design quality and shorten design cycle. While the existence of fluctuation in design variables or operation condition has great influence on the quality. In addition to that, iterative solution in numerical simulation and optimization usually take huge computational time or endure expensive experiment cost In order to eliminate effect of perturbations in design and improve design efficiency, a CAE-based six sigma robust design method is developed in this paper. In the six sigma procedure for sheet metal forming, statistical technology and dual response surface approximate model as well as algorithm of 'Design for Six Sigma (DFSS)' are integrated together to perform reliability optimization and robust improvement. A deep drawing process of a rectangular cup is taken as an example to illustrate the method. The optimization solutions show that the proposed optimization procedure not only improves significantly the reliability and robustness of the forming quality, but also increases optimization efficiency with approximate model

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.

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.

78 FR 11683 - Division of Federal Employees' Compensation, Proposed Extension of Existing Collection; Comment...

Science.gov (United States)

2013-02-19

... concerning the proposed collection: Death Gratuity Forms (CA- 40, CA-41, and CA-42). A copy of the proposed... and Non- Appropriated Fund Instrumentality (NAFI) employees who die from injuries incurred in... to name alternate beneficiaries. Form CA-40 requests the information necessary from the employee to...

Roll forming of eco-friendly stud

Science.gov (United States)

Keum, Y. T.; Lee, S. Y.; Lee, T. H.; Sim, J. K.

2013-12-01

In order to manufacture an eco-friendly stud, the sheared pattern is designed by the Taguchi method and expanded by the side rolls. The seven geometrical shape of sheared pattern are considered in the structural and thermal analyses to select the best functional one in terms of the durability and fire resistance of dry wall. For optimizing the size of the sheared pattern chosen, the L9 orthogonal array and smaller-the-better characteristics of the Taguchi method are used. As the roll gap causes forming defects when the upper-and-lower roll type is adopted for expanding the sheared pattern, the side roll type is introduced. The stress and strain distributions obtained by the FEM simulation of roll-forming processes are utilized for the design of expanding process. The expanding process by side rolls shortens the length of expanding process and minimizes the cost of dies. Furthermore, the stud manufactured by expanding the sheared pattern of the web is an eco-friend because of the scrapless roll-forming process. In addition, compared to the conventionally roll-formed stud, the material cost is lessened about 13.6% and the weight is lightened about 15.5%.

Normal form and synchronization of strict-feedback chaotic systems

International Nuclear Information System (INIS)

Wang, Feng; Chen, Shihua; Yu Minghai; Wang Changping

2004-01-01

This study concerns the normal form and synchronization of strict-feedback chaotic systems. We prove that, any strict-feedback chaotic system can be rendered into a normal form with a invertible transform and then a design procedure to synchronize the normal form of a non-autonomous strict-feedback chaotic system is presented. This approach needs only a scalar driving signal to realize synchronization no matter how many dimensions the chaotic system contains. Furthermore, the Roessler chaotic system is taken as a concrete example to illustrate the procedure of designing without transforming a strict-feedback chaotic system into its normal form. Numerical simulations are also provided to show the effectiveness and feasibility of the developed methods

Multiple chronic conditions and life expectancy

DEFF Research Database (Denmark)

DuGoff, Eva H; Canudas-Romo, Vladimir; Buttorff, Christine

2014-01-01

BACKGROUND: The number of people living with multiple chronic conditions is increasing, but we know little about the impact of multimorbidity on life expectancy. OBJECTIVE: We analyze life expectancy in Medicare beneficiaries by number of chronic conditions. RESEARCH DESIGN: A retrospective cohort...... study using single-decrement period life tables. SUBJECTS: Medicare fee-for-service beneficiaries (N=1,372,272) aged 67 and older as of January 1, 2008. MEASURES: Our primary outcome measure is life expectancy. We categorize study subjects by sex, race, selected chronic conditions (heart disease, cancer...... and increasing numbers of comorbid conditions. CONCLUSIONS: Social Security and Medicare actuaries should account for the growing number of beneficiaries with multiple chronic conditions when determining population projections and trust fund solvency....

Design Challenges of an Episode-Based Payment Model in Oncology: The Centers for Medicare & Medicaid Services Oncology Care Model.

