WorldWideScience

Sample records for stamps medicaid housing

  1. How Do Stamp Duties Affect the Housing Market?

    OpenAIRE

    Davidoff, Ian; Leigh, Andrew

    2013-01-01

    Land transfer taxes are a substantial portion of the cost of moving house in many developed countries. Since stamp duties are endogenous with respect to the house price, we create an instrumental variable that is the stamp duty on a property, given that postcode's starting house price and the national house price trend. In a specification with postcode and year fixed effects, this instrument effectively captures policy changes and nonlinearities in the stamp duty schedule. We find that the im...

  2. State strategies for coordinating Medicaid and housing services.

    Science.gov (United States)

    Kleinman, Rebecca; Kehn, Matthew; Wishon Siegwarth, Allison; Brown, Jonathan

    2017-06-01

    This article reports findings from case studies of 4 states (Illinois, Louisiana, Massachusetts, and Tennessee) that used different approaches to coordinate Medicaid services with temporary or permanent housing supports for individuals with psychiatric disabilities. Data were collected through document review, telephone interviews with state officials and managed care organizations, and site visits to behavioral health and housing providers, and consumer organizations. Qualitative analyses focused on identifying key features of each state's approach, including the strengths and limitations from multiple perspectives. All 4 states facilitated partnerships between behavioral health and housing providers. Each state used managed care strategies to some degree and identified opportunities to use Medicaid to finance the coordination of services with housing providers. These financing strategies included using flexible case rates to fund community support workers; using a 1915(i) state plan amendment to fund intensive Medicaid behavioral health services for those in permanent supportive housing; funding new local entities to support local partnerships between health and housing organizations; and creating a Medicaid supportive housing benefit. These 4 states took advantage of the flexibility that Medicaid offers to implement different service models in an effort to improve the coordination of behavioral health services and housing. The strategies used in these states may be useful to other states and communities seeking to strengthen coordination of care for individuals who require housing support. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  3. Simulation Study on Hot Stamping Forming of the Drive Axle Housing of Heavy Truck

    Science.gov (United States)

    Dai, Yongqian; Ji, Jianyi; Luo, Lingjiang

    2018-01-01

    Aiming at the national energy-saving and emission reduction requirements, lightweight of the heavy truck is imminent. Several parameters related to hot stamping forming process of heavy truck drive axle housing are studied in this paper. The results show that the existing two-step stamping with air cooling molding process, can be improved into one-step hot stamping process. The initial temperature of the blank, stamping speed and other parameters related to the forming process were optimized. The results provides useful reference for improving the existing forming process of the drive axle housing, and it is also helpful for realizing the lightweight design of drive axle housing.

  4. The Confluence of Sociology, Statistics, and Public Policy in the Quality Control of the Food Stamps, AFDC, and Medicaid Family Assistance Programs.

    Science.gov (United States)

    Press, S. James; Tanur, Judith M.

    1991-01-01

    Relevance of the intersection of sociology, statistics, and public policy to the study of quality control in three family assistance programs--food stamps, Aid to Families with Dependent Children (AFDC), and Medicaid--is reviewed using a study by the National Academy of Sciences of methods for improving quality control systems. (SLD)

  5. Impact of a New York City supportive housing program on Medicaid expenditure patterns among people with serious mental illness and chronic homelessness.

    Science.gov (United States)

    Lim, Sungwoo; Gao, Qi; Stazesky, Elsa; Singh, Tejinder P; Harris, Tiffany G; Levanon Seligson, Amber

    2018-01-10

    A rapid increase of Medicaid expenditures has been a serious concern, and housing stability has been discussed as a means to reduce Medicaid costs. A program evaluation of a New York City supportive housing program has assessed the association between supportive housing tenancy and Medicaid savings among New York City housing program applicants with serious mental illness and chronic homelessness or dual diagnoses of mental illness and substance use disorder, stratified by distinctive Medicaid expenditure patterns. The evaluation used matched data from administrative records for 2827 people. Sequence analysis identified 6 Medicaid expenditure patterns during 2 years prior to baseline among people placed in the program (n = 737) and people eligible but not placed (n = 2090), including very low Medicaid coverage, increasing Medicaid expenditure, low, middle, high, and very high Medicaid expenditure patterns. We assessed the impact of the program on Medicaid costs for 2 years post-baseline via propensity score matching and bootstrapping. The housing program was associated with Medicaid savings during 2 years post-baseline (-$9526, 95% CI = -$19,038 to -$2003). Stratified by Medicaid expenditure patterns, Medicaid savings were found among those with very low Medicaid coverage (-$15,694, 95% CI = -$35,926 to -$7983), increasing Medicaid expenditures (-$9020, 95% CI = -$26,753 to -$1705), and high Medicaid expenditure patterns (-$14,450, 95% CI = -$38,232 to -$4454). Savings were largely driven by shorter psychiatric hospitalizations in the post-baseline period among those placed. The supportive housing program was associated with Medicaid savings, particularly for individuals with very low Medicaid coverage, increasing Medicaid expenditures, and high Medicaid expenditures pre-baseline.

  6. Expanded Medicaid Provides Access to Substance Use, Mental Health, and Physician Visits to Homeless and Precariously Housed Persons.

    Science.gov (United States)

    Parker, R David; Cima, Michael J; Brown, Zachary; Regier, Michael

    2018-04-01

    To describe the Medicaid costs associated with persons who are homeless or unstably housed. A retrospective secondary data analysis linked Medicaid recipient data with a statewide homeless management information system. A total of 19,950 persons received a housing service between 2012 and 2015 including 14,136 persons with Medicaid. Five of the most frequent diagnoses were substance abuse or mental health conditions in 42.83% of all diagnoses. The most frequent service was outpatient mental health and emergency department physician services. These costs totaled $166,653,689 with prescription drug costs at $62,800,463, with a total cost of $672,242,449, averaging $14,632.42 per 12-month period per person. The potential changes in Medicaid could lead to cost transfers or a reduction in services. Recognizing these are significant costs by homeless and unstably housed persons only, these high costs warrant the determination of points in care where effective cost saving interventions may be employed.

  7. Why Stamp Duties are an Increasing Financial Burden on Australian Home Buyers

    OpenAIRE

    Wood, Gavin A.

    1994-01-01

    The purchaser of housing incurs stamp duty liabilities in all Australian States. These stamp duties are levied on the conveyance of residential property and mortgage sums secured. In general, stamp duties were a growing financial burden on home buyers during the period 1985-1991. This paper examines the role of house price inflation in causing increases in average rates of stamp duty, the responsiveness of average rates of stamp duty to future changes in the nominal tax base and the effective...

  8. Stamping through astronomy

    CERN Document Server

    Dicati, Renato

    2013-01-01

    Stamps and other postal documents are an attractive vehicle for presenting astronomy and its development. Written with expertise and great enthusiasm, this unique book offers a historical and philatelic survey of astronomy and some related topics on space exploration. It contains more than 1300 color reproductions of stamps relating to the history of astronomy, ranging from the earliest observations of the sky to modern research conducted with satellites and space probes. Featured are the astronomers and astrophysicists who contributed to this marvelous story – not only Ptolemy, Copernicus, Kepler, Newton, Herschel, and Einstein but also hundreds of other minor protagonists who played an important role in the development of this, the most ancient yet the most modern of all the sciences. The book also examines in depth the diverse areas which have contributed to the history of astronomy, including the instrumentation, the theories, and the observations. Many stamps illustrate the beauty and the mystery of ce...

  9. Prenatal Care: Medicaid Recipients and Uninsured Women Obtain Insufficient Care. Report to the Chairman, Subcommittee on Human Resources and Intergovernmental Relations, Committee on Government Operations, House of Representatives.

    Science.gov (United States)

    General Accounting Office, Washington, DC. Div. of Human Resources.

    Women who had no health insurance or who were enrolled in Medicaid were interviewed to determine the extent of their prenatal care. Those most likely to obtain insufficient care were the women who were uninsured, poorly educated, Black or Hispanic, or teenagers from large urban areas. Barriers to earlier or more frequent prenatal care were the…

  10. Rapid thermal processing by stamping

    Science.gov (United States)

    Stradins, Pauls; Wang, Qi

    2013-03-05

    A rapid thermal processing device and methods are provided for thermal processing of samples such as semiconductor wafers. The device has components including a stamp (35) having a stamping surface and a heater or cooler (40) to bring it to a selected processing temperature, a sample holder (20) for holding a sample (10) in position for intimate contact with the stamping surface; and positioning components (25) for moving the stamping surface and the stamp (35) in and away from intimate, substantially non-pressured contact. Methods for using and making such devices are also provided. These devices and methods allow inexpensive, efficient, easily controllable thermal processing.

  11. Medicaid Drug Claims Statistics

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Medicaid Drug Claims Statistics CD is a useful tool that conveniently breaks up Medicaid claim counts and separates them by quarter and includes an annual count.

  12. Slashes to Medicaid pose threat to PWAs.

    Science.gov (United States)

    1995-01-01

    Congressional proposals are calling for cuts in Medicaid of up to $180 billion over the next 7 years. Because Medicaid is the largest source of health insurance for people living with HIV, the AIDS Action Council is educating policy makers about what is at stake. The Council's work has included testimony before the House Commerce Committee Subcommittee on Health and Environment and participation in a White House briefing on Medicaid sponsored by National AIDS Policy Director, Patsy Fleming, and Clinton's Special Assistant on Health Policy, Chris Jennings. At the briefing, Jennings assured participants that the President pledges to preserve Medicaid's entitlement status and keep cuts well under the Republicans' proposed cut of $182 billion. AIDS Action also prepared fact sheets for 10 states that detail the reliance of the HIV/AIDS community on Medicaid in each of those states. They are also supporting a postcard and telephone campaign organized by the Save Our Security Coalition (SOS), spearheaded by the health policy group Families USA. The postcards oppose Medicare and Medicaid cuts and ask the President to veto any such cuts.

  13. Flexible Stamp for Nanoimprint Lithography

    DEFF Research Database (Denmark)

    Nielsen, Theodor; Pedersen, Rasmus H.; Hansen, Ole

    2005-01-01

    by membranes. The bending stiffness difference between the imprint areas and the membranes ensures that the deformation of the stamp during the imprint process mainly takes place in the membranes, leaving the imprint structures unaffected. By this design the strong demand to the parallelism between stamp...... and substrate in the imprint situation is decoupled from the pressing tool and the wafer quality. The stamp consist of 1562 imprint areas (1 mm × 1 mm) containing the patterns to be replicated. The imprinted patterns are characterized with respect to the imprint depth and the polymer residual layer thickness...

  14. Fabrication of Nanoimprint stamps for photonic crystals

    International Nuclear Information System (INIS)

    Kouba, J; Kubenz, M; Mai, A; Ropers, G; Eberhardt, W; Loechel, B

    2006-01-01

    We report on fabrication of nanoimprint stamps for fabrication of two dimensional photonic crystals in visible range of spectra. Nanoimprint stamps made of silicon and/or nickel were successfully fabricated using electron beam lithography and advanced dry etching techniques. The quality of the stamps was evaluated using scanning electron microscopy. The fabricated stamps were also evaluated by imprinting them into suitable polymer materials

  15. Implementation of time stamping service

    OpenAIRE

    Tomažin , Vito

    2015-01-01

    This thesis deals with different ways of how to safely time-stamp digital content. The need for time-stamping arises when we would like to create evidence that certain content existed (or that a certain person was present somewhere) in a precisely specified period of time, so that later we can refer to this evidence. Creating temporal order in the digital world can prove to be difficult, since no data, including time, is recorded permanently. The system clock, which measures time with the ...

  16. Food Stamps. Learning Packet No. 2.

    Science.gov (United States)

    American Bar Association, Washington, DC. Clearinghouse for Offender Literacy Programs.

    This package of instructional materials is designed to aid adults in prison to perform the functional skill of applying for food stamps. The materials consist of instructions for teachers, a sample application for food stamps, a student's work sheet and answer sheet, vocabulary flash cards, and resource materials on food stamps. (MKM)

  17. 7 CFR 916.115 - Lot stamping.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Lot stamping. 916.115 Section 916.115 Agriculture... and Regulations § 916.115 Lot stamping. Except when loaded directly into railway cars, exempted under... Inspection Service lot stamp number, assigned by such Service, showing that such fruit has been USDA...

  18. 7 CFR 917.150 - Lot stamping.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Lot stamping. 917.150 Section 917.150 Agriculture... CALIFORNIA Rules and Regulations Regulation of Daily Shipments § 917.150 Lot stamping. Except when loaded..., prior to shipment, with a Federal-State Inspection Service lot stamp number, assigned by such Service...

  19. Stamp Verification for Automated Document Authentication

    DEFF Research Database (Denmark)

    Micenková, Barbora; van Beusekom, Joost; Shafait, Faisal

    Stamps, along with signatures, can be considered as the most widely used extrinsic security feature in paper documents. In contrast to signatures, however, for stamps little work has been done to automatically verify their authenticity. In this paper, an approach for verification of color stamps ...

  20. Medicaid and Rural Health

    Science.gov (United States)

    ... Reimbursement Economic Impact Analysis Tool Rural Health IT Curriculum Resources Sustainability Planning Tools Testing New Approaches RHIhub ... the Centers of Medicare and Medicaid website. What types of challenges do rural providers face related to ...

  1. Medicaid CHIP ESPC Database

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Environmental Scanning and Program Characteristic (ESPC) Database is in a Microsoft (MS) Access format and contains Medicaid and CHIP data, for the 50 states and...

  2. Stamping the Earth from space

    CERN Document Server

    Dicati, Renato

    2017-01-01

    This unique book presents a historical and philatelic survey of Earth exploration from space. It covers all areas of research in which artificial satellites have contributed in designing a new image of our planet and its environment: the atmosphere and ionosphere, the magnetic field, radiation belts and the magnetosphere, weather, remote sensing, mapping of the surface, observation of the oceans and marine environments, geodesy, and the study of life and ecological systems. Stamping the Earth from Space presents the results obtained with the thousands of satellites launched by the two former superpowers, the Soviet Union and the United States, and also those of the many missions carried out by the ESA, individual European countries, Japan, China, India, and the many emerging space nations. Beautifully illustrated, it contains almost 1100 color reproductions of philatelic items. In addition to topical stamps and thematic postal documents, the book provides an extensive review of astrophilatelic items. The most...

  3. Medicaid Disproportionate Share Hospital Payments

    Data.gov (United States)

    U.S. Department of Health & Human Services — Medicaid Disproportionate Share Hospital (DSH) Payments This link provides you with information about Medicaid DSH Payments. You can find information on DSH Audit...

  4. Medicare and Medicaid Linked Files

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Medicare-Medicaid Linked Enrollee Analytic Data Source (MMLEADS) has been developed to allow for the examination of all Medicare and Medicaid enrollment and...

  5. Medicaid Moving Forward

    Science.gov (United States)

    ... net hospitals and health centers that serve low-income communities, including many of the uninsured. It is also the main source of coverage and financing for both nursing home and community-based long-term care. Altogether, Medicaid finances 16% of ...

  6. The STAMP Software for State Space Models

    Directory of Open Access Journals (Sweden)

    Roy Mendelssohn

    2011-05-01

    Full Text Available This paper reviews the use of STAMP (Structural Time Series Analyser, Modeler and Predictor for modeling time series data using state-space methods with unobserved components. STAMP is a commercial, GUI-based program that runs on Windows, Linux and Macintosh computers as part of the larger OxMetrics System. STAMP can estimate a wide-variety of both univariate and multivariate state-space models, provides a wide array of diagnostics, and has a batch mode capability. The use of STAMP is illustrated for the Nile river data which is analyzed throughout this issue, as well as by modeling a variety of oceanographic and climate related data sets. The analyses of the oceanographic and climate data illustrate the breadth of models available in STAMP, and that state-space methods produce results that provide new insights into important scientific problems.

  7. Frequent Emergency Department Visits and Hospitalizations Among Homeless People With Medicaid: Implications for Medicaid Expansion.

    Science.gov (United States)

    Lin, Wen-Chieh; Bharel, Monica; Zhang, Jianying; O'Connell, Elizabeth; Clark, Robin E

    2015-11-01

    We examined factors associated with frequent hospitalizations and emergency department (ED) visits among Medicaid members who were homeless. We included 6494 Massachusetts Medicaid members who received services from a health care for the homeless program in 2010. We used negative binomial regression to examine variables associated with frequent utilization. Approximately one third of the study population had at least 1 hospitalization and two thirds had 1 or more ED visits. More than 70% of hospitalizations and ED visits were incurred by only 12% and 21% of these members, respectively. Homeless individuals with co-occurring mental illness and substance use disorders were at greatest risk for frequent hospitalizations and ED visits (e.g., incidence rate ratios [IRRs] = 2.9-13.8 for hospitalizations). Individuals living on the streets also had significantly higher utilization (IRR = 1.5). Despite having insurance coverage, homeless Medicaid members experienced frequent hospitalizations and ED visits. States could consider provisions under the Patient Protection and Affordable Care Act (e.g., Medicaid expansion and Health Homes) jointly with housing programs to meet the needs of homeless individuals, which may improve the quality and cost effectiveness of care.

  8. Time Stamps for Fixed-Point Approximation

    DEFF Research Database (Denmark)

    Damian, Daniela

    2001-01-01

    Time stamps were introduced in Shivers's PhD thesis for approximating the result of a control-flow analysis. We show them to be suitable for computing program analyses where the space of results (e.g., control-flow graphs) is large. We formalize time-stamping as a top-down, fixed-point approximat......Time stamps were introduced in Shivers's PhD thesis for approximating the result of a control-flow analysis. We show them to be suitable for computing program analyses where the space of results (e.g., control-flow graphs) is large. We formalize time-stamping as a top-down, fixed...

  9. Medicaid expansion and mental health: A Minnesota case study.

    Science.gov (United States)

    Diaz Vickery, Katherine; Guzman-Corrales, Laura; Owen, Ross; Soderlund, Dana; Shimotsu, Scott; Clifford, Pam; Linzer, Mark

    2016-03-01

    The health status and psychosocial needs of the Medicaid expansion population have been estimated but not measured. This population includes childless adults predicted to have high rates of mental illness, especially among the homeless. Given limitations in access to mental health services, it is unclear how prepared the U.S. health care system is to care for the needs of the expansion population. Using enrollment and claims data from the Minnesota Department of Human Services, this study presents prevalence rates of mental illness diagnoses and measures of unstable housing in Minnesota's childless-adult early Medicaid expansion population. Rates are compared with prior predictions of serious psychological distress and mental illness constructed from the National Survey on Drug Use and Health (NSDUH) using χ2 and t tests. Diagnoses of mental illness in Minnesota's childless-adult early Medicaid expansion population were more than 15% higher than prevalence measures of mental illness/distress for the current Medicaid population. Diagnosis rates fell within confidence intervals of estimates of mental illness for Minnesota's Medicaid expansion population. Almost 1 in 3 enrollees had a marker of unstable housing; of this group, half had mental illness and/or distress. Findings support predictions of the high burden of mental illness and unstable housing among the Medicaid expansion population. Minnesota offers lessons to other regions working to care for such populations: (a) the use of flexible financing structures to build integrated care systems and (b) passage of legislation to allow data sharing among mental health, social services, and medical care. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  10. Stamping SERS for creatinine sensing

    Science.gov (United States)

    Li, Ming; Du, Yong; Zhao, Fusheng; Zeng, Jianbo; Santos, Greggy M.; Mohan, Chandra; Shih, Wei-Chuan

    2015-03-01

    Urine can be obtained easily, readily and non-invasively. The analysis of urine can provide metabolic information of the body and the condition of renal function. Creatinine is one of the major components of human urine associated with muscle metabolism. Since the content of creatinine excreted into urine is relatively constant, it is used as an internal standard to normalize water variations. Moreover, the detection of creatinine concentration in urine is important for the renal clearance test, which can monitor the filtration function of kidney and health status. In more details, kidney failure can be imminent when the creatinine concentration in urine is high. A simple device and protocol for creatinine sensing in urine samples can be valuable for point-of-care applications. We reported quantitative analysis of creatinine in urine samples by using stamping surface enhanced Raman scattering (S-SERS) technique with nanoporous gold disk (NPGD) based SERS substrate. S-SERS technique enables label-free and multiplexed molecular sensing under dry condition, while NPGD provides a robust, controllable, and high-sensitivity SERS substrate. The performance of S-SERS with NGPDs is evaluated by the detection and quantification of pure creatinine and creatinine in artificial urine within physiologically relevant concentration ranges.

  11. Medicaid Analytic eXtract (MAX) Chartbooks

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Medicaid Analytic eXtract Chartbooks are research tools and reference guides on Medicaid enrollees and their Medicaid experience in 2002 and 2004. Developed for...

  12. Medicaid Enrollment Data Collected through MBES

    Data.gov (United States)

    U.S. Department of Health & Human Services — For the quarter beginning with January 1, 2014, states began reporting Medicaid enrollment data as part of their Medicaid expenditure reporting through the Medicaid...

  13. Evolutions of Advanced Stamping CAE — Technology Adventures and Business Impact on Automotive Dies and Stamping

    Science.gov (United States)

    Wang, Chuantao (C. T.)

    2005-08-01

    In the past decade, sheet metal forming and die development has been transformed to a science-based and technology-driven engineering and manufacturing enterprise from a tryout-based craft. Stamping CAE, especially the sheet metal forming simulation, as one of the core components in digital die making and digital stamping, has played a key role in this historical transition. The stamping simulation technology and its industrial applications have greatly impacted automotive sheet metal product design, die developments, die construction and tryout, and production stamping. The stamping CAE community has successfully resolved the traditional formability problems such as splits and wrinkles. The evolution of the stamping CAE technology and business demands opens even greater opportunities and challenges to stamping CAE community in the areas of (1) continuously improving simulation accuracy, drastically reducing simulation time-in-system, and improving operationalability (friendliness), (2) resolving those historically difficult-to-resolve problems such as dimensional quality problems (springback and twist) and surface quality problems (distortion and skid/impact lines), (3) resolving total manufacturability problems in line die operations including blanking, draw/redraw, trim/piercing, and flanging, and (4) overcoming new problems in forming new sheet materials with new forming techniques. In this article, the author first provides an overview of the stamping CAE technology adventures and achievements, and industrial applications in the past decade. Then the author presents a summary of increasing manufacturability needs from the formability to total quality and total manufacturability of sheet metal stampings. Finally, the paper outlines the new needs and trends for continuous improvements and innovations to meet increasing challenges in line die formability and quality requirements in automotive stamping.

  14. Evolutions of Advanced Stamping CAE -- Technology Adventures and Business Impact on Automotive Dies and Stamping

    International Nuclear Information System (INIS)

    Wang Chuantao

    2005-01-01

    In the past decade, sheet metal forming and die development has been transformed to a science-based and technology-driven engineering and manufacturing enterprise from a tryout-based craft. Stamping CAE, especially the sheet metal forming simulation, as one of the core components in digital die making and digital stamping, has played a key role in this historical transition. The stamping simulation technology and its industrial applications have greatly impacted automotive sheet metal product design, die developments, die construction and tryout, and production stamping. The stamping CAE community has successfully resolved the traditional formability problems such as splits and wrinkles. The evolution of the stamping CAE technology and business demands opens even greater opportunities and challenges to stamping CAE community in the areas of (1) continuously improving simulation accuracy, drastically reducing simulation time-in-system, and improving operationalability (friendliness) (2) resolving those historically difficult-to-resolve problems such as dimensional quality problems (springback and twist) and surface quality problems (distortion and skid/impact lines) (3) resolving total manufacturability problems in line die operations including blanking, draw/redraw, trim/piercing, and flanging, and (4) overcoming new problems in forming new sheet materials with new forming techniques. In this article, the author first provides an overview of the stamping CAE technology adventures and achievements, and industrial applications in the past decade. Then the author presents a summary of increasing manufacturability needs from the formability to total quality and total manufacturability of sheet metal stampings. Finally, the paper outlines the new needs and trends for continuous improvements and innovations to meet increasing challenges in line die formability and quality requirements in automotive stamping

  15. Stamp Detection in Color Document Images

    DEFF Research Database (Denmark)

    Micenkova, Barbora; van Beusekom, Joost

    2011-01-01

    , moreover, it can be imprinted with a variable quality and rotation. Previous methods were restricted to detection of stamps of particular shapes or colors. The method presented in the paper includes segmentation of the image by color clustering and subsequent classification of candidate solutions...... by geometrical and color-related features. The approach allows for differentiation of stamps from other color objects in the document such as logos or texts. For the purpose of evaluation, a data set of 400 document images has been collected, annotated and made public. With the proposed method, recall of 83...

  16. Medicaid Managed Care Enrollment Report

    Data.gov (United States)

    U.S. Department of Health & Human Services — This report is composed annually and profiles enrollment statistics on Medicaid managed care programs on a plan-specific level. This report also provides...

  17. Dental Care - Medicaid and Chip

    Data.gov (United States)

    U.S. Department of Health & Human Services — Dental health is an important part of peoples overall health. States are required to provide dental benefits to children covered by Medicaid and the Childrens Health...

  18. Medicaid Drug Rebate Program Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — Product Data for Drugs in the Medicaid Drug Rebate Program. The rebate drug product data file contains the active drugs that have been reported by participating drug...

  19. Medicare and Medicaid Statistical Supplement

    Data.gov (United States)

    U.S. Department of Health & Human Services — The CMS Office of Enterprise Data and Analytics (OEDA) produced an annual Medicare and Medicaid Statistical Supplement report providing detailed statistical...

  20. Medicare and Medicaid Research Review

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Centers for Medicare and Medicaid Services (CMS), Office of Information Products and Data Analysis (OIPDA), is pleased to present our journal, Medicare and...

  1. Medicaid Enrollment - New Adult Group

    Data.gov (United States)

    U.S. Department of Health & Human Services — Total Medicaid Enrollees - VIII Group Break Out Report Reported on the CMS-64 The enrollment information is a state-reported count of unduplicated individuals...

  2. METAMORPHOSES OF THE ENVIRONMENTAL STAMP IN ROMANIA

    Directory of Open Access Journals (Sweden)

    CARAUS MADALINA

    2015-12-01

    Full Text Available Romania's alignment to European standards is a difficult process with many legislative changes, with direct impact on taxpayers. The necessity of collecting substantial revenues to the State budget, which provide vital economic growth of the Romanian State, loses the substance when we are talking about taxes levied in relation to taxpayer. The environmental stamp, otherwise a controversial tax, represent for the State another way to earn revenue in advance, “as a loan", because in the end it's forced to repay the amounts concerned taxpayers, under the effect of a final and irrevocable court decision. The effects of the legislative changes bring every time complaints both from taxpayers, because they can demand repayment of the environmental stamp only during the period of prescription, as well as on the part of public servants who are grappling with a large volume of work, with the possibility of overcoming the term to handle requests. An equitable solution in solving these distortions would be the inclusion of the environmental stamp within the tax on means of transport, tax that is paid annually by vehicle owners. At the moment the level of the environmental stamp is calculated depending on the CO2 emissions, exhaust emissions and the age of the vehicle. Tax on means of transport is calculated based on engine capacity, an amount determined by CO2 emissions multiplying with each group of 200 cc or fraction on it. Therefore the unification of the two taxes would create a balance for all categories of vehicles.

  3. Stamping Die Making. 439-318/320.

    Science.gov (United States)

    Yunke, P.; And Others

    Each unit in this curriculum guide on stamping die making contains an introduction, objectives, materials required, lessons, space for notes, figures, and diagrams. There are 29 units in this guide, dealing with the following topics: EZ-MILL programming; EZ-MILL BATT; print of punch and EZ-MILL part programming; download to Computer Numerical…

  4. Fast thermal nanoimprint lithography by a stamp with integrated heater

    DEFF Research Database (Denmark)

    Tormen, Massimo; Malureanu, Radu; Pedersen, Rasmus Haugstrup

    2008-01-01

    We propose fast nanoimprinting lithography (NIL) process based on the use of stamps with integrated heater. The latter consists of heavily ion implantation n-type doped silicon layer buried below the microstructured surface of the stamp. The stamp is heated by Joule effect, by 50 μs 25 Hz...

  5. Ex-Post : The Investment Performance of Collectible Stamps

    NARCIS (Netherlands)

    Dimson, E.; Spaenjers, C.

    2009-01-01

    This paper investigates the returns on British collectible postage stamps over the very long run, based on stamp catalogue prices. Between 1900 and 2008, we find an annualized return on stamps of 6.7% in nominal terms, which is equivalent to an average real return of 2.7% per annum. Prices have

  6. Implications of Medicaid coverage in a program for Latino substance users.

    Science.gov (United States)

    Bachman, Sara S; Walter, Angela W; Kuilan, Nellie; Lundgren, Lena M

    2008-02-01

    This cross-sectional study explored baseline differences between Medicaid covered and uninsured clients (n=368) in the Project La Voz, a community outreach program targeting Latino substance users. Independent variables included client demographics, health status and health service use; the dependent variable was Medicaid coverage vs. uninsured. Bi-variate analyses and three binomial logistic regression models were conducted. The first logistic regression model examining client characteristics indicated that La Voz enrollees with Medicaid coverage were more likely to be women, reside in stable housing, and report poor health status. Employment and educational status were not significantly associated with having Medicaid. A second model, examining the association between health care utilization in the past 30 days and Medicaid coverage, indicated that LaVoz enrollees with Medicaid were significantly more likely to have entered substance use treatment. In the third model, client characteristics and health care use were examined in one model; all variables remained significant except for gender. IMPLICATIONS FOR PROGRAM PLANNING: Massachusetts recent health care reform efforts include substance abuse treatment benefits through Medicaid. Specific strategies are needed to ensure that Latinos substance abusers, particularly those who are homeless, gain Medicaid coverage and then have access to needed services.

  7. Hot stamping advanced manufacturing technology of lightweight car body

    CERN Document Server

    Hu, Ping; He, Bin

    2017-01-01

    This book summarizes the advanced manufacturing technology of original innovations in hot stamping of lightweight car body. A detailed description of the technical system and basic knowledge of sheet metal forming is given, which helps readers quickly understand the relevant knowledge in the field. Emphasis has been placed on the independently developed hot stamping process and equipment, which help describe the theoretical and experimental research on key problems involving stress field, thermal field and phase transformation field in hot stamping process. Also, a description of the formability at elevated temperature and the numerical simulation algorithms for high strength steel hot stamping is given in combination with the experiments. Finally, the book presents some application cases of hot stamping technology such as the lightweight car body design using hot stamping components and gradient hardness components, and the cooling design of the stamping tool. This book is intended for researchers, engineers...

  8. Addressing the Social Determinants of Health Through Medicaid Managed Care.

    Science.gov (United States)

    Machledt, David

    2017-11-01

    With its emphasis on coordinated care and prevention, managed care should be tailor-made to tackle social determinants of health. But various challenges discourage Medicaid health plans and providers from assisting beneficiaries with nonmedical concerns such as housing insecurity or parenting skills that are integral to improving health outcomes and lowering costs. To better address these social factors, the Centers for Medicare and Medicaid Services (CMS) updated its Medicaid managed care rule in early 2016. To explore the impact of several provisions of the new regulation that influence states’ ability to address social determinants of health through managed care. Several provisions in the new Medicaid managed care rule signal CMS’s intent to increase access to high-value nonmedical interventions. For instance, the regulation financially incentivizes health plans to address these needs by allowing certain nonclinical services to be included as covered services when calculating the capitated rate and medical loss ratios. In addition, the regulation encourages states to improve care coordination, adopt alternative payment models, and provide long-term services and supports in the home and community for beneficiaries with functional limitations.

  9. Hot stamping of AA7075 aluminum sheets

    Science.gov (United States)

    Mendiguren, J.; Saenz de Argandona, E.; Galdos, L.

    2016-11-01

    In this work the formability of a high strength aluminium alloy (AA7075-T6) for the stamping of an automotive component has been studied. Due to the low formability of the selected alloy, two different heat assisted forming strategies have been analysed. On the one hand, the W-temper process, where the thermal process is carried out prior to the forming operation. On the other hand, the hot stamping process, where the thermal process is carried out at the same time as the forming. The results showed that both technology were able to form the component avoiding any failure of the material. On the contrary, both processes reduced the final mechanical properties of the material compared to the as received material condition. However, the obtained mechanical properties doubled the strength of commonly used 5xxx and 6xxx aluminium alloys.

  10. Medicaid CHIP Environmental Scanning and Program Char...

    Data.gov (United States)

    U.S. Department of Health & Human Services — ESPC development is sponsored by the CMS Center for Medicare and Medicaid Innovation in partnership with the Center for Medicaid and CHIP Services (CMCS) under the...

  11. Expansion of Medicaid Covered Smoking Cessation Services

    Data.gov (United States)

    U.S. Department of Health & Human Services — Expansionof Medicaid Covered Smoking Cessation Services - Maternal Smoking and Birth Outcomes. To assess whether Medicaid coverage of smoking cessation services...

  12. DOUBLE SHEAR DESIGN TO REDUCED STAMPING FORCE

    Directory of Open Access Journals (Sweden)

    Rudi Kurniawan Arief

    2017-12-01

    Full Text Available Ideally processing of part using stamping machine using only 70-80 % of available force to keep machine in good shape for a long periods. But in some certain case the force may equal to or exceed the available maximum force so the company must sent the process to another outsource company. A case found in a metal stamping company where a final product consist of 3 parts to assembly with one part exceeded the force of available machine. This part can only process in a 1000 tons machine while this company only have 2 of this machine with full workload. Sending this parts outsource will induce delivery problems because other parts are processed, assembled and paint inhouse, this also need additional transportation cost and extra supervision to ensure the quality and delivery schedule. The only exit action of this problem is by reducing the force tonnage. This paper using punch inclining method to reduce the force. The incline punch will distributed the force along the inclined surface that reduce stamping force as well. Inclined surface of punch also cause another major problems that the product becoming curved after process. This problems solved with additional flattening process that add more process cost but better than to outsource the process. Chisel type of inclining punch tip was choosen to avoid worst deformation of product. This paper will give the scientific recomendation to the company.

  13. Medicaid: State and Federal Actions Have Been Taken to Improve Children's Access to Dental Services, but More Can Be Done. Testimony before the Subcommittee on Domestic Policy, Committee on Oversight and Government Reform, House of Representatives. GAO-10-112T

    Science.gov (United States)

    Iritani, Katherine M.

    2009-01-01

    In this statement, Katherine M. Iritani, Acting Director, Health Care reports that dental disease remains a significant problem for children in Medicaid. Although dental services are a mandatory benefit for the 30 million children served by Medicaid, these children often experience elevated levels of dental problems and have difficulty finding…

  14. Stamp duties in Indian states - a case for reform

    OpenAIRE

    Alm, James; Annez, Patricia; Modi, Arbind

    2004-01-01

    The authors review the options for reform of stamp duties on immovable property transfers collected by Indian state governments. After briefly reviewing some of the many administrative difficulties experienced with the tax, they turn to an examination of its economic impacts. A review of stamp duties internationally indicates that Indian rates are exceptionally high, at rates often above 1...

  15. Design and Development of a Soap Stamping and Tableting ...

    African Journals Online (AJOL)

    A soap stamping and tableting machine comprising a printing die/pattern inscriptioner, cutting blade, conveyor belt, and two electric motors was developed and tested. Performance test analysis conducted showed that the machine operated with an optimal stamping/tableting capacity of 10205 soap tablets per hour with an ...

  16. 75 FR 68583 - Medicaid; Federal Funding for Medicaid Eligibility Determination and Enrollment Activities

    Science.gov (United States)

    2010-11-08

    ... Information Retrieval Systems. Specifically, we are proposing to amend the definition of Mechanized Claims... Medicaid Management Information Systems (MMISs) meet certain defined standards and conditions in terms of.... Background A. The Current State of the Medicaid Management Information System (MMIS) A Medicaid management...

  17. Lessons from Early Medicaid Expansions Under Health Reform..

    Data.gov (United States)

    U.S. Department of Health & Human Services — Lessons from Early Medicaid Expansions Under Health Reform, Interviews with Medicaid Officials In a new study entitled Lessons from Early Medicaid Expansions Under...

  18. Impact of Medicaid Expansion on Medicaid-covered Utilization of Buprenorphine for Opioid Use Disorder Treatment.

    Science.gov (United States)

    Wen, Hefei; Hockenberry, Jason M; Borders, Tyrone F; Druss, Benjamin G

    2017-04-01

    Buprenorphine has been proven effective in treating opioid use disorder. However, the high cost of buprenorphine and the limited prescribing capacity may restrict access to this effective medication-assisted treatment for opioid use disorder. To examine whether Medicaid expansion and physician prescribing capacity may have impacted buprenorphine utilization covered by Medicaid. We used a quasi experimental difference-in-differences design to compare the pre-post changes in Medicaid-covered buprenorphine prescriptions and buprenorphine spending between the 26 states that implemented Medicaid expansions under the Affordable Care Act in 2014 and those that did not. All Medicaid enrollees in the expansion states and the nonexpansion and late-expansion states. Quarterly Medicaid prescriptions for buprenorphine and spending on buprenorphine from the Centers for Medicare and Medicaid Services Medicaid Drug Utilization files 2011 to 2014. State implementation of Medicaid expansions in 2014 was associated with a 70% increase (Pbuprenorphine prescriptions and a 50% increase (Pbuprenorphine spending. Physician prescribing capacity was also associated with increased buprenorphine utilization. Medicaid expansion has the potential to reduce the financial barriers to buprenorphine utilization and improve access to medication-assisted treatment of opioid use disorder. Active physician participation in the provision of buprenorphine is needed for ensuring that Medicaid expansion achieves its full potential in improving treatment access.

  19. Facile stamp patterning method for superhydrophilic/superhydrophobic surfaces

    Energy Technology Data Exchange (ETDEWEB)

    Lyu, Sungnam, E-mail: blueden@postech.ac.kr; Hwang, Woonbong, E-mail: whwang@postech.ac.kr [Department of Mechanical Engineering, POSTECH, Pohang 680-749 (Korea, Republic of)

    2015-11-16

    Patterning techniques are essential to many research fields such as chemistry, biology, medicine, and micro-electromechanical systems. In this letter, we report a simple, fast, and low-cost superhydrophobic patterning method using a superhydrophilic template. The technique is based on the contact stamping of the surface during hydrophobic dip coating. Surface characteristics were measured using scanning electron microscopy and energy-dispersive X-ray spectroscopic analysis. The results showed that the hydrophilic template, which was contacted with the stamp, was not affected by the hydrophobic solution. The resolution study was conducted using a stripe shaped stamp. The patterned line was linearly proportional to the width of the stamp line with a constant narrowing effect. A surface with regions of four different types of wetting was fabricated to demonstrate the patterning performance.

  20. A cracked beam or plate transversely loaded by a stamp

    Science.gov (United States)

    Nied, H. F.; Erdogan, F.

    1979-01-01

    In this paper the problem of an infinite elastic beam or a plate containing a crack is considered. The medium is loaded transversely through a stamp which may be rigid or elastic. The problem is a coupled crack-contact problem which cannot be solved by treating the crack and contact problems separately and by using a superposition technique. First the Green's functions for the general case are obtained. Then the integral equations for a cracked infinite strip loaded by a frictionless stamp are obtained. With the question of fracture in mind, the primary interest in the paper has been in calculating the stress intensity factors. The results are given for a rigid flat stamp with sharp edges and for an elastic curved stamp. The effect of friction at the supports on the stress intensity factors is also studied and a numerical example is given.

  1. design and development of a soap stamping and tableting machine

    African Journals Online (AJOL)

    2012-07-02

    pattern inscriptioner, cutting blade, conveyor belt, and two electric motors was developed and tested. Performance test analysis conducted showed that the machine operated with an optimal stamping/tableting capacity of 10205.

  2. 45 CFR 162.1901 - Medicaid pharmacy subrogation transaction.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Medicaid pharmacy subrogation transaction. 162... STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Medicaid Pharmacy Subrogation § 162.1901 Medicaid pharmacy subrogation transaction. The Medicaid pharmacy subrogation transaction is the...

  3. Considering health insurance: how do dialysis initiates with Medicaid coverage differ from persons without Medicaid coverage?

    Science.gov (United States)

    Wetmore, James B; Rigler, Sally K; Mahnken, Jonathan D; Mukhopadhyay, Purna; Shireman, Theresa I

    2010-01-01

    Type of health insurance is an important mediator of medical outcomes in the United States. Medicaid, a jointly sponsored Federal/State programme, is designed to serve medically needy individuals. How these patients differ from non-Medicaid-enrolled incident dialysis patients and how these differences have changed over time have not been systematically examined. Using data from the United States Renal Data System, we identified individuals initiating dialysis from 1995 to 2004 and categorized their health insurance status. Longitudinal trends in demographic, risk behaviour, functional, comorbidity, laboratory and dialysis modality factors, as reported on the Medical Evidence Form (CMS-2728), were examined in all insurance groups. Polychotomous logistic regression was used to estimate adjusted generalized ratios (AGRs) for these factors by insurance status, with Medicaid as the referent insurance group. Overall, males constitute a growing percentage of both Medicaid and non-Medicaid patients, but in contrast to other insurance groups, Medicaid has a higher proportion of females. Non-Caucasians also constitute a higher proportion of Medicaid patients than non-Medicaid patients. Body mass index increased in all groups over time, and all groups witnessed a significant decrease in initiation on peritoneal dialysis. Polychotomous regression showed generally lower AGRs for minorities, risk behaviours and functional status, and higher AGRs for males, employment and self-care dialysis, for non-Medicaid insurance relative to Medicaid. While many broad parallel trends are evident in both Medicaid and non-Medicaid incident dialysis patients, many important differences between these groups exist. These findings could have important implications for policy planners, providers and payers.

  4. The Medicaid Medically Improved Group, Losing Disability...

    Data.gov (United States)

    U.S. Department of Health & Human Services — According to findings reported in, The Medicaid Medically Improved Group, Losing Disability Status and Growing Earnings, published in Volume 4, Issue 1 of the...

  5. Continuous Eligibility for Medicaid and CHIP Coverage

    Data.gov (United States)

    U.S. Department of Health & Human Services — States have the option to provide children with 12 months of continuous coverage through Medicaid and CHIP, even if the family experiences a change in income during...

  6. Medicare-Medicaid Eligible Beneficiaries and Potentiall...

    Data.gov (United States)

    U.S. Department of Health & Human Services — More than one in four hospitalizations for those with both Medicare and full Medicaid coverage was potentially avoidable, according to findings reported in...

  7. Wisconsins Experience with Medicaid Auto Enrollment

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Patient Protection and Affordable Care Act (ACA) relies heavily on the expansion of Medicaid eligibility to cover uninsured populations. In February 2008,...

  8. Medicaid Adult Health Care Quality Measures

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Affordable Care Act (Section 1139B) requires the Secretary of HHS to identify and publish a core set of health care quality measures for adult Medicaid...

  9. Medicaid Statistical Information System (MSIS) Tables

    Data.gov (United States)

    U.S. Department of Health & Human Services — The 25 MSIS statistical tables contain national state-by-state data. These tables contain high-level aggregated statistics relating to Medicaid eligibility and...

  10. Linking Medicare, Medicaid, and Cancer Registry Data...

    Data.gov (United States)

    U.S. Department of Health & Human Services — Linking Medicare, Medicaid, and Cancer Registry Data to Study the Burden of Cancers in West Virginia In the United States, the elderly carry an unequal burden of...

  11. Medicaid expenditures for children living with smokers

    Directory of Open Access Journals (Sweden)

    Levy Douglas E

    2011-05-01

    Full Text Available Abstract Background Children's exposure to secondhand smoke is associated with increased morbidity. We estimated Medicaid expenditures for children living with smokers compared to those living with no smokers in the United States. Methods Data were overall and service-specific (i.e., inpatient, ambulatory, emergency department, prescription drug, and dental annual Medicaid expenditures for children 0-11 years old from the 2000-2007 Medical Expenditures Panel Surveys. Smokers' presence in households was determined by adult respondents' self reports. There were 25,835 person-years of observation. We used multivariate analyses to adjust for child, parent, and geographic characteristics. Results Children with Medicaid expenditures were nearly twice as likely to live with a smoker as other children in the U.S. population. Adjusted analyses revealed no detectable differences in children's overall Medicaid expenditures by presence of smokers in the household. Medicaid children who lived with smokers on average had $10 (95% CI $3, $18 higher emergency department expenditures per year than those living with no smokers. Conclusions Living with at least one smoker (a proxy for secondhand smoke exposure is unrelated to children's overall short-term Medicaid expenditures, but has a modest impact on emergency department expenditures. Additional research is necessary to understand the relationship between secondhand smoke exposure and long-term health and economic outcomes.

  12. Autonomous houses. Autonomous house

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, S. (Tokai University, Tokyo (Japan). Faculty of Engineering)

    1991-09-30

    Self-sufficiency type houses are outlined. On condition that people gain a certain amount of income in relation with the society, they self-suffice under the given environment, allowing themselves to accept a minimum of industrial products with small environmental load. Ordinary supply from outside of fossil energy and materials which depend on it is minimized. Types are classified into three: energy, energy materials and perfect self-sufficiency. A study project for environment symbiotic houses is progressing which is planned by the Ministry of Construction and Institute of Building Energy Conservation and is invested by a private company. Its target is making a house for halving an environmental load by CO{sub 2}, for the purpose of creating the environment symbiotic house which is nice to and in harmony with the global environment and human beings. As a part of the studies on energy-saving and resource conservation on houses, introduced is a plan of an autonomous house at Izu-Atagawa. The passive method and high thermal-insulation are used for air conditioning, and hot spring water for hot water supply. Electric power is generated by hydroelectric power generation using mountain streams and by solar cells. Staple food is purchased, while subsidiary food is sufficed. 17 refs., 4 figs., 1 tab.

  13. "Stamp-off" to micropattern sparse, multicomponent features.

    Science.gov (United States)

    Desai, Ravi A; Rodriguez, Natalia M; Chen, Christopher S

    2014-01-01

    Spatially patterned subtractive de-inking, a process we term "stamp-off," provides a simple method to generate sparse, multicomponent protein micropatterns. It has been applied to control cell adhesion, study adhesion biology, as well as to micropattern fragile surfaces. This technique can also readily be applied to study nanoscale interactions between cell membrane receptors and surface-immobilized ligands. It is based on conventional microcontact printing and as such requires the same reagents, including photolithographically defined masters, a spin-coater, poly(dimethyl siloxane) (PDMS), and conventional cell culture reagents such as glass coverslips and adhesive proteins. Stamp-off is conceptually simplified into three steps: (1) generation of an appropriate cell culture substrate, PDMS-coated glass, (2) micropatterning with stamp-off, and (3) cell deposition. After elaborating each of these three methods, we discuss limitations of the technique and its applications. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Optimum utilization of low ash carbonaceous constituents in stamp charging

    Energy Technology Data Exchange (ETDEWEB)

    Dash, P.S.; Krishnan, S.H.; Sharma, R. [Tata Steel, Jamshedpur (India)

    2004-07-01

    To produce high strength coke at reasonable cost, Tata Steel went for stamp charging along with 40-45% imported coal. It is imperative to design the base stamp charge coal blend so as to possess enough fluidity to assimilate these infusible inerts and still produce coke with high coke strength after reaction (CSR). This paper describes the scope of utilising low ash carbonaceous inerts like fluid coke (a petroleum coke made in a fluidized bed) and anthracite optimally in the stamp charging blend by replacing the present imported semi-soft coal with high fluidity imported coals. The laboratory scale experimentation and its results regarding improvement in coke properties and yield are also described. 5 refs., 2 figs., 3 tabs.

  15. Time Stamp Synchronization of PEFP Distributed Control Systems

    International Nuclear Information System (INIS)

    Song, Young Gi; An, Eun Mi; Kwon, Hyeok Jung; Cho, Yong Sub

    2010-01-01

    Proton Engineering Frontier Project (PEFP) proton linac consists of several types of control systems, such as soft Input Output Controllers (IOC) and embedded IOC based on Experimental Physics Industrial Control System (EPICS) for each subsection of PEFP facility. One of the important factors is that IOC's time clock is synchronized. The synchronized time and time stamp can be achieved with Network Time Protocol (NTP) and EPICS time stamp record without timing hardware. The requirement of the time accuracy of IOCs is less than 1 second. The main objective of this study is to configure a master clock and produce Process Variable (PV) time stamps using local CPU time synchronized from the master clock. The distributed control systems are attached on PEFP control network

  16. The Formability of Friction Stir Welds in Automotive Stamping Environments

    Energy Technology Data Exchange (ETDEWEB)

    Grant, Glenn J.; Davies, Richard W.; Stephens, Elizabeth V.; Wazny, Scott; Kaunitz, Leon; Waldron, Douglas J.

    2006-02-01

    Automobile body and truck cab structures are composed primarily of stampings formed from monolithic and constant gage blanks. Cost and weight penalties can arise when strength or other requirements in one small area of the part leads to the use of a material or gage that is overmatched to the needs of the rest of the stamping. Tailor Welded Blanks (TWBs) are hybrid sheet products composed of either different materials or different thickness sheets that are joined together, then subjected to a stamping operation to create a formed assembly. The strategy is employed generally to save weight and material costs in the formed assembly by placing higher strength or thicker sections only where needed. The forming or stamping process requires the joint to be severely deformed along with the parent sheets. Aluminum TWBs for automotive applications are particularly problematic because of the low formability of aluminum weld metal. Friction Stir Welding (FSW) is a process recently applied to Aluminum TWBs that has the potential to produce a higher quality weld. The current study presents data on the mechanical properties, formability, and FSW weld process parameter development for friction stir welded aluminum, Tailor Welded Blanks. Friction stir welded TWBs can be shown to have higher formability, higher ductility, and lower defect content than many competing joining processes, and they can be fabricated at speeds appropriate for automotive manufacturing.

  17. The Formability of Friction Stir Welds in Automotive Stamping Environments

    Energy Technology Data Exchange (ETDEWEB)

    Grant, Glenn J.; Davies, Richard W.; Stephens, Elizabeth V.; wazny, scott; Kaunitz, Leon; Waldron, D.

    2005-04-01

    Automobile body and truck cab structures are composed primarily of stampings formed from monolithic and constant gage blanks. Cost and weight penalties can arrise when strength or other requirements in one small area of the part leads to the use of a material or gage that is overmatched to the needs of the rest of the stamping. Tailor Welded Blanks (TWBs) are hybrid sheet products composed of either different materials or different thickness sheets that are joined together, then subjected to a stamping operation to create a formed assembly. The strategy is employed generally to save weight and material costs in the formed assembly by placing higher strength or thicker sections only where needed. The forming or stamping process requires the joint to be severely deformed along with the parent sheets. Aluminum TWBs for automotive applications are particularly problematic because of the low formability of aluminum weld metal. Friction Stir Welding (FSW) is a process recently applied to Aluminum TWBs that has the potential to produce a higher quality weld. The current study presents data on the mechanical properties, formability, and FSW weld process parameter development for friction stir woined, aluminum, Tailor Welded Blanks. Friction stir welded TWBs can be shown to have higher formability, higher ductility, and lower defect content than many competing joining processes, and they can be fabricated at speeds appropriate for automotive manufacturing.

  18. Modelling the deformation process of flexible stamps for nanoimprint lithography

    DEFF Research Database (Denmark)

    Sonne, Mads Rostgaard

    The present thesis is devoted to numerical modelling of the deformation process of flexible stamps for nanoimprint lithography (NIL). The purpose of those models is to be able to predict the deformation and stretch of the flexixble stamps in order to take that into account when designing the plan...... 2D silicon master used in the NIL process. Two different manufacturing processes are investigated; (i) Embossing of an electroplated nickel foil into a hydrogen silsesquioxane (HSQ) polymer resist on a double-curved surface, (ii) NIL of a flexible polytetrafluoroethylene (PTFE) stamps...... into a polymethyl methacrylate (PMMA) resist. Challenges comprise several non-linear phenomena. First of all geometrical non-linearities arising from the inherent large strains and deformations during the process are modelled. Then, the constitutive behaviors of the nickel foil and the PTFE polymer during...... deformation are addressed. This is achieved by a general elasto-plastic description for the nickel foil and a viscoelastic-viscoplastic model for the PTFE material, in which the material parameters are found. Last, the contact conditions between the deforming stamp and the injection moulding tool insert...

  19. 46 CFR 53.10-10 - Certification by stamping.

    Science.gov (United States)

    2010-10-01

    ... boilers shall be as indicated in HG-530 of section IV of the ASME Boiler and Pressure Vessel Code... 46 Shipping 2 2010-10-01 2010-10-01 false Certification by stamping. 53.10-10 Section 53.10-10 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING HEATING BOILERS Tests...

  20. 41 CFR 101-25.103-3 - Trading stamps or bonus goods received from contractors.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Trading stamps or bonus... PROCUREMENT 25-GENERAL 25.1-General Policies § 101-25.103-3 Trading stamps or bonus goods received from contractors. When contracts contain a price reduction clause, any method (such as trading stamps or bonus...

