... challenging exclusive contracts involving cable-affiliated programming; and amendments to its rules to ensure that buying groups utilized by small and medium-sized multichannel video programming distributors..., identified by MB Docket No. 12-68, by any of the following methods: Federal Communications Commission's Web...
... programming beyond its October 5, 2012 expiration date. Instead of this prohibition, the Commission will address exclusive contracts involving satellite-delivered, cable-affiliated programming on a case-by-case...). Summary of the Report and Order and Order on Reconsideration I. Introduction 1. In this Report and Order...
..., movie studio, and other businesses with some of Comcast's cable programming and online content... number of cable subscribers and homes passed by a single MSO in particular markets (accomplished via...
... competition is an increase in employment in the video programming sector of the economy. The relationship... on Commission precedent in which the Commission has considered certain Regional Sports Networks.... Conversely, when programming is non- replicable and valuable to consumers, such as regional sports...
... Access Program; Final Rule #0;#0;Federal Register / Vol. 77 , No. 96 / Thursday, May 17, 2012 / Rules and... Market Access Program AGENCY: Foreign Agricultural Service and Commodity Credit Corporation, USDA. ACTION... Access Program (MAP) by updating and merging the application requirements and the activity plan...
Silva, Bruno Berstel-Da
Rules represent a simplified means of programming, congruent with our understanding of human brain constructs. With the advent of business rules management systems, it has been possible to introduce rule-based programming to nonprogrammers, allowing them to map expert intent into code in applications such as fraud detection, financial transactions, healthcare, retail, and marketing. However, a remaining concern is the quality, safety, and reliability of the resulting programs. This book is on business rules programs, that is, rule programs as handled in business rules management systems. Its
Juan D. Deaton; Luiz A. DaSilva; Christian Wernz
A current trend in spectrum regulation is to incorporate spectrum sharing through the design of spectrum access rules that support Dynamic Spectrum Access (DSA). This paper develops a decision-theoretic framework for regulators to assess the impacts of different decision rules on both primary and secondary operators. We analyze access rules based on sensing and exclusion areas, which in practice can be enforced through geolocation databases. Our results show that receiver-only sensing provides insufficient protection for primary and co-existing secondary users and overall low social welfare. On the other hand, using sensing information between the transmitter and receiver of a communication link, provides dramatic increases in system performance. The performance of using these link end points is relatively close to that of using many cooperative sensing nodes associated to the same access point and large link exclusion areas. These results are useful to regulators and network developers in understanding in developing rules for future DSA regulation.
Fosse, Henrik Barslund; Raimondos-Møller, Pascalis
When Vietnam joined the World Trade Organization (WTO) in 2007 it was granted an accession period up to 2014. During this period tariffs would have to fall according to the accession agreement. This paper evaluates this 2007–2014 trade liberalization by building an applied general equilibrium model...
Hennig, Teresa; Hepworth, George; Yudovich, Dagi (Doug)
Authoritative and comprehensive coverage for building Access 2013 Solutions Access, the most popular database system in the world, just opened a new frontier in the Cloud. Access 2013 provides significant new features for building robust line-of-business solutions for web, client and integrated environments. This book was written by a team of Microsoft Access MVPs, with consulting and editing by Access experts, MVPs and members of the Microsoft Access team. It gives you the information and examples to expand your areas of expertise and immediately start to develop and upgrade projects. Exp
This document evaluates the benefits, costs, and other impacts of a DOT rulemaking related to : the accessibility of commuter rail transportation and intercity passenger rail service. In keeping with Executive Order 12866, Executive Order 13563, and ...
Lettau, M.; Uhlig, H.F.H.V.S.
This paper studies the relationships between learning about rules of thumb (represented by classifier systems) and dynamic programming. Building on a result about Markovian stochastic approximation algorithms, we characterize all decision functions that can be asymptotically obtained through
... Programming Distribution and Carriage AGENCY: Federal Communications Commission. ACTION: Final rule... carriage of video programming vendors by multichannel video programming distributors (program carriage... and Order, Leased Commercial Access; Development of Competition and Diversity in Video Programming...
This document deals with the procurements planned for the construction of an Atomic Vapor Laser Isotope Separation (AVLIS) production plant. Several large-scale AVLIS facilities have already been built and tested; a full-scale engineering demonstration facility is currently under construction. The experience gained from these projects provides the procurement basis for the production plant construction and operation. In this document, the status of the AVLIS process procurement is presented from two viewpoints. The AVLIS Production Plant Work Breakdown Structure is referenced at the level of the items to be procured. The availability of suppliers for the items at this level is discussed. In addition, the work that will result from the AVLIS enrichment plant project is broken down by general procurement categories (construction, mechanical equipment, etc.) and the current AVLIS suppliers are listed according to these categories. A large number of companies in all categories are currently providing AVLIS equipment for the Full-Scale Demonstration Facility in Livermore, California. These companies form an existing and expanding supplier network for the AVLIS program. Finally, this document examines the relationship between the AVLIS construction project/operational facility and established commercial suppliers. The goal is to utilize existing industrial capability to meet the needs of the project in a competitive procurement situation. As a result, costs and procurement risks are both reduced because the products provided come from within the AVLIS suppliers' experience base. At the same time, suppliers can benefit by the potential to participate in AVLIS technology spin-off markets. 35 figures.
The final rule of fuels and fuel additives: renewable fuel standard program is published on May 1, 2007 and is effective on September 1, 2007. You will find the links to this final rule and technical amendments supporting this rule.
This final rule makes Federal employee health insurance accessible to employees of certain Indian tribal entities. Section 409 of the Indian Health Care Improvement Act (codified at 25 U.S.C. 1647b) authorizes Indian tribes, tribal organizations, and urban Indian organizations that carry out certain programs to purchase coverage, rights, and benefits under the Federal Employees Health Benefits (FEHB) Program for their employees. Tribal employers and tribal employees will be responsible for the full cost of benefits, plus an administrative fee.
In the paper, an application of dynamic programming approach for optimization of association rules from the point of view of knowledge representation is considered. The association rule set is optimized in two stages, first for minimum cardinality and then for minimum length of rules. Experimental results present cardinality of the set of association rules constructed for information system and lower bound on minimum possible cardinality of rule set based on the information obtained during algorithm work as well as obtained results for length.
... Operations Program Management § 91.1075 Training program: Special rules. Other than the program manager, only... approved curriculums, curriculum segments, and portions of curriculum segments applicable for use in...
Medicare program: hospital outpatient prospective payment system and CY 2011 payment rates; ambulatory surgical center payment system and CY 2011 payment rates; payments to hospitals for graduate medical education costs; physician self-referral rules and related changes to provider agreement regulations; payment for certified registered nurse anesthetist services furnished in rural hospitals and critical access hospitals. Final rule with comment period; final rules; and interim final rule with comment period.
The final rule with comment period in this document revises the Medicare hospital outpatient prospective payment system (OPPS) to implement applicable statutory requirements and changes arising from our continuing experience with this system and to implement certain provisions of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (Affordable Care Act). In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare hospital outpatient services paid under the prospective payment system. These changes are applicable to services furnished on or after January 1, 2011. In addition, this final rule with comment period updates the revised Medicare ambulatory surgical center (ASC) payment system to implement applicable statutory requirements and changes arising from our continuing experience with this system and to implement certain provisions of the Affordable Care Act. In this final rule with comment period, we set forth the applicable relative payment weights and amounts for services furnished in ASCs, specific HCPCS codes to which these changes apply, and other pertinent ratesetting information for the CY 2011 ASC payment system. These changes are applicable to services furnished on or after January 1, 2011. In this document, we also are including two final rules that implement provisions of the Affordable Care Act relating to payments to hospitals for direct graduate medical education (GME) and indirect medical education (IME) costs; and new limitations on certain physician referrals to hospitals in which they have an ownership or investment interest. In the interim final rule with comment period that is included in this document, we are changing the effective date for otherwise eligible hospitals and critical access hospitals that have been reclassified from urban to rural under section 1886(d)(8)(E) of the Social Security
... military publication will request the advertiser to observe them. The advertising of credit will conform to... 32 National Defense 3 2010-07-01 2010-07-01 true Advertising rules and educational programs. 552... Reservations § 552.62 Advertising rules and educational programs. (a) The Department of the Army expects that...
... Corporation 7 CFR Part 1485 Market Access Program AGENCY: Foreign Agricultural Service and Commodity Credit... Trade Programs, Program Operations Division; or by phone: (202) 720- 4327; or by fax: (202) 720-9361; or... submitted later than 3 months after the end of a MAP Participant's program year. At any given time, total...
National Oceanic and Atmospheric Administration, Department of Commerce — This limited access system limits the number of charter vessels that may participate in the guided sport fishery for halibut in area 2C and 3A. NMFS issues a charter...
... rules pertaining to carriage of video programming vendors by multichannel video programming distributors... promoting competition and diversity in the video programming and video distribution markets. In this.... Federal Communications Commission's Web site: http://www.fcc.gov/cgb/ecfs/ . Follow the instructions for...
... subpart to provide flight training, testing, and checking under contract or other arrangement to those... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Training program: Special rules. 121.402... REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Training Program § 121.402 Training program: Special...
Amin, Talha M.
The areas of machine learning, data mining, and knowledge representation have many different formats used to represent information. Decision rules, amongst these formats, are the most expressive and easily-understood by humans. In this thesis, we use dynamic programming to design decision rules and analyze them. The use of dynamic programming allows us to work with decision rules in ways that were previously only possible for brute force methods. Our algorithms allow us to describe the set of all rules for a given decision table. Further, we can perform multi-stage optimization by repeatedly reducing this set to only contain rules that are optimal with respect to selected criteria. One way that we apply this study is to generate small systems with short rules by simulating a greedy algorithm for the set cover problem. We also compare maximum path lengths (depth) of deterministic and non-deterministic decision trees (a non-deterministic decision tree is effectively a complete system of decision rules) with regards to Boolean functions. Another area of advancement is the presentation of algorithms for constructing Pareto optimal points for rules and rule systems. This allows us to study the existence of “totally optimal” decision rules (rules that are simultaneously optimal with regards to multiple criteria). We also utilize Pareto optimal points to compare and rate greedy heuristics with regards to two criteria at once. Another application of Pareto optimal points is the study of trade-offs between cost and uncertainty which allows us to find reasonable systems of decision rules that strike a balance between length and accuracy.
National Oceanic and Atmospheric Administration, Department of Commerce — ERDDAP (the Environmental Research Division's Data Access Program) is a data server that gives you a simple, consistent way to download subsets of scientific...
... of Behavior and User Agreement AGENCY: Office of the Chief Information Officer, HUD. ACTION: Notice... (EIV) System User Access, Authorization Form and Rules Of Behavior and User Agreement. OMB Approval...
The Architectural and Transportation Barriers Compliance Board (Access Board or Board) is issuing a final rule that revises its existing accessibility guidelines for non-rail vehicles--namely, buses, over-the-road buses, and vans--acquired or remanufactured by entities covered by the Americans with Disabilities Act. The revised guidelines ensure that such vehicles are readily accessible to, and usable by, individuals with disabilities. The U.S. Department of Transportation (DOT) is required to revise its accessibility standards for transportation vehicles acquired or remanufactured by entities covered by the Americans with Disabilities Act (ADA) to be consistent with the final rule.
Brink, R.F.M. van den
Spectral Management (SpM) involves managing an access network such that different systems can co-exist with each other. In relation to DSL systems, spectral management ensures that they can co-exist within the same cable. The use of spectral signal limits (specified via mandatory access rules) is a
This paper is devoted to the study of an extension of dynamic programming approach which allows sequential optimization of approximate decision rules relative to the length and coverage. We introduce an uncertainty measure R(T) which is the number of unordered pairs of rows with different decisions in the decision table T. For a nonnegative real number β, we consider β-decision rules that localize rows in subtables of T with uncertainty at most β. Our algorithm constructs a directed acyclic graph Δβ(T) which nodes are subtables of the decision table T given by systems of equations of the kind "attribute = value". This algorithm finishes the partitioning of a subtable when its uncertainty is at most β. The graph Δβ(T) allows us to describe the whole set of so-called irredundant β-decision rules. We can describe all irredundant β-decision rules with minimum length, and after that among these rules describe all rules with maximum coverage. We can also change the order of optimization. The consideration of irredundant rules only does not change the results of optimization. This paper contains also results of experiments with decision tables from UCI Machine Learning Repository. © 2012 Elsevier Inc. All rights reserved.
The Department of Veterans Affairs (VA) amends its medical regulations concerning eligibility for the Health Care for Homeless Veterans (HCHV) program. The HCHV program provides per diem payments to non-VA community-based facilities that provide housing, outreach services, case management services, and rehabilitative services, and may provide care and/or treatment to homeless veterans who are enrolled in or eligible for VA health care. The rule modifies VA's HCHV regulations to conform to changes enacted in the Honoring America's Veterans and Caring for Camp Lejeune Families Act of 2012. Specifically, the rule removes the requirement that homeless veterans be diagnosed with a serious mental illness or substance use disorder to qualify for the HCHV program. This change makes the program available to all homeless veterans who are enrolled in or eligible for VA health care. The rule also updates the definition of homeless to match in part the one used by the Department of Housing and Urban Development (HUD). The rule further clarifies that the services provided by the HCHV program through non-VA community-based providers must include case management services, including non-clinical case management, as appropriate.
Medicaid program: rescission of School-Based Administration/Transportation final rule, Outpatient Hospital Services final rule, and partial rescission of Case Management Interim final rule. Final rule.
This rule finalizes our proposal to rescind the December 28, 2007 final rule entitled, "Elimination of Reimbursement under Medicaid for School Administration Expenditures and Costs Related to Transportation of School-Age Children Between Home and School;" the November 7, 2008 final rule entitled, "Clarification of Outpatient Hospital Facility (Including Outpatient Hospital Clinic) Services Definition;" and certain provisions of the December 4, 2007 interim final rule entitled, "Optional State Plan Case Management Services." These regulations have been the subject of Congressional moratoria and have not yet been implemented (or, with respect to the case management interim final rule, have only been partially implemented) by CMS. In light of concerns raised about the adverse effects that could result from these regulations, in particular, the potential restrictions on services available to beneficiaries and the lack of clear evidence demonstrating that the approaches taken in the regulations are warranted, CMS is rescinding the two final rules in full, and partially rescinding the interim final rule. Rescinding these provisions will permit further opportunity to determine the best approach to further the objectives of the Medicaid program in providing necessary health benefits coverage to needy individuals.
... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Program accessibility: Electronic and information technology. 6.152 Section 6.152 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE FEDERAL TRADE...
This chapter is devoted to the study of an extension of dynamic programming approach that allows sequential optimization of exact decision rules relative to the length and coverage. It contains also results of experiments with decision tables from UCI Machine Learning Repository. © Springer-Verlag Berlin Heidelberg 2013.
... chapter is eligible under this subpart to conduct training, testing, and checking under contract or other... contract with, or otherwise arrange to use the services of, a training center certificated under part 142... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Training program: Special rules. 135.324...
This chapter is devoted to the study of an extension of dynamic programming approach which allows optimization of approximate decision rules relative to the length and coverage. We introduce an uncertainty measure that is the difference between number of rows in a given decision table and the number of rows labeled with the most common decision for this table divided by the number of rows in the decision table. We fix a threshold γ, such that 0 ≤ γ < 1, and study so-called γ-decision rules (approximate decision rules) that localize rows in subtables which uncertainty is at most γ. Presented algorithm constructs a directed acyclic graph Δ γ T which nodes are subtables of the decision table T given by pairs "attribute = value". The algorithm finishes the partitioning of a subtable when its uncertainty is at most γ. The chapter contains also results of experiments with decision tables from UCI Machine Learning Repository. © 2014 Springer International Publishing Switzerland.
This paper is devoted to the study of an extension of dynamic programming approach which allows optimization of partial decision rules relative to the length or coverage. We introduce an uncertainty measure J(T) which is the difference between number of rows in a decision table T and number of rows with the most common decision for T. For a nonnegative real number γ, we consider γ-decision rules (partial decision rules) that localize rows in subtables of T with uncertainty at most γ. Presented algorithm constructs a directed acyclic graph Δ γ(T) which nodes are subtables of the decision table T given by systems of equations of the kind "attribute = value". This algorithm finishes the partitioning of a subtable when its uncertainty is at most γ. The graph Δ γ(T) allows us to describe the whole set of so-called irredundant γ-decision rules. We can optimize such set of rules according to length or coverage. This paper contains also results of experiments with decision tables from UCI Machine Learning Repository.
Engelhardt, Christopher R; Mazurek, Micah O
Environmental correlates of problem behavior among individuals with autism spectrum disorder remain relatively understudied. The current study examined the contribution of in-room (i.e. bedroom) access to a video game console as one potential correlate of problem behavior among a sample of 169 boys with autism spectrum disorder (ranging from 8 to 18 years of age). Parents of these children reported on (1) whether they had specific rules regulating their child's video game use, (2) whether their child had in-room access to a variety of screen-based media devices (television, computer, and video game console), and (3) their child's oppositional behaviors. Multivariate regression models showed that in-room access to a video game console predicted oppositional behavior while controlling for in-room access to other media devices (computer and television) and relevant variables (e.g. average number of video game hours played per day). Additionally, the association between in-room access to a video game console and oppositional behavior was particularly large when parents reported no rules on their child's video game use. The current findings indicate that both access and parental rules regarding video games warrant future experimental and longitudinal research as they relate to problem behavior in boys with autism spectrum disorder. © The Author(s) 2013.
Full Text Available A current limitation in embedded controller design and programming is the lack of database support in development tools such as Esterel Studio. This article proposes a way of integrating databases and Esterel by providing two application programming interfaces (APIs which enable the use of relational databases inside Esterel programs. As databases and Esterel programs are often executed on different machines, result sets returned as responses to database queries may be processed either locally and according to Esterel’s synchrony hypothesis, or remotely along several of Esterel’s execution cycles. These different scenarios are reflected in the design and usage rules of the two APIs presented in this article, which rely on Esterel’s facilities for extending the language by external data types, external functions, and procedures, as well as tasks. The APIs’ utility is demonstrated by means of a case study modelling an automated warehouse storage system, which is constructed using Lego Mindstorms robotics kits. The robot’s controller is programmed in Esterel in a way that takes dynamic ordering information and the warehouse’s floor layout into account, both of which are stored in a MySQL database.
Full Text Available Abstract A current limitation in embedded controller design and programming is the lack of database support in development tools such as Esterel Studio. This article proposes a way of integrating databases and Esterel by providing two application programming interfaces (APIs which enable the use of relational databases inside Esterel programs. As databases and Esterel programs are often executed on different machines, result sets returned as responses to database queries may be processed either locally and according to Esterel's synchrony hypothesis, or remotely along several of Esterel's execution cycles. These different scenarios are reflected in the design and usage rules of the two APIs presented in this article, which rely on Esterel's facilities for extending the language by external data types, external functions, and procedures, as well as tasks. The APIs' utility is demonstrated by means of a case study modelling an automated warehouse storage system, which is constructed using Lego Mindstorms robotics kits. The robot's controller is programmed in Esterel in a way that takes dynamic ordering information and the warehouse's floor layout into account, both of which are stored in a MySQL database.
Medicare Program; CY 2018 Updates to the Quality Payment Program; and Quality Payment Program: Extreme and Uncontrollable Circumstance Policy for the Transition Year. Final rule with comment period and interim final rule with comment period.
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) established the Quality Payment Program for eligible clinicians. Under the Quality Payment Program, eligible clinicians can participate via one of two tracks: Advanced Alternative Payment Models (APMs); or the Merit-based Incentive Payment System (MIPS). We began implementing the Quality Payment Program through rulemaking for calendar year (CY) 2017. This final rule with comment period provides updates for the second and future years of the Quality Payment Program. In addition, we also are issuing an interim final rule with comment period (IFC) that addresses extreme and uncontrollable circumstances MIPS eligible clinicians may face as a result of widespread catastrophic events affecting a region or locale in CY 2017, such as Hurricanes Irma, Harvey and Maria.
... Organization and Program Management, and Rules of Practice; Interim Commission Review of Public Company... of 2002 (the ``Act''), and its Rules of Organization and Program Management and Rules of Practice to... Organization and Program Management \\3\\ to provide delegations of authority to the Chief Accountant related to...
The Department of Veterans Affairs (VA) is establishing a grant program (Veterans Employment Pay for Success (VEPFS)) under the authority of the U.S.C. to award grants to eligible entities to fund projects that are successful in accomplishing employment rehabilitation for Veterans with service-connected disabilities. VA will award grants on the basis of an eligible entity's proposed use of a Pay for Success (PFS) strategy to achieve goals. This interim final rule establishes regulations for awarding a VEPFS grant, including the general process for awarding the grant, criteria and parameters for evaluating grant applications, priorities related to the award of a grant, and general requirements and guidance for administering a VEPFS grant program.
Most integrations of artificial intelligence (AI) capabilities with non-AI (usually FORTRAN-based) application programs require the latter to execute separately to run as a subprogram or, at best, as a coroutine, of the AI system. In many cases, this organization is unacceptable; instead, the requirement is for an AI facility that runs in embedded mode; i.e., is called as subprogram by the application program. The design and implementation of a Prolog-based AI capability that can be invoked in embedded mode are described. The significance of this system is twofold: Provision of Prolog-based symbol-manipulation and deduction facilities makes a powerful symbolic reasoning mechanism available to applications programs written in non-AI languages. The power of the deductive and non-procedural descriptive capabilities of Prolog, which allow the user to describe the problem to be solved, rather than the solution, is to a large extent vitiated by the absence of the standard control structures provided by other languages. Embedding invocations of Prolog rule bases in programs written in non-AI languages makes it possible to put Prolog calls inside DO loops and similar control constructs. The resulting merger of non-AI and AI languages thus results in a symbiotic system in which the advantages of both programming systems are retained, and their deficiencies largely remedied.
... COMMISSION Access Authorization Program for Nuclear Power Plants AGENCY: Nuclear Regulatory Commission... revision to Regulatory Guide 5.66, ``Access Authorization Program for Nuclear Power Plants.'' This guide... Authorization Requirements for Nuclear Power Plants,'' and 10 CFR part 26, ``Fitness for Duty Programs.'' The RG...
Ramoni, Rachel B; Asher, Sheetal R; White, Joel M; Vaderhobli, Ram; Ogunbodede, Eyitope O; Walji, Muhammad F; Riedy, Christine; Kalenderian, Elsbeth
A person's right to access his or her protected health information is a core feature of the U.S. Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule. If the information is stored electronically, covered entities must be able to provide patients with some type of machine-readable, electronic copy of their data. The aim of this study was to understand how academic dental institutions execute the Privacy Rule's right of access in the context of electronic health records (EHRs). A validated electronic survey was distributed to the clinical deans of 62 U.S. dental schools during a two-month period in 2014. The response rate to the survey was 53.2% (N=33). However, three surveys were partially completed, and of the 30 completed surveys, the 24 respondents who reported using axiUm as the EHR at their dental school clinic were the ones on which the results were based (38.7% of total schools at the time). Of the responses analyzed, 86% agreed that clinical modules should be considered part of a patient's dental record, and all agreed that student teaching-related modules should not. Great variability existed among these clinical deans as to whether administrative and financial modules should be considered part of a patient record. When patients request their records, close to 50% of responding schools provide the information exclusively on paper. This study found variation among dental schools in their implementation of the Privacy Rule right of access, and although all the respondents had adopted EHRs, a large number return records in paper format.
... COMMISSION Video Programming and Accessibility Advisory Committee; Announcement of Date of Next Meeting... meeting of the Video Programming Accessibility Advisory Committee (``Committee'' or ``VPAAC''). The... description, access to emergency programming, and access to user interfaces, menus, and programming guides...
... Service 7 CFR Part 205 National Organic Program; Notice on the Ruminant Slaughter Stock Provision of the... National Organic Program (NOP) to amend the provision on ruminant slaughter stock under the NOP regulations... ruminant slaughter stock requirements as codified by the final rule on access to pasture published on...
Since the Transportation Equity Act for the 21st Century authorized the Access to Jobs program in June 1998, the Department of Transportation has made several important decisions about the program's...
Cwiak, Carol L
The number of emergency management higher education programs has grown dramatically since 1994 when the FEMA Higher Education Program was created to propagate and support such growth. Data collected annually since 2007 from emergency management higher education programs shows that these programs face some consistent challenges. These challenges were coupled with annual data on program access and support indicators via dimensional analysis to answer the questions: To what extent are the challenges linked to a lack of access or support? If there is linkage, what can be gleaned from these linkages that can help address the challenges through improving access and support? The analysis showed that lack of access to funding and resources, and lack of support from partner organizations, has an impact on emergency management higher education. Discussion of that impact is followed with detailed recommendations that are focused on strengthening both internal and external access and support relationships for emergency management higher education programs.
... Service 7 CFR Part 1735 RIN 0572-AC24 Expansion of 911 Access; Telecommunications Loan Program AGENCY... access and integrated emergency communications systems in rural areas for the Telecommunications Loan... Villano, Assistant Administrator, Telecommunications Program, USDA--Rural Utilities Service, 1400...
Full Text Available Introduction. In 1999-2000, a Norwegian youth cracked a DVD-access code and published a decryptation program on the Internet. He was sued by the US DVD Copy Control Association (DVD-CCA and the Norwegian Motion Picture Association (MAP, allies of the US Motion Picture Association of America (MPAA, arrested by Norwegian police and charged with data crime. Two Norwegian court rulings in 2003 unanimously ruled that the program did not amount to a breach of Norwegian law, and he was fully acquitted. In the US, there have been related cases, some with other outcomes. Method. Based on a theoretical framework developed by Zwass, the paper discusses these court rulings and the wider issues of intellectual property rights versus public access rights. Analysis. The DVD-Jon case illustrates that intellectual property rights can conflict with public access rights, as the struggle between proprietary software and public domain software, as well as the SPARC and Open Archives Initiative reflect. Results. An assessment of the DVD-Jon case based on the Zwass framework does not give a clear information ethics answer. The analysis depends on whether one ascribes to consequentialist (e.g., utilitarian or de-ontological reflection, and also on which side of the digital gap is to be accorded most weight. Conclusion. While copyright interests are being legally strengthened, there may be ethically- grounded access rights that outweigh property rights.
Lehner, William D
... Training Corps, and Officer Candidate School. Three areas are covered: historical patterns in officer accessions and historical changes in Navy pre-commissioning training and education philosophy and policy...
... and Urban Development GENERAL HUD PROGRAM REQUIREMENTS; WAIVERS Pet Ownership for the Elderly or Persons With Disabilities Pet Ownership Requirements for Housing Programs § 5.350 Mandatory pet rules for... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Mandatory pet rules for housing...
Habib Akbari Alashti
Full Text Available Considering the necessity of desirable operation of limited water resources and assuming the significant role of dams in controlling and consuming the surface waters, highlights the advantageous of suitable operation rules for optimal and sustainable operation of dams. This study investigates the hydroelectric supply of a one-reservoir system of Karoon3 using nonlinear programming (NLP, genetic algorithm (GA, genetic programming (GP and fixed length gen GP (FLGGP in real-time operation of dam considering two approaches of static and dynamic operation rules. In static operation rule, only one rule curve is extracted for all months in a year whereas in dynamic operation rule, monthly rule curves (12 rules are extracted for each month of a year. In addition, nonlinear decision rule (NLDR curves are considered, and the total deficiency function as the target (objective function have been used for evaluating the performance of each method and approach. Results show appropriate efficiency of GP and FLGGP methods in extracting operation rules in both approaches. Superiority of these methods to operation methods yielded by GA and NLP is 5%. Moreover, according to the results, it can be remarked that, FLGGP method is an alternative for GP method, whereas the GP method cannot be used due to its limitations. Comparison of two approaches of static and dynamic operation rules demonstrated the superiority of dynamic operation rule to static operation rule (about 10% and therefore this method has more capabilities in real-time operation of the reservoirs systems.
... unnecessary. The Aircraft Owners and Pilots Association (AOPA) submitted comments urging the NTSB to delete... the Administrator's order. In setting forth its rationale for this proposed deletion, AOPA asserts many of the same points articulated by the NBAA. AOPA's comments suggests the NTSB's rules provide its...
Office of Postsecondary Education, US Department of Education, 2012
The Technological Innovation and Cooperation for Foreign Information Access (TICFIA) Program supports projects focused on developing innovative technologies for accessing, collecting, organizing, preserving, and disseminating information from foreign sources to address the U.S.' teaching and research needs in international education and foreign…
The Health Resources and Services Administration (HRSA) administers section 340B of the Public Health Service Act (PHSA), referred to as the "340B Drug Pricing Program" or the "340B Program." This final rule will apply to all drug manufacturers that are required to make their drugs available to covered entities under the 340B Program. This final rule sets forth the calculation of the 340B ceiling price and application of civil monetary penalties (CMPs).
Remote Memory Access (RMA) programming enables direct access to low-level hardware features to achieve high performance for distributed-memory programs. However, the design of RMA programming schemes focuses on the memory access and less on the synchronization. For example, in contemporary RMA programming systems, the widely used producer-consumer pattern can only be implemented inefficiently, incurring in an overhead of an additional round-trip message. We propose Notified Access, a scheme where the target process of an access can receive a completion notification. This scheme enables direct and efficient synchronization with a minimum number of messages. We implement our scheme in an open source MPI-3 RMA library and demonstrate lower overheads (two cache misses) than other point-to-point synchronization mechanisms for each notification. We also evaluate our implementation on three real-world benchmarks, a stencil computation, a tree computation, and a Colicky factorization implemented with tasks. Our scheme always performs better than traditional message passing and other existing RMA synchronization schemes, providing up to 50% speedup on small messages. Our analysis shows that Notified Access is a valuable primitive for any RMA system. Furthermore, we provide guidance for the design of low-level network interfaces to support Notified Access efficiently.
... Control Medicaid Eligibility Quality Control (meqc) Program § 431.818 Access to records: MEQC program. (a) The agency, upon written request, must mail to the HHS staff all records, including complete local... State has an alternate method of submitting these records that is approved by CMS or has received, on an...
... methods of achieving program accessibility include— (i) Using audio-visual materials and devices to depict... would result in a fundamental alteration in the nature of a program or activity or in undue financial... such alteration or burdens. The decision that compliance would result in such alteration or burdens...
... program accessibility include— (i) Using audio-visual materials and devices to depict those portions of an... action that it can demonstrate would result in a fundamental alteration in the nature of a program or... § 530.150(a) would result in such alteration or burdens. The decision that compliance would result in...
... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict... action that it can demonstrate would result in a fundamental alteration in the nature of a program or... § 720.150(a) would result in such alteration or burdens. The decision that compliance would result in...
...), alternative methods of achieving program accessibility include— (i) Using audio-visual materials and devices... action that it can demonstrate would result in a fundamental alteration in the nature of a program or... § 1153.150(a) would result in such alteration or burdens. The decision that compliance would result in...
... methods of achieving program accessibility include— (i) Using audio-visual materials and devices to depict... can demonstrate would result in a fundamental alteration in the nature of a program or activity or in...) would result in such alteration or burdens. The decision that compliance would result in such alteration...
... program accessibility include— (i) Using audio-visual materials and devices to depict those portions of an... fundamental alteration in the nature of a program or activity or in undue financial and administrative burdens... has the burden of proving that compliance with § 2416.150(a) would result in such alteration or...
...), alternative methods of achieving program accessibility include— (i) Using audio-visual materials and devices... can demonstrate would result in a fundamental alteration in the nature of a program or activity or in...) would result in such alteration or burdens. The decision that compliance would result in such alteration...
... program accessibility include— (i) Using audio-visual materials and devices to depict those portions of an... result in a fundamental alteration in the nature of a program or activity or in undue financial and... agency has the burden of proving that compliance with § 1207.150(a) would result in such alteration or...
... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict... action that it can demonstrate would result in a fundamental alteration in the nature of a program or... § 500.150(a) would result in such alteration or burdens. The decision that compliance would result in...
... methods of achieving program accessibility include— (i) Using audio-visual materials and devices to depict... demonstrate would result in a fundamental alteration in the nature of a program or activity or in undue... such alteration or burdens. The decision that compliance would result in such alteration or burdens...
... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict... action that it can demonstrate would result in a fundamental alteration in the nature of a program or... § 507.150(a) would result in such alteration or burdens. The decision that compliance would result in...
... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict... action that it can demonstrate would result in a fundamental alteration in the nature of a program or... § 1014.150(a) would result in such alteration or burdens. The decision that compliance would result in...
... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict... action that it can demonstrate would result in a fundamental alteration in the nature of a program or... § 144.150(a) would result in such alteration or burdens. The decision that compliance would result in...
... COMMISSION 47 CFR Part 79 Accessibility of User Interfaces, and Video Programming Guides and Menus... authority for requiring MVPDs to ensure that video programming guides and menus that ] provide channel and... the instructions for submitting comments. Federal Communications Commission's Web site: http...
... COMMISSION Video Programming and Accessibility Advisory Committee; Announcement of Date of Next Meeting... meeting of the Video Programming Accessibility Advisory Committee (``Committee'' or ``VPAAC''). The..., and the delivery of video description, access to emergency programming, and the interoperability and...
... COMMISSION Video Programming and Emergency Access Advisory Committee; Announcement of Establishment and... Programming and Emergency Access Advisory Committee (``Committee'' or ``VPEAAC'') of the Federal... name to the Video Programming Accessibility Advisory Committee (``VPAAC''). The Commission further...
Hwang, Mee Jeong; Kim, Kil Yoo; Kang, Dae Il; Yang, Joon Eon; Ha, Jae Joo
The objective of the Maintenance Rule is to require monitoring of the overall continuing effectiveness of licensee maintenance programs to ensure that safety related and certain nonsafety-related SSCs are capable of performing their intended functions and, for nonsafety-related equipment failures will not occur that prevent the fulfillment of safety-related functions, and failures resulting in scrams and unnecessary actuations of safety-related systems are minimized. That is, proper maintenance is essential to plant safety. U.S. Maintenance Rule, which was effective July 1996 in USA., was not officially adopted in Korea by Korean regulatory body. However, since many PSA and IPE have been performed for NPPs, the philosophy and usefulness of the Maintenance Rule as well as performance-based regulation are being acceptable. We survey the Maintenance Rule program and applications in the USA, and also developed the Maintenance Rule program to apply to Korean NPPs. In addition, we applied the Maintenance Rule Program apply to Ulchin 3,4 Units roughly with the Maintenance Rule Program developed in this project.
... of Housing and Urban Development GENERAL HUD PROGRAM REQUIREMENTS; WAIVERS Pet Ownership for the Elderly or Persons With Disabilities Pet Ownership Requirements for Housing Programs § 5.356 Housing... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Housing programs: Pet rule...
Khan, Aziz; Mathelier, Anthony
JASPAR is a widely used open-access database of curated, non-redundant transcription factor binding profiles. Currently, data from JASPAR can be retrieved as flat files or by using programming language-specific interfaces. Here, we present a programming language-independent application programming interface (API) to access JASPAR data using the Representational State Transfer (REST) architecture. The REST API enables programmatic access to JASPAR by most programming languages and returns data in eight widely used formats. Several endpoints are available to access the data and an endpoint is available to infer the TF binding profile(s) likely bound by a given DNA binding domain protein sequence. Additionally, it provides an interactive browsable interface for bioinformatics tool developers. This REST API is implemented in Python using the Django REST Framework. It is accessible at http://jaspar.genereg.net/api/ and the source code is freely available at https://bitbucket.org/CBGR/jaspar under GPL v3 license. email@example.com, firstname.lastname@example.org. Supplementary data are available at Bioinformatics online.
This final rule establishes a permanent certification program for the purpose of certifying health information technology (HIT). This final rule is issued pursuant to the authority granted to the National Coordinator for Health Information Technology (the National Coordinator) by section 3001(c)(5) of the Public Health Service Act (PHSA), as added by the Health Information Technology for Economic and Clinical Health (HITECH) Act. The permanent certification program will eventually replace the temporary certification program that was previously established by a final rule. The National Coordinator will use the permanent certification program to authorize organizations to certify electronic health record (EHR) technology, such as Complete EHRs and/or EHR Modules. The permanent certification program could also be expanded to include the certification of other types of HIT.
Medicare Program; End-Stage Renal Disease Prospective Payment System, Coverage and Payment for Renal Dialysis Services Furnished to Individuals With Acute Kidney Injury, End-Stage Renal Disease Quality Incentive Program, Durable Medical Equipment, Prosthetics, Orthotics and Supplies Competitive Bidding Program Bid Surety Bonds, State Licensure and Appeals Process for Breach of Contract Actions, Durable Medical Equipment, Prosthetics, Orthotics and Supplies Competitive Bidding Program and Fee Schedule Adjustments, Access to Care Issues for Durable Medical Equipment; and the Comprehensive End-Stage Renal Disease Care Model. Final rule.
This rule updates and makes revisions to the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for calendar year 2017. It also finalizes policies for coverage and payment for renal dialysis services furnished by an ESRD facility to individuals with acute kidney injury. This rule also sets forth requirements for the ESRD Quality Incentive Program, including the inclusion of new quality measures beginning with payment year (PY) 2020 and provides updates to programmatic policies for the PY 2018 and PY 2019 ESRD QIP. This rule also implements statutory requirements for bid surety bonds and state licensure for the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP). This rule also expands suppliers' appeal rights in the event of a breach of contract action taken by CMS, by revising the appeals regulation to extend the appeals process to all types of actions taken by CMS for a supplier's breach of contract, rather than limit an appeal for the termination of a competitive bidding contract. The rule also finalizes changes to the methodologies for adjusting fee schedule amounts for DMEPOS using information from CBPs and for submitting bids and establishing single payment amounts under the CBPs for certain groupings of similar items with different features to address price inversions. Final changes also are made to the method for establishing bid limits for items under the DMEPOS CBPs. In addition, this rule summarizes comments on the impacts of coordinating Medicare and Medicaid Durable Medical Equipment for dually eligible beneficiaries. Finally, this rule also summarizes comments received in response to a request for information related to the Comprehensive ESRD Care Model and future payment models affecting renal care.
Holbein, M E Blair; Berglund, Jelena P; Weatherwax, Kevin; Gerber, David E; Adamo, Joan E
The Food and Drug Administration Expanded Access (EA) program and "Right-to-Try" legislation aim to provide seriously ill patients who have no other comparable treatment options to gain access to investigational drugs and biological agents. Physicians and institutions need to understand these programs to respond to questions and requests for access. FDA EA programs and state and federal legislative efforts to provide investigational products to patients by circumventing FDA regulations were summarized and compared. The FDA EA program includes Single Patient-Investigational New Drug (SP-IND), Emergency SP-IND, Intermediate Sized Population IND, and Treatment IND. Approval rates for all categories exceed 99%. Approval requires FDA and Institutional Review Board (IRB) approval, and cooperation of the pharmaceutical partner is essential. "Right-to-Try" legislation bypasses some of these steps, but provides no regulatory or safety oversight. The FDA EA program is a reasonable option for patients for whom all other therapeutic interventions have failed. The SP-IND not only provides patient access to new drugs, but also maintains a balance between immediacy and necessary patient protection. Rather than circumventing existing FDA regulations through proposed legislation, it seems more judicious to provide the knowledge and means to meet the EA requirements. © 2015 Wiley Periodicals, Inc.
probabilistic versions of abductive logic programming, the approach is characterized by higher generality and a flexible and adaptable architecture which incorporates integrity constraints and interaction with external constraint solvers. % A PALP is translated in a systematic way into a CHR program which...
Gebremariam, Mekdes K; Lien, Nanna; Torheim, Liv Elin; Andersen, Lene F; Melbye, Elisabeth L; Glavin, Kari; Hausken, Solveig E S; Sleddens, Ester F C; Bjelland, Mona
The existence of socioeconomic differences in dietary behaviors is well documented. However, studies exploring the mechanisms behind these differences among adolescents using comprehensive and reliable measures of mediators are lacking. The aims of this study were (a) to assess the psychometric properties of new scales assessing the perceived rules and accessibility related to the consumption of vegetables and soft drinks and (b) to explore their mediating role in the association between parental education and the corresponding dietary behaviors. A cross-sectional survey including 440 adolescents from three counties in Norway (mean age 14.3 years (SD = 0.6)) was conducted using a web-based questionnaire. Principal component analysis, test-retest and internal reliability analysis were conducted. The mediating role of perceived accessibility and perceived rules in the association between parental education and the dietary behaviors was explored using linear regression analyses. Factor analyses confirmed two separate subscales, named "accessibility" and "rules", both for vegetables and soft drinks (factor loadings >0.60). The scales had good internal consistency reliability (0.70-0.87). The test-retest reliability of the scales was moderate to good (0.44-0.62). Parental education was inversely related to the consumption of soft drinks and positively related to the consumption of vegetables. Perceived accessibility and perceived rules related to soft drink consumption were found to mediate the association between parental education and soft drink consumption (47.5 and 8.5 % of total effect mediated). Accessibility of vegetables was found to mediate the association between parental education and the consumption of vegetables (51 % of total effect mediated). The new scales developed in this study are comprehensive and have adequate validity and reliability; they are therefore considered appropriate for use among 13-15 year-olds. Parents, in particular those with a
A class of Probabilistic Abductive Logic Programs (PALPs) is introduced and an implementation is developed in CHR for solving abductive problems, providing minimal explanations with their probabilities. Both all-explanations and most-probable-explanations versions are given. Compared with other...... probabilistic versions of abductive logic programming, the approach is characterized by higher generality and a flexible and adaptable architecture which incorporates integrity constraints and interaction with external constraint solvers. A PALP is transformed in a systematic way into a CHR program which serves...