Science.gov (United States)

Kline, Ronald M; Muldoon, L Daniel; Schumacher, Heidi K; Strawbridge, Larisa M; York, Andrew W; Mortimer, Laura K; Falb, Alison F; Cox, Katherine J; Bazell, Carol; Lukens, Ellen W; Kapp, Mary C; Rajkumar, Rahul; Bassano, Amy; Conway, Patrick H

2017-07-01

The Centers for Medicare & Medicaid Services developed the Oncology Care Model as an episode-based payment model to encourage participating practitioners to provide higher-quality, better-coordinated care at a lower cost to the nearly three-quarter million fee-for-service Medicare beneficiaries with cancer who receive chemotherapy each year. Episode payment models can be complex. They combine into a single benchmark price all payments for services during an episode of illness, many of which may be delivered at different times by different providers in different locations. Policy and technical decisions include the definition of the episode, including its initiation, duration, and included services; the identification of beneficiaries included in the model; and beneficiary attribution to practitioners with overall responsibility for managing their care. In addition, the calculation and risk adjustment of benchmark episode prices for the bundle of services must reflect geographic cost variations and diverse patient populations, including varying disease subtypes, medical comorbidities, changes in standards of care over time, the adoption of expensive new drugs (especially in oncology), as well as diverse practice patterns. Other steps include timely monitoring and intervention as needed to avoid shifting the attribution of beneficiaries on the basis of their expected episode expenditures as well as to ensure the provision of necessary medical services and the development of a meaningful link to quality measurement and improvement through the episode-based payment methodology. The complex and diverse nature of oncology business relationships and the specific rules and requirements of Medicare payment systems for different types of providers intensify these issues. The Centers for Medicare & Medicaid Services believes that by sharing its approach to addressing these decisions and challenges, it may facilitate greater understanding of the model within the oncology

CERAMIC WASTE FORM DATA PACKAGE

Energy Technology Data Exchange (ETDEWEB)

Amoroso, J.; Marra, J.

2014-06-13

The purpose of this data package is to provide information about simulated crystalline waste forms that can be used to select an appropriate composition for a Cold Crucible Induction Melter (CCIM) proof of principle demonstration. Melt processing, viscosity, electrical conductivity, and thermal analysis information was collected to assess the ability of two potential candidate ceramic compositions to be processed in the Idaho National Laboratory (INL) CCIM and to guide processing parameters for the CCIM operation. Given uncertainties in the CCIM capabilities to reach certain temperatures throughout the system, one waste form designated 'Fe-MP' was designed towards enabling processing and another, designated 'CAF-5%TM-MP' was designed towards optimized microstructure. Melt processing studies confirmed both compositions could be poured from a crucible at 1600{degrees}C although the CAF-5%TM-MP composition froze before pouring was complete due to rapid crystallization (upon cooling). X-ray diffraction measurements confirmed the crystalline nature and phase assemblages of the compositions. The kinetics of melting and crystallization appeared to vary significantly between the compositions. Impedance spectroscopy results indicated the electrical conductivity is acceptable with respect to processing in the CCIM. The success of processing either ceramic composition will depend on the thermal profiles throughout the CCIM. In particular, the working temperature of the pour spout relative to the bulk melter which can approach 1700{degrees}C. The Fe-MP composition is recommended to demonstrate proof of principle for crystalline simulated waste forms considering the current configuration of INL's CCIM. If proposed modifications to the CCIM can maintain a nominal temperature of 1600{degrees}C throughout the melter, drain, and pour spout, then the CAF-5%TM-MP composition should be considered for a proof of principle demonstration.

Considerations Regarding Students’ Social Protection

Directory of Open Access Journals (Sweden)

Iuliana Cenar

2016-01-01

Full Text Available The paper entitled “Considerations Regarding Students’ Social Protection” addresses the main forms of support offered to students and their families, divided in relation to the aim pursued, which may be relate to stimulating students’ performance and discipline, material and financial support (social assistance, supplementing family income. For these components there were taken into account: the circumstances in which it acquires to status of beneficiary, evolutionary dimensions in terms of beneficiary numbers, the amounts awarded, the need to ensure the complementarities with the informal side of social protection.

31 CFR 360.36 - Payment during life of sole owner.

Science.gov (United States)

2010-07-01

...) FISCAL SERVICE, DEPARTMENT OF THE TREASURY BUREAU OF THE PUBLIC DEBT REGULATIONS GOVERNING DEFINITIVE... owner. A savings bond registered in single ownership form (i.e., without a coowner or beneficiary) will...

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...

78 FR 39054 - Agency Information Collection Activities: Proposed Request and Comment Request

Science.gov (United States)

2013-06-28

... fail to have in their care the specified entitled child beneficiaries. SSA uses the information Forms... to promote the economic security of the Nation's people through its administration of the Old Age...

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...