  1. 26 CFR 301.7209-1 - Unauthorized use or sale of stamps.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Unauthorized use or sale of stamps. 301.7209-1... § 301.7209-1 Unauthorized use or sale of stamps. (a) Any person who buys, sells, offers for sale, uses... regulations made pursuant thereto, any stamp, coupon, ticket, book, or other device prescribed by the...

  2. The Role of Data in Health Care Disparities in Medicaid...

    Data.gov (United States)

    U.S. Department of Health & Human Services — According to findings reported in The Role of Data in Health Care Disparities in Medicaid Managed Care, published in Volume 2, Issue 4 of the Medicare and Medicaid...

  3. Medicare-Medicaid Enrollee Profiles (State and National)

    Data.gov (United States)

    U.S. Department of Health & Human Services — Today there are over 10 million Medicare-Medicaid enrollees in the United States.To provide a greater understanding of the Medicare-Medicaid enrollee population, the...

  4. Financial Performance of Health Plans in Medicaid Mana...

    Data.gov (United States)

    U.S. Department of Health & Human Services — This study assesses the financial performance of health plans that enroll Medicaid members across the key plan traits, specifically Medicaid dominant, publicly...

  5. Medicaid Analytic eXtract (MAX) General Information

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Medicaid Analytic eXtract (MAX) data is a set of person-level data files on Medicaid eligibility, service utilization, and payments. The MAX data are created to...

  6. Medicaid Fraud Control Units (MFCU) Annual Spending and Performance Statistics

    Data.gov (United States)

    U.S. Department of Health & Human Services — Medicaid Fraud Control Units (MFCU or Unit) investigate and prosecute Medicaid fraud as well as patient abuse and neglect in health care facilities. OIG certifies,...

  7. Medicare-Medicaid Dual Enrollment from 2006 through 2011

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Medicare-Medicaid Coordination Office (MMCO) is releasing an analysis of trends in Medicare-Medicaid enrollee population and demographic characteristics from...

  8. The Effects of Medicaid Policy Changes on Adults Service...

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Effects of Medicaid Policy Changes on Adults Service Use Patterns in Kentucky and Idaho According to findings reported in The Effects of Medicaid Policy Changes...

  9. The Impact of Medicaid Peer Support Utilization on Cost

    Data.gov (United States)

    U.S. Department of Health & Human Services — According to findings reported in The Impact of Medicaid Peer Support Utilization on Cost, published in Volume 4, Issue 1 of the Medicare and Medicaid Research...

  10. Physician Willingness and Resources to Serve More Medicaid..

    Data.gov (United States)

    U.S. Department of Health & Human Services — Sixteen million people will gain Medicaid under health reform. This study compares primary care physicians (PCPs) on reported acceptance of new Medicaid patients and...

  11. Medicaid and Managed Care: Key Data, Trends, and Issues

    Science.gov (United States)

    ... only about 20% of total Medicaid spending on services. This is because disabled and elderly beneficiaries, who account for most Medicaid spending, largely remain in fee-for-service (FFS), and because expensive services, such as nursing ...

  12. Medicaid Policies and Practices in US State Prison Systems

    OpenAIRE

    Rosen, David L.; Dumont, Dora M.; Cislo, Andrew M.; Brockmann, Bradley W.; Traver, Amy; Rich, Josiah D.

    2014-01-01

    Medicaid is an important source of health care coverage for prison-involved populations. From 2011 to 2012, we surveyed state prison system (SPS) policies affecting Medicaid enrollment during incarceration and upon release; 42 of 50 SPSs participated.

  13. Methods University Health System Can Use to Expand Medicaid Coverage to Uninsured Poor Parents with Medicaid Eligible Children: Policy Analysis

    National Research Council Canada - National Science Library

    McMahon, III, Robert T

    2006-01-01

    Bexar County, low-income, uninsured parents with Medicaid-eligible children have been negatively impacted by reductions in Medicaid eligibility standards made by the Texas State Legislature in 2003...

  14. 78 FR 79081 - Medicare and Medicaid Programs; Emergency Preparedness Requirements for Medicare and Medicaid...

    Science.gov (United States)

    2013-12-27

    ... makes it essential that health care providers and suppliers ensure that emergency management is... providers and suppliers. The four elements of the emergency preparedness program are as follows: Risk...; Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers...

  15. Housing culture

    DEFF Research Database (Denmark)

    Roesdahl, Else; Scholkmann, Barbara

    2007-01-01

    On houses and their furniture and fittings, and on the study of this - with a comparison of rural, urban, monastic and aristocratic housing, and a special section on heating technologies.......On houses and their furniture and fittings, and on the study of this - with a comparison of rural, urban, monastic and aristocratic housing, and a special section on heating technologies....

  16. Efficient methods of nanoimprint stamp cleaning based on imprint self-cleaning effect

    International Nuclear Information System (INIS)

    Meng Fantao; Chu Jinkui; Luo Gang; Zhou Ye; Carlberg, Patrick; Heidari, Babak; Maximov, Ivan; Montelius, Lars; Xu, H Q; Nilsson, Lars

    2011-01-01

    Nanoimprint lithography (NIL) is a nonconventional lithographic technique that promises low-cost, high-throughput patterning of structures with sub-10 nm resolution. Contamination of nanoimprint stamps is one of the key obstacles to industrialize the NIL technology. Here, we report two efficient approaches for removal of typical contamination of particles and residual resist from stamps: thermal and ultraviolet (UV) imprinting cleaning-both based on the self-cleaning effect of imprinting process. The contaminated stamps were imprinted onto polymer substrates and after demolding, they were treated with an organic solvent. The images of the stamp before and after the cleaning processes show that the two cleaning approaches can effectively remove contamination from stamps without destroying the stamp structures. The contact angles of the stamp before and after the cleaning processes indicate that the cleaning methods do not significantly degrade the anti-sticking layer. The cleaning processes reported in this work could also be used for substrate cleaning.

  17. Predicting State Investment in Medicaid Home- and Community-Based Services, 2000-2011.

    Science.gov (United States)

    Miller, Nancy A; Kirk, Adele

    2016-01-01

    Although state use of Medicaid home- and community-based services (HCBS) to provide long-term services and supports to older adults and individuals with physical disabilities continues to increase, progress is uneven across states. We used generalized linear models to examine state factors associated with increased allocation of Medicaid dollars to HCBS for the period 2000 to 2011. We observed enhanced growth in states that began the period with limited investment in HCBS, as reflected in significant year trends among these states. The political environment appeared to be an important influence on states' investment for states with limited initial allocation to HCBS, as was housing affordability, a policy amenable variable. There continues to be wide variation in states' relative investment, calling for additional policy attention and research.

  18. Soil Temperature and Moisture Profile (STAMP) System Handbook

    Energy Technology Data Exchange (ETDEWEB)

    Cook, David R. [Argonne National Lab. (ANL), Argonne, IL (United States)

    2016-11-01

    The soil temperature and moisture profile system (STAMP) provides vertical profiles of soil temperature, soil water content (soil-type specific and loam type), plant water availability, soil conductivity, and real dielectric permittivity as a function of depth below the ground surface at half-hourly intervals, and precipitation at one-minute intervals. The profiles are measured directly by in situ probes at all extended facilities of the SGP climate research site. The profiles are derived from measurements of soil energy conductivity. Atmospheric scientists use the data in climate models to determine boundary conditions and to estimate the surface energy flux. The data are also useful to hydrologists, soil scientists, and agricultural scientists for determining the state of the soil. The STAMP system replaced the SWATS system in early 2016.

  19. Reactive wet stamping for patterning of polyelectrolyte multilayers.

    Science.gov (United States)

    Cho, Chungyeon; Valverde, Lauralee; Ozin, Geoffrey A; Zacharia, Nicole S

    2010-08-17

    Patterning of soft films, especially their bulk and not only their surface properties, presents a challenge. Several lithographic techniques do exist, but many of them are complex or limited in their ability to change properties. A few methods of patterning polyelectrolyte multilayers (PEM) have been reported, including microcontact printing and selectively growing layers on patterned self-assembled monolayers, but these all come with certain limitations. We present here the use of a modified microcontact printing method, reactive wet stamping (r-WETs), using a hydrogel stamp soaked in aqueous solutions to create patterns in PEMs. With this technique we are able to locally cause swelling and porosity changes in the PEM films and use our method to qualitatively study the evolution of the porous film morphology. This technique has the potential to locally control chemical functionality, film thickness, and mechanical properties, leading to a new ability to control film architectures both at the film surface and within the bulk of the film.

  20. CO2 Laser Cutting of Hot Stamping Boron Steel Sheets

    OpenAIRE

    Pasquale Russo Spena

    2017-01-01

    This study investigates the quality of CO2 laser cutting of hot stamping boron steel sheets that are employed in the fabrication of automotive body-in-white. For this purpose, experimental laser cutting tests were conducted on 1.2 mm sheets at varying levels of laser power, cutting speed, and oxygen pressure. The resulting quality of cut edges was evaluated in terms of perpendicularity tolerance, surface irregularity, kerf width, heat affected zone, and dross extension. Experimental tests wer...

  1. Monitoring enzymatic degradation of pericellular matrices through SERS stamping

    Science.gov (United States)

    Yan, Bo; Hong, Yan; Chen, Tianhong; Reinhard, Björn M.

    2012-06-01

    We introduce a surface enhanced Raman spectroscopy (SERS) stamping approach for acquiring cell-surface specific vibrational spectra of individual living cells under physiological conditions. The SERS stamping approach utilizes a nanostructured metal surface on top of a lithographically defined piston that can be translated in 3-dimensions with nanometer resolution to contact living cells in solution with a pristine metal surface. We applied this approach to characterize the chemical composition of the cellular surface of living MCF7 breast cancer cells and to monitor its change upon addition of the enzyme hyaluronidase, which degrades major constituents of the pericellular matrix. Although the cell surface spectra show significant cell-to-cell fluctuations, a statistical barcode analysis of the spectra ensembles reveals systematic changes in the cell surface SERS spectra upon addition of hyaluronidase, which are consistent with a thinning of the pericellular matrix.We introduce a surface enhanced Raman spectroscopy (SERS) stamping approach for acquiring cell-surface specific vibrational spectra of individual living cells under physiological conditions. The SERS stamping approach utilizes a nanostructured metal surface on top of a lithographically defined piston that can be translated in 3-dimensions with nanometer resolution to contact living cells in solution with a pristine metal surface. We applied this approach to characterize the chemical composition of the cellular surface of living MCF7 breast cancer cells and to monitor its change upon addition of the enzyme hyaluronidase, which degrades major constituents of the pericellular matrix. Although the cell surface spectra show significant cell-to-cell fluctuations, a statistical barcode analysis of the spectra ensembles reveals systematic changes in the cell surface SERS spectra upon addition of hyaluronidase, which are consistent with a thinning of the pericellular matrix. Electronic supplementary information

  2. ANALYSIS OF FOOD STAMP PROGRAM PARTICIPATION AND FOOD EXPENDITURES

    OpenAIRE

    Smallwood, David M.; Blaylock, James R.

    1985-01-01

    A two equation model is developed to examine jointly the determinants of household food stamp program participation and program effects on food expenditures. The model is unique in that it postulates that the participation decision is based on a cost-benefit ratio, selected socioeconomic characteristics, and the potential for increasing both food and nonfood expenditures. Data from the 1977-78 USDA Nationwide Food Consumption Survey Supplemental Low Income Sample is used to estimate the model...

  3. Use of tobacco tax stamps to prevent and reduce illicit tobacco trade--United States, 2014.

    Science.gov (United States)

    Chriqui, Jamie; DeLong, Hillary; Gourdet, Camille; Chaloupka, Frank; Edwards, Sarah Matthes; Xu, Xin; Promoff, Gabbi

    2015-05-29

    Tobacco use is the leading cause of preventable disease and death in the United States. Increasing the unit price on tobacco products is the most effective tobacco prevention and control measure. Illicit tobacco trade (illicit trade) undermines high tobacco prices by providing tobacco users with cheaper-priced alternatives. In the United States, illicit trade primarily occurs when cigarettes are bought from states, jurisdictions, and federal reservation land with lower or no excise taxes, and sold in jurisdictions with higher taxes. Applying tax stamps to tobacco products, which provides documentation that taxes have been paid, is an important tool to combat illicit trade. Comprehensive tax stamping policy, which includes using digital, encrypted ("high-tech") stamps, applying stamps to all tobacco products, and working with tribes on stamping agreements, can further prevent and reduce illicit trade. This report describes state laws governing tax stamps on cigarettes, little cigars (cigarette-sized cigars), roll-your-own tobacco (RYOT), and tribal tobacco sales across the United States as of January 1, 2014, and assesses the extent of comprehensive tobacco tax stamping in the United States. Forty-four states (including the District of Columbia [DC]) applied traditional paper ("low-tech") tax stamps to cigarettes, whereas four authorized more effective high-tech stamps. Six states explicitly required stamps on other tobacco products (i.e., tobacco products other than cigarettes), and in approximately one third of states with tribal lands, tribes required tax stamping to address illicit purchases by nonmembers. No U.S. state had a comprehensive approach to tobacco tax stamping. Enhancing tobacco tax stamping across the country might further prevent and reduce illicit trade in the United States.

  4. Medicaid reimbursement, prenatal care and infant health.

    Science.gov (United States)

    Sonchak, Lyudmyla

    2015-12-01

    This paper evaluates the impact of state-level Medicaid reimbursement rates for obstetric care on prenatal care utilization across demographic groups. It also uses these rates as an instrumental variable to assess the importance of prenatal care on birth weight. The analysis is conducted using a unique dataset of Medicaid reimbursement rates and 2001-2010 Vital Statistics Natality data. Conditional on county fixed effects, the study finds a modest, but statistically significant positive relationship between Medicaid reimbursement rates and the number of prenatal visits obtained by pregnant women. Additionally, higher rates are associated with an increase in the probability of obtaining adequate care, as well as a reduction in the incidence of going without any prenatal care. However, the effect of an additional prenatal visit on birth weight is virtually zero for black disadvantaged mothers, while an additional visit yields a substantial increase in birth weight of over 20 g for white disadvantaged mothers. Copyright © 2015 Elsevier B.V. All rights reserved.

  5. Ectopic Pregnancy Rates in the Medicaid Population

    Science.gov (United States)

    STULBERG, Debra B.; CAIN, Loretta R.; DAHLQUIST, Irma; LAUDERDALE, Diane S.

    2013-01-01

    Objective The Centers for Disease Control and Prevention last estimated a national ectopic pregnancy rate in 1992, when it was 1.97 percent of all reported pregnancies. Since then rates have been reported among privately insured women and regional healthcare provider populations, ranging from 1.6 to 2.45 percent. This study assessed the rate of ectopic pregnancy among Medicaid beneficiaries (New York, California, and Illinois, 2000–03), a previously unstudied population. Study Design We identified Medicaid administrative claims records for inpatient and outpatient encounters with a principal ICD9 diagnosis code for ectopic pregnancy. We calculated the ectopic pregnancy rate among female beneficiaries ages 15–44 as the number of ectopic pregnancies divided by the number of total pregnancies, which included spontaneous abortions, induced abortions, ectopic pregnancies, and all births. We used Poisson regression to assess the risk of ectopic pregnancy by age and race. Results Four-year Medicaid ectopic pregnancy rates were 2.38 percent of pregnancies in New York, 2.07 percent in California, and 2.43 percent in Illinois. Risk was higher among Black women compared to whites in all states (RR= 1.26, 95% CI 1.25 – 1.28, pectopic pregnancy than reported for privately insured women nationwide in the same years. Relying on private insurance databases may underestimate ectopic pregnancy’s burden in the United States population. Furthermore, within this low-income population racial disparities exist. PMID:23313717

  6. Financial performance of health plans in Medicaid managed care.

    Science.gov (United States)

    McCue, Mike

    2012-01-01

    This study assesses the financial performance of health plans that enroll Medicaid members across the key plan traits, specifically Medicaid dominant, publicly traded, and provider-sponsored. National Association of Insurance Commissioners (NAIC) financial data, coupled with selected state financial data, were analyzed for 170 Medicaid health plans for 2009. A mean test compared the mean values for medical loss, administrative cost, and operating margin ratios across these plan traits. Medicaid dominant plans are plans with 75 percent of their total enrollment in the Medicaid line of business. Plans that are Medicaid dominant and publicly traded incurred a lower medical loss ratio and higher administrative cost ratio than multi-product and non-publicly traded plans. Medicaid dominant plans also earned a higher operating profit margin. Plans offering commercial and Medicare products are operating at a loss for their Medicaid line of business. Health plans that do not specialize in Medicaid are losing money. Higher medical cost rather than administrative cost is the underlying reason for this financial loss. Since Medicaid enrollees do not account for their primary book of business, these plans may not have invested in the medical management programs to reduce inappropriate emergency room use and avoid costly hospitalization.

  7. Comparison of the hot-stamped boron-alloyed steel and the warm-stamped medium-Mn steel on microstructure and mechanical properties

    International Nuclear Information System (INIS)

    Li, Xiaodong; Chang, Ying; Wang, Cunyu; Hu, Ping; Dong, Han

    2017-01-01

    The application of high strength steels (HSS) for automotive structural parts is an effective way to realize lightweight and enhance safety. Therefore, improvements in mechanical properties of HSS are needed. In the present study, the warm stamping process of the third generation automotive medium-Mn steel was discussed, the characteristics of martensitic transformation were investigated, as well as the microstructure and mechanical properties were analyzed, compared to the popular hot-stamped 22MnB5 steel in the automotive industry. The results are indicated as follows. Firstly, the quenching rate of the medium-Mn steel can be selected in a wide range based on its CCT curves, which is beneficial to the control of forming process. Secondly, the influence of stamping temperature and pressure on the M s temperature of the medium-Mn steel is not obvious and can be neglected, which is favorable to the even distribution of martensitic microstructure and mechanical properties. Thirdly, the phenomenon of decarbonization is hardly found on the surface of the warm-stamped medium-Mn steel, and the ultra-fine-grained microstructure is found inside the medium-Mn steel after warm stamping. Besides, the warm-stamped medium-Mn steel holds the better comprehensive properties, such as a lower yield ratio, higher total elongation and higher tear toughness than the hot-stamped 22MnB5 steel. Furthermore, an actual warm-stamped B-pillar of medium-Mn steel is stamped and ultra-fine-grained martensitic microstructure is obtained. The mechanical properties are evenly distributed. As a result, this paper proves that the warm-stamped medium-Mn steel part can meet the requirements of lightweight and crash safety, and is promising for the industrial production of automotive structural parts.

  8. Lessons from early Medicaid expansions under health reform: interviews with Medicaid officials.

    Science.gov (United States)

    Sommers, Benjamin D; Arntson, Emily; Kenney, Genevieve M; Epstein, Arnold M

    2013-01-01

    The Affordable Care Act (ACA) dramatically expands Medicaid in 2014 in participating states. Meanwhile, six states have already expanded Medicaid since 2010 to some or all of the low-income adults targeted under health reform. We undertook an in-depth exploration of these six "early-expander" states-California, Connecticut, the District of Columbia, Minnesota, New Jersey, and Washington-through interviews with high-ranking Medicaid officials. We conducted semi-structured interviews with 11 high-ranking Medicaid officials in six states and analyzed the interviews using qualitative methods. Interviews explored enrollment outreach, stakeholder involvement, impact on beneficiaries, utilization and costs, implementation challenges, and potential lessons for 2014. Two investigators independently analyzed interview transcripts and iteratively refined the codebook until reaching consensus. We identified several themes. First, these expansions built upon pre-existing state-funded insurance programs for the poor. Second, predictions about costs and enrollment were challenging, indicating the uncertainty in projections for 2014. Other themes included greater than anticipated need for behavioral health services in the expansion population, administrative challenges of expansions, and persistent barriers to enrollment and access after expanding eligibility-though officials overall felt the expansions increased access for beneficiaries. Finally, political context-support or opposition from stakeholders and voters-plays a critical role in shaping the success of Medicaid expansions. Early Medicaid expansions under the ACA offer important lessons to federal and state policymakers as the 2014 expansions approach. While the context of each state's expansion is unique, key shared experiences were significant implementation challenges and opportunities for expanding access to needed services.

  9. Mathematical Modeling of Hydroelastic Oscillations of the Stamp and the Plate, Resting on Pasternak Foundation

    Science.gov (United States)

    Mogilevich, L. I.; Popov, V. S.; Popova, A. A.; Christoforova, A. V.

    2018-01-01

    The forced oscillations of the elastic fixed stamp and the plate, resting on Pasternak foundation are studied. The oscillations are caused by pressure pulsation in liquid layer between the stamp and the plate. Pasternak model is chosen as an elastic foundation. The laws of the stamp movement, the plate deflection and pressure in the liquid are discovered on the basis of hydroelasticity problem analytical solution. The functions of amplitude deflection distribution and liquid pressure along the plate are constructed, as well as the stamp amplitude-frequency characteristic. The obtained mathematical model allows to investigate the dynamics of hydroelastic interaction of the stamp with the plate, resting on elastic foundation, to define resonance frequencies of the plate and the stamp and corresponding deflections amplitudes, as well as liquid presser amplitudes.

  10. Why housing?

    Science.gov (United States)

    Aidala, Angela A; Sumartojo, Esther

    2007-11-01

    Housing/lack of housing and HIV are powerfully linked. Housing occupies an important place in the causal chains linking poverty and inequality, and HIV risk and outcomes of infection. The articles in this Special Supplement of AIDS and Behavior confirm the impact of homelessness, and poor or unstable housing, on HIV/AIDS, and challenge scientists to test and policy makers to implement the promise of housing as an innovative response to the epidemic. In order to influence the development of policies on housing to benefit at-risk or HIV-infected persons, however, proponents must justify why this association exists, and how housing can help end the epidemic as well as improve the care and health of persons living with HIV/AIDS. We introduce this supplement with a discussion of the "why" question.

  11. Time series analysis of tool wear in sheet metal stamping using acoustic emission

    Science.gov (United States)

    Vignesh Shanbhag, V.; Pereira, P. Michael; Rolfe, F. Bernard; Arunachalam, N.

    2017-09-01

    Galling is an adhesive wear mode that often affects the lifespan of stamping tools. Since stamping tools represent significant economic cost, even a slight improvement in maintenance cost is of high importance for the stamping industry. In other manufacturing industries, online tool condition monitoring has been used to prevent tool wear-related failure. However, monitoring the acoustic emission signal from a stamping process is a non-trivial task since the acoustic emission signal is non-stationary and non-transient. There have been numerous studies examining acoustic emissions in sheet metal stamping. However, very few have focused in detail on how the signals change as wear on the tool surface progresses prior to failure. In this study, time domain analysis was applied to the acoustic emission signals to extract features related to tool wear. To understand the wear progression, accelerated stamping tests were performed using a semi-industrial stamping setup which can perform clamping, piercing, stamping in a single cycle. The time domain features related to stamping were computed for the acoustic emissions signal of each part. The sidewalls of the stamped parts were scanned using an optical profilometer to obtain profiles of the worn part, and they were qualitatively correlated to that of the acoustic emissions signal. Based on the wear behaviour, the wear data can be divided into three stages: - In the first stage, no wear is observed, in the second stage, adhesive wear is likely to occur, and in the third stage severe abrasive plus adhesive wear is likely to occur. Scanning electron microscopy showed the formation of lumps on the stamping tool, which represents galling behavior. Correlation between the time domain features of the acoustic emissions signal and the wear progression identified in this study lays the basis for tool diagnostics in stamping industry.

  12. Multi-cycle rolled aluminum alloy 3103 sandwiches: mechanical properties and stamp ability

    OpenAIRE

    Nosova Ekaterina; Erisov Yaroslav; Grechnikov Fedor

    2017-01-01

    Constructional part producing by sheet stamping of multilayer composites requires the stamping ability data. The aim of a work is to estimate mechanical properties, stamping ratio and anisotropy indexes of 2, 4, 8 and 12 layer sandwiches produced from aluminium alloy AA3103. The pieces were received by the cold rolling. Interoperation annealing was at 500°C for 1 hour. Charts of tensile strength, yield stress, elongation depending on layer thickness were composed. It was found that cold strai...

  13. 49 CFR 238.119 - Rim-stamped straight-plate wheels.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Rim-stamped straight-plate wheels. 238.119 Section... Requirements § 238.119 Rim-stamped straight-plate wheels. (a)(1) Except as provided in paragraph (a)(2) of this... than a private car, that is equipped with a rim-stamped straight-plate wheel if a brake shoe acts on...

  14. Determination of the Interfacial Heat Transfer Coefficient in the Hot Stamping of AA7075

    OpenAIRE

    Ji Kang; Liu Xiaochuan; El Fakir Omer; Liu Jun; Zhang Qunli; Wang Liliang

    2016-01-01

    The interfacial heat transfer coefficient (IHTC) is a key parameter in hot stamping processes, in which a hot blank is formed and quenched by cold dies simultaneously. The IHTC should therefore be identified and used in FE simulations to improve the accuracy of simulation results of hot stamping processes. In this work, a hot stamping simulator was designed and assembled in a Gleeble 3800 thermo-mechanical testing system and a FE model was built in PAM-STAMP to determine the IHTC values betwe...

  15. Determination of the interfacial heat transfer coefficient in the hot stamping of AA7075

    OpenAIRE

    Liu Xiaochuan; Ji Kang; Fakir Omer El; Liu Jun; Zhang Qunli; Wang Liliang

    2015-01-01

    The interfacial heat transfer coefficient (IHTC) is a key parameter in hot stamping processes, in which a hot blank is formed and quenched by cold dies simultaneously. The IHTC should therefore be identified and used in FE models to improve the accuracy of simulation results of hot stamping processes. In this work, a hot stamping simulator was designed and assembled in a Gleeble 3800 thermo-mechanical testing system and a FE model was built in PAM-STAMP to determine the IHTC value between a h...

  16. Minerals on postage stamps: A mix of art, history, economics and geography

    Science.gov (United States)

    Glover, Paul

    2010-05-01

    Most people would agree that minerals represent some of the most beautiful natural objects known to mankind, especially in the form of precious and semi-precious gemstones. It is hardly surprising, therefore, that they are often illustrated on stamps. Examples are the fine crystalline forms represented as coloured etchings in the French 1986 issue, and the stylized simplicity of the mineral stamps that were part of the Swiss Pro Patria series, issued annually between 1958 and 1961. I aim in this presentation to introduce the beautiful world of mineral illustrations on stamps. The talk cannot be comprehensive because of the very large number of minerals and stamps concerned, but it will introduce the range of minerals depicted on stamps, then look in some greater detail at several sets from France, Southern Africa and East Germany. Minerals become the subject of sets of stamps for many reasons. In many cases, it is part of an attempt by the particular national post office to depict the whole of the natural history of their country in stamp form - a statement of nationality and politics. The 1986 French issue was an example which followed sets of stamps that had already portrayed insects, flowers, trees and birds native to France. We also find that certain countries have produced several sets of stamps to mark the importance to their economy of mining particular minerals. Many African states depend upon minerals for much of their wealth and economic power, explaining why, for instance, Sierra Leone issued over 35 stamps on the subject of diamonds between 1965 and 1978, and why over 77% of mineral stamps come from countries with major mining interests. Countries with traditional links with the history of the study of geology and mining also produce mineral stamps. These are usually European countries with a long record of the study of the Earth, such as Germany and Switzerland. Curiously enough, though, despite its fine tradition of geological observation and research

  17. Do Medicaid home and community based service waivers save money?

    Science.gov (United States)

    Harrington, Charlene; Ng, Terence; Kitchener, Martin

    2011-10-01

    This article estimates the potential savings to the Medicaid program of using 1915c Home and Community Based Services (HCBS) waivers rather than institutional care. For Medicaid HCBS waiver expenditures of $25 billion in 2006, we estimate the national savings to be over $57 billion, or $57,338 per waiver participant in 2006 compared with the cost of Medicaid institutional care (for which all waiver participants are eligible). When taking into account a potential 50% "woodwork effect" (for people who might have refused institutional services), the saving would be $21 billion. This analysis demonstrates that HCBS waiver programs present significant direct financial savings to Medicaid long-term care (LTC) programs.

  18. State-level Medicaid expenditures attributable to smoking.

    Science.gov (United States)

    Armour, Brian S; Finkelstein, Eric A; Fiebelkorn, Ian C

    2009-07-01

    Medicaid recipients are disproportionately affected by tobacco-related disease because their smoking prevalence is approximately 53% greater than that of the overall US adult population. This study estimates state-level smoking-attributable Medicaid expenditures. We used state-level and national data and a 4-part econometric model to estimate the fraction of each state's Medicaid expenditures attributable to smoking. These fractions were multiplied by state-level Medicaid expenditure estimates obtained from the Centers for Medicare and Medicaid Services to estimate smoking-attributable expenditures. The smoking-attributable fraction for all states was 11.0% (95% confidence interval, 0.4%-17.0%). Medicaid smoking-attributable expenditures ranged from $40 million (Wyoming) to $3.3 billion (New York) in 2004 and totaled $22 billion nationwide. Cigarette smoking accounts for a sizeable share of annual state Medicaid expenditures. To reduce smoking prevalence among recipients and the growth rate in smoking-attributable Medicaid expenditures, state health departments and state health plans such as Medicaid are encouraged to provide free or low-cost access to smoking cessation counseling and medication.

  19. An interactive and flexible approach to stamping design and optimization

    International Nuclear Information System (INIS)

    Roy, Subir; Kunju, Ravi; Kirby, David

    2004-01-01

    This paper describes an efficient method that integrates finite element analysis (FEA), mesh morphing and response surface based optimization in order to implement an automated and flexible software tool to optimize stamping tool and process design. For FEA, a robust and extremely fast inverse solver is chosen. For morphing, a state of the art mesh morpher that interactively generates shape variables for optimization studies is used. The optimization algorithm utilized in this study enables a global search for a multitude of parameters and is highly flexible with regards to the choice of objective functions. A quality function that minimizes formability defects resulting from stretching and compression is implemented

  20. 76 FR 21949 - Medicaid Program; Federal Funding for Medicaid Eligibility Determination and Enrollment Activities

    Science.gov (United States)

    2011-04-19

    ..., enacted on March 23, 2010), as amended by the Health Care and Education Reconciliation Act of 2010 (Pub. L... new Exchanges, it is essential that States have modern and cost-effective eligibility systems that.../Medicaid Information Technology Guidance, version 1.0,'' and the Funding Opportunity Announcement for...

  1. Trends in emergency Medicaid expenditures for recent and undocumented immigrants.

    Science.gov (United States)

    DuBard, C Annette; Massing, Mark W

    2007-03-14

    Undocumented immigrants and legal immigrants who have been in the United States less than 5 years are excluded from Medicaid eligibility, with the exception of limited coverage for emergency conditions (Emergency Medicaid). New immigrant population growth has been rapid in recent years, but little is known about use of health services by this group or the conditions for which Emergency Medicaid coverage has been applied. To describe Emergency Medicaid use by recent and undocumented immigrants including patient characteristics, diagnoses, and recent spending trends in North Carolina, a state with a rapidly increasing population of undocumented immigrants. Descriptive analysis of North Carolina Medicaid administrative data for all claims reimbursed under Emergency Medicaid eligibility criteria 2001 through 2004 in North Carolina, a state with high immigration from Mexico and Latin America. Patients are recent and undocumented immigrants who meet categorical and income criteria for Medicaid coverage, but are excluded from full coverage due to legal status. Patient characteristics, hospitalizations, diagnoses, and Medicaid spending for emergency care. A total of 48,391 individuals received services reimbursed under Emergency Medicaid during the 4-year period of this study. The patient population was 99% undocumented, 93% Hispanic, 95% female, and 89% in the 18- to 40-year age group. Total spending increased by 28% from 2001 through 2004, with more rapid spending increases among elderly (98%) and disabled (82%) patients. In 2004, childbirth and complications of pregnancy accounted for 82% of spending and 91% of hospitalizations. Injury, renal failure, gastrointestinal disease, and cardiovascular conditions were also prevalent. Childbirth and complications of pregnancy account for the majority of Emergency Medicaid spending for undocumented immigrants in North Carolina. Spending for elderly and disabled patients, however, is increasing at a faster rate. Among nonpregnant

  2. CO2 Laser Cutting of Hot Stamping Boron Steel Sheets

    Directory of Open Access Journals (Sweden)

    Pasquale Russo Spena

    2017-10-01

    Full Text Available This study investigates the quality of CO2 laser cutting of hot stamping boron steel sheets that are employed in the fabrication of automotive body-in-white. For this purpose, experimental laser cutting tests were conducted on 1.2 mm sheets at varying levels of laser power, cutting speed, and oxygen pressure. The resulting quality of cut edges was evaluated in terms of perpendicularity tolerance, surface irregularity, kerf width, heat affected zone, and dross extension. Experimental tests were based on a L9(34 orthogonal array design, with the effects of the process parameters on the quality responses being determined by means of a statistical analysis of variance (ANOVA. Quadratic mathematical models were developed to determine the relationships between the cutting parameters and the quality responses. Finally, a routine based on an optimization criterion was employed to predict the optimal setting of cutting factors and its effect on the quality responses. A confirmation experiment was conducted to verify the appropriateness of the optimization routine. The results show that all of the examined process parameters have a key role in determining the cut quality of hot stamping boron steel sheets, with cutting speed and their interactions having the most influencing effects. Particularly, interactions can have an opposite behavior for different levels of the process parameters.

  3. Core-satellite supraparticles to ballistically stamp nanostructures on surfaces.

    Science.gov (United States)

    Oppmann, Maximilian; Miller, Franziska; Thürauf, Sandra; Groppe, Philipp; Prieschl, Johannes; Stauch, Claudia; Mandel, Karl

    2018-03-27

    Nanostructured surfaces are of great importance in a very wide range of fields. They can be obtained by imprint or deposition techniques. However, these are usually sophisticated to perform. Generally, it is not easy to equip an object/product with a nanostructure post manufacturing. Yet, it would be very beneficial to achieve a modification of an arbitrary surface with a nanostructure of choice at a later stage by an approach that is simple to perform without the need of sophisticated equipment or excessive treatment by physico-chemical methods. Herein, such a process is reported which combines two "old-fashioned" techniques, namely sandblasting and rubber-stamping, and translates them to the "nano-world". By creating core-satellite supraparticles via spray-drying, a ballistic core-satellite stamp particle system is obtained which can be used to easily transfer a wide range of nanoparticles to a great variety of surfaces to equip these with a nanostructure and subsequently advanced properties. These include water-repellant, anti-fouling or anti-dust surfaces. Moreover, it is also demonstrated that the approach can be used to manufacture well-defined nano-imprinted surfaces. Such surfaces showed an improved spreading behavior for aliphatic alcohols, thus rendering such surfaces for instance very susceptible for disinfectants. All in all, the simple technique described herein has a great potential for creating nanostructured surfaces on nearly any surface.

  4. Stamping, Clapping and Chanting: An Ancient Learning Pathway?

    Directory of Open Access Journals (Sweden)

    Marion M. Long

    2006-04-01

    Full Text Available In this review I explore the effect of temporal integration as a means of improving learning in schoolchildren. I focus first on theorists that have linked physical activity with a positive effect on children’s learning and second to psychological studies that have established the existence of innate temporal patterns. These findings are related to a model of temporal integration that I have developed from Croce’s writings on aesthetics (1900. From philosophy to neurology, I discuss recent neurological findings relating to timing and conclude that an organ of temporal integration, regulation and coordination operates in the brain with respect to physical, intuitive and higher cognitive function. I link recent findings in neurophysiology to notably similar findings in recent biomusicological studies. The finding that humans have an involuntary physical response to loud, low-frequency sounds are attributed to an innate legacy of proto-music and proto-dance behaviour among hominids. I develop the model of temporal integration further by examining the literature on stamping and clapping patterns of ancient traditional dances in relation to Husserl’s writings on theoretical succession. From philosophy to pedagogy, I summarise the review by proposing stamping, clapping and chanting as a means of achieving improved temporal integration.

  5. Size Effect Studies on Tensile Tests for Hot Stamping Steel

    Science.gov (United States)

    Chen, Xiaodu; Li, Yuanyuan; Han, Xianhong; Zhang, Junbo

    2018-02-01

    Tensile tests have been widely used to determine basic mechanical properties of materials. However, the properties measured may be related to geometrical factors of the tested samples especially for high-strength steels; this makes the properties' definitions and comparisons difficult. In this study, a series of tensile tests of ultra-high-strength hot-stamped steel were performed; the geometric shapes and sizes as well as the cutting direction were modified. The results demonstrate that the hot-stamped parts were isotropic and the cutting direction had no effect; the measured strengths were practically unrelated to the specimen geometries, including both size and shape. The elongations were slightly related to sample sizes within the studied range but highly depended on the sample shape, represented by the coefficient K. Such phenomena were analyzed and discussed based on microstructural observations and fracture morphologies. Moreover, two widely used elongation conversion equations, the Oliver formula and Barba's law, were introduced to verify their applicability, and a new interpolating function was developed and compared.

  6. Two Important Stamp Motifs in Roman Britain and Thereafter

    Directory of Open Access Journals (Sweden)

    Diana C. Briscoe

    2016-03-01

    Full Text Available Stamped pottery has had a long and varied history in Britain. There have been periods when it flourished and periods when it almost totally disappeared. This article considers two variations of the rosette motif (A 5 and their fortunes from the late Iron Age to the Early Saxon period. Having been of little importance in the Iron Age and early Roman periods, they became some of the most widely used and distributed motifs in the fourth century. By the fifth century, they were still important, but formed a much smaller proportion of the total motifs than in the fourth century. In the vast majority of cases, there is no correlation between the find spots of fourth and fifth century examples. However, I have identified nine locations where one or other of the two motifs have been found on a late Roman site, which lies within a mile of another site with the same motif, but from the post-Roman period. In these rare conjunctions, I believe that ongoing usage of the motif can be demonstrated from Roman to post-Roman times. It is also clear that pot stamp evidence can be vital in identifying these highly unusual locations and pointing other researchers to sites worthy of special attention.

  7. Elsa Baxter, head of the Swiss Post Office's Stamps and Philately Unit, presents to Robert Aymar, CERN's Director-General, the Swiss commemorative stamp dedicated to CERN

    CERN Multimedia

    Patrice Loiez

    2004-01-01

    'I am delighted to offer you a special stamp which commemorates your Laboratory's fifty-year history and pays tribute to its achievements, its pioneering spirit and its perseverance' said Mrs Baxter to Robert Aymar, CERN's Director-General.

  8. 76 FR 14637 - State Medicaid Fraud Control Units; Data Mining

    Science.gov (United States)

    2011-03-17

    ...] State Medicaid Fraud Control Units; Data Mining AGENCY: Office of Inspector General (OIG), HHS. ACTION... and analyzing State Medicaid claims data, known as data mining. To support and modernize MFCU efforts... (FFP) in the costs of defined data mining activities under specified conditions. In addition, we...

  9. 78 FR 29055 - State Medicaid Fraud Control Units; Data Mining

    Science.gov (United States)

    2013-05-17

    ...] State Medicaid Fraud Control Units; Data Mining AGENCY: Office of Inspector General (OIG), HHS. ACTION... analyzing State Medicaid data, known as data mining. To support and modernize MFCU efforts to effectively... costs of defined data mining activities under specified circumstances. In addition, we finalize...

  10. The Oregon experiment--effects of Medicaid on clinical outcomes

    NARCIS (Netherlands)

    Baicker, K.; Taubman, S.L.; Allen, H.L.; Bernstein, M.; Gruber, J.H.; Newhouse, J.P.; Schneider, E.C.; Wright, B.J.; Zaslavsky, A.M.; Finkelstein, A.N.; Carlson, M.; Edlund, T.; Gallia, C.; Smith, J.; et al.,

    2013-01-01

    BACKGROUND: Despite the imminent expansion of Medicaid coverage for low-income adults, the effects of expanding coverage are unclear. The 2008 Medicaid expansion in Oregon based on lottery drawings from a waiting list provided an opportunity to evaluate these effects. METHODS: Approximately 2 years

  11. Trends in Medicaid fee-for-service outpatient drug utilization ...

    African Journals Online (AJOL)

    in the total number of prescriptions as also the prices of generic drugs. Thus, higher utilization of generic drugs may offer substantial savings to Medicaid programs at the state level. Keywords: Fee-for-service programs, Medicaid program, Generic drug utilization; Branded drugs,. Patient Protection and Affordable Care Act.

  12. 76 FR 57807 - Medicaid Program; Recovery Audit Contractors

    Science.gov (United States)

    2011-09-16

    ... that it was fundamentally opposed to contingency fees in Medicare and Medicaid auditing. According to... States to coordinate with other contractors and entities auditing Medicaid providers and with State and.... Once a State elects to participate in the program, it is required to comply with its State Plan, as...

  13. Women Putting Our Stamp on America: Biographies and Activities for National Women's History Month, March 1999.

    Science.gov (United States)

    National Women's History Project, Windsor, CA.

    This booklet, intended for use by educators and by workplace and community organizers, introduces women who have been featured on U.S. postage stamps as well as a few of the women who clearly merit such honor in the future. Postage stamps featuring women have been relatively few and far between and have only skimmed the surface of U.S. women in…

  14. Food Stamps and Food Insecurity: What Can Be Learned in the Presence of Nonclassical Measurement Error?

    Science.gov (United States)

    Gundersen, Craig; Kreider, Brent

    2008-01-01

    Policymakers have been puzzled to observe that food stamp households appear more likely to be food insecure than observationally similar eligible nonparticipating households. We reexamine this issue allowing for nonclassical reporting errors in food stamp participation and food insecurity. Extending the literature on partially identified…

  15. 27 CFR 70.332 - Unauthorized use or sale of stamps.

    Science.gov (United States)

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Unauthorized use or sale....332 Unauthorized use or sale of stamps. Any person who buys, sells, offers for sale, uses, transfers... Code or in regulations made pursuant thereto, any stamp, coupon, ticket, book, or other device...

  16. Clay Houses

    Science.gov (United States)

    Pedro, Cathy

    2011-01-01

    In this article, the author describes a project designed for fourth-graders that involves making clay relief sculptures of houses. Knowing the clay houses will become a family heirloom makes this lesson even more worth the time. It takes three classes to plan and form the clay, and another two to underglaze and glaze the final products.

  17. Determination of the Interfacial Heat Transfer Coefficient in the Hot Stamping of AA7075

    Directory of Open Access Journals (Sweden)

    Ji Kang

    2016-01-01

    Full Text Available The interfacial heat transfer coefficient (IHTC is a key parameter in hot stamping processes, in which a hot blank is formed and quenched by cold dies simultaneously. The IHTC should therefore be identified and used in FE simulations to improve the accuracy of simulation results of hot stamping processes. In this work, a hot stamping simulator was designed and assembled in a Gleeble 3800 thermo-mechanical testing system and a FE model was built in PAM-STAMP to determine the IHTC values between a hot aluminium alloy 7075 blank and cold dies. The IHTC values were determined at different contact pressures under both dry and lubricated (Omega-35 conditions. In addition, a model to calculate the IHTC value at different contact pressures and area densities of lubricant was developed for the hot stamping process, which was proved to be working well with verification tests.

  18. Determination of the interfacial heat transfer coefficient in the hot stamping of AA7075

    Directory of Open Access Journals (Sweden)

    Liu Xiaochuan

    2015-01-01

    Full Text Available The interfacial heat transfer coefficient (IHTC is a key parameter in hot stamping processes, in which a hot blank is formed and quenched by cold dies simultaneously. The IHTC should therefore be identified and used in FE models to improve the accuracy of simulation results of hot stamping processes. In this work, a hot stamping simulator was designed and assembled in a Gleeble 3800 thermo-mechanical testing system and a FE model was built in PAM-STAMP to determine the IHTC value between a hot aluminium alloy 7075 blank and cold dies. The IHTC was determined at different contact pressures under both dry and lubricated (Omega-35 conditions. In addition, a model to calculate the IHTC value at different contact pressures and area densities of lubricant was developed for the hot stamping process.

  19. Influence of preconsolidation on consolidation quality after stamp forming of C/PEEK composites

    Science.gov (United States)

    Slange, T. K.; Warnet, L.; Grouve, W. J. B.; Akkerman, R.

    2016-10-01

    Stamp forming is a rapid manufacturing technology used to shape flat blanks of thermoplastic composite material into three-dimensional components. Currently, expensive autoclave and press consolidation are used to preconsolidate blanks. This study investigates the influence of preconsolidation on final consolidation quality after stamp forming and explores the potential of alternative blank manufacturing methods that could reduce part costs. Blanks were manufactured using various blank manufacturing methods and subsequently were stamp formed. The consolidation quality both before and after stamp forming was compared, where the focus was on void content as the main measure for consolidation quality. The void content was characterized through thickness and density measurements, as well as by microscopy analysis. Results indicate that preconsolidation quality does have an influence on the final consolidation quality. This is due to the severe deconsolidation and limited reconsolidation during stamp forming. Nevertheless, the potential of automated fiber placement and ultrasonic spot welding as alternative blank manufacturing methods was demonstrated.

  20. Automatic machine for the stamp charging of cakes of coal for coking. Machine automatique pour le pilonnage des pains de charbon a cokefier

    Energy Technology Data Exchange (ETDEWEB)

    Baro, R.; Crauser, L.; Mely, A.

    1988-06-29

    This machine, which consists of several basic stamp chargers that are interlinked and each of which has several stamps, has a total length that is one run less than the length of the stamp charging box, all the stamps being a constant distance apart which is at most equal to the said run so that the alternating movement of the machine along the rung ensures that the coal is stamp charged along the whole length of the stamp charging box, the stamps being, in addition, braked and stopped when necessary by an idler roller device that acts automatically in the stamp's ascending direction.

  1. Titanium nitride stamps replicating nanoporous anodic alumina films

    International Nuclear Information System (INIS)

    Navas, D; Sanchez, O; Asenjo, A; Jaafar, M; Baldonedo, J L; Vazquez, M; Hernandez-Velez, M

    2007-01-01

    Fabrication of nanostructured TiN films by magnetron sputtering using nanoporous anodic alumina films (NAAF) as substrates is reported. These hard nanostructured films could be used for pre-patterning aluminium foils and to obtain nanoporous films replicating the starting NAAF over a wide range of pore diameters and spacings. Pre-patterned Al foils are obtained by compression with pressures lower than those previously reported, then a new NAAF can be fabricated by means of only one anodization process. As an example, one of the TiN stamps was used for pre-patterning an Al foil at a pressure of 200 kg cm -2 and then it was anodized in oxalic acid solution obtaining the corresponding replica of the starting NAAF

  2. A novel time stamping technique for distributed data acquisition systems

    Science.gov (United States)

    Subramaniam, E. T.

    2012-12-01

    In this paper, we discuss the design and implementation of a synchronizing technique for data acquisition systems, which can effectively use the normal, standard local area network cables to provide a time stamp, with a range up to 32 days, resolution of 10 ns, and synchronization within ± 5 ns. This system may be used to synchronize data being collected by independent heterogeneous data acquisition modules, that acquire events independently. Such distributed systems are generally designed with a tree-like structure or independent self-triggered acquisition boxes. These leaf edges are connected through branches to the root node, via non-bus based inter-connecting links. The present system has been tested with a set of self-triggered digital signal processing based data acquisition engines, having a 100 MHz analog to digital converter front end.

  3. Cliff House

    OpenAIRE

    Treser, Steven Thomas

    2006-01-01

    This thesis began with the goal of designing a bold house cantilevered over the edge of a cliff 120 feet above the water, and evolved into the study of how to design when starting with the primary form of a cube. The cube was chosen as representing the crystalline form of the rock upon which the house sits. The outside shell of the house is horizontal, board formed concrete, also in reference to the layered rock of the cliff face. There are two primary forces cutting away the mas...

  4. Impact of state Medicaid coverage on utilization of inpatient rehabilitation facilities among patients with stroke.

    Science.gov (United States)

    Skolarus, Lesli E; Burke, James F; Morgenstern, Lewis B; Meurer, William J; Adelman, Eric E; Kerber, Kevin A; Callaghan, Brian C; Lisabeth, Lynda D

    2014-08-01

    Poststroke rehabilitation is associated with improved outcomes. Medicaid coverage of inpatient rehabilitation facility (IRF) admissions varies by state. We explored the role of state Medicaid IRF coverage on IRF utilization among patients with stroke. Working age ischemic stroke patients with Medicaid were identified from the 2010 Nationwide Inpatient Sample. Medicaid coverage of IRFs (yes versus no) was ascertained. Primary outcome was discharge to IRF (versus other discharge destinations). We fit a logistic regression model that included patient demographics, Medicaid coverage, comorbidities, length of stay, tissue-type plasminogen activator use, state Medicaid IRF coverage, and the interaction between patient Medicaid status and state Medicaid IRF coverage while accounting for hospital clustering. Medicaid did not cover IRFs in 4 (TN, TX, SC, WV) of 42 states. The impact of State Medicaid IRF coverage was limited to Medicaid stroke patients (P for interaction stroke patients in states with Medicaid IRF coverage, Medicaid stroke patients hospitalized in states without Medicaid IRF coverage were less likely to be discharged to an IRF of 11.6% (95% confidence interval, 8.5%-14.7%) versus 19.5% (95% confidence interval, 18.3%-20.8%), Pstroke patients with Medicaid. Given the increasing stroke incidence among the working age and Medicaid expansion under the Affordable Care Act, careful attention to state Medicaid policy for poststroke rehabilitation and analysis of its effects on stroke outcome disparities are warranted. © 2014 American Heart Association, Inc.

  5. Pediatric dentist density and preventive care utilization for Medicaid children

    Science.gov (United States)

    Heidenreich, James F.; Kim, Amy S.; Scott, JoAnna M.; Chi, Donald L.

    2014-01-01

    Purpose This study evaluates the relationship between county-level pediatric dentist density and dental care utilization for Medicaid-enrolled children in Washington State. Methods This is a cross-sectional analysis of 604,885 children ages 0-17 enrolled in the Washington State Medicaid Program for ≥11 months in 2012. The relationship between county-level pediatric dentist density, defined as the number of pediatric dentists per 10,000 Medicaid-enrolled children, and preventive dental care utilization was evaluated using linear regression models. Results In 2012, 179 pediatric dentists practiced in 16 of the 39 counties in Washington. County-level pediatric dentist density varied from zero to 5.98 pediatric dentists per 10,000 Medicaid-enrolled children. County-level preventive dental care utilization ranged from 32 percent to 81 percent, with 62 percent of Medicaid-enrolled children in Washington utilizing preventive dental services. After adjusting for confounders, county-level density was significantly associated with county-level dental care utilization (β=1.67, 95 percent CI=0.02, 3.32, p=0.047). Conclusions There is a significant relationship between pediatric dentist density and the proportion of Medicaid-enrolled children who utilize preventive dental care services. Policies aimed at improving pediatric oral health disparities should include strategies to increase the number of oral health care providers, including pediatric dentists, in geographic areas with large proportions of Medicaid-enrolled children. PMID:26314606

  6. Measuring Medicaid Physician Participation Rates and Implications for Policy.

    Science.gov (United States)

    Sommers, Benjamin D; Kronick, Richard

    2016-04-01

    Policy makers continue to debate Medicaid expansion under the Affordable Care Act, and concerns remain about low provider participation in the program. However, there has been little research on how various measures of physician participation may reflect different elements of capacity for care within the Medicaid program and how these distinct measures correlate with one another across states. Our objectives were to describe several alternative measures of provider participation in Medicaid using recently publicly available data, to compare state rankings across these different metrics, and to discuss potential advantages and disadvantages of each measure for research and policy purposes. Overall, we find that Medicaid participation as measured by raw percentages of physicians taking new Medicaid patients is only weakly correlated with population-based measures that account for both participation rates and the numbers of physicians per capita or physicians per Medicaid beneficiary. Participation rates for all physicians versus primary care physicians also offer different information about state-level provider capacity. Policy makers should consider multiple dimensions of provider access in assessing policy options in Medicaid, and further research is needed to evaluate the linkages between these provider-based measures and beneficiaries' perceptions of access to care in the program. Copyright © 2016 by Duke University Press.

  7. Obstetricians' receptiveness to teen prenatal patients who are Medicaid recipients.

    Science.gov (United States)

    Gifford, B

    1997-08-01

    To test the accuracy of various physicians' participation in Medicaid models. Primary data on 221 obstetricians and gynecologists in the Chicago area by telephone interviews over a four-month period. These data were combined with secondary data from the American Medical Association Master File (1993) and U.S. Census data (1990). Telephone interviewers posing as the older sisters of a pregnant teenager who is a Medicaid recipient sought information regarding the care provided in a first prenatal care appointment (e.g., appointment duration, tests administered, delivery privileges, appointment availability). A "receptionist helpfulness" variable was developed through pretesting on obstetricians in another city. Inter-interviewer reliability was enhanced through common interview technique education. Only 81 obstetricians (36.7 percent) accepted new Medicaid patients. This finding is lower than previous research on physician participation in Medicaid. There was strong empirical support for both dimensions-cost containment and limited access-of the physicians' receptiveness model, the model introduced with this research. There was limited support for the dual market and residential segregation models of physician participation in Medicaid. It is argued that this study's research design is more accurate in reflecting the barriers that a pregnant Medicaid-eligible patient encounters when seeking office-based prenatal care. As such, combining the physicians' receptiveness model with other physician participation in Medicaid models provides a more complete picture of access barriers to prenatal care for our most needy populations.