... development of pet rules. 5.353 Section 5.353 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development GENERAL HUD PROGRAM REQUIREMENTS; WAIVERS Pet Ownership for the Elderly or Persons With Disabilities Pet Ownership Requirements for Housing Programs § 5.353 Housing...
Smith, Carol Lynn [Iowa State Univ., Ames, IA (United States)
One of the main purposes of a programming language is to provide a framework within which a user can convey the specification of a task to an information processing system. A model is proposed in which name accessing conventions can be analyzed and compared.
... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Program accessibility: discrimination prohibited. 9.149 Section 9.149 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF DISABILITY IN...
... FOUNDATION ON THE ARTS AND THE HUMANITIES INSTITUTE OF MUSEUM AND LIBRARY SERVICES ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE INSTITUTE OF MUSEUM AND... services to accessible buildings, assignment of aides to beneficiaries, home visits, delivery of services...
... Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT COMMUNITY DEVELOPMENT BLOCK GRANTS FOR INDIAN TRIBES AND ALASKA NATIVE VILLAGES Grant... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Public access to program records...
... accessibility include— (i) Using audio-visual materials and devices to depict those portions of an historic... result in a fundamental alteration in the nature of a program or activity or in undue financial and... agency has the burden of proving that compliance with § 711.150(a) would result in such alteration or...
... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict...) Require the agency to take any action that it can demonstrate would result in a fundamental alteration in... proving that compliance with § 2104.150(a) would result in such alteration or burdens. The decision that...
... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict...) Require the agency to take any action that it can demonstrate would result in a fundamental alteration in... proving that compliance with § 149.150(a) would result in such alteration or burdens. The decision that...
... accessibility include— (i) Using audio-visual materials and devices to depict those portions of an historic... result in a fundamental alteration in the nature of a program or activity or in undue financial and... agency has the burden of proving that compliance with § 1200.150(a) would result in such alteration or...
... accessibility include— (i) Using audio-visual materials and devices to depict those portions of an historic... demonstrate would result in a fundamental alteration in the nature of a program or activity or in undue... such alteration or burdens. The decision that compliance would result in such alteration or burdens...
... accessibility include— (i) Using audio-visual materials and devices to depict those portions of an historic... result in a fundamental alteration in the nature of a program or activity or in undue financial and... agency has the burden of proving that compliance with § 2301.150(a) would result in such alteration or...
... accessibility include— (i) Using audio-visual materials and devices to depict those portions of an historic... fundamental alteration in the nature of a program or activity or in undue financial and administrative burdens... has the burden of proving that compliance with § 1636.150(a) would result in such alteration or...
... (a)(3), alternative methods of achieving program accessibility include— (i) Using audio-visual...) Require the agency to take any action that it can demonstrate would result in a fundamental alteration in... proving that compliance with § 1313.150(a) would result in such alteration or burdens. The decision that...
The Department of Veterans Affairs (VA) is issuing this final rule that amends the regulations governing the Servicemembers' Group Life Insurance Traumatic Injury Protection (TSGLI) program by adding certain genitourinary (GU) system losses to the TSGLI Schedule of Losses and defining terms relevant to these new losses. This amendment is necessary to make qualifying GU losses a basis for paying TSGLI benefits to servicemembers with severe GU injuries. The intended effect is to expand the list of losses for which TSGLI payments can be made. This document adopts as a final rule, without change, the interim final rule published in the Federal Register on December 2, 2011.
... COMMISSION Video Programming and Accessibility Advisory Committee; Announcement of Date of Next Meeting... meeting of the Video Programming Accessibility Advisory Committee (``Committee'' or ``VPAAC''). The meeting will address the provision of closed captioning of Internet programming previously captioned on...
This rule amends the regulations for the STOP (ServicesTrainingOfficersProsecutors) Violence Against Women Formula Grant Program (STOP Program) and the general provisions governing Office on Violence Against Women (OVW) programs to comply with statutory changes and reduce repetition of statutory language. Also, this rule implements statutory requirements for nondisclosure of confidential or private information relating to all OVW grant programs.
Roque da Silva Araújo
Full Text Available ABSTRACT Objective: to verify causes of inactivity in the Home Delivery Medicament Program, as referred by users from a Primary Health Care Service in São Paulo, comparing them to the causes registered in the program and analyzing them in the theoretical model Concept of Access to Health. Methods: cross-sectional study, interviewing 111 inactive users; and documentary study in the program records. Results: half of the users did not know the condition of inactivity. Discrepancies were found between the user's and the program's information, observing different levels of agreement: Absence of physician and administrative staff member 0%; Transfer to other service 25%; Death 50%; Option to quit 50%; Address change 57% and Change in therapeutic schedule 80%. The users' feeling of accepting the program was observed. In the health access concept, inactivity can be explained in the information dimension, in the degree of asymmetry between the patient's and the health professional's knowledge, identified through the indicators: education, knowledge and information sources. Conclusions: due to the low education level, the user does not assimilate the information on the steps of the program flowchart, does not return for the assessment that guarantees its continuity. Consequently, (she stops receiving the medication and spends a long time without treatment, increasing the cardiovascular risk of hypertensive (92% of the sample, diabetic (44% and dyslipidemic patients (31%.
Juan G Victores
Full Text Available In this paper, we present an accessible interface in the context of our work on bringing advanced robotics closer to everyday domestic users. This interface allows inexperienced users to be capable of programming an assistive robotic arm to perform a specific desired task in a household environment. The programming process is performed through the developed Web Browsable interface, within which a Task Creator Wizard plays an essential role. The robot's open architecture enables flexible multi-modal interaction. In addition to the touch buttons provided by the Web Browsable interface when presented on a touch screen, voice commands and the use of the Wii RemoteTM controller for intuitive robotic movement have also been enabled. The Web Browsable interface has been designed to provide high accessibility while taking aesthetic details into account, in order to prevent distraction caused by boredom of the user.
Carlos Javier Carvajal Montealegre
Full Text Available This paper describes the data mining process to obtain classification rules over an information security incident data collection, explaining in detail the use of genetic programming as a mean to model the incidents behavior and representing such rules as decision trees. The described mining process includes several tasks, such as the GP (Genetic Programming approach evaluation, the individual's representation and the algorithm parameters tuning to upgrade the performance. The paper concludes with the result analysis and the description of the rules obtained, suggesting measures to avoid the occurrence of new informatics attacks. This paper is a part of the thesis work degree: Information Security Incident Analytics by Data Mining for Behavioral Modeling and Pattern Recognition (Carvajal, 2012.
Medicare program; revisions to payment policies under the Physician Fee Schedule, Clinical Laboratory Fee Schedule, access to identifiable data for the Center for Medicare and Medicaid Innovation Models & other revisions to Part B for CY 2015. Final rule with comment period.
This major final rule with comment period addresses changes to the physician fee schedule, and other Medicare Part B payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services, as well as changes in the statute. See the Table of Contents for a listing of the specific issues addressed in this rule.
... PROTECTION 12 CFR Part 1012 RIN 3170-AA06 Interstate Land Sales Registration Program, Special Rules of... substantially equivalent state law, Filing assistance, Purchasers' revocation rights, Land registration... (76 FR 79486), republishing implementing regulations under the Interstate Land Sales Full Disclosure...
Tsakonas, A.; Dounias, G.; Jantzen, Jan
We demonstrate, compare and discuss the application of two genetic programming methodologies for the construction of rule-based systems in two medical domains: the diagnosis of Aphasia's subtypes and the classification of Pap-Smear Test examinations. The first approach consists of a scheme that c...
... (Act) to mean all States, the District of Columbia, and the Commonwealth of Puerto Rico. Producers in... an independent analysis of the dairy checkoff programs. The independent analysis, conducted by... thereof, on dairy products imported into the United States. This final rule, in accordance with the 2008...
... for development of pet rules. 5.380 Section 5.380 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development GENERAL HUD PROGRAM REQUIREMENTS; WAIVERS Pet Ownership for the Elderly or Persons With Disabilities Pet Ownership Requirements for Public Housing...
Hartly, L. (Tennessee Valley Authority, Chattanooga (United States)); Sonnett, D.E.; Barnard, D.D. (Life Cycle Technical Services, Inc., Charleston, SC (United States))
Tennessee Valley Authority (TVA) initiated a pilot reliability-centered maintenance (RCM) program at the Sequoyah nuclear plant in 1990. A straightforward methodology using failure modes and effects analysis (but not modeling) was followed. The pilot established that RCM was a viable approach resulting in improved maintenance practices that justified the cost and effort of the program. TVA obtained a corporate commitment to continue and expand the program to include all nuclear stations. About the same time TVA committed to RCM, the US Nuclear Regulatory Commission (NRC) announced that a maintenance rule would be issued, and TVA personnel became active in industry committees formed to respond to this rule. Certain modifications to the methodology, and especially improvements in documentation of TVA's RCM program, were identified and made as a result. This paper discusses aspects of TVA's RCM program that improved the utility's position to respond to the maintenance rule and also to support future plant license renewal programs.
National School Lunch Program and School Breakfast Program: Nutrition Standards for All Foods Sold in School as Required by the Healthy, Hunger-Free Kids Act of 2010. Final rule and interim final rule.
This rule adopts as final, with some modifications, the National School Lunch Program and School Breakfast Program regulations set forth in the interim final rule published in the Federal Register on June 28, 2013. The requirements addressed in this rule conform to the provisions in the Healthy, Hunger-Free Kids Act of 2010 regarding nutrition standards for all foods sold in schools, other than food sold under the lunch and breakfast programs. Most provisions of this final rule were implemented on July 1, 2014, a full year subsequent to publication of the interim final rule. This was in compliance with section 208 of the Healthy, Hunger-Free Kids Act of 2010, which required that State and local educational agencies have at least one full school year from the date of publication of the interim final rule to implement the competitive food provisions. Based on comments received on the interim final rule and implementation experience, this final rule makes a few modifications to the nutrition standards for all foods sold in schools implemented on July 1, 2014. In addition, this final rule codifies specific policy guidance issued after publication of the interim rule. Finally, this rule retains the provision related to the standard for total fat as interim and requests further comment on this single standard.
Full Text Available By ratifying the Aarhus Convention in 2005 the EU committed itself to guaranteeing broad access to justice in environmental matters both at the national and the EU level. Yet, in spite of the clear-cut obligations incumbent upon the EU, EU courts have consistently rebuked pleas for a softening of the standing requirements in the context of direct actions against EU acts that might have an impact on the environment and/or public health. In addition, the internal review procedure set out by the 2006 Aarhus Regulation has been interpreted so restrictively by the EU institutions that that its added value in the stride toward better access to courts in environmental matters remains ephemeral at best. This led the General Court to finding that the Aarhus Regulation, by excluding general EU acts from the scope of internal review, was in breach of Article 9(3 of the Aarhus Convention. In its recent rulings of 13 January 2015, however, the Court of Justice of the EU (CJEU overruled the General Court by holding that the Aarhus Regulation could not be reviewed in light of the Aarhus Convention. With its refusal to use Article 9(3 of the Aarhus Convention as a reference criterion for the purpose of reviewing the EU’s compliance with the Aarhus Convention’s obligations, the CJEU avoided tackling the unsatisfactory level of judicial protection in environmental cases at the EU level. This paper argues that the rulings of the CJEU are to be qualified as a significant step backwards for judicial protection in environmental matters at the EU level. It is established that, instead of addressing the current failings of the EU with respect to access to justice in environmental cases, the CJEU’s hands-off approach paves the way for yet another decade of non-compliance by the EU in the realm of access to justice in environmental cases.
2015 Edition Health Information Technology (Health IT) Certification Criteria, 2015 Edition Base Electronic Health Record (EHR) Definition, and ONC Health IT Certification Program Modifications. Final rule.
This final rule finalizes a new edition of certification criteria (the 2015 Edition health IT certification criteria or "2015 Edition'') and a new 2015 Edition Base Electronic Health Record (EHR) definition, while also modifying the ONC Health IT Certification Program to make it open and accessible to more types of health IT and health IT that supports various care and practice settings. The 2015 Edition establishes the capabilities and specifies the related standards and implementation specifications that Certified Electronic Health Record Technology (CEHRT) would need to include to, at a minimum, support the achievement of meaningful use by eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) under the Medicare and Medicaid EHR Incentive Programs (EHR Incentive Programs) when such edition is required for use under these programs.
This rule implements policy, assigns responsibilities, and provides guidance and procedures for the SAPR Program; establishes the processes and procedures for the Sexual Assault Forensic Examination (SAFE) Kit; establishes the multidisciplinary Case Management Group (CMG) and provides guidance on how to handle sexual assault; establishes SAPR minimum program standards, SAPR training requirements, and SAPR requirements for the DoD Annual Report on Sexual Assault in the Military. The Department of Defense Sexual Assault Prevention and Response (SAPR) program continues to evolve, and the Department is committed to incorporating best practices and Congressional requirements to ensure that sexual assault victims receive the services they need. As part of this commitment and in addition to the Interim Final Rule, the Department is exploring the feasibility and advisability of extending the Restricted Reporting option to DoD civilians and contractors serving overseas.
... Access; Development of Competition and Diversity in Video Programming Distribution and Carriage; Revision... Video Programming Distribution and Carriage AGENCY: Federal Communications Commission. ACTION: Final... carriage of video programming vendors by multichannel video programming distributors (``MVPDs''), known as...
Nguyen, Su; Zhang, Mengjie; Tan, Kay Chen
Automated design of dispatching rules for production systems has been an interesting research topic over the last several years. Machine learning, especially genetic programming (GP), has been a powerful approach to dealing with this design problem. However, intensive computational requirements, accuracy and interpretability are still its limitations. This paper aims at developing a new surrogate assisted GP to help improving the quality of the evolved rules without significant computational costs. The experiments have verified the effectiveness and efficiency of the proposed algorithms as compared to those in the literature. Furthermore, new simplification and visualisation approaches have also been developed to improve the interpretability of the evolved rules. These approaches have shown great potentials and proved to be a critical part of the automated design system.
Engelhardt, Christopher R.; Mazurek, Micah O.
Environmental correlates of problem behavior among individuals with autism spectrum disorder remain relatively understudied. The current study examined the contribution of in-room (i.e. bedroom) access to a video game console as one potential correlate of problem behavior among a sample of 169 boys with autism spectrum disorder (ranging from 8 to…
Sevre, E. O.; Lee, S.
The goal of this research is to develop an interface that will simplify user interaction with software for scientists. The motivating factor of the research is to develop tools that assist scientists with limited motor skills with the efficient generation and use of software tools. Reliance on computers and programming is increasing in the world of geology, and it is increasingly important for geologists and geophysicists to have the computational resources to use advanced software and edit programs for their research. I have developed a prototype of a program to help geophysicists write programs using a simple interface that requires only simple single-mouse-clicks to input code. It is my goal to minimize the amount of typing necessary to create simple programs and scripts to increase accessibility for people with disabilities limiting fine motor skills. This interface can be adapted for various programming and scripting languages. Using this interface will simplify development of code for C/C++, Java, and GMT, and can be expanded to support any other text based programming language. The interface is designed around the concept of maximizing the amount of code that can be written using a minimum number of clicks and typing. The screen is split into two sections: a list of click-commands is on the left hand side, and a text area is on the right hand side. When the user clicks on a command on the left hand side the applicable code is automatically inserted at the insertion point in the text area. Currently in the C/C++ interface, there are commands for common code segments that are often used, such as for loops, comments, print statements, and structured code creation. The primary goal is to provide an interface that will work across many devices for developing code. A simple prototype has been developed for the iPad. Due to the limited number of devices that an iOS application can be used with, the code has been re-written in Java to run on a wider range of devices
Racine, Elizabeth F; Delmelle, Eric; Major, Elizabeth; Solomon, Corliss A
The Supplemental Nutrition Assistance Program (SNAP) is the largest food assistance program in the United States. Participants receive electronic benefits that are redeemable at a variety of food stores. Previous research notes that low-income neighborhoods often lack supermarkets with high-quality, affordable food. The first aim of this study was to explore the number and spatial distribution of SNAP stores by type and to assess how SNAP benefit redemption is linked to store type in North Carolina in 2015. The second aim was to compare the demographics of populations living in areas with a high concentration of SNAP participants vs areas with a lower concentration of SNAP participants. The third aim was to test for disparities in the availability of and access to SNAP-authorized stores in areas with high vs low concentration of SNAP participants stratified by rural/urban status. US Department of Agriculture and US Census data were used to explore the spatial distribution of SNAP stores at the census block group level utilizing a Geographic Information System. The 9,556 North Carolina SNAP stores in 2015 categorized into full-variety and limited-variety stores. Proximity to limited-variety SNAP food stores and full-variety SNAP food stores within access range (1 mile in urban areas and 10 miles in rural areas). Wilcoxon rank sum and χ 2 tests are used to compare the distance to and concentration of SNAP stores by rurality and SNAP participant concentration at census block group scale. Among the SNAP stores in North Carolina, 83% are limited-variety stores and 17% are full-variety stores. There are disparities in the demographics of individuals living in census block groups with a high proportion of SNAP participants compared to census block groups with a lower proportion of SNAP participants. More households in higher SNAP participant census block groups were non-white, did not have a car, and had children compared to census block groups with lower SNAP
Filippo M. Zerilli
Full Text Available This paper explores dynamics of formalization and informalization as interlinked social processes as a contribution to a critical understanding of rule of law capacity building programs in the framework of EU enlargement process. It also challenges the assumption according to which informality would be a modality characteristic of countries of the “Global South”.
Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2018 Rates; Quality Reporting Requirements for Specific Providers; Medicare and Medicaid Electronic Health Record (EHR) Incentive Program Requirements for Eligible Hospitals, Critical Access Hospitals, and Eligible Professionals; Provider-Based Status of Indian Health Service and Tribal Facilities and Organizations; Costs Reporting and Provider Requirements; Agreement Termination Notices. Final rule.
We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2018. Some of these changes implement certain statutory provisions contained in the Pathway for Sustainable Growth Rate (SGR) Reform Act of 2013, the Improving Medicare Post-Acute Care Transformation Act of 2014, the Medicare Access and CHIP Reauthorization Act of 2015, the 21st Century Cures Act, and other legislation. We also are making changes relating to the provider-based status of Indian Health Service (IHS) and Tribal facilities and organizations and to the low-volume hospital payment adjustment for hospitals operated by the IHS or a Tribe. In addition, we are providing the market basket update that will apply to the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits for FY 2018. We are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) for FY 2018. In addition, we are establishing new requirements or revising existing requirements for quality reporting by specific Medicare providers (acute care hospitals, PPS-exempt cancer hospitals, LTCHs, and inpatient psychiatric facilities). We also are establishing new requirements or revising existing requirements for eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) participating in the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. We are updating policies relating to the Hospital Value-Based Purchasing (VBP) Program, the Hospital Readmissions Reduction Program, and the Hospital-Acquired Condition (HAC) Reduction Program. We also are making changes relating to transparency of accrediting organization survey
Sullivan, Clair; Staib, Andrew; Khanna, Sankalp; Good, Norm M; Boyle, Justin; Cattell, Rohan; Heiniger, Liam; Griffin, Bronwyn R; Bell, Anthony Jr; Lind, James; Scott, Ian A
We explored the relationship between the National Emergency Access Target (NEAT) compliance rate, defined as the proportion of patients admitted or discharged from emergency departments (EDs) within 4 hours of presentation, and the risk-adjusted in-hospital mortality of patients admitted to hospital acutely from EDs. Retrospective observational study of all de-identified episodes of care involving patients who presented acutely to the EDs of 59 Australian hospitals between 1 July 2010 and 30 June 2014. The relationship between the risk-adjusted mortality of inpatients admitted acutely from EDs (the emergency hospital standardised mortality ratio [eHSMR]: the ratio of the numbers of observed to expected deaths) and NEAT compliance rates for all presenting patients (total NEAT) and admitted patients (admitted NEAT). ED and inpatient data were aggregated for 12.5 million ED episodes of care and 11.6 million inpatient episodes of care. A highly significant (P NEAT compliance rates was found; eHSMR declined to a nadir of 73 as total and admitted NEAT compliance rates rose to about 83% and 65% respectively. Sensitivity analyses found no confounding by the inclusion of palliative care and/or short-stay patients. As NEAT compliance rates increased, in-hospital mortality of emergency admissions declined, although this direct inverse relationship is lost once total and admitted NEAT compliance rates exceed certain levels. This inverse association between NEAT compliance rates and in-hospital mortality should be considered when formulating targets for access to emergency care.
This final rule updates the prospective payment rates for inpatient rehabilitation facilities (IRFs) for federal fiscal year (FY) 2018 as required by the statute. As required by section 1886(j)(5) of the Social Security Act (the Act), this rule includes the classification and weighting factors for the IRF prospective payment system's (IRF PPS) case-mix groups and a description of the methodologies and data used in computing the prospective payment rates for FY 2018. This final rule also revises the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) diagnosis codes that are used to determine presumptive compliance under the "60 percent rule," removes the 25 percent payment penalty for inpatient rehabilitation facility patient assessment instrument (IRF-PAI) late transmissions, removes the voluntary swallowing status item (Item 27) from the IRF-PAI, summarizes comments regarding the criteria used to classify facilities for payment under the IRF PPS, provides for a subregulatory process for certain annual updates to the presumptive methodology diagnosis code lists, adopts the use of height/weight items on the IRF-PAI to determine patient body mass index (BMI) greater than 50 for cases of single-joint replacement under the presumptive methodology, and revises and updates measures and reporting requirements under the IRF quality reporting program (QRP).
Poliana Remundini de Lima
Full Text Available A cross-sectional study aimed to describe the access and integrality of attention to children before one year old, born between January of 2010 and December of 2012 in a Brazilian city, in a newborn attention program. From the 24.560 children, 55.0% were users of the Unified Health System (SUS; 10.1% children presented low weight at birth; 6,332 (46.9% children received BCG vaccine at the nursing consultation day; 13,590 (79.5% children had neonatal screening being less than seven days old; 17,035 (69.4% children were vaccinated for Hepatitis B at birth. Within SUS users, 68% of children went to nursing consultation at their first week of life and, 37.8% went to a medical consultation being 10 days old. The study presents information of care after birth at the primary healthcare as potential instrument to coordinate assistance to this clientele.
The Health Resources and Services Administration (HRSA) administers section 340B of the Public Health Service Act (PHSA), known as the "340B Drug Pricing Program" or the "340B Program." HRSA published a final rule on January 5, 2017, that set forth the calculation of the ceiling price and application of civil monetary penalties. The final rule applied to all drug manufacturers that are required to make their drugs available to covered entities under the 340B Program. On August 21, 2017, HHS solicited comments on further delaying the effective date of the January 5, 2017, final rule to July 1, 2018 (82 FR 39553). HHS proposed this action to allow a more deliberate process of considering alternative and supplemental regulatory provisions and to allow for sufficient time for additional rulemaking. After consideration of the comments received on the proposed rule, HHS is delaying the effective date of the January 5, 2017, final rule, to July 1, 2018.
Hebert, Kathy; Dias, Andre; Franco, Emiliana; Tamariz, Leonardo; Steen, Dylan; Arcement, Lee M
In order to provide efficient utilization of resources in an outpatient setting for acute exacerbation of heart failure (HF), the authors piloted an open-access outpatient intravenous (IV) diuretic program (IVDP) to evaluate utilization in an HF disease management program (HFDMP), patient characteristics for users of the program, and safety. An outpatient HFDMP at Jackson Memorial Hospital in Miami, Florida, enrolling 577 patients 18 years and older with an ejection fraction ≤40% was implemented. For symptoms or weight gain ≥5 pounds, patients were eligible to use an open-access IVDP during clinic hours. A total of 130 HFDM patients (22.5%) used the IVDP. IVDP users were more likely to be diabetic, with lower body mass indices than non-IVDP users. New York Heart Association class IV patients and previously hospitalized patients were more likely to use the IVDP. There were no documented adverse reactions for patients receiving treatment and no difference in mortality between groups. This open-access outpatient IVDP model for patients with HF was readily utilized by the HFDMP participants and appears safe for use in this population. This unique model may provide alternative access for acute HF treatment. Congest Heart Fail. © 2011 Wiley Periodicals, Inc.
... AGENCY Cross-Media Electronic Reporting Rule State Authorized Program Revision Approval: State of New...'s approval, under regulations for Cross-Media Electronic Reporting, of the State of New York's..., the final Cross-Media Electronic Reporting Rule (CROMERR) was published in the Federal Register (70 FR...
Dounias, George; Tsakonas, Athanasios; Jantzen, Jan
This paper demonstrates two methodologies for the construction of rule-based systems in medical decision making. The first approach consists of a method combining genetic programming and heuristic hierarchical rule-base construction. The second model is composed by a strongly-typed genetic progra...
Luna, José María; Romero, José Raúl; Romero, Cristóbal; Ventura, Sebastián
This paper proposes a novel grammar-guided genetic programming algorithm for subgroup discovery. This algorithm, called comprehensible grammar-based algorithm for subgroup discovery (CGBA-SD), combines the requirements of discovering comprehensible rules with the ability to mine expressive and flexible solutions owing to the use of a context-free grammar. Each rule is represented as a derivation tree that shows a solution described using the language denoted by the grammar. The algorithm includes mechanisms to adapt the diversity of the population by self-adapting the probabilities of recombination and mutation. We compare the approach with existing evolutionary and classic subgroup discovery algorithms. CGBA-SD appears to be a very promising algorithm that discovers comprehensible subgroups and behaves better than other algorithms as measures by complexity, interest, and precision indicate. The results obtained were validated by means of a series of nonparametric tests.
Staib, Andrew; Sullivan, Clair; Griffin, Bronwyn; Bell, Anthony; Scott, Ian
compliance) has prompted a re-examination of the 4-h rule, the evidence underpinning its introduction and its benefits and risks to patients What does this paper add? This paper is executive summary of key findings from a systematic literature review on the benefits and limitations of NEAT (the 4-h rule) commissioned by the Queensland Clinical Senate to inform future policy and targets. What are the implications for practitioners? There is evidence that a time-based target has been associated with a reduction in in-hospital mortality for emergency admissions to Australian hospitals. Concerns remain regarding a time-based target alone being used to drive redesign efforts at improving access to emergency care. A time-based target should be coupled with close monitoring of patient outcomes of emergency care. Target thresholds need to be evidence based and separate targets should be reported for admitted, discharged and all patients presenting to the ED.
Smith, Lisa J; Gradisar, Michael; King, Daniel L
Adolescents' video gaming is increasing at a rapid rate. Yet, little is known about what factors contribute toward more hours of gaming per week, as well as what factors may limit or protect adolescents from excessive gaming. The aim of the present study was to examine associations between adolescents' accessibility to video gaming devices, the locations played (i.e., bedroom, shared rooms), parental regulation of technology use, and the amount of hours spent video gaming during the week (weekdays vs. weekends). Adolescents (N=422; age 16.3±2.0 years, 41% male) completed an online questionnaire battery, including demographics, video gaming behaviors (e.g., hours played weekdays/weekends, time of day played, devices owned, locations played, etc.), and a questionnaire measuring aspects of parents' regulation of game playing (e.g., rules, limit setting, co-gaming). Accessibility to the adolescents' own devices, but not shared devices or device portability, was predictive of hours gaming on weekdays and weekends. Location (i.e., bedroom) was associated with increased gaming across the week. Parents discussing cybersafety was predictive of lower hours of gaming (weekdays and weekends). However, limit setting, monitoring, and co-gaming showed no significant effects. Adolescents' access to their own gaming equipped devices, as well as gaming in their bedrooms, were linked to increased hours of gaming. The findings suggest that in order to curb the increase in hours gaming, parents are advised to delay the ownership of adolescents' devices, encourage use in shared rooms, and discuss aspects of cybersafety with their teenage children.
... information technology professionals and developers. Conducting trainings/webinars on issues related to accessible technology in the workplace, including use of emerging technologies to facilitate employment and... of the Assistant Secretary for Office of Disability Employment Program Accessible Technology Action...
... Federal Aviation Administration 14 CFR Chapter 1 Airport Improvement Program (AIP): Policy Regarding Access to Airports From Residential Property; Correction AGENCY: Federal Aviation Administration (FAA... paragraph in the Proposed Policy Regarding Access to Airports From Residential Property that was published...
Whetten, Justin; van der Goes, David N; Tran, Huy; Moffett, Maurice; Semper, Colin; Yonas, Howard
Access to Critical Cerebral Emergency Support Services (ACCESS) was developed as a low-cost solution to providing neuro-emergent consultations to rural hospitals in New Mexico that do not offer comprehensive stroke care. ACCESS is a two-way audio-visual program linking remote emergency department physicians and their patients to stroke specialists. ACCESS also has an education component in which hospitals receive training from stroke specialists on the triage and treatment of patients. This study assessed the clinical and economic outcomes of the ACCESS program in providing services to rural New Mexico from a healthcare payer perspective. A decision tree model was constructed using findings from the ACCESS program and existing literature, the likelihood that a patient will receive a tissue plasminogen activator (tPA), cost of care, and resulting quality adjusted life years (QALYs). Data from the ACCESS program includes emergency room patients in rural New Mexico from May 2015 to August 2016. Outcomes and costs have been estimated for patients who were taken to a hospital providing neurological telecare and patients who were not. The use of ACCESS decreased neuro-emergent stroke patient transfers from rural hospitals to urban settings from 85% to 5% (no tPA) and 90% to 23% (tPA), while stroke specialist reading of patient CT/MRI imaging within 3 h of onset of stroke symptoms increased from 2% to 22%. Results indicate that use of ACCESS has the potential to save $4,241 ($3,952-$4,438) per patient and increase QALYs by 0.20 (0.14-0.22). This increase in QALYs equates to ∼73 more days of life at full health. The cost savings and QALYs are expected to increase when moving from a 90-day model to a lifetime model. The analysis demonstrates potential savings and improved quality-of-life associated with the use of ACCESS for patients presenting to rural hospitals with acute ischemic stroke (AIS).
This paper is devoted to the consideration of software system Dagger created in KAUST. This system is based on extensions of dynamic programming. It allows sequential optimization of decision trees and rules relative to different cost functions, derivation of relationships between two cost functions (in particular, between number of misclassifications and depth of decision trees), and between cost and uncertainty of decision trees. We describe features of Dagger and consider examples of this systems work on decision tables from UCI Machine Learning Repository. We also use Dagger to compare 16 different greedy algorithms for decision tree construction. © 2013 Taylor and Francis Group, LLC.
Alkhalid, Abdulaziz; Amin, Talha; Chikalov, Igor; Hussain, Shahid; Moshkov, Mikhail; Zielosko, Beata
This paper is devoted to the consideration of software system Dagger created in KAUST. This system is based on extensions of dynamic programming. It allows sequential optimization of decision trees and rules relative to different cost functions, derivation of relationships between two cost functions (in particular, between number of misclassifications and depth of decision trees), and between cost and uncertainty of decision trees. We describe features of Dagger and consider examples of this system's work on decision tables from UCI Machine Learning Repository. We also use Dagger to compare 16 different greedy algorithms for decision tree construction.
The Department of Veterans Affairs (VA) is issuing this interim final rule that amends the regulations governing the Servicemembers' Group Life Insurance Traumatic Injury Protection (TSGLI) program by adding certain genitourinary (GU) system losses to the TSGLI Schedule of Losses and defining terms relevant to these new losses. This amendment is necessary to make qualifying GU losses a basis for paying GU-injured Servicemembers TSGLI benefits. The intended effect is to expand the list of losses for which TSGLI payments can be made.
This final rule amends Department of Veterans Affairs (VA) regulations to establish a new program to provide grants to eligible entities to provide adaptive sports activities to disabled veterans and disabled members of the Armed Forces. This rulemaking is necessary to implement a change in the law that authorizes VA to make grants to entities other than the United States Olympic Committee for adaptive sports programs. It establishes procedures for evaluating grant applications under this grant program, and otherwise administering the grant program. This rule implements section 5 of the VA Expiring Authorities Extension Act of 2013.
This interim final rule amends Department of Veterans Affairs (VA) regulations to establish a new program to provide grants to eligible entities to provide adaptive sports activities to disabled veterans and disabled members of the Armed Forces. This rulemaking is necessary to implement a change in the law that authorizes VA to make grants to entities other than the United States Olympic Committee for adaptive sports programs. It establishes procedures for evaluating grant applications under this grant program, and otherwise administering the grant program. This rule implements section 5 of the VA Expiring Authorities Extension Act of 2013.
Friedman, R H; Frank, A D
A rule-based computer system was developed to perform clinical decision-making support within a medical information system, oncology practice, and clinical research. This rule-based system, which has been programmed using deterministic rules, possesses features of generalizability, modularity of structure, convenience in rule acquisition, explanability, and utility for patient care and teaching, features which have been identified as advantages of artificial intelligence (AI) rule-based systems. Formal rules are primarily represented as conditional statements; common conditions and actions are stored in system dictionaries so that they can be recalled at any time to form new decision rules. Important similarities and differences exist in the structure of this system and clinical computer systems utilizing artificial intelligence (AI) production rule techniques. The non-AI rule-based system possesses advantages in cost and ease of implementation. The degree to which significant medical decision problems can be solved by this technique remains uncertain as does whether the more complex AI methodologies will be required.
Araújo, Roque da Silva; Arcuri, Edna Apparecida Moura; Lopes, Victor Cauê
to verify causes of inactivity in the Home Delivery Medicament Program, as referred by users from a Primary Health Care Service in São Paulo, comparing them to the causes registered in the program and analyzing them in the theoretical model Concept of Access to Health. cross-sectional study, interviewing 111 inactive users; and documentary study in the program records. half of the users did not know the condition of inactivity. Discrepancies were found between the user's and the program's information, observing different levels of agreement: Absence of physician and administrative staff member 0%; Transfer to other service 25%; Death 50%; Option to quit 50%; Address change 57% and Change in therapeutic schedule 80%. The users' feeling of accepting the program was observed. In the health access concept, inactivity can be explained in the information dimension, in the degree of asymmetry between the patient's and the health professional's knowledge, identified through the indicators: education, knowledge and information sources. due to the low education level, the user does not assimilate the information on the steps of the program flowchart, does not return for the assessment that guarantees its continuity. Consequently, (s)he stops receiving the medication and spends a long time without treatment, increasing the cardiovascular risk of hypertensive (92% of the sample), diabetic (44%) and dyslipidemic patients (31%). verificar causas de inatividade no Programa Remédio em Casa, referidas por usuários de Unidade Básica de Saúde de São Paulo, comparando-as às registradas pelo programa e analisando-as no modelo teórico Conceito de Acesso à Saúde. estudo transversal entrevistando 111 usuários inativos; e documental, nos registros do programa. metade dos usuários desconhecia a condição de inatividade. Constatadas discrepâncias nas informações usuário versus programa, observando-se diferentes níveis de concordância: Falta de médico e funcion
Office of Postsecondary Education, US Department of Education, 2012
The International Education Programs Service (IEPS) administers 14 education programs. These programs are complementary in nature and designed to benefit a variety of audiences through training programs, research, start-up or enhancement projects, and fellowships. This paper provides brief descriptions of these programs.
This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2018 to implement changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. In addition, this final rule with comment period updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program.
... provide accommodations requiring the assistance of other persons (e.g., American Sign Language interpreters, communication access realtime translation (CART) providers, transcribers, captioners, and readers...
Stark, Paul S.
The challenge was given to transform aviation-related programs to keep them from being eliminated. These programs were to be discontinued due to enrollment declines, costs, legislative mandates, lack of administrative support, and drastic state budget reductions. The New Rule was a paradigm shift of focus to the global market for program…
... Rural Utilities Service Rural Broadband Access Loans and Loan Guarantees Program AGENCY: Rural Utilities... for the Rural Broadband Access Loans and Loan Guarantees Program for fiscal year (FY) 2011. A Notice..., 2011, at 76 FR 13797, prior to the passage of a final appropriations bill identifying a definite...
The Health Resources and Services Administration (HRSA) administers section 340B of the Public Health Service Act (PHSA), referred to as the "340B Drug Pricing Program" or the "340B Program." HRSA published a final rule on January 5, 2017, that set forth the calculation of the ceiling price and application of civil monetary penalties. The final rule applied to all drug manufacturers that are required to make their drugs available to covered entities under the 340B Program. In accordance with a January 20, 2017, memorandum from the Assistant to the President and Chief of Staff, entitled "Regulatory Freeze Pending Review," HRSA issued an interim final rule that delayed the effective date of the final rule published in the Federal Register (82 FR 1210, (January 5, 2017)) to May 22, 2017. HHS invited commenters to provide their views on whether a longer delay of the effective date to October 1, 2017, would be more appropriate. After consideration of the comments received on the interim final rule, HHS is delaying the effective date of the January 5, 2017 final rule, to October 1, 2017.
These final rules amend Medicare regulations to clarify which useful life guidelines may be used by providers of health care services to determine the useful life of a depreciable asset for Medicare reimbursement purposes. Current regulations state that providers must utilize the Departmental useful life guidelines or, if none have been published by the Department, either the American Hospital Association (AHA) useful life guidelines of 1973 of IRS guidelines. We are eliminating the reference to IRS guidelines because these are now outdated for Medicare purposes since they have been rendered obsolete either by the IRS or by statutory change. We are also deleting the specific reference to the 1973 AHA guidelines since these guidelines are updated by the AHA periodically. In addition, we are clarifying that certain tax legislation on accelerated depreciation, passed by Congress, does not apply to the Medicare program.
This document adopts as final, without change, the interim final rule amending regulations of the Department of Veterans Affairs (VA) to reflect changes made by the Post-9/11 Veterans Educational Assistance Improvements Act of 2010, effective August 1, 2011, that affect payment of vocational rehabilitation benefits for certain service-disabled veterans. Pursuant to these changes, a veteran, who is eligible for a subsistence allowance under chapter 31 of title 38, United States Code, and educational assistance under chapter 33 of title 38, United States Code, may participate in a rehabilitation program under chapter 31 and elect to receive a payment equal in amount to an applicable military housing allowance payable under title 37, United States Code, instead of the regular subsistence allowance under chapter 31. In addition, payments of subsistence allowances during periods between school terms are discontinued, and payments during periods of temporary school closings are modified.
Hinds, Richard M; Klifto, Christopher S; Naik, Amish A; Sapienza, Anthony; Capo, John T
The Internet is a common resource for applicants of hand surgery fellowships, however, the quality and accessibility of fellowship online information is unknown. The objectives of this study were to evaluate the accessibility of hand surgery fellowship Web sites and to assess the quality of information provided via program Web sites. Hand fellowship Web site accessibility was evaluated by reviewing the American Society for Surgery of the Hand (ASSH) on November 16, 2014 and the National Resident Matching Program (NRMP) fellowship directories on February 12, 2015, and performing an independent Google search on November 25, 2014. Accessible Web sites were then assessed for quality of the presented information. A total of 81 programs were identified with the ASSH directory featuring direct links to 32% of program Web sites and the NRMP directory directly linking to 0%. A Google search yielded direct links to 86% of program Web sites. The quality of presented information varied greatly among the 72 accessible Web sites. Program description (100%), fellowship application requirements (97%), program contact email address (85%), and research requirements (75%) were the most commonly presented components of fellowship information. Hand fellowship program Web sites can be accessed from the ASSH directory and, to a lesser extent, the NRMP directory. However, a Google search is the most reliable method to access online fellowship information. Of assessable programs, all featured a program description though the quality of the remaining information was variable. Hand surgery fellowship applicants may face some difficulties when attempting to gather program information online. Future efforts should focus on improving the accessibility and content quality on hand surgery fellowship program Web sites.
Saurman, Emily; Lyle, David; Kirby, Sue; Roberts, Russell
The Mental Health Emergency Care-Rural Access Program (MHEC-RAP) is a telehealth solution providing specialist emergency mental health care to rural and remote communities across western NSW, Australia...
Dennis, Kristopher; Linden, Kelly; Balboni, Tracy; Chow, Edward
Palliating symptoms of advanced and metastatic cancers are one of the most common indications for radiation therapy (RT), and the demand for palliative RT is increasing. Dedicated rapid access palliative RT programs improve access to care, and can deliver RT in a more efficient and evidence-based manner than standard RT programs. In this narrative review, we discuss the role of palliative RT in comprehensive cancer care, and challenges that have faced patients trying to access it. We describe how rapid access programs developed to address these challenges and provide an overview of dedicated programs worldwide. Finally, we show how these programs can serve as models for multidisciplinary care and education, and sources of exciting research opportunities in clinical care and advanced technologies.
... multichannel video programming distributor that uses the same distribution technology as the competitor... authority to fashion appropriate sanctions for violations of its protective orders, including but not...
Isehunwa, Oluwaseyi O; Carlton, Erik L; Wang, Yang; Jiang, Yu; Kedia, Satish; Chang, Cyril F; Fijabi, Daniel; Bhuyan, Soumitra S
There is little research at the national level on access to employee wellness programs and the use of preventive care services. This study examined the use of seven preventive care services among U.S working adults with access to employee wellness programs. The study population comprised 17,699 working adults aged ≥18 years, obtained from the 2015 National Health Interview Survey. Multivariate logistic regression models examined the relationship between access to employee wellness programs and use of seven preventive care services: influenza vaccination, blood pressure check, diabetes check, cholesterol check, Pap smear test, mammogram, and colon cancer screening. Data analysis began in Fall 2016. Overall, 46.6% of working adults reported having access to employee wellness programs in 2015. Working adults with access to employee wellness programs had higher odds of receiving influenza vaccination (OR=1.57, 95% CI=1.43, 1.72, paccess to employee wellness programs and the use of Pap smear test and colon cancer screening services. Using a nationally representative sample of individuals, this study found a positive association between access to employee wellness programs and the use of preventive care services. The results support favorable policies to encourage implementing wellness programs in all worksites, especially those with <50 employees. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Laura J. McLachlin; Emilyn A. Sheffield; Donald A. Penland; Charles W. Nelson
The Heritage Corridors Project was a unique partnership between the California Department of Parks and Recreation, the California State University, and the Across California Conservancy. The purpose of the project was to develop a map of selected northern California outdoor recreation and heritage sites. Data about facility accessibility improvements (restrooms, clear...