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

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

Redefining Social Design in 1970s Belgium: Affordable Design vs. Elite Design

NARCIS (Netherlands)

Gimeno Martinez, J.C.

2011-01-01

The 1960s was the decade when democratization became a central issue in social affairs and politics, a trend that had a twofold effect on furniture design. A renewed interest in design creativity led to the emergence of new forms and typologies, and of a new, more dynamic relationship between user,

Multicultural personality questionnaire : Development of a short form

NARCIS (Netherlands)

Van Der Zee, Karen; Van Oudenhoven, Jan Pieter; Ponterotto, Joseph G.; Fietzer, Alexander W.

2013-01-01

This study reports on the development of the Multicultural Personality Questionnaire-Short Form among 511 participants. Using a split-sample scale validation design, Study 1 (N = 260) employed a principal component analysis and rigorous item selection criteria to extract a 40-item short form

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.

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.

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.

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 ...

75 FR 80563 - Agency Information Collection Activities: Proposed Request and Comment Request

Science.gov (United States)

2010-12-22

.... The respondents are a statistically valid sample of all RSI/DI beneficiaries in current pay status or... SSN. We send this form to the employer to identify the employees involved, to resolve the discrepancy...

Form gene clustering method about pan-ethnic-group products based on emotional semantic

Science.gov (United States)

Chen, Dengkai; Ding, Jingjing; Gao, Minzhuo; Ma, Danping; Liu, Donghui

2016-09-01

The use of pan-ethnic-group products form knowledge primarily depends on a designer's subjective experience without user participation. The majority of studies primarily focus on the detection of the perceptual demands of consumers from the target product category. A pan-ethnic-group products form gene clustering method based on emotional semantic is constructed. Consumers' perceptual images of the pan-ethnic-group products are obtained by means of product form gene extraction and coding and computer aided product form clustering technology. A case of form gene clustering about the typical pan-ethnic-group products is investigated which indicates that the method is feasible. This paper opens up a new direction for the future development of product form design which improves the agility of product design process in the era of Industry 4.0.

Advanced Wear Simulation for Bulk Metal Forming Processes

Directory of Open Access Journals (Sweden)

Behrens Bernd-Arno

2016-01-01

Full Text Available In the recent decades the finite element method has become an essential tool for the cost-efficient virtual process design in the metal forming sector in order to counter the constantly increasing quality standards, particularly from the automotive industry as well as intensified international competition in the forging industry. An optimized process design taking precise tool wear prediction into account is a way to increase the cost-efficiency of the bulk metal forming processes. The main objective of the work presented in this paper is a modelling algorithm, which allows predicting die wear with respect to a geometry update during the forming simulation. Changes in the contact area caused by geometry update lead to the different die wear distribution. It primarily concerns the die areas, which undergo high thermal and mechanical loads.

Towards Enhanced Affective Design: Rethinking the Notion of Design

Science.gov (United States)

Kim, SuKyoung; Cho, Youngil

2017-09-01

Design disciplines have been contributing to shaping the life of human beings, as well as fostering culture and heritage. Design disciplines and research have been rapidly transforming, and not only objects but also services are target of design. This paper reviews design disciplines towards enhanced affective design, which attributes to intuitive knowledge. It aims at rethinking the notion of design to propose a conceptual framework for integrating user experience into objects that strengthen the form and function based design with pleasing.

Lessons Learned from Applying Design Thinking in a NASA Rapid Design Study in Aeronautics

Science.gov (United States)

McGowan, Anna-Maria; Bakula, Casey; Castner, Raymond

2017-01-01

provided valuable experience by allowing team members from different technological backgrounds to work side-by-side instead of dividing into smaller teams, as is frequently done in traditional multidisciplinary design. The team also learned how to work with qualitative data obtained primarily through the 70-plus interviews that were conducted over the course of this project, which was a sharp contrast to using quantitative data with regards to identifying, capturing, analyzing, storing, and recalling the data. When identifying potential interviewees who may have useful contributions to the design subject area, the team found great value in talking to non-traditional users and potential beneficiaries of autonomous aeronautics systems whose impact on the aeronautics autonomy ecosystem is growing swiftly. Finally, the team benefitted from using "sacrificial prototyping," which is a method of rapidly prototyping draft concepts and ideas with the intent of enabling potential users to provide significant feedback early in the design process. This contrasts the more common approach of using expensive prototypes that focus on demonstrating technical feasibility. The unique design approach and lessons learned by the team throughout this process culminated in a final design concept that was quite different than what the team originally assumed would be the design concept initially. A summary of the more usercentered final design concept is also provided.