  8. White House

    Science.gov (United States)

    ... to navigation the WHITE HOUSE President Donald J. Trump Get in Touch Home Briefing Room From the ... Americans The Administration The Administration President Donald J. Trump Vice President Mike Pence First Lady Melania Trump ...

  9. Conformal House

    DEFF Research Database (Denmark)

    Ryttov, Thomas; Sannino, Francesco

    2010-01-01

    fixed point. As a consistency check we recover the previously investigated conformal windows bounds when restricting to a single matter representation. The earlier conformal windows can be imagined to be part now of the new conformal house. We predict the nonperturbative anomalous dimensions...... at the infrared fixed points. We further investigate the effects of adding mass terms to the condensates on the conformal house chiral dynamics and construct the simplest instanton induced effective Lagrangian terms....

  10. Analysis of roll-stamped light guide plate fabricated with laser-ablated stamper

    Science.gov (United States)

    Na, Hyunjun; Hong, Seokkwan; Kim, Jongsun; Hwang, Jeongho; Joo, Byungyun; Yoon, Kyunghwan; Kang, Jeongjin

    2017-12-01

    LGP (light guide plate) is one of the major components of LCD (liquid crystal display), and it makes surface illumination for LCD backlit. LGP is a transparent plastic plate usually produced by injection molding process. On the back of LGP there are micron size patterns for extraction of light. Recently a roll-stamping process has achieved the high mass productivity of thinner LGPs. In order to fabricate optical patterns on LGPs, a fabricating tool called as a stamper is used. Micro patterns on metallic stampers are made by several micro machining processes such as chemical etching, LIGA-reflow, and laser ablation. In this study, a roll-stamping process by using a laser ablated metallic stamper was dealt with in consideration of the compatibility with the roll-stamping process. LGP fabricating tests were performed using a roll-stamping process with four different roll pressures. Pattern shapes on the stamper fabricated by laser ablation and transcription ratios of the roll-stamping process were analyzed, and LGP luminance was evaluated. Based on the evaluation, optical simulation model for LGP was made and simulation accuracy was evaluated. Simulation results showed good agreements with optical performance of LGPs in the brightness and uniformity. It was also shown that the roll-stamped LGP has the possibility of better optical performance than the conventional injection molded LGP. It was also shown that the roll-stamped LGP with the laser ablated stamper is potential to have better optical performance than the conventional injection molded LGP.

  11. A unique patterned diamond stamp for a periodically hierarchical nanoarray structure

    Science.gov (United States)

    Wang, Yi; Shen, Yanting; Xu, Weiqing; Xu, Shuping; Li, Hongdong

    2016-10-01

    A diamond stamp with a hierarchical pattern was designed for the direct preparation of a periodic nanoarray structure, which was prepared by the reactive ion etching technique with a hierarchical ultrathin alumina membrane (HUTAM) as a mask. The optimal etching conditions for fabricating the diamond stamp were discussed in order to realize a vertical nanopore structure, avoiding structural damage from lateral etching. By using this diamond stamp, a polymer film with the desired hierarchical nanorod array structure can be obtained easily via the simple stamping process, which greatly simplifies the processing procedure. More importantly, the stamp is reusable because of its super-hardness, which ensures the reproducibility of the nanorod array pattern. Another merit is that the smooth surface of the etched diamond can avoid the use of a release agent. Our results prove that this hard stamp can be used for quick preparation of an elaborate periodic nanoarray structure. This study is significant in that it solves the problems of high cost and easy damage of stamps in nanoimprint lithography, and it might inspire more sophisticated applications of such an ordered structure in nanoplasmonics, biochemical sensing and nanophotonic devices.

  12. Ambulatory practice variation in Maryland: Implications for Medicaid cost management

    Science.gov (United States)

    Stuart, Mary; Steinwachs, Donald; Harlow, Jennifer; Fox, Michael

    1990-01-01

    Simulation modeling with data from the Maryland Medicaid Management Information System has provided an opportunity to examine policy options and assess their likely impact on savings before program decisions were made. Analysis of a large sample of the Maryland Aid to Families with Dependent Children (AFDC) Medicaid subpopulation confirms that a significant difference in utilization and cost to Medicaid exists between usual sources of care for AFDC clients even after controlling for patient demographics and case-mix differences. Findings indicate that savings from reduced use of hospital outpatient departments may offset increases of as much as 40–50 percent in physician fees under certain assumptions. PMID:10113498

  13. Trends in Medicaid physician fees, 2003-2008.

    Science.gov (United States)

    Zuckerman, Stephen; Williams, Aimee F; Stockley, Karen E

    2009-01-01

    Medicaid physician fees increased 15.1 percent, on average, between 2003 and 2008. This was below the general rate of inflation, resulting in a reduction in real fees. Only primary care fees grew at the rate of inflation-20 percent between 2003 and 2008. However, because of slow growth in Medicare fees, Medicaid fees closed a small portion of their ongoing gap relative to Medicare-growing from 69 percent to 72 percent of Medicare. The increase in Medicaid fees relative to Medicare fees resulted from relative increases for primary care and obstetrical services, but not for other services.

  14. Surge in newly identified diabetes among medicaid patients in 2014 within medicaid expansion States under the affordable care act.

    Science.gov (United States)

    Kaufman, Harvey W; Chen, Zhen; Fonseca, Vivian A; McPhaul, Michael J

    2015-05-01

    Twenty-six states and the District of Columbia expanded Medicaid in January 2014 pursuant to the Affordable Care Act (ACA); 24 states did not. This created an opportunity to examine the impact of Medicaid expansion on the number of Medicaid patients with newly identified diabetes among enrollees (19-64 years of age) who had laboratory testing through Quest Diagnostics. Newly identified diabetes was defined as an ICD-9 diagnosis code of 250.x (diabetes) or hemoglobin A1c of >6.4% (46 mmol/mol) within the first 6 months of a calendar year and the absence of both in the preceding calendar year within our data repository. We identified 215,398 and 218,890 patients who met our definition of newly diagnosed diabetes within the first 6 months of 2013 (control period) and 2014 (study period), respectively (a 1.6% increase). We identified 26,237 Medicaid-enrolled patients with new diabetes in the control period vs. 29,673 in the study period: an increase of 13%. The number of Medicaid-enrolled patients with newly identified diabetes increased by 23% (14,625 vs. 18,020 patients) in the 26 states (and District of Columbia) that expanded Medicaid compared with an increase of 0.4% (11,612 vs. 11,653 patients) in the 24 states that did not expand Medicaid during this period. Similar differences were observed in younger and older adults and for both men and women. This study suggests that in the states that expanded Medicaid under the ACA, an increased number of Medicaid patients with diabetes are being diagnosed and treated earlier. This could be anticipated to lead to better long-term outcomes. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  15. Resistless Fabrication of Nanoimprint Lithography (NIL Stamps Using Nano-Stencil Lithography

    Directory of Open Access Journals (Sweden)

    Juergen Brugger

    2013-10-01

    Full Text Available In order to keep up with the advances in nano-fabrication, alternative, cost-efficient lithography techniques need to be implemented. Two of the most promising are nanoimprint lithography (NIL and stencil lithography. We explore here the possibility of fabricating the stamp using stencil lithography, which has the potential for a cost reduction in some fabrication facilities. We show that the stamps reproduce the membrane aperture patterns within ±10 nm and we validate such stamps by using them to fabricate metallic nanowires down to 100 nm in size.

  16. Conical tungsten stamps for the replication of pore arrays in anodic aluminium oxide films

    Science.gov (United States)

    LeClere, D. J.; Thompson, G. E.; Derby, B.

    2009-06-01

    A tungsten master stamp has been generated by applying a novel procedure that includes two-step anodizing, followed by sequential anodizing and pore widening to develop nominally funnelled pores. These conical-shaped pores were filled with tungsten by sputter coating to manufacture a master stamp. Under a pressure of 65 MPa, the master stamp successfully embossed the surface of annealed and electropolished aluminium. The embossed surface was then used to control the position of pores created by anodizing under the conditions used to produce the original pore array.

  17. Limited indications of tax stamp discordance and counterfeiting on cigarette packs purchased in tobacco retailers, 97 counties, USA, 2012.

    Science.gov (United States)

    Lee, Joseph G L; Golden, Shelley D; Ribisl, Kurt M

    2017-12-01

    Increasing the per-unit cost of tobacco products is one of the strongest interventions for tobacco control. In jurisdictions with higher taxes in the U.S., however, cigarette pack litter studies show a substantial proportion of littered packs lack the appropriate tax stamp. More limited but still present counterfeiting also exists. We sought to examine the role of tobacco retailers as a source for untaxed and counterfeit products. Data collectors purchased Newport Green (menthol) or Marlboro Red cigarette packs in a national probability-based sample of tobacco retailers (in 97 counties) from June-October 2012. They made no effort to buy counterfeit or untaxed cigarettes. In this cross-sectional study, we assessed the presence, tax authority, and type (low-tech thermal vs. encrypted) of cigarette pack tax stamps; concordance of tax stamps with where the pack was purchased; and, for Marlboro cigarettes, publicly available visible indicators of counterfeiting. We purchased 2147 packs of which 2033 had tax stamps. Packs missing stamps were in states that do not require them. We found very limited discordance between store location and tax stamp(s) (tax stamps (13%). This occurred entirely with low-tech tax stamps and was not identified with encrypted tax stamps. We found no clear evidence of counterfeit products. Almost all tax stamps matched the location of purchase. Litter studies may be picking up legal tax avoidance instead of illegal tax evasion or, alternatively, purchase of illicit products requires special request by the purchaser.

  18. How Medicaid agencies administer mental health services: results from a 50-state survey.

    Science.gov (United States)

    Verdier, James; Barrett, Allison

    2008-10-01

    This brief report describes some notable variations in how state Medicaid agencies administer and fund Medicaid mental health services. Hour-long telephone interviews were conducted with all state and District of Columbia Medicaid directors or their designees. Responses indicated that Medicaid and mental health agencies were located within the same umbrella agency in 28 states, potentially facilitating collaboration. The mental health agency provided funding for some Medicaid mental health services in 32 states, and counties provided such funding in 22 states. Medicaid agencies generally delegated more authority to state mental health agencies in states where some Medicaid funding came from mental health sources and also in states where both agencies were in the same umbrella agency. The increasing role of Medicaid in funding state mental health services, combined with new federal limits on Medicaid financing of these services, underscores the importance of interagency collaboration and better alignment of Medicaid and mental health responsibilities.

  19. Migration Patterns for Medicaid Enrollees 2005-2007

    Data.gov (United States)

    U.S. Department of Health & Human Services — Baugh and Verghese used unduplicated Medicaid enrollment records for 2005-2007 to examine enrollee migration between states. This study, published in Volume 3, Issue...

  20. Medicaid Coverage Of Cessation Treatments And Barriers To Treatments

    Data.gov (United States)

    U.S. Department of Health & Human Services — 2008-2017. American Lung Association. Cessation Coverage. Medicaid data compiled by the Centers for Disease Control and Prevention’s Office on Smoking and Health...

  1. Medicaid Analytic eXtract (MAX) Rx Table Listing

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Statistical Compendium table listing (below) enables users to choose to view Medicaid prescription drug tables for 1999 - 2009, and to select the tables for the...

  2. Drug Products in the Medicaid Drug Rebate Program

    Data.gov (United States)

    U.S. Department of Health & Human Services — Active drugs that have been reported by participating drug manufacturers under the Medicaid Drug Rebate Program. All drugs are identified by National Drug Code...

  3. Medicare and Medicaid Trends in Health Care Sectors

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Centers for Medicare and Medicaid Services (CMS) provides monthly and fiscal-year-to-date income and expenditure trends for Medicare Hospital Insurance (HI) and...

  4. Potential Medicaid Cost Savings from Maternity Care Based..

    Data.gov (United States)

    U.S. Department of Health & Human Services — Medicaid pays for about half the births in the United States, at very high cost. Compared to usual obstetrical care, care by midwives at a birth center could reduce...

  5. Express Lane Eligibility for Medicaid and CHIP Coverage

    Data.gov (United States)

    U.S. Department of Health & Human Services — States may rely on eligibility information from "Express Lane" agency programs to streamline and simplify enrollment and renewal in Medicaid and CHIP. Express Lane...

  6. State Medicaid and CHIP Applications, Eligibility Determinations, and Enrollment Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — All states (including the District of Columbia) are required to provide data to The Centers for Medicare & Medicaid Services (CMS) on a range of indicators...

  7. Increased Use of Dental Services by Children in Medicaid

    Data.gov (United States)

    U.S. Department of Health & Human Services — This report analyzes the use of dental services by children enrolled in Medicaid from federal fiscal years (FFY) 2000 to 2010. The number and percent of children...

  8. Medicaid Managed Care Penetration Rates and Expansion Enr...

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Medicaid managed care penetration rates and expansion enrollment by state charts are composed annually by the Data and System Group (DSG) of the Centers for...

  9. Medicare-Medicaid Ever-enrolled Trends Report

    Data.gov (United States)

    U.S. Department of Health & Human Services — This detailed Excel document accompanies the PDF report on national trends in Medicare-Medicaid dual enrollment from 2006 through the year prior to the current year....

  10. State-County Profiles of Medicare-Medicaid dual Benes

    Data.gov (United States)

    U.S. Department of Health & Human Services — This 6-page document provides key statistics on Medicare-Medicaid dual enrollees enrollment, service utilization, expenditures, and chronic conditions for 2012. 2012...

  11. Medicaid Coverage Of Cessation Treatments And Barriers To Treatments

    Data.gov (United States)

    U.S. Department of Health & Human Services — 2008-2017. American Lung Association. Cessation Coverage. Medicaid data compiled by the Centers for Disease Control and Prevention’s Office on Smoking and Health...

  12. Medicaid and CHIP Payment and Access Commission - statistics

    Data.gov (United States)

    U.S. Department of Health & Human Services — MACStats includes state-specific information about program enrollment, spending, eligibility levels, optional Medicaid benefits covered, and the federal medical...

  13. Center for Medicare & Medicaid Services (CMS) , Medicare Claims data

    Data.gov (United States)

    U.S. Department of Health & Human Services — 2003 forward. CMS compiles claims data for Medicare and Medicaid patients across a variety of categories and years. This includes Inpatient and Outpatient claims,...

  14. National Profile of Medicare-Medicaid dual Beneficiaries

    Data.gov (United States)

    U.S. Department of Health & Human Services — This provides key statistics on Medicare-Medicaid dual enrollees enrollment, service utilization, expenditures, and chronic conditions for 2012. 2012 is the most...

  15. Medicaid Coverage Of Cessation Treatments And Barriers To Treatments

    Data.gov (United States)

    U.S. Department of Health & Human Services — 2008-2018. American Lung Association. Cessation Coverage. Medicaid data compiled by the Centers for Disease Control and Prevention’s Office on Smoking and Health...

  16. Medicaid Coverage Of Cessation Treatments And Barriers To Treatments

    Data.gov (United States)

    U.S. Department of Health & Human Services — 2008-2016. American Lung Association. Cessation Coverage. Medicaid data compiled by the Centers for Disease Control and Prevention’s Office on Smoking and Health...

  17. Characterization of Medicaid policy for immediate postpartum contraception.

    Science.gov (United States)

    Moniz, Michelle H; Dalton, Vanessa K; Davis, Matthew M; Forman, Jane; Iott, Bradley; Landgraf, Jessica; Chang, Tammy

    2015-12-01

    Long-acting reversible contraception (LARC) is safe, effective and cost-saving when provided immediately postpartum but currently underutilized due to nonreimbursement by Medicaid and other insurers. The objectives of this study were to (a) determine which state Medicaid agencies provide specific reimbursement for immediate postpartum LARC and (b) identify modifiable policy-level barriers and facilitators of immediate postpartum LARC access. We conducted semistructured telephone interviews with representatives of 40 Medicaid agencies to characterize payment methodology for immediate postpartum LARC. We coded transcripts using grounded theory and content analysis principles. Three categories of immediate postpartum LARC payment methodology emerged: state Medicaid agency (a) provides separate or increased bundled payment (n=15), (b) is considering providing enhanced payment (n=9) or (c) is not considering enhanced payment (n=16). Two major themes emerged related to Medicaid decision-making about immediate postpartum LARC coverage: (a) Health effects: States with payment for immediate postpartum LARC frequently cited improved maternal/child health outcomes as motivating their reimbursements. Conversely, states without payment expressed misinformation about LARC's clinical effects and lack of advocacy from local providers about clinical need for this service. (b) Financial implications: States providing payment emphasized overall cost savings. Conversely, states without reimbursement expressed concern about immediate budget constraints and potential adverse impact on existing global payment methodology for inpatient care. Many states have recently provided Medicaid coverage of immediate postpartum LARC, and several other states are considering such coverage. Addressing misinformation about clinical effects and concerns about cost-effectiveness of immediate postpartum LARC may promote adoption of immediate postpartum LARC reimbursement in Medicaid agencies currently

  18. Closing Kynect and Restructuring Medicaid Threaten Kentucky's Health and Economy.

    Science.gov (United States)

    Wright, Charles B; Vanderford, Nathan L

    2017-08-01

    Following passage of the Patient Protection and Affordable Care Act (ACA) in the United States, the Kentucky Health Benefit Exchange, Kynect, began operating in Kentucky in October 2013. Kentucky expanded Medicaid eligibility in January 2014. Together, Kynect and Medicaid expansion provided access to affordable health care coverage to hundreds of thousands of individuals in Kentucky. However, following the Kentucky gubernatorial election in 2015, the newly inaugurated governor moved to dismantle Kynect and restructure the Medicaid expansion, jeopardizing public health gains and the state economy. As the first state to announce both the closure and restructuring of a state health insurance marketplace and Medicaid expansion, Kentucky may serve as a test case for the rest of the nation for reversal of ACA-related health policies. This article describes Kynect and the Kentucky Medicaid expansion and examines the potential short-term and long-term impacts that may occur following changes in state health policy. Furthermore, this article will offer potential strategies to ameliorate the expected negative impacts of disruption of both Kynect and the Medicaid expansion, such as the creation of a new state insurance marketplace under a new governor, the implementation of a private option, and increasing the state minimum wage for workers. Copyright © 2017 by Duke University Press.

  19. Impact of Wisconsin Medicaid Policy Change on Dental Sealant Utilization.

    Science.gov (United States)

    Okunseri, Christopher; Okunseri, Elaye; Garcia, Raul I; Gonzalez, Cesar; Visotcky, Alexis; Szabo, Aniko

    2018-02-01

    In September 2006, Wisconsin Medicaid changed its policy to allow nondentists to become certified Medicaid providers and to bill for sealants in public health settings. This study examined changes in patterns of dental sealant utilization in first molars of Wisconsin Medicaid enrollees associated with a policy change. The Electronic Data Systems of Medicaid Evaluation and Decision Support for Wisconsin from 2001 to 2009. Retrospective claims data analysis of Wisconsin Dental Medicaid for children aged 6-16 years. A total of 479,847 children followed up for 1,441,300 person-years with 64,546 visits were analyzed. The rate of visits for sealants by dentists increased significantly from 3 percent per year prepolicy to 11 percent per year postpolicy, and that of nondentists increased from 18 percent per year to 20 percent after the policy change, but this was not significant. Non-Hispanic blacks had the lowest visit rates for sealant application by dentists and nondentists pre- and postpolicy periods. The Wisconsin Medicaid policy change was associated with increased rates of visits for dental sealant placement by dentists. The rate of visits with sealant placements by nondentists increased at the same rate pre- and postpolicy change. © Health Research and Educational Trust.

  20. Can Medicaid Claims Validly Ascertain Foster Care Status?

    Science.gov (United States)

    Raghavan, Ramesh; Brown, Derek S; Allaire, Benjamin T

    2017-08-01

    Medicaid claims have been used to identify populations of children in foster care in the current literature; however, the ability of such an approach to validly ascertain a foster care population is unknown. This study linked children in the National Survey of Child and Adolescent Well-Being-I to their Medicaid claims from 36 states using their Social Security numbers. Using this match, we examined discordance between caregiver report of foster care placement and the foster care eligibility code contained in the child's Medicaid claims. Only 73% of youth placed in foster care for at least a year displayed a Medicaid code for foster care eligibility. Half of all youth coming into contact with child welfare displayed discordance between caregiver report and Medicaid claims. Children with emergency department utilization, and those in primary care case management health insurance arrangements, had the highest odds of accurate ascertainment. The use of Medicaid claims to identify a cohort of children in foster care results in high rates of underascertainment. Supplementing administrative data with survey data is one way to enhance validity of ascertainment.

  1. Mars Express/MARSIS - Analysis and solution of an anomaly event: MARSIS Data Bad Time Stamp

    Science.gov (United States)

    Giuppi, S.; Cartacci, M.; Cicchetti, A.; Noschese, R.; Orosei, R.

    2011-10-01

    This paper describes the detection, the analysis and the possible solutions of an anomaly event occurred sometimes in MARSIS science data consisting in the corruption of the Spacecraft Event Time (SCET): MARSIS Data Bad Time Stamp.

  2. Process control for sheet-metal stamping process modeling, controller design and shop-floor implementation

    CERN Document Server

    Lim, Yongseob; Ulsoy, A Galip

    2014-01-01

    Process Control for Sheet-Metal Stamping presents a comprehensive and structured approach to the design and implementation of controllers for the sheet metal stamping process. The use of process control for sheet-metal stamping greatly reduces defects in deep-drawn parts and can also yield large material savings from reduced scrap. Sheet-metal forming is a complex process and most often characterized by partial differential equations that are numerically solved using finite-element techniques. In this book, twenty years of academic research are reviewed and the resulting technology transitioned to the industrial environment. The sheet-metal stamping process is modeled in a manner suitable for multiple-input multiple-output control system design, with commercially available sensors and actuators. These models are then used to design adaptive controllers and real-time controller implementation is discussed. Finally, experimental results from actual shopfloor deployment are presented along with ideas for further...

  3. 31 CFR 500.410 - Currency, coins, and postage and other stamps.

    Science.gov (United States)

    2010-07-01

    ... postage and other stamps issued by North Korea, North Viet-Nam, Cambodia, or South Viet-Nam are merchandise of North Korean, North Vietnamese, Cambodian, or South Vietnamese origin subject to § 500.204(a)(1). ...

  4. A burial with a stamp seal depicting a Bes-like figure from Abusir

    Czech Academy of Sciences Publication Activity Database

    Dulíková, V.; Odler, M.; Březinová, Helena; Havelková, P.

    2015-01-01

    Roč. 2015, č. 15 (2015), s. 69-75 ISSN 1214-3189 Institutional support: RVO:67985912 Keywords : Abusir * Old Kingdom * First Intermediate Period * stamp seal * amulet * Bes * reed coffin * entheses Subject RIV: AC - Archeology, Anthropology, Ethnology

  5. Designing and Operating Cost-Effective Medicaid Non-Emergency Transportation Programs; A Guidebook for State Medicaid Agencies

    Science.gov (United States)

    1998-08-01

    Millions of Americans depend on Medicaid-funded transportation to reach medical appointments. In rural areas where medical providers are often in short supply, communities are far from primary care physicians or specialists, and public transportation...

  6. High Thermal Conductivity and High Wear Resistance Tool Steels for cost-effective Hot Stamping Tools

    Science.gov (United States)

    Valls, I.; Hamasaiid, A.; Padré, A.

    2017-09-01

    In hot stamping/press hardening, in addition to its shaping function, the tool controls the cycle time, the quality of the stamped components through determining the cooling rate of the stamped blank, the production costs and the feasibility frontier for stamping a given component. During the stamping, heat is extracted from the stamped blank and transported through the tool to the cooling medium in the cooling lines. Hence, the tools’ thermal properties determine the cooling rate of the blank, the heat transport mechanism, stamping times and temperature distribution. The tool’s surface resistance to adhesive and abrasive wear is also an important cost factor, as it determines the tool durability and maintenance costs. Wear is influenced by many tool material parameters, such as the microstructure, composition, hardness level and distribution of strengthening phases, as well as the tool’s working temperature. A decade ago, Rovalma developed a hot work tool steel for hot stamping that features a thermal conductivity of more than double that of any conventional hot work tool steel. Since that time, many complimentary grades have been developed in order to provide tailored material solutions as a function of the production volume, degree of blank cooling and wear resistance requirements, tool geometries, tool manufacturing method, type and thickness of the blank material, etc. Recently, Rovalma has developed a new generation of high thermal conductivity, high wear resistance tool steel grades that enable the manufacture of cost effective tools for hot stamping to increase process productivity and reduce tool manufacturing costs and lead times. Both of these novel grades feature high wear resistance and high thermal conductivity to enhance tool durability and cut cycle times in the production process of hot stamped components. Furthermore, one of these new grades reduces tool manufacturing costs through low tool material cost and hardening through readily

  7. Insulation from basaltic stamp sand. Final technical report

    Energy Technology Data Exchange (ETDEWEB)

    Williams, F. D.

    1981-04-01

    A Midwest Appropriate Technology Grant was awarded to determine the technical and economic feasibility of producing mineral-fiber insulation directly from extensive deposits of basaltic sand produced during former mining and milling operations in the Keweenaw Peninsula region of Michigan's Upper Peninsula. The amounts of local basaltic sands available and representative chemical compositions were determined. The variation of viscosity with temperature and chemical composition was estimated. Samples were melted and either pulled or blown into fiber. In all cases fiber could be made with a reasonable tensile strength to ensure usefulness. It was concluded that it was technically feasible to produce fibers from basaltic stamp sands of the Upper Peninsula of Michigan. A technical feasibility study using published data, a cost and design analysis of a basalt fiber production plant, a market survey of fiber needs, and an economic analysis for investing in a basalt fiber venture was undertaken. These studies concluded that the local production of basaltic insulation was both feasible and economically reasonable. It was suggested that the plant be located in a region of greater population density with lower utility costs. A representative one-third of these studies is included as appendices A, B, C, and D.

  8. Investigation of the reduction of mouldboard ploughshare wear through hot stamping and hardfacing processes

    OpenAIRE

    YAZICI, Aysel

    2014-01-01

    The effects of the hot stamping process and different hardfacing techniques, such as shielded metal arc welding (SMAW) and gas metal arc welding (GMAW), on the abrasive wear of ploughshares were investigated under field operational conditions. The abrasive wear losses were determined by measuring the weight and dimension changes before and after tillage. The wear losses of hot-stamped and hardfaced ploughshares were less significant than those of the conventionally heat-treated ploughshare sp...

  9. Springback analysis of AA5754 after hot stamping: Experiments and FE modelling

    OpenAIRE

    Wang, A; Zhong, K; El Fakir, O; Sun, C; Wang, L; Lin, J; Dean, TA

    2016-01-01

    In this paper, the springback of the aluminium alloy AA5754 under hot stamping conditions was characterised under stretch and pure bending conditions. It was found that elevated temperature stamping was beneficial for springback reduction, particularly when using hot dies. Using cold dies, the flange springback angle decreased by 9.7 % when the blank temperature was increased from 20 to 450 ?C, compared to the 44.1 % springback reduction when hot dies were used. Various other forming conditio...

  10. Expanding Medicaid, Expanding the Electorate: The Affordable Care Act's Short-Term Impact on Political Participation.

    Science.gov (United States)

    Haselswerdt, Jake

    2017-08-01

    The Affordable Care Act is a landmark piece of social legislation with the potential to reshape health care in the United States. Its potential to reshape politics is also considerable, but existing scholarship suggests conflicting expectations about the law's policy feedbacks, especially given uneven state-level implementation. In this article I focus on the policy feedbacks of the law's Medicaid expansion on political participation, using district-level elections data for 2012 and 2014 US House races and cross-sectional survey data from 2014. I find that the increases in Medicaid enrollment associated with the expansion are related to considerably higher voter turnout and that this effect was likely due to both an increase in turnout for new beneficiaries and a backlash effect among conservative voters opposed to the law and its implementation. These results have important implications for our understanding of the ACA and of the impact of welfare state expansions on political participation, particularly in federalized systems. Copyright © 2017 by Duke University Press.

  11. SCHREINER HOUSE

    African Journals Online (AJOL)

    lte.-.inteJtme.n-t .in 19 21 . .. ~/ . In the oldest part of the house a panel has been left to show visitors the composition and method of construction of the walls during the mid-nineteenth century .. At that time cement was imported, expensive and therefore usually used only for plastering ex- ternally. An examination of the panel ...

  12. A Fully Automated and Robust Method to Incorporate Stamping Data in Crash, NVH and Durability Analysis

    Science.gov (United States)

    Palaniswamy, Hariharasudhan; Kanthadai, Narayan; Roy, Subir; Beauchesne, Erwan

    2011-08-01

    Crash, NVH (Noise, Vibration, Harshness), and durability analysis are commonly deployed in structural CAE analysis for mechanical design of components especially in the automotive industry. Components manufactured by stamping constitute a major portion of the automotive structure. In CAE analysis they are modeled at a nominal state with uniform thickness and no residual stresses and strains. However, in reality the stamped components have non-uniformly distributed thickness and residual stresses and strains resulting from stamping. It is essential to consider the stamping information in CAE analysis to accurately model the behavior of the sheet metal structures under different loading conditions. Especially with the current emphasis on weight reduction by replacing conventional steels with aluminum and advanced high strength steels it is imperative to avoid over design. Considering this growing need in industry, a highly automated and robust method has been integrated within Altair Hyperworks® to initialize sheet metal components in CAE models with stamping data. This paper demonstrates this new feature and the influence of stamping data for a full car frontal crash analysis.

  13. Hot Stamping of Boron Steel Using Partition Heating for Tailored Properties: Experimental Trials and Numerical Analysis

    Science.gov (United States)

    Mu, Yanhong; Wang, Baoyu; Zhou, Jing; Huang, Xu; Li, Xuetao

    2017-11-01

    Hot-stamped components with tailored properties are becoming popular for their better performance in collision. In this article, an M-shaped part with varying properties was formed by hot stamping using partition heating. Different soaking temperatures induce different austenite fractions at the different regions of the blank, resulting in the partitioned microstructure and mechanical properties in a single part. In the high-temperature region, the average tensile strength and elongation are 1565 MPa and 8.65 pct, respectively, and the average tensile strength and elongation are 626 MPa and 24.37 pct, respectively, in the low-temperature region. A finite element model of hot stamping using partition heating was established based on the relationship of austenite fraction with heating temperature determined by the dilatometer test and the stress-strain curve of 22MnB5 with different austenite fractions acquired from the hot tensile test.The differences of temperature, thickness, and Vickers hardness in different zones of the M-shaped part during forming and quenching stages were analyzed. The effects of hot stamping parameters, such as stamping velocity and heating temperature, on the forming and mechanical properties of the tailored M-shaped part were investigated, providing theoretical guidance for the production of tailored hot-stamped components using partition heating.

  14. Carbon nanotube substrates and catalyzed hot stamp for polishing and patterning the substrates

    Science.gov (United States)

    Wang, Yuhuang [Evanston, IL; Hauge, Robert H [Houston, TX; Schmidt, Howard K [Houston, TX; Kim, Myung Jong [Houston, TX; Kittrell, W Carter [Houston, TX

    2009-09-08

    The present invention is generally directed to catalyzed hot stamp methods for polishing and/or patterning carbon nanotube-containing substrates. In some embodiments, the substrate, as a carbon nanotube fiber end, is brought into contact with a hot stamp (typically at 200-800.degree. C.), and is kept in contact with the hot stamp until the morphology/patterns on the hot stamp have been transferred to the substrate. In some embodiments, the hot stamp is made of material comprising one or more transition metals (Fe, Ni, Co, Pt, Ag, Au, etc.), which can catalyze the etching reaction of carbon with H.sub.2, CO.sub.2, H.sub.2O, and/or O.sub.2. Such methods can (1) polish the carbon nanotube-containing substrate with a microscopically smooth finish, and/or (2) transfer pre-defined patterns from the hot stamp to the substrate. Such polished or patterned carbon nanotube substrates can find application as carbon nanotube electrodes, field emitters, and field emitter arrays for displays and electron sources.

  15. Early Childhood Caries and the Impact of Current U.S. Medicaid Program: An Overview

    Directory of Open Access Journals (Sweden)

    Bussma Ahmed Bugis

    2012-01-01

    Full Text Available Pediatric dental caries is the most common chronic disease among children. Above 40% of the U.S. children aged 2–11 years have dental caries; more than 50% of them come from low-income families. Under dental services of the Medicaid program, children enrolled in Medicaid must receive preventive dental services. However, only 1/5 of them utilize preventive dental services. The purpose of this overview is to measure the impact of Medicaid dental benefits on reducing oral health disparities among Medicaid-eligible children. This paper explains the importance of preventive dental care, children at high risk of dental caries, Medicaid dental benefits, utilization of dental preventive services by Medicaid-eligible children, dental utilization influencing factors, and outcome evaluation of Medicaid in preventing dental caries among children. In conclusion, despite the recent increase of children enrolled in Medicaid, utilizing preventive dental care is still a real challenge that faces Medicaid.

  16. 77 FR 5317 - Medicaid Program; Covered Outpatient Drugs

    Science.gov (United States)

    2012-02-02

    ..., commenters must leave their comments in the CMS drop slots located in the main lobby of the building. A stamp... of the following services: Inpatient Hospital Services; Hospice Services; Dental Services, except... exclusivity. We have included these changes within our definition of line extension drugs. (See G.2. Treatment...

  17. Tribological performances of new steel grades for hot stamping tools

    Science.gov (United States)

    Medea, F.; Venturato, G.; Ghiotti, A.; Bruschi, S.

    2017-09-01

    In the last years, the use of High Strength Steels (HSS) as structural parts in car body-in-white manufacturing has rapidly increased thanks to their favourable strength-to-weight ratio and stiffness, which allow a reduction of the fuel consumption to accommodate the new restricted regulations for CO2 emissions control. The survey of the technical and scientific literature shows a large interest in the development of different coatings for the blanks from the traditional Al-Si up to new Zn-based coatings and on the analysis of hard PVD, CVD coatings and plasma nitriding applied on the tools. By contrast, fewer investigations have been focused on the development and test of new tools steels grades capable to improve the wear resistance and the thermal properties that are required for the in-die quenching during forming. On this base, the paper deals with the analysis and comparison the tribological performances in terms of wear, friction and heat transfer of new tool steel grades for high-temperature applications, characterized by a higher thermal conductivity than the commonly used tools. Testing equipment, procedures as well as measurements analyses to evaluate the friction coefficient, the wear and heat transfer phenomena are presented. Emphasis is given on the physical simulation techniques that were specifically developed to reproduce the thermal and mechanical cycles on the metal sheets and dies as in the industrial practice. The reference industrial process is the direct hot stamping of the 22MnB5 HSS coated with the common Al-Si coating for automotive applications.

  18. Social Work's Role in Medicaid Reform: A Qualitative Study.

    Science.gov (United States)

    Bachman, Sara S; Wachman, Madeline; Manning, Leticia; Cohen, Alexander M; Seifert, Robert W; Jones, David K; Fitzgerald, Therese; Nuzum, Rachel; Riley, Patricia

    2017-12-01

    To critically analyze social work's role in Medicaid reform. We conducted semistructured interviews with 46 stakeholders from 10 US states that use a range of Medicaid reform approaches. We identified participants using snowball and purposive sampling. We gathered data in 2016 and analyzed them using qualitative methods. Multiple themes emerged: (1) social work participates in Medicaid reform through clinical practice, including care coordination and case management; (2) there is a gap between social work's practice-level and systems-level involvement in Medicaid innovations; (3) factors hindering social work's involvement in systems-level practice include lack of visibility, insufficient clarity on social work's role and impact, and too few resources within professional organizations; and (4) social workers need more training in health transformation payment models and policy. Social workers have unique skills that are valuable to building health systems that promote population health and reduce health inequities. Although there is considerable opportunity for social work to increase its role in Medicaid reform, there is little social work involvement at the systems level.

  19. Diversity of Physicians’ Handwriting and Name Stamp in Chemotherapy Prescriptions: Potential Target for Fraud

    Directory of Open Access Journals (Sweden)

    Asiyeh Amouei

    2018-02-01

    Full Text Available BBackgrounds: Verification and authentication of the paper-based handwritten prescriptions is of great importance for antineoplastic medications that are good targets for forgery and fraud. Pharmacists usually investigate handwriting, signature and name stamp of prescribers to verify prescriptions in Iran. Anecdotal reports of variations in handwriting and name stamp of physicians who wrote antineoplastic prescriptions raised concerns in this regard. The aim of the study was to investigate the reported diversity and evaluate the quality of writing physician identity and required items in antineoplastic prescriptions.Methods: All insured hand-written prescriptions contained at least one antineoplastic medication and were dispensed by four main authorized community pharmacies dispensing antineoplastic medications in Tehran during one month were included. Prescriptions that were written by specialties other than oncology-related fields were excluded. Prescriptions of each physician were evaluated considering handwriting and name stamp by experienced pharmacy staff and the frequency of detected handwriting and name stamp types was recorded.Results: Of the 11022 included prescriptions, 10944 were eligible and written by 241 physicians. Median (third quartile number of physicians’ prescriptions was 17 (51. Maximum number of observed handwriting and name stamp types were eight and six respectively. High prescribers tended to have several handwriting and name stamp types.Conclusion: The observed diversity and variation in handwriting and name stamp of the physicians in antineoplastic prescriptions may facilitate the entrance of forged prescription and makes fraud detection difficult. Administrative and regulatory interventions in addition to notification of health care professionals about the observed potential might be necessary.

  20. Homelessness, substance misuse, and access to public entitlements in a soup kitchen population.

    Science.gov (United States)

    Nwakeze, Peter C; Magura, Stephen; Rosenblum, Andrew; Joseph, Herman

    2003-01-01

    The study examined the effects of homelessness on access to public entitlements (Medicaid and food stamp programs) in a soup kitchen population. Data were collected between 1997 and 1999 from a sample of 343 adults at two soup kitchen sites in New York City. Five hypotheses, focusing on the effects of housing status (literal homelessness, unstable housing, and domiciled), frequency of drug/heavy alcohol use, drug/alcohol-user treatment history and childcare responsibilities on access to Medicaid and food stamp programs were tested. Multiple logistic regression analysis indicated that both literal homelessness and unstable housing were associated with less access to Medicaid and food stamps. Other significant findings were: current drug/alcohol-user treatment experience was associated with greater access to both Medicaid and food stamps, frequency of drug/heavy alcohol use was associated with less access to Medicaid only, and caring for children was associated with greater access to food stamps only. These findings support the crucial role of housing status in mediating access to entitlements, and the importance of drug/alcohol-user treatment involvement as a cue to seeking entitlements. The need to reduce health disparities through active and sustained outreach programs designed to enhance homeless persons' access to Medicaid and food stamp programs was discussed.

  1. Artificial Neural Network (ANN) based microstructural prediction model for 22MnB5 boron steel during tailored hot stamping

    OpenAIRE

    Chokshi, Prasun; Dashwood, R. J.; Hughes, Darren J.

    2017-01-01

    Because of demand for lower emissions and better crashworthiness, the use of hot stamped 22MnB5 boron steel has greatly increased in manufacturing of automobile components. However, for many applications it is required that only certain regions in hot stamped parts are fully hardened whereas other regions need be more ductile. The innovative process of tailored hot stamping does this by controlling the localized microstructures through tailored cooling rates by dividing the tooling into heate...

  2. Medicaid expansion: the dynamic health care policy landscape.

    Science.gov (United States)

    Hahn, Joyce A; Sheingold, Brenda Helen

    2013-01-01

    The Supreme Court decision of June 2012 left states free to decide on how to undertake Medicaid expansion without facing the substantial financial penalties envisioned by the Affordable Care Act. Currently, 25 states and the District of Columbia are moving forward with the expansion; 22 have decided not to move forward and the remaining 3 are still debating the issue. The evidence to date suggests Medicaid expansion would have several benefits to states including improved population health from expanded coverage, improved financial positions of hospitals and other providers, and economic benefits such as increased employment and tax revenues. Because of these potential impacts of Medicaid expansion on patients and providers of health care, the nursing profession may wish to play an educational or advocacy role in the ongoing debate.

  3. Early-life Medicaid Coverage and Intergenerational Economic Mobility.

    Science.gov (United States)

    O'Brien, Rourke L; Robertson, Cassandra L

    2018-04-01

    New data reveal significant variation in economic mobility outcomes across U.S. localities. This suggests that social structures, institutions, and public policies-particularly those that influence critical early-life environments-play an important role in shaping mobility processes. Using new county-level estimates of intergenerational economic mobility for children born between 1980 and 1986, we exploit the uneven expansions of Medicaid eligibility across states to isolate the causal effect of this specific policy change on mobility outcomes. Instrumental-variable regression models reveal that increasing the proportion of low-income pregnant women eligible for Medicaid improved the mobility outcomes of their children in adulthood. We find no evidence that Medicaid coverage in later childhood years influences mobility outcomes. This study has implications for the normative evaluation of this policy intervention as well as our understanding of mobility processes in an era of rising inequality.

  4. Economic impact of a Medicaid population health management program.

    Science.gov (United States)

    Rust, George; Strothers, Harry; Miller, William Johnson; McLaren, Susan; Moore, Barbara; Sambamoorthi, Usha

    2011-10-01

    A population health management program was implemented to assess growth in health care expenditures for the disabled segment of Georgia's Medicaid population before and during the first year of a population health outcomes management program, and to compare those expenditures with projected costs based on various cost inflation trend assumptions. A retrospective, nonexperimental approach was used to analyze claims data from Georgia Medicaid claims files for all program-eligible persons for each relevant time period (intent-to-treat basis). These included all non-Medicare, noninstitutionalized Medicaid aged-blind-disabled adults older than 18 years of age. Comparisons of health care expenditures and utilization were made between base year (2003-2004) and performance year one (2006-2007), and of the difference between actual expenditures incurred in the performance year vs. projected expenditures based on various cost inflation assumptions. Demographic characteristics and clinical complexity of the population (as measured by the Chronic Illness and Disability Payment System risk score) actually increased from baseline to implementation. Actual expenditures were less than projected expenditures using any relevant medical inflation assumption. Actual expenditures were less than projected expenditures by $9.82 million when using a conservative US general medical inflation rate, by $43.6 million using national Medicaid cost trends, and by $106 million using Georgia Medicaid's own cost projections for the non-dually eligible disabled segment of Medicaid enrollees. Quadratic growth curve modeling also demonstrated a lower rate of increase in total expenditures. The rate of increase in expenditures was lower over the first year of program implementation compared with baseline. Weighted utilization rates were also lower in high-cost categories, such as inpatient days, despite increases in the risk profile of the population. Varying levels of cost avoidance could be inferred

  5. Stamped coal cakes in cokemaking technology Part 2 - The investigation of cake strength

    Energy Technology Data Exchange (ETDEWEB)

    Abel, F.; Rosenkranz, J.; Kuyumcu, H.Z. [Technical University of Berlin, Berlin (Germany)

    2009-07-15

    Coking of coal blends using high volatile coals with poor caking properties to produce a high quality coke for blast furnace application can be achieved by compacting the whole coal blend before the pyrolysis in the so called stamp charge operation. Using stamp charging not only improves the flexibility of the cokemaking plant using cost efficient raw materials, but also increases oven throughput. Therefore, in recent years, densification of coals has been introduced even to coals with good carbonisation properties when heat recovery ovens are used. At the Department for Mechanical Process Engineering and Solids Processing of the Technical University Berlin, the two subprocesses, densification and strengthening during stamping, were theoretically and experimentally investigated. The research work aims on the development of an integrated mathematical model, allowing the calculation of cake density and strength of the coal cake for a given coal blend and as a function of the stamping energy. In the first part of the paper, investigations on the stampability of coal blends were reported. In this paper, the development of a new strength test device for the systematic investigation of mechanical strength of coal compacts produced by stamping is described. Results from compressive strength tests indicate an elastic-plastic behaviour with failure by plastic fracture. Shear test results show similarity to the yield limit description in soil mechanics.

  6. Influence of Plastic Deformation on Martensitic Transformation During Hot Stamping of Complex Structure Auto Parts

    Science.gov (United States)

    Shen, Yuhan; Song, Yanli; Hua, Lin; Lu, Jue

    2017-04-01

    The ultra-high strength steel auto parts manufactured by hot stamping are widely applied for weight reduction and safety improvement. During the hot stamping process, hot forming and quenching are performed in one step wherein plastic deformation and phase transformation simultaneously take place and affect each other. Thereinto, the influence of deformation on martensitic transformation is of great importance. In the present paper, the influence of plastic deformation on martensitic transformation during hot stamping of complex structure auto parts was investigated. For this purpose, a B-pillar reinforced panel in B1500HS steel was manufactured by hot stamping, and the process was simulated by finite element software based on a thermo-mechanical-metallurgical coupled model. Considering various deformation degrees, the microstructures and mechanical properties at four typical locations of the hot stamped B-pillar reinforced panel were detected. The results show that the martensitic content and the microhardness increase with the increase in the deformation amount. There are two reasons causing this phenomenon: (1) the increase in mechanical driving force and (2) the increased probability of the martensitic nucleation at crystal defects. The x-ray diffraction analysis indicates the carbon enrichment in retained austenite which results from the carbon diffusion during the low-carbon martensite formation. Furthermore, the carbon content decreases with the increase in the deformation amount, because the deformation of austenite suppresses the carbon diffusion.

  7. Medicaid spending on contraceptive coverage and pregnancy-related care

    Science.gov (United States)

    2014-01-01

    Objective Up to 50% of pregnancies are unintended in the United States, and the healthcare costs associated with pregnancy are the most expensive among hospitalized conditions. The current study aims to assess Medicaid spending on various methods of contraception and on pregnancy care including unintended pregnancies. Methods We analyzed Medicaid health claims data from 2004 to 2010. Women 14–49 years of age initiating contraceptive methods and pregnant women were included as separate cohorts. Medicaid spending was summarized using mean all-cause and contraceptive healthcare payments per patient per month (PPPM) over a follow-up period of up to 12 months. Medicaid payments were also estimated in 2008 per female member of childbearing age per month (PFCPM) and per member per month (PMPM). Medicaid payments on unintended pregnancies were also evaluated PFCPM and PMPM in 2008. Results For short-acting reversible contraception (SARC) users, all-cause payments and contraceptive payments PPPM were respectively $365 and $18.3 for oral contraceptive (OC) users, $308 and $19.9 for transdermal users, $215 and $21.6 for vaginal ring users, and $410 and $8.8 for injectable users. For long-acting reversible contraception (LARC) users (follow-up of 9–10 months), corresponding payments were $194 and $36.8 for IUD users, and $237 and $29.9 for implant users. Pregnancy cohort all-cause mean healthcare payments PPPM were $610. Payments PFCPM and PMPM for contraceptives were $1.44 and $0.54, while corresponding costs of pregnancies were estimated at $39.91 and $14.81, respectively. Payments PFCPM and PMPM for contraceptives represented a small fraction at 6.56% ($1.44/$21.95) and 6.63% ($0.54/$8.15), respectively of the estimated payments for unintended pregnancy. Conclusions This study of a large sample of Medicaid beneficiaries demonstrated that, over a follow-up period of 12 months, Medicaid payments for pregnancy were considerably higher than payments for either SARC or

  8. CMS Medicare and Medicaid EHR Incentive Program, Electronic Health Record Products Used for Attestation

    Data.gov (United States)

    U.S. Department of Health & Human Services — Data set merges information about the Centers for Medicare and Medicaid Services, Medicare and Medicaid EHR Incentive Programs attestations with the Office of the...

  9. 75 FR 58203 - Medicare, Medicaid, and Children's Health Insurance Programs; Additional Screening Requirements...

    Science.gov (United States)

    2010-09-23

    .... Ambulatory surgical centers, end-stage renal disease facilities, Federally qualified health centers... Parts 405, 424, 438, et al. Medicare, Medicaid, and Children's Health Insurance Programs; Additional...-AQ20 Medicare, Medicaid, and Children's Health Insurance Programs; Additional Screening Requirements...

  10. Utilization of smoking cessation medication benefits among medicaid fee-for-service enrollees 1999?2008

    OpenAIRE

    Kahende, Jennifer; Malarcher, Ann; England, Lucinda; Zhang, Lei; Mowery, Paul; Xu, Xin; Sevilimedu, Varadan; Rolle, Italia

    2017-01-01

    Objective To assess state coverage and utilization of Medicaid smoking cessation medication benefits among fee-for-service enrollees who smoked cigarettes. Methods We used the linked National Health Interview Survey (survey years 1995, 1997?2005) and the Medicaid Analytic eXtract files (1999?2008) to assess utilization of smoking cessation medication benefits among 5,982 cigarette smokers aged 18?64 years enrolled in Medicaid fee-for-service whose state Medicaid insurance covered at least one...

  11. A framework for development of an intelligent system for design and manufacturing of stamping dies

    International Nuclear Information System (INIS)

    Hussein, H M A; Kumar, S

    2014-01-01

    An integration of computer aided design (CAD), computer aided process planning (CAPP) and computer aided manufacturing (CAM) is required for development of an intelligent system to design and manufacture stamping dies in sheet metal industries. In this paper, a framework for development of an intelligent system for design and manufacturing of stamping dies is proposed. In the proposed framework, the intelligent system is structured in form of various expert system modules for different activities of design and manufacturing of dies. All system modules are integrated with each other. The proposed system takes its input in form of a CAD file of sheet metal part, and then system modules automate all tasks related to design and manufacturing of stamping dies. Modules are coded using Visual Basic (VB) and developed on the platform of AutoCAD software

  12. Numerical simulation of temperature field, microstructure evolution and mechanical properties of HSS during hot stamping

    International Nuclear Information System (INIS)

    Shi, Dongyong; Liu, Wenquan; Ying, Liang; Hu, Ping; Shen, Guozhe

    2013-01-01

    The hot stamping of boron steels is widely used to produce ultra high strength automobile components without any spring back. The ultra high strength of final products is attributed to the fully martensitic microstructure that is obtained through the simultaneous forming and quenching of the hot blanks after austenization. In the present study, a mathematical model incorporating both heat transfer and the transformation of austenite is presented. A FORTRAN program based on finite element technique has been developed which permits the temperature distribution and microstructure evolution of high strength steel during hot stamping process. Two empirical diffusion-dependent transformation models under isothermal conditions were employed respectively, and the prediction capability on mechanical properties of the models were compared with the hot stamping experiment of an automobile B-pillar part

  13. Multi-cycle rolled aluminum alloy 3103 sandwiches: mechanical properties and stamp ability

    Directory of Open Access Journals (Sweden)

    Nosova Ekaterina

    2017-01-01

    Full Text Available Constructional part producing by sheet stamping of multilayer composites requires the stamping ability data. The aim of a work is to estimate mechanical properties, stamping ratio and anisotropy indexes of 2, 4, 8 and 12 layer sandwiches produced from aluminium alloy AA3103. The pieces were received by the cold rolling. Interoperation annealing was at 500°C for 1 hour. Charts of tensile strength, yield stress, elongation depending on layer thickness were composed. It was found that cold strain hardening does not disappear after annealing if the foil’s thickness become 0.4 mm and less. Microstructure analysis has shown a good contact between layers for all samples and thicker outer layers.

  14. Modeling the constitutive and frictional behavior of PTFE flexible stamps for nanoimprint lithography

    DEFF Research Database (Denmark)

    Sonne, Mads Rostgaard; Hattel, Jesper Henri

    2013-01-01

    In the present work, the deformation on micro-scale of PTFE flexible stamps for nanoimprint lithography is modeled. This is achieved via a combination of proper models for the constitutive behavior as well as the frictional conditions between the deforming PTFE stamp and the steel tool. The model...... was verified through an experiment, where a PTFE sheet was deformed by a steel sphere mounted in a tensile test machine. Good agreement between simulations and experimental results is found, both regarding force–displacement and corresponding principal strain measurements. As expected, applying the correct...... frictional behavior between PTFE and steel on micro-scale is shown to be of major importance in order to accurately simulate the strain field in the deformed PTFE stamp. © 2013 Elsevier B.V. All rights reserved...

  15. Micromechanical exfoliation of two-dimensional materials by a polymeric stamp

    International Nuclear Information System (INIS)

    Costa, M C Ferraz da; Ribeiro, H B; Kessler, F; Souza, E A T de; Fechine, G J M

    2016-01-01

    In this work, an alternative technique to the traditional micromechanical exfoliation of two-dimensional materials is proposed, consisting of isolated flakes of graphite and molybdenum disulphide onto polymeric surfaces films. The set made up of polymer and flakes is fabricated by using a hot-press machine called polymeric stamp. The polymeric stamp was used to allocate flakes and also to allow the exfoliation process to take place just in one face of isolated flake. Optical microscopy, Raman spectroscopy and photoluminescence spectroscopy results showed that multilayers, bilayers and single layers of graphene and MoS 2 were obtained by using a polymeric stamp as tool for micromechanical exfoliation. These crystals were more easily found because the exfoliation process concentrates them in well-defined locations. The results prove the effectiveness of the method by embedding two-dimensional materials into polymers to fabricate fewer layers crystals in a fast, economic and clean way. (paper)

  16. Micromechanical exfoliation of two-dimensional materials by a polymeric stamp

    Science.gov (United States)

    Ferraz da Costa, M. C.; Ribeiro, H. B.; Kessler, F.; de Souza, E. A. T.; Fechine, G. J. M.