... programming. 76.1507 Section 76.1507 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST... access to satellite cable programming. (a) Any provision that applies to a cable operator under §§ 76... provides video programming on its open video system, except as limited by paragraph (a) (1)-(3) of this...
Grembowski, D; Milgrom, P M
OBJECTIVE: Washington State's Access to Baby and Child Dent stry (ABCD) Program, first implemented in Spokane County in 1995, offers extended dental benefits to participating Medicaid-enrolled children and higher fees for certified providers. This study aimed to determine the program's effect on children's dental utilization and dental fear, and on parent satisfaction and knowledge. METHODS: The study used a posttest-only comparison group design. Trained interviewers conducted telephone interviews with 465 parents of chi dren ages 13 to 36 months (49% ABCD, 51% Medicaid-enrolled children not in ABCD). One year later, 282 of 465 parents completed a follow-up survey. Utilization and expenditures were calculated from Medicaid claims. RESULTS: Forty-three percent of children in the ABCD Program visited a dentist in the follow-up year, compared with 12% of Medicaid-enrolled children not in the ABCD Program. An ABCD child was 5.3 times as likely to have had at least one dental visit as a child not in the program. ABCD children were 4 to 13 times as likely to have used specific dental services. Parents of ABCD children were more likely to report having ever tried to make a dental appointment, less likely to report that their children were fearful of the dentist, and were more satisfied, compared to parents of non-ABCD children. CONCLUSION: The authors conclude that the ABCD Program was effective in increasing access for preschool children enrolled in Medicaid, reducing dental fear, and increasing parent satisfaction. PMID:11236017
....150 Section 1600.150 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE JAPAN-UNITED STATES FRIENDSHIP... action that it can demonstrate would result in a fundamental alteration in the nature of a program or...
Craig, Dana; Etcheverry, Jose; Ferris, Stefan
This Note provides an analysis of Mexico's "Telesecundaria" program within the context of Mexico's new education reform framework offering a succinct background of the project, as well as key policy lessons that can be useful for other jurisdictions interested in the development of distance education programs. This Note uses a literature…
Brunelle, J P; Goulet, C; Arguin, H
To reduce the number of transgressions to the rule, the occurrence of violent acts and to prevent injuries, Hockey Québec adopted the Fair-Play Program (FPP). The objective of the present study was to evaluate the effectiveness of the FPP. 52 Bantam (14-15 years) teams participated in this cohort study. In total, 49 games (13 with the FPP, 36 without FPP) were systematically assessed for transgressions to the rule. Body checking was allowed in all games. Transgressions to the rule data were obtained using a real time observation system in a natural setting, while injury data were collected through a self-administered questionnaire. Data were analysed using generalised linear models with generalised estimating equations accounting for potential team effect. The number of penalties per game was significantly lower (p hockey world promote fair play values. Moreover, this project clearly showed the importance of program evaluation and the value of direct observation in a natural setting.
Full Text Available Abstract Exceptional pupils enrolled in Canadian French immersion programs rarely have access to the same range of special education programs and services that are available to students in the regular English program. More often than not, students with special needs are encouraged to transfer to English programs to access necessary support services. This counselling-out process perpetuates the elitist status commonly attributed to French immersion programs. From a critical pedagogy perspective, this inquiry examines the lack of incentive on the part of multiple French immersion stakeholders to accommodate students with special needs. It further attempts to unveil the myths created by these stakeholders to better understand this discriminatory educational practice. The impact of federal and provincial funding models on access to special education programs and services is discussed, and the application of funding allocations by English-language district school boards is explored. The inquiry concludes with recommendations to promote more inclusionary practices.
GAO General Accounting Office GME Graduate Medical Education GMO General Medical Officer GPA Grade Point Average xiv HPLRP Health...uniformed services as they transform themselves to meet new challenges, the departments concerned must offer, in addition to challenging and rewarding...9 Title 37 U.S.C. § 1008, “Presidential recommendations concerning adjustments and changes in pay and allowances,” last accessed November
... importance of reading the proposed CLIA provisions in concert with the applicable HIPAA provisions. As... effects, distributive impacts, and equity). Executive Order 13563 emphasizes the importance of quantifying... nonprofit status as reported in the American Hospital Association Fast Fact Sheet updated June 24, 2010...
..., fishing, wildlife observation, photography, and environmental education and interpretation. Eligibility... hunting, fishing, wildlife-observation, photography, environmental education and interpretation, or other... Environmental Programs Division (CEPD), U.S. Department of Agriculture (USDA) FSA CEPD, STOP 0513, 1400...
... Federal Aviation Administration 14 CFR Chapter I Airport Improvement Program (AIP): Policy Regarding Access to Airports From Residential Property AGENCY: Federal Aviation Administration (FAA). ACTION: Final... through-the-fence access to a federally-obligated airport from an adjacent or nearby property, when that...
... Federal Aviation Administration 14 CFR Chapter I Airport Improvement Program (AIP): Policy Regarding Access to Airports From Residential Property AGENCY: Federal Aviation Administration (FAA), DOT. ACTION... policy, based on Federal law, concerning through-the-fence access to a federally obligated airport from...
... Federal Aviation Administration Airport Improvement Program (AIP): Interim Policy Regarding Access to Airports From Residential Property AGENCY: Federal Aviation Administration (FAA). ACTION: Interim policy... clarifying FAA policy concerning through-the-fence access to a federally-obligated airport from an adjacent...
... Administration (FTA), DOT. ACTION: Notice of Availability of Fiscal Year 2009 Funds: Solicitation of Grant...) announces the availability of funds in Fiscal Year (FY) 2009 for the Over-the-Road Bus (OTRB) Accessibility... OTRB Accessibility Program makes funds available to private operators of over-the-road buses to finance...
McClellan, Sean R; Snowden, Lonnie
This study examined the association between language access programming and quality of psychiatric care received by persons with limited English proficiency (LEP). In 1999, the California Department of Mental Health required county Medicaid agencies to implement a "threshold language access policy" to meet the state's Title VI obligations. This policy required Medi-Cal agencies to provide language access programming, including access to interpreters and translated written material, to speakers of languages other than English if the language was spoken by at least 3,000, or 5%, of the county's Medicaid population. Using a longitudinal study design with a nonequivalent control group, this study examined the quality of care provided to Spanish speakers with LEP and a severe mental illness before and after implementation of mandatory language access programming. Quality was measured by receipt of at least two follow-up medication visits within 90 days or three visits within 180 days of an initial medication visit over a period of 38 quarter-years. On average, only 40% of Spanish-speaking clients received at least three medication follow-up visits within 180 days. In multivariate analyses, language access programming was not associated with receipt of at least two medication follow-up visits within 90 days or at least three visits within 180 days. This study found no evidence that language access programming led to increased rates of follow-up medication visits for clients with LEP.
Kolomaznik, I. (HGF VSB-TU Ostrava, Ostrava-Poruba (Czech Republic))
The program system has been developed to store and process data. The Rockware system can be used for graphic outputs and some special operations and calculations. This system allows graphic outputs based on text files which contain graphic instructions. A modern database program Microsoft Access 97 is used for data storage, whereas the Borland compiler Delphi 3 serves as the programming medium, and the Topol program of the Help Service Mapping Company is used for graphic outputs. 3 figs.
Kolomaznik, I. [HGF VSB-TU Ostrava, Ostrava-Poruba (Czech Republic)
The program system has been developed to store and process data. The Rockware system can be used for graphic outputs and some special operations and calculations. This system allows graphic outputs based on text files which contain graphic instructions. A modern database program Microsoft Access 97 is used for data storage, whereas the Borland compiler Delphi 3 serves as the programming medium, and the Topol program of the Help Service Mapping Company is used for graphic outputs. 3 figs.
Luna, Jose Maria; Pechenizkiy, Mykola; Del Jesus, Maria Jose; Ventura, Sebastian
Real-world data usually comprise features whose interpretation depends on some contextual information. Such contextual-sensitive features and patterns are of high interest to be discovered and analyzed in order to obtain the right meaning. This paper formulates the problem of mining context-aware association rules, which refers to the search for associations between itemsets such that the strength of their implication depends on a contextual feature. For the discovery of this type of associations, a model that restricts the search space and includes syntax constraints by means of a grammar-based genetic programming methodology is proposed. Grammars can be considered as a useful way of introducing subjective knowledge to the pattern mining process as they are highly related to the background knowledge of the user. The performance and usefulness of the proposed approach is examined by considering synthetically generated datasets. A posteriori analysis on different domains is also carried out to demonstrate the utility of this kind of associations. For example, in educational domains, it is essential to identify and understand contextual and context-sensitive factors that affect overall and individual student behavior and performance. The results of the experiments suggest that the approach is feasible and it automatically identifies interesting context-aware associations from real-world datasets.
Full Text Available As well known that AUN (Asean University Network.AUN and ABET (Accreditation Boardb for Enginnering and Technology are non-profit organitatinon which have. AUN (Asean University Network were using variable with refer to AUN’s criteria’s there consist of fifteen which are: Expected Learning Outcomes, Programme Specification, Programme Structure and Content, Teaching and Learning Strategy, Student Assessment, Academic Staff Quality, Support Staff Quality, Student Quality, Student Advice and Support, Facilities and Infrastructure, Quality Assurance of Teaching/Learning Process, Staff Development Activities, Stakeholders Feedback, Output, Stakeholders Satisfaction,and adopted score's scale 7. In there here, we discuss the fifteen AUN’s of AUN in the criterias. There servqual of as can be into five dimensions, assurance, empathy, responsive, reliability and facilty in order to make the assessment's process easier. This research outcome indicated that this proposed method can be used to evaluate an education program. The validation result by using AUN's data and the analysis of servqual rule base Asean University Network almost have the same pattern with correlation value is 0,985 and this is can be accepted because its validity have reach 97%.
In the paper, we present a comparison of dynamic programming and greedy approaches for construction and optimization of approximate decision rules relative to the number of misclassifications. We use an uncertainty measure that is a difference between the number of rows in a decision table T and the number of rows with the most common decision for T. For a nonnegative real number γ, we consider γ-decision rules that localize rows in subtables of T with uncertainty at most γ. Experimental results with decision tables from the UCI Machine Learning Repository are also presented. © 2013 Springer-Verlag.
Sanchez, Sheila M.; Huerta, Adrian H.; Venegas, Kristan M.
This study highlights the narratives of five Latino males from three different postsecondary institutions--a community college, a four-year public state college, and a large private research university--and the impact of their participation in college preparation programs. The data is drawn from a study in which the impact of college preparation…
Ramsey, Jennifer; Gorgol, Laura
In 2001, the Bill & Melinda Gates Foundation launched a 10-year, multi-million dollar initiative, the Washington State Achievers Program (WSA), to increase opportunities for low-income students to attend postsecondary institutions in Washington State. The Bill & Melinda Gates Foundation granted funds to the College Success Foundation…
.... 1600.149 Section 1600.149 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE JAPAN-UNITED STATES FRIENDSHIP... unusable by handicapped persons, be denied the benefits of, be excluded from participation in, or otherwise...
The Women in Machining (WIM) program is a Machine Action Project (MAP) initiative that was developed in response to a local skilled metalworking labor shortage, despite a virtual absence of women and people of color from area shops. The project identified post-war stereotypes and other barriers that must be addressed if women are to have an equal…
... audio-visual materials and devices to depict those portions of an historic property that cannot... result in a fundamental alteration in the nature of a program or activity or in undue financial and... agency has the burden of proving that compliance with § 51-10.150(a) would result in such alteration or...
... include— (i) Using audio-visual materials and devices to depict those portions of an historic property... demonstrate would result in a fundamental alteration in the nature of a program or activity or in undue... such alteration or burdens. The decision that compliance would result in such alteration or burdens...
... audio-visual materials and devices to depict those portions of an historic property that cannot... fundamental alteration in the nature of a program or activity or in undue financial and administrative burdens... has the burden of proving that compliance with § 2205.150(a) would result in such alteration or...
... audio-visual materials and devices to depict those portions of an historic property that cannot... fundamental alteration in the nature of a program or activity or in undue financial and administrative burdens... has the burden of proving that compliance with § 2706.150(a) would result in such alteration or...
... include— (i) Using audio-visual materials and devices to depict those portions of an historic property... demonstrate would result in a fundamental alteration in the nature of a program or activity or in undue... such alteration or burdens. The decision that compliance would result in such alteration or burdens...
... include— (i) Using audio-visual materials and devices to depict those portions of an historic property... demonstrate would result in a fundamental alteration in the nature of a program or activity or in undue... such alteration or burdens. The decision that compliance would result in such alteration or burdens...
...— (i) Using audio-visual materials and devices to depict those portions of an historic property that... demonstrate would result in a fundamental alteration in the nature of a program or activity or in undue... alteration or burdens. The decision that compliance would result in such alteration or burdens must be made...
... include— (i) Using audio-visual materials and devices to depict those portions of an historic property... can demonstrate would result in a fundamental alteration in the nature of a program or activity or in...) would result in such alteration or burdens. The decision that compliance would result in such alteration...
...) Using audio-visual materials and devices to depict those portions of an historic property that cannot... fundamental alteration in the nature of a program or activity or in undue financial and administrative burdens... has the burden of proving that compliance with § 15.150(a) would result in such alteration or burdens...
The purpose of this lesson plan is to introduce the importance of social media and the Internet on public relations and marketing. The lesson describes the new rules for public relations versus the old rules. It is a more in depth look at how, and why, to use blogging, social media, and the Internet for promoting a company and appealing to buyers.…
Swindeman, M. J. [Argonne National Lab. (ANL), Argonne, IL (United States); Jetter, R. I. [Argonne National Lab. (ANL), Argonne, IL (United States); Sham, T. -L. [Argonne National Lab. (ANL), Argonne, IL (United States)
One of the objectives of the high temperature design methodology activities is to develop and validate both improvements and the basic features of ASME Boiler and Pressure Vessel Code, Section III, Rules for Construction of Nuclear Facility Components, Division 5, High Temperature Reactors, Subsection HB, Subpart B (HBB). The overall scope of this task is to develop a computer program to aid assessment procedures of components under specified loading conditions in accordance with the elevated temperature design requirements for Division 5 Class A components. There are many features and alternative paths of varying complexity in HBB. The initial focus of this computer program is a basic path through the various options for a single reference material, 316H stainless steel. However, the computer program is being structured for eventual incorporation all of the features and permitted materials of HBB. This report will first provide a description of the overall computer program, particular challenges in developing numerical procedures for the assessment, and an overall approach to computer program development. This is followed by a more comprehensive appendix, which is the draft computer program manual for the program development. The strain limits rules have been implemented in the computer program. The evaluation of creep-fatigue damage will be implemented in future work scope.
... Office (Appendix A) or Blenda Younger, Office of Program Management, (202) 366-2053. Corrections On page... the Special Warranty for the Over-the-Road Bus Accessibility Program that is most current as of the... thereto. Any U.S. DOL Special Warranty that may be provided and any documents cited therein are...
... Transit Administration (FTA), DOT. ACTION: Notice of Availability of Fiscal Year 2012 Funds: Solicitation... availability of funds in Fiscal Year (FY) 2012 for the Over-the-Road Bus Accessibility (OTRB) Program... OTRB program makes funds available to private operators of over-the-road buses to finance the...
... access use of the Internet on NARA-supplied computers? 1254.32 Section 1254.32 Parks, Forests, and Public... of the Internet on NARA-supplied computers? (a) Public access computers (workstations) are available... use personally owned diskettes on NARA personal computers. You may not load files or any type of...
The Department is issuing a final rule establishing the organizational integrity requirements for Federal funding recipients under the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (Leadership Act). This rule requires that funding announcements and agreements with funding recipients include a clause that states that the recipient is opposed to prostitution and sex trafficking because of the psychological and physical risks they pose for women, men and children. This rule also modifies the requirements for recipient-affiliate separation and eliminates the requirement for an additional certification by funding recipients.
APL provides convenient associative data manipulation functions in a high level language. Six statements were added to PL/1 via a preprocessor: CREATE, INSERT, FIND, FOR EACH, REMOVE, and DELETE. They allow complete control of all data base operations. During execution, data base management programs perform the functions required to support the APL language. VAAM is the data base management system designed to support the APL language. APL/VAAM is used by CADANCE, an interactive graphic computer system. VAAM is designed to support heavily referenced files. Virtual memory files, which utilize the paging mechanism of the operating system, are used. VAAM supports a full network data structure. The two basic blocks in a VAAM file are entities and sets. Entities are the basic information element and correspond to PL/1 based structures defined by the user. Sets contain the relationship information and are implemented as arrays.
HHS is issuing this final rule to clarify how section 340B(e) of the Public Health Service Act (PHSA) will be implemented. The final rule applies section 340B(e) of the PHSA only to drugs transferred, prescribed, sold, or otherwise used for the rare condition or disease for which the orphan drug was designated under section 526 of the Federal Food, Drug, and Cosmetic Act (FFDCA). The final rule also sets forth that it is the responsibility of the 340B covered entity to maintain auditable records that demonstrate compliance with the terms of the orphan drug exclusion requirements. This rule will provide clarity in the marketplace, maintain the 340B savings for newly-eligible covered entities, and protect the financial incentives for manufacturing orphan drugs designated for a rare disease or condition as indicated in the Affordable Care Act and intended by Congress.
.... II. Interim Rule While the immediate financial crisis that led to the creation of the TLGP in October... a limited universe of IDIs would not create a significant burden that would outweigh its...
AleJoseph J. Schwerha
Full Text Available The recent amendments to Rule 26 of the Federal Rules of Civil Procedure created a two-tiered approach to discovery of electronically stored information (â€œESIâ€. Responding parties must produce ESI that is relevant, not subject to privilege, and reasonably accessible. However, because some methods of storing ESI, such as on magnetic backup tapes and within enormous databases, require substantial cost to access and search their contents, the rules permit parties to designate those repositories as â€œnot reasonably accessibleâ€ because of undue burden or cost. But even despite the difficulty in searching for ESI, the partyâ€™s duty to preserve potentially responsive evidence remains; it simply gains the option to forgo poring over the material. Further, the court might nevertheless compel production if the requesting party demonstrates good cause.Regardless of whether the responding party believes certain documents to be reasonably accessible or not, courts may still require their production.Â Â In such cases, the court may then choose to order production, but shift the costs of doing so to the requesting party.Â Throughout this process, the burden and cost of production are central themes.Â Â Their determination is fluid, varying from case to case and even over time in the same situation.Â Â Nowhere is this more evident than where a responding party has numerous, geographically dispersed computers under its control that may contain responsive ESI to a request for production of documents.Â Traditionally, a responding party would be forced to make a decision of whether or not to send out computer forensic experts to all of these locations to make forensically sound copies of all of those computers and then analyze each.Â Â This process is time consuming and costly.Â Recently, several companies have put forth substantial solutions that facially allow a responding party to capture and analyze data
This final rule establishes requirements for State agencies, local educational agencies, and schools operating the Community Eligibility Provision, a reimbursement option that allows the service of school meals to all children at no-cost in high poverty schools without collecting household applications. By eliminating the household application process and streamlining meal counting and claiming procedures through the Community Eligibility Provision, local educational agencies may substantially reduce administrative burden related to operating the National School Lunch and School Breakfast Programs. This rule codifies many requirements that were implemented through policy guidance following enactment of the Healthy, Hunger-Free Kids Act of 2010, as well as provisions of the proposed rule. These requirements will result in consistent, national implementation of the Community Eligibility Provision.
This major final rule with comment period addresses changes to the physician fee schedule, clinical laboratory fee schedule, and other Medicare Part B payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. This final rule with comment period also includes a discussion in the Supplementary Information regarding various programs. (See the Table of Contents for a listing of the specific issues addressed in the final rule with comment period.)
The Secretary of the Department of Health and Human Services (HHS) hereby issues this final rule with comment period to implement a methodology and payment rates for the Indian Health Service (IHS) Purchased/Referred Care (PRC), formerly known as the Contract Health Services (CHS), to apply Medicare payment methodologies to all physician and other health care professional services and non-hospital-based services. Specifically, it will allow the health programs operated by IHS, Tribes, Tribal organizations, and urban Indian organizations (collectively, I/T/U programs) to negotiate or pay non-I/T/U providers based on the applicable Medicare fee schedule, prospective payment system, Medicare Rate, or in the event of a Medicare waiver, the payment amount will be calculated in accordance with such waiver; the amount negotiated by a repricing agent, if applicable; or the provider or supplier's most favored customer (MFC) rate. This final rule will establish payment rates that are consistent across Federal health care programs, align payment with inpatient services, and enable the I/T/U to expand beneficiary access to medical care. A comment period is included, in part, to address Tribal stakeholder concerns about the opportunity for meaningful consultation on the rule's impact on Tribal health programs.
Vaagan, Robert; Koehler, Wallace
Introduction: In 1999-2000, a Norwegian youth cracked a DVD-access code and published a decryption program on the Internet. He was sued by the US DVD Copy Control Association (DVD-CCA) and the Norwegian Motion Picture Association (MAP), allies of the US Motion Picture Association of America (MPAA), arrested by Norwegian police and charged with…
... From the Federal Register Online via the Government Publishing Office NATIONAL CREDIT UNION ADMINISTRATION Office of Small Credit Unions (OSCUI) Grant Program Access for Credit Unions AGENCY: National Credit Union Administration (NCUA). ACTION: Notice of Funding Opportunity. SUMMARY: The National Credit...
... Commodity Credit Corporation Notice of Funds Availability: Inviting Applications for the Market Access... assistance for generic or brand promotion activities. For generic activities, funding priority is given to... government agencies can participate directly in the brand program. The MAP generally operates on a...
... Commodity Credit Corporation Notice of Funds Availability: Inviting Applications for the Market Access... marketing and promotion activities. MAP participants may receive assistance for generic or brand promotion... brand program. The MAP generally operates on a reimbursement basis. III. Eligibility Information 1...
... preschool through grade 12, or a student enrolled in postsecondary education or training who has a parent or... Doc No: 2013-12491] DEPARTMENT OF EDUCATION Applications for New Awards; Child Care Access Means Parents in School Program AGENCY: Office of Postsecondary Education, Department of Education. ACTION...
... (download plus upload speeds) for both fixed and mobile broadband service and the broadband lending speed will be a minimum bandwidth of 5 megabits per second for both fixed and mobile service to the customer...; ] DEPARTMENT OF AGRICULTURE Rural Utilities Service Rural Broadband Access Loans and Loan Guarantees Program...
... Customer Information and Customer Notice AGENCY: Office of Thrift Supervision (OTS), Treasury. ACTION... of Proposal: Interagency Guidance on Response Programs for Unauthorized Access to Customer Information and Customer Notice. OMB Number: 1550-0110. Form Numbers: N/A. Regulation requirement: 12 CFR Part...
... Management Measures for the Atlantic Sea Scallop Fishery § 648.60 Sea scallop area access program....83(a)(1), and the additional restrictions for Atlantic cod, haddock, and yellowtail flounder... (d)(4). (A) Atlantic cod. Such vessel may bring onboard and possess only up to 100 lb (45.4 kg) of...
Ooms, L.; Veenhof, C.
Introduction: The Dutch government stimulates sport and physical activity opportunities in the neighborhood to make it easier for people to adopt a physically active lifestyle. Seven National Sports Federations (NSFs) were funded to develop easily accessible sporting programs, targeted at groups
Unroe, Kathleen T; Hollmann, Peter A; Goldstein, Alanna C; Malone, Michael L
Commencing in 2017, the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 will change how Medicare pays health professionals. By enacting MACRA, Congress brought an end to the (un)sustainable growth rate formula while also setting forth a vision for how to transform the U.S. healthcare system so that clinicians deliver higher-quality care with smarter spending by the Centers for Medicare and Medicaid Services (CMS). In October 2016, CMS released the first of what stakeholders anticipate will be a number of (annual) rules related to implementation of MACRA. CMS received extensive input from stakeholders including the American Geriatrics Society. Under the Quality Payment Program, CMS streamlined multiple Medicare value-based payment programs into a new Merit-based Incentive Payment System (MIPS). CMS also outlined how it will provide incentives for participation in Advanced Alternative Payment Models (called APMs). Although Medicare payments to geriatrics health professionals will not be based on the new MIPS formula until 2019, those payments will be based upon performance during a 90-day period in 2017. This article defines geriatrics health professionals as clinicians who care for a predominantly older adult population and who are eligible to bill under the Medicare Physician Fee Schedule. Given the current paucity of eligible APMs, this article will focus on MIPS while providing a brief overview of APMs. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.
The Environmental Protection Agency (EPA) is issuing a final rule representing the next step in establishing a voluntary nationwide program to make new cars significantly cleaner burning than today’s current cars.
Snowden, Lonnie R; McClellan, Sean R
We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal...
Macian-Sorribes, Hector; Pulido-Velazquez, Manuel
This contribution presents a methodology for defining optimal seasonal operating rules in multireservoir systems coupling expert criteria and stochastic optimization. Both sources of information are combined using fuzzy logic. The structure of the operating rules is defined based on expert criteria, via a joint expert-technician framework consisting in a series of meetings, workshops and surveys carried out between reservoir managers and modelers. As a result, the decision-making process used by managers can be assessed and expressed using fuzzy logic: fuzzy rule-based systems are employed to represent the operating rules and fuzzy regression procedures are used for forecasting future inflows. Once done that, a stochastic optimization algorithm can be used to define optimal decisions and transform them into fuzzy rules. Finally, the optimal fuzzy rules and the inflow prediction scheme are combined into a Decision Support System for making seasonal forecasts and simulate the effect of different alternatives in response to the initial system state and the foreseen inflows. The approach presented has been applied to the Jucar River Basin (Spain). Reservoir managers explained how the system is operated, taking into account the reservoirs' states at the beginning of the irrigation season and the inflows previewed during that season. According to the information given by them, the Jucar River Basin operating policies were expressed via two fuzzy rule-based (FRB) systems that estimate the amount of water to be allocated to the users and how the reservoir storages should be balanced to guarantee those deliveries. A stochastic optimization model using Stochastic Dual Dynamic Programming (SDDP) was developed to define optimal decisions, which are transformed into optimal operating rules embedding them into the two FRBs previously created. As a benchmark, historical records are used to develop alternative operating rules. A fuzzy linear regression procedure was employed to
Kramer, C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Martin, E. Fadrhonc [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Thompson, P. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Goldman, C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)
Estimates of the total opportunity for investment in cost-effective energy efficiency in the United States are typically in the range of several hundred billion dollars (Choi Granade, et al., 2009 and Fulton & Brandenburg, 2012).1,2 To access this potential, many state policymakers and utility regulators have established aggressive energy efficiency savings targets. Current levels of taxpayer and utility bill-payer funding for energy efficiency is only a small fraction of the total investment needed to meet these targets (SEE Action Financing Solutions Working Group, 2013). Given this challenge, some energy efficiency program administrators are working to access private capital sources with the aim of amplifying the funds available for investment. In this context, efficient access to secondary market capital has been advanced as one important enabler of the energy efficiency industry “at scale.”3 The question of what role secondary markets can play in bringing energy efficiency to scale is largely untested despite extensive attention from media, technical publications, advocates, and others. Only a handful of transactions of energy efficiency loan products have been executed to date, and it is too soon to draw robust conclusions from these deals. At the same time, energy efficiency program administrators and policymakers face very real decisions regarding whether and how to access secondary markets as part of their energy efficiency deployment strategy.
Medicare and Medicaid programs: hospital outpatient prospective payment and ambulatory surgical center payment systems and quality reporting programs; Hospital Value-Based Purchasing Program; organ procurement organizations; quality improvement organizations; Electronic Health Records (EHR) Incentive Program; provider reimbursement determinations and appeals. Final rule with comment period and final rules.
: This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2014 to implement applicable statutory requirements and changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. In addition, this final rule with comment period updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program, the ASC Quality Reporting (ASCQR) Program, and the Hospital Value-Based Purchasing (VBP) Program. In the final rules in this document, we are finalizing changes to the conditions for coverage (CfCs) for organ procurement organizations (OPOs); revisions to the Quality Improvement Organization (QIO) regulations; changes to the Medicare fee-for-service Electronic Health Record (EHR) Incentive Program; and changes relating to provider reimbursement determinations and appeals.
Full Text Available Increasing access to clinically beneficial targeted cancer medicines is a challenge in every country due to their high cost. We describe the interplay of innovative policies and programs involving multiple stakeholders to facilitate access to these medicines in Thailand, as well as the utilization of selected targeted therapies over time.We selected two medicines on the 2013 Thai national list of essential medicines (NLEM [letrozole and imatinib] and three unlisted medicines for the same indications [trastuzumab, nilotinib and dasatinib]. We created timelines of access policies and programs for these products based on scientific and grey literature. Using IMS Health sales data, we described the trajectories of sales volumes of the study medicines between January 2001 and December 2012. We compared estimated average numbers of patients treated before and after the implementation of policies and programs for each product.Different stakeholders implemented multiple interventions to increase access to the study medicines for different patient populations. During 2007-2009, the Thai Government created a special NLEM category with different coverage requirements for payers and issued compulsory licenses; payers negotiated prices with manufacturers and engaged in pooled procurement; pharmaceutical companies expanded patient assistance programs and lowered prices in different ways. Compared to before the interventions, estimated numbers of patients treated with each medicine increased significantly afterwards: for letrozole from 645 (95% CI 366-923 to 3683 (95% CI 2,748-4,618; for imatinib from 103 (95% CI 72-174 to 350 (95% CI 307-398; and for trastuzumab from 68 (95% CI 45-118 to 412 (95% CI 344-563.Government, payers, and manufacturers implemented multi-pronged approaches to facilitate access to targeted cancer therapies for the Thai population, which differed by medicine. Routine monitoring is needed to assess clinical and economic impacts of these
This interim final rule with comment period establishes policies for assessing the financial and quality performance of Medicare Shared Savings Program (Shared Savings Program) Accountable Care Organizations (ACOs) affected by extreme and uncontrollable circumstances during performance year 2017, including the applicable quality reporting period for the performance year. Under the Shared Savings Program, providers of services and suppliers that participate in ACOs continue to receive traditional Medicare fee-for-service (FFS) payments under Parts A and B, but the ACO may be eligible to receive a shared savings payment if it meets specified quality and savings requirements. ACOs in performance-based risk agreements may also share in losses. This interim final rule with comment period establishes extreme and uncontrollable circumstances policies for the Shared Savings Program that will apply to ACOs subject to extreme and uncontrollable events, such as Hurricanes Harvey, Irma, and Maria, and the California wildfires, effective for performance year 2017, including the applicable quality data reporting period for the performance year.
Padmanabhan, Poornima; Wise, Alyssa Friend
Low-cost laptop programs attempt to address gaps in access to computers in developing countries. However, the translation of computing access from intention to actuality is mediated by many situational factors. This research presents a case study of how access to a set of laptops donated to a school for socially disadvantaged children in India was…
Balis, Laura E; Strayer, Thomas; Ramalingam, NithyaPriya; Wilson, Meghan; Harden, Samantha M
Open-access, community-based programs are recommended to assist older adults in meeting physical activity guidelines, but the characteristics, impact, and scalability of these programs is less understood. The Land-Grant University Cooperative Extension System, an organization providing education through county-based educators, functions as a delivery system for these programs. A systematic review was conducted to determine characteristics of effective older adult physical activity programs and the extent to which programs delivered in Extension employ these characteristics. A systematic review of peer-reviewed and grey literature was conducted from August 2016 to February 2017. The review was limited to open-access (available to all), community-based physical activity interventions for older adults (≥65 years of age). The peer-reviewed literature search was conducted in PubMed and EBSCOhost; the grey literature search for Extension interventions was conducted through Extension websites, Land-Grant Impacts, and the Journal of Extension. Sixteen peer-reviewed studies and 17 grey literature sources met inclusion criteria and were analyzed. Peer-reviewed and Extension programs were similar in their limited use of behavioral theories and group-based strategies. Compared to Extension programs, those in the peer-reviewed literature were more likely to use a combination of physical activity components and be delivered by trained professionals. The results indicate notable differences between peer-reviewed literature and Extension programs and present an opportunity for Extension programs to more effectively use evidence-based program characteristics, including behavioral theories and group dynamics, a combination of physical activity components, and educator/agent-trained delivery agents.
Army’s New Non-Citizen Recruting Program,” online http://www.scribd.com/doc/12866758/Margaret-Stock. Last accessed in February 2011. 89 Stock... Recruting Program.” Online at http://www.scribd.com/doc/12866758/Margaret-Stock. Last accessed in February 2011. United States Army, Field Manual 3-24
Purpose: This study aims to examine the question of how long a behavioral skills training program should be in order to result in measurable behavioral change. Design/methodology/approach: An empirical field study was conducted to compare two different lengths of time for a managerial skills training program aimed at achieving behavioral change.…
... proposed rule, which we discuss in this final rule, overwhelmingly reinforced this perception. II..., remote monitoring of vital signs, continuing medical education, and nursing call centers are all...
Jin, Hao-Qiang; Jost, Gabriele; Biegel, Bryan A. (Technical Monitor)
The purpose of this study is to evaluate the feasibility of remote memory access (RMA) programming on shared memory parallel computers. We discuss different RMA based implementations of selected CFD application benchmark kernels and compare them to corresponding message passing based codes. For the message-passing implementation we use MPI point-to-point and global communication routines. For the RMA based approach we consider two different libraries supporting this programming model. One is a shared memory parallelization library (SMPlib) developed at NASA Ames, the other is the MPI-2 extensions to the MPI Standard. We give timing comparisons for the different implementation strategies and discuss the performance.
Haacker-Santos, R.; Allen, L.; Batchelor, R. L.
As undergraduate research experiences have become an unofficial pre-requisite to enter graduate school programs in the sciences, we have to make sure that these experiences are inclusive and accessible to all students. Program managers who make a conscious effort to recruit students from traditionally under-represented groups, including veterans, non-traditional students or students with disabilities, are often unaware of the financial and program implications these students require, and discover that their current program design might inadvertently exclude or not fully support these students. The SOARS Program, an undergraduate-to-graduate bridge program in the atmospheric sciences, has supported this group of students for over 15 years. We have found that we needed to adjust some program elements and secure extra funding sources to holistically support our students in their research experience, however, the program and the students have reaped tremendous benefits. Involving non-traditional students or veterans in our program has raised the maturity level and problem solving skills of the group, and having students with disabilities participate has been a vehicle for broadening perspective and diverse knowledge into the field of study, e.g. researching weather and climate beyond what you can 'see'. This presentation will highlight some of the findings from the SOARS program experience, and will share practices for recruitment and holistic support to ensure student success. We will share resources and tips on inclusive program design, including working with students with family commitments or physical disabilities, and will report on the enormous program benefits and peer learning these students have brought to the student cohorts and research labs they are working in.
Schroeder, Krista; Ratcliffe, Sarah J; Perez, Adriana; Earley, David; Bowman, Cory; Lipman, Terri H
The purpose of this study was to evaluate Dance for Health, an intergenerational program to increase access to physical activity in an underserved, high risk urban community. Dance for Health was developed using community-based participatory research methods and evaluated using an observational study design. The program entailed two hour line dancing sessions delivered by trained dance instructors in the neighborhood recreation center. The weekly sessions were delivered for one month in the spring and one month in the fall from 2012-2016. Nurse practitioner students mentored local high school students to assess outcomes: achievement of target heart rate, Borg Rating of Perceived Exertion, number of pedometer steps during dance session, Physical Activity Enjoyment Scale, and adiposity. Analytic methods included descriptive statistics and mixed effects models. From 2012-2016, 521 participants ranging from 2-79 years attended Dance for Health. Approximately 50% of children and 80% of adults achieved target heart rate. Achievement of target heart rate was not related to perceived exertion, though it was related to pedometer steps in adults. All participants rated the program highly for enjoyment. There was no change in adiposity. Dance for Health demonstrated high levels of community engagement and enjoyment. It led to adequate levels of exertion, particularly for adults. Our evaluation can inform program refinement and future intergenerational physical activity programs. Dance is an enjoyable, culturally appropriate, low cost method for increasing access to physical activity for children and families. Copyright © 2017 Elsevier Inc. All rights reserved.
... of Property Disposition Program multifamily housing facilities. 9.152 Section 9.152 Housing and Urban... housing facilities. (a) Substantial alteration. If the agency undertakes alterations to a PDP multifamily... in a PDP multifamily housing project shall, to the maximum extent feasible, be made to be readily...
This final rule updates the payment rates for inpatient rehabilitation facilities (IRFs) for Federal fiscal year (FY) 2010 (for discharges occurring on or after October 1, 2009 and on or before September 30, 2010) as required under section 1886(j)(3)(C) of the Social Security Act (the Act). Section 1886(j)(5) of the Act requires the Secretary to publish in the Federal Register on or before the August 1 that precedes the start of each fiscal year, the classification and weighting factors for the IRF prospective payment system's (PPS) case-mix groups and a description of the methodology and data used in computing the prospective payment rates for that fiscal year. We are revising existing policies regarding the IRF PPS within the authority granted under section 1886(j) of the Act.
This final rule updates the prospective payment rates for inpatient rehabilitation facilities (IRFs) for Federal fiscal year (FY) 2009 (for discharges occurring on or after October 1, 2008 and on or before September 30, 2009) as required under section 1886(j)(3)(C) of the Social Security Act (the Act). Section 1886(j)(5) of the Act requires the Secretary to publish in the Federal Register on or before the August 1 that precedes the start of each fiscal year, the classification and weighting factors for the IRF prospective payment system's (PPS) case-mix groups and a description of the methodology and data used in computing the prospective payment rates for that fiscal year. We are revising existing policies regarding the PPS within the authority granted under section 1886(j) of the Act.
..., methodologies, procedures, or technology, whether or not patentable; (2) trademarks, copyrights, literary works... Article 8, Rule 3 (Fraudulent Acts) CHX Article 9, Rule 2 (Just & Equitable Trade Principles) CHX Article 11, Rule 2 (Maintenance of Books and Records) CHX Article 6, Rule 5 (Supervision of Registered...
..., methodologies, procedures, or technology, whether or not patentable; (2) trademarks, copyrights, literary works... Condition) CHX Article 8, Rule 3 (Fraudulent Acts) CHX Article 9, Rule 2 (Just & Equitable Trade Principles) CHX Article 11, Rule 2 (Maintenance of Books and Records) CHX Article 6, Rule 5 (Supervision of...
..., methodologies, procedures, or technology, whether or not patentable; (2) trademarks, copyrights, literary works... Article 8, Rule 3 (Fraudulent Acts) CHX Article 9, Rule 2 (Just & Equitable Trade Principles) CHX Article 11, Rule 2 (Maintenance of Books and Records) CHX Article 6, Rule 5 (Supervision of Registered...
The Department of Veterans Affairs (VA) is amending its VA Health Professional Scholarship Program (HPSP) regulations. VA is also establishing regulations for a new program, the Visual Impairment and Orientation and Mobility Professional Scholarship Program (VIOMPSP). These regulations comply with and implement sections 302 and 603 of the Caregivers and Veterans Omnibus Health Services Act of 2010 (the 2010 Act). Section 302 of the 2010 Act established the VIOMPSP, which authorizes VA to provide financial assistance to certain students seeking a degree in visual impairment or orientation or mobility, in order to increase the supply of qualified blind rehabilitation specialists for VA and the United States. Section 603 of the 2010 Act reauthorized and modified HPSP, a program that provides scholarships for education or training in certain health care occupations.
De Russis, Luigi; Corno, Fulvio
A considerable amount of research has been carried out towards enabling average users to customize their smart homes through trigger-action ("if... then...") programming. However, inhabitants of such smart environments keep having problems understanding, administering, troubleshooting, and deriving benefits from the technologies employed in their homes. By synthesizing a broad body of research on end-user programming in smart homes with observations of commercial products and our own experien...
Lynch, Sarah; Hayes, Sharon; Napolitano, Melissa; Hufnagel, Katrina
Background More than one third of college students who are overweight or obese are in need of weight loss programs tailored to college students. However, the availability and accessibility of these programs is unknown. Objective The aim of this study is to examine the availability and ease of access to weight loss programs for students at 10 universities with the largest undergraduate enrollment. Methods The 10 public universities with the largest student bodies with a mean (SD) undergraduate...
Soares, Neelkamal S; Hobson, Wendy L; Ruch-Ross, Holly; Finneran, Maureen; Varrasso, Denia A; Keller, David
The CATCH (Community Access to Child Health) Program, which supports pediatricians who engage with the community to improve child health, increase access to health care, and promote advocacy through small seed grants, was last evaluated in 1998. The objective was to describe the characteristics of CATCH grant recipients and projects and assess the community impact of funded projects. Prospective data was collected from CATCH applications (grantee characteristics, topic area and target population for projects funded from 2006-2012) and post-project 2-year follow-up survey (project outcomes, sustainability, and impact for projects funded from 2008 through 2010). From 2006 through 2012, the CATCH Program awarded 401 projects to grantees working mostly in general pediatrics. Eighty-five percent of projects targeted children covered by Medicaid, 33% targeted uninsured children, and 75% involved a Latino population. Main topic areas addressed were nutrition, access to health care, and medical home. Sixty-nine percent of grantees from 2008 to 2010 responded to the follow-up survey. Ninety percent reported completing their projects, and 86% of those projects continued to exist in some form. Grantees reported the development of community partnerships (77%) and enhanced recognition of child health issues in the community (73%) as the most frequent changes due to the projects. The CATCH Program funds community-based projects led by pediatricians that address the medical home and access to care. A majority of these projects and community partnerships are sustained beyond their original CATCH funding and, in many cases, are leveraged into additional financial or other community support.