77 FR 2990 - Extension of the Designation of El Salvador for Temporary Protected Status and Automatic...

Science.gov (United States)

2012-01-20

... DEPARTMENT OF HOMELAND SECURITY U.S. Citizenship and Immigration Services [CIS No. 2510-11; DHS... Beneficiaries; Correction AGENCY: U.S. Citizenship and Immigration Services (USCIS), DHS. ACTION: Notice... Operations Directorate, U.S. Citizenship and Immigration Services, Department of Homeland Security, 20...

The Costs of Decedents in the Medicare Program: Implications for Payments to Medicare+Choice Plans

Science.gov (United States)

Buntin, Melinda Beeuwkes; Garber, Alan M; McClellan, Mark; Newhouse, Joseph P

2004-01-01

Objective To discuss and quantify the incentives that Medicare managed care plans have to avoid (through selective enrollment or disenrollment) people who are at risk for very high costs, focusing on Medicare beneficiaries in the last year of life—a group that accounts for more than one-quarter of Medicare's annual expenditures. Data Source Medicare administrative claims for 1994 and 1995. Study Design We calculated the payment a plan would have received under three risk-adjustment systems for each beneficiary in our 1995 sample based on his or her age, gender, county of residence, original reason for Medicare entitlement, and principal inpatient diagnoses received during any hospital stays in 1994. We compared these amounts to the actual costs incurred by those beneficiaries. We then looked for clinical categories that were predictive of costs, including costs in a beneficiary's last year of life, not accounted for by the risk adjusters. Data Extraction Methods The analyses were conducted using claims for a 5 percent random sample of Medicare beneficiaries who died in 1995 and a matched group of survivors. Principal Findings Medicare is currently implementing the Principal Inpatient Diagnostic Cost Groups (PIP-DCG) risk adjustment payment system to address the problem of risk selection in the Medicare+Choice program. We quantify the strong financial disincentives to enroll terminally ill beneficiaries that plans still have under this risk adjustment system. We also show that up to one-third of the selection observed between Medicare HMOs and the traditional fee-for-service system could be due to differential enrollment of decedents. A risk adjustment system that incorporated more of the available diagnostic information would attenuate this disincentive; however, plans could still use clinical information (not included in the risk adjustment scheme) to identify beneficiaries whose expected costs exceed expected payments. Conclusions More disaggregated prospective

Electrically assisted forming modeling and control

CERN Document Server

Salandro, Wesley A; Bunget, Cristina; Mears, Laine; Roth, John T

2015-01-01

Maximizing reader insights into the latest research findings and applications of Electrically-Assisted Forming (EAF) – whereby metals are formed under an electric current field – this book explains how such a process produces immediate improved formability of metals beyond the extent of thermal softening, and allows metals to be formed to greater elongation with lower mechanical energy as well as allowing for lightweight brittle metals such as magnesium and titanium to be formed without external heating or annealing, enabling the more effective use of these lightweight metals in design. Including case studies that illustrate and support the theoretical content and real-world applications of the techniques discussed, this book also serves to enrich readers understanding of the underlying theories that influence electro-plastic behaviour. The authors have extensive experience in studying Electrically-Assisted Forming and have written extensively on the topic with publications including experimental works, t...

IMO Fireball report form: results and prospects

Science.gov (United States)

Hankey, M.; Perlerin, V.

2015-01-01

At the 2014 IMC, we presented the new IMO (International Meteor Organization) online, Fireball report (available at fireballs.imo.net). This fireball report form was specifically designed for use by people with no astronomy experience who witnessed a fireball, a bolide or a suspected similar phenomenon. The IMO version of the form has been officially launched in February 2015. Since then, the form has been translated in different languages and customized for organizations around the world. In this paper, we will present preliminary results of the form and provide tips to improve the online presence of local organizations, in order to promote usage. We will also highlight procedures to be followed by local organizations to get a custom version of the form.

Visual Artist or Visual Designer? Visual Communication Design Education

OpenAIRE

Arsoy, Aysu

2010-01-01

ABSTRACT: Design tools and contents have been digitalized, forming the contemporary fields of the visual arts and design. Corporate culture demands techno-social experts who understand the arts, design, culture and society, while also having a high level of technological proficiency. New departments have opened offering alternatives in art and design education such as Visual Communication Design (VCD) and are dedicated to educating students in the practical aspect of using digital technologi...