    2016-02-01

    In this work, an alternative technique to the traditional micromechanical exfoliation of two-dimensional materials is proposed, consisting of isolated flakes of graphite and molybdenum disulphide onto polymeric surfaces films. The set made up of polymer and flakes is fabricated by using a hot-press machine called polymeric stamp. The polymeric stamp was used to allocate flakes and also to allow the exfoliation process to take place just in one face of isolated flake. Optical microscopy, Raman spectroscopy and photoluminescence spectroscopy results showed that multilayers, bilayers and single layers of graphene and MoS2 were obtained by using a polymeric stamp as tool for micromechanical exfoliation. These crystals were more easily found because the exfoliation process concentrates them in well-defined locations. The results prove the effectiveness of the method by embedding two-dimensional materials into polymers to fabricate fewer layers crystals in a fast, economic and clean way.

  17. viStaMPS: The Application For Viewing And Manipulating StaMPS Results

    Science.gov (United States)

    Sousa, Joaquim; Sousa, Antonio; Magalhaes, Luis; Ruiz, Antonio

    2013-12-01

    viStaMPS (visual StaMPS) is a new visual application developed to enhance the visualization, manipulation and exportation of StaMPS results. The programmed application is developed in Matlab® through the Graphical User Interface (GUI) and no coding is required for running it, which avoids any programming language knowledge for standard uses. This tool integrates fully new features together with various scripts from StaMPS, allowing the generation of the desired plots/maps in a user-friendly interface. It is done by simply clicking some buttons or changing some parameters located in visual panels, instead of input commands in a prompt. Moreover, since it is written in Matlab, it gives the users the opportunity to access the data very easily and make their own modifications. Being a research tool, viStaMPS is continually under development and will count on the dynamism of its users to improve and/or add new features.

  18. A framework for development of an intelligent system for design and manufacturing of stamping dies

    Science.gov (United States)

    Hussein, H. M. A.; Kumar, S.

    2014-07-01

    An integration of computer aided design (CAD), computer aided process planning (CAPP) and computer aided manufacturing (CAM) is required for development of an intelligent system to design and manufacture stamping dies in sheet metal industries. In this paper, a framework for development of an intelligent system for design and manufacturing of stamping dies is proposed. In the proposed framework, the intelligent system is structured in form of various expert system modules for different activities of design and manufacturing of dies. All system modules are integrated with each other. The proposed system takes its input in form of a CAD file of sheet metal part, and then system modules automate all tasks related to design and manufacturing of stamping dies. Modules are coded using Visual Basic (VB) and developed on the platform of AutoCAD software.

  19. Investigation of the influence of process parameters on adhesive wear under hot stamping conditions

    Science.gov (United States)

    Schwingenschlögl, P.; Weldi, M.; Merklein, M.

    2017-09-01

    Current challenges like increasing safety standards and reducing fuel consumption motivate lightweight construction in modern car bodies. Besides using lightweight workpiece materials like aluminum, hot stamping has been established as a key technology for producing safety relevant components. Producing hot stamped parts out of ultra-high strength steels offers the possibility to improve the crash performance. At the same time the weight of car structure is reduced by using thinner sheet thicknesses. In order to avoid oxide scale formation and ensure corrosion protection, AlSi coatings are commonly deposited on the sheet surfaces used for direct hot stamping. This workpiece coating has a critical impact on the tribological conditions within the forming process and, as a consequence, influences the quality of hot stamped parts as well as tool wear. AlSi coatings have been identified as major reason for adhesive wear, which represents the main wear mechanism in hot stamping. Within this study, the influence of the process parameters on adhesive wear are investigated in dependency of workpiece and tool temperatures, drawing velocities and contact pressures. The tribological behavior is analyzed based on strip drawing experiments under direct hot stamping conditions. The experiments are performed with AlSi coated 22MnB5 in contact with the hot working tool steel 1.2367. For analyzing the amount of adhesion on the friction jaws, the surfaces are characterized by optical measurements. The experiments indicate that higher workpiece temperatures cause severe adhesive wear on the tool surface, while an increase of drawing velocity or contact pressure led to reduced adhesion. The measured friction coefficients decreased with rising amount of adhesion and remained at a constant level after a certain adhesive layer was built up on the tool surface.

  20. 45 CFR 162.1902 - Standard for Medicaid pharmacy subrogation transaction.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Standard for Medicaid pharmacy subrogation... DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Medicaid Pharmacy Subrogation § 162.1902 Standard for Medicaid pharmacy subrogation transaction. The Secretary adopts the Batch Standard...

  1. 42 CFR 441.206 - Documentation needed by the Medicaid agency.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Documentation needed by the Medicaid agency. 441.206 Section 441.206 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... SPECIFIC SERVICES Abortions § 441.206 Documentation needed by the Medicaid agency. FFP is not available in...

  2. 42 CFR 455.21 - Cooperation with State Medicaid fraud control units.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Cooperation with State Medicaid fraud control units... Detection and Investigation Program § 455.21 Cooperation with State Medicaid fraud control units. In a State with a Medicaid fraud control unit established and certified under subpart C of this part, (a) The...

  3. 42 CFR 1007.9 - Relationship to, and agreement with, the Medicaid agency.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Relationship to, and agreement with, the Medicaid... agreement with, the Medicaid agency. (a) The unit must be separate and distinct from the Medicaid agency. (b... review or overrule the referral of a suspected criminal violation to an appropriate prosecuting authority...

  4. Global city aspirations, graduated citizenship and public housing: analysing the consumer citizenships of neoliberalism

    OpenAIRE

    Dallas Rogers; Michael Darcy

    2014-01-01

    Global city discourses rearticulate the relationships between the state, urban space and the global economy. At the local level, global city reconfigurations stamp the mark of a global economic order onto local citizenship practices. Public housing is a legacy of specific national (welfare) states where citizenship rights arose from territorially bound constitutional discourses, and is incompatible in its current form with the consumer-based rights and responsibilities of a global economic or...

  5. STAMPS: software tool for automated MRI post-processing on a supercomputer

    OpenAIRE

    Bigler, Don C.; Aksu, Yaman; Yang, Qing X.

    2009-01-01

    This paper describes a Software Tool for Automated MRI Post-processing (STAMP) of multiple types of brain MRIs on a workstation and for parallel processing on a supercomputer (STAMPS). This software tool enables the automation of nonlinear registration for a large image set and for multiple MR image types. The tool uses standard brain MRI post-processing tools (such as SPM, FSL, and HAMMER) for multiple MR image types in a pipeline fashion. It also contains novel MRI post-processing features....

  6. A compact system for large-area thermal nanoimprint lithography using smart stamps

    DEFF Research Database (Denmark)

    Pedersen, Rasmus Haugstrup; Hansen, Ole; Kristensen, Anders

    2008-01-01

    We present a simple apparatus for thermal nanoimprint lithography. In this work, the stamp is designed to significantly reduce the requirements for pressure application on the external imprint system. By MEMS-based processing, an air cavity inside the stamp is created, and the required pressure f...... is presented. Test imprints of micrometer- and nanometer-scale structures are performed and characterized with respect to uniformity across a large area (35 mm radius). State-of-the-art uniformity for mu m-scale features is demonstrated....

  7. Development and introduction of stamping technique for large-size laterals of NPP pipelines

    International Nuclear Information System (INIS)

    Romashko, N.I.; Moshnin, E.N.; Timokhin, V.S.; Bryukhanov, Yu.V.; Lebedev, V.A.

    1984-01-01

    The results of development and introduction of stamping technique for large-size laterals of NPP high-pressure pipelines are presented. The main experimental data characterizing technological possibilities of the process are given. The technological process and design of the stamp assure production of laterals from ovalized bars per one heating of the bar and per one running of the press cronnhead. Introduction of new technology decreased labour input of lateral production, reliability and serviceability of pipelines increased in this case. Introduction of this technology gives a considerable benefit

  8. Transfer printing of 3D hierarchical gold structures using a sequentially imprinted polymer stamp

    International Nuclear Information System (INIS)

    Zhang Fengxiang; Low, Hong Yee

    2008-01-01

    Complex three-dimensional (3D) hierarchical structures on polymeric materials are fabricated through a process referred to as sequential imprinting. In this work, the sequentially imprinted polystyrene film is used as a soft stamp to replicate hierarchical structures onto gold (Au) films, and the Au structures are then transferred to a substrate by transfer printing at an elevated temperature and pressure. Continuous and isolated 3D structures can be selectively fabricated with the assistance of thermo-mechanical deformation of the polymer stamp. Hierarchical Au structures are achieved without the need for a corresponding three-dimensionally patterned mold

  9. Foster Care Involvement among Medicaid-Enrolled Children with Autism

    Science.gov (United States)

    Cidav, Zuleyha; Xie, Ming; Mandell, David S.

    2018-01-01

    The prevalence and risk of foster care involvement among children with autism spectrum disorder (ASD) relative to children with intellectual disability (ID), children with ASD and ID, and typically developing children were examined using 2001-2007 Medicaid data. Children were followed up to the first foster care placement or until the end of 2007;…

  10. Market environment and Medicaid acceptance: What influences the access gap?

    Science.gov (United States)

    Bond, Amelia; Pajerowski, William; Polsky, Daniel; Richards, Michael R

    2017-12-01

    The U.S. health care system is undergoing significant changes. Two prominent shifts include millions added to Medicaid and greater integration and consolidation among firms. We empirically assess if these two industry trends may have implications for each other. Using experimentally derived ("secret shopper") data on primary care physicians' real-world behavior, we observe their willingness to accept new privately insured and Medicaid patients across 10 states. We combine this measure of patient acceptance with detailed information on physician and commercial insurer market structure and show that insurer and provider concentration are each positively associated with relative improvements in appointment availability for Medicaid patients. The former is consistent with a smaller price discrepancy between commercial and Medicaid patients and suggests a beneficial spillover from greater insurer market power. The findings for physician concentration do not align with a simple price bargaining explanation but do appear driven by physician firms that are not vertically integrated with a health system. These same firms also tend to rely more on nonphysician clinical staff. Copyright © 2017 John Wiley & Sons, Ltd.

  11. Medicaid Nursing Home Pay for Performance: Where Do We Stand?

    Science.gov (United States)

    Arling, Greg; Job, Carol; Cooke, Valerie

    2009-01-01

    Purpose: Nursing home pay-for-performance (P4P) programs are intended to maximize the value obtained from public and private expenditures by measuring and rewarding better nursing home performance. We surveyed the 6 states with operational P4P systems in 2007. We describe key features of six Medicaid nursing home P4P systems and make…

  12. Increasing Medicaid Revenue Generation for Services by School Psychologists

    Science.gov (United States)

    Hybza, Megan M.; Stokes, Trevor F.; Hayman, Marilee; Schatzberg, Tracy

    2013-01-01

    We examined a performance improvement package with components of feedback, goal setting, and prompting to generate additional revenue by improving the consistency of Medicaid billing submitted by 74 school psychologists serving 102 schools. A multiple baseline design across three service areas of a county school system demonstrated the…

  13. 75 FR 46833 - 45th Anniversary of Medicare and Medicaid

    Science.gov (United States)

    2010-08-03

    ... net for some of the most vulnerable Americans: low-income children, parents, seniors, and people with... long-term care coverage to more than 56 million low-income Americans. With too many communities..., 2010 45th Anniversary of Medicare and Medicaid By the President of the United States of America A...

  14. Medicaid in Ohio: The Politics of Expansion, Reauthorization, and Reform.

    Science.gov (United States)

    Skinner, Daniel

    2015-12-01

    When, in 2012, the US Supreme Court held that Medicaid expansion sanctioned by the Affordable Care Act (ACA) was essentially optional for states, it ushered in a newly contentious state politics. States led by Republican governors and legislatures opposed to the ACA had to decide whether to accept extensive federal funding to expand Medicaid for citizens in their states who were earning up to 138 percent of the federal poverty level. This Report from the States focuses on Ohio, whose Republican governor successfully navigated the rancorous politics of Medicaid to expand the state's program in 2014. Working at odds with his own party and gaining praise from traditional political opponents for his leadership on the issue, John Kasich circumvented the state legislature, turning to the Controlling Board to bring about initial expansion. In the wake of Kasich's landslide reelection in 2014, the politics of expansion and reauthorization have given way to a pervasive discourse of "reform." In this next phase Kasich has endorsed policy positions (e.g., cost sharing, a focus on "personal responsibility") that reunite him with his party's more traditional view of Medicaid while continuing to emphasize the importance of expansion. Copyright © 2016 by Duke University Press.

  15. 75 FR 69037 - Medicaid Program; Recovery Audit Contractors

    Science.gov (United States)

    2010-11-10

    ... States related to Federal/State funding of State start-up, operation and maintenance costs of Medicaid... requirements for States to assure that adequate appeal processes are in place for providers to dispute adverse... of the demonstrated cost effectiveness of the Medicare RACs, the TRHCA required CMS to implement a...

  16. People, Places, Power: Medicaid Concentration and Local Political Participation.

    Science.gov (United States)

    Michener, Jamila D

    2017-10-01

    The geographic concentration of disadvantage is a key mechanism of inequity. In the United States, the spatial patterning of disadvantage renders it more than the sum of its individual parts and disproportionately harms economically and racially marginalized Americans. This article focuses specifically on the political effects of Medicaid beneficiaries being concentrated in particular locales. After offering a framework for conceptualizing the community-wide consequences of such policy concentration, I analyze aggregate multiyear data to examine the effect of Medicaid density on county-level voter turnout and local organizational strength. I find that, as the proportion of county residents enrolled in Medicaid increases, the prevalence of civic and political membership associations declines and aggregate rates of voting decrease. These results suggest that, if grassroots political action is to be part of a strategy to achieve health equity, policy makers and local organizations must make efforts to counteract the sometimes demobilizing "place-based" political effects of "people-based" policies such as Medicaid. Copyright © 2017 by Duke University Press.

  17. 42 CFR 495.304 - Medicaid provider scope and eligibility.

    Science.gov (United States)

    2010-10-01

    ... SERVICES (CONTINUED) STANDARDS AND CERTIFICATION STANDARDS FOR THE ELECTRONIC HEALTH RECORD TECHNOLOGY... patient volume attributable to individuals receiving Medicaid. (2) Have a minimum 20 percent patient... in a FQHC or RHC and have a minimum 30 percent patient volume attributable to needy individuals, as...

  18. Trends in Medicaid fee-for-service outpatient drug utilization ...

    African Journals Online (AJOL)

    Results: The results indicate that prescription-drug utilization of Medicaid FFS program decreased by 20 % during the period (2010 – 2012) as also drug expenditure during the same period. Although constituting nearly 70 % and about 75 % of the total drug utilization in 2010 and 2012, respectively, generics represent only ...

  19. Trends in Medicaid Reimbursements for Insulin From 1991 Through 2014.

    Science.gov (United States)

    Luo, Jing; Avorn, Jerry; Kesselheim, Aaron S

    2015-10-01

    Insulin is a vital medicine for patients with diabetes mellitus. Newer, more expensive insulin products and the lack of generic insulins in the United States have increased costs for patients and insurers. To examine Medicaid payment trends for insulin products. Cost information is available for all 50 states and has been recorded since the 1990s. A time-series analysis comparing reimbursements and prices. Using state- and national-level Medicaid data from 1991 to 2014, we identified all patients who used 1 or more of the 16 insulin products that were continuously available in the United States between 2006 and 2014. Insulin products were classified into rapid-acting and long-acting analogs, short-acting, intermediate, and premixed insulins based on American Diabetes Association Guidelines. Inflation-adjusted payments made to pharmacies by Medicaid per 1 mL (100 IU) of insulin in 2014 US dollars. Since 1991, Medicaid reimbursement per unit (1 mL) of insulin dispensed has risen steadily. In the 1990s, Medicaid reimbursed pharmacies between $2.36 and $4.43 per unit. By 2014, reimbursement for short-acting insulins increased to $9.64 per unit; intermediate, $9.22; premixed, $14.79; and long-acting, $19.78. Medicaid reimbursement for rapid-acting insulin analogs rose to $19.81 per unit. The rate of increase in reimbursement was higher for insulins with patent protection ($0.20 per quarter) than without ($0.05 per quarter) (Pvolume peaked at 29.9 million units in quarter 4 of 2005 and was 21.2 million units in quarter 2 of 2014. Between 1991 and 2014, there was a near-exponential upward trend in Medicaid payments on a per-unit basis for a wide variety of insulin products regardless of formulation, duration of action, and whether the product was patented. Although reimbursements for newer, patent-protected insulin analogs increased at a faster rate than reimbursements for older insulins, payments increased for all products we examined. Our findings suggest a lack of

  20. Internet-Based Training to Improve Preschool Playground Safety: Evaluation of the Stamp-in-Safety Programme

    Science.gov (United States)

    Schwebel, David C.; Pennefather, Jordan; Marquez, Brion; Marquez, Jessie

    2015-01-01

    Objective: Playground injuries result in over 200,000 US pediatric emergency department visits annually. One strategy to reduce injuries is improved adult supervision. The Stamp-in-Safety programme, which involves supervisors stamping rewards for children playing safely, has been demonstrated in preliminary classroom-based work to reduce child…

  1. Experimental Investigations of the In-Die Quenching Efficiency and Die Surface Temperature of Hot Stamping Aluminium Alloys

    Directory of Open Access Journals (Sweden)

    Kailun Zheng

    2018-04-01

    Full Text Available The in-die quenching is a key stage in the hot stamping volume production chain which determines the post-formed strength of lightweight alloy components, tool life, and hot stamping productivity. In this paper, the performance of in-die quenching, reflected by the quenching efficiency (the time of work-piece held within stamping dies and die surface temperature during the simulated hot stamping process of AA6082, was experimentally and analytically investigated. A range of in-die quenching experiments were performed for different initial work-piece and die temperatures, quenching pressures, work-piece thickness, and die clearances, under hot stamping conditions. In addition, a one-dimensional (1D closed-form heat transfer model was used to calculate the die surface temperature evolution that is difficult to obtain during practical manufacture situations. The results have shown that the in-die quenching efficiency can be significantly increased by decreasing the initial work-piece and die temperatures. Die clearances are required to be designed precisely to obtain sufficiently high quenching rates and satisfying post-formed strength for hot-stamped panel components. This study systematically considered an extensive variety of influencing factors on the in-die quenching performance, which can provide practical guides for stamping tool designers and manufacture systems for hot-stamping volume production.

  2. Stamping an S on DMEK Donor Tissue to Prevent Upside-Down Grafts: Laboratory Validation and Detailed Preparation Technique Description.

    Science.gov (United States)

    Veldman, Peter B; Dye, Philip K; Holiman, Jeffrey D; Mayko, Zachary M; Sáles, Christopher S; Straiko, Michael D; Stoeger, Christopher G; Terry, Mark A

    2015-09-01

    To report endothelial cell loss (ECL) caused by a novel S-stamp preparation technique for Descemet membrane endothelial keratoplasty (DMEK). Six cadaveric human corneas were prepared for DMEK transplantation using a single standardized technique, including the application of a dry ink gentian violet S-stamp to the stromal side of Descemet membrane. Endothelial cell death was evaluated and quantified using computerized analysis of vital dye staining. ECL caused by the S-stamp was 0.6% (range 0.1%-1.0%), which comprised less than one-tenth of the total ECL caused by our preparation of the DMEK graft from the start to finish, including recovery, prestripping, S-stamping, and trephination (13.7% total ECL, range 9.9%-17.6%). Our novel S-stamp donor tissue preparation technique is intuitive to learn and holds the promise of preventing iatrogenic primary graft failure due to upside-down grafts without causing unacceptable increases in ECL.

  3. Aluminium Pneumoconiosis I. In Vitro Comparison of Stamped Aluminium Powders Containing Different Lubricating Agents and a Granular Aluminium Powder

    Science.gov (United States)

    Corrin, B.

    1963-01-01

    The discrepancy in previous reports of the action of aluminium on the lung may be explained by differences between stamped and granular aluminium powders. A stamped powder of the variety causing pulmonary fibrosis showed a brisk reaction with water, but a granular powder was unreactive. This difference is primarily due to the granular particles being covered by inert aluminium oxide, the formation of which is partially prevented in the stamping process by stearine and mineral oil. The reactivity of the flake-like stamped particles is also dependent on their large surface area per unit volume. The appearance of aluminium pneumoconiosis in Britain is explained by the introduction of mineral oil into the stamping industry for, in contrast to stearine, mineral oil permits the powder to react with water. The lung damage is believed to be caused by a soluble form of aluminium. PMID:14072616

  4. 77 FR 286 - Medicaid Program: Initial Core Set of Health Care Quality Measures for Medicaid-Eligible Adults

    Science.gov (United States)

    2012-01-04

    .../Reproductive Health, Complex Health Care Needs, and Mental Health and Substance Use. Workgroups were assigned... all health care delivery systems (for example, fee-for-service, managed care, primary care case...: Initial Core Set of Health Care Quality Measures for Medicaid-Eligible Adults AGENCY: Office of the...

  5. Medicaid Statistical Information System (MSIS): a data source for quality reporting for Medicaid and the Children's Health Insurance Program (CHIP).

    Science.gov (United States)

    MacTaggart, Patricia; Foster, Ashley; Markus, Anne

    2011-04-01

    Section 401 of the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) requires the Department of Health and Human Services (HHS) to identify and publish healthcare quality measures for children enrolled in the Children's Health Insurance Program (CHIP) or Medicaid. CHIPRA also requires core measures to identify disparities by race and ethnicity, among other factors. State Medicaid and CHIP programs are currently facing significant budgetary pressures that are likely to increase with eligibility expansions and programmatic changes resulting from the Patient Protection and Affordable Care Act (PPACA). To limit the burden on states and increase the likelihood of states' voluntarily reporting on core pediatric quality measures, HHS may consider utilizing existing data sources. This article examines the feasibility of utilizing Medicaid Statistical Information System (MSIS) data to identify and analyze the core children's healthcare quality measures required by CHIPRA. Five key themes related to the feasibility of using MSIS as a data source for quality measures are identified: states have significant experience with data collection, performance measurement, and quality oversight for children in Medicaid and CHIP; CHIPRA provisions related to reporting of quality measures will be implemented at a time when states are facing major fiscal constraints; MSIS provides potential opportunities as it offers a rich source of data, but the difficulties in obtaining clean data should not be underestimated; MSIS has limitations; and states, the federal government, providers, and enrollees benefit from standardization in data and quality measurement.

  6. United States housing, 2013

    Science.gov (United States)

    Delton Alderman

    2016-01-01

    This publication provides an overview of the 2013 U.S. housing market, including updated information and data, and is part of an ongoing series of quarterly and annual housing reports that provide historical information on housing permits, starts, houses under construction, and completions. In addition, short briefs present information regarding house sales,...

  7. House Demolitions

    Directory of Open Access Journals (Sweden)

    Mordechai Kremnitzer

    2015-05-01

    Full Text Available This article discusses the nature of “house demolitions” as used by the State of Israel in the West Bank and East Jerusalem. In our opinion, and in contrast to the view of Israel’s Supreme Court, such demolition orders constitute a penal sanction. As a penal sanction, we argue that this measure violates the basic principles of criminal liability. Even if this conclusion is not accepted, it will be argued that making innocent people homeless is an illegal collective measure. Even if assuming arguendo that it is not an illegal collective measure, it violates the basic principle of personal responsibility. The general conclusion of the article is that the examination of the nature of sanctions should go beyond the labels that are attached to them. Labeling sanctions as either penal or civil may not always reflect its true nature, and labels are sometimes deliberately used or rather misused in order to escape from the requirements stemming from the true essence of a sanction.

  8. Medicaid funding for abortion: providers' experiences with cases involving rape, incest and life endangerment.

    Science.gov (United States)

    Kacanek, Deborah; Dennis, Amanda; Miller, Kate; Blanchard, Kelly

    2010-06-01

    The Hyde Amendment bans federal Medicaid funding for abortion in the United States except if a pregnancy resulted from rape or incest or endangers the life of the woman. Some evidence suggests that providers do not always receive Medicaid reimbursement for abortions that should qualify for funding. From October 2007 to February 2008, semistructured in-depth interviews about experiences with Medicaid reimbursement for qualifying abortions were conducted with 25 respondents representing abortion providers in six states. A thematic analysis approach was used to explore respondents' knowledge of and experiences seeking Medicaid reimbursement for qualifying abortions, as well as individual, clinical and structural influences on reimbursement. The numbers of qualifying cases that were and were not reimbursed were assessed. More than half of Medicaid-eligible cases reported by respondents in the past year were not reimbursed. Respondents reported that filing for reimbursement takes excessive staff time and is hampered by bureaucratic claims procedures and ill-informed Medicaid staff, and that reimbursements are small. Many had stopped seeking Medicaid reimbursement and relied on nonprofit abortion funds to cover procedure costs. Respondents reporting receiving reimbursement said that streamlined forms, a statewide education intervention and a legal intervention to ensure that Medicaid reimbursed claims facilitated the process. The policy governing federal funding of abortion is inconsistently implemented. Eliminating administrative burdens, educating providers about women's rights to obtain Medicaid reimbursement for abortion in certain circumstances and holding Medicaid accountable for reimbursing qualifying cases are among the steps that may facilitate Medicaid reimbursement for qualifying abortions.

  9. Time-stamping system for nuclear physics experiments at RIKEN RIBF

    Science.gov (United States)

    Baba, H.; Ichihara, T.; Ohnishi, T.; Takeuchi, S.; Yoshida, K.; Watanabe, Y.; Ota, S.; Shimoura, S.; Yoshinaga, K.

    2015-03-01

    A time-stamping system for nuclear physics experiments has been introduced at the RIKEN Radioactive Isotope Beam Factory. Individual trigger signals can be applied for separate data acquisition (DAQ) systems. After the measurements are complete, separately taken data are merged based on the time-stamp information. In a typical experiment, coincidence trigger signals are formed from multiple detectors to take desired events only. The time-stamping system allows the use of minimum bias triggers. Since coincidence conditions are given by software, a variety of physics events can be flexibly identified. The live time for a DAQ system is important when attempting to determine reaction cross-sections. However, the combined live time for separate DAQ systems is not clearly known because it depends not only on the DAQ dead time but also on the coincidence conditions. Using the proposed time-stamping system, all trigger timings can be acquired, so that the combined live time can be easily determined. The combined live time is also estimated using Monte Carlo simulations, and the results are compared with the directly measured values in order to assess the accuracy of the simulation.

  10. Human factors science and safety engineering : can the STAMP model serve in establishing a common language?

    NARCIS (Netherlands)

    Karanikas, Nektarios; Schwarz, M; Harfmann, J

    2017-01-01

    A symbiotic relationship between human factors and safety scientists is needed to ensure the provision of holistic solutions for problems emerging in modern socio-technical systems. System Theoretic Accident Model and Processes (STAMP) tackles both interactions and individual failures of human and

  11. Impact of Electronic Signatures and Time Stamping for the Protection of Electronic Agreements

    Directory of Open Access Journals (Sweden)

    Tadas Limba

    2012-12-01

    Full Text Available The article e495 valuates the impact of e-signatures and time stamping on electronic contracts and electronic documents for performing e-business opportunities and goals, and analyses e-signature application for business cases. Various electronic services, virtual shopping, electronic cash transactions are becoming increasingly popular as they allow users to quickly perform different actions, operations and functions. It is important not only for convenience, but also to ensure consumer data security and reliability. Security reasons are not enough for security transmitted data, since this method does not allow clarification of information about sender identity.Use of electronic signatures, electronic identities, checgs and ensures a very high level of data security in interchange data processes. E-signature allows e-business companies to transfer the company’s operation business processes and their application to the organization and management in the electronic environment, also automate internal and external compans processes, includinggon-going business processes.The object of paper is .-signature and time stamping application in the theoretical and practical way.The goal of this paper while evaluating and estimating the .-signature and time stamping application, i’s regulation and legal implementation worldwidesand in Lithuania—is to provideluseful recommendations for more efficient impact developing -commerce and -business in situations when -signature and time stamping is used for ensuring electronic contracs security.

  12. Impact of Electronic Signatures and Time Stamping for the Protection of Electronic Agreements

    Directory of Open Access Journals (Sweden)

    Tadas Limba

    2013-02-01

    Full Text Available The article e495 valuates the impact of e-signatures and time stamping on electronic contracts and electronic documents for performing e-business opportunities and goals, and analyses e-signature application for business cases. Various electronic services, virtual shopping, electronic cash transactions are becoming increasingly popular as they allow users to quickly perform different actions, operations and functions. It is important not only for convenience, but also to ensure consumer data security and reliability. Security reasons are not enough for security transmitted data, since this method does not allow clarification of information about sender identity. Use of electronic signatures, electronic identities, checgs and ensures a very high level of data security in interchange data processes. E-signature allows e-business companies to transfer the company’s operation business processes and their application to the organization and management in the electronic environment, also automate internal and external compans processes, includinggon-going business processes. The object of paper is .-signature and time stamping application in the theoretical and practical way. The goal of this paper while evaluating and estimating the .-signature and time stamping application, i’s regulation and legal implementation worldwidesand in Lithuania—is to provideluseful recommendations for more efficient impact developing -commerce and -business in situations when -signature and time stamping is used for ensuring electronic contracs security.

  13. Time-stamping system for nuclear physics experiments at RIKEN RIBF

    International Nuclear Information System (INIS)

    Baba, H.; Ichihara, T.; Ohnishi, T.; Takeuchi, S.; Yoshida, K.; Watanabe, Y.; Ota, S.; Shimoura, S.; Yoshinaga, K.

    2015-01-01

    A time-stamping system for nuclear physics experiments has been introduced at the RIKEN Radioactive Isotope Beam Factory. Individual trigger signals can be applied for separate data acquisition (DAQ) systems. After the measurements are complete, separately taken data are merged based on the time-stamp information. In a typical experiment, coincidence trigger signals are formed from multiple detectors to take desired events only. The time-stamping system allows the use of minimum bias triggers. Since coincidence conditions are given by software, a variety of physics events can be flexibly identified. The live time for a DAQ system is important when attempting to determine reaction cross-sections. However, the combined live time for separate DAQ systems is not clearly known because it depends not only on the DAQ dead time but also on the coincidence conditions. Using the proposed time-stamping system, all trigger timings can be acquired, so that the combined live time can be easily determined. The combined live time is also estimated using Monte Carlo simulations, and the results are compared with the directly measured values in order to assess the accuracy of the simulation

  14. 41 CFR 101-25.103-4 - Disposition of promotional materials, trading stamps, or bonus goods.

    Science.gov (United States)

    2010-07-01

    ..., arrange for transfer of promotional materials, trading stamps, or bonus goods, without reimbursement in...) The contract does not contain a price reduction clause, or (2) The contractor refuses to grant a price... promotional items as a price reduction, and (4) The procuring or receiving agency has no practical use for the...

  15. Impacting Mediators of Change for Physical Activity among Elderly Food Stamp Recipients

    Science.gov (United States)

    Dye, Cheryl J.; Williams, Joel E.; Kemper, Karen A.; McGuire, Francis A.; Aybar-Damali, Begum

    2012-01-01

    A multidisciplinary team developed and pilot-tested a curriculum, delivered by trained lay educators, to increase self-efficacy for physical activity among elderly food stamp recipients. Curriculum development was guided by a comprehensive literature review. Process evaluation was used to revise the curriculum and to assess lay educator training…

  16. 75 FR 4911 - Food Stamp Program: Eligibility and Certification Provisions of the Farm Security and Rural...

    Science.gov (United States)

    2010-01-29

    .... Several commenters suggested that the Department amend the current regulations to clarify that human trafficking victims and certain family members are eligible for food stamps to ensure that victims and their...). The guidance reflects the requirements under the ``Trafficking Victims Protection Act of 2000'' (Pub...

  17. Fabrication of microlens array on silicon surface using electrochemical wet stamping technique

    Science.gov (United States)

    Lai, Lei-Jie; Zhou, Hang; Zhu, Li-Min

    2016-02-01

    This paper focuses on the fabrication of microlens array (MLA) on silicon surface by taking advantage of a novel micromachining approach, the electrochemical we stamping (E-WETS). The E-WETS allows the direct imprinting of MLA on an agarose stamp into the substrate through a selective anodic dissolution process. The pre-patterned agarose stamp can direct and supply the solution preferentially on the contact area between the agarose stamp and the substrate, to which the electrochemical reaction is confined. The anodic potential vs. saturated calomel electrode is optimized and 1.5 V is chosen as the optimum value for the electrochemical polishing of p-Si. A refractive MLA on a PMMA mold is successfully transferred onto the p-Si surface. The machining deviations of the fabricated MLA from those on the mold are 0.44% in diameter and 2.1% in height respectively, and the machining rate in HF is around 1.1 μm/h. The surface roughness of the fabricated MLA is less than 12 nm owing to the electrochemical polishing process. The results demonstrate that E-WETS is a promising approach to fabricate MLA on p-Si surface with high accuracy and efficiency.

  18. Honoring Avicenna, the great Persian physician on the world's postage stamps.

    Science.gov (United States)

    Afshar, Ahmadreza

    2010-09-01

    Many nations are indebted to Avicenna (Ibn-Sina) for their scientific progressions and civilization. Many countries in the Middle East, Africa, and Europe have honored Avicenna, the great Persian scientist, by depicting his vignette on their postage stamps. The symbolic value of Avicenna has been chosen to commemorate scientific occasions, achievements and anniversaries, which represents the ultimate performance of conscious honoring.

  19. 42 CFR 71.3 - Designation of yellow fever vaccination centers; Validation stamps.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Designation of yellow fever vaccination centers... Designation of yellow fever vaccination centers; Validation stamps. (a) Designation of yellow fever vaccination centers. (1) The Director is responsible for the designation of yellow fever vaccination centers...

  20. Food Stamp and School Lunch Programs Alleviate Food Insecurity in Rural America. Fact Sheet

    Science.gov (United States)

    Smith, Kristin; Savage, Sarah

    2007-01-01

    The Food Stamp and the National School Lunch Programs play a vital role in helping poor, rural Americans obtain a more nutritious diet and alleviate food insecurity and hunger. This fact sheet looks at the extent to which rural America depends on these programs and describes characteristics of beneficiaries of these federal nutrition assistance…

  1. Studying the Solar System Can Be More than Just "Stamp Collecting"

    Science.gov (United States)

    LoPresto, Michael C.

    2017-01-01

    While teaching his first-ever introductory college astronomy course, I heard a graduate student make the comment that compared to other areas of astronomy, studying the solar system is just "stamp collecting." Coverage of the solar system in an introductory college astronomy course certainly "could" consist mostly of showing…

  2. Stamped coal cakes in cokemaking technology Part 1 - A parameter study on stampability

    Energy Technology Data Exchange (ETDEWEB)

    Abel, F.; Rosenkranz, J.; Kuyumcu, H.Z. [Technical University of Berlin, Berlin (Germany)

    2009-07-15

    Coking of coal blends using high volatile coals with poor caking properties to produce a high quality coke for blast furnace application can be achieved by compacting the whole coal blend before pyrolysis in the so called stamp charge operation. Using stamp charging not only improves the flexibility of the coke making plant using cost efficient raw materials, but oven throughput is also increased. Therefore, in recent years, densification of coals has been introduced even to coals with good carbonisation properties when heat recovery ovens are used. At the Department for Mechanical Process Engineering and Solids Processing of the Technical University Berlin, the two subprocesses, densification and strengthening during stamping, were theoretically and experimentally investigated. The research work aims on the development of an integrated mathematical model, allowing the calculation of cake density and strength of the coal cake for a given coal blend depending on the stamping energy. The first part of this paper defines the overall process objectives and presents results from systematic investigations of the effects of several coal properties on the so called stampability as the integral model parameter for compacting. Surface moisture, coal granulometry and mechanical properties have significant influence on the densification. The incorporation of these parameters into the model allows the differentiated calculation of the cake density.

  3. Silicon oxide nanoimprint stamp fabrication by edge lithography reinforced with silicon nitride

    NARCIS (Netherlands)

    Zhao, Yiping; Berenschot, Johan W.; de Boer, Meint J.; Jansen, Henricus V.; Tas, Niels Roelof; Huskens, Jurriaan; Elwenspoek, Michael Curt

    2007-01-01

    The fabrication of silicon oxide nanoimprint stamp employing edge lithography in combination with silicon nitride deposition is presented. The fabrication process is based on conventional photolithography an weg etching methods. Nanoridges with width dimension of sub-20 nm were fabricated by edge

  4. Micropatterning of a stretchable conductive polymer using inkjet printing and agarose stamping

    DEFF Research Database (Denmark)

    Hansen, Thomas Steen; Hassager, Ole; Larsen, Niels Bent

    2007-01-01

    ,4-ethylenedioxythiophene) (PEDOT). The agarose stamping produced 50 μm wide conducting lines with high spatial fidelity. The deactivation agent was found to cause some degradation of the remaining conducting lines, as revealed by a stronger increase in resistance upon straining compared to the pristine polymer material...

  5. MECHANICAL VIBRATION INHIBITS OSTEOCLAST FORMATION BY REDUCING DC-STAMP RECEPTOR EXPRESSION IN OSTEOCLAST PRECURSOR CELLS

    Science.gov (United States)

    Kulkarni, R.N.; Voglewede, P.A.; Liu, D.

    2014-01-01

    It is well known that physical inactivity leads to loss of muscle mass, but it also causes bone loss. Mechanistically, osteoclastogenesis and bone resorption have recently been shown to be regulated by vibration. However, the underlying mechanism behind the inhibition of osteoclast formation is yet unknown. Therefore, we investigated whether mechanical vibration of osteoclast precursor cells affects osteoclast formation by the involvement of fusion-related molecules such as dendritic cell-specific transmembrane protein (DC-STAMP), and P2X7 receptor (P2X7R). RAW264.7 (a murine osteoclastic-like cell line) cells were treated with 20 ng/ml receptor activator of NF-κB ligand (RANKL). For 3 consecutive days, the cells were subjected to 1 hour of mechanical vibration with 20 µm displacement at a frequency of 4 Hz and compared to the control cells that were treated under the same condition but without the vibration. After 5 days of culture, osteoclast formation was determined. Gene expression of DC-STAMP and P2X7R by RAW264.7 cells were determined after 1 hour mechanical vibration, while protein production of the DC-STAMP was determined after 6 hours of post incubation after vibration. As a result, mechanical vibration of RAW264.7 cells inhibited the formation of osteoclasts. Vibration down-regulated DC-STAMP gene expression by 1.6-fold in the presence of RANKL and by 1.4-fold in the absence of RANKL. Additionally, DC-STAMP protein production was also down-regulated by 1.4-fold in the presence of RANKL and by 1.2-fold in the absence of RANKL in RAW264.7 cells in response to mechanical vibration. However, vibration did not affect P2X7R gene expression. Mouse anti-DC-STAMP antibody inhibited osteoclast formation in the absence of vibration. Our results suggest that mechanical vibration of osteoclast precursor cells reduce DC-STAMP expression in osteoclast precursor cells leading to the inhibition of osteoclast formation. PMID:23994170

  6. Mechanical vibration inhibits osteoclast formation by reducing DC-STAMP receptor expression in osteoclast precursor cells.

    Science.gov (United States)

    Kulkarni, Rishikesh N; Voglewede, Philip A; Liu, Dawei

    2013-12-01

    It is well known that physical inactivity leads to loss of muscle mass, but it also causes bone loss. Mechanistically, osteoclastogenesis and bone resorption have recently been shown to be regulated by vibration. However, the underlying mechanism behind the inhibition of osteoclast formation is yet unknown. Therefore, we investigated whether mechanical vibration of osteoclast precursor cells affects osteoclast formation by the involvement of fusion-related molecules such as dendritic cell-specific transmembrane protein (DC-STAMP) and P2X7 receptor (P2X7R). RAW264.7 (a murine osteoclastic-like cell line) cells were treated with 20ng/ml receptor activator of NF-κB ligand (RANKL). For 3 consecutive days, the cells were subjected to 1h of mechanical vibration with 20μm displacement at a frequency of 4Hz and compared to the control cells that were treated under the same condition but without the vibration. After 5days of culture, osteoclast formation was determined. Gene expression of DC-STAMP and P2X7R by RAW264.7 cells was determined after 1h of mechanical vibration, while protein production of the DC-STAMP was determined after 6h of postincubation after vibration. As a result, mechanical vibration of RAW264.7 cells inhibited the formation of osteoclasts. Vibration down-regulated DC-STAMP gene expression by 1.6-fold in the presence of RANKL and by 1.4-fold in the absence of RANKL. Additionally, DC-STAMP protein production was also down-regulated by 1.4-fold in the presence of RANKL and by 1.2-fold in the absence of RANKL in RAW264.7 cells in response to mechanical vibration. However, vibration did not affect P2X7R gene expression. Mouse anti-DC-STAMP antibody inhibited osteoclast formation in the absence of vibration. Our results suggest that mechanical vibration of osteoclast precursor cells reduces DC-STAMP expression in osteoclast precursor cells leading to the inhibition of osteoclast formation. © 2013 Elsevier Inc. All rights reserved.

  7. United States housing, 2012

    Science.gov (United States)

    Delton Alderman

    2013-01-01

    Provides current and historical information on housing market in the United States. Information includes trends for housing permits and starts, housing completions for single and multifamily units, and sales and construction. This report will be updated annually.

  8. American Housing Survey (AHS)

    Data.gov (United States)

    Department of Housing and Urban Development — The AHS is the largest, regular national housing sample survey in the United States. The U.S. Census Bureau conducts the AHS to obtain up-to-date housing statistics...

  9. TARP Monthly Housing Scorecard

    Data.gov (United States)

    Department of the Treasury — Treasury and the U.S. Department of Housing and Urban Development (HUD) jointly produce a Monthly Housing Scorecard on the health of the nation’s housing market. The...

  10. White House Communications Agency

    National Research Council Canada - National Science Library

    Gimble, Thomas

    1995-01-01

    The Chairman, House Committee on Government Reform and Oversight; the Chairman, House Subcommittee on National Security, International Affairs, and Criminal Justice, Committee on Government Reform and Oversight...

  11. To Bill or Not to Bill: Medicaid Billing for Special Education Related Services in Arkansas Public Schools

    OpenAIRE

    Smith, Myra Kay Davis

    1997-01-01

    TO BILL OR NOT TO BILL: MEDICAID BILLING FOR SPECIAL EDUCATION RELATED SERVICES IN ARKANSAS PUBLIC SCHOOLS Myra Kay Davis Smith (ABSTRACT) Medicaid is a complicated system for educators to access. LEAs can access Medicaid funds by: billing through a contracted service, establishing their own billing system, or may choose not billing Medicaid. The purpose of this study was to investigate the Medicaid billing processes used in Arkansas public schools. The study ...

  12. Access of Rural AFDC Medicaid Beneficiaries to Mental Health Services

    OpenAIRE

    Lambert, David; Agger, Marc S.

    1995-01-01

    This article examines geographic differences in the use of mental health services among Aid to Families with Dependent Children (AFDC)-eligible Medicaid beneficiaries in Maine. Findings indicate that rural AFDC beneficiaries have significantly lower utilization of mental health services than urban beneficiaries. Specialty mental health providers account for the majority of ambulatory visits for both rural and urban beneficiaries. However, rural beneficiaries rely more on primary-care provider...

  13. Does Managed Care Hurt Health? Evidence from Medicaid Mothers

    OpenAIRE

    Anna Aizer; Janet Currie; Enrico Moretti

    2007-01-01

    Most Americans are now in some form of managed care plan that restricts access to services in order to reduce costs. It is difficult to determine whether these restrictions affect health because individuals and firms self-select into managed care. We investigate the effect of managed care using a California law that required some pregnant women on Medicaid to enter managed care. We use a unique longitudinal database of California births in which we observe changes in the regime faced by indiv...

  14. Social Security Numbers in Medicaid Records: Reporting and Validity, 2009

    OpenAIRE

    John L. Czajka; Shinu Verghese

    2013-01-01

    This report presents findings from a validation study of Social Security numbers (SSNs) in Medicaid Statistical Information System (MSIS) records for the fourth quarter of federal fiscal year 2009. The study produced results for the nation and the states on how often SSNs were reported in MSIS records and how often the reported SSNs passed a validation test at the U.S. Census Bureau, based on data obtained from the Social Security Administration.

  15. The Affordable Care Act Medicaid Expansions and Personal Finance.

    Science.gov (United States)

    Caswell, Kyle J; Waidmann, Timothy A

    2017-09-01

    Using a novel data set from a major credit bureau, we examine the early effects of the Affordable Care Act Medicaid expansions on personal finance. We analyze less common events such as personal bankruptcy, and more common occurrences such as medical collection balances, and change in credit scores. We estimate triple-difference models that compare individual outcomes across counties that expanded Medicaid versus counties that did not, and across expansion counties that had more uninsured residents versus those with fewer. Results demonstrate financial improvements in states that expanded their Medicaid programs as measured by improved credit scores, reduced balances past due as a percent of total debt, reduced probability of a medical collection balance of $1,000 or more, reduced probability of having one or more recent medical bills go to collections, reduction in the probability of experiencing a new derogatory balance of any type, reduced probability of incurring a new derogatory balance equal to $1,000 or more, and a reduction in the probability of a new bankruptcy filing.

  16. Evaluation of Contact Heat Transfer Coefficient and Phase Transformation during Hot Stamping of a Hat-Type Part

    Science.gov (United States)

    Kim, Heung-Kyu; Lee, Seong Hyeon; Choi, Hyunjoo

    2015-01-01

    Using an inverse analysis technique, the heat transfer coefficient on the die-workpiece contact surface of a hot stamping process was evaluated as a power law function of contact pressure. This evaluation was to determine whether the heat transfer coefficient on the contact surface could be used for finite element analysis of the entire hot stamping process. By comparing results of the finite element analysis and experimental measurements of the phase transformation, an evaluation was performed to determine whether the obtained heat transfer coefficient function could provide reasonable finite element prediction for workpiece properties affected by the hot stamping process. PMID:28788046

  17. Polymer microlens replication by Nanoimprint Lithography using proton beam fabricated Ni stamp

    International Nuclear Information System (INIS)

    Dutta, R.K.; Kan, J.A. van; Bettiol, A.A.; Watt, F.

    2007-01-01

    It is essential to have a simplified and a rapid method for fabricating micro/nano structures in different kinds of polymeric materials. Though it is possible to fabricate arrays of microlens directly by P beam writing (PBW), it is restricted to a few types of resist materials. Therefore we have fabricated a Ni electroplated metallic stamp comprising of arrays of inverse/negative features of microlenses. The metallic stamp of about 500 μm thick is made on a silicon wafer coated with 10 μm thick polymethylglutarimide (PMGI) resist and the desired structures are written by PBW followed by thermal reflow and Ni electroplating. An array of microlenses is imprinted on a polycarbonate (PC) substrate by the Nanoimprint Lithography (NIL) technique and the replicated microlenses featuring various numerical apertures, diameters and pitches are characterized

  18. Silicon micro-masonry using elastomeric stamps for three-dimensional microfabrication

    International Nuclear Information System (INIS)

    Keum, Hohyun; Eisenhaure, Jeffrey D; Kim, Seok; Carlson, Andrew; Ning, Hailong; Mihi, Agustin; Braun, Paul V; Rogers, John A

    2012-01-01

    We present a micromanufacturing method for constructing microsystems, which we term ‘micro-masonry’ based on individual manipulation, influenced by strategies for deterministic materials assembly using advanced forms of transfer printing. Analogous to masonry in construction sites, micro-masonry consists of the preparation, manipulation, and binding of microscale units to assemble microcomponents and microsystems. In this paper, for the purpose of demonstration, we used microtipped elastomeric stamps as manipulators and built three dimensional silicon microstructures. Silicon units of varied shapes were fabricated in a suspended format on donors, retrieved, delivered, and placed on a target location on a receiver using microtipped stamps. Annealing of the assembled silicon units permanently bound them and completed the micro-masonry procedure. (paper)

  19. Characterization of the interfacial heat transfer coefficient for hot stamping processes

    Science.gov (United States)

    Luan, Xi; Liu, Xiaochuan; Fang, Haomiao; Ji, Kang; El Fakir, Omer; Wang, LiLiang

    2016-08-01

    In hot stamping processes, the interfacial heat transfer coefficient (IHTC) between the forming tools and hot blank is an essential parameter which determines the quenching rate of the process and hence the resulting material microstructure. The present work focuses on the characterization of the IHTC between an aluminium alloy 7075-T6 blank and two different die materials, cast iron (G3500) and H13 die steel, at various contact pressures. It was found that the IHTC between AA7075 and cast iron had values 78.6% higher than that obtained between AA7075 and H13 die steel. Die materials and contact pressures had pronounced effects on the IHTC, suggesting that the IHTC can be used to guide the selection of stamping tool materials and the precise control of processing parameters.

  20. Combined Randomized-Local Hough Transform versus UpWrite Transform in stamp detection

    Directory of Open Access Journals (Sweden)

    Daniela Tondini

    2003-10-01

    Full Text Available The conventional Hough Transform used for detection of objects with known shape and size has proved its robustness. One typical task for this transform can be the detection of stamp(s on an envelope. Unfortunately, the Hough Transform has an important drawback: the heavy computational effort and, as consequence, a big execution time. This paper introduces a variant of Hough Transform that speeds up the process. One important aid is given by a filtering step based on a fast analysis of a rough deformation model. This method is a combination of Randomized and Local Hough Transform. Experiments were made comparing the modified Hough Transform approach with the UpWrite Transform and they proved that the first approach preserves the quality of the Hough Transform results at a higher speed.

  1. Influence of operating parameters on coke end temperature in stamp charged batteries

    Energy Technology Data Exchange (ETDEWEB)

    Yadav, U.S.; Sarkar, P.; Deshpande, D.P. [Tata Steel, Jamshedpur (India)

    2004-07-01

    Coke end temperature (CET) indicates the final temperature of coke mass after pushing it out from the oven and before quenching and thus is an indicator of the preparedness of the coke. Analysis of plant data from stamp charged batteries at Tata Steel show that it depends on coal blend characteristics and battery conditions. Increased input coal ash, its crushing fineness and volatile matters increases but the moisture decreases it. The heating rate, battery and regenerator temperatures all increase the coke end temperature. The present paper documents that observations on parameters influencing coke end temperature under stamp charged conditions and attempts to hypothesise the possible explanation for the results obtained. 3 refs., 10 figs., 2 tabs.

  2. Modeling and Simulating Material Behavior during Hot Blank - Cold Die (HB-CD) Stamping of Aluminium Alloy Sheets

    Science.gov (United States)

    Zhang, Nan; Abu-Farha, Fadi

    2016-08-01

    Hot blank - cold die (HB-CD) stamping, non-isothermal hot stamping, of aluminium alloy sheets offers great opportunities for high production rates at low cost, while overcoming limited material formability issues. Yet developing an accurate model that can describe the complex material behavior over the wide ranging conditions of HB-CD stamping (temperatures ranging between 25 and 350 °C) is challenging. Moreover, validation of the developed models under transient conditions is problematic. This work presents he results of a comprehensive characterization, material modeling, FE simulation and experimental validation effort to capture the behavior of an aluminium alloy sheet during HB-CD stamping. In particular, we highlight the integration between temperature measurements (thermography) and strain measurements (digital image correlation) for the accurate validation of model predictions of non-isothermal material deformation.

  3. 75 FR 11913 - Chrysler, LLC; Warren Stamping Plant, Including On-Site Leased Workers From Caravan Knight...

    Science.gov (United States)

    2010-03-12

    ... firm. The workers produce stamping parts for automobiles. New information shows that workers leased... under the control of the subject firm to be considered leased workers. Based on these findings, the...

  4. Intergenerational enrollment and expenditure changes in Medicaid: trends from 1991 to 2005.

    Science.gov (United States)

    Patrick, Stephen W; Freed, Gary L

    2012-09-20

    From its inception, Medicaid was aimed at providing insurance coverage for low income children, elderly, and disabled. Since this time, children have become a smaller proportion of the US population and Medicaid has expanded to additional eligibility groups. We sought to evaluate relative growth in spending in the Medicaid program between children and adults from 1991-2005. We hypothesize that this shifting demographic will result in fewer resources being allocated to children in the Medicaid program. We utilized retrospective enrollment and expenditure data for children, adults and the elderly from 1991 to 2005 for both Medicaid and Children's Health Insurance Program Medicaid expansion programs. Data were obtained from the Centers for Medicare and Medicaid Services using their Medicaid Statistical Information System. From 1991 to 2005, the number of enrollees increased by 83% to 58.7 million. This includes increases of 33% for children, 100% for adults and 50% for the elderly. Concurrently, total expenditures nationwide rose 150% to $273 billion. Expenditures for children increased from $23.4 to $65.7 billion, adults from $46.2 to $123.6 billion, and elderly from $39.2 to $71.3 billion. From 1999 to 2005, Medicaid spending on long-term care increased by 31% to $84.3 billion. Expenditures on the disabled grew by 61% to $119 billion. In total, the disabled account for 43% and long-term care 31%, of the total Medicaid budget. Our study did not find an absolute decrease in the overall resources being directed toward children. However, increased spending on adults on a per-capita and absolute basis, particularly disabled adults, is responsible for much of the growth in spending over the past 15 years. Medicaid expenditures have grown faster than inflation and overall national health expenditures. A national strategy is needed to ensure adequate coverage for Medicaid recipients while dealing with the ongoing constraints of state and federal budgets.