Petrakis, P. L.
TimeSet is a shareware program for accessing digital time services by telephone. At its initial release, it was capable of capturing time signals only from the U.S. Naval Observatory to set a computer's clock. Later the ability to synchronize with the National Institute of Standards and Technology was added. Now, in Version 7.10, TimeSet is able to access three additional telephone time services in Europe - in Sweden, Austria, and Italy - making a total of five official services addressable by the program. A companion program, TimeGen, allows yet another source of telephone time data strings for callers equipped with TimeSet version 7.10. TimeGen synthesizes UTC time data strings in the Naval Observatory's format from an accurately set and maintained DOS computer clock, and transmits them to callers. This allows an unlimited number of 'freelance' time generating stations to be created. Timesetting from TimeGen is made feasible by the advent of Becker's RighTime, a shareware program that learns the drift characteristics of a computer's clock and continuously applies a correction to keep it accurate, and also brings .01 second resolution to the DOS clock. With clock regulation by RighTime and periodic update calls by the TimeGen station to an official time source via TimeSet, TimeGen offers the same degree of accuracy within the resolution of the computer clock as any official atomic time source.
This final rule updates the meal pattern requirements for the Child and Adult Care Food Program to better align them with the Dietary Guidelines for Americans, as required by the Healthy, Hunger-Free Kids Act of 2010. This rule requires centers and day care homes participating in the Child and Adult Care Food Program to serve more whole grains and a greater variety of vegetables and fruit, and reduces the amount of added sugars and solid fats in meals. In addition, this final rule supports mothers who breastfeed and improves consistency with the Special Supplemental Nutrition Program for Women, Infants, and Children and with other Child Nutrition Programs. Several of the changes are extended to the National School Lunch Program, School Breakfast Program, and Special Milk Program. These changes are based on the Dietary Guidelines for Americans, science-based recommendations made by the National Academy of Medicine (formerly the Institute of Medicine of the National Academies), cost and practical considerations, and stakeholder's input. This is the first major revision of the Child and Adult Care Food Program meal patterns since the Program's inception in 1968. These improvements to the meals served in the Child and Adult Care Food Program are expected to safeguard the health of young children by ensuring healthy eating habits are developed early, and improve the wellness of adult participants.
Emily Saurman; David Lyle; Sue Kirby; Russell Roberts
The Mental Health Emergency Care-Rural Access Program (MHEC-RAP) is a telehealth solution providing specialist emergency mental health care to rural and remote communities across western NSW, Australia. This is the first time and motion (T&M) study to examine program efficiency and capacity for a telepsychiatry program. Clinical services are an integral aspect of the program accounting for 6% of all activities and 50% of the time spent conducting program activities, but half of this time ...
Medicare Program; Merit-Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) Incentive Under the Physician Fee Schedule, and Criteria for Physician-Focused Payment Models. Final rule with comment period.
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) repeals the Medicare sustainable growth rate (SGR) methodology for updates to the physician fee schedule (PFS) and replaces it with a new approach to payment called the Quality Payment Program that rewards the delivery of high-quality patient care through two avenues: Advanced Alternative Payment Models (Advanced APMs) and the Merit-based Incentive Payment System (MIPS) for eligible clinicians or groups under the PFS. This final rule with comment period establishes incentives for participation in certain alternative payment models (APMs) and includes the criteria for use by the Physician-Focused Payment Model Technical Advisory Committee (PTAC) in making comments and recommendations on physician-focused payment models (PFPMs). Alternative Payment Models are payment approaches, developed in partnership with the clinician community, that provide added incentives to deliver high-quality and cost-efficient care. APMs can apply to a specific clinical condition, a care episode, or a population. This final rule with comment period also establishes the MIPS, a new program for certain Medicare-enrolled practitioners. MIPS will consolidate components of three existing programs, the Physician Quality Reporting System (PQRS), the Physician Value-based Payment Modifier (VM), and the Medicare Electronic Health Record (EHR) Incentive Program for Eligible Professionals (EPs), and will continue the focus on quality, cost, and use of certified EHR technology (CEHRT) in a cohesive program that avoids redundancies. In this final rule with comment period we have rebranded key terminology based on feedback from stakeholders, with the goal of selecting terms that will be more easily identified and understood by our stakeholders.
... countermeasures; (7) pandemic influenza diagnostics, personal respiratory devices, and respiratory support devices... medical records of an individual who applied to both programs. ] Justification for Waiver of Delayed... affect the following elements of family well-being. Family safety, family stability, marital commitment...
... the unit of general local government's most recently awarded open grant. If the unit of general local government has no open grants, the program income retained by the unit of general local government will be.... Nonentitlement areas include those units of general local government that do not receive CDBG funds directly...
... workers' compensation program or plan generally has an obligation to pay the United States the reasonable charges for healthcare services provided in or through any facility of the Uniformed Services to a... DEFENSE (CONTINUED) MISCELLANEOUS COLLECTION FROM THIRD PARTY PAYERS OF REASONABLE CHARGES FOR HEALTHCARE...
... from improved physical well-being, enhanced self-esteem, and a greater sense of personal accomplishment... the Federal poverty level. The program offers participants training at community service assignments... in community service activities and to also move SCSEP participants into unsubsidized employment...
Identity theft worries have found their way into medical practices. By August 1, 2009, all "creditors" must have a written program to prevent, detect, and minimize damage from identity theft. Any medical practice that bills patients is considered a creditor. Like HIPAA, these new Red Flag guidelines will serve to protect your practice from lawsuits as well as protect your patients from identity theft of their financial, personal, and medical information.
Rowland, Sandi; Leider, Jonathon P; Davidson, Clare; Brady, Joanne; Knudson, Alana
To characterize the expansion of a community dental access program (CDP) in rural Maryland providing urgent dental care to low-income individuals, as well as the CDP's impact on dental-related visits to a regional emergency department (ED). We used de-identified CDP and ED claims data to construct a data set of weekly counts of CDP visits and dental-related ED visits among Maryland adults. A time series model examined the association over time between visits to the CDP and ED visits for fiscal years (FYs) 2011 through 2015. The CDP served approximately 1600 unique clients across 2700 visits during FYs 2011 through 2015. The model suggested that if the CDP had not provided services during that time period, about 670 more dental-related visits to the ED would have occurred, resulting in $215 000 more in charges. Effective ED dental diversion programs can result in substantial cost savings to taxpayers, and more appropriate and cost-effective care for the patient. Community dental access programs may be a viable way to patch the dental safety net in rural communities while holistic solutions are developed.
Margherio, Cara; Horner-Devine, M. Claire; Mizumori, Sheri J. Y.; Yen, Joyce W.
BRAINS: Broadening the Representation of Academic Investigators in NeuroScience is a National Institutes of Health–funded, national program that addresses challenges to the persistence of diverse early-career neuroscientists. In doing so, BRAINS aims to advance diversity in neuroscience by increasing career advancement and retention of post-PhD, early-career neuroscientists from underrepresented groups (URGs). The comprehensive professional development program is structured to catalyze conversations specific to URGs in neuroscience and explicitly addresses factors known to impact persistence such as a weak sense of belonging to the scientific community, isolation and solo status, inequitable access to resources that impact career success, and marginalization from informal networks and mentoring relationships. While we do not yet have data on the long-term impact of the BRAINS program on participants’ career trajectory and persistence, we introduce the BRAINS program theory and report early quantitative and qualitative data on shorter-term individual impacts within the realms of career-advancing behaviors and career experiences. These early results suggest promising, positive career productivity, increased self-efficacy, stronger sense of belonging, and new perspectives on navigating careers for BRAINS participants. We finish by discussing recommendations for future professional development programs and research designed to broaden participation in the biomedical and life sciences. PMID:27587858
Muldoon, Katherine A; Muzaaya, Godfrey; Betancourt, Theresa S; Ajok, Mirriam; Akello, Monica; Petruf, Zaira; Nguyen, Paul; Baines, Erin K; Shannon, Kate
.... Among a group of young female abductees in northern Uganda, this study examined access to post-abduction reintegration programming and tested for between group differences in mental health status...
..., methodologies, procedures, or technology, whether or not patentable; (2) trademarks, copyrights, literary works...) (Books and Records; Financial Condition) CHX Article 8, Rule 3 (Fraudulent Acts) CHX Article 9, Rule 2 (Just & Equitable Trade Principles) CHX Article 11, Rule 2 (Maintenance of Books and Records) CHX...
Nikitin, Sergey; Zaitseva, Natalia; Demina, Olga; Solovieva, Vera; Mazin, Evgeny; Mikhalev, Sergey; Smolov, Maxim; Rubinov, Anatoly; Vlasov, Peter; Lepikhin, Dmitry; Khachko, Denis; Fokin, Valery; Queen, Cary; Zosimov, Viktor
We have constructed a very large virtual diversity space containing more than 1013 chemical compounds. The diversity space is built from about 400 combinatorial libraries, which have been expanded by choosing sizeable collections of suitable R-groups that can be attached to each link point of their scaffolds. These R-group collections have been created by selecting reagents that have drug-like properties from catalogs of available chemicals. As members of known combinatorial libraries, the compounds in the diversity space are in general synthetically accessible and useful as potential drug leads. Hence, the diversity space can be used as a vast source of compounds by a de novo drug design program. For example, we have used such a program to generate inhibitors of HIV integrase enzyme that exhibited activity in the micromolar range.
Medicare and Medicaid programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; electronic reporting pilot; Inpatient Rehabilitation Facilities Quality Reporting Program; revision to Quality Improvement Organization regulations. Final rule with comment period.
This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2013 to implement applicable statutory requirements and changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. In addition, this final rule with comment period updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program, the ASC Quality Reporting (ASCQR) Program, and the Inpatient Rehabilitation Facility (IRF) Quality Reporting Program. We are continuing the electronic reporting pilot for the Electronic Health Record (EHR) Incentive Program, and revising the various regulations governing Quality Improvement Organizations (QIOs), including the secure transmittal of electronic medical information, beneficiary complaint resolution and notification processes, and technical changes. The technical changes to the QIO regulations reflect CMS' commitment to the general principles of the President's Executive Order on Regulatory Reform, Executive Order 13563 (January 18, 2011).
Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System Policy Changes and Fiscal Year 2016 Rates; Revisions of Quality Reporting Requirements for Specific Providers, Including Changes Related to the Electronic Health Record Incentive Program; Extensions of the Medicare-Dependent, Small Rural Hospital Program and the Low-Volume Payment Adjustment for Hospitals. Final rule; interim final rule with comment period.
We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2016. Some of these changes implement certain statutory provisions contained in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable Care Act), the Pathway for Sustainable Growth Reform(SGR) Act of 2013, the Protecting Access to Medicare Act of 2014, the Improving Medicare Post-Acute Care Transformation Act of 2014, the Medicare Access and CHIP Reauthorization Act of 2015, and other legislation. We also are addressing the update of the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits for FY 2016.As an interim final rule with comment period, we are implementing the statutory extensions of the Medicare dependent,small rural hospital (MDH)Program and changes to the payment adjustment for low-volume hospitals under the IPPS.We also are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) for FY 2016 and implementing certain statutory changes to the LTCH PPS under the Affordable Care Act and the Pathway for Sustainable Growth Rate (SGR) Reform Act of 2013 and the Protecting Access to Medicare Act of 2014.In addition, we are establishing new requirements or revising existing requirements for quality reporting by specific providers (acute care hospitals,PPS-exempt cancer hospitals, and LTCHs) that are participating in Medicare, including related provisions for eligible hospitals and critical access hospitals participating in the Medicare Electronic Health Record (EHR)Incentive Program. We also are updating policies relating to the
Medicare Program; hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system changes and FY2011 rates; provider agreements and supplier approvals; and hospital conditions of participation for rehabilitation and respiratory care services; Medicaid program: accreditation for providers of inpatient psychiatric services. Final rules and interim final rule with comment period.
program has been approved by CMS. We are also issuing an interim final rule with comment period to implement a provision of the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 relating to Medicare payments for outpatient services provided prior to a Medicare beneficiary's inpatient admission.
Alexandros V. Gerbessiotis
Full Text Available In this work we make a strong case for remote memory access (RMA as the effective way to program a parallel computer by proposing a framework that supports RMA in a library independent, simple and intuitive way. If one uses our approach the parallel code one writes will run transparently under MPI-2 enabled libraries but also bulk-synchronous parallel libraries. The advantage of using RMA is code simplicity, reduced programming complexity, and increased efficiency. We support the latter claims by implementing under this framework a collection of benchmark programs consisting of a communication and synchronization performance assessment program, a dense matrix multiplication algorithm, and two variants of a parallel radix-sort algorithm and examine their performance on a LINUX-based PC cluster under three different RMA enabled libraries: LAM MPI, BSPlib, and PUB. We conclude that implementations of such parallel algorithms using RMA communication primitives lead to code that is as efficient as the message-passing equivalent code and in the case of radix-sort substantially more efficient. In addition our work can be used as a comparative study of the relevant capabilities of the three libraries.
Basic health program: state administration of basic health programs; eligibility and enrollment in standard health plans; essential health benefits in standard health plans; performance standards for basic health programs; premium and cost sharing for basic health programs; federal funding process; trust fund and financial integrity. Final rule.
This final rule establishes the Basic Health Program (BHP), as required by section 1331 of the Affordable Care Act. The BHP provides states the flexibility to establish a health benefits coverage program for low-income individuals who would otherwise be eligible to purchase coverage through the Affordable Insurance Exchange (Exchange, also called Health Insurance Marketplace). The BHP complements and coordinates with enrollment in a QHP through the Exchange, as well as with enrollment in Medicaid and the Children's Health Insurance Program (CHIP). This final rule also sets forth a framework for BHP eligibility and enrollment, benefits, delivery of health care services, transfer of funds to participating states, and federal oversight. Additionally, this final rule amends another rule issued by the Secretary of the Department of Health and Human Services (Secretary) in order to clarify the applicability of that rule to the BHP.
Myra, D.; Ready, C.
The Yakima Tributary Access and Habitat Program (YTAHP) was organized to restore salmonid passage to Yakima tributaries that historically supported salmonids and to improve habitat in areas where access is restored. This program intends to (a) screen unscreened diversion structures to prevent fish entrainment into artificial waterways; (b) provide for fish passage at man-made barriers, such as diversion dams, culverts, siphons and bridges; and (c) provide information and assistance to landowners interested in to contributing to the improvement of water quality, water reliability and stream habitat. The YTAHP developed from a number of groups actively engaged in watershed management, and/or habitat restoration within the Yakima River Basin. These groups include the Washington State Fish and Wildlife (WDFW), Kittitas County Conservation District (KCCD), North Yakima Conservation District (NYCD), Kittitas County Water Purveyors (KCWP), and Ahtanum Irrigation District (AID). The US Bureau of Reclamation (Reclamation) and Yakama Nation (YN) both participated in the development of the objectives of YTAHP. Other entities that will be involved during permitting or project review may include the YN, the federal Natural Resources Conservation Service (NRCS), the US Fish and Wildlife Service (USFWS), the National Marine Fisheries Service (NMFS), and US Army Corps of Engineers (COE). The objectives of YTAHP are listed below and also include subtasks detailed in the report: (1) Conduct Early Action Projects; (2) Review Strategic Plan; (3) Restore Access, including stream inventory, prioritization, implementation; and (4) Provide opportunities to improve habitat and conserve resources. The BPA YTAHP funding supported activities of the program which are described in this report. These activities are primarily related to objective 1 (conduct early action projects) and parts of objectives 2-4. The work supported by YTAHP funding will support a series of scheduled projects and be
Acevedo-Gil, Nancy; Zerquera, Desiree D.
This chapter examines community college first-year experience programs using critical race theory and ecological theory. The study draws on diverse students' experiences with access, support, and long-term success within community colleges to assess how these programs foster student success, as told through the voices of student participants.
Medicare Program; End-Stage Renal Disease Prospective Payment System, Payment for Renal Dialysis Services Furnished to Individuals With Acute Kidney Injury, and End-Stage Renal Disease Quality Incentive Program. Final rule.
This rule updates and makes revisions to the end-stage renal disease (ESRD) prospective payment system (PPS) for calendar year (CY) 2018. It also updates the payment rate for renal dialysis services furnished by an ESRD facility to individuals with acute kidney injury (AKI). This rule also sets forth requirements for the ESRD Quality Incentive Program (QIP), including for payment years (PYs) 2019 through 2021.
Palmer, Emma; Hart, Steve; Freeman, Patricia R
To describe the development and delivery of a comprehensive training program for Kentucky pharmacists to enable dispensation of naloxone per protocol. In May 2015, the Kentucky Board of Pharmacy (KBP) promulgated regulations outlining the requirements for pharmacists to initiate the dispensing of naloxone under a physician-approved protocol. The Advancing Pharmacy Practice in Kentucky Coalition, a partnership between Kentucky's Colleges of Pharmacy, KBP, and state and local pharmacists associations, developed and offered educational programming to fulfill this regulation. Pharmacists who completed the 90-minute program could apply to KBP for registration as a naloxone-certified pharmacist. The program consists of a 90-minute session covering naloxone access, opioid overdoses, the pharmacology and use of naloxone, protocol development, patient identification, and resources. Sessions were offered live and via webinar. Sessions have also been incorporated into the pharmacy curriculum at the 2 colleges of pharmacy in Kentucky. Between June 28, 2015, and June 1, 2016, a total of 1254 pharmacists and 348 student pharmacists completed training. Of those, 646 (52%) have applied to KBP and received naloxone-certified status. The program was well received, with 87% of learners ranking the usefulness of the information presented as excellent. Learners cited screening tips, protocol information, patient screening information, and education resources as information they will implement in their practice. The swift deployment of training to a wide variety of pharmacy professionals has resulted in a substantial number of naloxone-certified pharmacists across Kentucky. Through a coordinated training initiative involving all major pharmacy stakeholders, we reached many individuals rapidly, documenting the value of this approach for future training endeavors. This educational initiative may enhance pharmacy practice across Kentucky and the nation by expanding and educating on the
Margherio, Cara; Horner-Devine, M Claire; Mizumori, Sheri J Y; Yen, Joyce W
Broadening the Representation of Academic Investigators in NeuroScience is a National Institutes of Health-funded, national program that addresses challenges to the persistence of diverse early-career neuroscientists. In doing so, BRAINS aims to advance diversity in neuroscience by increasing career advancement and retention of post-PhD, early-career neuroscientists from underrepresented groups (URGs). The comprehensive professional development program is structured to catalyze conversations specific to URGs in neuroscience and explicitly addresses factors known to impact persistence such as a weak sense of belonging to the scientific community, isolation and solo status, inequitable access to resources that impact career success, and marginalization from informal networks and mentoring relationships. While we do not yet have data on the long-term impact of the BRAINS program on participants' career trajectory and persistence, we introduce the BRAINS program theory and report early quantitative and qualitative data on shorter-term individual impacts within the realms of career-advancing behaviors and career experiences. These early results suggest promising, positive career productivity, increased self-efficacy, stronger sense of belonging, and new perspectives on navigating careers for BRAINS participants. We finish by discussing recommendations for future professional development programs and research designed to broaden participation in the biomedical and life sciences. © 2016 C. Margherio et al. CBE—Life Sciences Education © 2016 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).
This rule amends current Medicaid regulations to implement section 2161 of the Omnibus Budget Reconciliation Act of 1981 (Pub. L 97-35) which imposes reductions in Federal matching payments for fiscal years 1982 through 1984. In the regulations, we describe the conditions and specify minimum criteria under which States may lower the reduction. The conditions are the existence of the qualified hospital cost review program, a specific level of unemployment in a State, and a specific amount of fraud and abuse recoveries by a State or, for fiscal year 1982 only, a combination of fraud and abuse and third party liability recoveries. We intend these regulations to provide guidance as to when the reductions, and offsets against the reductions, will be made and how States can qualify for the offsets. In addition, we have issued a notice of proposed rulemaking elsewhere in this issue of the Federal Register that contains proposed policies concerning recoveries from liable third parties for purposes of implementing section 2161.
1988 Underground Storage Tanks; Technical Requirements; Final Rule and Underground Storage Tanks Containing Petroleum-Financial Responsibility Requirements and State Program Approval Objective; Final Rule
EPA's 1988 regulations concerning USTs are contained in 40 CFR Part 280, 40 CFR Part 281 and 40 CFR Parts 282.50-282.105 and divided into three sections: technical requirements, financial responsibility requirements, and state program approval objectives.
Kim, Kirang; Hong, Seo Ah; Yun, Sung Ha; Ryou, Hyun Joo; Lee, Sang Sun; Kim, Mi Kyung
The objective of this study was to evaluate the effect of a healthy school tuck shop program, developed as a way of creating a healthy and nutritional school environment, on students' access to healthy foods. Five middle schools and four high schools (775 students) participated in the healthy school tuck shop program, and nine schools (1,282 students) were selected as the control group. The intervention program included restriction of unhealthy foods sold in tuck shops, provision of various f...
... 45 Public Welfare 1 2010-10-01 2010-10-01 false General reimbursement rules. 149.300 Section 149.300 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE EARLY RETIREE REINSURANCE PROGRAM Reimbursement Methods § 149.300 General reimbursement...
Nadash, Pamela; Miller, Edward Alan; Porell, Frank W; Birchander, Ellen; Glickman, Lillian; Burr, Jeffrey A
This article describes the online Management of Aging Services Masters Program at the University of Massachusetts Boston and reports on a recent Program review. The Program has experienced rapid growth, evolving from seven matriculating students in 2003 to 108 in 2012. It has graduated 125 students and boasts a 78% completion rate. The authors describe the Program and report on faculty and student perceptions of performance. The Program demonstrates sound pedagogical practice for online education, incorporating techniques to foster community and encourage students and faculty interaction. Distance learning holds considerable promise for expanding access to gerontological education to reach future aging services professionals.
Full Text Available Appropriate wireless access point deployment (APD is essential for ensuring seamless user communication. Optimal APD enables good telecommunication quality, balanced capacity loading, and optimal deployment costs. APD is a typical NP-complex problem because improving wireless networking infrastructure has multiple objectives (MOs. This paper proposes a method that integrates a goal-programming-driven model (PM and a genetic algorithm (GA to resolve the MO-APD problem. The PM identifies the target deployment subject of four constraints: budget, coverage, capacity, and interference. The PM also calculates dynamic capacity requirements to replicate real wireless communication. Three experiments validate the feasibility of the PM. The results demonstrate the utility and stability of the proposed method. Decision makers can easily refer to the PM-identified target deployment before allocating APs.
McClellan, Sean R.
Objectives. We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal (California’s Medicaid program) for Spanish-speaking persons with limited English proficiency, and whether it reduced language-based treatment access disparities. Methods. Using a time series nonequivalent control group design, we studied county-level penetration of language assistance programming over 10 years (1997–2006) for Spanish-speaking persons with limited English proficiency covered under Medi-Cal. We used linear regression with county fixed effects to control for ongoing trends and other influences. Results. When county mental health plans contracted with community-based organizations, those implementing language assistance programming increased penetration rates of Spanish-language mental health services under Medi-Cal more than other plans (0.28 percentage points, a 25% increase on average; P language-related disparities. Conclusions. Mental health treatment programs operated by community-based organizations may have moderately improved access after implementing required language assistance programming, but the programming did not reduce entrenched disparities in the accessibility of mental health services. PMID:23865663
Snowden, Lonnie R; McClellan, Sean R
We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal (California's Medicaid program) for Spanish-speaking persons with limited English proficiency, and whether it reduced language-based treatment access disparities. Using a time series nonequivalent control group design, we studied county-level penetration of language assistance programming over 10 years (1997-2006) for Spanish-speaking persons with limited English proficiency covered under Medi-Cal. We used linear regression with county fixed effects to control for ongoing trends and other influences. When county mental health plans contracted with community-based organizations, those implementing language assistance programming increased penetration rates of Spanish-language mental health services under Medi-Cal more than other plans (0.28 percentage points, a 25% increase on average; P language-related disparities. Mental health treatment programs operated by community-based organizations may have moderately improved access after implementing required language assistance programming, but the programming did not reduce entrenched disparities in the accessibility of mental health services.
Lee, L. R.; Montague, K. A.; Charvat, J. M.; Wear, M. L.; Thomas, D. M.; Van Baalen, M.
Since the 2010 NASA directive to make the Life Sciences Data Archive (LSDA) and Lifetime Surveillance of Astronaut Health (LSAH) data archives more accessible by the research and operational communities, demand for astronaut medical data has increased greatly. LSAH and LSDA personnel are working with Human Research Program on many fronts to improve data access and decrease lead time for release of data. Some examples include the following: Feasibility reviews for NASA Research Announcement (NRA) data mining proposals; Improved communication, support for researchers, and process improvements for retrospective Institutional Review Board (IRB) protocols; Supplemental data sharing for flight investigators versus purely retrospective studies; Work with the Multilateral Human Research Panel for Exploration (MHRPE) to develop acceptable data sharing and crew consent processes and to organize inter-agency data coordinators to facilitate requests for international crewmember data. Current metrics on data requests crew consenting will be presented, along with limitations on contacting crew to obtain consent. Categories of medical monitoring data available for request will be presented as well as flow diagrams detailing data request processing and approval steps.
Callahan, Rebecca M.; Shifrer, Dara
Purpose EL education policy has long directed schools to address English learner (EL) students’ linguistic and academic development, and must do so without furthering inequity or segregation (Lau, 1974; Castañeda, 1981). The recent ESSA (2015) reauthorization expresses a renewed focus on evidence of equity, effectiveness, and opportunity to learn. We propose that high school course taking patterns provide evidence of program effectiveness and equity in access. Research Design Using data from the nationally representative Educational Longitudinal Study of 2002 (ELS: 2002), we employ multinomial regression models to predict students’ likelihood of completing two types of high school coursework (basic graduation, college preparatory) by their linguistic status. Findings Despite considerable linguistic, sociodemographic, and academic controls, marked disparities in high school course taking patterns remain, with EL students experiencing significantly less academic exposure. Implications for Policy and Practice Building on McKenzie and Scheurich’s (2004) notion of an equity trap and evidence of a long-standing EL opportunity gap, we suggest that school leaders might use our findings and their own course taking patterns to prompt discussions about the causes and consequences of local EL placement processes. Such discussions have the potential to raise awareness about how educators and school leaders approach educational equity and access, key elements central to the spirit of EL education policy. PMID:27429476
Walker, Tarik; Deutchman, Mark; Ingram, Beth; Walker, Ely; Westfall, John M
Colorectal cancer (CRC) is a significant source of morbidity and mortality in the United States. Colonoscopy can be an extension of the care provided by a family physician to help substantially reduce CRC morbidity and mortality. Family physicians trained in colonoscopy can provide access to care in rural and medically underserved areas. The Department of Family Medicine and the Colorado Area Health Education Center (AHEC) developed the Endoscopy Training for Primary Care (ETPC) program to teach primary care physicians to perform colonoscopy. The program included online didactic education, a formal endoscopy simulator experience, and proctoring by a current endoscopist. Participants completed a baseline and follow-up survey assessing CRC screening knowledge and the effectiveness of the endoscopy training for ongoing screening activities. To date, 94 practitioners and health professional students have participated in the study. Ninety-one (97%) completed the online didactic portion of the training. Sixty-five participants (77%) were physicians or medical students, and the majority (64%) was in the field of family medicine. The year 4 (2011) follow-up cohort was comprised of 62% respondents working in an urban background and 26% in rural communities. Many participants remain in a queue for proctoring by a trained endoscopist. Several participants are successfully performing a significant number of colonoscopies. ETPC program showed success in recruiting a large number of physicians and students to participate in training. The program enhanced perceptions about the value of colon cancer screening and providing screening endoscopy in primary care practice. Providing sites for simulation training throughout Colorado provided opportunity for providers in rural regions to participate. As a result of this training, thousands of patients underwent testing to prevent colon cancer. Future research relating to colonoscopy training by family physicians should focus on quality
... public interest and for the protection of investors; to foster cooperation and coordination among the... activity, conduct, or output in relation to such provision or rule; provided, however, Common Rules shall...., EDGA Exchange, Inc., EDGX Exchange, Inc., Financial Industry Regulatory Authority, Inc., International...
Myra, David (South Central Washington Resource Conservation and Development Council, Ellensburg, WA); Ready, Carol A. (Kittitas County Water Purveyors, Ellensburg, WA)
This report covers activities conducted by the Yakima Tributary Access and Habitat Program under Bonneville Power Administration (BPA) grant project No. 2002-025-00 for fiscal year 2002. The Yakima Tributary Access and Habitat Program (YTAHP, Program) was organized to restore salmonid passage to Yakima tributaries that historically supported salmonids and improve habitat in areas where access is restored. Specifically, this program is designed to (a) screen unscreened diversion structures to prevent fish entrainment into artificial waterways; (b) provide for fish passage at man-made barriers, such as diversion dams, culverts, siphons and bridges; and (c) provide information and assistance to landowners interested in to contributing to the improvement of water quality, water reliability and stream habitat. The YTAHP developed from a number of groups actively engaged in watershed management, and/or habitat restoration within the Yakima River Basin. These groups include the Washington State Fish and Wildlife (WDFW), Kittitas County Conservation District (KCCD), North Yakima Conservation District (NYCD), Kittitas County Water Purveyors (KCWP), and Ahtanum Irrigation District (AID). The US Bureau of Reclamation (Reclamation) and Yakama Nation (YN) both participated in the development of the objectives of YTAHP. Other entities that will be involved during permitting or project review may include the YN, the federal Natural Resources Conservation Service (NRCS), the US Fish and Wildlife Service (USFWS), the National Marine Fisheries Service (NMFS), and US Army Corps of Engineers (COE). Achievements of YTAHP with BPA Action Plan funding during FY 2002 were to: (1) Establish contracts with RC&D and YTAHP participants. (2) Determine contract mechanism for MWH engineering services. (3) Provide engineering designs and services for 11 early action projects, including inverted siphons, pump and gravity diversion screening, diversion metering, rock weirs for improved fish passage
Das, Saptarshi; Pan, Indranil; Das, Shantanu; Gupta, Amitava
Genetic algorithm (GA) has been used in this study for a new approach of suboptimal model reduction in the Nyquist plane and optimal time domain tuning of proportional-integral-derivative (PID) and fractional-order (FO) PI(λ)D(μ) controllers. Simulation studies show that the new Nyquist-based model reduction technique outperforms the conventional H(2)-norm-based reduced parameter modeling technique. With the tuned controller parameters and reduced-order model parameter dataset, optimum tuning rules have been developed with a test-bench of higher-order processes via genetic programming (GP). The GP performs a symbolic regression on the reduced process parameters to evolve a tuning rule which provides the best analytical expression to map the data. The tuning rules are developed for a minimum time domain integral performance index described by a weighted sum of error index and controller effort. From the reported Pareto optimal front of the GP-based optimal rule extraction technique, a trade-off can be made between the complexity of the tuning formulae and the control performance. The efficacy of the single-gene and multi-gene GP-based tuning rules has been compared with the original GA-based control performance for the PID and PI(λ)D(μ) controllers, handling four different classes of representative higher-order processes. These rules are very useful for process control engineers, as they inherit the power of the GA-based tuning methodology, but can be easily calculated without the requirement for running the computationally intensive GA every time. Three-dimensional plots of the required variation in PID/fractional-order PID (FOPID) controller parameters with reduced process parameters have been shown as a guideline for the operator. Parametric robustness of the reported GP-based tuning rules has also been shown with credible simulation examples. Copyright © 2011 ISA. Published by Elsevier Ltd. All rights reserved.
... end according to the DAS rules specified in § 648.10(e)(5)(iv). (f) Good Samaritan credit. See § 648... replacement rules, the vessel owner could choose to adopt the larger baseline of the two vessels, which would... restrictive differential DAS counting factor derived from paragraph (n)(1)(ii) of this section for the sub...
Civilian Health and Medical Program of the Uniformed Services (CHAMPUS)/TRICARE: Refills of Maintenance Medications Through Military Treatment Facility Pharmacies or National Mail Order Pharmacy Program. Final rule.
This final rule implements section 702 (c) of the Carl Levin and Howard P. "Buck" McKeon National Defense Authorization Act for Fiscal Year 2015 which states that beginning October 1, 2015, the pharmacy benefits program shall require eligible covered beneficiaries generally to refill non-generic prescription maintenance medications through military treatment facility pharmacies or the national mail-order pharmacy program. An interim final rule is in effect. Section 702(c) of the National Defense Authorization Act for Fiscal Year 2015 also terminates the TRICARE For Life Pilot Program on September 30, 2015. The TRICARE For Life Pilot Program described in section 716(f) of the National Defense Authorization Act for Fiscal Year 2013, was a pilot program which began in March 2014 requiring TRICARE For Life beneficiaries to refill non-generic prescription maintenance medications through military treatment facility pharmacies or the national mail-order pharmacy program. TRICARE for Life beneficiaries are those enrolled in the Medicare wraparound coverage option of the TRICARE program. This rule includes procedures to assist beneficiaries in transferring covered prescriptions to the mail order pharmacy program.
Smyth, Daniel; Francheville, Jordan W; Rankin, Robin; Beck, Jeremy; Hoare, Connie; Materniak, Stefanie; German, Greg; Barrett, Lisa; Bunimov-Wall, Natalie
The availability of curative hepatitis C therapies has created an opportunity to improve delivery and access. Local providers, government, industry, and community groups in Prince Edward Island developed an innovative province-wide care model. Our goal was to describe the first year of program implementation. Using a community based prospective observational study design, all chronic hepatitis C referrals received from April 2015 to April 2016 were recorded in a database. Primary analysis assessed the time from referral to assessment/treatment, as well as the number of referrals, assessments, and treatment initiations. Secondary objectives included: 1) Treatment effectiveness using intention-to-treat analysis; and 2) Patient treatment experience assessed using demographics, adverse events, and medication adherence. During the study period 242 referrals were received, 123 patients were seen for intake assessments, and 93 initiated direct-acting antiviral therapy based on medical need. This is compared to 4 treatment initiations in the previous 2 years. The median time from assessment to treatment initiation was 3 weeks. Eighty-two of 84 (97.6%, 95% CI 91.7 - 99.7%) patients for whom outcome data were available achieved sustained virologic response at 12 weeks post-treatment; 1 was lost to follow-up and 1 died from an unrelated event. In the voluntary registry, 39.7% of patients reported missed treatment doses. In conclusion, results from the first 12 months of this multi-phase hepatitis C elimination strategy demonstrate improved access to treatment, and high rates of safe engagement and cure for patients living with chronic hepatitis C genotype 1 infections.
... 45 Public Welfare 1 2010-10-01 2010-10-01 false Program administration. 152.6 Section 152.6 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS PRE-EXISTING CONDITION INSURANCE PLAN PROGRAM PCIP Program Administration § 152.6 Program administration. (a) General rule. Section 1101(b)(1) of the...
Muldoon, Katherine A; Muzaaya, Godfrey; Betancourt, Theresa S; Ajok, Mirriam; Akello, Monica; Petruf, Zaira; Nguyen, Paul; Baines, Erin K; Shannon, Kate
Reintegration programs are commonly offered to former combatants and abductees to acquire civilian status and support services to reintegrate into post-conflict society. Among a group of young female abductees in northern Uganda, this study examined access to post-abduction reintegration programming and tested for between group differences in mental health status among young women who had accessed reintegration programming compared to those who self-reintegrated. This cross-sectional study analysed interviews from 129 young women who had previously been abducted by the Lords Resistance Army (LRA). Data was collected between June 2011-January 2012. Interviews collected information on abduction-related experiences including age and year of abduction, manner of departure, and reintegration status. Participants were coded as 'reintegrated' if they reported ≥1 of the following reintegration programs: traditional cleansing ceremony, received an amnesty certificate, reinsertion package, or had gone to a reception centre. A t-test was used to measure mean differences in depression and anxiety measured by the Acholi Psychosocial Assessment Instrument (APAI) to determine if abductees who participated in a reintegration program had different mental status from those who self-reintegrated. From 129 young abductees, 56 (43.4%) had participated in a reintegration program. Participants had been abducted between 1988-2010 for an average length of one year, the median age of abduction was 13 years (IQR:11-14) with escaping (76.6%), being released (15.6%), and rescued (7.0%) being the most common manner of departure from the LRA. Traditional cleansing ceremonies (67.8%) were the most commonly accessed support followed by receiving amnesty (37.5%), going to a reception centre (28.6%) or receiving a reinsertion package (12.5%). Between group comparisons indicated that the mental health status of abductees who accessed ≥1 reintegration program were not significantly different from
Drewry, Jonathan; Sen, Bisakha; Wingate, Martha; Bronstein, Janet; Foster, E Michael; Kotelchuck, Milton
The 2002 "unborn child ruling" resulted in State Children's Health Insurance Program (SCHIP) expansion for states to cover prenatal care for low-income women without health insurance. Foreign-born Latinas who do not qualify for Medicaid coverage theoretically should have benefited most from the policy ruling given their documented low rates of prenatal care utilization. This study compares prenatal care utilization and subsequent birth outcomes among foreign-born Latinas in six states that used the unborn child ruling to expand coverage to those in ten states that did not implement the expansion. This policy analysis examines cross-sectional pooled US natality data from the pre-enactment years (2000-2003) versus post-enactment years (2004-2007) to estimate the effect of the UCR on prenatal care utilization and birth outcome measures for foreign-born Latinas. Then using a difference-in-difference estimator, we assessed these differences across time for states that did or did not enact the unborn child ruling. Analyses were then replicated on a high-risk subset of the population (single foreign-born Latinas with lower levels of education). The SCHIP unborn child ruling policy expansion increased PNCU over time in the six enacting states. Foreign-born Latinas in expansion enacting states experienced increases in prenatal care utilization though only the high-risk subset were statistically significant. Birth outcomes did not change. The SCHIP unborn child ruling policy was associated with enhanced PNC for a subset of high-risk foreign-born Latinas.
Vander Kloet, Marie
It is increasingly understood that university education must be accessible to persons with disabilities. The responsibility to make the university accessible is arguably shared by all of us and yet, the extent to which it has become fully accessible is certainly suspect. By undertaking qualitative, discursive analysis of websites, online texts and…
Novel Humanitarian Aid Program: The Glivec International Patient Assistance Program-Lessons Learned From Providing Access to Breakthrough Targeted Oncology Treatment in Low- and Middle-Income Countries.
Garcia-Gonzalez, Pat; Boultbee, Paula; Epstein, David
Imatinib was the first targeted therapy approved for the treatment of cancer. With its approval, it was immediately clear to Novartis that this breakthrough therapy would require an innovative approach to worldwide access, with special consideration of low- and middle-income countries. Lack of government reimbursement, universal health care, or health insurance coverage, few trained specialty physicians or diagnostic services, and poor health care infrastructure were, and continue to be, contributing barriers to access to treatment in low- and middle-income countries. The Glivec International Patient Assistance Program (GIPAP) is an international drug donation program established by Novartis Pharma AG and implemented in partnership with The Max Foundation, a nonprofit, nongovernmental organization. GIPAP was established in 2001, essentially in parallel with the first approval of imatinib for chronic myeloid leukemia. Since 2001, GIPAP has made imatinib accessible to all medically and financially eligible patients within 80 countries on an ongoing basis as long as their physicians prescribe it and no other means of access exists. To date, more than 49,000 patients have benefited from GIPAP, and 2.3 million monthly doses of imatinib have been approved through the program. GIPAP represents an innovative drug donation model that has set the standard for access programs for other targeted or innovative therapies. The purpose of this article is to describe the structure of GIPAP, as well as important lessons that have contributed to the success of the program. This article may assist other companies with the development of successful and far-reaching patient assistance programs in the future.
Ramamurthy, M. K.
Increasingly, the conduct of science requires close international collaborations to share data, information, knowledge, expertise, and other resources. This is particularly true in the geosciences where the highly connected nature of the Earth system and the need to understand global environmental processes have heightened the importance of scientific partnerships. As geoscience studies become a team effort involving networked scientists and data providers, it is crucial that there is open and reliable access to earth system data of all types, software, tools, models, and other assets. That environment demands close attention to security-related matters, including the creation of trustworthy cyberinfrastructure to facilitate the efficient use of available resources and support the conduct of science. Unidata and EarthCube, both of which are NSF-funded and community-driven programs, recognize the importance of collaborations and the value of networked communities. Unidata, a cornerstone cyberinfrastructure facility for the geosciences, includes users in nearly 180 countries. The EarthCube initiative is aimed at transforming the conduct of geosciences research by creating a well-connected and facile environment for sharing data and in an open, transparent, and inclusive manner and to accelerate our ability to understand and predict the Earth system. We will present the Unidata and EarthCube community perspectives on the approaches to balancing an environment that promotes open and collaborative eScience with the needs for security and communication, including what works, what is needed, the challenges, and opportunities to advance science.
Ooms, L.; Veenhof, C.