Engineering-Scale Demonstration of DuraLith and Ceramicrete Waste Forms

Energy Technology Data Exchange (ETDEWEB)

Josephson, Gary B.; Westsik, Joseph H.; Pires, Richard P.; Bickford, Jody; Foote, Martin W.

2011-09-23

To support the selection of a waste form for the liquid secondary wastes from the Hanford Waste Immobilization and Treatment Plant, Washington River Protection Solutions (WRPS) has initiated secondary waste form testing on four candidate waste forms. Two of the candidate waste forms have not been developed to scale as the more mature waste forms. This work describes engineering-scale demonstrations conducted on Ceramicrete and DuraLith candidate waste forms. Both candidate waste forms were successfully demonstrated at an engineering scale. A preliminary conceptual design could be prepared for full-scale production of the candidate waste forms. However, both waste forms are still too immature to support a detailed design. Formulations for each candidate waste form need to be developed so that the material has a longer working time after mixing the liquid and solid constituents together. Formulations optimized based on previous lab studies did not have sufficient working time to support large-scale testing. The engineering-scale testing was successfully completed using modified formulations. Further lab development and parametric studies are needed to optimize formulations with adequate working time and assess the effects of changes in raw materials and process parameters on the final product performance. Studies on effects of mixing intensity on the initial set time of the waste forms are also needed.

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....

Disposal criticality analysis methodology for fissile waste forms

International Nuclear Information System (INIS)

Davis, J.W.; Gottlieb, P.

1998-03-01

A general methodology has been developed to evaluate the criticality potential of the wide range of waste forms planned for geologic disposal. The range of waste forms include commercial spent fuel, high level waste, DOE spent fuel (including highly enriched), MOX using weapons grade plutonium, and immobilized plutonium. The disposal of these waste forms will be in a container with sufficiently thick corrosion resistant barriers to prevent water penetration for up to 10,000 years. The criticality control for DOE spent fuel is primarily provided by neutron absorber material incorporated into the basket holding the individual assemblies. For the immobilized plutonium, the neutron absorber material is incorporated into the waste form itself. The disposal criticality analysis methodology includes the analysis of geochemical and physical processes that can breach the waste package and affect the waste forms within. The basic purpose of the methodology is to guide the criticality control features of the waste package design, and to demonstrate that the final design meets the criticality control licensing requirements. The methodology can also be extended to the analysis of criticality consequences (primarily increased radionuclide inventory), which will support the total performance assessment for the respository

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

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...

Microstructural analysis of hot press formed 22MnB5 steel

Science.gov (United States)

Aziz, Nuraini; Aqida, Syarifah Nur; Ismail, Izwan

2017-10-01

This paper presents a microstructural study on hot press formed 22MnB5 steel for enhanced mechanical properties. Hot press forming process consists of simultaneous forming and quenching of heated blank. The 22MnB5 steel was processed at three different parameter settings: quenching time, water temperature and water flow rate. 22MnB5 was processed using 33 full factorial design of experiment (DOE). The full factorial DOE was designed using three factors of quenching time, water temperature and water flow rate at three levels. The factors level were quenching time range of 5 - 11 s, water temperature; 5 - 27°C and water flow rate; 20 - 40 L/min. The as-received and hot press forming processed steel was characterised for metallographic study and martensitic structure area percentage using JEOL Field Emission Scanning Electron Microscopic (FESEM). From the experimental finding, the hot press formed 22MnB5 steel consisted of 50 to 84% martensitic structure area. The minimum quenching time of 8 seconds was required to obtain formed sample with high percentage of martensite. These findings contribute to initial design of processing parameters in hot press forming of 22MnB5 steel blanks for automotive component.

Potential Trade Effects of Adding Vietnam to the Generalized System of Preferences Program

National Research Council Canada - National Science Library

Martin, Michael F; Jones, Vivian C

2008-01-01

.... The GSP statute provides the President with the authority to designate any country a beneficiary developing country, provided the country complies with various trade policy and labor conditions...

Effect of food service form on eating rate: meal served in a separated form might lower eating rate.

Science.gov (United States)

Suh, Hyung Joo; Jung, Eun Young

2016-01-01

In this study, we investigated the association between food form (mixed vs separated) and eating rate. The experiment used a within-subjects design (n=29, young healthy women with normal weight). Test meals (white rice and side dishes) with the same content and volume were served at lunch in a mixed or separated form. The form in which the food was served had significant effects on consumption volume and eating rate; subjects ate significantly more (p<0.05) when a test meal was served as a mixed form (285 g, 575 kcal) compared to a separated form (244 g, 492 kcal). Moreover, subjects also ate significantly faster (p<0.05) when the test meal was served as a mixed form (22.4 g/min) as compared to a separated form (16.2 g/min). Despite consuming more when the test meal was served as a mixed form than when served as a separated form, the subjects did not feel significantly fuller. In conclusion, we confirmed that meals served in a separated form might lower the eating rate and, moreover, slower eating might be associated with less energy intake, without compromising satiety.