  5. Intergenerational enrollment and expenditure changes in Medicaid: trends from 1991 to 2005

    Directory of Open Access Journals (Sweden)

    Patrick Stephen W

    2012-09-01

    Full Text Available Abstract Background From its inception, Medicaid was aimed at providing insurance coverage for low income children, elderly, and disabled. Since this time, children have become a smaller proportion of the US population and Medicaid has expanded to additional eligibility groups. We sought to evaluate relative growth in spending in the Medicaid program between children and adults from 1991-2005. We hypothesize that this shifting demographic will result in fewer resources being allocated to children in the Medicaid program. Methods We utilized retrospective enrollment and expenditure data for children, adults and the elderly from 1991 to 2005 for both Medicaid and Children’s Health Insurance Program Medicaid expansion programs. Data were obtained from the Centers for Medicare and Medicaid Services using their Medicaid Statistical Information System. Results From 1991 to 2005, the number of enrollees increased by 83% to 58.7 million. This includes increases of 33% for children, 100% for adults and 50% for the elderly. Concurrently, total expenditures nationwide rose 150% to $273 billion. Expenditures for children increased from $23.4 to $65.7 billion, adults from $46.2 to $123.6 billion, and elderly from $39.2 to $71.3 billion. From 1999 to 2005, Medicaid spending on long-term care increased by 31% to $84.3 billion. Expenditures on the disabled grew by 61% to $119 billion. In total, the disabled account for 43% and long-term care 31%, of the total Medicaid budget. Conclusion Our study did not find an absolute decrease in the overall resources being directed toward children. However, increased spending on adults on a per-capita and absolute basis, particularly disabled adults, is responsible for much of the growth in spending over the past 15 years. Medicaid expenditures have grown faster than inflation and overall national health expenditures. A national strategy is needed to ensure adequate coverage for Medicaid recipients while dealing with the

  6. Boron nitride stamp for ultra-violet nanoimprinting lithography fabricated by focused ion beam lithography

    International Nuclear Information System (INIS)

    Altun, Ali Ozhan; Jeong, Jun-Ho; Rha, Jong-Joo; Kim, Ki-Don; Lee, Eung-Sug

    2007-01-01

    Cubic boron nitride (c-BN) is one of the hardest known materials (second after diamond). It has a high level of chemical resistance and high UV transmittance. In this study, a stamp for ultra-violet nanoimprint lithography (UV-NIL) was fabricated using a bi-layered BN film deposited on a quartz substrate. Deposition of the BN was done using RF magnetron sputtering. A hexagonal boron nitride (h-BN) layer was deposited for 30 min before c-BN was deposited for 30 min. The thickness of the film was measured as 160 nm. The phase of the c-BN layer was investigated using Fourier transform infrared (FTIR) spectrometry, and it was found that the c-BN layer has a 40% cubic phase. The deposited film was patterned using focused ion beam (FIB) lithography for use as a UV-NIL stamp. Line patterns were fabricated with the line width and line distance set at 150 and 150 nm, respectively. The patterning process was performed by applying different currents to observe the effect of the current value on the pattern profile. The fabricated patterns were investigated using AFM, and it was found that the pattern fabricated by applying a current value of 50 picoamperes (pA) has a better profile with a 65 nm line depth. The UV transmittance of the 160 nm thick film was measured to be 70-86%. The hardness and modulus of the BN was measured to be 12 and 150 GPa, respectively. The water contact angle of the stamp surface was measured at 75 0 . The stamp was applied to UV-NIL without coating with an anti-adhesion layer. Successful imprinting was proved via scanning electron microscope (SEM) images of the imprinted resin

  7. Boron nitride stamp for ultra-violet nanoimprinting lithography fabricated by focused ion beam lithography

    Energy Technology Data Exchange (ETDEWEB)

    Altun, Ali Ozhan [Nano-Mechanical Systems Research Center, Korea Institute of Machinery and Materials, 171 Jang-dong, Yuseung-gu, Daejeon 305-343 (Korea, Republic of); Jeong, Jun-Ho [Nano-Mechanical Systems Research Center, Korea Institute of Machinery and Materials, 171 Jang-dong, Yuseung-gu, Daejeon 305-343 (Korea, Republic of); Rha, Jong-Joo [Surface Technology Research Center, Korea Institute of Machinery and Materials, 66 Sangnam-Dong, Changwon-Shi, Kyungnam-Do (Korea, Republic of); Kim, Ki-Don [Nano-Mechanical Systems Research Center, Korea Institute of Machinery and Materials, 171 Jang-dong, Yuseung-gu, Daejeon 305-343 (Korea, Republic of); Lee, Eung-Sug [Nano-Mechanical Systems Research Center, Korea Institute of Machinery and Materials, 171 Jang-dong, Yuseung-gu, Daejeon 305-343 (Korea, Republic of)

    2007-11-21

    Cubic boron nitride (c-BN) is one of the hardest known materials (second after diamond). It has a high level of chemical resistance and high UV transmittance. In this study, a stamp for ultra-violet nanoimprint lithography (UV-NIL) was fabricated using a bi-layered BN film deposited on a quartz substrate. Deposition of the BN was done using RF magnetron sputtering. A hexagonal boron nitride (h-BN) layer was deposited for 30 min before c-BN was deposited for 30 min. The thickness of the film was measured as 160 nm. The phase of the c-BN layer was investigated using Fourier transform infrared (FTIR) spectrometry, and it was found that the c-BN layer has a 40% cubic phase. The deposited film was patterned using focused ion beam (FIB) lithography for use as a UV-NIL stamp. Line patterns were fabricated with the line width and line distance set at 150 and 150 nm, respectively. The patterning process was performed by applying different currents to observe the effect of the current value on the pattern profile. The fabricated patterns were investigated using AFM, and it was found that the pattern fabricated by applying a current value of 50 picoamperes (pA) has a better profile with a 65 nm line depth. The UV transmittance of the 160 nm thick film was measured to be 70-86%. The hardness and modulus of the BN was measured to be 12 and 150 GPa, respectively. The water contact angle of the stamp surface was measured at 75{sup 0}. The stamp was applied to UV-NIL without coating with an anti-adhesion layer. Successful imprinting was proved via scanning electron microscope (SEM) images of the imprinted resin.

  8. A rapid co-culture stamping device for studying intercellular communication

    OpenAIRE

    Amin Hassanzadeh-Barforoushi; Jonathan Shemesh; Nona Farbehi; Mohsen Asadnia; Guan Heng Yeoh; Richard P. Harvey; Robert E. Nordon; Majid Ebrahimi Warkiani

    2016-01-01

    Regulation of tissue development and repair depends on communication between neighbouring cells. Recent advances in cell micro-contact printing and microfluidics have facilitated the in-vitro study of homotypic and heterotypic cell-cell interaction. Nonetheless, these techniques are still complicated to perform and as a result, are seldom used by biologists. We report here development of a temporarily sealed microfluidic stamping device which utilizes a novel valve design for patterning two a...

  9. A new marking technique for peripheral lung nodules avoiding pleural puncture: the intrathoracic stamping method.

    Science.gov (United States)

    Kawada, Masaya; Okubo, Tetsuyuki; Poudel, Saseem; Suzuki, Yoshinori; Kawarada, Yo; Kitashiro, Shuji; Okushiba, Shunichi; Katoh, Hiroyuki

    2013-03-01

    While performing thoracoscopic wedge resection of the lung, the location of the lesion is generally identified by visual inspection or palpation. When difficulty in identification of the lesion by thoracoscopy is anticipated, preoperative marking is performed. However, complications and technical difficulties plague current marking techniques. To overcome this problem, we designed a new, safe and easy marking technique that avoids pleural puncture, called the intrathoracic stamping method.

  10. Improved Formability by Control of Strain Distribution in Sheet Stamping Using Electromagnetic Impulses

    OpenAIRE

    Daehn, G. S.; Shang, J.; Vohnout, V. J.

    2004-01-01

    Stamping failures consist of, broadly speaking, either tearing (excessive local strain energy) or wrinkling (insufficient or inappropriate local strain energy). Good parts are produced when the strain energy or plastic work is effectively distributed during the forming process such that tears and wrinkles are eliminated. The process window framed by tearing and wrinkling limits can be rather small for some materials, notably aluminum alloys. At present, there are no established methods of dir...

  11. A new marking technique for peripheral lung nodules avoiding pleural puncture: the intrathoracic stamping method

    OpenAIRE

    Kawada, Masaya; Okubo, Tetsuyuki; Poudel, Saseem; Suzuki, Yoshinori; Kawarada, Yo; Kitashiro, Shuji; Okushiba, Shunichi; Katoh, Hiroyuki

    2012-01-01

    While performing thoracoscopic wedge resection of the lung, the location of the lesion is generally identified by visual inspection or palpation. When difficulty in identification of the lesion by thoracoscopy is anticipated, preoperative marking is performed. However, complications and technical difficulties plague current marking techniques. To overcome this problem, we designed a new, safe and easy marking technique that avoids pleural puncture, called the intrathoracic stamping method.

  12. Characterization of the interfacial heat transfer coefficient for hot stamping processes

    OpenAIRE

    Luan, X; Liu, X; Fang, H; Ji, K; El Fakir, O; Wang, L

    2016-01-01

    In hot stamping processes, the interfacial heat transfer coefficient (IHTC) between the forming tools and hot blank is an essential parameter which determines the quenching rate of the process and hence the resulting material microstructure. The present work focuses on the characterization of the IHTC between an aluminium alloy 7075-T6 blank and two different die materials, cast iron (G3500) and H13 die steel, at various contact pressures. It was found that the IHTC between AA7075 and cast ir...

  13. Anisotropic behaviour law for sheets used in stamping: A comparative study of steel and aluminium

    OpenAIRE

    Sinou, Jean-Jacques; Macquaire, Bruno

    2008-01-01

    International audience; For a car manufacturer, reducing the weight of vehicles is an obvious aim. Replacing steel by aluminium moves towards that goal. Unfortunately, aluminium's stamping numerical simulation results are not yet as reliable as those of steel. Punch-strength and spring-back phenomena are not correctly described. This study on aluminium validates the behaviour law Hill 48 quadratic yield criterion with both isotropic and kinematic hardening. It is based on the yield surface an...

  14. Low temperature high density plasma nitriding of stainless steel molds for stamping of oxide glasses

    Directory of Open Access Journals (Sweden)

    Aizawa Tatsuhiko

    2016-01-01

    Full Text Available Various kinds of stainless steels have been widely utilized as a die for mold- and direct-stamping processes of optical oxide glasses. Since they suffered from high temperature transients and thermal cycles in practice, they must be surface-treated by dry and wet coatings, or, by plasma nitriding. Martensitic stainless steel mold was first wet plated by the nickel phosphate (NiP, which was unstable at the high temperature stamping condition; and, was easy to crystalize or to fracture by itself. This issue of nuisance significantly lowered the productivity in fabrication of optical oxide-glass elements. In the present paper, the stainless steel mold was surface-treated by the low-temperature plasma nitriding. The nitrided layer by this surface modification had higher nitrogen solute content than 4 mass%; the maximum solid-solubility of nitrogen is usually 0.1 mass% in the equilibrium phase diagram. Owing to this solid-solution with high nitrogen concentration, the nitrided layer had high hardness over 1400 HV within its thickness of 50 μm without any formation of nitrides after plasma nitriding at 693 K for 14.4 ks. This plasma-nitrided mold was utilized for mold-stamping of two colored oxide glass plates at 833 K; these plates were successfully deformed and joined into a single glass plate by this stamping without adhesion or galling of oxide glasses onto the nitrided mold surface.

  15. Using stamping punch force variation for the identification of changes in lubrication and wear mechanism

    Science.gov (United States)

    Voss, B. M.; Pereira, M. P.; Rolfe, B. F.; Doolan, M. C.

    2017-09-01

    The growth in use of Advanced High Strength Steels in the automotive industry for light-weighting and safety has increased the rates of tool wear in sheet metal stamping. This is an issue that adds significant costs to production in terms of manual inspection and part refinishing. To reduce these costs, a tool condition monitoring system is required and a firm understanding of process signal variation must form the foundation for any such monitoring system. Punch force is a stamping process signal that is widely collected by industrial presses and has been linked closely to part quality and tool condition, making it an ideal candidate as a tool condition monitoring signal. In this preliminary investigation, the variation of punch force due to different lubrication conditions and progressive wear are examined. Linking specific punch force signature changes to developing lubrication and wear events is valuable for die wear and stamping condition monitoring. A series of semi-industrial channel forming trials were conducted under different lubrication regimes and progressive die wear. Punch force signatures were captured for each part and Principal Component Analysis (PCA) was applied to determine the key Principal Components of the signature data sets. These Principal Components were linked to the evolution of friction conditions over the course of the stroke for the different lubrication regimes and mechanism of galling wear. As a result, variation in punch force signatures were correlated to the current mechanism of wear dominant on the formed part; either abrasion or adhesion, and to changes in lubrication mechanism. The outcomes of this study provide important insights into punch force signature variation, that will provide a foundation for future work into the development of die wear and lubrication monitoring systems for sheet metal stamping.

  16. Boron nitride stamp for ultra-violet nanoimprinting lithography fabricated by focused ion beam lithography

    Science.gov (United States)

    Ozhan Altun, Ali; Jeong, Jun-Ho; Rha, Jong-Joo; Kim, Ki-Don; Lee, Eung-Sug

    2007-11-01

    Cubic boron nitride (c-BN) is one of the hardest known materials (second after diamond). It has a high level of chemical resistance and high UV transmittance. In this study, a stamp for ultra-violet nanoimprint lithography (UV-NIL) was fabricated using a bi-layered BN film deposited on a quartz substrate. Deposition of the BN was done using RF magnetron sputtering. A hexagonal boron nitride (h-BN) layer was deposited for 30 min before c-BN was deposited for 30 min. The thickness of the film was measured as 160 nm. The phase of the c-BN layer was investigated using Fourier transform infrared (FTIR) spectrometry, and it was found that the c-BN layer has a 40% cubic phase. The deposited film was patterned using focused ion beam (FIB) lithography for use as a UV-NIL stamp. Line patterns were fabricated with the line width and line distance set at 150 and 150 nm, respectively. The patterning process was performed by applying different currents to observe the effect of the current value on the pattern profile. The fabricated patterns were investigated using AFM, and it was found that the pattern fabricated by applying a current value of 50 picoamperes (pA) has a better profile with a 65 nm line depth. The UV transmittance of the 160 nm thick film was measured to be 70 86%. The hardness and modulus of the BN was measured to be 12 and 150 GPa, respectively. The water contact angle of the stamp surface was measured at 75°. The stamp was applied to UV-NIL without coating with an anti-adhesion layer. Successful imprinting was proved via scanning electron microscope (SEM) images of the imprinted resin.

  17. Validation of the stamping method for CaSO{sub 4}:RE + Teflon® pellets production

    Energy Technology Data Exchange (ETDEWEB)

    Nunes, Maira G.; Rodrigues, Leticia L.C., E-mail: mgnunes@ipen.br, E-mail: lcrodri@ipen.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2014-07-01

    The IPEN method for the CaSO{sub 4}:RE + Teflon® production, developed and patented at the Dosimetric Materials Laboratory - LMD/IPEN in the earlier 1980's, is highly time-demanding, so that the use of the stamping method, already widely industrially applied, would enhance the CaSO{sub 4}:RE + Teflon® pellets production. Thus, validating the stamping method, by comparing the dosimetric properties of a batch of pellets produced by each method, became a must. The stamped batch presents the same mean non-irradiated signals either after sintering or annealing while IPEN batch mean non-irradiated signals vary in 23%. The mean TL signal after irradiation was about 50 nC, but the standard deviation varies from 20% to 33% for IPEN batch and keeps in 10% for the stamped batch. 24 h after the irradiation, the TL signal decreased to about 35 nC, with no differences in IPEN batch standard deviation and a decrease to 5% in stamped batch standard deviation, for the five performed essays. Calibration curves present a linear behavior over the entire studied dose range and the same coefficients for both methods, however, the uncertainties in the coefficients determined to the calibration curve obtained with stamped pellets are significantly smaller, leading to a more precise dose determination. This results show that the stamping method produces more homogeneous batches, with pellets that maintain the dosimetric characteristics of the detectors produced by IPEN method, in such a way that the stamping method can substitute with advantages the IPEN method in the CaSO{sub 4}:RE + Teflon® dosimetric pellets production. (author)

  18. Application of a Model for Quenching and Partitioning in Hot Stamping of High-Strength Steel

    Science.gov (United States)

    Zhu, Bin; Liu, Zhuang; Wang, Yanan; Rolfe, Bernard; Wang, Liang; Zhang, Yisheng

    2018-04-01

    Application of quenching and partitioning process in hot stamping has proven to be an effective method to improve the plasticity of advanced high-strength steels (AHSSs). In this study, the hot stamping and partitioning process of advanced high-strength steel 30CrMnSi2Nb is investigated with a hot stamping mold. Given the specific partitioning time and temperature, the influence of quenching temperature on the volume fraction of microstructure evolution and mechanical properties of the above steel are studied in detail. In addition, a model for quenching and partitioning process is applied to predict the carbon diffusion and interface migration during partitioning, which determines the retained austenite volume fraction and final properties of the part. The predicted trends of the retained austenite volume fraction agree with the experimental results. In both cases, the volume fraction of retained austenite increases first and then decreases with the increasing quenching temperature. The optimal quenching temperature is approximately 290 °C for 30CrMnSi2Nb with the partition conditions of 425 °C and 20 seconds. It is suggested that the model can be used to help determine the process parameters to obtain retained austenite as much as possible.

  19. Fabrication of 3D high aspect ratio PDMS microfluidic networks with a hybrid stamp.

    Science.gov (United States)

    Kung, Yu-Chun; Huang, Kuo-Wei; Fan, Yu-Jui; Chiou, Pei-Yu

    2015-04-21

    We report a novel methodology for fabricating large-area, multilayer, thin-film, high aspect ratio, 3D microfluidic structures with through-layer vias and open channels that can be bonded between hard substrates. It is realized by utilizing a hybrid stamp with a thin plastic sheet embedded underneath a PDMS surface. This hybrid stamp solves an important edge protrusion issue during PDMS molding while maintaining necessary stamp elasticity to ensure the removal of PDMS residues at through-layer regions. Removing edge protrusion is a significant progress toward fabricating 3D structures since high aspect ratio PDMS structures with flat interfaces can be realized to facilitate multilayer stacking and bonding to hard substrates. Our method also allows for the fabrication of 3D deformable channels, which can lead to profound applications in electrokinetics, optofluidics, inertial microfluidics, and other fields where the shape of the channel cross section plays a key role in device physics. To demonstrate, as an example, we have fabricated a microfluidic channel by sandwiching two 20 μm wide, 80 μm tall PDMS membranes between two featureless ITO glass substrates. By applying electrical bias to the two ITO substrates and pressure to deform the thin membrane sidewalls, strong electric field enhancement can be generated in the center of a channel to enable 3D sheathless dielectrophoretic focusing of biological objects including mammalian cells and bacteria at a flow speed up to 14 cm s(-1).

  20. Prevention of crack in stretch flanging process using hot stamping technique

    Science.gov (United States)

    Syafiq, Y. Mohd; Hamedon, Z.; Azila Aziz, Wan; Razlan Yusoff, Ahmad

    2017-10-01

    Demand for enhancing of passenger safety as well as weight reduction of automobiles has increased the use of high strength steel sheets. As a sheet metal is a lightweight having high strength is suitable for producing automotive parts such as white body panel. The stretch flanging of the high strength steel sheet is a problem due to high springback and easy to crack. This study uses three methods to stretch flange the sheets; using lubricants, shear-edge polishing and hot stamping. The effectiveness of these methods will be measured by comparing the flange length of each methods can achieved. For stretch flange with lubricant and polished sheared edge, the flange length failed to achieve the target 15 mm while hot stamping improved the formability of the sheet and preventing the occurrence of the springback and crack. Hot stamping not only improved formability of the sheet but also transformed the microstructure into martensite thus improve the hardness and the strength of the sheet after been quenched with the dies.

  1. Investigations on the Hot Stamping of AW-7921-T4 Alloy Sheet

    Directory of Open Access Journals (Sweden)

    M. Kumar

    2017-01-01

    Full Text Available AW-7xxx alloys have been nowadays considered for greater light weighting potential in automotive industry due to its higher strength compared to AW-5xxx and AW-6xxx alloys. However, due to their lower formability the forming processes are still in development. This paper investigates one such forming process called hot stamping. The investigation started by carrying out hot tensile testing of an AW-7xxx alloy, that is, AW-7921 at temperatures between 350°C and 475°C, to measure the strength and formability. Formability was found to improve with increasing temperature and was sensitive to the strain rate. Dynamic recovery is considered as usual reason for the formability improvement. However, examining the precipitation states of the as-received condition and after hot stamping using differential scanning calorimetry (DSC, the dissolution of precipitates was also believed to contribute to this increase in formability. Following solution heat treatment there was no precipitation during cooling across the cooling rates investigated (5–10°C/s. Samples taken from parts hot stamped at 10 and 20 mm s−1 had similar yield strengths. A 3-step paint baking heat treatment yielded a higher postpaint baking strength than a single step treatment.

  2. Conformal contact and pattern stability of stamps used for soft lithography

    Science.gov (United States)

    Bietsch, Alexander; Michel, Bruno

    2000-10-01

    Patterning in soft lithography techniques such as microcontact printing or light-coupling mask lithography is mediated by surface topographical patterns of elastomeric stamps: intimate contact with the substrate is achieved locally at the protruding areas, whereas a gap remains between the substrate and recessed zones. This principle challenges the properties of the stamp, especially when printing high-resolution or extreme aspect-ratio patterns with high accuracy. On the one hand, the stamp must be soft enough to enable conformal contact with the substrate, which means that it must adapt elastically without leaving voids created by the natural roughness of the substrate. On the other hand, a precise definition of micropatterns requires a rigid material. In this article, we analyze the conditions of elasticity, roughness, and energy of adhesion to establish conformal contact between an elastomer and the target surface. Furthermore, we address questions of replication accuracy and evaluate local elastic deformation induced by normal forces using model calculations for simple pattern geometries. Pressure applied during contact leads to a sagging or collapse of the unsupported areas. We discuss implications on both material and pattern design that allow spontaneous propagation of conformal contact while inhibiting the spreading of collapse.

  3. On the die face design for stamping an automotive engine hood

    Science.gov (United States)

    Chen, Ming-Zhi; Wang, Shi-Wei; Lin, Ching-I.; Chen, Fuh-Kuo

    2017-09-01

    Since the engine hood is mainly manufactured in the drawing operation, the die addendum design is the key to the success of manufacturing a defect free product. In this study, the existing die addendum designs corresponding to those engine hoods were reviewed and the design parameters were constructed. The preliminary study was then performed to examine the influences of the stamping die angle, binder surface shape, and die open line shape on the defects occurred in the part. Based on the simulation results, the optimum design for the die addendum face was then investigated and a systematic design guideline was proposed. In order to validate the proposed design guideline, actual engine hoods were stamped according to the finite element analysis and the production part shapes, thickness distributions, and the stretch at the central region were compared with those obtained from the finite element simulations. The consistent agreement between the product parts and the simulation results confirms the validity of the design guideline proposed in the present study for stamping an engine hood.

  4. Evaluation of resistless Ga+ beam lithography for UV NIL stamp fabrication

    Science.gov (United States)

    Rumler, M.; Fader, R.; Haas, A.; Rommel, M.; Bauer, A. J.; Frey, L.

    2013-09-01

    This paper presents an alternative rapid prototyping approach for the fabrication of stamps for UV nanoimprint lithography. In this process, areas implanted with gallium serve as an etch mask for the dry etching of quartz. The implantation is performed using a focused ion beam system. To avoid charging of the quartz substrate the use of thin layers of chromium or carbon on the quartz substrate has been evaluated. The resulting quartz structures exhibit very smooth surfaces after dry etching, if the implantation dose is high enough to form a stable etch mask. Furthermore, anisotropic etching could be realized by optimization of a quartz etching process involving C4F8 and O2 after the use of resistless Ga+ beam lithography. Finally, imprints into a UV curing resist are performed successfully with the manufactured stamps, proving that the presence of Ga rich areas on the stamp is not detrimental to the curing of the resist or the functionality of the anti-sticking layer.

  5. Social Housing in Denmark

    DEFF Research Database (Denmark)

    Vestergaard, Hedvig; Scanlon, Kath J

    2014-01-01

    Social housing is a cornerstone in the Danish welfare society and is accessible for all households. By law, social housing must be rented at cost rents, which are based on historical costs; rents do not respond to market forces. Social housing aims to provide good standard, secure and affordable...... housing for all. It especially addresses the housing needs of lower-income households as well as new house-holds. This chapter presents how the self-owning Danish non-profit housing associations construct and manage one fifth of the Danish housing stock. Here the tenants’ democracy sets the framework...... for the individual associations as well as each housing estate. In principle, each estate and the association it belongs to must balance its books. An important feature of the sector is the build-up of a funding system which makes it possible to support the financing of major renovations and energy measures as well...

  6. Essays on Housing Markets

    DEFF Research Database (Denmark)

    Bäckman, Claes

    In Denmark and in many countries around the world, housing markets are of considerable importance for households and policy-makers alike. As the boom and bust in the US and Danish housing market so aptly demonstrated, disruptions in the housing market potentially have wide-ranging consequences...... for individual households and for the aggregate economy. Housing is important because we all have to live somewhere, but also because it serves as a considerable source of both wealth and debt. As such, housing market policy can not only create vast benefits for many, but can also have substantial negative...... impacts for all, and should therefore be a topic of major interest for economists and policy makers alike. This Ph.D. thesis, entitled “Essays on Housing Markets”, analyzes the Danish housing market during the 2000s, with a focus on how policy changes affected house prices and how changes in house prices...

  7. Situation-Based Housing

    DEFF Research Database (Denmark)

    Duelund Mortensen, Peder

    2011-01-01

    Presentation of urban housing research on flexible housing types in the Copenhagen Region: Theoretical background, methodology, analyse of spatial organization, interviews and results. Cases: Pærehaven in Ølby, Køge and M-house in Ørestad, Copenhagen......Presentation of urban housing research on flexible housing types in the Copenhagen Region: Theoretical background, methodology, analyse of spatial organization, interviews and results. Cases: Pærehaven in Ølby, Køge and M-house in Ørestad, Copenhagen...

  8. House Price, House Quality and Economic Growth

    NARCIS (Netherlands)

    De Vries, P.; Boelhouwer, P.J.

    2010-01-01

    The literature on housing markets suggest that periods of economic growth are characterised by a demand for better housing quality and increasing prices. The basic principles of the theory are that the short-run price fluctuations occur due to market imperfection, while over the long term, causality

  9. Workforce issues and consumer satisfaction in Medicaid personal assistance services.

    Science.gov (United States)

    Anderson, Wayne L; Wiener, Joshua M; Khatutsky, Galina

    2006-01-01

    This study used a survey of older people and younger persons with disabilities who were receiving Medicaid-financed home and community-based services (HCBS) to assess the effect of workforce issues on consumer satisfaction. We found that recruitment problems had very strong negative and significant effects on consumer satisfaction. An interruption in service was a more important and significant indicator of consumer dissatisfaction than not having the same worker over time. We also found that problems with worker training and respect and treatment of consumers strongly and significantly affected satisfaction with paid care. Efforts to improve workforce issues are needed to improve the quality of care of these services.

  10. Using research for successful Medicare and Medicaid risk marketing.

    Science.gov (United States)

    Jacobs, S; Nelson, A M; Wood, S D

    1996-01-01

    Medicare/Medicaid risk marketing is a vital business challenge, one that countless managed care organizations are facing right now. Early entry into new markets and aggressive participation in existing markets are essential to meet competitive pressures. Health plans intent on success in government risk programs should conduct research to learn the medical needs, wants, and desires of older persons in the geographic area they serve. Original, market-specific research yields critical marketing and clinical data that can be used to improve care and member satisfaction along with customer loyalty and retention.

  11. Oregon's Coordinated Care Organizations and Their Effect on Prenatal Care Utilization Among Medicaid Enrollees.

    Science.gov (United States)

    Oakley, Lisa P; Harvey, S Marie; Yoon, Jangho; Luck, Jeff

    2017-09-01

    Introduction Previous studies indicate that inadequate prenatal care is more common among women covered by Medicaid compared with private insurance. Increasing the proportion of pregnant women who receive early and adequate prenatal care is a Healthy People 2020 goal. We examined the impact of the implementation of Oregon's accountable care organizations, Coordinated Care Organizations (CCOs), for Medicaid enrollees, on prenatal care utilization among Oregon women of reproductive age enrolled in Medicaid. Methods Using Medicaid eligibility data linked to unique birth records for 2011-2013, we used a pre-posttest treatment-control design that compared prenatal care utilization for women on Medicaid before and after CCO implementation to women never enrolled in Medicaid. Additional stratified analyses were conducted to explore differences in the effect of CCO implementation based on rurality, race, and ethnicity. Results After CCO implementation, mothers on Medicaid had a 13% increase in the odds of receiving first trimester care (OR 1.13, CI 1.04, 1.23). Non-Hispanic (OR 1.20, CI 1.09, 1.32), White (OR 1.20, CI 1.08, 1.33) and Asian (OR 2.03, CI 1.26, 3.27) women on Medicaid were more likely to receive initial prenatal care in the first trimester after CCO implementation and only Medicaid women in urban areas were more likely (OR 1.14, CI 1.05, 1.25) to initiate prenatal care in the first trimester. Conclusion Following Oregon's implementation of an innovative Medicaid coordinated care model, we found that women on Medicaid experienced a significant increase in receiving timely prenatal care.

  12. Medicaid Waivers and Public Sector Mental Health Service Penetration Rates for Youth.

    Science.gov (United States)

    Graaf, Genevieve; Snowden, Lonnie

    2018-01-22

    To assist families of youth with serious emotional disturbance in financing youth's comprehensive care, some states have sought and received Medicaid waivers. Medicaid waivers waive or relax the Medicaid means test for eligibility to provide insurance coverage to nonpoor families for expensive, otherwise out-of-reach treatment for youth with Serious Emotional Disturbance (SED). Waivers promote treatment access for the most troubled youth, and the present study investigated whether any of several Medicaid waiver options-and those that completely omit the means test in particular-are associated with higher state-wide public sector treatment penetration rates. The investigators obtained data from the U.S. Census, SAMHSA's Uniform Reporting System, and the Centers for Medicare and Medicaid Services. Analysis employed random intercept and random slope linear regression models, controlling for a variety of state demographic and fiscal variables, to determine whether a relationship between Medicaid waiver policies and state-level public sector penetration rates could be observed. Findings indicate that, whether relaxing or completely waiving Medicaid's qualifying income limits, waivers increase public sector penetration rates, particularly for youth under age 17. However, completely waiving Medicaid income limits did not uniquely contribute to penetration rate increases. States offering Medicaid waivers that either relax or completely waive Medicaid's means test to qualify for health coverage present higher public sector treatment rates for youth with behavioral health care needs. There is no evidence that restricting the program to waiving the means test for accessing Medicaid would increase treatment access. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  13. Access to dental care services for Medicaid children: variations by urban/rural categories in Illinois.

    Science.gov (United States)

    Byck, Gayle R; Walton, Surrey M; Cooksey, Judith A

    2002-01-01

    Poor oral health status and limited access to dental care have been recognized as problems for children from Medicaid and low-income families. However, little is known about dental access for Medicaid-enrolled children in rural areas. This study examines differences between rural and urban counties in dental utilization rates of Illinois children enrolled in either Medicaid or the Children's Health Insurance Program. How the overall dentist supply, the dentist Medicaid participation rate, and county level sociodemographic factors relate to Medicaid dental utilization are examined. Illinois counties were aggregated into four urban/rural categories. Descriptive analysis showed lower utilization rates in the rural categories (25 and 27%) compared with the metropolitan categories (35 and 31%). Rural areas had a substantially lower supply of dentists, and consequently a lower supply of dentists participating in Medicaid, despite the substantially higher Medicaid participation rate of dentists in the rural categories (45 and 51%) than in the metropolitan categories (22 and 32%). However, regression results indicated no significant relationship between the rate of utilization of Medicaid-enrolled children and rural status after controlling for several dental supply and population factors. The most important factors relating to Medicaid-enrolled children's dental utilization, regardless of urban or rural status, were the proportion of children enrolled in Medicaid and the participating dentist to population ratio. Without the high participation rate of dentists in rural areas, access to oral health care for rural children enrolled in Medicaid would have been worse. Policy makers should focus on maintaining high rural dentist participation rates as well as addressing future supply problems that may exacerbate difficulties with access in rural areas.

  14. Geography and the Medicaid mental health care infrastructure: implications for health care reform.

    Science.gov (United States)

    Cummings, Janet R; Wen, Hefei; Ko, Michelle; Druss, Benjamin G

    2013-10-01

    Medicaid is the largest payer of mental health (MH) care in the United States, and this role will increase among states that opt into the Medicaid expansion. However, owing to the dearth of MH care providers who accept Medicaid, expanded coverage may not increase access to services. Facilities that provide specialty outpatient MH services and accept Medicaid compose the backbone of the community-based treatment infrastructure for Medicaid enrollees. For states that opt into the expansion, it is important to understand which local communities may face the greatest barriers to access these facilities. To examine the availability of outpatient MH facilities that accept Medicaid across US counties and whether specific types of communities are more likely to lack this infrastructure. Data from the 2008 National Survey of Mental Health Treatment Facilities and Area Resource File were merged. A generalized ordered logistic regression with state fixed effects was estimated to examine determinants of accessibility of these facilities. Covariates included the percentages of residents who are black, Hispanic, living in poverty, and living in a rural area. An ordered variable assessed whether a county had no access to outpatient MH facilities that accept Medicaid, intermediate access to these facilities (ie, ≥1 facility, but not top quintile of facility to Medicaid enrollee per capita ratio), or high access (ie, top quintile of facility to Medicaid enrollee per capita ratio). More than one-third of counties do not have any outpatient MH facilities that accept Medicaid. Communities with a larger percentage of residents who are black (marginal effect [ME] = 3.9%; 95% CI, 1.2%-6.6%), Hispanic (ME = 4.8%; 95% CI, 2.3%-7.4%), or living in a rural area (ME = 27.9%; 95% CI, 25.3%-30.4%) are more likely to lack these facilities. Many communities may face constraints on the MH safety-net system as Medicaid is expanded, especially rural communities and communities with a large

  15. Housing Inventory Count

    Data.gov (United States)

    Department of Housing and Urban Development — This report displays the data communities reported to HUD about the nature of their dedicated homeless inventory, referred to as their Housing Inventory Count (HIC)....

  16. Allegheny County Older Housing

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Older housing can impact the quality of the occupant's health in a number of ways, including lead exposure, housing quality, and factors that may exacerbate...

  17. Housing of Hobson's Choice

    DEFF Research Database (Denmark)

    Vestergaard, Hedvig

    2010-01-01

    This paper looks at policies implemented to improve troubled housing estates during more than two decades. Based on evaluations of implemented programmes and case studies the paper provides a basis for discussing a number of questions: • Why do we have troubled housing estates? • What...... is the definition of troubled housing estates? • Who lives on troubled housing estates? • Who owns and manages the troubled housing estates? • What have been the reasons behind improvement programmes for troubled housing estates? • What kind of improvement programmes have been implemented and with what kind...... of results? • Have improvement programmes changed the position of the estates on the local housing markets? • What are the changes in policies and results? • What are the perspectives for policy initiatives in the field of troubled housing estates?...

  18. 77 FR 13697 - Medicare and Medicaid Programs; Electronic Health Record Incentive Program-Stage 2

    Science.gov (United States)

    2012-03-07

    ... encouraged to leave their comments in the CMS drop slots located in the main lobby of the building. A stamp... expanding the use of EHRs through the concept of meaningful use. Section 1903(t)(6)(C) of the Act also...

  19. 75 FR 24437 - Medicare and Medicaid Programs; Changes in Provider and Supplier Enrollment, Ordering and...

    Science.gov (United States)

    2010-05-05

    ... drop slots located in the main lobby of the building. A stamp- in clock is available for persons... the concept of ``surrogate NPIs'' nor did it contain a provision for the establishment of ``surrogate...

  20. 78 FR 19917 - Medicaid Program; Increased Federal Medical Assistance Percentage Changes Under the Affordable...

    Science.gov (United States)

    2013-04-02

    ... encouraged to leave their comments in the CMS drop slots located in the main lobby of the building. A stamp... FMAP. Although some commenters supported flexibility in concept, the overall position favored in the...

  1. State Medicaid Early and Periodic Screening, Diagnosis and Treatment guidelines

    Science.gov (United States)

    Hom, Jacqueline M.; Lee, Jessica Y.; Silverman, Janice; Casamassimo, Paul S.

    2015-01-01

    Background The authors evaluated adherence of state Medicaid Early and Periodic Screening, Diagnosis and Treatment (EPSDT) guidelines to recommended best oral health practices for infants and toddlers. Methods The authors obtained state EPSDT guidelines via the Internet or from the Medicaid-CHIP State Dental Association in Washington. The authors identified best oral health practices through the American Academy of Pediatric Dentistry (AAPD), Chicago. They evaluated each EPSDT dental periodicity schedule with regard to the timing and content of seven key oral health domains for infants and toddlers. Results Thirty-two states and the District of Columbia (D.C.) had EPSDT dental periodicity schedules. With the exception of the dentist referral domain, 29 states (88 percent) adhered to the content and timing of best oral health practices, as established by the AAPD guideline. For the dentist referral domain, 31 of the 32 states and D.C. (94 percent) required referral of children to a dentist, but only 11 states (33 percent adhered to best oral health practices by requiring referral by age 1 year. Conclusions With the exception of the timing of the first dentist referral, there was high adherence to best oral health practices for infants and toddlers among states with separate EPSDT dental periodicity schedules. Practical Implications States with low adherence to best oral health practices, especially regarding the dental visit by age 1 year can strengthen the oral health content of their EPSDT schedules by complying with the AAPD recommendations. PMID:23449906

  2. Community health workers and medicaid managed care in New Mexico.

    Science.gov (United States)

    Johnson, Diane; Saavedra, Patricia; Sun, Eugene; Stageman, Ann; Grovet, Dodie; Alfero, Charles; Maynes, Carmen; Skipper, Betty; Powell, Wayne; Kaufman, Arthur

    2012-06-01

    We describe the impact of community health workers (CHWs) providing community-based support services to enrollees who are high consumers of health resources in a Medicaid managed care system. We conducted a retrospective study on a sample of 448 enrollees who were assigned to field-based CHWs in 11 of New Mexico's 33 counties. The CHWs provided patients education, advocacy and social support for a period up to 6 months. Data was collected on services provided, and community resources accessed. Utilization and payments in the emergency department, inpatient service, non-narcotic and narcotic prescriptions as well as outpatient primary care and specialty care were collected on each patient for a 6 month period before, for 6 months during and for 6 months after the intervention. For comparison, data was collected on another group of 448 enrollees who were also high consumers of health resources but who did not receive CHW intervention. For all measures, there was a significant reduction in both numbers of claims and payments after the community health worker intervention. Costs also declined in the non-CHW group on all measures, but to a more modest degree, with a greater reduction than in the CHW group in use of ambulatory services. The incorporation of field-based, community health workers as part of Medicaid managed care to provide supportive services to high resource-consuming enrollees can improve access to preventive and social services and may reduce resource utilization and cost.

  3. Healthcare Utilization and Costs of Systemic Lupus Erythematosus in Medicaid

    Directory of Open Access Journals (Sweden)

    Hong J. Kan

    2013-01-01

    Full Text Available Objective. Healthcare utilization and costs associated with systemic lupus erythematosus (SLE in a US Medicaid population were examined. Methods. Patients ≥ 18 years old with SLE diagnosis (ICD-9-CM 710.0x were extracted from a large Medicaid database 2002–2009. Index date was date of the first SLE diagnosis. Patients with and without SLE were matched. All patients had a variable length of followup with a minimum of 12 months. Annualized healthcare utilization and costs associated with SLE and costs of SLE flares were assessed during the followup period. Multivariate regressions were conducted to estimate incremental healthcare utilization and costs associated with SLE. Results. A total of 14,777 SLE patients met the study criteria, and 14,262 were matched to non-SLE patients. SLE patients had significantly higher healthcare utilization per year than their matched controls. The estimated incremental annual cost associated with SLE was $10,984, with the highest increase in inpatient costs (P<0.001. Cost per flare was $11,716 for severe flares, $562 for moderate flares, and $129 for mild flares. Annual total costs for patients with severe flares were $49,754. Conclusions. SLE patients had significantly higher healthcare resource utilization and costs than non-SLE patients. Patients with severe flares had the highest costs.

  4. Fostering Health: The Affordable Care Act, Medicaid, and Youth Transitioning from Foster Care. Policy Brief

    Science.gov (United States)

    Wilson-Simmons, Renée; Dworsky, Amy; Tongue, Denzel; Hulbutta, Marikate

    2016-01-01

    The Affordable Care Act includes language that requires states to provide Medicaid coverage to youth who were in foster care in their state before aging out of the child welfare system. However, most states have interpreted the law differently for youth who move to their state after aging out, determining that automatic Medicaid coverage is an…

  5. Medicaid dental coverage alone may not lower rates of dental emergency department visits.

    Science.gov (United States)

    Fingar, Kathryn R; Smith, Mark W; Davies, Sheryl; McDonald, Kathryn M; Stocks, Carol; Raven, Maria C

    2015-08-01

    Medicaid was expanded to millions of individuals under the Affordable Care Act, but many states do not provide dental coverage for adults under their Medicaid programs. In the absence of dental coverage, patients may resort to costly emergency department (ED) visits for dental conditions. Medicaid coverage of dental benefits could help ease the burden on the ED, but ED use for dental conditions might remain a problem in areas with a scarcity of dentists. We examined county-level rates of ED visits for nontraumatic dental conditions in twenty-nine states in 2010 in relation to dental provider density and Medicaid coverage of nonemergency dental services. Higher density of dental providers was associated with lower rates of dental ED visits by patients with Medicaid in rural counties but not in urban counties, where most dental ED visits occurred. County-level Medicaid-funded dental ED visit rates were lower in states where Medicaid covered nonemergency dental services than in other states, although this difference was not significant after other factors were adjusted for. Providing dental coverage alone might not reduce Medicaid-funded dental ED visits if patients do not have access to dental providers. Project HOPE—The People-to-People Health Foundation, Inc.

  6. The Effect of Medicaid Physician Fee Increases on Health Care Access, Utilization, and Expenditures.

    Science.gov (United States)

    Callison, Kevin; Nguyen, Binh T

    2018-04-01

    To evaluate the effect of Medicaid fee changes on health care access, utilization, and spending for Medicaid beneficiaries. We use the 2008 and 2012 waves of the Medical Expenditure Panel Survey linked to state-level Medicaid-to-Medicare primary care reimbursement ratios obtained through surveys conducted by the Urban Institute. We also incorporate data from the Current Population Survey and the Area Resource Files. Using a control group made up of the low-income privately insured, we conduct a difference-in-differences analysis to assess the relationship between Medicaid fee changes and access to care, utilization of health care services, and out-of-pocket medical expenditures for Medicaid enrollees. We find that an increase in the Medicaid-to-Medicare payment ratio for primary care services results in an increase in outpatient physician visits, emergency department utilization, and prescription fills, but only minor improvements in access to care. In addition, we report an increase in total annual out-of-pocket expenditures and spending on prescription medications. Compared to the low-income privately insured, increased primary care reimbursement for Medicaid beneficiaries leads to higher utilization and out-of-pocket spending for Medicaid enrollees. © Health Research and Educational Trust.

  7. Medicaid, family spending, and the financial implications of crowd-out.

    Science.gov (United States)

    Dillender, Marcus

    2017-05-01

    A primary purpose of health insurance is to protect families from medical expenditure risk. Despite this goal and despite the fact that research has found that Medicaid can crowd out private coverage, little is known about the effect of Medicaid on families' spending patterns. This paper implements a simulated instrumental variables strategy with data from the Consumer Expenditure Survey to estimate the effect of an additional family member becoming eligible for Medicaid on family-level health insurance coverage and spending. The results indicate that an additional family member becoming eligible for Medicaid increases the number of people in the family with Medicaid coverage by about 0.135-0.142 and decreases the likelihood that a family has any medical spending in a quarter by 2.7 percentage points. As previous research often finds with different data sets, I find evidence that Medicaid expansions crowd out some private coverage. Unlike most other data sets, the Consumer Expenditure Survey allows for considering the financial implications of crowd-out. The results indicate that families that transition from private coverage to Medicaid are able to spend significantly less on health insurance expenses, meaning Medicaid expansions can be welfare improving for families even when crowd-out occurs. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Safety net providers defend their niche in Medicaid market, enroll members in own health plans.

    Science.gov (United States)

    1997-12-01

    Safety net providers don't have to be cut out of managed Medicaid due to their high costs of caring for the poor and uninsured. See how Boston Medical Center and Cambridge Hospital got involved in the Massachusetts Medicaid waiver program and negotiated special rates and provisions.

  9. 76 FR 15105 - Medicare and Medicaid Programs; Civil Money Penalties for Nursing Homes

    Science.gov (United States)

    2011-03-18

    ... harm, or resulting in a resident's death is not eligible for the civil money penalty reduction that... the death of a resident; and, the civil money penalty was not imposed for a repeated deficiency that... Medicare and Medicaid Services 42 CFR Part 488 Medicare and Medicaid Programs; Civil Money Penalties for...

  10. 76 FR 62074 - Proposed Revision of Performance Standards for State Medicaid Fraud Control Units

    Science.gov (United States)

    2011-10-06

    ...] Proposed Revision of Performance Standards for State Medicaid Fraud Control Units AGENCY: Office of... Control Units (MFCUs or Units). This proposal would replace and supersede standards published on September..., including 42 CFR Sec. 455.21, ``Cooperation with State Medicaid fraud control units,'' and 42 CFR 455.23...

  11. 77 FR 32645 - Revision of Performance Standards for State Medicaid Fraud Control Units

    Science.gov (United States)

    2012-06-01

    ...] Revision of Performance Standards for State Medicaid Fraud Control Units AGENCY: Office of Inspector... Fraud Control Units (MFCU or Unit). These standards replace and supersede standards published on... Association of Medicaid Fraud Control Units (the Association), which submitted extensive comments on each of...

  12. 42 CFR 431.636 - Coordination of Medicaid with the Children's Health Insurance Program (CHIP).

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Coordination of Medicaid with the Children's Health Insurance Program (CHIP). 431.636 Section 431.636 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES...'s Health Insurance Program (CHIP). (a) Statutory basis. This section implements— (1) Section 2102(b...

  13. Psychotropic Medication Trends among Children and Adolescents with Autism Spectrum Disorder in the Medicaid Program

    Science.gov (United States)

    Schubart, Jane R.; Camacho, Fabian; Leslie, Douglas

    2014-01-01

    This study characterized psychotropic medication use among Medicaid-enrolled children and adolescents with autism spectrum disorders by examining trends over time, including length of treatment and polypharmacy using 4 years of administrative claims data from 41 state Medicaid programs (2000-2003). The data set included nearly 3 million children…

  14. Using patient evaluations to empirically assess medicaid programs for social justice.

    Science.gov (United States)

    Clark, Paul Alexander; Gesell, Sabina B

    2010-09-01

    The Medicaid program serves a social justice function in the United States. The program's effectiveness in achieving this aim is traditionally evaluated in terms of resource allocation and distribution using measures and concepts such as financing, access, and enrollment. The patient's perspective in ascertaining the quality of actual care delivery has not been utilized to ascertain social justice. This paper uses the confidential evaluations of 40% of the hospitals in Rhode Island, New Jersey, and Connecticut to compare the experiences of Medicaid patients versus privately insured patients hospitalized in 2002 and cross-validates results in independent samples collected in 2003 and 2004. The results found that Medicaid patients experienced interactions with physicians that resulted in lower ratings of statistical and practical significance than privately insured patients. Admissions and discharge processes were also rated lower by Medicaid patients. The "hotel" amenities provided by hospitals-room and meals-were rated more favorably by Medicaid patients. Yet there were no significant differences in Medicaid and private insurance patients' overall satisfaction with their acute care experience. Medicaid patients' evaluations should be considered a key component of evaluating whether a state's Medicaid program has achieved patients' and society's need for social justice.

  15. Healthcare Service Use and Costs for Autism Spectrum Disorder: A Comparison between Medicaid and Private Insurance

    Science.gov (United States)

    Wang, Li; Mandell, David S.; Lawer, Lindsay; Cidav, Zuleyha; Leslie, Douglas L.

    2013-01-01

    Healthcare costs and service use for autism spectrum disorder (ASD) were compared between Medicaid and private insurance, using 2003 insurance claims data in 24 states. In terms of costs and service use per child with ASD, Medicaid had higher total healthcare costs (22,653 vs. 5,254), higher ASD-specific costs (7,438 vs. 928), higher psychotropic…

  16. 75 FR 19976 - Centers for Medicare & Medicaid Services; Delegation of Authority

    Science.gov (United States)

    2010-04-16

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Secretary Centers for Medicare & Medicaid Services; Delegation of Authority Notice is hereby given that I have delegated to the Administrator, Centers for Medicare & Medicaid Services (CMS), or his or her successor, the...

  17. 75 FR 11185 - Centers for Medicare & Medicaid Services; Delegation of Authority

    Science.gov (United States)

    2010-03-10

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Secretary Centers for Medicare & Medicaid Services; Delegation of Authority Notice is hereby given that I have delegated to the Administrator, Centers for Medicare & Medicaid Services (CMS), or his or her successor, the...

  18. 75 FR 44313 - Medicare and Medicaid Programs; Electronic Health Record Incentive Program

    Science.gov (United States)

    2010-07-28

    ... MCO Managed Care Organization MITA Medicaid Information Technology Architecture MMIS Medicaid... ARRA amends Titles XVIII and XIX of the Social Security Act (the Act) by establishing incentive... require EPs, eligible hospitals, and CAHs to perform functions for which standards have not been...

  19. 76 FR 51147 - Medicaid Program; Eligibility Changes Under the Affordable Care Act of 2010

    Science.gov (United States)

    2011-08-17

    ... of the Patient Protection and Affordable Care Act of 2010 and the Health Care and Education... Exchanges (``Exchanges''), and coordination between Medicaid, the Children's Health Insurance Program (CHIP... Medicaid and CHIP eligibility, enrollment simplification, and coordination. In addition, this proposed rule...

  20. Disabling health care? Medicaid managed care and people with disabilities in America

    DEFF Research Database (Denmark)

    Hiranandani, Vanmala Sunder

    2011-01-01

    have considerable latitude in designing their Medicaid programs through decisions such as eligible services, calculation of income and assets for enrollment, and optional categories for benefits. As Medicaid programs face uncertainty in coming years, first-hand accounts of the most vulnerable...

  1. Assisted Housing - Public Housing Authorities - National Geospatial Data Asset (NGDA)

    Data.gov (United States)

    Department of Housing and Urban Development — Public Housing was established to provide decent and safe rental housing for eligible low-income families, the elderly, and persons with disabilities. Public housing...

  2. Molecular dynamics study on the effects of stamp shape, adhesive energy, and temperature on the nanoimprint lithography process

    International Nuclear Information System (INIS)

    Kang, Ji-Hoon; Kim, Kwang-Seop; Kim, Kyung-Woong

    2010-01-01

    Molecular dynamics simulations of nanoimprint lithography (NIL) were performed to investigate the effects of three critical process parameters in NIL: stamp shape, adhesive energy between the stamp and polymer film, and imprint temperature. The proposed simulation model of the NIL process consists of an amorphous SiO 2 stamp with a line pattern, an amorphous poly(methylmethacrylate) film, and a Si substrate under the periodic boundary condition in the horizontal direction to simulate a real NIL process imprinting periodical line patterns. The behavior of polymer deformation and the effects of adhesion on pattern transfer were investigated by observing the deformation process, calculating the imprint and separation forces, and analyzing the density and stress distribution inside the polymer film. In addition, their dependency on the process parameters is also discussed with reference to the changes in pattern shape, adhesive energy between the stamp and polymer atoms, and imprint temperature of the polymer film. During the imprint process, the rectangular pattern shows inferior cavity filling and higher stress concentration compared to trapezoidal and triangular patterns because it requires much larger flow and deformation of the polymer film. Low imprint temperature also produces high stress concentration and large imprint force due to the lower fluidity of polymer film. In the separation process, the rectangular pattern generates the largest separation force and causes the most serious defects of the transferred pattern and even the polymer film, while the triangular pattern shows the most satisfactory pattern transfer. In addition, the adhesive energy between the stamp and the polymer film also strongly influences the adhesion between the stamp and the polymer film. Low adhesive energy reduces the separation force of the stamp and transferred pattern defects, and therefore enhances the quality of pattern transfer.