Introduction: The Dutch government stimulates sport and physical activity opportunities in the neighborhood to make it easier for people to adopt a physically active lifestyle. Seven National Sports Federations (NSFs) were funded to develop easily accessible sporting programs, targeted at groups
This article examines how three urban elementary school teachers adapted pedagogical strategies from a school district--adopted core reading program to increase their students' access to the curriculum. Using teacher interviews and classroom observations to construct a descriptive case study of teacher adaptation, analysis reveals that the…
Medicare and Medicaid programs: hospital outpatient prospective payment; ambulatory surgical center payment; hospital value-based purchasing program; physician self-referral; and patient notification requirements in provider agreements. Final rule with comment period.
This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) for CY 2012 to implement applicable statutory requirements and changes arising from our continuing experience with this system. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare hospital outpatient services paid under the OPPS. In addition, this final rule with comment period updates the revised Medicare ambulatory surgical center (ASC) payment system to implement applicable statutory requirements and changes arising from our continuing experience with this system. In this final rule with comment period, we set forth the relative payment weights and payment amounts for services furnished in ASCs, specific HCPCS codes to which these changes apply, and other ratesetting information for the CY 2012 ASC payment system. We are revising the requirements for the Hospital Outpatient Quality Reporting (OQR) Program, adding new requirements for ASC Quality Reporting System, and making additional changes to provisions of the Hospital Inpatient Value-Based Purchasing (VBP) Program. We also are allowing eligible hospitals and CAHs participating in the Medicare Electronic Health Record (EHR) Incentive Program to meet the clinical quality measure reporting requirement of the EHR Incentive Program for payment year 2012 by participating in the 2012 Medicare EHR Incentive Program Electronic Reporting Pilot. Finally, we are making changes to the rules governing the whole hospital and rural provider exceptions to the physician self-referral prohibition for expansion of facility capacity and changes to provider agreement regulations on patient notification requirements.
Mahmud, Aidalina; Aljunid, Syed Mohamed
Access to healthcare is essential in the pursuit of universal health coverage. Components of access are availability, accessibility (spatial and non-spatial), affordability and acceptability. Measuring spatial accessibility is common approach to evaluating access to health care. This study aimed to determine the availability and spatial accessibility of subsidised mammogram screening in Peninsular Malaysia. Availability was determined from the number and distribution of facilities. Spatial accessibility was determined using the travel impedance approach to represent the revealed access as opposed to potential access measured by other spatial measurement methods. The driving distance of return trips from the respondent's residence to the facilities was determined using a mapping application. The travel expenditure was estimated by multiplying the total travel distance by a standardised travel allowance rate, plus parking fees. Respondents in this study were 344 breast cancer patients who received treatment at 4 referral hospitals between 2015 and 2016. In terms of availability, there were at least 6 major entities which provided subsidised mammogram programs. Facilities with mammogram involved with these programs were located more densely in the central and west coast region of the Peninsula. The ratio of mammogram facility to the target population of women aged 40-74 years ranged between 1: 10,000 and 1:80,000. In terms of accessibility, of the 3.6% of the respondents had undergone mammogram screening, their mean travel distance was 53.4 km (SD = 34.5, range 8-112 km) and the mean travel expenditure was RM 38.97 (SD = 24.00, range RM7.60-78.40). Among those who did not go for mammogram screening, the estimated travel distance and expenditure had a skewed distribution with median travel distance of 22.0 km (IQR 12.0, 42.0, range 2.0-340.0) and the median travel cost of RM 17.40 (IQR 10.40, 30.00, range 3.40-240.00). Higher travel impedance was noted among those who
Bellström, Peter; Kilbrink, Nina
In this chapter we describe a pilot survey on applying problem-based learning (PBL) in an undergraduate programming course. During the course the students have applied PBL as a complement to traditional teaching and learning techniques. The PBL problem in this survey combines both knowledge about programming and knowledge about databases. We argue that to handle programming the students have to learn programming according to the deep approach to learning in order to be able to apply their knowledge in new programming situations and contexts. The result from this pilot survey indicates from both a tutor and a student perspective that PBL could be one method to reach a deeper understanding on how to access databases in a programming language.
Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Short Inpatient Hospital Stays; Transition for Certain Medicare-Dependent, Small Rural Hospitals Under the Hospital Inpatient Prospective Payment System; Provider Administrative Appeals and Judicial Review. Final rule with comment period; final rule.
This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2016 to implement applicable statutory requirements and changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. In addition, this final rule with comment period updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program. Further, this document includes certain finalized policies relating to the hospital inpatient prospective payment system: Changes to the 2-midnight rule under the short inpatient hospital stay policy; and a payment transition for hospitals that lost their status as a Medicare-dependent, small rural hospital (MDH) because they are no longer in a rural area due to the implementation of the new Office of Management and Budget delineations in FY 2015 and have not reclassified from urban to rural before January 1, 2016. In addition, this document contains a final rule that finalizes certain 2015 proposals, and addresses public comments received, relating to the changes in the Medicare regulations governing provider administrative appeals and judicial review relating to appropriate claims in provider cost reports.
Saurman, Emily; Lyle, David; Kirby, Sue; Roberts, Russell
The Mental Health Emergency Care-Rural Access Program (MHEC-RAP) is a telehealth solution providing specialist emergency mental health care to rural and remote communities across western NSW, Australia. This is the first time and motion (T&M) study to examine program efficiency and capacity for a telepsychiatry program. Clinical services are an integral aspect of the program accounting for 6% of all activities and 50% of the time spent conducting program activities, but half of this time is spent completing clinical paperwork. This finding emphasizes the importance of these services to program efficiency and the need to address variability of service provision to impact capacity. Currently, there is no efficiency benchmark for emergency telepsychiatry programs. Findings suggest that MHEC-RAP could increase its activity without affecting program responsiveness. T&M studies not only determine activity and time expenditure, but have a wider application assessing program efficiency by understanding, defining, and calculating capacity. T&M studies can inform future program development of MHEC-RAP and similar telehealth programs, both in Australia and overseas. PMID:25089774
This interim final rule amends the National School Lunch Program and School Breakfast Program regulations to establish nutrition standards for all foods sold in schools, other than food sold under the lunch and breakfast programs. Amendments made by Section 208 of the Healthy, Hunger-Free Kids Act of 2010 (HHFKA) require the Secretary to establish nutrition standards for such foods, consistent with the most recent Dietary Guidelines for Americans, and directs the Secretary to consider authoritative scientific recommendations for nutrition standards; existing school nutrition standards, including voluntary standards for beverages and snack foods; current State and local standards; the practical application of the nutrition standards; and special exemptions for infrequent school-sponsored fundraisers (other than fundraising through vending machines, school stores, snack bars, à la carte sales and any other exclusions determined by the Secretary). In addition, this interim final rule requires schools participating in the National School Lunch Program and School Breakfast Program to make potable water available to children at no charge in the place where lunches are served during the meal service, consistent with amendments made by section 203 of the HHFKA, and in the cafeteria during breakfast meal service. This interim final rule is expected to improve the health and well-being of the Nation's children, increase consumption of healthful foods during the school day, and create an environment that reinforces the development of healthy eating habits.
Koning, H.M.; Glatz, T.
Most adolescents have their first encounter with alcohol in early or middle adolescence. Parents’ rule setting about alcohol has been shown to be important to delay the onset and reduce the frequency of adolescents’ alcohol drinking, but less is known about the potential role of parents’ beliefs
... and for the protection of investors; to foster cooperation and coordination among the SROs; to remove... application of the such provisions or rule, or a Dual Member's activity, conduct, or output in relation to... Exchange, Inc., Chicago Stock Exchange, Inc., Financial Industry Regulatory Authority, Inc., International...
... and for the protection of investors; to foster cooperation and coordination among the SROs; to remove... application of the such provisions or rule, or a Dual Member's activity, conduct, or output in relation to... Exchange, Inc., Chicago Stock Exchange, Inc., Financial Industry Regulatory Authority, Inc., International...
Castellano, Daniel; Antón Aparicio, Luis M; Esteban, Emilio; Sánchez-Hernández, Alfredo; Germà, Jose Ramón; Batista, Norberto; Maroto, Pablo; Pérez-Valderrama, Begoña; Luque, Raquel; Méndez-Vidal, María José
Based on the TROPIC study results, cabazitaxel was approved for the management of metastatic castration-resistant prostate cancer (mCRPC) progressing on or after docetaxel. This multi-centre program provided early access to cabazitaxel to patients with mCRPC before its commercialization. Safety data from 153 Spanish patients receiving cabazitaxel 25 mg/m(2) i.v. Q3W, plus oral prednisone/prednisolone 10 mg daily, are reported. Median age of patients was 70 years (26.8% ≥ 75 years), 94.1 and 26.8% had bone and visceral metastasis, respectively. Most had an Eastern Cooperative Oncology Group ≤ 1 (88.9%) and had received a median of 8.0 cycles of last docetaxel treatment. The median of cabazitaxel cycles and cumulative dose were 6.0 (Interquartile range [IQR]: 4.0; 8.0) and 148.9 (IQR: 98.2; 201.4) mg/m(2), respectively. Adverse events (AEs) possibly related to cabazitaxel occurred in 143 (93.5%) patients. The most frequent grade ≥ 3 AEs were neutropenia (n = 25, 16.3%) and asthenia (n = 17, 11.1%). Febrile neutropenia and grade ≥ 3 diarrhea occurred in 5.2% of the patients each. There were five (3.3%) possibly treatment-related deaths, mainly infection-related. G-CSFs were used in 114 (74.5%) patients, generally as prophylaxis (n = 107; 69.9%). Grade ≥ 3 peripheral neuropathy and nail disorders were uncommon. Cabazitaxel administration, in a real-world setting, is tolerated by Spanish patients with mCRPC, and the AEs are manageable.
Raimondos-Møller, Pascalis; Woodland, Alan D.
Well known tariff reform rules that are guaranteed to increase welfare will not necessarily increase market access, while rules that are guaranteed to increase market access will not necessarily increase welfare. The present paper proposes a new set of tariff reforms that can achieve both objecti...
... System (ADAMS): You may access publicly available documents online in the NRC Library at http://www.nrc...), that integrates the performance requirements contained within 10 CFR 73.56, ``Personnel Access Authorization Requirements for Nuclear Power Plants,'' and the criminal history checks of 10 CFR 73.57...
In recent years, several writing centers have been set up in colleges and universities of Taiwan. Almost at the same time, many self-access learning centers are being designed and built on campuses all over the island. Whether these two institutes function jointly or independently, dissatisfaction arises. In order to run the self-access learning…
Dryman, M Taylor; McTeague, Lisa M; Olino, Thomas M; Heimberg, Richard G
Internet-delivered cognitive-behavioral therapy (ICBT) has been established as both efficacious and effective in reducing symptoms of social anxiety. However, most research has been conducted in controlled settings, and little is known regarding the utility of such programs in an open-access format. The present study examined the use, adherence, and effectiveness of Joyable, an open-access, Internet-delivered, coach-supported CBT-based intervention for social anxiety. Participants were 3,384 registered users (Mage [SD] = 29.82 [7.89]; 54% male) that created an account between 2014 and 2016. Characteristics of use, factors related to attrition and adherence, and within-group outcomes were examined. The primary outcome measure was the Social Phobia Inventory. On average, participants remained in the program for 81.02 days (SD = 60.50), during which they completed 12.14 activities (SD = 11.09) and 1.53 exposures (SD = 3.18). About half (57%) had contact with a coach. Full adherence to the program was achieved by 16% of participants, a rate higher than previously published open-access studies of ICBT. Social anxiety symptoms were significantly reduced for participants that engaged in the program, with medium within-group effects from baseline through the cognitive restructuring module (d = 0.63-0.76) and large effects from baseline through the exposure module (d = 1.40-1.83). Response rates were high (72%). Exposures and coach contact were significant predictors of retention and outcome. This open-access online CBT-based program is effective in reducing social anxiety symptoms and has the potential to extend Internet-based mental health services to socially anxious individuals unwilling or unable to seek face-to-face evidence-based therapy. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
These rules define the technical, financial and legal conditions applied to imports and/or exports made by the user on the French public power transmission grid (Reseau Public de Transport - RPT), considering the available capacity on interconnections and any particular technical constraints of the European interconnected network, notably in terms of safety: 1 - definitions; 2 - general conditions (scope, participation conditions, user obligations, signature, enforcement and duration of the participation agreement, attachment of transactions to a balance responsible entity, rules modification procedure, access to the information system, financial conditions, guarantee of exchange programmes, transfer of rights and obligations, intellectual property, confidentiality, force majeure, responsibility, termination, notifications and operational exchange procedures, territorial application of the rules, applicable law and language, dispute resolution); 3 - conditions for the application of imports and exports (allocating transmission capacity on interconnections, allocating import capacity, changing a capacity allocation mechanism, the different categories of exchange programmes, standard programmes, weekly programmes, daily programmes, nominations in the event of a failure in the information system, information published by RTE); 4 - conditions for the application of intra-day transactions (intra-day transaction requests, processing intra-day transaction requests, modification of an intra-day transactions programme). 16 models of correspondence documents are given in appendixes.
Kaye, D L; Fornari, V; Scharf, M; Fremont, W; Zuckerbrot, R; Foley, C; Hargrave, T; Smith, B A; Wallace, J; Blakeslee, G; Petras, J; Sengupta, S; Singarayer, J; Cogswell, A; Bhatia, I; Jensen, P
Although, child mental health problems are widespread, few get adequate treatment, and there is a severe shortage of child psychiatrists. To address this public health need many states have adopted collaborative care programs to assist primary care to better assess and manage pediatric mental health concerns. This report adds to the small literature on collaborative care programs and describes one large program that covers most of New York state. CAP PC, a component program of New York State's Office of Mental Health (OMH) Project TEACH, has provided education and consultation support to primary care providers covering most of New York state since 2010. The program is uniquely a five medical school collaboration with hubs at each that share one toll free number and work together to provide education and consultation support services to PCPs. The program developed a clinical communications record to track information about all consultations which forms the basis of much of this report. 2-week surveys following consultations, annual surveys, and pre- and post-educational program evaluations have also been used to measure the success of the program. CAP PC has grown over the 6years of the program and has provided 8013 phone consultations to over 1500 PCPs. The program synergistically provided 17,523 CME credits of educational programming to 1200 PCPs. PCP users of the program report very high levels of satisfaction and self reported growth in confidence. CAP PC demonstrates that large-scale collaborative consultation models for primary care are feasible to implement, popular with PCPs, and can be sustained. The program supports increased access to child mental health services in primary care and provides child psychiatric expertise for patients who would otherwise have none. Copyright © 2017. Published by Elsevier Inc.
Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2017; Medicare Advantage Bid Pricing Data Release; Medicare Advantage and Part D Medical Loss Ratio Data Release; Medicare Advantage Provider Network Requirements; Expansion of Medicare Diabetes Prevention Program Model; Medicare Shared Savings Program Requirements. Final rule.
This major final rule addresses changes to the physician fee schedule and other Medicare Part B payment policies, such as changes to the Value Modifier, to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services, as well as changes in the statute. This final rule also includes changes related to the Medicare Shared Savings Program, requirements for Medicare Advantage Provider Networks, and provides for the release of certain pricing data from Medicare Advantage bids and of data from medical loss ratio reports submitted by Medicare health and drug plans. In addition, this final rule expands the Medicare Diabetes Prevention Program model.
Kalthoum Ibrahim Yousif
Full Text Available End-stage renal disease is a worldwide problem that requires highly skilled nursing care. Hemodialysis (HD is a corner-stone procedure in the management of most patients who require renal replacement therapy. Adequate vascular access is essential for the successful use of HD. Appropriate knowledge in taking care of vascular access is essential for minimizing complications and accurately recognizing vascular access-related problems. This study was to evaluate the effect of an educational program for vascular access care on nurses’ knowledge at nine dialysis centers in Khartoum State. This was a Quasi experimental study (pre-and post-test for the same group. Sixty-one nurses working in these HD centers were chosen by simple random sampling method. A structured face-to-face interview questionnaire based on the Kidney Dialysis Outcome Quality Initiative (K/DOQI clinical practice guidelines for vascular access care was used. Instrument validity was determined through content validity by a panel of experts. Reliability of the instrument was tested by a pilot study to test the knowledge scores for 15 nurses. The Pearson correlation coefficient obtained was (r = 0.82. Data collection was taken before and after the educational intervention. A follow-up test was performed three month later, using the same data collection tools. Twenty-two individual variables assessing the knowledge levels in aspects related to the six K/DOQI guidelines showed improvement in all scores of the nurses’ knowledge after the educational intervention; and the differences from the preeducational scores were statistically significant (P < 0.001. The study showed that a structured educational program based on the K/DOQI clinical practice guidelines had a significant impact on the dialysis nurses knowledge in caring for vascular access in HD patients. The knowledge level attained was maintained for at least three months after the educational intervention.
Yousif, Kalthoum Ibrahim; Abu-Aisha, Hasan; Abboud, Omar Ibrahim
End-stage renal disease is a worldwide problem that requires highly skilled nursing care. Hemodialysis (HD) is a corner-stone procedure in the management of most patients who require renal replacement therapy. Adequate vascular access is essential for the successful use of HD. Appropriate knowledge in taking care of vascular access is essential for minimizing complications and accurately recognizing vascular access-related problems. This study was to evaluate the effect of an educational program for vascular access care on nurses' knowledge at nine dialysis centers in Khartoum State. This was a Quasi experimental study (pre-and post-test for the same group). Sixty-one nurses working in these HD centers were chosen by simple random sampling method. A structured face-to-face interview questionnaire based on the Kidney Dialysis Outcome Quality Initiative (K/DOQI) clinical practice guidelines for vascular access care was used. Instrument validity was determined through content validity by a panel of experts. Reliability of the instrument was tested by a pilot study to test the knowledge scores for 15 nurses. The Pearson correlation coefficient obtained was (r = 0.82). Data collection was taken before and after the educational intervention. A follow-up test was performed three month later, using the same data collection tools. Twenty-two individual variables assessing the knowledge levels in aspects related to the six K/DOQI guidelines showed improvement in all scores of the nurses' knowledge after the educational intervention; and the differences from the preeducational scores were statistically significant (P < 0.001). The study showed that a structured educational program based on the K/DOQI clinical practice guidelines had a significant impact on the dialysis nurses knowledge in caring for vascular access in HD patients. The knowledge level attained was maintained for at least three months after the educational intervention.
This final rule will refine the resource-based practice expense relative value units (RVUs) and make other changes to Medicare Part B payment policy. The policy changes concern: Medicare Economic Index, practice expense for professional component services, definition of diabetes for diabetes self-management training, supplemental survey data for practice expense, geographic practice cost indices, and several coding issues. In addition, this rule updates the codes subject to the physician self-referral prohibition. We also make revisions to the sustainable growth rate and the anesthesia conversion factor. These changes will ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. We are also finalizing the calendar year (CY) 2003 interim RVUs and are issuing interim RVUs for new and revised procedure codes for CY 2004. As required by the statute, we are announcing that the physician fee schedule update for CY 2004 is -4.5 percent, the initial estimate of the sustainable growth rate for CY 2004 is 7.4 percent, and the conversion factor for CY 2004 is $35.1339. We published a proposed rule (68 FR 50428) in the Federal Register on Part B drug payment reform on August 20, 2003. This proposed rule would also make changes to Medicare payment for furnishing or administering certain drugs and biologicals. We have not finalized these proposals to take into account that the Congress is considering legislation that would address these issues. We will continue to monitor legislative activity that would reform the Medicare Part B drug payment system. If legislation is not enacted soon on this issue, we remain committed to completing the regulatory process.
Benyo, Theresa L.
Integration of a supersonic inlet simulation with a computer aided design (CAD) system is demonstrated. The integration is performed using the Project Integration Architecture (PIA). PIA provides a common environment for wrapping many types of applications. Accessing geometry data from CAD files is accomplished by incorporating appropriate function calls from the Computational Analysis Programming Interface (CAPRI). CAPRI is a CAD vendor neutral programming interface that aids in acquiring geometry data directly from CAD files. The benefits of wrapping a supersonic inlet simulation into PIA using CAPRI are; direct access of geometry data, accurate capture of geometry data, automatic conversion of data units, CAD vendor neutral operation, and on-line interactive history capture. This paper describes the PIA and the CAPRI wrapper and details the supersonic inlet simulation demonstration.
Love, Susan M; Sanders, Matthew R; Metzler, Carol W; Prinz, Ronald J; Kast, Elizabeth Z
11 focus groups (N = 160) of high-risk parents in Los Angeles County were asked to assess the value of social media to deliver an evidence-based parenting program, Triple P-Positive Parenting Program, to reduce child maltreatment. For feasibility, (N = 238) parents were surveyed regarding their internet use. Parents responded enthusiastically to the online program, and expressed the importance of a sense of community and learning through the experiences of others. 78% of the young, high-poverty, minority parents used the internet. An online evidence-based parenting program delivered in social media could enhance accessibility and engagement of high-risk parents - a powerful tool to reduce child maltreatment.
... 34 Education 3 2010-07-01 2010-07-01 false Grants for Access and Persistence Program (GAP) State Grant Allotment Case Study A Appendix A to Subpart C of Part 692 Education Regulations of the Offices of...) State Grant Allotment Case Study ER29OC09.010 ER29OC09.011 ER29OC09.012 ER29OC09.013 ER29OC09.014...
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Medicare Program; Medicare Shared Savings Program; Accountable Care Organizations--Revised Benchmark Rebasing Methodology, Facilitating Transition to Performance-Based Risk, and Administrative Finality of Financial Calculations. Final rule.
Under the Medicare Shared Savings Program (Shared Savings Program), providers of services and suppliers that participate in an Accountable Care Organization (ACO) continue to receive traditional Medicare fee-for-service (FFS) payments under Parts A and B, but the ACO may be eligible to receive a shared savings payment if it meets specified quality and savings requirements. This final rule addresses changes to the Shared Savings Program, including: Modifications to the program's benchmarking methodology, when resetting (rebasing) the ACO's benchmark for a second or subsequent agreement period, to encourage ACOs' continued investment in care coordination and quality improvement; an alternative participation option to encourage ACOs to enter performance-based risk arrangements earlier in their participation under the program; and policies for reopening of payment determinations to make corrections after financial calculations have been performed and ACO shared savings and shared losses for a performance year have been determined.
Full Text Available Shared memory applications running transparently on top of NUMA architectures often face severe performance problems due to bad data locality and excessive remote memory accesses. Optimizations with respect to data locality are therefore necessary, but require a fundamental understanding of an application's memory access behavior. The information necessary for this cannot be obtained using simple code instrumentation due to the implicit nature of the communication handled by the NUMA hardware, the large amount of traffic produced at runtime, and the fine access granularity in shared memory codes. In this paper an approach to overcome these problems and thereby to enable an easy and efficient optimization process is presented. Based on a low-level hardware monitoring facility in coordination with a comprehensive visualization tool, it enables the generation of memory access histograms capable of showing all memory accesses across the complete address space of an application's working set. This information can be used to identify access hot spots, to understand the dynamic behavior of shared memory applications, and to optimize applications using an application specific data layout resulting in significant performance improvements.
National Oceanic and Atmospheric Administration, Department of Commerce — This is a compilation of several data sets related to the Galveston Texas Seaturtle Headstart program. Most notable is the Kemp's ridley headstart program...
Wilson, Zakiya S.; Iyengar, Sitharama S.; Pang, Su-Seng; Warner, Isiah M.; Luces, Candace A.
Increasing college degree attainment for students from disadvantaged backgrounds is a prominent component of numerous state and federal legislation focused on higher education. In 1999, the National Science Foundation (NSF) instituted the "Computer Science, Engineering, and Mathematics Scholarships" (CSEMS) program; this initiative was designed to provide greater access and support to academically talented students from economically disadvantaged backgrounds. Originally intended to provide financial support to lower income students, this NSF program also advocated that additional professional development and advising would be strategies to increase undergraduate persistence to graduation. This innovative program for economically disadvantaged students was extended in 2004 to include students from other disciplines including the physical and life sciences as well as the technology fields, and the new name of the program was Scholarships for Science, Technology, Engineering and Mathematics (S-STEM). The implementation of these two programs in Louisiana State University (LSU) has shown significant and measurable success since 2000, making LSU a Model University in providing support to economically disadvantaged students within the STEM disciplines. The achievement of these programs is evidenced by the graduation rates of its participants. This report provides details on the educational model employed through the CSEMS/S-STEM projects at LSU and provides a path to success for increasing student retention rates in STEM disciplines. While the LSU's experience is presented as a case study, the potential relevance of this innovative mentoring program in conjunction with the financial support system is discussed in detail.
Gershman, Jennifer A; Gershman, Jason A; Fass, Andrea D; Popovici, Ioana
The purpose of this study is to assess Florida physicians' attitudes and knowledge toward accessing the state's prescription drug monitoring program (PDMP). Five thousand medical doctors and osteopathic physicians licensed in Florida were randomly selected for a voluntary and anonymous 15-question self-administered survey approved by the Institutional Review Board. Surveys were distributed through U.S. postal service mail. Likert-scale questions were used to assess prior knowledge (1 = none to 5 = excellent) and attitudes toward accessing the PDMP (1 = strongly disagree to 5 = strongly agree). The study yielded a response rate of 7.8%, 71.5% of whom agreed or strongly agreed that the PDMP is a useful tool. Among participants that have access and answered the PDMP usefulness question, 94.8% agree or strongly agree that it is a useful tool. There were 63 out of 64 physicians (98.4%) who conducted 25 or more searches who agreed or strongly agreed that the PDMP is a useful tool for monitoring patients' controlled substance histories. There were 72.5% of participants with access that answered the "doctor shopping" question who agreed that "doctor shopping" will decrease. Among the 64 most frequent PDMP users, 69.4% agreed or strongly agreed that they have prescribed fewer controlled substances after accessing the PDMP. The study revealed that a majority of participants believe that the PDMP is a useful tool for monitoring patients' controlled substance histories. More continuing education programs should be provided to Florida physicians to enhance their knowledge regarding PDMPs. Wiley Periodicals, Inc.
Bassilios, Bridget; Nicholas, Angela; Reifels, Lennart; King, Kylie; Fletcher, Justine; Machlin, Anna; Ftanou, Maria; Blashki, Grant; Burgess, Philip; Pirkis, Jane
Introduced in July 2001, Australian Access to Allied Psychological Services (ATAPS) was the inaugural national policy initiative to provide community access to government-funded psychological services in primary care. Our aim was to examine the achievements of ATAPS in relation to its stated objectives using a set of indicators that largely drew on data from a minimum data set that we designed for the evaluation of ATAPS. We used de-identified professional-, consumer- and session-level data from the minimum dataset, and secondary analyses of our quantitative and qualitative data collected for a series of specific evaluation studies. Available data covered the period from 1 July 2003 to 31 December 2012. Approximately 350,000 referrals were made to the ATAPS program over the 9.5 year analysis period, 79 % of which resulted in services. Over 1.4 million sessions were offered. Overall, 29 % of consumers were male, 4 % children, and 3 % Aboriginal people; 54 % of consumers had depression and 41 % an anxiety disorder; at least 60 % were on low incomes; and around 50 % resided outside of major cities. The most common interventions delivered were cognitive and behavioural therapies. Selected outcome measures indicated improvement in mental health symptoms. Access to Allied Psychological Services achieved its objectives within a decade of operation. The program delivered evidence-based services to a substantial number of consumers who were disadvantaged and historically would not have accessed services. Importantly, where data were available, there were indications that ATAPS achieved positive clinical outcomes for consumers. This suggests that ATAPS carved an important niche by successfully addressing unmet need of hard-to-reach consumers and through means that were not available via other programs. It will be interesting to see the effects from July 2016 of the reform of ATAPS, which will see ATAPS subsumed under psychological services commissioned by regional
... documented distributions of actual time worked or other equitable cost allocation methods. (d) Specific costs charged to an overhead or indirect cost pool that can be identified directly as a program cost must be... classification of costs as administrative costs or program costs? 641.859 Section 641.859 Employees' Benefits...
... Commodity Credit Corporation Notice of Funds Availability: Inviting Applications for the Market Access... Notice of Funds Availability. DATES: All applications must be received by 5 p.m. Eastern Daylight Time... overseas marketing and promotion activities. MAP participants may receive assistance for generic or brand...
... Commodity Credit Corporation Notice of Funds Availability: Inviting Applications for the Market Access... publish a notice in the Federal Register rescinding this Notice of Funds Availability. DATES: All... marketing and promotion activities. MAP Participants may receive assistance for generic or brand promotion...
Greenberg, Maya Delgado; Kuns, Jerry
Accessible Global Positioning Systems (GPS) are changing the way many people with visual impairments (that is, those who are blind or have low vision) travel. GPS provides real-time orientation information so that a traveler with a visual impairment can make informed decisions about path of travel and destination. Orientation and mobility (O&M)…
... Customer Information and Customer Notice AGENCY: Office of Thrift Supervision (OTS), Treasury. ACTION... for Unauthorized Access to Customer Information and Customer Notice. OMB Number: 1550-0110. Form...) Ensure the security and confidentiality of customer records and information; (2) protect against any...
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND... data more accessible and user-friendly. FOR FURTHER INFORMATION CONTACT: Daniel W. Sigelman, Office of... INFORMATION: FDA is announcing the availability of a report entitled ``Food and Drug Administration...
...-party device (e.g., a laptop, tablet, smart phone) or if additional services are required to make use of... computers without conditional access capability, mobile devices (such as tablets and smartphones) that do... televisions--a function that digital tuning adapters (``DTAs'') and similar devices perform today. These...
Fonjungo, Peter N; Boeras, Debrah I; Zeh, Clement; Alexander, Heather; Parekh, Bharat S; Nkengasong, John N
Access to point-of-care testing (POCT) improves patient care, especially in resource-limited settings where laboratory infrastructure is poor and the bulk of the population lives in rural settings. However, because of challenges in rolling out the technology and weak quality assurance measures, the promise of human immunodeficiency virus (HIV)-related POCT in resource-limited settings has not been fully exploited to improve patient care and impact public health. Because of these challenges, the Joint United Nations Programme on HIV/AIDS (UNAIDS), in partnership with other organizations, recently launched the Diagnostics Access Initiative. Expanding HIV programs, including the "test and treat" strategies and the newly established UNAIDS 90-90-90 targets, will require increased access to reliable and accurate POCT results. In this review, we examine various components that could improve access and uptake of quality-assured POC tests to ensure coverage and public health impact. These components include evaluation, policy, regulation, and innovative approaches to strengthen the quality of POCT. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail email@example.com.
R Smit (Rob)
htmlabstractThis thesis studies the extraction of embedded business rules, using the idioms of the used framework to identify them. Embedded business rules exist as source code in the software system and knowledge about them may get lost. Extraction of those business rules could make them accessible
... 3084-AA98 16 CFR Part 310 Telemarketing Sales Rule Fees AGENCY: Federal Trade Commission. ACTION: Final... Telemarketing Sales Rule (``TSR'') by updating the fees charged to entities accessing the National Do Not Call... of the Code of Federal Regulations as follows: PART 310--TELEMARKETING SALES RULE 0 1. The authority...
... CFR Part 310 RIN 3084-AA98 Telemarketing Sales Rule Fees AGENCY: Federal Trade Commission. ACTION... Telemarketing Sales Rule (``TSR'') by updating the fees ] charged to entities accessing the National Do Not Call... follows: PART 310--TELEMARKETING SALES RULE 0 1. The authority citation for part 310 continues to read as...
... CFR Part 310 RIN 3084-AA98 Telemarketing Sales Rule Fees AGENCY: Federal Trade Commission. ACTION... Telemarketing Sales Rule (``TSR'') by updating the fees charged to entities accessing the National Do Not Call... of the Code of Federal Regulations as follows: PART 310--TELEMARKETING SALES RULE 0 1. The authority...
..., Office of Program Management, 202-366-3800, for general information about the OTRB Program. Contact... FTA's Transportation Electronic Awards Management System (TEAM) for the projects identified in Tables... under the Special Warranty Provisions of the Department of Labor Guidelines ``Section 5333(b), Federal...
Wainer, Allison L.; Ingersoll, Brooke R.
Systematic research focused on developing and improving strategies for the dissemination and implementation of effective ASD services is essential. An innovative and promising area of research is the use of telehealth programs to train parents of children with ASD in intervention techniques. A hybrid telehealth program, combining self-directed…
In 1999, the Bill & Melinda Gates Foundation began an innovative scholarship program that provides full financial support to low-income minority students across the United States. The Gates Millennium Scholars (GMS) program has already awarded more than 10,000 scholarships to exceptional students, with the ultimate goal of funding at least…
Warschauer, Mark; Zheng, Binbin; Niiya, Melissa; Cotten, Shelia; Farkas, George
Seeking to improve teaching and learning and to narrow gaps between students of high and low socioeconomic status, many school districts in the United States are implementing one-to-one laptop programs. In this comparative case study, we examine one-to-one laptop programs in Colorado, California, and Alabama, all of which deployed low-cost netbook…
Iman Mingher Obied
Full Text Available The study sheds light on the phonological rules as part of communication used through language. It tackles the reasons behind them, types, characteristics and functions. Finally, it focuses on conclusion that reaches at.
... oversight program costs, they are in line with the pro rata percentage for that SRO of United States... recent three years, plus a pro rata share (based on average trading volume for the most recent three...
Stewart, Shannon C. [Bonneville Power Administration (BPA), Portland, OR (United States)
The Bonneville Power Administration (BPA) is proposing to fund a canal-stream crossing and fish screen improvement project on Cooke Creek in Kittitas County, Washington. The project proposes to place the Ellensburg Water Company’s (EWC) main canal into a siphon passing underneath Cooke Creek, to build a fish screen on the EWC diversion on Cooke Creek, and to restore the Cooke Creek channel to a more natural state. The goal of this project is to improve fish habitat conditions in the Yakima River Basin and to protect ESA listed Mid-Columbia steelhead and bull trout. This project is part of the Yakima Tributary Access and Habitat Program, which works with landowners, water purveyors, and municipalities to restore fish passage to Yakima River tributaries that historically supported salmonids and to improve habitat in areas where access is restored.
Bassilios, Bridget; Telford, Nicolas; Rickwood, Debra; Spittal, Matthew J; Pirkis, Jane
Access to Allied Psychological Services (ATAPS) was introduced in 2001 by the Australian Government to provide evidence-based psychological interventions for people with high prevalence disorders. headspace, Australia's National Youth Mental Health Foundation, was established in 2006 to promote and facilitate improvements in the mental health, social wellbeing and economic participation of young people aged 12-25 years. Both programs provided free or low cost psychological services. This paper aims to describe the uptake of psychological services by people aged 12-25 years via ATAPS and headspace, the characteristics of these clients, the types of services received and preliminary client outcomes achieved. Data from 1 July 2009 to 30 June 2012 were sourced from the respective national web-based minimum datasets used for routine data collection in ATAPS and headspace. In total, 20,156 and 17,337 young people accessed two or more psychological services via ATAPS and headspace, respectively, in the 3-year analysis period. There were notable differences between the clients of, and the services delivered by, the programs. ATAPS clients were less likely to be male (31 vs 39%) and to reside in major cities (51 vs 62%) than headspace clients; ATAPS clients were also older (18-21 vs 15-17 years modal age group). There was some variation in the number and types of psychological sessions that young people received via the programs but the majority received at least one session of cognitive behavioural therapy. Based on limited available outcome data, both programs appear to have produced improvements in clients' mental health; specifically, psychological distress as assessed by the Kessler-10 (K-10) was reduced. ATAPS and headspace have delivered free or low-cost psychological services to 12-25 year olds with somewhat different characteristics. Both programs have had promising effects on mental health. ATAPS and headspace have operated in a complementary fashion to fill a
Rangel Gomez, Maria Gudelia; Tonda, Josana; Zapata, G Rogelio; Flynn, Michael; Gany, Francesca; Lara, Juanita; Shapiro, Ilan; Rosales, Cecilia Ballesteros
While individuals of Mexican origin are the largest immigrant group living in the U.S., this population is also the highest uninsured. Health disparities related to access to health care, among other social determinants, continue to be a challenge for this population. The government of Mexico, in an effort to address these disparities and improve the quality of life of citizens living abroad, has partnered with governmental and non-governmental health-care organizations in the U.S. by developing and implementing an initiative known as Ventanillas de Salud -Health Windows-(VDS). The VDS is located throughout the Mexican Consular network and aim to increase access to health care and health literacy, provide health screenings, and promote healthy lifestyle choices among low-income and immigrant Mexican populations in the U.S.
Raimondos-Møller, Pascalis; Woodland, Alan D.
objectives of trade policy is problematic and calls for finding alternative tariff reform rules that can achieve both objectives at the same time. The present paper contributes to this aim by using a new set of tariff reforms that are based on local optimality. Using such reforms it is shown that market......According to the literature, well known tariff reform rules that are guaranteed to increase welfare will not necessarily increase market access, while rules that are guaranteed to increase market access will not necessarily increase welfare. Such conflict between welfare and market access...
Loman, Nicholas J; Pallen, Mark J
Pallen Mark J
... Governmental Affairs Bureau, 202-418-2498 (voice), 202-418-1169 (TTY), or [email protected] (e-mail); or... gaps in video programming through the provision of video description on television and closed...
National Oceanic and Atmospheric Administration, Department of Commerce — This data type was designed for analyzed wave data originating from the National Ocean Service (NOS) Coastal Wave Program. The data are organized into 3 record...
Responses about organizational learning from 128 British small business owners were compared to workers' statements about training. Owners often bent rules and fudged paperwork to access funding or demonstrate compliance. Workplace imperatives and government program regulations often drove these practices and subverted learning. (Contains 41…
Crispen, Patrick Douglas
Explains five rules to protect computers from viruses. Highlights include commercial antivirus software programs and the need to upgrade them periodically (every year to 18 months); updating virus definitions at least weekly; scanning attached files from email with antivirus software before opening them; Microsoft Word macro protection; and the…
Crispen, Patrick Douglas
Provides rules for protecting computers from viruses, Trojan horses, or worms. Topics include purchasing commercial antivirus programs and keeping them updated; updating virus definitions weekly; precautions before opening attached files; macro virus protection in Microsoft Word; and precautions with executable files. (LRW)
This final rule updates the Home Health Prospective Payment System (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor; effective for home health episodes of care ending on or after January 1, 2017. This rule also: Implements the last year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates; updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the 2nd-year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity (that is, nominal case-mix growth) between CY 2012 and CY 2014; finalizes changes to the methodology used to calculate payments made under the HH PPS for high-cost "outlier" episodes of care; implements changes in payment for furnishing Negative Pressure Wound Therapy (NPWT) using a disposable device for patients under a home health plan of care; discusses our efforts to monitor the potential impacts of the rebasing adjustments; includes an update on subsequent research and analysis as a result of the findings from the home health study; and finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model, which was implemented on January 1, 2016; and updates to the Home Health Quality Reporting Program (HH QRP).
Moon S. Chen, Jr
Full Text Available This paper describes the development and implementation of a Hmong Cervical Cancer Intervention Program utilizing a patient navigation model to raise cervical cancer awareness for Hmong women through educational workshops and to assist Hmong women in obtaining a Pap test. Out of 402 women who participated in a baseline survey, the Patient Navigation Program was able to enroll 109 participants who had not had a Pap test in the past 3 years and had never had a Pap test. Through utilization of outreach, an awareness campaign and patient navigation support, at least 38 percent of 109 participants obtained a Pap test. Overall, 21 workshops and 43 outreach activities were conducted by the Hmong Women’s Heritage Association, leading to 63 percent of those enrolled in the Patient Navigation Program who could be contacted to obtain a Pap test.
Hossain, M W; Khan, H T; Begum, A
This paper studies the effectiveness of "Jiggasha," an innovative communication approach for the promotion of family planning in Dhaka, Bangladesh. Data from the 1996 Jiggasha follow-up survey were used, which gathered information by interviewing a network sample of 1862 married women and a subsample of 608 men. The study used the sample constituted by women respondents and included data on socioeconomic and demographic characteristics of the respondents and their knowledge, attitude and practice relating to contraceptives. Findings showed that Jiggasha respondents have more access to radio than television. All respondents reported having a radio in their homes and they emphasized the importance of broadcasting more family planning messages via both electronic media. Only 16% of the women in the study setting were exposed to group meetings. Of the respondents reporting participation in group meetings, 38.25% joined in a Jiggasha meeting, 23.15% in a Grameen Bank group meeting, and 4.70% in a Bangladesh Rural Advancement Committee group meeting. Logistic regression analysis indicated more access to Jiggashas among women over 30 years of age than among the younger age groups. Religion and education levels of respondents have significant impact on access to Jiggashas. Husbands' approval plays an important role among the Jiggasha respondents in using family planning method. This study provides important information for policy-makers to make family planning program a success.
Evenson, Kelly R; Wen, Fang; Lee, Sarah M; Heinrich, Katie M; Eyler, Amy
A Healthy People 2010 developmental objective (22-12) was set to increase the proportion of the nation's public and private schools that provide access to their physical activity spaces and facilities for all persons outside of normal school hours. The purpose of this study was to describe the prevalence of indoor and outdoor facilities at schools and the availability of those facilities to the public in 2000 and 2006. In 2000 and 2006, the School Health Policies and Programs Study (SHPPS) was conducted in each state and in randomly selected districts, schools, and classrooms. This analysis focused on the school level questionnaire from a nationally representative sample of public and nonpublic elementary, middle, and high schools (n = 921 in 2000 and n = 984 in 2006). No meaningful changes in the prevalence of access to school physical activity facilities were found from 2000 to 2006, for youth or adult community sports teams, classes, or open gym. These national data indicate a lack of progress from 2000 and 2006 toward increasing the proportion of the nation's public and private schools that provide access to their physical activity facilities for all persons outside of normal school hours.