Towards Free-Form Kinetic Structures

DEFF Research Database (Denmark)

Parigi, Dario; Kirkegaard, Poul Henning

2012-01-01

of pin-slot paths starting from the local displacements of element [2] [3]. In the design of kinetic structures, in particular when complex three dimensional and non regular configurations are involved, the functionality is frequently related to a global displacement capability of the assembly rather...... for the generation of free-form kinetic structures....

Design Transformation based on Nature and Identity Formation in the Design of Landscape Elements

Directory of Open Access Journals (Sweden)

Zulkifli Muslim

2016-01-01

Full Text Available There is a lack of initiative from the designers to integrate the environmental resources in the material and design production of local urban landscape elements that reflects human culture and lifestyle. Based on criteria and principles of symbol design and transformation process, this paper describes the symbiotic relationship between local plants (flower and designs of landscape elements. Using visual analysis, the researcher manipulated shapes and forms of local plant images in producing possible shapes and forms for a design of landscape element (lamp post. The results indicate that the design transformation is a systematic process that allows for variations in design without losing the core characteristics and identity of the basic elements of nature.

La empleabilidad y los beneficiarios del Seguro de Capacitación y Empleo en Mar del Plata Employability and beneficiaries of the Training and Employment Insurance in Mar del Plata

Directory of Open Access Journals (Sweden)

Ana Julia Atucha

2011-12-01

Full Text Available El objetivo de este documento es analizar si la participación de los beneficiarios del Partido de General Pueyrredon en el Seguro de Capacitación y Empleo implicó mejoras en su empleabilidad. En particular, se examinan las relaciones entre formación y empleo de este colectivo, como aproximación a la medición del impacto de esta política de mercado de trabajo en Mar del Plata. La información utilizada se basa en la "Encuesta de Informalidad y Beneficiarios de Programas Sociales" en el aglomerado, llevada a cabo en octubre de 2009 por el Grupo Estudios del Trabajo de la Facultad de Ciencias Económicas y Sociales de la Universidad Nacional de Mar del Plata, en el marco de un proyecto en convenio con la OIT. Esta fuente primaria fue complementada por entrevistas telefónicas a destinatarios seleccionados. El acercamiento se efectuó a través de una exploración de las trayectorias formativas seguidas por los destinatarios, de la valoración que ha tenido la capacitación respecto a la mejora sobre su empleabilidad y de la tarea de vinculación entre demandantes y oferentes que realiza la Oficina de Empleo. Entre los principales resultados se detectaron gran proporción de beneficiarios sin una trayectoria formativa que los califique sobre un oficio, percepciones negativas respecto a su empleabilidad y situaciones de inactividad. El documento deja planteada la necesidad de optimizar las tareas de orientación y vinculación al mercado de trabajo para mejorar la situación del grupo bajo análisis.This paper is aimed to analyze whether the participation of beneficiaries in the Training and Employment Insurance improved their employability. In particular, the relationship between training and employment of this group, as an approach to measuring the effect of this labor market policy in Mar del Plata, will be examined. The information come from the "Survey of Informality and Beneficiaries of Social Programs" collected in Mar del Plata

Closed form fourier-based transmit beamforming for MIMO radar

KAUST Repository

Lipor, John J.; Ahmed, Sajid; Alouini, Mohamed-Slim

2014-01-01

-pattern, current research uses iterative algorithms, first to synthesize the waveform covariance matrix, R, then to design the actual waveforms to realize R. In contrast to this, we present a closed form method to design R that exploits discrete Fourier transform

7 CFR 91.102 - Form of official identification symbols.

Science.gov (United States)

2010-01-01

... 7 Agriculture 3 2010-01-01 2010-01-01 false Form of official identification symbols. 91.102... LABORATORY TESTING PROGRAMS SERVICES AND GENERAL INFORMATION Designation of Approved Symbols for Identification of Commodities Officially Tested By AMS § 91.102 Form of official identification symbols. Two...

QuikForm: Intelligent deformation processing of structural alloys

Energy Technology Data Exchange (ETDEWEB)

Bourcier, R.J.; Wellman, G.W.