  3. Zero energy house

    OpenAIRE

    Milián Martínez, Irene; Vink, Willem; Ortiz Braulio, Ruben

    2008-01-01

    The zero energy house project talks about sustainability. In general terms the house is designed to produce as much energy as it consume. If you take a look to the house its possible to find several systems that takes as much profit as possible to the renewable energies like photovoltaic electricity production, geothermal energy used to run a heat pump or a well thought isolated house. First of all it’s possible to find general information about the topics in house, to make people understa...

  4. Inadequate housing in Ghana

    Directory of Open Access Journals (Sweden)

    Franklin Obeng-Odoom

    2011-01-01

    Full Text Available Two themes are evident in housing research in Ghana. One involves the study of how to increase the number of dwellings to correct the overall housing deficit, and the other focuses on how to improve housing for slum dwellers. Between these two extremes, there is relatively little research on why the existing buildings are poorly maintained. This paper is based on a review of existing studies on inadequate housing. It synthesises the evidence on the possible reasons for this neglect, makes a case for better maintenance and analyses possible ways of reversing the problem of inadequate housing.

  5. Patient Experience Of Provider Refusal Of Medicaid Coverage And Its Implications.

    Science.gov (United States)

    Bhandari, Neeraj; Shi, Yunfeng; Jung, Kyoungrae

    2016-01-01

    Previous studies show that many physicians do not accept new patients with Medicaid coverage, but no study has examined Medicaid enrollees' actual experience of provider refusal of their coverage and its implications. Using the 2012 National Health Interview Survey, we estimate provider refusal of health insurance coverage reported by 23,992 adults with continuous coverage for the past 12 months. We find that among Medicaid enrollees, 6.73% reported their coverage being refused by a provider in 2012, a rate higher than that in Medicare and private insurance by 4.07 (p<.01) and 3.68 (p<.001) percentage points, respectively. Refusal of Medicaid coverage is associated with delaying needed care, using emergency room (ER) as a usual source of care, and perceiving current coverage as worse than last year. In view of the Affordable Care Act's (ACA) Medicaid expansion, future studies should continue monitoring enrollees' experience of coverage refusal.

  6. Early Experience of Financial Performance and Solvency of Medicaid-Focused Insurers Under ACA Expansion.

    Science.gov (United States)

    McCue, Michael J

    2017-12-01

    To allow for greater coverage of the uninsured, the Affordable Care Act expanded Medicaid coverage in 2014. Accessing financial data of state health insurers from the National Association of Insurance Commissioners, this data trend study compares the financial performance and solvency of Medicaid-focused health insurers prior to and after the first year expansion of Medicaid coverage. After the first year of Medicaid expansion, there was a significant increase in operating profit margin ratio for Medicaid-focused health insurers within expansion states. Lower medical loss ratio as well as no change in administrative costs contributed to this profitable position. The risk-based capital ratio for solvency increased significantly for health insurers in nonexpansion states while there was no change in this ratio for health insurers in expansion states. Conversely, the other important solvency ratio of cash flow margin increased significantly for health insurers in expansion states but not for insurers in nonexpansion states.

  7. Moodulmaja Passion House = "Passion House" modular home

    Index Scriptorium Estoniae

    2015-01-01

    Moodulmaja Passion House. Arhitektuuri sihtkapitali innovatsioonipreemia 2013 kvaliteetse disaini ja perspektiivika arendustegevuse oskusliku sidumise eest. Arhitekt Eero Endjärv (Arhitekt11), sisearhitekt Hannelore Kääramees (Arhitekt11)

  8. The Impact of Medicaid Reform on Children?s Dental Care Utilization in Connecticut, Maryland, and Texas

    OpenAIRE

    Nasseh, Kamyar; Vujicic, Marko

    2014-01-01

    Objective To measure the impact of Medicaid reforms, in particular increases in Medicaid dental fees in Connecticut, Maryland, and Texas, on access to dental care among Medicaid-eligible children. Data 2007 and 2011?2012 National Survey of Children?s Health. Study Design Difference-in-differences and triple differences models were used to measure the impact of reforms. Principal Findings Relative to Medicaid-ineligible children and all children from a group of control states, preventive denta...

  9. Comparison of preventive care in Medicaid managed care and Medicaid fee for service in institutions and private practices.

    Science.gov (United States)

    Fairbrother, G; Hanson, K L; Butts, G C; Friedman, S

    2001-01-01

    To compare preventive screening for children in Medicaid managed care (MMC) with children in Medicaid fee for service (M-FFS) in private and institutional settings. The sample included randomly selected institutions and private practice physicians in New York City. Within setting, children in MMC and M-FFS were sampled randomly and charts reviewed for immunizations and lead and anemia screening. In both institutions and private practices, children enrolled in MMC appeared more likely to be up-to-date than their M-FFS counterparts for immunizations (institution, P private practice, P institution, P private practice, P institution, P private practice, P private physicians. When considering 10 different attributes of managed care plans, no clear pattern of association with better preventive care services was observed. The positive effect of managed care on preventive care services was largely explained by more visits and longer follow-up time; however, there were differences between institutions and private practices, with enrollment in MMC associated with some positive effect on screenings in private practices.

  10. Clinical Benefits Associated With Medicaid Coverage Before Diagnosis of Gynecologic Cancers

    Science.gov (United States)

    Basch, Ethan M.; Meng, Ke; Barber, Emma L.; Gehrig, Paola A.; Brewster, Wendy R.; Meyer, Anne-Marie

    2016-01-01

    Purpose: Many low-income patients enroll in Medicaid at the time of cancer diagnosis, which improves survival outcomes. Medicaid enrollment before cancer diagnosis may confer additional benefits. Our objective was to compare stage at diagnosis and overall mortality between women with and without Medicaid enrollment before gynecologic cancer diagnosis. Methods and Materials: Women younger than 65 years with a gynecologic cancer (2003 to 2008) were identified through the North Carolina Central Cancer Registry and linked to state Medicaid enrollment files. Those with and without Medicaid enrollment within 6 months before diagnosis were identified. Propensity matching was used to balance the exposure groups. Stage at diagnosis was evaluated by using logistic regression, and all-cause mortality was assessed with Cox proportional hazard models. Results: Of 564 women, one half (n = 282) had prediagnosis Medicaid enrollment. Disease sites included the cervix (44%), uterus (25%), ovary (26%), and vulva/vagina (5%). More than one half (51%) of cancers were advanced stage. Women without prediagnosis Medicaid had an increased odds of advanced-stage disease (hazard ratio, 1.46; 95% CI, 1.03 to 2.05). Crude survival outcomes differed significantly between the groups; however, when adjusted for stage at diagnosis, lack of prediagnosis Medicaid coverage had a hazard ratio of 1.19 (95% CI, 0.92 to 1.53). Conclusion: Medicaid enrollment before gynecologic cancer diagnosis is associated with an earlier stage at presentation. Given the existence of a cervical cancer screening program in North Carolina and lack of Medicaid expansion, these data suggest that screening programs alone are not sufficient to counteract the delay in diagnosis that is common for uninsured individuals. PMID:27246688

  11. Assisted Housing - Multifamily Properties - Assisted

    Data.gov (United States)

    Department of Housing and Urban Development — HUD's Multifamily Housing property portfolio consist primarily of rental housing properties with five or more dwelling units such as apartments or town houses, but...

  12. SINCERITIES: Inferring gene regulatory networks from time-stamped single cell transcriptional expression profiles.

    Science.gov (United States)

    Papili Gao, Nan; Ud-Dean, S M Minhaz; Gandrillon, Olivier; Gunawan, Rudiyanto

    2017-09-14

    Single cell transcriptional profiling opens up a new avenue in studying the functional role of cell-to-cell variability in physiological processes. The analysis of single cell expression profiles creates new challenges due to the distributive nature of the data and the stochastic dynamics of gene transcription process. The reconstruction of gene regulatory networks (GRNs) using single cell transcriptional profiles is particularly challenging, especially when directed gene-gene relationships are desired. We developed SINCERITIES (SINgle CEll Regularized Inference using TIme-stamped Expression profileS) for the inference of GRNs from single cell transcriptional profiles. We focused on time-stamped cross-sectional expression data, commonly generated from transcriptional profiling of single cells collected at multiple time points after cell stimulation. SINCERITIES recovers directed regulatory relationships among genes by employing regularized linear regression (ridge regression), using temporal changes in the distributions of gene expressions. Meanwhile, the modes of the gene regulations (activation and repression) come from partial correlation analyses between pairs of genes. We demonstrated the efficacy of SINCERITIES in inferring GRNs using in silico time-stamped single cell expression data and single cell transcriptional profiles of THP-1 monocytic human leukemia cells. The case studies showed that SINCERITIES could provide accurate GRN predictions, significantly better than other GRN inference algorithms such as TSNI, GENIE3 and JUMP3. Moreover, SINCERITIES has a low computational complexity and is amenable to problems of extremely large dimensionality. Finally, an application of SINCERITIES to single cell expression data of T2EC chicken erythrocytes pointed to BATF as a candidate novel regulator of erythroid development. The MATLAB and R version of SINCERITIES is freely available from the following websites: http://www.cabsel.ethz.ch/tools/sincerities.html and

  13. 77 FR 29648 - Medicare and Medicaid Programs; Quarterly Listing of Program Issuances-January Through March 2012

    Science.gov (United States)

    2012-05-18

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-9073-N] Medicare and Medicaid Programs; Quarterly Listing of Program Issuances--January Through March 2012 AGENCY... that were published from January through March 2012, relating to the Medicare and Medicaid programs and...

  14. 42 CFR 431.830 - Basic elements of the Medicaid quality control (MQC) claims processing assessment system.

    Science.gov (United States)

    2010-10-01

    ... ORGANIZATION AND GENERAL ADMINISTRATION Quality Control Medicaid Quality Control (mqc) Claims Processing Assessment System § 431.830 Basic elements of the Medicaid quality control (MQC) claims processing assessment... 42 Public Health 4 2010-10-01 2010-10-01 false Basic elements of the Medicaid quality control (MQC...

  15. Studying the Solar System Can Be More Than Just "Stamp Collecting"

    Science.gov (United States)

    LoPresto, Michael C.

    2017-04-01

    While teaching his first-ever introductory college astronomy course, I heard a graduate student make the comment that compared to other areas of astronomy, studying the solar system is just "stamp collecting." Coverage of the solar system in an introductory college astronomy course certainly could consist mostly of showing images and reporting facts, but by using observations that can be made from images and also data and other known facts about the objects, instruction on solar system topics can be more conceptual, involving just as much inquiry and discovery as any area of astronomy or physics.

  16. Analysis of the Phenomenon of Speculative Trading in One of its Basic Manifestations:. Postage Stamp Bubbles

    Science.gov (United States)

    Roehner, B.; Sornette, D.

    We document and analyze the empirical facts concerning one of the clearest evidence of speculation in financial trading as observed in the postage collection stamp market. We unravel some of the mechanisms of speculative behavior which emphasize the role of fancy and collective behavior. In our conclusion, we propose a classification of speculative markets based on two parameters, namely the amplitude of the price peak and a second parameter that measures its "sharpness". This study is offered to anchor modeling efforts to realistic market constraints and observations.

  17. Time stamp generation with inverse FIR filters for Positron Emission Tomography

    International Nuclear Information System (INIS)

    Namias, Mauro

    2009-01-01

    Photon coincidence detection is the process by which Positron Emission Tomography (PET) works. This requires the determination of the time of impact of each coincident photon at the detector system, also known as time stamp. In this work, the timestamp was generated by means of digital time-domain deconvolution with FIR filters for a INa(Tl) based system. The detector deadtime was reduced from 350 ns to 175 ns while preserving the system's energy resolution and a direct relation between the amount of light collected and the temporal resolution was found.(author)

  18. Use of atomic force microscopy in the forensic application of chronological order of toners and stamping inks in questioned documents.

    Science.gov (United States)

    Kang, Tae-Yi; Lee, Joong; Park, Byung-Wook

    2016-04-01

    This paper describes the application of the atomic force microscopy (AFM) as a nano-indentation method and introduces a new method of identifying the chronological order of the application of the toner and stamping ink on the surface of documents by removing either of them. Various toners were used as samples for the AFM nano-indentation method. The chronological order of the application of the toner and stamping ink with either the toner placed over the stamping ink or the stamping ink placed over the toner, could be identified, regardless of the kinds of toners made by various companies. This paper provides the new approach for physically removing the toner and checking the material below it to identify questioned documents, which allows the method to be used to appraise documents forensically. Blind testing has shown that the method to analyze the chronological order of toner-printed documents and the seal stamping on them could accurately identify the order in all samples, while minimizing damage to the samples. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Does the Food Stamp Program cause obesity? A realist review and a call for place-based research.

    Science.gov (United States)

    DeBono, Nathaniel L; Ross, Nancy A; Berrang-Ford, Lea

    2012-07-01

    The high prevalence of obesity among low income groups has led some to question the role of food assistance programs in contributing to the problem. The USDA's Food Stamp Program (now known as the Supplemental Nutrition Assistance Program - SNAP) is the largest food assistance program in the United States with over 40 million participants. This paper employed systematic realist review methods to determine whether participation in the Food Stamp Program causes obesity and the causal pathways through which this relationship may exist. Findings indicate a more consistent positive relationship for women than for men, especially for women who are long term users of the program. All studies discussed the "food stamp cycle" and an "income effect" as explanations for the role of food stamps in increased obesity yet evidence for these factors is limited. Curiously, the research in this field does not address obesogenic environments and we suggest that the absence of an understanding of household behavior in local contexts is a significant impediment to the reform of the Food Stamp Program. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. Fabrication of a roller type PDMS stamp using SU-8 concave molds and its application for roll contact printing

    International Nuclear Information System (INIS)

    Park, Jongho; Kim, Beomjoon

    2016-01-01

    Continuous fabrication of micropatterns at low-cost is attracting attention in various applications within industrial fields. To meet such demands, we have demonstrated a roll contact printing technique, using roller type polydimethylsiloxane (PDMS) stamps with roll-to-flat and roll-to-roll stages. Roller type PDMS stamps for roll contact printing were fabricated using a custom-made metal support and SU-8 microstructures fabricated on concave substrates as a mold. The molding/casting method which we developed here provided faster and easier fabrication than conventional methods for roller type stamps. Next, roll contact printing was performed using fabricated roller type PDMS stamps with roll-to-flat and roll-to-roll stages. Patterns with minimum widths of 3 μm and 2.1 μm were continuously fabricated for each stage, respectively. In addition, the relationship between applied pressures and dimensional changes of roll contact printed patterns was investigated. Finally, we confirmed that roll contact printing and the new fabrication method for roller stamps presented in this study demonstrated the feasibility for industrial applications. (paper)

  1. Implications of the Supreme Court's ACA Medicaid decision.

    Science.gov (United States)

    Perkins, Jane

    2013-03-01

    In the typical case, states are expected to act like independent sovereigns and reject federal funding conditions they do not like. In National Federation of Independent Business v. Sebelius (NFIB), however, the Supreme Court found that Congress unduly coerced states when it enacted the Affordable Care Act's Medicaid expansion provision. This article provides an overview to NFIB and discusses its implications. Focusing on Chief Justice Roberts' plurality opinion, the article explains that undue coercion may occur when the following four elements come together: (1) Congress enacts a new spending program; (2) Congress seeks to induce state participation in the new program by threatening to terminate all federal funding to an existing program; (3) the federal funding to the existing program is significant; and (4) the requirements of the new program are not related to the old program and, thus, could not have been anticipated by the state. © 2013 American Society of Law, Medicine & Ethics, Inc.

  2. Medicare and Medicaid programs; advance directives--HCFA. Final rule.

    Science.gov (United States)

    1995-06-27

    This final rule responds to public comments on the March 6, 1992 interim final rule with comment period that amended the Medicare and Medicaid regulations governing provider agreements and contracts to establish requirements for States, hospitals, nursing facilities, skilled nursing facilities, providers of home health care or personal care services, hospice programs and managed care plans concerning advance directives. An advance directive is a written instruction, such as a living will or durable power of attorney for health care, recognized under State law, relating to the provision of health care when an individual's condition makes him or her unable to express his or her wishes. The intent of the advance directives provisions is to enhance an adult individual's control over medical treatment decisions. This rule confirms the interim final rule with several minor changes based on our review and consideration of public comments.

  3. CHIP and Medicaid: Evolving to Meet the Needs of Children.

    Science.gov (United States)

    Hill, Ian; Benatar, Sarah; Howell, Embry; Courtot, Brigette; Wilkinson, Margaret; Hoag, Sheila D; Orfield, Cara; Peebles, Victoria

    2015-01-01

    To examine the evolution of Children's Health Insurance Program (CHIP) and Medicaid programs after passage of the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA), focusing on policies affecting eligibility, enrollment, renewal, benefits, access to care, cost sharing, and preparation for health care reform. Case studies were conducted in 10 states during 2012-which included key informant interviews and consumer focus groups-and a national survey of state CHIP program administrators was conducted in early 2013. Despite the recession that persisted during much of the study period, many states expanded children's coverage by raising upper income eligibility limits or by covering new groups made eligible by CHIPRA. Simplifying rules and procedures for enrollment and renewal continued to be a major priority for CHIP and Medicaid, and CHIPRA played a direct role in spurring innovation. CHIPRA's outreach grants played an important role in supporting and supplementing state outreach efforts. Important legacies of CHIPRA are the law's mandatory requirements for comprehensive dental benefits coverage and mental health parity for all types of CHIP programs. Although most states already offered generous coverage of these benefits, the mandate may have protected them from cuts during the economic downturn. Federal Maintenance of Effort rules were a crucial protection for CHIP, especially during the recession when state budget shortfalls could have led to program cuts. Passage of the Affordable Care Act has raised questions surrounding the future role of CHIP in a reformed health care system. A growing number of stakeholders have recommended a 2-year extension of federal CHIP funding to allow complex transition issues to be resolved. Copyright © 2015 Academic Pediatric Association. All rights reserved.

  4. 75 FR 4100 - Affirmative Fair Housing, Marketing (AFHM) Plan-Multifamily Housing, Affirmative Fair Housing...

    Science.gov (United States)

    2010-01-26

    ..., Marketing (AFHM) Plan-Multifamily Housing, Affirmative Fair Housing Marketing (AFHM) Plan-Single Family Housing and Affirmative Fair Housing Marketing (AFHM) Plan- Cooperatives/Condominiums AGENCY: Office of...: Title of Proposal: Affirmative Fair Housing, Marketing (AFHM) Plan- MultifamilyHousing, Affirmative Fair...

  5. The collection of Tuvan stamps (1926–1943 in the National Museum of the Republic of Tuva and the prospects of philately in Tuva

    Directory of Open Access Journals (Sweden)

    Kaadyr-ool A. Bicheldey

    2016-09-01

    Full Text Available Stamps of the People’s Republic of Tuva (PRT, 1921-1944 as indicia and as items of collectors’ interest, are universally renowned, and as such have been the subject of a good deal of research. These works contain more than a mere story of Tuvan stamps – they provide a lot of useful information on Tuva, its history, including the history of postal service in the region. This article describes the collection of indicia (more than 500 pieces dated 1926-1943 and preserved at Aldan Maadyr National Museum of Tuva. On the basis of this analysis we have formulated the current problems and prospects of philately in the region. The stamp collection in the National Museum fills 4 albums of various sizes and a number of envelopes with 1-72 stamps in each. The compilers of 2 albums attempted to systematize stamps by issue date, but this work is far from complete. There is no definitive collection of Tuvan stamps to act as a model for others, regardless of the quality of the stamps preserved. The rest of the stamps in the museum collection is in unsorted state. Overall, the degree of preservation can be tentatively described as average. Given the great interest of scholars and collectors, Tuvan stamps are relatively little studies. The overall bulk of material on the uses of stamps in Tuva lacks an overarching study. We have summed up the main research problems that call for in-depth research, including studying Tuvan stamps as pieces of art, the financial and economic viability of issuing stamps in PRT, the official documentations licensing the issue, full catalogization of all existing issues, the study of individual stamps, etc. Especially urgent is the issue of propagating knowledge of history of Tuvan postal service as a precondition for collecting and preserving PRT stamps. Archives of many Tuvan families may contain unique stamps, rare envelopes or postcards – but few of their owners recognize the full value of what they have. This puts unique

  6. Radon in Syrian houses

    International Nuclear Information System (INIS)

    Othman, I.; Hushari, M.; Raja, G.; Alsawaf, A.

    1996-01-01

    A nationwide investigation of radon levels in Syrian houses was carried out during the period 1991-1993. Passive radon diffusion dosemeters using polycarbonate detectors were distributed in houses all over Syria. Detectors were subjected to electrochemical etching to reveal latent tracks of alpha particles. The mean radon concentration in Syrian houses was found to be 45 Bq m -3 with some values several times higher. This investigation indicated that there were a few houses in Syria that require remedial action. Most houses that have high levels of radon were found in the southern area, especially in the Damascus governorate. The study also indicated that radon concentrations were higher in old houses built from mud with no tiling. (author)

  7. How Medicaid Expansion Affected Out-of-Pocket Health Care Spending for Low-Income Families.

    Science.gov (United States)

    Glied, Sherry; Chakraborty, Ougni; Russo, Therese

    2017-08-01

    ISSUE. Prior research shows that low-income residents of states that expanded Medicaid under the Affordable Care Act are less likely to experience financial barriers to health care access, but the impact on out-of-pocket spending has not yet been measured. GOAL. Assess how the Medicaid expansion affected out-of-pocket health care spending for low-income families compared to those in states that did not expand and consider whether effects differed in states that expanded under conventional Medicaid rules vs. waiver programs. METHODS. Analysis of the Consumer Expenditure Survey 2010–2015. KEY FINDINGS AND CONCLUSIONS. Compared to families in nonexpansion states, low-income families in states that did expand Medicaid saved an average of $382 in annual spending on health care. In these states, low-income families were less like to report any out-of-pocket spending on insurance premiums or medical care than were similar families in nonexpansion states. For families that did have some out-of-pocket spending, spending levels were lower in states that expanded Medicaid. Low-income families in Medicaid expansion states were also much less likely to have catastrophically high spending levels. The form of coverage expansion — conventional Medicaid or waiver rules — did not have a statistically significant effect on these outcomes.

  8. TRICARE Applied Behavior Analysis (ABA) Benefit: Comparison with Medicaid and Commercial Benefits.

    Science.gov (United States)

    Maglione, Margaret; Kadiyala, Srikanth; Kress, Amii; Hastings, Jaime L; O'Hanlon, Claire E

    2017-01-01

    This study compared the Applied Behavior Analysis (ABA) benefit provided by TRICARE as an early intervention for autism spectrum disorder with similar benefits in Medicaid and commercial health insurance plans. The sponsor, the Office of the Under Secretary of Defense for Personnel and Readiness, was particularly interested in how a proposed TRICARE reimbursement rate decrease from $125 per hour to $68 per hour for ABA services performed by a Board Certified Behavior Analyst compared with reimbursement rates (defined as third-party payment to the service provider) in Medicaid and commercial health insurance plans. Information on ABA coverage in state Medicaid programs was collected from Medicaid state waiver databases; subsequently, Medicaid provider reimbursement data were collected from state Medicaid fee schedules. Applied Behavior Analysis provider reimbursement in the commercial health insurance system was estimated using Truven Health MarketScan® data. A weighted mean U.S. reimbursement rate was calculated for several services using cross-state information on the number of children diagnosed with autism spectrum disorder. Locations of potential provider shortages were also identified. Medicaid and commercial insurance reimbursement rates varied considerably across the United States. This project concluded that the proposed $68-per-hour reimbursement rate for services provided by a board certified analyst was more than 25 percent below the U.S. mean.

  9. New method for springback compensation for the stamping of sheet metal components

    Science.gov (United States)

    Birkert, A.; Hartmann, B.; Straub, M.

    2017-09-01

    The need for car body structures of higher strength and at the same time lower weight results in serious challenges for the stamping process. Especially the use of high strength steel and aluminium sheets is causing growing problems with regard to elastic springback. To produce accurate parts the stamping dies must be adjusted more or less by the amount of the springback in the opposite direction. For this purpose well-known software solutions use the Displacement Adjustment Method or algorithms which are closely based on that method. A crucial issue of this method is that the generated die surfaces deviate from those of the target geometry with regard to surface area. A new Physical Compensation Method has been developed and validated which takes geometrical nonlinearity into account and creates compensated die geometries with equal-in-area die surfaces. In contrast to the standard mathematical/geometrical approach, the adjusted geometry is generated by a physical approach, which makes use of the virtual part stiffness. Hereby the target geometry is being deformed mechanically in a virtual process based on the springback simulation results by applying virtual forces in an additional elastic simulation. By doing so better part dimensions can be obtained in less tool optimization loops.

  10. A Material Perspective on Consequence of Deformation Heating During Stamping of DP Steels

    Science.gov (United States)

    Şimşir, C.; Çetin, B.; Efe, M.; Davut, K.; Bayramin, B.

    2017-09-01

    Recent studies showed that, during stamping of high strength steels at industrially relevant production rates, local temperature in the blank may rise up to 200°C - 300°C due to deformation heating. Moreover, die temperature may also rise up to 100°C - 150°C for progressive stamping dies. Based on the common assumption that the blank softens as the temperature increases, thermal softening creates a margin in Forming Limit Diagram (FLD) and therefore the FLD determined at room temperature can safely be used for those cases. In this article, the validity of this assumption on DP590 steel is questioned by high temperature tensile tests (RT - 300°C) at various strain rates (10-3 s-1 - 1 s-1). The results indicated a decrease both in uniform and total elongation in 200°C - 300°C range together with several other symptoms of Dynamic Strain Aging (DSA) at all strain rates. Concurrent with the DSA, the simulated FLD confirms the lower formability at high temperature and strain rates. Thus, it is concluded FLD determined at RT may not be valid for the investigated steels.

  11. Predication of coke strength from textural analysis of stamp charged coke supported by coal petrography

    Energy Technology Data Exchange (ETDEWEB)

    Sharma, R.; Dash, P.S.; Chakraborty, D.; Banerjee, P.K.; Kumar, D. [Tata Steel, Jamshedpur (India)

    2005-07-01

    Materials science tells us that defects or flaws in a solid material control the mechanical behaviour of that material. Similarly, in a coke, its strength is associated with the microstructure and texture. Optical microscopy is the most appropriate method for measuring these features. Attempts were made to correlate different types of textures with the strength of stamp charged coke at Tata Steel. The studies revealed that anisotropic carbon is less reactive to carbon dioxide compared to isotropic carbon. There may be two reasons for this: a lower surface area of the carbon available for reaction; the intrinsic reactivity may be lower for molecules which constitute anisotropic carbon. The strength after reaction depends on its anisotropic texture - the smaller size mosaic texture contributes to higher post strength. There are very few reports about use of micro textural analysis to predict cold strength of coke. Test results show that there exists an influence of isotropic carbon on M{sub 10} index. With an increase in isotropic texture, the M{sub 10} index deteriorates. The performance of coke in blast furnaces may be improved by improving room temperature and high temperature strength of coke by selecting coal with higher vitrinite distribution in the present blend through the stamp charging route. 18 refs., 12 figs., 3 tabs.

  12. Virtual method for the determination of an optimum thermal design of hot stamping tools

    Science.gov (United States)

    Weiß, W.; Koplenig, M.; Alb, M.; Graf, J.

    2016-11-01

    This work presents a new virtual method for the optimised thermal design of hot stamping tools. It provides optimal positions of the tool's tempering ducts with respect to the average working temperature and its homogeneous distribution on the surface of a tool. It consists of a specific procedure for hot stamping tool design and a software framework in order to interconnect three domains: (I) a parametrised CAD tool model, (II) a linear thermal solver using a fast boundary element method and (III) an optimisation algorithm. This enables the automated set-up, simulation and optimisation of a duct topology. The boundary conditions for the simulations are derived from a reduced model of the thermal loading of the tool. The virtual method proposed is demonstrated on simplified tool segment geometries. The results are transferred to complex tool designs used in industry. For a selected use case, the number of ducts could be reduced by 50% through the application of the proposed method. These results are validated virtually based on an existing design. Hence, the new virtual method contributes to a CAE-driven tool design and a more efficient tool manufacturing.

  13. Smoking prevalence in Medicaid has been declining at a negligible rate.

    Directory of Open Access Journals (Sweden)

    Shu-Hong Zhu

    Full Text Available In recent decades the overall smoking prevalence in the US has fallen steadily. This study examines whether the same trend is seen in the Medicaid population.National Health Interview Survey (NHIS data from 17 consecutive annual surveys from 1997 to 2013 (combined N = 514,043 were used to compare smoking trends for 4 insurance groups: Medicaid, the Uninsured, Private Insurance, and Other Coverage. Rates of chronic disease and psychological distress were also compared.Adjusted smoking prevalence showed no detectable decline in the Medicaid population (from 33.8% in 1997 to 31.8% in 2013, trend test P = 0.13, while prevalence in the other insurance groups showed significant declines (38.6%-34.7% for the Uninsured, 21.3%-15.8% for Private Insurance, and 22.6%-16.8% for Other Coverage; all P's<0.005. Among individuals who have ever smoked, Medicaid recipients were less likely to have quit (38.8% than those in Private Insurance (62.3% or Other Coverage (69.8%; both P's<0.001. Smokers in Medicaid were more likely than those in Private Insurance and the Uninsured to have chronic disease (55.0% vs 37.3% and 32.4%, respectively; both P's<0.01. Smokers in Medicaid were also more likely to experience severe psychological distress (16.2% for Medicaid vs 3.2% for Private Insurance and 7.6% for the Uninsured; both P's<0.001.The high and relatively unchanging smoking prevalence in the Medicaid population, low quit ratio, and high rates of chronic disease and severe psychological distress highlight the need to focus on this population. A targeted and sustained campaign to help Medicaid recipients quit smoking is urgently needed.

  14. Medicaid Coverage Expansions and Cigarette Smoking Cessation Among Low-income Adults.

    Science.gov (United States)

    Koma, Jonathan W; Donohue, Julie M; Barry, Colleen L; Huskamp, Haiden A; Jarlenski, Marian

    2017-12-01

    Expanding Medicaid coverage to low-income adults may have increased smoking cessation through improved access to evidence-based treatments. Our study sought to determine if states' decisions to expand Medicaid increased recent smoking cessation. Using pooled cross-sectional data from the Behavioral Risk Factor Surveillance Survey for the years 2011-2015, we examined the association between state Medicaid coverage and the probability of recent smoking cessation among low-income adults without dependent children who were current or former smokers (n=36,083). We used difference-in-differences estimation to examine the effects of Medicaid coverage on smoking cessation, comparing low-income adult smokers in states with Medicaid coverage to comparable adults in states without Medicaid coverage, with ages 18-64 years to those ages 65 years and above. Analyses were conducted for the full sample and stratified by sex. Residence in a state with Medicaid coverage among low-income adult smokers ages 18-64 years was associated with an increase in recent smoking cessation of 2.1 percentage points (95% confidence interval, 0.25-3.9). In the comparison group of individuals ages 65 years and above, residence in a state with Medicaid coverage expansion was not associated with a change in recent smoking cessation (-0.1 percentage point, 95% confidence interval, -2.1 to 1.8). Similar increases in smoking cessation among those ages 18-64 years were estimated for females and males (1.9 and 2.2 percentage point, respectively). Findings are consistent with the hypothesis that Medicaid coverage expansions may have increased smoking cessation among low-income adults without dependent children via greater access to preventive health care services, including evidence-based smoking cessation services.

  15. Potential unintended pregnancies averted and cost savings associated with a revised Medicaid sterilization policy.

    Science.gov (United States)

    Borrero, Sonya; Zite, Nikki; Potter, Joseph E; Trussell, James; Smith, Kenneth

    2013-12-01

    Medicaid sterilization policy, which includes a mandatory 30-day waiting period between consent and the sterilization procedure, poses significant logistical barriers for many women who desire publicly funded sterilization. Our goal was to estimate the number of unintended pregnancies and the associated costs resulting from unfulfilled sterilization requests due to Medicaid policy barriers. We constructed a cost-effectiveness model from the health care payer perspective to determine the incremental cost over a 1-year time horizon of the current Medicaid sterilization policy compared to a hypothetical, revised policy in which women who desire a postpartum sterilization would face significantly reduced barriers. Probability estimates for potential outcomes in the model were based on published sources; costs of Medicaid-funded sterilizations and Medicaid-covered births were based on data from the Medicaid Statistical Information System and The Guttmacher Institute, respectively. With the implementation of a revised Medicaid sterilization policy, we estimated that the number of fulfilled sterilization requests would increase by 45%, from 53.3% of all women having their sterilization requests fulfilled to 77.5%. Annually, this increase could potentially lead to over 29,000 unintended pregnancies averted and $215 million saved. A revised Medicaid sterilization policy could potentially honor women's reproductive decisions, reduce the number of unintended pregnancies and save a significant amount of public funds. Compared to the current federal Medicaid sterilization policy, a hypothetical, revised policy that reduces logistical barriers for women who desire publicly funded, postpartum sterilization could potentially avert over 29,000 unintended pregnancies annually and therefore lead to cost savings of $215 million each year. © 2013.

  16. State Housing Revival

    DEFF Research Database (Denmark)

    Donovan, Elizabeth

    2015-01-01

    Government funded housing for people in need is a challenge many countries face around the world. This research investigates how to sustainably regenerate post-war suburban state housing in New Zealand, in particular, the suburb of Glen Innes in Auckland. Reviving the community and regenerating...... affordable housing. Together the conclusions drawn from empirical and ethnographic research, informed a general design toolbox and guidelines. The established guidelines and toolbox were applied at a master plan level and in-depth to an existing state house within the specific neighbourhood in Glen Innes...

  17. Studies on the finite element simulation in sheet metal stamping processes

    Science.gov (United States)

    Huang, Ying

    The sheet metal stamping process plays an important role in modern industry. With the ever-increasing demand for shape complexity, product quality and new materials, the traditional trial and error method for setting up a sheet metal stamping process is no longer efficient. As a result, the Finite Element Modeling (FEM) method has now been widely used. From a physical point of view, the formability and the quality of a product are influenced by several factors. The design of the product in the initial stage and the motion of the press during the production stage are two of these crucial factors. This thesis focuses on the numerical simulation for these two factors using FEM. Currently, there are a number of commercial FEM software systems available in the market. These software systems are based on an incremental FEM process that models the sheet metal stamping process in small incremental steps. Even though the incremental FEM is accurate, it is not suitable for the initial conceptual design for its needing of detailed design parameters and enormous calculation times. As a result, another type of FEM, called the inverse FEM method or one-step FEM method, has been proposed. While it is less accurate than that of the incremental method, this method requires much less computation and hence, has a great potential. However, it also faces a number of unsolved problems, which limits its application. This motivates the presented research. After the review of the basic theory of the inverse method, a new modified arc-length search method is proposed to find better initial solution. The methods to deal with the vertical walls are also discussed and presented. Then, a generalized multi-step inverse FEM method is proposed. It solves two key obstacles: the first one is to determine the initial solution of the intermediate three-dimensional configurations and the other is to control the movement of nodes so they could only slide on constraint surfaces during the search by

  18. Can laboratory and pilot recycling trials predict adhesive removal in commercial recycling systems? : results from the USPS environmentally benign stamp project

    Science.gov (United States)

    Carl Houtman; Daniel Seiter; Nancy Ross Sutherland; Donald Donermeyer

    2002-01-01

    The ultimate goal of the US Postal Service (USPS) Environmentally Benign Stamp Program is to develop stamp laminates, i.e., face paper, adhesive and siliconized liner, that do not cause difficulties in recycling mills. The criterion for success, and the USPS definition of benignity, is the avoidance of process and product quality hardships when such PSA laminates are...

  19. Housing Data Base for Sustainable Housing Provision

    African Journals Online (AJOL)

    Sultan

    Residential Real Estate. Properties in Nigeria: How Fair are the. Market Prices. JO RIND 9(2), 429-438. Israel, A. A. and Bashiru, A. R. (2008). Public and Private Developers as Agents in. Urban Housing Delivery in Sub-. Saharan Africa: the Situation in Lagos state. Humanity and Social Sciences. Journal, 3(2), 143-150.

  20. Housing Survey. Campus Housing: Finding the Balance

    Science.gov (United States)

    O'Connor, Shannon

    2016-01-01

    Depending on where you look for statistics, the number of students enrolling in colleges or universities is increasing, decreasing or remaining the about the same. Regardless of those trends, campus housing is a marketing tool for institutions looking to draw students to and keep them on campus. Schools need to offer sufficient beds and…

  1. Dream house in Australia

    DEFF Research Database (Denmark)

    Andersen, Michael Asgaard

    2004-01-01

    This first book in the Utzon Library, which deals with Utzon's own houses, contains a number of drawings that have not previously been published. This is especially true of the four projects for his house in Bayview, Sydney, which unfortunately never got past the drawing stage, as Utzon had left ...

  2. Environment and Housing Market

    OpenAIRE

    Armengot Paradinas, Jaime; Ramírez Pacheco, Gema Maria; Bernal Pérez, Eduardo

    2012-01-01

    The present paper studies the relationship between residential environment and building value. This allows us to know the elements of definition of the value of a particular housing market area and the variables that define that price. The objective of the research is to identify patterns within the residential housing market in the city area of Madrid.

  3. Housing consumption and urbanization

    OpenAIRE

    Lozano-Gracia, Nancy; Young, Cheryl

    2014-01-01

    Rapid urbanization in Sub-Saharan Africa places immense pressure on urban services to meet the needs of the burgeoning urban population. Although several country- or city-level reports offer insight into the housing challenges of specific places, little is known about regional patterns affecting housing markets. This lack of clear knowledge on the relative importance of the factors influen...

  4. Ndebele Inspired Houses

    Science.gov (United States)

    Rice, Nicole

    2012-01-01

    The house paintings of the South African Ndebele people are more than just an attempt to improve the aesthetics of a community; they are a source of identity and significance for Ndebele women. In this article, the author describes an art project wherein students use the tradition of Ndebele house painting as inspiration for creating their own…

  5. Dream house in Australia

    DEFF Research Database (Denmark)

    Andersen, Michael Asgaard

    2004-01-01

    This first book in the Utzon Library, which deals with Utzon's own houses, contains a number of drawings that have not previously been published. This is especially true of the four projects for his house in Bayview, Sydney, which unfortunately never got past the drawing stage, as Utzon had left ...... Australia when the authorities finally got around to approving the project....

  6. Multiple pump housing

    Science.gov (United States)

    Donoho, II, Michael R.; Elliott; Christopher M.

    2010-03-23

    A fluid delivery system includes a first pump having a first drive assembly, a second pump having a second drive assembly, and a pump housing. At least a portion of each of the first and second pumps are located in the housing.

  7. Fabrication of a metallic roll stamp with low internal stress and high hardness for large area display applications by a pulse reverse current electroforming process

    International Nuclear Information System (INIS)

    Kim, Joongeok; Han, Jungjin; Kim, Taekyung; Kang, Shinill

    2014-01-01

    With the increasing demand for large scale micro/nano components in the fields of display, energy and electrical devices, etc, the establishment of a roll imprinting process has become a priority. The fabrication of a roll stamp with high dimensional accuracy and uniformity is one of the key issues in the roll imprinting process, because the roll stamp determines the properties of the replicated micro/nano structures. In this study, a method to fabricate a metallic roll stamp with low internal stress, high flatness, and high hardness was proposed by a pulse reverse current (PRC) electroforming process. The effects of PRC electroforming processes on the internal stress, hardness, and grain size of the electroformed stamp were examined, and the optimum process conditions were suggested. As a practical example of the proposed method, various micro-patterns for electronic circuits were fabricated via the roll imprinting process using a PRC electroformed stamp. (paper)

  8. The Nordic Housing Enabler

    DEFF Research Database (Denmark)

    Helle, Tina; Slaug, Bjørn; Brandt, Åse

    2010-01-01

    This study addresses development of a content valid cross-Nordic version of the Housing Enabler and investigation of its inter-rater reliability when used in occupational therapy rating situations, involving occupational therapists, clients and their home environments. The instrument was translated...... from the original Swedish version of the Housing Enabler, and adapted according to accessibility norms and guidelines for housing design in Sweden, Denmark, Finland and Iceland. This iterative process involved occupational therapists, architects, building engineers and professional translators......, resulting in the Nordic Housing Enabler. For reliability testing, the sampling strategy and data collection procedures used were the same in all countries. Twenty voluntary occupational therapists, pair-wise but independently from each other, collected data from 106 cases by means of the Nordic Housing...

  9. Nordic Housing Enabler

    DEFF Research Database (Denmark)

    Helle, Tina; Brandt, Åse

    2009-01-01

    Development and reliability testing of the Nordic Housing Enabler – an instrument for accessibility assessment of the physical housing. Tina Helle & Åse Brandt University of Lund, Health Sciences, Faculty of Medicine (SE) and University College Northern Jutland, Occupational Therapy department (DK......). Danish Centre for Assistive Technology. Abstract. For decades, accessibility to the physical housing environment for people with functional limitations has been of interest politically, professionally and for the users. Guidelines and norms on accessible housing design have gradually been developed......, however, the built environment shows serious deficits when it comes to accessibility. This study addresses development of a content valid cross-Nordic version of the Housing Enabler and investigation of inter-rater reliability, when used in occupational therapy practice. The instrument was translated from...

  10. 78 FR 66364 - Medicare & Medicaid Programs: Application From the Accreditation Commission for Health Care for...

    Science.gov (United States)

    2013-11-05

    ...] Medicare & Medicaid Programs: Application From the Accreditation Commission for Health Care for Continued... Accreditation Commission for Health Care (ACHC) for continued recognition as a national accrediting organization...) announcing Accreditation Commission for Health Care's request for approval of its hospice accreditation...

  11. MEDICAID and SCHIP: Recent HHS Approvals of Demonstration Waiver Projects Raise Concerns

    National Research Council Canada - National Science Library

    2002-01-01

    States provide health care coverage to about 40 million low-income uninsured adults and children largely through two federal-state programs-Medicaid and the State Children's Health Insurance Program (SCHIP...

  12. Medicaid: A Primer - Key Information on the Nation's Health Coverage Program for Low-Income People

    Science.gov (United States)

    ... including severe mental illness. Health homes involve the integration and coordination of primary, acute, mental and behavioral ... Managed Care Programs op. cit. 47 The Crunch Continues: Medicaid Spending, Coverage and Policy in the Midst ...

  13. Effect of Long-term Care Use on Medicare and Medicaid...

    Data.gov (United States)

    U.S. Department of Health & Human Services — Individuals eligible and enrolled simultaneously for Medicare and Medicaid commonly referred to as dual eligible or duals have often been cited as accounting for a...

  14. Assisted Housing - Public Housing Developments - National Geospatial Data Asset (NGDA)

    Data.gov (United States)

    Department of Housing and Urban Development — The general location of an entire Public Housing Development. A distinct address is chosen to represent the general location of an entire Public Housing Development,...

  15. Utilization, spending, and price trends for benzodiazepines in the US Medicaid program: 1991-2009.

    Science.gov (United States)

    Gorevski, Elizabeth; Bian, Boyang; Kelton, Christina M L; Martin Boone, Jill E; Guo, Jeff J

    2012-04-01

    Although it is well-known that drug costs in the US have risen precipitously over the last 25 years, what is much less appreciated is how this rise in cost has occurred across so many seemingly distinct drug markets. To describe trends in the utilization, spending, and average per-prescription cost of benzodiazepines individually, in subgroups, and overall, in the Medicaid program. Medicaid has been the primary public payer for benzodiazepines over the past 2 decades. A retrospective, descriptive analysis was performed for the years 1991-2009 using the publicly available national Summary Files from the Medicaid State Drug Utilization Data maintained by the Centers for Medicare & Medicaid Services. Quarterly prescription counts and reimbursement amounts were calculated for all benzodiazepines reimbursed by Medicaid. Average per-prescription spending as a proxy for drug price was found by dividing reimbursement by the number of prescriptions. Prescriptions for benzodiazepines among Medicaid beneficiaries increased from 8.0 million in 1991 to 17.1 million in 2009. Expenditures rose from $131.6 million to $171.1 million over the same time period. The average per-prescription price was a little over $10 in 2009. Whereas utilization of intermediate- and long-acting agents increased over time, prescriptions for short-acting drugs fell from 1.1 million to 0.3 million (1991-2009). The percentage rise in Medicaid spending on benzodiazepines since 1991 (30.0%) was less than the general rate of inflation (57.5%), as measured by the percentage change in the consumer price index over the same time period. Relative to the rise in the number of Medicaid beneficiaries (more than doubled over the study period), there is no evidence of an extraordinary rise in the utilization of benzodiazepines. Moreover, both nominal and real average prices of benzodiazepines have fallen, primarily because of generic entry over the last 2 decades.

  16. Saving Teens: Using a Policy Discontinuity to Estimate the Effects of Medicaid Eligibility

    OpenAIRE

    Bruce D. Meyer; Laura R. Wherry

    2012-01-01

    This paper uses a policy discontinuity to identify the immediate and long-term effects of public health insurance coverage during childhood. Our identification strategy exploits a unique feature of several early Medicaid expansions that extended eligibility only to children born after September 30, 1983. This feature resulted in a large discontinuity in the lifetime years of Medicaid eligibility of children at this birthdate cutoff. Those with family incomes at or just below the poverty line ...

  17. Impact of Chronic Condition Status and Severity on Dental Utilization for Iowa Medicaid-Enrolled Children

    Science.gov (United States)

    Chi, Donald L.; Momany, Elizabeth T.; Neff, John; Jones, Michael P.; Warren, John J.; Slayton, Rebecca L.; Weber-Gasparoni, Karin; Damiano, Peter C.

    2011-01-01

    Background Although Medicaid-enrolled children with a chronic condition (CC) may be less likely to use dental care because of factors related to their CC, dental utilization for this population is poorly understood. Objective To assess the relationship between CC status and CC severity, respectively, on dental utilization for Iowa Medicaid-enrolled children. Research Design Retrospective cohort study of Iowa Medicaid data (January 1, 2003 to December 31, 2006). Subjects Medicaid-enrolled children aged 3 to 14 (N = 71,115) years. Measures The 3M Corporation Clinical Risk Grouping methods were used to assess CC status (no/yes) and CC severity (episodic/life-long/malignancy/complex). The outcome variable was any dental utilization in 2006. Secondary outcomes included use of diagnostic, preventive, routine restorative, or complex restorative dental care. Results After adjusting for model covariates, Iowa Medicaid-enrolled children with a CC were significantly more likely to use each type of dental care except routine restorative care (P = 0.86) than those without a CC, although the differences in the odds were small (4%–6%). Compared with Medicaid-enrolled children with an episodic CC, children with a life-long CC were less likely to use routine restorative care (P children with a malignancy were more likely to use complex restorative care (P children with a complex CC were less likely to use each type of dental care except complex restorative care (P = 0.97). Conclusions There were differences in dental utilization for Iowa Medicaid-enrolled children by CC status and CC severity. Children with complex CCs were the least likely to use dental care. Future research efforts should seek to understand why subgroups of Medicaid-enrolled children with a CC exhibit lower dental utilization. PMID:21150799

  18. Modeling and simulation of stamp deflections in nanoimprint lithography: Exploiting backside grooves to enhance residual layer thickness uniformity

    DEFF Research Database (Denmark)

    Taylor, Hayden; Smistrup, Kristian; Boning, Duane

    2011-01-01

    We describe a model for the compliance of a nanoimprint stamp etched with a grid of backside grooves. We integrate the model with a fast simulation technique that we have previously demonstrated, to show how etched grooves help reduce the systematic residual layer thickness (RLT) variations...

  19. 75 FR 52981 - Chrysler, LLC; Twinsburg Stamping Plant, Including On-Site Leased Workers from Caravan Knight...

    Science.gov (United States)

    2010-08-30

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF LABOR Employment and Training Administration Chrysler, LLC; Twinsburg Stamping Plant, Including On-Site Leased Workers from Caravan Knight Facilities Management LLC, Wackenhut Security, CR Associates, and Syncreon, Twinsburg, OH; Amended Certification Regarding...

  20. 75 FR 11913 - Chrysler, LLC, Sterling Stamping Plant, Including On-Site Leased Workers from Caravan Knight...

    Science.gov (United States)

    2010-03-12

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF LABOR Employment and Training Administration Chrysler, LLC, Sterling Stamping Plant, Including On-Site Leased Workers from Caravan Knight Facilities Management LLC, Sterling Heights, MI; Amended Certification Regarding Eligibility To Apply for Worker Adjustment...

  1. The new Swiss commemorative stamp dedicated to CERN available at the Organization's Meyrin post office on Tuesday, 9 March!

    CERN Multimedia

    Maximilien Brice

    2004-01-01

    For some people, the stamp's rays are spreading outwards towards the infinitely large, while for others they focus inwards towards the infinitely small. It's a bit like the proverbial half-full or half-empty glass or a picture that conveys two different images, depending on how you look at it.

  2. Medicaid Expansion Under the Affordable Care Act and Insurance Coverage in Rural and Urban Areas.

    Science.gov (United States)

    Soni, Aparna; Hendryx, Michael; Simon, Kosali

    2017-04-01

    To analyze the differential rural-urban impacts of the Affordable Care Act Medicaid expansion on low-income childless adults' health insurance coverage. Using data from the American Community Survey years 2011-2015, we conducted a difference-in-differences regression analysis to test for changes in the probability of low-income childless adults having insurance in states that expanded Medicaid versus states that did not expand, in rural versus urban areas. Analyses employed survey weights, adjusted for covariates, and included a set of falsification tests as well as sensitivity analyses. Medicaid expansion under the Affordable Care Act increased the probability of Medicaid coverage for targeted populations in rural and urban areas, with a significantly greater increase in rural areas (P rural populations (P urban and rural low-income populations, and it specifically increased Medicaid coverage more in rural versus urban populations. There was some evidence that the expansion was accompanied by some shifting from individual purchased insurance to Medicaid in rural areas, and there is a need for future work to understand the implications of this shift on expenditures, access to care and utilization. © 2017 National Rural Health Association.

  3. Comparison of Orthodontic Medicaid Funding in the United States 2006 to 2015

    Directory of Open Access Journals (Sweden)

    Gerald Minick

    2017-08-01

    Full Text Available IntroductionOrthodontic treatment is reimbursed by Medicaid based on orthodontic and financial need with qualifiers determined by individual states. Changes in Medicaid-funded orthodontic treatment following the “Great Recession” in 2007 and the enactment of the Affordable Care Act in 2010 were compared for the 50 United States and the District of Columbia to better understand disparities in access to care. The results from this 2015 survey were compared to data gathered in 2006 (1.Materials and methodsMedicaid officials were contacted by email, telephone, or postal mail regarding the age limit for treatment, practitioner type who can determine eligibility and provide treatment, records required for case review, and rate and frequency of reimbursement. When not attained by direct contact, the information was gleaned from online websites, provider manuals, and state orthodontists.ResultsInformation gathered from 50 states and the District of Columbia documents that Medicaid program characteristics and expenditures continue to vary by state. Expenditures and reimbursement rates have decreased since 2006 and vary widely by geographic region. Some states have tightened restrictions on qualifiers and increased submission requirements by providers.ConclusionThe variation and lack of uniformity that still exists among Medicaid orthodontic programs in different states creates disparities in orthodontic care for US citizens. Barriers to care for Medicaid-funded orthodontic treatment have increased since 2006.

  4. Linking Medicaid Expansion and Cuts to Disproportionate-Share Hospitals: Will Safety Nets Survive?

    Science.gov (United States)

    Gurewitsch Allen, Edith D; Bittle, Mark J

    2015-08-01

    The predominant mechanism by which the health care reforms of the Patient Protection and Affordable Care Act of 2010 are to be financed is through the government's simultaneous defunding of major portions of Medicare and Medicaid, including the reduction of up to 75% of federal payments to disproportionate-share hospitals. The justification for curtailment of other public programs is that after Medicaid expansion under the Affordable Care Act, the decrease in the proportion of uninsured among the U.S. population will render disproportionate-share hospital payments extraneous and unnecessary. Such justification was reiterated in the recent American College of Obstetricians and Gynecologists Committee Opinion No. 627, entitled Health Care for Unauthorized Immigrants. Herein, the soundness of the Committee Opinion's proposed policy is evaluated by reviewing available literature on the potential effect of Medicaid disproportionate-share hospital cuts with and without concomitant Medicaid expansion. Limitations of Medicaid expansion efforts before and under the Affordable Care Act, the disproportionate-share hospital payment program, and other legislation providing safety net hospitals with (some) relief of financial burdens related to uncompensated care are explicated. Findings raise concern that acceptance of cuts of up to 75% of federal disproportionate-share hospital funds on the premise that nationwide state expansion of Medicaid will offset the difference may be overly optimistic. Indeed, foregoing disproportionate-share hospital payments undercuts the otherwise laudable intent of Committee Opinion No. 627, namely to advocate for universal health care for all women, including undocumented immigrants.