Armentano, T.V.; Loucks, O.L.
The goal of The Institute of Energy (TIE) 1977 to 1979 ACCESS program was to define the national need for ecological and environmental data and the extent to which present data documentation and archiving are meeting this need. The principal steps focussed on current data documentation and research in government, private and academic sectors of the natural science technical community, particularly as they bear on the accessibility of environmental data to secondary users. The extent to which existing data services are satisfying the needs of data users also was emphasized. The results indicate that the potential contributions which existing data and models could make are not being achieved because of inconsistencies in data documentation, inadequate communication between data suppliers and data users, and a lack of overall coordination of the data bases in national research and monitoring programs. A nationally coordinated network is proposed which focuses on regional data centers and ties together the hierarchy of data bases (national, state, and local) with the broad spectrum of potential users. The network concept includes immediate development of a comprehensive catalog of data resources in each region, with later production of a data abstract journal as one of two methods for communicating between regional and local data centers and the user community.
... Regional Office for grant-specific issues; or Blenda Younger, Office of Program Management, 202-366-4345... FTA's Transportation Electronic Awards Management System (TEAM) for the projects identified in Tables... under the Special Warranty Provisions of the Department of Labor Guidelines ``Section 5333(b), Federal...
maximize workplace efficiency. As a result of targeting these high-quality applicants and creating more efficient leadership training programs, these...organization, which is known for exceptionally high safety standards and performance, small inefficiencies in the areas of teamwork and leadership ...recruiting needs. We found that the Navy is inadequately assessing applicant skills and attributes through its primary use of cognitive testing
Freedman, Darcy A; Flocke, Susan; Shon, En-Jung; Matlack, Kristen; Trapl, Erika; Ohri-Vachaspati, Punam; Osborne, Amanda; Borawski, Elaine
Evaluate farmers' market (FM) use patterns among Supplemental Nutrition Assistance Program (SNAP) recipients. Cross-sectional survey administered June to August, 2015. Cleveland and East Cleveland, OH. A total of 304 SNAP recipients with children. Participants lived within 1 mile of 1 of 17 FMs. Most were African American (82.6%) and female (88.1%), and had received SNAP for ≥5 years (65.8%). Patterns of FM shopping, awareness of FM near home and of healthy food incentive program, use of SNAP to buy fruits and vegetables and to buy other foods at FMs, receipt of healthy food incentive program. Two-stage cluster analysis to identify segments with similar FM use patterns. Bivariate statistics including chi-square and ANOVA to evaluate main outcomes, with significance at P ≤ .05. A total of 42% reported FM use in the past year. Current FM shoppers (n = 129) were segmented into 4 clusters: single market, public market, multiple market, and high frequency. Clusters differed significantly in awareness of FM near home and the incentive program, use of SNAP to buy fruit and vegetables at FMs, and receipt of incentive. Findings highlight distinct types of FM use and had implications for tailoring outreach to maximize first time and repeat use of FMs among SNAP recipients. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.
York, Eric James
Growing out of research in Technical Communication, Composition Studies, and Writing Program Administration, the articles in this dissertation explicitly seek to address changes in the practices and products of writing and writing studies wrought by the so-called "digital revolution" in communication technology, which has been ongoing in…
..., requirements, and standards of the Architectural Barriers Act (42 U.S.C. 4151-4157), as established in 41 CFR...) NATIONAL COMMISSION ON LIBRARIES AND INFORMATION SCIENCE ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY NATIONAL COMMISSION ON LIBRARIES AND INFORMATION SCIENCE...
.... An article published in 2004 in the Journal of the American Medical Association (Berwick, D.M. and... environment'' as they ``engender trust in families, creating a better working relationship between hospital... technical assistance programs (such as Medicare Learning Network at http://www.cms.gov/MLNGenInfo/ ) to make...
Weiner Bryan J
Full Text Available Abstract Background Foundations and public agencies commonly fund focused initiatives for individual grantees. These discrete, stand-alone initiatives can risk failure by being carried out in isolation. Fostering synergy among grantees' initiatives is one strategy proposed for promoting the success and impact of grant programs. We evaluate an explicit strategy to build synergy within the Robert Wood Johnson Foundation's Southern Rural Access Program (SRAP, which awarded grants to collaboratives within eight southeastern U.S. states to strengthen basic health care services in targeted rural counties. Methods We interviewed 39 key participants of the SRAP, including the program director within each state and the principal subcontractors heading the program's funded initiatives that supported heath professionals' recruitment, retention and training, made loans to health care providers, and built networks among providers. Interews were recorded and transcribed. Two investigators independently coded the transcripts and a third investigator distilled the main points. Results Participants generally perceived that the SRAP yielded more synergies than other grant programs in which they had participated and that these synergies added to the program's impact. The synergies most often noted were achieved through relationship building among grantees and with outside agencies, sharing information and know-how, sharing resources, combining efforts to yield greater capacity, joining voices to advocate for common goals, and spotting gaps in services offered and then filling these gaps. The SRAP's strategies that participants felt fostered synergy included targeting funding to culturally and geographically similar states, supporting complementary types of initiatives, promoting opportunities to network through semi-annual meetings and regular conference calls, and the advocacy efforts of the program's leadership. Participants noted that synergies were sometimes
Burke, Eva; Gold, Judy; Razafinirinasoa, Lalaina; Mackay, Anna
Young people often express a preference for seeking family planning information and services from the private sector. However, in many Marie Stopes International (MSI) social franchise networks, the proportion of young clients, and particularly those under 20 years of age, remains low. Marie Stopes Madagascar (MSM) piloted a youth voucher program that joins a supply-side intervention-youth-friendly social franchisee training and quality monitoring-with a corresponding demand-side-component, free vouchers that reduce financial barriers to family planning access for young people. Young people identified by MSM's community health educators (CHEs) received a free voucher redeemable at a BlueStar social franchisee for a package of voluntary family planning and sexually transmitted infection (STI) information and services. BlueStar social franchisees-private providers accredited by MSM-are reimbursed for the cost of providing these services. We reviewed service statistics data from the first 18 months of the youth voucher program, from July 2013 to December 2014, as well as client demographic profile data from July 2015. Findings: Between July 2013 and December 2014, 58,417 vouchers were distributed to young people by CHEs through a range of community mobilization efforts, of which 43,352 (74%) were redeemed for family planning and STI services. Most clients (78.5%) chose a long-acting reversible contraceptive (LARC), and just over half (51%) of young people benefited from STI counseling as part of their voucher service. Most (78%) services were provided in the Analamanga region (the capital and its surroundings), which was expected given the population density in this region and the high concentration of BlueStar franchisees. The client profile data snapshot from July 2015 revealed that 69% of voucher clients had never previously used a contraceptive method, and 96% of clients were aged 20 or younger, suggesting that the voucher program is successfully reaching the
MicroShield® is a comprehensive photon/gamma ray shielding and dose assessment programme. It is widely used for designing shields, estimating source strength from radiation measurements, minimising exposure to people, and teaching shielding principles. Integrated tools allow the graphing of results, material and source file creation, source inference with decay (dose-to-Bq calculations accounting for decay and daughter buildup), the projection of exposure rate versus time as a result of decay, access to material and nuclide data, and decay heat calculations. The latest version is able to export results using Microsoft Office (formatted and colour-coded for readability). Sixteen geometries accommodate offset dose points and as many as ten standard shields plus source self-shielding and cylinder cladding are available. The library data (radionuclides, attenuation, build-up and dose conversion) reflect standard data from ICRP 38 and 107* as well as ANSI/ANS standards and RSICC publicat...
The final rule of fuels and fuel additives: renewable fuel standard program is published on March 26, 2010 and is effective on July 1, 2010. You will find the links to this final rule and technical amendments supporting this rule.
Vachharajani, Tushar J; Moossavi, Shahriar; Salman, Loay; Wu, Steven; Dwyer, Amy C; Ross, Jamie; Dukkipati, Ramanath; Maya, Ivan D; Yevzlin, Alexander S; Agarwal, Anil; Abreo, Kenneth D; Work, Jack; Asif, Arif
The development of interventional nephrology has undoubtedly led to an improvement in patient care at many facilities across the United States. However, these services have traditionally been offered by interventional nephrologists in the private practice arena. While interventional nephrology was born in the private practice setting, several academic medical centers across the United States have now developed interventional nephrology programs. University Medical Centers (UMCs) that offer interventional nephrology face challenges, such as smaller dialysis populations, limited financial resources, and real or perceived political "turf" issues." Despite these hurdles, several UMCs have successfully established interventional nephrology as an intricate part of a larger nephrology program. This has largely been accomplished by consolidating available resources and collaborating with other specialties irrespective of the size of the dialysis population. The collaboration with other specialties also offers an opportunity to perform advanced procedures, such as application of excimer laser and endovascular ultrasound. As more UMCs establish interventional nephrology programs, opportunities for developing standardized training centers will improve, resulting in better quality and availability of nephrology-related procedures, and providing an impetus for research activities. © 2011 Wiley Periodicals, Inc.
Perinatal drug and alcohol use is associated with serious medical and psychiatric morbidity for pregnant and postpartum women and their newborns. Participation in prenatal care has been shown to improve outcomes, even in the absence of treatment for substance use disorders. Unfortunately, women with substance use disorders often do not receive adequate prenatal care. Barriers to accessing care for pregnant women with substance use disorders include medical and psychiatric comorbidities, transportation, caring for existing children, housing and food insecurity, and overall lack of resources. In a health care system where care is delivered by each discipline separately, lack of communication between providers causes poorly coordinated services and missed opportunities. The integration of mental health and substance use treatment services in medical settings is a goal of health care reform. However, this approach has not been widely promoted in the context of maternity care. The Dartmouth-Hitchcock Medical Center Perinatal Addiction Treatment Program provides an integrated model of care for pregnant and postpartum women with substance use disorders, including the colocation of midwifery services in the context of a dedicated addiction treatment program. A structured approach to screening and intervention for drug and alcohol use in the outpatient prenatal clinic facilitates referral to treatment at the appropriate level. Providing midwifery care within the context of a substance use treatment program improves access to prenatal care, continuity of care throughout pregnancy and the postpartum, and availability of family planning services. The evolution of this innovative approach is described. This article is part of a special series of articles that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health. © 2015 by the American College of Nurse-Midwives.
Palmer, Robert T.; Davis, Ryan J.
Researchers, policymakers, and administrations have shown great concern over the efficacy of college remediation, which has prompted some states to eliminate remedial programs from public 4-year institutions. However, research suggests that eliminating these programs may have unintended consequences on college access and opportunity for…
Since 1990, high school students in Washington have had the choice of earning college credit through the Running Start program. Running start is a dual enrollment and dual credit program that allows eleventh and twelfth grade high school students to take college courses at any of Washington's 34 community and technical colleges, Central Washington…
Madeline Carpinelli Wallack
Full Text Available Purpose: The 340B Drug Pricing Program is a federal program designed to reduce the amount that safety net providers spend on outpatient drugs. The Patient Protection and Affordable Health Care Act of 2010 extended eligibility for 340B to critical access hospitals (CAHs for all drugs except those designated as “orphan.” Because this policy is unprecedented, this study quantifies the gross financial impact that this exemption has on a group of CAHs. Methods: Drug spending for 2010 from 18 CAHs in Minnesota and Wisconsin are reviewed to identify the prevalence of orphan drug purchases and to calculate the price differentials between the 340B price and the hospitals’ current cost. Results: The 18 CAHs’ purchases of orphan drugs comprise an average of 44% of the total annual drug budgets, but only 5% of units purchased, thus representing a very high proportion of their expenditures. In the aggregate, the 18 hospitals would have saved $3.1 million ($171,000 average per hospital had purchases of drugs with orphan designations been made at the 340B price. Because CAH claims for Medicare are reimbursed on a cost-basis, the Federal government is losing an opportunity for savings. Conclusion: The high prevalence of orphan drug use and considerable potential for cost reduction through the 340B program demonstrate the loss of benefit to the hospitals, Federal government and the states.
Bracarda, Sergio; Gernone, Angela; Gasparro, Donatello; Marchetti, Paolo; Ronzoni, Monica; Bortolus, Roberto; Fratino, Lucia; Basso, Umberto; Mazzanti, Roberto; Messina, Caterina; Tucci, Marcello; Boccardo, Francesco; Cartenì, Giacomo; Pinto, Carmine; Fornarini, Giuseppe; Mattioli, Rodolfo; Procopio, Giuseppe; Chiuri, Vincenzo; Scotto, Tiziana; Dondi, Davide; Di Lorenzo, Giuseppe
Cabazitaxel is a novel taxane that is approved for use in metastatic castration-resistant prostate cancer based on the Phase III TROPIC study, which showed improved overall survival with cabazitaxel/prednisone versus mitoxantrone/prednisone. A global early-access program was initiated in order to provide early access to cabazitaxel in docetaxel-pretreated patients and to obtain real-world data. We report interim safety results from an Italian prospective, single-arm, multicenter, open-label trial of 218 patients receiving cabazitaxel 25 mg/m2 every 3 weeks plus prednisolone 10 mg/day, until disease progression, unacceptable toxicity, investigator's decision or death. Patients completing treatment received a median of six cabazitaxel cycles. The most common grade 3/4 adverse events were neutropenia (33.9%), leukopenia (15.6%), anemia (6%) and asthenia (6%). No peripheral neuropathy or nail disorders were observed. These results confirm that cabazitaxel has a manageable safety profile in daily clinical practice and support its use in patients with prostate cancer who progress during or after a docetaxel-based therapy.
Wang, Hua; Norton, Edward C; Rozier, R Gary
To provide national estimates of implementation effects of the State Children's Health Insurance Program (SCHIP) on dental care access and use for low-income children. The 1997-2002 National Health Interview Survey. The study design is based on variation in the timing of SCHIP implementation across states and among children observed before and after implementation. Two analyses were conducted. The first estimated the total effect of SCHIP implementation on unmet need for dental care due to cost in the past year and dental services use for low-income children (family income below state SCHIP eligibility thresholds) using county and time fixed effects models. The second analysis estimated differences in dental care access and use among low-income children with SCHIP or Medicaid coverage and their uninsured counterparts, using instrumental variables methods to control for selection bias. Both analyses controlled for child and family characteristics. When SCHIP had been implemented for more than 1 year, the probability of unmet dental care needs for low-income children was lowered by 4 percentage points. Compared with their uninsured counterparts, those who had SCHIP or Medicaid coverage were less likely to report unmet dental need by 8 percentage points (standard error: 2.3), and more likely to have visited a dentist within 6 or 12 months by 17 (standard error: 3.7) and 23 (standard error: 3.6) percentage points, respectively. SCHIP program type had no differential effects. Consistent results from two analytical approaches provide evidence that SCHIP implementation significantly reduced financial barriers for dental care for low-income children in the U.S. Low-income children enrolled in SCHIP or Medicaid had substantially increased use of dental care than the uninsured.
Ning, Sheyang; Ogura Iwasaki, Tomoko; Takeuchi, Ken
In order to decrease program bit error rate (BER) of array-level operation in AlxOy resistive random access memory (ReRAM), program BERs are compared by using 4 × 4 basic set and reset with verify methods on multiple 1024-bit-pages in 50 nm, mega-bit class ReRAM arrays. Further, by using an optimized reset method, 8.5% total BER reduction is obtained after 104 write cycles due to avoiding under-reset or weak reset and ameliorating over-reset caused wear-out. Then, under-set and over-set are analyzed by tuning the set word line voltage (VWL) of ±0.1 V. Moderate set current shows the best total BER. Finally, 2000 write cycles are applied at 125 and 25 °C, respectively. Reset BER increases 28.5% at 125 °C whereas set BER has little difference, by using the optimized reset method. By applying write cycles over a 25 to 125 to 25 °C temperature variation, immediate reset BER change can be found after the temperature transition.
The program of IAU scientific meetings is one of the most important means by which the IAU pursues its goal of promoting astronomy through international collaboration. A large fraction of the Union's budget is devoted to the support of these IAU scientific meetings. The IAU Executive Committee (EC) places great emphasis on maintaining high scientific standards, coverage of a balanced spectrum of topics, and an appropriately broad and international flavour for the program of IAU meetings. In that respect, the ICSU rules on non-discrimination in the access of qualified scientists from all parts of the world to any IAU meeting apply. The ICSU rules on non-discrimination are described in the document “Freedom, Responsibility and Universality of Science”, available on http://www.icsu.org/Gestion/img/ICSU_DOC_DOWNLOAD/2205_DD_FILE_Freedom_Responsibility_Universality_of_Science_booklet.pdf
Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2018, SNF Value-Based Purchasing Program, SNF Quality Reporting Program, Survey Team Composition, and Correction of the Performance Period for the NHSN HCP Influenza Vaccination Immunization Reporting Measure in the ESRD QIP for PY 2020. Final rule.
This final rule updates the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year (FY) 2018. It also revises and rebases the market basket index by updating the base year from 2010 to 2014, and by adding a new cost category for Installation, Maintenance, and Repair Services. The rule also finalizes revisions to the SNF Quality Reporting Program (QRP), including measure and standardized resident assessment data policies and policies related to public display. In addition, it finalizes policies for the Skilled Nursing Facility Value-Based Purchasing Program that will affect Medicare payment to SNFs beginning in FY 2019. The final rule also clarifies the regulatory requirements for team composition for surveys conducted for investigating a complaint and aligns regulatory provisions for investigation of complaints with the statutory requirements. The final rule also finalizes the performance period for the National Healthcare Safety Network (NHSN) Healthcare Personnel (HCP) Influenza Vaccination Reporting Measure included in the End-Stage Renal Disease (ESRD) Quality Incentive Program (QIP) for Payment Year 2020.
Allison P Hawkes
Full Text Available A large local health department in Colorado partnered with 15 school districts to develop an approach to evaluate changes in access to healthy foods in reimbursable school lunches and a la carte offerings.School district nutrition managers were engaged at the start of this project. Health department dietitians developed criteria to classify food items as "Lower Fat and less added Sugar" (LFS and "Higher Fat and more added Sugar" (HFS based on the percentage of calories from fat and grams of added sugar. Lunch production sheets were obtained for two time periods, food items and the number of planned servings recorded. LFS and HFS planned servings were summed for each time period, and a LFS to HFS ratio calculated by dividing LFS planned servings by HFS planned servings. Additional analyses included calculating LFS: HFS ratios by school district, and for a la carte offerings.In 2009, the LFS: HFS ratio was 2.08, in 2011, 3.71 (P<0.0001. The method also detected changes in ratios at the school district level. For a la carte items, in 2009 the ratio of LFS: HFS was 0.53, and in 2011, 0.61 (not statistically significant.This method detected an increase in the LFS: HFS ratio over time and demonstrated that the school districts improved access to healthful food/drink by changing the contents of reimbursable school lunches. The evaluation method discussed here can generate information that districts can use in helping sustain and expand their efforts to create healthier environments for children and adults. Although federal regulations now cover all food and beverages served during the school day, there are still opportunities to improve and measure changes in food served in other settings such as child care centers, youth correction facilities, or in schools not participating in the National School Lunch Program.
The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) transformed the nation's welfare system into one that requires work in exchange for time-limited assistance. The law eliminated the Aid to Families with Dependent Children (AFDC) program and replaced it with the Temporary Assistance for Needy Families (TANF) program. The law provides States flexibility to design their TANF programs in ways that strengthen families and promote work, responsibility, and self-sufficiency while holding them accountable for results. Many States are using this flexibility to provide welfare to work assistance to two parent families, which was more difficult to do under the old welfare rules. However, pre-existing regulations regarding the definition of "unemployed parent" prevent some States from providing intact families with health insurance to help them stay employed. This rule will eliminate this vestige of the old welfare system in order to promote work, strengthen families, and simplify State program administration. In general under PRWORA, States must ensure that families who would have qualified for Medicaid health benefits under the prior welfare law are still eligible. While under the previous law receipt of AFDC qualified families for Medicaid, the new statute does not tie receipt of TANF to Medicaid. Instead, subject to some exceptions, Medicaid eligibility for families and children now depends upon whether a family would have qualified for AFDC under the rules in effect on July 16, 1996. Similarly, Federal foster care eligibility depends on whether the child would have qualified for AFDC under the rules in effect on July 16, 1996. In order for a family to qualify for assistance under the pre-PRWORA AFDC rules, its child had to be deprived of parental support or care due to the death, absence, incapacity, or unemployment of a parent. Two parent families generally qualified only under the "unemployment" criterion which was narrowly defined in
Kitaev, Alexei; Mayers, Dominic; Preskill, John
We show that superselection rules do not enhance the information-theoretic security of quantum cryptographic protocols. Our analysis employs two quite different methods. The first method uses the concept of a reference system—in a world subject to a superselection rule, unrestricted operations can be simulated by parties who share access to a reference system with suitable properties. By this method, we prove that if an n -party protocol is secure in a world subject to a superselection rule, then the security is maintained even if the superselection rule is relaxed. However, the proof applies only to a limited class of superselection rules, those in which the superselection sectors are labeled by unitary irreducible representations of a compact symmetry group. The second method uses the concept of the format of a message sent between parties—by verifying the format, the recipient of a message can check whether the message could have been sent by a party who performed charge-conserving operations. By this method, we prove that protocols subject to general superselection rules (including those pertaining to non-Abelian anyons in two dimensions) are no more secure than protocols in the unrestricted world. However, the proof applies only to two-party protocols. Our results show in particular that, if no assumptions are made about the computational power of the cheater, then secure quantum bit commitment and strong quantum coin flipping with arbitrarily small bias are impossible in a world subject to superselection rules.
Rial-Sebbag, Emmanuelle; Blasimme, Alessandro
On May 6th 2014, the European Court of Human Rights added yet a new element to the judicial history of stem cells as it ruled in Durisotto v. Italy [appeal n. 62804/13]. The ruling rejected a patient claim to access an unproven cell therapy-an outcome that is certainly to be welcomed. However, this ruling is a missed occasion to clarify and reaffirm some important legal distinctions that could have greatly benefited the whole field of regenerative medicine. We claim that the ethical and political assumptions that sustain the regulation of expanded access programs to new therapies should be carefully scrutinized, with particular attention to the justifications for the risks connected to unconventional therapies. A clear legal definition of what counts as compassionate cure as distinct from unregulated and untested therapies cannot be provided unless those points are previously addressed.
Authors present algorithms for optimization of inhibitory rules relative to the length and coverage. Inhibitory rules have a relation "attribute ≠ value" on the right-hand side. The considered algorithms are based on extensions of dynamic programming. Paper contains also comparison of length and coverage of inhibitory rules constructed by a greedy algorithm and by the dynamic programming algorithm. © 2012 Springer-Verlag.
Taber, J.; Toigo, M.; Bravo, T. K.; Hubenthal, M.; McQuillan, P. J.; Welti, R.
The IRIS Education and Outreach Program has been an integral part of IRIS for the past 10 years and during that time has worked to advance awareness and understanding of seismology and earth science while inspiring careers in geophysics. The focus on seismology and the use of seismic data has allowed the IRIS E&O program to develop and disseminate a unique suite of products and services for a wide range of audiences. One result of that effort has been increased access to the IRIS Data Management System by non-specialist audiences and simplified use of location and waveform data. The Seismic Monitor was one of the first Web-based tools for observing near-real-time seismicity. It continues to be the most popular IRIS web page, and thus it presents aspects of seismology to a very wide audience. For individuals interested in more detailed ground motion information, waveforms can be easily viewed using the Rapid Earthquake Viewer, developed by the University of South Carolina in collaboration with IRIS E&O. The Seismographs in Schools program gives schools the opportunity to apply for a low-cost educational seismograph and to receive training for its use in the classroom. To provide better service to the community, a new Seismographs in Schools website was developed in the past year with enhanced functions to help teachers improve their teaching of seismology. The site encourages schools to make use of seismic data and communicate with other educational seismology users throughout the world. Users can view near-real-time displays of other participating schools, upload and download data, and use the “find a teacher” tool to contact nearby schools that also may be operating seismographs. In order to promote and maintain program participation and communication, the site features a discussion forum to encourage and support the growing global community of educational seismograph users. Any data that is submitted to the Seismographs in Schools Website is also accessible
... 42 Public Health 4 2010-10-01 2010-10-01 false Basic rule. 438.602 Section 438.602 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Certifications and Program Integrity § 438.602 Basic rule. As a condition...
Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Organ Procurement Organization Reporting and Communication; Transplant Outcome Measures and Documentation Requirements; Electronic Health Record (EHR) Incentive Programs; Payment to Nonexcepted Off-Campus Provider-Based Department of a Hospital; Hospital Value-Based Purchasing (VBP) Program; Establishment of Payment Rates Under the Medicare Physician Fee Schedule for Nonexcepted Items and Services Furnished by an Off-Campus Provider-Based Department of a Hospital. Final rule with comment period and interim final rule with comment period.
This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2017 to implement applicable statutory requirements and changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. In addition, this final rule with comment period updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program. Further, in this final rule with comment period, we are making changes to tolerance thresholds for clinical outcomes for solid organ transplant programs; to Organ Procurement Organizations (OPOs) definitions, outcome measures, and organ transport documentation; and to the Medicare and Medicaid Electronic Health Record Incentive Programs. We also are removing the HCAHPS Pain Management dimension from the Hospital Value-Based Purchasing (VBP) Program. In addition, we are implementing section 603 of the Bipartisan Budget Act of 2015 relating to payment for certain items and services furnished by certain off-campus provider-based departments of a provider. In this document, we also are issuing an interim final rule with comment period to establish the Medicare Physician Fee Schedule payment rates for the nonexcepted items and services billed by a nonexcepted off-campus provider-based department of a hospital in accordance with the provisions of section 603.
This final rule establishes regulations for contracting with community-based treatment facilities in the Health Care for Homeless Veterans (HCHV) program of the Department of Veterans Affairs (VA). The HCHV program assists certain homeless veterans in obtaining treatment from non-VA community-based providers. The final rule formalizes VA's policies and procedures in connection with this program and clarifies that veterans with substance use disorders may qualify for the program.
Chamratrithirong, Aphichat; Ford, Kathleen; Punpuing, Sureeporn; Prasartkul, Pramote
Vulnerability to Human Immunodeficiency Virus (HIV) infection among factory workers is a global problem. This study investigated the effectiveness of an intervention to increase AIDS knowledge, perceived accessibility to condoms and condom use among young factory workers in Thailand. The intervention was a workplace program designed to engage the private sector in HIV prevention. A cross-sectional survey conducted in 2008 to measure program outcomes in factories in Thailand was used in this study. The workplace intervention included the development of policies for management of HIV-positive employees, training sessions for managers and workers, and distribution of educational materials and condoms. A multi-level analysis was used to investigate the effect of HIV/AIDS prevention program components at the workplace on HIV/AIDS knowledge, perceived accessibility to condoms and condom use with regular sexual partners among 699 young factory workers (aged 18-24 years), controlling for their individual socio-demographic characteristics. Interventions related to the management and services component including workplace AIDS policy formulation, condom services programs and behavioral change campaigns were found to be significantly related to increased AIDS knowledge, perceived accessibility to condoms and condom use with regular partners. The effect of the HIV/AIDS training for managers, peer leaders and workers was positive but not statistically significant. With some revision of program components, scaling up of workplace interventions and the engagement of the private sector in HIV prevention should be seriously considered.
Izumi, Betty T; Higgins, Cesar E; Baron, Andrea; Ness, Sylvia J; Allan, Bryan; Barth, Elizabeth T; Smith, Teresa M; Pranian, Katy; Frank, Brian
This study explored the feasibility of using a 23-week subsidized community-supported agriculture program to increase access to and intake of vegetables among Federally Qualified Health Center patients. Outcomes were measured using pre-post intervention surveys (n = 9). Process data were collected in post-intervention surveys and focus groups (n = 15). Most participants (77%) indicated that the program improved their health and all (100%) reported that they were eating a greater variety of vegetables because of their participation in the program. Three themes emerged from the focus groups: increased access to fresh and/or organic vegetables, improved diet quality, and the importance of social support during the program. Linking subsided community-supported agriculture programs with Federally Qualified Health Centers has the potential to increase access to and intake of vegetables among low-income patients. However, further research is needed with a larger sample size and a more robust study design. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
Squitieri, Lee; Chung, Kevin C
In 2015, the U.S. Congress passed the Medicare Access and Children's Health Insurance Program Reauthorization Act, which effectively repealed the Centers for Medicare and Medicaid Services sustainable growth rate formula and established the Centers for Medicare and Medicaid Services Quality Payment Program. The Medicare Access and Children's Health Insurance Program Reauthorization Act represents an unparalleled acceleration toward value-based payment models and a departure from traditional volume-driven fee-for-service reimbursement. The Quality Payment Program includes two paths for provider participation: the Merit-Based Incentive Payment System and Advanced Alternative Payment Models. The Merit-Based Incentive Payment System pathway replaces existing quality reporting programs and adds several new measures to create a composite performance score for each provider (or provider group) that will be used to adjust reimbursed payment. The advanced alternative payment model pathway is available to providers who participate in qualifying Advanced Alternative Payment Models and is associated with an initial 5 percent payment incentive. The first performance period for the Merit-Based Incentive Payment System opens January 1, 2017, and closes on December 31, 2017, and is associated with payment adjustments in January of 2019. The Centers for Medicare and Medicaid Services estimates that the majority of providers will begin participation in 2017 through the Merit-Based Incentive Payment System pathway, but aims to have 50 percent of payments tied to quality or value through Advanced Alternative Payment Models by 2018. In this article, the authors describe key components of the Medicare Access and Children's Health Insurance Program Reauthorization Act to providers navigating through the Quality Payment Program and discuss how plastic surgeons may optimize their performance in this new value-based payment program.
Marie Vander Kloet
It is increasingly understood that university education must be accessible to persons with disabilities. The responsibility to make the university accessible is arguably shared by all of us and yet, the extent to which it has become fully accessible is certainly suspect. By undertaking qualitative, discursive analysis of websites, online texts and other materials provided by Ontario’s teaching and learning centres, this paper seeks to do two things. First, it provides a critical overview of t...
Full Text Available This paper is concerned with games against nature and multi-criteria decision making under uncertainty along with scenario planning. We focus on decision problems where a deterministic evaluation of criteria is not possible. The procedure we propose is based on weighted goal programming and may be applied when seeking a mixed strategy. A mixed strategy allows the decision maker to select and perform a weighted combination of several accessible alternatives. The new method takes into consideration the decision maker’s preference structure (importance of particular goals and nature (pessimistic, moderate or optimistic attitude towards a given problem. It is designed for one-shot decisions made under uncertainty with unknown probabilities (frequencies, i.e. for decision making under complete uncertainty or decision making under strategic uncertainty. The procedure refers to one-stage models, i.e. models considering combinations of scenarios and criteria (scenario-criterion pairs as distinct meta-attributes, which means that the novel approach can be used in the case of totally independent payoff matrices for particular targets. The algorithm does not require any information about frequencies, which is especially desirable for new decision problems. It can be successfully applied by passive decision makers, as only criteria weights and the coefficient of optimism have to be declared.
... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Flight altitude rules. 91.515 Section 91...) AIR TRAFFIC AND GENERAL OPERATING RULES GENERAL OPERATING AND FLIGHT RULES Large and Turbine-Powered Multiengine Airplanes and Fractional Ownership Program Aircraft § 91.515 Flight altitude rules. (a...
Köklü, Seyfettin; Köksal, Iftihar; Akarca, Ulus Salih; Balkan, Ayhan; Güner, Rahmet; Demirezen, Aylin; Sahin, Memduh; Akhan, Sila; Ozaras, Reşat; Idilman, Ramazan
Background. Daclatasvir and asunaprevir dual therapy is approved for the treatment of HCV genotype 1b infection in several countries. To evaluate the efficacy and safety of daclatasvir and asunaprevir dual therapy in Turkish patients. Sixty-one patients with HCV genotype 1b were enrolled in the Turkish early access program. Most of the patients were in difficult-to-treat category. Patients were visited at each 4 week throughout the follow-up period. Laboratory findings and adverse events were recorded at each visit. Fifty-seven of 61 enrolled patients completed 24 weeks of treatment. Two patients died as a result of underlying diseases at 12-14th weeks of treatment. Two patients stopped the treatment early as a consequence of virological breakthrough, and 2 patients had viral relapse at the post-treatment follow-up. Overall SVR12 rates were 90% (55/61) and 93.2% (55/59) according to intention-to-treat (ITT) and per protocol (PP) analysis respectively. In ITT analysis, SVR12 was achieved by 93% (13/14) in relapsers, 80% (12/15) in interferon-ineligible patients and 91% (20/22) in previous nonresponder patients. SVR12 rates were 86.5% and 91.4% in patients with cirrhosis according to ITT and PP analysis respectively. SVR12 was 95.8% in non-cirrhosis group in both analysis. Patients with previous protease inhibitor experience had an SVR12 of 87.5%. Common adverse events developed in 28.8% of patients. There were no treatment related severe adverse event or grade-4 laboratory abnormality. Daclatasvir and asunaprevir dual therapy is found to be effective and safe in difficult-to-treat Turkish patients with HCV genotype 1b infection.
Hennig, Teresa; Griffith, Geoffrey L
A comprehensive guide to programming for Access 2010 and 2007. Millions of people use the Access database applications, and hundreds of thousands of developers work with Access daily. Access 2010 brings better integration with SQL Server and enhanced XML support; this Wrox guide shows developers how to take advantage of these and other improvements. With in-depth coverage of VBA, macros, and other programming methods for building Access applications, this book also provides real-world code examples to demonstrate each topic.: Access is the leading database that is used worldwide; While VBA rem
Fisher, Karin; Smith, Tony; Nairn, Karen; Anderson, Donna
To better understand issues related to access to injecting equipment for people who inject drugs (PWID) in a rural area of New South Wales (NSW), Australia. Cross-sectional face-to-face survey using convenience and snowball sampling. Six regional and rural population centres in Northern NSW, within the Hunter New England Local Health District. The sample included 190 PWID who had accessed a needle and syringe program outlet within 4 weeks of the survey. Data include demographic information, preferred location for accessing injecting equipment, reasons for that preference, whether they obtained enough equipment, travelling distance to an NSP and self-reported hepatitis C virus status. Sixty percent self-identified as Aboriginal people. The median age of respondents was 32 years and 60% were men. A significantly larger proportion (P equipment at a community health facility (62.6%), as opposed to other secondary outlets, where they gained enough equipment (67.4%). Just over 80% said they were tested for HCV in the past year, with about 37% told they had tested positive. There are complex dimensions affecting how rural PWID access secondary NSP outlets. Although access is similarly limited as other rural health services because of the nature of injecting drug use and sensitivities existing in rural communities, there is potential for application of unique access models, such as, promoting secondary distribution networks. © 2016 National Rural Health Alliance Inc.
McClellan, Sean R; Wu, Frances M; Snowden, Lonnie R
Title VI of the 1964 Civil Rights Act prohibits federal funds recipients from providing care to limited English proficiency (LEP) persons more limited in scope or lower in quality than care provided to others. In 1999, the California Department of Mental Health implemented a "threshold language access policy" to meet its Title VI obligations. Under this policy, Medi-Cal agencies must provide language assistance programming in a non-English language where a county's Medical population contains either 3000 residents or 5% speakers of that language. We examine the impact of threshold language policy-required language assistance programming on LEP persons' access to mental health services by analyzing the county-level penetration rate of services for Russian, Spanish, and Vietnamese speakers across 34 California counties, over 10 years of quarterly data. Exploiting a time series with nonequivalent control group study design, we studied this phenomena using linear regression with random county effects to account for trends over time. Threshold language policy-required assistance programming led to an immediate and significant increase in the penetration rate of mental health services for Russian (8.2, P language speaking persons. Threshold language assistance programming was effective in increasing mental health access for Russian and Vietnamese, but not for Spanish-speaking LEP persons.
Access Control, Security, Trust, and Logic Deconstructing Access Control Decisions A Logical Approach to Access Control PRELIMINARIES A Language for Access ControlSets and Relations Syntax SemanticsReasoning about Access Control Logical RulesFormal Proofs and Theorems Soundness of Logical RulesBasic Concepts Reference Monitors Access Control Mechanisms: Tickets and Lists Authentication Security PoliciesConfidentiality, Integrity, and Availability Discretionary Security Policies Mandatory Security Policies Military Security Policies Commercial PoliciesDISTRIBUTED ACCESS CONTROL Digital Authenti
Medicare and Medicaid Programs; CY 2018 Home Health Prospective Payment System Rate Update and CY 2019 Case-Mix Adjustment Methodology Refinements; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements. Final rule.
This final rule updates the home health prospective payment system (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor, effective for home health episodes of care ending on or after January 1, 2018. This rule also: Updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the third year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity (that is, nominal case-mix growth) between calendar year (CY) 2012 and CY 2014; and discusses our efforts to monitor the potential impacts of the rebasing adjustments that were implemented in CY 2014 through CY 2017. In addition, this rule finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model and to the Home Health Quality Reporting Program (HH QRP). We are not finalizing the implementation of the Home Health Groupings Model (HHGM) in this final rule.
Knowledge representation and extraction are very important tasks in data mining. In this work, we proposed a variety of rule-based greedy algorithms that able to obtain knowledge contained in a given dataset as a series of inhibitory rules containing an expression “attribute ≠ value” on the right-hand side. The main goal of this paper is to determine based on rule characteristics, rule length and coverage, whether the proposed rule heuristics are statistically significantly different or not; if so, we aim to identify the best performing rule heuristics for minimization of rule length and maximization of rule coverage. Friedman test with Nemenyi post-hoc are used to compare the greedy algorithms statistically against each other for length and coverage. The experiments are carried out on real datasets from UCI Machine Learning Repository. For leading heuristics, the constructed rules are compared with optimal ones obtained based on dynamic programming approach. The results seem to be promising for the best heuristics: the average relative difference between length (coverage) of constructed and optimal rules is at most 2.27% (7%, respectively). Furthermore, the quality of classifiers based on sets of inhibitory rules constructed by the considered heuristics are compared against each other, and the results show that the three best heuristics from the point of view classification accuracy coincides with the three well-performed heuristics from the point of view of rule length minimization.
Fransen, Mirjam P; Dekker, Evelien; Timmermans, Daniëlle R M; Uiters, Ellen; Essink-Bot, Marie-Louise
To explore the accessibility of standardized printed information materials of the national Dutch colorectal cancer screening program among low health literate screening invitees and to assess the effect of the information on their knowledge about colorectal cancer and the screening program. Linguistic tools were used to analyze the text and design characteristics. The accessibility, comprehensibility and relevance of the information materials were explored in interviews and in observations (n=25). The effect of the information on knowledge was assessed in an online survey (n=127). The materials employed a simple text and design. However, respondents expressed problems with the amount of information, and the difference between screening and diagnostic follow-up. Knowledge significantly increased in 10 out of 16 items after reading the information but remained low for colorectal cancer risk, sensitivity of testing, and the voluntariness of colorectal cancer screening. Despite intelligible linguistic and design characteristics, screening invitees with low health literacy had problems in accessing, comprehending and applying standard information materials on colorectal cancer screening, and lacked essential knowledge for informed decision-making about participation. To enable equal access to informed decision-making, information strategies need to be adjusted to the skills of low health literate screening invitees. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Antonipillai, Valentina; Baumann, Andrea; Hunter, Andrea; Wahoush, Olive; O'Shea, Timothy
Changes to the Interim Federal Health Program (IFHP) in 2012 reduced health care access for refugees and refugee claimants, generating concerns among key stakeholders. In 2014, a new IFHP temporarily reinstated access to some health services; however, little is known about these changes, and more information is needed to map the IFHP's impact. This study explores barriers occurring during the time period of the IFHP reforms to health care access and provision for refugees. A stakeholder analysis, using 23 semi-structured interviews, was conducted to obtain insight into stakeholder perceptions of the 2014 reforms, as well as stakeholders' position and their influence to assess the acceptability of the IFHP changes. The majority of stakeholders expressed concerns about the 2014 IFHP changes as a result of the continuing barriers posed by the 2012 retrenchments and the emergence of new barriers to health care access and provision for refugees. Key barriers identified included lack of communication and awareness, lack of continuity and comprehensive care, negative political discourse and increased costs. A few stakeholders supported the reforms as they represented some, but limited, access to health care. Overall, the reforms to the IFHP in 2014 generated barriers to health care access and provision that contributed to confusion among stakeholders, the transfer of refugee health responsibility to provincial authorities and the likelihood of increased health outcome disparities, as refugees and refugee claimants chose to delay seeking health care. The study recommends that policy-makers engage with refugee health stakeholders to formulate a policy that improves health care provision and access for refugee populations.
This major final rule with comment period addresses changes to the physician fee schedule, and other Medicare Part B payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services, as well as changes in the statute.
Medicare program; extension of the payment adjustment for low-volume hospitals and the Medicare-dependent hospital (MDH) program under the hospital inpatient prospective payment systems (IPPS) for acute care hospitals for fiscal year 2014. Interim final rule with comment period.
This interim final rule with comment period implements changes to the payment adjustment for low-volume hospitals and to the Medicare-dependent hospital (MDH) program under the hospital inpatient prospective payment systems (IPPS) for FY 2014 (through March 31, 2014) in accordance with sections 1105 and 1106, respectively, of the Pathway for SGR Reform Act of 2013.