1994-09-01

There currently exists a critical need for tools to enhance the industrial competitiveness and agility of US industries involved in deformation processing of structural alloys. In response to this need, Sandia National Laboratories has embarked upon the QuikForm Initiative. The goal of this program is the development of computer-based tools to facilitate the design of deformation processing operations. The authors are currently focusing their efforts on the definition/development of a comprehensive system for the design of sheet metal stamping operations. The overall structure of the proposed QuikForm system is presented, and the focus of their thrust in each technical area is discussed.

ATTRIBUTES OF FORM IN THE BUILT ENVIRONMENT THAT INFLUENCE PERCEIVED WALKABILITY.

Science.gov (United States)

Oreskovic, Nicolas M; Charles, Pablina Roth Suzanne Lanyi; Shepherd, Dido Tsigaridi Kathrine; Nelson, Kerrie P; Bar, Moshe

2014-01-01

A recent focus of design and building regulations, including form-based codes and the Leadership in Energy and Environmental Design for Neighborhood Development rating system, has been on promoting pedestrian activity. This study assessed perceptions of walkability for residential and commercial streetscapes with different design attributes in order to inform form-based regulations and codes that aim to impact walkability. We scored 424 images on four design attributes purported to influence walkability: variation in building height, variation in building plane, presence of ground-floor windows, and presence of a street focal point. We then presented the images to 45 adults, who were asked to rate the images for walkability. The results showed that perceived walkability varied according to the degree to which a particular design attribute was present, with the presence of ground-floor windows and a street focal point most consistently associated with a space's perceived walkability. Understanding if and which design attributes are most related to walkability could allow planners and developers to focus on the most salient built-environment features influencing physical activity, as well as provide empirical scientific evidence for form-based regulations and zoning codes aimed at impacting walkabilit.

Computer Programming Games and Gender Oriented Cultural Forms

Science.gov (United States)

AlSulaiman, Sarah Abdulmalik

I present the design and evaluation of two games designed to help elementary and middle school students learn computer programming concepts. The first game was designed to be "gender neutral", aligning with might be described as a consensus opinion on best practices for computational learning environments. The second game, based on the cultural form of dress up dolls was deliberately designed to appeal to females. I recruited 70 participants in an international two-phase study to investigate the relationship between games, gender, attitudes towards computer programming, and learning. My findings suggest that while the two games were equally effective in terms of learning outcomes, I saw differences in motivation between players of the two games. Specifically, participants who reported a preference for female- oriented games were more motivated to learn about computer programming when they played a game that they perceived as designed for females. In addition, I describe how the two games seemed to encourage different types of social activity between players in a classroom setting. Based on these results, I reflect on the strategy of exclusively designing games and activities as "gender neutral", and suggest that employing cultural forms, including gendered ones, may help create a more productive experience for learners.

Specialty Payment Model Opportunities and Assessment: Oncology Model Design Report.

Science.gov (United States)

Huckfeldt, Peter J; Chan, Chris; Hirshman, Samuel; Kofner, Aaron; Liu, Jodi L; Mulcahy, Andrew W; Popescu, Ioana; Stevens, Clare; Timbie, Justin W; Hussey, Peter S

2015-07-15

This article describes research related to the design of a payment model for specialty oncology services for possible testing by the Center for Medicare and Medicaid Innovation at the Centers for Medicare & Medicaid Services (CMS). Cancer is a common and costly condition. Episode-based payment, which aims to create incentives for high-quality, low-cost care, has been identified as a promising alternative payment model for oncology care. Episode-based payment systems can provide flexibility to health care providers to select among the most effective and efficient treatment alternatives, including activities that are not currently reimbursed under Medicare payment policies. However, the model design also needs to ensure that high-quality care is delivered and that beneficial treatments are not withheld from patients. CMS asked MITRE and RAND to conduct analyses to inform design decisions related to an episode-based oncology model for Medicare beneficiaries undergoing chemotherapy treatment for cancer. In particular, this study focuses on analyses of Medicare claims data related to the definition of the initiation of an episode of chemotherapy, patterns of spending during and surrounding episodes of chemotherapy, and attribution of episodes of chemotherapy to physician practices. We found that the time between the primary cancer diagnosis and chemotherapy initiation varied widely across patients, ranging from one day to over seven years, with a median of 2.4 months. The average level of total monthly payments varied considerably across cancers, with the highest spending peak of $9,972 for lymphoma, and peaks of $3,109 for breast cancer and $2,135 for prostate cancer.