  5. Geographic Disparities in Availability of Opioid Use Disorder Treatment for Medicaid Enrollees.

    Science.gov (United States)

    Abraham, Amanda J; Andrews, Christina M; Yingling, Marissa E; Shannon, Jerry

    2018-02-01

    To examine county-level geographic variation in treatment admissions among opioid treatment programs (OTPs) that accept Medicaid in the continental United States. Data come from the 2012 National Survey of Substance Abuse Treatment Services. We used local measures of spatial autocorrelation (LISA) analysis to identify (1) clusters of counties with higher and lower than average rates of opioid use disorders and (2) clusters of counties with higher and lower than average treatment admissions among OTPs that accept Medicaid, adjusting for county population size. Our results reveal several clusters of counties with higher than average rates of opioid use disorder (OUD) and lower than average treatment admissions among OTPs that accept Medicaid. These clusters are highly concentrated in the Southeast region of the country and include Arkansas, Kentucky, Louisiana, Mississippi, and Tennessee. Medicaid enrollees in areas in the Southeast have the largest gaps between county-level OUD rates and estimated county-level capacity for treatment, as measured by county-level total treatment admissions among OTPs that accept Medicaid. Policy makers should consider strategies to increase the availability of OTPs with the capacity to serve Medicaid enrollees. © Health Research and Educational Trust.

  6. The Cost of Cost-Sharing: The Impact of Medicaid Benefit Design on Influenza Vaccination Uptake

    Directory of Open Access Journals (Sweden)

    Charles Stoecker

    2017-03-01

    Full Text Available Prior research indicates that cost-sharing and lack of insurance coverage reduce preventive services use among low-income persons. State Medicaid policy may affect the uptake of recommended adult vaccinations. We examined the impact of three aspects of Medicaid benefit design (coverage for vaccines, prohibiting cost-sharing, and copayment amounts on vaccine uptake in the fee-for-service Medicaid population 19–64 years old. We combined previously published reports to obtain state Medicaid policy information from 2003 and 2012. Data on influenza vaccination uptake were taken from the Behavioral Risk Factor Surveillance System. We used a differences-in-differences framework, controlling for national trends and state differences, to estimate the effect of each benefit design factor on vaccination uptake in different Medicaid-eligible populations. Each additional dollar of copayment for vaccination decreased influenza vaccination coverage 1–6 percentage points. The effects of covering vaccines or prohibiting cost-sharing were mixed. Imposing copayments for vaccination is associated with lower vaccination coverage. These findings have implications for the implementation of Medicaid expansion in states that currently impose copayments.

  7. Forming of an axially tailored automotive channel section through hot stamping of tailor-welded blanks

    Science.gov (United States)

    Peister, C.; George, R.; Omer, K.; Worswick, M. J.; Malcolm, S.; Dykeman, J.; Yau, C.; Soldaat, R.; Bernert, W.

    2017-09-01

    In this work, top-hat cross-section axial crush rail specimens with tailored properties along their length were investigated. These top-hat channels were hot stamped in a fully cooled die set from tailor-welded blanks (TWBs). The blanks were laser-welded and comprised Usibor® 1500-AS joined to Ductibor® 500-AS in 1.2 mm and 1.6 mm thicknesses. Micro-hardness measurements were taken along the length of the formed specimens to map the hardness profile along their length. The effect of gauge thickness on hardness was evaluated. The hardness profile of these TWB parts was compared to that of parts formed using tailored in-die heating (IDH).

  8. Weld Repair of a Stamped Pressure Vessel in a Radiologically Controlled Zone

    Energy Technology Data Exchange (ETDEWEB)

    Cannell, Gary L. [Fluor Enterprises, Inc.; Huth, Ralph J. [CH2MHill Plateau Remediation Company; Hallum, Randall T. [Fluor Government Group

    2013-08-26

    In September 2012 an ASME B&PVC Section VIII stamped pressure vessel located at the DOE Hanford Site Effluent Treatment Facility (ETF) developed a through-wall leak. The vessel, a steam/brine heat exchanger, operated in a radiologically controlled zone (by the CH2MHill PRC or CHPRC), had been in service for approximately 17 years. The heat exchanger is part of a single train evaporator process and its failure caused the entire system to be shut down, significantly impacting facility operations. This paper describes the activities associated with failure characterization, technical decision making/planning for repair by welding, logistical challenges associated with performing work in a radiologically controlled zone, performing the repair, and administrative considerations related to ASME code requirements.

  9. Scandiatransplant acceptable mismatch program (STAMP) a bridge to transplanting highly immunized patients

    DEFF Research Database (Denmark)

    Koefoed-Nielsen, Pernille; Weinreich, I; Bengtsson, M

    2017-01-01

    BACKGROUND: Highly immunized patients are a challenge for organ transplantation programs. One way of increasing the likelihood of transplantation in this group of patients is to expand the possible donations by defining acceptable HLA mismatches. In the Scandiatransplant Acceptable Mismatch Program...... (STAMP), a de-centralized approach has been implemented in 2009. AIMS: The program has been improved during the years from utilizing HLA-A, -B, -DR matching only to include typing of all deceased donors for HLA-A, -B, -C, -DRB1 and -DQB1. The calculation of a transplantability score (TS) has been...... introduced in order to take both HLA and AB0 into consideration resulting in a more realistic picture of the transplantability chance. MATERIALS AND METHODS: Patients were selected for eligibility and results of immunisation status were prepared in each of the 9 tissue typing laboratories, while access...

  10. Construction of Time-Stamped Mobility Map for Path Tracking via Smith-Waterman Measurement Matching

    Directory of Open Access Journals (Sweden)

    Mu Zhou

    2014-01-01

    Full Text Available Path tracking in wireless and mobile environments is a fundamental technology for ubiquitous location-based services (LBSs. In particular, it is very challenging to develop highly accurate and cost-efficient tracking systems applied to the anonymous areas where the floor plans are not available for security and privacy reasons. This paper proposes a novel path tracking approach for large Wi-Fi areas based on the time-stamped unlabeled mobility map which is constructed from Smith-Waterman received signal strength (RSS measurement matching. Instead of conventional location fingerprinting, we construct mobility map with the technique of dimension reduction from the raw measurement space into a low-dimensional embedded manifold. The feasibility of our proposed approach is verified by the real-world experiments in the HKUST campus Wi-Fi networks, sMobileNet. The experimental results prove that our approach is adaptive and capable of achieving an adequate precision level in path tracking.

  11. SOCIAL RESPONSIBILITY SCORE: COMPARATIVE STUDY BETWEEN PUBLIC And PRIVATE COMPANIES, BASED In ibase SOCIAL stamp

    Directory of Open Access Journals (Sweden)

    Alexandre Reis

    2008-01-01

    Full Text Available The present article intends to arguing the existing differences and similarities between Social Responsibility actions and praticals developed by the private and public companies. This comparative study of exploring character was carried with the companies owners of Social Stamp IBASE, wich published its Social Balances in the model considered for the institute in the year of 2004. For such, beyond the documentary research involving the published balances, a conceptual revision over the main subjects was necessary and also it constitutes part of the study. The joined results supply measurable and representative information about the main characteristics of social action of the companies, propitiating a comparative analysis and the emission of critical considerations, that do not finish themselves, but establishes a possibility of different readings concerning the models of social responsible management undertaken by companies from public and private segments.

  12. Spectral analysis of postage stamps and banknotes from the region of Rijeka in Croatia

    Science.gov (United States)

    Jelovica Badovinac, I.; Orlić, N.; Lofrumento, C.; Dobrinić, J.; Orlić, M.

    2010-07-01

    Micro-Raman spectroscopy and X-ray emission spectroscopy induced using radioactive source have been applied to analyze two types of samples important for the history of Rijeka, Croatian port on the Adriatic Sea. In this paper we will present study of thirty-three original Hungarian postage stamps issued for Rijeka and overprinted with the word FIUME in 1918, after the World War I and the one-Lira banknotes (one original brown banknote and four trial prints: brown, blue, green and dark green) from Economy bank for Rijeka, Istria and Slovenian Littoral (1945-1947), the so-called Jugolire. This investigation was carried out to determine the differences between the original machine, original hand-made and fake overprints FIUME and to compare the pigments used on original banknote from circulation with the pigments on the trial prints.

  13. Spectral analysis of postage stamps and banknotes from the region of Rijeka in Croatia

    Energy Technology Data Exchange (ETDEWEB)

    Jelovica Badovinac, I., E-mail: ijelov@phy.uniri.h [Department of Physics, University of Rijeka, Omladinska 14, 51000 Rijeka (Croatia); Orlic, N. [Department of Physics, University of Rijeka, Omladinska 14, 51000 Rijeka (Croatia); Lofrumento, C. [Dipartimento di Chimica, Universita di Firenze, Via della Lastruccia 3, 50019 Sesto Fiorentino (Italy); Dobrinic, J. [Faculty of Engineering, University of Rijeka, Vukovarska 58, 51000 Rijeka (Croatia); Orlic, M. [Department of Civil Engineering, Polytechnic of Zagreb, Av. V. Holjevca 15, 10000 Zagreb (Croatia)

    2010-07-21

    Micro-Raman spectroscopy and X-ray emission spectroscopy induced using radioactive source have been applied to analyze two types of samples important for the history of Rijeka, Croatian port on the Adriatic Sea. In this paper we will present study of thirty-three original Hungarian postage stamps issued for Rijeka and overprinted with the word FIUME in 1918, after the World War I and the one-Lira banknotes (one original brown banknote and four trial prints: brown, blue, green and dark green) from Economy bank for Rijeka, Istria and Slovenian Littoral (1945-1947), the so-called Jugolire. This investigation was carried out to determine the differences between the original machine, original hand-made and fake overprints FIUME and to compare the pigments used on original banknote from circulation with the pigments on the trial prints.

  14. Spectral analysis of postage stamps and banknotes from the region of Rijeka in Croatia

    International Nuclear Information System (INIS)

    Jelovica Badovinac, I.; Orlic, N.; Lofrumento, C.; Dobrinic, J.; Orlic, M.

    2010-01-01

    Micro-Raman spectroscopy and X-ray emission spectroscopy induced using radioactive source have been applied to analyze two types of samples important for the history of Rijeka, Croatian port on the Adriatic Sea. In this paper we will present study of thirty-three original Hungarian postage stamps issued for Rijeka and overprinted with the word FIUME in 1918, after the World War I and the one-Lira banknotes (one original brown banknote and four trial prints: brown, blue, green and dark green) from Economy bank for Rijeka, Istria and Slovenian Littoral (1945-1947), the so-called Jugolire. This investigation was carried out to determine the differences between the original machine, original hand-made and fake overprints FIUME and to compare the pigments used on original banknote from circulation with the pigments on the trial prints.

  15. Finite element analysis and optimization of process parameters during stamp forming of composite materials

    International Nuclear Information System (INIS)

    Venkatesan, S; Kalyanasundaram, S

    2010-01-01

    In the manufacture of parts for high performance structures using composite materials, the quality and robustness of the parts is of utmost importance. The quality of the produced parts depends largely on the process parameters and manufacturing methodologies. This study presents the use of a temperature dependant orthotropic material for a coupled structural-thermal analysis of the stamp forming process. The study investigated the effects of process parameters such as pre-heat temperature, blank holder force and process time on the formability of composite materials. Temperature was found to be the dominant factor governing the formability of the composite material while higher blank holder forces were deemed to be important for achieving high quality of the parts manufactured. Finally, an optimum set of parameters was used to compare the simulations with experimental results using an optical strain measurement system.

  16. Determination of stamp deformation during imprinting on semi-spherical surfaces

    DEFF Research Database (Denmark)

    Kafka, Jan; Matschuk, Maria; Pranov, Henrik

    of sol-gel was applied onto spherical injection mold inserts and subsequently imprinted using a flexible stamp. A hard curing step transformed the sol-gel into a quartz-like and durable material. As an example, we present theory and results regarding the imprint of pillar nanostructures on semi......-spherical mold surfaces. Imprints were realized on three different radii of circumferenceof the spherical mold: R = 0.5 mm, R = 1.0 mm, and R = 2 mm. After hard-curing of theimprinted sol-gel, the inserts were used for cold-mold as well as vario-therm injection molding.The polymer replicas and the inserts were...

  17. Weighing obligations to home care workers and Medicaid recipients.

    Science.gov (United States)

    Treacy, Paul C; MacKay, Douglas

    2017-01-01

    In June 2016, a US Department of Labor rule extending minimum wage and overtime pay protections to home care workers such as certified nursing assistants and home health aides survived its final legal challenge and became effective. However, Medicaid officials in certain states reported that during the intervening decades when these protections were not in place, their states had developed a range of innovative services and programs providing home care to people with disabilities-services and programs that would be at risk if workers were newly owed minimum wage and overtime pay. In this article, we examine whether the Department of Labor was right to extend these wage protections to home care workers even at the risk of a reduction in these home care services to people with disabilities. We argue that it was right to do so. Home care workers are entitled to these protections, and, although it is permissible under certain conditions for government to infringe workers' occupational rights and entitlements, these conditions are not satisfied in this case.

  18. Time-stamp correction of magnetic observatory data acquired during unavailability of time-synchronization services

    Science.gov (United States)

    Coïsson, Pierdavide; Telali, Kader; Heumez, Benoit; Lesur, Vincent; Lalanne, Xavier; Jiang Xin, Chang

    2017-09-01

    During magnetic observatory data acquisition, the data time stamp is kept synchronized with a precise source of time. This is usually done using a GPS-controlled pulse per second (PPS) signal. For some observatories located in remote areas or where internet restrictions are enforced, only the magnetometer data are transmitted, limiting the capabilities of monitoring the acquisition operations. The magnetic observatory in Lanzhou (LZH), China, experienced an unnoticed interruption of the GPS PPS starting 7 March 2013. The data logger clock drifted slowly in time: in 6 months a lag of 27 s was accumulated. After a reboot on 2 April 2014 the drift became faster, -2 s per day, before the GPS PPS could be restored on 8 July 2014. To estimate the time lags that LZH time series had accumulated, we compared it with data from other observatories located in East Asia. A synchronization algorithm was developed. Natural sources providing synchronous events could be used as markers to obtain the time lag between the observatories. The analysis of slices of 1 h of 1 s data at arbitrary UTC allowed estimating time lags with an uncertainty of ˜ 11 s, revealing the correct trends of LZH time drift. A precise estimation of the time lag was obtained by comparing data from co-located instruments controlled by an independent PPS. In this case, it was possible to take advantage of spikes and local noise that constituted precise time markers. It was therefore possible to determine a correction to apply to LZH time stamps to correct the data files and produce reliable 1 min averaged definitive magnetic data.

  19. Framework for simulation-driven design of stamping dies considering elastic die and press deformations

    Science.gov (United States)

    Pilthammar, Johan; Wall, Johan; Sigvant, Mats

    2017-10-01

    Sheet metal forming (SMF) simulations are used extensively throughout the development phase of industrial stamping dies. In these SMF simulations, the die and press are normally considered as rigid. Previous research has however shown that elastic deformation in these parts has a significant negative impact on process performance. This paper demonstrates methods for counteracting these negative effects, with a high potential for improved production support and a reduced lead time through a shorter try-out process. A structural finite element model (FE-model) of a simplified die is studied. To account for elastic deformation, the blankholder surfaces are first virtually reworked by adjusting the nodal positions on the die surfaces attaining a pressure distribution in accordance to the design phase SMF simulations with rigid surfaces. The elastic FE-model with reworked surfaces then represents a stamping die in running production. The die is now assumed to be exposed to changed process conditions giving an undesired blankholder pressure distribution. The changed process conditions could for example be due to a change of press line. An optimization routine is applied to compensate the negative effects of the new process conditions. The optimization routine uses the contact forces acting on the shims of the spacer blocks and cushion pins as optimization variables. A flexible simulation environment using MATLAB and ABAQUS is used. ABAQUS is executed from MATLAB and the results are automatically read back into MATLAB. The suggested optimization procedure reaches a pressure distribution very similar to the initial distribution assumed to be the optimum, and thereby verifying the method. Further research is needed for a method to transform the calculated forces in the optimization routine back to shims thicknesses. Furthermore, the optimization time is relatively long and needs to be reduced in the future for the method to reach its full potential.

  20. Recognition of Time Stamps on Full-Disk Hα Images Using Machine Learning Methods

    Science.gov (United States)

    Xu, Y.; Huang, N.; Jing, J.; Liu, C.; Wang, H.; Fu, G.

    2016-12-01

    Observation and understanding of the physics of the 11-year solar activity cycle and 22-year magnetic cycle are among the most important research topics in solar physics. The solar cycle is responsible for magnetic field and particle fluctuation in the near-earth environment that have been found increasingly important in affecting the living of human beings in the modern era. A systematic study of large-scale solar activities, as made possible by our rich data archive, will further help us to understand the global-scale magnetic fields that are closely related to solar cycles. The long-time-span data archive includes both full-disk and high-resolution Hα images. Prior to the widely use of CCD cameras in 1990s, 35-mm films were the major media to store images. The research group at NJIT recently finished the digitization of film data obtained by the National Solar Observatory (NSO) and Big Bear Solar Observatory (BBSO) covering the period of 1953 to 2000. The total volume of data exceeds 60 TB. To make this huge database scientific valuable, some processing and calibration are required. One of the most important steps is to read the time stamps on all of the 14 million images, which is almost impossible to be done manually. We implemented three different methods to recognize the time stamps automatically, including Optical Character Recognition (OCR), Classification Tree and TensorFlow. The latter two are known as machine learning algorithms which are very popular now a day in pattern recognition area. We will present some sample images and the results of clock recognition from all three methods.

  1. American Housing Survey (AHS) 2011

    Data.gov (United States)

    Department of Housing and Urban Development — The AHS is the largest, regular national housing sample survey in the United States. The U.S. Census Bureau conducts the AHS to obtain up-to-date housing statistics...

  2. Housing Affordability Data System (HADS)

    Data.gov (United States)

    Department of Housing and Urban Development — The Housing Affordability Data System (HADS) is a set of files derived from the 1985 and later national American Housing Survey (AHS) and the 2002 and later Metro...

  3. Approaching the Macuti House

    DEFF Research Database (Denmark)

    Sollien, Silje Erøy

    2011-01-01

    for a strategy to intervene in the "macuti neighbourhoods", conserve the built environment and improve living conditions for the generally poor population living in crowded conditions with lack of suitable urban infrastructure. The macuti house, a type of semi-urban Swahili one story house built of mangrove...... with zink sheet roofs like in most African urban areas, is preferred. However, increased attention on the macuti house and the particular way it was developed in urban Ilha, offers a way to question the identity of the city, its relationship to a wider Swahili building culture and its particuar development...

  4. Discrimination between authentic and false tax stamps from liquor bottles using laser-induced breakdown spectroscopy and chemometrics

    International Nuclear Information System (INIS)

    Gonzaga, Fabiano Barbieri; Rocha, Werickson Fortunato de Carvalho; Correa, Deleon Nascimento

    2015-01-01

    This work describes the preliminary application of a compact and low-cost laser-induced breakdown spectroscopy (LIBS) instrument for falsification detection of tax stamps used in alcoholic beverages. The new instrument was based on a diode-pumped passively Q-switched Nd:YLF microchip laser and a mini-spectrometer containing a Czerny–Turner polichromator coupled to a non-intensified, non-gated, and non-cooled 2048 pixel linear sensor array (200 to 850 nm spectral range). Twenty-three tax stamp samples were analyzed by firing laser pulses within two different regions of each sample: a hologram and a blank paper region. For each acquired spectrum, the emitted radiation was integrated for 3000 ms under the continuous application of laser pulses at 100 Hz (integration of 300 plasmas). Principal component analysis (PCA) or hierarchical cluster analysis (HCA) of all emission spectra from the hologram or blank paper region revealed two well-defined groups of authentic and false samples. Moreover, for the hologram data, three subgroups of false samples were found. Additionally, partial least squares discriminant analysis (PLS-DA) was successfully applied for the detection of the false tax stamps using all emission spectra from hologram or blank paper region. The discrimination between the samples was mostly ascribed to different levels of calcium concentration in the samples. - Highlights: • Compact and low-cost laser-induced breakdown spectrometer • Analysis of tax stamps used in alcoholic beverages • Detection of false tax stamps using the LIBS spectra and chemometrics • Falsification detection ascribed to different levels of calcium concentration

  5. Discrimination between authentic and false tax stamps from liquor bottles using laser-induced breakdown spectroscopy and chemometrics

    Energy Technology Data Exchange (ETDEWEB)

    Gonzaga, Fabiano Barbieri, E-mail: fbgonzaga@inmetro.gov.br [Chemical Metrology Division, National Institute of Metrology, Quality and Technology (INMETRO), Av. Nossa Senhora das Graças, 50, Xerém, 25250-020 Duque de Caxias, RJ (Brazil); Rocha, Werickson Fortunato de Carvalho [Chemical Metrology Division, National Institute of Metrology, Quality and Technology (INMETRO), Av. Nossa Senhora das Graças, 50, Xerém, 25250-020 Duque de Caxias, RJ (Brazil); Correa, Deleon Nascimento [Technical–Scientific Police Superintendency, Criminalistic Institute Dr. Octávio Eduardo de Brito Alvarenga—IC-SPTC-SP, 05507-060 São Paulo, SP (Brazil)

    2015-07-01

    This work describes the preliminary application of a compact and low-cost laser-induced breakdown spectroscopy (LIBS) instrument for falsification detection of tax stamps used in alcoholic beverages. The new instrument was based on a diode-pumped passively Q-switched Nd:YLF microchip laser and a mini-spectrometer containing a Czerny–Turner polichromator coupled to a non-intensified, non-gated, and non-cooled 2048 pixel linear sensor array (200 to 850 nm spectral range). Twenty-three tax stamp samples were analyzed by firing laser pulses within two different regions of each sample: a hologram and a blank paper region. For each acquired spectrum, the emitted radiation was integrated for 3000 ms under the continuous application of laser pulses at 100 Hz (integration of 300 plasmas). Principal component analysis (PCA) or hierarchical cluster analysis (HCA) of all emission spectra from the hologram or blank paper region revealed two well-defined groups of authentic and false samples. Moreover, for the hologram data, three subgroups of false samples were found. Additionally, partial least squares discriminant analysis (PLS-DA) was successfully applied for the detection of the false tax stamps using all emission spectra from hologram or blank paper region. The discrimination between the samples was mostly ascribed to different levels of calcium concentration in the samples. - Highlights: • Compact and low-cost laser-induced breakdown spectrometer • Analysis of tax stamps used in alcoholic beverages • Detection of false tax stamps using the LIBS spectra and chemometrics • Falsification detection ascribed to different levels of calcium concentration.

  6. Utilization of smoking cessation medication benefits among medicaid fee-for-service enrollees 1999-2008.

    Directory of Open Access Journals (Sweden)

    Jennifer Kahende

    Full Text Available To assess state coverage and utilization of Medicaid smoking cessation medication benefits among fee-for-service enrollees who smoked cigarettes.We used the linked National Health Interview Survey (survey years 1995, 1997-2005 and the Medicaid Analytic eXtract files (1999-2008 to assess utilization of smoking cessation medication benefits among 5,982 cigarette smokers aged 18-64 years enrolled in Medicaid fee-for-service whose state Medicaid insurance covered at least one cessation medication. We excluded visits during pregnancy, and those covered by managed care or under dual enrollment (Medicaid and Medicare. Multivariate logistic regression was used to determine correlates of cessation medication benefit utilization among Medicaid fee-for-service enrollees, including measures of drug coverage (comprehensive cessation medication coverage, number of medications in state benefit, varenicline coverage, individual-level demographics at NHIS interview, age at Medicaid enrollment, and state-level cigarette excise taxes, statewide smoke-free laws, and per-capita tobacco control funding.In 1999, the percent of smokers with ≥1 medication claims was 5.7% in the 30 states that covered at least one Food and Drug Administration (FDA-approved cessation medication; this increased to 9.9% in 2008 in the 44 states that covered at least one FDA-approved medication (p<0.01. Cessation medication utilization was greater among older individuals (≥ 25 years, females, non-Hispanic whites, and those with higher educational attainment. Comprehensive coverage, the number of smoking cessation medications covered and varenicline coverage were all positively associated with utilization; cigarette excise tax and per-capita tobacco control funding were also positively associated with utilization.Utilization of medication benefits among fee-for-service Medicaid enrollees increased from 1999-2008 and varied by individual and state-level characteristics. Given that the

  7. Allegheny County Housing Tenure

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Home ownership provides a number of financial, social, and health benefits to American families. Especially in areas with housing price appreciation, home ownership...

  8. Rental Housing Finance Survey

    Data.gov (United States)

    Department of Housing and Urban Development — The purpose of the RHFS is to provide current and continuous measure of the financial health and property characteristics of single-family and multifamily rental...

  9. Sustainable Housing Design

    DEFF Research Database (Denmark)

    Lauring, Gert Michael

    2016-01-01

    Sustainable Housing Design. Integrating technical and housing quality aspects of sustainable architecture in civil engineering education. Summary An integrated design approach to sustainable architecture is outlined that combines concerns for zero energy building, good indoor climate and adequate...... phases. The outcome shows that integrated design further solutions where sustainable urban forms of settlement can be highly energy efficient while also attractive from a user perspective. Key words: Sustainable architecture, integrated design, zero-energy-housing, dense urban living. 1. Introduction...... When designing sustainable housing, energy optimization and satisfactory indoor climates are central issues that need to be incorporated from early design phases if to reach a coherent design. It might also be argued that the energy consumption of contemporary buildings only plays a rela-tively minor...

  10. In-house (disability

    Directory of Open Access Journals (Sweden)

    Safak Pavey

    2010-07-01

    Full Text Available In May 2007 UNHCR established an internal working group to look at developing in-house policies for people with disabilities both for the benefit of people of concern to us and for staff members.

  11. Nordic Housing Enabler

    DEFF Research Database (Denmark)

    Helle, Tina; Brandt, Åse

    . For reliability testing, the sample strategy and data collection procedures were the same in all countries. In total, twenty voluntary occupational therapists collected data from 106 cases by means of the Nordic Housing Enabler. Inter-rater reliability was calculated by means of percentage agreement and kappa......Development and reliability testing of the Nordic Housing Enabler – an instrument for accessibility assessment of the physical housing. Tina Helle & Åse Brandt University of Lund, Health Sciences, Faculty of Medicine (SE) and University College Northern Jutland, Occupational Therapy department (DK......, however, the built environment shows serious deficits when it comes to accessibility. This study addresses development of a content valid cross-Nordic version of the Housing Enabler and investigation of inter-rater reliability, when used in occupational therapy practice. The instrument was translated from...

  12. In a Private House

    Directory of Open Access Journals (Sweden)

    Alexei Volkov

    2016-09-01

    Full Text Available The article features the advantages of living in a private house, such as feeling of privacy and safety and redistribution of roles between spouses, which have a positive impact on the family relationships, housekeeping and raising children. Besides, living in the country allows to cut down expenses: energy efficiency of present-day building materials enables to build a warm private house with minimum expenditure on warming, and with the possibility to freely regulate the heating system.

  13. Housing Characteristics, 1990

    International Nuclear Information System (INIS)

    1992-01-01

    This report on energy consumption in the residential sector covers the following topics: housing trends 1980--1990, new housing trends, availability and usage of natural gas by households, changes in appliance usage (refrigerators, entertainment appliances, cooking appliances, convenience appliances), age of major household appliances and equipment, household energy conservation activities, demand-side management programs, and a portrait of households using solar or wood as a source of energy

  14. Finn Juhl's House

    DEFF Research Database (Denmark)

    Munch, Anders V.; Ottensten, Lizette

    Introduction to the architecture, interior design and design items of the Danish designer Finn Juhl's own house, built 1942 in Ordrup, north of Copenhagen. The interior setting is interpreted on the background of Juhl's many writings on design.......Introduction to the architecture, interior design and design items of the Danish designer Finn Juhl's own house, built 1942 in Ordrup, north of Copenhagen. The interior setting is interpreted on the background of Juhl's many writings on design....

  15. Passive houses in Norway

    Energy Technology Data Exchange (ETDEWEB)

    Halse, Andreas

    2008-12-15

    The paper analyzes the introduction of passive houses in the Norwegian house market. Passive houses are houses with extremely low levels of energy consumption for heating, and have not yet been built in Norway, but have started to enter the market in Germany and some other countries. The construction sector is analyzed as a sectoral innovation system. The different elements of the innovation system are studied. This includes government agencies, producers, consumers, finance and education. The analysis shows that passive and low-energy houses are on the verge of market breakthrough. This can partly be explained by economic calculations, and partly by processes of learning and change in the institutional set-up of the sector. The construction sector is a sector characterized by low innovative intensity and little interaction between different agents. Those working to promote passive houses have to some extent managed to cope with these challenges. This has happened by breaking away from the traditional focus of Norwegian energy efficiency policies on technology and the economically rational agents, by instead focusing on knowledge and institutional change at the level of the producers. (Author)

  16. Association Between Health Plan Exit From Medicaid Managed Care and Quality of Care, 2006-2014.

    Science.gov (United States)

    Ndumele, Chima D; Schpero, William L; Schlesinger, Mark J; Trivedi, Amal N

    2017-06-27

    State Medicaid programs have increasingly contracted with insurers to provide medical care services for enrollees (Medicaid managed care plans). Insurers that provide these plans can exit Medicaid programs each year, with unclear effects on quality of care and health care experiences. To determine the frequency and interstate variation of health plan exit from Medicaid managed care and evaluate the relationship between health plan exit and market-level quality. Retrospective cohort of all comprehensive Medicaid managed care plans (N = 390) during the interval 2006-2014. Plan exit, defined as the withdrawal of a managed care plan from a state's Medicaid program. Eight measures from the Healthcare Effectiveness Data and Information Set were used to construct 3 composite indicators of quality (preventive care, chronic disease care management, and maternity care). Four measures from the Consumer Assessment of Healthcare Providers and Systems were combined into a composite indicator of patient experience, reflecting the proportion of beneficiaries rating experiences as 8 or above on a 0-to-10-point scale. Outcome data were available for 248 plans (68% of plans operating prior to 2014, representing 78% of beneficiaries). Of the 366 comprehensive Medicaid managed care plans operating prior to 2014, 106 exited Medicaid. These exiting plans enrolled 4 848 310 Medicaid beneficiaries, with a mean of 606 039 beneficiaries affected by plan exits annually. Six states had a mean of greater than 10% of Medicaid managed care recipients enrolled in plans that exited, whereas 10 states experienced no plan exits. Plans that exited from a state's Medicaid market performed significantly worse prior to exiting than those that remained in terms of preventive care (57.5% vs 60.4%; difference, 2.9% [95% CI, 0.3% to 5.5%]), maternity care (69.7% vs 73.6%; difference, 3.8% [95% CI, 1.7% to 6.0%]), and patient experience (73.5% vs 74.8%; difference, 1.3% [95% CI, 0.6% to 1

  17. Housing data base for sustainable housing provision | Anunobi ...

    African Journals Online (AJOL)

    The paper examined selected data requirements for housing provision in selected housing estates as applicable to house owners with the view of determining the degree of relevance to mass housing provision. The research employed a mixed method approach by collecting both quantitative and qualitative data which ...

  18. Housing management and maintenance practise of Dutch housing associations

    NARCIS (Netherlands)

    Straub, A.

    This paper summarises the state-of-the-art in housing management and maintenance practise of Dutch housing associations based on a survey conducted among almost all housing associations. We address the question what the current developments are in housing management and maintenance practice in the

  19. Medicaid status is associated with higher surgical site infection rates after spine surgery.

    Science.gov (United States)

    Manoso, Mark W; Cizik, Amy M; Bransford, Richard J; Bellabarba, Carlo; Chapman, Jens; Lee, Michael J

    2014-09-15

    The Spine End Results Registry (2003-2004) is a registry of prospectively collected data of all patients undergoing spinal surgery at the University of Washington Medical Center and Harborview Medical Center. Insurance data were prospectively collected and used in multivariate analysis to determine risk of perioperative complications. Given the negative financial impact of surgical site infections (SSIs) and the higher overall complication rates of patients with a Medicaid payer status, we hypothesized that a Medicaid payer status would have a significantly higher SSI rate. The medical literature demonstrates lesser outcomes and increased complication rates in patients who have public insurance than those who have private insurance. No one has shown that patients with a Medicaid payer status compared with Medicare and privately insured patients have a significantly increased SSI rate for spine surgery. The prospectively collected Spine End Results Registry provided data for analysis. SSI was defined as treatment requiring operative debridement. Demographic, social, medical, and the surgical severity index risk factors were assessed against the exposure of payer status for the surgical procedure. The population included Medicare (N = 354), Medicaid (N = 334), the Veterans' Administration (N = 39), private insurers (N = 603), and self-pay (N = 42). Those patients whose insurer was Medicaid had a 2.06 odds (95% confidence interval: 1.19-3.58, P = 0.01) of having a SSI compared with the privately insured. The study highlights the increased cost of spine surgical procedures for patients with a Medicaid payer status with the passage of the Patient Protection and Affordable Care Act of 2010. The Patient Protection and Affordable Care Act of 2010 provisions could cause a reduction in reimbursement to the hospital for taking care of patients with Medicaid insurance due to their higher complication rates and higher costs. This very issue could inadvertently lead to access

  20. Hospitalization of elderly Medicaid long-term care users who transition from nursing homes.

    Science.gov (United States)

    Wysocki, Andrea; Kane, Robert L; Dowd, Bryan; Golberstein, Ezra; Lum, Terry; Shippee, Tetyana

    2014-01-01

    To compare hospitalizations of dually eligible older adults who had an extended Medicaid nursing home (NH) stay and transitioned out to receive Medicaid home- and community-based services (HCBS) with hospitalizations of those who remained in the NH. Retrospective matched cohort study using Medicaid and Medicare claims and NH assessment data. Community (receiving Medicaid HCBS) or NH. Dually eligible fee-for-service beneficiaries aged 65 and older in Arkansas, Florida, Minnesota, New Mexico, Texas, Vermont, and Washington from 2003 to 2005. Individuals who had a Medicaid NH stay of at least 90 days and transitioned to Medicaid HCBS (N = 1,169) were matched to individuals who had a Medicaid NH stay of at least 90 days and remained in the NH (N = 1,169). Potentially preventable hospitalizations (defined according to ambulatory-care-sensitive conditions) and all hospitalizations were examined. Cox proportional hazards models were used to compare the risk of hospitalization between the groups, accounting for the differing time at risk and censoring. Being a NH transitioner increased the hazard of experiencing a potentially preventable hospitalization by 40% (95% confidence interval (CI) = 1.01-1.93) over remaining in the NH. NH transitioners had a 58% (95% CI = 1.32-1.91) greater risk of experiencing any type of hospitalization than NH stayers. Individuals who transitioned from the NH to HCBS had a greater risk of hospitalization. Most of the attention in long-term care transition programs has been focused on NH readmission, but programs encouraging NH transition should recognize that individuals may be at greater risk for hospitalization after returning to the community. Planning for the medical needs of individuals who transition from an extended NH stay may improve their posttransition outcomes. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

  1. Comparing the Medicaid Retrospective Drug Utilization Review Program Cost-Savings Methods Used by State Agencies.

    Science.gov (United States)

    Prada, Sergio I

    2017-12-01

    The Medicaid Drug Utilization Review (DUR) program is a 2-phase process conducted by Medicaid state agencies. The first phase is a prospective DUR and involves electronically monitoring prescription drug claims to identify prescription-related problems, such as therapeutic duplication, contraindications, incorrect dosage, or duration of treatment. The second phase is a retrospective DUR and involves ongoing and periodic examinations of claims data to identify patterns of fraud, abuse, underutilization, drug-drug interaction, or medically unnecessary care, implementing corrective actions when needed. The Centers for Medicare & Medicaid Services requires each state to measure prescription drug cost-savings generated from its DUR programs on an annual basis, but it provides no guidance or unified methodology for doing so. To describe and synthesize the methodologies used by states to measure cost-savings using their Medicaid retrospective DUR program in federal fiscal years 2014 and 2015. For each state, the cost-savings methodologies included in the Medicaid DUR 2014 and 2015 reports were downloaded from Medicaid's website. The reports were then reviewed and synthesized. Methods described by the states were classified according to research designs often described in evaluation textbooks. In 2014, the most often used prescription drugs cost-savings estimation methodology for the Medicaid retrospective DUR program was a simple pre-post intervention method, without a comparison group (ie, 12 states). In 2015, the most common methodology used was a pre-post intervention method, with a comparison group (ie, 14 states). Comparisons of savings attributed to the program among states are still unreliable, because of a lack of a common methodology available for measuring cost-savings. There is great variation among states in the methods used to measure prescription drug utilization cost-savings. This analysis suggests that there is still room for improvement in terms of

  2. Vaccination benefits and cost-sharing policy for non-institutionalized adult Medicaid enrollees in the United States

    OpenAIRE

    Stewart, Alexandra M.; Lindley, Megan C.; Chang, Kristen H.M.; Cox, Marisa A.

    2013-01-01

    Medicaid is the largest funding source of health services for the poorest people in the United States. Medicaid enrollees have greater health care, needs, and higher health risks than other individuals in the country and, experience disproportionately low rates of preventive care. Without, Medicaid coverage, poor uninsured adults may not be vaccinated or would, rely on publicly-funded programs that provide vaccinations. We examined each programs’ policies related to benefit coverage and, copa...

  3. Prenatal and Postpartum Care Disparities in a Large Medicaid Program.

    Science.gov (United States)

    Parekh, Natasha; Jarlenski, Marian; Kelley, David

    2018-03-01

    Objectives Pennsylvania's maternal mortality, infant mortality, and preterm birth rates rank 24th, 35th, and 25th in the country, and are higher among racial and ethnic minorities. Provision of prenatal and postpartum care represents one way to improve these outcomes. We assessed the extent of disparities in the provision and timeliness of prenatal and postpartum care for women enrolled in Pennsylvania Medicaid. Methods We performed a cross-sectional evaluation of representative samples of women who delivered live births from November 2011 to 2015. Our outcomes were three binary effectiveness-of-care measures: prenatal care timeliness, frequency of prenatal care, and postpartum care timeliness. Pennsylvania's Managed Care Organizations (MCOs) were required to submit these outcomes to the state after reviewing administrative and medical records through a standardized, validated sampling process. We assessed for differences in outcomes by race, ethnicity, region, year, and MCO using logistic regression. Results We analyzed data for 12,228 women who were 49% White, 31% Black/African American, 4% Asian, and 15% Hispanic/Latina. Compared to Black/African American women, white and Asian women had higher odds of prenatal and postpartum care. Hispanic/Latina women had higher frequency of prenatal care than non-Hispanic women. Pennsylvania's Southeast had lower prenatal care and Northwest had lower postpartum care than other regions. Prenatal care significantly decreased in 2014 and increased in 2015. We observed differences between MCOs, and as MCO performance diminished, racial disparities within each plan widened. We explored hypotheses for observed disparities in secondary analyses. Conclusions for Practice Our data demonstrate that interventions should address disparities by race, region, and MCO in equity-promoting measures.

  4. Understanding Housing Delays and Relocations Within the Housing First Model.

    Science.gov (United States)

    Zerger, Suzanne; Pridham, Katherine Francombe; Jeyaratnam, Jeyagobi; Hwang, Stephen W; O'Campo, Patricia; Kohli, Jaipreet; Stergiopoulos, Vicky

    2016-01-01

    This study explores factors contributing to delays and relocations during the implementation of the Housing First model in Toronto, Ontario. While interruptions in housing tenure are expected en route to recovery and housing stability, consumer and service provider views on finding and keeping housing remain largely unknown. In-person interviews and focus groups were conducted with 48 study participants, including 23 case managers or housing workers and 25 consumers. The following three factors contributed to housing delays and transfers: (1) the effectiveness of communication and collaboration among consumers and service providers, (2) consumer-driven preferences and ambivalence, and (3) provider prioritization of consumer choice over immediate housing access. Two strategies--targeted communications and consumer engagement in housing searches--supported the housing process. Several factors affect the timing and stability of housing. Communication between and among providers and consumers, and a shared understanding of consumer choice, can further support choice and recovery.

  5. 77 FR 17070 - Medicare and Medicaid Programs; Application From Det Norske Veritas Healthcare (DNVHC) for...

    Science.gov (United States)

    2012-03-23

    ... for persons wishing to retain a proof of filing by stamping in and retaining an extra copy of the... accrediting body's approved program would be deemed to have met the Medicare conditions. A national... the national accrediting body making the request, describing the nature of the request, and providing...

  6. 75 FR 65282 - Medicare and Medicaid Programs; Requirements for Long Term Care Facilities; Hospice Services

    Science.gov (United States)

    2010-10-22

    ... treatment to ensure an optimal outcome for the patient. A healthcare worker should be able to find all the... encouraged to leave their comments in the CMS drop slots located in the main lobby of the building. A stamp..., particularly palliative care, is an important part of nursing home care. Palliative care means patient and...

  7. 76 FR 65891 - Medicare and Medicaid Programs; Reform of Hospital and Critical Access Hospital Conditions of...

    Science.gov (United States)

    2011-10-24

    ... encouraged to leave their comments in the CMS drop slots located in the main lobby of the building. A stamp... impediments may be unduly limiting access to care and/or delaying treatment for patients and causing undue... the State in which the hospital is located, a doctor of dental surgery or dental medicine. CMS...

  8. Health Care Utilization Patterns of Homeless Individuals in Boston: Preparing for Medicaid Expansion Under the Affordable Care Act

    Science.gov (United States)

    Zhang, Jianying; O’Connell, Elizabeth; Taube, Robert; Clark, Robin E.

    2013-01-01

    Objectives. We studied 6494 Boston Health Care for the Homeless Program (BHCHP) patients to understand the disease burden and health care utilization patterns for a group of insured homeless individuals. Methods. We studied merged BHCHP data and MassHealth eligibility, claims, and encounter data from 2010. MassHealth claims and encounter data provided a comprehensive history of health care utilization and expenditures, as well as associated diagnoses, in both general medical and behavioral health services sectors and across a broad range of health care settings. Results. The burden of disease was high, with the majority of patients experiencing mental illness, substance use disorders, and a number of medical diseases. Hospitalization and emergency room use were frequent and total expenditures were 3.8 times the rate of an average Medicaid recipient. Conclusions. The Affordable Care Act provides a framework for reforming the health care system to improve the coordination of care and outcomes for vulnerable populations. However, improved health care coverage alone may not be enough. Health care must be integrated with other resources to address the complex challenges presented by inadequate housing, hunger, and unsafe environments. PMID:24148046

  9. State Medicaid Expansion Tobacco Cessation Coverage and Number of Adult Smokers Enrolled in Expansion Coverage - United States, 2016.

    Science.gov (United States)

    DiGiulio, Anne; Haddix, Meredith; Jump, Zach; Babb, Stephen; Schecter, Anna; Williams, Kisha-Ann S; Asman, Kat; Armour, Brian S

    2016-12-09

    In 2015, 27.8% of adult Medicaid enrollees were current cigarette smokers, compared with 11.1% of adults with private health insurance, placing Medicaid enrollees at increased risk for smoking-related disease and death (1). In addition, smoking-related diseases are a major contributor to Medicaid costs, accounting for about 15% (>$39 billion) of annual Medicaid spending during 2006-2010 (2). Individual, group, and telephone counseling and seven Food and Drug Administration (FDA)-approved medications are effective treatments for helping tobacco users quit (3). Insurance coverage for tobacco cessation treatments is associated with increased quit attempts, use of cessation treatments, and successful smoking cessation (3); this coverage has the potential to reduce Medicaid costs (4). However, barriers such as requiring copayments and prior authorization for treatment can impede access to cessation treatments (3,5). As of July 1, 2016, 32 states (including the District of Columbia) have expanded Medicaid eligibility through the Patient Protection and Affordable Care Act (ACA),* ,† which has increased access to health care services, including cessation treatments (5). CDC used data from the Centers for Medicare and Medicaid Services (CMS) Medicaid Budget and Expenditure System (MBES) and the Behavioral Risk Factor Surveillance System (BRFSS) to estimate the number of adult smokers enrolled in Medicaid expansion coverage. To assess cessation coverage among Medicaid expansion enrollees, the American Lung Association collected data on coverage of, and barriers to accessing, evidence-based cessation treatments. As of December 2015, approximately 2.3 million adult smokers were newly enrolled in Medicaid because of Medicaid expansion. As of July 1, 2016, all 32 states that have expanded Medicaid eligibility under ACA covered some cessation treatments for all Medicaid expansion enrollees, with nine states covering all nine cessation treatments for all Medicaid expansion

  10. Passive House Solutions

    Energy Technology Data Exchange (ETDEWEB)

    Strom, I.; Joosten, L.; Boonstra, C. [DHV Sustainability Consultants, Eindhoiven (Netherlands)

    2006-05-15

    PEP stands for 'Promotion of European Passive Houses' and is a consortium of European partners, supported by the European Commission, Directorate General for Energy and Transport. In this working paper an overview is given of Passive House solutions. An inventory has been made of Passive House solutions for new build residences applied in each country. Based on this, the most common basic solutions have been identified and described in further detail, including the extent to which solutions are applied in common and best practice and expected barriers for the implementation in each country. An inventory per country is included in the appendix. The analysis of Passive House solutions in partner countries shows high priority with regard to the performance of the thermal envelope, such as high insulation of walls, roofs, floors and windows/ doors, thermal bridge-free construction and air tightness. Due to the required air tightness, special attention must be paid to indoor air quality through proper ventilation. Finally, efficient ((semi-)solar) heating systems for combined space and DHW heating still require a significant amount of attention in most partner countries. Other basic Passive House solutions show a smaller discrepancy with common practice and fewer barriers have been encountered in partner countries. In the next section, the general barriers in partner countries have been inventoried. For each type of barrier a suggested approach has been given. Most frequently encountered barriers in partner countries are: limited know-how; limited contractor skills; and acceptation of Passive Houses in the market. Based on the suggested approaches to overcoming barriers, this means that a great deal of attention must be paid to providing practical information and solutions to building professionals, providing practical training to installers and contractors and communication about the Passive House concept to the market.

  11. Studies of OC-STAMP in Osteoclast Fusion: A New Knockout Mouse Model, Rescue of Cell Fusion, and Transmembrane Topology.

    Directory of Open Access Journals (Sweden)

    Hanna Witwicka

    Full Text Available The fusion of monocyte/macrophage lineage cells into fully active, multinucleated, bone resorbing osteoclasts is a complex cell biological phenomenon that utilizes specialized proteins. OC-STAMP, a multi-pass transmembrane protein, has been shown to be required for pre-osteoclast fusion and for optimal bone resorption activity. A previously reported knockout mouse model had only mononuclear osteoclasts with markedly reduced resorption activity in vitro, but with paradoxically normal skeletal micro-CT parameters. To further explore this and related questions, we used mouse ES cells carrying a gene trap allele to generate a second OC-STAMP null mouse strain. Bone histology showed overall normal bone form with large numbers of TRAP-positive, mononuclear osteoclasts. Micro-CT parameters were not significantly different between knockout and wild type mice at 2 or 6 weeks old. At 6 weeks, metaphyseal TRAP-positive areas were lower and mean size of the areas were smaller in knockout femora, but bone turnover markers in serum were normal. Bone marrow mononuclear cells became TRAP-positive when cultured with CSF-1 and RANKL, but they did not fuse. Expression levels of other osteoclast markers, such as cathepsin K, carbonic anhydrase II, and NFATc1, were not significantly different compared to wild type. Actin rings were present, but small, and pit assays showed a 3.5-fold decrease in area resorbed. Restoring OC-STAMP in knockout cells by lentiviral transduction rescued fusion and resorption. N- and C-termini of OC-STAMP were intracellular, and a predicted glycosylation site was shown to be utilized and to lie on an extracellular loop. The site is conserved in all terrestrial vertebrates and appears to be required for protein stability, but not for fusion. Based on this and other results, we present a topological model of OC-STAMP as a 6-transmembrane domain protein. We also contrast the osteoclast-specific roles of OC- and DC-STAMP with more generalized

  12. Understanding sexual activity and Chlamydia testing rate based on linked national survey and Medicaid claims data.

    Directory of Open Access Journals (Sweden)

    Guoyu Tao

    Full Text Available Monitoring adherence to national recommendations for annual chlamydia screening of female adolescents and young adult women is important for targeting quality improvement interventions to improve low screening rates. However, accurate measurement of rates may vary depending on the data source used to determine eligible sexually-active women.The 2001-2004 NHANES data linked with Medicaid administrative data by respondent's unique identifier, the 2011-2012 NHANES data, and the 2004 and 2010 Medicaid data were used in this cross-sectional analysis. We defined self-reported sexual activity by self-reported sexual behaviors, claim-identified sexual activity by reproductive-related claims among women who had ≥ one healthcare claim, HEDIS-defined sexual activity by reproductive-related claims among women who were enrolled in Medicaid for ≥330 days and had ≥ one healthcare claim, and chlamydia tests by claims submitted in the 12 months prior to the survey interview.Of Medicaid women aged 18-25 years, 91.5% self-reported to be sexually-active. Of self-reported sexually-active women aged 18-25 years, 92.0% had ≥ one healthcare claim in the 12 months prior to the survey interview; of this subpopulation, only 58.8% were enrolled in Medicaid for ≥ 330 days in the 12 months prior to the survey interview; of this further subpopulation, 74.1% had healthcare claims identifying them as sexually-active in the 12 months prior to the survey interview. Of HEDIS-defined sexually-active women, 42.4% had chlamydia testing.Our study suggests that the number of sexually-active women aged 18-25 years used as the denominator in the chlamydia testing measure could be significantly different, depending upon the definition applied and the data used. Our data highlight the limited representativeness of Medicaid population in the current HEDIS measure on chlamydia testing when a high proportion of women who were enrolled in Medicaid for <330 days had been excluded from

  13. Loss of Medicaid insurance after successful bariatric surgery: an unintended outcome.

    Science.gov (United States)

    Mehaffey, J Hunter; Charles, Eric J; Kron, Irving L; Schirmer, Bruce; Hallowell, Peter T

    2018-01-01

    Bariatric surgery leads to dramatic weight loss and improved overall health, which may affect insurance status for certain patients. Traditional Medicaid provides coverage for children, pregnant women, and disabled adults, while expanded Medicaid provides insurance coverage to all adults with incomes up to 138% of the federal poverty level. We hypothesized that successful bariatric surgery would lead to improved health status but an unintended loss of Medicaid coverage. All patients who underwent bariatric surgery at a single institution in a non-expansion state from 1985 through 2015 were identified using a prospectively collected database. Univariate and multivariate analyses were used to identify differences in patients who lost Medicaid coverage after bariatric surgery. Over the 30-year study period, 3487 patients underwent bariatric surgery, with 373 (10.7%) having Medicaid coverage at the time of surgery. This cohort of patients had a median age of 37 years and a preoperative Body Mass Index (BMI) of 54 kg/m 2 . At one-year follow-up, 155 (41.6%) patients lost Medicaid coverage, of which 76 (49.0%) had no coverage. The preoperative prevalence of diabetes (32.3 vs. 44.0%, p = 0.02), age (36 vs. 38 years, p = 0.01), and BMI (53 vs. 55 kg/m 2 , p = 0.04) were significantly lower in patients who no longer qualified for Medicaid after bariatric surgery. Multivariate regression demonstrated that for every 10 point increase in BMI (OR 0.755, p = 0.01), a patient was 25% less likely to lose their coverage at one year. Successful surgery in a state not expanding Medicaid resulted in over 40% of patients losing Medicaid coverage postoperatively, with half of those patients returning for follow-up with no insurance coverage at all. This barrier to care has major implications in patients undergoing bariatric surgery, which requires life-long follow-up and nutrition screening.