Lubogo, David; Ddamulira, John Bosco; Tweheyo, Raymond; Wamani, Henry
The HIV/AIDS health challenge continues to ravage many resource-constrained countries of the world. Approximately 75 % of all the global HIV/AIDS related deaths totaling 1.6 (1.4-1.9) million in 2012 occurred in sub-Saharan Africa, Uganda contributed 63,000 (52,000-81,000) to these deaths. Most of the morbidity and mortality associated with HIV/AIDS can be averted if individuals with HIV/AIDS have improved access to HIV care and treatment. The aim of this study therefore, was to explore the factors associated with access to HIV care services among HIV seropositive clients identified by a home based HIV counseling and testing program in Kumi district, eastern Uganda. In a cross sectional study conducted in February 2009, we explored predictor variables: socio-demographics, health facility and community factors related to access to HIV care and treatment. The main outcome measure was reported receipt of cotrimoxazole for prophylaxis. The majority [81.1 % (284/350)] of respondents received cotrimoxazole prophylaxis (indicating access to HIV care). The main factors associated with access to HIV care include; age 25-34 years (AOR = 5.1, 95 % CI: 1.5-17.1), male sex (AOR = 2.3, 95 % CI: 1.2-4.4), urban residence (AOR = 2.5, CI: 1.1-5.9) and lack of family support (AOR = 0.5, CI: 0.2-0.9). There was relatively high access to HIV care and treatment services at health facilities for HIV positive clients referred from the Kumi home based HIV counseling and testing program. The factors associated with access to HIV care services include; age group, sex, residence and having a supportive family. Stakeholders involved in providing HIV care and treatment services in similar settings should therefore consider these socio-demographic variables as they formulate interventions to improve access to HIV care services.
Full Text Available The main objective of this work is to analyze and extend security model of mobile devices running on Android OS. Provided security extension is a Linux kernel security module that allows the system administrator to restrict program's capabilities with per-program profiles. Profiles can allow capabilities like network access, raw socket access, and the permission to read, write, or execute files on matching paths. Module supplements the traditional Android capability access control model by providing mandatory access control (MAC based on path. This extension increases security of access to system objects in a device and allows creating security sandboxes per application.
... 42 Public Health 2 2010-10-01 2010-10-01 false Basic rules. 408.80 Section 408.80 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PREMIUMS FOR SUPPLEMENTARY MEDICAL INSURANCE Direct Remittance: Group Payment § 408.80 Basic rules. (a...
... 42 Public Health 3 2010-10-01 2010-10-01 false Basic rules. 418.301 Section 418.301 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HOSPICE CARE Payment for Hospice Care § 418.301 Basic rules. (a) Medicare payment for covered...
Tuot, Delphine S; Lopez, Monica; Miller, Cecily; Karliner, Leah S
Language barriers render interaction with the health care system difficult and lead to health disparities for patients with limited English proficiency (LEP). Despite a long-standing legal obligation for large health care organizations in the United States to try to provide free language access services for patients with LEP, professional interpretation is not always widely accessible, and even when it is, its use is often suboptimal. A dual-handset phone with 24-hour access to professional telephonic interpretation was placed at the bedside of all patients admitted to the general medicine floor of a tertiary care academic hospital. Nurses and physicians were surveyed before and after the easy-access interpretation program's implementation. Distribution of pre- and postimplementation surveys to 127 and 122 nurses, respectively, yielded a total of 163 completed surveys (overall participation rate, 65%). Distribution of surveys to 96 and 78 physicians, respectively, yielded 116 completed surveys (overall participation rate, 67%). After implementation, use of professional telephonic interpreters for communication with LEP patients increased fourfold, without a decrease in use of professional in-person interpreters. There were significant increases in professional interpreter use during brief communications with high error potential, including medication administration (odds ratio [OR] = 1.9, 95% confidence interval [CI] 1.1-3.2) and pre-rounding (OR = 3.4, 95% CI 1.2-9.8). Increasing ease of access to dual-handset interpreter telephones promotes use of professional interpreters in the acute care setting. Future hospital policy should focus on further integrating language services into the hospital environment, accompanied by an educational program to assist in shifting professional norms toward use of professional interpreters.
Medicare program; FY 2014 inpatient prospective payment systems: changes to certain cost reporting procedures related to disproportionate share hospital uncompensated care payments. Interim final rule with comment period.
: In the fiscal year (FY) 2014 inpatient prospective payment systems (IPPS)/long-term care hospital (LTCH) PPS final rule, we established the methodology for determining the amount of uncompensated care payments made to hospitals eligible for the disproportionate share hospital (DSH) payment adjustment in FY 2014 and a process for making interim and final payments. This interim final rule with comment period revises certain operational considerations for hospitals with Medicare cost reporting periods that span more than one Federal fiscal year and also makes changes to the data that will be used in the uncompensated care payment calculation in order to ensure that data from Indian Health Service (IHS) hospitals are included in Factor 1 and Factor 3 of that calculation.
Giffen, Carol A; Wagner, Elizabeth L; Adams, John T; Hitchcock, Denise M; Welniak, Lisbeth A; Brennan, Sean P; Carroll, Leslie E
The National Heart, Lung, and Blood Institute (NHLBI), within the United States' National Institutes of Health (NIH), established the Biologic Specimen and Data Repository Information Coordinating Center (BioLINCC) in 2008 to develop the infrastructure needed to link the contents of the NHLBI Biorepository and the NHLBI Data Repository, and to promote the utilization of these scientific resources by the broader research community. Program utilization metrics were developed to measure the impact of BioLINCC on Biorepository access by researchers, including visibility, program efficiency, user characteristics, scientific impact, and research types. Input data elements were defined and are continually populated as requests move through the process of initiation through fulfillment and publication. This paper reviews the elements of the tracking metrics which were developed for BioLINCC and reports the results for the first six on-line years of the program.
Marie Vander Kloet
Full Text Available It is increasingly understood that university education must be accessible to persons with disabilities. The responsibility to make the university accessible is arguably shared by all of us and yet, the extent to which it has become fully accessible is certainly suspect. By undertaking qualitative, discursive analysis of websites, online texts and other materials provided by Ontario’s teaching and learning centres, this paper seeks to do two things. First, it provides a critical overview of the types of training currently available at Ontario universities for teaching assistants on accessibility and teaching. This review will outline initiatives directed towards compliance with Accessibility for Ontarians with Disabilities Act (AODA requirements, those focused on education and advocacy (as well as areas of overlap and broader equity training which encompasses accessibility. Second, this paper, considering the content of the reviewed material and informed by critical disability studies, offers up an articulation of future directions for research, writing, advocacy, and training on teaching assistant development on accessible teaching. Il est de plus en plus accepté que l’éducation universitaire doit être accessible aux personnes handicapées. Certes, la responsabilité de rendre l’université accessible est partagée par tous et pourtant, la mesure dans laquelle celle-ci est devenue totalement accessible est sans nul doute suspecte. Après avoir entrepris des analyses qualitatives et discursives de sites web, de textes en ligne et d’autres documents fournis par des centres d’enseignement et d’apprentissage de l’Ontario, on cherche dans cet article à accomplir deux choses. Tout d’abord, l’article présente un aperçu critique des types de formation disponibles à l’heure actuelle dans les universités de l’Ontario à l’intention des enseignants auxiliaires sur l’accessibilité et l’enseignement. Cet examen va d
Love, Susan M.; Sanders, Matthew R.; Metzler, Carol W.; Prinz, Ronald J.; Kast, Elizabeth Z.
11 focus groups (N = 160) of high-risk parents in Los Angeles County were asked to assess the value of social media to deliver an evidence-based parenting program, Triple P—Positive Parenting Program, to reduce child maltreatment. For feasibility, (N = 238) parents were surveyed regarding their internet use. Parents responded enthusiastically to the online program, and expressed the importance of a sense of community and learning through the experiences of others. 78% of the young, high-pover...
Moessner, Markus; Minarik, Carla; Özer, Fikret; Bauer, Stephanie
The majorities of individual suffering from eating disorders do not seek or receive adequate professional treatment. Internet-based approaches promise to facilitate access to conventional healthcare by providing an easy-access, low-threshold contact. The current study investigated whether an Internet-based program for the prevention and early intervention for eating disorders (ProYouth) may contribute to the actual and intended uptake of professional care. Characteristics of individuals who seek help are explored as well as barriers to help-seeking. The sample included 453 ProYouth participants who were surveyed three months after registration. Actual help-seeking behavior, intended help-seeking, potential help-seeking, and barriers to help-seeking were assessed. Within three months of participation, 43 individuals (9.5%) took up treatment, 32 (7.8%) intended to start treatment, and 163 (43.1%) of the remaining reported that they would seek professional help in case of need (potential help-seeking). Approximately 50% of (potential) help-seekers stated that participation in ProYouth has changed their attitude towards help-seeking. Mental health literacy and shame/stigma were the most frequently mentioned barriers. This is the first study indicating that an online program for prevention and early intervention may serve as facilitator in accessing conventional healthcare.
D. Rem (Dana); D.R. Gasper (Des)
textabstractSpecial arrangements were made by the European Union for decision-making on the possible accession of Romania and Bulgaria. A regime of extra procedures was added to the arrangements used for the Eastern European countries which joined the Union in 2004. This paper examines how the
Moatti, J P; Vlahov, D; Feroni, I; Perrin, V; Obadia, Y
In Marseille, southeastern France, HIV prevention programs for injection drug users (IDUs) simultaneously include access to sterile syringes through needle exchange programs (NEPs), legal pharmacy sales and, since 1996, vending machines that mechanically exchange new syringes for used ones. The purpose of this study was to compare the characteristics of IDUs according to the site where they last obtained new syringes. During 3 days in September 1997, all IDUs who obtained syringes from 32 pharmacies, four NEPs and three vending machines were offered the opportunity to complete a self-administered questionnaire on demographics, drug use characteristics and program utilization. Of 485 individuals approached, the number who completed the questionnaire was 141 in pharmacies, 114 in NEPs and 88 at vending machines (response rate = 70.7%). Compared to NEP users, vending machine users were younger and less likely to be enrolled in a methadone program or to report being HIV infected, but more likely to misuse buprenorphine. They also had lower financial resources and were less likely to be heroin injectors than both pharmacy and NEP users. Our results suggest that vending machines attract a very different group of IDUs than NEPs, and that both programs are useful adjuncts to legal pharmacy sales for covering the needs of IDUs for sterile syringes in a single city. Assessment of the effectiveness and cost-effectiveness of combining such programs for the prevention of HIV and other infectious diseases among IDUs requires further comparative research. Copyright 2001 S. Karger AG, Basel
Dobbs, Jennifer Kwon
This article explores the development of the Summer Tools, Information, Motivation, and Education (SummerTIME) Writing Program, the only program of its kind in Los Angeles that conducts self-assessment. The author describes the geographical and political boundaries separating inner-city Los Angeles high school graduates from higher education,…
Rackley, Benjamin P; Wheat, John R; Moore, Cynthia E; Garner, Robert G; Harrell, Barbara W
Rural Health Leaders Pipeline programs are intended to increase the number of youth interested in and pursuing health professions in rural communities. This paper presents 2 complementary approaches to Rural Health Leaders Pipeline programs. Two different organizations in Alabama recruit students from 18 specified counties. One organization is a rural, community-based program with college freshmen and upperclassmen from rural communities. Students shadow health professionals for 6 weeks, attend classes, visit medical schools, complete and present health projects, and receive support from online tutors. The second organization is a university-based program that supplements an existing 11th grade-medical school rural medicine pipeline with 10 minority students from rural communities who have graduated from high school and plan to enter college as premedical students in the following academic year. Students participate in classes, tutorials, seminars, and other activities. Students earn college credits during the 7-week program, maintain contact with program staff during the school year, and by performance and interest can continue in this pipeline program for a total of 4 consecutive summers, culminating in application to medical school. Each organization provides stipends for students. Early experiences have been positive, although Rural Health Leaders Pipeline programs are expensive and require long-term commitments.
Kirby, Ronald F.; McGillivray, Robert G.
Special transportation assistance is currently provided for elderly and handicapped persons in the United States through a variety of programs at the federal, state, and local levels of government. The programs are concerned with improving the mobility of the client groups served, thereby making various activities and locations in urban areas more…
Siminiceanu, Radu I.; Catano, Nestor
We propose an approach to formally verify Plural specifications based on access permissions and typestates, by model-checking automatically generated abstract state-machines. Our exhaustive approach captures all the possible behaviors of abstract concurrent programs implementing the specification. We describe the formal methodology employed by our technique and provide an example as proof of concept for the state-machine construction rules. The implementation of a fully automated algorithm to generate and verify models, currently underway, provides model checking support for the Plural tool, which currently supports only program verification via data flow analysis (DFA).
National Oceanic and Atmospheric Administration, Department of Commerce — As part of its bioeffects assessment program. NOAA has begun a series of surveys of the toxicity and other biological effects of toxicants in selected bays and...
National Oceanic and Atmospheric Administration, Department of Commerce — This dataset consists of Coral Reef Assessment and Monitoring Program (CRAMP) surveys taken in 1999 and include quantitative estimates of substrate type, rugosity,...
Kash, Bita A; Deshmukh, A A
The purpose of this study was to develop a marketing plan for the Physical and Occupational Therapy (PT/OT) department at a Critical Access Hospital (CAH). We took the approach of understanding and analyzing the rural community and health care environment, problems faced by the PT/OT department, and developing a strategic marketing plan to resolve those problems. We used hospital admissions data, public and physician surveys, a SWOT analysis, and tools to evaluate alternative strategies. Lack of awareness and negative perception were key issues. Recommended strategies included building relationships with physicians, partnering with the school district, and enhancing the wellness program.
Medicare program; payment policies under the physician fee schedule, five-year review of work relative value units, clinical laboratory fee schedule: signature on requisition, and other revisions to part B for CY 2012. Final rule with comment period.
This final rule with comment period addresses changes to the physician fee schedule and other Medicare Part B payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. It also addresses, implements or discusses certain statutory provisions including provisions of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable Care Act) and the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008. In addition, this final rule with comment period discusses payments for Part B drugs; Clinical Laboratory Fee Schedule: Signature on Requisition; Physician Quality Reporting System; the Electronic Prescribing (eRx) Incentive Program; the Physician Resource-Use Feedback Program and the value modifier; productivity adjustment for ambulatory surgical center payment system and the ambulance, clinical laboratory, and durable medical equipment prosthetics orthotics and supplies (DMEPOS) fee schedules; and other Part B related issues.
Full Text Available Productivity—the hallmark of linguistic competence—is typically attributed to algebraic rules that support broad generalizations. Past research on spoken language has documented such generalizations in both adults and infants. But whether algebraic rules form part of the linguistic competence of signers remains unknown. To address this question, here we gauge the generalization afforded by American Sign Language (ASL. As a case study, we examine reduplication (X→XX—a rule that, inter alia, generates ASL nouns from verbs. If signers encode this rule, then they should freely extend it to novel syllables, including ones with features that are unattested in ASL. And since reduplicated disyllables are preferred in ASL, such rule should favor novel reduplicated signs. Novel reduplicated signs should thus be preferred to nonreduplicative controls (in rating, and consequently, such stimuli should also be harder to classify as nonsigns (in the lexical decision task. The results of four experiments support this prediction. These findings suggest that the phonological knowledge of signers includes powerful algebraic rules. The convergence between these conclusions and previous evidence for phonological rules in spoken language suggests that the architecture of the phonological mind is partly amodal.
... delete NYSE Rule 445 (Anti-Money Laundering Compliance Program) and adopt new Rule 3310 (Anti-Money..., subject to certain amendments, NASD Rule 3011 (Anti- Money Laundering Compliance Program) and related Interpretive Material NASD IM-3011-1 and 3011-2 as consolidated FINRA Rule 3310 (Anti-Money Laundering...
Medicare program; changes to the hospital inpatient prospective payment system for acute care hospitals and fiscal year 2010 rates; and changes to the long-term care hospital prospective payment system and rate years 2010 and 2009 rates. Final rules and interim final rule with comment period.
We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems, and to implement certain provisions made by the TMA, Abstinence Education, and QI Program Extension Act of 2007, the Medicare Improvements for Patients and Providers Act of 2008, and the American Recovery and Reinvestment Act of 2009. In addition, in the Addendum to this final rule, we describe the changes to the amounts and factors used to determine the rates for Medicare acute care hospital inpatient services for operating costs and capital-related costs. These changes are applicable to discharges occurring on or after October 1, 2009. We also are setting forth the update to the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits. The updated rate-of-increase limits are effective for cost reporting periods beginning on or after October 1, 2009. Second, we are updating the payment policy and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) for rate year (RY) 2010, including responding to public comments received on a June 3, 2009 supplemental proposed rule relating to the proposed RY 2010 Medicare Severity Long-Term Care Diagnosis-Related Groups (MS-LTC-DRG) relative weights and the proposed RY 2010 high-cost outlier (HCO) fixed-loss amount. In the Addendum to this final rule, we also set forth the changes to the payment rates, factors, and other payment rate policies under the LTCH PPS for RY 2010. These changes are applicable to discharges occurring on or after October 1, 2009. In addition, we are responding to public comments received on and finalizing a June 3, 2009 interim final rule with comment period that revised the MS-LTC-DRG relative weights for
Watts, Sarah E; Andrews, Gavin
Mental disorders are widespread and universal. They are frequently accompanied by considerable harmful consequences for the individual and come at a significant economic cost to a community. Yet while effective evidence based prevention and treatment exists, there are a number of barriers to access, implement and disseminate. Cognitive behavior therapy programs, such as those available at www.thiswayup.com.au are widely available using the Internet in high income countries, such as Australia. With the ubiquitous uptake of Internet users globally, it is suggested that low and middle income countries should consider ways to embrace and scale up these cost effective programs. An explanation of why and some suggestions as to how this can be done are presented. Crown Copyright © 2014. Published by Elsevier B.V. All rights reserved.
Thorhauge, Anne Mette
of the game manager in order to implement the rules and provide a world for the other players. In online role-playing games, a programmed system simulates the rule system as well as part of the game manager’s tasks, while the rest of the activity is up to the players to define. Some aspects may translate more......This article presents a critical view of the concept of rules in game studies on the basis of a case study of role-playing across media. Role-playing in its traditional form is a complex activity including a game system and a number of communicative conventions where one player takes the role...... or less unproblematically across media, others are transformed by the introduction of the programmed system. This reveals some important perspectives on the sort of rules that can be simulated in a programmed system and what this means to the concept of rules in game studies....
DiFranza, J R; Savageau, J A; Aisquith, B F
This study evaluated the influence of age, gender, vending machine lockout devices, and tobacco industry-sponsored voluntary compliance programs ("It's the Law" programs) on underage youths' ability to purchase tobacco. Twelve youths made 480 attempts to purchase tobacco in Massachusetts from over-the-counter retailers and vending machines with and without remote control lockout devices. Half the vendors were participating in It's the Law programs. In communities with no requirements for lockout devices, illegal sales were far more likely from vending machines than from over-the-counter sources (odds ratio [OR] = 5.9, 95% confidence interval [CI] = 3.3, 10.3). Locks on vending machines made them equivalent to over-the-counter sources in terms of illegal sales to youths. Vendors participating in It's the Law programs were as likely to make illegal sales as nonparticipants (OR = 0.87, 95% CI = 0.57, 1.35). Girls and youths 16 years of age and older were more successful at purchasing tobacco. The It's the Law programs are ineffective in preventing illegal sales. While locks made vending machines equivalent to over-the-counter sources in their compliance with the law, they are not a substitute for law enforcement.
Mates, Barbara T.
Describes several programs that were developed by staff at the Cleveland (Ohio) Public Library to be accessible to users with disabilities. Highlights include a Braille reading program; sensory garden; poetry club; book club based on talking books; wheelchair athletics; touching museum artifacts; and a mobile library for users who could not visit…
... Development GENERAL HUD PROGRAM REQUIREMENTS; WAIVERS Pet Ownership for the Elderly or Persons With Disabilities General Requirements § 5.318 Discretionary pet rules. Pet rules promulgated by project owners and... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Discretionary pet rules. 5.318...
Haas, Mark; Spargo, Benjamin H.; Wit, Ernst-Jan C.; Meehan, Shane M.
True access recirculation (AR) measured by ultrasound dilution technique is usually absent in well-working shunts. It occurs with low access flows (Qa). High access flow rates are assumed to prevent AR. Two major exceptions to these rules are known: presence of intra-access strictures and
... Harbor Access Channel, MD AGENCY: Coast Guard, DHS. ACTION: Temporary final rule. SUMMARY: The Coast... and National Harbor Access Channel during the event. DATES: This rule is effective on July 8, 2012... ``Special Local Regulations for [[Page 39631
Doyle, M D; Ang, C S; Martin, D C; Noe, A
We have designed a prototype knowledge management online environment for the biomedical sciences which integrates access to online representations of the scientific literature, bibliographic databases, high-performance visualization technologies, large-scale scientific databases, and tools for authoring new-generation scientific publications. This system will provide widespread access to its resources by using the World Wide Web for its underlying architecture. This system expands upon our Weblet Interactive Remote Visualization (IRV) server technology to produce a set of dedicated Internet "visualization servers" which provide interactive control of real-time visualizations from the Visible Embryo Project database from within Web pages viewed with our WebRouser software package. This system will be used to develop a set of prototype applications for both online education of medical students in developmental anatomy and for an interactive patient education system for expectant parents. We recognize that knowledge represented by these national resource databases is not static, therefore it is essential to include tools for both the creation of new "compound documents" which incorporate embedded objects, as well as for managing the peer-review of scholarly publications, in order to ensure the integrity of new knowledge as it is added to these databases in the future. We have therefore begun to design integrated tools for our system which facilitate both the creation of and the validation of new generations of scientific knowledge.
Sale, Elizabeth; Hendricks, Michelle; Weil, Virginia; Miller, Collin; Perkins, Scott; McCudden, Suzanne
This paper evaluates the effectiveness of the Counseling on Access to Lethal Means (CALM) suicide prevention program. CALM trains mental health providers how to counsel suicidal individuals and those who support them on mean restriction during times of crisis. Pre/post/3-month follow-up assessments measured knowledge of lethal means, confidence and comfort in discussing means restriction (self-efficacy), and future intentions to counsel clients on means restriction. Change in the number of clients receiving lethal means counseling was also assessed. All constructs increased significantly at posttest. Confidence and counseling intentions were sustained at follow-up and significantly more clients received means counseling in the 3 months following the CALM training. Knowledge and comfort levels decreased at follow-up but not to pre-training levels. CALM is effective at increasing mental health professionals' comfort, knowledge, and frequency of talking about means restriction with clients. an effective means restriction training program. A template to assess clients for suicidality and lethal means access and booster sessions are recommended to further sustain effects.
... enactments are a source of further evidence of housing discrimination ] based on sexual orientation or gender...., Laws Prohibiting Discrimination Based on Sexual Orientation and Gender Identity (Institute of Real... exclusion or discrimination on the basis of sexual orientation or gender identity in HUD programs. Such...
Cameron, Gary; Frensch, Karen; Preyde, Michele; Quosai, Trudy Smit
This article presents the findings from a longitudinal investigation of the prevalence of negative contact with the law for a sample of youth 12-18 months after graduating from residential and intensive children's mental health programming. Results of this study suggest serious community adaptation difficulties face many youth graduating from…
The Food and Drug Administration (FDA, the Agency, or we) is amending its regulations on accreditation of third-party certification bodies to conduct food safety audits and to issue certifications to provide for a reimbursement (user fee) program to assess fees for the work FDA performs to establish and administer the third-party certification program under the FDA Food Safety Modernization Act (FSMA).
The revision of CERN Safety rules is in progress and the following new Safety rules have been issued on 15-04-2008: Safety Procedure SP-R1 Establishing, Updating and Publishing CERN Safety rules: http://cern.ch/safety-rules/SP-R1.htm; Safety Regulation SR-S Smoking at CERN: http://cern.ch/safety-rules/SR-S.htm; Safety Regulation SR-M Mechanical Equipment: http://cern.ch/safety-rules/SR-M.htm; General Safety Instruction GSI-M1 Standard Lifting Equipment: http://cern.ch/safety-rules/GSI-M1.htm; General Safety Instruction GSI-M2 Standard Pressure Equipment: http://cern.ch/safety-rules/GSI-M2.htm; General Safety Instruction GSI-M3 Special Mechanical Equipment: http://cern.ch/safety-rules/GSI-M3.htm. These documents apply to all persons under the Director General’s authority. All Safety rules are available at the web page: http://www.cern.ch/safety-rules The Safety Commission
We are surrounded by data, numerical, categorical and otherwise, which must to be analyzed and processed to convert it into information that instructs, answers or aids understanding and decision making. Data analysts in many disciplines such as business, education or medicine, are frequently asked to analyze new data sets which are often composed of numerous tables possessing different properties. They try to find completely new correlations between attributes and show new possibilities for users. Action rules mining discusses some of data mining and knowledge discovery principles and then describe representative concepts, methods and algorithms connected with action. The author introduces the formal definition of action rule, notion of a simple association action rule and a representative action rule, the cost of association action rule, and gives a strategy how to construct simple association action rules of a lowest cost. A new approach for generating action rules from datasets with numerical attributes...
Fogarasi, Andras; De Waele, Liesbeth; Bartalini, Gabriella; Jozwiak, Sergiusz; Laforgia, Nicola; Verhelst, Helene; Petrak, Borivoj; Pedespan, Jean-Michel; Witt, Olaf; Castellana, Ramon; Crippa, Stefania; Gislimberti, Gabriella; Gyorsok, Zsuzsanna
Everolimus, a mammalian target of rapamycin (mTOR) inhibitor, has been shown to be effective and safe in the treatment of subependymal giant cell astrocytoma (SEGA) associated with tuberous sclerosis complex (TSC). The Everolimus For Fast Expanded aCcess in TSC SEGA (EFFECTS) study was designed to provide everolimus access to patients with SEGA associated with TSC and to mainly assess the safety and also efficacy of everolimus in a real-world setting. EFFECTS was a phase 3b, open-label, noncomparative, multicenter, expanded access study. Eligible patients were ≥ 3 years of age, with a definite diagnosis of TSC, and with at least one SEGA lesion identified by MRI or CT scan. Patients received once daily everolimus (dose adjusted to attain a trough level of 5-15 ng/mL). Safety evaluation was the primary objective and included collection of adverse events (AEs) and serious AEs, with their severity and relationship to everolimus. Efficacy evaluation, which was the secondary objective, was based on the best overall response as per medical judgment. Of the 120 patients enrolled, 100 (83.3%) completed the study. Median age of patients was 11 years (range, 1-47). Median daily dose of everolimus was 5.82 mg (range, 2.0-11.8). Median duration of exposure was 56.5 weeks (range, 0.3-130). The overall incidence of AEs was 74.2%. Aphthous stomatitis (18 [15.0%]), pyrexia (18 [15.0%]), bronchitis (11 [9.2%]), and stomatitis (10 [8.3%]) were the most common AEs reported. Overall, 25 patients had grade 3 AEs; most frequent was stomatitis (4 [3.3%]). Grade 4 AEs were reported in three (2.5%) patients. A total of 62 (51.7%) patients had suspected drug-related AEs, of which 15 (12.5%) were of grade 3 or 4. In eight (6.7%) patients, AEs led to drug discontinuation. With regard to efficacy, 81 (67.5%) patients had a partial response, 35 (29.2%) had a stable disease, and one (0.8%) had progressive disease. The response was unknown in three (2.5%) patients. This study confirms the
Valverde, Ana M; Reed, Shelby D; Schulman, Kevin A
The 1983 Orphan Drug Act created incentives for the development of orphan drugs. Despite its successes, including a substantial increase in new drugs, approved orphan drugs still treat fewer than 5 percent of registered rare diseases. In addition, concerns have arisen about the high prices of many of these therapies, which can cost hundreds of thousands of dollars per patient each year. In this article, we propose a new "grant-and-access pathway," in which drug developers could opt to compete for federal grants to subsidize the costs of clinical testing. In return for the grant funding, companies would no longer claim orphan drug tax credits and would agree to price caps for marketed products based on the duration and costs associated with drug development, expected market size, and target rate of return. We identify scenarios in which such a policy could provide a net benefit to society.
Smith, Maxwell L; Wilkerson, Trent; Grzybicki, Dana M; Raab, Stephen S
Few reports have documented the effectiveness of Lean quality improvement in changing anatomic pathology patient safety. We used Lean methods of education; hoshin kanri goal setting and culture change; kaizen events; observation of work activities, hand-offs, and pathways; A3-problem solving, metric development, and measurement; and frontline work redesign in the accessioning and gross examination areas of an anatomic pathology laboratory. We compared the pre- and post-Lean implementation proportion of near-miss events and changes made in specific work processes. In the implementation phase, we documented 29 individual A3-root cause analyses. The pre- and postimplementation proportions of process- and operator-dependent near-miss events were 5.5 and 1.8 (P < .002) and 0.6 and 0.6, respectively. We conclude that through culture change and implementation of specific work process changes, Lean implementation may improve pathology patient safety.
... AGRICULTURE DIRECT MULTI-FAMILY HOUSING LOANS AND GRANTS Multi-Family Housing Occupancy § 3560.157 Occupancy... access. A copy of these rules must be attached to the tenant's lease upon initial occupancy. At a minimum... office locations, hours, and emergency telephone numbers; (8) The restrictions on storage and...
Chris F Westbury
Full Text Available Bayes’ Rule is a way of calculating conditional probabilities. It is difficult to find an explanation of its relevance that is both mathematically comprehensive and easily accessible to all readers. This article tries to fill that void, by laying out the nature of Bayes’ Rule and its implications for clinicians in a way that assumes little or no background in probability theory. It builds on Meehl & Rosen’s (1955 classic paper, by laying out algebraic proofs that they simply allude to, and by providing extremely simple and intuitively accessible examples of the concepts that they assumed their reader understood, and provides examples of how the rule applies in a variety of clinical settings.
Te-I Albert Tsai
Full Text Available New Urbanist development in the U.S. aims at enhancing a sense of community and seeks to return to the design of early transitional neighborhoods which have pedestrian-oriented environments with retail shops and services within walking distances of housing. Meanwhile, 6000 of Taiwan’s community associations have been running community empowerment programs supported by the Council for Cultural Affairs that have helped many neighborhoods to rebuild so-called community cohesion. This research attempts to evaluate whether neighborhoods with facilities near housing and shorter travel distances within a neighborhood would promote stronger social interactions and form a better community attachment than neighborhoods that have various opportunities for residents to participate in either formal or informal social gatherings. After interviewing and surveying residents from 19 neighborhoods in Taipei’s Beitou District, and correlating the psychological sense of community with inner neighborhood’s daily travel distances and numbers of participatory activities held by community organizations under empowerment programs together with frequencies of regular individual visits and casual meetings, statistical evidence yielded that placing public facilities near residential locations is more effective than providing various programs for elevating a sense of community.
Fenwick, Matthew; Sesanker, Colbert; Schiller, Martin R; Ellis, Heidi Jc; Hinman, M Lee; Vyas, Jay; Gryk, Michael R
Scientists are continually faced with the need to express complex mathematical notions in code. The renaissance of functional languages such as LISP and Haskell is often credited to their ability to implement complex data operations and mathematical constructs in an expressive and natural idiom. The slow adoption of functional computing in the scientific community does not, however, reflect the congeniality of these fields. Unfortunately, the learning curve for adoption of functional programming techniques is steeper than that for more traditional languages in the scientific community, such as Python and Java, and this is partially due to the relative sparseness of available learning resources. To fill this gap, we demonstrate and provide applied, scientifically substantial examples of functional programming, We present a multi-language source-code repository for software integration and algorithm development, which generally focuses on the fields of machine learning, data processing, bioinformatics. We encourage scientists who are interested in learning the basics of functional programming to adopt, reuse, and learn from these examples. The source code is available at: https://github.com/CONNJUR/CONNJUR-Sandbox (see also http://www.connjur.org).
Based on dynamic programming approach we design algorithms for sequential optimization of exact and approximate decision rules relative to the length and coverage [3, 4]. In this paper, we use optimal rules to construct classifiers, and study two questions: (i) which rules are better from the point of view of classification-exact or approximate; and (ii) which order of optimization gives better results of classifier work: length, length+coverage, coverage, or coverage+length. Experimental results show that, on average, classifiers based on exact rules are better than classifiers based on approximate rules, and sequential optimization (length+coverage or coverage+length) is better than the ordinary optimization (length or coverage).
Olive, Geoffrey C.
Improving Web accessibility for disabled users visiting a university's Web site is explored following the World Wide Web Consortium (W3C) guidelines and Section 508 of the Rehabilitation Act rules for Web page designers to ensure accessibility. The literature supports the view that accessibility is sorely lacking, not only in the USA, but also…
ITAINNOVA, Zaragoza, Spain
The AIDA-2020 Transnational Access program offers access to 10 European facilities, including the Electromagnetic Compatibility Laboratory (EMClab) at Instituto Tecnológico de Aragón (ITAINNOVA) in Spain.
Universite catholique de Louvain, Belgium
The AIDA-2020 Transnational Access program offers access to 10 European facilities, including the Centre de Recherche du Cyclotron (CRC) at the Universite catholique de Louvain (UCLouvain) in Belgium.
In this document, the Commission adopts further measures to improve the structure, efficiency, and quality of the video relay service (VRS) program, reducing the inefficiencies in the program, as well as reducing the risk of waste, fraud, and abuse, and ensuring that the program makes full use of advances in commercially-available technology. These measures involve a fundamental restructuring of the program to support innovation and competition, drive down ratepayer and provider costs, eliminate incentives for waste that have burdened the Telecommunications Relay Services (TRS) Fund in the past, and further protect consumers. The Commission adopts several measures in order to: ensure that VRS users can easily select their provider of choice by promoting the development of interoperability and portability standards; enable consumers to use off-the-shelf devices and deploying a VRS application to work with these devices; create a centralized TRS User Registration Database to ensure VRS user eligibility; encourage competition and innovation in VRS call handling services; spur research and development on VRS services by entering into a Memorandum of Understanding with the National Science Foundation; and pilot a National Outreach Program to educate the general public about relay services. In this document, the Commission also adopts new VRS compensation rates that move these rates toward actual costs over the next four years which will better approximate the actual, reasonable costs of providing VRS, and will reduce the costs of operating the program. The Commission takes these steps to ensure the integrity of the TRS Fund while providing stability and certainty to providers.
Medicare and state health care programs: fraud and abuse, civil money penalties and intermediate sanctions for certain violations by health maintenance organizations and competitive medical plans--HHS. Final rule.
This final rule implements sections 9312(c)(2), 9312(f), and 9434(b) of Public Law 99-509, section 7 of Public Law 100-93, section 4014 of Public Law 100-203, sections 224 and 411(k)(12) of Public Law 100-360, and section 6411(d)(3) of Public Law 101-239. These provisions broaden the Secretary's authority to impose intermediate sanctions and civil money penalties on health maintenance organizations (HMOs), competitive medical plans, and other prepaid health plans contracting under Medicare or Medicaid that (1) substantially fail to provide an enrolled individual with required medically necessary items and services; (2) engage in certain marketing, enrollment, reporting, or claims payment abuses; or (3) in the case of Medicare risk-contracting plans, employ or contract with, either directly or indirectly, an individual or entity excluded from participation in Medicare. The provisions also condition Federal financial participation in certain State payments on the State's exclusion of certain prohibited entities from participation in HMO contracts and waiver programs. This final rule is intended to significantly enhance the protections for Medicare beneficiaries and Medicaid recipients enrolled in a HMO, competitive medical plan, or other contracting organization under titles XVIII and XIX of the Social Security Act.
Medicare program; inpatient rehabilitation facility prospective payment system for federal fiscal year 2012; changes in size and square footage of inpatient rehabilitation units and inpatient psychiatric units. Final rule.
This final rule will implement section 3004 of the Affordable Care Act, which establishes a new quality reporting program that provides for a 2 percent reduction in the annual increase factor beginning in 2014 for failure to report quality data to the Secretary of Health and Human Services. This final rule will also update the prospective payment rates for inpatient rehabilitation facilities (IRFs) for Federal fiscal year (FY) 2012 (for discharges occurring on or after October 1, 2011 and on or before September 30, 2012) as required under section 1886(j)(3)(C) of the Social Security Act (the Act). Section 1886(j)(5) of the Act requires the Secretary to publish in the Federal Register on or before the August 1 that precedes the start of each FY the classification and weighting factors for the IRF prospective payment system (PPS) case-mix groups and a description of the methodology and data used in computing the prospective payment rates for that fiscal year. We are also consolidating, clarifying, and revising existing policies regarding IRF hospitals and IRF units of hospitals to eliminate unnecessary confusion and enhance consistency. Furthermore, in accordance with the general principles of the President's January 18, 2011 Executive Order entitled "Improving Regulation and Regulatory Review," we are amending existing regulatory provisions regarding ''new'' facilities and changes in the bed size and square footage of IRFs and inpatient psychiatric facilities (IPFs) to improve clarity and remove obsolete material.
ACCESS (Actively-Corrected Coronograph for Exoplanet System Studies) was one of four medium-class exoplanet concepts selected for the NASA Astrophysics Strategic Mission Concept Study (ASMCS) program in 2008/2009. The ACCESS study evaluated four major coronograph concepts under a common space observatory. This paper describes the high precision pointing control system (PCS) baselined for this observatory.
Characterizes types of indexing programs used by Research Publications, Inc. and describes provision of access to four major projects: "The Official Washington Post Index" (provides access to newspaper and microfilm edition); "The Eighteenth Century"; "The Declassified Documents Reference System" (ongoing fiche…
authorized authoritative databases in IMESA for security , insider threat, and intelligence programs, as applicable. (2) Develop business rules and...protocols pertinent to the file in question, and the guidelines of FBI CJIS Security Policy (Reference (ab)). 2. ADMINISTRATIVE CONTROLS. Those DoD...Workers Identification Credential. Transportation Security Administration issued identification credential for access to secure areas of the nation’s
Lishness, Alan [Gulf Of Maine Research Inst., Portland, ME (United States); Peake, Leigh [Gulf Of Maine Research Inst., Portland, ME (United States)
Under Phase I of the Smart Grid Data Access Pilot Program, the Gulf of Maine Research Institute (GMRI) partnered with Central Maine Power (CMP), and the Maine Mathematics and Science Alliance (MMSA) and engaged key vendors Tilson Government Services, LLC (Tilson), and Image Works to demonstrate the efficacy of PowerHouse, an interactive online learning environment linking middle school students with their home electricity consumption data provided through CMP’s Advanced Metering Infrastructure (AMI). The goal of the program is to harness the power of youth to alter home energy consumption behaviors using AMI data. Successful programs aimed at smoking cessation, recycling, and seat belt use have demonstrated the power of young people to influence household behaviors. In an era of increasing concern about energy costs, availability, and human impacts on global climate, GMRI sought to demonstrate the effectiveness of a student-focused approach to understanding and managing household energy use. We also sought to contribute to a solid foundation of science-literate students who can analyze evidence to find solutions to increasingly complex energy challenges.
Meredith, David M.; Borromeo, Mark D.; Deering, Tye G.; Casey, Bradford H.; Savage, Trisha K.; Mayer, Paul R.; Hoang, Chinh; Tung, Kuang-Chi; Kumar, Manonmani; Shen, Chengcheng; Swift, Galvin H.
The lineage-specific basic helix-loop-helix transcription factor Ptf1a is a critical driver for development of both the pancreas and nervous system. How one transcription factor controls diverse programs of gene expression is a fundamental question in developmental biology. To uncover molecular strategies for the program-specific functions of Ptf1a, we identified bound genomic regions in vivo during development of both tissues. Most regions bound by Ptf1a are specific to each tissue, lie near genes needed for proper formation of each tissue, and coincide with regions of open chromatin. The specificity of Ptf1a binding is encoded in the DNA surrounding the Ptf1a-bound sites, because these regions are sufficient to direct tissue-restricted reporter expression in transgenic mice. Fox and Sox factors were identified as potential lineage-specific modifiers of Ptf1a binding, since binding motifs for these factors are enriched in Ptf1a-bound regions in pancreas and neural tube, respectively. Of the Fox factors expressed during pancreatic development, Foxa2 plays a major role. Indeed, Ptf1a and Foxa2 colocalize in embryonic pancreatic chromatin and can act synergistically in cell transfection assays. Together, these findings indicate that lineage-specific chromatin landscapes likely constrain the DNA binding of Ptf1a, and they identify Fox and Sox gene families as part of this process. PMID:23754747
Oliveira,Stanley R. de M.; Zaïane, Osmar R.; Saygın, Yücel; Saygin, Yucel
The sharing of association rules is often beneficial in industry, but requires privacy safeguards. One may decide to disclose only part of the knowledge and conceal strategic patterns which we call restrictive rules. These restrictive rules must be protected before sharing since they are paramount for strategic decisions and need to remain private. To address this challenging problem, we propose a unified framework for protecting sensitive knowledge before sharing. This framework encompasses:...
Baum, William M
Behavior analysis risks intellectual isolation unless it integrates its explanations with evolutionary theory. Rule-governed behavior is an example of a topic that requires an evolutionary perspective for a full understanding. A rule may be defined as a verbal discriminative stimulus produced by the behavior of a speaker under the stimulus control of a long-term contingency between the behavior and fitness. As a discriminative stimulus, the rule strengthens listener behavior that is reinforce...
Taghian, Mehrdad; Rosbjerg, Dan; Haghighi, Ali
model is developed to optimize simultaneously both the conventional rule curve and the hedging rule. In the compound model, a simple genetic algorithm is coupled with a simulation program, including an inner linear programming algorithm. In this way, operational policies are imposed by priority concepts......As a common approach to reservoir operating policies, water levels at the end of each time interval should be kept at or above the rule curve. In this study, the policy is captured using rationing of the target yield to reduce the intensity of severe water shortages. For this purpose, a hybrid...