75 FR 11912 - Division of Coal Mine Workers' Compensation; Proposed Collection; Comment Request

Science.gov (United States)

2010-03-12

... payment provisions of the Black Lung Act for survivors of deceased miners. Completion of this form... benefits. Form CM-912 is authorized for use by the Black Lung Benefits Act 30 U.S.C. 901, et seq., 20 CFR... eligibility for benefits of a survivor of a Black Lung Act beneficiary. Type of Review: Revision. Agency...

78 FR 35982 - Division of Coal Mine Workers' Compensation; Proposed Collection; Comment Request

Science.gov (United States)

2013-06-14

... payment provisions of the Black Lung Act for survivors of deceased miners. Completion of this form... benefits. Form CM-912 is authorized for use by the Black Lung Benefits Act 30 U.S.C. 901, et seq., 20 CFR... eligibility for benefits of a survivor of a Black Lung Act beneficiary. Type of Review: Extension. Agency...

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

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

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.

Ship design methodologies of preliminary design

CERN Document Server

Papanikolaou, Apostolos

2014-01-01

This book deals with ship design and in particular with methodologies of the preliminary design of ships. The book is complemented by a basic bibliography and five appendices with useful updated charts for the selection of the main dimensions and other basic characteristics of different types of ships (Appendix A), the determination of hull form  from the data of systematic hull form series (Appendix B), the detailed description of the relational method for the preliminary estimation of ship weights (Appendix C), a brief review of the historical evolution of shipbuilding science and technology from the prehistoric era to date (Appendix D) and finally a historical review of regulatory developments of ship's damage stability to date (Appendix E).  The book can be used as textbook for ship design courses or as additional reading for university or college students of naval architecture courses and related disciplines; it may also serve as a reference book for naval architects, practicing engineers of rel...

Reductions in Sepsis Mortality and Costs After Design and Implementation of a Nurse-Based Early Recognition and Response Program

Science.gov (United States)

Jones, Stephen L.; Ashton, Carol M.; Kiehne, Lisa; Gigliotti, Elizabeth; Bell-Gordon, Charyl; Disbot, Maureen; Masud, Faisal; Shirkey, Beverly A.; Wray, Nelda P.

2016-01-01

Background Sepsis is a leading cause of death, but evidence suggests that early recognition and prompt intervention can save lives. In 2005 Houston Methodist Hospital prioritized sepsis detection and management in its ICU. In late 2007, because of marginal effects on sepsis death rates, the focus shifted to designing a program that would be readily used by nurses and ensure early recognition of patients showing signs suspicious for sepsis, as well as the institution of prompt, evidence-based interventions to diagnose and treat it. Methods The intervention had four components: organizational commitment and data-based leadership; development and integration of an early sepsis screening tool into the electronic health record; creation of screening and response protocols; and education and training of nurses. Twice-daily screening of patients on targeted units was conducted by bedside nurses; nurse practitioners initiated definitive treatment as indicated. Evaluation focused on extent of implementation, trends in inpatient mortality, and, for Medicare beneficiaries, a before-after (2008–2011) comparison of outcomes and costs. A federal grant in 2012 enabled expansion of the program. Results By year 3 (2011) 33% of inpatients were screened (56,190 screens in 9,718 unique patients), up from 10% in year 1 (2009). Inpatient sepsis-associated death rates decreased from 29.7% in the preimplementation period (2006–2008) to 21.1% after implementation (2009–2014). Death rates and hospital costs for Medicare beneficiaries decreased from preimplementation levels without a compensatory increase in discharges to postacute care. Conclusion This program has been associated with lower inpatient death rates and costs. Further testing of the robustness and exportability of the program is under way. PMID:26484679

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.

78 FR 46418 - Proposed Information Collection (Obligation To Report Factors Affecting Entitlement) Activity...

Science.gov (United States)

2013-07-31

... (Obligation To Report Factors Affecting Entitlement) Activity; Comment Request AGENCY: Veterans Benefits... use of other forms of information technology. Title: Obligation to Report Factors Affecting... entitlement factors. Individual factors such as income, marital status, and the beneficiary's number of...

Liberating Learning Object Design from the Learning Style of Student Instructional Designers

Science.gov (United States)

Akpinar, Yavuz

2007-01-01

Learning objects are a new form of learning resource, and the design of these digital environments has many facets. To investigate senior instructional design students' use of reflection tools in designing learning objects, a series of studies was conducted using the Reflective Action Instructional Design and Learning Object Review Instrument…

The impact of medical insurance for the poor in Georgia: a regression discontinuity approach.