  14. Medicaid Coverage of Smoking Cessation Counseling and Medication Is Underutilized for Pregnant Women.

    Science.gov (United States)

    Scheuermann, Taneisha S; Richter, Kimber P; Jacobson, Lisette T; Shireman, Theresa I

    2017-05-01

    Policies to promote smoking cessation among Medicaid-insured pregnant women have the potential to assist a significant proportion of pregnant smokers. In 2010, Kansas Medicaid began covering smoking cessation counseling for pregnant smokers. Our aim was to evaluate the use of smoking cessation benefits provided to pregnant women as a result of the Kansas Medicaid policy change that provided reimbursement for physician-provided smoking cessation counseling. We examined Kansas Medicaid claims data to estimate rates of delivery of smoking cessation treatment to Medicaid-insured pregnant women in Kansas from fiscal year 2010 through 2013. We analyzed the number of pregnant women who received physician-provided smoking cessation counseling indicated by procedure billing codes (ie, G0436 and G0437) and medication (ie, nicotine replacement therapy, bupropion, or varenicline) located in outpatient managed care encounter and fee-for-service claims data. We estimated the number of Medicaid-insured pregnant smokers using the national smoking prevalence (14%) in this population and the number of live births reported in Kansas. Annually from 2010 to 2013, approximately 27.2%-31.6% of pregnant smokers had claims for nicotine replacement therapy, bupropion, or varenicline. Excluding claims for bupropion, a medication commonly prescribed to treat depression, claims ranged from 9.3% to 11.1%. Following implementation of Medicaid coverage for smoking cessation counseling, less than 1% of estimated smokers had claims for counseling. This low claims rate suggests that simply changing policy is not sufficient to ensure use of newly implemented benefits, and that there probably remain critical gaps in smoking cessation treatment. This study evaluates the use of Medicaid reimbursement for smoking cessation counseling among low-income pregnant women in Kansas. We describe the Medicaid claims rates of physician-provided smoking cessation counseling for pregnant women, an evidence-based and

  15. Social Housing Provision in Copenhagen

    DEFF Research Database (Denmark)

    Tsenkova, Sasha; Vestergaard, Hedvig

    The paper provides an overview of trends and processes of change affecting new social housing provision in Denmark with a focus on Copenhagen. The local responses are reviewed within the context of changes to the unitary national housing system that functions with a robust range of private and non......-profit housing providers, and a wide range of fiscal and regulatory instruments enhancing the competitive performance of the social housing sector. The research analyses recent housing policy measures and their impact on new social housing provision in Copenhagen. The emphasis is on the mix of housing policy...... instruments implemented in three major policy domains-fiscal, financial and regulatory-to promote the production of new social housing. The system of new social housing provision is examined as a dynamic process of interaction between public and private institutions defining housing policy outcomes...

  16. State Medicaid Expansions for Parents Led to Increased Coverage and Prenatal Care Utilization among Pregnant Mothers.

    Science.gov (United States)

    Wherry, Laura R

    2017-12-28

    To evaluate impacts of state Medicaid expansions for low-income parents on the health insurance coverage, pregnancy intention, and use of prenatal care among mothers who became pregnant. Person-level data for women with a live birth from the 1997-2012 Pregnancy Risk Assessment Monitoring System. The sample was restricted to women who were already parents using information on previous live births and combined with information on state Medicaid policies for low-income parents. I used a measure of expanded generosity of state Medicaid eligibility for low-income parents to estimate changes in health insurance, pregnancy intention, and prenatal care for pregnant mothers associated with Medicaid expansion. I found an increase in prepregnancy health insurance coverage and coverage during pregnancy among pregnant mothers, as well as earlier initiation of prenatal care, associated with the expansions. Among pregnant mothers with less education, I found an increase in the adequacy of prenatal care utilization. Expanded Medicaid coverage for low-income adults has the potential to increase a woman's health insurance coverage prior to pregnancy, as well as her insurance coverage and medical care receipt during pregnancy. © Health Research and Educational Trust.

  17. Social Work’s Role in Medicaid Reform: A Qualitative Study

    Science.gov (United States)

    Wachman, Madeline; Manning, Leticia; Cohen, Alexander M.; Seifert, Robert W.; Jones, David K.; Fitzgerald, Therese; Nuzum, Rachel; Riley, Patricia

    2017-01-01

    Objectives. To critically analyze social work’s role in Medicaid reform. Methods. We conducted semistructured interviews with 46 stakeholders from 10 US states that use a range of Medicaid reform approaches. We identified participants using snowball and purposive sampling. We gathered data in 2016 and analyzed them using qualitative methods. Results. Multiple themes emerged: (1) social work participates in Medicaid reform through clinical practice, including care coordination and case management; (2) there is a gap between social work’s practice-level and systems-level involvement in Medicaid innovations; (3) factors hindering social work’s involvement in systems-level practice include lack of visibility, insufficient clarity on social work’s role and impact, and too few resources within professional organizations; and (4) social workers need more training in health transformation payment models and policy. Conclusions. Social workers have unique skills that are valuable to building health systems that promote population health and reduce health inequities. Although there is considerable opportunity for social work to increase its role in Medicaid reform, there is little social work involvement at the systems level. PMID:29236537

  18. The impact of changing medicaid enrollments on New Mexico's Immunization Program.

    Directory of Open Access Journals (Sweden)

    Michael A Schillaci

    Full Text Available Immunizations are an important component to pediatric primary care. New Mexico is a relatively poor and rural state which has sometimes struggled to achieve and maintain its childhood immunization rates. We evaluated New Mexico's immunization rates between 1996 and 2006. Specifically, we examined the increase in immunization rates between 2002 and 2004, and how this increase may have been associated with Medicaid enrollment levels, as opposed to changes in government policies concerning immunization practices.This study examines trends in childhood immunization coverage rates relative to Medicaid enrollment among those receiving Temporary Assistance for Needy Families (TANF in New Mexico. Information on health policy changes and immunization coverage was obtained from state governmental sources and the National Immunization Survey. We found statistically significant correlations varying from 0.86 to 0.93 between immunization rates and Medicaid enrollment.New Mexico's improvement and subsequent deterioration in immunization rates corresponded with changing Medicaid coverage, rather than the state's efforts to change immunization practices. Maintaining high Medicaid enrollment levels may be important for achieving high childhood immunization levels.

  19. Easy-to-read consumer communications: a missing link in Medicaid managed care.

    Science.gov (United States)

    Root, J; Stableford, S

    1999-02-01

    Effective consumer communication is key to successfully moving Medicaid recipients into managed care systems and realizing the promised cost savings from the upheaval. Yet, little attention has been paid to educating these consumers with easy-to-read materials. The Maine Area Health Education Center (AHEC) Health Literacy Center, with the support of the Center for Health Care Strategies, Inc., addressed the problem by offering three national skills training workshops called Writing for the Medicaid Market. The training was marketed to public and private organizations providing Medicaid managed care services, including state Medicaid officials, health benefit counselor staff (enrollment brokers), managed care plan (HMO) staff, and consumer advocates. The training addressed the core issue in health literacy: the mismatch between the low literacy skills of the target population and the high reading level of most health and managed care materials. Posttraining survey data revealed that training was successful in skill building, but also that it addressed only the tip of the iceberg. Faulty and/or nonexistent communication planning limits the success not only of Medicaid, but of other large health and social programs as well. The authors outline the broad scope of the national health literacy problem, share their posttraining survey data, discuss lessons extrapolated from both their data and their experience, and propose a national agenda to address a vast and generally ignored public problem.

  20. Treatment outcomes and costs of dental sealants among children enrolled in Medicaid.

    Science.gov (United States)

    Weintraub, J A; Stearns, S C; Rozier, R G; Huang, C C

    2001-11-01

    This retrospective cohort analysis of children enrolled in the North Carolina Medicaid program compared the likelihood of restorative treatments and associated cumulative Medicaid expenditures for teeth with or without dental sealants. We assessed the dental experience of the cohort of 15 438 children from 1985 to 1992 on the basis of enrollment and claims files. We conducted regression analyses for outcomes (caries-related services involving the occlusal surface [CRSOs] of permanent first molars) and cumulative expenditures, controlling for characteristics of the child, the treating dentist, and the child's county of residence. Overall, 23% of children received at least 1 sealant and 33% at least 1 CRSO. Sealants were effective in preventing CRSOs, although the degree of effectiveness was highest for children with the greater levels of CRSOs before sealant placement. Estimated cumulative Medicaid expenditures indicated expenditure savings from sealants within 2 years of application for children with 2 or more prior CRSOs. Sealant placement was associated with expenditure savings to Medicaid for certain high-risk children, so Medicaid and, more broadly, society will benefit by providing for sealant placement in these children.

  1. Ectopic Pregnancy Rates and Racial Disparities in the Medicaid Population, 2004–08

    Science.gov (United States)

    STULBERG, Debra B.; CAIN, Loretta R.; DAHLQUIST, Irma; LAUDERDALE, Diane S.

    2014-01-01

    Objective To assess 2004–08 ectopic pregnancy rates among Medicaid recipients in 14 states and 2000–08 time trends in 3 states, and to identify differences in rate by race/ethnicity. Design Secondary analysis of Medicaid administrative claims data. Setting United States. Subjects Women ages 15–44 enrolled in Medicaid in Arizona, California, Colorado, Florida, Illinois, Indiana, Iowa, Louisiana, Massachusetts, Michigan, Minnesota, Mississippi, New York, or Texas in 2004–08 (n=19,135,106), and in California, Illinois and New York in 2000–03. Interventions None. Main Outcome Measure Number of ectopic pregnancies divided by the number of total pregnancies (spontaneous abortions, induced abortions, ectopic pregnancies, and all births). Results The 2004–08 Medicaid ectopic pregnancy rate for all 14 states combined was 1.40% of all reported pregnancies. Adjusted for age, the rate was 1.47%. Ectopic pregnancy incidence was 2.3 per 1,000 woman-years. In states for which longer-term data were available (California, Illinois and New York), the rate declined significantly 2000–08. In all 14 states, Black women were more likely to experience an ectopic pregnancy compared to whites (Relative Risk 1.46, 95% Confidence Interval 1.45–1.47). Conclusions Ectopic pregnancy remains an important health risk for women enrolled in Medicaid. Black women are at consistently higher risk than whites. PMID:25439806

  2. Ectopic pregnancy rates and racial disparities in the Medicaid population, 2004-2008.

    Science.gov (United States)

    Stulberg, Debra B; Cain, Loretta R; Dahlquist, Irma; Lauderdale, Diane S

    2014-12-01

    To assess 2004-2008 ectopic pregnancy rates among Medicaid recipients in 14 states and 2000-2008 time trends in three states and to identify differences in rate by race/ethnicity. Secondary analysis of Medicaid administrative claims data. Not applicable. Women ages 15-44 enrolled in Medicaid in Arizona, California, Colorado, Florida, Illinois, Indiana, Iowa, Louisiana, Massachusetts, Michigan, Minnesota, Mississippi, New York, or Texas in 2004-2008 (n = 19,135,106) and in California, Illinois, and New York in 2000-2003. None. Number of ectopic pregnancies divided by the number of total pregnancies (spontaneous abortions, induced abortions, ectopic pregnancies, and all births). The 2004-2008 Medicaid ectopic pregnancy rate for all 14 states combined was 1.40% of all reported pregnancies. Adjusted for age, the rate was 1.47%. Ectopic pregnancy incidence was 2.3 per 1,000 woman-years. In states for which longer term data were available (California, Illinois, and New York), the rate declined significantly in 2000-2008. In all 14 states, black women were more likely to experience an ectopic pregnancy compared with whites (relative risk, 1.46; 95% confidence interval, 1.45-1.47). Ectopic pregnancy remains an important health risk for women enrolled in Medicaid. Black women are at consistently higher risk than whites. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  3. Studying prescription drug use and outcomes with medicaid claims data: strengths, limitations, and strategies.

    Science.gov (United States)

    Crystal, Stephen; Akincigil, Ayse; Bilder, Scott; Walkup, James T

    2007-10-01

    Medicaid claims and eligibility data, particularly when linked to other sources of patient-level and contextual information, represent a powerful and under-used resource for health services research on the use and outcomes of prescription drugs. However, their effective use poses many methodological and inferential challenges. This article reviews strengths, limitations, challenges, and recommended strategies in using Medicaid data for research on the initiation, continuation, and outcomes of prescription drug therapies. Drawing from published research using Medicaid data by the investigators and other groups, we review several key validity and methodological issues. We discuss strategies for claims-based identification of diagnostic subgroups and procedures, measuring and modeling initiation and persistence of regimens, analysis of treatment disparities, and examination of comorbidity patterns. Based on this review, we discuss "best practices" for appropriate data use and validity checking, approaches to statistical modeling of longitudinal patterns in the presence of typical challenges, and strategies for strengthening the power and potential of Medicaid datasets. Finally, we discuss policy implications, including the potential for the research use of Medicare Part D data and the need for further initiatives to systematically develop and optimally use research datasets that link Medicaid and other sources of clinical and outcome information.

  4. Domotics Project Housing Block.

    Science.gov (United States)

    Morón, Carlos; Payán, Alejandro; García, Alfonso; Bosquet, Francisco

    2016-05-23

    This document develops the study of an implementation project of a home automation system in a housing placed in the town of Galapagar, Madrid. This house, which is going to be occupied by a four-member family, consists of 67 constructed square meters distributed in lounge, kitchen, three bedrooms, bath, bathroom and terrace, this being a common arrangement in Spain. Thus, this study will allow extracting conclusions about the adequacy of the home automation in a wide percentage of housing in Spain. In this document, three house automation proposals are developed based on the requirements of the client and the different home automation levels that the Spanish House and Building Automation Association has established, besides two parallel proposals relating to the safety and the technical alarms. The mentioned proposed systems are described by means of product datasheets and descriptions, distribution plans, measurements, budgets and flow charts that describe the functioning of the system in every case. An evaluation of each system is included, based on other studies conclusions on this matter, where expected energy savings from each design, depending on the current cost of lighting, water and gas, as well as the expected economic amortization period is evaluated.

  5. Domotics Project Housing Block

    Directory of Open Access Journals (Sweden)

    Carlos Morón

    2016-05-01

    Full Text Available This document develops the study of an implementation project of a home automation system in a housing placed in the town of Galapagar, Madrid. This house, which is going to be occupied by a four-member family, consists of 67 constructed square meters distributed in lounge, kitchen, three bedrooms, bath, bathroom and terrace, this being a common arrangement in Spain. Thus, this study will allow extracting conclusions about the adequacy of the home automation in a wide percentage of housing in Spain. In this document, three house automation proposals are developed based on the requirements of the client and the different home automation levels that the Spanish House and Building Automation Association has established, besides two parallel proposals relating to the safety and the technical alarms. The mentioned proposed systems are described by means of product datasheets and descriptions, distribution plans, measurements, budgets and flow charts that describe the functioning of the system in every case. An evaluation of each system is included, based on other studies conclusions on this matter, where expected energy savings from each design, depending on the current cost of lighting, water and gas, as well as the expected economic amortization period is evaluated.

  6. Control rod housing alignment

    International Nuclear Information System (INIS)

    Dixon, R.C.; Deaver, G.A.; Punches, J.R.; Singleton, G.E.; Erbes, J.G.; Offer, H.P.

    1990-01-01

    This patent describes a process for measuring the vertical alignment between a hole in a core plate and the top of a corresponding control rod drive housing within a boiling water reactor. It comprises: providing an alignment apparatus. The alignment apparatus including a lower end for fitting to the top of the control rod drive housing; an upper end for fitting to the aperture in the core plate, and a leveling means attached to the alignment apparatus to read out the difference in angularity with respect to gravity, and alignment pin registering means for registering to the alignment pin on the core plate; lowering the alignment device on a depending support through a lattice position in the top guide through the hole in the core plate down into registered contact with the top of the control rod drive housing; registering the upper end to the sides of the hole in the core plate; registering the alignment pin registering means to an alignment pin on the core plate to impart to the alignment device the required angularity; and reading out the angle of the control rod drive housing with respect to the hole in the core plate through the leveling devices whereby the angularity of the top of the control rod drive housing with respect to the hole in the core plate can be determined

  7. Situation based housing

    DEFF Research Database (Denmark)

    Duelund Mortensen, Peder; Welling, Helen; Wiell Nordberg, Lene

    2007-01-01

    In the Nordic countries, there is a century-old tradition of dwellings that can be adapted, rebuilt and recycled regardless of time and place. Functionalism broke with this tradition and created the function-determined dwelling, which was planned on the basis of functional analyses and analyses...... of the average family's lifestyle. These dwellings were ground-breaking when they were built, but today are clearly a product of their time. The reaction to functionalism and the postwar mass production gave rise to flexible dwelling with countless possibilities for room division. The housing of this period has...... characteristics which in the long run have proven to be unfortunate both in terms in terms of durability and architectural quality. Today there is a focus on the development of more open and functionally non-determined housing. A number of new housing schemes in and around Copenhagen reveal a variety...

  8. House Prices and Taxes

    DEFF Research Database (Denmark)

    Gjedsted Nielsen, Mads

    of only 31%. We use 2007 municipal reform in Denmark in which 256 municipalities changed tax rates, as an exogenous shock to taxes. The exogeneity of the shock to taxes and the size of the data set is an improvement over earlier studies. Our findings significantly downward adjust the degree of tax......This paper is the first to consider a large scale natural experiment to estimate the effect of taxes on house prices. We find that a 1 percentage-point increase in income tax rates lead to a drop in house prices of at most 2.2%. This corresponds to a tax capitalization for the average household...... capitalization from earlier studies. Furthermore, we find no effect of property taxes on house prices. We attribute this to the low levels of Danish municipal property tax rates compared to income tax rates....

  9. The book house

    DEFF Research Database (Denmark)

    Jensen, Niels Henrik; Agger, Steen

    1989-01-01

    base retrieval system for novice users - both adults and children. The use of icons within a spatial metaphor to facilitate direct manipulation of the displayed objects on the screen forms the basis for the interface in guiding the users' navigation in the BOOK HOUSE. This report, one of three......The BOOK HOUSE (and its predecessor, the BOOK AUTOMAT) are computer systems aimed at supporting library users in finding fiction. They are examples of systems using a cognitive work analysis as the basis for design and evaluation - and build on studies of the information retrieval task using actual...... user-librarian negotiations. These studies led to the identification of a set of strategies for searching and retrieving literature as well as a mutri-kimensional framework for classifying fiction. Both of these have been necessary prerequisites for the design of the BOOK HOUSE, a flexible on-line data...

  10. The Nordic Housing Enabler

    DEFF Research Database (Denmark)

    Helle, T.; Nygren, C.; Slaug, B.

    2014-01-01

    , resulting in the Nordic Housing Enabler. For reliability testing, the sampling strategy and data collection procedures used were the same in all countries. Twenty voluntary occupational therapists, pair-wise but independently of each other, collected data from 106 cases by means of the Nordic Housing......This study addresses development of a content-valid cross-Nordic version of the Housing Enabler and investigation of its inter-rater reliability when used in occupational therapy rating situations, involving occupational therapists, clients, and their home environments. The instrument...... Enabler. Inter-rater reliability was calculated by means of percentage agreement and kappa statistics. Overall good percentage agreement for the personal and environmental components of the instrument was shown, indicating that the instrument was sufficiently reliable for application in practice...

  11. Microstructure and Tensile-Shear Properties of Resistance Spot Welded 22MnMoB Hot-Stamping Annealed Steel

    Science.gov (United States)

    Li, Yang; Cui, Xuetuan; Luo, Zhen; Ao, Sansan

    2017-01-01

    The present paper deals with the joining of 22MnMoB hot-stamping annealed steel carried out by the spot welding process. Microstructural characterization, microhardness testing and tensile-shear testing were conducted. The effects of the welding parameters, including the electrode tip diameter, welding current, welding time and electrode force upon the tensile-shear properties of the welded joints, were investigated. The results showed that a weld size of 9.6 mm was required to ensure pullout failure for the 1.8 -mm-thick hot-stamping annealed steel sheet. The welding current had the largest influence upon the tensile-shear properties of the 22MnMoB steel welded joint. The bulk resistance should play an important role in the nugget formation. In pullout failure mode, failure was initiated at the heat-affected zone, where softening occurs owing to the tempering of martensite.

  12. Characterization of patterns of Localized Doping Using Stamping technique for Selective n-Emitter Solar Cell Structure

    Science.gov (United States)

    Mangkornkaew, A.; Fangsuwannarak, T.

    2017-10-01

    In the present, a novel cost-effective process scheme for single step selective emitter diffusion was implemented. It is based on the fabrication of acid-resist pattern using a stamping technique with collaboration of a spin on dopant (SOD) and chemical etched-back emitter methods. The SOD diffusion process provided heavily doping n-emitter. Acid-resist pattern without exploitation of a complex method as a photolithography, was stamped as a metal contact pattern for prevention of a localized heavy-dope region from etching back. Phosphorus doping profiles were controlled by etching back time to provide the formation of n-type selective emitter. Sheet resistance is tunable from 10 to 180 Ohm/Sq on localized n-layer. After removal of the patterned acid-resist, the selective n-emitter solar cell structure was obtained under one-step diffusion to achieve a better blue-light response and low contact resistance.

  13. Impact of fee increases on dental utilization rates for children living in Connecticut and enrolled in Medicaid.

    Science.gov (United States)

    Beazoglou, Tryfon; Douglass, Joanna; Myne-Joslin, Veronica; Baker, Patricia; Bailit, Howard

    2015-01-01

    In 2008, Connecticut's Medicaid program administration increased children's dental fees to match approximately the 70th percentile of what the market fees were for dental care in 2005. These Medicaid program changes occurred at the same time as a national economic recession, which took place from 2007 through 2009. The authors obtained Medicaid eligibility, claims, and provider data before and after the fee increase, in 2006 and 2009 through 2012, respectively. Their analysis examined changes in utilization rates, service mix, expenditures, and dentists' participation. The authors qualitatively assessed the general impact of the recession on utilization rate changes. The Medicaid fee increase, program improvements, and the recession resulted in a dramatic increase in utilization rates. For children continuously enrolled in Medicaid, utilization rates increased from 45.9% in 2006 to 71.6% in 2012. Rates increased across sex, race, ethnicity, and geographic areas. These increased utilization rates eliminated the disparities in access to dental services between children with private insurance and children receiving Medicaid benefits. Children enrolled in Medicaid now have utilization rates that are similar to or higher than privately insured children. Expenditures increased $62 million; this represents less than 1% of 2012 State Medicaid expenditures. Dentist participation increased by 72%. These results suggest that dentists will participate in the Medicaid program if adequately compensated, and low-income families will seek dental services. The Medicaid fee increase, program improvements, and the recession had a dramatic impact on reducing disparities in children's access to dental care in Connecticut. One solution to the substantial disparities in access to dental care is to increase Medicaid fees to competitive levels. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.

  14. Renovation of social housing

    DEFF Research Database (Denmark)

    Jensen, Stina Rask; Hvejsel, Marie Frier; Kirkegaard, Poul Henning

    in the renovation of social housing. Methodologically, this hypothesis is investigated by re-reading the task of energy renovation through the lens of tectonic architectural theory. Specifically, Eduard Sekler’s etymological distinction between structure, construction, and tectonics is developed as a framework...... for addressing the spatial implications and potentials of technical initiatives in contemporary energy renovations within the continuum described by Scott. The framework is applied in two case studies of recent energy renovations of social housing dwellings. Finally, the paper discusses whether the technical...

  15. Situation based housing

    DEFF Research Database (Denmark)

    Duelund Mortensen, Peder; Welling, Helen; Wiell Nordberg, Lene

    2007-01-01

    of approaches to these goals. This working paper reviews not only a selection of new housing types, but also dwellings from the past, which each contain an aspect of changeability. Our study is based on information from users in the selected housing schemes, gathered from questionnaires, information about...... for living. The suitable condition consists of the dwelling's ability for physical displacement, spatial changes that can suit changing life styles. The situational condition is the not defined, the unfinished and the transitory, which continuously challenges the imagination and calls for the experiment. Our...

  16. Developing roll-to-roll manufacturing system for flexible and stretchable electronics by direct stamping of silver nano-ink

    OpenAIRE

    Kim, Jiseok

    2014-01-01

    Direct stamping of silver nanoparticle based ink has been developed for cost-effective and process-effective manufacturing of flexible or stretchable electronic devices. Facile removal of residual layer from deposited silver nanoparticles (AgNPs) layer results in high fidelity of final silver electrode without further post-processes. Scanning electron microscopy (SEM) images and energy dispersive x-ray spectroscopic analysis have revealed residue-free transfer of microscale inter-digitated ca...

  17. Development of low-friction and wear-resistant surfaces for low-cost Al hot stamping tools

    OpenAIRE

    Dong Y.; Formosa D.; Fernandez J.; Li X.; Fuentes G.; Zoltan K.; Dong H.

    2015-01-01

    In this study, advanced surfaces and coatings have been developed using plasma thermochemical treatment, PVD coating, electroless Ni-BN plating and duplex surface engineering to produce low-friction and wear-resistant surfaces for cast iron stamping tools. Their microstructural and nano-mechanical properties were systematically analysed and the tribological behaviour of these new surfaces and coatings were evaluated. The experimental results have shown that under dry sliding condition, the tr...

  18. Development of a new biaxial testing system for generating forming limit diagrams for sheet metals under hot stamping conditions

    OpenAIRE

    Shao, Z; Li, N; Lin, J; Dean, TA

    2016-01-01

    Conventional experimental approaches used to generate forming limit diagrams (FLDs) for sheet metals at different linear strain paths are not applicable to hot stamping and cold die quenching processes because cooling occurs prior to deformation and consistent values of heating rate, cooling rate, deformation temperature and strain rate are not easy to obtain. A novel biaxial testing system for use in a Gleeble testing machine has been adopted to generate forming limits of sheet metals, inclu...

  19. Image Subtraction Reduction of Open Clusters M35 & NGC 2158 in the K2 Campaign 0 Super Stamps

    Science.gov (United States)

    Soares-Furtado, M.; Hartman, J. D.; Bakos, G. Á.; Huang, C. X.; Penev, K.; Bhatti, W.

    2017-04-01

    We observed the open clusters M35 and NGC 2158 during the initial K2 campaign (C0). Reducing these data to high-precision photometric timeseries is challenging due to the wide point-spread function (PSF) and the blending of stellar light in such dense regions. We developed an image-subtraction-based K2 reduction pipeline that is applicable to both crowded and sparse stellar fields. We applied our pipeline to the data-rich C0 K2 super stamp, containing the two open clusters, as well as to the neighboring postage stamps. In this paper, we present our image subtraction reduction pipeline and demonstrate that this technique achieves ultra-high photometric precision for sources in the C0 super stamp. We extract the raw light curves of 3960 stars taken from the UCAC4 and EPIC catalogs and de-trend them for systematic effects. We compare our photometric results with the prior reductions published in the literature. For de-trended TFA-corrected sources in the 12-12.25 {{{K}}}{{p}} magnitude range, we achieve a best 6.5-hour window running rms of 35 ppm, falling to 100 ppm for fainter stars in the 14-14.25 {{{K}}}{{p}} magnitude range. For stars with {K}p> 14, our de-trended and 6.5-hour binned light curves achieve the highest photometric precision. Moreover, all our TFA-corrected sources have higher precision on all timescales investigated. This work represents the first published image subtraction analysis of a K2 super stamp. This method will be particularly useful for analyzing the Galactic bulge observations carried out during K2 campaign 9. The raw light curves and the final results of our de-trending processes are publicly available at http://k2.hatsurveys.org/archive/.

  20. "Managing" the poor: neoliberalism, Medicaid HMOs and the triumph of consumerism among the poor.

    Science.gov (United States)

    Maskovsky, J

    2000-10-01

    In order to explore the contradictions of neoliberal health policy, this article examines Medicaid managed care in Philadelphia. At the federal and state levels, government is increasingly promoting private-sector market-based strategies over policies formerly associated with the welfare state, arguing that the former are the most effective means of achieving economic growth and guaranteeing social welfare. A prime example of this shift, Medicaid managed care is a policy by which states contract with private-sector health maintenance organizations to provide health coverage to the poor. Drawing on ethnographic and historical data, this paper shows how Pennsylvania's Medicaid managed care program has created access barriers for poor Philadelphians. It also illustrates how ideologies that justify this policy shift serve to mask its detrimental effects on the poor. By contrasting the state's consumerist model with one group's protest efforts, this article calls into question the neoliberal ideology that undergirds health and welfare "reform."

  1. The Choices programme: a simple, front-of-pack stamp making healthy choices easy.

    Science.gov (United States)

    Dötsch-Klerk, Mariska; Jansen, Léon

    2008-01-01

    Some food products fit better within a healthy diet than others, but how can consumers tell? The Choices programme is a simple and internationally-applicable programme to help consumers make a healthy choice on food and beverages and to stimulate industry towards healthy product innovation in all food groups. The essence of the programme is a front-of-pack stamp on products that pass an evaluation against scientific criteria. To that end generic criteria have been established for levels of saturated fat, trans fat, sugars and sodium, which are based on international dietary guidelines (FAO/WHO). For some food categories there are specific criteria for these nutrients as well as for dietary fibre and calories. In this way the criteria are challenging without being impossible to meet. The programme has been initiated by food industry and is open to all companies in food industry, retail and catering. The approach is also supported by nutritional scientists, governments and NGOs. An independent scientific committee is responsible for designing and periodically reviewing the qualifying criteria. The current qualifying criteria were developed by scientific committees in the Netherlands and Belgium. These criteria will now be reviewed by an International Scientific Committee, consisting of internationally-recognised food and nutrition experts. To accommodate the developments in nutrition science and food technology, this review will take place every two years.

  2. Mechanical behavior and modelisation of Ti-6Al-4V titanium sheet under hot stamping conditions

    Science.gov (United States)

    Sirvin, Q.; Velay, V.; Bonnaire, R.; Penazzi, L.

    2017-10-01

    The Ti-6Al-4V titanium alloy is widely used for the manufacture of aeronautical and automotive parts (solid parts). In aeronautics, this alloy is employed for its excellent mechanical behavior associated with low density, outstanding corrosion resistance and good mechanical properties up to 600°C. It is especially used for the manufacture of fuselage frames, on the pylon for carrying out the primary structure (machining forged blocks) and the secondary structure in sheet form. In this last case, the sheet metal forming can be done through various methods: at room temperature by drawing operation, at very high temperature (≃900°C) by superplastic forming (SPF) and at intermediate temperature (≥750°C) by hot forming (HF). In order to reduce production costs and environmental troubles, the cycle times reduction associated with a decrease of temperature levels are relevant. This study focuses on the behavior modelling of Ti-6Al-4V alloy at temperatures above room temperature to obtained greater formability and below SPF condition to reduce tools workshop and energy costs. The displacement field measurement obtained by Digital Image Correlation (DIC) is based on innovative surface preparation pattern adapted to high temperature exposures. Different material parameters are identified to define a model able to predict the mechanical behavior of Ti-6Al-4V alloy under hot stamping conditions. The hardening plastic model identified is introduced in FEM to simulate an omega shape forming operation.

  3. Capillary-Force-Assisted Clean-Stamp Transfer of Two-Dimensional Materials.

    Science.gov (United States)

    Ma, Xuezhi; Liu, Qiushi; Xu, Da; Zhu, Yangzhi; Kim, Sanggon; Cui, Yongtao; Zhong, Lanlan; Liu, Ming

    2017-11-08

    A simple and clean method of transferring two-dimensional (2D) materials plays a critical role in the fabrication of 2D electronics, particularly the heterostructure devices based on the artificial vertical stacking of various 2D crystals. Currently, clean transfer techniques rely on sacrificial layers or bulky crystal flakes (e.g., hexagonal boron nitride) to pick up the 2D materials. Here, we develop a capillary-force-assisted clean-stamp technique that uses a thin layer of evaporative liquid (e.g., water) as an instant glue to increase the adhesion energy between 2D crystals and polydimethylsiloxane (PDMS) for the pick-up step. After the liquid evaporates, the adhesion energy decreases, and the 2D crystal can be released. The thin liquid layer is condensed to the PDMS surface from its vapor phase, which ensures the low contamination level on the 2D materials and largely remains their chemical and electrical properties. Using this method, we prepared graphene-based transistors with low charge-neutral concentration (3 × 10 10 cm -2 ) and high carrier mobility (up to 48 820 cm 2 V -1 s -1 at room temperature) and heterostructure optoelectronics with high operation speed. Finally, a capillary-force model is developed to explain the experiment.

  4. A Fully Integrated Humidity Sensor System-on-Chip Fabricated by Micro-Stamping Technology

    Directory of Open Access Journals (Sweden)

    Chih-Ting Lin

    2012-08-01

    Full Text Available A fully integrated humidity sensor chip was designed, implemented, and tested. Utilizing the micro-stamping technology, the pseudo-3D sensor system-on-chip (SSoC architecture can be implemented by stacking sensing materials directly on the top of a CMOS-fabricated chip. The fabricated sensor system-on-chip (2.28 mm × 2.48 mm integrated a humidity sensor, an interface circuit, a digital controller, and an On-Off Keying (OOK wireless transceiver. With low power consumption, i.e., 750 μW without RF operation, the sensitivity of developed sensor chip was experimentally verified in the relative humidity (RH range from 32% to 60%. The response time of the chip was also experimentally verified to be within 5 seconds from RH 36% to RH 64%. As a consequence, the implemented humidity SSoC paves the way toward the an ultra-small sensor system for various applications.

  5. Hot stamping of AA6082 tailor welded blanks: experiment and FE simulation

    Directory of Open Access Journals (Sweden)

    Liu Jun

    2016-01-01

    Full Text Available An advanced forming technology, solution Heat treatment, Forming and in-die Quenching (HFQ®, has been employed to form AA6082 tailor welded blanks (TWBs. In comparison with conventional stamping of TWBs, the mechanical properties and formability of AA6082 laser TWBs could be improved under the HFQ® forming condition. The TWB was divided into three physical zones, i.e. base metal, heat affected zone (HAZ and weld zone, based on the hardness distribution. It was found that the degraded hardness of the weldment can be restored after HFQ® forming. TWBs of AA6082 with different thickness ratios of 2 (2–1 mm, 1.3 (2–1.5 mm and 1 (1.5–1.5 mm were used to study the TWB thickness ratio effects on the forming behaviour. Hemispherical punch dome tests on the TWBs with varying thickness ratios demonstrated different formabilities, and indicated increased displacement of the weld line with increasing thickness ratio. Finite element (FE modelling was adopted to analyse the weld line movement and strain distributions during HFQ® forming.

  6. Forming and quenching behaviours in hot stamping of thin quenchable sheets

    Directory of Open Access Journals (Sweden)

    Nakagawa Yuki

    2015-01-01

    Full Text Available A thin aluminium-coated quenchable steel sheet was hot-stamped to investigate the effect of the thickness. The sheets having 0.6, 1.0 and 1.6 mm in thickness were heated at 900 ∘C by a furnace and formed after 7 s from the furnace. The cooling rates of 0.6 mm and 1.0 mm in thickness from 900 ∘C to 400 ∘C under air cooling were 20.9 ∘C/s and 13.6 ∘C/s, respectively. The hardness of the air-cooled sheets having 1.0 mm in thickness was 300 HV1, whereas that of the sheet having 0.6 mm in thickness was 380 HV1 because of the high cooling rate. The Vickers hardness of the U-bent sheets of 0.6 and 1.0 mm after 7 s from the furnace without the holding time at the bottom dead centre were 500 and 430 HV1, respectively.

  7. Improving the Quality of Hot Stamping Parts with Innovative Press Technology and Inline Process Control

    Science.gov (United States)

    Vollmer, R.; Palm, C.

    2017-09-01

    The increasing number of hot stamped parts in the automotive industry is challenging different process areas. This paper presents a method how to improve the production rates over the whole life cycle of a hot forming part. In the core element of a hot forming line, the hydraulic press, mainly two processing steps are performed. Forming and quenching of the sheet metal part. In addition to the forming operation, it is inevitable to optimize the quenching condition in the bottom dead centre in order to reach a fully martensitic structure and tight geometrical tolerances of the part. Deviations in the blank thickness, tool wear, polishing of classical tools impair the quenching condition and therefore the part quality over the time. A new press and tool design has been developed to counter this effect by providing homogenous contact pressure over the whole die. Especially with a multi cavity tool, the new method is advantageous. Test series have shown that the new tool and press concept can produce parts with a blank thickness of 1.0 mm within 8.0 s cycle time. The so called PCH flex principle makes it possible to produce such high output rates under reliable conditions.

  8. Effect of cooling rate during hot stamping on low cyclic fatigue of boron steel sheet

    Science.gov (United States)

    Suh, Chang Hee; Jang, Won Seok; Oh, Sang Kyun; Lee, Rac Gyu; Jung, Yun-Chul; Kim, Young Suk

    2012-08-01

    Boron steel is widely used throughout the automobile industry due to its high tensile strength and hardenability. When boron steel is used for body parts, only high strength is required for crashworthiness. However, when boron steel is used for chassis parts, a high fatigue life is needed. The microstructure of boron steel is mainly affected by the cooling rate during hot stamping. Therefore, this study investigated the low cyclic fatigue life according to the cooling rate. The fatigue life increased at a low strain amplitude when the cooling rate was fast. However, at a high strain amplitude, the fatigue life decreased, due to the low ductility and fracture toughness of the martensite formed by rapid cooling. Martensite formed by a fast cooling rate shows excellent fatigue life at a low total strain amplitude; however, a multiphase microstructure formed by a slow cooling rate is recommended if the parts experience high and low total strain amplitudes alternately. In addition, the cooling rate has little effect on the distribution of solute boron and boron precipitations, so it is expected that boron rarely affects low cyclic fatigue.

  9. Investigation of the Phase Formation of AlSi-Coatings for Hot Stamping of Boron Alloyed Steel

    Science.gov (United States)

    Veit, R.; Hofmann, H.; Kolleck, R.; Sikora, S.

    2011-01-01

    Hot stamping of boron alloyed steel is gaining more and more importance for the production of high strength automotive body parts. Within hot stamping of quenchenable steels the blank is heated up to austenitization temperature, transferred to the tool, formed rapidly and quenched in the cooled tool. To avoid scale formation during the heating process of the blank, the sheet metal can be coated with an aluminium-silicum alloy. The meltimg temperature of this coating is below the austenitization temperature of the base material. This means, that a diffusion process between base material and coating has to take place during heating, leading to a higher melting temperature of the coating. In conventional heating devices, like roller hearth furnaces, the diffusion process is reached by relatively low heating rates. New technologies, like induction heating, reach very high heating rates and offer great potentials for the application in hot stamping. Till now it is not proofed, that this technology can be used with aluminum-silicon coated materials. This paper will present the results of comparative heating tests with a conventional furnace and an induction heating device. For different time/temperature-conditions the phase formation within the coating will be described.

  10. Discrimination between authentic and false tax stamps from liquor bottles using laser-induced breakdown spectroscopy and chemometrics

    Science.gov (United States)

    Gonzaga, Fabiano Barbieri; Rocha, Werickson Fortunato de Carvalho; Correa, Deleon Nascimento

    2015-07-01

    This work describes the preliminary application of a compact and low-cost laser-induced breakdown spectroscopy (LIBS) instrument for falsification detection of tax stamps used in alcoholic beverages. The new instrument was based on a diode-pumped passively Q-switched Nd:YLF microchip laser and a mini-spectrometer containing a Czerny-Turner polichromator coupled to a non-intensified, non-gated, and non-cooled 2048 pixel linear sensor array (200 to 850 nm spectral range). Twenty-three tax stamp samples were analyzed by firing laser pulses within two different regions of each sample: a hologram and a blank paper region. For each acquired spectrum, the emitted radiation was integrated for 3000 ms under the continuous application of laser pulses at 100 Hz (integration of 300 plasmas). Principal component analysis (PCA) or hierarchical cluster analysis (HCA) of all emission spectra from the hologram or blank paper region revealed two well-defined groups of authentic and false samples. Moreover, for the hologram data, three subgroups of false samples were found. Additionally, partial least squares discriminant analysis (PLS-DA) was successfully applied for the detection of the false tax stamps using all emission spectra from hologram or blank paper region. The discrimination between the samples was mostly ascribed to different levels of calcium concentration in the samples.

  11. Prototyping of masks, masters, and stamps/molds for soft lithography using an office printer and photographic reduction

    Science.gov (United States)

    Deng; Wu; Brittain; Whitesides

    2000-07-15

    This paper describes a practical method for the fabrication of photomasks, masters, and stamps/molds used in soft lithography that minimizes the need for specialized equipment. In this method, CAD files are first printed onto paper using an office printer with resolution of 600 dots/in. Photographic reduction of these printed patterns transfers the images onto 35-mm film or microfiche. These photographic films can be used, after development, as photomasks in 1:1 contact photolithography. With the resulting photoresist masters, it is straightforward to fabricate poly(dimethylsiloxane) (PDMS) stamps/molds for soft lithography. This process can generate microstructures as small as 15 microm; the overall time to go from CAD file to PDMS stamp is 4-24 h. Although access to equipment-spin coater and ultraviolet exposure tool-normally found in the clean room is still required, the cost of the photomask itself is small, and the time required to go from concept to device is short. A comparison between this method and all other methods that generate film-type photomasks has been performed using test patterns of lines, squares, and circles. Three microstructures have also been fabricated to demonstrate the utility of this method in practical applications.

  12. Medicaid capital reimbursement policy and environmental artifacts of nursing home culture change.

    Science.gov (United States)

    Miller, Susan C; Cohen, Neal; Lima, Julie C; Mor, Vincent

    2014-02-01

    To examine how Medicaid capital reimbursement policy is associated with nursing homes (NHs) having high proportions of private rooms and small households. Through a 2009/2010 NH national survey, we identified NHs having small households and high proportions of private rooms (≥76%). A survey of state Medicaid officials and policy document review provided 2009 policy data. Facility- and county-level covariates were from Online Survey, Certification and Reporting, the Area Resource File, and aggregated resident assessment data (minimum data set). The policy of interest was the presence of traditional versus fair rental capital reimbursement policy. Average Medicaid per diem rates and the presence of NH pay-for-performance (p4p) reimbursement were also examined. A total of 1,665 NHs in 40 states were included. Multivariate logistic regression analyses (with clustering on states) were used. In multivariate models, Medicaid capital reimbursement policy was not significantly associated with either outcome. However, there was a significantly greater likelihood of NHs having many private rooms when states had higher Medicaid rates (per $10 increment; adjusted odds ratio [AOR] 1.13; 95% CI 1.049, 1.228), and in states with versus without p4p (AOR 1.78; 95% CI 1.045, 3.036). Also, in states with p4p NHs had a greater likelihood of having small households (AOR 1.78; 95% CI 1.045, 3.0636). Higher NH Medicaid rates and reimbursement incentives may contribute to a higher presence of 2 important environmental artifacts of culture change-an abundance of private rooms and small households. However, longitudinal research examining policy change is needed to establish the cause and effect of the associations observed.

  13. Changes in Payer Mix and Physician Reimbursement After the Affordable Care Act and Medicaid Expansion

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    Christine D. Jones MD, MS

    2015-08-01

    Full Text Available Although uncompensated care for hospital-based care has fallen dramatically since the implementation of the Affordable Care Act and Medicaid expansion, the changes in hospital physician reimbursement are not known. We evaluated if payer mix and physician reimbursement by encounter changed between 2013 and 2014 in an academic hospitalist practice in a Medicaid expansion state. This was a retrospective cohort study of all general medicine inpatient admissions to an academic hospitalist group in 2013 and 2014. The proportion of encounters by payer and reimbursement/inpatient encounter were compared in 2013 versus 2014. A sensitivity analysis determined the relative contribution of different factors to the change in reimbursement/encounter. Among 37 540 and 40 397 general medicine inpatient encounters in 2013 and 2014, respectively, Medicaid encounters increased (17.3% to 30.0%, P < .001, uninsured encounters decreased (18.4% to 6.3%, P < 0.001, and private payer encounters also decreased (14.1% to 13.3%, P = .001. The median reimbursement/encounter increased 4.2% from $79.98/encounter in 2013 to $83.36/encounter in 2014 (P < .001. In a sensitivity analysis, changes in length of stay, proportions in encounter type by payer, payer mix, and reimbursement for encounter type by payer accounted for −0.7%, 0.8%, 2.0%, and 2.3% of the reimbursement change, respectively. From 2013 to 2014, Medicaid encounters increased, and uninsured and private payer encounters decreased within our hospitalist practice. Reimbursement/encounter also increased, much of which could be attributed to a change in payer mix. Further analyses of physician reimbursement in Medicaid expansion and non-expansion states would further delineate reimbursement changes that are directly attributable to Medicaid expansion.

  14. Consumer/patient encounters with prescription drug monitoring programs: evidence from a Medicaid population.

    Science.gov (United States)

    Goodin, Amie; Blumenschein, Karen; Freeman, Patricia Rippetoe; Talbert, Jeffery

    2012-07-01

    Prescription drug monitoring programs issue reports about a patient's controlled substance prescription history upon request to physicians, law enforcement officials, and pharmacists. The dual purposes of these programs are to reduce the abuse and diversion of controlled substances while not preventing access to these medications for legitimate medical need. The purpose of this study was to examine the experiences of Medicaid patients with Kentucky's Prescription Drug Monitoring Program (PDMP). A random sample of Medicaid patients was surveyed in 2010; respondents were matched with patient retrospective claims data from 6 months prior to the survey's administration. Kentucky Medicaid patients from across the state. A combination of patient surveys and Medicaid claims data was used to test the relationship between patient characteristics and patient-reported interactions with physicians regarding their PDMP reports and whether they experienced difficulty obtaining or filling a prescription for a controlled substance due to a PDMP report. Most Medicaid patients are unaffected by the PDMP; however, patients diagnosed with chronic non-cancer pain conditions and patients reporting a Hispanic ethnicity are significantly more likely to have a physician discuss their PDMP report with them. Patients diagnosed with chronic non-cancer pain conditions are also significantly more likely to report difficulty obtaining a prescription for a controlled substance than patients that have not been diagnosed with chronic non-cancer pain conditions. Patients living in rural areas are significantly less likely than patients in urban areas to report difficulty obtaining a prescription for a controlled substance. The utilization of controlled substance prescriptions by respondents was not measured or monitored. The Medicaid population examined in this study may not be representative of the population as a whole. These results suggest that more attention to the consumer/patient perspective

  15. Service Use in the Month and Year Prior to Suicide Among Adults Enrolled in Ohio Medicaid.

    Science.gov (United States)

    Fontanella, Cynthia A; Warner, Lynn A; Hiance-Steelesmith, Danielle L; Sweeney, Helen Anne; Bridge, Jeffrey A; McKeon, Richard; Campo, John V

    2017-07-01

    The purpose of this study was to inform suicide prevention efforts by estimating the incidence of suicide among adult Medicaid enrollees and describing clinical profiles and service utilization patterns among decedents. Death certificate data for adults (N=1,338) ages 19 to 65 who died by suicide between January 1, 2008, and December 31, 2013, were linked with Ohio Medicaid data. The suicide rate was 18.9 deaths per 100,000 Ohio Medicaid enrollees. Most decedents (83%) made a general medical or mental health visit within one year of suicide, with 50% doing so within 30 days and 27% within one week before death. In the year before suicide, the median number of visits was 16, indicating a subgroup with intensive service utilization. Decedents whose visits were proximal to suicide (within 30 days) rather than distal (31-365 days) were more likely to have individual and co-occurring behavioral and general medical conditions and to be Medicaid eligible through disability. In the year before suicide, most visits (79%) were outpatient general medical visits. Also in the year before suicide, decedents with serious psychiatric disorders were more likely than those without such disorders to make only mental health visits, and those with chronic general medical conditions were more likely than those without such conditions to make only general medical visits. Medicaid enrollment designates a "virtual boundary" around a subpopulation of health care consumers relevant to national suicide prevention efforts. Findings highlight the potential of using Medicaid data to identify individuals at risk of suicide for screening, prevention, and intervention.

  16. The patient perspective: utilizing focus groups to inform care coordination for high-risk medicaid populations.

    Science.gov (United States)

    Sheff, Alex; Park, Elyse R; Neagle, Mary; Oreskovic, Nicolas M

    2017-07-25

    Care coordination programs for high-risk, high-cost patients are a critical component of population health management. These programs aim to improve outcomes and reduce costs and have proliferated over the last decade. Some programs, originally designed for Medicare patients, are now transitioning to also serve Medicaid populations. However, there are still gaps in the understanding of what barriers to care Medicaid patients experience, and what supports will be most effective for providing them care coordination. We conducted two focus groups (n = 13) and thematic analyses to assess the outcomes drivers and programmatic preferences of Medicaid patients enrolled in a high-risk care coordination program at a major academic medical center in Boston, MA. Two focus groups identified areas where care coordination efforts were having a positive impact, as well as areas of unmet needs among the Medicaid population. Six themes emerged from the focus groups that clustered in three groupings: In the first group (1) enrollment in an existing medical care coordination programs, and (2) provider communication largely presented as positive accounts of assistance, and good relationships with providers, though participants also pointed to areas where these efforts fell short. In the second group (3) trauma histories, (4) mental health challenges, and (5) executive function difficulties all presented challenges faced by high-risk Medicaid patients that would likely require redress through additional programmatic supports. Finally, in the third group, (6) peer-to-peer support tendencies among patients suggested an untapped resource for care coordination programs. Programs aimed at high-risk Medicaid patients will want to consider programmatic adjustments to attend to patient needs in five areas: (1) provider connection/care coordination, (2) trauma, (3) mental health, (4) executive function/paperwork and coaching support, and (5) peer-to-peer support.

  17. The return on investment of a Medicaid tobacco cessation program in Massachusetts.

    Science.gov (United States)

    Richard, Patrick; West, Kristina; Ku, Leighton

    2012-01-01

    A high proportion of low-income people insured by the Medicaid program smoke. Earlier research concerning a comprehensive tobacco cessation program implemented by the state of Massachusetts indicated that it was successful in reducing smoking prevalence and those who received tobacco cessation benefits had lower rates of in-patient admissions for cardiovascular conditions, including acute myocardial infarction, coronary atherosclerosis and non-specific chest pain. This study estimates the costs of the tobacco cessation benefit and the short-term Medicaid savings attributable to the aversion of inpatient hospitalization for cardiovascular conditions. A cost-benefit analysis approach was used to estimate the program's return on investment. Administrative data were used to compute annual cost per participant. Data from the 2002-2008 Medical Expenditure Panel Survey and from the Behavioral Risk Factor Surveillance Surveys were used to estimate the costs of hospital inpatient admissions by Medicaid smokers. These were combined with earlier estimates of the rate of reduction in cardiovascular hospital admissions attributable to the tobacco cessation program to calculate the return on investment. Administrative data indicated that program costs including pharmacotherapy, counseling and outreach costs about $183 per program participant (2010 $). We estimated inpatient savings per participant of $571 (range $549 to $583). Every $1 in program costs was associated with $3.12 (range $3.00 to $3.25) in medical savings, for a $2.12 (range $2.00 to $2.25) return on investment to the Medicaid program for every dollar spent. These results suggest that an investment in comprehensive tobacco cessation services may result in substantial savings for Medicaid programs. Further federal and state policy actions to promote and cover comprehensive tobacco cessation services in Medicaid may be a cost-effective approach to improve health outcomes for low-income populations.

  18. Long-term acute care hospitals and Georgia Medicaid: Utilization, outcomes, and cost

    Directory of Open Access Journals (Sweden)

    Evan S. Cole

    2016-09-01

    Full Text Available Objectives: Because most research on long-term acute care hospitals has focused on Medicare, the objective of this research is to describe the Georgia Medicaid population who received care at a long-term acute care hospital, the type and volume of services provided by these long-term acute care hospitals, and the costs and outcomes of these services. For those with select respiratory conditions, we descriptively compare costs and outcomes to those of patients who received care for the same services in acute care hospitals. Methods: We describe Georgia Medicaid recipients admitted to a long-term acute care hospital between 2011 and 2012. We compare them to a population of Georgia Medicaid recipients admitted to an acute care hospital for one of five respiratory diagnosis-related groups. Measurements used include patient descriptive information, admissions, diagnosis-related groups, length of stay, place of discharge, 90-day episode costs, readmissions, and patient risk scores. Results: We found that long-term acute care hospital admissions for Medicaid patients were fairly low (470 90-day episodes and restricted to complex cases. We also found that the majority of long-term acute care hospital patients were blind or disabled (71.2%. Compared to patients who stayed at an acute care hospital, long-term acute care hospital patients had higher average risk scores (13.1 versus 9.0, lengths of stay (61 versus 38 days, costs (US$143,898 versus US$115,056, but fewer discharges to the community (28.4% versus 51.8%. Conclusion: We found that the Medicaid population seeking care at long-term acute care hospitals is markedly different than the Medicare populations described in other long-term acute care hospital studies. In addition, our study revealed that Medicaid patients receiving select respiratory care at a long-term acute care hospital were distinct from Medicaid patients receiving similar care at an acute care hospital. Our findings suggest that

  19. Medicaid Consent to Sterilization forms: historical, practical, ethical, and advocacy considerations.

    Science.gov (United States)

    Block-Abraham, Dana; Arora, Kavita S; Tate, Danielle; Gee, Rebekah E

    2015-06-01

    The US government developed a Medicaid Consent to Sterilization form in the mid-1970s to protect vulnerable populations from coerced sterilization. US health care practices have evolved significantly since that time. The form, however, has not changed, and may be preventing access to desired services for the same vulnerable populations it was originally created to protect. This paper discusses the relevant historical, practical use, ethical, and advocacy considerations of the Medicaid sterilization consent form and proposes changes to make the form more pertinent to today's medical environment.

  20. Housing Problems of Minorities

    Science.gov (United States)

    Weaver, Robert

    1975-01-01

    This testimony, before a public hearing of the New York City Commission on Human Rights in May 1974, reviews the status of minority group housing and the effects of federal programs upon it, advocating an approach which recognizes the intrinsic locational and real estate value of many black ghettos. (Author/JM)