Medicare and Medicaid programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; physician-owned hospitals: data sources for expansion exception; physician certification of inpatient hospital services; Medicare Advantage organizations and Part D sponsors: CMS-identified overpayments associated with submitted payment data. Final rule with comment period.
This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2015 to implement applicable statutory requirements and changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. In addition, this final rule with comment period updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program. In this document, we also are making changes to the data sources permitted for expansion requests for physician-owned hospitals under the physician self-referral regulations; changes to the underlying authority for the requirement of an admission order for all hospital inpatient admissions and changes to require physician certification for hospital inpatient admissions only for long-stay cases and outlier cases; and changes to establish a formal process, including a three-level appeals process, to recoup overpayments that result from the submission of erroneous payment data by Medicare Advantage (MA) organizations and Part D sponsors in the limited circumstances in which the organization or sponsor fails to correct these data.
W Vernon, Ty; R Miller, Amber; A Ko, Jordan; C Barrett, Amy; S McGarry, Elizabeth
Adolescents with ASD face numerous personal and contextual barriers that impede the development of social motivation and core competencies, warranting the need for targeted intervention. A randomized controlled trial was conducted with 40 adolescents to evaluate the merits of a multi-component socialization intervention that places emphasis on experiential learning. This investigation evaluated the impact of the 20-week START program on the social functioning of adolescents with ASD. Significant Group × Time differences between START and waitlist control groups were found across multiple measures. Secondary analyses of the entire program cohort also yielded significant improvement trends across all measures. These findings may be an important step in identifying optimal strategies to target the complex factors limiting optimal social development in ASD.
Students in the Environmental Studies major at the University of Southern California fulfill their curriculum requirements by taking a broad range of courses in the social and natural sciences. Climate change is often taught in 1-2 lectures in these courses with limited examination of this complex topic. Several upper division elective courses focus on the science, policy, and social impacts of climate change. In an upper division course focused on the scientific tools used to determine paleoclimate and predict future climate, I have developed a project where students download, manipulate, and analyze data from the National Climatic Data Center. Students are required to download 100 or more years of daily temperature records and use the statistical program R to analyze that data, calculating daily, monthly, and yearly temperature averages along with changes in the number of extreme hot or cold days (≥90˚F and ≤30˚F, respectively). In parallel, they examine population growth, city expansion, and changes in transportation looking for correlations between the social data and trends observed in the temperature data. Students examine trends over time to determine correlations to urban heat island effect. This project exposes students to "real" data, giving them the tools necessary to critically analyze scientific studies without being experts in the field. Utilizing the existing, public, online databases provides almost unlimited, free data. Open source statistical programs provide a cost-free platform for examining the data although some in-class time is required to help students navigate initial data importation and analysis. Results presented will highlight data compiled over three years of course projects.
Ashenafi, Addis; Karim, Ali Mehryar; Ameha, Agazi; Erbo, Amano; Getachew, Nebiyu; Betemariam, Wuleta
In January 2011, Health Extension Workers (HEWs) of Ethiopia's Health Extension Program (HEP) began providing pneumonia case management for children less than five years of age through the integrated Community Case Management (iCCM) strategy. To report the effect of HEP, following the introduction of iCCM, and other accessibility factors on care-seeking behaviors for common childhood illnesses (acute respiratory infection [ARI], diarrhea, and fever). Three possible care-seeking outcomes for childhood illnesses were considered: not seeking appropriate care, seeking care from HEP sources, or seeking care from other appropriate sources. The baseline care-seeking outcomes from the Ethiopian Demographic and Health Survey, 2011, were compared with the care-seeking outcomes in a follow-up iCCM survey in December 2012. The effects of the HEP intensity and other factors on care-seeking outcomes were estimated using regression analyses. Appropriate care-seeking for children with acute respiratory infection, ARI, diarrhea, or fever increased two-fold, from 19% at baseline to 38% at follow-up, mainly due to an increase in seeking care for common child- hood illnesses from HEWs. Higher intensity of the HEP and other accessibility factors were associated with higher care-seeking for childhood illnesses from HEP sources. Incorporating iCCM within the HEP service package significantly improved the appropriate care-seeking behaviors for childhood illnesses in rural Ethiopia.
Koleti, Amar; Terryn, Raymond; Stathias, Vasileios; Chung, Caty; Cooper, Daniel J; Turner, John P; Vidovic, Dušica; Forlin, Michele; Kelley, Tanya T; D'Urso, Alessandro; Allen, Bryce K; Torre, Denis; Jagodnik, Kathleen M; Wang, Lily; Jenkins, Sherry L; Mader, Christopher; Niu, Wen; Fazel, Mehdi; Mahi, Naim; Pilarczyk, Marcin; Clark, Nicholas; Shamsaei, Behrouz; Meller, Jarek; Vasiliauskas, Juozas; Reichard, John; Medvedovic, Mario; Ma'ayan, Avi; Pillai, Ajay; Schürer, Stephan C
The Library of Integrated Network-based Cellular Signatures (LINCS) program is a national consortium funded by the NIH to generate a diverse and extensive reference library of cell-based perturbation-response signatures, along with novel data analytics tools to improve our understanding of human diseases at the systems level. In contrast to other large-scale data generation efforts, LINCS Data and Signature Generation Centers (DSGCs) employ a wide range of assay technologies cataloging diverse cellular responses. Integration of, and unified access to LINCS data has therefore been particularly challenging. The Big Data to Knowledge (BD2K) LINCS Data Coordination and Integration Center (DCIC) has developed data standards specifications, data processing pipelines, and a suite of end-user software tools to integrate and annotate LINCS-generated data, to make LINCS signatures searchable and usable for different types of users. Here, we describe the LINCS Data Portal (LDP) (http://lincsportal.ccs.miami.edu/), a unified web interface to access datasets generated by the LINCS DSGCs, and its underlying database, LINCS Data Registry (LDR). LINCS data served on the LDP contains extensive metadata and curated annotations. We highlight the features of the LDP user interface that is designed to enable search, browsing, exploration, download and analysis of LINCS data and related curated content. © The Author(s) 2017. Published by Oxford University Press on behalf of Nucleic Acids Research.
Full Text Available INTRODUCTION: Uganda scaled-up Early HIV Infant Diagnosis (EID when simplified methods for testing of infants using dried blood spots (DBS were adopted in 2006 and sample transport and management was therefore made feasible in rural settings. Before this time only 35% of the facilities that were providing EID services were reached through the national postal courier system, Posta Uganda. The transportation of samples during this scale-up, therefore, quickly became a challenge and varied from facility to facility as different methods were used to transport the samples. This study evaluates a novel specimen transport network system for EID testing. METHODS: A retrospective study was done in mid-2012 on 19 pilot hubs serving 616 health facilities in Uganda. The effect on sample-result turnaround time (TAT and the cost of DBS sample transport on 876 sample-results was analyzed. RESULTS: The HUB network system provided increased access to EID services ranging from 36% to 51%, drastically reduced transportation costs by 62%, reduced turn-around times by 46.9% and by a further 46.2% through introduction of SMS printers. CONCLUSIONS: The HUB model provides a functional, reliable and efficient national referral network against which other health system strengthening initiatives can be built to increase access to critical diagnostic and treatment monitoring services, improve the quality of laboratory and diagnostic services, with reduced turn-around times and improved quality of prevention and treatment programs thereby reducing long-term costs.
Kiyaga, Charles; Sendagire, Hakim; Joseph, Eleanor; McConnell, Ian; Grosz, Jeff; Narayan, Vijay; Esiru, Godfrey; Elyanu, Peter; Akol, Zainab; Kirungi, Wilford; Musinguzi, Joshua; Opio, Alex
Uganda scaled-up Early HIV Infant Diagnosis (EID) when simplified methods for testing of infants using dried blood spots (DBS) were adopted in 2006 and sample transport and management was therefore made feasible in rural settings. Before this time only 35% of the facilities that were providing EID services were reached through the national postal courier system, Posta Uganda. The transportation of samples during this scale-up, therefore, quickly became a challenge and varied from facility to facility as different methods were used to transport the samples. This study evaluates a novel specimen transport network system for EID testing. A retrospective study was done in mid-2012 on 19 pilot hubs serving 616 health facilities in Uganda. The effect on sample-result turnaround time (TAT) and the cost of DBS sample transport on 876 sample-results was analyzed. The HUB network system provided increased access to EID services ranging from 36% to 51%, drastically reduced transportation costs by 62%, reduced turn-around times by 46.9% and by a further 46.2% through introduction of SMS printers. The HUB model provides a functional, reliable and efficient national referral network against which other health system strengthening initiatives can be built to increase access to critical diagnostic and treatment monitoring services, improve the quality of laboratory and diagnostic services, with reduced turn-around times and improved quality of prevention and treatment programs thereby reducing long-term costs.
Batterink, Laura J; Oudiette, Delphine; Reber, Paul J; Paller, Ken A
Natural languages contain countless regularities. Extraction of these patterns is an essential component of language acquisition. Here we examined the hypothesis that memory processing during sleep contributes to this learning. We exposed participants to a hidden linguistic rule by presenting a large number of two-word phrases, each including a noun preceded by one of four novel words that functioned as an article (e.g., gi rhino). These novel words (ul, gi, ro and ne) were presented as obeying an explicit rule: two words signified that the noun referent was relatively near, and two that it was relatively far. Undisclosed to participants was the fact that the novel articles also predicted noun animacy, with two of the articles preceding animate referents and the other two preceding inanimate referents. Rule acquisition was tested implicitly using a task in which participants responded to each phrase according to whether the noun was animate or inanimate. Learning of the hidden rule was evident in slower responses to phrases that violated the rule. Responses were delayed regardless of whether rule-knowledge was consciously accessible. Brain potentials provided additional confirmation of implicit and explicit rule-knowledge. An afternoon nap was interposed between two 20-min learning sessions. Participants who obtained greater amounts of both slow-wave and rapid-eye-movement sleep showed increased sensitivity to the hidden linguistic rule in the second session. We conclude that during sleep, reactivation of linguistic information linked with the rule was instrumental for stabilizing learning. The combination of slow-wave and rapid-eye-movement sleep may synergistically facilitate the abstraction of complex patterns in linguistic input. Copyright © 2014 Elsevier Ltd. All rights reserved.
Todd, C G; Leslie, K E; Millman, S T; Bielmann, V; Anderson, N G; Sargeant, J M; DeVries, T J
The objectives of this study were to evaluate the effects of free-access acidified milk replacer feeding on the pre- and postweaning health of dairy and veal calves. Individually housed calves were systematically assigned at birth to 1 of 2 feeding programs: free-access feeding (ad libitum) of acidified milk replacer (ACD, n=249) or traditional restricted feeding (3L fed twice daily) of milk replacer (RES, n=249). Calves were fed milk replacer containing 24% crude protein and 18% fat. Acidified milk replacer was prepared to a target pH between 4.0 and 4.5 using formic acid. Calves were weaned off milk replacer at approximately 6wk of age. Weaning occurred over 5d, and during this weaning period, ACD calves had access to milk replacer for 12h/d and RES calves were offered only one feeding of milk replacer (3 L) daily. Calves were monitored daily for signs of disease. Fecal consistency scores were assigned each week from birth until weaning. A subset of calves was systematically selected for fecal sampling at 3 time points between 7 and 27d of age. Fecal samples were analyzed for enterotoxigenic Escherichia coli F5, Cryptosporidium parvum, rotavirus, and coronavirus. Hip width, hip height, body length, heart girth, and body weight were measured at birth and weaning. Postweaning body weight measurements were collected from the heifers at approximately 8mo of age. Postweaning body weight and carcass grading information was collected from the veal calves at slaughter once a live weight between 300 and 350kg had been achieved. The odds of ACD calves being treated for a preweaning disease event tended to be lower than that of the RES calves (1.2 vs. 5.2%, respectively). Preweaning mortality, postweaning disease treatment, and postweaning mortality did not differ between feeding treatments. The ACD feeding treatment supported greater preweaning average daily gain (0.59 vs. 0.43kg/d) and structural growth than RES feeding. Postweaning average daily gain and carcass
Discusses rules of etiquette for communicating via computer networks, including conversing as politely as you would face-to-face; ethical behavior; becoming familiar with the domain that you are in; rules for discussion groups; quality of writing; sharing appropriate knowledge; and respecting individuals' privacy. (LRW)
Keiding, Hans; Peleg, Bezalel
is binary if it is rationalized by an acyclic binary relation. The foregoing result motivates our definition of a binary effectivity rule as the effectivity rule of some binary SCR. A binary SCR is regular if it satisfies unanimity, monotonicity, and independence of infeasible alternatives. A binary...
Bergshoeff, Eric A.; Riccioni, F.
We show that the solitonic branes of ten-dimensional IIA/IIB string theory must satisfy, upon toroidal compactification, a specific wrapping rule in order to reproduce the number of half-supersymmetric solitonic branes that follows from a supergravity analysis. The realization of this wrapping rule
National Center for Educational Research and Development (DHEW/OE), Washington, DC. Panel on Educational Terminology.
This is a revision of the "Rules for Thesaurus Preparation," published in October 1966. These rules are designed to help the Central ERIC staff and the staffs of the ERIC Clearinghouses make similar decisions related to the addition and modification of terms in the "Thesaurus of ERIC Descriptors," Second Edition. In addition to…
Iemhoff, R.; Bezhanishvili, N.; Bezhanishvili, Guram
We introduce stable canonical rules and prove that each normal modal multi-conclusion consequence relation is axiomatizable by stable canonical rules. We apply these results to construct finite refutation patterns for modal formulas, and prove that each normal modal logic is axiomatizable by stable
Bezhanishvili, G.; Bezhanishvili, N.; Iemhoff, R.
We introduce stable canonical rules and prove that each normal modal multi-conclusion consequence relation is axiomatizable by stable canonical rules. We apply these results to construct finite refutation patterns for modal formulas, and prove that each normal modal logic is axiomatizable by stable
....113 Accessing critical energy infrastructure information. (a) Scope. This section governs access to critical energy infrastructure information (CEII). The rules governing submission of CEII are contained in...) Definitions. For purposes of this section: (1) Critical energy infrastructure information means specific...
Richard S. Kay, University of Connecticut-School of Law, Estados Unidos
Full Text Available Abstract: Democracy require protection of certain fundamental rights, but can we expect courts to follow rules? There seems little escape from the proposition that substantive constitutional review by an unelected judiciary is a presumptive abridgement of democratic decision-making. Once we have accepted the proposition that there exist human rights that ought to be protected, this should hardly surprise us. No one thinks courts are perfect translators of the rules invoked before them on every occasion. But it is equally clear that rules sometimes do decide cases. In modern legal systems the relative roles of courts and legislators with respect to the rules of the system is a commonplace. Legislatures make rules. Courts apply them in particular disputes. When we are talking about human rights, however, that assumption must be clarified in at least one way. The defense of the practice of constitutional review in this article assumes courts can and do enforce rules. This article also makes clear what is the meaning of “following rules”. Preference for judicial over legislative interpretation of rights, therefore, seems to hang on the question of whether or not judges are capable of subordinating their own judgment to that incorporated in the rules by their makers. This article maintains that, in general, entrenched constitutional rules (and not just constitutional courts can and do constrain public conduct and protect human rights. The article concludes that the value judgments will depend on our estimate of the benefits we derive from the process of representative self-government. Against those benefits we will have to measure the importance we place on being able to live our lives with the security created by a regime of human rights protected by the rule of law. Keywords: Democracy. Human Rights. Rules. Judicial Review.
Sabde, Yogesh; De Costa, Ayesha; Diwan, Vishal
The government in Madhya Pradesh (MP), India in 2006, launched "Janani Express Yojana" (JE), a decentralized, 24X7, free emergency transport service for all pregnant women under a public-private partnership. JE supports India's large conditional cash transfer program, the "Janani Suraksha Yojana" (JSY) in the province and transports on average 60,000 parturients to hospital every month. The model is a relatively low cost one that potentially could be adopted in other parts of India and South Asia. This paper describes the uptake, time taken and geographic equity in access to the service to transport women to a facility in two districts of MP. This was a facility based cross sectional study. We interviewed parturients (n = 468) who delivered during a five day study period at facilities with >10 deliveries/month (n = 61) in two study districts. The women were asked details of transportation used to arrive at the facility, time taken and their residential addresses. These details were plotted onto a Geographic Information System (GIS) to estimate travelled distances and identify statistically significant clusters of mothers (hot spots) reporting delays >2 hours. JE vehicles were well dispersed across the districts and used by 236 (50.03%) mothers of which 111(47.03%) took >2 hours to reach a facility. Inability of JE vehicle to reach a mother in time was the main reason for delays. There was no correlation between the duration of delay and distance travelled. Maps of the travel paths and travel duration of the women are presented. The study identified hot spots of mothers with delays >2 hours and explored the possible reasons for longer delays. The JE service was accessible in all parts of the districts. Relatively high utilization rates of JE indicate that it ably supported JSY program to draw more women for institutional deliveries. However, half of the JE users experienced long (>2 hour) delays. The delayed mothers clustered in difficult terrains of the districts
This regulation clarifies that entities involved in the financing of the non-Federal share of Medicaid payments must be a unit of government; clarifies the documentation required to support a Medicaid certified public expenditure; limits Medicaid reimbursement for health care providers that are operated by units of government to an amount that does not exceed the health care provider's cost of providing services to Medicaid individuals; requires all health care providers to receive and retain the full amount of total computable payments for services furnished under the approved Medicaid State plan; and makes conforming changes to provisions governing the State Child Health Insurance Program (SCHIP) to make the same requirements applicable, with the exception of the cost limit on reimbursement. The Medicaid cost limit provision of this regulation does not apply to: Stand-alone SCHIP program payments made to governmentally-operated health care providers; Indian Health Service (IHS) facilities and tribal 638 facilities that are paid at the all-inclusive IHS rate; Medicaid Managed Care Organizations (MCOs), Prepaid Inpatient Health Plans (PIHPs), and Prepaid Ambulatory Health Plans (PAHPs); Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs). Moreover, disproportionate share hospital (DSH) payments and payments authorized under Section 701(d) and Section 705 of the Benefits Improvement Protection Act of 2000 are not subject to the newly established Medicaid cost limit for governmentally-operated health care providers. Except as noted above, all Medicaid payments and SCHIP payments made under the authority of the State plan and under waiver and demonstration authorities, as well as associated State Medicaid and SCHIP financing arrangements, are subject to all provisions of this regulation. Finally, this regulation solicits comments from the public on issues related to the definition of the Unit of Government.
Yuruk, Emrah; Tuken, Murat; Colakerol, Aykut; Serefoglu, Ege Can
Smoking is the most important risk factor for bladder cancer and smoking cessation is associated with reduced risk of tumor recurrence and progression. The aim of this study is to assess the awareness of non-muscle invasive bladder cancer (NMIBC) patients regarding the importance of smoking cessation, determine their access to smoking cessation programs and the effects of smoking cessation on recurrence rates of NMIBC. NMIBC patients who were followed with cystoscopy were included in the study. Their demographic properties were recorded, along with their smoking habits, awareness regarding the effects of smoking on bladder cancer and previous attempts for smoking cessation. Moreover, the patients were asked whether they applied for a smoking cessation program. Recurrence of bladder cancer during the follow-up period was also noted. A total of 187 patients were included in the study. The mean age was 64.68±12.05 (range: 15-90) and the male to female ratio was 167/20. At the time of diagnosis, 114 patients (61.0%) were active smokers, 35 patients (18.7%) were ex-smokers and 38 patients (20.3%) had never smoked before. After the diagnosis, 83.3% of the actively smoking patients were advised to quit smoking and 57.9% of them quit smoking. At the time of the study, 46.52% of the NMIBC patients were aware of the link between smoking and bladder cancer, whereas only 4.1% of the smoking patients were referred to smoking cessation programs. After a mean follow-up of 32.28±11.42 months, 84 patients (44.91%) had recurrence; however, current smoking status or awareness of the causative role of smoking on NMIBC did not affect the recurrence. In our study group, the majority of the NMIBC patients were not aware of the association between smoking and bladder cancer. Although most of the physicians advised patients to quit smoking, a significant amount of the patients were still active smokers during follow-up. Only a small proportion of patients were referred to smoking
Saillour-Glénisson, Florence; Duhamel, Sylvie; Fourneyron, Emmanuelle; Huiart, Laetitia; Joseph, Jean Philippe; Langlois, Emmanuel; Pincemail, Stephane; Ramel, Viviane; Renaud, Thomas; Roberts, Tamara; Sibé, Matthieu; Thiessard, Frantz; Wittwer, Jerome; Salmi, Louis Rachid
Improvement of coordination of all health and social care actors in the patient pathways is an important issue in many countries. Health Information (HI) technology has been considered as a potentially effective answer to this issue. The French Health Ministry first funded the development of five TSN ("Territoire de Soins Numérique"/Digital health territories) projects, aiming at improving healthcare coordination and access to information for healthcare providers, patients and the population, and at improving healthcare professionals work organization. The French Health Ministry then launched a call for grant to fund one research project consisting in evaluating the TSN projects implementation and impact and in developing a model for HI technology evaluation. EvaTSN is mainly based on a controlled before-after study design. Data collection covers three periods: before TSN program implementation, during early TSN program implementation and at late TSN program implementation, in the five TSN projects' territories and in five comparison territories. Three populations will be considered: "TSN-targeted people" (healthcare system users and people having characteristics targeted by the TSN projects), "TSN patient users" (people included in TSN experimentations or using particular services) and "TSN professional users" (healthcare professionals involved in TSN projects). Several samples will be made in each population depending on the objective, axis and stage of the study. Four types of data sources are considered: 1) extractions from the French National Heath Insurance Database (SNIIRAM) and the French Autonomy Personalized Allowance database, 2) Ad hoc surveys collecting information on knowledge of TSN projects, TSN program use, ease of use, satisfaction and understanding, TSN pathway experience and appropriateness of hospital admissions, 3) qualitative analyses using semi-directive interviews and focus groups and document analyses and 4) extractions of TSN
It is a commonplace within philosophy that the ontology of institutions can be captured in terms of constitutive rules. What exactly such rules are, however, is not well understood. They are usually contrasted to regulative rules: constitutive rules (such as the rules of chess) make institutional
Optimality of decision rules (patterns) can be measured in many ways. One of these is referred to as length. Length signifies the number of terms in a decision rule and is optimally minimized. Another, coverage represents the width of a rule’s applicability and generality. As such, it is desirable to maximize coverage. A totally optimal decision rule is a decision rule that has the minimum possible length and the maximum possible coverage. This paper presents a method for determining the presence of totally optimal decision rules for “complete” decision tables (representations of total functions in which different variables can have domains of differing values). Depending on the cardinalities of the domains, we can either guarantee for each tuple of values of the function that totally optimal rules exist for each row of the table (as in the case of total Boolean functions where the cardinalities are equal to 2) or, for each row, we can find a tuple of values of the function for which totally optimal rules do not exist for this row.
Grembi, Veronica; Nannicini, Tommaso; Troiano, Ugo
Fiscal rules are laws aimed at reducing the incentive to accumulate debt, and many countries adopt them to discipline local governments. Yet, their effectiveness is disputed because of commitment and enforcement problems. We study their impact applying a quasi-experimental design in Italy. In 1999......, the central government imposed fiscal rules on municipal governments, and in 2001 relaxed them below 5,000 inhabitants. We exploit the before/after and discontinuous policy variation, and show that relaxing fiscal rules increases deficits and lowers taxes. The effect is larger if the mayor can be reelected...
Shooshan Sonya E
Full Text Available Abstract Background: Indexing is a crucial step in any information retrieval system. In MEDLINE, a widely used database of the biomedical literature, the indexing process involves the selection of Medical Subject Headings in order to describe the subject matter of articles. The need for automatic tools to assist MEDLINE indexers in this task is growing with the increasing number of publications being added to MEDLINE. Methods: In this paper, we describe the use and the customization of Inductive Logic Programming (ILP to infer indexing rules that may be used to produce automatic indexing recommendations for MEDLINE indexers. Results: Our results show that this original ILP-based approach outperforms manual rules when they exist. In addition, the use of ILP rules also improves the overall performance of the Medical Text Indexer (MTI, a system producing automatic indexing recommendations for MEDLINE. Conclusion: We expect the sets of ILP rules obtained in this experiment to be integrated into MTI.
Névéol, Aurélie; Shooshan, Sonya E; Claveau, Vincent
Indexing is a crucial step in any information retrieval system. In MEDLINE, a widely used database of the biomedical literature, the indexing process involves the selection of Medical Subject Headings in order to describe the subject matter of articles. The need for automatic tools to assist MEDLINE indexers in this task is growing with the increasing number of publications being added to MEDLINE. In this paper, we describe the use and the customization of Inductive Logic Programming (ILP) to infer indexing rules that may be used to produce automatic indexing recommendations for MEDLINE indexers. Our results show that this original ILP-based approach outperforms manual rules when they exist. In addition, the use of ILP rules also improves the overall performance of the Medical Text Indexer (MTI), a system producing automatic indexing recommendations for MEDLINE. We expect the sets of ILP rules obtained in this experiment to be integrated into MTI.
Puustjärvi, Juha; Puustjärvi, Leena
A business rule defines or constraints some aspect of the business. In healthcare sector many of the business rules are dictated by law or medical regulations, which are constantly changing. This is a challenge for the healthcare organizations. Although there is available several commercial business rule management systems the problem from pharmacies point of view is that these systems are overly geared towards the automation and manipulation of business rules, while the main need in pharmacies lies in easy retrieving of business rules within daily routines. Another problem is that business rule management systems are isolated in the sense that they have their own data stores that cannot be accessed by other information systems used in pharmacies. As a result, a pharmacist is burdened by accessing many systems inside a user task. In order to avoid this problem we have modeled business rules as well as their relationships to other relevant information by OWL (Web Ontology Language) such that the ontology is shared among the pharmacy's applications. In this way we can avoid the problems of isolated applications and replicated data. The ontology also encourages pharmacies business agility, i.e., the ability to react more rapidly to the changes required by the new business rules. The deployment of the ontology requires that stored business rules are annotated by appropriate metadata descriptions, which are presented by RDF/XML serialization format. However, neither the designer nor the pharmacists are burdened by RDF/XML format as there are sophisticated graphical editors that can be used.
Andreyeva, Tatiana; Luedicke, Joerg; Middleton, Ann E; Long, Michael W; Schwartz, Marlene B
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) has important potential for preventing diet-related disease in low-income children. WIC food packages were recently revised to offer foods that better reflect dietary recommendations for Americans. This article reports on how implementation of the new healthier WIC food packages affected access of low-income populations to healthy foods (eg, whole grains, fruit and vegetables, and lower-fat milk). A pre-post store inventory was completed using a standardized instrument to assess availability, variety, quality and prices of WIC-approved foods (65 food items). Stores were assessed before (spring 2009) and shortly after the new WIC package implementation (spring 2010). All convenience stores and nonchain grocery stores located in five towns of Connecticut (N=252), including 33 WIC-authorized stores and 219 non-WIC stores. The healthy food supply score was constructed to summarize postrevision changes in availability, variety, prices of healthy foods, and produce quality. The effect of the WIC food package revisions was measured by differential changes in the scores for stores authorized to accept WIC benefits and stores not participating in WIC, including differences by neighborhood income. Multivariate multilevel regression models were estimated. The 2009 introduction of the revised WIC food packages has significantly improved availability and variety of healthy foods in WIC-authorized and (to a smaller degree) non-WIC convenience and grocery stores. The increase in the composite score of healthy food supply varied from 16% in WIC convenience and grocery stores in higher-income neighborhoods to 39% in lower-income areas. Improved availability and variety of whole-grain products were responsible for most of the increase in the composite score of healthy food supply. Designed as cost-neutral changes, the WIC food package revisions have improved access to healthy foods for WIC participants
Parente, Phillip; Ng, Siobhan; Parnis, Francis; Guminski, Alex; Gurney, Howard
Cabazitaxel is a next generation taxane that has been shown to improve overall survival in patients with metastatic castration-resistant prostate cancer (mCRPC) whose disease progressed during or after docetaxel-based therapy. A worldwide early access program (EAP) study was established to provide access to cabazitaxel ahead of commercial availability and to evaluate its safety and tolerability. The Australian EAP included patient-reported outcomes to evaluate the impact of cabazitaxel on quality of life (QoL). The final safety and QoL results from the Australian EAP for cabazitaxel are reported. Australian patients with mCRPC previously treated with a docetaxel-containing regimen received cabazitaxel (25 mg/m2 ) every 3 weeks plus prednisone/prednisolone (10 mg daily) until disease progression, death, unacceptable toxicity, physician's decision or patient's refusal of further treatment. QoL data was collected using the AQoL-8D questionnaire. 104 patients from 18 Australian sites (median age at baseline, 70) enrolled in the EAP and completed at least one AQoL-8D questionnaire. Patients received a median of 6 cycles of cabazitaxel. 67 patients (64.4%) experienced grade ≥3 treatment-emergent adverse events (TEAEs); the most frequent TEAEs were neutropenia, febrile neutropenia, diarrhoea, and vomiting. QoL scores remained stable with increasing treatment cycles. The results suggest that the safety profile cabazitaxel is manageable in the Australian clinical practice setting and that QoL is maintained with little or no detrimental effect of cabazitaxel in patients continuing on treatment without disease progression. © 2017 John Wiley & Sons Australia, Ltd.
Sydee, Ahmed Nasim
In the first essay, a theoretical model is developed to determine the time path of optimal access price in the telecommunications industry. Determining the optimal access price is an important issue in the economics of telecommunications. Setting a high access price discourages potential entrants; a low access price, on the other hand, amounts to confiscation of private property because the infrastructure already built by the incumbent is sunk. Furthermore, a low access price does not give the incumbent incentives to maintain the current network and to invest in new infrastructures. Much of the existing literature on access pricing suffers either from the limitations of a static framework or from the assumption that all costs are avoidable. The telecommunications industry is subject to high stranded costs and, therefore, to address this issue a dynamic model is imperative. This essay presents a dynamic model of one-way access pricing in which the compensation involved in deregulatory taking is formalized and then analyzed. The short run adjustment after deregulatory taking has occurred is carried out and discussed. The long run equilibrium is also analyzed. A time path for the Ramsey price is shown as the correct dynamic price of access. In the second essay, a theoretical model is developed to determine the time path of optimal access price for an infrastructure that is characterized by congestion and lumpy investment. Much of the theoretical literature on access pricing of infrastructure prescribes that the access price be set at the marginal cost of the infrastructure. In proposing this rule of access pricing, the conventional analysis assumes that infrastructure investments are infinitely divisible so that it makes sense to talk about the marginal cost of investment. Often it is the case that investments in infrastructure are lumpy and can only be made in large chunks, and this renders the marginal cost concept meaningless. In this essay, we formalize a model of
First page Back Continue Last page Overview Graphics. Wireless Access. Wireless connect to the Base station. Easy and Convenient access. Costlier as compared to the wired technology. Reliability challenges. We see it as a complementary technology to the DSL.
... Part 128-1 RIN 1110-AA32 Federal Bureau of Investigation Anti-Piracy Warning Seal Program AGENCY...- Piracy Warning Seal (APW Seal). The proposed rule will provide access to the APW Seal to all copyright... on the day the comment period closes. Discussion. The FBI's Anti-Piracy Warning (APW) Seal is a...
... governs the halibut fishery. The IFQ Program is a limited access system for managing the fixed- gear... definition. The proposed regulations had used the phrase ``constructive total loss,'' which is a term used by... that in the final rule the regulations be revised to define the phrase ``constructive total loss'' to...
reviewed and high quality, there are a number of questionable journals, i.e. journals that do not subscribe to most or any of the practices of legitimate, academic journals. There is no single rule or test to indicate whether an open access journal ...
... circumvention of copyright protection systems for access control technologies which was published July 27, 2010... for Access Control Technologies AGENCY: Copyright Office, Library of Congress. ACTION: Final Rule... prohibition against circumvention of technological measures that effectively control access to copyrighted...
Newton, Amanda S; Wozney, Lori; Bagnell, Alexa; Fitzpatrick, Eleanor; Curtis, Sarah; Jabbour, Mona; Johnson, David; Rosychuk, Rhonda J; Young, Michael; Ohinmaa, Arto; Joyce, Anthony; McGrath, Patrick
There is a demand to make first-line treatments, including cognitive behavioural therapy (CBT) for adolescent anxiety disorders, more widely available. Internet-based CBT is proposed to circumvent access and availability barriers and reduce health care system costs. Recent reviews suggest more evidence is needed to establish the treatment effects of Internet-based CBT in children and adolescents and to determine related economic impacts. This pilot trial aims to collect the necessary data to inform the planning of a full-scale RCT to test the effectiveness of the Internet-based CBT program Breathe (Being Real, Easing Anxiety: Tools Helping Electronically). We are conducting a 27-month, 2-arm parallel-group, pilot randomized controlled trial (RCT). Outcomes will inform the planning of a full-scale RCT aimed to test the effectiveness of Internet-based CBT with a population of adolescents with moderate to mild anxiety problems. In the pilot RCT we will: (1) define a minimal clinically important difference (MCID) for the primary outcome measure (total anxiety score using the Multidimensional Anxiety Scale for Children); (2) determine a sample size for the full-scale RCT; (3) estimate recruitment and retention rates; (4) measure intervention acceptability to inform critical intervention changes; (5) determine the use of co-interventions; and (6) conduct a cost-consequence analysis to inform a cost-effectiveness analysis in the full-scale RCT. Adolescents aged 13-17 years seeking care for an anxiety complaint from a participating emergency department, mobile or school-based crisis team, or primary care clinic are being screened for interest and eligibility. Enrolled adolescents are being randomly allocated to either 8 weeks of Internet-based CBT with limited telephone and e-mail support, or a control group with access to a static webpage listing anxiety resources. Adolescents are randomly assigned using a computer generated allocation sequence. Data are being collected
The 11th edition of the Staff Rules and Regulations, dated 1 January 2007, adopted by the Council and the Finance Committee in December 2006, is currently being distributed to departmental secretariats. The Staff Rules and Regulations, together with a summary of the main modifications made, will be available, as from next week, on the Human Resources Department's intranet site: http://cern.ch/hr-web/internal/admin_services/rules/default.asp The main changes made to the Staff Rules and Regulations stem from the five-yearly review of employment conditions of members of the personnel. The changes notably relate to: the categories of members of the personnel (e.g. removal of the local staff category); the careers structure and the merit recognition system; the non-residence, installation and re-installation allowances; the definition of family, family allowances and family-related leave; recognition of partnerships; education fees. The administrative circulars, some of which are being revised following the ...
The Revised Total Coliform Rule (RTCR) aims to increase public health protection through the reduction of potential pathways for fecal contamination in the distribution system of a public water system (PWS).
Ferraz, Inhaúma Neves; Garcia, Ana Cristina Bicharra
.... Although most data mining techniques, such as the use of association rules, may substantially reduce the search effort over large data sets, often, the consequential outcomes surpass the amount...
Open access week Van 19 tot en met 25 oktober 2015 vond wereldwijd de Open Access Week plaats. Tijdens deze week werden er over de hele wereld evenementen georganiseerd waar open access een rol speelt. Ook in Nederland zijn er diverse symposia, workshops en debatten georganiseerd zoals het debat in
The American Geological Institute Minority Participation Program (MPP): Thirty Years of Improving Access to Opportunities in the Geosciences Through Undergraduate and Graduate Scholarships for Underrepresented Minorities
Callahan, C. N.; Byerly, G. R.; Smith, M. J.
are used to gauge the needs of the scholar, and to access the success of the overall program. The MPP Advisory Committee aims to match the profession of the mentor with the scholar's academic interest. Throughout the year, mentors and scholars communicate about possible opportunities in the geosciences such as internships, participation in symposia, professional society meetings, and job openings. Mentors have also been active in helping younger students cope with the major changes involved in relocating to a new region of the country or a new college culture. We believe that AGI is well positioned to advance diversity in the geosciences through its unique standing as the major professional organization in the geosciences. AGI maintains strong links to its professional Member Societies, state and federal agencies and funding programs, many with distinctive programs in the geoscience education. AGI Corporate Associates have consistently pledged to support diversity issues in geoscience education. Current plans include seeking funding for 48 undergraduate awards at \\2500 each and \\24,000 to support undergraduate travel to professional meetings. We also expect to increase the size of our graduate scholarship program to 30 students and raise an additional \\$30,000 to support graduate travel to professional meetings.
... Equities (Anti-Money Laundering Compliance Program) and adopt new Rule 3310--NYSE Amex Equities (Anti-Money..., subject to certain amendments, NASD Rule 3011 (Anti- Money Laundering Compliance Program) and related Interpretive Material NASD IM-3011-1 and 3011-2 as consolidated FINRA Rule 3310 (Anti-Money Laundering...
... operating rules, or a railroad's program under § 217.9 of this chapter, will not be considered a legitimate... 49 Transportation 4 2010-10-01 2010-10-01 false Criteria for consideration of operating rules... operating rules compliance data. (a) Each railroad's program shall include criteria and procedures for...
VISITS The rules and conditions to be followed for visits in the SM18 Hall are laid out in the EDMS 1205328 document. No visit is allowed without prior reservation. ACCESS Special access right is needed ONLY from 7 p.m. to 7 a.m. and during week-ends. From 1 December, the current SM18 access database will be closed and a new one “SM18-OWH outside normal hours” started from scratch. Requests, via EDH SM18-OWH, will have to be duly justified. For further information, please contact Evelyne Delucinge.
Ölmezoğulları, E.; Arı, İsmail
Due to copyright restrictions, the access to the full text of this article is only available via subscription. To extract useful and actionable information in real-time, the information technology (IT) world is coping with big data problems today. In this paper, we present implementation details and performance results of ReCEPtor, our system for "online" Association Rule Mining (ARM) over big and fast data streams. Specifically, we added Apriori and two different FP-Growth algorithms insi...
Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2017 Rates; Quality Reporting Requirements for Specific Providers; Graduate Medical Education; Hospital Notification Procedures Applicable to Beneficiaries Receiving Observation Services; Technical Changes Relating to Costs to Organizations and Medicare Cost Reports; Finalization of Interim Final Rules With Comment Period on LTCH PPS Payments for Severe Wounds, Modifications of Limitations on Redesignation by the Medicare Geographic Classification Review Board, and Extensions of Payments to MDHs and Low-Volume Hospitals. Final rule.
We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2017. Some of these changes will implement certain statutory provisions contained in the Pathway for Sustainable Growth Reform Act of 2013, the Improving Medicare Post-Acute Care Transformation Act of 2014, the Notice of Observation Treatment and Implications for Care Eligibility Act of 2015, and other legislation. We also are providing the estimated market basket update to apply to the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits for FY 2017. We are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) for FY 2017. In addition, we are making changes relating to direct graduate medical education (GME) and indirect medical education payments; establishing new requirements or revising existing requirements for quality reporting by specific Medicare providers (acute care hospitals, PPS-exempt cancer hospitals, LTCHs, and inpatient psychiatric facilities), including related provisions for eligible hospitals and critical access hospitals (CAHs) participating in the Electronic Health Record Incentive Program; updating policies relating to the Hospital Value-Based Purchasing Program, the Hospital Readmissions Reduction Program, and the Hospital-Acquired Condition Reduction Program; implementing statutory provisions that require hospitals and CAHs to furnish notification to Medicare beneficiaries, including Medicare Advantage enrollees, when the beneficiaries receive outpatient observation services for more than 24 hours; announcing the implementation of the Frontier Community Health Integration Project Demonstration; and
A Pilot Randomized Controlled Trial of the ACCESS Program: A Group Intervention to Improve Social, Adaptive Functioning, Stress Coping, and Self-Determination Outcomes in Young Adults with Autism Spectrum Disorder.
Oswald, Tasha M; Winder-Patel, Breanna; Ruder, Steven; Xing, Guibo; Stahmer, Aubyn; Solomon, Marjorie
The purpose of this pilot randomized controlled trial was to investigate the acceptability and efficacy of the Acquiring Career, Coping, Executive control, Social Skills (ACCESS) Program, a group intervention tailored for young adults with autism spectrum disorder (ASD) to enhance critical skills and beliefs that promote adult functioning, including social and adaptive skills, self-determination skills, and coping self-efficacy. Forty-four adults with ASD (ages 18-38; 13 females) and their caregivers were randomly assigned to treatment or waitlist control. Compared to controls, adults in treatment significantly improved in adaptive and self-determination skills, per caregiver report, and self-reported greater belief in their ability to access social support to cope with stressors. Results provide evidence for the acceptability and efficacy of the ACCESS Program.
Callaghan-Koru, Jennifer A; Hyder, Adnan A; George, Asha; Gilroy, Kate E; Nsona, Humphreys; Mtimuni, Angella; Bryce, Jennifer
Community case management (CCM) is a promising task-shifting strategy for expanding treatment of childhood illness that is increasingly adopted by low-income countries. Its success depends in part on how the strategy is perceived by those responsible for its implementation. This study uses qualitative methods to explore health workers' and managers' perceptions about CCM provided by health surveillance assistants (HSAs) during the program's first year in Malawi. Managers and HSAs agreed that CCM contributed beneficially by expanding access to the underserved and reducing caseloads at health facilities. Managers differed among themselves in their endorsements of CCM, most offered constrained endorsement, and a few had stronger justifications for CCM. In addition, HSAs uniformly wanted continued expansion of their clinical role, while managers preferred to view CCM as a limited mandate. The HSAs also reported motivating factors and frustrations related to system constraints and community pressures related to CCM. The impact of CCM on motivation and workload of HSAs is noted and deserves further attention.